肌萎缩侧索硬化患者膈肌运动诱发电位

目的 初步探讨膈股运动诱发电位（DMEP）在肌萎缩侧索硬化（ALS）患者的应用及特点。方法 以表面电极在肋间隙处记录37例ALS患者及31例正常对照者经颅及经项磁刺激时产生的膈肌复合肌肉动作电位潜伏期和波幅,并计算中枢运动传导时间（CMCT）。22例ALS患者同时接受了用力肺活量百分比（％FVC）测定。结果 ALS患者较对照者颈及皮层潜伏期延长,颈及皮层波幅对数降低,CMCT延长,皮层潜伏期、皮层波幅对数、CMCT均与锥体束受累相关;皮层潜伏期和CMCT与临床呼吸困难相关,颈潜伏期与％FVC相关。结论 CMCT、颈及皮层潜伏期是DMEP参数中反映ALS患者呼吸功能障碍的敏感指标。CMCT反映ALS患者与呼吸功能相关的皮质脊髓束功能,CMCT与颈潜伏期结合有助于全面准确地揭示ALS患者呼吸受累的本质。

Diaphragmatic motor evoked potential in amyotrophic lateral sclerosis patients

Objective To investigate the features and application of diaphragmatic motor evoked potential(DMEP) in amyotrophic lateral sclerosis(ALS) patients. Methods To record the latency and amplitude of diaphragmatic compound muscle action potential(DCMAP) from 37 ALS patients and 31 control subjects with surface electrodes after transcranial and transcervical magnetic stimulation, central motor conduction time(CMCT) was calculated. The percentage of forced vital capacity (%FVC) was performed in 22 ALS patients simultaneously. Results Cortical and cervical latencies of the ALS patients were longer than those of the controls, and cortical and cervical amplitudes of the ALS patients were lower than those of the controls. CMCT of the ALS patients were longer than that of the controls. Cortical latency, cortical amplitude and CMCT were all correlated with the dysfunction of the pyramidal tract. Cortical latency and CMCT were also correlated with the clinical respiratory dysfunction, cervical latency was correlated with %FVC. Conclusions CMCT, Cortical and cervical latencies are sensitive index in DMEP parameters reflecting respiratory dysfunction in ALS, CMCT reflects cortical spinal tract function of ALS patients associated with respiration. It would be helpful to detect the neurological basis of the respiratory disturbance in ALS combining CMCT with cervical latency.