Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France.
Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France; Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France.
Clin Neurophysiol. 2018 Apr;129(4):874-884. doi: 10.1016/j.clinph.2017.12.008. Epub 2017 Dec 24.
Infraclinical sensory alterations have been reported at early stages of amyotrophic lateral sclerosis (ALS). While previous studies mainly focused on early somatosensory evoked potentials (SEPs), late SEPs, which reflect on cortical pathways involved in cognitive-motor functions, are relatively underinvestigated. Early and late SEPs were compared to assess their alterations in ALS.
Median and ulnar nerves were electrically stimulated at the wrist, at 9 times the perceptual threshold, in 21 ALS patients without clinical evidence of sensory deficits, and 21 age- and gender-matched controls. SEPs were recorded at the Erb point using surface electrodes and using a needle inserted in the scalp, in front of the primary somatosensory area (with reference electrode on the ear lobe).
Compared to controls, ALS patients showed comparable peripheral (N9) and early cortical component (N20, P25, N30) reductions, while the late cortical components (N60, P100) were more depressed than the early ones.
The peripheral sensory alteration likely contributed to late SEP depression to a lesser extent than that of early SEPs.
Late SEPs may provide new insights on abnormal cortical excitability affecting brain areas involved in cognitive-motor functions.
在肌萎缩侧索硬化症（ALS）的早期阶段，已经报道了亚临床感觉改变。虽然以前的研究主要集中在早期体感诱发电位（SEPs）上，但反映与认知运动功能相关皮质通路的晚期 SEPs 相对研究较少。比较早期和晚期 SEPs，以评估它们在 ALS 中的改变。
在 21 名无临床感觉缺陷证据的 ALS 患者和 21 名年龄和性别匹配的对照者中，用电刺激腕部正中神经和尺神经，刺激强度为感知阈值的 9 倍。使用表面电极在 Erb 点记录 SEPs，并使用插入头皮前部（参考电极在耳垂上）的针记录 SEPs，在前体感区。
与对照组相比，ALS 患者的外周（N9）和早期皮质成分（N20、P25、N30）减少相似，而晚期皮质成分（N60、P100）较早期皮质成分更为抑制。
与早期 SEP 相比，外周感觉改变可能对晚期 SEP 抑制的贡献较小。
晚期 SEPs 可能为异常皮质兴奋性影响与认知运动功能相关的大脑区域提供新的见解。
