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Castro J, Oliveira Santos M, Swash M, de Carvalho M. Segmental motor neuron dysfunction in amyotrophic lateral sclerosis: Insights from H reflex paradigms. Muscle Nerve 2024; 69:303-312. [PMID: 38220221 DOI: 10.1002/mus.28035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION/AIMS In amyotrophic lateral sclerosis (ALS), the role of spinal interneurons in ALS is underrecognized. We aimed to investigate pre- and post-synaptic modulation of spinal motor neuron excitability by studying the H reflex, to understand spinal interneuron function in ALS. METHODS We evaluated the soleus H reflex, and three different modulation paradigms, to study segmental spinal inhibitory mechanisms. Homonymous recurrent inhibition (H'RI ) was assessed using the paired H reflex technique. Presynaptic inhibition of Ia afferents (H'Pre ) was evaluated using D1 inhibition after stimulation of the common peroneal nerve. We also studied inhibition of the H reflex after cutaneous stimulation of the sural nerve (H'Pos ). RESULTS Fifteen ALS patients (median age 57.0 years), with minimal signs of lower motor neuron involvement and good functional status, and a control group of 10 healthy people (median age 57.0 years) were studied. ALS patients showed reduced inhibition, compared to controls, in all paradigms (H'RI 0.35 vs. 0.11, p = .036; H'Pre 1.0 vs. 5.0, p = .001; H'Pos 0.0 vs. 2.5, p = .031). The clinical UMN score was a significant predictor of the amount of recurrent and presynaptic inhibition. DISCUSSION Spinal inhibitory mechanisms are impaired in ALS. We argue that hyperreflexia could be associated with dysfunction of spinal inhibitory interneurons. In this case, an interneuronopathy could be deemed a major feature of ALS.
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Affiliation(s)
- José Castro
- Faculdade de Medicina, Instituto de Fisiologia, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
- Department of Neurosciences and Mental Health, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Miguel Oliveira Santos
- Faculdade de Medicina, Instituto de Fisiologia, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
- Department of Neurosciences and Mental Health, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Michael Swash
- Faculdade de Medicina, Instituto de Fisiologia, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
- Departments of Neurology and Neuroscience, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Mamede de Carvalho
- Faculdade de Medicina, Instituto de Fisiologia, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
- Department of Neurosciences and Mental Health, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
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Nito M, Hashizume W, Jimenji M, Suzuki K, Sato T, Fujii H, Miyasaka T, Shindo M, Naito A. Oligosynaptic inhibition mediated by group Ia afferents from flexor digitorum superficialis to wrist flexors in humans. Exp Brain Res 2018; 236:1849-1860. [PMID: 29679107 DOI: 10.1007/s00221-018-5268-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/17/2018] [Indexed: 11/24/2022]
Abstract
Effects of low-threshold afferents from the flexor digitorum superficialis (FDS) to the flexor carpi radialis (FCR), flexor carpi ulnaris (FCU) and extensor carpi ulnaris (ECU) motoneurons were examined using a post-stimulus time-histogram (PSTH) and electromyogram-averaging (EMG-A) methods in seven healthy human subjects. Electrical conditioning stimulation to the median nerve branch innervating FDS with the intensity immediately below the motor threshold was delivered. In the PSTH study, the stimulation produced a trough (inhibition) in 19/44 (43%) of FCR and 17/41 (41%) of FCU motor units. Remaining motor units received no facilitatory and inhibitory effects. The central latency of the inhibition was 1.1 ± 0.6 ms (mean ± SD) and 0.6 ± 0.4 ms longer than that of the homonymous monosynaptic Ia facilitation of FCR and FCU, respectively. In the EMG-A study, the stimulation produced a trough (inhibition) in EMG-A of FCR and FCU in all the seven subjects. Amount of the inhibition was 14.5 ± 3.8% (FCR) and 17.9 ± 2.5% (FCU). Since the inhibition diminished after withdrawal of tonic vibration stimuli to the FDS muscle belly, group Ia afferents should be responsible for the inhibition. The stimulation did not produce facilitatory or inhibitory effect on ECU motoneurons in both the PSTH and EMG-A studies. These findings suggest that group Ia afferents from FDS inhibit excitability of motoneurons supplying FCR and FCU through an oligo (di- or tri-) synaptic path in the spinal cord. The reflex arcs would function to prevent wrist flexion during hand grasping movements.
