Dynamische Reorganisation und Rückbildung von Hemiparesen

Zusammenfassung

Der Schlaganfall ist die häufigste Ursache für eine Behinderung im Erwachsenenalter. Der mit Abstand größte Teil dieser Behinderungen geht auf bleibende Armparesen zurück. Die Plastizität des Gehirns ermöglicht häufig in den Wochen und Monaten nach einem Schlaganfall eine teilweise, seltener auch vollständige Rückbildung der motorischen Ausfälle. Einige kürzlich erschienene Arbeiten haben erstmals longitudinale PET- und fMRT-Untersuchungen angewendet, um die Zusammenhänge zwischen neuronaler Plastizität und Rückbildung von Hemiparesen genauer zu untersuchen. In diesen Studien wurden neue Ergebnisse zur dynamischen Reorganisation im motorischen System berichtet, die für das Verständnis der Regenerationsvorgänge im Gehirn wichtig sind. Durch den Einsatz dieser prospektiven Studien mit funktioneller Bildgebung konnten erstmals auch rehabilitative und pharmakologische Therapieeffekte bildgebend dargestellt werden.

Abstract

Stroke is the leading cause of chronic disability in adults. In most stroke victims, this disability is related to hemiparesis. Cerebral plasticity has been proposed to explain recovery after resolution of edema and reperfusion of viable tissue. Recently, several longitudinal neurofunctional imaging studies in stroke patients have investigated how plasticity relates to recovery of motor function. These studies reported new findings on the dynamic reorganization of the motor system that are important for the understanding of stroke recovery. Longitudinal functional studies with PET and fMRI also provide an opportunity to image effects of rehabilitation and pharmacological treatments on plasticity.

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