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

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 he...

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Publicado en:NeuroRehabilitation Vol. 26; no. 2; pp. 167 - 172
Autores principales: Jang SH, Hong J, Ahn SH, Son SM, Cho YW
Formato: case study diagnostic images tracings Journal Article
Publicado: Sage Publications Inc. 2010
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Sage Publications Inc.
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        atl: Motor function reorganization in a patient with a brainstem lesion: DTT, fMRI and TMS study.
      aug:
        au:
          Jang SH
          Hong J
          Ahn SH
          Son SM
          Cho YW
        affil: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea
      sug:
        subj:
          Diagnostic Imaging
          Hemiplegia Physiopathology
          Motor Skills
          Neuronal Plasticity
          Adult
          Male
          Adult: 19-44 years
          Male
      ab: 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.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        tracings
        Journal Article
      ougenre: Article
    language: English
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