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Gradwell MA, Ozeri-Engelhard N, Eisdorfer JT, Laflamme OD, Gonzalez M, Upadhyay A, Medlock L, Shrier T, Patel KR, Aoki A, Gandhi M, Abbas-Zadeh G, Oputa O, Thackray JK, Ricci M, George A, Yusuf N, Keating J, Imtiaz Z, Alomary SA, Bohic M, Haas M, Hernandez Y, Prescott SA, Akay T, Abraira VE. Multimodal sensory control of motor performance by glycinergic interneurons of the mouse spinal cord deep dorsal horn. Neuron 2024; 112:1302-1327.e13. [PMID: 38452762 DOI: 10.1016/j.neuron.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/31/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
Sensory feedback is integral for contextually appropriate motor output, yet the neural circuits responsible remain elusive. Here, we pinpoint the medial deep dorsal horn of the mouse spinal cord as a convergence point for proprioceptive and cutaneous input. Within this region, we identify a population of tonically active glycinergic inhibitory neurons expressing parvalbumin. Using anatomy and electrophysiology, we demonstrate that deep dorsal horn parvalbumin-expressing interneuron (dPV) activity is shaped by convergent proprioceptive, cutaneous, and descending input. Selectively targeting spinal dPVs, we reveal their widespread ipsilateral inhibition onto pre-motor and motor networks and demonstrate their role in gating sensory-evoked muscle activity using electromyography (EMG) recordings. dPV ablation altered limb kinematics and step-cycle timing during treadmill locomotion and reduced the transitions between sub-movements during spontaneous behavior. These findings reveal a circuit basis by which sensory convergence onto dorsal horn inhibitory neurons modulates motor output to facilitate smooth movement and context-appropriate transitions.
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Affiliation(s)
- Mark A Gradwell
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Nofar Ozeri-Engelhard
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; Neuroscience PhD program, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Jaclyn T Eisdorfer
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Olivier D Laflamme
- Dalhousie PhD program, Dalhousie University, Halifax, NS, Canada; Department of Medical Neuroscience, Atlantic Mobility Action Project, Brain Repair Center, Dalhousie University, Halifax, NS, Canada
| | - Melissa Gonzalez
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; Department of Biomedical Engineering, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Aman Upadhyay
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; Neuroscience PhD program, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Laura Medlock
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Tara Shrier
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Komal R Patel
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Adin Aoki
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Melissa Gandhi
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Gloria Abbas-Zadeh
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Olisemaka Oputa
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Joshua K Thackray
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; Human Genetics Institute of New Jersey, Rutgers University, The State University of New Jersey, Piscataway, NJ, USA; Tourette International Collaborative Genetics Study (TIC Genetics)
| | - Matthew Ricci
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Arlene George
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Nusrath Yusuf
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; Neuroscience PhD program, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Jessica Keating
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Zarghona Imtiaz
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Simona A Alomary
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Manon Bohic
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Michael Haas
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Yurdiana Hernandez
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Steven A Prescott
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Turgay Akay
- Department of Medical Neuroscience, Atlantic Mobility Action Project, Brain Repair Center, Dalhousie University, Halifax, NS, Canada
| | - Victoria E Abraira
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA; W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA.
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Gebehart C, Büschges A. The processing of proprioceptive signals in distributed networks: insights from insect motor control. J Exp Biol 2024; 227:jeb246182. [PMID: 38180228 DOI: 10.1242/jeb.246182] [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] [Indexed: 01/06/2024]
Abstract
The integration of sensory information is required to maintain body posture and to generate robust yet flexible locomotion through unpredictable environments. To anticipate required adaptations in limb posture and enable compensation of sudden perturbations, an animal's nervous system assembles external (exteroception) and internal (proprioception) cues. Coherent neuronal representations of the proprioceptive context of the body and the appendages arise from the concerted action of multiple sense organs monitoring body kinetics and kinematics. This multimodal proprioceptive information, together with exteroceptive signals and brain-derived descending motor commands, converges onto premotor networks - i.e. the local neuronal circuitry controlling motor output and movements - within the ventral nerve cord (VNC), the insect equivalent of the vertebrate spinal cord. This Review summarizes existing knowledge and recent advances in understanding how local premotor networks in the VNC use convergent information to generate contextually appropriate activity, focusing on the example of posture control. We compare the role and advantages of distributed sensory processing over dedicated neuronal pathways, and the challenges of multimodal integration in distributed networks. We discuss how the gain of distributed networks may be tuned to enable the behavioral repertoire of these systems, and argue that insect premotor networks might compensate for their limited neuronal population size by, in comparison to vertebrate networks, relying more heavily on the specificity of their connections. At a time in which connectomics and physiological recording techniques enable anatomical and functional circuit dissection at an unprecedented resolution, insect motor systems offer unique opportunities to identify the mechanisms underlying multimodal integration for flexible motor control.
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Affiliation(s)
- Corinna Gebehart
- Champalimaud Foundation, Champalimaud Research, 1400-038 Lisbon, Portugal
| | - Ansgar Büschges
- Department of Animal Physiology, Institute of Zoology, Biocenter Cologne, University of Cologne, Zülpicher Strasse 47b, 50674 Cologne, Germany
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Hackethal S, Maino P, Koetsier E, Manconi M. Spinal cord stimulation in severe pharmacoresistant restless legs syndrome-two case reports. Front Neurol 2023; 14:1219881. [PMID: 38099065 PMCID: PMC10720037 DOI: 10.3389/fneur.2023.1219881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/18/2023] [Indexed: 12/17/2023] Open
Abstract
Restless legs syndrome is a prevalent, sleep-related sensorimotor disorder with relevant impact on the patients' quality of life. For patients suffering from severe, pharmacoresistant restless legs syndrome, few therapeutic options remain to alleviate symptoms. In this case series, two patients with severe, pharmacoresistant restless legs syndrome were treated with epidural spinal cord stimulation and repeatedly assessed with polysomnography, including sleep structure and periodic limb movements as objective biomarkers not subject to placebo effects, during a 6-month follow-up period. One of the patients experienced excellent short- and long-term efficacy on subjective symptom severity (International RLS Study group rating scale 1 vs. 34 points at 3 months) and objective sleep parameters such as sleep architecture and periodic limb movements during sleep, while the second patient only reported short-term benefits from spinal cord stimulation. Ultimately, both patients opted for removal of the device for inefficacy. Based on the complex pathophysiology of restless legs syndrome and presumed mechanism of action of spinal cord stimulation in chronic pain disorders, we provide a detailed hypothesis on the possible modulating effect of spinal cord stimulation on the key symptoms of restless legs syndrome. Apart from describing a new therapeutic option for pharmacoresistant restless legs syndrome, our findings might also provide further insights into the pathophysiology of the syndrome.
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Affiliation(s)
- Sandra Hackethal
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Paolo Maino
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Eva Koetsier
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
- Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
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Abstract
Spasticity is characterized by an enhanced size and reduced threshold for activation of stretch reflexes and is associated with "positive signs" such as clonus and spasms, as well as "negative features" such as paresis and a loss of automatic postural responses. Spasticity develops over time after a lesion and can be associated with reduced speed of movement, cocontraction, abnormal synergies, and pain. Spasticity is caused by a combination of damage to descending tracts, reductions in inhibitory activity within spinal cord circuits, and adaptive changes within motoneurons. Increased tone, hypertonia, can also be caused by changes in passive stiffness due to, for example, increase in connective tissue and reduction in muscle fascicle length. Understanding the cause of hypertonia is important for determining the management strategy as nonneural, passive causes of stiffness will be more amenable to physical rather than pharmacological interventions. The management of spasticity is determined by the views and goals of the patient, family, and carers, which should be integral to the multidisciplinary assessment. An assessment, and treatment, of trigger factors such as infection and skin breakdown should be made especially in people with a recent change in tone. The choice of management strategies for an individual will vary depending on the severity of spasticity, the distribution of spasticity (i.e., whether it affects multiple muscle groups or is more prominent in one or two groups), the type of lesion, and the potential for recovery. Management options include physical therapy, oral agents; focal therapies such as botulinum injections; and peripheral nerve blocks. Intrathecal baclofen can lead to a reduction in required oral antispasticity medications. When spasticity is severe intrathecal phenol may be an option. Surgical interventions, largely used in the pediatric population, include muscle transfers and lengthening and selective dorsal root rhizotomy.
