原发性震颤、帕金森病、原发性震颤-帕金森病综合征的表面肌电特点  

The surface electromyography characteristics of essential tremor,Parkinson′s disease and essential tremor-Parkinson′s disease syndrome

作　　者：冯焕焕[1] 林仲希 庄平 周涌涛[1] 张伟 许二赫[1] 陈彪[1] Feng Huanhuan;Lin Zhongxi;Zhuang Ping;Zhou Yongtao;Zhang Wei;Xu Erhe;Piu Chan(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing Institute of Geriatrics,Beijing 100053,China;Beijing Institute of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]首都医科大学宣武医院神经内科、北京市老年病医疗研究中心,北京100053 [2]首都医科大学宣武医院北京功能神经外科研究所,北京100053 [3]徐州医科大学附属医院神经内科,徐州221006

出　　处：《中华神经科杂志》2025年第3期254-260,共7页Chinese Journal of Neurology

基　　金：国家重点研发计划(2021YFC2501200)。

摘　　要：目的比较原发性震颤(ET)、帕金森病、原发性震颤-帕金森病综合征(ET-PD)患者的表面肌电特点。方法采集首都医科大学宣武医院神经内科帕金森及运动障碍病诊疗中心于2020年8月至2023年12月收治的74例伴有震颤患者(包括ET组23例、帕金森病组30例、ET-PD组21例)的双上肢表面肌电图结果,进行功率谱分析,探讨其表面肌电活动特点。采用单因素方差分析和卡方检验比较3组患者表面肌电图的各项电生理参数。结果ET组震颤频率为(6.06±0.68)Hz,震颤幅度为(1200.91±360.69)μV,交替收缩所占比例为30.4%(7/23),谐波共振所占比例为34.8%(8/23)。帕金森病组震颤频率为(4.81±0.61)Hz,震颤幅度为(1057.40±354.52)μV,交替收缩所占比例为73.3%(22/30),谐波共振所占比例为70.0%(21/30)。ET-PD组的静止性和姿势性震颤频率分别为(5.04±0.44)Hz和(5.80±0.47)Hz,震颤幅度分别为(1026.05±191.90)μV和(1196.67±212.12)μV,交替收缩所占比例分别为52.4%(11/21)和38.1%(8/21),谐波共振所占比例分别为52.4%(11/21)和33.3%(7/21)。进行方差分析发现,帕金森病组和ET-PD组的静止性震颤频率低于ET组,也低于ET-PD组的姿势性震颤频率(F=27.439,P<0.001)。帕金森病交替收缩模式所占的比例高于ET组(χ^(2)=9.669,P=0.002)和ET-PD组(姿势性震颤;χ^(2)=6.333,P=0.012)。帕金森病组谐波共振所占的比例高于ET组(χ^(2)=6.517,P=0.011)和ET-PD组(姿势性震颤;χ^(2)=6.708,P=0.010)。各组间震颤幅度比较差异无统计学意义(F=2.143,P=0.100)。结论ET以姿势性震颤为主,震颤频率偏快,交替收缩和谐波共振所占的比例低;帕金森病以静止性震颤为主,震颤频率偏慢,交替收缩和谐波共振所占的比例高;ET-PD的各项参数介于ET和帕金森病之间,为临床震颤鉴别提供客观依据。ObjectiveTo compare the surface electromyography characteristics of essential tremor(ET),Parkinson′s disease(PD)and essential tremor-Parkinson′s disease syndrome(ET-PD).MethodsA total of 74 patients[ET group(n=23),PD group(n=30),and ET-PD group(n=21)]admitted to the Parkinson′s and Movement Disorders Center of the Department of Neurology of Xuanwu Hospital from August 2020 to December 2023 were enrolled,and results of their bilateral upper limbs surface electromyography(sEMG)were collected.sEMG activities were analyzed offline.Power spectral analysis was performed to explore the sEMG activities.One-way analysis of variance and chi-square test were used to compare the differences of electrophysiological parameters.ResultsFor the ET group characterized by postural tremor,the frequency was(6.06±0.68)Hz,the amplitude was(1200.91±360.69)μV,the proportion of alternating contractions was 30.4%(7/23),and the proportion of harmonic resonances was 34.8%(8/23).For the PD group characterized by rest tremor,the frequency was(4.81±0.61)Hz,the amplitude was(1057.40±354.52)μV,the proportion of alternating contractions was 73.3%(22/30),and the proportion of harmonic resonances was 70.0%(21/30).For the ET-PD group in rest and postural state respectively,the frequencies were(5.04±0.44)Hz and(5.80±0.47)Hz,the amplitudes were(1026.05±191.90)μV and(1196.67±212.12)μV,the proportions of alternating contractions were 52.4%(11/21)and 38.1%(8/21),and the proportions of harmonic resonances were 52.4%(11/21)and 33.3%(7/21).Analysis of variance revealed that tremor frequencies for the PD group and the ET-PD group in rest state were lower than the ET group and the ET-PD group in postural state(F=27.439,P<0.001).The proportion of alternating contractions for the PD group was higher than the ET group(χ^(2)=9.669,P=0.002)and the ET-PD group in postural state(χ^(2)=6.333,P=0.012).The proportion of harmonic resonances for the PD group was higher than the ET group(χ^(2)=6.517,P=0.011)and the ET-PD group in postural state(χ^(2)=

关 键 词：特发性震颤 帕金森病 原发性震颤-帕金森病综合征 肌电描记术 

分 类 号：R74[医药卫生—神经病学与精神病学]