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脊髓损伤患者皮质脊髓束传导障碍与步态障碍。

Impaired transmission in the corticospinal tract and gait disability in spinal cord injured persons.

机构信息

Department of Physical Exercise and Sport Sciences, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Neurophysiol. 2010 Aug;104(2):1167-76. doi: 10.1152/jn.00382.2010. Epub 2010 Jun 16.


DOI:10.1152/jn.00382.2010
PMID:20554839
Abstract

Rehabilitation following spinal cord injury is likely to depend on recovery of corticospinal systems. Here we investigate whether transmission in the corticospinal tract may explain foot drop (inability to dorsiflex ankle) in persons with spinal cord lesion. The study was performed in 24 persons with incomplete spinal cord lesion (C1 to L1) and 15 healthy controls. Coherence in the 10- to 20-Hz frequency band between paired tibialis anterior muscle (TA) electromyographic recordings obtained in the swing phase of walking, which was taken as a measure of motor unit synchronization. It was significantly correlated with the degree of foot drop, as measured by toe elevation and ankle angle excursion in the first part of swing. Transcranial magnetic stimulation was used to elicit motor-evoked potentials (MEPs) in the TA. The amplitude of the MEPs at rest and their latency during contraction were correlated to the degree of foot drop. Spinal cord injured participants who exhibited a large foot drop had little or no MEP at rest in the TA muscle and had little or no coherence in the same muscle during walking. Gait speed was correlated to foot drop, and was the lowest in participants with no MEP at rest. The data confirm that transmission in the corticospinal tract is of importance for lifting the foot during the swing phase of human gait.

摘要

脊髓损伤后的康复可能依赖于皮质脊髓系统的恢复。在这里,我们研究皮质脊髓束的传递是否可以解释脊髓损伤患者的足下垂(无法背屈踝关节)。该研究在 24 名不完全性脊髓损伤患者(C1 至 L1)和 15 名健康对照者中进行。在步行摆动相期间,对胫骨前肌(TA)的成对肌电图记录进行 10-20Hz 频带的相干性分析,这被用作运动单位同步性的测量。它与足下垂的程度显著相关,足下垂程度由摆动相早期的脚趾抬高和踝关节角度的偏移来衡量。经颅磁刺激用于诱发 TA 中的运动诱发电位(MEP)。静息时 MEP 的振幅及其在收缩期间的潜伏期与足下垂的程度相关。在 TA 肌肉中静息时几乎没有或没有 MEP 且在行走时同一肌肉中几乎没有相干性的脊髓损伤参与者表现出较大的足下垂。步速与足下垂相关,在静息时没有 MEP 的参与者中步速最低。这些数据证实,皮质脊髓束的传递对于在人类步态的摆动相期间抬起脚很重要。

相似文献

[1]
Impaired transmission in the corticospinal tract and gait disability in spinal cord injured persons.

J Neurophysiol. 2010-6-16

[2]
Assessment of transmission in specific descending pathways in relation to gait and balance following spinal cord injury.

Prog Brain Res. 2015

[3]
Functional implications of corticospinal tract impairment on gait after spinal cord injury.

Spinal Cord. 2013-8-13

[4]
Ankle paresis in incomplete spinal cord injury: relation to corticospinal conductivity and ambulatory capacity.

J Clin Neurophysiol. 2008-8

[5]
Changes in cortically related intermuscular coherence accompanying improvements in locomotor skills in incomplete spinal cord injury.

J Neurophysiol. 2006-4

[6]
Increases in corticospinal tract function by treadmill training after incomplete spinal cord injury.

J Neurophysiol. 2005-10

[7]
Motor imagery of foot dorsiflexion and gait: effects on corticospinal excitability.

Clin Neurophysiol. 2008-11

[8]
Reduction of common synaptic drive to ankle dorsiflexor motoneurons during walking in patients with spinal cord lesion.

J Neurophysiol. 2005-8

[9]
Electromyography detects mechanically-induced suprasegmental spinal motor tract injury: review of decompression at spinal cord level.

Clin Neurophysiol. 2009-4

[10]
Corticospinal inhibition of transmission in propriospinal-like neurones during human walking.

Eur J Neurosci. 2008-10

引用本文的文献

[1]
Electrophysiological Approaches to Understanding Brain-Muscle Interactions During Gait: A Systematic Review.

Bioengineering (Basel). 2025-4-29

[2]
Intermittent hypoxia-induced enhancements in corticospinal excitability predict gains in motor learning and metabolic efficiency.

Sci Rep. 2025-2-24

[3]
A bibliometric analysis of the top 100 most cited articles on corticospinal tract regeneration from 2004 to 2024.

Front Neurosci. 2025-1-28

[4]
Alpha and beta/low-gamma frequency bands may have distinct neural origin and function during post-stroke walking.

Exp Brain Res. 2024-10

[5]
Intermittent Hypoxia-Induced Enhancements in Corticospinal Excitability Predict Gains in Motor Learning and Metabolic Efficiency.

Res Sq. 2024-4-24

[6]
Variability of corticospinal and spinal reflex excitability for the ankle dorsiflexor tibialis anterior across repeated measurements in people with and without incomplete spinal cord injury.

Exp Brain Res. 2024-3

[7]
Effect of three-hour ankle joint immobilization with an ankle foot orthosis on corticospinal excitability and ankle joint angle excursion during gait.

J Phys Ther Sci. 2023-12

[8]
Assessment of Dorsiflexion Ability across Tasks in Persons with Subacute SCI after Combined Locomotor Training and Transcutaneous Spinal Stimulation.

Bioengineering (Basel). 2023-4-26

[9]
Intramuscular coherence enables robust assessment of modulated supra-spinal input in human gait: an inter-dependence study of visual task and walking speed.

Exp Brain Res. 2023-6

[10]
Effect of virtual running with exercise on functionality in pre-frail and frail elderly people: randomized clinical trial.

Aging Clin Exp Res. 2023-7

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