Abstract
Conduction in the central motor pathways of the brain and spinal cord was studied in 12 patients with motor neuron disease. Six healthy volunteers served as controls. Transcutaneous electrical stimulation of the cortex, cervical cord, thoracic cord and conus medullaris was used to determine motor latencies to the biceps brachii, thenar eminence and tibialis anterior muscles. Prominent, and often asymmetrical, slowing of central motor conduction was demonstrated in seven of the 12 patients; these findings were most marked in the spinal cord and in most cases correlated with clinical features of corticospinal involvement. In general it was more difficult to excite motor pathways in the central nervous system in the patients with motor neuron disease than in control subjects. Evidence of subclinical involvement of central motor pathways was found in five patients. The central lesion in motor neuron disease may thus contribute more significantly to the clinical deficit than has been realised, since the clinical signs of the upper motor neuron lesion are often masked by the more obvious lower motor neuron features.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brownell B., Oppenheimer D. R., Hughes J. T. The central nervous system in motor neurone disease. J Neurol Neurosurg Psychiatry. 1970 Jun;33(3):338–357. doi: 10.1136/jnnp.33.3.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cowan J. M., Rothwell J. C., Dick J. P., Thompson P. D., Day B. L., Marsden C. D. Abnormalities in central motor pathway conduction in multiple sclerosis. Lancet. 1984 Aug 11;2(8398):304–307. doi: 10.1016/s0140-6736(84)92683-7. [DOI] [PubMed] [Google Scholar]
- Desmedt J. E., Cheron G. Spinal and far-field components of human somatosensory evoked potentials to posterior tibial nerve stimulation analysed with oesophageal derivations and non-cephalic reference recording. Electroencephalogr Clin Neurophysiol. 1983 Dec;56(6):635–651. doi: 10.1016/0013-4694(83)90031-7. [DOI] [PubMed] [Google Scholar]
- Dyck P. J., Stevens J. C., Mulder D. W., Espinosa R. E. Frequency of nerve fiber degeneration of peripheral motor and sensory neurons in amyotrophic lateral sclerosis. Morphometry of deep and superficial peroneal nerves. Neurology. 1975 Aug;25(8):781–785. doi: 10.1212/wnl.25.8.781. [DOI] [PubMed] [Google Scholar]
- Gurney M. E., Belton A. C., Cashman N., Antel J. P. Inhibition of terminal axonal sprouting by serum from patients with amyotrophic lateral sclerosis. N Engl J Med. 1984 Oct 11;311(15):933–939. doi: 10.1056/NEJM198410113111501. [DOI] [PubMed] [Google Scholar]
- Hanyu N., Oguchi K., Yanagisawa N., Tsukagoshi H. Degeneration and regeneration of ventral root motor fibers in amyotrophic lateral sclerosis. Morphometric studies of cervical ventral roots. J Neurol Sci. 1982 Jul;55(1):99–115. doi: 10.1016/0022-510x(82)90173-3. [DOI] [PubMed] [Google Scholar]
- Marsden C. D., Merton P. A., Morton H. B. Direct electrical stimulation of corticospinal pathways through the intact scalp in human subjects. Adv Neurol. 1983;39:387–391. [PubMed] [Google Scholar]
- Merton P. A., Hill D. K., Morton H. B., Marsden C. D. Scope of a technique for electrical stimulation of human brain, spinal cord, and muscle. Lancet. 1982 Sep 11;2(8298):597–600. doi: 10.1016/s0140-6736(82)90670-5. [DOI] [PubMed] [Google Scholar]
- Merton P. A., Morton H. B. Stimulation of the cerebral cortex in the intact human subject. Nature. 1980 May 22;285(5762):227–227. doi: 10.1038/285227a0. [DOI] [PubMed] [Google Scholar]
- Schwartz M. S., Swash M. Pattern of involvement in the cervical segments in the early stage of motor neurone disease: a single fibre EMG study. Acta Neurol Scand. 1982 May;65(5):424–431. doi: 10.1111/j.1600-0404.1982.tb03099.x. [DOI] [PubMed] [Google Scholar]
- Snooks S. J., Swash M. Motor conduction velocity in the human spinal cord: slowed conduction in multiple sclerosis and radiation myelopathy. J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1135–1139. doi: 10.1136/jnnp.48.11.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]