Catano A, Houa M, Noël P
Department of Neurology and Rehabilitation, University Hospital Centre A. Vésale, Montigny-le-Tilleul, Belgium.
Electroencephalogr Clin Neurophysiol. 1997 Aug;105(4):290-6. doi: 10.1016/s0924-980x(97)00021-0.
There is little information on the silent period during facilitation of the target muscle at the acute stage of stroke and the ultimate clinical status. We studied 69 subjects with transcranial magnetic stimulation: 20 matched controls and 49 hemiparetic patients investigated 7 and 90 days after the stroke (D7, D90). We measured the silent period duration (SPD) in the first dorsal interosseous muscle at 10 and 100% of maximal voluntary isometric contraction (VIC). The SPD index (the ratio of SPD at VIC 100% by SPD at VIC 10%) at D7 was matched with the clinical outcome at D90. Two patterns of responses could be determined at D7. In the normal subjects and in 27 out of 32 patients who eventually recovered satisfactory function at D90, the SPDs were stable during facilitation (SPD index 100%). On the contrary, in 10 out of the 17 patients with a poor functional outcome, the mean SPD decreased when VIC was increased (SPD index 80%); besides, their muscle tone was significantly increased at D90. Similar patterns were still present in the patients at D90: the mean SPD indexes were not significantly different from D7. We conclude that in the early stage of stroke, a low SPD index appears to be correlated with the eventual occurrence of spasticity.
关于中风急性期目标肌肉易化过程中的静息期以及最终临床状态的信息较少。我们对69名受试者进行了经颅磁刺激研究：20名匹配的对照组和49名偏瘫患者在中风后7天和90天（D7、D90）进行调查。我们在最大自主等长收缩（VIC）的10%和100%时测量第一背侧骨间肌的静息期持续时间（SPD）。D7时的SPD指数（VIC 100%时的SPD与VIC 10%时的SPD之比）与D90时的临床结果相匹配。在D7时可确定两种反应模式。在正常受试者以及32名最终在D90恢复满意功能的患者中的27名中，易化过程中SPD稳定（SPD指数100%）。相反，在17名功能结局较差的患者中的10名中，VIC增加时平均SPD降低（SPD指数80%）；此外，他们在D90时肌张力显著增加。在D90时患者中仍存在类似模式：平均SPD指数与D7时无显著差异。我们得出结论，在中风早期，低SPD指数似乎与最终痉挛的发生相关。
