SUPRASPINAL CONTROL OF TRANSMISSION IN REFLEX PATHS TO MOTONEURONES AND PRIMARY AFFERENTS

Operation regimes of spinal circuits controlling locomotion and role of supraspinal drives and sensory feedback

Locomotion in mammals is directly controlled by the spinal neuronal network, operating under the control of supraspinal signals and somatosensory feedback that interact with each other. However, the functional architecture of the spinal locomotor network, its operation regimes, and the role of supraspinal and sensory feedback in different locomotor behaviors, including at different speeds, remain unclear. We developed a computational model of spinal locomotor circuits receiving supraspinal drives and limb sensory feedback that could reproduce multiple experimental data obtained in intact and spinal-transected cats during tied-belt and split-belt treadmill locomotion. We provide evidence that the spinal locomotor network operates in different regimes depending on locomotor speed. In an intact system, at slow speeds (< 0.4 m/s), the spinal network operates in a non-oscillating state-machine regime and requires sensory feedback or external inputs for phase transitions. Removing sensory feedback related to limb extension prevents locomotor oscillations at slow speeds. With increasing speed and supraspinal drives, the spinal network switches to a flexor-driven oscillatory regime and then to a classical half-center regime. Following spinal transection, the spinal network can only operate in the state-machine regime. Our results suggest that the spinal network operates in different regimes for slow exploratory and fast escape locomotor behaviors, making use of different control mechanisms.

Uncovering and leveraging the return of voluntary motor programs after paralysis using a bi-cortical neuroprosthesis

Rehabilitative and neuroprosthetic approaches after spinal cord injury (SCI) aim to reestablish voluntary control of movement. Promoting recovery requires a mechanistic understanding of the return of volition over action, but the relationship between re-emerging cortical commands and the return of locomotion is not well established. We introduced a neuroprosthesis delivering targeted bi-cortical stimulation in a clinically relevant contusive SCI model. In healthy and SCI cats, we controlled hindlimb locomotor output by tuning stimulation timing, duration, amplitude, and site. In intact cats, we unveiled a large repertoire of motor programs. After SCI, the evoked hindlimb lifts were highly stereotyped, yet effective in modulating gait and alleviating bilateral foot drag. Results suggest that the neural substrate underpinning motor recovery had traded-off selectivity for efficacy. Longitudinal tests revealed that the return of locomotion after SCI was correlated with recovery of the descending drive, which advocates for rehabilitation interventions directed at the cortical target.

Corticospinal vs Rubrospinal Revisited: An Evolutionary Perspective for Sensorimotor Integration

The knowledge about how different subsystems participate and interplay in sensorimotor control is fundamental to understand motor deficits associated with CNS injury and movement recovery. The role of corticospinal (CS) and rubrospinal (RS) projections in motor control has been extensively studied and compared, and it is clear that both systems are important for skilled movement. However, during phylogeny, the emerging cerebral cortex took a higher hierarchical role controlling rubro-cerebellar circuits. Here, we present anatomical, neurophysiological, and behavioral evidence suggesting that both systems modulate complex segmental neuronal networks in a parallel way, which is important for sensorimotor integration at spinal cord level. We also highlight that, although specializations exist, both systems could be complementary and potentially subserve motor recovery associated with CNS damage.

Converging integration between ascending proprioceptive inputs and the corticospinal tract motor circuit underlying skilled movement control

Converging interactions between ascending proprioceptive afferents and descending corticospinal tract projections are critical in the modulation and coordination of skilled motor behaviors. Fundamental to these processes are the functional inputs and the mechanisms of integration in the brain and spinal cord between proprioceptive and corticospinal tract information. In this review, we first highlight key connections between corticospinal tract motor circuit and spinal interneurons that receive proprioceptive inputs. We will also address corticospinal tract access to the presynaptic inhibitory system in the spinal cord and its role in modulating proprioceptive stimuli. Lastly, we will focus on the corticospinal neuron influences on the dorsal column nuclei complex, an integration hub for processing ascending somatosensory information.

Pioneers in CNS inhibition: 2. Charles Sherrington and John Eccles on inhibition in spinal and supraspinal structures

This article reviews the contributions of the English neurophysiologist, Charles Scott Sherrington [1857-1952], and his Australian PhD trainee and collaborator, John Carew Eccles [1903-1997], to the concept of central inhibition in the spinal cord and brain. Both were awarded Nobel Prizes; Sherrington in 1932 for "discoveries regarding the function of neurons," and Eccles in 1963 for "discoveries concerning the ionic mechanisms involved in excitation and inhibition in central portions of the nerve cell membrane." Both spoke about central inhibition at their Nobel Prize Award Ceremonies. The subsequent publications of their talks were entitled "Inhibition as a coordinative factor" and "The ionic mechanism of postsynaptic inhibition", respectively. Sherrington's work on central inhibition spanned 41 years (1893-1934), and for Eccles 49 years (1928-1977). Sherrington first studied central inhibition by observing hind limb muscle responses to electrical (peripheral nerve) and mechanical (muscle) stimulation. He used muscle length and force measurements until the early 1900s and electromyography in the late 1920s. Eccles used these techniques while working with Sherrington, but later employed extracellular microelectrode recording in the spinal cord followed in 1951 by intracellular recording from spinal motoneurons. This considerably advanced our understanding of central inhibition. Sherrington's health was poor during his retirement years but he nonetheless made a small number of largely humanities contributions up to 1951, one year before his death at the age of 94. In contrast, Eccles retained his health and vigor until 3 years before his death and published prolifically on many subjects during his 22 years of official retirement. His last neuroscience article appeared in 1994 when he was 91. Despite poor health he continued thinking about his life-long interest, the mind-brain problem, and was attempting to complete his autobiography in the last years of his life.

