H波変動の臨床的意義

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By means of evoked electromyogram, variation of H wave amplitude was studied in the normal and patients who suffered from rigidity or spasticity. H wave was elicited by stimulating tibial nerve at popliteal fossa and recorded from the surface electrode on soleus muscle. Forty-six normal subjects, 51 patients with spasticity and 28 with rigidity were examined. We have dealt the frequency of H wave amplitude as describing normal distribution and applied arithmetic mean, standard deviation and coefficient of variation to clinical analysis. As the result of analysis of frequency distribution of H wave amplitude among these three types, it became apparent that the factors mentioned above were not always represent specificity of distribution of H wave amplitude. This is the reason I studied fundamental qualities of the frequency distribution of H wave amplitude. The results are as follows. 1) The principle of frequency distribution of H wave amplitude in normal and spastic is also adaptable to rigid cases with tremor. It is concluded that in any case a hundred or more H waves are sufficient in order to write frequency distribution of H wave amplitude. 2) The frequency distribution of the maximal H wave amplitude represents the common characteristics of some magnitudes. 3) The frequency distribution H wave amplitude as a whole belongs to binomial distribution. 4) This frequency distribution figure consists of two different factors. One is contained in the accumulation area and the other in the scattering area of the curve. 5) The form of frequency distribution can be modified by administration of some drugs. Central nervous system facilitating drug raised the distal part of the curve. C.N.S. inhibiting preparation raises the proximal part. 6) The quality of H wave amplitude is represented by following formulas and values ; frequency distribution, arithmetic mean, mode, median, quartile distance, relative quartile distance from the point of mode, relative quartile distance from the point of median, standard deviation, coefficient of variation, skewness and binomial probability. From these analysis it is considered that the physiological differences between the normal and the spastic or the rigid lie in disturbances of mechanism which controls the form of frequency distribution of H wave amplitude. Two different pathological representative forms of rigidity and spasticity might be derived from the difference of the disturbances. It is evident, however, that rigidity and spasticity have common faulty factors in part among them. Analysis of the frequency distribution of H wave amplitude should be considered as a useful method in clinical neurology.
千葉大学の論文

H波変動の臨床的意義

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