Mazzocchio R, Rossi A
Istituto di Scienze Neurologiche, Università di Siena.
Ital J Neurol Sci. 1989 Jun;10(3):337-47. doi: 10.1007/BF02333781.
The study was performed on a group of 17 patients with spastic paraparesis: 12 with hereditary spastic paraparesis, 3 with cord compression and 2 with complete spinal transection. 10 healthy volunteers acted as controls. Recurrent inhibition of the soleus alpha-motoneurones was estimated at rest and during voluntary contraction of triceps surae. At rest, there was evidence for a substantial decrease in the excitability of Renshaw cells in 9 out of the 12 patients with hereditary spastic paraparesis; this was also observed in the 2 patients with complete spinal transection, while the 3 patients with cord compression exhibited a normal Renshaw cell activity. In 3 out of 4 patients with hereditary spastic paraparesis, the changes in Renshaw cell excitability expected to occur during voluntary contraction were not found, whereas in one patient with hereditary spastic paraparesis and one with spastic paraparesis due to cord compression recurrent inhibition was normally influenced by the motor command. Our results indicate that recurrent inhibition is likely to be differently affected according to the type and/or localization of the lesion. It is also suggested that the central nervous system might control the excitability of Renshaw cells at rest and during voluntary contraction via partly separate pathways. The role of recurrent inhibition in spasticity is discussed.
该研究对一组17例痉挛性截瘫患者进行：12例为遗传性痉挛性截瘫，3例为脊髓受压，2例为完全性脊髓横断。10名健康志愿者作为对照。在比目鱼肌α运动神经元静息时和小腿三头肌随意收缩时评估其反复抑制作用。静息时，12例遗传性痉挛性截瘫患者中有9例显示Renshaw细胞兴奋性显著降低；2例完全性脊髓横断患者也观察到这种情况，而3例脊髓受压患者的Renshaw细胞活动正常。4例遗传性痉挛性截瘫患者中有3例未发现随意收缩时预期的Renshaw细胞兴奋性变化，而1例遗传性痉挛性截瘫患者和1例因脊髓受压导致痉挛性截瘫的患者，其反复抑制作用受到运动指令的正常影响。我们的结果表明，反复抑制可能因病变类型和/或部位的不同而受到不同影响。还提示中枢神经系统可能通过部分独立的途径在静息时和随意收缩时控制Renshaw细胞的兴奋性。文中讨论了反复抑制在痉挛中的作用。
