Firing pattern of fasciculations in ALS - Evidence for axonal and neuronal origin
Firing pattern of fasciculations in ALS - Evidence for axonal and neuronal origin
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DOI：
10.1212/01.wnl.0000300559.14806.2a
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发表时间：
2008-01-29
期刊：
影响因子：
9.9
通讯作者：
Zwarts, Machiel J.
中科院分区：
文献类型：
--
作者：
Kleine, Bert U.;Stegeman, Dick F.;Zwarts, Machiel J.
背景：在肌萎缩侧索硬化症（ALS）中，肌束震颤的起源存在争议。方法：采用高密度表面肌电图记录10例ALS患者肱二头肌或股外侧肌15 min的肌束震颤电位（Fpsiculation potentials，FPs）。记录被分解成不同的FP波形和它们的点火时刻。结果：30种不同类型的FPs（8，597个ISI）中，有23种的不应期在3 ~ 4 msec之间，而在100次以上的FPs中，ISI的不应期在3 ~ 4 msec之间。大于15 msec的ISI呈泊松分布。这23个FP中的5个放电双峰，ISI约为5 msec，表明超正常。这与运动轴突中产生的FP一致。2)在其他7例FP中，占11，266例ISI，不应期为17至46 msec。首选ISI持续时间约为80 msec。这两个时间因素是一致的起源在脊髓运动neurons.Conclusions：发射模式分析，高密度表面肌电图的基础上，可以检测肌萎缩侧索硬化症的轴突和神经元起源的成束电位（FPs）。两种FP类型在同一肌肉内共存。认识到临床上相同的肌束震颤掩盖了两种类型的FP的存在，可以以非侵入性的方式进行研究，这将在运动神经元疾病的研究中引入一个新的方面。
Background: In amyotrophic lateral sclerosis (ALS), the origin of fasciculations is disputed. We hypothesized that the discharge pattern of fasciculation potentials (FPs) would be different for FPs arising in the motor axon or in the spinal motor neuron.Method: FPs were recorded by high-density surface EMG of the biceps brachii or vastus lateralis muscle for 15 minutes in 10 patients with ALS. Records were decomposed into different FP waveforms and their firing moments. Interspike interval (ISI) histograms were constructed for FPs that fired more than 100 times.Results: Two types of ISI histograms were found. 1) In 23 of 30 different FPs with a total of 8,597 ISIs, the refractory period was 3 to 4 msec. ISIs longer than 15 msec had a Poisson distribution. Five of these 23 FPs discharged doublets with an ISI of approximately 5 msec, indicative of supernormality. This is consistent with the FPs arising in motor axons. 2) In the other 7 FPs, accounting for 11,266 ISIs, the refractory period was 17 to 46 msec. The preferred ISI duration was around 80 msec. Both timing factors are consistent with origin in the spinal motor neuron.Conclusions: Firing pattern analysis, based on high-density surface EMG, can detect fasciculation potentials (FPs) of axonal and neuronal origin in amyotrophic lateral sclerosis. The two FP types coexist within the same muscle. The recognition that clinically identical fasciculations conceal the existence of two types of FP that can be studied in a noninvasive manner will introduce a new aspect in the research of motor neuron disease.