A quantitative study of muscle spindles and tendon organs in some intrinsic muscles of the hand in the bonnet monkey (Macaca radiata)

Neuregulin-1/ErbB4 upregulates acetylcholine receptors via Akt/mTOR/p70S6K: a study in a rat model of obstetric brachial plexus palsy and in vitro

In obstetric brachial plexus palsy (OBPP), the operative time window for nerve reconstruction of the intrinsic muscles of the hand (IMH) is much shorter than that of biceps. The reason is that the atrophy of IMH becomes irreversible more quickly than that of biceps. A previous study confirmed that the motor endplates of denervated intrinsic muscles of the forepaw (IMF) were destabilized, while those of denervated biceps remained intact. However, the specific molecular mechanism of regulating the self-repair of motor endplates is still unknown. In this study, we use a rat model of OBPP with right C5-C6 rupture plus C7-C8-T1 avulsion and left side as a control. Bilateral IMF and biceps are harvested at 5 weeks postinjury to assess relative protein and mRNA expression. We also use L6 skeletal myoblasts to verify the effects of signaling pathways regulating acetylcholine receptor (AChR) protein synthesis in vitro. The results show that in the OBPP rat model, the protein and mRNA expression levels of NRG-1/ErbB4 and phosphorylation of Akt/mTOR/p70S6K are lower in denervated IMF than in denervated biceps. In L6 myoblasts stimulated with NRG-1, overexpression and knockdown of ErbB4 lead to upregulation and downregulation of AChR subunit protein synthesis and Akt/mTOR/p70S6K phosphorylation, respectively. Inhibition of mTOR abolishes protein synthesis of AChR subunits elevated by NRG-1/ErbB4. Our findings suggest that in the OBPP rat model, lower expression of AChR subunits in the motor endplates of denervated IMF is associated with downregulation of NRG-1/ErbB4 and phosphorylation of Akt/mTOR/p70S6K. NRG-1/ErbB4 can promote protein synthesis of the AChR subunits in L6 myoblasts via phosphorylation of Akt/mTOR/p70S6K.

Monkey flexor and abductor pollicis brevis motoneuron pools: Proximal dendritic trees and small motoneurons

Transverse sections of the monkey cervical spinal cord from a previous study (Jenny and Inukai, 1983 [1]) were reanalyzed using Neurolucida to create a three-dimensional display of flexor pollicis brevis and abductor pollicis brevis (FAbPBr) motoneurons and dendrites that had been jointly labeled with horse radish peroxidase (HRP). These data were correlated with similar data from a reanalysis of an extensor digitorum communis (EDC) motoneuron pool (Jenny, Cheney, and Jenny, 2018 [2]). The FAbPBr motoneuron columns were located in the C8 (caudal) and T1 segments of the spinal cord and within the most dorsal and medial regions of the motor column pools that innervate hand muscles. Small motoneurons (cell body areas less than 500 µm² and presumed to be gamma motoneurons) comprised about four percent of the motoneurons and were located throughout the length of the motoneuron pool. HRP labeled dendrites extended radially (360°) from the motoneuron soma but greater numbers of dendrites were directed either dorsomedial to the base of the dorsal horn or medial to the ventromedial gray matter. The longer HRP labeled dendrites and their branch dendrites usually continued in the same radial direction as when originating from the cell body or proximal dendrite. As such we considered the radial direction of the longer HRP labeled dendrites to be a reasonable estimate of the radial direction of the more distal dendritic trees [2]. Both the EDC and FAbPBr motoneuron groups had a greater number of dendrites oriented in dorsal and medial directions from the motoneuron column. Our data continue to suggest that motoneuron dendritic trees have direction-oriented dendrites that extend toward functional terminal regions.

Functional properties of human muscle spindles

Muscle spindles are ubiquitous encapsulated mechanoreceptors found in most mammalian muscles. There are two types of endings, primary and secondary, and both are sensitive to changes in muscle length and velocity, with the primary endings having a greater dynamic sensitivity. Unlike other mechanoreceptors in the somatosensory system, muscle spindles are unique in possessing motor innervation, via γ-motoneurons (fusimotor neurons), that control their sensitivity to stretch. Much of what we know about human muscles spindles comes from studying the behavior of their afferents via intraneural microelectrodes (microneurography) inserted into accessible peripheral nerves. We review the functional properties of human muscle spindles, comparing and contrasting with what we know about the functions of muscle spindles studied in experimental animals. As in the cat, many human muscle spindles possess a background discharge that is related to the degree of muscle stretch, but mean firing rates are much lower (~10 Hz). They can faithfully encode changes in muscle fascicle length in passive conditions, but higher level extraction of information is required by the central nervous system to measure changes in muscle length during muscle contraction. Moreover, although there is some evidence supporting independent control of human muscle spindles via fusimotor neurons, any effects are modest compared with the clearly independent control of fusimotor neurons observed in the cat.

