Caramia M D, Iani C, Bernardi G
Clinica Neurologica, Università di Roma Tor Vergata, Ospedale S. Eugenio, Italy.
Neuroreport. 1996 Jul 29;7(11):1756-60. doi: 10.1097/00001756-199607290-00012.
The present study aims to provide neurophysiological evidence of ipsilateral activation during motor recovery in patients after stroke. The effects of cortical reorganization were investigated using magnetic brain stimulation in order to record motor evoked potentials (MEPs) both from contralateral and ipsilateral hands. Ten healthy subjects and 13 patients were examined. The patients had suffered their first hemispheric stroke and consequent motor deficit. While ipsilateral responses (iMEPs) were absent in normal subjects, they were obtained from both ipsilateral and contralateral hands in patients. The ipsilateral MEP differed from contralateral MEP in the following respects: (1) elicitation during contraction; (2) a shorter latency; (3) a lower amplitude. The presence of optimal iMEPs (lower excitability threshold, larger amplitude) in recovered hands points to a role for the undamaged hemisphere, and in particular to the involvement of secondary motor areas. We suggest that iMEPs in general may be a marker of brain plasticity, and that the specific type described here appear in the context of fast autochthonous motor recovery.
本研究旨在为中风后患者运动恢复过程中同侧激活提供神经生理学证据。使用脑磁刺激研究皮质重组的影响，以便记录对侧手和同侧手的运动诱发电位（MEP）。对10名健康受试者和13名患者进行了检查。这些患者首次发生半球性中风并伴有相应的运动功能缺损。正常受试者未出现同侧反应（iMEP），但在患者的同侧手和对侧手均记录到了iMEP。同侧MEP与对侧MEP在以下方面存在差异：（1）收缩时引出；（2）潜伏期较短；（3）波幅较低。恢复手出现最佳iMEP（兴奋性阈值较低、波幅较大）表明未受损半球发挥了作用，尤其是二级运动区的参与。我们认为，一般来说iMEP可能是脑可塑性的一个标志，此处描述的特定类型出现在快速自发运动恢复的背景下。
