脑血管畸形患者运动皮质可塑性的功能MRI研究

Plasticity of the Motor Cortex in Patients with Cerebral Vascular Malformations:A Functional MR Imaging Study

目的 :探讨应用功能MRI(fMRI)研究位于或邻近初级运动中枢脑血管畸形患者运动皮质功能的可塑性。方法 :8例患者采集双手对掌运动激发后功能图像 ,观察功能区的分布特征 :计算活动指数 (AI)值 ;测量不同活动区信号强度 (SI)上升百分率。结果 :8例患者运动激发后在手运动区 (HRA)、辅助运动区 (SMA)、中央后回、额前区、顶叶等区域见活动。 5例有功能区移位的患者正常侧HRA活动区扩大 ,AI值为 0 3 9± 0 0 7,3例功能区无移位患者的AI值为 0 87± 0 12 (P <0 0 5 )。正常侧不同部位SI上升百分率均较病灶侧相应部位高 (P >0 0 5 )。结论

Aim:To inverstigate the plasticity of the cortical motor areas with functional magnetic resonance imaging (fMRI) for patients with cerebral vascular malformations in or near the primary motor cortex.Methods:Functional images were acquired in 8 cases while patient performed repetitive finger to thumb opposition movements. Activation was determined and the activation index (AI) of the HRA and the SI rising percentage of the differrent areas were calculated.Results:Activations following motor tasks localized to the HRA area and the postcentral gyrus and the supplementary motor area (SMA) and the prefrontal area as well as the parietal area. The ipsilateral extent of the activation increased in 5 cases with eloquent area shift, and its AI was 0.39±0.07, and AI was 0.87±0.12 in another 3 cases without eloquent area deviation ( P <0 05). The signal rising percentage in the HRA or SMA or the postcentral gyrus of the contralateral side was larger than those in the similar areas of the ipsilateral side ( P >0.05). Conclusion:Plasticity is represented with the ipsilateral increased activation and the activation in the nonsomatotopic hand motor areas in patients with cerebral vascular malformations.