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脑图谱在出生时非进行性神经肌肉疾病康复中的重要性。

The importance of brain mapping for rehabilitation in birth nonprogressive neuromuscular diseases.

作者信息

Tolmacheva Aleksandra, Agranovich Olga, Blagovechtchenski Evgeny

机构信息

Center for Cognition and Decision Making, National Research University Higher School of Economics, Moscow, Russia.

G.I. Turner Scientific Research Institute for Children's Orthopaedics, Ministry of Health of Russia, Saint Petersburg, Russia.

出版信息

Front Neuroimaging. 2024 Jul 15;3:1359491. doi: 10.3389/fnimg.2024.1359491. eCollection 2024.

Abstract

While motor mapping has been extensively studied in acquired motor conditions, a lack has been observed in terms of research on neurological disorders present since birth, with damage to the spinal cord and peripheral nerves (hence, defined in this study as nonprogressive neuromuscular diseases). Despite an injury at the level below the brain, the subsequent changes in the motor system involve cortical reorganization. In the scientific community, the need for a comprehensive approach targeting the brain is increasingly recognized for greater motor recovery in these patients. Transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) are the most utilized techniques for motor mapping. The knowledge obtained through motor mapping may be used to develop effective individual neuromodulation therapy that helps in functional motor recovery. This brief review compares the results of the brain mapping of a few existing studies in individuals with nonprogressive motor disorders of nonbrain origin present at birth to the brain mapping of individuals with similar acquired motor conditions. The review reveals some particular features in terms of central adaptation in individuals with birth conditions compared to their acquired counterparts, such as the nonsomatotopic presentation of involved muscles in the sensorimotor cortex and nonadjacent cortical areas. This topic is undoubtedly intriguing, justifying further research in the field. This review also discusses the benefits these patients can obtain from neuromodulation therapy addressed to the central nervous system and the importance of individual neurophysiological assessment in designing rehabilitation therapy for children with birth motor disorders.

摘要

虽然运动映射在后天获得性运动疾病中已得到广泛研究,但对于先天性存在的神经系统疾病,即脊髓和周围神经损伤(因此,本研究将其定义为非进行性神经肌肉疾病)的研究却有所欠缺。尽管损伤发生在大脑以下水平,但运动系统随后的变化涉及皮质重组。在科学界,越来越认识到需要一种针对大脑的综合方法,以促进这些患者获得更好的运动恢复。经颅磁刺激(TMS)和功能磁共振成像(fMRI)是运动映射中最常用的技术。通过运动映射获得的知识可用于开发有效的个体化神经调节疗法,以帮助实现功能性运动恢复。这篇简短的综述比较了一些现有研究中,出生时即存在非脑源性非进行性运动障碍个体的脑图谱结果,与具有类似后天获得性运动疾病个体的脑图谱结果。该综述揭示了与后天获得性疾病个体相比,出生时即存在疾病个体在中枢适应方面的一些特殊特征,例如感觉运动皮层和非相邻皮质区域中受累肌肉的非躯体定位表现。这个话题无疑很有趣,值得在该领域进行进一步研究。本综述还讨论了这些患者可从针对中枢神经系统的神经调节疗法中获得的益处,以及个体神经生理学评估在为患有先天性运动障碍的儿童设计康复治疗中的重要性。

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