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目的:采用经颅磁刺激技术(TMS)探讨症状性运动部位相关癫患者发作间期运动皮质的兴奋性。方法:对诊断明确的34例癫患者(分治疗组和未治疗组)及20例年龄、性别匹配的正常对照组进行单脉冲经颅磁刺激,刺激部位头颅相应的运动手区和颈7棘突外侧,并于对侧小指外展肌记录运动诱发电位(MEP),分析其阈强度(TI)、周围潜伏期(PL)及皮质潜伏期(CL)、中枢传导时间(CCT)和静息期(SP)。结果:所有癫患者PL、CL及CCT均在正常范围内,但TI和SP明显低于正常对照组(P< 0.01)。在癫患者中,未治疗组TI及SP明显低于治疗组(P< 0.01),致灶侧TI及SP低于非致灶侧(P< 0.05),但非致灶侧SP亦缩短。结论:单脉冲低频TMS能有效地反映中枢运动皮质的功能状态,用于症状性运动部位相关癫患者发作间期运动皮质兴奋性研究具有重要的实用价值。
Objective: To investigate the excitability of motor cortex during interictal epilepsy by using TMS (Transcranial Magnetic Stimulation Technique). Methods: Thirty-four patients with epilepsy (divided into untreated group and untreated group) and 20 age-matched and normal-matched normal control group were subjected to single-pulse transcranial magnetic stimulation to stimulate the corresponding hand region and neck 7 The MEP was recorded on the lateral spinous process, and the threshold intensity (TI), peripheral latency (PL), cortical latency (CL), central conduction time (CCT) and resting period (SP). Results: PL, CL and CCT in all epilepsy patients were in the normal range, but TI and SP were significantly lower than those in the normal control group (P <0.01). In epileptic patients, TI and SP in the untreated group were significantly lower than those in the untreated group (P <0.01), TI and SP in the apocynosis were lower than those in the non-apocrine side (P <0.05) Also shortened. Conclusion: Single-pulse low-frequency TMS can effectively reflect the functional status of the central motor cortex, which is of important practical value in the study of excitability of motor cortex during the interictal epilepsy associated with symptomatic locomotion.