Dietz V, Berger W, Horstmann G A
Department of Clinical Neurology and Neurophysiology, University of Freiburg, West Germany.
Ann Neurol. 1988 Nov;24(5):660-9. doi: 10.1002/ana.410240511.
The leg muscle electromyographic responses induced during stance by impulsive displacements of a treadmill belt (directed forward or backward and at different rates) were studied in a group of patients with Parkinson's disease and a group of age-matched healthy subjects. Young normal subjects were also studied both before and after intake of a dopamine antagonist (haloperidol). Compensatory gastrocnemius electromyographic responses resulting from backward-directed displacements were significantly smaller in both the patients and the young normal subjects following intake of haloperidol. The reduced sensitivity of the gastrocnemius muscle to stretch correlated with an inability to compensate for the perturbations. In the patients, the gastrocnemius response was followed by enhanced activation of the tibialis anterior muscle. This was not the case in the normal subjects after intake of dopamine antagonist and is probably not, therefore, the consequence of acute dopamine deficiency. In the patients the angular rotation at the ankle joint induced during faster backward-directed displacements was slower than that in normal subjects, despite identical amounts of gastrocnemius electromyographic activity. This supports earlier findings of changes in intrinsic muscle stiffness in Parkinson's disease. None of these differences were seen when the tibialis anterior muscle was stretched. This differential behavior of the antagonist leg muscles can best be explained by the different function fulfilled by these muscles in regulation of stance and gait.
在一组帕金森病患者和一组年龄匹配的健康受试者中，研究了跑步机皮带脉冲式位移（向前或向后且速率不同）在站立期诱发的腿部肌肉肌电图反应。还对年轻正常受试者在服用多巴胺拮抗剂（氟哌啶醇）前后进行了研究。在服用氟哌啶醇后，患者和年轻正常受试者中由向后位移引起的腓肠肌代偿性肌电图反应均显著减小。腓肠肌对拉伸的敏感性降低与无法补偿扰动相关。在患者中，腓肠肌反应后胫骨前肌的激活增强。服用多巴胺拮抗剂后的正常受试者并非如此，因此这可能不是急性多巴胺缺乏的结果。在患者中，尽管腓肠肌肌电图活动量相同，但在更快的向后位移过程中踝关节的角旋转比正常受试者慢。这支持了帕金森病中固有肌肉僵硬度变化的早期发现。当拉伸胫骨前肌时，未观察到这些差异。拮抗腿部肌肉的这种不同行为最好通过这些肌肉在调节站立和步态中所起的不同作用来解释。