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Affiliation(s)
- Mitsuhiro Nito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Wataru Hashizume
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Manabu Jimenji
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Katsuhiko Suzuki
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Toshiaki Sato
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Hiromi Fujii
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Takuji Miyasaka
- Department of Judo Therapy, Teikyo University Faculty of Medical Technology, Utsunomiya, Japan
| | - Masaomi Shindo
- Graduate School of Health Science, The Graduate School of Matsumoto University, Matsumoto, Japan
| | - Akira Naito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan.
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Inhibition of Group Ia Afferents Between Brachioradialis and Flexor Carpi Radialis in Humans: A Study Using an Electromyogram-Averaging Method. J Clin Neurophysiol 2017; 35:138-143. [PMID: 29206768 DOI: 10.1097/wnp.0000000000000444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Our previous studies using a poststimulus time histogram method demonstrated inhibitory spinal reflex arcs (inhibition) between the brachioradialis (BR) and flexor carpi radialis (FCR) in humans. Group I afferents mediated the inhibition through an oligosynaptic path. In this study, effects of the inhibition on excitability of the motoneuron pools were examined, and we tried to clarify which afferents of group Ia or Ib are responsible for the inhibition. METHODS We evaluated the effects of low-threshold afferents between BR and FCR on FCR and BR motoneuron pools, respectively, using an electromyogram-averaging method in 14 healthy human subjects. Changes of rectified and averaged electromyogram of BR by electrical conditioning stimulation with the intensity below the motor threshold to the median nerve branch innervating FCR (FCR nerve) and those of FCR by the stimulation to the radial nerve branch innervating BR (BR nerve) were evaluated. RESULTS The stimulation to the FCR and BR nerves produced an early and significant trough of rectified and averaged electromyogram of BR and FCR, respectively, in all the subjects. The amount of inhibition of BR and FCR was 13.2 ± 3.4% (mean ± SD) and 14.2 ± 1.4%, respectively. The trough of BR and FCR diminished by tonic vibration stimuli to a respective FCR and BR. Such a trough was never provoked by cutaneous stimulation. CONCLUSIONS The inhibition between BR and FCR depresses excitability of the FCR and BR motoneuron pools, respectively. Group Ia afferents should mediate the inhibition.
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Giboin LS, Sangari S, Lackmy-Vallée A, Messé A, Pradat-Diehl P, Marchand-Pauvert V. Corticospinal control from M1 and PMv areas on inhibitory cervical propriospinal neurons in humans. Physiol Rep 2017; 5:5/20/e13387. [PMID: 29084839 PMCID: PMC5661226 DOI: 10.14814/phy2.13387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 11/24/2022] Open
Abstract
Inhibitory propriospinal neurons with diffuse projections onto upper limb motoneurons have been revealed in humans using peripheral nerve stimulation. This system is supposed to mediate descending inhibition to motoneurons, to prevent unwilling muscle activity. However, the corticospinal control onto inhibitory propriospinal neurons has never been investigated so far in humans. We addressed the question whether inhibitory cervical propriospinal neurons receive corticospinal inputs from primary motor (M1) and ventral premotor areas (PMv) using spatial facilitation method. We have stimulated M1 or PMv using transcranial magnetic stimulation (TMS) and/or median nerve whose afferents are known to activate inhibitory propriospinal neurons. Potential input convergence was evaluated by studying the change in monosynaptic reflexes produced in wrist extensor electromyogram (EMG) after isolated and combined stimuli in 17 healthy subjects. Then, to determine whether PMv controlled propriospinal neurons directly or through PMv-M1 interaction, we tested the connectivity between PMv and propriospinal neurons after a functional disruption of M1 produced by paired continuous theta burst stimulation (cTBS). TMS over M1 or PMv produced reflex inhibition significantly stronger on combined stimulations, compared to the algebraic sum of effects induced by isolated stimuli. The extra-inhibition induced by PMv stimulation remained even after cTBS which depressed M1 excitability. The extra-inhibition suggests the existence of input convergence between peripheral afferents and corticospinal inputs onto inhibitory propriospinal neurons. Our results support the existence of direct descending influence from M1 and PMv onto inhibitory propriospinal neurons in humans, possibly though direct corticospinal or via reticulospinal inputs.
