Vucic Steve, Cairns Kevin D, Black Kristin R, Chong Peter Siao Tick, Cros Didier
Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, GRB 1256 Boston, MA 02114, USA.
Clin Neurophysiol. 2006 Feb;117(2):392-7. doi: 10.1016/j.clinph.2005.10.011. Epub 2006 Jan 3.
Cervical nerve root stimulation (CRS) is a technique of assessing the proximal segments of motor axons destined to upper extremity muscles. Few studies report normal values. The objective was to determine CMAP onset-latencies and CMAP amplitude, area, and duration changes in healthy controls for the abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps, and riceps muscles. In addition, to determine the tolerability of CRS, as measured by the visual analog scale (VAS).
We studied 21 healthy volunteers prospectively with CRS using four target muscles (APB, ADM, biceps, and triceps) bilaterally. Collision studies were used in all APB recordings. VAS was obtained in all subjects.
Mean CMAP onset-latencies were: APB 14 +/- 1.5 ms; ADM 14.2 +/- 1.5 ms; biceps 5.4 +/- 0.6 ms; triceps 5.4 +/- 1.0 ms. Onset-latency significantly correlated with height for all nerves. The mean change in CMAP amplitude and area (%) between most distal stimulation and CRS was: APB reduction of 15.1 +/- 11.6 and 4.9 +/- 3.6%; ADM reduction of 21.1 +/- 10.7 and 17.2 +/- 8.8; biceps reduction of 10 +/- 11.5 and reduction of 8.7 +/- 6.8; triceps increase of 3.3 +/- 5.2 and 11.0 +/- 9.9% respectively. Mean CMAP duration change between most distal stimulation and CRS was: APB, increase of 20.4 +/- 7.4%; ADM, increase of 14.4 +/- 8.5%; biceps, increase of 13.9 +/- 10.8%; triceps, increase of 7.7 +/- 6.7%. The mean VAS score was 3.8 +/- 1.2, and all subjects completed the study.
The present study establishes normative data and indicates that CRS is a well-tolerated technique.
The normal values may be used as reference data for the needle CRS technique in the assessment of proximal conduction abnormalities.
颈神经根刺激（CRS）是一种评估支配上肢肌肉的运动轴突近端节段的技术。很少有研究报告正常值。本研究的目的是确定健康对照者拇短展肌（APB）、小指展肌（ADM）、肱二头肌和肱三头肌的复合肌肉动作电位（CMAP）起始潜伏期以及CMAP波幅、面积和时限的变化。此外，通过视觉模拟评分法（VAS）确定CRS的耐受性。
我们前瞻性地对21名健康志愿者双侧使用CRS刺激四块目标肌肉（APB、ADM、肱二头肌和肱三头肌）进行研究。所有APB记录均采用碰撞试验。所有受试者均进行VAS评分。
CMAP平均起始潜伏期分别为：APB 14±1.5毫秒；ADM 14.2±1.5毫秒；肱二头肌5.4±0.6毫秒；肱三头肌5.4±1.0毫秒。所有神经的起始潜伏期与身高显著相关。最远端刺激与CRS之间CMAP波幅和面积的平均变化率（%）分别为：APB降低15.1±11.6和4.9±3.6%；ADM降低21.1±10.7和17.2±8.8；肱二头肌降低10±11.5和8.7±6.8；肱三头肌分别增加3.3±5.2和11.0±9.9%。最远端刺激与CRS之间CMAP时限的平均变化为：APB增加20.4±7.4%；ADM增加14.4±8.5%；肱二头肌增加13.9±10.8%；肱三头肌增加7.7±6.7%。VAS平均评分为3.8±1.2，所有受试者均完成了研究。
本研究建立了规范性数据，并表明CRS是一种耐受性良好的技术。
这些正常值可作为针式CRS技术评估近端传导异常的参考数据。
