Physiologic tremor
Physiologic tremor
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生理性震颤
作者：
C. van Buskirk;R. Fink
自 1886 年起，人们就认识并记录了意志肌肉收缩的生理性震颤，但产生这种震颤的机制仍然模糊不清，有待推测和实验。生理性震颤的首次记录通常归功于希弗、坎尼和滕斯托尔，他们测量了意志收缩时肌肉活动的节律。他们研究中的大部分记录都是通过使用紧贴收缩肌肉的鼓来获得的，但他们通过记录身体部位的实际运动来记录一些真正的震颤。这些录音主要来自对手的策略肌肉和拇指。他们发现 20 名受试者的意志运动震颤范围在 8 至 13 cps 之间，平均为 10 cps。他们观察到，同一个人从一次检查到另一次检查，以及一个人与另一个人之间的这种节奏存在差异。同年，霍斯利和施德2通过记录大脑皮层和辐射冠受到刺激后肌肉收缩的节律，研究了狗、猫、兔子和猴子的肌肉收缩引起的震颤。他们还测量了反射性肌肉收缩的节奏。所有这些记录都显示出相同的一般频率，范围在 8 到 13 cps 之间。他们还研究了刺激绳索切断端后的震颤，获得了相似的频率。周围神经的刺激显示出常见的强直性收缩，这取决于神经刺激的速率。根据这些观察，他们得出结论，这种节律活动的起源部位是在脊髓内。自 1886 年以来，许多研究者都在研究生理性震颤，但添加的新信息却很少。 GriBths，3 于 1888 年，以及 Herringham。 1890 年，他指出，对肌肉施加负荷会增加生理性震颤的幅度，而不会改变频率。 Jasper 和 Andrew、J Schwab 和 Cobb,6 以及 Lindqvist' 都研究了脑电图的 α 节律与生理性震颤之间的关系。结论是，尽管它们的频率相似，但不存在因果关系。最近，Halliday 和 Redfearn,8s@ 使用自动频率分析仪来研究人类的生理性震颤，还指出，随着负载的增加，震颤的幅度会增加。他们发现震颤频谱在 5 到 15 cps 之间，但峰值频率在 9 或 10 cps 左右。然而，他们确实注意到同一个人的一次检查与下一次检查的频率存在差异。本体感觉敏感性显着改变的痨病患者震颤的频谱分析表明，缺乏 10-cps 频率，并且负载频率发生变化，这种反应与正常受试者的反应不同。这些作者将他们的数据解释为支持这样的论点，即生理性震颤是由于围绕脊髓反射弧的振荡引起的，并得出结论，在结核病患者中注意到的变化是人们在伺服环机制失效的情况下所预期的变化。 Marshall 和 Walsh'O 在最近的另一项生理性震颤研究中发现，主要频率为 10 cps，范围在 7 到 12 cps 之间，他们还发现
PHYSIOLOGIC TREMOR of volitional muscle contraction has been recognized and recorded since 1886, yet the mechanisms producing this tremor have remained obscure and open to speculation and experimentation. The first recording of physiologic tremor is usually credited to Schiifer, Canney, and Tunstall,' who measured the rhythm of muscular activity in volitional contraction. Most of the recordings in their study were obtained by using a tambour placed against the contracting muscle, but they made a few records of true tremor by recording actual movement of the body part. The recordings were chiefly from the opponens policis muscle and thumb. In 20 subjects, they found the range of tremor with volitional movement to be between 8 and 13 cps, with an average of 10 cps. They observed that there were variations of this rhythm from one examination to another in the same person, as well as variations from one person to another. In the same year, Horsley and Schder2 studied the tremor with muscle contraction in dogs, cats, rabbits, and monkeys by recording the rhythm of muscle contraction after stimulation of the cerebral cortex and the corona radiata. They also measured the rhythm of reflex muscular contractions. All of these records revealed the same general frequency, a range of between 8 and 13 cps. They also studied the tremor after stimulation of the cut end of the cord, obtaining similar frequencies. Stimulation of the peripheral nerve revealed the usual tetanic contractions, dependent upon the rate of stimulation of the nerve. From these observations, they concluded that the site of origin of this rhythmic activity was within the spinal cord. Since 1886, various investigators have studied physiologic tremor, but very little new information has been added. GriBths,3 in 1888, and Herringham.' in 1890, noted that loading the muscle would increase the amplitude of physiologic tremor without altering the frequency. Jasper and Andrew,J Schwab and Cobb,6 and Lindqvist' all studied the relationship between the alpha rhythm of the electroencephalogram and physiologic tremor. The conclusion was reached that there is no causal relationship despite their similarity in frequency. More recently, Halliday and Redfearn,8s@ using an automatic frequency analyzer for the study of physiologic tremor in man, have also pointed out that, with loading, there is an increase in amplitude of the tremor. They found a spectrum of tremor between 5 and 15 cps but with peak frequencies around 9 or 10 cps. However, they did notice that there was a variation in frequency from one examination to the next in the same person. The frequency spectral analysis of tremor in tabetic patients with marked alteration in proprioceptive sensibility indicated an absence of 10-cps frequencies, as well as a change in frequency on loading, a response differing from that of the normal subject. These authors have interpreted their data as supporting the contention that physiologic tremor is due to oscillation around a spinal reflex arc and concluded that the changes noted in tabetic patients are the changes one would expect in the presence of a failing servoloop mechanism. Marshall and Walsh,'O in another recent study of physiologic tremor, found a predominant frequency of 10 cps, with a range of between 7 and 12 cps, and they also found