中老年人脑白质疏松症的电刺激运动诱发电位研究

Clinical study of electrical stimulation motor evoked potential in middle and old aged people with luekoariosis

目的 :探讨电刺激运动诱发电位在中老年人脑白质疏松的临床应用价值。方法 :用大脑皮层电刺激仪刺激大脑上、下肢皮层运动区及颈椎7、胸椎1 2 棘突的相应皮肤 ,在大鱼际肌及胫前肌记录相应的运动诱发电位 (MEP) ,分别对 30例脑白质疏松的中老年人和 30例无白质疏松的对照组进行测定。结果 :脑白质疏松MEP的异常率 37% ,和正常人比较有显著性差异 (χ2 =9 79,P <0 0 1) ,其异常形式有 :中枢运动传导时间 (CMCT)延长 ,MEP潜伏期 (PL)延长 ,波幅增大和波形消失。下肢CMCT和PL延长与对照组比较有显著差异 (t=11 8,P <0 0 1)。结论 :MEP客观反映了脑白质疏松中老年人的运动传导功能 ,对判断亚临床锥体束损害有实用价值。

Objective:To investigate the clinical value of motor evoked potentials (MEP′s)in middle and old aged people with leukoariosis(LA).Methods:MEPs were recorded from big thenar and anterior tibial muscle,when stimulating cerebral motor area and spinal process of C 7 and T 1,2 by CCS Ⅰelectrical stimulator of 30 elder persons with LA and 30 normal subjects respectively.Results:The abnormality rate of MEP was 37% in patients with LA.A significant difference between abnormality rate of MEP in LA and that in normal group was noted .Shown are the prolongation of central motor conduction time (CMCT)of MEP,the increase of bilateral CMCT difference,and the decrease of MEP amplitude,In the prolongation of CMCT and PL of lower limb when stimulated,there is a significant (P<0 01)difference between LA and normal subjects.Conclusion:MEP could be regarded as an objective index to reflect the motor function of elder people with LA,and it might be practical and beneficial to diagnose the LA for the judgement of subclinical damage of pyramid tract