Department of Neurology and Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
Clin Neurophysiol. 2010 Feb;121(2):248-54. doi: 10.1016/j.clinph.2009.09.024. Epub 2009 Dec 29.
OBJECTIVE: To examine the neuromodulatory effect of whole-hand mesh-glove (MG) stimulation on motor cortical pathways, we explored motor cortical excitability before and after suprathreshold whole-hand MG stimulation using transcranial magnetic stimulation (TMS). METHODS: Twenty-eight healthy volunteers (14 controls) were studied at baseline, immediately post and 1h post-MG stimulation for 30 min. Motor thresholds (MTs), motor evoked potentials (MEPs) recruitment curve, short intracortical inhibition (SICI) and intracortical facilitation (ICF) after paired magnetic stimuli were evaluated. RESULTS: After MG stimulation the MTs were significantly reduced and slope of MEP recruitment curve significantly increased; furthermore, the stimulation led to a sustained decrease of SICI and increase of ICF in the contralateral motor cortex. These effects lasted for at least 60 min and were stronger 1h post-stimulation compared with testing immediately after stimulation. A sham group did not show any differences before and after MG stimulation. CONCLUSIONS: We provide a first demonstration that MG whole-hand stimulation induces increases in motor cortical excitability lasting at least 1h. Both the strength of the corticospinal projections and the inhibitory and facilitatory intracortical mechanisms are involved. Synaptic modifications such as long-term potentiation mechanisms may underlie this stimulation-induced cortical plasticity changes. SIGNIFICANCE: Present results prove the MG stimulation to be a promising tool in neurorehabilitation.
目的:通过经颅磁刺激(TMS)研究超阈值全手网套(MG)刺激对运动皮质通路的神经调节作用,探讨MG 刺激前后运动皮质兴奋性的变化。
方法:28 名健康志愿者(14 名对照)在基线、MG 刺激后即刻和刺激后 30 分钟内进行 1 小时的研究。评估运动阈值(MTs)、运动诱发电位(MEPs)募集曲线、双磁刺激后的短程皮质内抑制(SICI)和皮质内易化(ICF)。
结果:MG 刺激后 MTs 明显降低,MEP 募集曲线斜率明显增加;此外,刺激导致对侧运动皮质 SICI 持续降低和 ICF 增加。这些效应至少持续 60 分钟,刺激后 1 小时的效应比刺激后即刻更强。假刺激组在 MG 刺激前后均无差异。
结论:我们首次证明,MG 全手刺激可引起运动皮质兴奋性增加,持续至少 1 小时。皮质脊髓投射的强度以及抑制和易化性的皮质内机制都参与其中。长时程增强机制等突触修饰可能是这种刺激诱导的皮质可塑性变化的基础。
意义:目前的结果证明 MG 刺激是神经康复的一种有前途的工具。
Clin Neurophysiol. 2009-12-29
Clin Neurophysiol. 2011-7-18