Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Stroke Vasc Neurol. 2022 Dec;7(6):518-526. doi: 10.1136/svn-2022-001568. Epub 2022 Jun 30.
Previous studies have suggested that impairment occurs in the lower motor neuron (LMN) pathway after stroke, but more research remains to be supported.
In this study, we tested the hypotheses: (1) both motor cortex and peripheral nerve pathways have decreased excitability and structural damage after stroke; (2) parameters of transcranial magnetic stimulation motor evoked potentials (TMS-MEP) can be used as predictors of motor function and stroke prognosis.
We studied five male cynomolgus monkeys with ischaemic stroke. TMS-MEP, cranial MRI, behavioural assessment, neurological scales and pathology were applied.
Elevated resting motor threshold (RMT) (p<0.05), decreased TMS-MEP amplitudes (p<0.05) and negative RMT lateralisation were detected in both the affected motor cortex (AMC) and the paretic side median nerve (PMN) at 2 weeks poststroke. Disturbed structure and loose arrangement of myelin sheaths were observed in the PMN through H&E staining and LFB staining at 12 weeks poststroke. The primate Rankin Scale (used for assess the stroke prognosis) scores at 2-12 weeks after middle cerebral artery occlusion were [1, (1; 3)], [1, (1;2)], [1, (1; 1.5)] and [1, (1; 1.5)], respectively. The RMT and RMT lateralisation (AMC) were predictors of stroke prognosis, and the RMT lateralisation of PMN and latency of AMC were predictors of motor impairment.
Both upper motor neuron (UMN) and LMN pathway excitability is reduced after stroke, and structural damage in median nerve 12 weeks after stroke occur. In addition, RMT and RMT lateralisation are predictors of stroke prognosis and motor impairment.
先前的研究表明，中风后会出现下运动神经元（LMN）通路的损伤，但仍需要更多的研究来支持。
在本研究中，我们检验了以下假设：（1）中风后运动皮层和周围神经通路的兴奋性和结构损伤均降低；（2）经颅磁刺激运动诱发电位（TMS-MEP）的参数可用作运动功能和中风预后的预测指标。
我们研究了 5 只患有缺血性中风的雄性食蟹猴。应用 TMS-MEP、颅 MRI、行为评估、神经学量表和病理学。
中风后 2 周，受影响的运动皮层（AMC）和麻痹侧正中神经（PMN）的静息运动阈值（RMT）升高（p<0.05），TMS-MEP 幅度降低（p<0.05），RMT 侧化呈阴性。中风后 12 周，PMN 通过 H&E 染色和 LFB 染色观察到结构紊乱和髓鞘疏松排列。大脑中动脉闭塞后 2-12 周灵长类动物 Rankin 量表（用于评估中风预后）评分分别为[1，（1；3）]、[1，（1；2）]、[1，（1；1.5）]和[1，（1；1.5）]。RMT 和 RMT 侧化（AMC）是中风预后的预测指标，PMN 的 RMT 侧化和 AMC 的潜伏期是运动障碍的预测指标。
中风后 UMN 和 LMN 通路的兴奋性均降低，中风后 12 周正中神经出现结构损伤。此外，RMT 和 RMT 侧化是中风预后和运动障碍的预测指标。
