Chang C W
Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, PR China.
Electroencephalogr Clin Neurophysiol. 1998 Jun;109(3):199-202. doi: 10.1016/s0924-980x(98)00011-3.
Neuronal degradation accompanied by axonal degeneration has been known to occur in lower motor neurons following a stroke. In the present study, the functional integrity of neuromuscular transmission was assessed, utilizing a sensitive electrodiagnostic method consisting of stimulated single-fiber electromyography (SFEMG), along with axonal microstimulation, in paralytic muscles of stroke patients. Neuromuscular jitter was measured in the hemiplegic side extensor digitorum communis (EDC) as well as in anterior tibial (AT) muscles for 28 stroke patients and also for 13 age-matched controls. The disease duration, i.e. from the onset of stroke until the stimulated SFEMG examination, extended from 2 months to 8 years. Mean jitters obtained in EDC and AT muscles of stroke patients were found to be significantly greater than those in normal controls. Mean jitters obtained in severely weak muscles of stroke patients were greater than those in moderately weak muscles. Positive correlations were noted between the increased jitter and the disease duration from the onset of stroke until the time of the stimulated SFEMG test. These findings demonstrate a dysfunction of neuromuscular transmission in the paralytic muscles of stroke patients and suggests that trans-synaptic degeneration of motor neurons may occur in stroke. Furthermore, the neuronal degradation in stroke was positively correlated with the course duration of the disease.
已知中风后下运动神经元会发生伴有轴突退变的神经元退变。在本研究中，采用一种敏感的电诊断方法，包括刺激单纤维肌电图（SFEMG）以及轴突微刺激，对中风患者麻痹肌肉的神经肌肉传递功能完整性进行了评估。对28例中风患者以及13例年龄匹配的对照者的偏瘫侧指总伸肌（EDC）和胫前肌（AT）进行了神经肌肉颤抖测量。病程，即从中风发作到进行刺激SFEMG检查的时间，从2个月到8年不等。发现中风患者EDC和AT肌肉的平均颤抖明显大于正常对照者。中风患者严重无力肌肉的平均颤抖大于中度无力肌肉。在从中风发作到刺激SFEMG测试时的颤抖增加与病程之间发现了正相关。这些发现表明中风患者麻痹肌肉存在神经肌肉传递功能障碍，并提示中风可能发生运动神经元的跨突触退变。此外，中风中的神经元退变与疾病病程呈正相关。
