MOVEMENT DEFICITS CAUSED BY HYPEREXCITABLE STRETCH REFLEXES IN SPASTIC HUMANS
MOVEMENT DEFICITS CAUSED BY HYPEREXCITABLE STRETCH REFLEXES IN SPASTIC HUMANS
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DOI：
10.1093/brain/109.5.1043
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发表时间：
1986-10-01
期刊：
影响因子：
14.5
通讯作者：
AGARWAL, GC
中科院分区：
文献类型：
--
作者：
CORCOS, DM;GOTTLIEB, GL;AGARWAL, GC
摘要 指导痉挛患者在不同距离上对目标进行准确、快速的踝背屈和跖屈运动。记录胫骨前肌 (TA) 和比目鱼肌 (SOL) 的踝关节位置和表面肌电图 (EMG)。在接受测试的 8 名痉挛患者中，有 3 名患者的背屈引起了拮抗肌 (SOL) 的速度依赖性激活，从而阻碍了运动，以至于肢体无意中逆转了运动方向。我们认为这种激活起源于反射，因为它（1）是紧密同步的，（2）具有大的峰值幅度，（3）发生在运动开始后约50毫秒，（4）是速度依赖性的，在背屈时有反射诱导的拮抗剂激活的3名患者中的一个也在跖屈期间表现出持续的阵挛。这种情况通常只有在目标超出时才会发生，因此肢体的返回会拉伸比目鱼肌并引发阵挛。我们得出的结论是，在某些患者中，过度活跃的牵张反射会导致运动缺陷。
SUMMARYSpastic patients were instructed to make accurate, rapid ankle dorsiflexion and plantarflexion movements over different distances to a target. Ankle position and surface electromyograms (EMGs) from tibialis anterior (TA) and soleus (SOL) muscles were recorded. In 3 of 8 spastic patients tested, dorsiflexion evoked velocity-dependent activation of the antagonist (SOL) muscle which impeded the movement to the extent that the limb unintentionally reversed movement direction. We propose that this activation is reflex in origin since it (1) is tightly synchronized, (2) has a large peak amplitude, (3) occurs about 50 ms after the initiation of the movement, and (4) is velocity dependentOne of the 3 patients who had reflex-induced antagonist activation in dorsiflexion also demonstrated sustained clonus during plantarflexion. This usually occurred only if the target had been overshot so that the return of the limb stretched the soleus muscle and triggered clonus We conclude that in some patients, hyperactive stretch reflexes cause movement deficits.