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Affiliation(s)
- Louis-Solal Giboin
- Sensorimotor Performance Lab, Sport Science Department, Universität Konstanz, Konstanz, Germany
| | - Sina Sangari
- Sorbonne Universités, Laboratoire d'Imagerie Biomédicale (LIB), UPMC Univ Paris 06, INSERM, CNRS, Paris, France
| | - Alexandra Lackmy-Vallée
- Sorbonne Universités, Laboratoire d'Imagerie Biomédicale (LIB), UPMC Univ Paris 06, INSERM, CNRS, Paris, France
| | - Arnaud Messé
- Department of Computational Neuroscience, University Medical Center Eppendorf, Hamburg University, Hamburg, Germany
| | - Pascale Pradat-Diehl
- Sorbonne Universités, Laboratoire d'Imagerie Biomédicale (LIB), UPMC Univ Paris 06, INSERM, CNRS, Paris, France.,Département des maladies du système nerveux, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Véronique Marchand-Pauvert
- Sorbonne Universités, Laboratoire d'Imagerie Biomédicale (LIB), UPMC Univ Paris 06, INSERM, CNRS, Paris, France
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Sato T, Nito M, Suzuki K, Fujii H, Hashizume W, Miyasaka T, Shindo M, Naito A. Oligosynaptic inhibition of group Ia afferents from brachioradialis to triceps brachii motor neurons in humans. Muscle Nerve 2017; 57:122-128. [PMID: 28398686 DOI: 10.1002/mus.25664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 11/10/2022]
Abstract
INTRODUCTION This study examines effects of low-threshold afferents from the brachioradialis (BR) on excitability of triceps brachii (TB) motor neurons in humans. METHODS We evaluated the effects using a post stimulus time histogram (PSTH) and electromyogram averaging (EMG-A) methods in 13 healthy human participants. Electrical conditioning stimulation to the radial nerve branch innervating BR with the intensity below the motor threshold was delivered. RESULTS In the PSTH study, the stimulation produced a trough (inhibition) in 36/69 TB motor units for all the participants. A cutaneous stimulation never provoked such inhibition. The central latency of the inhibition was 1.5 ± 0.5 ms longer than that of the homonymous facilitation. In the EMG-A study, the stimulation produced inhibition in EMG-A of TB in all participants. The inhibition diminished with a tonic vibration stimulation to BR. DISCUSSION These findings suggest that oligosynaptic inhibition mediated by group Ia afferents from BR to TB exists in humans. Muscle Nerve 57: 122-128, 2018.
