肌肉传入神经对人类脊髓损伤中长时间屈曲性退缩反射的作用

Contribution of muscle afferents to prolonged flexion withdrawal reflexes in human spinal cord injury.

作者信息

Hornby T G, Tysseling-Mattiace V M, Benz E N, Schmit B D

机构信息

Department of Physical Therapy, University of Illinois, Chicago, Illinois 60612, USA.

出版信息

J Neurophysiol. 2004 Dec;92(6):3375-84. doi: 10.1152/jn.00152.2004. Epub 2004 Jul 14.

Abstract

The contribution of force-sensitive muscular afferents to prolonged flexion withdrawal reflexes, or flexor spasms, after human spinal cord injury (SCI) was investigated. In three separate experimental conditions, flexion reflexes were triggered in subjects with SCI using trains of electrocutaneous stimuli delivered at the foot and lower leg and compared with reflexes elicited via intramuscular (i.m.) electrical stimuli. In the first experiment, flexion reflexes were elicited using i.m. stimuli to the tibialis anterior (TA) in the majority of subjects tested. The ratio of peak isometric ankle to hip torques during i.m.-triggered reflexes were proportionally similar to those evoked by electrocutaneous foot or shank stimulation, although the latency to onset and peak flexion torques were significantly longer with i.m. stimulation. In the second experiments, the amplitude and frequency of i.m. TA stimulation were varied to alter the stimulus-induced muscle torque. Peak ankle and hip torques generated during the flexion reflex responses were correlated to a greater extent with stimulus-induced muscle torques as compared with the modulated stimulus parameters. In the third experimental series, i.m. stimuli delivered to the gastrocnemius (GS) elicited flexion reflexes in approximately half of the subjects tested. The combined data indicate a potentially prominent role of the stimulus-induced muscle contraction to the magnitude and latency of flexor reflex behaviors after i.m. TA stimulation. Results after i.m. GS stimulation indicate multi-joint flexion reflexes can also be elicited, although to a lesser extent than i.m. TA stimulation.

摘要

研究了力敏性肌肉传入神经对人类脊髓损伤(SCI)后长时间屈肌退缩反射或屈肌痉挛的作用。在三种不同的实验条件下,对脊髓损伤患者使用施加于足部和小腿的一系列皮肤电刺激引发屈肌反射,并与通过肌内(i.m.)电刺激引发的反射进行比较。在第一个实验中,在大多数受试对象中,通过对胫骨前肌(TA)进行肌内刺激来引发屈肌反射。在肌内触发的反射过程中,等长踝关节与髋关节扭矩峰值的比例与皮肤电刺激足部或小腿所引发的比例相似,尽管肌内刺激时的起始潜伏期和峰值屈肌扭矩明显更长。在第二个实验中,改变肌内TA刺激的幅度和频率以改变刺激诱发的肌肉扭矩。与调制后的刺激参数相比,在屈肌反射反应过程中产生的踝关节和髋关节扭矩峰值与刺激诱发的肌肉扭矩在更大程度上相关。在第三个实验系列中,对腓肠肌(GS)进行肌内刺激,在大约一半的受试对象中引发了屈肌反射。综合数据表明,刺激诱发的肌肉收缩对肌内TA刺激后屈肌反射行为的幅度和潜伏期可能具有重要作用。肌内GS刺激后的结果表明,也可以引发多关节屈肌反射,尽管程度比肌内TA刺激要小。

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