Sympathetic activity in man after spinal cord injury. Outflow to muscle below the lesion.
Sympathetic activity in man after spinal cord injury. Outflow to muscle below the lesion.
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脊髓损伤后人的交感神经活动。
DOI：
10.1093/brain/109.4.695
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
B. Wallin
中科院分区：
文献类型：
--
作者：
L. Stjernberg;H. Blumberg;B. Wallin
对9例C5 ~ T8脊髓损伤患者的腓肌神经束进行了微电极记录。4例病变不完全，有一定感觉，但病变平面以下无自主运动功能。所有患者的肌腱痉挛增加。5例患者记录了EMG，并显示了一些外周去神经支配的迹象。对2例患者进行了神经-皮肤-肌肉同步记录，并对19例正常人进行了对照记录。在患者中，自发神经活动稀疏，但在0.5-1.1秒的潜伏期后，强机械和电刺激施加到病变水平以下的皮肤，刺激膀胱和深呼吸诱导传出脉冲的爆发，传导速度为0.65 m × s-1。放电后常伴有皮肤血管收缩和/或皮肤阻力降低。结论是神经爆发包含脊髓起源的交感神经冲动。与正常人的主要区别是患者的自发性肌肉交感神经活动低得多;没有证据表明患者的动脉压力感受性反射调制肌肉交感神经活动;在患者中，给定的刺激引起交感神经反射放电，同时发生在肌肉和皮肤神经分支。膀胱内压的增加仅引起患者肌肉交感神经活动的微弱增加，但仍发生了显著的高血压反应。有人建议，分散的脊髓交感神经元的兴奋性，肌肉通常会减少，而不是夸张的交感神经流出的机制必须是重要的，以唤起事件的高血压患者脊髓损伤。
Microelectrode recordings were made in peroneal muscle nerve fascicles in 9 patients with traumatic spinal cord lesions at the C5 to T8 level. In 4 patients the lesion was incomplete with some sensibility but no voluntary motor function below the level of the lesion. All patients had increased tendon jerks. EMG was recorded in 5 patients and showed signs of some peripheral denervation. Simultaneous recordings from nerves to skin and to muscle were made in 2 patients and control recordings were made in 19 normal subjects. In the patients, spontaneous neural activity was sparse but after a latency of 0.5-1.1 s strong mechanical and electrical stimuli applied to the skin below the level of the lesion, stimulation of the urinary bladder and deep breaths induced bursts of efferent impulses with a conduction velocity of 0.65 m X s-1. The discharges were often followed by cutaneous vasoconstriction and/or reduction of skin resistance. It is concluded that the neural bursts contained sympathetic impulses of spinal origin. The main differences between patients and normal subjects were spontaneous muscle sympathetic activity was much lower in the patients; no evidence of arterial baroreflex modulation of muscle sympathetic activity was obtained in the patients; and in the patients a given stimulus induced sympathetic reflex discharges which occurred synchronously in muscle and skin nerve branches. Increases of intravesical pressure induced only weak increases of muscle sympathetic activity in the patients but nevertheless marked hypertensive reactions occurred. It is suggested that the excitability of decentralized spinal sympathetic neurons to muscles is usually decreased and that mechanisms other than exaggerated sympathetic outflow must be important for evoking episodes of high blood pressure in patients with spinal cord injuries.