Ipsilateral motor pathway without contralateral motor pathway in a stroke patient

Title
Ipsilateral motor pathway without contralateral motor pathway in a stroke patient
Author(s)
장성호여상석
Keywords
TRANSCRANIAL MAGNETIC STIMULATION; DIFFUSION TENSOR TRACTOGRAPHY; MIRROR MOVEMENTS; RECOVERY; LOCALIZATION; PLASTICITY; MECHANISM; CORTEX
Issue Date
201206
Publisher
IOS PRESS
Citation
NEUROREHABILITATION, v.30, no.4, pp.303 - 306
Abstract
The ipsilateral motor pathway from the unaffected motor cortex to the affected extremity is one of the mechanisms of motor recovery following stroke. We report on a stroke patient who showed the ipsilateral motor pathway without the contralateral motor pathway on functional MRI and diffusion tensor tractography. A 53-year-old left hemiparetic patient with an infarct in the right middle cerebral artery territory was evaluated. During a period of three months after onset, motor function of the affected (left) hand had recovered slowly, to the extent that the patient was able to overcome gravity. FM R I showed that only the unaffected (left) primary sensorimotor cortex was activated by movements of the unaffected (right) hand or of the affected (left) hand. On diffusion tensor tractography, the corticospinal tract of the left hemisphere originated from the primary sensori-motor cortex and descended through the known corticospinal tract pathway. By contrast, the right corticospinal tract showed a disruption with Wallerian degeneration to the upper medulla. We conclude that the motor function of the affected (left) hand appeared to be controlled only by the ipsilateral motor pathway from the left motor cortex to the left hand. Motor function of the affected hand appeared to have been reorganized to the ipsilateral motor pathway from the unaffected motor cortex to the affected hand.
URI
http://hdl.handle.net/YU.REPOSITORY/28082http://dx.doi.org/10.3233/NRE-2012-0759
ISSN
1053-8135
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의과대학 > 재활의학교실 > Articles
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