Udupa Kaviraja, Chen Robert
Division of Neurology, Department of Medicine, University of Toronto and Division of Brain Imaging & Behaviour Systems - Neuroscience, Toronto Western Research Institute, Toronto, Canada.
Handb Clin Neurol. 2013;116:375-86. doi: 10.1016/B978-0-444-53497-2.00031-0.
Central motor conduction time (CMCT) is the time taken for neural impulses to travel through the central nervous system on their way to the target muscles. When the motor cortex is stimulated with transcranial magnetic stimulation (TMS), CMCT is calculated by subtracting the peripheral conduction time from the motor evoked potential latency elicited by motor cortical TMS. CMCT in infants and children reaches adult level at about age of 6 years for the lower limbs. The alterations of CMCT in various neurological conditions are reviewed in this chapter. Prolongation of CMCT occurs due to slowing of conduction through rapidly conducting corticospinal fibers, as seen in various disorders such as demyelinating diseases (multiple sclerosis, MS), amyotrophic lateral sclerosis, structural lesions in the corticospinal tract such as stroke and compressive myelopathy, and neurodegenerative disorders including multiple system atrophy and progressive supranuclear palsy. As CMCT is prolonged in certain clinical conditions, it is of diagnostic value in some neurological disorders such as myelopathy, amyotrophic lateral sclerosis, and MS when used together with other clinical and electrophysiological measures. It could also be used as a prognostic marker in some of neurological conditions, such as myelopathy and MS.
中枢运动传导时间(CMCT)是神经冲动在到达目标肌肉途中通过中枢神经系统所需的时间。当用经颅磁刺激(TMS)刺激运动皮层时,CMCT通过从运动皮层TMS诱发的运动诱发电位潜伏期减去外周传导时间来计算。婴幼儿和儿童下肢的CMCT在约6岁时达到成人水平。本章将综述CMCT在各种神经系统疾病中的变化。CMCT延长是由于快速传导的皮质脊髓纤维传导减慢所致,见于多种疾病,如脱髓鞘疾病(多发性硬化症,MS)、肌萎缩侧索硬化症、皮质脊髓束的结构性病变如中风和压迫性脊髓病,以及神经退行性疾病,包括多系统萎缩和进行性核上性麻痹。由于CMCT在某些临床情况下会延长,因此当与其他临床和电生理指标一起使用时,它在某些神经系统疾病如脊髓病、肌萎缩侧索硬化症和MS中具有诊断价值。它也可作为某些神经系统疾病如脊髓病和MS的预后指标。