多发性硬化症患者运动活性的纵向fMRI研究

作     者：Pantano P. Mainero C. Lenzi D. 袁海峰 

作者机构：Dept. Neurological Sciences University of Rome 'La Sapienza' Viale dell'Università30 I-00185 RomeItaly 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第12期

页      面：25-26页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：多发性硬化症 fMRI研究 感觉运动皮质 功能磁共振成像 脑损伤患者 脑功能活动 临床病程 可塑性变化 负相关 显著性差异 

摘      要：Using functional MRI (fMRI), patients with multiple sclerosis showed a greater extent of motor activation than controls. Although functional changes are often interpreted as adaptive and as a contributing factor in limiting the clinical deficit, no longitudinal studies have yet been performed for multiple sclerosis. Sixteen patients with multiple sclerosis, two patients with possible multiple sclerosis and nine age-matched controls underwent two fMRI studies with a time interval of 15-26 months. The motor task consisted of a self-paced sequential finger opposition movement with the right hand. Patients with multiple sclerosis exhibited greater bilateral activation than controls in both fMRI studies. At follow-up, patients showed a reduction in functional activity in the ipsilateral sensorimotor cortex and in the contralateral cerebellum. No significant differences between the two fMRI studies were observed in controls. Activation changes in ipsilateral motor areas correlated inversely with age, extent and progression of T1 lesion load, and occurrence of a new relapse. This study may help the understanding of the evolution of brain plastic changes in multiple sclerosis indicating that, in younger patients with a less structural brain damage and benign clinical course, the brain reorganizes its functional activity towards a more lateralized pattern of brain activation. The tendency towards a normalization of brain functional activity is hampered in older patients and in those developing relapses or new irreversible brain damage.