H-reflex disinhibition by lumbar muscle inflammation in a mouse model of spinal cord injury

Inflammation is a common comorbidity in patients with traumatic spinal cord injury (SCI). Recent reports indicate that inflammation hinders functional recovery in animal models of SCI. However, the spinal mechanisms underlying this alteration are currently unknown. Considering that spinal plasticity is a therapeutic target in patients and animal models of SCI, these mechanisms remain to be clarified. Using injections of complete Freund's adjuvant (CFA) in lumbar muscles as a model of persistent inflammation, the objective of this study was to assess the impact of inflammation on spinal reflex excitability after a complete midthoracic spinal transection in mice. To this end, the excitability of spinal reflexes was examined by measuring H-reflex frequency-dependent depression (FDD) on days 7, 14 and 28 following a complete spinal transection. H-reflex parameters were compared between spinal mice with CFA and control spinal mice. On day 7, lumbar muscle inflammation disinhibited the H-reflex, reflected by an attenuation of H-reflex FDD (p < 0.01), although this effect did not persist later on, either on day 14 or day 28. These results indicate that lumbar muscle inflammation alters spinal reflex excitability transiently in spinal mice. Considering that changes in spinal reflex excitability are associated with poor functional recovery after SCI, this implies that inflammation should be treated effectively to promote optimal recovery following SCI.

Spinal control of motor outputs by intrinsic and externally induced electric field potentials

Despite numerous studies on spinal neuronal systems, several issues regarding their role in motor behavior remain unresolved. One of these issues is how electric fields associated with the activity of spinal neurons influence the operation of spinal neuronal networks and how effects of these field potentials are combined with other means of modulating neuronal activity. Another closely related issue is how external electric field potentials affect spinal neurons and how they can be used for therapeutic purposes such as pain relief or recovery of motor functions by transspinal direct current stimulation. Nevertheless, progress in our understanding of the spinal effects of electric fields and their mechanisms has been made over the last years, and the aim of the present review is to summarize the recent findings in this field.

Reflex wind-up in early chronic spinal injury: plasticity of motor outputs

In this study we evaluate temporal summation (wind-up) of reflexes in select distal and proximal hindlimb muscles in response to repeated stimuli of the distal tibial or superficial peroneal nerves in cats 1 mo after complete spinal transection. This report is a continuation of our previous paper on reflex wind-up in the intact and acutely spinalized cat. To evaluate reflex wind-up in both studies, we recorded electromyographic signals from the following left hindlimb muscles: lateral gastrocnemius (LG), tibialis anterior (TA), semitendinosus (ST), and sartorius (Srt), in response to 10 electrical pulses to the tibial or superficial peroneal nerves. Two distinct components of the reflex responses were considered, a short-latency compound action potential (CAP) and a longer duration bout of sustained activity (SA). These two response types were shown to be differentially modified by acute spinal injury in our previous work (Frigon A, Johnson MD, Heckman CJ. J Physiol 590: 973-989, 2012). We show that these responses exhibit continued plasticity during the 1-mo recovery period following acute spinalization. During this early chronic phase, wind-up of SA responses returned to preinjury levels in one muscle, the ST, but remained depressed in all other muscles tested. In contrast, CAP response amplitudes, which were initially potentiated following acute transection, returned to preinjury levels in all muscles except for Srt, which continued to show marked increase. These findings illustrate that spinal elements exhibit considerable plasticity during the recovery process following spinal injury and highlight the importance of considering SA and CAP responses as distinct phenomena with unique underlying neural mechanisms.NEW & NOTEWORTHY This research is the first to assess temporal summation, also called wind-up, of muscle reflexes during the 1-mo recovery period following spinal injury. Our results show that two types of muscle reflex activity are differentially modulated 1 mo after spinal cord injury (SCI) and that spinal reflexes are altered in a muscle-specific manner during this critical period. This postinjury plasticity likely plays an important role in spasticity experienced by individuals with SCI.

Corticospinal and reciprocal inhibition actions on human soleus motoneuron activity during standing and walking

Reciprocal Ia inhibition constitutes a key segmental neuronal pathway for coordination of antagonist muscles. In this study, we investigated the soleus H-reflex and reciprocal inhibition exerted from flexor group Ia afferents on soleus motoneurons during standing and walking in 15 healthy subjects following transcranial magnetic stimulation (TMS). The effects of separate TMS or deep peroneal nerve (DPN) stimulation and the effects of combined (TMS + DPN) stimuli on the soleus H-reflex were assessed during standing and at mid- and late stance phases of walking. Subthreshold TMS induced short-latency facilitation on the soleus H-reflex that was present during standing and at midstance but not at late stance of walking. Reciprocal inhibition was increased during standing and at late stance but not at the midstance phase of walking. The effects of combined TMS and DPN stimuli on the soleus H-reflex significantly changed between tasks, resulting in an extra facilitation of the soleus H-reflex during standing and not during walking. Our findings indicate that corticospinal inputs and Ia inhibitory interneurons interact at the spinal level in a task-dependent manner, and that corticospinal modulation of reciprocal Ia inhibition is stronger during standing than during walking.

rTMS modulates reciprocal inhibition in patients with traumatic spinal cord injury

STUDY DESIGN

Randomized, double-blind, crossover, sham-controlled trial.

OBJECTIVES

Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) leads to a significant reduction of spasticity in subjects with spinal cord injury (SCI), but the physiological basis of this effect is still not well understood. The purpose of this study was to evaluate the disynaptic reciprocal Ia inhibition of soleus motoneurons in SCI patients.

