肌萎缩侧索硬化症中的激光和体感诱发电位
Laser and somatosensory evoked potentials in amyotrophic lateral sclerosis.
作者信息
Isak Baris, Tankisi Hatice, Johnsen Birger, Pugdahl Kirsten, Finnerup Nanna Brix, Fuglsang-Frederiksen Anders
机构信息
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Clin Neurophysiol. 2016 Oct;127(10):3322-8. doi: 10.1016/j.clinph.2016.08.008. Epub 2016 Aug 16.
OBJECTIVE
Mild involvement of sensory nerves has been reported in previous studies in ALS patients. In this study, we assessed sensory pathways in ALS patients using laser evoked potentials (LEPs) and somatosensory evoked potentials (SSEPs).
METHODS
We recruited 18 ALS patients and 31 healthy subjects. Neodymium-doped yttrium aluminium perovskite (Nd:YAP)-laser was used to evoke LEPs in upper (UE) and lower (LE) extremities. N1 and N2P2 potentials were obtained from contralateral insular cortex (T3 or T4) and vertex (Cz), respectively. Median SSEPs were recorded from C3' or C4' and tibial SSEPs from Cz'.
RESULTS
Compared to controls, ALS patients had longer N2 and P2 latencies, and smaller N2P2 amplitudes in both UE- and LE-LEPs (p<0.05), and longer latencies for median and tibial SSEPs (p<0.05). LEPs and SSEPs were abnormal in 72.2% and 56.6% patients, respectively.
CONCLUSIONS
Cortical potentials showed that A-beta or A-delta sensory fibres, or both, were impaired in more than half of the ALS patients.
SIGNIFICANCE
The findings support that ALS is a multi-systemic disorder involving, although to a lesser degree, other systems than the motor.
目的
先前的研究报道肌萎缩侧索硬化症(ALS)患者存在感觉神经轻度受累情况。在本研究中,我们使用激光诱发电位(LEP)和体感诱发电位(SSEP)评估ALS患者的感觉通路。
方法
我们招募了18例ALS患者和31名健康受试者。使用掺钕钇铝石榴石(Nd:YAP)激光在上肢(UE)和下肢(LE)诱发LEP。分别从对侧岛叶皮质(T3或T4)和头顶(Cz)获得N1和N2P2电位。从中线C3′或C4′记录正中神经SSEP,从头顶Cz′记录胫神经SSEP。
结果
与对照组相比,ALS患者在UE-LEP和LE-LEP中N2和P2潜伏期更长,N2P2波幅更小(p<0.05),正中神经和胫神经SSEP潜伏期更长(p<0.05)。分别有72.2%和56.6%的患者LEP和SSEP异常。
结论
皮质电位显示,超过半数的ALS患者中A-β或A-δ感觉纤维或两者均受损。
意义
这些发现支持ALS是一种多系统疾病,尽管程度较轻,但除运动系统外还累及其他系统。