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Biomedical subjects

G A Horstmann

Publications and source records attributed to G A Horstmann.

33 records · Page 2Linked to original sources

[CT/MRI correlated stereometry with ultrasound in brain surgery].

Today the accuracy of medical imaging systems lies between +/- 0.5 mm (CT) and +/- 2.5 mm (MRI). In neurosurgery the overall uncertainty may reach the dimension centimetres. A non-tactile ultrasonic measurement system is described that allows three-dimensional measurement with a theoretical accuracy of +/- 0.1 mm in a frequency range between 50 and 70 kHz. In practice the accuracy is better than +/- 1 mm with a repetition rate of 10 per second for the x,y,z-data sets.

Angiography, Digital Subtraction↗

Human postural reflexes and gravity--an under water simulation.

This study represents the first attempt to investigate the influence of gravity on postural adjustments. Subjects were displaced while standing under water on a movable platform, while the buoyancy of the body was adjusted by using a variety of lead vests. Under water, an approximately linear relationship was found between body weight and impulse directed electromyographic response amplitudes in the leg and thigh muscles. Loading of the subjects out of water resulted in a saturation of the response amplitude. The biomechanical signals recorded during the displacements indicated that neither vestibulospinal nor muscle proprioceptive reflex mechanisms can account for the effect observed under water. It is suggested that the EMG responses are mediated by reflexes which are activated by pressure receptors within the body in order to hold the centre of gravity over the feet.

Adult↗

Compensation of translational and rotational perturbations in human posture: stabilization of the centre of gravity.

EMG responses in the leg muscles, head acceleration and joint movements induced by dorsiflexing rotation of the ankle have been analysed. Perturbations were induced while subjects were standing on a platform with the ankle joints co-linear with the axis of rotation or while standing above the axis (between 5 and 25 cm), which introduced an additional translational component to the displacement. The former condition was followed by a monosynaptic gastrocnemius reflex potential and a late tibialis anterior activation (latency about 100 ms); in the latter condition the monosynaptic reflex response became smaller and a longer latency gastrocnemius response (latency about 70 ms) appeared, the strength and duration of which increased in parallel with the translational component, while the amplitude of the tibialis anterior activity decreased. Neither vestibulospinal nor muscle proprioceptive mechanisms can solely account for this effect as the biomechanical parameters were little changed in the different conditions. It is suggested that the controlled variable in the investigated task is to hold the bodies' centre of gravity over the feet which makes the change in the pattern meaningful: pure dorsiflexion of the feet is followed by a backwards sway of the body, thus a tibialis anterior activation is functionally essential to hold the centre of gravity over the feet. A backwards translation of the feet withdraws the supporting surface, thus a gastrocnemius activation is needed to restore the centre of gravity over the feet. The inhibition of the monosynaptic reflex with increasing translation is suggested to arise from a reciprocal modulation of mono- and polysynaptic gastrocnemius reflex responses.

Acceleration↗

Significance of proprioceptive mechanisms in the regulation of stance.

Compensatory electromyographic (EMG) responses and several biomechanical parameters were studied following impulsive disturbance of the limbs during stance of human volunteers on a treadmill. Treadmill acceleration impulses were backwards or forwards directed, or their initial direction was reversed after 30 ms. Backwards directed impulses were followed by gastrocnemius, forwards directed ones by tibialis anterior EMG responses (latency 65 to 75 ms) whose durations depended on impulse duration. When the direction of the impulse was reversed, the respective antagonistic leg muscles were activated again with a delay of 68 to 75 ms after onset of stretch of these muscles. The behaviour of the EMG responses could best be correlated to the displacement at the ankle joint and may be described in terms of a stretch reflex response. The results indicate that these stretch reflex responses help control of the body's centre of gravity thereby preventing falling. Head movements induced by the impulses showed little correlation with the appearance of the EMG responses, suggesting that the vestibular system is unlikely to be directly involved in the generation of these responses. Vestibular signals may, however, significantly contribute to slow body sway stabilization.

Adult↗

Perturbations of human posture: influence of impulse modality on EMG responses and cerebral evoked potentials.

Leg muscle EMG responses and cerebral evoked potentials (CP), elicited by perturbations of stance while on a treadmill with split belts, were analyzed in order to study the relationship between compensatory leg muscle responses and afferent input to supraspinal centers. Various conditions of perturbation were used to establish the extent to which compensatory EMG responses and CPs show congruent behavior. Four different treadmill acceleration rates were applied in three different conditions (unilateral perturbation, directed forward or backward; bilateral perturbation, directed forward or backward; and opposing bilateral perturbation). EMG responses and CPs showed parallel increases in amplitude with increasing displacement velocity. The EMG responses showed distinct differences, predominantly in the response amplitude, between the different perturbation conditions, whereas the CPs were affected only to a minor degree. Tibialis anterior EMG responses were more closely related to the CP following forward perturbation than the corresponding gastrocnemius responses were to the CP following backward perturbation. We conclude that the EMG responses are more closely related than the CPs to displacement parameters and suggest that this is due to the further spinal processing of the afferent input needed to generate an appropriate EMG response. The closer relationship between the tibialis anterior response and CP may reflect a predominant central representation and control of tibialis anterior activation in the regulation of posture. The functional implications of these findings are discussed.

