Iwatsuki Katsuyuki, Yoshida Akihito, Shinohara Takaaki, Nakano Tomonori, Uemura Jun-Ichi, Goto Sae, Hirayama Masaaki, Hoshiyama Minoru, Hirata Hitoshi
Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan; Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.
Clin Neurophysiol. 2016 Aug;127(8):2733-2738. doi: 10.1016/j.clinph.2016.05.273. Epub 2016 May 28.
The recovery function of somatosensory evoked magnetic fields (SEFs) was recorded to investigate excitatory and inhibitory balance in the somatosensory cortex of patients with carpal tunnel syndrome.
SEFs were recorded in patients and controls. Recordings were taken following median nerve stimulation with single and double pulses with interstimulus intervals of 10-200ms. The root mean square for the N20m component following the second stimulation was analyzed. SEFs following stimulation of the first and middle digits were also recorded and the location for the equivalent current dipoles was estimated in three-dimensional planes.
Distances on the vertical axis between the equivalent current dipoles for the first and third digits were shorter in patients than in control participants. The root mean square for the N20m recovered earlier in patients compared to controls; this was statistically significant at an interstimulus interval of 10ms. There was no relationship between N20m recovery and the equivalent current dipole location in the primary somatosensory cortex.
Carpal tunnel syndrome was associated with functional disinhibition and destruction of the somatotopic organization in the primary somatosensory cortex.
Disinhibitory changes might induce a maladaptation of the central nervous system relating to pain.
记录体感诱发电磁场（SEFs）的恢复功能，以研究腕管综合征患者体感皮层的兴奋与抑制平衡。
对患者和对照组进行SEFs记录。在正中神经受到单脉冲和双脉冲刺激后进行记录，刺激间隔为10 - 200毫秒。分析第二次刺激后N20m成分的均方根。还记录了刺激第一和中指后的SEFs，并在三维平面上估计等效电流偶极子的位置。
患者中第一和第三指等效电流偶极子在垂直轴上的距离比对照组短。与对照组相比，患者的N20m均方根恢复得更早；在10毫秒的刺激间隔时，这具有统计学意义。N20m恢复与初级体感皮层中等效电流偶极子位置之间没有关系。
腕管综合征与初级体感皮层中功能去抑制和躯体定位组织破坏有关。
去抑制性变化可能会导致中枢神经系统与疼痛相关的适应不良。
