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目的应用fMRI研究双手交替运动模式下中央沟附近脑肿瘤患者运动功能重组的方式及特征。方法6名正常受试者和14名脑肿瘤患者采用双手交替对指运动模式行fMRI扫描,比较正常受试者与脑肿瘤患者脑激活的异同。结果正常人单手对指运动主要激活运动手对侧的大脑半球和同侧小脑半球。脑肿瘤患者非受累手运动所致的激活与正常受试者基本相同;而当受累手运动时,则出现运动功能的重组,包括肿瘤对侧正常半球内M1区的代偿性激活、肿瘤侧半球MI活动的减弱、双侧SMA等次级运动中枢激活区的增大以及双侧小脑半球的激活。结论采取双手交替运动模式,fMRI不仅显示了受累侧运动区的变形与移位,而且揭示了一种新的功能重组模式,即运动功能重组可能涉及分布于全脑的整个神经网络。
Objective To study the modalities and characteristics of motor function in patients with brain tumors near the central gully in the mode of alternating hands and hands using fMRI. Methods Six normal subjects and 14 patients with brain tumors were screened by fMRI with alternating hands and fingers. The similarities and differences of brain activation between normal subjects and brain tumor patients were compared. Results Normal single-handedness refers to the movement of the main hand movement of the contralateral hemisphere and ipsilateral cerebellar hemisphere. The activation of uninvolved hand motions in patients with brain tumors is similar to that of normal subjects; however, when involved in hand motions, there is a reorganization of motor functions, including compensatory activation of the M1 region in the contralateral normal hemisphere to the tumor, Diminished hemispheric MI activity, increased activation of the secondary motor center such as bilateral SMA, and activation of the bilateral cerebellar hemispheres. Conclusions Taking both hands alternating movement mode, fMRI not only shows the deformation and displacement of the affected side motor area, but also reveals a new functional recombination mode, in which motor function reorganization may involve the whole neural network distributed in the whole brain.