Michels R, Wessel K, Klöhn S, Kömpf D
Department of Neurology, Medical University of Lübeck, FRG.
Electroencephalogr Clin Neurophysiol. 1993 Aug;89(4):235-41. doi: 10.1016/0168-5597(93)90101-t.
Afferent and efferent central pathways were tested by electrically elicited long-latency reflexes (LLRs), somatosensory evoked potentials (SEPs), and motor potentials (MEPs) evoked by transcranial magnetic stimulation (TMS) in 37 patients with multiple sclerosis. Of these 27 (72.9%) had abnormal results, with bilateral abnormalities in 17 (45.9%). MEPs were abnormal in 21 (56.8%), LLRs in 17 (45.9%) and SEPs in 16 (43.2%). Compared with TMS (MEPs) alone, additional testing of LLRs and SEPs revealed abnormalities in 6 additional patients (2 LLRs, 3 SEPs, 1 LLR and SEP). When the hands were analysed separately 32 (47.3%) showed abnormal results with TMS, 29 (39.2%) with LLRs and 22 (29.7%) with SEPs. All hands with absent or delayed N20 components of the SEP also had abnormal LLRs, supporting the hypothesis that LLRs and SEPs share the same afferent pathways. In contrast to this, 10 hands had normal LLRs but slightly delayed central motor conduction times. Calculating the sum of the latency of the N20 component of the SEP and the latency of the MEP, we found a mean cortical relay time for the LLR of 8.5 +/- 4.7 msec, which is compatible with a polysynaptic transcortical pathway. This is supported by our finding of a linear correlation between the LLR latency and the sum of N20 and MEP latencies.
通过电诱发长潜伏期反射（LLR）、体感诱发电位（SEP）以及经颅磁刺激（TMS）诱发的运动电位（MEP），对37例多发性硬化患者的传入和传出中枢通路进行了检测。其中27例（72.9%）结果异常，17例（45.9%）为双侧异常。MEP异常21例（56.8%），LLR异常17例（45.9%），SEP异常16例（43.2%）。与单独检测TMS（MEP）相比，额外检测LLR和SEP又发现6例患者存在异常（2例LLR、3例SEP、1例LLR和SEP均异常）。当分别分析双手时，TMS检测显示32例（47.3%）结果异常，LLR检测显示29例（39.2%）异常，SEP检测显示22例（29.7%）异常。所有SEP的N20成分缺失或延迟的手，其LLR也均异常，这支持了LLR和SEP共享相同传入通路的假说。与此相反，10只手的LLR正常，但中枢运动传导时间略有延迟。计算SEP的N20成分潜伏期与MEP潜伏期之和，我们发现LLR的平均皮质中继时间为8.5±4.7毫秒，这与多突触经皮质通路相符。我们发现LLR潜伏期与N20和MEP潜伏期之和之间存在线性相关性，这一发现支持了上述观点。
