A Preliminary Study Of Resting FMRI In Postganglionic Injury Of Brachial Plexus

OBJECTIVE: Brachial plexus preganglionic injury not only leads to dysfunction of the affected limb,but also induces extensive brain function reorganization.In this article,Rest-state functional magnetic resonance imaging(Rs-fMRI)and Amplitude of low-frequency(ALFF)are used to study brain Rs-fMRI data in patients with brachial plexus postganglionic injury,and analysis of brain function changes in patients with brachial plexus postganglionic injury at resting state,and compared with changes in brain function of brachial plexus preganglionic injury.METHODS: 10 patients with left brachial plexus postganglionic injury,10 patients with right brachial plexus postganglionic injury and 10 healthy controls were enrolled in the Rs-fMRI scan.The ALFF method was used to analyze the activity of each brain region,and the patients with left brachial plexus postganglionic injury group and control group,right brachial plexus postganglionic injury group and control group,left brachial plexus postganglionic injury group and right brachial plexus postganglionic injury group underwent the two-sample t-test to compare differences in ALFF values,and the difference was considered statistically significant at P < 0.001 corrected by Alphasim.RESULTS: Compared with the healthy control group,the ALFF values of the bilateral posterior cerebellar lobes,the left inferior temporal gyrus,and the right frontal gyrus were significantly increased and the right anterior cerebellum,anterior cingulate gyrus,thalamus and bilateral limbic lobe were significantly reduced in the patients with right brachial plexus postganglionic injury;the ALFF values of the bilateral posterior cerebellum,the right inferior temporal gyrus,the right superior gyrus and the left occipital gyrus were significantly increased,and the bilateral thalamus,lenticular nucleus,cingulate gyrus were significantly reduced in the patients with left brachial plexus postganglionic injury.We found that the right and left brachial postganglionic injury can lead to increased ALFF values in the bilateral posterior cerebellum,inferior temporal gyrus,and superior Frontal gyrus,and reducedALFF values in the bilateral anterior cingulate gyrus and thalamus.In addition,patients with right brachial plexus postganglionic injury had higher ALFF values in bilateral cingulate gyrus and left precuneus than in patients with left brachial plexus postganglionic injury.CONCLUSION: Abnormal brain function after brachial plexus postganglionic injury,suggesting the ability of the brain to adapt and remodel after brachial plexus postganglionic injury.Both patients with left and right brachial plexus postganglionic injury and some patients with left and right brachial plexus preganglionic injuries have some common brain remodeling patterns.As with brachial plexus preganglionic lesions,dominant-hand brachial plexus postganglionic injury can induce greater extents of brain function reorganization than nondominant-hand.Moreover,the alternations of brain functional activities were not restricted regions of motor representation but also involved some greater-order recognition-related brain regions.These results provide a new understanding of cerebral cortical function reorganization after brachial plexus postganglionic injury.