Facilitation Of Soleus H-reflex Research Articles

Modulation of soleus H-reflex excitability following cervical transspinal conditioning stimulation in humans

The aim of this study was to establish the effects of transcutaneous spinal cord (transspinal) stimulation over the cervical region on soleus H-reflex excitability in healthy subjects while at rest. Reflex effects were established at subthreshold and suprathreshold cervical transspinal conditioning stimulation intensities of the extensor carpi radialis transspinal evoked potential. Twenty soleus H-reflexes at 0.125 Hz were recorded randomly under control conditions and following transspinal conditioning stimulation at conditioning-test intervals that ranged from 0 to 55 ms and tested in increment of 5 ms steps and at 100 ms. Cervical transspinal stimulation at suprathreshold and not at subthreshold intensities produced short, medium, and long-latency soleus H-reflex facilitation. The observed facilitatory reflex effects are consistent with activation of excitatory components of long propriospinal neurons. We propose the use of cervical transspinal stimulation to potentiate excitatory neuronal interactions between arms and legs in neurological disorders.

Patellar tendon vibration reduces the increased facilitation from quadriceps to soleus in post-stroke hemiparetic individuals

BackgroundStimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke. ObjectivesTo determine whether vibration of the quadriceps can modify the enhanced heteronymous facilitation of the soleus muscle observed in people with spastic stroke after femoral nerve stimulation and compare post-vibration effects on soleus facilitation in control and stroke individuals. MethodsModulation of voluntary soleus EMG activity induced by femoral nerve stimulation (2×motor threshold) was assessed before, during and after vibration of the patellar tendon in 10 healthy controls and 17 stroke participants. ResultsVoluntary soleus EMG activity was facilitated by femoral nerve stimulation in 4/10 (40%) controls and 11/17 (65%) stroke participants. The level of facilitation was greater in the stroke than control group. Vibration significantly reduced early heteronymous facilitation in both groups (50% of pre-vibration values). However, the delay in recovery of soleus facilitation after vibration was shorter for the stroke than control group. The control condition with the vibrator turned off had no effect on the modulation. ConclusionsPatellar tendon vibration can reduce the facilitation between knee and ankle extensors, which suggests effective presynaptic inhibition but decreased post-activation depression in the lower limb of people after chronic hemiparetic stroke. Further studies are warranted to determine whether such vibration could be used to reduce the abnormal extension synergy of knee and ankle extensors in people after hemiparetic stroke.

The role of the supporting lower limb function in the premotor changes in the H-reflex of m. soleus

In studies on healthy humans we examined changes in the H reflex amplitude and the intensity of background EMG of the soleus muscle within the premotor period of voluntary extension of the contralateral ankle joint. The tested persons were in the lying prone position with relaxed legs, or in the standing position with support on both feet or only on one foot with additional hand support. The soleus H reflex was induced using the standard technique by transcutaneous stimulation (1 ms long current pulses) of the tibial nerve afferents in the region of the popliteal dimple. Using superficial electrodes, we recorded the integral EMG reflex discharge from the m. soleus, amplified, and visualized it using a two-channel digital oscillograph, Handiscope HS3 (TiePieEngeneering, Netherlands). In other tests, we also recorded tonic background EMG activity from the soleus muscle. After fullwave rectification and low-frequency filtration we estimated the area under the integral curve enveloping oscillations of the above mentioned EMG. In the lying position the extension of contralateral ankle joint evoked anticipatory facilitation of the testing soleus H-reflex. It manifested in 90–60 ms and reached the maximum 30 ms before the conditioning movement. Considerable changes of the soleus background EMG-activity did not occur during the premotor period. Consequently, it is supposed that the mechanism leading to the H-reflex facilitation is the decrease of presynaptic inhibition at 1a. In the standing position with support on both feet contralateral ankle joint extension caused anticipatory inhibition of the soleus H-reflex and simultaneous suppression of background EMG 90–60 ms before the conditioning movement. These results indicate the anticipatory changes of muscle tone and suggest participation of postsynaptic mechanism in the inhibition of the testing H-reflex. When the moving contralateral extremity had no support, the contralateral ancle joint extension did not cause anticipatory inhibition but facilitation of the soleus H-reflex. Its time course was similar to that observed in the lying position. The considerable changes of the soleus background EMG-activity did not arise. The results of the experiments indicate that the nature of premotor changes in the spinal neuron circuits, associated with the lower limb muscles, depends not only on the type of upcoming voluntary movement. Being caused by the contralateral limb movements, they depend greatly on the fulfillment or nonfulfillment of the support function by the lower limbs.

