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Biomedical subjects

F Awiszus

Publications and source records attributed to F Awiszus.

At least 19 recordsLinked to original sources

Characterization of human joint proprioception by means of a threshold hunting paradigm.

A method has been developed to measure the proprioceptive performance of movement detection in human joints, with the threshold hunting paradigm commonly used in other sensory modalities. Methods applied in former studies regarding movement detection were very time consuming (hours), making them not applicable to patients. Using the threshold hunting paradigm, the subject changes the parameter value continuously around the threshold producing a threshold hunting curve, which itself might be valuable for investigation of movement detection performance. The method presented here, is very quick compared to other studies in this field, especially when velocity is hunted and the threshold values are very low. The threshold parameter value is stable since there is a control at any time over the subject's stimulus perception. Furthermore, a Monte Carlo simulation showed that hunting curves can clearly be distinguished from guessing. Also reliability is given. All these points allow to use the method to evaluate the proprioceptive performance of a single individual. Considering the results, the method described may be useful for basic and clinical investigations regarding the proprioceptive performance limits of movement detection aspects.

Adult

[Influence of retropatellar arthrosis on the proprioceptive ability of patients with gonarthrosis].

Degenerative changes of the retropatellar articular surface contribute to a great extent to functional disability in patients with osteoarthritic knees. Therefore, in the present study we examined the influence of retropatellar osteoarthritis (OA) on proprioception in patients with knee OA. Comparison of movement sense determined by threshold levels for the perception of knee motion was performed in 10 patients with severe, in 10 patients with moderate, and in 9 patients with mild retropatellar OA. In addition, detection failures occurring during movement sense measurements were analysed. At correct movement detections, threshold levels did not differ between the three groups of patients regardless the extent of retropatellar OA. In contrast, analysis of detection failures occurring during movement sense measurements revealed significantly higher failure rates with greater severity of retropatellar OA. In conclusion, our study gives evidence for increased proprioceptive deficits with greater severity of retropatellar articular surface damage. Hereby, analysis of detection failures occurring during movement sense measurements proved to be a feasible tool for the assessment of proprioceptive deficits.

Humans

[Measuring knee joint kinesthesis for determining proprioceptive deficits in varus gonarthrosis].

Studying knee osteoarthrosis proprioceptive deficits play a growing role. However, the methods for the detection of these deficits using joint position sense measurements have been criticized recently. Therefore, we developed a new method for the measurement of knee-joint kinaesthesia. At 5 different angular velocities of passive knee movement both movement and stop detection were tested. Tests were performed both in 25 patients with osteoarthrosis of the knee and in a control group of 20 age related normal subjects. In addition to the measurements of movement detection and stop-detection thresholds, a specific detection-failure analysis was performed in our study. In addition to a significant improvement of proprioceptive abilities with increasing angular velocities, detection failure analysis brought about significant differences between patients with knee osteoarthrosis and normal subjects yielding a significant proprioceptive deficit in osteoarthrosis of the knee. In contrast, in case of correct movement detection or stop-detection there were no significant differences in the detection-threshold values between normal and ostheoarthrotic knees. In conclusion, both the lack of differences in detection thresholds between the arthrosis and the control-groups and the increased detection failure rates in arthrosis patients gave evidence for these proprioceptive differences being a result of central nervous dysregulation in knee osteoarthrosis.

Humans

[Intraoperative monitoring of the function of the peroneal nerve in knee joint operations].

Operations on the knee are known to be associated with postoperative neurological complications. There is no consensus opinion on the causes of these complications. The aim of the present study was to develop a method for the intraoperative monitoring of the function of the common peroneal nerve. This was done as to identify intraoperative factors that might be responsible for reversible and irreversible neurological deficits. Computer-aided neuromonitoring is based on online digitizing of the surface EMG of the anterior tibial muscle. An algorithm continuously modifies the amplitude to determine the motor threshold. The method described has been used in 18 patients undergoing high tibial osteotomy. In 10 of the 18 patients, the nerve is rendered completely non-excitable after an average tourniquet application time of 59 min. This non-excitability was reversed on release of the tourniquet. In the remaining 8 patients, excitability was maintained throughout the ischaemic period, which did not exceed 60 minutes in any of the cases. Our method enables accurate quantification of the neural function throughout the entire operation, and convincingly documents the influence of ischaemia on peripheral nerve block.