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Affiliation(s)
- Jonathan Marsden
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
| | - Valerie Stevenson
- Department of Therapies and Rehabilitation, National Hospital for Neurology and Neurosurgery UCLH, London, United Kingdom
| | - Louise Jarrett
- Department of Neurology, Royal Devon and Exeter Hospital, Exeter, United Kingdom
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5
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Spinal Cord Circuits: Models and Reality. NEUROPHYSIOLOGY+ 2022. [DOI: 10.1007/s11062-022-09927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Henrich MC, Steffen Frahm K, Coghill RC, Kæseler Andersen O. Spinal nociception is facilitated during cognitive distraction. Neuroscience 2022; 491:134-145. [DOI: 10.1016/j.neuroscience.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/25/2022]
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7
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Landelle C, Lungu O, Vahdat S, Kavounoudias A, Marchand-Pauvert V, De Leener B, Doyon J. Investigating the human spinal sensorimotor pathways through functional magnetic resonance imaging. Neuroimage 2021; 245:118684. [PMID: 34732324 DOI: 10.1016/j.neuroimage.2021.118684] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 01/29/2023] Open
Abstract
Most of our knowledge about the human spinal ascending (sensory) and descending (motor) pathways comes from non-invasive electrophysiological investigations. However, recent methodological advances in acquisition and analyses of functional magnetic resonance imaging (fMRI) data from the spinal cord, either alone or in combination with the brain, have allowed us to gain further insights into the organization of this structure. In the current review, we conducted a systematic search to produced somatotopic maps of the spinal fMRI activity observed through different somatosensory, motor and resting-state paradigms. By cross-referencing these human neuroimaging findings with knowledge acquired through neurophysiological recordings, our review demonstrates that spinal fMRI is a powerful tool for exploring, in vivo, the human spinal cord pathways. We report strong cross-validation between task-related and resting-state fMRI in accordance with well-known hemicord, postero-anterior and rostro-caudal organization of these pathways. We also highlight the specific advantages of using spinal fMRI in clinical settings to characterize better spinal-related impairments, predict disease progression, and guide the implementation of therapeutic interventions.
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Affiliation(s)
- Caroline Landelle
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Ovidiu Lungu
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - Anne Kavounoudias
- CNRS, UMR7291, Laboratory of Cognitive Neurosciences, Aix-Marseille University, Marseille, France
| | | | - Benjamin De Leener
- Department of Computer Engineering and Software Engineering, Polytechnique Montreal, Montreal, QC, Canada; CHU Sainte-Justine Research Centre, Montreal, QC, Canada
| | - Julien Doyon
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Henrich MC, Frahm KS, Andersen OK. Spinal spatial integration of nociception and its functional role assessed via the nociceptive withdrawal reflex and psychophysical measures in healthy humans. Physiol Rep 2021; 8:e14648. [PMID: 33217191 PMCID: PMC7679129 DOI: 10.14814/phy2.14648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/11/2022] Open
Abstract
Animal studies have previously shown that deep dorsal horn neurons play a role in the processing of spatial characteristics of nociceptive information in mammals. Human studies have supported the role of the spinal neurons; however, the mechanisms involved, and its significance, remain to be clarified. The aim of this study was to investigate spatial aspects of the spinal integration of concurrent nociceptive electrical stimuli in healthy humans using the Nociceptive Withdrawal Reflex (NWR) as an objective indication of spinal nociceptive processing. Fifteen healthy volunteers participated in the study. Electrical stimuli were delivered, using five electrodes located across the sole of the foot in a mediolateral disposition, as a single or double simultaneous stimuli with varying Inter-Electrode Distances (IEDs). The stimulation intensity was set at 1.5× NWR threshold (TA muscle). The size of the NWR was quantified in the 60-180 ms poststimulus window as a primary outcome measure. Psychophysical measures were secondary outcomes. Single stimulation elicited significantly smaller NWRs and perceived intensity than double stimulation (p < .01), suggesting the presence of spatial summation occurring within the spinal processing. During double stimulation, increasing the inter-electrode distance produced significantly smaller NWR sizes (p < .05) but larger pain intensity ratings (p < .05). By the NWR, spatial summation was shown to affect the nociceptive processing within the spinal cord. The inhibited motor response obtained when simultaneously stimulating the medial and lateral side of the sole of the foot suggests the presence of an inhibitory mechanism with a functional, behaviorally oriented function.
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Affiliation(s)
- Mauricio Carlos Henrich
- Integrative Neuroscience, Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg Ø, Denmark
| | - Ken Steffen Frahm
- Integrative Neuroscience, Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg Ø, Denmark
| | - Ole Kaeseler Andersen
- Integrative Neuroscience, Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg Ø, Denmark
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Merlet AN, Harnie J, Frigon A. Inhibition and Facilitation of the Spinal Locomotor Central Pattern Generator and Reflex Circuits by Somatosensory Feedback From the Lumbar and Perineal Regions After Spinal Cord Injury. Front Neurosci 2021; 15:720542. [PMID: 34393721 PMCID: PMC8355562 DOI: 10.3389/fnins.2021.720542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/08/2021] [Indexed: 02/03/2023] Open
Abstract
Somatosensory feedback from peripheral receptors dynamically interacts with networks located in the spinal cord and brain to control mammalian locomotion. Although somatosensory feedback from the limbs plays a major role in regulating locomotor output, those from other regions, such as lumbar and perineal areas also shape locomotor activity. In mammals with a complete spinal cord injury, inputs from the lumbar region powerfully inhibit hindlimb locomotion, while those from the perineal region facilitate it. Our recent work in cats with a complete spinal cord injury shows that they also have opposite effects on cutaneous reflexes from the foot. Lumbar inputs increase the gain of reflexes while those from the perineal region decrease it. The purpose of this review is to discuss how somatosensory feedback from the lumbar and perineal regions modulate the spinal locomotor central pattern generator and reflex circuits after spinal cord injury and the possible mechanisms involved. We also discuss how spinal cord injury can lead to a loss of functional specificity through the abnormal activation of functions by somatosensory feedback, such as the concurrent activation of locomotion and micturition. Lastly, we discuss the potential functions of somatosensory feedback from the lumbar and perineal regions and their potential for promoting motor recovery after spinal cord injury.
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Affiliation(s)
- Angèle N Merlet
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jonathan Harnie
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Alain Frigon
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
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Lelic D, Olesen AE, Grønlund D, Jure FA, Drewes AM. Opioid Specific Effects on Central Processing of Sensation and Pain: A Randomized, Cross-Over, Placebo-Controlled Study. THE JOURNAL OF PAIN 2021; 22:1477-1496. [PMID: 34229074 DOI: 10.1016/j.jpain.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Moderate to severe pain is often treated with opioids, but central mechanisms underlying opioid analgesia are poorly understood. Findings thus far have been contradictory and none could infer opioid specific effects. This placebo-controlled, randomized, 2-way cross-over, double-blinded study aimed to explore opioid specific effects on central processing of external stimuli. Twenty healthy male volunteers were included and 3 sets of assessments were done at each of the 2 visits: 1) baseline, 2) during continuous morphine or placebo intravenous infusion and 3) during simultaneous morphine + naloxone or placebo infusion. Opioid antagonist naloxone was introduced in order to investigate opioid specific effects by observing which morphine effects are reversed by this intervention. Quantitative sensory testing, spinal nociceptive withdrawal reflexes (NWR), spinal electroencephalography (EEG), cortical EEG responses to external stimuli and resting EEG were measured and analyzed. Longer lasting pain (cold-pressor test - hand in 2° water for 2 minutes, tetanic electrical), deeper structure pain (bone pressure) and strong nociceptive (NWR) stimulations were the most sensitive quantitative sensory testing measures of opioid analgesia. In line with this, the principal opioid specific central changes were seen in NWRs, EEG responses to NWRs and cold-pressor EEG. The magnitude of NWRs together with amplitudes and insular source strengths of the corresponding EEG responses were attenuated. The decreases in EEG activity were correlated to subjective unpleasantness scores. Brain activity underlying slow cold-pressor EEG (1-4Hz) was decreased, whereas the brain activity underlying faster EEG (8-12Hz) was increased. These changes were strongly correlated to subjective pain relief. This study points to evidence of opioid specific effects on perception of external stimuli and the underlying central responses. The analgesic response to opioids is likely a synergy of opioids acting at both spinal and supra-spinal levels of the central nervous system. Due to the strong correlations with pain relief, the changes in EEG signals during cold-pressor test have the potential to serve as biomarkers of opioid analgesia. PERSPECTIVE: This exploratory study presents evidence of opioid specific effects on the pain system at peripheral and central levels. The findings give insights into which measures are the most sensitive for assessing opioid-specific effects.
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Affiliation(s)
- Dina Lelic
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
| | - Anne Estrup Olesen
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Debbie Grønlund
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Fabricio Ariel Jure
- Integrative Neuroscience, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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11
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Dimitrijevic MR, Kakulas BA. Spinal cord injuries, human neuropathology and neurophysiology. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2020; 39:353-358. [PMID: 33458591 PMCID: PMC7783432 DOI: 10.36185/2532-1900-039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 11/18/2022]
Abstract
A correlative approach to human spinal cord injuries (SCI) through the combination of neuropathology and neurophysiology provides a much better understanding of the condition than with either alone. Among the benefits so derived is the wide range of interventions applicable to the restorative neurology (RN) of SCI so that the neurological status of the SCI patient is thereby much improved. The neurophysiological and neuropathological elements underlying these advances are described.