SETTING

Department of Neurology, Merano, Italy and TMS Laboratory, Paracelsus Medical University, Salzburg, Austria.

METHODS

Nine subjects with incomplete cervical or thoracic SCI received 5 days of daily sessions of real or sham rTMS applied over the contralateral M1. We compared the reciprocal inhibition, the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool for Spasticity at baseline, after the last session and 1 week later in the real rTMS and sham stimulation groups.

RESULTS

We found that real rTMS significantly reduced lower limb spasticity and restored the impaired excitability in the disynaptic reciprocal inhibitory pathway.

CONCLUSIONS

In a small proof-of-concept study, rTMS strengthened descending projections between the motor cortex and inhibitory spinal interneuronal circuits. This reversed a defect in reciprocal inhibition after SCI, and reduced leg spasticity.

Presynaptic inhibition of spinal sensory feedback ensures smooth movement

The precision of skilled movement depends on sensory feedback and its refinement by local inhibitory microcircuits. One specialized set of spinal GABAergic interneurons forms axo-axonic contacts with the central terminals of sensory afferents, exerting presynaptic inhibitory control over sensory-motor transmission. The inability to achieve selective access to the GABAergic neurons responsible for this unorthodox inhibitory mechanism has left unresolved the contribution of presynaptic inhibition to motor behavior. We used Gad2 as a genetic entry point to manipulate the interneurons that contact sensory terminals, and show that activation of these interneurons in mice elicits the defining physiological characteristics of presynaptic inhibition. Selective genetic ablation of Gad2-expressing interneurons severely perturbs goal-directed reaching movements, uncovering a pronounced and stereotypic forelimb motor oscillation, the core features of which are captured by modeling the consequences of sensory feedback at high gain. Our findings define the neural substrate of a genetically hard-wired gain control system crucial for the smooth execution of movement.

Identification of a cellular node for motor control pathways

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.

Synchronous and asynchronous electrically evoked motor activities during wind-up stimulation are differentially modulated following an acute spinal transection

In this study, we used a novel technique to study reflex wind-up when the spinal cord is intact and following an acute spinal transection. Specifically, we evaluated reflex responses evoked by a series of 10 electrical pulses to the tibial or superficial peroneal nerves in 9 decerebrate adult cats, before and after an acute spinal transection. Electromyograms were recorded in four hindlimb muscles (lateral gastrocnemius, tibialis anterior, semitendinosus, and sartorius) to evaluate reflex amplitude, duration, and the temporal summation of reflex responses, so-called wind-up. We identified two distinct reflex responses evoked by electrical stimulation of the tibial or superficial peroneal nerves on the basis of their pattern of change following acute spinal transection, a short-latency (∼10 ms) compound action potential (CAP) that was followed by a burst of sustained activity (SA). Wind-up of CAP and SA amplitudes was clearly present when the spinal cord was intact but was drastically reduced after acute spinalization in some muscles. Moreover, CAP and SA reflex responses were differentially modified by the acute spinalization. When the effects of acute spinal transection were significant, CAP responses were increased after acute spinalization, whereas SA responses were reduced, suggesting that the two signals are regulated by different neuronal mechanisms. The present results provide the first assessment of reflex wind-up before and after an acute spinal transection in the same animals and indicate that different reflex components must be considered separately when evaluating changes in neuronal excitability following SCI.

Plasticity of corticospinal neural control after locomotor training in human spinal cord injury

Spinal lesions substantially impair ambulation, occur generally in young and otherwise healthy individuals, and result in devastating effects on quality of life. Restoration of locomotion after damage to the spinal cord is challenging because axons of the damaged neurons do not regenerate spontaneously. Body-weight-supported treadmill training (BWSTT) is a therapeutic approach in which a person with a spinal cord injury (SCI) steps on a motorized treadmill while some body weight is removed through an upper body harness. BWSTT improves temporal gait parameters, muscle activation patterns, and clinical outcome measures in persons with SCI. These changes are likely the result of reorganization that occurs simultaneously in supraspinal and spinal cord neural circuits. This paper will focus on the cortical control of human locomotion and motor output, spinal reflex circuits, and spinal interneuronal circuits and how corticospinal control is reorganized after locomotor training in people with SCI. Based on neurophysiological studies, it is apparent that corticospinal plasticity is involved in restoration of locomotion after training. However, the neural mechanisms underlying restoration of lost voluntary motor function are not well understood and translational neuroscience research is needed so patient-orientated rehabilitation protocols to be developed.

Bilateral postsynaptic actions of pyramidal tract and reticulospinal neurons on feline erector spinae motoneurons

Trunk muscles are important for postural adjustments associated with voluntary movements but little has been done to analyze mechanisms of supraspinal control of these muscles at a cellular level. The present study therefore aimed to investigate the input from pyramidal tract (PT) neurons to motoneurons of the musculus longissimus lumborum of the erector spinae and to analyze to what extent it is relayed by reticulospinal (RS) neurons. Intracellular records from motoneurons were used to evaluate effects of electrical stimulation of medullary pyramids and of axons of RS neurons descending in the medial longitudinal fasciculus (MLF). The results revealed that similar synaptic actions were evoked from the ipsilateral and contralateral PTs, including disynaptic and trisynaptic EPSPs and trisynaptic IPSPs. Stimulation of the MLF-evoked monosynaptic and disynaptic EPSPs and disynaptic or trisynaptic IPSPs in the same motoneurons. All short-latency PSPs of PT origin were abolished by transection of the MLF, while they remained after transection of PT fibers at a spinal level. Hence, RS neurons might serve as the main relay neurons of the most direct PT actions on musculus (m.) longissimus. However, longer-latency IPSPs remaining after MLF or PT spinal lesions and after ipsilateral or contralateral hemisection of spinal cord indicate that PT actions are also mediated by ipsilaterally and/or contralaterally located spinal interneurons. The bilateral effects of PT stimulation thereby provide an explanation why trunk movements after unilateral injuries of PT neurons (e.g., stroke) are impaired to a lesser degree than movements of the extremities.

