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Updated: Mar 18, 2026

Corticospinal Excitability Modulation During Action Observation

Corticospinal Excitability Modulation During Action Observation

Published on: December 31, 2013

Predicting hand function after hemidisconnection.

Hanna Küpper¹, Manfred Kudernatsch², Tom Pieper³

¹1 Department of Paediatric Neurology and Developmental Medicine, Children's Hospital, University of Tübingen, Germany Hanna.Kuepper@med.uni-tuebingen.de.

Brain : a Journal of Neurology

|July 8, 2016

Summary

This summary is machine-generated.

Hemidisconnection surgery can preserve hand grasping ability in hemiparetic patients with pre- or perinatal brain lesions, especially when brainstem and corticospinal tract connectivity show asymmetry. Normal preoperative hand function predicts grasping loss after surgery.

Keywords:

congenital hemiparesis diffusion-weighted MRI tractography hemidisconnection ipsilateral (re)organization

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Area of Science:

Neuroscience
Neurosurgery
Neuroimaging

Background:

Hemidisconnection procedures (hemispherectomy/hemispherotomy) typically result in contralateral hemiparesis.
Some patients with pre-existing hemiparesis maintain or regain hand grasping function post-surgery.

Purpose of the Study:

To predict preserved contralateral grasping ability after hemidisconnection.
To investigate the role of ipsilateral corticospinal projections in maintaining hand function.

Main Methods:

Analysis of brainstem asymmetry using magnetic resonance imaging (MRI) volumetry.
Assessment of corticospinal tract structural connectivity via MRI diffusion tractography.
Correlation of imaging findings with preoperative and postoperative hand function in 102 patients.

Main Results:

Preserved grasping post-hemidisconnection was observed in 25/102 patients, primarily those with pre- or perinatal brain lesions.
Patients with preserved grasping exhibited significantly more asymmetric brainstem volumes and corticospinal tract connectivity compared to those who lost function.
Normal preoperative hand function and post-neonatal/progressive lesions predicted a loss of grasping ability.

Conclusions:

Ipsilateral corticospinal projections may underlie preserved grasping in hemiparetic patients undergoing hemidisconnection.
Brainstem and corticospinal tract asymmetries identified by MRI are key indicators for predicting preserved hand function.
Patient selection based on lesion type and neuroimaging can optimize outcomes for hemidisconnection surgery.