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Affiliation(s)
- Milan R. Dimitrijevic
- Foundation for Movement Recovery Oslo, Norway
- Baylor College of Medicine Houston, TX, USA
| | - Byron A. Kakulas
- Perron Institute for Neurological and Translational Neuroscience, Perth, Western Australia, Australia
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12
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Militskova A, Mukhametova E, Fatykhova E, Sharifullin S, Cuellar CA, Calvert JS, Grahn PJ, Baltina T, Lavrov I. Supraspinal and Afferent Signaling Facilitate Spinal Sensorimotor Network Excitability After Discomplete Spinal Cord Injury: A Case Report. Front Neurosci 2020; 14:552. [PMID: 32655351 PMCID: PMC7323764 DOI: 10.3389/fnins.2020.00552] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/04/2020] [Indexed: 12/25/2022] Open
Abstract
Objective In this study, we evaluated the role of residual supraspinal and afferent signaling and their convergence on the sublesional spinal network in subject diagnosed with complete paralysis (AIS-A). Methods A combination of electrophysiologic techniques with positional changes and subject-driven reinforcement maneuvers was implemented in this study. Electrical stimulation was applied transcutaneously at the T9-L2 vertebra levels and the spinal cord motor evoked potentials (SEMP) were recorded from leg muscles. To test the influence of positional changes, the subject was placed in (i) supine, (ii) upright with partial body weight bearing and (iii) vertically suspended without body weight bearing positions. Results Increase in amplitude of SEMP was observed during transition from supine to upright position, supporting the role of sensory input in lumbosacral network excitability. Additionally, amplitudes of SEMP were facilitated during reinforcement maneuvers, indicating a supralesional influence on sub-lesional network. After initial assessment, subject underwent rehabilitation therapy with following electrophysiological testing that reviled facilitation of SEMP. Conclusion These results demonstrate that combination of electrophysiological techniques with positional and reinforcement maneuvers can add to the diagnostics of discomplete SCI. These findings also support an idea that integration of supraspinal and afferent information on sub-lesional circuitry plays a critical role in facilitation of spinal sensorimotor network in discomplete SCI.
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Affiliation(s)
- Alena Militskova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Elvira Mukhametova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Elsa Fatykhova
- Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia
| | | | - Carlos A Cuellar
- Centro de Investigación en Ciencias de la Salud, Universidad Anáhuac México, Huixquilucan, Mexico
| | - Jonathan S Calvert
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Peter J Grahn
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | - Tatiana Baltina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Igor Lavrov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia.,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States.,Department of Neurology, Mayo Clinic, Rochester, MN, United States
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13
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Kotani N, Morishita T, Yatsugi A, Fujioka S, Kamada S, Shiota E, Tsuboi Y, Inoue T. Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease. Front Neurol 2020; 11:215. [PMID: 32328021 PMCID: PMC7160316 DOI: 10.3389/fneur.2020.00215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/09/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction: Elderly people often exhibit "frailty," and motor dysfunction occurs. Several studies have reported about the relationship between motor dysfunction and frailty in Parkinson's disease (PD). This study aimed to test whether the core exercise using the hybrid assistive limb lumbar type for care support (HAL-CB02) may improve the motor functions in frailty patients with or without PD and to explore the optimal patient selection from the frailty cohort. Materials and Methods: We recruited 16 frailty patients (PD = 8; non-PD = 8). The participants performed core exercise and squats using HAL-CB02 for five sessions a week. Outcome measures were 10-m walking test, step length, timed up-and-go test, 30-s chair stand test, and visual analog scale. Evaluation was conducted at baseline, post-exercise, and 1- and 3-month follow-ups. Results: Both PD and non-PD patients showed significant improvement in all evaluation items post-exercise. Moreover, no significant difference was found in the improvement value between the two groups. Conclusions: Our results suggest that biofeedback exercise with HAL-CB02 is a safe and promising treatment for frailty patients. Motor dysfunction in PD patients may be partly due to physical frailty, and biofeedback exercise with HAL-CB02 is proposed as a treatment option.
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Affiliation(s)
- Naoya Kotani
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.,Department of Rehabilitation Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Takashi Morishita
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Aya Yatsugi
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.,Department of Rehabilitation Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Satoshi Kamada
- Department of Rehabilitation Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Etsuji Shiota
- Department of Rehabilitation Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Tooru Inoue
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
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14
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Huang H, Young W, Skaper S, Chen L, Moviglia G, Saberi H, Al-Zoubi Z, Sharma HS, Muresanu D, Sharma A, El Masry W, Feng S. Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (IANR/CANR version 2019). J Orthop Translat 2019; 20:14-24. [PMID: 31908929 PMCID: PMC6939117 DOI: 10.1016/j.jot.2019.10.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/13/2019] [Indexed: 12/11/2022] Open
Abstract
Functional restoration after spinal cord injury (SCI) is one of the most challenging tasks in neurological clinical practice. With a view to exploring effective neurorestorative methods in the acute, subacute, and chronic phases of SCI, “Clinical Therapeutic Guidelines of Neurorestoration for Spinal Cord Injury (China Version 2016)” was first proposed in 2016 by the Chinese Association of Neurorestoratology (CANR). Given the rapid advances in this field in recent years, the International Association of Neurorestoratology (IANR) and CANR formed and approved the “Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (IANR/CANR version 2019)”. These guidelines mainly introduce restoring damaged neurological structure and functions by varying neurorestorative strategies in acute, subacute, and chronic phases of SCI. These guidelines can provide a neurorestorative therapeutic standard or reference for clinicians and researchers in clinical practice to maximally restore functions of patients with SCI and improve their quality of life. The translational potential of this article This guideline provided comprehensive management strategies for SCI, which contains the evaluation and diagnosis, pre-hospital first aid, treatments, rehabilitation training, and complications management. Nowadays, amounts of neurorestorative strategies have been demonstrated to be benefit in promoting the functional recovery and improving the quality of life for SCI patients by clinical trials. Also, the positive results of preclinical research provided lots of new neurorestorative strategies for SCI treatment. These promising neurorestorative strategies are worthy of translation in the future and can promote the advancement of SCI treatments.
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Affiliation(s)
- Hongyun Huang
- Institute of Neurorestoratology, Third Medical Center of PLA General Hospital, Beijing, People's Republic of China.,Hongtianji Neuroscience Academy, Lingxiu Building, No.1 at Gucheng Street, Beijing, People's Republic of China
| | - Wise Young
- W. M. Keck Center for Collaborative Neuroscience, Rutgers, State University of New Jersey, Piscataway, NJ, USA
| | - Stephen Skaper
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Lin Chen
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, People's Republic of China
| | - Gustavo Moviglia
- Center of Research and Engineer of Tissues and Cellular Therapy, Maimonides University, Buenos Aires, Argentina
| | - Hooshang Saberi
- Department of Neurosurgery, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ziad Al-Zoubi
- Jordan Ortho and Spinal Centre, Al-Saif Medical Center, Amman, Jordan
| | - Hari Shanker Sharma
- Intensive Experimental CNS Injury and Repair, University Hospital, Uppsala University, Uppsala, Sweden
| | - Dafin Muresanu
- Department of Neurosciences "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alok Sharma
- Department of Neurosurgery, LTM Medical College, LTMG Hospital, Mumbai, Mumbai, India
| | - Wagih El Masry
- Spinal Injuries Unit, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - Shiqing Feng
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
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15
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Rhudy JL, Hellman N, Sturycz CA, Toledo TA, Palit S. Modified Biofeedback (Conditioned Biofeedback) Promotes Antinociception by Increasing the Nociceptive Flexion Reflex Threshold and Reducing Temporal Summation of Pain: A Controlled Trial. THE JOURNAL OF PAIN 2019; 21:663-676. [PMID: 31683023 DOI: 10.1016/j.jpain.2019.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 01/12/2023]
Abstract
This study examined whether a modified version of biofeedback (ie, Conditioned Biofeedback) that incorporated placebo analgesia-like manipulations could promote antinociception in healthy, pain-free participants. During Conditioned Biofeedback (n = 28), sympathetic arousal level was displayed visually and participants were asked to reduce it while they received painful electric stimulations that were surreptitiously controlled by their arousal level. Thus, electric pain decreased as arousal decreased to associate successful arousal-reduction/relaxation with pain relief, and to promote expectations for future pain relief. A Biofeedback Only group (n = 24) controlled for the general effects of biofeedback/relaxation. A Biofeedback+Shock group (n = 21) controlled for the effects of practicing biofeedback during painful shocks. Nociceptive flexion reflex (NFR) threshold and temporal summation of pain (TS-pain) were used to assess changes in spinal nociception and pain facilitation, respectively. Results indicated all groups showed pre- to postbiofeedback increases in NFR threshold, but only the Conditioned Biofeedback group showed pre- to postbiofeedback reductions in TS-pain. Moreover, Conditioned Biofeedback resulted in a persistent (prebiofeedback) increase in NFR threshold across sessions, whereas Biofeedback Only resulted in a persistent (prebiofeedback) decrease in TS-pain. In sum, Conditioned Biofeedback may promote antinociception in healthy participants thus reducing risk for chronic pain. The study was registered prospectively on ClinicalTrials.gov (TU1560). PERSPECTIVE: A modified version of biofeedback that employs placebo analgesia manipulations was successful in increasing descending inhibition and reducing pain facilitation in healthy volunteers. As a result, it may be an effective means of reducing risk of future chronic pain onset by promoting an antinociceptive pain profile.
