未经证实:使用经颅磁刺激(TMS)来描绘两种神经退行性疾病的上运动神经元(UMN)体征:肌萎缩侧索硬化症(ALS)和多系统萎缩(MSA)。
UNASSIGNED:对包括UMN损伤的临床体征和TMS结果在内的医疗记录进行回顾性分析。UMN标志被归类为无,温和,根据各种反射的神经系统检查,严重。然后从手部和腿部肌肉记录TMS引起的运动诱发电位(MEP),以计算中枢运动传导时间(CMCT)。这代表了快速,沿着皮质脊髓束的单突触传导。分析了两种疾病的UMN体征与CMCT之间的关系。
UNASSIGNED:上肢和下肢ALS和MSA的UMN体征的患病率和严重程度相当。然而,CMCT的异常在ALS中更常见:在ALS患者中,上肢有44%的CMCT异常,但在MSA患者中只有7%的CMCT异常;下肢CMCT异常在ALS中占55%,在MSA中占20%.部分ALS患者四肢CMCT异常,无UMN征象,这对大多数MSA患者来说是不正确的。
未经证实:在ALS和MSA中,CMCT的异常是不同的,即使对于那些临床上有类似的UMN症状的人。有时候,CMCT可以在没有临床UMN体征的情况下揭示UMN损伤。差异可能源于运动下降途径中不同纤维的选择性变性。必须进行纵向研究以积累神经影像学和病理学发现。
UNASSIGNED:CMCT可用于区分ALS和MSA。
UNASSIGNED: Using transcranial magnetic stimulation (TMS) to delineate upper motor neuron (UMN) signs of two neurodegenerative disorders: amyotrophic lateral sclerosis (ALS) and multiple system atrophy (MSA).
UNASSIGNED: Medical records including clinical signs for UMN damage and TMS results were reviewed retrospectively. The UMN signs were classified into none, mild, and severe based on neurological examination of various reflexes. Then TMS-elicited motor evoked potentials (MEPs) were recorded from a hand and a leg muscle to calculate the central motor conduction time (CMCT), which represents fast, mono-synaptic conduction along the corticospinal tract. Relations between the UMN signs and CMCT were analysed for the two diseases.
UNASSIGNED: Prevalence and severity of the UMN signs for ALS and MSA were comparable for both upper and lower limbs. However, abnormality in CMCT was found more frequently in ALS: CMCT abnormalities were found in upper limbs for 44% in ALS patients but only for 7% in MSA patients; CMCT abnormalities in lower limbs were 55% in ALS and 20% in MSA. Some ALS patients showed abnormal CMCT in limbs without UMN signs, which was not true for most MSA patients.
UNASSIGNED: The abnormalities of CMCT were different in ALS and MSA, even for those who clinically had similar UMN signs. Sometimes, CMCT can reveal UMN damage in the absence of clinical UMN signs. Differences presumably derive from selective degeneration of different fibres in the motor descending pathways. Longitudinal studies must be conducted to accumulate neuroimaging and pathological findings.
UNASSIGNED: CMCT can be useful to differentiate ALS and MSA.