Ipsilateral motor pathway confirmed by diffusion tensor tractography in a patient with schizencephaly.
We evaluated the hand motor function of a right hemiparetic patient with schizencephaly using a combination of fMRI, transcranial magnetic stimulation, and diffusion tensor tractography (DTT). Only the unaffected (right) primary sensori-motor cortex was found to be activated during either affected (right) or unaffected hand movements. Evoked motor potentials with similar characteristics were obtained from both abductor pollicis brevis muscles simultaneously when stimulating the unaffected motor cortex. Moreover, a tract presumed to be a corticospinal tract was observed in the unaffected hemisphere by DTT, however, no tract was observed in the affected hemisphere. Our results indicate that the ipsilateral corticospinal tract extended from the unaffected (right) motor cortex to both hands. This finding may reflect functional reorganization of motor function in a patient with congenital brain disorder.
Department of Physical Medicine and Rehabilitation, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Republic of Korea.
Yun-Hee
YH
Kim
Sung Ho
SH
Jang
Bong Soo
BS
Han
Yong-Hyun
YH
Kwon
Sung H
SH
You
Woo Mok
WM
Byun
Ji-Won
JW
Park
Woo Kyung
WK
Yoo
D000328:Adult; D001927:Brain Diseases / Q000473:pathology / Q000503:physiopathology; D001931:Brain Mapping; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004558:Electric Stimulation / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology / Q000528:radiation effects; D007839:Functional Laterality; D006225:Hand / Q000294:innervation / Q000503:physiopathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging; D008280:Magnetics; D008297:Male; D009044:Motor Cortex / Q000002:abnormalities* / Q000098:blood supply; D009132:Muscles / Q000502:physiology / Q000528:radiation effects; D009434:Neural Pathways / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology / Q000528:radiation effects; D012886:Skull / Q000002:abnormalities*; D013997:Time Factors