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Affiliation(s)
- Jamie L Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | | | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Shreela Palit
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
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16
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17
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Ahmed RU, Alam M, Zheng YP. Experimental spinal cord injury and behavioral tests in laboratory rats. Heliyon 2019; 5:e01324. [PMID: 30906898 PMCID: PMC6411514 DOI: 10.1016/j.heliyon.2019.e01324] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/01/2018] [Accepted: 03/04/2019] [Indexed: 12/15/2022] Open
Abstract
Traumatic spinal cord injury (SCI) results in some serious neurophysiological consequences that alter healthy body functions and devastate the quality of living of individuals. To find a cure for SCI, researchers around the world are working on different neurorepair and neurorehabilitation modalities. To test a new treatment for SCI as well as to understand the mechanism of recovery, animal models are being widely used. Among them, SCI rat models are arguably the most prominent. Furthermore, it is important to select a suitable behavioral test to evaluate both the motor and sensory recovery following any therapeutic intervention. In this paper, we review the rat models of spinal injury and commonly used behavioral tests to serve as a useful guideline for neuroscientists in the field of SCI research.
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18
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Tsao YC, Lai KL, Chen JT, Liao KK, Wang SJ. Paired nociceptive blink stimuli can facilitate trigeminofacial circuit at a long inter-stimulus interval. J Chin Med Assoc 2019; 82:30-34. [PMID: 30839400 DOI: 10.1097/jcma.0000000000000003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS Conditioned responses of paired nociceptive blink reflex (nBR) can reflect the excitability of trigeminofacial circuit. In the present study, we studied paired homotopic nBR with different inter-stimulus intervals (ISI). By monitoring different ISIs and consequential conditioned R2 of nBR, we aimed to investigate the impact of ISIs on the recovery cycle of nBR in normal individuals. METHODS Twelve healthy volunteers (mean age: 29.9 ± 7.0 years; M/F: 7/5) were enrolled in this study. After individuals' reflex threshold was determined, triple pulses were given in pairs with ISIs 125 to 10000 milliseconds randomly. We calculated the ratio of conditioned and unconditioned nBR area-under-curve (AUC) (defined as recovery index), and amplitude of each ISI. RESULTS The average latency of unconditioned nR2 is 42.6 ± 5.5 ms, with amplitude of 53.4 ± 43.9 μV and the AUC of 563.5 ± 480.6 ms·μV. The conditioned nBR/unconditioned nBR response ratio was less than 100% while the ISI is shorter than 1667 ms, suggesting an inhibited conditioned response. The recovery index and the amplitude of conditioned nBR gradually increased with increasing ISI. The recovery index was greater than 100% at ISI of 10 s (p = 0.005), implying full recovery and facilitation of conditioned nBR. CONCLUSION Our study established the time-dependent dynamic recovery curve of paired nBR. The facilitated nBR at ISI longer than 10 s might be associated with temporal summation to the facial motor neurons after repeated stimuli. Our study results provided potential applications for patients with pain disorders involving trigeminofacial region.
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Affiliation(s)
- Yu-Chien Tsao
- Department of Internal Medicine, Yonghe Cardinal Tien Hospital, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine
| | - Jen-Tse Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine
- Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, ROC
| | - Kwong-Kum Liao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine
- Brain Research Center National Yang-Ming University, Taipei, Taiwan, ROC
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19
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Sayenko DG, Atkinson DA, Mink AM, Gurley KM, Edgerton VR, Harkema SJ, Gerasimenko YP. Vestibulospinal and Corticospinal Modulation of Lumbosacral Network Excitability in Human Subjects. Front Physiol 2018; 9:1746. [PMID: 30574093 PMCID: PMC6291495 DOI: 10.3389/fphys.2018.01746] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/20/2018] [Indexed: 12/21/2022] Open
Abstract
As part of a project aimed to develop a novel, non-invasive techniques for comprehensive assessment of supraspinal-spinal connectivity in humans, the present study sought to explore the convergence of descending vestibulospinal and corticospinal pathways onto lumbosacral motor pools. Transcutaneous electrical spinal stimulation-evoked motor potentials were recorded from knee and ankle flexors and extensors in resting neurologically intact participants. Descending influences on lumbosacral motor neurons were studied using galvanic vestibular (GVS) or transcranial magnetic stimulation (TMS) to elicit descending vestibulospinal or corticospinal volleys, respectively. Facilitatory conditioning effects of descending corticospinal volleys were manifested by a significant increase of spinally evoked motor potentials in recorded knee and ankle muscles bilaterally, and were observed at the 10–30 ms conditioning-test intervals (CTIs); whereas, facilitatory conditioning effects of vestibulospinal volleys manifested at longer latencies (CTIs of 90 and 110 ms), and lasted up to 250 ms. TMS mediated volleys revealed the conditioning effects at both short and long latencies, suggestive of both direct and indirect influence. In contrast, vestibulospinally mediated conditioning effects occurred at longer latencies, consistent with this pathway’s known anatomical and functional interfaces with other descending systems including the reticulospinal pathway and, suggestively, propriospinal interneurons. Our work demonstrates the utility and sensitivity of transcutaneous spinal stimulation in human neurophysiological studies as a technique for quantitative characterization of excitatory conditioning effects in multiple lumbosacral motor pools, obtained through descending pathways. This characterization becomes critical in understanding the neuroplasticity in the central nervous system during motor learning and neurological recovery.
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Affiliation(s)
- Dimitry G Sayenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Center for Neuroregeneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston, TX, United States
| | - Darryn A Atkinson
- Neuroscience Collaborative Center, Frazier Rehab Institute, Louisville, KY, United States.,Department of Neurological Surgery, University of Louisville, Louisville, KY, United States
| | - Amber M Mink
- Neuroscience Collaborative Center, Frazier Rehab Institute, Louisville, KY, United States.,Department of Physiology and Biophysics, University of Louisville, Louisville, KY, United States
| | - Katelyn M Gurley
- School of Medicine, Louisiana State University, New Orleans, LA, United States
| | - V Reggie Edgerton
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan J Harkema
- Neuroscience Collaborative Center, Frazier Rehab Institute, Louisville, KY, United States.,Department of Neurological Surgery, University of Louisville, Louisville, KY, United States
| | - Yury P Gerasimenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Pavlov Institute of Physiology, St. Petersburg, Russia
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20
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Temporal Profile and Limb-specificity of Phasic Pain-Evoked Changes in Motor Excitability. Neuroscience 2018; 386:240-255. [DOI: 10.1016/j.neuroscience.2018.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/20/2018] [Accepted: 06/24/2018] [Indexed: 12/17/2022]
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21
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Levy J, Hartley S, Mauruc-Soubirac E, Leotard A, Lofaso F, Quera-Salva MA, Bensmail D. Spasticity or periodic limb movements? Eur J Phys Rehabil Med 2017; 54:698-704. [PMID: 29205982 DOI: 10.23736/s1973-9087.17.04886-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Spasticity and spasms are distressing features of the upper motor neuron syndrome (UMNS) following spinal cord injuries (SCI) or multiple sclerosis (MS), and have common therapeutic implications. Despite an increase of antispastic drugs and strategies, sometimes up to the surgical implant of intrathecal baclofen pump, some patients still complain of disabling spasms, which poses diagnostic and therapeutic challenges. Although clinically similar, flexor spasms due to pyramidal tract disruption must be clearly differentiated from periodic limb movements (PLM), often accompanying restless leg syndrome (RLS) and occurring during sleep. We raised the hypothesis of this differential as a diagnostic confusion in this particular population. AIM The aim of this study was twofold: 1) to search for RLS with PLM in consecutive patients referred for uncontrolled disabling spasms despite treatment, by nocturnal polysomnography (PSG); 2) to report the efficacy of dopaminergic agonists on PLM in this population. DESIGN Observational prospective study. SETTING Spasticity Clinic at the Raymond-Poincaré University Hospital, Garches, France. POPULATION All consecutive patients with MS or SCI, referred to our spasticity clinic from March 2014 to July 2016 for the management of persistent and disabling spasms despite treatment. Obvious daytime spasticity or flexor spasms were not considered. When spasms prevailed at evening, night, or in supine position, patients underwent a nocturnal PSG. METHODS Patients were assessed for RLS by clinical interview and for PLM by PSG. Patients with confirmed PLM (≥15 per hour of sleep) were treated with low dosage of pramipexole (after an iron deficiency was ruled out) and reassessed by PSG the following night. RESULTS Forty-five patients were included. All fulfilled RLS criteria, and PLMs were confirmed in 39 patients. Median PLM index, and related arousals were 45.9 (19.8-76.2) and 5.1 (1.5-15) events per hour respectively. Nine patients treated with pramipexole underwent an early second PSG which showed an improvement of PLM index and arousals (P=0.0007 and P=0.01, respectively). CONCLUSIONS In this princeps study, we demonstrated that in SCI and MS patients, "persistent spasms" inefficiently treated by antispastic drugs could in fact be PLM. Furthermore, we first reported the efficacy of dopaminergic agonists for PLM in an MS and SCI population. CLINICAL REHABILITATION IMPACT This study brings new insights on abnormal movements, often misinterpreted as spasticity, and their management. We suggest to include a PSG in the diagnostic approach of uncontrolled spasms prevailing at night or in supine position, to search for PLM, which are easily treatable.
