Gallas S, Moirot P, Debono G, Navarre I, Denis P, Marie J P, Verin E
Service de Physiologie Digestive, Urinaire, Respiratoire et Sportive, CHU de Rouen, Rouen Cedex, France.
Neurogastroenterol Motil. 2007 Jun;19(6):453-8. doi: 10.1111/j.1365-2982.2006.00892.x.
This work aimed to study mylohyoid motor-evoked potentials (MHMEPs) and examined if it is related to chronic stroke dysphagia. Conduction time (CT) and amplitudes of the right and left MHMEPs in response to focal cortical magnetic stimulations over affected and unaffected hemispheres were recorded in 16 stroke patients with aspiration (n = 9) or residue (n = 7) and compared with eight control patients. In control group, MHMEPs were present on ipsilateral and contralateral sides after stimulation of both hemispheres and permitted to determine a dominant hemisphere. In stroke patients, after stimulation of the affected hemisphere, ipsilateral MEPs had a longer CT and lower amplitudes in patients with aspiration compared with patients with residue or control patients (P < 0.05). Contralateral CT was not different between the three groups, but amplitudes were lower in patients with residue and aspiration than in control patients (P < 0.01). In the unaffected hemisphere, MHMEPs were present, and not different between the three groups for the ipsilateral side and amplitudes were decreased in contralateral side in patients with residue. In conclusion, MHMEP alterations of the affected hemisphere related to chronic stroke dysphagia severity and were closed to normal in the unaffected hemisphere.
这项研究旨在探讨下颌舌骨肌运动诱发电位（MHMEPs），并检验其与慢性卒中后吞咽困难是否相关。记录了16例有吞咽误吸（n = 9）或食物残留（n = 7）的卒中患者在患侧和健侧半球进行局灶性皮质磁刺激时左右侧MHMEPs的传导时间（CT）和波幅，并与8例对照患者进行比较。在对照组中，刺激双侧半球后，同侧和对侧均能引出MHMEPs，并可确定优势半球。在卒中患者中，刺激患侧半球后，与有食物残留的患者或对照患者相比，有吞咽误吸的患者同侧运动诱发电位的CT更长，波幅更低（P < 0.05）。三组之间对侧CT无差异，但有食物残留和吞咽误吸的患者波幅低于对照患者（P < 0.01）。在健侧半球，能引出MHMEPs，三组同侧无差异，有食物残留的患者对侧波幅降低。总之，患侧半球的MHMEP改变与慢性卒中后吞咽困难的严重程度相关，而健侧半球接近正常。
