• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.216-219
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• 2014

Purpose: We presented with a patient with traumatic brain injury who showed a transcallosal ipsilateral motor pathway from unaffected motor cortex to affected extremities, as evaluated by diffusion tensor tractography (DTT). Methods: One patient and six age-matched normal subjects were enrolled. A 42-year-old left hemiparetic male who suffered from brain injury by motor vehicle accident 9 years ago showed a leukomalactic lesion in the right corona radiata and parieto-temporal lobe. His left extremities were completely paralyzed initially, but recovered slowly over 2 years. At the time of the evaluation, he was able to grasp and release an object, and to walk with spastic gait pattern. DTT was performed using 1.5 T with a Synergy-L Sensitivity Encoding head coil. DTT was obtained with termination criteria of FA <0.2 and an angle change > $45^{\circ}c$. Results: The motor tracts of the unaffected (left) hemisphere of the patient and control subjects originated from the motor cortex and descended along the known corticospinal tract without any transcallosal tract. By contrast, the tract of the affected (right) hemisphere originated from the left premotor cortex, descended through the left corona radiata, and then crossed the mid-portion of the corpus callosum. The tract then descended through the known corticospinal tract pathway to the right medulla. Conclusion: We conclude that the transcallosal ipsilateral motor pathway from the unaffected hemisphere appeared to contribute to the motor recovery in this patient.

• The Korean Journal of Physiology and Pharmacology
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• 제7권6호
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• pp.295-301
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• 2003

Striatum plays a crucial role in the movement control and habitual learning. It receives an information from wide area of cerebral cortex as well as an extensive serotonergic (5-hydroxytryptamine, 5-HT) input from raphe nuclei. In the present study, the effects of 5-HT to modulate synaptic transmission were studied in the rat corticostriatal brain slice using in vitro extracellular recording technique. Synaptic responses were evoked by stimulation of cortical glutamatergic inputs on the corpus callosum and recorded in the dorsal striatum. 5-HT reversibly inhibited coticostriatal glutamatergic synaptic transmission in a dose-dependent fashion (5, 10, 50, and $10{\mu}M$), maximally reducing in the corticostriatal population spike (PS) amplitude to $40.1{\pm}5.0$% at a concentration of $50{\mu}M$ 5-HT. PSs mediated by non-NMDA glutamate receptors, which were isolated by bath application of the NMDA receptor antagonist, d,l-2-amino-5-phospohonovaleric acid (AP-V), were decreased by application of $50{\mu}M$ 5-HT. However, PSs mediated by NMDA receptors, that were activated by application of zero $Mg^{2+}$ aCSF, were not significantly affected by $50{\mu}M$ 5-HT. To test whether the corticostriatal synaptic inhibitions by 5-HT might involve a change in the probability of neurotransmitter release from presynaptic nerve terminals, we measured the paired-pulse ratio (PPR) evoked by 2 identical pulses (50 ms interpulse interval), and found that PPR was increased ($33.4{\pm}5.2$%) by 5-HT, reflecting decreased neurotransmitter releasing probability. These results suggest that 5-HT may decrease neurotransmitter release probability of glutamatergic corticostriatal synapse and may be able to selectively decrease non-NMDA glutamate receptor-mediated synaptic transmission.

• 대한유전성대사질환학회지
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• 제15권2호
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• pp.87-92
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• 2015

뮤코다당증(mucopolysaccharidosis)은 글리코사미노글리칸(glycosaminoglycans)의 분해에 필요한 리소좀 효소의 결함으로 인해 야기되는 질병으로 글리코사미노글리칸의 대사 산물이 세포의 리소좀 내에 축적되어 세포, 조직 그리고 기관의 기능 이상을 초래해 신체적, 신경학적인 퇴행을 보이며, 심한 경우 조기에 사망하게 되는 다양한 임상양상을 보이는 질환이다. 뮤코다당증 가운데 가장 높은 비율을 차지하는 헌터증후군(뮤코다당증 제2형)은 조기에 진단하여 효소보충요법을 시행하는 것이 중요하다. 본 증례는 언어발달지연과 등과 엉덩이에 몽고반점, 간비대, 두껍고 거친 피부가 있었으며 과성장된 신체 검진소견을 보였던 환아에서, 뇌자기공명영상 검사 결과에서 뇌교량체에 다수의 낭종, 백색질에 비정상 신호 증가 병변들, 미만성 뇌수축 소견을 보여 헌터증후군을 의심하였으며 효소검사 결과를 통해 확진하였다. 저자들은 언어발달지연을 주소로 내원한 환아에게 시행한 뇌자기공명영상에서 조기에 헌터증후군을 의심하여 효소검사를 통해 확진을 할 수 있었던 증례를 경험하였기에 이를 보고하는 바이다.