Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-18T00:57:16.368Z Has data issue: false hasContentIssue false

A Comparison of Methods to Assess the Excitability of Lower Motoneurones

Published online by Cambridge University Press:  18 September 2015

Ivan G. Milanov*
Affiliation:
Institute of Neurology, Psychiatry and Neurosurgery, Bulgarian Medical Academy, Sofia
*
Institute of Neurology, Psychiatry & Neurosurgery, Bui. “Lenin” – IV km. Sofia 1113, Bulgaria
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The purpose of this investigation was to compare three methods of assessing the excitability of lower motoneurones—TA-reflex, H-reflex and F-wave—in 120 patients with spastic hemiparesis following a stroke. The H-reflex was recorded from the soleus muscle after submaximal electrostimulation of the tibial nerve. The T-Achilles (TA) reflex was recorded from the soleus muscle after percussion of the Achilles tendon. The F-wave was recorded in the distal limb muscles after supramaximal electrostimulation of the median, ulnar, fibular and tibial nerves. The patient’s healthy side was used as a control. The TA-reflex, H-reflex and F-wave showed increased amplitudes on the spastic side. All amplitude ratios: TA/M, H/M, Fmax/M and Fmean/M were increased. The H-reflex thresholds were decreased. The F-wave duration, persistence and number of phases were also increased on the spastic side. Despite clinically decreased muscle tone, there were no changes in TA or H-reflex parameters after treatment. On the other hand, F-wave parameters tended to normalize after treatment in all groups. In conclusion, the F-wave is a more sensitive method than the TA and H-reflexes in assessing the excitability of the lower motoneurone.