Electromyography

[Intraoperative computer-assisted measurement of stimulation threshold of the common peroneal nerve in osteotomy of the head of the tibia].

Using a computer-assisted threshold hunting paradigm the motoric threshold of the common peroneal nerve was monitored in 18 patients during a high tibial osteotomy (HTO). The exposed nerve (lateral approach) was stimulated proximal to the osteotomy area and the surface EMG of the M. tibialis anterior was used to guide a threshold hunting device. Motoric threshold as a sensitive indicator of nerve function was found to be almost unaffected by several surgical steps of HTO. Only forceful rotation of a subperiostal Hohmann device during high peroneal osteotomy evoked a slight threshold shift that was fully reversible with device repositioning. The tourniquet, however, affected the threshold significantly. In 10 of the 18 patients the nerve became completely inexcitable after an average time of 59 min. The inexcitability was reversible after opening of the tourniquet. On the other hand, the eight patients maintaining an excitability throughout the entire ischemic period had tourniquet times that did not exceed 60 min. There are several factors that may be responsible for the observed inexcitability after long ischemic periods and we conclude that tourniquet time minimization appears appropriate to avoid neurological deficits during a high tibial osteotomy.

Adult

Spike train analysis.

Procedures for the analysis of stimulus-correlated spike train data are reviewed. All procedures considered attempt to extract excitability changes evoked by the stimulus at the neuron investigated. The methods covered range from rather simple methods that require very little computational effort (raw spike train displays; peri-stimulus-time histogram (PSTH)) to more sophisticated procedures that attempt to extract all information available in the recorded spike-train data.

Action Potentials

Influence of stimulus cross talk on results of the twitch-interpolation technique at the biceps brachii muscle.

Biceps brachii muscles of five healthy volunteers were tested with a high-resolution twitch-interpolation technique. Parameters of the electrical surface stimulation were varied. It was found that a supramaximal stimulus strength activates both biceps and triceps brachii motor units simultaneously severely affecting twitch-interpolation results. Crosstalk contamination of twitches, however, can be avoided, if submaximal stimuli are used yielding twitch-interpolation results for the biceps-brachii that are similar to those of the quadriceps muscle.

Adult

[Use of automatic, computer-assisted EEG analysis in clinical practice].

Digital EEG-recorders are being increasingly accepted for clinical routine application, thereby offering the possibility for an automated computerised EEG evaluation. This paper presents the results of a corresponding computer programme developed in our group. Based on 313 clinical routine-EEG we compared the computer reports to the visual EEG-interpretations and obtained the following result: Background activity is reliably detected with a rate comparable to a human interpreter. Similar results were observed with focussed pathological activity. Intermittent activity (Parenrhythmia, dysrhythmia) however lacks a sufficiently high score of correct evaluation and requires further development. Epileptiform potentials, especially spikes, are detected with high sensitivity, however, at the cost of low specificity, and are therefore still in need of further improvement.

Cerebral Cortex

Comparison of single motor unit responses to transcranial magnetic and peroneal nerve stimulation in the tibialis anterior muscle of patients with amyotrophic lateral sclerosis.

