Shindo K, Tsunoda S, Shiozawa Z, Mano T
Third Department of Internal Medicine, Yamanashi Medical University.
Rinsho Shinkeigaku. 1991 Aug;31(8):831-6.
Muscle sympathetic nerve activity (MSA) was quantitatively analyzed in amyotrophic lateral sclerosis (ALS) by using microneurography. Studies were conducted in 10 ALS patients (2 males, 8 females; mean age 56.4 SD 17.3 years; range 31-77 years). The duration of the disease after onset of symptoms was from 0.8 to 2.5 years. They were classified as a type of classical ALS having mild degree of bulbar signs, an ability to walk by themselves and no subjective breathing impairment. Control groups were selected from 16 healthy age-matched volunteers (8 males, 8 females; mean age 52.9, SD 15.5 years; range 29-76 years). MSA was recorded directly from peroneal nerve fascicles at the popliteal fossa by means of tungsten microelectrodes. The changes in MSA, blood pressure and heart rate were analyzed in the ALS groups and controls laid at recumbent and 30 degrees head-up tilted positions. The parasympathetic functions were evaluated by CVR-R and baroreflex latency. MSA bursts/minute, bursts/100 heart rate and total MSA at recumbent position were significantly higher (p less than 0.01), but their changes at 30 head-up tilted position were slightly lower in the ALS groups compared with the controls. Furthermore, a linear correlation between age of the subjects and MSA in the controls was not found in ALS groups. There were no differences between both groups in blood pressure and heart rate at the two positions. The parasympathetic function was normal in ALS groups. In ALS, sympathetic hyperfunction independent of cardiovascular systems was found especially at the recumbent position. These findings were considered specific to ALS, but the etiology was unclear.
采用微神经ography术对肌萎缩侧索硬化症(ALS)患者的肌肉交感神经活动(MSA)进行了定量分析。研究纳入了10例ALS患者(2例男性,8例女性;平均年龄56.4岁,标准差17.3岁;年龄范围31 - 77岁)。症状出现后的病程为0.8至2.5年。他们被归类为具有轻度延髓体征、能够自行行走且无主观呼吸障碍的经典ALS类型。对照组选取了16名年龄匹配的健康志愿者(8例男性,8例女性;平均年龄52.9岁,标准差15.5岁;年龄范围29 - 76岁)。通过钨微电极直接从腘窝处的腓总神经束记录MSA。分析了ALS组和对照组在卧位和头高位倾斜30度体位时MSA、血压和心率的变化。通过CVR - R和压力反射潜伏期评估副交感神经功能。ALS组卧位时的MSA爆发次数/分钟、每100次心率的爆发次数和总MSA显著更高(p < 0.01),但与对照组相比,ALS组在头高位倾斜30度体位时这些指标的变化略低。此外,ALS组未发现受试者年龄与MSA之间存在线性相关性。两组在两个体位的血压和心率无差异。ALS组的副交感神经功能正常。在ALS患者中,发现了独立于心血管系统的交感神经功能亢进,尤其是在卧位时。这些发现被认为是ALS所特有的,但病因尚不清楚。