Khoubesserian P, Telerman-Toppet N, Welraeds D, Coërs C
Rev Neurol (Paris). 1983;139(11):635-42.
Neuromuscular biopsies were obtained in 10 patients with traumatic spinal cord lesions at various levels and in one patient with cerebral lesions due to a long lasting coma. In all cases, there was a rapid onset of both fibers types atrophy, with numerous transitional type III and intermediate fibers. Only the two patients with cervical lesions had an increased terminal innervation ratio suggesting denervation. Our observations do not support the hypothesis of a transneuronal degeneration. These changes cannot be related to disuse only as the atrophy does not preferentially involve type II fibers. The underlying neural mechanism of spasticity in muscle of patients with cortico-spinal lesions could explain the change of the histochemical pattern of the muscle fibers.
对10例不同节段创伤性脊髓损伤患者及1例因长期昏迷导致脑损伤的患者进行了神经肌肉活检。在所有病例中,两种纤维类型均迅速萎缩,出现大量过渡性III型和中间纤维。只有2例颈部损伤患者的终末神经支配率增加,提示失神经支配。我们的观察结果不支持跨神经元变性的假说。这些变化不能仅归因于废用,因为萎缩并非优先累及II型纤维。皮质脊髓损伤患者肌肉痉挛的潜在神经机制可以解释肌纤维组织化学模式的变化。