Responses of single tibialis anterior motor units to transcranial magnetic stimulation and to a synchronized Ia volley evoked by peripheral nerve electrical stimulation were obtained in amyotrophic lateral sclerosis (ALS) patients and normal controls. Whereas the units of normal subjects exhibited rather stereotyped short-latency spike density peaks in response to both types of stimulus, the responses of ALS patient units were much less uniform. All ALS patient units exhibited a response to the synchronized Ia volley indistinguishable from that of normal subjects, indicating that the investigated spinal motoneurons are capable of normal excitatory responses in ALS patients. More than half of the ALS patient units responded to the transcranial magnetic stimulus with prolonged spike-density peaks appearing at a latency consistent with the notion that these pathological peaks are evoked by some relatively hyperexcitable structures presynaptic to the corticomotoneurons.

Adult

Repetitive activity of a branched Hodgkin-Huxley axon with multiple encoding sites.

Afferent activity in a receptor afferent fiber with several encoding sites is generally believed to represent the activity of the fastest pacemaker that resets all more slowly encoding sites. Alternatively, some impulse mixing as well as some nonlinear summation of receptor current to a single encoder have been considered. In this article the repetitive firing activity of a Hodgkin-Huxley axon consisting of two branches that join into a single stem axon was investigated. The model axon was stimulated by constant-current injection into either the right or the left or both branches. It was found that the model axon generated an (infinite) train of action potentials if the input current was large enough. The discharge frequency found was constant, and on combined stimulation of both branches with different current, the site of impulse initiation was always in the branch receiving the higher input current, excluding a simple impulse mixing. On the other hand, the combined stimulation of both branches evoked repetitive firing with a higher frequency than expected by the pacemaker-resetting hypothesis. Moreover, a stimulus that is subthreshold for repetitive firing if injected into one branch yields repetitive firing when it is injected into both branches, a behavior inconsistent with impulse mixing and pacemaker resetting. On the other hand, current injection into one branch allowed repetitive activity only within a rather limited range of firing frequencies. Using distributed current injection into both branches, however, allowed many more different firing frequencies. Such behavior is inconsistent with both pacemaker resetting and (nonlinear) input current summation. Consequently, the repetitive firing behavior of a branched Hodgkin-Huxley axon with multiple encoding sites appears to be more complex than postulated in the simple hypotheses.

Action Potentials

Correlations between size parameters and the amplitude of the excitatory postsynaptic potential evoked by magnetic brain stimulation in human hand muscle motoneurons.

According to the size principle for motoneurons one would expect that an excitatory stimulus given to a motoneuronal pool should evoke small excitatory postsynaptic potentials (EPSPs) in large and large EPSPs in small motoneurons of the pool. In this study this expectation was tested for the motoneuron pool of the first dorsal interosseus muscle of man excited by a magnetic stimulus given to the contralateral motor cortex. In total, 60 first dorsal interosseus motor units from three healthy volunteers were investigated. For each unit the EPSP size induced by the magnetic brain stimulus was assessed indirectly through a cross correlation of magnetic brain stimuli with motor unit discharges during a slight voluntary contraction. In addition to the indirect measurement of EPSP size, three indicators of motoneuronal size were obtained for each unit: the area the macroelectromyogram (Macro EMG) of the unit encloses with the baseline, the peak-to-peak amplitude of the Macro EMG, and the "true" latency from the magnetic stimulus to the motor unit which in turn provides an indirect estimate for the conduction velocity of the motoneuronal axon. It was found that all three measures of motoneuron size were significantly negatively correlated with the estimates of EPSP amplitude. Such significant negative correlations were found not only in the pooled data but also in the data from each subject individually. These correlations reveal that a magnetic brain stimulus induces small EPSPs in large and large EPSPs in small motoneurons of the first dorsal interosseus muscle of man.

Adult

Quantification of D- and I-wave effects evoked by transcranial magnetic brain stimulation on the tibialis anterior motoneuron pool in man.

