Altered Corticospinal projections to Ankle Muscles in Subjects with Cerebral palsy and Adult hemiplegia

J Korean Assoc EMG Electrodiagn Med 1999;1(1):61-65.
Published online January 1, 1999.

Abstract

Objectives : To compare the corticospinal projections from motor cortex to motor neurons of ankle muscles in normal subjects and in subjects with cerebral palsy and adult hemiplegia. Methods : Firteen normal subjects, 11 subjects with cerebral palsy, and 10 subjects with adult hemiplegia were tested. We performed transcranial magnetic stimulation to motor neurons of tibialis anterior(TA) and soleus(SOL)muscles. Results : In normal subjects and subjectswith adult hemiplegia, transcranial magnetic stimulation produced strong facilitation of TA motor neurons, but little or no facilitation of SOL motor neurons. In subjects with cerebral palsy, transcranial magnetic stimulation produced almost equal to above facilitation of SOL motor neurons compared to that of TA motor neurons. Conclusion : It is postulated that the projections from motor cortex to spinal motor neurons are altered in cerebral palsy. These abnormal projections may contribute ro impairment of voluntary movements experienced by these subjects. Determining the mechanism of this abnormal projection may well be important for understanding the pathophysiology of the abnormal movement patterns which are shown in patients with cerebral palsy.

Key Words: Cerebral Palsy, adult hemiplegia, Corticospinal tract, Transcranial magnetic stimulation