臂丛损伤健侧C7神经移位术前后运动想象任务fMRI研究

发布时间：2018-11-21 12:27

【摘要】：目的:运用功能磁共振成像(f MRI)研究臂丛神经根性撕脱伤患者健侧C7神经移位术前后执行运动想象任务时激活脑区的特点,探讨周围神经损伤影响运动想象的神经机制。方法:14例右侧全臂丛根性撕脱伤患者及7例健康对照接受磁共振检查,其中7名患者接受术前f MRI检查,另7名患者于健侧C7神经根移位于患肢正中神经术后接受f MRI检查。任务为分别想象双侧手抓握运动。结果:健康对照组想象右手抓握运动激活双侧辅助运动区(SMA)、双侧运动前区(PMA)以及左侧顶下小叶、左侧基底节区等脑区。14例臂丛损伤患者想象健侧手抓握运动时激活脑区与健康对照类似。术后组患者想象患手抓握运动时激活双侧SMA区、左侧初级运动皮质(PMC(M1))、左侧PMA区以及双侧顶上小叶。右侧臂丛损伤神经移位术后组激活图像减去术前组激活图像后保留右侧顶上小叶。结论:运动想象与真实运动有共用的脑功能区;臂丛损伤后周围神经传入、传出通道的完整性受损是引起运动想象任务脑功能网络改变的基础。
[Abstract]:Objective: to study the characteristics of activation of brain region during motor imagination before and after normal C7 nerve transposition in patients with brachial plexus root avulsion by functional magnetic resonance imaging (f MRI), and to explore the neural mechanism of peripheral nerve injury affecting motor imagination. Methods: fourteen patients with right total brachial plexus root avulsion and 7 healthy controls were examined by magnetic resonance imaging (MRI). Among them, 7 patients underwent f MRI before operation, and 7 patients underwent f MRI examination after the transfer of C7 nerve root to the median nerve of the affected limb. The task was to visualize the grip movement on both sides of the hand. Results: the healthy control group imagines that the right hand grip activates the bilateral auxiliary motor area (SMA), and the left inferior parietal lobule. 14 patients with brachial plexus injury imagined that the activation of the brain region in the contralateral grip movement was similar to that in the healthy control group. In the postoperative group, the bilateral SMA area, the left primary motor cortex (PMC (M1), the left PMA area and the bilateral superior parietal lobule were visualized. The activation images of the right brachial plexus injury group were subtracted from the preoperative ones and the right superior parietal lobule was preserved. Conclusion: motor imagination has a common brain function area with real movement, and the integrity of peripheral nerve afferent and efferent channels after brachial plexus injury is the basis of brain functional network change in motor imagination task.
【作者单位】：复旦大学附属华山医院放射科;复旦大学附属华山医院手外科;华山医院宝山分院放射科;
【基金】：国家自然科学基金(项目编号:30872408)~~
【分类号】：R445.2;R688

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