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Trial of Contralateral Seventh Cervical Nerve Transfer for Spastic Arm Paralysis 期刊论文 WOS高被引论文

编号：

3a548c6f-49d8-40ab-8e48-8b7e7e44319f
作者：

Zheng, MouXiong(郑谋雄)#^[1,2,5,6,7]Hua, XuYun^[1,2,5,6,7];Feng, JunTao(冯俊涛)^[1,2,5,6,7]Li, Tie^[1,2,5,6,7];Lu, YeChen^[1,2,5,6,7];Shen, YunDong(沈云东)^[1,2,5,6,7]Cao, XiaoHua^[8,9];Zhao, NaiQing^[3];Lyu, JiaYing^[3];Xu, JianGuang(徐建光)^[1,2,5,6]Gu, YuDong(顾玉东)^[1,2,5,6]Xu, WenDong(徐文东)*^{[1,2,4,5,6,7]}
语种：

英文
期刊：

NEW ENGLAND JOURNAL OF MEDICINE ISSN：0028-4793 2018 年 378 卷 1 期 (22 - 34) ; JAN 4
收录：
摘要：

BACKGROUND
Spastic limb paralysis due to injury to a cerebral hemisphere can cause long-term disability. We investigated the effect of grafting the contralateral C7 nerve from the nonparalyzed side to the paralyzed side in patients with spastic arm paralysis due to chronic cerebral injury.
METHODS
We randomly assigned 36 patients who had had unilateral arm paralysis for more than 5 years to undergo C7 nerve transfer plus rehabilitation (18 patients) or to undergo rehabilitation alone (18 patients). The primary outcome was the change from baseline to month 12 in the total score on the Fugl-Meyer upper-extremity scale (scores range from 0 to 66, with higher scores indicating better function).
RESULTS
The mean increase in Fugl-Meyer score in the paralyzed arm was 17.7 in the surgery group and 2.6 in the control group (difference, 15.1; 95% confidence interval, 12.2 to 17.9; P<0.001). With regard to improvements in spasticity as measured on the Modified Ashworth Scale (an assessment of five joints, each scored from 0 to 5, with higher scores indicating more spasticity), the smallest between-group difference was in the thumb, with 6, 9, and 3 patients in the surgery group having a 2-unit improvement, a 1-unit improvement, or no change, respectively, as compared with 1, 6, and 7 patients in the control group (P = 0.02). Transcranial magnetic stimulation and functional imaging showed connectivity between the ipsilateral hemisphere and the paralyzed arm. There were no significant differences from baseline to month 12 in power, tactile threshold, or two-point discrimination in the hand on the side of the donor graft.
CONCLUSIONS
In this single-center trial involving patients who had had unilateral arm paralysis due to chronic cerebral injury for more than 5 years, transfer of the C7 nerve from the nonparalyzed side to the side of the arm that was paralyzed was associated with a greater improvement in function and reduction of spasticity than rehabilitation alone over a period of 12 months. Physiological connectivity developed between the ipsilateral cerebral hemisphere and the paralyzed hand. (Funded by the National Natural Science Foundation of China and others; Chinese Clinical Trial Registry number, 13004466.)
推荐引用方式
GB/T 7714：

Zheng Mou-Xiong,Hua Xu-Yun,Feng Jun-Tao, et al. Trial of Contralateral Seventh Cervical Nerve Transfer for Spastic Arm Paralysis [J].NEW ENGLAND JOURNAL OF MEDICINE,2018,378(1):22-34.
APA：

Zheng Mou-Xiong,Hua Xu-Yun,Feng Jun-Tao,Li Tie,&Xu Wen-Dong.(2018).Trial of Contralateral Seventh Cervical Nerve Transfer for Spastic Arm Paralysis .NEW ENGLAND JOURNAL OF MEDICINE,378(1):22-34.
MLA：

Zheng Mou-Xiong, et al. "Trial of Contralateral Seventh Cervical Nerve Transfer for Spastic Arm Paralysis" .NEW ENGLAND JOURNAL OF MEDICINE 378,1(2018):22-34.

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