Objective. Schizencephaly is a rare congenital malformation that causes motor impairment. To determine the treatment strategy, each domain of the motor functions should be appropriately evaluated. We correlated a color map of diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS) with the hand function test (HFT) to identify the type of hand function that each test (DTI and TMS) reflects. Further, we attempted to demonstrate the motor neuron organization in schizencephaly. Method. This retrospective study was conducted on 12 patients with schizencephaly. TMS was conducted in the first dorsal interosseous (FDI), biceps (BB), and deltoid muscles of the upper extremity, and contralateral MEP (cMEP) and ipsilateral MEP (iMEP) were recorded. The HFT included the grip strength, box and block (B&B), and 9-hole peg test. The schizencephalic cleft was confirmed using magnetic resonance imaging, and the corticospinal tract (CST) was identified using the color map of DTI. The symmetry indices for the peduncle and CST at pons level were calculated as the ratios of the cross-sectional area of the less-affected side and that of the more-affected side. Result. In the more-affected hemisphere TMS, no iMEP was obtained. In the less-affected hemisphere TMS, the iMEP response was detected in 9 patients and cMEP in all patients, which was similar to the pattern observed in unilateral lesion. Paretic hand grip strength was strongly correlated with the presence of iMEP (). The symmetry index of the color map of DTI was significantly correlated with the B&B (, ), whereas the symmetry index of the peduncle was not correlated with all HFTs. Conclusion. In patients with schizencephaly, the iMEP response rate is correlated with the hand function related to strength, while the symmetricity of the CST by the color map of DTI is correlated with the hand function associated with dexterity. Additionally, we suggest the possible motor organization pattern of schizencephaly following interhemispheric competition.

中文翻译：

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精神分裂症的运动组织：经颅磁刺激的结果和运动束投射的扩散张量成像与手功能的不同领域相关

客观。裂脑畸形是一种罕见的先天性畸形，会导致运动障碍。为了确定治疗策略，应适当评估运动功能的每个领域。我们将扩散张量成像 (DTI) 和经颅磁刺激 (TMS) 的彩色图与手功能测试 (HFT) 相关联，以确定每个测试（DTI 和 TMS）反映的手功能类型。此外，我们试图证明精神分裂症中的运动神经元组织。方法. 这项回顾性研究对 12 名精神分裂症患者进行。对上肢第一背侧骨间肌（FDI）、二头肌（BB）和三角肌进行TMS，记录对侧MEP（cMEP）和同侧MEP（iMEP）。HFT 包括握力、盒子和块 (B&B) 和 9 孔钉测试。使用磁共振成像确认裂脑裂，使用 DTI 的彩色图识别皮质脊髓束 (CST)。脑桥水平的花序梗和 CST 的对称指数计算为受影响较小侧的横截面积与受影响较大侧的横截面积之比。结果. 在受影响更大的半球 TMS 中，没有获得 iMEP。在受影响较小的半球 TMS 中，9 名患者检测到 iMEP 反应，所有患者都检测到 cMEP，这与单侧病变中观察到的模式相似。麻痹性握力与 iMEP 的存在密切相关（）。DTI色彩图的对称指数与B&B显着相关（, )，而花序梗的对称性指数与所有 HFT 均不相关。结论。在精神分裂症患者中，iMEP 反应率与与力量相关的手部功能相关，而由 DTI 的颜色图得出的 CST 对称性与与灵活性相关的手部功能相关。此外，我们提出了大脑半球间竞争后可能出现的裂脑运动组织模式。