Boërio D, Hogrel J-Y, Lefaucheur J-P, Wang F C, Verschueren A, Pouget J, Carrera E, Kuntzer T
Service de physiologie-explorations fonctionnelles, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France.
Neurophysiol Clin. 2008 Feb;38(1):31-8. doi: 10.1016/j.neucli.2007.09.007. Epub 2007 Oct 11.
The value of various indexes to characterize the stimulus-response curve of human motor nerves was assessed in 40 healthy subjects recruited from four European centers of investigation (Créteil, Lausanne, Liège, Marseille). Stimulus-response curves were established by stimulating the right median and ulnar motor nerves at the wrist, with stimulus durations of 0.05 and 0.5 ms. The following parameters were studied: the threshold intensity of stimulation to obtain 10% (I 10), 50% (I 50), and 90% (I 90) of the maximal compound muscle action potential, the ratios I 10/I 50, I 90/I 50, (I 90 - I 10)/I 10, (I 90-I 50)/I 50, and (I 50 - I 10)/I 10, and the slopes of the stimulus-response curves with or without normalization to I 50. For each parameter, within-center variability and reproducibility (in a test-retest study) were assessed and between-center comparisons were made. For most of the parameters, the results varied significantly within and between the centers. Within the centers, only the ratios I 10/I 50 and I 90/I 50 were found constant and reproducible. Between the centers, the absolute intensity thresholds (I 10, I 50, I 90) and the ratio I 90/I 50 did not show significant differences at stimulus duration of 0.5 ms, whatever the stimulated nerve. The reduced variability and good reproducibility of the ratios I 10/I 50 and I 90/I 50 open perspectives in neurophysiological practice for the use of these indexes of the stimulus-response curve, a rapid and noninvasive test.
在从四个欧洲研究中心（克雷泰伊、洛桑、列日、马赛）招募的40名健康受试者中，评估了各种用于表征人类运动神经刺激 - 反应曲线的指标的价值。通过在手腕处刺激右侧正中神经和尺神经运动神经来建立刺激 - 反应曲线，刺激持续时间为0.05毫秒和0.5毫秒。研究了以下参数：获得最大复合肌肉动作电位的10%（I10）、50%（I50）和90%（I90）时的刺激阈值强度，I10/I50、I90/I50、(I90 - I10)/I10、(I90 - I50)/I50和(I50 - I10)/I10的比值，以及刺激 - 反应曲线在归一化至I50或未归一化时的斜率。对于每个参数，评估了中心内变异性和可重复性（在重测研究中）并进行了中心间比较。对于大多数参数，中心内和中心间的结果差异显著。在各中心内，仅发现I10/I50和I90/I50的比值是恒定且可重复的。在各中心之间，无论刺激的是哪条神经，在刺激持续时间为0.5毫秒时，绝对强度阈值（I10、I50、I90）和I90/I50的比值均未显示出显著差异。I10/I50和I90/I50比值的变异性降低和良好的可重复性为神经生理学实践中使用这些刺激 - 反应曲线指标开辟了前景，这是一种快速且无创的测试。