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Affiliation(s)
- Toshiaki Sato
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Mitsuhiro Nito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Katsuhiko Suzuki
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Hiromi Fujii
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Wataru Hashizume
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Takuji Miyasaka
- Department of Judo Therapy, Teikyo University Faculty of Medical Technology, Utsunomiya, Japan
| | - Masaomi Shindo
- Graduate School of Health Sciences, Matsumoto University, Matsumoto, Japan
| | - Akira Naito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
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van den Bos MAJ, Geevasinga N, Menon P, Burke D, Kiernan MC, Vucic S. Physiological processes influencing motor-evoked potential duration with voluntary contraction. J Neurophysiol 2016; 117:1156-1162. [PMID: 28031404 DOI: 10.1152/jn.00832.2016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/13/2016] [Accepted: 12/27/2016] [Indexed: 11/22/2022] Open
Abstract
Voluntary contraction leads to facilitation of motor-evoked potentials (MEPs) producing greater amplitude, shorter onset latency, and prolonged duration of the electromyography potential. Whereas hyperexcitability of spinal motoneurons and changes in descending corticospinal volleys have been proposed as putative mechanisms for changes in MEP amplitude and onset latency, a contribution of propriospinal interneurons, exerting modulatory effects on α-motoneurons, has been proposed as a potential explanation for prolongation of MEP duration. The aim of the present study is to gain further insight into the physiological processes underlying changes in MEP duration. Transcranial magnetic stimulation (TMS) studies were undertaken on 30 healthy controls, using a 90-mm circular coil, with MEPs recorded at rest and during facilitation, produced by contraction of abductor pollicis brevis. In the same experiment, short interval-intracortical inhibition (SICI) was recorded at rest. Facilitation resulted in a significant prolongation of MEP duration, which increased with stimulus intensity and was accompanied by an increase in MEP amplitude. The main effect (TMS intensity × activation state) was correlated with MEP duration (F = 10.9, P < 0.001), whereas TMS intensity (F = 30.5, P < 0.001) and activation state (F = 125.8, P < 0.001) in isolation were correlated with MEP amplitude. There was a significant inverse relationship between SICI and MEP duration at rest (R2 = 0.141, P = 0.041) and during facilitation (R2 = 0.340, P = 0.001). The present findings suggest that similar physiological processes mediate changes in the facilitated MEP duration and amplitude and that both cortical and nonpropriospinal spinal mechanisms contribute to changes in MEP duration.NEW & NOTEWORTHY Muscle contraction is associated with a significant increase in motor-evoked potential (MEP) duration and amplitude. Whereas the increase in MEP duration was linear, the amplitude increase exhibited a ceiling effect. Importantly, the MEP duration increase strongly correlated with short interval-intracortical inhibition, a biomarker of motor cortical function. This suggests that whereas similar physiological processes contribute to changes in facilitated MEP duration and amplitude, cortical mechanisms appear to contribute to MEP duration changes.
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Affiliation(s)
| | | | - Parvathi Menon
- Sydney Medical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, New South Wales, Australia
| | - David Burke
- Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia; and
| | - Matthew C Kiernan
- Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia; and.,Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Steve Vucic
- Sydney Medical School, University of Sydney, Sydney, Australia; .,Department of Neurology, Westmead Hospital, New South Wales, Australia
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Shinozaki K, Nito M, Kobayashi S, Hayashi M, Miyasaka T, Hashizume W, Shindo M, Naito A. Monosynaptic facilitation of group I afferents between brachioradialis and extensor carpi radialis in humans. Neurosci Res 2016; 114:30-34. [PMID: 27553707 DOI: 10.1016/j.neures.2016.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/26/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
Abstract
Spinal reflex arcs mediated by low-threshold (group I) afferents from muscle spindles and Golgi tendon organs modulate motoneuron excitabilities to coordinate smooth movements. In this study, the reflex arcs between the brachioradialis (BR) and extensor carpi radialis muscles (ECR) were examined in nine healthy human subjects using a post-stimulus time-histogram method. Electrical conditioning stimuli (ES) to the radial nerve branches innervating BR (BR nerve) and ECR (ECR nerve) with the intensity just below the motor threshold were delivered and firings of the ECR and BR motor units were recorded in 6 and 7 of the nine subjects, respectively. ES to the BR and ECR nerves induced a peak (facilitation) in 27/59 ECR and 22/68 BR motor units, respectively, in every subject. Such facilitation was never provoked by pure cutaneous stimulation. The remaining motor units received no effects by ES. The central synaptic delay of the facilitation was almost equal to that of the homonymous facilitation. These findings suggest that facilitation between BR and ECR exists in humans. Group I afferents should mediate the facilitation through a monosynaptic path in the spinal cord.
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Affiliation(s)
| | - Mitsuhiro Nito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, Yamagata, Japan
| | | | - Masahiro Hayashi
- Okitama Public General Hospital, Kawanishi-Machi Higashiokitama-Gun, Japan
| | - Takuji Miyasaka
- Department of Judo Therapy, Teikyo University Faculty of Medical Technology, Utsunomiya, Japan
| | - Wataru Hashizume
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, Yamagata, Japan
| | - Masaomi Shindo
- Graduate School of Health Sciences, Matsumoto University, Matsumoto, Japan
| | - Akira Naito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, Yamagata, Japan.
