评估肌肉疲劳的中枢和外周起源

疲劳是很多内科及神经疾患的常见表现，理解这些疾病肌肉疲劳的中枢或者外周起源对制定针对性的肌肉疲劳治疗措施具有重要指导意义。综述肌肉疲劳发生的中枢因素（包括脊髓水平和激素上水平所有可以导致运动神经元兴奋性下降的因素）、外周因素（包括神经肌肉的传播、肌肉动作电位的扩散、兴奋-收缩偶联），并讨论采用直接（最大自主收缩、抽搐力）和间接（抽搐叠加、肌电图、运动皮质刺激）的检测方法评估肌肉疲劳的中枢和外周起源。
atigue is a common phenomenon in many medical and neurologic diseases. Understanding the origins of fatigue in these diseases is of great guiding significance in developing targeted interventions for muscle fatigue. In this review, the central origin (including all the supraspinal and spinal physiological phenomena capable of inducing a decrease in motoneuron excitation) and the peripheral origin (including neuromuscular transmission, propagation of action potentials in muscle, excitation-contraction coupling) of muscle fatigue were summarized. The methods of assessing the central or peripheral origin of muscle fatigue were discussed, including the direct measurement (maximal voluntary contraction force, twitch force) and the indirect tests (twitch interpolation, electromyography, motor cortical stimulation).