Urban P P, Hopf H C, Fleischer S, Zorowka P G, Müller-Forell W
Department of Neurology, University of Mainz, Germany.
Brain. 1997 Jun;120 ( Pt 6):1077-84. doi: 10.1093/brain/120.6.1077.
We investigated cortico-lingual and cortico-orofacial tract function utilizing transcranial magnetic stimulation in 18 consecutive patients with dysarthria due to hemispheric stroke. Delayed responses (conduction time > mean + 2.5 SD of that of 43 controls) or absent responses were considered abnormal. In all patients, motor-cortex stimulation of the lesion side demonstrated absent (13 patients) or delayed (five patients) responses to the tongue bilaterally (17 patients) or unilaterally (one patient). In 14 patients the contralateral orofacial responses were either absent (13 patients) or delayed (one patient). According to the electrophysiological findings, all lesions revealed by CT or MRI, were located within the pyramidal tract at the lower motor cortex (n = 4), the corona radiata (n = 7), and the genu of the internal capsule (n = 3) or its posterior limb (n = 4). We conclude that interruption of the cortico-bulbar tract fibres to muscles involved in articulation is a frequent cause of dysarthria in hemispheric stroke.
我们利用经颅磁刺激对18例因半球性卒中导致构音障碍的连续患者的皮质 - 舌和皮质 - 口面部传导束功能进行了研究。延迟反应（传导时间>43名对照者平均值 + 2.5标准差）或无反应被视为异常。在所有患者中，对病变侧运动皮质进行刺激时，双侧（17例患者）或单侧（1例患者）舌部反应缺失（13例患者）或延迟（5例患者）。在14例患者中，对侧口面部反应缺失（13例患者）或延迟（1例患者）。根据CT或MRI显示的电生理结果，所有病变均位于锥体束在下运动皮质（n = 4）、放射冠（n = 7）、内囊膝部（n = 3）或其后肢（n = 4）。我们得出结论，参与发音的肌肉的皮质 - 延髓束纤维中断是半球性卒中导致构音障碍的常见原因。
