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[人类锥体束损害后随意运动的延迟起始(作者译)]

[Delayed initiation of voluntary movements after pyramidal lesions in man (author's transl)].

作者信息

Jung R, Dietz V

出版信息

Arch Psychiatr Nervenkr (1970). 1975 Dec 31;221(2):87-109. doi: 10.1007/BF00431047.

Abstract

The reaction times for rapid movements in muscles of arm and leg were measured in 20 patients with unilateral lesions of the motor cortex and the internal capsule. Rapid unilateral and bilateral movements after an acoustic signal (click) on the pyramidally paretic side were compared with the normal side. In these patients and in 10 normal subjects, electromyographic and mechanical recordings from symmetrical muscles of both sides were compared. 2. All patients with pyramidal lesions showed in the case of unilateral movements a marked prolongation of motor latency in the affected muscles: compared to the normal side, the movement started 30-160 msec later in muscles contralateral to the lesion of the motor cortex. In contrast, normal subjects showed equal latencies on both sides with maximal differences of 10-20 msec. 3. When movements were executed bilaterally the latency prolongation in the pyramidally paretic muscles was markedly diminished or disappeared in later stages. In most patients the bilateral movements started simultaneously in the normal and the paretic muscles, except in 5 recent lesions of the contralateral motor cortex. 4. The significance of the findings is discussed in terms of the function of the human motor cortex in starting and controlling voluntary movements. It is assumed that the disappearance of latency prolongation when movements are executed bilaterally in patients with unilateral pyramidal lesions can be best explained by homolateral projections of uncrossed pyramidal fibres to the motoneurones. 5. These results, and other observations, suggest that the motor cortex starts and controls voluntary movements via rapidly conducting pyramidal fibres to the motoneurones. This occurs after a preprogramming and a readiness posture is established by other cerebral structures. The prolongation of motor latencies after motor cortex lesions is probably due to a disturbance in the rapidly conducting cortico-spinal projections to spinal motoneurones and interneurones.

摘要

对20例运动皮层和内囊单侧损伤的患者,测量其手臂和腿部肌肉快速运动的反应时间。将锥体束性轻瘫侧在声音信号(咔哒声)后进行的快速单侧和双侧运动与正常侧进行比较。在这些患者以及10名正常受试者中,比较双侧对称肌肉的肌电图和机械记录。2. 所有锥体束损伤患者在单侧运动时,患侧肌肉的运动潜伏期均显著延长:与正常侧相比,运动皮层损伤对侧肌肉的运动开始时间要晚30 - 160毫秒。相比之下,正常受试者两侧潜伏期相等,最大差异为10 - 20毫秒。3. 当进行双侧运动时,锥体束性轻瘫肌肉的潜伏期延长在后期明显减少或消失。在大多数患者中,正常肌肉和轻瘫肌肉的双侧运动同时开始,但有5例对侧运动皮层近期损伤的患者除外。4. 根据人类运动皮层在启动和控制随意运动中的功能,对这些发现的意义进行了讨论。据推测,单侧锥体束损伤患者在进行双侧运动时潜伏期延长消失,最好用未交叉的锥体束纤维向运动神经元的同侧投射来解释。5. 这些结果以及其他观察结果表明,运动皮层通过快速传导的锥体束纤维至运动神经元来启动和控制随意运动。这发生在其他脑结构建立预编程和准备姿势之后。运动皮层损伤后运动潜伏期延长可能是由于向脊髓运动神经元和中间神经元的快速传导的皮质脊髓投射受到干扰。

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