经颅磁刺激对帕金森氏病患者的运动诱发电位的研究  

Motor evoked potential in Parkinson's disease by transcranial magnetic stimulation

作　　者：康君芳[1,2] 张宝荣[1] 尹厚民[1] 冯蔚[1] 

机构地区：[1]浙江大学医学院附属第二医院神经内科,浙江杭州310009 [2]浙江省奉化市人民医院神经内科,浙江奉化315500

出　　处：《中国病理生理杂志》2009年第4期725-728,共4页Chinese Journal of Pathophysiology

摘　　要：目的:本研究主要通过经颅磁刺激(TMS)检测帕金森氏病(PD)患者的运动诱发电位(MEP),总结PD患者的MEP特点,探讨PD患者的运动皮质兴奋性。方法:选取健康志愿者20例作为正常对照组(A组),男12例,女8例,年龄52-79岁,平均(62.3±16.7)岁。通过TMS检测左右两侧MEP,作左右侧比较。选取2007年5月-8月浙江大学医学院附属第二医院神经内科住院或门诊的PD患者共21例(B组),均症状左右不对称,男12例,女9例,年龄46-80岁,平均(63.3±16.7)岁,按症状轻重程度比较MEP,且将PD组与正常组比较。结果:正常对照组左右侧MEP参数无显著差异。PD组与正常对照组相比,静息运动阈值(RMT)降低,波幅(Amp)升高,皮质潜伏期(CL)缩短,有显著差异,中枢运动传导时间(CMCT)改变无显著差异。PD症状重侧与轻侧相比较,重侧的RMT更低,有显著差异,AMP、CL、CMCT改变无显著差异。结论:PD患者的运动皮质兴奋性增高,且与症状严重程度相关。利用PD患者的MEP特点有助于辅助诊断,有助于评估症状严重程度,以RMT敏感性最高。AIM： To explore the characteristics of motor evoked potential （MEP） and cortical excitability in Parkinson＇s disease by transcranial magnetic stimulation （TMS）. METHODS： 20 normal volunteers were enrolled as control （group A）, with the average age of （62. 3 ± 16. 7） year old ranged from 52 to 79 years including 12 males and 8 females. MEP were assessed and compared separately between left and right hemispheres. 21 patients with Parkinson＇s disease（PD） in asymmetry symptoms were performed in this study （group B）, with the average age of （63.3 ± 16. 7） year old ranged from 46 to 80 years including 12 males and 9 females. UPDRS motor scores （ UPDRSⅢ ） were assessed before the check of cortical excitability （MEP）. Motor evoked potentials （MEP） was assessed and compared separately on the mi- nor and the serious bodyside, compared to control group. RESULTS ： The indexes of MEP from both sides of normal control had no significant diversity. Amp was increased and both rest motor threshold （RMT） and cortical latency （CL） were also decreased significantly in PD patient compared to the normal control. On the serious side of PD, RMT decreased significantly compared to the minor side. Amp, CL and central motor conduct time （CMCT） changed without significant di- versity between minor and serious bodyside. CONCLUSION： The motor cortical excitability is increased in PD patients. The excitability is higher with the more serious symptom side. The character of MEP in PD patients may be helpful to make a diagnosis and evaluate the severity of symptoms.

关 键 词：帕金森氏病 经颅磁刺激 诱发电位 运动 

分 类 号：R741.044[医药卫生—神经病学与精神病学]