Fève A, Bathien N, Rondot P
Inserm U 97, centre Paul Broca, Paris, France.
J Neurol Neurosurg Psychiatry. 1994 Jan;57(1):100-4. doi: 10.1136/jnnp.57.1.100.
Movement-related cortical potentials (MRCPs) were recorded from scalp electrodes during wrist flexion in 15 dystonic patients with bilateral (nine) or unilateral (six) circumscribed lesions in the striatum (eight), pallidum (six), or anterior thalamus (one). The results were compared with those of 10 age-matched healthy volunteers. The early (BP) and late (NS') MRCP components were assessed in terms of their gradients and distribution on the scalp in Cz, C3', and C4'. The gradients of both BP and NS' components were significantly flatter in the patients with bilateral lesions than in the control subjects. Also, the BP gradient was maximum at Cz, and the NS' component was contralaterally predominant in the control subjects but not in the patients. In patients with unilateral lesions, the gradients were flatter (p < 0.05) during movement of the dystonic wrist than during movement of the normal wrist. This difference was significant for BP and NS', regardless of the location of the electrodes. Also, the normal topographic predominance of BP at Cz and of contralateral NS' disappeared. The BP and NS' components of the MRCPs are thought to reflect preparatory activity in the supplementary motor area and the primary motor cortex before movement. Reduced BP and NS' gradients in patients with both bilateral and unilateral lesions of the basal ganglia, which project towards the supplementary motor area, are consistent with this hypothesis. The bilateral nature of these reductions suggests that both the ipsilateral and the contralateral motor cortex are involved in the genesis of the MRCPs and that the dystonia in these patients is associated with impaired motor preparation.
在15例患有双侧（9例）或单侧（6例）局限性纹状体（8例）、苍白球（6例）或丘脑前核（1例）病变的肌张力障碍患者进行腕关节屈曲时，通过头皮电极记录与运动相关的皮层电位（MRCPs）。将结果与10名年龄匹配的健康志愿者的结果进行比较。根据早期（BP）和晚期（NS'）MRCP成分在Cz、C3'和C4'头皮上的梯度和分布进行评估。双侧病变患者的BP和NS'成分梯度均明显比对照组平坦。此外，对照组中BP梯度在Cz处最大，NS'成分在对侧占优势，而患者则不然。在单侧病变患者中，肌张力障碍手腕运动期间的梯度比正常手腕运动期间更平坦（p<0.05）。无论电极位置如何，BP和NS'的这种差异均显著。此外，BP在Cz处以及对侧NS'的正常地形优势消失。MRCPs的BP和NS'成分被认为反映了运动前辅助运动区和初级运动皮层的准备活动。向辅助运动区投射的基底神经节双侧和单侧病变患者中BP和NS'梯度降低，与这一假设一致。这些降低的双侧性表明同侧和对侧运动皮层均参与了MRCPs的产生，并且这些患者的肌张力障碍与运动准备受损有关。
