肌萎缩侧索硬化症中上下运动神经元变性的相互作用。
Interplay of upper and lower motor neuron degeneration in amyotrophic lateral sclerosis.
作者信息
de Carvalho Mamede, Poliakov Artiom, Tavares Cristiano, Swash Michael
机构信息
Instituto de Medicina Molecular and Institute of Physiology, Faculty of Medicine, University of Lisbon, Portugal.
Instituto de Medicina Molecular and Institute of Physiology, Faculty of Medicine, University of Lisbon, Portugal.
出版信息
Clin Neurophysiol. 2017 Nov;128(11):2200-2204. doi: 10.1016/j.clinph.2017.08.024. Epub 2017 Sep 19.
OBJECTIVE
We studied motor unit recruitment to test a new method to identify motor unit firing rate (FR) variability.
METHODS
We studied 68 ALS patients, with and without upper neuron signs (UMN) in lower limbs, 24 patients with primary lateral sclerosis (PLS), 13 patients with spinal cord lesion and 39 normal subjects. All recordings were made from tibialis anterior muscles of normal strength. Subjects performed a very slight contraction in order to activate 2 motor units in each recording. 5-7 motor unit pairs were recorded in each subject. Mean consecutive differences (MCD) were calculated for each pair of potentials. The mean MCD for each muscle was estimated as the mean from the total number of pairs recorded. Ap value<0.01 was accepted as significant.
RESULTS
MCD of FR frequency was less in the subjects with spinal cord lesion and PLS. In addition, the FR frequency of the 1st motor unit in a pair of units was markedly reduced in PLS, and in subjects with spinal cord lesions.
CONCLUSION
These results support a lower threshold and reduced FR fluctuation in spinal motor neurons of spastic patients.
SIGNIFICANCE
This method can be developed for detection of UMN lesions.
目的
我们研究运动单位募集情况以测试一种识别运动单位放电频率（FR）变异性的新方法。
方法
我们研究了68例肌萎缩侧索硬化症（ALS）患者，其中部分患者下肢有或无上位神经元体征（UMN），24例原发性侧索硬化症（PLS）患者，13例脊髓损伤患者以及39名正常受试者。所有记录均取自肌力正常的胫前肌。受试者进行非常轻微的收缩，以便在每次记录中激活2个运动单位。每位受试者记录5 - 7对运动单位。计算每对电位的平均连续差值（MCD）。每块肌肉的平均MCD通过记录的总对数的平均值来估算。p值<0.01被认为具有显著性。
结果
脊髓损伤患者和PLS患者的FR频率的MCD较低。此外，在PLS患者以及脊髓损伤患者中，一对运动单位中第一个运动单位的FR频率明显降低。
结论
这些结果支持痉挛患者脊髓运动神经元的阈值较低且FR波动减少。
意义
这种方法可用于检测UMN病变。
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