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中风患者行走过程中来自腓浅神经的反射

Reflexes from the superficial peroneal nerve during walking in stroke subjects.

作者信息

Zehr E P, Fujita K, Stein R B

机构信息

Division of Neuroscience, University of Alberta, Edmonton, Alberta T6G 2S2, Canada.

出版信息

J Neurophysiol. 1998 Feb;79(2):848-58. doi: 10.1152/jn.1998.79.2.848.

Abstract

The function of ipsilateral cutaneous reflexes was studied with short trains of stimuli presented pseudorandomly to the superficial peroneal nerve (SP; innervates the top of the foot) during treadmill walking in neurologically intact (NI) subjects and subjects who had had a stroke. Ankle and knee joint angles together with electromyograms (EMG) of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG), vastus lateralis (VL), and biceps femoris (BF) muscles were recorded. Net reflex EMG and kinematic responses to stimulation were quantified in each of the 16 parts of the step cycle and responses compared between the stroke and NI subjects. Stimulation strongly suppressed extensor muscles throughout stance in the stroke subjects. TA muscle showed a significant suppression during swing phase that was correlated with reduced ankle dorsiflexion in both stroke and NI subjects. BF reflexes were facilitatory during parts of swing and VL reflexes were suppressive throughout stance in the stroke subjects. There was a significant correlation between BF facilitation and knee flexion during swing, which was stronger in NI subjects. We conclude that only part of the stumble correction to foot dorsum electrical stimulation observed in NI subjects is maintained after stroke, and that new, suppressive responses are seen.

摘要

在神经功能正常(NI)的受试者和中风患者在跑步机上行走时,以伪随机方式向腓浅神经(SP;支配足背)施加短串刺激,研究同侧皮肤反射的功能。记录踝关节和膝关节角度以及胫骨前肌(TA)、比目鱼肌(SOL)、腓肠肌内侧头(MG)、股外侧肌(VL)和股二头肌(BF)的肌电图(EMG)。在步行周期的16个部分中,对刺激的净反射EMG和运动学反应进行量化,并比较中风患者和NI受试者之间的反应。在中风患者中,刺激在整个站立期强烈抑制伸肌。在摆动期,TA肌在中风患者和NI受试者中均表现出显著抑制,且与踝关节背屈减少相关。在中风患者中,BF反射在摆动期的部分时间内具有易化作用,而VL反射在整个站立期均具有抑制作用。在摆动期,BF易化与膝关节屈曲之间存在显著相关性,在NI受试者中更强。我们得出结论,中风后,NI受试者中观察到的对足背电刺激的部分绊倒纠正得以保留,并且出现了新的抑制性反应。

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