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Affiliation(s)
- Jonathan Levy
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France - .,Research Unit (UMR) 1179, French National Institute of Health and Medical Research (Inserm), University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France -
| | - Sarah Hartley
- Sleep Unit (EA4047), Department of Physiology and Functional Testing, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France
| | - Elsa Mauruc-Soubirac
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France
| | - Antoine Leotard
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France.,Sleep Unit (EA4047), Department of Physiology and Functional Testing, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France
| | - Frédéric Lofaso
- Research Unit (UMR) 1179, French National Institute of Health and Medical Research (Inserm), University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.,Sleep Unit (EA4047), Department of Physiology and Functional Testing, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France
| | - Maria-Antonia Quera-Salva
- Sleep Unit (EA4047), Department of Physiology and Functional Testing, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France
| | - Djamel Bensmail
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré University Hospital, Assistance Publique, Hôpitaux de Paris (AP-HP), Garches, France.,Research Unit (UMR) 1179, French National Institute of Health and Medical Research (Inserm), University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
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22
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Cremoux S, Tallet J, Dal Maso F, Berton E, Amarantini D. Impaired corticomuscular coherence during isometric elbow flexion contractions in humans with cervical spinal cord injury. Eur J Neurosci 2017; 46:1991-2000. [DOI: 10.1111/ejn.13641] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Sylvain Cremoux
- LAMIH, UMR CNRS 8201; Université de Valenciennes et du Hainaut-Cambrésis; F-59313 Valenciennes France
| | - Jessica Tallet
- Toulouse NeuroImaging Center; Université de Toulouse, Inserm, UPS; Toulouse France
| | - Fabien Dal Maso
- Département de Kinésiologie; Université de Montréal; Montréal QC Canada
- School of Physical and Occupational Therapy; McGill University; Montréal QC Canada
| | - Eric Berton
- Aix-Marseille Université; CNRS, ISM UMR 7287; Marseille Cedex 09 France
| | - David Amarantini
- Toulouse NeuroImaging Center; Université de Toulouse, Inserm, UPS; Toulouse France
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23
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Manickaraj N, Bisset LM, Devanaboyina VSPT, Kavanagh JJ. Chronic pain alters spatiotemporal activation patterns of forearm muscle synergies during the development of grip force. J Neurophysiol 2017; 118:2132-2141. [PMID: 28724779 DOI: 10.1152/jn.00210.2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 02/04/2023] Open
Abstract
It is largely unknown how the CNS regulates multiple muscle systems in the presence of pain. This study used muscle synergy analysis to investigate multiple forearm muscles in individuals with chronic elbow pain during the development of grip force. Eleven individuals with chronic elbow pain and 11 healthy age-matched control subjects developed grip force to 15% and 30% of maximum voluntary contraction (MVC). Surface electromyography was obtained from six forearm muscles during force development before nonnegative matrix factorization was performed. The relationship between muscle synergies and standard clinical tests of elbow pain were examined by linear regression. During grip force development to 15% MVC the pain group had a lower number of forearm muscle synergies, increased similarity in spatial activation patterns, increased cocontraction of forearm flexors, and a greater magnitude of muscle weightings across the forearm when performing the task. During the 30% MVC grip the numbers of muscle synergies were the same for both groups; however, the pain group had lower activation and reduced variability in the timing of peak activation. The timing of peak activation was delayed in the pain group regardless of the task, and performing the grip in different wrist postures did not affect muscle synergy characteristics in either group. Although localized pain causes direct dysfunction of an affected muscle, this study provides evidence that the timing and amplitude of agonist and antagonist muscle activity are also affected with chronic pain.NEW & NOTEWORTHY Muscle activation patterns of individuals with chronic elbow pain are simplified compared with healthy individuals. This is apparent as individuals with pain exhibit fewer forearm muscle synergies, and increased similarity of activation patterns between forearm muscles, when performing pain-free isometric gripping. As such, even during pain-free tasks it is possible to observe changes in motor control in people with chronic pain.
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Affiliation(s)
- Nagarajan Manickaraj
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Leanne M Bisset
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | | | - Justin J Kavanagh
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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24
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Nalbantoğlu M, Battal H, Kiziltan ME, Akalin MA, Kiziltan G. Stiff Person Syndrome with Pyramidal Signs. Noro Psikiyatr Ars 2017; 53:188-190. [PMID: 28360797 DOI: 10.5152/npa.2015.11310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 05/19/2015] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mecbure Nalbantoğlu
- Department of Neurology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Hasan Battal
- Department of Physical Therapy and Rehabilitation, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Meral E Kiziltan
- Department of Neurology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Mehmet Ali Akalin
- Department of Neurology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Güneş Kiziltan
- Department of Neurology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
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25
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The nociceptive withdrawal response of the foot in the spinalized rat exhibits limited dependence on stimulus location. Exp Brain Res 2017; 235:2027-2038. [PMID: 28343308 DOI: 10.1007/s00221-017-4940-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 03/01/2017] [Indexed: 12/31/2022]
Abstract
The nociceptive withdrawal response (NWR) of the limb is a protective, multi-joint movement in response to noxious stimulation of the homonymous limb. Previous studies in animal models differed as to the dependence of the response direction and magnitude on stimulus location. The specific aim of our research was to use three-dimensional high-speed video to determine whether movement of the foot in response to heat stimuli delivered to the foot and lower leg depended on the location of the stimulus. In particular, we sought to determine whether the movement strategy was categorical or continuous. In spinalized rats, localized, presumably nociceptive heat stimuli were delivered along three dimensions-circumferentially around the lower leg, circumferentially around the foot and along the plantar surface of the foot. Our results demonstrate that in spite of a wide range of stimulus locations over the hind foot and leg, response directions were restricted to two-rostral/medial/dorsal and caudal/medial/dorsal-directions, consistent with a categorical strategy. Further, the preference for these two directions was also reflected in the distance of the movement, which was greatest for stimuli directly opposite the preferred response directions. However, significant but weak dependencies of response direction and distance on stimulus location were found for all three dimensions of stimulus application, supporting a continuous strategy. Together, our results demonstrate, based on movement analysis, that the NWR employs a hybrid categorical-continuous strategy that may minimize the harmful consequences of noxious stimuli.
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Benthall KN, Hough RA, McClellan AD. Descending propriospinal neurons mediate restoration of locomotor function following spinal cord injury. J Neurophysiol 2017; 117:215-229. [PMID: 27760818 PMCID: PMC5209543 DOI: 10.1152/jn.00544.2016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/17/2016] [Indexed: 12/30/2022] Open
Abstract
Following spinal cord injury (SCI) in the lamprey, there is virtually complete recovery of locomotion within a few weeks, but interestingly, axonal regeneration of reticulospinal (RS) neurons is mostly limited to short distances caudal to the injury site. To explain this situation, we hypothesize that descending propriospinal (PS) neurons relay descending drive from RS neurons to indirectly activate spinal central pattern generators (CPGs). In the present study, the contributions of PS neurons to locomotor recovery were tested in the lamprey following SCI. First, long RS neuron projections were interrupted by staggered spinal hemitransections on the right side at 10% body length (BL; normalized from the tip of the oral hood) and on the left side at 30% BL. For acute recovery conditions (≤1 wk) and before axonal regeneration, swimming muscle burst activity was relatively normal, but with some deficits in coordination. Second, lampreys received two spaced complete spinal transections, one at 10% BL and one at 30% BL, to interrupt long-axon RS neuron projections. At short recovery times (3-5 wk), RS and PS neurons will have regenerated their axons for short distances and potentially established a polysynaptic descending command pathway. At these short recovery times, swimming muscle burst activity had only minor coordination deficits. A computer model that incorporated either of the two spinal lesions could mimic many aspects of the experimental data. In conclusion, descending PS neurons are a viable mechanism for indirect activation of spinal locomotor CPGs, although there can be coordination deficits of locomotor activity. NEW & NOTEWORTHY In the lamprey following spinal lesion-mediated interruption of long axonal projections of reticulospinal (RS) neurons, sensory stimulation still elicited relatively normal locomotor muscle burst activity, but with some coordination deficits. Computer models incorporating the spinal lesions could mimic many aspects of the experimental results. Thus, after disruption of long-axon projections from RS neurons in the lamprey, descending propriospinal (PS) neurons appear to be a viable compensatory mechanism for indirect activation of spinal locomotor networks.
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Affiliation(s)
- Katelyn N Benthall
- Division of Biological Sciences, University of Missouri, Columbia, Missouri; and
| | - Ryan A Hough
- Division of Biological Sciences, University of Missouri, Columbia, Missouri; and
| | - Andrew D McClellan
- Division of Biological Sciences, University of Missouri, Columbia, Missouri; and
- Interdisciplinary Neuroscience Program, University of Missouri, Columbia, Missouri
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Yang Y, Solis-Escalante T, Yao J, van der Helm FCT, Dewald JPA, Schouten AC. Nonlinear Connectivity in the Human Stretch Reflex Assessed by Cross-Frequency Phase Coupling. Int J Neural Syst 2016; 26:1650043. [DOI: 10.1142/s012906571650043x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Communication between neuronal populations is facilitated by synchronization of their oscillatory activity. Although nonlinearity has been observed in the sensorimotor system, its nonlinear connectivity has not been widely investigated yet. This study investigates nonlinear connectivity during the human stretch reflex based on neuronal synchronization. Healthy participants generated isotonic wrist flexion while receiving a periodic mechanical perturbation to the wrist. Using a novel cross-frequency phase coupling metric, we estimate directional nonlinear connectivity, including time delay, from the perturbation to brain and to muscle, as well as from brain to muscle. Nonlinear phase coupling is significantly stronger from the perturbation to the muscle than to the brain, with a shorter time delay. The time delay from the perturbation to the muscle is 33 ms, similar to the reported latency of the spinal stretch reflex at the wrist. Source localization of nonlinear phase coupling from the brain to the muscle suggests activity originating from the motor cortex, although its effect on the stretch reflex is weak. As such nonlinear phase coupling between the perturbation and muscle activity is dominated by the spinal reflex loop. This study provides new evidence of nonlinear neuronal synchronization in the stretch reflex at the wrist joint with respect to spinal and transcortical loops.
