de Carvalho Mamede, Scotto Manuel, Lopes Arminda, Swash Michael
Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal.
Amyotroph Lateral Scler Other Motor Neuron Disord. 2002 Sep;3(3):131-6. doi: 10.1080/146608202760834139.
In upper motor neuron (UMN) syndromes, F-waves are of higher amplitude, increased duration, and increased latency. Increased F-wave frequency in UMN syndromes is not well documented. We have studied the effect of corticospinal lesion on F-wave frequency, M-wave amplitude, distal motor latency and on the Neurophysiological Index (CMAP amplitude/DML x % F-wave frequency) which we have described previously in amyotrophic lateral sclerosis (ALS).
We studied 145 abductor digiti minimi (ADM) muscles in 75 patients with ALS. Six groups of hands were defined, based on strength of the ADM, as assessed clinically by the MRC scale, and the presence or absence of UMN signs in the same upper limb.
CMAP amplitude and area were decreased, and DML increased, in weaker muscles (MRC < 3) causing a change in the ALS Neurophysiological Index. In general, UMN signs were not correlated with increased F-wave frequency. In five weak hands F-responses were studied in individual motor units. A larger number of responding motor units in these weak limbs with UMN signs was observed.
F-wave excitability is largely dependent on the size of the lower motor neuron pool.
在上运动神经元（UMN）综合征中，F波具有更高的波幅、更长的持续时间和更长的潜伏期。UMN综合征中F波频率增加的情况尚无充分记录。我们研究了皮质脊髓损伤对F波频率、M波幅、远端运动潜伏期以及我们之前在肌萎缩侧索硬化症（ALS）中描述的神经生理指数（复合肌肉动作电位波幅/远端运动潜伏期×F波频率百分比）的影响。
我们研究了75例ALS患者的145块小指展肌（ADM）。根据MRC量表临床评估的ADM力量以及同一上肢UMN体征的有无，将手分为六组。
较弱的肌肉（MRC<3）中复合肌肉动作电位波幅和面积降低，远端运动潜伏期增加，导致ALS神经生理指数发生变化。一般来说，UMN体征与F波频率增加无关。在五只无力的手中，对单个运动单位的F反应进行了研究。在这些有UMN体征的无力肢体中观察到更多有反应的运动单位。
F波兴奋性在很大程度上取决于下运动神经元池的大小。
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