Motor function reorganization in a patient with a brainstem lesion: DTT, fMRI and TMS study

Title
Motor function reorganization in a patient with a brainstem lesion: DTT, fMRI and TMS study
Author(s)
장성호홍지헌안상호손수민조윤우
Keywords
TRANSCRANIAL MAGNETIC STIMULATION; DIFFUSION TENSOR TRACTOGRAPHY; CORTICOSPINAL TRACT; PONTINE INFARCT; RECOVERY; MRI; INJURY; CONNECTIVITY; CORTEX; STROKE
Issue Date
201003
Publisher
IOS PRESS
Citation
NEUROREHABILITATION, v.26, no.2, pp.167 - 171
Abstract
Objective: We report on a hemiparetic patient who showed a new motor pathway posterior to the lesion in the midbrain and upper pons, demonstrated by three combined method of diffusion tensor tractography (DTT)/functional MRI (fMRI)/transcranial magnetic stimulation (TMS). Methods: A 21-year-old left hemiparetic male who suffered from tuberous meningitis at the age of 12 months after birth. The evaluations were performed at 20 years after onset. Brain MRI showed focal encephalomalatic lesions due to infarcts in right anterior thalamus, midbrain and upper pons. DTT, fMRI and TMS were performed simultaneously. Results: The contralateral primary sensori-motor cortex was activated during either affected or unaffected hand movements. DTT showed that the motor tracts descended along the known pathway of the CST, with the exception of the motor tract of the affected hemisphere, which descended along the posterior portion to the lesion in the right midbrain and the pons, and then rejoined the CST in the mid-pons. The TMS results suggested that the motor tract of the affected hemisphere had the characteristics of a CST. Conclusion: We believe that the motor function of the affected hand in this patient had been recovered through the pathway posterior to the lesion in the midbrain and upper pons.
URI
http://hdl.handle.net/YU.REPOSITORY/22774http://dx.doi.org/10.3233/NRE-2010-0550
ISSN
1053-8135
Appears in Collections:
의과대학 > 재활의학교실 > Articles
의과대학 > 영상의학과학교실 > Articles
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