Functional MRI Evidence for Motor Cortex Reorganization Adjacent to a Lesion in a Primary Motor Cortex

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Abstract
The object of this study was to verify motor cortex reorganization in patients with primary motor cortex injury using functional magnetic resonance imaging. Ten control subjects and two patients with primary motor cortex injury, caused by a traumatic brain injury in patient 1 and meningioma in patient 2, were evaluated. Functional magnetic resonance imaging was performed using the blood oxygenation level–dependent technique at 1.5 T with hand movements. The contralateral primary sensorimotor cortex was activated by unaffected hand movements. However, only the contralateral primary sensory cortex in patient 1 and the premotor area in patient 2 were activated by affected hand movements, which were totally absent in control subjects. We believe that the hand motor function of injured primary motor cortex was shifted into the primary sensory cortex in patient 1 and premotor area in patient 2. In conclusion, this finding may reflect a functional reorganization of the motor area in patients with a primary motor cortex injury.