经运动皮层磁刺激对原发性直立性震颤的调制作用
Modulation of primary orthostatic tremor by magnetic stimulation over the motor cortex.
作者信息
Tsai C H, Semmler J G, Kimber T E, Thickbroom G, Stell R, Mastaglia F L, Thompson P D
机构信息
Department of Neurology, Royal Adelaide Hospital, Australia.
出版信息
J Neurol Neurosurg Psychiatry. 1998 Jan;64(1):33-6. doi: 10.1136/jnnp.64.1.33.
OBJECTIVES
To study the role of corticomotor neuronal pathways in primary orthostatic tremor.
METHODS
Transcranial magnetic stimuli at an intensity 10% above the resting motor threshold were delivered over the leg motor cortex in two patients with primary orthostatic tremor while standing still. Electromyographic responses in both tibialis anterior muscles were recorded after 20 stimuli given randomly at intervals of 120 to 180 seconds. Differences between predicted and actual times of occurrence of tremor bursts after the stimuli were used to calculate a resetting index, with a value of 0 representing no resetting and a value of 1 representing complete resetting.
RESULTS
Transcranial magnetic stimulation evoked EMG responses in both tibialis anterior muscles, followed by transient suppression of tremor before reappearance of rhythmic EMG activity. Analysis of the timing of tremor bursts from EMG recordings before and after the magnetic stimuli disclosed that the phase of orthostatic tremor could be reset by brain stimulation (mean resetting indices 0.93 and 0.82).
CONCLUSION
The results suggest that a central oscillator, involving the motor cortex, has a crucial role in either the generation or modulation of orthostatic tremor.
目的
研究皮质运动神经元通路在原发性直立性震颤中的作用。
方法
在两名原发性直立性震颤患者静止站立时，以高于静息运动阈值10%的强度经颅磁刺激腿部运动皮层。在以120至180秒的间隔随机给予20次刺激后，记录双侧胫前肌的肌电图反应。刺激后震颤爆发的预测时间与实际发生时间之间的差异用于计算重置指数，值为0表示无重置，值为1表示完全重置。
结果
经颅磁刺激诱发双侧胫前肌的肌电图反应，随后在有节律的肌电图活动再次出现之前，震颤出现短暂抑制。对磁刺激前后肌电图记录中震颤爆发时间的分析表明，直立性震颤的相位可通过脑刺激重置（平均重置指数分别为0.93和0.82）。
结论
结果提示，涉及运动皮层的中枢振荡器在直立性震颤的产生或调节中起关键作用。
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