Machii Katsuyuki, Ugawa Yoshikazu, Kokubo Yasumasa, Sasaki Ryogen, Kuzuhara Shigeki
Department of Neurology, School of Medicine, Mie University, 2-174 Edobashi, Tsu Mie, 514-8507, Japan.
Clin Neurophysiol. 2003 Mar;114(3):564-8. doi: 10.1016/s1388-2457(02)00416-9.
To evaluate the recovery function of the sensory cortex in patients with Kii amyotrophic lateral sclerosis/parkinsonism-dementia complex (Kii ALS/PDC) using somatosensory evoked potentials (SEPs) elicited by paired stimuli of the median nerve at the wrist.
Five patients with Kii ALS/PDC were compared with 5 patients with classical ALS, 5 with Parkinson's disease (PD), and 7 healthy normal volunteers. SEPs were recorded from the hand sensory area contralateral to the side of stimulation. Recovery functions of N20-P25 and P25-N33 components were evaluated by comparing the second SEPs elicited by paired pulse stimuli at various interstimulus intervals (ISIs, 20-300 ms) with the SEPs elicited by single stimuli.
Conventional SEPs to a single stimulus had a normal latency and size in all patients. The recovery function of the N20-P25 and P25-N33 components showed significantly less suppression at short ISIs without any facilitation at long ISIs in Kii ALS/PDC patients than in normal subjects, classical ALS or PD patients.
In Kii ALS/PDC, the sensory cortex is disinhibited or hyperexcitable. These abnormalities may reflect cortical pathology in the sensory cortex and may be partly due to a secondary effect on the sensory cortex from the primary parkinsonian pathological changes.
采用腕部正中神经成对刺激诱发的体感诱发电位（SEP）评估木曾肌萎缩侧索硬化/帕金森病痴呆综合征（木曾ALS/PDC）患者感觉皮层的恢复功能。
将5例木曾ALS/PDC患者与5例经典ALS患者、5例帕金森病（PD）患者及7名健康正常志愿者进行比较。从刺激侧对侧的手部感觉区记录SEP。通过比较不同刺激间隔（ISI，20 - 300毫秒）的成对脉冲刺激诱发的第二个SEP与单刺激诱发的SEP，评估N20 - P25和P25 - N33成分的恢复功能。
所有患者对单刺激的常规SEP潜伏期和波幅均正常。与正常受试者、经典ALS或PD患者相比，木曾ALS/PDC患者中，N20 - P25和P25 - N33成分的恢复功能在短ISI时抑制明显减少，在长ISI时无易化现象。
在木曾ALS/PDC中，感觉皮层去抑制或兴奋性过高。这些异常可能反映感觉皮层的皮质病理变化，可能部分归因于原发性帕金森病病理改变对感觉皮层的继发影响。
