Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
Neurol Sci. 2019 Jan;40(1):181-186. doi: 10.1007/s10072-018-3614-9. Epub 2018 Oct 24.
The aim of this study was to examine and characterize the reversibility of the cervical somatosensory electrophysiological pathways during neutral and flexed neck positions. The parameters of somatosensory evoked potentials (SEPs) during neutral and flexed neck positions (N9, N13, and N20 SEP latencies; N9-N13 and N13-N20 inter-peak latencies; and the changes in N9-N13 and N13-N20 inter-peak latency during neutral and flexed neck positions) were measured in the patients with Hirayama disease (HD) and also in the healthy controls. In patients with HD, there was a significant difference in the mean value of N13-N20 inter-peak latency during the flexed neck position compared to that of the healthy controls (p < 0.05). In a multivariate logistic regression analysis, N13-N20 inter-peak latency during the flexed neck position significantly correlated with the presence of HD (p < 0.05). Collectively, in this cohort of patients with HD, the neck flexion of patients with HD showed a reversible effect on the SEP parameter, especially in N13-N20 inter-peak latency. Conventional diagnosis of HD is based on nerve conduction studies and electromyography along with a cervical flexion MRI, and our study suggests the possibility of an additional and cost-effective electrophysiological marker that may be helpful in the diagnosis of HD.
本研究旨在探讨和描述颈椎体感诱发电位（SEP）在中立位和前屈位时的可恢复性。研究测量了平山病（HD）患者和健康对照组在中立位和前屈位时 SEP 参数（N9、N13 和 N20 潜伏期；N9-N13 和 N13-N20 峰间潜伏期；以及 N9-N13 和 N13-N20 峰间潜伏期在中立位和前屈位时的变化）。与健康对照组相比，HD 患者在前屈位时 N13-N20 峰间潜伏期的平均值存在显著差异（p<0.05）。在多变量逻辑回归分析中，前屈位时的 N13-N20 峰间潜伏期与 HD 的存在显著相关（p<0.05）。综上所述，在本队列的 HD 患者中，HD 患者的颈部前屈对 SEP 参数表现出可恢复的影响，尤其是在 N13-N20 峰间潜伏期。HD 的常规诊断基于神经传导研究、肌电图以及颈椎前屈 MRI，我们的研究提示存在一种额外的、具有成本效益的电生理标志物，这可能有助于 HD 的诊断。
