肌萎缩侧索硬化症中的双皮质刺激
Double cortical stimulation in amyotrophic lateral sclerosis.
作者信息
Yokota T, Yoshino A, Inaba A, Saito Y
机构信息
Department of Neurology, Tokyo Medical and Dental University, Japan.
出版信息
J Neurol Neurosurg Psychiatry. 1996 Dec;61(6):596-600. doi: 10.1136/jnnp.61.6.596.
OBJECTIVE
Transcranial double magnetic stimulation on the motor cortex was used to investigate central motor tract function in 16 patients with amyotrophic lateral sclerosis, five with spinal muscular atrophy, and 16 age matched normal controls.
METHODS
Surface EMG responses were recorded from the relaxed abductor pollicis brevis (APB) muscle.
RESULTS
Responses to test stimuli were markedly attenuated by a subthreshold conditioning stimulus given at a condition-test (C-T) interval of 1-4 ms in normal controls and patients with spinal muscular atrophy, but attenuation was mild in patients with amyotrophic lateral sclerosis. In the normal controls this suppression was caused by activation of the intracortical inhibitory mechanism because responses to electrical test stimuli and the H wave were not suppressed by the same magnetic subthreshold conditioning stimulus. In amyotrophic lateral sclerosis the effect of the conditioning cortical stimulus on the H wave was also in the normal range.
CONCLUSION
The intracortical inhibitory mechanism may be impaired in patients with amyotrophic lateral sclerosis.
目的
采用经颅双磁刺激运动皮层的方法，对16例肌萎缩侧索硬化患者、5例脊髓性肌萎缩患者及16例年龄匹配的正常对照者的中枢运动传导通路功能进行研究。
方法
记录放松状态下拇短展肌（APB）的表面肌电图反应。
结果
在正常对照者和脊髓性肌萎缩患者中，当条件刺激-测试刺激（C-T）间隔为1-4毫秒时，阈下条件刺激可使测试刺激的反应明显减弱，但在肌萎缩侧索硬化患者中减弱程度较轻。在正常对照者中，这种抑制是由皮质内抑制机制的激活引起的，因为相同的阈下磁条件刺激不会抑制对电测试刺激的反应和H波。在肌萎缩侧索硬化患者中，条件性皮质刺激对H波的影响也在正常范围内。
结论
肌萎缩侧索硬化患者的皮质内抑制机制可能受损。
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