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帕金森病和肌阵挛性癫痫中高通气对体感诱发电位高频振荡的恢复功能及影响

Recovery function of and effects of hyperventilation on somatosensory evoked high-frequency oscillation in Parkinson's disease and myoclonus epilepsy.

作者信息

Mochizuki Hitoshi, Machii Katsuyuki, Terao Yasuo, Furubayashi Toshiaki, Hanajima Ritsuko, Enomoto Hiroyuki, Uesugi Haruo, Shiio Yasushi, Kamakura Keiko, Kanazawa Ichiro, Ugawa Yoshikazu

机构信息

Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Neurosci Res. 2003 Aug;46(4):485-92. doi: 10.1016/s0168-0102(03)00129-9.

Abstract

To evaluate recovery function of and effects of hyperventilation (HV) on high-frequency oscillations (HFOs) of median nerve somatosensory evoked potential (SEP), we recorded SEPs in 8 Parkinson's disease (PD) patients with enlarged HFOs, 4 myoclonus epilepsy (ME) patients and 10 healthy volunteers (N). SEP was recorded from the hand sensory area contralateral to the median nerve stimulated at the wrist. Responses were amplified with filters set at 0.5 and 3000 Hz. HFOs were obtained by digitally filtering raw SEPs from 500 to 1000 Hz. We measured amplitudes of the N20 onset-peak (N20o-p), N20 peak-P25 peak (N20p-P25p), P25 peak-N33 peak (P25p-N33p), the early (1st-2nd) and late (3rd) HFOs. For the recovery function study, paired-pulse stimuli at various interstimulus intervals (20, 50, 100, 150, 200 and 300 ms) were given. To investigate effects of HV, amplitudes of several components of SEPs recorded after HV were compared with those before HV. In PD and ME, the N20o-p recovery curve showed significantly less suppression as compared with those of N. The P25p-N33p recovery curve of ME showed longer suppression than those of N and PD. There were no significant differences in the early or late HFOs recovery curves among three groups. At the dysinhibited state after HV, the late HFO was reduced in association with a significant enlargement of the N20p-P25p amplitude in normal subjects. This suggests that the late HFOs should reflect bursts of inhibitory interneurons. In the ME patients, the early HFOs significantly decreased by HV. The pattern in ME patients may be explained by a kind of compensation for already enhanced SEPs (giant SEP) in the dysinhibited situation. We conclude that (1) Giant HFOs are normally regulated by inhibitory neuronal systems involving in paired stimulation SEP. (2) The late HFOs must reflect bursts of GABAergic inhibitory interneurons.

摘要

为评估过度换气(HV)对正中神经体感诱发电位(SEP)高频振荡(HFOs)的恢复功能及影响,我们记录了8例HFOs增大的帕金森病(PD)患者、4例肌阵挛性癫痫(ME)患者和10名健康志愿者(N)的SEP。在手腕处刺激正中神经,从对侧手部感觉区记录SEP。用设置为0.5和3000Hz的滤波器放大反应。通过对原始SEP进行500至1000Hz的数字滤波获得HFOs。我们测量了N20起始峰(N20o-p)、N20峰-P25峰(N20p-P25p)、P25峰-N33峰(P25p-N33p)、早期(第1-2个)和晚期(第3个)HFOs的振幅。对于恢复功能研究,给予不同刺激间隔(20、50、100、150、200和300ms)的成对脉冲刺激。为研究HV的影响,将HV后记录的SEP各成分振幅与HV前进行比较。在PD和ME中,与N相比,N20o-p恢复曲线的抑制作用明显较小。ME的P25p-N33p恢复曲线的抑制时间比N和PD更长。三组之间早期或晚期HFOs恢复曲线无显著差异。在HV后的去抑制状态下,正常受试者的晚期HFO减少,同时N20p-P25p振幅显著增大。这表明晚期HFOs应反映抑制性中间神经元的爆发。在ME患者中,HV使早期HFOs显著降低。ME患者的这种模式可能是对去抑制状态下已增强的SEP(巨大SEP)的一种补偿。我们得出结论:(1)巨大HFOs通常受涉及成对刺激SEP的抑制性神经元系统调节。(2)晚期HFOs必定反映GABA能抑制性中间神经元的爆发。

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