Schnitzler A, Benecke R
Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany.
Neurosci Lett. 1994 Oct 10;180(1):41-5. doi: 10.1016/0304-3940(94)90909-1.
In two representative patients suffering from focal isolated ischemic lesions of the arm-associated (patient 1) or leg-associated (patient 2) primary motor cortex excitatory responses (motor evoked potentials, MEPs) and inhibitory phenomena (silent period, SP) following transcranial magnetic motor cortex stimulation (TMS) are demonstrated. Furthermore, supramaximal peripheral nerve stimulations for testing spinal inhibitory actions were performed. Results were compared to a control group of 12 normal subjects. In patient 1, SP induced by TMS in the clinically affected left extensor carpi radialis muscle (ECR) was lacking in the presence of an only marginally reduced MEP and a normal spinal silent period in this muscle. Normal MEPs and SP durations were observed in the right ECR and in the first dorsal interosseus (FDI) and anterior tibial (TA) muscles on both sides. Similarly, in patient 2 a loss of SP induced by TMS in the clinically affected right TA was observed with normal SP durations in the left TA and both FDI muscles and normal MEP amplitudes in all muscles studied. It is concluded that both early and late phases of SP induced by TMS are of cortical origin and generated in the primary motor cortex.
在两名具有代表性的患者中，展示了经颅磁运动皮层刺激（TMS）后，与手臂相关（患者1）或腿部相关（患者2）的原发性运动皮层兴奋性反应（运动诱发电位，MEP）和抑制现象（静息期，SP）的局灶性孤立缺血性病变。此外，还进行了超强外周神经刺激以测试脊髓抑制作用。将结果与12名正常受试者的对照组进行比较。在患者1中，临床受影响的左侧桡侧腕伸肌（ECR）中由TMS诱导的SP缺失，而该肌肉中的MEP仅略有降低且脊髓静息期正常。在右侧ECR以及两侧的第一背侧骨间肌（FDI）和胫前肌（TA）中观察到正常的MEP和SP持续时间。同样，在患者2中，观察到临床受影响的右侧TA中由TMS诱导的SP缺失，而左侧TA和双侧FDI肌肉中的SP持续时间正常，并且在所有研究的肌肉中MEP幅度正常。得出的结论是，TMS诱导的SP的早期和晚期阶段均起源于皮层，且在原发性运动皮层中产生。
