【摘要】 目的观察经颅磁刺激（ＴＭＳ）引起的运动抑制效应－肌肉静息期（ＳＰ）的改变并探讨用其评价中枢性瘫痪的可能性。方法采用ＭＥＳ１０磁刺激器及９ｃｍ环状刺激线圈，以５０％的阈上刺激强度在头顶进行ＴＭＳ。记录ＴＭＳ对侧第一骨间肌（ＦＤＩ）持续中等用力收缩时的肌电反应。共测定２３例轻偏瘫的脑卒中患者健侧与偏瘫侧ＳＰ时限，计算患侧与健侧ＳＰ时限之比值，并与２５名年龄相当的正常人所得正常值进行比较。结果患者偏瘫肢体之ＳＰ时限为４２３±３１４ｍｓ，较正常人（１４５±３７ｍｓ）及自身健侧肢体（１５４±５４ｍｓ）明显延长（Ｐ＜００１及００５）；患侧／健侧肢体ＳＰ比值为２８±１９，亦明显高于正常对照组之侧间比值１０１±０１５（Ｐ＜０．０１）。结论轻度偏瘫的脑卒中患者常伴有ＳＰ延长，因而ＳＰ可作为研究和评价中风患者中枢运动功能损伤的一项神经电生理指标。更多还原

【Abstract】 Objective To investigate the changes of muscle silent period (SP) induced by transcranial magnetic stimulation (TMS) and its value in the evaluation of motor function in patient with stroke. Methods 25 normals and 23 stroke patients with mild hemiparesis were involved in this study. A MES 10 magnetic stimulator and a 9 cm round coil were used to stimulate the brain at an intensity 50% above threshold for MEP with the subjects making sustained moderate contraction of the contralateral FDI. SP duration and interside ratio were measured and calculated and then compared between the two groups. Results Normal values of SP duration and interside ratio were 145±37 ms and 1.01±0.15 respectively. The SP duration on the paralytic side in stroke patients was 423±314 ms, significantly prolonged in comparison with that on the normal side (154±54 ms, P <0.05) and that of normal value ( P <0.01). The interside SP ratio (paralytic/normal side) in stroke patients was 2.8±1.9, also significantly higher than the normal value ( P <0.01). Conclusion SP might be a sensitive and valuble neurophysiological parameter in evaluation of the motor function of patients with central motor dysfunction.更多还原