Article

Most rehabilitative interventions following stroke emphasize the
improvement of motor deficits but rarely address sensory function and
sensorimotor control. We report here a case of cerebral infarction localized to
the postcentral gyrus that presented with severe impairment of motor control due
to profound proprioceptive sensory loss. We attempted to demonstrate the
mechanism for the motor impairment using functional magnetic resonance imaging (fMRI). CASE REPORT:
A 70-year-old woman developed abrupt loss of motor control
of the right hand, concomitant with the loss of proprioception of the hand. An
fMRI was conducted 12 days after stroke onset. Movement of the unaffected hand
activated the normal sensorimotor network in the brain, including the
contralateral primary sensorimotor cortex, supplementary motor areas, and
ipsilateral cerebellum. However, movement of the affected hand activated only the
contralateral primary motor cortex and activation of the cerebral sensorimotor
network was severely depressed. Diffusion tensor tractography revealed that the
corticospinal tracts were intact. Intensive rehabilitation and the use of visual
support enabled the patient to live an independent life. CONCLUSION: Loss of
motor control may occur even with a normal corticospinal tract when
proprioception is severely impaired by dysfunction of the sensorimotor network in
the brain.

Langue : ANGLAIS