Mori Francesco, Koch Giacomo, Foti Calogero, Bernardi Giorgio, Centonze Diego
Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy.
Prog Brain Res. 2009;175:429-39. doi: 10.1016/S0079-6123(09)17528-3.
Spasticity is a common disorder in patients with injury of the brain and spinal cord, especially in patients affected by multiple sclerosis (MS). In MS, spasticity is a major cause of long-term disability, it significantly impacts daily activities and quality of life and is only partially influenced by traditional spasmolytic drugs. Transcranial magnetic stimulation (TMS) is a noninvasive tool that can be used to modulate cortical excitability of the leg motor area, inducing remote effects on the excitability of the spinal circuits. The H reflex is a reliable electrophysiologic measure of the stretch reflex, and has been used in previous studies to test the effects of rTMS of the motor cortex on spinal circuitry. Based on these premises, originating from physiological studies in normal subjects, some studies have demonstrated that rTMS of the leg motor cortex can be beneficial in the management of spasticity by enhancing corticospinal tract excitability and reducing H reflex amplitude.
痉挛是脑和脊髓损伤患者的常见病症，尤其是在患有多发性硬化症（MS）的患者中。在MS中，痉挛是长期残疾的主要原因，它对日常活动和生活质量有重大影响，并且仅受到传统解痉药物的部分影响。经颅磁刺激（TMS）是一种非侵入性工具，可用于调节腿部运动区的皮质兴奋性，对脊髓回路的兴奋性产生远程影响。H反射是牵张反射的可靠电生理测量指标，在先前的研究中已被用于测试运动皮层重复经颅磁刺激（rTMS）对脊髓回路的影响。基于这些源自正常受试者生理学研究的前提，一些研究表明，腿部运动皮层的rTMS通过增强皮质脊髓束兴奋性和降低H反射幅度，可能有助于痉挛的管理。
