Nagaoka Masanori, Kakuda Naoyuki
Department of Rehabilitation Medicine, Juntendo University Graduate School, Bunkyo-Ku, Tokyo 113-8421, Japan.
Brain Nerve. 2008 Dec;60(12):1399-408.
Considering the various studies conducted on spasticity, it is quite evident that the signs and symptoms of this disorder vary. In some cases of spasticity, spasms may be noted. An increase in velocity-dependent stretch reflexes has been proposed as a cardinal feature of spasticity. There are 2 possible mechanisms underlying increased stretch reflex of spasticity: one is the changes in gamma innervations and the other is one the changes in spinal motoneurons. Changes in gamma innervations for spasticity are not evident while the muscle are at rest. On the other hand, changes are clear in normal subjects during voluntary contraction of muscles, but not in sbjects with spasticity. We have discussed the changes in membrane properties caused by presynaptic inhibition, reciprocal Ia inhibitory function, recurrent inhibition, and autogenic Ib inhibition as the other candidate spinal mechanisms for spasticity.
考虑到针对痉挛进行的各种研究,很明显这种病症的体征和症状各不相同。在某些痉挛病例中,可能会出现痉挛。速度依赖性牵张反射增强被认为是痉挛的一个主要特征。痉挛时牵张反射增强有两种可能的机制:一种是γ运动神经支配的变化,另一种是脊髓运动神经元的变化。在肌肉静止时,痉挛时γ运动神经支配的变化并不明显。另一方面,在正常受试者肌肉自主收缩时变化明显,但在痉挛患者中则不明显。我们已经讨论了由突触前抑制、交互性Ia抑制功能、回返性抑制和自生Ib抑制引起的膜特性变化,将其作为痉挛的其他潜在脊髓机制。