Functional MRI evidence for motor cortex reorganization adjacent to a lesion in a primary motor cortex

Objective: The object of this study was to verify motor cortex reorganization in patients with primary motor cortex injury using functional magnetic resonance imaging. Design: 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. Results: 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. Conclusion: 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.