Meyer B U, Zipper S, Conrad B, Benecke R
Abteilung für klinische Neurophysiologie der Universität Göttingen.
EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1988 Dec;19(4):241-6.
The application of transcranial brain stimulation widens the range of neurophysiological tools available for the diagnostic evaluation of impaired function in central conduction pathways. A standardized examination of 25 patients with multiple sclerosis (diagnoses of different certainties using the classification by Bauer) was performed with electrical brain stimulation and EMG recordings from 3 muscles in each of the upper and lower extremities (Fig. 2). The occurrence and the change (amplitude, latency) of abnormal cortically evoked muscle responses correlated with the distribution and the severity of the clinical motor deficits respectively (Fig. 1 to 4 and Tab. 1). Furthermore, in some cases, abnormal responses were found in clinically unaffected limbs. Non-invasive stimulation of the motor cortex may reveal lesions affecting the function of the fast conducting component of the corticospinal tract even when there is no pathological clinical finding. In patients suspected of having multiple sclerosis the use of this technique may allow greater diagnostic certainty or even an early diagnosis.
经颅脑刺激的应用拓宽了可用于诊断评估中枢传导通路功能受损的神经生理学工具范围。对25例多发性硬化症患者（按照鲍尔分类法作出不同确定性的诊断）进行了标准化检查，采用脑电刺激以及对上下肢各3块肌肉进行肌电图记录（图2）。异常皮层诱发电位肌肉反应的出现及变化（波幅、潜伏期）分别与临床运动功能缺损的分布及严重程度相关（图1至4及表1）。此外，在某些情况下，在临床未受累的肢体中也发现了异常反应。即使没有临床病理表现，对运动皮层进行非侵入性刺激也可能揭示影响皮质脊髓束快速传导成分功能的病变。对于疑似患有多发性硬化症的患者，使用该技术可能会提高诊断的确定性，甚至实现早期诊断。
