Sabbahi Mohamed, Etnyre Bruce, Al-Jawayed Ibrahim, Jankovic Joseph
Texas Woman's University, Houston, TX 77030, USA.
Clin Neurophysiol. 2003 Feb;114(2):288-94. doi: 10.1016/s1388-2457(02)00375-9.
The purpose of this study was to examine neurophysiological characteristics of dystonia patients using electromyographic soleus H-reflex methods.
Thirty normal healthy individuals were compared to 27 patients with focal (cervical) or generalized dystonia. Three H-reflex assessment methods were included: the ratio of maximum H-reflex to direct muscle potential (H/M ratio); vibration inhibition (H(v)/H(c) ratio); and H-reflex recovery curves (HRRC).
Average H/M ratios between groups were not statistically significant. The average H(v)/H(c) ratio for the generalized dystonia group was significantly greater than the focal dystonia and normal groups. Average values of the HRRC showed the generalized dystonia group had significantly greater disinhibition than the focal dystonia and control groups during the early inhibition phase. The HRRC for the focal dystonia group was greater than normal and more similar to the generalized dystonia group during the late phases of the recovery curve. The average value of the localized late facilitation phase for the focal dystonia group was significantly greater than the control group and less than the generalized dystonia group. No differences were observed between groups for the average localized late inhibition phase of the recovery curve.
Soleus H-reflex measures identified neurophysiologic differences between generalized dystonia, cervical dystonia and normal conditions.
This methodology enables analysis of the underlying characteristics of dystonic pathologies using soleus H-reflex methods rather than upper extremity H-reflex techniques.
本研究旨在采用比目鱼肌肌电图H反射方法，研究肌张力障碍患者的神经生理学特征。
将30名正常健康个体与27名局灶性（颈部）或全身性肌张力障碍患者进行比较。包括三种H反射评估方法：最大H反射与直接肌肉电位的比值（H/M比值）；振动抑制（H(v)/H(c)比值）；以及H反射恢复曲线（HRRC）。
组间平均H/M比值无统计学意义。全身性肌张力障碍组的平均H(v)/H(c)比值显著高于局灶性肌张力障碍组和正常组。HRRC的平均值显示，在早期抑制阶段，全身性肌张力障碍组的去抑制作用明显大于局灶性肌张力障碍组和对照组。在恢复曲线的后期，局灶性肌张力障碍组的HRRC大于正常组，且更类似于全身性肌张力障碍组。局灶性肌张力障碍组局部晚期易化期的平均值显著大于对照组，小于全身性肌张力障碍组。恢复曲线的平均局部晚期抑制期在组间未观察到差异。
比目鱼肌H反射测量结果显示全身性肌张力障碍、颈部肌张力障碍与正常情况之间存在神经生理学差异。
该方法能够使用比目鱼肌H反射方法而非上肢H反射技术，分析肌张力障碍性疾病的潜在特征。
