PubMed Health⌕ Search

PubMed · 12867030

The ipsilateral human motor cortex can functionally compensate for acute contralateral motor cortex dysfunction.

Abstract

What promotes motor recovery from stroke? To date, studies of recovery from stroke have shown alterations in function in various cortical areas, including the contralesional (unaffected) motor cortex (M1). However, whether these changes contribute to recovery or are mere epiphenomena remains unclear. We therefore sought evidence that the ipsilateral M1 can compensate for dysfunction of the contralateral M1. We recorded the change in force production during a finger-tapping task in response to acute disruption of M1 function by repetitive transcranial magnetic stimulation (rTMS). Neither control (occipital) nor ipsilateral M1 rTMS lead to a change in tapping force. RTMS over contralateral M1 had a short-lived effect and induced changes in ipsilateral M1 excitability around the time that these behavioral effects abated, consistent with delayed compensation by the ipsilateral M1. Simultaneous bilateral M1 stimulation, designed to prevent compensation by the ipsilateral M1, had a large and prolonged effect on tapping force. This is the first demonstration that the ipsilateral primary motor cortex is capable of functionally significant compensation for focal contralateral cortical dysfunction in the adult human and provides a rational basis for interventional treatments aimed at promoting functional compensation in unaffected cortical areas after stroke.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Lucy H A Strens, Noa Fogelson, Paul Shanahan, John C Rothwell, Peter Brown. 2003-07-15. The ipsilateral human motor cortex can functionally compensate for acute contralateral motor cortex dysfunction.. https://doi.org/10.1016/s0960-9822(03)00453-6

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The effect of excessive tibial torsion on the capacity of muscles to extend the hip and knee during single-limb stance.

Excessive tibial torsion, a rotational deformity about the long axis of the tibia, is common in patients with cerebral palsy who walk with a crouch gait. Previous research suggests that this deformity may contribute to crouch gait by reducing the capacity of soleus to extend the knee; however, the effects of excess external torsion on the capacity of other muscles to extend the stance limb during walking are unknown. A computer model of the musculoskeletal system was developed to simulate a range of tibial torsion deformities. A dynamic analysis was then performed to determine the effect of these deformities on the capacity of lower limb muscles to extend the hip and knee at body positions corresponding to the single-limb stance phase of a normal gait cycle. Analysis of the model confirmed that excessive external torsion reduces the extension capacity of soleus. In addition, our analysis revealed that several important muscles crossing the hip and knee are also adversely affected by excessive tibial torsion. With a tibial torsion deformity of 30 degrees , the capacities of soleus, posterior gluteus medius, and gluteus maximus to extend both the hip and knee were all reduced by over 10%. Since a tibial torsion deformity reduces the capacity of muscles to extend the hip and knee, it may be a significant contributor to crouch gait, especially when greater than 30 degrees from normal, and thus should be considered by clinicians when making treatment decisions.

Biomechanical Phenomena↗

Predicting the subject-specific primary stability of cementless implants during pre-operative planning: preliminary validation of subject-specific finite-element models.

Pre-operative planning help the surgeon in taking the proper clinical decision. The ultimate goal of this work is to develop numerical models that allow the surgeon to estimate the primary stability during the pre-operative planning session. The present study was aimed to validate finite-element (FE) models accounting for patient and prosthetic size and position as planned by the surgeon. For this purpose, the FE model of a cadaveric femur was generated starting from the CT scan and the anatomical position of a cementless stem derived by a skilled surgeon using a pre-operative CT-based planning simulation software. In-vitro experimental measurements were used as benchmark problem to validate the bone-implant relative micromotions predicted by the patient-specific FE model. A maximum torque in internal rotation of 11.4 Nm was applied to the proximal part of the hip stem. The error on the maximum predicted micromotion was 12% of the peak micromotion measured experimentally. The average error over the entire range of applied torques was only 7% of peak measurement. Hence, the present study confirms that it is possible to accurately predict the level of primary stability achieved for cementless stems using numerical models that account for patient specificity and surgical variability.

Biomechanical Phenomena↗

Experimental validation of intact and implanted distal femur finite element models.

Four finite element (FE) models of intact and distal femur of knee replacements were validated relative to measured bone strains. FE models of linear tetrahedrons were used. Femoral replacements with cemented stemless, cemented and noncemented femoral stems of the PFC Sigma Modular Knee System were analyzed. Bone strains were recorded at ten locations on the cortex. The magnitude of the FE bone strains corresponded to the mean measured strains, with an overall agreement of 10%. Linear regression between the FE and mean experimental strains produced slopes between 0.94 and 1.06 and R(2) values between 0.92 and 0.99. RSME values were less than 12%. The FE models were able to adequately replicate the mechanical behavior of distal femur reconstructions.

Biomechanical Phenomena↗