The silent period after transcranial magnetic stimulation is of exclusive cortical origin: evidence from isolated cortical ischemic lesions in man
The silent period after transcranial magnetic stimulation is of exclusive cortical origin: evidence from isolated cortical ischemic lesions in man
复制标题
经颅磁刺激后的静默期是唯一的皮质起源：来自人类孤立皮质缺血性病变的证据
DOI：
10.1016/0304-3940(94)90909-1
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发表时间：
1994
影响因子：
2.5
通讯作者：
R. Benecke
中科院分区：
文献类型：
--
作者：
A. Schnitzler;R. Benecke
在患有手臂相关（患者1）或腿部相关（患者2）的局灶性孤立缺血性病变的两个代表性患者中，证实了经颅磁运动皮层刺激（TMS）后的初级运动皮层兴奋性反应（运动诱发电位，MEP）和抑制现象（沉默期，SP）。此外，进行用于测试脊髓抑制作用的超最大外周神经刺激。结果进行了比较，12名正常人的对照组。在患者1中，在临床上受影响的左桡侧腕伸肌（ECR）中TMS诱导的SP缺乏，在该肌肉中仅存在轻微减少的MEP和正常的脊髓静默期。在右侧ECR和两侧第一骨间背侧肌（FDI）和胫骨前肌（TA）观察到正常MEP和SP持续时间。类似地，在患者2中，在临床受影响的右侧TA中观察到TMS诱导的SP损失，在左侧TA和FDI肌肉中观察到正常的SP持续时间，并且在所有研究的肌肉中观察到正常的MEP振幅。结论：TMS诱发的SP早相和晚相均起源于皮层，产生于初级运动皮层。
In two representative patients suffering from focal isolated ischemic lesions of the arm-associated (patient 1) or leg-associated (patient 2) primary motor cortex excitatory responses (motor evoked potentials, MEPs) and inhibitory phenomena (silent period, SP) following transcranial magnetic motor cortex stimulation (TMS) are demonstrated. Furthermore, supramaximal peripheral nerve stimulations for testing spinal inhibitory actions were performed. Results were compared to a control group of 12 normal subjects. In patient 1, SP induced by TMS in the clinically affected left extensor carpi radialis muscle (ECR) was lacking in the presence of an only marginally reduced MEP and a normal spinal silent period in this muscle. Normal MEPs and SP durations were observed in the right ECR and in the first dorsal interosseus (FDI) and anterior tibial (TA) muscles on both sides. Similarly, in patient 2 a loss of SP induced by TMS in the clinically affected right TA was observed with normal SP durations in the left TA and both FDI muscles and normal MEP amplitudes in all muscles studied. It is concluded that both early and late phases of SP induced by TMS are of cortical origin and generated in the primary motor cortex.