Abstract
IntroductionThe purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI).MethodsTwelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared.ResultsThe inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally.ConclusionsThe resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex.
Highlights
The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI)
By placing an region of interest (ROI) in the hand area contralateral to the injured side or the intact side, significant functional connectivity was found between bilateral M1 areas and bilateral supplementary motor area (SMA) (Fig. 1 (c and d) and Table 2)
Task-based fMRI scan is challenging for most BPAI patients who have to accomplish motor function of the affected wrist and fingers by bilateral associated movements, which result in movement artifacts
Summary
The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Results The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. Conclusions The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after. After contralateral C7 nerve transfer, the bilateral limbs of patients with BPAI share a single pyramidal pathway, descending from the cerebral cortex ipsilateral to the affected plexus, resulting in restoration of the affected arm function.
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