Type
Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

References

1. Diamantopoulos, E, Olsen, PZ.Excitability of motor neurons in spinal shock in man. J Neurol Neurosurg Psychiatry 1967; 30: 427431.CrossRefGoogle ScholarPubMed
2. Matthews, WB.Ratio of maximum H-reflex to maximum M-response as a measure of spasticity. J Neurol Neurosurg Psychiatry 1966; 29: 201204.CrossRefGoogle ScholarPubMed
3. Davies, TW.Definition of human reflex excitability by statistical analysis of quantal EMG responses. Brain Res 1984; 293: 386389.CrossRefGoogle Scholar
4. Hugon, M.Methodology of the Hoffmann reflex in man. In: Desmedí, JE, ed. New Developments in Electromyography and Clinical Neurophysiology. Basel: Karger, 1973; 277293.Google Scholar
5. Magladery, JW, McDougal, DB.Electrophysiological studies of nerve and reflex activity in normal man. I. Identification of certain reflexes in electromyogram and the conduction velocity of peripheral nerve fibres. Bull Johns Hopkins Hosp 1950; 86: 265290.Google Scholar
6. Dawson, GD, Merton, PA.“Recurrent” discharges from motoneurones. Abstracts 2nd International Congress of Physiological Sciences, Bruxelles 1956; 221222.Google Scholar
7. Gassel, MM, Marchiafava, PL, Pompeiano, O.Modulation of the recurrent discharge of alpha motoneurons in decerebrate and spinal cats. Arch Ital Biol 1965; 103: 114.Google ScholarPubMed
8. Schiller, HH, Staolberg, E.F-responses studied with single fibre EMG in normal subjects and spastic patients. J Neurol Neurosurg Psychiatry 1978; 41: 4553.CrossRefGoogle ScholarPubMed
9. Wong, PKH, Verrier, M, Ashby, P.The effect of vibration on the F-wave in normal man. Electromyogr Clin Neurophysiol 1977; 17: 319329.Google ScholarPubMed
10. Fisher, MA, Shahani, BT, Young, RR.Quantitative assessment of excitability at segmental levels of the central nervous system caudal to acute lesions. Neurology 1076; 26: 366367.Google Scholar
11. Fisher, MA, Shahani, BT, Young, RR.Assessing segmental excitability after acute rostral lesions. I. The F-response. Neurology (NY) 1978; 28: 12651271.CrossRefGoogle ScholarPubMed
12. Delwaide, PJ.Electrophysiological analysis of the mode of action of muscle relaxants in spasticity. Ann Neurol 1985; 17: 9095.CrossRefGoogle ScholarPubMed
13. Fisher, MA, Penn, RD.Evidence for changes in segmental motoneurone pools by chronic cerebellar stimulation and its clinical significance. J Neurol Neurosurg Psychiatry 1978; 41: 630635.CrossRefGoogle ScholarPubMed
14. McLellan, DL.Effect of Baclofen upon monosynaptic and tonic vibration reflexes in patients with spasticity. J Neurol Neurosurg Psychiatry 1973; 36: 555560.CrossRefGoogle ScholarPubMed
15. Knutsson, E, Lindblom, U, Martensson, A.Differences in effects on gamma and alpha spasticity induced by the GABA derivative Baclofen (Lioresal). Brain 1973; 96: 2946.CrossRefGoogle ScholarPubMed
16. Eisen, A, Odusote, K.Amplitude of the F-wave: a potential means of documenting spasticity. Neurology (NY) 1979; 29: 13061309.CrossRefGoogle ScholarPubMed
17. Liberson, WT, Chen, LCY, Fok, SK, et al. “H”-reflexes and “F”- waves in hémiplégies. Electromyogr Clin Neurophysiol 1977; 17: 247264.Google Scholar
18. Fisher, MA.F-response analysis of motor disorders of central origin. J Neurol Sci 1983; 62: 1322.CrossRefGoogle ScholarPubMed
19. Fisher, MA.F/M ratios in polyneuropathy and spastic hyperreflexia. Muscle & Nerve 1988; 2: 217222.CrossRefGoogle Scholar
20. Basmajian, JV, Shankardass, K, Russel, D, et al. Treatment for spasticity: double blind study of a new drug. Arch Phys Med Rehabil 1984; 65:698701.Google ScholarPubMed
21. Lossius, R, Dietrichson, P, Lunde, PKM.Effect of diazepam and desmethyldiazepam on spasticity and rigidity. A quantitative study of reflexes and plasma concentrations. Acta Neurol Scand 1980; 61:378383.CrossRefGoogle ScholarPubMed
22. Wiesendanger, M, Chapman, CE, Macpherson, J, et al. Neurophysiological investigations of tizanidine. In: Conrad, B, Benecke, R, Bauer, HJ, eds. Die Klinische Wertung der Spastizitat. Stuttgart: FK Schattauer Verlag, 1984; 3955.Google Scholar
23. Lapierre, Y, Bonchard, S, Tansey, C, et al. Treatment of spasticity with tizanidine in multiple sclerosis. Can J Neurol Sci 1987; 14: 513517.CrossRefGoogle ScholarPubMed
24. Sica, REP, Bronstein, A.Changes in the excitability of segmental motoneurone pools by chronic cerebellar dentate nucleus stimulation. Electromyogr Clin Neurophysiol 1984; 24: 163176.Google Scholar
25. McLellan, DL, Selwyn, M.Time course of clinical and physiological effects of stimulation of the cerebellar surface in patients with spasticity. J Neurol Neurosurg Psychiatry 1978; 41: 150160.CrossRefGoogle ScholarPubMed
26. Minitrijevic, MR, Illis, LS, Nakajima, K, et al. Spinal cord stimulation for the control of spasticity in patients with chronic spinal cord injury: II. Neurophysiological observations. CNS Trauma 1986; 3: 145152.Google Scholar
27. Nakamura, S.Evaluation of spinal cord stimulation for post-apoplectic spastic hemiplegia. Neurosurgery 1985; 17: 253259.CrossRefGoogle Scholar
28. Davidoff, RA.Effects of Baclofen on synaptic activity in the spinal cord. In: Feldman, RG, Young, RR, Koella, WP, eds. Spasticity: Disordered Motor Control. Chicago: Year Book Medical Publishers, 1980; 335344.Google Scholar
29. Duncan, GW, Shahani, BT, Young, RR.An evaluation of Baclofen treatment for certain symptoms in patients with spinal cord lesions. Neurology 1976; 26: 441446.CrossRefGoogle ScholarPubMed
30. Schmidt, HT, Lee, RH, Spehlmann, R.Comparison of dantrolene sodium and diazepam in the treatment of spasticity. J Neurol Neurosurg Psychiatry 1976; 39: 350356.CrossRefGoogle ScholarPubMed
31. Cioni, B, Meglio, M, Zamponi, A.Effect of spinal cord stimulation on motor performances in hémiplégies. Stereotact Funct Neurosurgery 1989; 52: 4255.CrossRefGoogle Scholar
32. Crayton, JW, King, S.Inter-individual variability of the H-reflex in normal subjects. Electromyogr Clin Neurophysiol 1981; 21: 183200.Google ScholarPubMed
33. Peioglou-Harmoussi, S, Howel, D, Fawcett, PRW, et al. F-response behaviour in a control population. J Neurol Neurosurg Psychiatry 1985; 48: 11521158.Google Scholar
34. Hoang, D.Acupuncture therapy for paralysis due to stroke and multiple sclerosis. Am J Acupuncture 1981; 9: 129138.Google Scholar
35. Stux, G.Efficacy of acupuncture in spastic disorders of skeletal muscle. Am J Acupuncture 1979; 2: 167169.Google Scholar
36. Burke, D, Hammond, C, Skuse, N, et al. A phenothiazine derivative in the treatment of spasticity. J Neurol Neurosurg Psychiatry 1975; 38: 469474.CrossRefGoogle ScholarPubMed
37. Jones, RF, Burke, D, Marosszeky, JE, et al. A new agent for the control of spasticity. J Neurol Neurosurg Psychiatry 1970; 33: 464468.CrossRefGoogle ScholarPubMed
38. Bishop, B.Machover, S, Johnston, R, et al. A quantitative assessment of gamma-motoneuron contribution to the Achilles tendon reflex in normal subjects. Arch Phys Med Rehabil 1986; 49: 145154.Google Scholar
39. Stam, J, Tan, KM.Tendon reflex variability and method of stimulation. Electroencephalogr Clin Neurophysiol 1987; 67: 463467.CrossRefGoogle ScholarPubMed
40. Winer, BJ.Statistical principles in experimental design. London: McGram-Hill 1970; 672.Google Scholar
41. Potts, FA, Shahani, BT, Young, RR.F-response amplitude and its relationship to the motor unit. Neurology (NY) 1981; 31: 66.Google Scholar
42. Delwaide, PJ.Human monosynaptic reflexes and presynaptic inhibition. In: Desmedt, JE, ed. New Developments in Electromyography and Clinical Neurophysiology. Basel: Karger, 1973; 508522.Google Scholar