Changes In Reflex Amplitude Research Articles

Beyond the Bottom of the Foot: Topographic Organization of the Foot Dorsum in Walking.

Sensory feedback from the foot dorsum during walking has only been studied globally by whole nerve stimulation. Stimulating the main nerve innervating the dorsal surface produces a functional stumble corrective response that is phase-dependently modulated. We speculated that effects evoked by activation of discrete skin regions on the foot dorsum would be topographically organized, as with the foot sole. Nonnoxious electrical stimulation was delivered to five discrete locations on the dorsal surface of the foot during treadmill walking. Muscle activity from muscles acting at the ankle, knee, hip, and shoulder were recorded along with ankle, knee, and hip kinematics and kinetic information from forces under the foot. All data were sorted on the basis of stimulus occurrence in 12 step cycle phases, before being averaged together within a phase for subsequent analysis. Results reveal dynamic changes in reflex amplitudes and kinematics that are site specific and phase dependent. Most responses from discrete sites on the foot dorsum were seen in the swing phase suggesting function to conform foot trajectory to maintain stability of the moving limb. In general, responses from lateral stimulation differed from medial stimulation, and effects were largest from stimulation at the distal end of the foot at the metatarsals; that is, in anatomical locations where actual impact with an object in the environment is most likely during swing. Responses to stimulation extend to include muscles at the hip and shoulder. We reveal that afferent feedback from specific cutaneous locations on the foot dorsum influences stance and swing phase corrective responses. This emphasizes the critical importance of feedback from the entire foot surface in locomotor control and has application for rehabilitation after neurological injury and in footwear development.

EMG Normalization Masks Changes in Reflex Amplitude in Response to Dopaminergic Medication in Parkinson’s Disease.

EMG Normalization Masks Changes in Reflex Amplitude in Response to Dopaminergic Medication in Parkinson’s Disease.

The amplitude of interlimb cutaneous reflexes in the leg is influenced by fingertip touch and vision during treadmill locomotion.

Light touch at the fingertip has been shown to influence postural control during standing and walking. Interlimb cutaneous reflexes have been proposed to provide a neural link between the upper and lower limbs to assist in interlimb coordination during activities such as walking. In this study, we tested the hypothesis that cutaneous sensory pathways linking the arm and leg will be facilitated if subjects use light touch to assist with postural control during treadmill walking. To test this, interlimb cutaneous reflexes from the median nerve, serving the skin contact region, and radial nerve, serving an irrelevant sensory territory, were tested in the legs of subjects walking on treadmill in an unstable environment. Interlimb cutaneous reflexes were tested while subjects (a) touched or (b) did not touch a stable contact with their fingertip, and while the eyes were either (c) open or (d) closed. Reflexes arising from both nerves were facilitated when vision was removed that was then ameliorated when touch was provided. These changes in reflex amplitude during the eyes closed conditions were mirrored by changes in background muscle activity. We suggest that this facilitation of interlimb reflexes from both nerves arises from a generalized increase in excitability related to the postural anxiety of walking on a treadmill with the eyes closed, which is then restored by the provision of light touch. However, the influence of touch when the eyes were open differed depending upon the nerve stimulated. Radial nerve reflexes in the legs were suppressed when touch was provided, mirroring a suppression in the background muscle activity. In contrast, median nerve reflexes in the leg were larger when touch was provided with the eyes open, despite a suppression of background muscle activity. This nerve-specific effect of touch on the amplitude of the interlimb cutaneous reflexes suggests that touch sensory information from the median nerve was facilitated when that input was functionally relevant.

Cutaneous stimulation of discrete regions of the sole during locomotion produces "sensory steering" of the foot.

BackgroundWhile the neural and mechanical effects of whole nerve cutaneous stimulation on human locomotion have been previously studied, there is less information about effects evoked by activation of discrete skin regions on the sole of the foot. Electrical stimulation of discrete foot regions evokes position-modulated patterns of cutaneous reflexes in muscles acting at the ankle during standing but data during walking are lacking. Here, non-noxious electrical stimulation was delivered to five discrete locations on the sole of the foot (heel, and medial and lateral sites on the midfoot and forefoot) during treadmill walking. EMG activity from muscles acting at the hip, knee and ankle were recorded along with movement at these three joints. Additionally, 3 force sensing resistors measuring continuous force changes were placed at the heel, and the medial and lateral aspects of the right foot sole. All data were sorted based on stimulus occurrence in twelve step-cycle phases, before being averaged together within a phase for subsequent analysis.MethodsNon-noxious electrical stimulation was delivered to five discrete locations on the sole of the foot (heel, and medial and lateral sites on the midfoot and forefoot) during treadmill walking. EMG activity from muscles acting at the hip, knee and ankle were recorded along with movement at these three joints. Additionally, 3 force sensing resistors measuring continuous force changes were placed at the heel, and the medial and lateral aspects of the right foot sole. All data were sorted based on stimulus occurrence in twelve step-cycle phases, before being averaged together within a phase for subsequent analysis.ResultsThe results demonstrate statistically significant dynamic changes in reflex amplitudes, kinematics and foot sole pressures that are site-specific and phase-dependent. The general trends demonstrate responses producing decreased underfoot pressure at the site of stimulation.ConclusionsThe responses to stimulation of discrete locations on the foot sole evoke a kind of “sensory steering” that may promote balance and maintenance of locomotion through the modulation of limb loading and foot placement. These results have implications for using sensory stimulation as a therapeutic modality during gait retraining (e.g. after stroke) as well as for footwear design and implementation of foot sole contact surfaces during gait.

