Wessel K, Zeffiro T, Lou J S, Toro C, Hallett M
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1428, USA.
Brain. 1995 Apr;118 ( Pt 2):379-93. doi: 10.1093/brain/118.2.379.
The brain regions controlling self-paced sequential finger movements in patients with cerebellar degeneration were studied by measuring changes in regional cerebral blood flow (rCBF) in eight patients using bolus injections of H2(15)O and PET. The results were compared with those obtained in eight normal age-matched control subjects. Patients and control subjects performed a self-paced sequential finger opposition task with the right hand, completing a sequence of movements every 4-6 s. Both groups had strong increases in the adjusted rCBF contralaterally in the primary motor cortex (M1) and ventral premotor area (PMv), in the caudal supplementary motor area (SMA) and cingulate motor area (CMA), and bilaterally in the prefrontal cortex (PFC), the lobus parietalis inferior (LPI), putamen and cerebellum. The cerebellum, PMv, rostral CMA, PFC and LPI were more active in the control subjects than in the patients, and the M1, SMA, caudal CMA and putamen were more active in the patients than in the control subjects. The reduced activity of the cerebellar neurons in the patients produced a complex pattern of rCBF increases and decreases in other brain regions. Our results suggest that for the preparation and execution of sequential finger movements, patients with cerebellar degeneration use a medial premotor system, including the SMA and caudal CMA, as well as the M1 and putamen, rather than the PMv, PFC, LPI and rostral CMA.
通过使用H2(15)O团注和正电子发射断层扫描（PET）测量8例小脑变性患者局部脑血流（rCBF）的变化，研究了控制自定节奏顺序手指运动的脑区。将结果与8名年龄匹配的正常对照受试者的结果进行比较。患者和对照受试者用右手执行自定节奏的顺序手指对掌任务，每4-6秒完成一系列动作。两组在对侧的初级运动皮层（M1）和腹侧运动前区（PMv）、尾侧辅助运动区（SMA）和扣带运动区（CMA）以及双侧前额叶皮层（PFC）、顶下叶（LPI）、壳核和小脑中，调整后的rCBF均有显著增加。小脑、PMv、吻侧CMA、PFC和LPI在对照受试者中比在患者中更活跃，而M1、SMA、尾侧CMA和壳核在患者中比在对照受试者中更活跃。患者小脑神经元活动的降低在其他脑区产生了rCBF增加和减少的复杂模式。我们的结果表明，对于顺序手指运动的准备和执行，小脑变性患者使用内侧运动前系统，包括SMA和尾侧CMA，以及M1和壳核，而不是PMv、PFC、LPI和吻侧CMA。
