Yang Yi-Chien, Chang Fang-Tzu, Chen Jui-Cheng, Tsai Chon-Haw, Lin Fu-Yu, Lu Ming-Kuei
Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Front Neurol. 2021 Jun 2;12:608322. doi: 10.3389/fneur.2021.608322. eCollection 2021.
Multiple system atrophy (MSA) is a neurodegenerative disorder manifesting as parkinsonism, cerebellar ataxia, and autonomic dysfunction. It is categorized into MSA with predominant parkinsonism (MSA-P) and into MSA with predominant cerebellar ataxia (MSA-C). The pathophysiology of motor control circuitry involvement in MSA subtype is unclear. Bereitschaftspotential (BP) is a feasible clinical tool to measure electroencephalographic activity prior to volitional motions. We recorded BP in patients with MSA-P and MSA-C to investigate their motor cortical preparation and activation for volitional movement. We included eight patients with MSA-P, eight patients with MSA-C, and eight age-matched healthy controls. BP was recorded during self-paced rapid wrist extension movements. The electroencephalographic epochs were time-locked to the electromyography onset of the voluntary wrist movements. The three groups were compared with respect to the mean amplitudes of early (1,500-500 ms before movement onset) and late (500-0 ms before movement onset) BP. Mean early BP amplitude was non-significantly different between the three groups. Mean late BP amplitude in the two patient groups was significantly reduced in the parietal area contralateral to the movement side compared with that in the healthy control group. In addition, the late BP of the MSA-C group but not the MSA-P group was significantly reduced at the central parietal area compared with that of the healthy control group. Our findings suggest that patients with MSA exhibit motor cortical dysfunction in voluntary movement preparation and activation. The dysfunction can be practicably evaluated using late BP, which represents the cerebello-dentato-thalamo-cortical pathway.
多系统萎缩（MSA）是一种神经退行性疾病，表现为帕金森综合征、小脑共济失调和自主神经功能障碍。它可分为以帕金森综合征为主的多系统萎缩（MSA-P）和以小脑共济失调为主的多系统萎缩（MSA-C）。MSA亚型中运动控制电路受累的病理生理学尚不清楚。运动准备电位（BP）是一种可行的临床工具，用于测量自主运动前的脑电图活动。我们记录了MSA-P和MSA-C患者的BP，以研究他们在自主运动中的运动皮层准备和激活情况。我们纳入了8例MSA-P患者、8例MSA-C患者和8例年龄匹配的健康对照者。在自定节奏的快速腕部伸展运动过程中记录BP。脑电图片段与自主腕部运动的肌电图起始时间锁定。比较三组在运动起始前早期（1500-500毫秒）和晚期（500-0毫秒）BP的平均振幅。三组之间早期BP平均振幅无显著差异。与健康对照组相比，两个患者组运动侧对侧顶叶区域的晚期BP平均振幅显著降低。此外，与健康对照组相比，MSA-C组而非MSA-P组在中央顶叶区域的晚期BP显著降低。我们的研究结果表明，MSA患者在自主运动准备和激活过程中存在运动皮层功能障碍。这种功能障碍可以通过代表小脑-齿状核-丘脑-皮质通路的晚期BP进行实际评估。
