Pierrot-Deseilligny Emmanuel, Marchand-Pauvert Véronique
Neurophysiologie Clinique, Rééducation, La Salpêtrière, Paris, France.
Adv Exp Med Biol. 2002;508:273-9. doi: 10.1007/978-1-4615-0713-0_33.
Peripheral stimuli facilitate, at a pre-motoneuronal level, the responses elicited in human upper limb motoneurons (MNs) by transcranial magnetic stimulation over the motor cortex (TMS). Several features indicate that the relevant premotoneurones are distinct from segmental interneurones and located rostral to MNs. Thus, corticospinal volleys would have an indirect (propriospinal) pathway to upper limb MNs, in addition to the direct cortico-motoneuronal pathway. Slightly increasing the corticospinal input causes the facilitation to be reversed to inhibition. This is consistent with a well-developed system of inhibitory intemeurones activated by corticospinal and afferent inputs inhibiting propriospinal neurones (PNs). Corticospinal activation of these inhibitory interneurones would explain why propriospinally-mediated corticospinal EPSPs are weak in primate MNs after artificial (electrical or magnetic) activation of the corticospinal system by itself. However, indirect evidence for descending facilitation of PNs can be provided during normal voluntary contractions, while using the modulation of the ongoing EMG or of the H reflex.
外周刺激在运动神经元前水平促进经颅磁刺激运动皮层(TMS)诱发的人类上肢运动神经元(MNs)反应。若干特征表明,相关的运动前神经元不同于节段性中间神经元,且位于运动神经元的头侧。因此,皮质脊髓冲动除了直接的皮质-运动神经元通路外,还有一条通向上肢运动神经元的间接(脊髓 propriospinal)通路。稍微增加皮质脊髓输入会使促进作用转变为抑制作用。这与一个由皮质脊髓和传入输入激活的抑制性中间神经元系统相一致,该系统抑制脊髓 propriospinal 神经元(PNs)。这些抑制性中间神经元的皮质脊髓激活可以解释为什么在通过人工(电或磁)激活皮质脊髓系统后,脊髓 propriospinal 介导的皮质脊髓兴奋性突触后电位在灵长类运动神经元中较弱。然而,在正常的自主收缩过程中,利用对正在进行的肌电图或 H 反射的调制,可以提供脊髓 propriospinal 神经元下行促进作用的间接证据。