Neurology:肉毒毒素治疗喉肌张力障碍的近期和远期中枢作用

2022-08-21 Naomi MedSci原创

喉肌张力障碍(LD)是孤立的任务特异性局灶性肌张力障碍,选择性地损害语音产生。LD 患者的左侧楔前叶是短期 BoNT 中枢作用部位,而中间治疗持续时间为6-12年的患者的前额-小脑轴参加BonT反应。

喉肌张力障碍(LD)是一种孤立的任务特异性局灶性肌张力障碍,可选择性地损害语音产生。LD 治疗的首选方法是将肉毒杆菌神经毒素(BoNT)注射入患者喉部肌肉。然而,目前还不清楚这种治疗效果是否对疾病的病理生理学有持久的影响。近日一项发表在Neurology上的研究试图探究BoNT 治疗对 LD 患者脑功能的短期和长期影响。

研究人员共对161名受试者进行功能磁共振成像研究。统计分析检查了 LD 患者的中枢性骨质营养不良效应,根据治疗的有效性和持续时间进行分层。

  • 接受 BoNT 注射治疗并受益的 LD 患者与未接受 BoNT 治疗和未受益治疗的 LD 患者相比,其左侧楔前叶活动减少。
  • 此外,BoNT 治疗的内收肌 LD 患者右丘脑活动减少,而 BoNT 治疗的外展肌 LD 患者左下额叶皮质活动减少。
  • 在治疗时间较短(1-5年)和较长(13-28年)的患者之间,大脑活动没有统计学上的显著差异。
  • 然而,与治疗时间较短和较长的患者相比,中间治疗时间为6至12年的患者右侧小脑活动减少,右侧脑前额叶外皮活动减少。

该研究结果表明,LD 患者的左侧楔前叶是短期 BoNT 中枢作用的部位,而中间治疗持续时间为6-12年的患者的前额-小脑轴参与了 BoNT 反应。这些结构的参与指出通过调制语音运动序列的规划和协调,骨质营养不良治疗对肌张力障碍感觉运动网络的间接作用。

文献来源:

O'Flynn LC, Simonyan K. Short and Long-Term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia [published online ahead of print, 2022 Jun 28]. Neurology. 2022;10.1212/WNL.0000000000200850. doi:10.1212/WNL.0000000000200850

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    2022-08-23 zhmscau
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    2023-05-30 yinhl1978
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    2022-08-22 gujh

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