Acute changes in soleus H-reflex facilitation and central motor conduction after targeted physical exercises

We tested the acute effect of exercises targeted simultaneously at cortical and brainstem circuits on neural transmission through corticobulbar connections. Corticobulbar pathways represent a potential target for rehabilitation after spinal cord injury (SCI), which tends to spare brainstem circuits to a greater degree than cortical circuits. To explore this concept, able-bodied volunteers (n=20) underwent one session each of three exercises targeted at different nervous system components: treadmill walking (spinal locomotor circuits), isolated balance exercise (brainstem and other pathways), and multimodal balance plus skilled hand exercise (hand motor cortex and corticospinal tract). We found that short-interval soleus H-reflex facilitation increased after one session of balance and multimodal exercise by 13.2±4.0% and 8.3±4.7%, and slightly decreased by 1.9±4.4% after treadmill exercise (p=0.042 on ANOVA across exercise type). Increases in long-interval H-reflex facilitation were not significantly different between exercises. Both balance and multimodal exercise increased central motor conduction velocity by 4.3±2.6% and 4.5±2.8%, whereas velocity decreased by 4.3±2.7% after treadmill exercise (p=0.045 on ANOVA across exercise type). In conclusion, electrophysiological transmission between the motor cortex and spinal motor neurons in able-bodied subjects increased more following one session of balance exercise than treadmill exercise.

Remote Facilitation of Soleus H-reflex Induced by Clenching on Occlusal Stabilization Appliances

Remote Facilitation of Soleus H-reflex Induced by Clenching on Occlusal Stabilization Appliances

EFFECTS OF CHANGES IN HIP POSITION ON ACTIONS OF SPINAL INHIBITORY INTERNEURONS IN HUMANS

The aim of the present study was to establish whether in healthy human subjects the actions of group I muscle afferents arising from the same spinal segments as the soleus innervation (e.g., common peroneal nerve; CPN) or from more proximal spinal segments (femoral nerve; FN) on the soleus H-reflex are modified by changes in hip position. Control and conditioned soleus H-reflexes were elicited and recorded via conventional methods. In seated subjects, CPN and FN stimulation resulted in similar effects to the soleus H-reflex to that previously reported in healthy subjects. However, during hip angle changes, CPN stimulation at the C-T interval of 2 ms resulted in soleus H-reflex depression only when the hip was flexed at 30°, whereas with the hip flexed or extended at 10° the H-reflex was facilitated. CPN stimulation delivered at 100 ms also induced soleus H-reflex facilitation regardless of the hip angle tested. The heteronymous reflex facilitation (conditioned H-reflex with FN stimulation) did not vary systematically with hip angle changes. These findings indicate that hip proprioceptors interact with spinal inhibitory interneurons to enhance spinal reflex excitability under static conditions. This neural switch might constitute an important feature of movement regulation in humans.

Remote Facilitation of Soleus H-reflex Induced by Clenching on Occlusal Stabilization Appliances

Purpose : The purpose of this study was to examine the change in spinal cord excitability in a leg muscle during maximal voluntary clenching on a stabilization appliance.Materials and Methods : The H reflex of the soleus muscle was elicited in five healthy male volunteers by electrical stimulation of the tibial nerve under the following five dental occlusal conditions : mandibular rest position (RP : control), maximum voluntary clenching in the intercuspal position (IP), maximum voluntary clenching on a hard acrylic stabilization appliance (H-SA), maximum voluntary clenching on a soft stabilization appliance (S-SA) and maximum voluntary clenching on a very soft stabilization appliance (VS-SA).Results : The soleus H reflex modulations in the IP, H-SA, S-SA and VS-SA conditions were 117.6%, 119.5%, 126.2% and 133.6%, respectively. There was a significant difference between IP and S-SA, and IP and VS-SA (p=0.0001-0.0226) ; however, there was no significant difference between IP and H-SA (p=0.3412-0.9940). Significant positive correlations between the magnitude of the soleus H reflex and the masseter electromyogram activity were found in each subject (r=0.670-0.862, p<0.05).Conclusion : This study demonstrated that the spinal cord excitability in the motor pathway of a leg muscle was considerably raised during clenching on a soft stabilization appliance compared to a hard stabilization appliance, suggesting that a powerful biting action on a resilient intraoral appliance strongly influences the motor system in humans.

