Paquet Aude, Olliac Bertrand, Golse Bernard, Vaivre-Douret Laurence
Faculty of medicine, university of Paris Descartes, Paris, France; Inserm 1018, CESP, university Paris-Sud, UVSQ, university of Paris-Saclay, Paris, France; Department of child and adolescent psychiatry, Esquirol hospital, Limoges, France; Research and neurostimulation unit, research federation for psychiatry and innovation at Limousin, Esquirol hospital, Limoges, France.
Department of child and adolescent psychiatry, Esquirol hospital, Limoges, France; UMR 1094, university of Limoges, Limoges, France.
Neurophysiol Clin. 2017 Sep;47(4):261-268. doi: 10.1016/j.neucli.2017.07.001. Epub 2017 Aug 4.
Motor disorders are known in autism spectrum disorder (ASD), but muscle tone assessments are rarely performed. Muscle tone underpins movement. We investigated muscle tone in 34 ASD children using a standardized neuro-developmental battery, which uses the French norms for muscular tone in children.
Dangling and extensibility were used to examine passive muscle tone in the upper and lower limbs and the body axis. A comparison between muscles of the right and left sides enabled the determination of tonic laterality.
We found a disharmonious tonic typology, with a tonic component for the muscles of the trunk and the proximal muscles of the lower limbs and a laxity component for the ankles and the proximal and distal muscles of the upper limbs (wrists and shoulders). No establishment of tonic laterality was found in the upper limbs in 61% of ASD children (P<0.001).
The disturbed tonic organization influenced by subcortical structures, such as the cerebellum, may partially explain the motor disorders, and indefinite tonic laterality may also be linked to low hemispheric brain dominance described in autism. This preliminary examination is necessary before any gross motor assessments to understand the nature of movement disorders, explore typologies and highlight possible soft neuro-motor signs.
运动障碍在自闭症谱系障碍（ASD）中较为常见，但很少进行肌张力评估。肌张力是运动的基础。我们使用标准化神经发育测试组合对34名ASD儿童的肌张力进行了研究，该测试组合采用了法国儿童肌张力标准。
通过悬空和伸展性来检查上肢、下肢及身体轴的被动肌张力。比较左右两侧肌肉可确定紧张性偏侧化。
我们发现了一种不协调的紧张性类型，躯干肌肉和下肢近端肌肉存在紧张性成分，而脚踝以及上肢近端和远端肌肉（手腕和肩部）存在松弛成分。61%的ASD儿童上肢未出现紧张性偏侧化（P<0.001）。
受小脑等皮质下结构影响的紧张性组织紊乱可能部分解释了运动障碍，而不确定的紧张性偏侧化也可能与自闭症中描述的低半球脑优势有关。在进行任何粗大运动评估之前，进行这项初步检查对于了解运动障碍的性质、探索类型并突出可能的软神经运动体征是必要的。
