CHANGES IN EXCITABILITY OF MOTOR CORTICAL CIRCUITRY IN PATIENTS WITH PARKINSONS-DISEASE
CHANGES IN EXCITABILITY OF MOTOR CORTICAL CIRCUITRY IN PATIENTS WITH PARKINSONS-DISEASE
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DOI：
10.1002/ana.410370208
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发表时间：
1995-02-01
影响因子：
11.2
通讯作者：
ROTHWELL, JC
中科院分区：
文献类型：
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作者：
RIDDING, MC;INZELBERG, R;ROTHWELL, JC
我们使用经颅磁刺激技术对皮层运动区进行刺激，并记录第一背骨间肌的肌电图（EMG）反应，在双脉冲模式下测量了11名帕金森病患者（PD）在正常用药（开）和关（关）（停药后）和10名年龄匹配的对照组中休息时皮质-皮层抑制回路的兴奋性。与对照组相比，在短时间（1-5毫秒）的刺激间隔内，患者的皮质-皮质抑制量显著减少，在左旋多巴摄入后，这种情况得到改善。为了与之前使用经颅磁刺激的报告进行比较，我们还测量了在主动活动肌肉受到刺激时肌电图沉默期的持续时间，以及在活动和放松状态下唤起肌电图反应的阈值。无论肌肉是活跃还是放松，唤起肌电图反应的阈值都没有变化。然而，与关闭状态相比，打开状态下的沉默时间明显延长，尽管两种状态下的持续时间都与正常状态下的持续时间没有显著差异。我们认为帕金森病患者的运动皮质抑制机制可能存在异常，仅使用阈值或沉默期测量不容易检测到。
Using the technique of transcranial magnetic stimulation over the motor areas of cortex and recording electromyographic (EMG) responses from the first dorsal interosseous muscle, we measured the excitability of corticocortical inhibitory circuits at rest using a double pulse paradigm, in 11 patients with Parkinson's disease (PD) studied both on (ON) and off (OFF) (after overnight withdrawal) their normal medication and in 10 age-matched control subjects. There was a significant decrease in the amount of corticocortical inhibition at short (1-5 msec) interstimulus intervals in patients relative to their controls, which improved after L-dopa intake. For comparison with previous reports using transcranial magnetic stimulation we also measured the duration of the EMG silent period when stimuli were given to voluntarily active muscle, and the threshold for evoking an EMG response in both the active and relaxed states, There was no change in the threshold for evoking EMG responses whether muscles were active or relaxed. However, the silent period was significantly prolonged when ON compared with OFF, although in neither state was the duration significantly different from that seen in normals. We suggest that there may be abnormalities of motor cortical inhibitory mechanisms in patients with Parkinson's disease that are not readily detected using threshold or silent period measurements alone.