Dietz V, Quintern J, Berger W
Exp Brain Res. 1985;61(1):153-63. doi: 10.1007/BF00235630.
The cerebral potentials (c.p.) evoked by electrical stimulation of the tibial nerve during stance and in the various phases of gait of normal subjects were compared with the c.p. and leg muscle e.m.g. responses evoked by perturbations of stance and gait. Over the whole step cycle of gait the c.p. evoked by an electrical stimulus were of smaller amplitude (3 microV and 9 microV, respectively) than that seen in the stance condition, and appeared with a longer latency (mean times to first positive peak: 63 and 43 ms, respectively). When the electrical stimulus was applied during stance after ischaemic blockade of group I afferents, the c.p. were similar to those evoked during gait. The c.p. evoked by perturbations were larger in amplitude than those produced by the electrical stimulus, but similar in latencies in both gait and stance (mean 26 microV and 40 microV; 65 ms and 42 ms, respectively) and configurations. The large gastrocnemius e.m.g. responses evoked by the stance and gait perturbations arose with a latency of 65 to 70 ms. Only in the stance condition was a smaller, shorter latency (40 ms) response seen. It is concluded that during gait the signals of group I afferents are blocked at both segmental and supraspinal levels which was tested by tibial nerve stimulation. It is suggested that the e.m.g. responses induced in the leg by gait perturbations are evoked by group II afferents and mediated via a spinal pathway. The c.p. evoked during gait most probably reflect the processing of this group II input by supraspinal motor centres for the coordination of widespread arm and trunk muscle activation, necessary to restablish body equilibrium.
将正常受试者在站立期和步态各阶段经电刺激胫神经诱发的大脑电位(c.p.),与因站立和步态扰动诱发的c.p.及腿部肌肉肌电图(e.m.g.)反应进行了比较。在整个步态周期中,电刺激诱发的c.p.振幅较小(分别为3微伏和9微伏),低于站立状态下所见,且潜伏期较长(首次出现正峰的平均时间分别为63毫秒和43毫秒)。当在I组传入神经缺血性阻断后站立期施加电刺激时,c.p.与步态期诱发的相似。扰动诱发的c.p.振幅大于电刺激产生的,但在步态和站立期的潜伏期(分别平均为26微伏和40微伏;65毫秒和42毫秒)及波形相似。站立和步态扰动诱发的腓肠肌肌电图大反应潜伏期为65至70毫秒。仅在站立状态下可见较小、潜伏期较短(40毫秒)的反应。结论是,在步态期间,经胫神经刺激测试发现,I组传入神经的信号在节段和脊髓上水平均被阻断。提示步态扰动在腿部诱发的肌电图反应由II组传入神经诱发,并通过脊髓通路介导。步态期间诱发的c.p.很可能反映了脊髓上运动中枢对该II组输入的处理,以协调广泛的手臂和躯干肌肉激活,这对于重新建立身体平衡是必要的。