Effect of local cooling on excitation-contraction coupling in myasthenic muscle: Another mechanism of ice-pack test in myasthenia gravis

被引：12

作者：

Yamamoto, Daisuke ^{[1
]}

Imai, Tomihiro ^{[2
]}

Tsuda, Emiko ^{[1
]}

Hozuki, Takayoshi ^{[3
]}

Yamauchi, Rika ^{[4
]}

Hisahara, Shin ^{[1
]}

Kawamata, Jun ^{[1
]}

Shimohama, Shun ^{[1
]}

机构：

[1] Sapporo Med Univ, Sch Med, Dept Neurol, Sapporo, Hokkaido, Japan

[2] Sapporo Med Univ, Sch Hlth Sci, Dept Occupat Therapy, Sapporo, Hokkaido, Japan

[3] Sapporo Shirakabadai Hosp, Dept Neurol, Sapporo, Hokkaido, Japan

[4] Sunagawa City Med Ctr, Dept Neurol, Sunagawa, Japan

来源：

CLINICAL NEUROPHYSIOLOGY | 2017年 / 128卷 / 11期

基金：

日本学术振兴会;

关键词：

Myasthenia gravis; Excitation-contraction coupling; Local cooling; Ice-pack test; Accelerometer; Masseter; ANTIRYANODINE RECEPTOR ANTIBODIES; REPETITIVE NERVE-STIMULATION; CONCENTRIC NEEDLE ELECTRODES; EXTENSOR DIGITORUM COMMUNIS; CENTRAL CORE DISEASE; SINGLE-FIBER EMG; POSTTETANIC POTENTIATION; CONGENITAL MYOPATHIES; INTERCOSTAL MUSCLE; RYR1; MUTATIONS;

D O I：

10.1016/j.clinph.2017.08.030

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: The ice-pack test is a convenient diagnostic testing procedure for myasthenia gravis (MG). We investigated the underlying mechanism of the ice-pack test performed on bilateral masseters.& para;& para;Methods: We performed trigeminal repetitive nerve stimulation (RNS), excitation-contraction (E-C) coupling assessment (lmai's method) and bite force measurement before and after cooling of the masseters in MG patients and normal controls. After placing the ice-pack on the masseters for 3 min, serial recordings of the three tests were performed at various time intervals during 10 min after cooling.& para;& para;Results: The bite force increased significantly after cooling in ice-pack-positive MG patients. The acceleration and acceleration ratio (acceleration at a given time to baseline acceleration) of jaw movement increased significantly after cooling of the masseters in ice-pack-positive MG patients compared to ice-pack-negative patients and normal controls. The prolonged effect of cooling continued until the end of recording even though decremental response to RNS had returned to baseline value.& para;& para;Conclusions: Cooling of myasthenic muscle may induce two effects. One is relatively short effect on electrical synaptic transmission at the endplate, and another is prolonged effect on E-C coupling in the muscle.& para;& para;Significance: The ice-pack test induces a prolonged effect of ameliorating impaired E-C coupling in MG. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

引用

页码：2309 / 2317

页数：9

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