Journal Article↗

Interlimb coordination of leg-muscle activation during perturbation of stance in humans.

1. Electromyographic (EMG) responses were recorded in both legs, along with corresponding joint movements, after uni- and bilateral perturbations during stance on a treadmill with split belts. Displacements were directed forward, backward, or in opposing directions. They were induced by randomly timed ramp impulses at one of four different rates of treadmill acceleration. 2. Unilateral perturbations directed backward were followed by a bilateral gastrocnemius-EMG response, forward-directed perturbations by a bilateral tibialis anterior-EMG response. The amplitude of these responses was dependent on the rate of treadmill acceleration. Relative to the response of the displaced leg, the amplitude of the EMG response on the nondisplaced side was smaller when a gastrocnemius EMG response was induced, and about equal when the tibialis anterior muscle was activated. The onset latencies were shorter on the displaced side (displaced leg 75-96 ms, non-displaced leg 93-112 ms). 3. Bilateral perturbations in one direction were followed by larger EMG responses in both legs (in the gastrocnemius for backward-directed impulses, in the tibialis anterior for forward-directed impulses). For a given acceleration rate, their amplitude was about equal to the sum of the EMG amplitude of the displaced leg and that of the nondisplaced leg obtained during unilateral displacement. The inverse result was obtained when the legs were simultaneously displaced in opposite directions: EMG responses in both legs were significantly smaller than those obtained after unilateral displacement. 4. It is concluded that a unilateral displacement evokes reflex EMG responses in the synergistic muscles of both legs, which are graded according to the size of the proprioceptive input from the primarily displaced joint. During bilateral displacements, the activity induced by the respective contralateral leg is linearly summed or subtracted, depending on whether the legs are displaced in the same or in opposite directions. In view of the short latencies of these bilateral responses, it would seem that they are mediated by a spinal mechanism. 5. Distinct differences in the behavior of the antagonistic leg muscles were observed: 1) the coactivation of the contralateral leg muscle was significantly smaller when the gastrocnemius was stretched unilaterally, whereas it was about equal for the tibialis anterior; and 2) the gastrocnemius EMG responses were closely correlated with the displacement velocity, whereas the tibialis anterior response was more closely correlated with acceleration, i.e., the tibialis anterior response was more dynamic in nature.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

The contribution of vestibular input to the stabilization of human posture: a new experimental approach.

An experiment was designed to evaluate the vestibular contribution to the stabilization of upright stance in normals and in two patients with loss of vestibular function. A forward or backward displacement of a load (2 kg) by a torque motor attached to the subject induced opposing movements in the head and trunk. The small linear acceleration of the head in space of about 0.1 g was followed, with a latency of 50-65 ms, by EMG responses in the tibialis anterior and rectus femoris (backward acceleration) or gastrocnemius muscles (forward acceleration). These responses were absent in patients with a vestibular deficit. It is suggested that the observed EMG responses are due to fast acting vestibulospinal reflexes involved in the regulation of upright stance. For comparable head accelerations the integrated EMG responses induced by the vestibulospinal mechanism are about ten times smaller than those induced by spinal stretch reflexes during displacement of the feet. Vestibulospinal reflexes would appear, therefore, to play only a minor role in the compensation of stumbling.

Adult↗

Posture in Parkinson's disease: impairment of reflexes and programming.

The leg muscle electromyographic responses induced during stance by impulsive displacements of a treadmill belt (directed forward or backward and at different rates) were studied in a group of patients with Parkinson's disease and a group of age-matched healthy subjects. Young normal subjects were also studied both before and after intake of a dopamine antagonist (haloperidol). Compensatory gastrocnemius electromyographic responses resulting from backward-directed displacements were significantly smaller in both the patients and the young normal subjects following intake of haloperidol. The reduced sensitivity of the gastrocnemius muscle to stretch correlated with an inability to compensate for the perturbations. In the patients, the gastrocnemius response was followed by enhanced activation of the tibialis anterior muscle. This was not the case in the normal subjects after intake of dopamine antagonist and is probably not, therefore, the consequence of acute dopamine deficiency. In the patients the angular rotation at the ankle joint induced during faster backward-directed displacements was slower than that in normal subjects, despite identical amounts of gastrocnemius electromyographic activity. This supports earlier findings of changes in intrinsic muscle stiffness in Parkinson's disease. None of these differences were seen when the tibialis anterior muscle was stretched. This differential behavior of the antagonist leg muscles can best be explained by the different function fulfilled by these muscles in regulation of stance and gait.

