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  • 1
    ISSN: 1432-1106
    Keywords: Magnetic brain stimulation ; Hemispherectomy ; Corticospinal tract ; Cortico-reticulospinal pathways ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Numerous clinical studies on patients after hemispherectomy (HS) have provided clear evidence that two distinct groups can be recognized on the basis of the quality of their motor functions after operation. One of these consists of cases where HS was performed after normal brain maturation, the other of patients where the removed hemisphere was damaged early in life. The post-operative motor function has been found to be much better in the latter group. In the present paper it is demonstrated that in contrast to normal subjects ipsilateral compound muscle action potentials (CMAPs) induced by magnetic stimulation of the one intact motor cortex are present in patients after HS. The amplitudes of ipsilateral CMAPs in the muscles roughly correlate with their individual residual motor capacities and show a proximo-distal gradient. In patients with early brain damage prior to HS, CMAPs had short latencies and large amplitudes, whereas in patients with later acquired brain damage prior to HS, CMAPs had long latencies and small amplitudes. It is suggested that reinforcement of the ipsilateral corticospinal pathway may be responsible for residual motor functions in patients with early brain damage, whereas in patients with later acquired brain damage cortico-reticulospinal pathways may play a dominant role in ipsilateral motor control.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1106
    Keywords: Magnetic stimulation ; Single motor units ; Lower facial muscles ; Corticobulbar connexions ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract EMG responses were recorded from lower facial muscles (depressor labii inferioris or depressor anguli oris) of 12 normal subjects after magnetic stimulation of the motor cortex. Using a figure-of-eight stimulating coil, the largest responses were obtained from points around 8–10 cm lateral to the vertex. Usually they were bilateral and had the same latency (11–12 ms) on both sides of the face. Patients with complete Bell's palsy had no response in muscles on the same side as the lesion, indicating that the ipsilateral component to cortical stimulation was not the result of recrossing in the periphery of nerve fibres from the contralateral side. Single-unit studies showed that cortical stimulation produced two phases of motoneuronal facilitation: a short-latency (central motor delay from contralateral cortex to the intracranial portion of the facial nerve, 7.6 ms), short-duration (1– to 2-ms duration peak in the post-stimulus time histogram) input, which was more commonly evoked by contralateral than ipsilateral stimulation; and a longer latency (central delay 〉 15 ms), long-duration input evoked equally well from either hemisphere. The former may represent activity in a predominantly contralateral oligosynaptic corticobulbar pathway; the latter, a polysynaptic indirect (e.g. co-rticotegmento-nuclear) bilateral pathway to lower facial muscles.
    Type of Medium: Electronic Resource
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