肌萎缩侧索硬化症中的三重刺激技术（TST）
Triple stimulation technique (TST) in amyotrophic lateral sclerosis.
作者信息
Komissarow Leonid, Rollnik Jens D, Bogdanova Dessislava, Krampfl Klaus, Khabirov F A, Kossev Andon, Dengler Reinhard, Bufler Johannes
机构信息
Medical State Academy Kasan, Tatarstan, Russia.
出版信息
Clin Neurophysiol. 2004 Feb;115(2):356-60. doi: 10.1016/j.clinph.2003.10.003.
OBJECTIVE
The authors studied amyotrophic lateral sclerosis (ALS) patients using triple stimulation technique (TST) to detect upper motor neuron (UMN) involvement.
METHODS
Nineteen ALS patients (aged 45-72 years) were enrolled in the study. According to the El Escorial criteria, 6 diagnoses were suspected or possible, 6 probable, and 7 definite. Patients were examined clinically, with conventional (single-pulse) transcranial magnetic stimulation (TMS), and with TST (on one side only).
RESULTS
Among the whole group of patients, TST appeared to be more sensitive than conventional TMS techniques. In particular among suspected/possible ALS patients, TST area ratio was pathologic in 100%, while single-pulse TMS was abnormal only in 50% of cases. Overall, the use of TST area ratio was more sensitive than the analysis of TST amplitude ratio.
CONCLUSIONS
The results suggest that TST might be more sensitive and useful in the diagnosis of subclinical UMN involvement than conventional TMS techniques, even if TST is performed on one side only.
目的
作者使用三重刺激技术（TST）研究肌萎缩侧索硬化症（ALS）患者，以检测上运动神经元（UMN）受累情况。
方法
19例ALS患者（年龄45 - 72岁）纳入本研究。根据埃尔埃斯科里亚尔标准，6例诊断为疑似或可能，6例为很可能，7例为确诊。对患者进行临床检查、常规（单脉冲）经颅磁刺激（TMS）以及TST（仅在一侧进行）。
结果
在整个患者组中，TST似乎比传统TMS技术更敏感。特别是在疑似/可能的ALS患者中，TST面积比100%异常，而单脉冲TMS仅50%的病例异常。总体而言，使用TST面积比比分析TST振幅比更敏感。
结论
结果表明，即使TST仅在一侧进行，在诊断亚临床UMN受累方面，TST可能比传统TMS技术更敏感且更有用。
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