中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (4): 670-675.doi: 10.4103/1673-5374.180756

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

脑辅助运动区沉寂影响臂丛神经损伤后患者手功能的恢复

  

  • 收稿日期:2016-01-23 出版日期:2016-04-30 发布日期:2016-04-30
  • 基金资助:

    上海市卫生局青年科研基金项目(20124319)

Supplementary motor area deactivation impacts the recovery of hand function from severe peripheral nerve injury

Ye-chen Lu1, #, Han-qiu Liu2, #, Xu-yun Hua1, Yun-dong Shen1, *, Wen-dong Xu1, 3, Jian-guang Xu1, Yu-dong Gu1   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
    3 State Key Laboratory of Medical Neuroscience, Fudan University, Shanghai, China
  • Received:2016-01-23 Online:2016-04-30 Published:2016-04-30
  • Contact: Yun-dong Shen, M.D., yundongshen@163.com.
  • Supported by:

    This study was supported by the Youth Researcher Foundation of Shanghai Health Development Planning Commission, No. 20124319.

摘要:

臂丛神经损伤患者可恢复部分肢体的运动功能,但其手功能恢复不佳。影响手功能恢复的因素中最重要的是大脑的可塑性变化。在周围神经损伤后,参与运动控制的脑区-辅助运动区可能在脑重塑过程中扮演了重要角色。鉴于此,我们运用了想象运动作为任务,观察了全臂丛损伤患者臂丛神经损伤后中枢神经的可塑性。功能磁共振结果显示,想象运动未激发起全臂丛损伤患者双侧辅助运动区的明显激活,说明臂丛损伤患者在想象运动任务中,辅助运动区难以兴奋影响脑重塑。辅助运动区的沉寂可能成为臂丛神经损伤患者准备、启动与执行特定动作的严重障碍,以此影响临床预后效果。

orcid: 0000-0001-9727-753X (Ye-chen Lu)

关键词: 神经再生, 周围神经损伤, 臂丛神经损伤, 神经可塑性, 辅助运动区, 运动前区, 磁共振成像, 运动准备, 运动想象, 手功能的临床恢复, 皮质重塑, 模块化设计

Abstract:

Although some patients have successful peripheral nerve regeneration, a poor recovery of hand function often occurs after peripheral
nerve injury. It is believed that the capability of brain plasticity is crucial for the recovery of hand function. The supplementary motor area
may play a key role in brain remodeling after peripheral nerve injury. In this study, we explored the activation mode of the supplementary
motor area during a motor imagery task. We investigated the plasticity of the central nervous system after brachial plexus injury, using the
motor imagery task. Results from functional magnetic resonance imaging showed that after brachial plexus injury, the motor imagery task
for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor areas. This result indicates that it is
difficult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task, thereby impacting brain
remodeling. Deactivation of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of
preparing, initiating and executing certain movements, which may be partly responsible for the unsatisfactory clinical recovery of hand
function.

Key words: nerve regeneration, peripheral nerve injury, brachial plexus injury, neuronal plasticity, supplementary motor area, premotor area, magnetic resonance imaging, motor preparation, motor imagery, clinical restoration of hand function, cortical remodeling, block design, neural
regeneration