帕金森病患者的中枢电生理表现  

Central electrophysiology in Parkinson’s disease patients with different manifestations

作　　者：李文娟[1] 乔鸿飞[1] 傅静[1] 张慧[1] 苑媛媛 LI Wenjuan;QIAO Hongfei;FU Jing;ZHANG Hui;YUAN Yuanyuan(Department of Rehabilitation Medicine,Second Affiliated Hospital Of Xi’an Jiaotong University,Xi’an 710000,China)

机构地区：[1]西安交通大学第二附属医院康复医学科,西安710000

出　　处：《山西医科大学学报》2020年第9期995-998,共4页Journal of Shanxi Medical University

基　　金：陕西省自然科学基础研究计划项目(2017JM8053)。

摘　　要：目的研究帕金森病(Parkinson’s disease,PD)患者大脑皮层的活动状态,以制定个体化治疗方案,并为帕金森病发病机制的研究提供依据。方法招募不同临床表现的PD患者16名,其中静止性震颤者7名,运动迟缓者9名,Hoehn-Yahr分期2-3期,根据统一帕金森病评定量表-Ⅲ(unified Parkinson’s disease rating scale-Ⅲ,UPDRS-Ⅲ)中单侧肢体得分结果将每组患者肢体分为症状重侧和症状轻侧,所有患者四肢均行皮层运动阈值(motor threshold,MT)、运动诱发电位(motor evoked potential,MEP)、中枢传导时间(central motor conduction time,CMCT)检测,对比组间各检测值有无明显差异。结果静止性震颤组症状较重侧上肢MT与运动迟缓组比较差异有统计学意义(P<0.05),症状较轻侧MT、MEP潜伏期、波幅以及CMCT两组间差异均无统计学意义(P>0.05)。结论不同临床表现的PD患者皮层MT不同,皮层兴奋性的不同可能是导致PD不同临床表现的原因之一。Objective To know the activity of cerebral cortex in patients with Parkinson’s disease(PD),so as to formulate a persona-lized treatment plan and apply it to the basic research of PD.Methods Sixteen PD patients were recruited(Hoehn-Yahr Stage 2-3),including 7 patients with rest tremor and 9 patients with bradykinesia.The severer body side of symptoms was assessed with unified Parkinson’s disease rating scale-Ⅲ(UPDRS-Ⅲ).The indicators of corticomotor excitability,including motor threshold(MT),motor evoked potential(MEP)and central motor conduction time(CMCT)were observed and compared between the two groups in all limbs.Results MT of the severer upper extremity in patients with rest tremor was significant different from that in patients with bradykinesia(P<0.05),and there was no difference in MT of the slight side,the latency and amplitude MEP and CMCT between the two groups(P>0.05).Conclusion MT of PD patients with different clinical manifestations is different,and the difference of cortical excitability may be one of the reasons for the various clinical manifestations of PD.

关 键 词：帕金森病 中枢电生理 静止性震颤 运动迟缓 

分 类 号：R742[医药卫生—神经病学与精神病学]