The optimal neural strategy for a stable motor task requires a compromise between level of muscle cocontraction and synaptic gain of afferent feedback

Increasing joint stiffness by cocontraction of antagonist muscles and compensatory reflexes are neural strategies to minimize the impact of unexpected perturbations on movement. Combining these strategies, however, may compromise steadiness, as elements of the afferent input to motor pools innervating antagonist muscles are inherently negatively correlated. Consequently, a high afferent gain and active contractions of both muscles may imply negatively correlated neural drives to the muscles and thus an unstable limb position. This hypothesis was systematically explored with a novel computational model of the peripheral nervous system and the mechanics of one limb. Two populations of motor neurons received synaptic input from descending drive, spinal interneurons, and afferent feedback. Muscle force, simulated based on motor unit activity, determined limb movement that gave rise to afferent feedback from muscle spindles and Golgi tendon organs. The results indicated that optimal steadiness was achieved with low synaptic gain of the afferent feedback. High afferent gains during cocontraction implied increased levels of common drive in the motor neuron outputs, which were negatively correlated across the two populations, constraining instability of the limb. Increasing the force acting on the joint and the afferent gain both effectively minimized the impact of an external perturbation, and suboptimal adjustment of the afferent gain could be compensated by muscle cocontraction. These observations show that selection of the strategy for a given contraction implies a compromise between steadiness and effectiveness of compensations to perturbations. This indicates that a task-dependent selection of neural strategy for steadiness is necessary when acting in different environments.

A biomechanical and evolutionary perspective on the function of the lumbrical muscle

The lumbrical muscles of the hand originate from the flexor digitorum profundus tendons and insert onto the lateral band of the extensor tendons. Owing to these movable attachments, the function of this muscle is difficult to visualize. To better determine the function of this muscle, we considered its relative anatomy, biomechanical characteristics, and evolution. With the smallest physiological cross-sectional area in the upper extremity, the lumbrical muscles have weak motor function, which is only 1/10 of the interosseous muscle. Because they are spindle rich, the lumbrical muscles play an important role in the sensory feedback of the distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints of the fingers. The first 2 lumbrical muscles have lower variation in anatomy and higher density of muscle spindles compared to the ulnar 2 lumbricals. In addition, the index and middle finger lumbrical muscles are innervated by the median nerve, which also innervates the thenar muscles of the thumb. Therefore, it is possible that the first 2 lumbricals are functionally more important than the 2 ulnar lumbricals, specifically for precision pinch movements.

Biomechanics of the hand

By understanding the biomechanical motions that allow the hand to function effectively and how patients used the hand before their injury, the surgeon can best determine which surgical method is most suited to prevent permanent loss of function and significant impairment. The objective of this article is to discuss the biomechanics of the hand and, particularly, to assess the range of biomechanical motions that account for most of the hand functions and to determine the value of each function and which specific surgical procedures best restore the optimum function of the hand.

The representation of egocentric space in the posterior parietal cortex

The posterior parietal cortex (PPC) is the most likely site where egocentric spatial relationships are represented in the brain. PPC cells receive visual, auditory, somaesthetic, and vestibular sensory inputs; oculomotor, head, limb, and body motor signals; and strong motivational projections from the limbic system. Their discharge increases not only when an animal moves towards a sensory target, but also when it directs its attention to it. PPC lesions have the opposite effect: sensory inattention and neglect. The PPC does not seem to contain a "map" of the location of objects in space but a distributed neural network for transforming one set of sensory vectors into other sensory reference frames or into various motor coordinate systems. Which set of transformation rules is used probably depends on attention, which selectively enhances the synapses needed for making a particular sensory comparison or aiming a particular movement.

