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Neurochirurgie
Vol 49, N° 2-3  - mai 2003
pp. 154-162
Doi : NCHIR-05-2003-49-2-3C2-0028-3770-101019-ART04
BASES ANATOMIQUES DE LA MOTRICITÉ APPLIQUÉES À L'ÉTUDE DE LA SPASTICITÉ
 

P. MERTENS
[1]  Laboratoire d'Anatomie, Domaine Rockefeller, Faculté Lyon-Nord, Université Lyon I.

Tirés à part : P. Mertens

[2]  Laboratoire d'Anatomie, Domaine Rockefeller, Faculté Lyon Nord, 8, avenue Rockefeller, 69003 Lyon.

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Le motoneurone spinal se situe sous la triple influence permanente de fibres afférentes périphériques, d'interneurones et de nombreuses voies descendantes d'origine supra-spinale. Son activité reflète la synthèse de ces différentes modulation convergente à un moment donné. La spasticité se traduit par une exagération du réflexe monosynaptique, fibre IA – motoneurone α dans un contexte d'hyperexcitabilité spinale. Elle peut être induite par des lésions anatomiques variées du SNC affectant certains contrôles moteurs descendants, notamment réticulo-spinaux. Le rôle de la plasticité neuronale à l'étage spinal doit être également évoqué pour comprendre le profil évolutif progressif du syndrome spastique.

Abstract
Anatomical basis of motricity for the study of spasticity

The spinal motoneurone is under the permanent influence of peripheral afferent fibers, interneurons, and numerous descending projections from supraspinal structures. Motoneuronal activity summarizes these different and convergent modulations at one moment. Spasticity corresponds to exageration of monosynpatic reflex, from IA fiber to motoneuron α, associated with spinal hyperexitability. Various lesions of central nervous system give rise to spasticity, specially if they affect supra spinal descending controls, mainly reticulo-spinal tracts. The role of neuronal plasticity to explain the progressive time course of spasticity is also discussed.

Keywords: spasticity , neuroanatomy , motoneuron , interneuron , plasticity , descending projections






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