Cortical silent period evoked by transcranial magnetic stimulation in ischemic stroke
Cortical silent period evoked by transcranial magnetic stimulation in ischemic stroke
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DOI：
10.1016/s0924-980x(98)00014-9
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发表时间：
1998-06-01
期刊：
影响因子：
--
通讯作者：
Häkkinen, V
中科院分区：
文献类型：
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作者：
Ahonen, JP;Jehkonen, M;Häkkinen, V
目的：经颅磁刺激（TMS）运动皮层产生运动诱发电位（MEP）。除了这种兴奋性反应外，TMS还有抑制作用。当在随意肌肉收缩期间进行TMS时，MEP之后是肌电活动的暂停（皮质沉默期，SP）。方法：对50例急性半球性脑梗塞患者进行SP检测。使用具有圆形线圈和最大值的90%的固定强度的刺激器来诱发MEP。结果：50例患者中29例在患侧诱发出SP。患者组患侧的平均SP持续时间明显延长。患者组左右侧MEP波幅比（波幅与外周电刺激相应波幅的比值）和MEP潜伏期的均值无显著性差异。29例患者中25例（86%）SP延长，而MEP潜伏期或波幅比异常仅4例（14%）。平均SP持续时间显着延长，也在一个亚组的14例手功能正常的患者。结论：SP测量是一种易于执行和敏感的方法，以检测缺血性卒中运动系统功能的亚临床障碍。(C)1998爱思唯尔科学爱尔兰有限公司保留所有权利。
Objectives: Transcranial magnetic stimulation (TMS) of the motor cortex produces motor evoked potentials (MEPs). Besides this excitatory response, TMS has inhibitory effects. When TMS is performed during voluntary muscle contraction, the MEP is followed by a pause in electromyographic activity (cortical silent period, SP). The aim of this study was to evaluate the clincial usefulness of the SP. Methods: We studied SP changes in 50 patients with acute hemispheric brain infarction. A stimulator with a round coil and a fixed intensity of 90% of maximum was used to evoke MEPs. Results: SP was elicited on the affected side in 29 of the 50 patients. The mean SP duration was markedly longer on the affected side in the patient group. There were no significant differences between left and right sides in the means of the MEP amplitude ratio (amplitude related to corresponding amplitudes to peripheral electric stimulation) and MEP latencies in the patient group. Prolonged SP was found in 25 of the 29 patients (86%) whereas only 4 (14%) had abnormalities in MEP latency or amplitude ratio. The mean SP duration was significantly prolonged also in a subgroup of 14 patients with normal hand function. Conclusions: The SP measurement is an easily performed and sensitive method to detect even subclinical disturbances in motor system function in ischemic stroke. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.