Annals of Clinical Neurophysiology

The Korean Society of Clinical Neurophysiology (대한임상신경생리학회)
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Altered Peripheral Nerve Excitability Properties in Acute and Subacute Supratentorial Ischemic Stroke

급성 및 아급성 천막상 허혈성 뇌졸중에서 발생하는 말초신경 흥분성 변화

  • Seo, Jung Hwa (Department of Neurology, Inje University College of Medicine) ;
  • Ji, Ki Whan (Department of Neurology, Inje University College of Medicine) ;
  • Chung, Eun Joo (Department of Neurology, Inje University College of Medicine) ;
  • Kim, Sang Gin (Department of Neurology, Inje University College of Medicine) ;
  • Kim, Oeung Kyu (Department of Neurology, Inje University College of Medicine) ;
  • Paeing, Sung Hwa (Department of Neurosurgery, Inje University College of Medicine) ;
  • Bae, Jong Seok (Department of Neurology, Inje University College of Medicine)
  • 서정화 (인제대학교 의과대학 신경과학교실) ;
  • 지기환 (인제대학교 의과대학 신경과학교실) ;
  • 정은주 (인제대학교 의과대학 신경과학교실) ;
  • 김상진 (인제대학교 의과대학 신경과학교실) ;
  • 김응규 (인제대학교 의과대학 신경과학교실) ;
  • 팽성화 (인제대학교 의과대학 신경외과학교실) ;
  • 배종석 (인제대학교 의과대학 신경과학교실)
  • Received : 2012.07.04
  • Accepted : 2012.10.17
  • Published : 2012.12.30
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Abstract

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

Keywords

Acknowledgement

Supported by : Inje University

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