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Facilitation from flexor digitorum superficialis to extensor carpi radialis in humans. Exp Brain Res 2016; 234:2235-44. [PMID: 27010723 DOI: 10.1007/s00221-016-4629-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
Effects of low-threshold afferents from the flexor digitorum superficialis (FDS) to the extensor carpi radialis (ECR) motoneurons were examined using a post-stimulus time-histogram (PSTH) and electromyogram-averaging (EMG-A) methods in eight healthy human subjects. In the PSTH study in five of the eight subjects, electrical conditioning stimuli (ES) to the median nerve branch innervating FDS with the intensity below the motor threshold induced excitatory effects (facilitation) in 39 out of 92 ECR motor units. In 11 ECR motor units, the central synaptic delay of the facilitation was -0.1 ± 0.3 ms longer than that of the homonymous facilitation of ECR. Mechanical conditioning stimuli (MS) to FDS with the intensity below the threshold of the tendon(T)-wave-induced facilitation in 51 out of 51 ECR motor units. With the EMG-A method, early and significant peaks were produced by ES and MS in all the eight subjects. The difference between latencies of the peaks by ES and MS was almost equivalent to that of the Hoffmann- and T-waves of FDS by ES and MS. The peak was diminished by tonic vibration stimuli to FDS. These findings suggest that a facilitation from FDS to ECR exists in humans and group Ia afferents mediate the facilitation through a monosynaptic path.
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Sangari S, Iglesias C, El Mendili MM, Benali H, Pradat PF, Marchand-Pauvert V. Impairment of sensory-motor integration at spinal level in amyotrophic lateral sclerosis. Clin Neurophysiol 2016; 127:1968-77. [PMID: 26971478 DOI: 10.1016/j.clinph.2016.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Subclinical sensory defect can be detected early in ALS. Its impact on spinal excitability was assessed by testing the effects produced by intrinsic hand muscle afferents in triceps brachii motoneurons of patients with distal motor weakness. METHODS TMS was applied over the motor cortex to produce MEP in contralateral triceps during tonic contraction. The intensity varied to compare the full MEP recruitment curve in ALS patients and controls. Then, median and ulnar nerve stimulations at wrist level were combined to TMS to compare the resulting changes in MEP size in both groups. RESULTS MEP recruitment curves were similar in both groups but MEP threshold was significantly higher in ALS. At sub-threshold intensity for MEP, TMS depressed more EMG activity in ALS than in controls. Nerve stimuli increased MEP size in both groups with similar temporal characteristics but the level of facilitation was stronger in ALS. CONCLUSION Cortical hypo-excitability in ALS was accompanied with stronger intra-cortical inhibition in triceps area. While the corticospinal and peripheral inputs were likely depressed, spinal motoneuron response to combined inputs was particularly enhanced in ALS. SIGNIFICANCE Spinal network properties likely compensate for depression of afferent inputs leading to motoneuron hyper-excitability, which may contribute to excito-toxicity.
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Affiliation(s)
- Sina Sangari
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France
| | - Caroline Iglesias
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France
| | - Mohamed-Mounir El Mendili
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France
| | - Habib Benali
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France
| | - Pierre-François Pradat
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France; Département des maladies du système nerveux, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Véronique Marchand-Pauvert
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale, F-75013 Paris, France.
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Nakano H, Miyasaka T, Ogino T, Naito A. Facilitation between extensor carpi radialis and pronator teres in humans: a study using a post-stimulus time histogram method. Somatosens Mot Res 2014; 31:214-20. [PMID: 25026240 DOI: 10.3109/08990220.2014.928615] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Group I muscle afferents modulate the excitability of motor neurons through excitatory and inhibitory spinal reflexes. Spinal reflex relationships between various muscle pairs are well described in experimental animals but not in the human upper limb, which exhibits a fine control of movement. In the present study, spinal reflexes between the extensor carpi radialis (ECR) and pronator teres (PT) muscles were examined in healthy human subjects using a post-stimulus time histogram method. Electrical stimulation of low-threshold afferents of ECR nerves increased the motor neuron excitability in 31 of 76 PT motor units (MUs) in all eight subjects tested, while stimulation of low-threshold afferents of PT nerves increased the motor neuron excitability in 36 of 102 ECR MUs in all 10 subjects. The estimated central synaptic delay was almost equivalent to that of homonymous facilitation. Mechanical stimulation (MS) of ECR facilitated 16 of 30 PT MUs in all five subjects tested, while MS of PT facilitated 17 of 30 ECR MUs in all six subjects. These results suggest excitatory reflex (facilitation) between PT and ECR. Group I afferents should mediate the facilitation through a monosynaptic path.
