Urban P P, Hopf H C, Connemann B, Hundemer H P, Koehler J
University Department of Neurology, Mainz, Germany.
Brain. 1996 Jun;119 ( Pt 3):1031-8. doi: 10.1093/brain/119.3.1031.
Cortico-hypoglossal projections were investigated in 11 patients with unifocal ischaemic lesions of different brainstem levels using transcranial magnetic stimulation. Lesion topography was documented by MRI studies. In seven patients the projections to the ipsi- and contralateral hypoglossal nuclei were separately affected. Pontine lesions at the ventral paramedian base close to the midline affect the contralateral projections while lateral lesions at the pontine base affect the ipsilateral projections. Lesions of the paramedian dorsal pontine base do not involve the cortico-hypoglossal projections. Our findings indicate that the cortico-hypoglossal fibres branch off the main ventral pyramidal tract. Lesions of the dorso- and mediolateral medulla impair only the ipsilateral projections. We conclude that ipsilateral projections enter the hypoglossal nucleus from its lateral aspect and that the contralateral projections cross the midline at the pontomedullary junction.
利用经颅磁刺激技术，对11例不同脑干水平单灶性缺血性病变患者的皮质-舌下神经投射进行了研究。通过MRI研究记录病变的位置。在7例患者中，同侧和对侧舌下神经核的投射分别受到影响。靠近中线的脑桥腹侧旁正中基底部的病变影响对侧投射，而脑桥基底部外侧的病变影响同侧投射。脑桥背侧旁正中基底部的病变不涉及皮质-舌下神经投射。我们的研究结果表明，皮质-舌下神经纤维从主要的腹侧锥体束分出。延髓背侧和中外侧的病变仅损害同侧投射。我们得出结论，同侧投射从舌下神经核的外侧进入，对侧投射在脑桥延髓交界处交叉中线。
