A PSYCHOPHYSICAL STUDY OF THE MECHANISMS OF SENSORY RECOVERY FOLLOWING NERVE INJURY IN HUMANS
A PSYCHOPHYSICAL STUDY OF THE MECHANISMS OF SENSORY RECOVERY FOLLOWING NERVE INJURY IN HUMANS
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DOI：
10.1093/brain/117.1.149
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发表时间：
1994-02-01
期刊：
影响因子：
14.5
通讯作者：
JOHNSON, KO
中科院分区：
文献类型：
--
作者：
VANBOVEN, RW;JOHNSON, KO
24名受试者在三叉神经主要感觉分支受伤手术前和手术后1年进行了研究。为了研究神经损伤后恢复的基础，我们采用了11项心理物理测试，其中了解了潜在表现的神经机制。神经损伤后，所有受试者的感觉都严重受损。在接下来的几个星期和几个月里，业绩的恢复有条不紊地进行着。虽然受试者之间的恢复速度不同，但任务之间的恢复顺序却没有变化。回收率分为三个不同的类别。其中一项任务“笔触方向辨别”的恢复速度最快。神经损伤后2周，52%的受试者能分辨笔触方向；到3个月时，只有一个受试者不能完成这项任务。第二类包括对有害热、冷和机械刺激的疼痛阈值的恢复率，以及在评估触摸和振动检测、两点辨别、冷却检测和机械力主观大小估计任务中的损伤前表现。第三，最慢的一组包括升温检测和光栅方向识别的恢复率。在脸红方向和一点与两点辨别任务中，较早恢复到损伤前水平的表现与较晚恢复到接近正常水平的光栅方向任务的表现相关。光栅定向任务的独特之处在于，它提供了一种与受试者报告的感觉缺陷一致的测量方法。我们的心理物理学发现与神经生理学数据一致，表明主要的初级传入纤维类以相似的速度对皮肤进行神经再支配。一个解释本研究中心理物理发现的假设是，不同任务之间恢复速度的差异在很大程度上取决于它们对功能性神经支配密度的相对依赖。考虑了其他假设。
Twenty-four subjects were studied before and up to 1 year after surgery that produced injury to a major sensory branch of the trigeminal nerve. We employed a battery of 11 psychophysical tests, in which the neural mechanisms underlying performance are understood, to study the basis of recovery following nerve injury. immediately after nerve injury, sensation was profoundly impaired in all subjects. In the following weeks and months, the recovery of performance proceeded in an orderly fashion. Although the rates of recovery varied between subjects, the order of recovery between tasks did not. The recovery rates fell into three distinct categories. Recovery in one task, brush-stroke directional discrimination, was most rapid. Two weeks after nerve injury, 52% of subjects could discriminate brush-stroke direction; by 3 months only one subject could not perform this task. The second category comprised recovery rates for pain thresholds for noxious heat, cold and mechanical stimuli, and to preinjury performance in tasks assessing touch and vibration detection, two-point discrimination, cooling detection and subjective magnitude estimation of mechanical force. The third, slowest group included recovery rates for warming detection and grating orientation discrimination. Early recovery to preinjury performance levels in the blush-stroke direction and one-point versus two-point discrimination tasks was correlated with later recovery to near normal performance in the grating orientation task. The grating orientation task was unique in providing a measure that corresponded consistently with the subjects' reports of sensory deficits. Our psychophysical findings are consistent with neurophysiological data showing that the major primary afferent fibre classes reinnervate the skin at a similar rate. A hypothesis that accounts for the psychophysical findings in this study is that differences in recovery rates between tasks is determined largely by their relative dependencies on functional innervation density. Alternative hypotheses are considered.