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Affiliation(s)
- Yuan Yang
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands
| | - Teodoro Solis-Escalante
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands
| | - Jun Yao
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Frans C. T. van der Helm
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Julius P. A. Dewald
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Alfred C. Schouten
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500 AE, The Netherlands
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Stracke CP, Pettersson LG, Möller-Hartmann W, Krings T. Functional MRI of the Spinal Cord. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140090401700306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Germano AMC, Schmidt D, Milani TL. Effects of hypothermically reduced plantar skin inputs on anticipatory and compensatory balance responses. BMC Neurosci 2016; 17:41. [PMID: 27357844 PMCID: PMC4928340 DOI: 10.1186/s12868-016-0279-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/21/2016] [Indexed: 12/28/2022] Open
Abstract
Background Anticipatory and compensatory balance responses are used by the central nervous system (CNS) to preserve balance, hence they significantly contribute to the understanding of physiological mechanisms of postural control. It is well established that various sensory systems contribute to the regulation of balance. However, it is still unclear which role each individual sensory system (e.g. plantar mechanoreceptors) plays in balance regulation. This becomes also evident in various patient populations, for instance in diabetics with reduced plantar sensitivity. To investigate these sensory mechanisms, approaches like hypothermia to deliberately reduce plantar afferent input have been applied. But there are some limitations regarding hypothermic procedures in previous studies: Not only plantar aspects of the feet might be affected and maintaining the hypothermic effect during data collection. Therefore, the aim of the present study was to induce a permanent and controlled plantar hypothermia and to examine its effects on anticipatory and compensatory balance responses. We hypothesized deteriorations in anticipatory and compensatory balance responses as increased center of pressure excursions (COP) and electromyographic activity (EMG) in response to the hypothermic plantar procedure. 52 healthy and young subjects (23.6 ± 3.0 years) performed balance tests (unexpected perturbations). Subjects’ foot soles were exposed to three temperatures while standing upright: 25, 12 and 0 °C. COP and EMG were analyzed during two intervals of anticipatory and one interval of compensatory balance responses (intervals 0, 1 and 2, respectively). Results Similar plantar temperatures confirmed the successful implementation of the thermal platform. No significant COP and EMG differences were found for the anticipatory responses (intervals 0 and 1) under the hyperthermia procedure. Parameters in interval 2 showed generally decreased values in response to cooling. Conclusion No changes in anticipatory responses were found possibly due to sensory compensation processes of other intact afferents. Decreased compensatory responses may be interpreted as the additional balance threat, creating a more cautious behavior causing the CNS to generate a kind of over-compensatory behavior. Contrary to the expectations, there were different anticipatory and compensatory responses after reduced plantar inputs, thereby, revealing alterations in the organization of CNS inputs and outputs according to different task difficulties.
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Affiliation(s)
- Andresa M C Germano
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany.
| | - Daniel Schmidt
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany
| | - Thomas L Milani
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany
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Cremoux S, Amarantini D, Tallet J, Dal Maso F, Berton E. Increased antagonist muscle activity in cervical SCI patients suggests altered reciprocal inhibition during elbow contractions. Clin Neurophysiol 2016; 127:629-634. [DOI: 10.1016/j.clinph.2015.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/03/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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Rehabilitation-Dependent Neural Plasticity After Spinal Cord Injury. Transl Neurosci 2016. [DOI: 10.1007/978-1-4899-7654-3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Mackey AS, Uttaro D, McDonough MP, Krivis LI, Knikou M. Convergence of flexor reflex and corticospinal inputs on tibialis anterior network in humans. Clin Neurophysiol 2015; 127:706-715. [PMID: 26122072 DOI: 10.1016/j.clinph.2015.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/04/2015] [Accepted: 06/10/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Integration between descending and ascending inputs at supraspinal and spinal levels is a key characteristic of neural control of movement. In this study, we characterized convergence of the flexor reflex and corticospinal inputs on the tibialis anterior (TA) network in healthy human subjects. Specifically, we characterized the modulation profiles of the spinal TA flexor reflex following subthreshold and suprathreshold transcranial magnetic stimulation (TMS). We also characterized the modulation profiles of the TA motor evoked potentials (MEPs) following medial arch foot stimulation at sensory and above reflex threshold. METHODS TA flexor reflexes were evoked following stimulation of the medial arch of the foot with a 30 ms pulse train at innocuous intensities. TA MEPs were evoked following TMS of the leg motor cortex area. RESULTS TMS at 0.7 and at 1.2 MEP resting threshold increased the TA flexor reflex when TMS was delivered 40-100 ms after foot stimulation, and decreased the TA flexor reflex when TMS was delivered 25-110 ms before foot stimulation. Foot stimulation at sensory and above flexor reflex threshold induced a similar time-dependent modulation in resting TA MEPs, that were facilitated when foot stimulation was delivered 40-100 ms before TMS. The flexor reflex and MEPs recorded from the medial hamstring muscle were modulated in a similar manner to that observed for the TA flexor reflex and MEP. CONCLUSION Cutaneomuscular afferents from the distal foot can increase the output of the leg motor cortex area. Descending motor volleys that directly or indirectly depolarize flexor motoneurons increase the output of the spinal FRA interneuronal network. The parallel facilitation of flexor MEPs and flexor reflexes is likely cortical in origin. SIGNIFICANCE Afferent mediated facilitation of corticospinal excitability can be utilized to strengthen motor cortex output in neurological disorders.
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Affiliation(s)
- Ann S Mackey
- Graduate Center/Department of Physical Therapy, City University of New York, NY 10016, USA
| | - Denise Uttaro
- Graduate Center/Department of Physical Therapy, City University of New York, NY 10016, USA
| | - Maureen P McDonough
- Graduate Center/Department of Physical Therapy, City University of New York, NY 10016, USA
| | - Lisa I Krivis
- Graduate Center/Department of Physical Therapy, City University of New York, NY 10016, USA
| | - Maria Knikou
- Graduate Center/Department of Physical Therapy, City University of New York, NY 10016, USA.
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Schomburg ED, Steffens H, Pilyavskii AI, Maisky VA, Brück W, Dibaj P, Sears TA. Long lasting activity of nociceptive muscular afferents facilitates bilateral flexion reflex pattern in the feline spinal cord. Neurosci Res 2015; 95:51-8. [PMID: 25615850 DOI: 10.1016/j.neures.2015.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 12/28/2014] [Accepted: 01/13/2015] [Indexed: 01/10/2023]
Abstract
Chronic muscular limb pain requires the adoption of motor patterns distinct from the classic ipsilateral flexion, crossed extension and corresponding reciprocal inhibitions to acute exteroceptive stimulation. Using selective chemical activation of group III/IV afferents in gastrocnemius-soleus (GS) muscles we investigated bilaterally their reflex responses conditioned by (a) acute 'myositis' induced by intramuscular carrageenan; and (b) sub-acute 'myositis' induced by infusion of complete Freund's adjuvant (CFA). Reflex transmission was detected by monosynaptic testing and c-fos staining used to identify increased neuronal activity. In all control experiments with chemical stimulation of group III/IV afferents, ipsilateral responses conformed to the flexor reflex pattern. However, the expected contralateral facilitation of GS motoneurones occurred in fewer than 50% trials while only 9% of trials induced contralateral inhibition of flexor posterior-biceps-semitendinosus (PBSt) motoneurones. During carrageenan acute myositis contralateral PBSt was transiently facilitated by selective activation of group III/IV afferents. During CFA-induced myositis, contralateral only inhibition of GS motoneurones occurred instead of any facilitation, while bidirectionally a crossed facilitation of PBST dominated. These reflex changes were mirrored in an enhanced number of neurones with enhanced c-fos expression. Muscle pain, particularly if chronically persistent, requires another behavioural response pattern than acute exteroceptive pain.
