INVOLUNTARY STEPPING AFTER CHRONIC SPINAL-CORD INJURY - EVIDENCE FOR A CENTRAL RHYTHM GENERATOR FOR LOCOMOTION IN MAN
INVOLUNTARY STEPPING AFTER CHRONIC SPINAL-CORD INJURY - EVIDENCE FOR A CENTRAL RHYTHM GENERATOR FOR LOCOMOTION IN MAN
复制标题
DOI：
10.1093/brain/117.5.1143
复制
发表时间：
1994-10-01
期刊：
影响因子：
14.5
通讯作者：
GREEN, BA
中科院分区：
文献类型：
--
作者：
CALANCIE, B;NEEDHAMSHROPSHIRE, B;GREEN, BA
我们调查了一位有17年神经学不完全性颈髓损伤病史的受试者最近出现的一种不自主的下肢类踏步运动模式。这些动作是有节奏的、交替的和有力的，涉及到下肢的所有肌肉，可以通过躺下(仰卧)和伸展臀部来可靠地唤起。一旦达到这个姿势，动作就会在没有外界感官干扰的情况下自发地继续，其步长周期类似于3.5HZ的S(0.3赫兹)。这一速率可以通过特定的感官输入来增加或暂时停止。麻醉受试者紧绷的髋关节，我们在其中发现了病理证据，导致步态运动明显减弱，持续了大约15分钟。我们认为，(I)保留但有限的棘上紧张性促进，以及(Ii)从受试者右髋部到脊髓的异常、可能有害的传入血流的组合，可能是这种非常不寻常和非自愿运动模式的基础。这一研究对象的运动和肌电模式与许多报告中使用手术后简化的猫模型描述的那些惊人的相似，这表明我们正在见证第一个明确的例子，即中枢节律发生器用于在成年人身上行走。
We investigated a pattern of involuntary lower extremity stepping-like movements which recently appeared in a subject with a 17-year history of neurologically incomplete injury to the cervical spinal cord. The movements were rhythmic, alternating and forceful, involved all muscles of the lower extremities and could be reliably evoked by lying the subject down (supine) and extending his hips. Once in this position, the movements continued spontaneously in the absence of external sensory perturbations, with a step-cycle duration of similar to 3.5 s (0.3 Hz). This rate could be either increased or temporarily halted by specific sensory inputs. Anaesthetizing the subject's tight hip joint, in which we found evidence of pathology, led to a marked attenuation of the stepping movements for a period of similar to 15 min. We believe that a combination of (i) preserved but limited supraspinal tonic facilitation, and (ii) abnormal, perhaps noxious afferent in flow from the subject's right hip to the spinal cord may underlie the appearance of this highly unusual and involuntary movement pattern. The striking similarity between the movement and EMG patterns in this subject and those described in many reports using the surgically reduced cat model suggests that we were witnessing the first well-defined example of a central rhythm generator for stepping in the adult human.