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目的 对肌萎缩侧索硬化 (ALS)患者进行经颅电刺激咀嚼肌诱发电位的研究 ,建立评估ALS头区皮质脑干束的检查方法。方法 对 2 0例ALS患者和 30名健康志愿者进行双侧咀嚼肌经颅电刺激 ,双侧同时接受 ,分别记录同侧的根运动诱发电位 (R MEP)和对侧的皮层运动诱发电位(C MEP)的潜伏期、波幅 ,计算中枢运动传导时间 (CMCT)。结果 R MEP可在所有ALS患者中引出。R MEP的潜伏期 [(3 4 4± 0 5 3)ms]、波幅 [(2 79± 2 19)mV]与健康对照组比较差异无显著意义 ;而C MEP有 12例ALS患者不正常 ,C MEP的潜伏期 [(7 6 9± 1 5 8)ms]与健康对照组 [(5 83±1 4 0 )ms]比较差异有显著意义 ,CMCT显著延长 (P <0 0 1)。结论 C MEP为一种非创伤性评估ALS头区上运动神经元受损的较敏感方法。
Objective To study the method of transcranial electrical stimulation of masticatory muscle evoked potentials in patients with amyotrophic lateral sclerosis (ALS) and to establish a method for assessing cerebral cortex of ALS head cortex. Methods Twenty patients with ALS and 30 healthy volunteers were subjected to bilateral electro-acupuncture on masticatory muscles. Both groups received simultaneous R MEP and contralateral cortical motor evoked potentials C MEP) latency, amplitude, calculated central conduction time (CMCT). Results R MEP can be induced in all patients with ALS. The latency of R MEP [(34.4 ± 0.053) ms] and amplitude [(2 79 ± 2 19) mV] were not significantly different from those of the healthy controls, while C MEP had 12 patients with abnormal ALS and C There was significant difference between MEP latency [(7 6 9 ± 1 58) ms] and healthy control [(5 83 ± 1 40) ms], and CMCT was significantly prolonged (P 0 01). Conclusions C MEP is a noninvasive, more sensitive method for assessing motor neuron damage in the ALS head region.