Appearance of reciprocal facilitation of ankle extensors from ankle flexors in patients with stroke or spinal cord injury
Appearance of reciprocal facilitation of ankle extensors from ankle flexors in patients with stroke or spinal cord injury
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DOI：
10.1093/brain/awg036
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发表时间：
2003-02-01
期刊：
影响因子：
14.5
通讯作者：
Nielsen, JB
中科院分区：
文献类型：
--
作者：
Crone, C;Johnsen, LL;Nielsen, JB
本研究的目的是探讨在痉挛状态的拮抗运动神经元池之间的相互促进的病理生理作用。在15名健康人、6名偏瘫患者和11名脊髓损伤（SCI）患者中，通过预先刺激腓神经，观察比目鱼肌H反射。偏瘫患者从偏瘫发作后不久到2年后进行测试。而腓神经刺激产生的比目鱼肌H-反射在健康受试者的短潜伏期抑制，它产生的促进痉挛性脊髓损伤和偏瘫患者。这种促进被证明有一个低的阈值与激活组I传入兼容，最有可能介导的oligosynaptic（互惠）兴奋通路。这种易化与跟腱反射亢进的发展平行出现，这是唯一可能与易化正相关的临床发现。这表明，相互兴奋的外观起着一定的作用，在痉挛的病理生理。
The purpose of the present study was to investigate the pathophysiological role of reciprocal facilitation between antagonistic motoneuron pools in spasticity. The soleus H-reflex was conditioned by prior stimulation of the peroneal nerve in 15 healthy subjects, six hemiplegic patients and 11 spinal cord injured (SCI) patients. The hemiplegic patients were tested from soon after the onset of hemiplegia and up to 2 years later. Whereas stimulation of the peroneal nerve produced short-latency inhibition of the soleus H-reflex in healthy subjects, it produced facilitation in spastic SCI and hemiplegic patients. This facilitation was demonstrated to have a low threshold compatible with activation of group I afferents and was most likely mediated by an oligosynaptic (reciprocal) excitatory pathway. The facilitation appeared in parallel with the development of hyperactive Achilles tendon reflexes, which was the only clinical finding that could be correlated positively with the facilitation. It is suggested that the appearance of reciprocal excitation plays a role in the pathophysiology of spasticity.