健侧颈7神经根移位对全臂丛根性撕脱伤术后对侧运动皮层的远期影响

Long-term effect of contralteral C7 transference treating total brachial plexus avulsion on brain functional reorganization

目的观察健侧颈7移位术后2年运动皮层功能的重塑变化,以期从运动皮层功能重塑方面对临床远期随访的结果进行解释。方法 30只SD大鼠随机分为对照组、全臂丛根性撕脱伤组及颈7移位修复组,于术后24个月以微电极刺激技术检测各组大鼠患肢支配区在对侧大脑运动皮层的分布。结果术后24个月,对照组上肢支配区在大脑运动皮层的刺激位点数量在右侧为21.17±1.14个;在全臂丛根性撕脱伤组,颈部位点在术后两年仍占据着原前肢代表区;颈7移位术后左侧前肢代表区逐渐替代颈部位点,术后2年刺激位点数量为14.83±0.83。结论健侧颈7神经根移位治疗全臂丛根性撕脱伤能够引起成年大鼠对侧运动皮层远期的功能重塑。

Objective To observe the long--term changes of brain function after contralat eral C7 transference and try to explain the clinical follow--up results from the perspective of func- tional reorganization. Methods Thirty SD rats were randomly divided into Control,Brachial plex- us root avulsion injury and contralateral C7 transference groups. The movement evocation of mo- tor cortex was measured by intracortical microstimulation in contralateral in 24 months after oper ation. Results 24 months after operation, number of stimulation sites in contralateral cortex of the injured limbs was 21. 17 ± 1. 14 in Control group; In Brachial plexus root avulsion injury group,the sites of neck firmly occupied the left forelimb representation region throughout the en- tire process,while in the contralateral C7 transference group, the left forelimb representation re gion gradually replace the sites of neck,number of the sites was 14.83±0.83. Conclusion Con- tralateral C7 transference treating total brachial plexus avulsion could induce brain functional re- organization.