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Affiliation(s)
- Haruki Nakano
- Department of Rehabilitation Medicine, Osaka Medical College , Takatsuki , Japan
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Sozzi S, Do MC, Monti A, Schieppati M. Sensorimotor integration during stance: Processing time of active or passive addition or withdrawal of visual or haptic information. Neuroscience 2012; 212:59-76. [DOI: 10.1016/j.neuroscience.2012.03.044] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 03/30/2012] [Accepted: 03/30/2012] [Indexed: 12/27/2022]
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12
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Uysal H, Kızılay F, İnel ŞE, Özen H, Pek G. Medium-latency reflex response elicited from the flexor carpi radialis by radial nerve stimulation. Exp Brain Res 2011; 217:223-35. [DOI: 10.1007/s00221-011-2988-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 12/09/2011] [Indexed: 10/14/2022]
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Giboin LS, Lackmy-Vallée A, Burke D, Marchand-Pauvert V. Enhanced propriospinal excitation from hand muscles to wrist flexors during reach-to-grasp in humans. J Neurophysiol 2011; 107:532-43. [PMID: 22031772 DOI: 10.1152/jn.00774.2011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In humans, propriospinal neurons located at midcervical levels receive peripheral and corticospinal inputs and probably participate in the control of grip tasks, but their role in reaching movements, as observed in cats and primates, is still an open question. The effect of ulnar nerve stimulation on flexor carpi radialis (FCR) motor evoked potential (MEP) was tested during reaching tasks and tonic wrist flexion. Significant MEP facilitation was observed at the end of reach during reach-to-grasp but not during grasp, reach-to-point, or tonic contractions. MEP facilitation occurred at a longer interstimulus interval than expected for convergence of corticospinal and afferent volleys at motoneuron level and was not paralleled by a change in the H-reflex. These findings suggest convergence of the two volleys at propriospinal level. Ulnar-induced MEP facilitation was observed when conditioning stimuli were at 0.75 motor response threshold (MT), but not 1 MT. This favors an increased excitability of propriospinal neurons rather than depression of their feedback inhibition, as has been observed during tonic power grip tasks. It is suggested that the ulnar-induced facilitation of FCR MEP during reach may be due to descending activation of propriospinal neurons, assisting the early recruitment of large motoneurons for rapid movement. Because the feedback inhibitory control is still open, this excitation can be truncated by cutaneous inputs from the palmar side of the hand during grasp, thus assisting movement termination. It is concluded that the feedforward activation of propriospinal neurons and their feedback control may be involved in the internal model, motor planning, and online adjustments for reach-to-grasp movements in humans.
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Marchand-Pauvert V, Gerdelat-Mas A, Ory-Magne F, Calvas F, Mazevet D, Meunier S, Brefel-Courbon C, Vidailhet M, Simonetta-Moreau M. Both L-DOPA and HFS-STN restore the enhanced group II spinal reflex excitation to a normal level in patients with Parkinson’s disease. Clin Neurophysiol 2011; 122:1019-26. [DOI: 10.1016/j.clinph.2010.08.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 08/19/2010] [Accepted: 08/21/2010] [Indexed: 10/19/2022]
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Hagert E. Proprioception of the wrist joint: a review of current concepts and possible implications on the rehabilitation of the wrist. J Hand Ther 2010; 23:2-17. [PMID: 19963343 DOI: 10.1016/j.jht.2009.09.008] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 08/29/2009] [Accepted: 09/09/2009] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Narrative review. Recent years have brought new research findings on the subject of wrist joint proprioception, which entails an understanding of the wrist as part of a sensorimotor system where afferent information from nerve endings in the wrist joint affects the neuromuscular control of the joint. An understanding of proprioception is also essential to adequately rehabilitate patients after wrist injuries. The aim of this narrative review was to give the reader a background of proprioception as it relates to neuromuscular control and joint stability, what is presently known in relation to the wrist joint and how these findings may be applied to the field of wrist rehabilitation. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Elisabet Hagert
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Section of Orthopaedics, Karolinska Institutet, Stockholm, Sweden.