Tonic and phasic differential GABAergic inhibition of synaptic actions of joint afferents in the cat

The aim of this study was to examine the functional organization of the spinal neuronal networks activated by myelinated afferent fibers in the posterior articular nerve (PAN) of the anesthetized cat. Particular attention was given to the tonic and phasic GABAa inhibitory modulation of these networks. Changes in the synaptic effectiveness of the joint afferents were inferred from changes in the intraspinal focal potentials produced by electrical stimulation of the PAN. We found that conditioning stimulation of cutaneous nerves (sural, superficial peroneus and saphenous) and of the nucleus raphe magnus often inhibited, in a differential manner, the early and late components of the intraspinal focal potentials produced by stimulation of low and high threshold myelinated PAN afferents, respectively. The degree of the inhibition depended on the strength of both the conditioning and test stimuli and on the segmental level of recording. Conditioning stimulation of group I muscle afferents was less effective, but marked depression of the early and late focal potentials was produced by stimuli exceeding 5 xT. The i.v. injection of 1-2.5 mg/kg of picrotoxin, a GABAa blocker, had relatively minor effects on the early components of the PAN focal potentials, but was able to induce a significant increase of the late components. It also reduced the inhibitory effects of cutaneous and joint nerve conditioning on PAN focal responses. Conditioning autogenetic stimulation with high-frequency trains depressed the PAN focal potentials. The late components of the PAN responses remained depressed several minutes after discontinuing the conditioning train, even after picrotoxin administration. The present observations indicate that the neuronal networks activated by the low threshold PAN afferents show a relatively small post-activation depression and appear to be subjected to a minor tonic inhibitory GABAa control. In contrast, the pathways activated by stimulation of high threshold myelinated afferents have a strong post-activation depression and are subjected to a significant tonic GABAergic modulation. These contrasting features, together with the phasic differential GABAergic inhibition of the responses produced by stimulation of the different populations of joint afferents, may contribute to the preservation of the original information on joint position transmitted by large diameter joint afferents, in contrast with the tonic presynaptic inhibition exerted on the fine myelinated joint afferents, which may be involved in the adjustment of compensatory reactions to inflammation.

Step training-dependent plasticity in spinal cutaneous pathways

Plasticity after spinal cord injury can be initiated by specific patterns of sensory feedback, leading to a reorganization of spinal networks. For example, proprioceptive feedback from limb loading during the stance phase is crucial for the recovery of stepping in spinal-injured animals and humans. Our recent results showed that step training modified transmission from group I afferents of extensors in spinal cats. However, cutaneous afferents are also activated during locomotion and are necessary for proper foot placement in spinal cats. We therefore hypothesized that step training would also modify transmission in cutaneous pathways to facilitate recovery of stepping. We tested transmission in cutaneous pathways by comparing intracellular responses in lumbar motoneurons (n = 136) in trained (n = 11) and untrained (n = 7) cats spinalized 3-5 weeks before the acute electrophysiological experiment. Three cutaneous nerves were stimulated, and each evoked up to three motoneuronal responses mediated by at least three different pathways. Overall, of 71 cutaneous pathways tested, 10 were modified by step training: transmission was reduced in 7 and facilitated in 3. Remarkably, 6 of 10 involved the medial plantar nerve innervating the plantar surface of the foot, including two of the facilitated pathways. Because the cutaneous reflexes are exaggerated after spinalization, we interpret the decrease in most pathways as a normalization of cutaneous transmission necessary to recover locomotor movements. Overall, the results showed a high degree of specificity in plasticity among cutaneous pathways and indicate that transmission of skin inputs signaling ground contact, in particular, is modified by step training.

Motor cortical modulation of cutaneous reflex responses in the hindlimb of the intact cat

We have used the technique of spatial facilitation to examine the interactions between the signals conveyed by the corticospinal tract and those of cutaneous afferents in the hindlimb of the intact, walking cat. Microstimulation was applied to 20 cortical sites in the hindlimb representation of the motor cortex and to three different cutaneous nerves innervating the hindpaw in four cats. Conditioning stimuli to the motor cortex induced both facilitation and depression of cutaneous reflexes evoked by stimulation of nerves in the hindlimb contralateral to the cortical stimulation site. Facilitation was most frequently evoked by conditioning stimuli in the range of 10-30 ms before the cutaneous stimulation; depression was normally evoked by shorter and longer conditioning delays. Similar changes were observed after conditioning stimuli to the pyramidal tract, suggesting that the changes were independent of any changes in cortical excitability. Modulation of reflex activity varied according to the muscle under study, the cutaneous nerve used to evoke the reflex and the cortical site used to condition the reflex. Together, these results suggest that there is spatial convergence of corticospinal and cutaneous afferent activity and that this convergence is mediated by distinct subpopulations of spinal interneurons.

