Martin P G, Weerakkody N, Gandevia S C, Taylor J L
Prince of Wales Medical Research Institute and University of New South Wales, Sydney, NSW 2031, Australia.
J Physiol. 2008 Mar 1;586(5):1277-89. doi: 10.1113/jphysiol.2007.140426. Epub 2007 Sep 20.
The influence of group III and IV muscle afferents on human motor pathways is poorly understood. We used experimental muscle pain to investigate their effects at cortical and spinal levels. In two studies, electromyographic (EMG) responses in elbow flexors and extensors to stimulation of the motor cortex (MEPs) and corticospinal tract (CMEPs) were evoked before, during, and after infusion of hypertonic saline into biceps brachii to evoke deep pain. In study 1, MEPs and CMEPs were evoked in relaxed muscles and during contractions to a constant elbow flexion force. In study 2, responses were evoked during elbow flexion and extension to a constant level of biceps or triceps brachii EMG, respectively. During pain, the size of CMEPs in relaxed biceps and triceps increased (by approximately 47% and approximately 56%, respectively; P < 0.05). MEPs did not change with pain, but relative to CMEPs, they decreased in biceps (by approximately 34%) and triceps (by approximately 43%; P < 0.05). During flexion with constant force, ongoing background EMG and MEPs decreased for biceps during pain (by approximately 14% and 15%; P < 0.05). During flexion with a constant EMG level, CMEPs in biceps and triceps increased during pain (by approximately 30% and approximately 26%, respectively; P < 0.05) and relative to CMEPs, MEPs decreased for both muscles (by approximately 20% and approximately 17%; P < 0.05). For extension, CMEPs in triceps increased during pain (by approximately 22%) whereas MEPs decreased (by approximately 15%; P < 0.05). Activity in group III and IV muscle afferents produced by hypertonic saline facilitates motoneurones innervating elbow flexor and extensor muscles but depresses motor cortical cells projecting to these muscles.
目前对Ⅲ类和Ⅳ类肌肉传入神经对人体运动通路的影响了解甚少。我们利用实验性肌肉疼痛来研究它们在皮质和脊髓水平的作用。在两项研究中,在向肱二头肌注入高渗盐水诱发深部疼痛之前、期间和之后,诱发了肘部屈肌和伸肌对运动皮质刺激(运动诱发电位,MEPs)和皮质脊髓束(皮质运动诱发电位,CMEPs)的肌电图(EMG)反应。在研究1中,在放松肌肉时以及在以恒定肘部屈曲力收缩期间诱发MEPs和CMEPs。在研究2中,分别在肘部屈曲和伸展期间,以肱二头肌或肱三头肌EMG的恒定水平诱发反应。在疼痛期间,放松的肱二头肌和肱三头肌中CMEPs的大小增加(分别约增加47%和约56%;P<0.05)。MEPs并未随疼痛而改变,但相对于CMEPs,它们在肱二头肌中降低(约34%),在肱三头肌中降低(约43%;P<0.05)。在以恒定力屈曲期间,肱二头肌在疼痛期间持续的背景EMG和MEPs降低(分别约14%和15%;P<0.05)。在以恒定EMG水平屈曲期间,肱二头肌和肱三头肌中的CMEPs在疼痛期间增加(分别约30%和约26%;P<0.05),相对于CMEPs,两块肌肉的MEPs均降低(分别约20%和约17%;P<0.05)。对于伸展,肱三头肌中的CMEPs在疼痛期间增加(约22%),而MEPs降低(约15%;P<0.05)。高渗盐水产生的Ⅲ类和Ⅳ类肌肉传入神经活动促进支配肘部屈肌和伸肌的运动神经元,但抑制投射到这些肌肉的运动皮质细胞。