Abnormal reciprocal inhibition between antagonist muscles in Parkinson's disease
Abnormal reciprocal inhibition between antagonist muscles in Parkinson's disease
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DOI：
10.1093/brain/123.5.1017
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发表时间：
2000-05-01
期刊：
影响因子：
14.5
通讯作者：
Vidailhet, M
中科院分区：
文献类型：
--
作者：
Meunier, S;Pol, S;Vidailhet, M
在脊髓水平，双突触Ia相互抑制通过主动抑制拮抗性运动神经元和减少激动性运动神经元的抑制而起作用。帕金森氏病中这一通路的失活仍然存在争议。研究了15名对照组和16名帕金森病患者在静息和屈腕开始时对前臂屈肌H反射的双突触相互抑制。两名患者仅在停用抗帕金森病药物18小时后进行了重新评估。在静息状态下，患者和对照组的腕部对抗肌肉之间的Ia相互抑制水平没有显著差异。相比之下，这种抑制的明显异常表现在患者的自主活动中。在正常受试者中，在屈腕开始时，Ia的相互抑制显示出很大的减少，我们认为这种减少是起源于脊柱上的。在患者受影响较轻的一侧，下行调制仍然存在，但低于对照组；在受影响较重的一侧，这种调制几乎完全消失。这些运动诱导的双突触Ia相互抑制的异常与帕金森病密切相关，但可能不依赖L-多巴。它们可以在帕金森氏症患者观察到的精确自主运动的干扰中发挥作用。
Disynaptic Ia reciprocal inhibition acts, at the spinal level, by actively inhibiting antagonist motor neurons and reducing the inhibition of agonist motor neurons. The deactivation of this pathway in Parkinson's disease is still debated. Disynaptic reciprocal inhibition of H reflexes in the forearm flexor muscles was examined in 15 control subjects and 16 treated parkinsonian patients at rest and at the onset of a voluntary wrist flexion. Two patients mere reassessed 18 h after withdrawal of antiparkinsonian medication. At rest, the level of Ia reciprocal inhibition between the wrist antagonist muscles was not significantly different between patients and controls. In contrast, clear abnormalities of this inhibition were revealed by voluntary movements in the patients. In normal subjects, at the onset of a wrist flexion, Ia reciprocal inhibition showed a large decrease, and we argue that this decrease is supraspinal in origin. On the less affected sides of the patients the descending modulation was still present but lower than in controls; on the more affected sides this modulation had vanished almost completely. These movement-induced abnormalities of disynaptic Ia reciprocal inhibition were closely associated with Parkinson's disease but were probably not dependent on L-dopa. They could play a role in the disturbances of precise voluntary movements observed in Parkinson's disease.