Tonic differential supraspinal modulation of PAD and PAH of segmental and ascending intraspinal collaterals of single group I muscle afferents in the cat spinal cord

We compared in the anesthetized cat the effects of reversible spinalization by cold block on primary afferent depolarization (PAD) and primary afferent hyperpolarization (PAH) elicited in pairs of intraspinal collaterals of single group I afferents from the gastrocnemius nerve, one of the pairs ending in the L3 segment, around the Clarke's column nuclei, and the other in the L6 segment within the intermediate zone. PAD in each collateral was estimated by independent computer-controlled measurement of the intraspinal current required to maintain a constant probability of antidromic firing. The results indicate that the segmental and ascending collaterals of individual afferents are subjected to a tonic PAD of descending origin affecting in a differential manner the excitatory and inhibitory actions of cutaneous and joint afferents on the pathways mediating the PAD of group I fibers. The PAD-mediating networks appear to function as distributed systems whose output will be determined by the balance of the segmental and supraspinal influences received at that moment. It is suggested that the descending differential modulation of PAD enables the intraspinal arborizations of the muscle afferents to function as dynamic systems, in which information transmitted to segmental reflex pathways and to Clarke's column neurons by common sources can be decoupled by sensory and descending inputs, and funneled to specific targets according to the motor tasks to be performed.

Selectivity of the central control of sensory information in the mammalian spinal cord

Afferent feedback from muscle proprioceptors, as well as movement-induced activation of skin receptors plays an important role in the patterning of motor activity for stepping and postural control. An important component in this control is the presynaptic GABAergic modulation of the synaptic effectiveness of muscle and cutaneous afferents, known to change in phase with the locomotor cycle, during the execution of voluntary movements, or after a peripheral nerve injury. Recent electrophysiological studies, together with ultrastructural observations, indicate that the distribution of GABAa synapses in the intraspinal arborizations of muscle spindle and tendon organ afferents is not homogeneous. Namely, that some collaterals are the targets of one, or more, GABAergic interneurones, while other collaterals of the same fibre receive no GABAergic connections. In addition, both PAD and inhibition of PAD have a local character. This allows, at least in principle, decoupling the information arising from common sensory inputs. A spatially restricted modulation of PAD could play a significant role in the adjustment of the synaptic effectiveness of Ia afferents at the onset of voluntary contractions in humans, during movement-induced stimulation of the skin, or during the compensation of motor activity following partial denervation of muscles. Changes in the synchronization of the PAD-mediating interneurones can also have a profound effect on the information transmitted by a given set of afferent fibres. Data are presented that in the anesthetized cat, variation in the spontaneous activity of a population of dorsal horn neurones in laminae III-VI, that respond to stimulation of low-threshold cutaneous afferents, produce correlated fluctuations of monosynaptic reflexes by means of pre- and postsynaptic mechanisms. It is suggested that correlated changes in the level of PAD can also play a significant role in the presynaptic adjustment of the synaptic effectiveness of the afferent fibres during specific motor tasks.

Sensory rhizotomy for the treatment of childhood spasticity

Sensory rhizotomy in the treatment of spasticity has been evolving over the past century since its first use in 1888. This paper reviews its historical evolution, current physiologic basis, range in current surgical technique, and the outcome, along with complications seen over the past decade since its repopularization.

Raphe magnus and reticulospinal actions on primary afferent depolarization of group I muscle afferents in the cat

1. In the anaesthetized cat, electrical stimulation of the bulbar reticular formation produced a short latency (2.1 +/- 0.3 ms) positive potential in the cord dorsum. In contrast, stimulation of the nucleus raphe magnus with strengths below 50 microA evoked a slow negative potential with a mean latency of 5.5 +/- 0.6 ms that persisted after sectioning the contralateral pyramid and was abolished by sectioning the ipsilateral dorsolateral funiculus. 2. The field potentials evoked by stimulation of the bulbar reticular formation and of the nucleus raphe magnus had a different intraspinal distribution, suggesting activation of different sets of segmental interneurones. 3. Stimulation of these two supraspinal nuclei produced primary afferent depolarization (PAD) in single Ib fibres and inhibited the PAD elicited by group I volleys in single Ia fibres. The inhibition of the PAD of Ia fibres produced by reticulospinal and raphespinal inputs appears to be exerted on different interneurones along the PAD pathway. 4. It is concluded that, although reticulospinal and raphespinal pathways have similar inhibitory effects on PAD of Ia fibres, and similar excitatory effects on the PAD of Ib fibres, their actions are conveyed by partly independent pathways. This would allow their separate involvement in the control of posture and movement.

Subjective pain sensation is linearly correlated with the flexion reflex in man

In an attempt to define the relationship between physiological and psychological correlates of pain during low-level voluntary contraction, electrical stimuli between threshold and maximally tolerable intensities were delivered to the sole of the foot in 7 normal subjects. The two measures used to assess the response magnitude are: (1) the flexion reflex (FR) in the ipsilateral biceps femoris (BF), and (2) the estimate of perceived intensity reported on a visual analog scale (VAS). Our results showed that both BF FR area and VAS ratings bore a direct linear relationship with stimulus intensity and with each other, suggesting that at least under our paradigm, the sensory component of a nociceptive stimulus may already be largely set at the spinal interneuronal level.

Adrenergic and opioidergic modulation of a spinal reflex in the decerebrated rabbit

1. In the decerebrated and spinalized rabbit, electrical stimulation of the sural nerve evokes a short-latency reflex in the ipsilateral ankle extensor gastrocnemius medialis (GM) which is tonically suppressed by endogenous opioids. In the present study we have investigated the inhibitory influences affecting this reflex in non-spinalized, decerebrated rabbits. 2. In non-spinalized rabbits, the thresholds and latencies of the sural-GM reflex were significantly higher than in spinalized preparations. The opioid antagonist naloxone and the alpha-adrenoceptor antagonist idazoxan potentiated the reflex in both preparations. Naloxone was significantly more effective in spinalized rabbits whereas idazoxan had a much larger effect in non-spinalized animals. 3. When the spinal cord was sectioned in the presence of naloxone alone, the GM reflex always increased in size. An ipsilateral hemisection of the cord was as effective as total section in this respect. When the section was performed in the presence of idazoxan and naloxone, the response usually decreased in size. 4. The alpha 2-adrenoceptor agonist clonidine depressed the reflex in spinalized rabbits, an action that was reversed by idazoxan but not by naloxone. 5. These data show that in the decerebrated, non-spinalized rabbit, the sural-GM reflex is tonically suppressed by endogenous opioids, presumably acting at the segmental level, and by an ipsilateral descending pathway which involves an alpha-adrenoceptor-mediated synapse. Activity in this descending pathway masks the facilitatory effects of opioid antagonists on spinal reflexes in this preparation.

