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首页> 外文期刊>Neurosurgery >Cortical areas involved in virtual movement of phantom limbs: comparison with normal subjects.
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Cortical areas involved in virtual movement of phantom limbs: comparison with normal subjects.

机译：幻影肢体虚拟运动所涉及的皮质区域：与正常受试者的比较。

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OBJECTIVE: To demonstrate that amputees performing "virtual" movements of their amputated limb activate cortical areas previously devoted to their missing limb, we studied amputees with functional magnetic resonance imaging (fMRI) and positron emission tomographic (PET) scans and compared the results with those of normal volunteers performing imaginary movements during fMRI acquisitions. METHODS: Ten amputees (age range, 33-92 yr; average age, 49 yr; six men and four women; eight upper-limb and two lower-limb amputations) able to move their phantom limb at will were studied by fMRI (all patients) and PET scan (seven patients). The time between amputation and fMRI and PET studies ranged from 1 to 27 years (average, 13 yr). Patients were asked to perform virtual movements of the amputated limb and normal movements of the contralateral normal limb according to the functional images acquisition procedure. Movements of the stump were also used to differentiate stump cortical areas from virtual movement-activated areas. Ten right-handed volunteers, age- and sex-matched to the amputees, were also studied by fMRI. All volunteers were asked to perform four tasks during their fMRI study: imaginary movements of their right arm (1 task) and foot (1 task) and real movements of their left arm (1 task) and foot (1 task). RESULTS: In amputees, virtual movements of the missing limbs produced contralateral primary sensorimotor cortex activation on both fMRI and PET scans. These activation areas, different from the stump activation areas, were similar in location to contralateral normal limb-activated areas. Quantitatively, in two amputees who claimed to be able to perform both slow and fast virtual movements, regional cerebral blood flow measured by PET scan in the precentral gyrus increased significantly during fast movements in comparison with slow virtual movements. In normal subjects, significant differences between real versus imaginary fMRI activations were found (for both foot and hand movements); imaginary right hand and foot tasks activated primarily the contralateral supplementary motor areas, with no significant activation detected in the contralateral precentral or postcentral gyri. CONCLUSION: Primary sensorimotor cortical areas can be activated by phantom-limb movements and thus can be considered functional for several years or decades after amputation. In this study, we found that the location of the activation of these areas is comparable to that of activations produced by normal movements in control subjects or in amputees.
机译：目的：为了证明截肢的肢体进行“虚拟”运动的被截肢者激活了先前专用于其缺失肢体的皮质区域，我们对被截肢者进行了功能磁共振成像（fMRI）和正电子发射断层扫描（PET）扫描，并将结果与​​那些进行了比较fMRI采集期间进行想象运动的正常志愿者的数量。方法：通过功能磁共振成像研究了十个截肢者（年龄范围为33-92岁;平均年龄为49岁;六个男人和四个女人;八个上肢截肢和两个下肢截肢）可以随意移动其幻肢。患者）和PET扫描（七位患者）。截肢与fMRI和PET研究之间的时间为1至27年（平均13年）。根据功能图像获取程序，要求患者进行截肢的虚拟运动和对侧正常肢的正常运动。树桩的移动还用于区分树桩皮质区域与虚拟运动激活区域。 fMRI还研究了10名年龄和性别与被截肢者相匹配的右撇子志愿者。在进行功能磁共振成像研究期间，所有志愿者均被要求执行四项任务：右臂（1项任务）和脚（1项任务）的假想运动以及左臂（1项任务）和脚（1项任务）的真实运动。结果：在截肢者中，fMRI和PET扫描均显示虚假肢体运动导致对侧主要感觉运动皮层激活。这些激活区域不同于树桩激活区域，其位置与对侧正常肢体激活区域相似。在数量上，在声称能够同时进行慢速和快速虚拟运动的两个截肢者中，与慢速虚拟运动相比，快速运动期间通过中央前回的PET扫描测量的局部脑血流量显着增加。在正常受试者中，发现真实的和虚构的fMRI激活之间存在显着差异（对于脚和手的运动）;虚构的右手和脚任务主要激活了对侧辅助运动区，而对侧中央前或中央后回中未检测到明显的激活。结论：幻肢运动可激活主要的感觉运动皮层区域，因此在截肢后数年或数十年内可认为其功能正常。在这项研究中，我们发现这些区域的激活位置与对照组或被截肢者正常运动产生的激活位置相当。

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