Altered Excitability of the Motor Cortex after Minor Head Injury Revealed by Transcranial Magnetic Stimulation
Altered Excitability of the Motor Cortex after Minor Head Injury Revealed by Transcranial Magnetic Stimulation
复制标题
经颅磁刺激揭示轻微头部受伤后运动皮层兴奋性的改变
DOI：
10.1007/s007010050126
复制
发表时间：
1998
影响因子：
2.4
通讯作者：
M. Feinsod
中科院分区：
文献类型：
--
作者：
A. Chistyakov;J. Soustiel;H. Hafner;M. Elron;M. Feinsod
摘要本研究试图探讨单脉冲慢速（1 Hz）重复经颅磁刺激（TMS）引起的运动诱发电位（MEP）能否揭示轻微颅脑损伤患者脑运动系统隐匿的亚临床损伤。患者组对单脉冲TMS（STMS）的运动反应阈值明显高于对照组。所有存在皮质损伤的患者的中枢运动传导时间以及外周传导时间均正常。在患者组中观察到响应重复 TMS (RTMS) 的 MEP 变化的两种主要模式。 A. – 在整个刺激过程中 MEP 幅度逐渐减小，直至几乎完全消除。 B. – MEP 的振幅和波形呈混沌形式不规则。 MEP 潜伏期在整个刺激过程中保持稳定。 MEP 异常在几个月内逐渐恢复。对 STMS 的运动反应阈值较高以及 MEP 对 RTMS 的异常模式似乎反映了头部轻微受伤患者的皮质兴奋性短暂受损或“皮质疲劳”。需要进一步研究评估头部损伤后中枢神经系统疲劳现象的程度和病理生理机制。
SummaryThis study attempts to find out whether the motor evoked potential (MEP) elicited by single pulse and slow-rate (1 Hz) repetitive transcranial magnetic stimulation (TMS) can disclose concealed subclinical impairments in the cerebral motor system of patients with minor head injury.The motor response to single pulse TMS (STMS) of the patient groups was characterized by significantly higher threshold compared with that of the control group. The central motor conduction time, as well as the peripheral conduction time were normal in all patients pointing to cortical impairment.Two main patterns of MEP changes in response to repetitive TMS (RTMS) were observed in the patient group. A. – progressive decrease of the MEP amplitude throughout the stimulation session to a near complete abolition. B. – irregularity of the amplitude and the waveform of the MEP in a chaotic form. The MEP latency remained stable during the whole stimulation session. The MEP abnormalities recovered gradually over the period of a few months.The higher threshold of the motor response to STMS and the abnormal patterns of the MEP to RTMS seem to reflect transient impairment of cortical excitability or “cortical fatigue” in patients who sustained minor head injures. Further study is needed to evaluated the extent and the pathophysiological mechanisms of the central nervous system fatigue phenomenon following head injury.