Reflex pathways from group II muscle afferents. 3. Secondary spindle afferents and the FRA: a new hypothesis

A hypothesis is forwarded regarding the role of secondary spindle afferents and the FRA (flexor reflex afferents) in motor control. The hypothesis is based on evidence (cf. Lundberg et al. 1987a, b) summarized in 9 introductory paragraphs. Group II excitation. It is postulated that subsets of excitatory group II interneurones (transmitting disynaptic group II excitation to motoneurones) may be used by the brain to mediate motor commands. It is assumed that the brain selects subsets of interneurones with convergence of secondary afferents from muscles whose activity is required for the movement. During movements depending on coactivation of static gamma-motoneurones impulses in secondary afferents may servo-control transmission to alpha-motoneurones at an interneuronal level. The large group II unitary EPSPs in interneurones are taken to indicate that, given an adequate interneuronal excitability, impulses in single secondary afferents may fire the interneurone and produce EPSPs in motoneurones; interneuronal transmission would then be equivalent to that in a monosynaptic pathway but with impulses from different muscles combining into one line. It is postulated that impulses in the FRA are evoked by the active movements and that the role of the multisensory convergence from the FRA onto the group II interneurones is to provide the high background excitability which allows the secondary spindle afferents to operate as outlined above. The working hypothesis is put forward that a movement governed by the excitatory group II interneurones is initiated by descending activation of these interneurones, but is maintained in a later phase by the combined effect of FRA activity evoked by the movement and by spindle secondaries activated by descending activation of static gamma-motoneurones. As in the original "follow up length servo" hypothesis (Rossi 1927; Merton 1953), we assume that a movement at least in a certain phase can be governed from the brain solely or mainly via static gamma-motoneurones. However, our hypothesis implies that the excitatory group II reflex connexions have a strength which does not allow transmission to motoneurones at rest and that the increase in the gain of transmission during an active movement is supplied by the movement itself. Group II inhibition. It is suggested that the inhibitory reflex pathways like the excitatory ones have subsets of interneurones with limited group II convergence. When higher centres utilize a subset of excitatory group II interneurones to evoke a given movement, there may mobilize inhibitory subsets to inhibit muscles not required in the movement.(ABSTRACT TRUNCATED AT 400 WORDS)

The corticomotoneuronal component of the pyramidal tract: corticomotoneuronal connections and functions in primates

Corticomotoneuronal fibers make up a functional component of the pyramidal tract-corticospinal system which is characteristic of primates. The corticomotoneuronal fibers include large, rapidly conducting axons. They arise from somatotopically arranged areas of precentral cortex and the largest concentration of pyramidal cells of origin in the deep part of lamina V is in area 4. Their influence is exerted contralaterally on the spinal cord, where monosynaptic excitation of spinal motoneurons occurs. Motoneurons innervating distally acting muscles are preferentially excited and marked convergence of corticomotoneuronal influences occurs on these. The excitatory post-synaptic potentials in these motoneurons are characterized by the property of temporal facilitation. Intraspinal divergence of the terminal arborizations of individual corticomotoneuronal fibers could permit the engagement of large populations of motoneurons and also the activation of excitatory and inhibitory interneurons and propriospinal neurons for that region of the spinal cord. Corticomotoneuronal synapses may be located more distally on the dendrites of motoneurons than are the monosynaptic connections from group Ia afferents. The corticomotoneuronal excitation has been demonstrated to be effective in natural functional states when the conscious animal is performing learned movement tasks. Abolition of corticomotoneuronal influences causes a permanent deficit in the fractionation of use of distal muscles and an inability to carry out independent movements of the fingers.

Concussive head injury producing suppression of sensory transmission within the lumbar spinal cord in cats

This study examines the effects of concussive levels of a fluid-percussion head injury on sensory transmission within the lumbar spinal cord of the cat. Primary afferent depolarization (PAD) was suppressed for 2 to 5 minutes following injury, as assessed by dorsal root potentials and augmentation of antidromic dorsal root potentials, both evoked by stimulation of adjacent dorsal roots. Polysynaptic reflex discharges in ventral root potentials evoked by dorsal root stimulation were also profoundly suppressed during this same period, even when spontaneous and monosynaptic reflex discharges were facilitated. Changes in PAD produced by injury were abolished by spinal cord transection, but were not affected by midpontine transection. These findings suggest that concussive head injury can produce suppression of segmental sensory transmission by neurally mediated processes involving the bulbar brain stem. Recordings of dorsal root resting potentials, antidromic dorsal root potentials, and reductions of antidromic dorsal root potentials induced by tetanic root stimulation indicated that depressed segmental sensory function produced by injury was due to suppression of postsynaptic interneuronal transmission rather than to excitability changes in primary afferent fibers. Somatosensory cortical potentials evoked by dorsal root stimulation were profoundly depressed at the same time as segmental sensory transmission was suppressed, suggesting that suppressed segmental sensory transmission may also contribute to suppression of ascending sensory transmission. It is hypothesized that transmission failure of interneuronal systems in the initial period following insult may be a general response occurring in wide areas of the central nervous system, and not restricted to areas to which mechanical stress is directly applied. This response pattern may result from indiscriminate activation of interconnected excitatory and inhibitory elements of interneuronal systems.

