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感觉运动皮层损伤后的长期强制使用疗法可恢复猕猴对侧手的功能并促进其偏好。

Long-term forced-use therapy after sensorimotor cortex lesions restores contralesional hand function and promotes its preference in Macaca mulatta.

作者信息

Darling Warren G, Pizzimenti Marc A, Rotella Diane L, Ge Jizhi, Stilwell-Morecraft Kimberly S, Morecraft Robert J

机构信息

Department of Health and Human Physiology, Motor Control Laboratory, University of Iowa, N420 Field House, Iowa City, IA, USA, 52242.

Department of Anatomy and Cell Biology, University of Iowa, Iowa City, USA.

出版信息

Exp Brain Res. 2024 Dec 28;243(1):35. doi: 10.1007/s00221-024-06949-x.

Abstract

Injury to one cerebral hemisphere can result in paresis of the contralesional hand and subsequent preference of the ipsilesional hand in daily activities. However, forced use therapy in humans can improve function of the contralesional paretic hand and increase its use in daily activities, although the ipsilesional hand may remain preferred for fine motor activities. Studies in monkeys have shown that minimal forced use of the contralesional hand, which was the preferred hand prior to brain injury, can produce remarkable recovery of function. Here we tested the hypothesis that long-term forced use of the contralesional hand during the post-lesion period can return it to preferred status. Four rhesus monkeys received tests of hand preference prior to surgical lesions of primary motor cortex, lateral premotor cortex and anterior parietal cortex (F2P2 lesion) contralateral to the preferred hand. Beginning two weeks after the lesion, forced use therapy involving contralateral hand reaches to acquire food targets occurred 3X weekly with at least 300 reaches/session until 24 weeks post-lesion. Despite initial paresis of the contralesional hand, its manipulation skill returned to near pre-lesion levels or higher and all four monkeys returned to a contralesional hand preference late in the post-lesion period. Favorable reorganization of spared cortical and subcortical neural networks may promote recovery of hand function and preference. These results have relevance for the use of extensive forced-use therapy in humans who experience unilateral periRolandic injury to potentially support better recovery of contralesional hand function.

摘要

一侧大脑半球受损可导致对侧手麻痹,随后在日常活动中偏向使用同侧手。然而,在人类中进行的强制性使用疗法可改善对侧麻痹手的功能,并增加其在日常活动中的使用,尽管在精细运动活动中同侧手可能仍然更受青睐。对猴子的研究表明,极少地强制性使用对侧手(在脑损伤前它是更受青睐的手),就能产生显著的功能恢复。在此,我们检验了这样一个假设:在损伤后长期强制性使用对侧手可使其恢复到更受青睐的状态。四只恒河猴在对其更受青睐的手对侧的初级运动皮层、外侧运动前皮层和顶叶前皮层(F2P2损伤)进行手术损伤之前接受了手偏好测试。损伤后两周开始,每周三次进行涉及对侧手够取食物目标的强制性使用疗法,每次至少够取300次,直至损伤后24周。尽管对侧手最初出现麻痹,但其操作技能恢复到接近损伤前水平或更高水平,并且所有四只猴子在损伤后期都恢复了对侧手偏好。保留的皮层和皮层下神经网络的有利重组可能促进手功能和偏好的恢复。这些结果对于在经历单侧罗兰多周围损伤的人类中使用广泛的强制性使用疗法以潜在地支持对侧手功能更好地恢复具有参考意义。

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