Asahina M, Nakajima M, Kojima S, Hirayama K
Department of Neurology, School of Medicine, Chiba University.
Rinsho Shinkeigaku. 1994 Nov;34(11):1105-10.
Instability of erect stance in patients with autosomal dominant hereditary ataxia was investigated by posturography. Postural sway on a force-measuring platform was measured quantitatively and sway frequencies were analyzed. Thirty patients from 27 families (15 men and 15 women, mean age of 53.1 years (SD 11.1)) were divided into two clinical groups. Twelve patients (group A) had "pure" cerebellar signs with no somatosensory afferent symptoms. Eighteen patients (group B) had sensory disturbances or diminished reflexes of the lower limbs, and a delayed latency of scalp P37 in somatosensory evoked potentials subsequent to tibial nerve stimulation. Postural sway of the patients of both groups was larger than that of normal subjects. Group A patients had a high antero-posterior/lateral sway ratio. Group B patients had increased sway with eyes closed. With respect to sway frequencies, group A patients had a power spectrum peak around 3 Hz. Group B patients had a power spectrum peak around 1 Hz, and twelve of them had another 3 Hz component. Atrophy of the anterior lobe of the cerebellum shown by MRI was more prominent in patients who had the 3 Hz power spectrum peak than in patients lacking the 3 Hz peak. Quantitative posturography was useful to detect disturbances of the anterior lobe of the cerebellum and the spinal ascending system in patients with autosomal dominant hereditary ataxia.
采用姿势描记法研究常染色体显性遗传性共济失调患者直立姿势的稳定性。在测力平台上对姿势摇摆进行定量测量,并分析摇摆频率。来自27个家庭的30名患者(15名男性和15名女性,平均年龄53.1岁(标准差11.1))被分为两个临床组。12名患者(A组)有“单纯”小脑体征,无躯体感觉传入症状。18名患者(B组)有感觉障碍或下肢反射减弱,以及在胫神经刺激后体感诱发电位中头皮P37潜伏期延长。两组患者的姿势摇摆均大于正常受试者。A组患者前后/侧向摇摆比值较高。B组患者闭眼时摇摆增加。关于摇摆频率,A组患者在3Hz左右有一个功率谱峰值。B组患者在1Hz左右有一个功率谱峰值,其中12名患者还有另一个3Hz成分。MRI显示小脑前叶萎缩在有3Hz功率谱峰值的患者中比没有3Hz峰值的患者更明显。定量姿势描记法有助于检测常染色体显性遗传性共济失调患者小脑前叶和脊髓上行系统的紊乱。