Organization of corticospinal neurons in the monkey

The retrograde axonal transport method has been employed to identify the cell bodies of cortical neurons projecting directly to the spinal cord in the monkey. The investigation has focused on aspects of the laminar, columnar, and somatotopic organization of corticospinal neurons within each of the cytoarchitectural and functional subdivisions of the sensorimotor cortex. The principle findings of these experiments are that: i) cortical regions containing cell bodies of corticospinal neurons are the first motor cortex (area 4), the first somatic sensory cortex (areas 3a, 3b, 1, and 2), and part of the immediately adjacent posterior parietal cortex (area 5), the second somatic sensory cortex, the supplementary motor cortex (the medial aspect of area 6), and the medial part of the posterior parietal cortex in a region termed the supplementary sensory area; ii) corticospinal neurons display a somatotopic organization within each of these functional subdivisions of the sensorimotor cortex; iii) all corticospinal neurons arise from layer V of the cortex; and iv) corticospinal neurons within the first motor and first somatic sensory cortex often occur in clusters, perhaps reflecting a columnar organization in the sensorimotor cortex. These findings demonstrate the origins of the corticospinal system to be more extensive than previously recognized and show that a number of common features characterize the organization of corticospinal neurons in all cortical areas. Across cortical subdivisions, however, major differences exist in the extent of spinal segmental representations, in the manner in which corticospinal neurons occur in groups, and in the numerical density and sizes of corticospinal neurons. These aspects of the organization of the corticospinal system presumably reflect specialization of the different cortical areas in spinal cord sensory and motor control.

Morphine and supraspinal inhibition of spinal neurones: evidence that morphine decreases tonic descending inhibition in the anaesthetized cat

1 A study was made in cats anaesthetized with barbiturate or alpha-chloralose, of the excitation of dorsal horn neurones by impulses in unmyelinated (C) primary afferent fibres of the tibial nerve. 2 Block of conduction in the first lumbar segment by cooling produced large increases in the number of action potentials evoked by C fibre afferents in neurones of more caudal segments. 3 Morphine (0.3 to 1.0 mg/kg) reduced the excitation of neurones by C fibre afferents and also reduced the increase produced by blocking conduction in the spinal cord. Naloxone (0.1 to 0.3 mg/kg) reversed these effects of morphine. 4 This decrease in descending inhibition supports findings in the decerebrate cat but gives no support to the hypothesis that an important component of morphine analgesia is an activation of descending inhibitory pathways.

Organization of corticospinal neurons in the cat

The cells of origin of the corticospinal tract of the cat were identified using the retrograde horseradish peroxidase (HRP) labeling technique. Cortical neurons labeled from the spinal cord were confined to layer V and included large Betz cells, as well as many smaller neurons of this layer. Collections of 5-10 labeled neurons concentrated in areas of 300-500 micrometer diameter were observed, suggesting a columnar-type of organization of corticospinal neurons. Injections of HRP into different spinal segments were used to determine the somatotopic distribution of corticospinal neurons. Cortical neurons projecting to the cervical spinal enlargement were found in the lateral hemisphere, with more caudal spinal levels being represented successively more medial. There appeared to be little, if any, overlap in the distributions of neurons labeled from the cervical versus the lumbosacral spinal cord. Neurons projecting to the spinal enlargements were most abundant in the primary area 4, motor cortex (MI), but substantial populations of neurons were located in each of the subfields, areas 3a, 3b, 1 and 2, of the primary somatic sensory cortex (SI), plus area 2 pre-insularis of the second somatic sensory region (SII), and area 5 of the suprasylvian gyrus. This suggested, in view of the differences in inputs and response properties of neurons in these cortical regions, that the corticospinal projections from the different areas could represent multiple, independent functions in spinal cord sensory and motor control. The soma diameters of HRP-labeled corticospinal neurons varied widely, with a distinct, large-celled (Betz-type) and a small-celled population being present in the area 4 motor cortex. The largest labeled neurons of the somatic sensory cortical areas were intermediate in size. Three types of corticospinal neurons may exist, corresponding to the giant pyramidal (Betz) cells, the largest pyramidal neurons of the somatic sensory regions, and the abundant, smaller pyramidal cells which are found throughout the sensory and motor cortical fields.

The crossed extensor hallucis response in neurological disorders; an electromyographic analysis

The electromyographic activity in several leg muscles during the elicitation of "the crossed up-going toe sign" (CUT) was studied in patients and compared with that obtained in connection with the Babinski sign and in normal subjects. The results indicate that the patterns of activation and the responsible pathways are different for the CUT and Babinski signs. The difference between the normal subjects and the CUT positive patient is a matter of quantitative difference of coactivation of distal leg muscles during the test procedure rather than a change of reflex patterns.

Laying the ghost of 'muscles versus movements'

It is certainly a mark of great wisdom to the organizer of this meeting to have chosen Charles Phillips as our Guest Lecturer for this meeting.

Whilst I am grateful for this opportunity of saying a few words of introduction, I am sure it can be said of Charles Phillips that very little introduction is necessary, since we meet him at the most important meetings in Neurophysiology around the world. Any meeting on the motor system, of course, is not complete without the participation of Dr. Phillips. However, some of the less old-timers than myself, and the students, might be interested in the beginnings of Dr. Phillips’ career in neurophysiology and to know that he was first a clinical neurologist beginning his medical studies in Oxford just before the war, where he came under the influence of Sir Charles Sherrington with Jack Eccles as his tutor.

