NeuroRehabilitation - Volume 26, issue 2

Authors: Jang, Sung Ho | Hong, Ji-Heon | Ahn, Sang Ho | Son, Soo Min | Cho, Yoon Woo

Article Type: Research Article

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. Show more

Keywords: Corticospinal tract, functional MRI, diffusion tensor MRI, transcranial magnetic stimulation, motor recovery

DOI: 10.3233/NRE-2010-0550

Citation: NeuroRehabilitation, vol. 26, no. 2, pp. 167-171, 2010

Authors: Son, Su Min | Kwon, Yong-Hyun | Jang, Sung Ho

Article Type: Research Article

Abstract: Purpose: The object of this study was to demonstrate the reorganization of the affected hand motor function lateral to the congenital brain lesion in a patient using functional MRI (fMRI). Methods: Twelve normal control subjects and a 23-year-old man with a congenital brain lesion including the precentral knob were evaluated. FMRI was performed using the blood oxygen level-dependent technique at 1.5-T system with timed hand grasp-lease motor tasks. Results: The contralateral primary sensorimotor cortex centered on the precentral knob was activated during hand movements of the right side of the patient and of control subjects. However, …only the lateral area of the lesion was activated during left hand movements of the patient. Conclusions: It seems that the motor function of the left hand was reorganized into the lateral area of the lesion in this patient. This finding may reflect a cortical reorganization of the motor area. Show more

Keywords: Functional MRI, motor recovery, cortical reorganization

DOI: 10.3233/NRE-2010-0551

Citation: NeuroRehabilitation, vol. 26, no. 2, pp. 173-176, 2010

Authors: Zasler, Nathan

Article Type: Book Review

DOI: 10.3233/NRE-2010-0552

Citation: NeuroRehabilitation, vol. 26, no. 2, pp. 177-177, 2010