The Effects of Circumferential Air-Splint Pressure on Flexor Carpi Radialis H-Reflex in Subjects without Neurological Deficits

The purposes of this study were to investigate the effects of circumferential pressure on flexor carpi radialis (FCR) H-reflex in subjects without neuromuscular deficits and to evaluate the skin's contribution to this effect. FCR H-reflex was assessed in 43 subjects by measuring the peak-to-peak amplitude change before, during, and after circumferential pressure was applied to the forearm. Twelve H-reflexes (H/M ratio: M = 25%, SD = 14) were recorded before pressure application to obtain a baseline value (H(baseline)) to which all data were compared. A pneumatic 15 to 20-cm air splint inflated to 51-60 mmHg provided the pressure around the forearm. H-reflex recordings were taken at 1, 3, and 5 min. during (H(pressure)) and after pressure application. A second smaller study (placebo), in which the air splint was inflated to 0 mmHg, was conducted in 5 subjects to ensure that changes in reflex amplitudes were not a result of cutaneous effects. Two types of responses were observed in the FCR H-reflex following pressure application. One group of subjects significantly increased in H-reflex amplitude while another group decreased in H-reflex amplitude when compared to H(baseline). Regression analysis found that H(max) explained 37.2% of the variance when controlling for H(baseline). Subjects with larger H(max) showed an increase in H(pressure) while subjects with lower H(max) showed decreases in H(pressure) The placebo study revealed no differences in H-reflex amplitude from baseline values, implying that skin stimulation from the air splint has no role in the effects observed. The dichotomous result indicates that pressure influences the upper extremity differently than it does the lower extremity in certain individuals. Clinicians, using circumferential pressure as a therapeutic modality to lower muscle activity of the upper extremity, need to be cognizant that pressure may have contrasting effects on their patients.

Proprioception and myoclonus

This review focuses on sensory information originating from muscle spindles and its role in proprioception and motor control. The first part reminds of the structural and functional properties of these muscle mechanoreceptors, with arguments for an independent fusimotor command, i.e. the γ-motoneurons, that would regulate spindle mechanical sensitivity in keeping with the requirements of ongoing motor action. The possibility that dysfunction of the fusimotor system might be responsible for clinical signs is discussed with respect to the hyperexcitability of the sensorimotor cortex that is observed in myoclonus of cortical origin. What is known about the spindle afferents projections into the spinal cord and about the dysfunction of the spinal sensorimotor networks in patients with neurological disorders, is put together in the second part. It is stressed on the significant complexity of the monosynaptic reflex in spite of its “simple” organization. The monosynaptic reflex constitutes the only possible way for testing the excitability of motoneurons and spinal networks. This method is extensively used clinically to examine changes in the nervous system with diseases. When studying changes from the norm, it is important to understand how the reflex functions in neurologically normal conditions. Different mechanisms such as pre-synaptic inhibition, post-activation depression and motoneuronal intrinsic properties are reviewed as they may induce changes in reflex amplitude and have therefore consequences for interpretation of spinal excitability.

The influence of increased muscle spindle sensitivity on Achilles tendon jerk and H-reflex in relaxed human subjects

Whether the fusimotor system contributes to reflex gain changes during reinforcement maneuvers is re-examined in the light of new data. Recently, from direct recordings of spindle afferent activity originating from ankle flexor muscles, we showed that mental computation increased the muscle spindle mechanical sensitivity in completely relaxed human subjects without concomitant f -motoneuron activation, providing evidence for selective fusimotor drive activation. In the present study, the effects of mental computation were investigated on monosynaptic reflexes elicited in non-contracting soleus muscle either by direct nerve stimulation (Hoffmann reflex, H) or by tendon tap (Tendinous reflex, T). The aim was to relate the time course of the changes in reflex size to the increase in spindle sensitivity during mental task in order to explore whether fusimotor activation can influence the size of the monosynaptic reflex. The results show changes in reflex amplitude that parallel the increase in muscle spindle sensitivity. When T-reflex is consistently facilitated during mental effort, the H-reflex is either depressed or facilitated, depending on the subjects. These findings suggest that the increased activity in muscle spindle primary endings may account for mental computation-induced changes in both tendon jerk and H-reflex. The facilitation of T-reflex is attributed to the enhanced spindle mechanical sensitivity and the inhibition of H-reflex is attributed to post-activation depression following the increased Ia ongoing discharge. This study supports the view that the fusimotor sensitization of muscle spindles is responsible for changes in both the mechanically and electrically elicited reflexes. It is concluded that the fusimotor drive contributed to adjustment of the size of tendon jerk and H-reflex during mental effort. The possibility that a mental computation task may also operate by reducing the level of presynaptic inhibition is discussed on the basis of H-reflex facilitation.

