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脊髓损伤所致瘫痪肌肉的自主活动抑制。

Depression of involuntary activity in muscles paralyzed by spinal cord injury.

作者信息

Butler Jane E, Godfrey Sharlene, Thomas Christine K

机构信息

The Miami Project to Cure Paralysis and Department of Neurological Surgery, University of Miami, 1095 NW 14th Terrace, R-48, Miami, Florida 33136, USA.

出版信息

Muscle Nerve. 2006 May;33(5):637-44. doi: 10.1002/mus.20500.

Abstract

Involuntary muscle contractions are common after spinal cord injury (SCI). Increased sensitivity to Ia muscle afferent input may contribute to the development of these spasms. Since tendon vibration results in a period of postactivation depression of the Ia synapse, we sought to determine whether Achilles tendon vibration (80 HZ for 2 s) altered involuntary contractions evoked by superficial peroneal nerve (SPN) stimulation (5 pulses at 300 HZ) in paralyzed leg muscles of subjects with chronic (>1 year) SCI. Responses to SPN stimulation that were conditioned by vibration were reduced in 66% of trials (by 33+/-12% in tibialis anterior and 40+/-16% in soleus). These reductions in electromyographic activity are unlikely to be mediated by changes at the Ia synapse or motoneuron because vibration did not alter the magnitude of the soleus H reflex. The electromyographic reductions may involve long-lasting neuromodulatory effects on spinal inhibitory interneurons or synapses involved in the flexor reflex pathway. Vibration-evoked depression of electromyographic activity may be clinically useful in controlling involuntary muscle contractions after SCI.

摘要

脊髓损伤(SCI)后常出现非自主肌肉收缩。对Ia类肌传入输入的敏感性增加可能导致这些痉挛的发生。由于肌腱振动会导致Ia突触出现一段激活后抑制期,我们试图确定跟腱振动(80赫兹,持续2秒)是否会改变慢性(>1年)SCI患者瘫痪腿部肌肉中由腓浅神经(SPN)刺激(300赫兹,5个脉冲)诱发的非自主收缩。在66%的试验中,经振动调节的对SPN刺激的反应降低(胫骨前肌降低33±12%,比目鱼肌降低40±16%)。肌电图活动的这些降低不太可能由Ia突触或运动神经元的变化介导,因为振动并未改变比目鱼肌H反射的幅度。肌电图降低可能涉及对脊髓抑制性中间神经元或参与屈肌反射通路的突触的长期神经调节作用。振动诱发的肌电图活动抑制在控制SCI后的非自主肌肉收缩方面可能具有临床应用价值。

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