Electromyographic assessment of paratonia
Electromyographic assessment of paratonia
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DOI：
10.1007/s00221-016-4854-7
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发表时间：
2017-03-01
影响因子：
2
通讯作者：
Trompetto, Carlo
中科院分区：
文献类型：
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作者：
Marinelli, Lucio;Mori, Laura;Trompetto, Carlo
在最初的描述之后的许多年里，para - onia仍然是一个知之甚少的概念。它被描述为在肌肉张力评估过程中无法放松肌肉，受试者不由自主地促进或反对考官。虽然与认知障碍和额叶功能有关，但其机制尚不清楚。此外，区分对抗性旁张力症与帕金森性强直或痉挛的标准尚不明确。para - atonia在临床实践中非常常见，只有半定量的评定量表可用。本研究的目的是评估使用表面肌电图定量测量副张力的可行性。在一组认知障碍的para - atonic患者中，通过进行连续的节拍器同步的连续和不连续的肘部运动引起para - atonia。对肱二头肌和肱三头肌进行角测量和肌电图记录。双侧肌肉均可见辅助性（mitgehen）和对抗性（gegenhalten）旁张力。在自发性最大收缩正常化后，二头肌的张力异常高于三头肌。二头肌的辅助性旁张力高于对立性旁张力。重复运动仅在连续进行屈伸运动时才会引起对声爆发幅度的增加。随着动作的重复，辅助性和对立性旁张力均增加。只有对抗性共济失调随着更快的运动而增加。这是第一个使用肌电图定量和客观地描述张力异常的研究。与帕金森僵硬不同，对抗性张力随速度和连续动作重复而增加。与痉挛性一样，对抗性张力也依赖于速度，但与痉挛性不同的是，它在运动重复时增加而不是减少。对旁张力的定量测量有助于更好地了解其病理生理，并可用于认知障碍的研究。
Many years after its initial description, paratonia remains a poorly understood concept. It is described as the inability to relax muscles during muscle tone assessment with the subject involuntary facilitating or opposing the examiner. Although related to cognitive impairment and frontal lobe function, the underlying mechanisms have not been clarified. Moreover, criteria to distinguish oppositional paratonia from parkinsonian rigidity or spasticity are not yet available. Paratonia is very frequently encountered in clinical practice and only semi-quantitative rating scales are available. The purpose of this study is to assess the feasibility of a quantitative measure of paratonia using surface electromyography. Paratonia was elicited by performing consecutive metronome-synchronized continuous and discontinuous elbow movements in a group of paratonic patients with cognitive impairment. Goniometric and electromyographic recordings were performed on biceps and triceps brachii muscles. Facilitatory (mitgehen) and oppositional (gegenhalten) paratonia could be recorded on both muscles. After normalization with voluntary maximal contraction, biceps showed higher paratonia than triceps. Facilitatory paratonia was higher than oppositional on the biceps. Movement repetition induced increased paratonic burst amplitude only when flexion and extension movements were performed continuously. Both facilitatory and oppositional paratonia increased with movement repetition. Only oppositional paratonia increased following faster movements. This is the first study providing a quantitative and objective characterization of paratonia using electromyography. Unlike parkinsonian rigidity, oppositional paratonia increases with velocity and with consecutive movement repetition. Like spasticity, oppositional paratonia is velocity-dependent, but different from spasticity, it increases during movement repetition instead of decreasing. A quantitative measure of paratonia could help better understanding its pathophysiology and could be used for research purposes on cognitive impairment.