Transcranial stimulation in man evokes multiple descending volleys in the spinal cord giving rise to multiple subpeaks in a peri-stimulus-time histogram (PSTH) obtained from a cross-correlation of motor unit discharges with transcranial stimuli. The first volley is termed the D wave, as it is assumed to be evoked by direct excitation of pyramidal tract neurons, whereas the subsequent I waves appear to be generated by indirect excitation of the pyramidal tract neurons via cortical interneurons. It was the aim of this study to obtain an estimate of the effect induced by multiple volleys evoked by transcranial magnetic stimulation on the entire motoneuron pool of the tibialis anterior in awake subjects. A considerable part of a particular motoneuron pool was investigated by sampling responses of a large number (at least 19) from each muscle investigated. In total, three tibialis anterior muscles from three normal volunteers were studied. From each of the 63 units included in this study, a PSTH to 100 transcranial magnetic stimuli and a PSTH to 100 electrical stimuli given to the peroneal nerve were compiled. From the motor unit response to the peripheral nerve stimulation, the latency of the single-unit H reflex peak was obtained. This yielded, the timing of the subpeaks in response to the magnetic stimulation relative to the timing of the H reflex of the same unit, thus eliminating the influence of the peripheral conduction time from the motoneuron to the recording electrode. It was found that 50 (79%) of the motor units exhibited at least two subpeaks in response to the cortical stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Subdivision of primary afferents from passive cat muscle spindles based on a single slow-adaptation parameter.

38 primary afferents originating from de-efferented cat tibialis anterior muscle spindles were investigated. Ramp-and-hold stretches of the host muscle were performed with a varying amount of muscle pre-stretch while recording the primary afferent discharges. From the discharge responses an interspike interval function was estimated. This revealed a slow adaptation during the hold phase of stretch which could be approximated quite well by a power function. The slow-adaptation power function exponent (SAE) was found to be rather independent of the amount of pre-stretch applied to the host muscle and grouped around a value characteristic for each afferent. These 'characteristic SAEs' showed a clearly bimodal distribution within the population of primaries studied. Moreover, the distribution around both modes was narrow enough to justify the subdivision of the primary afferents according to their characteristic SAE as either high-SAE (10 afferents; 26%) or low-SAE (28 afferents; 74%) afferents. The most likely explanation for this bimodality of slow-adaptation behavior in primary afferents is given by the assumption that the afferent discharge of the passive spindle is mainly provided from a branch innervating either the bag1 (for high-SAE units) or the bag2 and chain (for low-SAE units) intrafusal fibers.

Action Potentials

Sensitivity of different stimulus-timing strategies for the detection of small excitations in noisy spike train data.

There are several different strategies to control the timing of a stimulus with respect to the ongoing discharge during the recording of neuronal stimulus-response characteristics. One possible strategy consists of delivering stimuli in such a way that a constant pre-stimulus spike density is reached. Another strategy enforces spike application with a constant stimulus latency after a spontaneous discharge. In this paper the sensitivity of these different strategies for statistical verification of small excitatory response components was investigated. It was found that the difference between observed post-stimulus spike distribution and expected spike distribution under the null hypothesis of no stimulus effect was larger using a constant-stimulus-latency (CSL) strategy with an appropriate value for the stimulus latency. Thus, the statistical verification of neuronal response components is clearly facilitated if a CSL strategy is used. This superiority of the CSL strategy is marked, especially for small excitations at neurons discharging slowly with low discharge variability.

Action Potentials

Quantification and statistical verification of neuronal stimulus responses from noisy spike train data.

Usually neuronal responses to short-lasting stimuli are displayed as peri-stimulus time histogram. The function estimated by such a histogram allows to obtain informations about stimulus-induced postsynaptic events as long as the interpretation is restricted to the first response component after the stimulus. The interpretation of secondary response components is much more difficult, as they may be either due to stimulus effects or represent an "echo" of the primary response. In the present paper two output functions are developed that do not show such an echoing of responses. The first one, the interspike interval change function, represents an ideal way to quantify a neuronal stimulus response as its amplitude was found to be almost independent of the stimulation strategy used during acquisition of the spike train data. The other function, the displaced impulses function, allows to verify the statistical significance of an observed response component. Both functions may be estimated from stimulus-correlated spike train data, even if the neuron under investigation shows considerable interspike-interval variability in the absence of stimulation. The concepts underlying these neuronal output functions are developed on simulated responses of a Hodgkin-Huxley-type model for a mammalian neuron at body temperature that is exposed to a transient excitatory conductance increase. Additionally, estimation of these output functions is also demonstrated on responses of human soleus motoneurons that were exposed to electrical stimuli of the tibial nerve in the popliteal fossa.

