Hemispheric dissociation between motor and sensory hand representations in congenital hemiparesis: TMS, fMRI, MEG

Abstract

Objectives: Many children with congenital hemiparesis possess ipsilateral cortico-spinal projections, which enable the contra-lesional hemisphere to exert direct motor control over the ipsilateral, paretic hand. A previous TMS and fMRI study on congenital hemiparesis caused by unilateral periventricular brain lesions could demonstrate that all patient with such ipsilateral cortico-spinal pathways nevertheless showed strong fMRI activation of the central (Rolandic) cortex of the affected hemisphere during active movements with the paretic hand, even when no motor tracts could be identified arising in the affected hemisphere. The purpose of the present study was to further characterize these unclear fMRI activation sites.