Presynaptic inhibition and disynaptic reciprocal 1a inhibition in Parkinson's disease, the effect of the dopaminergic treatment
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Dosyalar
Tarih
2010
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Son zamanlarda Parkinson Hastalığında spinal kord patolojisi ile ilgili çalışmalara daha fazla rastlanmaktadır. H refleks incelemesi spinal kordaki nörofizyolojik ve internörinal değişiklikleri inceleyen çalışmalarda önemli bir seçenektir. Dopaminerjik tedavinin spinal internöronal refleks yollarındaki etkisi daha az araştırılmış bir konudur. Bu çalışma Parkinson Hastalığında presinaptik ve disinaptik inhibisyon düzeylerini, dopaminerjik tedavinin etkisini incelemek üzere planlanmıştır. Metod: Presinaptik inhibisyon ve disinaptik resiprokal 1a inhibisyonu Parkinson hastalarında ve normal kontrollerde 1-100 ms intervallerle peroneal sinirin ve tibial sinirin ikili uyarımı ile araştırıldı. Test ve şartlanmış H refleks yanıt amplitüd değişiklikleri hesaplandı. Dopaminerjik tedavi öncesi ve sonrası etkilenen ve daha az etkilenen taraflarda karşılaştırıldı. Bulgular: Disinaptik ve presinaptik inhibisyon tüm deneklerde mevcuttu. Disinaptik resiprokal 1 a inhibisyonu etkilenen tarafta daha kısa süreliydi ve sadece 2 ms'lik intervalde vardı. 20 ms'lik interval için şartlanmış ve test H refleks oranı (presinaptik inhibisyon) etkilenen tarafta kontrollere göre anlamlı düşük bulundu (p: 0.046). 20-10-5-3-2 ms'lik intervallerdeki inhibisyon oranları tedavi sonrası etkilenen tarafta tedavi öncesine göre anlamlı artmıştı (p: 0.031, 0.027,0.014, 0.026, 0.037). Sonuç: Parkinson hastalığında tutulan tarafta presinaptik inhibisyon azalmış, disinaptik inhibisyon süresi kısalmış bulunmuştur. Dopaminerjik tedavi, her iki inhibisyon periyodunda anlamlı artışa neden olmuştur. Bu bulgular Parkinson hastalığında supraspinal etkilerde anormallik varlığını ve ayrıca bazı dopaya cevaplı nöral mekanizmaların rolünü düşündürmüştür.
Objective: In recent years, increasing number of studies about the spinal cord pathology in Parkinson's disease had been conducted. H reflex investigation is an important choice in the studies dealing with neurophysiological and interneuronal alterations of the spinal cord. The effect of the dopaminergic treatment on the spinal interneuronal reflex pathways is a relatively less investigated issue. This study has been adressed to assess the presynaptic and disynaptic inhibition levels in Parkinson's disease, and the effect of dopaminergic treatment. Methods: Presynaptic inhibition and dysynaptic reciprocal 1a inhibition is investigated by double stimulation of the tibial nerve at the popliteal fossa and peroneal nerve at the fibular head in patients with Parkinson's disease and also in control subjects for the 1-100 ms conditioning test intervals. The amplitude changes of the test and the conditioned H reflex responses were calculated and compared in the affected and less affected sides in both before and under dopaminergic treatment. Results: Disynaptic and presynaptic inhibitions existed in all subjects. Disynaptic reciprocal 1a inhibition was shortened only at 2 ms conditioning interval. The conditioned and test H reflex ratio (Hc/Ht) for the 20 ms conditioning test interval (presynaptic inhibition) was significantly smaller in the affected side than the controls (p: 0.046). The percentages of the inhibitions for the 20-10-5-3-2 ms conditioning intervals significantly increased in the affected side under treatment when compared with the ones obtained in the pretreatment period (p: 0.031, 0.027, 0.014, 0.026, 0.037). Conclusion: Presynaptic inhibition was decreased and disynaptic inhibition duration was shortened in the affected side of the patients with Parkinson's disease, dopaminergic treatment caused significant increases in both periods of inhibition. These findings indicate an abnormal supraspinal influence on the spinal cord in Parkinson's disease, and also the role of some dopa responsive neural mechanisms.
Objective: In recent years, increasing number of studies about the spinal cord pathology in Parkinson's disease had been conducted. H reflex investigation is an important choice in the studies dealing with neurophysiological and interneuronal alterations of the spinal cord. The effect of the dopaminergic treatment on the spinal interneuronal reflex pathways is a relatively less investigated issue. This study has been adressed to assess the presynaptic and disynaptic inhibition levels in Parkinson's disease, and the effect of dopaminergic treatment. Methods: Presynaptic inhibition and dysynaptic reciprocal 1a inhibition is investigated by double stimulation of the tibial nerve at the popliteal fossa and peroneal nerve at the fibular head in patients with Parkinson's disease and also in control subjects for the 1-100 ms conditioning test intervals. The amplitude changes of the test and the conditioned H reflex responses were calculated and compared in the affected and less affected sides in both before and under dopaminergic treatment. Results: Disynaptic and presynaptic inhibitions existed in all subjects. Disynaptic reciprocal 1a inhibition was shortened only at 2 ms conditioning interval. The conditioned and test H reflex ratio (Hc/Ht) for the 20 ms conditioning test interval (presynaptic inhibition) was significantly smaller in the affected side than the controls (p: 0.046). The percentages of the inhibitions for the 20-10-5-3-2 ms conditioning intervals significantly increased in the affected side under treatment when compared with the ones obtained in the pretreatment period (p: 0.031, 0.027, 0.014, 0.026, 0.037). Conclusion: Presynaptic inhibition was decreased and disynaptic inhibition duration was shortened in the affected side of the patients with Parkinson's disease, dopaminergic treatment caused significant increases in both periods of inhibition. These findings indicate an abnormal supraspinal influence on the spinal cord in Parkinson's disease, and also the role of some dopa responsive neural mechanisms.
Açıklama
Anahtar Kelimeler
Presynaptic Inhibition, Reciprocal Inhibition, Spinal Inhibitory Mechanisms, Parkinson's Disease, Dopaminergic Treatment
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
27
Sayı
3