Action Potentials

The relationship between estimates of Ia-EPSP amplitude and conduction velocity in human soleus motoneurons.

There are several parameters associated with motoneuron size, among which are the conduction velocity of the axon as well as the size of the excitatory postsynaptic potential (EPSP) induced by stimulation of Ia afferents in the corresponding muscle nerve. In particular, it has been established in animal experiments that small motoneurons with a low conduction velocity exhibit large Ia EPSPs, whereas large motoneurons with a high conduction velocity show small Ia EPSPs. Thus small motoneurons are recruited earlier than large ones. In this study, we investigated whether such a relationship between motoaxon conduction velocity and size of the Ia EPSPs could also be found for human soleus motoneurons. In total, 36 motor units from six healthy volunteers were activated by a slight voluntary contraction and exposed to 200 stimuli of the tibial nerve in the popliteal fossa. Stimuli were delivered using a special stimulus protocol ensuring a constant pre-stimulus spike density along with a constant rate of discharge of the investigated unit. From the stimulus-correlated spike train data a measure of Ia-EPSP amplitude was obtained, along with the single-unit H-reflex latency. Additionally, for each unit, the so-called surface macro EMG was recorded, which measures the complete electrical activity attributable to the unit investigated. From the macro EMB, the intramuscular delay from arrival of each action potential at the soleus muscle and the detection of the muscle-fiber action potential picked up by the recording needle electrode were measured. All single-unit H-reflex latencies were corrected for the corresponding intramuscular delays. From the corrected latencies, single-unit conduction velocities were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Abnormal EPSPs evoked by magnetic brain stimulation in hand muscle motoneurons of patients with amyotrophic lateral sclerosis.

Using cross-correlation between magnetic brain stimulation and discharges of a motoneuron made active by a slight voluntary contraction, an indirect estimate of the EPSP evoked by magnetic brain stimulation in single hand muscle motoneurons was obtained in patients with amyotrophic lateral sclerosis (ALS) and normal controls. In total, 60 motoneurons of 3 normal subjects and 70 motoneurons of 7 patients with ALS were investigated. All motoneurons of normal subjects responded to the magnetic brain stimulus with a short-latency EPSP with a rise time between 1 and 5 msec. In contrast, only 67% of the motoneurons from ALS patients responded with an EPSP while the remaining 33% exhibited a clear short-latency inhibition in response to the brain stimulus. For those units of ALS patients showing an EPSP, both latency and EPSP amplitude were indistinguishable from those of normal subjects. The EPSP rise time, however, was massively prolonged in some units (up to 18 msec). These results provide a physiological basis for the interpretation of surface EMG responses in patients with ALS.

Action Potentials

Reduction of a Hodgkin-Huxley-type model for a mammalian neuron at body temperature.

Hodgkin-Huxley-type models mimic the electrical behavior of excitable membranes quite realistically. However, inclusion of many different ionic channels into such a model yields a highly complex set of differential equations. In this paper a reduction of a "full" Hodgkin-Huxley-type model based on voltage-clamp data from small rat neurons in the supraoptic nucleus area is introduced. It was found that two of the ionic channel gating variables of the full model preserved a rather close relationship during simulations. This allowed to express one of these gating variables in terms of the other one thus reducing the number of differential equations the model is based on. The behavior of the reduced model was very similar to that of the full model. In particular, important physiological features as spike shape and constant-input-to-interspike-interval relationship were (almost) identical in the full and the reduced model.

Animals