Curt A, Ellaway P H
University of Zurich, University Hospital Balgrist, Zurich, Switzerland.
Handb Clin Neurol. 2012;109:63-75. doi: 10.1016/B978-0-444-52137-8.00004-8.
Preclinical studies for the repair of spinal cord injury (SCI) and potential therapies for accessing the inherent plasticity of the central nervous system (CNS) to promote recovery of function are currently moving into the translational stage. These emerging clinical trials of therapeutic interventions for the repair of SCI require improved assessment techniques and quantitative outcome measures to supplement the American Spinal Injuries Association (ASIA) Impairment Scales. This chapter attempts to identify those electrophysiological techniques that show the most promise for provision of objective and quantitative measures of sensory, motor, and autonomic function in SCI. Reviewed are: (1) somatosensory evoked potentials, including dermatomal somatosensory evoked potentials, and the electrical perceptual threshold as tests of the dorsal (posterior) column pathway; (2) laser evoked potentials and contact heat evoked potentials as tests of the anterior spinothalamic tract; (3) motor evoked potentials in limb muscles, in response to transcranial magnetic stimulation of the motor cortex as tests of the corticospinal tract, and the application of the technique to assessment of trunk and sphincter muscles; and (4) the sympathetic skin response as a test of spinal cord access to the sympathetic chain.
脊髓损伤(SCI)修复的临床前研究以及利用中枢神经系统(CNS)固有可塑性促进功能恢复的潜在疗法目前正进入转化阶段。这些针对SCI修复的治疗性干预措施的新兴临床试验需要改进评估技术和定量结果指标,以补充美国脊髓损伤协会(ASIA)损伤量表。本章试图确定那些在提供SCI中感觉、运动和自主神经功能的客观和定量测量方面最有前景的电生理技术。综述内容包括:(1)躯体感觉诱发电位,包括皮节躯体感觉诱发电位以及作为背(后)柱通路测试的电感知阈值;(2)激光诱发电位和接触热诱发电位作为脊髓丘脑前束的测试;(3)肢体肌肉中的运动诱发电位,作为皮质脊髓束测试,用于响应运动皮层的经颅磁刺激,以及该技术在躯干和括约肌肌肉评估中的应用;(4)交感皮肤反应作为脊髓与交感链连接的测试。