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Biomedical subjects

Jane E Butler

Publications and source records attributed to Jane E Butler.

28 records · Page 2Linked to original sources

Reflex inhibition of human inspiratory muscles in response to contralateral phrenic nerve stimulation.

In animals, high-intensity unilateral stimulation of the phrenic nerve results in short-latency inhibition of phrenic and intercostal nerve activity bilaterally. This study provides the first demonstration in human subjects of a short-latency inhibitory response in the contralateral scalene, parasternal intercostal and diaphragm muscles to single stimuli delivered at cervical level to the phrenic nerve. Electromyographic (EMG) responses were recorded with intramuscular and surface electrodes. An inhibitory response with an onset latency of approximately 35 ms followed by a long-latency excitatory response at approximately 100 ms were observed in the three inspiratory muscles. The inhibition was evident in single trials, averaged EMG, histograms of the discharge of single motor units, and even when the phrenic nerve stimulus intensity was relatively low. Thus, the inhibition may be mediated by large-diameter muscle afferents. The latency of this potent inhibitory response to contralateral phrenic nerve stimulation is too long to be mediated via a simple spinal circuit and may involve a brainstem projection.

Adult↗

Depression of activity in the corticospinal pathway during human motor behavior after strong voluntary contractions.

The corticospinal system plays an important role in control of voluntary movements in primates. Recently, we demonstrated that the effectiveness of this system is depressed after maximal exercise. Because the depression was absent after antidromic activation of the motoneurons, we argued that transmission across corticospinal synapses was involved. Here, we explore the possible functional consequences of such a depression. In humans, direct electrical stimulation of axons of corticospinal neurons at the cervicomedullary level evokes motor potentials in elbow flexor muscles. When tested during relaxation after a maximal voluntary contraction (MVC) of the elbow flexors, potentials in biceps brachii and brachioradialis were depressed for approximately 90 sec. The potentials were also depressed, although less markedly, when tested during a weak elbow flexion. Brief intermittent MVCs abolished the depression transiently, but during the intervening periods of relaxation, the depression appeared similar to that during continuous relaxation. The depression was greatest during relaxation after a 10 sec MVC and smaller after submaximal contractions. To look for effects of the depression on voluntary activity, we compared bilateral matching weak elbow flexions. After a conditioning 10 sec maximal elbow flexion of one arm, the electromyographic activity produced on that side was reduced relative to the activity on the contralateral side. Our findings support the view that synapses in the corticospinal system are depressed after strong voluntary contractions during both relaxation and activity. Furthermore, this depression can affect the production of voluntary movement.

Arm↗

Facilitation of triceps brachii muscle contraction by tendon vibration after chronic cervical spinal cord injury.

One way to improve the weak triceps brachii voluntary forces of people with chronic cervical spinal cord injury may be to excite the paralyzed or submaximally activated fraction of muscle. Here we examined whether elbow extensor force was enhanced by vibration (80 Hz) of the triceps or biceps brachii tendons at rest and during maximum isometric voluntary contractions (MVCs) of the elbow extensors performed by spinal cord-injured subjects. The mean +/- SE elbow extensor MVC force was 22 +/- 17.5 N (range: 0-23% control force, n = 11 muscles). Supramaximal radial nerve stimuli delivered during elbow extensor MVCs evoked force in six muscles that could be stimulated selectively, suggesting potential for force improvement. Biceps vibration at rest always evoked a tonic vibration reflex in biceps, but extension force did not improve with biceps vibration during triceps MVCs. Triceps vibration induced a tonic vibration reflex at rest in one-half of the triceps muscles tested. Elbow extensor MVC force (when >1% of control force) was enhanced by vibration of the triceps tendon in one-half of the muscles. Thus triceps, but not biceps, brachii tendon vibration increases the contraction strength of some partially paralyzed triceps brachii muscles.

Adult↗

The history of contraction of the wrist flexors can change cortical excitability.

Voluntary contractions induce thixotropic changes in intrafusal muscle fibres and hence, by induction or removal of "slack", the background discharge and sensitivity of spindle endings to stretch is altered. This study assessed whether such changes also altered the "excitability" of the motor cortex. Eleven subjects performed a series of voluntary conditioning contractions of the wrist flexors designed to remove slack in the intrafusal fibres (contract and test at intermediate length, termed "contract-test") or to introduce slack (contract at long length and test at intermediate length, termed "contract-long"). Surface electromyographic recordings were made from one wrist flexor, flexor carpi radialis. Subjects relaxed after each contraction, and 10 s later a test stimulus was applied to elicit a tendon tap response, H-reflex, or motor-evoked potential (MEP) to transcranial magnetic stimulation in the flexor carpi radialis. Each of the three test stimuli was applied during 15 consecutive pairs of contractions ("contract-long" and "contract-test"). Three subjects repeated the protocol using transmastoid electrical stimulation as the test stimulus to evoke a cervicomedullary motor-evoked potential (CMEP). For the group of subjects, after conditioning contractions designed to induce slack there was a significant reduction in the amplitude of the tendon reflex, no significant change in the H-reflex, and a small but significant reduction in the amplitude of the MEP. In one subject the CMEP was significantly reduced, while it was unchanged in two others. In the absence of corresponding changes in the H-reflex (or CMEP), changes in the size of the response to motor cortical stimulation suggest that the level of motor cortical "excitability" changes according to naturally induced variations in the discharge of muscle spindle afferents.

