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Ferullo, Marcello (2013) La valutazione della via motoria corticobulbare nella Sclerosi Laterale Amiotrofica: uno studio mediante Potenziali Evocati Motori da muscolo Trapezio capo superiore (metodo diretto). [Tesi di dottorato]

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Abstract (inglese)

Neurophysiology currently occupies a leading role in the diagnosis and monitoring of patients affected by Amyotrophic Lateral Sclerosis (ALS).
Electromyography (EMG) is very useful to determine the involvement of the lower motor neuron, while Transcranial Magnetic Stimulation (TMS) is the most appropriate technique for studying the upper motor neuron.
It is notoriously difficult to evaluate the bulbar district to examine the lower motor neuron and the upper motor neuron.
Here report a series of 55 patients affected by various clinical subtypes of ALS examined by MEP derived from the upper trapezius muscle (direct method).
The results show a great sensitivity in diagnosing the progressive bulbar palsy (PBP) clinical subtype, whereas a standard study with derivation from the lower limbs is more useful in the typical form of ALS.
Moreover, we show a more rigorous method of calculating central motor conduction time, in addition to an evaluation of the ratio between the amplitudes of the cortical and peripheral stimulus, obtained by the direct method

Abstract (italiano)

La Neurofisiologia attualmente occupa un ruolo di primo piano nella diagnosi e nel monitoraggio della Sclerosi Laterale Amiotrofica (SLA).
L'elettromiografia è molto utile per determinare un coinvolgimento del II neurone di moto, mentre la TMS è la tecnica più utile per lo studio del I motoneurone.
Tra i vari muscoli esaminabili l'esplorazione del distretto bulbare è sempre stata più difficoltosa da esaminare sia per lo studio del II motoneurone, sia, quando, oggetto della nostra valutazione diviene il primo motoneurone.
Riportiamo qui uno studio su 55 pazienti con vari sottotipi clinici di SLA esaminati mediante PEM con derivazione dal muscolo trapezio capo superiore (metodo diretto).
I risultati ottenuti mostrano una grande sensibilità diagnostica nel sottotipo clinico paralisi bulbare progressiva (PSP), mentre nella forma SLA tipica risulta più utile uno studio standard derivato dagli arti inferiori.
Vengono illustrati anche un più rigoroso metodo di calcolo del tempo di conduzione motoria centrale oltre alla valutazione del rapporto d'ampiezza tra lo stimolo corticale e quello periferico ottenuto sempre con metodo diretto

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Tipo di EPrint:Tesi di dottorato
Relatore:Corrado, Angelini
Dottorato (corsi e scuole):Ciclo 25 > Scuole 25 > SCIENZE MEDICHE, CLINICHE E SPERIMENTALI > NEUROSCIENZE
Data di deposito della tesi:31 Gennaio 2013
Anno di Pubblicazione:31 Gennaio 2013
Parole chiave (italiano / inglese):TMS, SLA, muscolo trapezio capo superiore, TCMC, Amplitude Ratio
Settori scientifico-disciplinari MIUR:Area 06 - Scienze mediche > MED/11 Malattie dell'apparato cardiovascolare
Struttura di riferimento:Dipartimenti > Dipartimento di Neuroscienze
Codice ID:5911
Depositato il:15 Ott 2013 09:39
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Bibliografia

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