上肢不同部位痛覺溫度刺激對大腦皮質興奮性的即時效應：先導性研究

The Immediate Cortical Excitability Change of Noxious Thermal Stimulation on the Different Parts of the Upper Extremity in Healthy Persons: A Pilot Study

林卷立(Chuan-Li Lin) ； 許妙如(Miao-Ju Hsu) ； 陳健智(Chien-Chih Chen) ； 林瑞泰(Ruey-Tay Lin) ； 黃茂雄(Mao-Hsiung Huang) ； 林昭宏(Jau-Hong Lin)

《物理治療》 39卷1期 (2014/03) Pp. 25-31

https://doi.org/10.6215/JFPT.PTS1373271332

摘要

Background and Purpose: Effects of noxious thermal stimulation (NTS) on functional recovery in upper limbs of stroke patients are evident, but the changes of cortical excitability after NTS intervention on different parts of the upper extremity are still unknown. This study aimed to investigate the immediate effect of NTS on the arm versus the forearm in healthy individuals. Methods: Twenty-two apparently healthy adults (age: 21.6±1.4 years) received a 30-minute NTS intervention (hot-pain: 46±1˚C; cold-pain 7±1˚C) on dominant arms or forearms with randomized sequences. Transcranial magnetic stimulation parameters including motor threshold (MT), motor evoked potential (MEP), and size of cortical motor output map (map size) from both hemispheres were assessed with abductor pollicis brevis as the target muscle before and after two separate NTS interventions. Results: One-way repeated measures ANOVA showed that after NTS on the dominant forearm, the MT decreased from 58.05±11.60 to 53.14±9.21% significantly (p＜.01), while the MEP and map size both increased significantly from 0.31±0.45 to 0.68±0.89 mV (p＜.01) and 4.78±3.80 to 11.05±7.91 (numbers) (p＜.01), respectively. However, the change scores for NTS on the arms showed no significant difference. Conclusion: This result indicates that the 30-minute NTS applied on the forearm may induce more cortical excitability than that on the arm. Clinical Implications: The preliminary finding can provide the neurophysiological basis of NTS intervention in clinical practice for patients.

關鍵字

溫度刺激 ； 皮質興奮性 ； 經顱磁刺激

並列摘要

Background and Purpose: Effects of noxious thermal stimulation (NTS) on functional recovery in upper limbs of stroke patients are evident, but the changes of cortical excitability after NTS intervention on different parts of the upper extremity are still unknown. This study aimed to investigate the immediate effect of NTS on the arm versus the forearm in healthy individuals. Methods: Twenty-two apparently healthy adults (age: 21.6±1.4 years) received a 30-minute NTS intervention (hot-pain: 46±1˚C; cold-pain 7±1˚C) on dominant arms or forearms with randomized sequences. Transcranial magnetic stimulation parameters including motor threshold (MT), motor evoked potential (MEP), and size of cortical motor output map (map size) from both hemispheres were assessed with abductor pollicis brevis as the target muscle before and after two separate NTS interventions. Results: One-way repeated measures ANOVA showed that after NTS on the dominant forearm, the MT decreased from 58.05±11.60 to 53.14±9.21% significantly (p＜.01), while the MEP and map size both increased significantly from 0.31±0.45 to 0.68±0.89 mV (p＜.01) and 4.78±3.80 to 11.05±7.91 (numbers) (p＜.01), respectively. However, the change scores for NTS on the arms showed no significant difference. Conclusion: This result indicates that the 30-minute NTS applied on the forearm may induce more cortical excitability than that on the arm. Clinical Implications: The preliminary finding can provide the neurophysiological basis of NTS intervention in clinical practice for patients.

並列關鍵字

Thermal stimulation ； Cortical excitability ； Transcranial magnetic stimulation

參考文獻

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Wu HC, Lin YC, Hsu MJ, Liu SM, Hsieh CL, Lin JH. Effect of thermal stimulation on upper extremity motor recovery 3 months after stroke. Stroke 2010;41:2378-80.

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