Department of Exercise and Sport Sciences, Panum Institute, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark.
Exp Brain Res. 2011 Sep;213(4):465-74. doi: 10.1007/s00221-011-2798-5. Epub 2011 Jul 22.
Antispastic medication is often used in the clinic together with physiotherapy. However, some of the antispastic drugs, e.g., baclofen and diazepam, may influence the plastic mechanisms that are necessary for motor learning and hence efficient physiotherapy. In the present study, we consequently investigated the influence of baclofen and diazepam on acquisition of a visuomotor skill. The study was designed as a semi-randomized, double-blinded, placebo-controlled, crossover study in 16 healthy human subjects. The motor skill task required the subjects to match a given force trajectory by increasing or decreasing ankle dorsiflexor torque. Subjects trained for a total of 30 min. Transcranial magnetic stimulation of the primary motor cortex leg area was applied to elicit motor evoked potentials in the anterior tibial muscle (TA). Coupling between populations of TA motor units was calculated in the frequency (coherence) domain during isometric dorsiflexion. Subjects receiving placebo showed statistically significant improvement in motor performance (q = 34.1, P = 0.014) accompanied by a statistically significant reduction in intramuscular coherence. Subjects receiving baclofen and diazepam conversely showed no progression in motor performance (P > 0.05), and the training was not accompanied by a decrease in intramuscular coherence. TA motor evoked potentials had significantly lower threshold following the training in the placebo group, whereas this was not the case in the treatment groups. These data indicate that diazepam and baclofen interfere with the acquisition of a motor skill by disrupting some of the neuroplastic changes that are involved in improved motor performance. This suggests that antispastic treatment should be used with caution in subjects receiving concomitant physiotherapy.
抗痉挛药物在临床上常与物理疗法一起使用。然而，一些抗痉挛药物，如巴氯芬和地西泮，可能会影响运动学习所必需的可塑性机制，从而影响物理治疗的效果。在本研究中，我们研究了巴氯芬和地西泮对视觉运动技能获得的影响。该研究设计为 16 名健康人体的半随机、双盲、安慰剂对照、交叉研究。运动技能任务要求受试者通过增加或减少踝背屈肌扭矩来匹配给定的力轨迹。受试者总共训练 30 分钟。经颅磁刺激初级运动皮层腿部区域，在前胫骨肌 (TA) 中引发运动诱发电位。在等长背屈时，在频域（相干性）计算 TA 运动单位群体之间的耦合。接受安慰剂的受试者在运动表现上有统计学上显著的改善（q = 34.1，P = 0.014），同时肌肉内相干性有统计学上显著降低。相反，接受巴氯芬和地西泮的受试者在运动表现上没有进展（P > 0.05），并且训练没有伴随肌肉内相干性的降低。在安慰剂组中，TA 运动诱发电位的阈值在训练后显著降低，而在治疗组中则没有这种情况。这些数据表明，地西泮和巴氯芬通过干扰参与运动表现改善的一些神经可塑性变化，干扰运动技能的获得。这表明在接受物理治疗的同时接受抗痉挛治疗时应谨慎使用。
