中风幸存者上肢肌肉共同收缩变化与皮质脊髓束损伤的相关性:来自肌电图和运动诱发电位的初步证据
Upper Limbs Muscle Co-contraction Changes Correlated With the Impairment of the Corticospinal Tract in Stroke Survivors: Preliminary Evidence From Electromyography and Motor-Evoked Potential.
作者信息
Sheng Wenfei, Li Shijue, Zhao Jiangli, Wang Yujia, Luo Zichong, Lo Wai Leung Ambrose, Ding Minghui, Wang Chuhuai, Li Le
机构信息
Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Faculty of Science and Technology, University of Macau, Taipa, Macao SAR, China.
出版信息
Front Neurosci. 2022 Jun 1;16:886909. doi: 10.3389/fnins.2022.886909. eCollection 2022.
OBJECTIVE
Increased muscle co-contraction of the agonist and antagonist muscles during voluntary movement is commonly observed in the upper limbs of stroke survivors. Much remain to be understood about the underlying mechanism. The aim of the study is to investigate the correlation between increased muscle co-contraction and the function of the corticospinal tract (CST).
METHODS
Nine stroke survivors and nine age-matched healthy individuals were recruited. All the participants were instructed to perform isometric maximal voluntary contraction (MVC) and horizontal task which consist of sponge grasp, horizontal transportation, and sponge release. We recorded electromyography (EMG) activities from four muscle groups during the MVC test and horizontal task in the upper limbs of stroke survivors. The muscle groups consist of extensor digitorum (ED), flexor digitorum (FD), triceps brachii (TRI), and biceps brachii (BIC). The root mean square (RMS) of EMG was applied to assess the muscle activation during horizontal task. We adopted a co-contraction index (CI) to evaluate the degree of muscle co-contraction. CST function was evaluated by the motor-evoked potential (MEP) parameters, including resting motor threshold, amplitude, latency, and central motor conduction time. We employed correlation analysis to probe the association between CI and MEP parameters.
RESULTS
The RMS, CI, and MEP parameters on the affected side showed significant difference compared with the unaffected side of stroke survivors and the healthy group. The result of correlation analysis showed that CI was significantly correlated with MEP parameters in stroke survivors.
CONCLUSION
There existed increased muscle co-contraction and impairment in CST functionality on the affected side of stroke survivors. The increased muscle co-contraction was correlated with the impairment of the CST. Intervention that could improve the excitability of the CST may contribute to the recovery of muscle discoordination in the upper limbs of stroke survivors.
目的
在中风幸存者的上肢中,通常会观察到在自主运动期间主动肌和拮抗肌的肌肉共同收缩增加。关于其潜在机制仍有许多有待了解之处。本研究的目的是调查肌肉共同收缩增加与皮质脊髓束(CST)功能之间的相关性。
方法
招募了9名中风幸存者和9名年龄匹配的健康个体。所有参与者均被指示进行等长最大自主收缩(MVC)以及包括海绵抓握、水平运输和海绵释放的水平任务。我们在中风幸存者上肢的MVC测试和水平任务期间记录了四个肌肉群的肌电图(EMG)活动。这些肌肉群包括指伸肌(ED)、指屈肌(FD)、肱三头肌(TRI)和肱二头肌(BIC)。应用EMG的均方根(RMS)来评估水平任务期间的肌肉激活情况。我们采用共同收缩指数(CI)来评估肌肉共同收缩的程度。通过运动诱发电位(MEP)参数评估CST功能,包括静息运动阈值、波幅、潜伏期和中枢运动传导时间。我们采用相关性分析来探究CI与MEP参数之间的关联。
结果
中风幸存者患侧的RMS、CI和MEP参数与未受影响侧以及健康组相比存在显著差异。相关性分析结果表明,中风幸存者中CI与MEP参数显著相关。
结论
中风幸存者患侧存在肌肉共同收缩增加以及CST功能受损。肌肉共同收缩增加与CST受损相关。能够改善CST兴奋性的干预措施可能有助于中风幸存者上肢肌肉不协调的恢复。
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