影响皮质静息期的因素:优化刺激位置、强度和肌肉收缩。
Factors influencing cortical silent period: optimized stimulus location, intensity and muscle contraction.
作者信息
Säisänen Laura, Pirinen Eriikka, Teitti Selja, Könönen Mervi, Julkunen Petro, Määttä Sara, Karhu Jari
机构信息
Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
出版信息
J Neurosci Methods. 2008 Mar 30;169(1):231-8. doi: 10.1016/j.jneumeth.2007.12.005. Epub 2007 Dec 23.
Inhibitory silent period (SP) is a transient suppression of voluntary muscle activity after depolarization of representative motor neuronal populations following transcranial magnetic stimulation (TMS). Our aim was to evaluate and present an optimal protocol for the measurement of SP by (1) determining the impact of muscle activation level and stimulus intensity (SI) on the duration of SP, and, (2) studying the relationship between motor evoked potential (MEP) and SP, using targeted stimulus delivery. Single magnetic pulses were focused on the optimal representation area of the thenar musculature on primary motor cortex. We utilized real-time 3D-positioning of TMS-evoked electric field on anatomical structures derived from individual MR-images. The SI varied from 80% to 120% of individual resting motor threshold (MT). Muscle activation levels varied from 20% to 80% of the maximal voluntary contraction (MVC). Contralateral SP lengthened significantly with increasing SI independent of target muscle activation. The peak amplitude of the MEP was affected by SI and force. Latency and duration of the MEP were practically unaffected by SI or force. Focal stimulation at 110-120% MT and approximately 50% MVC (with only negligible need for control) provides most stable and informative SP. MEP should be included in SP as the error from marking the onset diminishes. This study provides a guideline for the consistent measurement of SP, which is applicable when using navigated or traditional TMS.
抑制性静息期(SP)是经颅磁刺激(TMS)后,代表性运动神经元群体去极化后出现的随意肌活动的短暂抑制。我们的目的是通过以下方式评估并提出一种测量SP的最佳方案:(1)确定肌肉激活水平和刺激强度(SI)对SP持续时间的影响;(2)使用靶向刺激传递研究运动诱发电位(MEP)与SP之间的关系。单个磁脉冲聚焦于初级运动皮层上鱼际肌的最佳代表区域。我们利用基于个体磁共振图像的解剖结构对TMS诱发电场进行实时三维定位。SI在个体静息运动阈值(MT)的80%至120%之间变化。肌肉激活水平在最大自主收缩(MVC)的20%至80%之间变化。对侧SP随着SI的增加而显著延长,与目标肌肉激活无关。MEP的峰值幅度受SI和力量的影响。MEP的潜伏期和持续时间实际上不受SI或力量的影响。在110 - 120%MT和约50%MVC(仅需极少量控制)下进行局灶性刺激可提供最稳定且信息丰富的SP。由于标记起始点产生的误差减小,MEP应包含在SP测量中。本研究为SP的一致性测量提供了指导原则,适用于使用导航式或传统TMS的情况。