Cioni B, Meglio M, Zamponi A
Istituto di Neurochirugia, Università Cattolica, Roma, Italia.
Stereotact Funct Neurosurg. 1989;52(1):42-52. doi: 10.1159/000099485.
Spinal cord stimulation (SCS) was performed in 11 patients with stabilized spastic hemiparesis due to cerebrovascular ischaemic accident in order to improve their motor performances. The patients were studied before and after 5-7 days of stimulation of the cervical cord according to the following protocol: (1) clinical evaluation based on assessment of the neurological status and on Albert's motor scale and (2) neurophysiological evaluation of reflex voluntary and involuntary motor activity, obtained by means of surface electromyography. Improvement in motor performance following SCS occurred in 7 of the 11 patients. The effect appeared to be particularly evident during specific voluntary movements and gait. Analysis of the electromyography recordings showed that SCS mainly broke down pathological patterns of voluntary movement and reduced agonist-antagonist coactivation and clonus. A relationship between motor outcome and status of the sensory function was noticed as well. We conclude that SCS may play a role in the motor rehabilitation of post-stroke patients with spastic hemiparesis, provided that a careful selection be made before surgery.
对11例因脑血管缺血性意外导致痉挛性偏瘫已稳定的患者进行脊髓刺激（SCS），以改善其运动表现。根据以下方案，在颈髓刺激5 - 7天前后对患者进行研究：（1）基于神经学状态评估和阿尔伯特运动量表的临床评估；（2）通过表面肌电图获得的反射性自主和非自主运动活动的神经生理学评估。11例患者中有7例在SCS后运动表现得到改善。这种效果在特定的自主运动和步态中似乎尤为明显。肌电图记录分析表明，SCS主要打破了自主运动的病理模式，减少了主动肌 - 拮抗肌共同激活和阵挛。还注意到运动结果与感觉功能状态之间的关系。我们得出结论，只要在手术前进行仔细筛选，SCS可能在中风后痉挛性偏瘫患者的运动康复中发挥作用。
