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正常人和双侧前庭功能减退患者摇摆稳定反应中的姿势共同激活与适应

Postural coactivation and adaptation in the sway stabilizing responses of normals and patients with bilateral vestibular deficit.

作者信息

Keshner E A, Allum J H, Pfaltz C R

机构信息

Department of Otorhinolaryngology, University Hospital, Basel, Switzerland.

出版信息

Exp Brain Res. 1987;69(1):77-92. doi: 10.1007/BF00247031.

Abstract

The experiments were designed to test two hypotheses and their corollaries: 1. That adaptation of EMG responses to support surface rotations is due to a decrease in the gain of proprioceptively triggered long-loop stretch reflexes (Nashner 1976), and that the adaptation is dependent on a normally functioning vestibular system (Nashner et al. 1982); 2. That EMG responses to rotations are generated primarily by vestibulo-spinal reflexes triggered by head accelerations (Allum and Pfaltz 1985) and comprise a coactivation of opposing leg muscles (Allum and Büdingen 1979). Adaptation with successive dorsi-flexive rotations of the support surface was investigated in the EMG responses of the ankle muscles, soleus (SOL) and tibialis anterior (TA), as well as the neck muscles, trapezius (TRAP) and splenius capitis (SPLEN CAP), both for normal subjects and for patients with bilateral peripheral vestibular deficit. Both normals and patients who first received the stimulus with their eyes open demonstrated decreasing activation at medium latency (ML), that is, with an onset at about 125 ms, and long latency (LL) responses with an onset ca 200 ms. This was the case for both ankle and neck muscles when the EMG response areas for the first 3 and second 7 of 10 trials were compared. Ankle muscle responses in the patients were diminished in area with respect to normals both with the eyes open and with the eyes closed. Ankle torque recordings from the patients were also smaller in amplitude, and these attenuated differently from normal torque responses. Functional coupling of the opposing ML and LL SOL and TA muscle responses was confirmed by the nearly coincident onset times and significantly correlated EMG response areas. At ML, ankle torque was highly correlated with TA activity when the influence of SOL was controlled. At LL, SOL activity was highly correlated with torque when the influence of TA was controlled. The delay of torque adaptation beyond the period of ML activity in normals, but not in the patients was attributed to the proportionally balanced coactivated muscle patterns producing a consistent force output and level of stability in normals. The results indicate that the adaptation in EMG response amplitudes during a sway stabilisation task is not dependent on a normally functioning vestibular system nor on visual inputs but rather appears to be due to a generalized habituation in the postural control system.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

这些实验旨在检验两个假设及其推论

  1. 肌电图(EMG)对支撑面旋转的适应性是由于本体感受触发的长环牵张反射增益降低(纳什纳,1976年),且这种适应性依赖于正常运作的前庭系统(纳什纳等人,1982年);2. 对旋转的EMG反应主要由头部加速度触发的前庭脊髓反射产生(阿卢姆和普法尔茨,1985年),并且包括对抗性腿部肌肉的共同激活(阿卢姆和比丁根,1979年)。研究了正常受试者和双侧外周前庭功能减退患者在支撑面连续背屈旋转时,踝关节肌肉比目鱼肌(SOL)和胫骨前肌(TA)以及颈部肌肉斜方肌(TRAP)和头夹肌(SPLEN CAP)的EMG反应中的适应性。正常人和最初睁眼接受刺激的患者在中等潜伏期(ML)(即约125毫秒开始)和长潜伏期(LL)(约200毫秒开始)的反应中,激活程度均降低。当比较10次试验中前3次和后7次的EMG反应区域时,踝关节和颈部肌肉均是如此。患者的踝关节肌肉反应在睁眼和闭眼时面积均小于正常人。患者的踝关节扭矩记录幅度也较小,并与正常扭矩反应衰减方式不同。通过几乎同时的起始时间和显著相关的EMG反应区域,证实了对抗性ML和LL的SOL和TA肌肉反应的功能耦合。在ML时,当控制SOL的影响时,踝关节扭矩与TA活动高度相关。在LL时,当控制TA的影响时,SOL活动与扭矩高度相关。正常人扭矩适应延迟超过ML活动期,而患者则没有,这归因于正常情况下比例平衡的共同激活肌肉模式产生一致的力输出和稳定水平。结果表明,在摇摆稳定任务期间EMG反应幅度的适应性不依赖于正常运作的前庭系统,也不依赖于视觉输入,而是似乎归因于姿势控制系统中的普遍习惯化。(摘要截断于400字)

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