Corticospinal volleys evoked by transcranial stimulation of the brain in conscious humans
Corticospinal volleys evoked by transcranial stimulation of the brain in conscious humans
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DOI：
10.1179/016164103101201292
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发表时间：
2003-03-01
影响因子：
1.9
通讯作者：
Tonali, PA
中科院分区：
文献类型：
--
作者：
Di Lazzaro, V;Oliviero, A;Tonali, PA
在清醒的人类中，直接记录由不同的经颅刺激的磁和电技术诱发的皮质脊髓抽动，表明有可能以几种不同的方式激活运动皮质的神经元。侧方电刺激运动皮质优先激活皮质下白质中的皮质脊髓神经元轴突，并在锥体束中诱发D波。使用磁刺激激活皮质脊髓神经元的方式取决于大脑中感应电流的方向和线圈的形状。用八字形线圈在大脑中诱发前后电流的单相磁刺激，激活皮质脊髓神经元跨突触地招募1I波，随后的I波以较高的强度顺序出现，D波以非常高的强度出现。如果感应电流旋转到前后方向，则优先招募晚I波，当招募D波时，它的起始时间晚于电D波，这表明激活更接近锥体神经元的细胞体。内侧感应电流在电刺激引起D波的同一点激活两个皮质脊髓轴突，而在诱发I波的同时激活皮质轴突。以顶端为中心的非焦点大圆线圈，既能激活起始节段的锥体神经元，又能跨突触诱发潜伏期长于电性D波和I波的D波。利用双相磁刺激，双相脉冲的两个阶段都能激活下行运动输出，下行活动的招募模式取决于刺激的强度和每一次抽射对每个电流方向的相对阈值。
The direct recording in conscious humans of corticospinal volleys evoked by different magnetic and electric techniques of transcranial stimulation demonstrates that it is possible to activate neurones of the motor cortex in several different ways. Lateral electrical stimulation of the motor cortex preferentially activates the axons of corticospinal neurones in the subcortical white matter, and evokes a D-wave in pyramidal tract. The way of activation of corticospinal neurones using magnetic stimulation depends on the direction of the electrical current induced in the brain and on the shape of the coil. Monophasic magnetic stimulation with a focal figure-of-eight coil inducing posterior-anterior current in the brain activates corticospinal neurones trans-synaptically recruiting an 1I-wave, with later I-waves appearing in sequence at higher intensities and a D-wave at very high intensities. If the induced current is rotated to the anterior-posterior direction late I-Waves are preferentially recruited and when a D-wave is recruited, it has a later onset than the electrical D-wave, suggesting an activation nearer the cell body of the pyramidal neurones. A latero-medial induced current activates both corticospinal axons at the same point as electrical stimulation evoking a D wave and cortico-cortical axons evoking I-waves. A nonfocal large circular coil centered at the vertex is capable of activating pyramidal neurones both at the initial segment and trans-synaptically evoking a D wave with a longer latency than the electrical D-wave and I-waves. Using a biphasic magnetic stimulation, both phases of the biphasic pulse are capable of activating descending motor output and the pattern of recruitment of descending activity depends on the intensity of the stimulus and the relative threshold of each volley to each direction of current flow.