CHANGES IN THE BALANCE BETWEEN MOTOR CORTICAL EXCITATION AND INHIBITION IN FOCAL, TASK SPECIFIC DYSTONIA
CHANGES IN THE BALANCE BETWEEN MOTOR CORTICAL EXCITATION AND INHIBITION IN FOCAL, TASK SPECIFIC DYSTONIA
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DOI：
10.1136/jnnp.59.5.493
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发表时间：
1995-11-01
影响因子：
11
通讯作者：
KUJIRAI, T
中科院分区：
文献类型：
--
作者：
RIDDING, MC;SHEEAN, G;KUJIRAI, T
本文采用经颅磁刺激双脉冲模式研究了15例右手局部任务特异性肌张力障碍患者和8例年龄匹配的对照组的内源性运动皮层回路的兴奋性。左半球进行了检查，在5名患者，其余的，两个半球进行了测试。患者和对照组之间以及患者左右半球之间的刺激阈值无显著差异。在1-15 ms刺激间隔时，患者和对照组的左半球刺激的早期皮质抑制显著减少（P < 0.01）。患者左右半球的抑制量没有差异。它的结论是，在焦点任务特异性肌张力障碍有移动的兴奋和抑制之间的平衡，在局部电路的运动皮层，导致净减少的短潜伏期抑制的量。这些变化反映了基底神经节对运动皮层的输入受到干扰。皮质抑制回路的兴奋性降低可能是导致局灶性肌张力障碍患者在精细运动任务中发生过度和不适当肌肉收缩的一个因素。
Transcranial magnetic stimulation has been used in a double pulse paradigm to investigate the excitability of intrinsic motor cortical circuits in 15 patients with focal task specific dystonia of the right hand and a group of eight age matched controls. The left hemisphere was examined in five patients; in the remainder, both hemispheres were tested. There was no significant difference in stimulation threshold between patients and controls nor between the left and right hemispheres in the patients. There was a significant decrease in early corticocortical suppression when comparing stimulation of the left hemisphere in the patients and controls at interstimulus intervals of 1-15 ms (P < 0.01). There was no difference in the amount of suppression in the right and left hemispheres of the patients. It is concluded that in focal task specific dystonia there is shift in the balance between excitation and inhibition in local circuits of the motor cortex which leads to a net decrease in the amount of short latency suppression. These changes reflect disturbed basal ganglia input to the motor cortex. Reduced excitability of cortical inhibitory circuits may be one factor which contributes to the excessive and inappropriate muscle contraction which occurs during fine motor tasks in patients with focal dystonia.