Cerebral reorganization in patients with brachial plexus birth injury and residual shoulder problems
Björkman, Anders LU ; Weibull, Andreas LU ; Svensson, Hampus and Dahlin, Lars LU
(2016)
In Frontiers in Neurology
7(DEC).
- Abstract
The functional outcome after a brachial plexus birth injury (BPBI) is based on changes in the peripheral nerve and in the central nervous system. Most patients with a BPBI recover, but residual deficits in shoulder function are not uncommon. The aim of this study was to determine cerebral activation patterns in patients with BPBI and also residual symptoms from the shoulder. In seven patients (six females and one male, aged 17-23 years) with a BPBI and residual shoulder problems (Mallet score IV or lower), the cerebral response to active movement of the shoulder and elbow of the injured and healthy arm was monitored using functional magnetic resonance imaging at 3 T. Movements, i.e., shoulder rotation or elbow flexion and extension, of... (More)
The functional outcome after a brachial plexus birth injury (BPBI) is based on changes in the peripheral nerve and in the central nervous system. Most patients with a BPBI recover, but residual deficits in shoulder function are not uncommon. The aim of this study was to determine cerebral activation patterns in patients with BPBI and also residual symptoms from the shoulder. In seven patients (six females and one male, aged 17-23 years) with a BPBI and residual shoulder problems (Mallet score IV or lower), the cerebral response to active movement of the shoulder and elbow of the injured and healthy arm was monitored using functional magnetic resonance imaging at 3 T. Movements, i.e., shoulder rotation or elbow flexion and extension, of the injured side resulted in a more pronounced and more extended activation of the contralateral primary sensorimotor cortex compared to the activation seen after moving the healthy shoulder and elbow. In addition, moving the shoulder or elbow on the injured side resulted in increased activation in ipsilateral primary sensorimotor areas an also increased activation in associated sensorimotor areas, in both hemispheres, located further posterior in the parietal lobe, which are known to be important for integration of motor tasks and spatial aspects of motor control. Thus, in this preliminary study based on a small cohort, patients with BPBI and residual shoulder problems show reorganization in sensorimotor areas in both hemispheres of the brain. The increased activation in ipsilateral sensorimotor areas and in areas that deal with both integration of motor tasks and spatial aspects of motor control in both hemispheres indicates altered dynamics between the hemispheres, which may be a cerebral compensation for the injury.
(Less)
- author
- Björkman, Anders
LU
; Weibull, Andreas
LU
; Svensson, Hampus
and Dahlin, Lars
LU
- organization
- publishing date
- 2016-12-23
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Brachial plexus, Brachial plexus birth injury, Brain, Children, Nerve, Reorganization
- in
- Frontiers in Neurology
- volume
- 7
- issue
- DEC
- article number
- 240
- publisher
- Frontiers Media S. A.
- external identifiers
-
- scopus:85007587018
- pmid:28066323
- wos:000390487500001
- ISSN
- 1664-2295
- DOI
- 10.3389/fneur.2016.00240
- language
- English
- LU publication?
- yes
- id
- a10149aa-d56f-4ec9-b91e-c54efb30e753
- date added to LUP
- 2017-01-13 07:43:53
- date last changed
- 2024-04-19 16:58:14
@article{a10149aa-d56f-4ec9-b91e-c54efb30e753,
abstract = {{<p>The functional outcome after a brachial plexus birth injury (BPBI) is based on changes in the peripheral nerve and in the central nervous system. Most patients with a BPBI recover, but residual deficits in shoulder function are not uncommon. The aim of this study was to determine cerebral activation patterns in patients with BPBI and also residual symptoms from the shoulder. In seven patients (six females and one male, aged 17-23 years) with a BPBI and residual shoulder problems (Mallet score IV or lower), the cerebral response to active movement of the shoulder and elbow of the injured and healthy arm was monitored using functional magnetic resonance imaging at 3 T. Movements, i.e., shoulder rotation or elbow flexion and extension, of the injured side resulted in a more pronounced and more extended activation of the contralateral primary sensorimotor cortex compared to the activation seen after moving the healthy shoulder and elbow. In addition, moving the shoulder or elbow on the injured side resulted in increased activation in ipsilateral primary sensorimotor areas an also increased activation in associated sensorimotor areas, in both hemispheres, located further posterior in the parietal lobe, which are known to be important for integration of motor tasks and spatial aspects of motor control. Thus, in this preliminary study based on a small cohort, patients with BPBI and residual shoulder problems show reorganization in sensorimotor areas in both hemispheres of the brain. The increased activation in ipsilateral sensorimotor areas and in areas that deal with both integration of motor tasks and spatial aspects of motor control in both hemispheres indicates altered dynamics between the hemispheres, which may be a cerebral compensation for the injury.</p>}},
author = {{Björkman, Anders and Weibull, Andreas and Svensson, Hampus and Dahlin, Lars}},
issn = {{1664-2295}},
keywords = {{Brachial plexus; Brachial plexus birth injury; Brain; Children; Nerve; Reorganization}},
language = {{eng}},
month = {{12}},
number = {{DEC}},
publisher = {{Frontiers Media S. A.}},
series = {{Frontiers in Neurology}},
title = {{Cerebral reorganization in patients with brachial plexus birth injury and residual shoulder problems}},
url = {{http://dx.doi.org/10.3389/fneur.2016.00240}},
doi = {{10.3389/fneur.2016.00240}},
volume = {{7}},
year = {{2016}},
}