Effects on the ventral spinocerebellar tract neurones from Deiters' nucleus and the medial longitudinal fascicle in the cat

Effects from the vestibulospinal tract (VST) and from fibres descending in the medial longitudinal fascicle (MLF) on the cells of origin of the ventral spinocerebellar tract (VSCT) have been studied with intracellular recording. Out of 110 VSCT neurones, the VST evoked monosynaptic EPSPs in 27, di- or polysynaptic EPSPs in 56 and disynaptic IPSPs in 26. In 93 tested VSCT cells, MLF stimulation evoked monosynaptic EPSPs in 26, monosynaptic IPSPs in 2, di- or polysynaptic EPSPs in 25 and disynaptic IPSPs in 21. Convergence of monosynaptic EPSPs from VST and MLF was found in a small proportion of cells whereas the two descending pathways evoked reciprocal effects in another small group of neurones. Convergence of monosynaptic EPSPs from VST or MLF and from group I afferents was also modest. In 9 VSCT neurones there was convergence of monosynaptic excitation and disynaptic inhibition from the vestibulospinal tract and the same pattern from MLF was recorded in 9 neurones. The results are discussed in view of the hypothesis that VSCT neurones carry information on the interneuronal ttransmission in the spinal cord.

Voluntary and reflex control of the biceps brachii muscle in spastic-athetotic patients

A cross-correlation technique of analysis was used to measure the transmission characteristics of tonic stretch reflex (TSR) pathways in spastic-athetoid subjects sustaining a voluntary contraction in the biceps brachii muscle. A comparison was made with the transmission characteristics of normal subjects measured by the same technique. It was found that gain and phase characteristics of spastic patients did not display the large resonant peaks present in normals. It is proposed that the resonant peaks in the TSR transmission of normal subjects were caused by long loop pathways. The absence of these peaks in the spastic patients supports the hypothesis that short-circuiting of long loop pathways by hyperactive spinal reflexes is part of the mechanism of spasticity.

Blockade of the reticulospinal inhibitory pathway by anaesthetic agents

1. Adult cats were decerebrated at the intercollicular level. The effect of the anaesthetic agents, pentobarbitone, paraldehyde, tribromethanol, chloralose and procaine on the reticulospinal inhibitory pathway, which produced inhibition of segmental reflex potentials, was analysed.2. The doses which blocked this inhibitory pathway did not exceed the doses required to produce surgical level anaesthesia with any of the drugs.3. After the reticular inhibition of the reflex potentials was abolished, the reflex potentials were augmented by reticular stimulation with a higher intensity. This was thought to be due to spread of current to the excitatory pathways which were not completely depressed by the anaesthetic agent.4. The resistance of the reticular facilitation of the reflex potentials to inhibition by these drugs after abolition of inhibition corresponded in general to the degree of excitement in intact mice produced by the same drugs.5. These findings seem to indicate that the preferential block of the reticulospinal inhibitory pathway may be an important neural mechanism for the excitement stage of anaesthesia.

Presynaptic inhibition of the monosynaptic reflex by vibration

In cats, the monosynaptic reflex (MSR) elicited from L7 or S1 dorsal roots, or from the tibial nerve (H reflex) was suppressed by vibration at 50-500 c/s of the hind limb with innervation intact. The MSR was not suppressed by selective vibration of cutaneous receptors, and suppression was still observed after the hind limb was skinned. In contrast, the phenomenon disappeared when all muscle nerves were crushed. SUPPRESSION OF THE MSR BY VIBRATION WAS SHOWN TO BE MEDIATED BY PRESYNAPTIC INHIBITION BY THE FOLLOWING METHODS: correlation with onset of the dorsal root potential (DRP) evoked by vibration, and abolition of both DRP and reflex suppression by picrotoxin; demonstration of primary afferent depolarization and normal excitability of motoneurones to direct stimulation. Reasons are given for deducing that the muscle afferent fibres responsible for the presynaptic inhibition induced by vibration are group Ia rather than groups Ib or II, or afferent fibres from Pacinian corpuscles.

Cord cells responding to fine myelinated afferents from viscera, muscle and skin

1. Micro-electrode recordings were made in the thoracic cord of acute spinal cats. Cells, which were located in the histologically defined lamina 5, responded both to the fine myelinated afferents from the splanchnic nerve and to afferents from the skin. Splanchnic afferents inhibit the effect of converging cutaneous inputs for periods up to 150 msec. Skin stimuli may also inhibit the effect of afferent nerve impulses from viscera. Some cells respond monosynaptically to the splanchnic afferents, others indirectly.2. Fine myelinated afferents from gastrocnemius (group 3) stimulate lamina 5 cells which also have cutaneous receptive fields. Cutaneous and group 3 muscle afferents interact by mutual inhibition in their effect on the cells.3. Fine myelinated afferents from skin excite lamina 5 cells. The cutaneous responses of lamina 5 cells contrast with those of lamina 4 cells in the following respects: (a) the receptive fields are larger, (b) they respond with an increased latency to Abeta afferents, (c) there is a low pressure threshold at the edge, (d) they respond to a wide range of pressure stimuli from light brush to heavy pinch applied to the centre of the receptive fields and (e) they respond to ADelta afferents.4. Lamina 5 cells receive fine myelinated afferents either from viscera or from muscle or from skin. Lamina 4 receives large myelinated afferents from skin and lamina 6 receives large myelinated afferents from muscle. The results suggest the hypothesis that some fine myelinated afferents form a class of afferents which signal the state of tissue, and end on lamina 5 cells.