Anatomy and function of lumbrical muscles

The lumbrical muscles are unique in having their origin and insertion on tendons. The lumbricals assist in metacarpophalangeal joint flexion; they contribute to interphalangeal joint extension by acting as deflexors of the proximal interphalangeal joint. Anatomically, they are highly specialized in terms of their architectural properties, with a small physiologic cross-sectional area but long fiber length. Their unique properties indicate that they are probably important in fast, alternating movements and fine-tuning digit motion.

Does the nervous system depend on kinesthetic information to control natural limb movements?

This target article draws together two groups of experimental studies on the control of human movement through peripheral feedback and centrally generated signals of motor commands. First, during natural movement, feedback from muscle, joint, and cutaneous afferents changes; in human subjects these changes have reflex and kinesthetic consequences. Recent psychophysical and microneurographic evidence suggests that joint and even cutaneous afferents may have a proprioceptive role. Second, the role of centrally generated motor commands in the control of normal movements and movements following acute and chronic deafferentation is reviewed. There is increasing evidence that subjects can perceive their motor commands under various conditions, but that this is inadequate for normal movement; deficits in motor performance arise when the reliance on proprioceptive feedback is abolished either experimentally or because of pathology. During natural movement, the CNS appears to have access to functionally useful input from a range of peripheral receptors as well as from internally generated command signals. The unanswered questions that remain suggest a number of avenues for further research.

Implications of neural networks for how we think about brain function

Engineers use neural networks to control systems too complex for conventional engineering solutions. To examine the behavior of individual hidden units would defeat the purpose of this approach because it would be largely uninterpretable. Yet neurophysiologists spend their careers doing just that! Hidden units contain bits and scraps of signals that yield only arcane hints about network function and no information about how its individual units process signals. Most literature on single-unit recordings attests to this grim fact. On the other hand, knowing a system's function and describing it with elegant mathematics tell one very little about what to expect of interneuronal behavior. Examples of simple networks based on neurophysiology are taken from the oculomotor literature to suggest how single-unit interpretability might decrease with increasing task complexity. It is argued that trying to explain how any real neural network works on a cell-by-cell, reductionist basis is futile and we may have to be content with trying to understand the brain at higher levels of organization.

Peripheral median nerve block impairs precision pinch movement

OBJECTIVE

The objective of this study was to investigate the effects of a simulated peripheral median nerve lesion on precision pinch movement by the thumb and index finger.

METHODS

A median neuropathy was created by blocking the median nerve at the wrist using an anesthetic. The subjects (n=5) were asked to perform pulp-to-pulp precision pinch movements before and after the nerve block. Digit motion data was obtained with a marker-based motion analysis system.

RESULTS

The radial offset of the thumb tip, as defined by the minimum distance of the thumb tip to the flexion-extension plane of the index finger, showed an increase of 11.2mm after the nerve block. For the thumb, the nerve block caused a decrease in the range of motion at the metacarpophalangeal (MCP) joint, and a compensatory increase in the range of motion at the interphalangeal (IP) joint. The range of motion ratio (MCP:IP) changed from 1:4.8 (pre-block) to 1:1.0 (post-block). The maximum flexion angle at the MCP joint increased from 18.8 degrees (pre-block) to 33.7 degrees (post-block), and maximum flexion angle at the IP joint decreased from 42.6 degrees (pre-block) to 18.8 degrees (post-block). For the index finger, the nerve block caused a decrease in the range of motion at the MCP joint, and compensatory increases in the ranges of motion at the proximal and distal interphalangeal (PIP and DIP) joints. The range of motion ratio (MCP:PIP:DIP) changed from 1:1.1:0.7 (pre-block) to 1:2.4:1.8 (post-block). The maximum flexion angle at the MCP joint decreased from 56.8 degrees (pre-block) to 34.6 degrees (post-block), and the maximum flexion angle at the PIP joint increased from 51.2 degrees (pre-block) to 76.0 degrees (post-block), but the change at the DIP joint was insignificant.

CONCLUSIONS

The median nerve block caused remarkable degradation of the pinch performance as quantified by an inaccurate pulp-to-pulp contact of the thumb to the index finger and an alteration of joint motion of the digits.

SIGNIFICANCE

Many fine manual tasks require accurate pulp-to-pulp positioning of the thumb to the index finger. Within the hand, the median nerve is critical to the fine sensorimotor function due to the motor supply and the sensory endings to the thumb and index finger. People with median neuropathies (for example, carpal tunnel syndrome) experience clumsiness while performing simple manual tasks. The current approach to the examination of precision pinch movement may be utilized to quantify the apparent hand clumsiness observed in individuals with peripheral neuropathy such as carpal tunnel syndrome.

Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine

STUDY DESIGN

Tissue blocks comprising muscle and bone from C5 to C7 segments were harvested at autopsy from 16 individuals ranging in age from 4 to 77 years. The prevertebral longus colli and postvertebral multifidus muscle pairs from one side in each individual were randomly selected for this study of muscle spindles.

OBJECTIVES

To determine muscle spindle distribution, morphology, and density for the longus colli and multifidus in caudal segments of the human cervical spine, and to assess whether changes are evident from infancy to old age.

SUMMARY OF BACKGROUND DATA

Age-related changes to the osteoligamentous framework of the cervical spine have been well documented. Postural modification accompanies these structural alterations, but there have been limited attempts to document whether muscle sustains a comparable level of morphologic alteration. Previous studies have examined muscle spindles in the neck muscles of various animal models and in a variety of isolated human muscles. However, most of these studies incurred bias through sampling and methodologic assumptions.

METHODS

The longus colli and multifidus were resected between C5 and C7, and between left and right pairs selected randomly for spindle analysis. These vertebral segments were selected deliberately because they form the apex of the cervical lordosis and the site at which the greatest age-related modification occurs. The tissue was processed in paraffin, sectioned, and then stained by Masson's trichrome. Spindle characteristics were examined using light microscopy and analyzed by unbiased stereologic methods. A one-sample paired t test was used to ascertain whether the differences in spindle density between the two muscles were statistically significant.

RESULTS

The longus colli has a high density of muscle spindles, which appear clustered and concentrated anterolaterally, away from the vertebral body. The multifidus has a low density of muscle spindles, which are found predominantly as single units concentrated closely to the vertebral lamina. No change in spindle distribution, morphology, and density were observed with age.

CONCLUSIONS

The current study examined spindle characteristics for an intrinsic neck muscle pair whose coactivation contributes to segmental stability of the cervical spine. The distribution and morphology of muscle spindles differ between the longus colli and the multifidus. In addition, these muscles have significant differences in terms of mean spindle density. Spindle characteristics represent one of many factors that govern proprioceptive regulation in skeletal muscle, and in neck muscles, the central connectivity of these receptors remains undefined. Therefore, although there are anatomic differences between the neck flexor and extensor, the functional implications of these differences are not clear. It is also of interest that spindle characteristics remain unchanged in these intrinsic muscles whose underlying segments are subject to age-related osteoligamentous changes.

Strength measurements of the lumbrical muscles

This study was designed to measure the strength of the lumbrical muscles in the index and long fingers in patients with ulnar nerve paralysis. A hand-held dynamometer was used. The results show that in ulnar nerve damage the index and long fingers have a mean metacarpophalangeal (MCP) joint flexion strength of 0.8 kg (range 0.3-1.5), compared with 6.4 kg (range 4.6-7.9) in the noninvolved hand. Thus, the damaged fingers have only about 12% of the strength of those of the noninvolved hand. In the hand with ulnar paralysis, the loss of intrinsic strength (dorsal and palmar interosseous muscles) is considerable (almost 90%). The contribution of the interosseous muscles in maintaining the intrinsic position is considerably greater than that of the lumbricals. Comparing the Medical Research Council (MRC) scale (0-5) with the dynamometry measurements shows that MRC grade 3 correlates with about 0.8 kg, while grade 5 correlates with about 6.5 kg of MCP joint flexion strength.

Inhibition of hand muscle motoneurones by peripheral nerve stimulation in the relaxed human subject. Antidromic versus orthodromic input

In active muscle, a supramaximal conditioning stimulus to peripheral nerve produces a classic silent period in the EMG. The present experiments examined the effect of this type of conditioning stimulus on motoneurone excitability in relaxed muscle. EMG responses evoked by transcranial magnetic stimulation of the brain were recorded from the first dorsal interosseus muscle (FDI) in 10 healthy subjects and 5 patients with sensory neuropathy. These responses (motor evoked potentials) were conditioned by supramaximal peripheral nerve stimuli given 0-150 msec beforehand. In the normal subjects, the classic silent period in the FDI lasted about 100 msec. The same conditioning stimulus only abolished motor evoked potentials when the conditioning-test interval was so short that the antidromic peripheral nerve volley collided with the orthodromic volley set up by magnetic brain stimulation. At longer conditioning-test intervals, although remarkably inhibited (65% mean suppression between 10 and 40 msec), the test motor potential was never completely abolished and gradually recovered by 100 msec. Inhibition of cortically evoked motor potentials did not depend upon activity set up by the conditioning stimulus in peripheral nerve sensory fibres. The patients with complete peripheral sensory neuropathy had the same extent and time-course of inhibition as the normal subjects. We conclude that in relaxed subjects the inhibitory effect of peripheral conditioning results almost exclusively from the motoneuronal inhibitory mechanisms consequent to antidromic invasion.

