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目的 探讨皮层磁运动诱发电位 (MMEP)在不同年龄期小儿的年龄特征与发育规律。方法 对 197例 1～ 14岁健康儿童和 2 0例正常成人按年龄分 8组进行非易化状态下的经颅磁刺激 (TMS) ,分别在上肢拇短展肌和下肢展肌处记录MMEP。获取各项参数 ,分析观察MMEP的发育特征。结果 在肌松弛状态下 ,正常小儿除在周岁半前上肢和 3 .5岁前下肢较难记录到皮层反应波外 ,皆能满意获得不同年龄期上、下肢皮层MMEP。代表脊髓段运动神经电传导速度的颈 -腰中枢传导时间 (CCT)和传导速度(CCV)、以及代表颅内段运动传导的头 -颈CCT和CCV分别于 6岁和 10岁前达成人值。上、下肢皮层MMEP传导速度及校正CCT与年龄非常高度相关 (r值分别为 0 .79、0 .75 )。所有年龄组MMEP潜伏期左、右间差值较恒定 ,上、下肢分别不超过 2 .6ms和 3 .5ms。结论 皮层MMEP能很好反映小儿颅内和脊髓运动传导通路的生长发育和传导功能。鉴于CCT受身长影响及CCV与年龄高度相关性 ,应将CCV列入小儿MMEP常规检测指标。该技术无痛无创伤 ,可安全地用于婴儿期后各年龄小儿中枢运动神经功能的检测。
Objective To investigate the age characteristics and developmental rules of cortex magnetic motor evoked potentials (MMEP) in children of different ages. Methods TMS was performed on 197 healthy children aged from 1 to 14 and 20 normal adults under non-facilitated TMS in 8 groups according to age. MMEP. Obtain the parameters, analyze the developmental characteristics of MMEP. Results In the condition of muscle relaxation, the normal children were able to obtain the MMEP of upper and lower extremity cortex in all ages except the upper extremity before half-age and the lower extremity before 3.5 years old. The cervical-lumbar central conduction time (CCT) and conduction velocity (CCV), representing the motor nerve conduction velocity in the spinal cord segment, and the head-neck CCT and CCV representing motor movement in the intracranial segment reach adult values at 6 and 10 years of age . The MMEP conduction velocity and corrected CCT in the upper and lower extremities were highly correlated with age (r = 0.79, 0.75, respectively). In all age groups, the difference between the left and right of MMEP latency was relatively constant and the upper and lower limbs did not exceed 2.6 ms and 3.5 ms, respectively. Conclusion The cortical MMEP can well reflect the growth and conduction of the intracranial and spinal motor conduction pathways in children. In view of CCT affected by the length of the body and age-related CCV, CCV should be included in children’s routine testing indicators MMEP. The technology is painless and non-invasive and can be safely used for the detection of central motor nerve function in children of all ages after infancy.