Gómez-Fernández L, Maragoto-Rizo C, Calzada-Sierra D J, Infante-Velázquez E, Padilla-Puentes E
Laboratorio de EMG y EMT, Centro Internacional de Restauración Neurológica (CIREN), Ciudad Habana, Cuba.
Rev Neurol. 2004;39(7):613-7.
Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS.
It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods.
As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30% of recording from ALS patients response to TMS was absent, but only the 4.5% in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6.32, p = 0.011; and Kruskall-Wallis, H = 5.777, p = 0.0163, respectively).
Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases.
皮质脊髓功能障碍是原发性和肌萎缩侧索硬化症(PLS和ALS)中的常见表现。目的:比较肌萎缩侧索硬化症(ALS)和原发性侧索硬化症(PLS)患者经颅磁刺激(TMS)运动诱发电位(MEP)的表现。
对11例PLS患者和10例散发性ALS患者的MEP记录进行回顾性分析。使用非参数方法,选择中央运动传导时间和波幅比作为对四肢拇短展肌和胫前肌MEP进行统计分析的变量。
总体观察发现,两组患者异常记录的发生率都很高;ALS患者中有30%的TMS记录无反应,但PLS组中只有4.5%有相同特征。PLS患者中,最常见的发现是中央运动传导时间异常,而ALS患者中则是波幅比低;两组间这两个变量均显示出统计学显著差异(分别为:Kruskal-Wallis检验,H = 6.32,p = 0.011;以及Kruskal-Wallis检验,H = 5.777,p = 0.0163)。
皮质脊髓功能障碍在ALS和PLS患者中有不同特征,MEP分析可为这些疾病的鉴别诊断提供有用信息。