内收型痉挛性发声障碍患者皮质静息期缩短:广泛皮质兴奋性的证据
Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.
作者信息
Samargia Sharyl, Schmidt Rebekah, Kimberley Teresa Jacobson
机构信息
University of Minnesota Program of Rehabilitation Science, MMC 388 420, Delaware Street SE, Minneapolis, MN 55455, United States; University of Wisconsin River Falls Department of Communicative Disorders, 410 South Third Street River Falls, WI 54022, United States.
University of Minnesota Program of Rehabilitation Science, MMC 388 420, Delaware Street SE, Minneapolis, MN 55455, United States.
出版信息
Neurosci Lett. 2014 Feb 7;560:12-5. doi: 10.1016/j.neulet.2013.12.007. Epub 2013 Dec 12.
The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias.
本研究的目的是比较局灶性手部肌张力障碍(FHD)患者、内收肌痉挛性发音障碍(AdSD)患者和健康对照者在初级运动皮层手部区域的皮质抑制情况。分析了28名受试者的数据(FHD组n = 11,年龄53.25±8.74岁;AdSD组:n = 8,年龄56.38±7.5岁;健康对照组:n = 9,年龄41.67±10.85岁)。所有受试者均接受对左侧运动皮层的单脉冲经颅磁刺激(TMS),以测量右侧第一背侧骨间肌(FDI)的皮质静息期(CSP)。测量并比较了各组的CSP持续时间。以年龄作为协变量的单因素协方差分析显示出显著的组间效应(p<0.001)。事后分析显示,健康组的CSP持续时间显著长于AdSD组(p<0.001)和FHD组(p<0.001)。这些结果表明,皮质内抑制受损是FHD和AdSD的神经生理学特征。此外,AdSD中缩短的CSP为运动皮层中代表身体无症状区域的皮质抑制广泛降低提供了证据支持。这些发现可能为局灶性肌张力障碍的鉴别诊断及替代治疗的未来研究提供参考。