[Functional recuperation following lesions of the primary somatosensory fields. Study of compensatory mechanisms].
During a long time, lesions of the primary somatosensory area (S I) were considered as generating severe and definitive neurological sequelae. However, recent reports described a recovery following stroke and resective surgeries (for epilepsy or tumor). On the basis of these observations, of experimentations in animals, and of studies of the (re)organization of eloquent areas in man using new methods of functional mapping, brain plasticity phenomena underlying the recovery were analyzed. They seems to implicate the recruitment of local areas (sensory redundancies within S I), regional areas (primary motor area, secondary somatosensory area, posterior parietal cortex, insula), controlateral eloquent regions, and even learning of new compensatory strategies. Such data could allow us to extend surgical indications of resection of lesions located within S I. An improvement of our knowledge of these functional reshaping phenomena (unmasking of latent networks and/or participation of eloquent homologous and/or sprouting) and then their prediction remains mandatory, with the goal to optimize the surgical preplanning in functional regions, taking account of the individual dynamic spatiotemporal cortical organization. This better knowledge seems to be obtained by studying the correlations between pre- and post-operative functional neuroimaging (fMRI, MEG) data, and the intraoperative functional mapping results.
Duffau
H
H
Service de Neurochirurgie 1, Hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75651 Paris. hugues.duffau@psl.ap-hop-paris.fr
Capelle
L
L
D000818:Animals; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology; D006801:Humans; D009415:Nerve Net / Q000503:physiopathology; D009416:Nerve Regeneration / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology*; D010468:Perceptual Disorders / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology*; D013003:Somatosensory Cortex / Q000503:physiopathology / Q000601:surgery*
Récupération fonctionnelle à la suite de lésions de l'aire somato-sensorielle primaire. Etude des mécanismes de compensation.