Multiple Sclerosis, December 2001,
vol. 7, no. 6, pp. 364-370(7)
Diseases of the spinal cord are associated
with reactive changes in cerebral cortex organization.
Many studies in this area have examined
spinal cord conditions not associated with recovery, making it difficult
to consider the value of these cortical events in the restoration of neurological
function.
We studied patients with myelitis,
a syndrome of transient spinal cord inflammation, in order to probe cortical
changes that might contribute to recovery after disease of the spinal cord.
Seven patients, each of whom showed
improvement in hand motor function after a diagnosis of myelitis involving
cervical spinal cord, were clinically evaluated then studied with functional
MRI.
During right and left index finger
tapping, activation volumes were assessed in three cortical motor regions
within each hemisphere. Results were compared with findings in nine control
subjects.
Compared to the control group, myelitis
patients had larger activation volumes within contralateral sensorimotor
as well as contralateral premotor cortex.
The degree of daily hand use showed
a significant correlation with the volume of activation in contralateral
sensorimotor cortex.
Recovery from myelitis is associated
with an enlarged activation volume in contralateral motor cortices.
This change in motor cortex function
is related to behavioral experience, and thus may contribute to motor improvement.
The expanded activation in motor
cortex, seen with several forms of spinal cord insult, may have maximal
utility when corticospinal tract axons are preserved.
© 2002 ingenta
Cramer S.C. [3]; Fray E. [2]; Tievsky
A. [2]; Parker R.A. [5]; Riskind P.N. [1] *; Stein M.C. [1]; Wedeen V.
[4]; Rosen B.R. [4]
[1] Department of Neurology, Massachusetts
General Hospital, Harvard Medical School, Boston, Massachusetts, USA [2]
MGH-NMR Center, Massachusetts General Hospital, Harvard Medical School,
Charlestown, Massachusetts, USA [3] The Clinical Investigator Training
Program, Harvard-MIT Division of Health Sciences and Technology and Beth
Israel-Deaconess Medical Center in collaboration with Pfizer Inc. Harvard
Medical School, Boston, Massachusetts, USA [4] Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,
USA [5] Biometrics Center, Beth Israel-Deaconess Medical Center, Harvard
Medical School, Boston, Massachusetts, USA [*] Current addresses: Department
of Neurology, University of Massachusetts, Worcester, MA, USA
Abstract: