Central motor conduction in human chronic Chagas' disease

Segura, M.J.; Genovese, O.M.; Segura, Elsa; Sanz, Olga P.; Sica, R.E.P.

doi:10.1590/S0004-282X1994000100005

Abstracts

The possible involvement of spinal alpha motor neurons, dorsal root ganglia and sensory fibers in human chronic Chagas' disease was previously demonstrated. More recently neuropsychological and sensory evoked potentials studies suggest the existence of central nervous system abnormalities in these patients. We assessed the state of central motor pathways in 46 patients with chronic Chagas' disease and 30 healthy volunteers by means of percutaneous cortical and spinal electrical stimulation. No significative slowness in pyramidal tracts (PT) conduction was found when comparing both groups. Neither any individual patient exhibited abnormally delayed PT conduction values beyond the upper normal limit of the healthy volunteers. These results suggest that, in contrast with other neural systems, the large myelinated PT fibers are usually spared in human chronic Chagas' disease.

chronic Chagas' disease; central nervous system; motor evoked potentials

Estudios previos han demostrado que la enfermedad de Chagas cronica (ECHC) humana puede comprometer Ias motoneuronas espinales alfa, el ganglio de la raiz dorsal y Ias fibras sensitivas perifericas. Mas recientemente otras investigaciones han senalado que algunos de estos pacientes presentan anomalias en pruebas cognitivas y de potenciales evocados sensoriales, sugiriendo tambien la existencia de compromiso central en esta entidad. En linea con estos ultimos hallazgos hemos estudiado el estado de la conduccion motora central en 46 pacientes con ECHC y en 30 voluntarios sanos. Para ello se emplearon tecnicas de estimulacion electrica cortical transcraneana y espinal percutanea. No se encontro un enlentecimiento significativo en la conduccion piramidal del grupo con ECHC comparado con los voluntarios sanos. Considerados individualmente, en ningun paciente con ECHC la conduccion corticoespinal presento valores que excedieran el limite superior normal del grupo control. Estos resultados sugieren que a diferencia de lo que ocurre con otros sistemas neurales, Ias fibras piramidales mielinizadas de grueso calibre se encuentran usualmente indemnes en pacientes con ECHC.

enfermedad de Chagas cronica; sistema nervioso central; potenciales evocados motores

Central motor conduction in human chronic Chagas' disease

Conduction motora central en la enfermedad de Chagas cronica humana

M.J. Segura; O.M. Genovese; Elsa Segura; Olga P. Sanz; R.E.P. Sica

Departamento Medicina, Orientacion Neurologia, Facultad de Medicina, Universidade de Buenos Aires

SUMMARY

The possible involvement of spinal alpha motor neurons, dorsal root ganglia and sensory fibers in human chronic Chagas' disease was previously demonstrated. More recently neuropsychological and sensory evoked potentials studies suggest the existence of central nervous system abnormalities in these patients. We assessed the state of central motor pathways in 46 patients with chronic Chagas' disease and 30 healthy volunteers by means of percutaneous cortical and spinal electrical stimulation. No significative slowness in pyramidal tracts (PT) conduction was found when comparing both groups. Neither any individual patient exhibited abnormally delayed PT conduction values beyond the upper normal limit of the healthy volunteers. These results suggest that, in contrast with other neural systems, the large myelinated PT fibers are usually spared in human chronic Chagas' disease.

Key words: chronic Chagas' disease, central nervous system, motor evoked potentials.

RESUMEN

Estudios previos han demostrado que la enfermedad de Chagas cronica (ECHC) humana puede comprometer Ias motoneuronas espinales alfa, el ganglio de la raiz dorsal y Ias fibras sensitivas perifericas. Mas recientemente otras investigaciones han senalado que algunos de estos pacientes presentan anomalias en pruebas cognitivas y de potenciales evocados sensoriales, sugiriendo tambien la existencia de compromiso central en esta entidad. En linea con estos ultimos hallazgos hemos estudiado el estado de la conduccion motora central en 46 pacientes con ECHC y en 30 voluntarios sanos. Para ello se emplearon tecnicas de estimulacion electrica cortical transcraneana y espinal percutanea. No se encontro un enlentecimiento significativo en la conduccion piramidal del grupo con ECHC comparado con los voluntarios sanos. Considerados individualmente, en ningun paciente con ECHC la conduccion corticoespinal presento valores que excedieran el limite superior normal del grupo control. Estos resultados sugieren que a diferencia de lo que ocurre con otros sistemas neurales, Ias fibras piramidales mielinizadas de grueso calibre se encuentran usualmente indemnes en pacientes con ECHC.

Palavras llave: enfermedad de Chagas cronica, sistema nervioso central, potenciales evocados motores.

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Acknowledgment- This investigation received financial support from the UNDP/ World Bank / Who Special Programme for Research and Training in Tropical Diseases.

Aceite: 21 setembro 1993.

Dr. Roberto E.P. Sica - Division Neurologia, Hospital J.M. Ramos Mejia - Urquiza 609 - 1221 Buenos Aires - Argentina.

1. Genovese OM, Sanz OP, Correale J, Garcia Erro M, Sica REP Cerebral evoked potentials in human chronic Chagas' disease. Arq Neuropsiquiatr 1989, 47:274-278.
2. Hassan NF, Rossini PM, Cracco RQ, Cracco JB. Unexposed motor cortex activation by low voltage stimuli. In Morrocutti C, Rizzo PA (eds) Evoked potentials neurophysiological and clinical aspects. Amsterdam: Elsevier, 1985.
3. Lassek AM. The human pyramidal tract: IV. A study of the mature, myelinated fibers of the pyramid. J. Comp. Neurol. 1942, 76: 217-225.
4. Losavio A, Jones MC, Sanz OP, Mirkin G, Gonzalez Cappa SM, Muchnik S, Sica REP. A sequential study of peripheral nervous system involvement in experimental Chagas' disease. Am J Trop Med Hyg, 1989, 41:547-555.
5. Mangone CA, Pereyra SA, Genovese O, Segura E, Sica REP. Neuropsychological impairment in chronic Chagas' disease. Neurology 1992, 42, (Suppl 3):278.
6. Marsden CD, Merton PA, Morton HB. Percutaneous stimulation of spinal cord and brain: pyramidal tract conduction velocities in man. J Physiol 1982,328:6P.
7. Rossini P, Caramia M, Zarola F. Mechanisms of nervous propagation along central motor pathways: non-invasive evaluation in healthy subjects and in patients with neurological disease. Neurosurgery 1987, 20:183-191.
8. Sanz OP, Sica REP, Basso S, Fumo T. Compromiso del sistema nervioso periferico en la enfermedad de Chagas cronica. Medicina (Buenos Aires) 1980, 40(Suppl 1):231-233.
9. Sanz OP, Sica REP, Fumo T, Basso S. Spinal reflex activity in patients with chronic Chagas' disease. Medicina (Buenos Aires) 1982,42:633-636.
10. Segura MJ, Gandolfo CN, Sica REP. Estimulacion cortical transcraneana en humanos. Medicina (Buenos Aires) 1988, 48:108-109.
11. Segura MJ, Gandolfo CN, Sica REP. Central motor conduction in ischaemic and hemorrhagic cerebral lesions. Electromyogr CIin. Neurophysiol 1990,30:41-45.
12. Segura MJ, Gandolfo CN, Bueri JA, Sica REP. Transcranial stimulation: long-lasting effects on lower motor neuron excitability. Neurology 1990,40 (Suppl 1): 214.
13. Segura MJ, Gandolfo CN, Sica REP. Electrophysiological assessment of spinal cord lesions by means of transcranial cortical stimulation. Electromyogr Clin Neurophysiol 1992, 32:299-306.
14. Sica REP, Mc Comas AJ, Upton A. Impaired potentiation of H reflexes in patients with upper motoneuron lesions. J Neurol Neurosurg Psychiatry 1971,34:712-717.
15. Sica REP, Sanz OP, Aristimuno GG, Basso S, Pagano MA, Taratuto A, Fumo T, Ratusnu AF, Cotombi A. Muscle denervation in chronic Chagas' disease. Medicina (Buenos Aires) 1979,39:579-588.
16. Sica REP, Filipini D, Panizza M, Fumo, T, Baso S, Lazzari J, Molina HA Involvement of the peripheral sensory nervous system in human chronic Chagas' disease. Medicina (Buenos Aires) 1986, 46:662-668.
17. Thompson PD, Day BL, Rothwell JC, Dick JPR, Cowan JMA, Asselman P, Griffin GB, Sheehy MP, Marsden CD. The interpretation of electromyographic response to electrical stimulation of the motor cortex in diseases of the upper motor neuron. J Neurol Sci 1987, 80:91-110.

Publication Dates

Publication in this collection
19 Jan 2011
Date of issue
Mar 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Genovese OM, Sanz OP, Correale J, Garcia Erro M, Sica REP Cerebral evoked potentials in human chronic Chagas' disease. Arq Neuropsiquiatr 1989, 47:274-278.

[2] 2. Hassan NF, Rossini PM, Cracco RQ, Cracco JB. Unexposed motor cortex activation by low voltage stimuli. In Morrocutti C, Rizzo PA (eds) Evoked potentials neurophysiological and clinical aspects. Amsterdam: Elsevier, 1985.

[3] 3. Lassek AM. The human pyramidal tract: IV. A study of the mature, myelinated fibers of the pyramid. J. Comp. Neurol. 1942, 76: 217-225.

[4] 4. Losavio A, Jones MC, Sanz OP, Mirkin G, Gonzalez Cappa SM, Muchnik S, Sica REP. A sequential study of peripheral nervous system involvement in experimental Chagas' disease. Am J Trop Med Hyg, 1989, 41:547-555.

[5] 5. Mangone CA, Pereyra SA, Genovese O, Segura E, Sica REP. Neuropsychological impairment in chronic Chagas' disease. Neurology 1992, 42, (Suppl 3):278.

[6] 6. Marsden CD, Merton PA, Morton HB. Percutaneous stimulation of spinal cord and brain: pyramidal tract conduction velocities in man. J Physiol 1982,328:6P.

[7] 7. Rossini P, Caramia M, Zarola F. Mechanisms of nervous propagation along central motor pathways: non-invasive evaluation in healthy subjects and in patients with neurological disease. Neurosurgery 1987, 20:183-191.

[8] 8. Sanz OP, Sica REP, Basso S, Fumo T. Compromiso del sistema nervioso periferico en la enfermedad de Chagas cronica. Medicina (Buenos Aires) 1980, 40(Suppl 1):231-233.

[9] 9. Sanz OP, Sica REP, Fumo T, Basso S. Spinal reflex activity in patients with chronic Chagas' disease. Medicina (Buenos Aires) 1982,42:633-636.

[10] 10. Segura MJ, Gandolfo CN, Sica REP. Estimulacion cortical transcraneana en humanos. Medicina (Buenos Aires) 1988, 48:108-109.

[11] 11. Segura MJ, Gandolfo CN, Sica REP. Central motor conduction in ischaemic and hemorrhagic cerebral lesions. Electromyogr CIin. Neurophysiol 1990,30:41-45.

[12] 12. Segura MJ, Gandolfo CN, Bueri JA, Sica REP. Transcranial stimulation: long-lasting effects on lower motor neuron excitability. Neurology 1990,40 (Suppl 1): 214.

[13] 13. Segura MJ, Gandolfo CN, Sica REP. Electrophysiological assessment of spinal cord lesions by means of transcranial cortical stimulation. Electromyogr Clin Neurophysiol 1992, 32:299-306.

[14] 14. Sica REP, Mc Comas AJ, Upton A. Impaired potentiation of H reflexes in patients with upper motoneuron lesions. J Neurol Neurosurg Psychiatry 1971,34:712-717.

[15] 15. Sica REP, Sanz OP, Aristimuno GG, Basso S, Pagano MA, Taratuto A, Fumo T, Ratusnu AF, Cotombi A. Muscle denervation in chronic Chagas' disease. Medicina (Buenos Aires) 1979,39:579-588.

[16] 16. Sica REP, Filipini D, Panizza M, Fumo, T, Baso S, Lazzari J, Molina HA Involvement of the peripheral sensory nervous system in human chronic Chagas' disease. Medicina (Buenos Aires) 1986, 46:662-668.

[17] 17. Thompson PD, Day BL, Rothwell JC, Dick JPR, Cowan JMA, Asselman P, Griffin GB, Sheehy MP, Marsden CD. The interpretation of electromyographic response to electrical stimulation of the motor cortex in diseases of the upper motor neuron. J Neurol Sci 1987, 80:91-110.

Brasil

Brasil

Central motor conduction in human chronic Chagas' disease

Conduction motora central en la enfermedad de Chagas cronica humana

Abstracts

Publication Dates