神经肌肉电刺激后短潜伏期传入抑制的丧失和传入易化的出现。

Loss of short-latency afferent inhibition and emergence of afferent facilitation following neuromuscular electrical stimulation.

机构信息

Brain Behaviour Laboratory, Faculty of Medicine, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Neurosci Lett. 2012 Oct 31;529(1):80-5. doi: 10.1016/j.neulet.2012.08.072. Epub 2012 Sep 7.

Abstract

Neuromuscular electrical stimulation (NMES) increases the excitability of corticospinal (CS) pathways by altering circuits in motor cortex (M1). How NMES affects circuits interposed between the ascending afferent volley and descending CS pathways is not known. Presently, we hypothesized that short-latency afferent inhibition (SAI) would be reduced and afferent facilitation (AF) enhanced when NMES increased CS excitability. NMES was delivered for 40 min over the ulnar nerve. To assess CS excitability, motor evoked potentials (MEPs) were evoked using transcranial magnetic stimulation (TMS) delivered at 120% resting threshold for first dorsal interosseus muscle. These MEPs increased by ∼1.7-fold following NMES, demonstrating enhanced CS excitability. SAI and AF were tested by delivering a "conditioning" electrical stimulus to the ulnar nerve 18-25 ms and 28-35 ms before a "test" TMS pulse, respectively. Conditioned MEPs were compared to unconditioned MEPs evoked in the same trials. TMS was adjusted so unconditioned MEPs were not different before and after NMES. At the SAI interval, conditioned MEPs were 25% smaller than unconditioned MEPs before NMES but conditioned and unconditioned MEPs were not different following NMES. At the AF interval, conditioned MEPs were not different from unconditioned MEPs before NMES, but were facilitated by 33% following NMES. Thus, when NMES increases CS excitability there are concurrent changes in the effect of afferent input on M1 excitability, resulting in a net increase in the excitatory effect of the ascending afferent volley on CS circuits. Maximising this excitatory effect on M1 circuits may help strengthen CS pathways and improve functional outcomes of NMES-based rehabilitation programs.

摘要

神经肌肉电刺激(NMES)通过改变运动皮层(M1)中的回路来增加皮质脊髓(CS)通路的兴奋性。NMES 如何影响上行传入冲动和下行 CS 通路之间的回路尚不清楚。目前,我们假设当 NMES 增加 CS 兴奋性时,短潜伏期传入抑制(SAI)将减少,传入易化(AF)将增强。NMES 通过对尺神经进行 40 分钟的刺激来传递。为了评估 CS 兴奋性,使用经颅磁刺激(TMS)在第一背侧骨间肌的 120%静息阈值下诱发运动诱发电位(MEP)。NMES 后,MEP 增加了约 1.7 倍,表明 CS 兴奋性增强。通过在“测试”TMS 脉冲前 18-25ms 和 28-35ms 向尺神经发送“条件”电刺激来测试 SAI 和 AF。将条件 MEP 与同一试验中诱发的非条件 MEP 进行比较。调整 TMS 以使 NMES 前后非条件 MEP 没有差异。在 SAI 间隔,NMES 前条件 MEP 比非条件 MEP 小 25%,但 NMES 后条件和非条件 MEP 没有差异。在 AF 间隔,NMES 前条件 MEP 与非条件 MEP 没有差异,但 NMES 后条件 MEP 增强了 33%。因此,当 NMES 增加 CS 兴奋性时,传入输入对 M1 兴奋性的影响会同时发生变化,导致上行传入冲动对 CS 回路的兴奋性效应净增加。最大限度地提高 M1 回路的这种兴奋性效应可能有助于增强 CS 通路并改善基于 NMES 的康复计划的功能结果。

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