Shimizu Takahiro, Tsutsumi Ryosuke, Shimizu Kazutaka, Tominaga Naomi, Nagai Makiko, Ugawa Yoshikazu, Nishiyama Kazutoshi, Hanajima Ritsuko
Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan; Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.
J Neurol Sci. 2020 Aug 15;415:116927. doi: 10.1016/j.jns.2020.116927. Epub 2020 May 20.
The cerebellum is known to play a crucial role in sensori-motor adaptation, which includes the prism adaptation. TRH has been widely used as a treatment for cerebellar ataxia in Japan, however effects of TRH on cerebellar adaptation process have not been studied. Here, we studied effects of TRH treatment on the prism adaptation task.
Eighteen spinocerebellar degeneration (SCD) patients participated in this study. The participants received intravenous injection of 2 mg/day protirelin tartrate once a day for 14 days. In the prism adaptation task, the participants reached to the target on the screen wearing wedge prisms. We compared the Scale for Assessment and Rating of Ataxia (SARA), baseline errors and the aftereffect (AE) of the prism adaptation task between before and after TRH therapy.
TRH therapy improved SARA significantly (p = .005). Multiple regression analysis revealed that improvement of SARA score was mainly due to improvement of "Stance" category score. TRH decreased baseline errors of the prism adaptation task (p = .021), while unaffected AEs (p = .252).
TRH differentially affected clinical cerebellar ataxia including baseline reaching performance in the prism adaptation task, whereas TRH did not affect the learning process of prism adaptation. Different cerebellar functional aspects may underlie the learning process of sensori-motor adaptation and simple motor execution (clinically evaluated cerebellar ataxia).
已知小脑在感觉运动适应中起关键作用,其中包括棱镜适应。在日本,促甲状腺激素释放激素(TRH)已被广泛用作治疗小脑共济失调的药物,然而,TRH对小脑适应过程的影响尚未得到研究。在此,我们研究了TRH治疗对棱镜适应任务的影响。
18名脊髓小脑变性(SCD)患者参与了本研究。参与者每天接受一次静脉注射2毫克/天的促甲状腺素,持续14天。在棱镜适应任务中,参与者戴着楔形棱镜触及屏幕上的目标。我们比较了TRH治疗前后的共济失调评估和评分量表(SARA)、棱镜适应任务的基线误差和后效应(AE)。
TRH治疗显著改善了SARA(p = 0.005)。多元回归分析显示,SARA评分的改善主要归因于“姿势”类别评分的改善。TRH降低了棱镜适应任务的基线误差(p = 0.021),而对后效应无影响(p = 0.252)。
TRH对临床小脑共济失调有不同影响,包括棱镜适应任务中的基线触及表现,而TRH不影响棱镜适应的学习过程。感觉运动适应的学习过程和简单运动执行(临床评估的小脑共济失调)可能有不同的小脑功能方面作为基础。