脊髓型颈椎病病人经颅磁电刺激运动诱发电位的对比研究

目的探讨磁电刺激运动诱发电位（ＭＥＰ）在脊髓型颈椎病（ＣＳＭ）的应用价值，并对其临床相关性进行分析。方法采用经颅磁、电刺激对３０例脊髓型颈椎病病人以及年龄性别等相配匹的３０名健康成人分别于外展小指肌、肱二头肌及下肢展短肌表面进行ＭＥＰ的检测。结果全部病人的ＭＥＰ都出现异常，表现为潜伏期、中枢传导时间（ＣＭＣＴ）延长，时限增宽，波辐降低或不能引出。磁刺激ＭＥＰ的ＣＭＣＴ和皮层刺激潜伏期与脊髓型颈椎病临床日本整形外科协会（ＪＯＡ）评分间有密切相关性，能较好地反映ＣＳＭ病人的病情。结论ＭＥＰ在检测ＣＳＭ病人运动功能方面具有定量评价作用。与电刺激相比，磁刺激ＭＥＰ能更好地反映ＣＳＭ病人的病情。

Comparison between transcranial magnetic and electrical motor evoked potentials in cervical spondylotic myelopathy as well as their clinical correlation study

Objective To investigate the values of motor evoked potentials(MEPs) in cervical spondylotic myelopathy(CSM) and to compare transcranial magnetic stimulation MEP with electrical stimulation MEP as well as some other problems in MEP clinical applications. Methods 30 cervical spondylotic myelopathy patients and 30 matched healthy volenteers were examined by transcranial MEPs. Compound muscle action potentials(CMAPs) after transcranial stimulation were recorded from abductor digiti minimi, biceps and abductor hallucis brevis. Results All 30 patients had abnormal MEPs and manifested by elongation of cortical latency and central motor conduction time(CMCT), widened CMAPs duration as well as decreased amplitude or disappeared MEP. Correlation between abnormal degree of magnetic MEP and CSM patients' clinical JOA scores is statistically significant, and the usage of F wave to calculate CMCT could improve its preciseness. The cortical and peripheral latencies of MEPs in healthy volenteers were well correlated with body height, but CMCT was not. Conclusions Transcranial magnetic and electrical MEPs can quantitatively eveluate the motor dysfuction of CSM patients. Magnetic MEP is better correlated with clinical manifestations than electrical MEP and the uasage of F wave is more precise in calculating the central motor conduction time.