帕金森病运动诱发电位及其影响因素的研究

目的：从运动功能、电生理检测方面观察帕金森病（PD）患者的皮质兴奋性的改变及其影响因素。方法：共68例PD患者，另选择30名健康者为对照组。采用统一帕金森病评定量表（UP-DRS）、经颅磁刺激运动诱发电位（MEP）作为评定指标。结果：PD患者MEP的静息阈值（RMT）、中枢传导时间（CMCT）较正常对照组明显降低或缩短，而波幅（Amp）则无明显差异。〉5年患者的RMT（40．70±4．74），比≤5年患者的RMT（42．60±4．61）缩短；强直型患者的RMT（40．92±5．28），比震颤型患者的RMT（42．93±3．97）缩短，差异有统计学意义。结论：PD患者存在运动功能障碍，大脑皮质兴奋性升高；强直型和病程长的患者病情较重，大脑皮质兴奋性升高更明显。

Research of MEP and its influential factors in patients with Parkinson's disease

Objective：To investigate the MEP and its influential factors in Parkinson＇ s disease（PD）from motor function and electrophysiology. Methods： MEP was observed in sixty-eight patients with PD and 30 gender-age matched normal controls and the difference between two groups were recorded. Adoption of UPDRS and motor evoked potential （MEP） as assessment indicators. Excitability of motor cortex were assessed by rest threshold （RMT） , central motor conduction time （CMCT） and amplitude of motor evoked potential （MEP） . Results： ①RMT and CMCT of patients with PD decreased or were short ened significantly compared with controls, but MEP amplitudes were not changed. ②The RMT in long course（≥5 years） of PD patients was shortened compared with short course（〈5 years）group. The RMT of course of disease 〉5 years was 40. 70±4. 74,and that of course of disease ≤5 years was 42. 60± 4.61; The RMT of rigidity was 40.92±5.28,and that of the tremor was 42.93±3.97,showing statistically significant difference. Conclusion： PD patients have motor dysfunction. The increased motor cortical excitability in PD is observed in our study. The RMT was shortened with the longer course and rigidity. The rigidity and the course of disease become longer,and the cortex excitability increased.