LEVODOPA REDUCES MUSCLE TONE AND LOWER-EXTREMITY TREMOR IN PARKINSONS-DISEASE
LEVODOPA REDUCES MUSCLE TONE AND LOWER-EXTREMITY TREMOR IN PARKINSONS-DISEASE
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DOI：
10.1017/s0317167100039470
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发表时间：
1995-11-01
影响因子：
3
通讯作者：
FRANK, J
中科院分区：
文献类型：
--
作者：
BURLEIGH, A;HORAK, F;FRANK, J
目的：我们量化了左旋多巴在帕金森病患者维持站立状态下的治疗效果。方法：对对左旋多巴有波动反应的帕金森病患者和年龄匹配的对照组进行安静站立时肌电活动的评估。结果：所有帕金森病患者的小腿和躯干肌肉在“关闭”时都表现出高幅度的活动，其中3例出现4-5赫兹的震颤，当“打开”时，远端肌肉的活动幅度比近端的肌肉活动幅度降低得更多，而所有肌肉的震颤都受到了抑制，与肌肉的过度活动相对应，帕金森病患者的足底压力偏移的前后中心的速度和变异性增加，但压力漂移中心的平均位移与对照组无差异。帕金森病患者的压力中心漂移速度接近对照组，提示远端肌幅过大和震颤是导致压力中心速度过快的原因之一。结论：多巴胺能系统参与了立位时肌肉张力的调节，多巴胺能传递的耗竭可导致肢体肌肉张力增加和震颤，这可能是导致姿势和稳定性改变的原因之一。
Objective: We have quantified the effects of levodopa treatment in Parkinsonian subjects during maintained stance. Methods: Electromyographic muscle activity during quiet stance was assessed in subjects with Parkinson's disease, who exhibited a fluctuating response to levodopa, and in age-matched control subjects. Stance stability was also assessed from mean displacement and velocity of the center of pressure excursions during stance, Results: Lower extremity and trunk muscles showed high amplitude activity in all Parkinson's subjects when ''off', and a 4-5 Hz tremor in three of these subjects, When ''on'', the amplitude of muscle activity was reduced in the distal muscles more than the proximal, while tremor was suppressed in all muscles, Corresponding to the excessive muscle activity, the Parkinson's subjects had increased velocity and variability of velocity in the anterior-posterior center of foot pressure excursions, but the mean displacement of the center of pressure excursion was not different from the controls. The velocity of center of pressure excursions in the Parkinson's subjects ''on'', approached those of the control subjects suggesting that the excessive distal muscle amplitude and tremor contributed to the high velocity of the center of pressure. Conclusions: These findings suggest that dopaminergic systems are involved in the regulation of muscle tone during stance, Depletion of dopaminergic transmission results in increased muscle tone and tremor in the lower extremities which may contribute to changes in posture and stability.