背景與目的：神經功能退化疾病會導致異常的神經活性和引發動作失能症狀，巴金森氏病即為臨床常見的例子。本研究針對此類患者兩側大腦神經活性做一比較，並且探討患者神經活性與動作功能之關連性。方法：本研究徵召原發性巴金森氏病患者共32名，以經顱磁刺激(transcranial magnetic stimulation)評估患者雙側運動皮質區的神經活性，參數選用一個反應皮質興奮性神經活性的靜止動作閾值(resting motor threshold)和兩個反應皮質抑制性神經活性的短程和長程皮質內抑制(short-and long-interval intracortical inhibition)。另以十公尺行走速度反應患者的行走能力。結果：患者雙側運動皮質區的靜止動作閾值與自然行走速度(嚴重側對應腦：r=0.49，p=0.004；輕微側對應腦：=0.47，P=0.007)和快速行走速度(嚴重側對應腦：r=0.48，p=0.005；輕微側對應腦：r=0.46，p=0.007)皆具有中度正相關性；嚴重側對應腦的短程皮質內抑制度與自然行走速度（r=-0.53，p=0.002)和快速行走速度(r=-0.44，p=0.011)皆呈現中度負相關性。結論：原發性巴金森氏病患者大腦抑制性和興奮性神經活性異常與其行走能力相關。(物理治療2014;39(1):18-24)

Background and Purpose: Neural degeneration may induce abnormal cortical activation and movement disorders (e.g. Parkinson’s disease, PD). The purpose of the present study was to compare cortical activation between more affected primary motor cortex (M1) and less affected M1 and to investigate the relationship between cortical activation and functional performance in patients with PD. Methods: Thirty-two patients with idiopathic PD underwent transcranial magnetic stimulation (TMS) to measure activation of bilateral M1s with three paradigms: resting motor threshold (RMT) for cortical excitability, short- and long-interval intracortical inhibition (SICI and LICI) for inhibitory circuits. Ten-meter walking speed was also taken to represent the motor performance. Results: The results showed that there were positive correlations between bilateral RMTs and comfortable walking speed (more affected M1: r=0.49, p=0.004; less affected M1: r=0.47, /p=0.007) as well as fast walking speed (more affected M1: r=0.48, p=0.005; less affected M1: r=0.46,p=0.007). Additionally, SICI of more affected M1 negatively correlated to comfortable walking speed (r=-0.53, p=0.002) as well as fast walking speed ir= -0.44，0=0,011). Conclusion: Abnormal inhibitory and excitatory activation of M1 relates to walking ability of patients with PD. (FJPT 2014;39(1):18-24)