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Affiliation(s)
- E D Schomburg
- Institute of Physiology, University of Göttingen, Germany.
| | - H Steffens
- Institute of Physiology, University of Göttingen, Germany; Max-Planck-Institute of Biophysical Chemistry, Göttingen, Germany
| | - A I Pilyavskii
- Department of Movement Physiology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - V A Maisky
- Department of Movement Physiology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - W Brück
- Department of Neuropathology, University of Göttingen, Germany
| | - P Dibaj
- Max-Planck-Institute for Experimental Medicine, Göttingen, Germany
| | - T A Sears
- Wolfson CARD, Guy's Campus, King's College London, UK
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Reliability of H-reflex in vastus lateralis and vastus medialis muscles during passive and active isometric conditions. Eur J Appl Physiol 2014; 114:2509-19. [DOI: 10.1007/s00421-014-2969-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
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Levine AJ, Hinckley CA, Hilde KL, Driscoll SP, Poon TH, Montgomery JM, Pfaff SL. Identification of a cellular node for motor control pathways. Nat Neurosci 2014; 17:586-93. [PMID: 24609464 PMCID: PMC4569558 DOI: 10.1038/nn.3675] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 02/13/2014] [Indexed: 12/28/2022]
Abstract
The rich behavioral repertoire of animals is encoded in the CNS as a set of motorneuron activation patterns, also called 'motor synergies'. However, the neurons that orchestrate these motor programs as well as their cellular properties and connectivity are poorly understood. Here we identify a population of molecularly defined motor synergy encoder (MSE) neurons in the mouse spinal cord that may represent a central node in neural pathways for voluntary and reflexive movement. This population receives direct inputs from the motor cortex and sensory pathways and, in turn, has monosynaptic outputs to spinal motorneurons. Optical stimulation of MSE neurons drove reliable patterns of activity in multiple motor groups, and we found that the evoked motor patterns varied on the basis of the rostrocaudal location of the stimulated MSE. We speculate that these neurons comprise a cellular network for encoding coordinated motor output programs.
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Affiliation(s)
- Ariel J Levine
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA. [3]
| | - Christopher A Hinckley
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA. [3]
| | - Kathryn L Hilde
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Shawn P Driscoll
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Tiffany H Poon
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Jessica M Montgomery
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Samuel L Pfaff
- 1] Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA. [2] Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California, USA
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Kutz DF, Kaulich T, Föhre W, Gerwig M, Timmann D, Kolb FP. Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: 2. Biomechanical characteristics. Neurobiol Learn Mem 2014; 109:178-92. [PMID: 24445111 DOI: 10.1016/j.nlm.2013.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/18/2013] [Accepted: 12/27/2013] [Indexed: 10/25/2022]
Abstract
This study addresses cerebellar involvement in classically conditioned nociceptive lower limb withdrawal reflexes in standing humans. A preceding study compared electromyographic activities in leg muscles of eight patients with cerebellar disease (CBL) and eight age-matched controls (CTRL). The present study extends and completes that investigation by recording biomechanical signals from a strain-gauge-equipped platform during paired auditory conditioning stimuli (CS) and unconditioned stimuli (US) trials and during US-alone trials. The withdrawal reflex performance-lifting the stimulated limb (decreasing the vertical force from that leg, i.e. 'unloading') and transferring body weight to the supporting limb (increasing the vertical force from that leg, i.e. 'loading')-was quantified by the corresponding forces exerted onto the platform. The force changes were not simultaneous but occurred as a sequence of multiple force peaks at different times depending on the specific limb task (loading or unloading). Motor learning, expressed by the occurrence of conditioned responses (CR), is characterized by this sequence beginning already within the CSUS window. Loading and unloading were delayed and prolonged in CBL, resulting in incomplete rebalancing during the analysis period. Trajectory loops of the center of vertical pressure-derived from vertical forces-were also incomplete in CBL within the recording period. However, exposing CBL to a CS resulted in motor improvement reflected by shortening the time of rebalancing and by optimizing the trajectory loop. In summary, associative responses in CBL are not absent although they are less frequent and of smaller amplitude than in CTRL.
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Affiliation(s)
- D F Kutz
- Institute of Physiology, University of Munich, Pettenkoferstr. 12, 80336 München, Germany.
| | - Th Kaulich
- Institute of Physiology, University of Munich, Pettenkoferstr. 12, 80336 München, Germany.
| | - W Föhre
- Institute of Physiology, University of Munich, Pettenkoferstr. 12, 80336 München, Germany.
| | - M Gerwig
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - D Timmann
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - F P Kolb
- Institute of Physiology, University of Munich, Pettenkoferstr. 12, 80336 München, Germany.
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Response to Letter to the Editor. Pain 2014; 155:200-201. [DOI: 10.1016/j.pain.2013.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 09/29/2013] [Indexed: 11/22/2022]
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Sayenko DG, Angeli C, Harkema SJ, Edgerton VR, Gerasimenko YP. Neuromodulation of evoked muscle potentials induced by epidural spinal-cord stimulation in paralyzed individuals. J Neurophysiol 2013; 111:1088-99. [PMID: 24335213 DOI: 10.1152/jn.00489.2013] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Epidural stimulation (ES) of the lumbosacral spinal cord has been used to facilitate standing and voluntary movement after clinically motor-complete spinal-cord injury. It seems of importance to examine how the epidurally evoked potentials are modulated in the spinal circuitry and projected to various motor pools. We hypothesized that chronically implanted electrode arrays over the lumbosacral spinal cord can be used to assess functionally spinal circuitry linked to specific motor pools. The purpose of this study was to investigate the functional and topographic organization of compound evoked potentials induced by the stimulation. Three individuals with complete motor paralysis of the lower limbs participated in the study. The evoked potentials to epidural spinal stimulation were investigated after surgery in a supine position and in one participant, during both supine and standing, with body weight load of 60%. The stimulation was delivered with intensity from 0.5 to 10 V at a frequency of 2 Hz. Recruitment curves of evoked potentials in knee and ankle muscles were collected at three localized and two wide-field stimulation configurations. Epidural electrical stimulation of rostral and caudal areas of lumbar spinal cord resulted in a selective topographical recruitment of proximal and distal leg muscles, as revealed by both magnitude and thresholds of the evoked potentials. ES activated both afferent and efferent pathways. The components of neural pathways that can mediate motor-evoked potentials were highly dependent on the stimulation parameters and sensory conditions, suggesting a weight-bearing-induced reorganization of the spinal circuitries.
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Affiliation(s)
- Dimitry G Sayenko
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
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40
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Pain sensitivity is normalized after a repeated bout of eccentric exercise. Eur J Appl Physiol 2013; 113:2595-602. [DOI: 10.1007/s00421-013-2701-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/24/2013] [Indexed: 01/21/2023]
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The representation of egocentric space in the posterior parietal cortex. Behav Brain Sci 2013; 15 Spec No 4:691-700. [PMID: 23842408 DOI: 10.1017/s0140525x00072605] [Citation(s) in RCA: 244] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
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Schomburg ED, Kalezic I, Dibaj P, Steffens H. Reflex transmission to lumbar α-motoneurones in the mouse similar and different to those in the cat. Neurosci Res 2013; 76:133-40. [PMID: 23562791 DOI: 10.1016/j.neures.2013.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/26/2013] [Accepted: 03/26/2013] [Indexed: 11/15/2022]
Abstract
Investigation and interpretation of defective motor circuitries in transgenic mice required further basic results from wild-type mice. Therefore, we investigated the lumbar motor reflex pattern in anaesthetised mice using intracellular motoneuronal recording and monosynaptic reflex testing. Thresholds and latencies in mice were similar to those in cats: thresholds for monosynaptic (group I) EPSPs were slightly above 1T (T=threshold for the lowest threshold fibres), around 1.5T for group II EPSPs and above 10T for group III EPSPs; group I EPSPs were maximal with a stimulus strength around 2T, group II EPSPs were maximal with 5-8T; latencies to the group I incoming volley were below 1ms for monosynaptic group I EPSPs, around 3ms for polysynaptic group II EPSPs and above 4ms for polysynaptic group III EPSPs. In contrast to reflex actions in the cat, monosynaptic gastrocnemius-soleus reflexes were facilitated by conditioning stimulation of the peroneal, sural and tibial nerves, i.e. by a variety of different, probably flexor reflex afferents. This facilitation persisted after high lumbar spinalisation indicating an independency to supraspinal influences. Nociceptive muscle afferents facilitated the peroneal monosynaptic reflex while nociceptive cutaneous afferents from the foot sole inhibited the ipsilateral but facilitated the contralateral peroneal reflex.
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Affiliation(s)
- Eike D Schomburg
- Institute of Physiology, University of Göttingen, Göttingen, Germany.
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Abstract
This chapter deals with the neuronal mechanisms underlying impaired gait. The aim is, first, a better understanding of the underlying pathophysiology and, second, the selection of an adequate treatment. One of the first symptoms of a lesion within the central motor system perceived by patients is a movement disorder, which is most characteristic during locomotion, e.g. in patients suffering spasticity after stroke or a spinal cord injury or Parkinson disease. By the recording and analysis of electrophysiological and biomechanical signals during a movement, the significance of impaired reflex behavior or muscle tone and its contribution to the movement disorder can reliably be assessed. Adequate treatment should not be restricted to the correction of an isolated clinical sign but should be based on the mechanisms underlying the movement disorder that impairs the patient. Therapy should be directed toward functional training, which takes advantage of the plasticity of the nervous system. In the future a combination of repair and functional training will further improve the mobility of disabled patients.
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Affiliation(s)
- V Dietz
- Balgrist University Hospital, Zürich, Switzerland.
