title: Is one motor cortex enough for two hands?
abstract: We report on a patient with mirror movements sustained by a mono-hemispheric fast control of bilateral hand muscles and normal hand function. Transcranial magnetic stimulation of the right motor cortex evoked contractions of muscles in both hands while no responses were observed from the left hemisphere. Somatosensory-evoked potentials, functional magnetic resonance, and diffusion tractography showed evidence of sensorimotor dissociation and asymmetry of corticospinal projections, suggestive of reorganization after early unilateral left brain lesion. This is the first evidence that, in certain rare conditions, good hand function is possible with ipsilateral corticospinal reorganization, supporting the role of unexplored mechanisms of motor recovery.
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Fiori
authors.affiliation: Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany.|Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Staudt
authors.affiliation: The Australian e-Health Research Centre CSIRO, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Pannek
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Borghetti
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Biagi
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Scelfo
authors.affiliation: The Australian e-Health Research Centre CSIRO, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Rose
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Tosetti
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.|Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioni
authors.affiliation: IRCCS Stella Maris Foundation, Pisa, Italy.|Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Guzzetta
mesh_terms: D000293:Adolescent; D056324:Diffusion Tensor Imaging; D005073:Evoked Potentials, Somatosensory; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009044:Motor Cortex / Q000293:injuries / Q000473:pathology / Q000503:physiopathology*; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation