Thompson P D, Day B L, Rothwell J C, Dick J P, Cowan J M, Asselman P, Griffin G B, Sheehy M P, Marsden C D
J Neurol Sci. 1987 Aug;80(1):91-110. doi: 10.1016/0022-510x(87)90224-3.
The complexities of interpreting results of electrical stimulation of the motor cortex in pathological states are discussed and illustrated by reference to results from a variety of patients with diseases affecting the upper motor neurone (multiple sclerosis, cervical spondylosis and myelopathy, motor neurone disease, hemiparesis due to cerebral infarction, and hereditary spastic paraplegia). The abnormalities of the electromyographic (EMG) responses after anodal cortical stimulation consisted of delay in the latency to onset, dispersion or reduction in response size or even absence of EMG responses. These changes were not confined to any specific condition or pathology. Previous work has suggested that the sequence of events that follow anodal cortical stimulation involves repetitive excitatory inputs to spinal motoneurones and transmission across at least one central synapse. Accordingly, delayed latencies may not exclusively indicate slowing of motor conduction, while the absence of any response may not indicate complete failure of conduction in corticomotoneurone pathways.
本文讨论了在病理状态下解释运动皮质电刺激结果的复杂性，并通过参考各种影响上运动神经元疾病（多发性硬化症、颈椎病和脊髓病、运动神经元病、脑梗死所致偏瘫以及遗传性痉挛性截瘫）患者的结果进行说明。阳极皮质刺激后肌电图（EMG）反应的异常包括起始潜伏期延迟、反应大小离散或减小，甚至无EMG反应。这些变化并不局限于任何特定情况或病理状态。先前的研究表明，阳极皮质刺激后发生的一系列事件涉及对脊髓运动神经元的重复兴奋性输入以及至少一个中枢突触的传递。因此，潜伏期延迟可能并不完全表明运动传导减慢，而无任何反应可能并不表明皮质运动神经元通路传导完全失败。
