Beta-band intermuscular coherence: a novel biomarker of upper motor neuron dysfunction in motor neuron disease.
Beta-band intermuscular coherence: a novel biomarker of upper motor neuron dysfunction in motor neuron disease.
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DOI：
10.1093/brain/aws150
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Baker MR
中科院分区：
文献类型：
--
作者：
Fisher KM;Zaaimi B;Williams TL;Baker SN;Baker MR
在运动神经元疾病中，治疗的重点是用神经保护药理学药物预防或减缓神经元变性;因此早期诊断和治疗至关重要。将下运动神经元变性的针肌电图证据纳入诊断标准无疑具有先进的诊断，但通过包括亚临床上运动神经元疾病的测试，甚至可能更早地诊断。我们假设β-波段（15-30 Hz）肌间相干性可用作此类患者上运动神经元完整性的电生理标志物。我们测量了8例符合原发性侧索硬化症诊断标准的患者和6例进行性肌萎缩患者的肌间连贯性，以及16例年龄匹配的对照组。在运动神经元疾病的原发性侧索硬化症变体中，存在运动皮质层V锥体神经元的选择性破坏和皮质脊髓束的变性，而不涉及前角细胞。在进行性肌萎缩中，前角细胞选择性变性，但皮质脊髓束正常。所有原发性侧索硬化症患者的经颅磁刺激评估运动诱发电位异常，而进行性肌萎缩症患者的运动诱发电位与对照组相似。上肢和下肢肌间的连贯性进行了测量，分别在一个精确的抓地力和踝关节背屈任务。在所有对照受试者和所有进行性肌萎缩患者中均观察到显著的β-带相干性，但在原发性侧索硬化患者中未观察到。我们的结论是，在15-30赫兹范围内的肌间连贯性是依赖于一个完整的皮质脊髓束，但在面对选择性前角细胞破坏持续存在。基于从原发性侧索硬化症患者和对照受试者测量的相干值的分布，我们估计了给定测量反映皮质脊髓束变性的可能性。因此，肌间相干性有潜力作为亚临床上运动神经元参与运动神经元疾病的定量测试。
In motor neuron disease, the focus of therapy is to prevent or slow neuronal degeneration with neuroprotective pharmacological agents; early diagnosis and treatment are thus essential. Incorporation of needle electromyographic evidence of lower motor neuron degeneration into diagnostic criteria has undoubtedly advanced diagnosis, but even earlier diagnosis might be possible by including tests of subclinical upper motor neuron disease. We hypothesized that beta-band (15–30 Hz) intermuscular coherence could be used as an electrophysiological marker of upper motor neuron integrity in such patients. We measured intermuscular coherence in eight patients who conformed to established diagnostic criteria for primary lateral sclerosis and six patients with progressive muscular atrophy, together with 16 age-matched controls. In the primary lateral sclerosis variant of motor neuron disease, there is selective destruction of motor cortical layer V pyramidal neurons and degeneration of the corticospinal tract, without involvement of anterior horn cells. In progressive muscular atrophy, there is selective degeneration of anterior horn cells but a normal corticospinal tract. All patients with primary lateral sclerosis had abnormal motor-evoked potentials as assessed using transcranial magnetic stimulation, whereas these were similar to controls in progressive muscular atrophy. Upper and lower limb intermuscular coherence was measured during a precision grip and an ankle dorsiflexion task, respectively. Significant beta-band coherence was observed in all control subjects and all patients with progressive muscular atrophy tested, but not in the patients with primary lateral sclerosis. We conclude that intermuscular coherence in the 15–30 Hz range is dependent on an intact corticospinal tract but persists in the face of selective anterior horn cell destruction. Based on the distributions of coherence values measured from patients with primary lateral sclerosis and control subjects, we estimated the likelihood that a given measurement reflects corticospinal tract degeneration. Therefore, intermuscular coherence has potential as a quantitative test of subclinical upper motor neuron involvement in motor neuron disease.
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DOI：
10.1073/pnas.0308538101
发表时间：
2004-06-29
影响因子：
11.1
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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