Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2019
Changes in Central Motor Conduction Time and Its Implication on Dysfunction of Distal Upper Limb in Distal-Type Cervical Spondylotic Amyotrophy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Zheng Chaojun, Nie Cong, Zhu Yu, Yu Qing, Zhu Dongqing, Lu Feizhou, Weber Robert, Jiang Jianyuan
Аннотация
PURPOSE: Distal-type cervical spondylotic amyotrophy (CSA) is an uncommon syndrome associated with cervical spondylosis. The pathogenic mechanism of distal-type CSA is still unclear. The aim of the current study was to analyze central motor conduction time (CMCT) in the cases with distal-type CSA and to investigate the role of cervical cord compressive injury in the distal-type CSA.
METHODS: Both 28 cases with distal-type CSA and 21 healthy subjects accepted CMCT measures, motor unit number estimation, handgrip strength examination, and magnetic resonance imaging evaluation.
RESULTS: In this study, nine (9/28, 32.1%) cases with CSA presented with prolonged CMCT, and both reduced number of motor units and decreased handgrip strength were found in these 9 cases (P < 0.05). Magnetic resonance imaging evaluation showed that 7 of these 9 patients presented with proximal cervical cord compression with or even without distal selective compression consistent with segmental atrophy. A negative relationship between CMCT and both number of motor units and handgrip strength was found on the symptomatic side (P < 0.05), and there was a positive correlation between CMCT and amplitude of single motor unit potentials on the less symptomatic side (P < 0.05).
CONCLUSIONS: Corticospinal tract damage caused by proximal spinal cord compression may induce distal motor unit loss to worsen in some cases with distal-type CSA, which may contribute to the dysfunction of the distal upper limb in some cases with distal-type CSA. Therefore, treatment and rehabilitation efforts should account for both distal selective compression and proximal cord compression in distal-type CSA.
METHODS: Both 28 cases with distal-type CSA and 21 healthy subjects accepted CMCT measures, motor unit number estimation, handgrip strength examination, and magnetic resonance imaging evaluation.
RESULTS: In this study, nine (9/28, 32.1%) cases with CSA presented with prolonged CMCT, and both reduced number of motor units and decreased handgrip strength were found in these 9 cases (P < 0.05). Magnetic resonance imaging evaluation showed that 7 of these 9 patients presented with proximal cervical cord compression with or even without distal selective compression consistent with segmental atrophy. A negative relationship between CMCT and both number of motor units and handgrip strength was found on the symptomatic side (P < 0.05), and there was a positive correlation between CMCT and amplitude of single motor unit potentials on the less symptomatic side (P < 0.05).
CONCLUSIONS: Corticospinal tract damage caused by proximal spinal cord compression may induce distal motor unit loss to worsen in some cases with distal-type CSA, which may contribute to the dysfunction of the distal upper limb in some cases with distal-type CSA. Therefore, treatment and rehabilitation efforts should account for both distal selective compression and proximal cord compression in distal-type CSA.