Archives of neurology · 2011
New type of cortical neuroplasticity after nerve repair in brachial plexus lesions.
Клинический случайСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Beisteiner Roland, Höllinger Ilse, Rath Jakob, Wurnig Moritz, Hilbert Markus, Klinger Nicolaus, Geissler Alexander, Fischmeister Florian, Wöber Christian, Klösch Gerhard, Millesi Hanno, Grisold Wolfgang, Auff Eduard, Schmidhammer Robert
Аннотация
BACKGROUND: In brachial plexus avulsion, a recent technique connects the ending of the disrupted musculocutaneous nerve to the side of the intact phrenic nerve to regain elbow flexion. This requires the phrenic nerve to perform a new double function: independent control of breathing and elbow flexion. Neuroplastic changes associated with acquisition of double nerve functions have not yet been investigated.
OBJECTIVE: To evaluate neuroplastic changes associated with acquisition of double nerve functions in a monofunctional nerve (phrenic nerve).
DESIGN: Clinical and functional magnetic resonance imaging investigations during arm movements, forced inspiration, and motor control tasks.
SETTING: Investigations at the Medical University of Vienna, Vienna, Austria.
PARTICIPANTS: Three healthy control subjects, 2 patients with phrenic nerve end-to-side coaptation, and 1 control patient with C7 end-to-end coaptation (same clinical presentation but phrenic nerve unchanged).
RESULTS: Clinical documentation showed that both patients with phrenic nerve end-to-side coaptation were able to control the diaphragm and the biceps independently via the same phrenic nerve. In contrast to all controls, both patients with phrenic nerve end-to-side coaptation activated the cortical diaphragm areas with flexion of the diseased arm.
CONCLUSION: Our functional magnetic resonance imaging data indicate that the patient's cortical diaphragm areas reorganize in such a way that independent control of breathing and elbow flexion is possible with the same neuronal population.
OBJECTIVE: To evaluate neuroplastic changes associated with acquisition of double nerve functions in a monofunctional nerve (phrenic nerve).
DESIGN: Clinical and functional magnetic resonance imaging investigations during arm movements, forced inspiration, and motor control tasks.
SETTING: Investigations at the Medical University of Vienna, Vienna, Austria.
PARTICIPANTS: Three healthy control subjects, 2 patients with phrenic nerve end-to-side coaptation, and 1 control patient with C7 end-to-end coaptation (same clinical presentation but phrenic nerve unchanged).
RESULTS: Clinical documentation showed that both patients with phrenic nerve end-to-side coaptation were able to control the diaphragm and the biceps independently via the same phrenic nerve. In contrast to all controls, both patients with phrenic nerve end-to-side coaptation activated the cortical diaphragm areas with flexion of the diseased arm.
CONCLUSION: Our functional magnetic resonance imaging data indicate that the patient's cortical diaphragm areas reorganize in such a way that independent control of breathing and elbow flexion is possible with the same neuronal population.