Surface electromyography shows increased mirroring in Parkinson's disease patients without overt mirror movements
Surface electromyography shows increased mirroring in Parkinson's disease patients without overt mirror movements
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DOI：
10.1002/mds.20972
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发表时间：
2006-09-01
影响因子：
8.6
通讯作者：
Ziemann, Ulf
中科院分区：
文献类型：
--
作者：
Cincotta, Massimo;Giovannelli, Fabio;Ziemann, Ulf
帕金森氏病(PD)患者可出现镜像运动(MM)。经颅磁刺激数据表明，这些运动反映了健康成年人在复杂和艰苦的任务中可以观察到的“生理镜像”的异常增强。假设在帕金森病中，增强的镜像是由于基底节的输出不能支持负责执行严格的单手运动的皮质网络所致。如果是这样的话，很可能在没有明显MM的PD患者中也存在自主单手运动控制的细微变化。我们使用表面肌电信号(EMG)技术对12例无明显MM的轻至中度PD患者和2名对照组(12名年龄匹配的志愿者和10名年轻的健康志愿者)进行了验证。受试者在对侧拇短展肌持续紧张性收缩期间进行单侧拇指外展。所有患者都接受了多巴胺能治疗。在另一天，12名患者中有7名在停药后进行了重新测试。在这项任务中，帕金森病患者张力外展拇指表面肌电的不由自主镜面样增加明显大于年龄匹配或年轻的健康志愿者。在治疗后，镜像作用略大于药物治疗，尽管这种差异并不显著。我们的研究结果表明，单手运动控制功能障碍是帕金森病的一个普遍特征。这种运动偏侧化的缺陷很可能是帕金森病患者非对称性双手运动受损的原因。(C)2006年运动无序协会。
Patients with Parkinson's disease (PD) may present mirror movements (MM). Transcranial magnetic stimulation data indicate that these movements reflect an abnormal enhancement of the "physiological mirroring" that can be observed in healthy adults during complex and effortful tasks. It was hypothesized that, in PD, enhanced mirroring is caused by a failure of basal ganglia output to support the cortical network that is responsible for the execution of strictly unimanual movements. If so, it is likely that subtle alterations of voluntary unimanual motor control are also present in PD patients without overt MM. We tested this hypothesis by using surface electromyographic (EMG) techniques in 12 mildly to moderately affected PD patients without overt MM, and in 2 control groups (12 age-matched and 10 young healthy volunteers). Subjects performed unilateral phasic thumb abduction during a sustained tonic contraction of the opposite abductor pollicis brevis. All patients were tested on dopaminergic therapy. On a separate day, 7 of 12 patients were re-tested after withdrawal of medication. During this task, involuntary mirror-like increase in surface EMG of the tonically abducting thumb was significantly larger in PD patients than in age-matched or young healthy volunteers. Off therapy, mirroring was slightly greater than on medication, although this difference was not significant. Our findings suggest that dysfunction of unimanual motor control is a general feature of PD. It is likely that this deficient movement lateralization contributes to an impairment of non-symmetrical bimanual movements in PD. (c) 2006 Movement Disorder Society.