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Lukáčová N, Kisucká A, Pavel J, Hricová Ľ, Kucharíková A, Gálik J, Maršala M, Langfort J, Chalimoniuk M. Spinal cord transection modifies neuronal nitric oxide synthase expression in medullar reticular nuclei and in the spinal cord and increases parvalbumin immunopositivity in motoneurons below the site of injury in experimental rabbits. Acta Histochem 2012; 114:518-24. [PMID: 22000862 DOI: 10.1016/j.acthis.2011.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 09/09/2011] [Accepted: 09/22/2011] [Indexed: 10/16/2022]
Abstract
Using immunohistochemistry, we detected the expression of neuronal nitric oxide synthase (nNOS) in ventral medullary gigantocellular reticular nuclei and in the lumbosacral spinal cord 10 days after thoracic transection in experimental rabbits. We tried to determine whether neurons located below the site of injury are protected by the calcium binding protein parvalbumin (PV). Changes of nNOS immunoreactivity (IR) in spinal cord were correlated with the level of nNOS protein in dorsal and ventral horns. Ten days after transection, nNOS was upregulated predominantly in lateral gigantocellular nuclei. In the spinal cord, we revealed a significant increase of nNOS protein in the dorsal horn. This is consistent with a higher density of punctate and fiber-like immunostaining for nNOS in laminae III-IV and the up-regulation of nNOS-IR in neurons of the deep dorsal horn. After surgery, the perikarya of motoneurons remained nNOS immunonegative. Contrary to nNOS, the PV-IR was upregulated in α-motoneurons and small-sized neurons of the ventral horn. However, its expression was considerably reduced in neurons of the deep dorsal horn. The findings indicate that spinal transection affects nNOS and PV in different neuronal circuits.
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Hedayatpour N, Arendt-Nielsen L, Falla D. Facilitation of quadriceps activation is impaired following eccentric exercise. Scand J Med Sci Sports 2012; 24:355-62. [DOI: 10.1111/j.1600-0838.2012.01512.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2012] [Indexed: 11/29/2022]
Affiliation(s)
- N. Hedayatpour
- Department of Physical Education and Sport Science; University of Bojnord; Bojnord Iran
- Department of Health Science and Technology; Center for Sensory-Motor Interaction (SMI); Aalborg University; Aalborg Denmark
| | - L. Arendt-Nielsen
- Department of Health Science and Technology; Center for Sensory-Motor Interaction (SMI); Aalborg University; Aalborg Denmark
| | - D. Falla
- Pain Clinic; Center for Anesthesiology; Emergency and Intensive Care Medicine; University Hospital Göttingen; Göttingen Germany
- Department of Neurorehabilitation Engineering; Bernstein Focus Neurotechnology (BFNT) Göttingen; Bernstein Center for Computational Neuroscience; University Medical Center Göttingen; Georg-August University; Göttingen Germany
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Timmann D, Kaulich T, Föhre W, Kutz DF, Gerwig M, Kolb FP. Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: I. electrophysiological characteristics. THE CEREBELLUM 2012; 12:108-26. [PMID: 22836373 DOI: 10.1007/s12311-012-0400-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to demonstrate the involvement of the human cerebellum in the classically conditioned lower limb withdrawal reflex in standing subjects. Electromyographic activity was recorded from the main muscle groups of both legs of eight patients with cerebellar disease (CBL) and eight control subjects (CTRL). The unconditioned stimulus (US) consisted of electrical stimulation of the tibial nerve at the medial malleolus. The conditioning stimulus (CS) was an auditory signal given via headphones. Experiments started with 70 paired conditioning stimulus-unconditioned stimulus(CSUS) trials followed by 50 US-alone trials. The general reaction consisted of lifting and flexing the stimulated (stepping) leg with accompanying activation of the contralateral (supporting) leg. In CTRL, the ipsilateral (side of stimulation) flexor and contralateral extensor muscles were activated characteristically. In CBL, the magnitudes of ipsilateral flexor and contralateral extensor muscle activation were reduced comparably. In CTRL, the conditioning process increased the incidence of conditioned responses (CR), following a typical learning curve, while CBL showed a clearly lower CR incidence with a marginal increase, albeit, at a shorter latency. Conditioning processes also modified temporal parameters by shortening unconditioned response (UR) onset latencies and UR times to peak and, more importantly in CBL, also the sequence of activation of muscles, which became similar to that of CTRL. The expression of this reflex in standing subjects showed characteristic differences in the groups tested with the underlying associative processes not being restricted exclusively to the CR but also modifying parameters of the innate UR.
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Affiliation(s)
- D Timmann
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
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Serrao M, Ranavolo A, Andersen OK, Conte C, Don R, Cortese F, Mari S, Draicchio F, Padua L, Sandrini G, Pierelli F. Adaptive behaviour of the spinal cord in the transition from quiet stance to walking. BMC Neurosci 2012; 13:80. [PMID: 22800397 PMCID: PMC3445852 DOI: 10.1186/1471-2202-13-80] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 07/02/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Modulation of nociceptive withdrawal reflex (NWR) excitability was evaluated during gait initiation in 10 healthy subjects to investigate how load- and movement-related joint inputs activate lower spinal centres in the transition from quiet stance to walking. A motion analysis system integrated with a surface EMG device was used to acquire kinematic, kinetic and EMG variables. Starting from a quiet stance, subjects were asked to walk forward, at their natural speed. The sural nerve was stimulated and EMG responses were recorded from major hip, knee and ankle muscles. Gait initiation was divided into four subphases based on centre of pressure and centre of mass behaviours, while joint displacements were used to categorise joint motion as flexion or extension. The reflex parameters were measured and compared between subphases and in relation to the joint kinematics. RESULTS The NWR was found to be subphase-dependent. NWR excitability was increased in the hip and knee flexor muscles of the starting leg, just prior to the occurrence of any movement, and in the knee flexor muscles of the same leg as soon as it was unloaded. The NWR was hip joint kinematics-dependent in a crossed manner. The excitability of the reflex was enhanced in the extensor muscles of the standing leg during the hip flexion of the starting leg, and in the hip flexors of the standing leg during the hip extension of the starting leg. No notable reflex modulation was observed in the ankle muscles. CONCLUSIONS Our findings show that the NWR is modulated during the gait initiation phase. Leg unloading and hip joint motion are the main sources of the observed modulation and work in concert to prepare and assist the starting leg in the first step while supporting the contralateral leg, thereby possibly predisposing the lower limbs to the cyclical pattern of walking.
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Affiliation(s)
- Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy.
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Guo X, Ayala JE, Gonzalez M, Stancescu M, Lambert S, Hickman JJ. Tissue engineering the monosynaptic circuit of the stretch reflex arc with co-culture of embryonic motoneurons and proprioceptive sensory neurons. Biomaterials 2012; 33:5723-31. [PMID: 22594977 DOI: 10.1016/j.biomaterials.2012.04.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 04/16/2012] [Indexed: 01/08/2023]
Abstract
The sensory circuit of the stretch reflex arc is composed of intrafusal muscle fibers and their innervating proprioceptive neurons that convert mechanical information regarding muscle length and tension into action potentials that synapse onto the homonymous motoneurons in the ventral spinal cord which innervate the extrafusal fibers of the same muscle. To date, the in vitro synaptic connection between proprioceptive sensory neurons and spinal motoneurons has not been demonstrated. A functional in vitro system demonstrating this connection would enable the understanding of feedback by the integration of sensory input into the spinal reflex arc. Here we report a co-culture of rat embryonic motoneurons and proprioceptive sensory neurons from dorsal root ganglia (DRG) in a defined serum-free medium on a synthetic silane substrate (DETA). Furthermore, we have demonstrated functional synapse formation in the co-culture by immunocytochemistry and electrophysiological analysis. This work will be valuable for enabling in vitro model systems for the study of spinal motor control and related pathologies such as spinal cord injury, muscular dystrophy and spasticity by improving our understanding of the integration of the mechanosensitive feedback mechanism.
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Affiliation(s)
- Xiufang Guo
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, FL 32826, USA
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STEFFENS H, DIBAJ P, SCHOMBURG ED. In Vivo Measurement of Conduction Velocities in Afferent and Efferent Nerve Fibre Groups in Mice. Physiol Res 2012; 61:203-14. [DOI: 10.33549/physiolres.932248] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Electrophysiological investigations in mice, particularly with altered myelination, require reference data of the nerve conduction velocity (CV). CVs of different fibre groups were determined in the hindlimb of anaesthetized adult mice. Differentiation between afferent and efferent fibres was performed by recording at dorsal roots and stimulating at ventral roots, respectively. Correspondingly, recording or stimulation was performed at peripheral hindlimb nerves. Stimulation was performed with graded strength to differentiate between fibre groups. CVs of the same fibre groups were different in different nerves of the hindlimb. CVs for motor fibres were for the tibial nerve (Tib) 38.5±4.0 m/s (Aγ: 16.7±3.0 m/s), the sural nerve (Sur) 39.3±3.1 m/s (12.0±0.8 m/s) and the common peroneal nerve (Per) 46.7±4.7 m/s (22.2±4.4 m/s). CVs for group I afferents were 47.4±3.1 m/s (Tib), 43.8±3.8 m/s (Sur), 55.2±6.1 m/s (Per) and 42.9±4.3 m/s for the posterior biceps (PB). CVs of higher threshold afferents, presumably muscle and cutaneous, cover a broad range and do not really exhibit nerve specific differences. Ranges are for group II 22-38 m/s, for group III 9-19 m/s, and for group IV 0.8-0.9 m/s. Incontrovertible evidence was found for the presence of motor fibres in the sural nerve. The results are useful as references for further electrophysiological investigations particularly in genetically modified mice with myelination changes.
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