Recovery of motor functions by using spinal interneuronal systems

我们研究了人类由脊髓中间神经元插入的间接皮质运动神经元(C-M)通路，以证实这些通路是否对脊柱患者的功能恢复有用。(1)正常受试者上肢肌肉可观察到间接的C-M兴奋，当受试者单独收缩肌肉时，这种刺激难以被诱发。(2)通过重复联合刺激运动皮质和周围神经，我们可以在间接C-M兴奋中诱导长时程增强。增强作用持续约1小时。(3)我们对脊髓型颈椎病患者进行了运动分析，发现灵巧手功能与主要使用间接通路的近臂功能没有平行的损害。但术后手功能的恢复部分依赖于手臂功能。我们将改进间接通路中长时程增强的方法，以供临床使用。

We investigated indirect cortico-motoneuronal (C-M) pathways intercalated by spinal interneurons in humans, to confirm if the pathways are useful for functional recovery in spinal patients. (1) We could observe indirect C-M excitations in upper limb muscles of normal subjects, which were difficult to be evoked when subjects contracted a muscle in isolation. (2) We could induce long-term potentiation in the indirect C-M excitations, by using repetitive combined stimulation of the motor cortex and a peripheral nerve. The potentiation lasted for ca. 1 hour. (3) We performed movement analyses in patients with cervical myelopathy, and revealed that dexterous hand functions were not impaired in parallel with proximal arm functions, which are known to use mainly the indirect pathways. But postoperative recovery of hand functions partly depended on arm functions. We will improve the methods for long-term potentiation in the indirect pathways, for clinical use.