经颅磁刺激诱发缺血性脑卒中的皮质沉默期

J.-P Ahonen , M Jehkonen , P Dastidar , G Molnár , V Häkkinen
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引用次数: 60

摘要

目的:经颅磁刺激(TMS)产生运动诱发电位(MEPs)。除了兴奋性反应外,经颅磁刺激还具有抑制作用。当在随意肌收缩期间进行TMS时,MEP之后是肌电活动的暂停(皮质沉默期,SP)。方法:观察50例急性半脑梗死患者的SP变化。使用圆形线圈和固定强度为最大强度90%的刺激器来唤起mep。结果:50例患者中29例患侧SP被诱导。患者组患侧平均SP持续时间明显延长。患者组左右侧MEP波幅比(与周围电刺激对应波幅相关的波幅)和MEP潜伏期均值差异无统计学意义。29例患者中有25例(86%)发现SP延长,而只有4例(14%)出现MEP潜伏期或振幅比异常。在14例手功能正常的亚组中,平均SP持续时间也显著延长。结论:SP测量是一种简便、灵敏的方法,可检测缺血性卒中患者运动系统功能的亚临床障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cortical silent period evoked by transcranial magnetic stimulation in ischemic stroke

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). 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.

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