Schalow G, Zäch G A, Warzok R
Department of Clinical Research, Swiss Paraplegic Centre Nottwil.
J Auton Nerv Syst. 1995 Apr 8;52(2-3):125-50. doi: 10.1016/0165-1838(94)00153-b.
(1) Single nerve fibre action potentials (APs) of lower sacral nerve roots were recorded extracellularly with two pairs of wire electrodes during an operation in which an anterior root stimulator for bladder control was implanted in 9 humans with a spinal cord lesion and dyssynergia of the urinary bladder. Roots that were not saved and that were used to record from were later used for morphometry. (2) Nerve fibre groups were identified by conduction velocity distribution histograms of single afferent and efferent fibres and partly by nerve fibre diameter distribution histograms, and correlation analysis was performed. Group conduction velocity values were obtained additionally from compound action potentials (CAPs) evoked by electrical stimulation of nerve roots and the urinary bladder. (3) The group conduction velocities and group nerve fibre diameters had the following pair-values at 35.5 degrees C: Spindle afferents: SP1 (65 m/s/13.1 microns), SP2 (51/12.1); touch afferents: T1 (47/11.1), T2 (39/10.1), T3 (27/9.1), T4 (19/8.1); urinary bladder afferents: S1 (41 m/s/-), ST (35/-); alpha-motoneurons: alpha 13 (-/14.4), alpha 12 (65m/s/13.1 microns), alpha 11 (60?/12.1)(FF), alpha 2 (51/10.3)(FR), alpha 3 (41/8.2)(S); gamma-motoneurons: gamma beta (27/7.1), gamma 1 (21/6.6), gamma 21 (16/5.8), gamma 22 (14/5.1); preganglionic parasympathetic motoneurons: (10 m/s/3.7 microns). (4) The values of group conduction velocity and group nerve fibre diameter measured in the paraplegics were very similar to those obtained earlier from brain-dead humans and patients with no spinal cord lesions. Also, the number and the density of myelinated fibres were preserved in the roots. Thus, the classification and identification of nerve fibre groups remained preserved following spinal cord lesion. A direct comparison can thus be made of natural impulse patterns of afferent and efferent nerve fibres between paraplegics (pathologic) and brain-dead humans (supraspinal destroyed CNS, in many respects physiologic). (5) When changing the root temperature from 32 degrees C to 35.5 degrees C, the group conduction velocities changed in the following way in one case: SP2: 40 m/s (32 degrees C) to 50 m/s (35.5 degrees C), S1: 31.3 to 40, ST: 25 to 33.8, M: 12.5 to 13.8; alpha 2: 40 to 50, alpha 3: 33 to 40. The group conduction velocities showed different temperature dependence apart from SP2 fibres and alpha 2-motoneurons. (6) Upon retrograde bladder filling the urinary bladder stretch (S1) and tension receptor afferent (ST) activity levels were undulating and increased.(ABSTRACT TRUNCATED AT 400 WORDS)
(1)在一项手术过程中,使用两对线状电极细胞外记录9例患有脊髓损伤和膀胱协同失调的患者低位骶神经根的单神经纤维动作电位(APs)。在该手术中,为控制膀胱植入了前根刺激器。未保留且用于记录的神经根随后用于形态测量。(2)通过单根传入和传出纤维的传导速度分布直方图以及部分通过神经纤维直径分布直方图来识别神经纤维组,并进行相关性分析。另外,从神经根和膀胱电刺激诱发的复合动作电位(CAPs)中获取组传导速度值。(3)在35.5℃时,组传导速度和组神经纤维直径具有以下对应值:梭形传入纤维:SP1(65米/秒/13.1微米),SP2(51/12.1);触觉传入纤维:T1(47/11.1),T2(39/10.1),T3(27/9.1),T4(19/8.1);膀胱传入纤维:S1(41米/秒/-),ST(35/-);α运动神经元:α13(-/14.4),α12(65米/秒/13.1微米),α11(60?/12.1)(快疲劳型),α2(51/10.3)(快反应型),α3(41/8.2)(慢反应型);γ运动神经元:γβ(27/7.1),γ1(21/6.6),γ21(16/5.8),γ22(14/5.1);节前副交感运动神经元:(10米/秒/3.7微米)。(4)截瘫患者中测量的组传导速度和组神经纤维直径值与早期从脑死亡患者和无脊髓损伤患者获得的值非常相似。此外,神经根中有髓纤维的数量和密度得以保留。因此,脊髓损伤后神经纤维组的分类和识别得以保留。因此,可以直接比较截瘫患者(病理状态)和脑死亡患者(脊髓以上中枢神经系统破坏,在许多方面为生理状态)之间传入和传出神经纤维的自然冲动模式。(5)在将根温度从32℃改变到35.5℃时,在一个病例中组传导速度以如下方式变化:SP2:40米/秒(32℃)至50米/秒(35.5℃),S1:31.3至40,ST:25至33.8,M:12.5至13.8;α2:40至50,α3:33至40。除了SP2纤维和α2运动神经元外,组传导速度表现出不同的温度依赖性。(6)在逆行膀胱充盈时,膀胱牵张(S1)和张力感受器传入(ST)活动水平呈波动状且增加。(摘要截断于400字)