迟发性偏瘫后肌张力障碍中皮质内抑制的双侧损害：病理生理学意义
Bilateral impairment of intracortical inhibition in delayed-onset posthemiplegic dystonia: pathophysiological implications.
作者信息
Trompetto Carlo, Buccolieri Alessandro, Bove Marco, Brichetto Gianpaolo, Avanzino Laura, Marinelli Lucio, Abbruzzese Giovanni
机构信息
Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Via de Toni, 5, 16132 Genova, Italy.
出版信息
Clin Neurophysiol. 2006 Jun;117(6):1312-8. doi: 10.1016/j.clinph.2006.03.015. Epub 2006 May 5.
OBJECTIVE
To study short interval intracortical inhibition (SICI) in a rare patient with segmental dystonia of the left upper limb due to a vascular lesion in the contralateral putamen without corticospinal tract involvement.
METHODS
Paired-pulse transcranial magnetic stimulation (TMS) was applied to both hemispheres in a conditioning-test paradigm. Six interstimulus intervals (ISIs) and 4 conditioning stimulation intensities were investigated in two separate sessions.
RESULTS
Motor evoked potentials upon single-pulse TMS were within the normal range, whereas paired-pulse TMS revealed major changes in cortical excitability, proving that SICI was bilaterally absent.
CONCLUSIONS
The bilateral impairment of SICI cannot be considered the cause of dystonic contractions, but just a predisposing factor.
SIGNIFICANCE
The absence of SICI might be regarded as a condition able to promote maladaptive plastic changes triggered by focal lesions in the putamen.
目的
研究一名罕见的左侧上肢节段性肌张力障碍患者的短间隔皮质内抑制（SICI）情况，该患者因对侧壳核血管病变导致，且未累及皮质脊髓束。
方法
采用配对脉冲经颅磁刺激（TMS），以条件刺激-测试范式对双侧半球进行刺激。在两个单独的时段中，研究了6个刺激间隔（ISIs）和4种条件刺激强度。
结果
单脉冲TMS诱发的运动诱发电位在正常范围内，而配对脉冲TMS显示皮质兴奋性有重大变化，证明双侧均不存在SICI。
结论
SICI的双侧损害不能被视为肌张力障碍性收缩的原因，而只是一个诱发因素。
意义
SICI的缺失可能被视为一种能够促进由壳核局灶性病变引发的适应不良性可塑性变化的情况。
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