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首页> 外文期刊>Journal of Brachial Plexus and Peripheral Nerve Injury >Changes of medium-latency SEP-components following peripheral nerve lesion
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Changes of medium-latency SEP-components following peripheral nerve lesion

机译：周围神经病变后中潜伏期SEP成分的变化

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BackgroundAnimal studies have demonstrated complex cortical reorganization following peripheral nerve lesion. Central projection fields of intact nerves supplying skin areas which border denervated skin, extended into the deafferentiated cortical representation area. As a consequence of nerve lesions and subsequent reorganization an increase of the somatosensory evoked potentials (SEPs) was observed in cats when intact neighbouring nerves were stimulated. An increase of SEP-components of patients with nerve lesions may indicate a similar process of posttraumatic plastic cortical reorganization.MethodsTo test if a similar process of post-traumatic plastic cortical reorganization does occur in humans, the SEP of intact neighbouring hand nerves were recorded in 29 patients with hand nerve lesions. To hypothetically explain the observed changes of SEP-components, SEP recording following paired stimulation of the median nerve was performed in 12 healthy subjects.ResultsSurprisingly 16 of the 29 patients (55.2%) showed a reduction or elimination of N35, P45 and N60. Patients with lesions of two nerves showed more SEP-changes than patients with a single nerve lesion (85.7%; 6/7 nerves; vs. 34.2%; 13/38 nerves; Fisher's exact test, p < 0.05). With paired stimulation a suppression of the amplitude of N20, P25 and P45 (p < 0.05; sign test), and a marked increment of N35 (p < 0.05; sign test) and N60 (not significant; sign test) of the second response could be observed.ConclusionThe results of the present investigation do not provide evidence of collateral innervation of peripherally denervated cortical neurons by neurons of adjacent cortical representation areas. They rather suggest that secondary components of the excitatory response to nerve stimulation are lost in cortical areas, which surround the denervated region.
机译：背景动物研究表明，周围神经病变后皮质复杂地重组。完整神经的中央投射区提供了与神经支配的皮肤接壤的皮肤区域，延伸到了去铁皮质皮层代表区域。由于神经损伤和随后的重组，当刺激完整的邻近神经时，在猫体内观察到了体感诱发电位（SEPs）的增加。神经损伤患者的SEP成分增加可能表明创伤后可塑性皮层重组的过程相似。手神经病变29例。为了假设性地解释观察到的SEP成分变化，对12位健康受试者进行了正中神经配对刺激后的SEP记录。结果令人惊讶的是，这29名患者中有16名（55.2％）表现出N35，P45和N60减少或消除。与单神经病变患者相比，具有两条神经病变的患者表现出更多的SEP改变（85.7％; 6/7条神经; 34.2％; 13/38条神经; Fisher精确检验，p <0.05）。配对刺激可抑制N20，P25和P45的振幅（p <0.05;符号测试），并显着增加第二反应的N35（p <0.05;符号测试）和N60（不显着;符号测试）。结论本研究的结果并未提供邻近皮层代表区域的神经元对神经支配的周围神经无支配的神经支配的证据。他们宁愿表明神经刺激的兴奋性反应的次要成分在失神经区域周围的皮质区域中丢失。

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