Projection of thenar muscle afferents to frontal and parietal cortex of human subjects

There is some controversy about the projection of muscle afferents from the human upper limb to cerebral cortex and about their contribution to somatosensory evoked potentials. In 8 normal volunteers, the somatosensory projections of muscle and cutaneous afferents from the hand were recorded at 21 scalp sites, using a non-cephalic reference. Low-threshold thenar muscle afferents were selectively activated by intramuscular microstimulation. In addition, the averaged data for the projections were mapped for each individual. In each subject a focal parietal negativity was detected over the contralateral parietal cortex at a mean latency of 20.8 msec (S.D. 1.15 msec) following stimulation of thenar muscle afferents. The amplitude of the parietal 'N20-P25' was relatively small (mean 0.49 microV, range 0.18-1.56 microV). A small focal positivity was detected, maximal over contralateral frontal cortex at 22.8 msec (S.D. 2.05 msec) but recorded bilaterally. In all subjects subcortical positive waves (P9 and P14) were defined for the muscle afferent volley. This pattern of cortical activity was similar to that for the projection from the digital nerves of the index finger. For the cutaneous input the latency of the parietal 'N20' was 21.7 msec (S.D. 1.17 msec) and of the frontal 'P22' was 24.2 msec (S.D. 3.09 msec). The amplitude of the parietal 'N20-P25' was larger for the cutaneous projection (mean 1.59 microV; range 0.65-4.28 microV).

Lumbrical muscle function as revealed by a new and physiological approach

The lumbrical muscle is clearly one of several possible extensors of the interphalangeal joints. With an origin on the flexor digitorum profundus tendon it is credited with unloading the elastic tension across the interphalangeal joints and thereby facilitating their extension. Its role at the metacarpophalangeal joint is not a matter of universal agreement. Attempts to simulate its action with weights over pulleys have not clarified this role, since true simulation would require the development of a means of applying force along the course of the lumbrical without pre-determining which end would move. Such a system is herein described; it uses a Bowden cable, which is commonly used to activate the brakes of a bicycle. After constructing length-tension curves of the profundus muscle in four fresh cadavers prior to the onset of rigor mortis, the interaction of realistic lumbrical loads with profundus elastic tension was studied. By contraction a lumbrical muscle adds a small but significant flexor force at the metacarpophalangeal joint, and thereby it is also capable of contributing to radial deviation and possibly rotation. As it runs from a flexor tendon to an extensor tendon and is endowed with a great many muscle spindles, the lumbrical could play a part in the control of finger movement by monitoring the rate of hand closing during grasp.

The fine structure of human Golgi tendon organs as studied by three-dimensional reconstruction

Human Golgi tendon organs (GTOs) found at the musculo-tendinous junctions of lumbrical muscles were studied using serial sections for light and electron microscopy as the basis for a three-dimensional reconstruction. These GTOs had a thick capsule and were filled with longitudinally arranged collagen bundles. The GTOs were divided into three small compartments by septal cells: the 'neuronal compartment' containing myelinated nerve fibres, the 'terminal compartment' having axon terminals, and the 'fibrous compartment' containing only collagen fibrils. The three-dimensional reconstruction demonstrated that myelinated fibres rotated spirally before losing their myelin sheaths, and ended as unmyelinated axon terminals in the 'terminal compartment'. Axons abruptly changed course at the beginning of the terminals. Axon terminals extended many thin processes between the collagen fibrils, partially encircling them. Part of the axolemma of such indentations lacked Schwann cell coverings. The intimate contact of collagen fibrils with the axon terminals, especially in the indentations of the axons, are the presumptive site that could transmit shearing stresses to the axolemma, especially in areas devoid of Schwann cell cytoplasm.