脊髓损伤后神经元功能退化的机制与对策  

Degradation of neuronal function following a spinal cord injury: Mechanics and c ountermeasures

作　　者：Dietz V. Müller R. 陈云春 

机构地区：[1]Balgrist University Hospital, Spinal Cord Injury Center, Forchst rasse 340, 8008 Zurich, Switzerland Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第3期28-28,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：The aim of this study was to evaluate the course of spinal neuronal activity f ollowing spinal cord injury (SCI). In patients with a complete SCI, the leg musc le EMG activity early and up to 33 years after an SCI was analysed during locomo tor movements induced and assisted by a driven gait orthosis (DGO). Only in chro nic SCI patients did a premature exhaustion of neuronal activity occur. This was reflected in a reduced density and fading of leg muscle EMG activity. The early exhaustion of EMG activity was more pronounced in the leg flexor (e.g. biceps f emoris) than extensor (e.g. gastrocnemius) muscles. The timing of the leg muscle pattern remained unchanged in the chronic patients. A preserved amplitude of mo tor action potentials following repetitive peripheral nerve stimulation and duri ng spasms indicated an interneuronal site of impairment. In patients who partici pated in a locomotor training programme lasting up to 13 weeks, no positive effe ct on the slope of exhaustion was seen. It is concluded that a degradation of sp inal neuronal activity takes place following an SCI. If in the future regenerati on of spinal tract fibres becomes feasible in patients with complete SCI, such a n approach can only become functionally successful if neuronal activity below th e level of the lesion is maintained. This might be achieved by a continuous trai ning approach starting early after injury.The aim of this study was to evaluate the course of spinal neuronal activity f ollowing spinal cord injury (SCI). In patients with a complete SCI, the leg musc le EMG activity early and up to 33 years after an SCI was analysed during locomo tor movements induced and assisted by a driven gait orthosis (DGO). Only in chro nic SCI patients did a premature exhaustion of neuronal activity occur. This was reflected in a reduced density and fading of leg muscle EMG activity. The early exhaustion of EMG activity was more pronounced in the leg flexor (e.g. biceps f emoris) than extensor (e.g. gastrocnemius) muscles. The timing of the leg muscle pattern remained unchanged in the chronic patients. A preserved amplitude of mo tor action potentials following repetitive peripheral nerve stimulation and duri ng spasms indicated an interneuronal site of impairment. In patients who partici pated in a locomotor training programme lasting up to 13 weeks, no positive effe ct on the slope of exhaustion was seen. It is concluded that a degradation of sp inal neuronal activity takes place following an SCI. If in the future regenerati on of spinal tract fibres becomes feasible in patients with complete SCI, such a n approach can only become functionally successful if neuronal activity below th e level of the lesion is maintained. This might be achieved by a continuous trai ning approach starting early after injury.

关 键 词：脊髓损伤 神经元功能 脊髓神经元 腿部肌肉 痉挛发作 完全性 慢性患者 伸肌 股二头肌 屈肌 

分 类 号：R651.2[医药卫生—外科学]