Long-loop reflex from arm afferents to remote muscles in normal man.

The present study was designed to examine the effects of median nerve stimulation on motoneurones of remote muscles in healthy subjects using H-reflex, averaged EMG and PSTH methods. Stimulation of the median nerve induced facilitation of soleus H-reflex from about 50 ms and it reached a peak at about 100 ms of conditioning-test interval. Afferents that induced the facilitation consisted of at least two types of fibres, the high-threshold cutaneous fibres and the low-threshold fibres. When the effects were examined by the averaged surface EMG and PSTH, no facilitation but rather inhibition or inhibition-facilitation was induced in all tested muscles except for the upper limb muscles on the stimulated side. The inhibition latency was shortest in masseter muscle and longest in leg muscles, while values for the contralateral upper limb muscles were in the middle, indicating that the onset of inhibition was delayed from rostral to caudal muscles. Inputs from the median nerve converged to inhibitory interneurones, which mediate the masseter inhibitory reflex. Our findings suggested that inputs from the median nerve initially ascend to the brain, at least to the brainstem, and then descend to the spinal cord. Therefore, inhibition induced by median nerve stimulation was not considered as an interlimb reflex mediated by a propriospinal pathway, but long-loop reflex, at least via the pons. The discrepancy between the results of reflex and motor units suggests that facilitation of soleus H-reflex following median nerve stimulation was mainly due to reduced presynaptic inhibition.

COMPARISON OF ???PRESYNAPTIC INHIBITION??? FROM SUPINE TO STANDING USING ALTERNATIVE CONDITIONING PROTOCOLS

1454 Presynaptic inhibition (PI) is one of the spinal mechanisms hypothesized to be involved in the reflex modulation observed during movement. Several studies have used indirect methods of measurement to determine the role of PI in human movement. Hultborn et al. (1987) piloted an indirect PI protocol in which heteronymous Ia facilitation (HF) of the soleus motor pool via femoral nerve conditioning elicits a base-line soleus H-reflex facilitation. With changes in posture or onset of movement, changes in facilitation have been associated with changes in PI. Likewise, Iles (1996) designed a protocol which involved a conditioning stimulus to the deep peroneal nerve. This peroneal conditioning(PC) stimulus is reported to elicit a long-latency PI of the soleus motor pool at 90-120 ms. Both of these protocols compare test soleus H-reflexes to conditioned soleus H-reflexes to assess the amount of PI. However, the differences in methods may lead to observation of two different patterns of PI. The purpose of this study is to compare the results of these two conditioning protocols under two conditions: supine and standing. Independent groups were used with 11 subjects (6 female, 5 male; 23.9 ± 2.6 years) tested with an HF protocol, and 8 subjects (4 female, 4 male; 27.1 ± 3.7 years) tested with a PC protocol. Test and conditioned reflexes were collected at both supine and standing conditions. A 2 × 2 (condition x position) ANOVA was applied to each group to assess differences. Results demonstrated that the HF protocol led to significant 51.0% facilitation of the test H-reflex during supine but not standing testing (2.9%). PC led to significant depression of the test H-reflex at each condition (-32.7% supine,-29.8% standing). However, there was no difference in inhibition elicited between the two conditions. These results suggest that HF may be measuring the existing level of PI, while PC may only measure the potentially constant amount of PI available.

Modulation, probably presynaptic in origin, of monosynaptic Ia excitation during human gait.

