Cortical Reorganization Allows for Motor Recovery after Crossed Cerebrocerebellar Atrophy |
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Authors: | Antoine Feydy MD PhD Alexandre Krainik MD Bernard Bussel MD Marc A. Maier PhD |
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Affiliation: | Services d'Imagerie Médicale, INSERM U483, Paris, France. |
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Abstract: | The authors report the case of a 33-year-old woman who exhibited, at the age of 17, a left-sided hemiplegia, which was followed by good motor recovery, though with a permanent deficit in fine finger movements. She had a widespread loss of neural tissue in the right hemisphere (crossed cerebrocerebellar atrophy), including (1) marked atrophy and thinning of the precentral and postcentral gyri; (2) widespread deep white matter destruction, including the corticospinal tract; and (3) crossed cerebellar atrophy. Except over the supplementary motor area (SMA), transcranial magnetic stimulation did not elicit motor evoked potentials in the affected hand. Nevertheless, during opening and closing of the affected hand, functional magnetic resonance imaging showed an activation of the lesioned primary sensorimotor cortex (SMC), as well as of the intact SMA and the parietal areas, but not of the ipsilateral motor areas. The authors speculate that recovery was achieved by a motor command generated in the SMC and the parietal cortex, passing through corticospinal axons originating in the SMA. |
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Keywords: | Brain injury motor recovery neuronal plasticity functional MRI transcranial magnetic stimulation |
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