Title : The reorganization features of the corticospinal tract in postanoxic states in children
Abstract:
Introduction: Predicting outcomes of postanoxic states, especially concerning motor function control, is a crucial aspect of the rehabilitation process. This series of clinical observations presents the reorganization of cortical motor representations (primary motor cortex, premotor cortex, supplementary motor area) and the corticospinal tract in children with postanoxic encephalopathy.
Method: participants–4 patients with postanoxic encephalopathy (age 3-14 y.o.) were examined, including: clinical examination, voxel-based morphometry, diffusion tensor imaging (DTI), and diagnostic transcranial magnetic stimulation (TMS). Two patients were examined twice per first year of disease.
Results and conclusion:
Table 1. Parameters of MEP and CMCT (m. apb)
The data obtained demonstrate the potential for the restoration of corticospinal motor projections in patients with smaller volumes of atrophic changes in the primary motor, premotor cortex, and SMA, as well as consistently reproducible motor-evoked potentials (MEPs) of a larger area with lower MEP eliciting thresholds. In patients with pronounced atrophic changes in the primary motor cortex, even with the preservation and increase in the volume of dynamic pyramidal tracts, the prognosis for recovery was worse. The presented observations more likely confirm the significance of synaptogenesis in the restoration of motor functions in patients with established motor acts, considering the variability in the density of pyramidal tracts during the period of reorganization of brain structures.
