[磁电诱发复合肌电位的正常值和年龄相关变化]。

H Kloten, B U Meyer, T C Britton, R Benecke
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摘要

本文采用经颅磁刺激运动皮层和经皮磁刺激脊神经根的方法,对57例正常人进行了研究,以获得中央和外周运动潜伏期的规范性数据。在标准化条件下(刺激部位、刺激强度、随意强直背景激活程度),记录上肢和下肢不同肌肉的肌肉复合动作电位:肱二头肌、桡腕伸肌、背骨间肌、股内侧肌、胫骨前肌和指短伸肌。评估发作潜伏期、峰对峰幅度(最大m波的百分比)、肌肉复合动作电位的持续时间和结构(图1和表1-6)。通过刺激神经轴的两个不同点(皮质/颈或腰神经根)来确定中枢和外周运动潜伏期。中央运动潜伏期是通过从最快的皮层诱发肌肉反应的开始潜伏期减去外周传导时间来计算的。年龄越大,不仅外周运动潜伏期增加,而且中枢运动潜伏期也增加(表6)。在检查老年患者诊断下行运动束疾病时,必须考虑到这一点。
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[Normal values and age-related changes in magneto-electric evoked compound muscle potentials].

A number of 57 normal subjects was investigated using transcranial magnetic stimulation of the motor cortex and transcutaneous magnetic stimulation of the spinal nerve root in order to obtain normative data for central and peripheral motor latencies. Under standardized conditions (site of stimulation, stimulus intensity, degree of voluntary tonic background activation) muscle compound action potentials were recorded from different muscles of the upper and lower extremity: M. biceps brachii, M. extensor carpi radialis, M. interosseus dorsalis I, M. vastus medialis, M. tibialis anterior, and M. extensor digitorum brevis. Onset latency, peak to peak amplitude (% of maximal M-wave), duration and configuration of the muscle compound action potentials were evaluated (Fig. 1 and Tab. 1-6). Central and peripheral motor latencies were determined by stimulation over two different points of the neuraxis (cortex/cervical or lumbar nerve roots). Central motor latencies were calculated by subtracting the peripheral conduction time from the onset latency of the fastest cortically evoked muscle response. Not only the peripheral but also the central motor latencies were found to increase in higher ages (Tab. 6). This has to be taken into account when elderly patients are examined for diagnosis of disorders of the descending motor tracts.

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