Reorganization of Motor Network and the Effect of Cross Education Derived From Unilateral Coordination Training

편측 협응훈련에 의한 운동신경망의 재조직 및 교차훈련의 효과 -사례연구-

  • Park, Ji-Won (Dept. of Rehabilitation Medicine, College of Medicine, Chonbuk National University) ;
  • Kim, Jong-Man (Dept. of Physical Therapy, Division of Health, Seonam University) ;
  • Seo, Jeong-Hwan (Dept. of Rehabilitation Medicine & Research Institution of Clinical Medicine, College of Medicine, Chonbuk National University) ;
  • Kim, Yun-Hee (Dept. of Rehabilitation Medicine and Research Institute of Clinical Medicine, College of Medicine, Pochon CHA University)
  • 박지원 (전북대학교대학원 의학과 재활의학교실) ;
  • 김종만 (서남대학교 물리치료학과) ;
  • 서정환 (전북대학교병원 재활의학과) ;
  • 김연희 (포천중문의과대학 재활의학교실)
  • Published : 2002.09.17

Abstract

We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained left hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.

Keywords