Yaman M, Sahin S, Kiziltan M Erdemir
Department of Neurology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
Electromyogr Clin Neurophysiol. 2009 Jan-Feb;49(1):19-25.
Previous studies have shown that enhancement of blink reflex (BR) excitability exists in various movement disorders, notably those involving the cranio-cervical area. In this study the BR recovery curve of the late component (R2) and R2 area was evaluated to determine what changes occur under different conditions and the significance of these changes.
The recovery curve of the blink reflex (BR) was studied in patients with hemifacial spasm (HFS), post-facial syndrome (PFS), blepharospasm (BS), segmental cranio-cervical dystonia (SD), cervical dystonia without BS (CD), and healthy control subjects. Following initial comparisons between six groups where the increased excitability observed in BS, SD and CD were assumed to be of central origin and that of HFS and PFS of peripheral origin; two additional groups were established and compared in terms of recovery times.
Recovery values of 200, 400, 600, 800, 1000 ms and grades for all groups were significantly different when compared to the control group. The most significant difference observed between the groups was at 200 msn and the smallest at 800 msn interstimuli intervals. The subjects within the group referred to as the 'central origined group' recovered faster than those in the 'peripherally origined group' although no statistical difference was found between the two groups at stimulus interval.
Our findings suggest that the excitability changes observed among the groups can be attributed to a number of factors. Although the nature and anatomical substrate of the primary pathology involving the reflex cycle leads - to some extent - to differently enhanced excitability patterns, such differences were not considered statistically significant.
先前的研究表明，在各种运动障碍中，尤其是涉及颅颈区域的运动障碍，眨眼反射（BR）兴奋性增强。在本研究中，评估了晚期成分（R2）和R2区域的BR恢复曲线，以确定在不同条件下会发生哪些变化以及这些变化的意义。
对偏侧面肌痉挛（HFS）、面后综合征（PFS）、眼睑痉挛（BS）、节段性颅颈肌张力障碍（SD）、无BS的颈部肌张力障碍（CD）患者以及健康对照者的眨眼反射（BR）恢复曲线进行了研究。在对六组进行初步比较时，假设在BS、SD和CD中观察到的兴奋性增加源于中枢，而HFS和PFS的兴奋性增加源于外周；另外建立了两组，并就恢复时间进行了比较。
与对照组相比，所有组在200、400、600、800、1000毫秒时的恢复值和分级均有显著差异。组间观察到的最显著差异出现在200毫秒的刺激间隔，最小差异出现在800毫秒的刺激间隔。尽管在刺激间隔时两组之间未发现统计学差异，但所谓“中枢起源组”的受试者恢复速度比“外周起源组”的受试者快。
我们的研究结果表明，各组间观察到的兴奋性变化可归因于多种因素。虽然涉及反射周期的原发性病理的性质和解剖学基础在一定程度上导致了不同的兴奋性增强模式，但这些差异在统计学上并不显著。