Amplitude modulation of the human quadriceps tendon jerk reflex during gait

Amplitude modulation of the quadriceps tendon jerk reflex was investigated during the step cycle in normal human subjects. Reflex amplitude was compared with that obtained during a control stance condition, with "equivalent" levels of EMG activity and limb position. During gait there was a progressive decrease in the reflex amplitude early in the stance phase, i.e. during yielding of the knee, and it remained reduced throughout the step cycle. This pattern of changes in reflex amplitude correlated with neither the quadriceps EMG activity nor with the knee joint movements. The behavior of the tendon reflex was similar to that described for the modulation of the quadriceps H-reflex during the early stages of the stance phase of gait. In the latter study it was argued that changes in presynaptic inhibition of quadriceps la terminals could account for the amplitude modulation. We conclude that there is no dramatic change in the gamma drive to quadriceps muscle spindles: tendon reflexes are modulated during the step cycle in much the same way as H-reflexes, in spite of the peripheral and central differences between them. Similar behavior has been described for the soleus H-reflex and Achilles tendon reflex during gait although the modulation of these reflexes followed a different pattern than that seen in the quadriceps.

Changes in size of the stretch reflex of cat and man attributed to aftereffects in muscle spindles.

1. This is a report of experiments carried out on the cat and on man, which demonstrate that conditioning of a muscle by contraction and movement can lead to changes in amplitude of stretch reflexes elicited in that muscle. 2. In triceps surae of the cat, the reflex response to a brief stretch was recorded after conditioning with a whole-muscle contraction followed by a pause at a length either 5 mm longer or shorter than the length at which the reflex was elicited. Following conditioning at the long length the reflex response was less than half as large as that following conditioning at the short length. 3. The changes in reflex amplitude could be correlated with an altered stretch responsiveness of muscle spindles in the soleus muscle. When the muscle had been held long during conditioning, a subsequent brief stretch applied at an intermediate length elicited fewer impulses in primary endings of spindles than after conditioning at a short length. 4. The same kind of experiment was then carried out on adult human subjects. When a tendon tap was applied to the Achilles tendon after a voluntary contraction and relaxation of triceps surae with the muscle at a long length, (foot dorsiflexed) the reflex was frequently less than half the size it had been after a contraction at a short length (foot plantarflexed). It was concluded that the same kind of spindle aftereffects as observed for cat soleus spindles were responsible for the changes in reflex amplitude. 5. It was found both in the cat and in human subjects that the changes in reflex amplitude after conditioning became progressively less as the test length was made longer. 6. The explanation put forward to account for these observations is that stable cross-bridges form between actin and myosin filaments of passive intrafusal (and extrafusal) fibers. When the muscle is shortened several seconds after a contraction at a long length, the intrafusal fibers, stiffened by the presence of cross-bridges, fall slack. Slack does not develop after a contraction at a short muscle length, as the fiber is stretched to the test length. Since any slack must first be taken up by the test stretch, there is a smaller afferent response and consequently a smaller reflex contraction in response to a tendon tap after conditioning at a long length.(ABSTRACT TRUNCATED AT 400 WORDS)

Spinal reflexes and lateral geniculate nucleus activity during sleep: Quantitative relationships

The relationship between monosynaptic spinal reflex (MSR) activity and monophasic spike activity of the lateral geniculate nucleus (LGN) was studied in unanesthetized, unrestrained cats during spontaneous sleep. Relative to MSR modulation during slow-wave sleep (SWS), modulation during paradoxical sleep (PS) was toward decreased reflex amplitude within 500 ms subsequent to the onset of isolated LGN spikes ( t 0). These modulations, although statistically significant, were not particularly pronounced and were not always consistent for all animals. Reflex amplitude decreased in the 1 s following onset of either small (three to four spikes) or larger (≥ 5 spikes) spike bursts, but this reduction was significant only for the latter group. Consistent changes in reflex amplitude did not outlast brief spike bursts even when additional isolated spikes occurred in the extended sample interval (2.2 e post- t 0). Extended modulation (5 s post- t 0) of reflex activity was detected for bursts of ≥ 14 spikes. Whereas previous reports indicated variations in MSR activity only in association with bursts of LGN spikes, the present data suggest state-dependent modulation of such activity for isolated and low-frequency bursts as well as high-frequency spike bursts. A possible role for the caudal raphe nuclei in the generation of low frequency pontogeniculate (PGO) activity and related reflex variations is postulated, and bases for discrepancies between phasic MSR modulation during synchronized sleep in man and cat are explored.

Normal electrically induced reflexes (“H reflexes”) in a 2-week-old infant with acrania and cerebral dysgenesis

A patient with cerebral dysgenesis, who survived for 27 days after birth, had normal electrically induced reflexes (EIRs) at 2 weeks of age. Since neuropathological findings showed absence of pyramids, cortico-spinal tracts, and cerebellar vermis, it is obvious that these neural elements are not essential for the elicitation of the reflex, nor for the changes in reflex amplitude which occur when the infant goes from wakefulness to sleep, or vice versa.