Adult↗

Fast head tilt has only a minor effect on quick compensatory reactions during the regulation of stance and gait.

Sudden tilts of the head to the front or rear were induced during stance, balancing, gait and during perturbations of gait. The most prominent response in the leg muscle electromyogram (e.m.g.) to head tilt occurred in the tibialis anterior muscle (latency about 55 ms) following a backward tilt induced during balancing. During stance and gait, the e.m.g. activity related to head tilt was only a minor component of the leg muscle activity normally occurring during gait. When the head tilt was induced shortly after a perturbation of gait (treadmill acceleration impulse), the compensatory reaction in the leg muscles did not significantly differ from that seen after the gait perturbation alone. In addition, the rate of acceleration of the head was tested against the compensatory e.m.g. responses: No correlation of influence could be discerned. The results indicate that sudden head tilts and the resulting head acceleration have little influence on the e.m.g. patterns that occur during gait and perturbations of gait. It is assumed that these patterns are regulated by central programs, and that the compensation for leg perturbation is achieved mainly by spinal reflex mechanisms. It is discussed whether the lack of head tilt responses is the result of an antagonistic vestibular-neck interaction, or whether it indicates a reduced effectiveness of vestibulo- and cervico-spinal reflexes during gait.

Adult↗

Reproducibility and adaptation of the EMG responses of the lower leg following perturbations of upright stance.

The electromyographic (EMG) response of gastrocnemius, soleus and anterior tibialis muscles to a backwardly directed perturbation of stance was recorded in 12 normal subjects using surface electrodes and studied with regard to its reproducibility (test-retest reliability coefficients, variability coefficients) and to adaptational effects. (1) Reproducibility was shown to be uniformly high and can be interpreted as an index for the high intraindividual constancy of the results. (2) Adaptational effects have been found and should be circumvented, either by pre-adapting the subjects to the motor task, or by restriction of the period of measurement. (3) Variation of the position of the electrodes produced only small effects. The impedance of the surface electrodes was not critical if kept below 5 k omega. EMG investigations with surface electrodes during stance and perturbations of stance provide highly reliable results with respect to intraindividual changes but interindividual variability of the results clearly marks the limits of this method. The interindividual variability observed with surface electrodes is of the same order as that reported in the literature for inserted needle recording.

Adaptation, Physiological↗

Spastic paresis: impaired spinal reflexes and intact motor programs.

Leg muscle EMG responses evoked by short treadmill acceleration impulses applied during stance were analysed in patients with spastic hemiparesis. The compensatory reactions on the unaffected side consisted of a diphasic pattern of leg muscle activation. The first response could best be described as a polysynaptic spinal stretch reflex response. This response was absent on the spastic side, except for its later, declining component. This remainder of the first response and the following activation of the antagonistic muscle was identical on both the unaffected and the spastic side. This part of the pattern is assumed to be centrally programmed (at the spinal level) and triggered by the termination of the acceleration impulse.

Adolescent↗

Micro-stereometry: a frameless computerized navigating system for open microsurgery.

We are introducing a new type of ultrasonic-based three dimensional (3D) ranging system for the localization of small hand-held surgical tools to be used during operation in open and stereotactic brain surgery. The new device has been extensively tested in the laboratory and showed a linear localization accuracy of +/- .4 mm. The calibration of the system is automatically done by an active calibration frame as well as by pointing to fiducial markers. The position of the tool is sent to a visualization unit and overlaid in realtime on preoperatively scanned computed tomography (CT) and magnetic resonance imaging (MRI) pictures. First clinical tests showed the improved accuracy, handling, and versatility of the new stereometric navigation system, which will soon become the backbone of a computer-aided surgery (CAS) system with a variety of locatable tools.

Brain↗

Body sway stabilization in human posture.

Electromyographic (emg) responses and joint movements of the leg were analysed in subjects standing with eyes closed on a sinusoidally moving treadmill (0.16 Hz or 0.33 Hz, amplitude 33 cm). Activity in antagonistic leg muscles was reciprocally modulated, with a predominant gastrocnemius activation during deceleration of forward movement and tibialis anterior activation during deceleration of backward movement of the treadmill. In these phases, it was necessary to compensate for sway induced by body inertia. The match between treadmill movement and emg activity was better for the gastrocnemius than for the tibialis anterior muscle. The characteristic pattern of leg muscle emg activity is suggested to be modulated predominantly by vestibulo-spinal reflexes partly because treadmill movements did not evoke muscle strength, and partly because patients with loss of vestibular function showed basic alterations in the emg pattern and could only compensate for the slow sinus while standing unsupported.

Adult↗