Deuschl G, Seifert C, Heinen F, Illert M, Lücking C H
Neurologische Klinik, Universität Freiburg, Germany.
J Neurol Sci. 1992 Nov;113(1):85-90. doi: 10.1016/0022-510x(92)90269-q.
Reciprocal inhibition between forearm extensor and flexor muscles was tested by means of an H-reflex technique in patients with spasmodic torticollis and normal controls. In both, patients and controls three different phases of reciprocal inhibition could be demonstrated with maximal inhibition at conditioning test intervals of 0 ms, 15 ms and 100 ms, respectively. However, the quantitative amount of this inhibition was different for the patients and the controls. Significantly less inhibition was found for the second and the third phase of reciprocal inhibition in the patient group. Discriminant analysis showed a clear separation between normal subjects and patients if the amount of reciprocal inhibition of the second and third phase were taken into account. We were not able to detect any side differences neither for the patients nor for the controls. The findings demonstrate a functional disturbance of motor control mechanisms of a clinically unaffected extremity in spasmodic torticollis. This is believed to reflect a bilateral disturbance most likely within the basal ganglia or their outflow. Therefore, our data support the idea, that spasmodic torticollis is associated with or even due to a generalized rather than a focal disturbance of motor control mechanisms.
采用H反射技术对痉挛性斜颈患者和正常对照者进行了前臂伸肌和屈肌之间的交互抑制测试。在患者和对照者中，均可证明交互抑制的三个不同阶段，分别在条件测试间隔为0毫秒、15毫秒和100毫秒时出现最大抑制。然而，患者和对照者的这种抑制的定量程度有所不同。在患者组中，交互抑制的第二和第三阶段的抑制明显较少。判别分析表明，如果考虑第二和第三阶段的交互抑制量，正常受试者和患者之间有明显区分。无论是患者还是对照者，我们都未检测到任何左右侧差异。这些发现表明痉挛性斜颈患者临床上未受影响的肢体存在运动控制机制的功能障碍。这被认为最有可能反映了基底神经节或其传出通路内的双侧紊乱。因此，我们的数据支持这样一种观点，即痉挛性斜颈与运动控制机制的全身性而非局灶性紊乱有关，甚至是由其引起的。
