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痉挛:其生理学与管理。第一部分。痉挛的神经生理学:经典概念。

Spasticity: its physiology and management. Part I. Neurophysiology of spasticity: classical concepts.

作者信息

Bishop B

出版信息

Phys Ther. 1977 Apr;57(4):371-6. doi: 10.1093/ptj/57.4.371.

Abstract

Spasticity, seen so frequently in clinical situations, presents motor signs resembling those produced experimentally by transecting the brain stem of a cat at the intercollicular level. This paper reviews experimental results which elucidate the roles of different brain regions in the genesis of classical decerebrate rigidity and demonstrate the function of the gamma motor system in the maintenance of the rigidity. Interruption of the gamma-spindle loop of a muscle (i.e. interrupting the monosynaptic reflex arc subserving the stretch reflexes) abolishes rigidity in that muscle. This reflex-mediated gamma support of decrebrate rigidity is also a prominent feature of clinical spasticity, making classical decerebrate rigidity a useful model for studying the neural mechanisms underlying spasticity. Not all rididities, however, are gamma dependent. Those rigidities surviving dorsal root rhizotomy are called alpha rigidity. Alpha rigidity results when a brain lesion disrupts descending systems which normally exert a net inhibitory effect upon alpha motoneurons.

摘要

痉挛在临床中极为常见,其呈现出的运动体征类似于通过在猫的中脑丘间水平横断脑干而实验性产生的体征。本文回顾了一些实验结果,这些结果阐明了不同脑区在经典去大脑强直发生过程中的作用,并证明了γ运动系统在维持强直中的功能。切断肌肉的γ-肌梭环路(即中断介导牵张反射的单突触反射弧)可消除该肌肉的强直。这种由反射介导的对去大脑强直的γ支持也是临床痉挛的一个突出特征,使得经典去大脑强直成为研究痉挛潜在神经机制的有用模型。然而,并非所有的强直都依赖γ。那些在背根神经根切断术后仍存在的强直被称为α强直。当脑部病变破坏了通常对α运动神经元施加净抑制作用的下行系统时,就会产生α强直。

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