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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(6):1202-1206.
Ipsilateral Motor Pathway Confirmed by Brain Mapping in a Patient with Traumatic Brain Injury: A case report.
Jang, Sung Ho , Han, Bong Soo , Chang, Yongmin , Byun, Woo Mok , Ahn, Sang Ho , Kim, Sung Ho
1Department of Rehabilitation Medicine, Yeungnam University College of Medicine.
2Department of Diagnostic Radiology, Kyungpook National University College of Medicine.
3Department of Diagnostic Radiology, Yeungnam University College of Medicine.
4Department of Neurosurgery, Yeungnam University College of Medicine.
외상성 뇌손상환자에서 뇌지도화를 통해 증명된 동측 운동신경 경로 ⁣증례 보고⁣
장성호, 한봉수1, 장용민1, 변우목2, 안상호, 김성호3
영남대학교병원 재활의학과, 1경북대학교 의과대학 방사선과학교실

The aim of this study is to investigate the mechanism of motor recovery using both functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS) in a patient with hemorrhagic contusion on the right basal ganglia area. Functional MRI showed that the left primary sensorimotor cortex and the supplementary motor area were activated when the right fingers performed the flexion-extension exercise. On the other hand, the bilateral primary sensorimotor cortex and the left premotor area were activated with the excerise of left hand. Brain mapping for both abductor pollicis brevis muscles (APB) using TMS revealed that ipsilateral motor evoked potentials (MEPs) were obtained at left APB. Ipsilateral MEPs of left APB showed delayed latency and lower amplitude compared to that of right APB when stimulated at the left motor cortex. We concluded that ipsilateral motor pathway from undamaged motor cortex seems to contribute to the motor recovery in this patient and combining TMS with fMRI may provide a powerful tool for investigating the mechanism of motor recovery.

Key Words: Functional MRI, Magnetic stimulation, Motor cortex, Mapping, Neural plasticity


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