肩周炎患者运动诱发电位参数变化与中枢可塑性评估：精准康复的探索

关键词：肩周炎  运动诱发电位  经颅磁刺激  神经可塑性  康复

Keywords:adhesive capsulitis  motor evoked potentials  transcranial magnetic stimulation  neural plasticity  rehabilitation

摘要：

      摘要 目的：通过比较肩周炎患者运动诱发电位（motor evoked potential， MEP）指标差异及其与临床指标的相关性，探讨肩周炎的中枢神经机制及临床意义。 方法：纳入2023年12月—2025年6月期间的27例肩周炎患者，使用经颅磁刺激（transcranial magnetic stimulation， TMS）测量患侧与健侧MEP的静息运动阈值（resting motor threshold， RMT）、潜伏期及波幅，同时使用Constant-Murley量表（Constant-Murley Score， CMS）进行疼痛、肩关节活动度、日常活动及肌力评定。分析患侧与健侧RMT、潜伏期及波幅指标间的差异，以及患侧RMT、潜伏期及波幅与CMS评分各维度之间的相关性。 结果：患侧与健侧RMT、波幅之间存在显著性差异（P＜0.05），而患侧与健侧潜伏期之间无显著性差异（P＞0.05）。相关性分析结果显示，患侧潜伏期与患者年龄、病程呈正相关（r=0.41；r=0.385）。 结论：肩周炎患者存在中枢兴奋性下降，且随着病情发展及年龄增长，神经传导时间逐渐延长。

Abstract:

      Abstract Objective： To explore the central neural mechanisms and clinical significance of adhesive capsulitis by comparing differences in motor evoked potential （MEP） parameters and their correlations with clinical indicators. Method： A total of 27 patients with adhesive capsulitis admitted between December 2023 and June 2025 were enrolled. Transcranial magnetic stimulation （TMS） was used to measure the resting motor threshold （RMT）， latency， and amplitude of MEPs in the primary motor cortex on both the affected and unaffected sides. The Constant-Murley Score （CMS） was used to assess pain， shoulder joint mobility， daily activities， and muscle strength. Differences in RMT， latency， and amplitude between sides were analyzed， as well as the correlations between affected-side MEP parameters and each dimension of the CMS. Result： Significant differences were observed between the affected and unaffected sides in RMT and amplitude （P＜0.05）， while no significant difference was found in latency （P＞0.05）. Correlation analysis showed that latency on the affected side was positively correlated with age and disease duration （r=0.41；r=0.385）. Conclusion： The findings indicate decreased cortical excitability in patients with adhesive capsulitis, and neural conduction time gradually prolongs with disease progression and aging.