Modulation of presynaptic inhibition of Ia afferents projecting monosynaptically to soleus motoneurones was investigated during human gait. Changes in presynaptic inhibition of Ia afferents were deduced from alterations in the amount of heteronymous soleus H-reflex facilitation evoked by a constant femoral nerve stimulation. It has been shown that this facilitation is mediated through a monosynaptic Ia pathway and that during its first 0.5 ms it is still uncontaminated by any polysynaptic effect and can be used to assess ongoing presynaptic inhibition of Ia terminals to soleus motoneurones. During gait, heteronymous facilitation was reduced with respect to its control value (rest during sitting) and modulated during the step cycle: it reached its maximum at mid-stance and decreased to near zero by the end of stance. At the same time the H-reflex amplitude was to some extent similarly modulated. It is argued that this decrease in heteronymous Ia facilitation and in H-reflex amplitude reflects an increased, ongoing presynaptic inhibition of Ia terminals projecting onto soleus motoneurones, which could be from central and/or peripheral origin. D1 inhibition, i.e. the late and long-lasting inhibition of the soleus H-reflex evoked by a train of stimuli to the common peroneal nerve, was used as another method to assess presynaptic inhibition. This D1 inhibition was decreased during gait, and it is argued that this decrease might reflect an occlusion in presynaptic pathways or increased presynaptic inhibition of pathways mediating the conditioning volley.

A quantitative assessment of presynaptic inhibition of Ia afferents in spastics. Differences in hemiplegics and paraplegics.

Soleus H-reflex facilitation evoked by a supramaximal conditioning stimulation to the femoral nerve was investigated in 28 healthy control subjects and 35 spastic patients of whom 17 were paraplegics with bilateral spinal cord lesion and 18 were hemiplegics with unilateral cerebral lesion. Heteronymous facilitation from quadriceps to soleus was measured 0.4 ms after onset, while the monosynaptic Ia excitation is still uncontaminated by any non-monosynaptic effect and can be used to assess ongoing presynaptic inhibition on Ia terminals to soleus motor neurons. In paralegics, this heteronymous Ia facilitation was significantly larger than in control subjects (all individual results in these patients being above the mean observed in controls). This must reflect a decrease in presynaptic inhibition of Ia terminals in the paraplegics explored here. There was no correlation between this decreased presynaptic inhibition of Ia terminals and the degree of spasticity measured by Ashworth's scale. Surprisingly, the amount of heteronymous Ia facilitation in hemiplegics was the same as in normal subjects. This indicates that presynaptic inhibition of Ia terminals is unchanged in these patients and disagrees with the usual interpretation of reduced vibratory inhibition of the soleus H-reflex in hemiplegics. It is argued that this disagreement is due to the fact that vibratory inhibition of the reflex also depends on post-activation depression following repetitive synaptic transmission.

Jendrassik maneuver facilitates soleus H-reflex without change in average soleus motoneuron pool membrane potential

Facilitation of spinal reflex amplitude by remote muscle contraction, otherwise known as the Jendrassik maneuver (JM), was first shown over 100 years ago, yet the mechanism by which this facilitation operates remains undetermined. Earlier work has eliminated participation of the muscle spindle in JM-induced spinal reflex facilitation, leaving changes in postsynaptic (e.g., change in average soleus motoneuron membrane potential) and presynaptic (e.g., inhibition of presynaptic inhibition) mechanisms as viable candidates. We recorded background EMG in the soleus muscle during JM-induced soleus H-reflex facilitation in humans. The JM in this experiment consisted of wrist muscle contraction. Soleus background EMG was maintained by the subject at either a zero level (e.g., relaxed) or a specified moderate level prior to and during the JM. The JM increased H-reflex amplitude by comparable amounts in both situations, but had no effect on soleus background EMG. Given the well-known relationship between the average motoneuron pool membrane potential and background EMG, we conclude that JM facilitation of the soleus H-reflex is not caused by an increase in background excitatory input to the soleus motoneuron pool. Remaining candidates for mediation of JM induced H-reflex facilitation include change in stimulus-evoked afferent input at some point proximal to the muscle spindle, such as reduction in presynaptic inhibition, or a change in motoneuron input resistance.

Comparison of soleus H reflex facilitation at the onset of soleus contractions produced voluntarily and during the stance phase of human gait

ariations in the soleus monosynaptic reflex have been studied in normal human subjects during soleus contractions while walking, and compared with those observed during voluntary soleus activation. The monosynaptic reflex was always more facilitated during voluntary contractions than during walking. The EMG activity was identical in both situations. Under the assumption that this reflects and indentical excitability of the motoneuronal pool, this different soleus H-reflex facilitation can be attributed to a difference in the excitatory efficiency of the group I volley evoked by the H-reflex stimulation. It is suggested that the level of presynaptic inhibition exerted on Ia fibers could be lower during walking than during voluntary contraction.