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Hagert E, Persson JKE, Werner M, Ljung BO. Evidence of wrist proprioceptive reflexes elicited after stimulation of the scapholunate interosseous ligament. J Hand Surg Am 2009; 34:642-51. [PMID: 19249163 DOI: 10.1016/j.jhsa.2008.12.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 11/26/2008] [Accepted: 12/02/2008] [Indexed: 02/02/2023]
Abstract
PURPOSE Recent publications on the sensory innervation of wrist ligaments have challenged our understanding of ligaments as mere passive restraints in wrist stability. Mechanoreceptors in ligaments have a role in signaling joint perturbations, in which the afferent information is believed to influence periarticular muscles. The scapholunate interosseous ligament is one of the most richly innervated ligaments in the wrist. The purpose of our study was to investigate the possible existence of a wrist proprioceptive reflex, by which afferent information elicited in the scapholunate interosseous ligament was hypothesized to influence the muscles moving the wrist joint. METHODS Nine volunteers (4 women and 5 men; mean age, 26 years; range, 21-28 years) participated in this study. Using ultrasound guidance, a fine-wire electrode was inserted into the dorsal scapholunate interosseous ligament and stimulated with four 1-ms pulses at 200 Hz. Electromyographic activities in extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris muscles were recorded using surface electrodes with the wrist actively positioned in isometric extension, flexion, and radial and ulnar deviation. The average EMGs from 30 consecutive stimulations were rectified and analyzed using the Student's t-test to compare the prestimulus (t(1)) and poststimulus (t(2)) EMG activities. RESULTS Statistically significant changes in poststimulus EMG activity (t(1)- t(2)) were observed at various time intervals. Within 20 ms, an excitation was seen in the flexor carpi radialis and flexor carpi ulnaris in extension, radial and ulnar deviation, and in extensor carpi radialis brevis in flexion. Co-contractions between agonist and antagonist muscles were observed, with peaks around 150 ms after stimulus. CONCLUSIONS We present evidence of wrist ligamento-muscular reactions. The early-onset reactions may serve in a joint-protective manner, and later co-contractions indicate a supraspinal control of wrist neuromuscular stability. These findings contribute new information to the physiologic functions of the wrist joint, which may further our understanding of dynamic wrist stability and serve as a foundation for future studies on proprioceptive dysfunctions after wrist ligament injuries.
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Affiliation(s)
- Elisabet Hagert
- Department of Clinical Science and Education, Section of Hand Surgery, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
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Marchand-Pauvert V, Iglesias C. Properties of human spinal interneurones: normal and dystonic control. J Physiol 2007; 586:1247-56. [PMID: 18096600 DOI: 10.1113/jphysiol.2007.145904] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The muscles that control wrist posture receive large inputs from reflexes driven by hand afferents. In several studies, we have investigated these reflexes by electrical stimulation of cutaneous (median nerve) and proprioceptive (ulnar nerve) afferents from the hand. Median stimulation produced short latency inhibition in all motor nuclei investigated, possibly through inhibitory propriospinal-like interneurones. Ulnar stimulation produced similar inhibition but only in wrist extensors. In the other motor nuclei, ulnar stimulation produced short latency excitation mediated by group I motoneuronal drive through both monosynaptic and non-monosynaptic pathways involving excitatory propriospinal-like interneurones. This was followed by late excitations mediated through spinal group II and trans-cortical group I pathways. These results show that these pathways are concerned with the integration of afferent inputs, proprioceptive and cutaneous, to control of wrist posture during hand movements. Patients with focal hand dystonia exhibit abnormal postures. To investigate whether these spinal pathways contribute to these conditions, the effects of ulnar stimulation on wrist muscle activity during voluntary tonic contraction were examined in patients who suffer writer's cramp. Ulnar-induced inhibition of the wrist extensors was reduced on the dystonic side of patients compared with their normal side and controls. In patients who exhibited abnormal wrist posture, group II excitation of the wrist flexors was also modified on the dystonic side. Cutaneous stimuli, by contrast, increased wrist flexor EMG on both sides and only in patients who exhibited normal posture. We conclude that spinal interneurones have a significant role in integrating afferent inputs from the hand to control wrist posture during hand movements and that altered function in these spinal networks is associated with the complex pathophysiology of writer's cramp.
