Different cerebral plasticity of intrinsic and extrinsic hand muscles after peripheral neurotization in a patient with brachial plexus injury: A TMS and fMRI study. (14th September 2015)

• Record Type: Journal Article
• Authors: Li, Tie; Hua, Xu-Yun; Zheng, Mou-Xiong; Wang, Wei-Wei; Xu, Jian-Guang; Gu, Yu-Dong; Xu, Wen-Dong
• Is Part Of: Neuroscience letters. Volume 604(2015)
• Page Start: 140
• Page End: 144
• Publication Date: 2015-09-14
• Subjects: TMS transcranial magnetic stimulation -- fMRI functional magnetic resonance imaging -- MT motor threshold -- MEP motor evoke potential -- MI primary motor cortex -- CC7 contralateral cervical 7 -- FD flexor digitorum muscle -- APB abductor pollicis brevis muscle -- NCS nerve conduction studies -- BPI brachial plexus injury -- MSO maximal stimulator output -- SPM statistical parametric mapping -- FWE family wise error; Brachial plexus injury -- Peripheral neurotization -- Cerebral plasticity -- Neurophysiology and neuroimaging -- Motor cortex; Neurology -- Periodicals; Neurology -- Periodicals; Research -- Periodicals; Neurologie -- Périodiques; Neuroanatomie -- Périodiques; Neuropharmacologie -- Périodiques; Neurophysiologie -- Périodiques; Neurology; Periodicals; Electronic journals; 617.48
• DOI: 10.1016/j.neulet.2015.07.015
• Languages: English
• ISSNs: 0304-3940

Abstract

Highlights: Cerebral plasticity following BPI and neurotization varies in different functions. We combined TMS and fMRI to evaluate the brain plasticity after neurotization. The reorganization of proximal extrinsic hand muscles is relatively complete. The adaptive cerebral plasticity pattern is crucial for well clinical recovery. Abstract: Contralateral C7 (CC7) neurotization has been an important approach for brachial plexus injury (BPI). Patients can achieve relatively good grasping function driven by the proximal extrinsic hand muscle (flexor digitorum, FD) after CC7 neurotization, whereas the thumb opposition function driven by the distal intrinsic muscle (abductor pollicis brevis, APB) is poor. The present study aimed to investigate the brain reorganization patterns of the recovery processes of intrinsic and extrinsic hand functions after repairing the median nerve by CC7 neurotization. Transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) were used to evaluate the cerebral plasticity in one BPI patient after CC7 neurotization. After the CC7 neurotization, the patient showed improvements in the paralyzed hand. Combination of TMS and fMRI investigations demonstrated different cortical reshaping patterns of APB and FD. It was also found that the activated cortical areas of FD were located in bilateral motor cortices, but the area of APB was only located in ipsilateral motor cortex. The cerebral plasticity procedure appeared to be different in the gross and fine motor function recovery processes. It provided a new perspective into the cerebral plasticity induced by CC7 neurotization.