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脊髓损伤患者的振动反射效应。

Reflex effects of vibration in patients with spinal cord lesions.

作者信息

Dimitrijevic M R, Spencer W A, Trontelj J V, Dimitrijevic M

出版信息

Neurology. 1977 Nov;27(11):1078-86. doi: 10.1212/wnl.27.11.1078.

Abstract

The vibration reflex was studied in 49 patients with traumatic spinal cord lesions. It was elicited in all patients, even after presumably complete division of the cord. The vibration relfex consisted of a short-latency, brief outburst of phasic activity of motor units, followed by rapidly decreasing phasic component and a later slowly declining tonic component. When periods of vibration were repeated at short intervals of 2 to 10 seconds, the responses showed an approximately exponential decline, although the beginning of each subsequent response was always larger than the end of the preceding response. A large part of this decline can be characterized as a habituation of the vibration reflex. In comparison with the vibration reflex in normal subjects, the phasic component was increased and the tonic one reduced. The tonic component was especially susceptible to potentiation and dishabituation by voluntary effort to contract the vibrated muscle, even in some patients with no other evidence that the lesion was incomplete. We suggest that the tonic component of the human vibration reflex depends, at least in part, on segmental interneurons and their descending spinal pathways, while the phasic component depends mainly on the excitability level of spinal motoneurons.

摘要

对49例创伤性脊髓损伤患者的振动反射进行了研究。所有患者均能引出该反射,即使在脊髓可能已完全离断之后。振动反射由运动单位的短潜伏期、短暂的相位性活动爆发组成,随后是相位成分迅速下降,以及后期缓慢下降的紧张性成分。当以2至10秒的短间隔重复振动时,反应呈近似指数下降,尽管每个后续反应的开始总是大于前一个反应的结束。这种下降的很大一部分可被描述为振动反射的习惯化。与正常受试者的振动反射相比,相位成分增加,紧张性成分减少。即使在一些没有其他证据表明损伤不完全的患者中,紧张性成分也特别容易因有意识地努力收缩振动的肌肉而增强和去习惯化。我们认为,人类振动反射的紧张性成分至少部分取决于节段性中间神经元及其下行脊髓通路,而相位成分主要取决于脊髓运动神经元的兴奋性水平。

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