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Lourenço G, Bleton JP, Iglesias C, Vidailhet M, Marchand-Pauvert V. Abnormal spinal interactions from hand afferents to forearm muscles in writer's cramp. Clin Neurophysiol 2007; 118:2215-26. [PMID: 17768085 DOI: 10.1016/j.clinph.2007.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 07/02/2007] [Accepted: 07/05/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Spinal reflexes from hand to wrist muscles were investigated in writer's cramp. METHODS Stimulus-triggered rectified EMG averages after ulnar nerve and cutaneous stimulation, in wrist flexors and extensors during tonic contraction, were compared in 18 controls and 19 patients. RESULTS On the patient dystonic side, ulnar-induced EMG suppression was decreased in wrist extensors, and facilitation in wrist flexors modified dependent on the dystonic wrist posture during writing. No change was found on the patient non-dystonic side. Cutaneous stimulation increased wrist flexor EMG on both sides of the patients with normal wrist posture during writing, but had no effect in controls and patients with abnormal wrist posture. CONCLUSIONS Comparison between cutaneous and mixed nerve stimuli suggests that spindle afferents from intrinsic hand muscles may mediate patients' ulnar-induced EMG modulations. Abnormal proprioceptive control was only observed on dystonic side, while bilateral unusual cutaneous control was found in patients. Changes in spinal transmission were partly related to the dystonic wrist posture, suggesting that systems involved in sensory processing can be differentially altered in writer's cramp. SIGNIFICANCE Changes in spinal transmission, probably related to peripheral and/or cortical inputs, might either take part in primary or adaptive mechanisms underlying writer's cramp.
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Iglesias C, Marchand-Pauvert V, Lourenco G, Burke D, Pierrot-Deseilligny E. Task-related changes in propriospinal excitation from hand muscles to human flexor carpi radialis motoneurones. J Physiol 2007; 582:1361-79. [PMID: 17510184 PMCID: PMC2075255 DOI: 10.1113/jphysiol.2007.133199] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study addresses whether there is excitation from human hand muscles to flexor carpi radialis (FCR) motoneurones mediated through propriospinal circuits and, if so, whether it is used in specific motor tasks. Electrical stimuli to the ulnar nerve at wrist level produced an excitation in FCR motoneurones with characteristics typical of a propriospinally mediated effect: low threshold (0.6 x motor threshold (MT)), a group I effect that was not reproduced by purely cutaneous stimuli, long central delay (4.1 +/- 0.4 ms in single units), suppression when the stimulus intensity was increased, and facilitation of the corticospinal excitation at the premotoneuronal level. Ulnar-induced propriospinally mediated excitation was compared during selective voluntary contractions of the FCR and, at equivalent level of FCR EMG, during tasks in which the FCR was activated automatically in postural contractions rather than voluntarily (grip, pinching and pointing). The excitation was significantly greater during grip (and pinching) than during voluntary FCR contractions and pointing, whether measured in single motor units or tonic EMG activity, or whether the response to motor cortex stimulation was assessed as the compound motor-evoked potential or the corticospinal peak in single units. The discrepancy between the tasks appeared with ulnar intensities above 0.8 x MT and was then present across a wide range of stimulus intensities. This suggests a reduction in the corticospinal control of 'feedback inhibitory interneurones' mediating peripheral inhibition to propriospinal neurones during grip and pinching. The resulting more effective background excitation of propriospinal neurones by the peripheral input from hand muscles could contribute to stabilizing the wrist during grip.
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