Abnormalities of sensorimotor integration in focal dystonia - A transcranial magnetic stimulation study
Abnormalities of sensorimotor integration in focal dystonia - A transcranial magnetic stimulation study
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DOI：
10.1093/brain/124.3.537
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发表时间：
2001-03-01
期刊：
影响因子：
14.5
通讯作者：
Trompetto, C
中科院分区：
文献类型：
--
作者：
Abbruzzese, G;Marchese, R;Trompetto, C
我们研究了局灶性手肌张力障碍患者（12例手痉挛患者）和颈肌张力障碍患者（9例痉挛性斜颈患者）在外周刺激下运动皮质兴奋性的变化，并与16名年龄匹配的正常对照进行了比较。记录右拇短外展肌（APB）、第一背骨间肌（FDI）、桡侧腕屈肌和桡侧腕伸肌经颅磁刺激手部局部（八字形线圈）的运动诱发电位（MEP）。分析调节-试验（C-T）间隔50、200、600、1000 ms刺激右正中神经（或食指）后试验MEP大小的变化，外周刺激可显著降低正常对照和痉挛性斜颈患者APE和FDI肌的试验MEP大小，对正中神经刺激的抑制作用更大，在C-T间隔200 ms时达到最大；手痉挛患者在MEP大小测试中表现出显著的促进作用。本研究提示局灶性手肌张力障碍患者外周刺激后MEP抑制存在缺陷，肌张力障碍患者感觉输入的中枢加工异常，可能导致运动皮质兴奋性增加。
It has been postulated that sensorimotor integration is abnormal in dystonia, We investigated changes in motor cortical excitability induced by peripheral stimulation in patients with focal hand dystonia (12 patients with hand cramps) and with cervical dystonia (nine with spasmodic torticollis) compared with 16 age-matched normal controls, Motor evoked potentials (MEP) to focal (figure-of-eight coil) transcranial magnetic stimulation of the hand area were recorded from the right abductor pollicis brevis (APB), first dorsal interosseus (FDI), flexor carpi radialis and extensor carpi radialis muscles. Changes of test MEP size following conditioning stimulation of the right median nerve (or of the index finger) at conditioning-test (C-T) intervals of 50, 200, 600 and 1000 ms were analysed, Peripheral stimulation significantly reduced test MEP size in the APE and FDI muscles of normal control and spasmodic torticollis patients, The inhibitory effect was larger upon median nerve stimulation and reached a maximum at the C-T interval of 200 ms, On the contrary, hand cramp patients showed a significant facilitation of test MEP size. This study suggests that MEP suppression following peripheral stimulation is defective in patients with focal hand dystonia, Central processing of sensory input is abnormal in dystonia and may contribute to increased motor cortical excitability.