Electromyography↗

Fatigue of paralyzed and control thenar muscles induced by variable or constant frequency stimulation.

Muscles paralyzed by chronic (>1 yr) spinal cord injury fatigue readily. Our aim was to evaluate whether the fatigability of paralyzed thenar muscles (n = 10) could be reduced by the repeated delivery of variable versus constant frequency pulse trains. Fatigue was induced in four ways. Intermittent supramaximal median nerve stimulation (300-ms-duration trains) was delivered at 1) constant high frequency (13 pulses at 40 Hz each second for 2 min); 2) variable high frequency (each second for 2 min). The first two intervals of each variable frequency train were 5 and 20 ms. The remaining pulses were evenly distributed in time across 275 ms. The number of pulses varied for each subject such that the force time integral in the unfatigued state matched that evoked by a constant 40-Hz train; 3) constant low frequency (7 pulses at 20 Hz each second for 4 min); and 4) variable low frequency (each second for 4 min). The pulse pattern was the same as that for variable high frequency except that the force-time integral was matched to that produced by the constant low-frequency stimulation. These same experiments were performed on the thenar muscles of five able-bodied control subjects. The variable high-frequency trains used to fatigue paralyzed and control muscles had an average (+/- SE) of 12 +/- 2 and 10 +/- 1 pulses, respectively. Variable low-frequency trains had 7 +/- 1 and 6 +/- 1 pulses, respectively. Significant mean force declines of comparable magnitude (to 20-25% initial fatigue force or to 13-21% initial 50 Hz force) were seen in paralyzed muscles with all four stimulation protocols. The force reductions in paralyzed muscles were always accompanied by significant increases in half-relaxation time and decreases in force-time integral, irrespective of the stimulation protocol. Significant force decreases also occurred in control muscles during each fatigue test. Again, these force declines were similar whether constant or variable pulse patterns were used at high or low frequencies (to 40-60% initial fatigue force or to 29-36% initial 50 Hz force). The force reductions in control muscles were significantly less than those seen in paralyzed muscles, except when constant high-frequency stimulation was used. The variations in stimulation frequency, pulse pattern, and pulse number used in this study therefore had little influence on thenar muscle fatigue in control subjects or in spinal cord-injured subjects with chronic paralysis.

Adult↗

Effects of sustained stimulation on the excitability of motoneurons innervating paralyzed and control muscles.

The excitability of thenar motoneurons (reflected by F-wave persistence and amplitude) and thenar muscle force were measured during a stimulation protocol (90 s of 18-Hz supramaximal electrical stimulation of the median nerve) designed to induce muscle fatigue (force decline). Data from muscles (n = 15) paralyzed by chronic cervical spinal cord injury were compared with those obtained from control muscles (n = 6). The persistence of F waves in both paralyzed and control muscles increased from approximately 60 to approximately 76% during the first 10 s of the fatigue protocol. Persistence then declined progressively to approximately 33% at 90 s. These changes in F-wave persistence suggest that similar reductions occur in the excitability of the motoneurons to paralyzed and control motor units after sustained antidromic activation. Despite this, significantly larger force declines occurred in the paralyzed muscles of spinal cord-injured subjects (approximately 60%) than in the muscles of control subjects (approximately 15%). These data suggest that the decreases in motoneuron excitability for both the spinal cord-injured and control subjects are a result of activity-dependent changes in motoneuron properties that are independent of fatigue-related processes in the muscles.

Adult↗

Interaction of transcranial magnetic stimulation and electrical transmastoid stimulation in human subjects.

Transcranial magnetic stimulation activates corticospinal neurones directly and transsynaptically and hence, activates motoneurones and results in a response in the muscle. Transmastoid stimulation results in a similar muscle response through activation of axons in the spinal cord. This study was designed to determine whether the two stimuli activate the same descending axons. Responses to transcranial magnetic stimuli paired with electrical transmastoid stimuli were examined in biceps brachii in human subjects. Twelve interstimulus intervals (ISIs) from -6 ms (magnet before transmastoid) to 5 ms were investigated. When responses to the individual stimuli were set at 10-15 % of the maximal M-wave, responses to the paired stimuli were larger than expected at ISIs of -6 and -5 ms but were reduced in size at ISIs of -2 to 1 ms and at 3 to 5 ms. With individual responses of 3-5 % of maximal M-wave, facilitation still occurred at ISIs of -6 and -5 ms and depression of the paired response at ISIs of 0, 1, 4 and 5 ms. The interaction of the response to transmastoid stimulation with the multiple descending volleys elicited by magnetic stimulation of the cortex is complex. However, depression of the response to the paired stimuli at short ISIs is consistent with an occlusive interaction in which an antidromic volley evoked by the transmastoid stimulus collides with and annihilates descending action potentials evoked by the transcranial magnetic stimulus. Thus, it is consistent with the two stimuli activating some of the same corticospinal axons.

Adult↗

Differential fatigue of paralyzed thenar muscles by stimuli of different intensities.

Muscles paralyzed by injury or disease fatigue excessively when stimulated. This study examined whether the first few paralyzed thenar motor units recruited by electrical stimulation of the median nerve were more fatigue resistant than the total thenar motor unit population. The paralyzed thenar muscles of four subjects with chronic cervical spinal cord injury were fatigued by a 2-min intermittent 40-HZ protocol on 2 days. One experiment involved submaximal stimulation, the other supramaximal stimulation. These stimuli resulted in activation of part and all of the thenar muscles, respectively. Relative force loss, force-time integral decline, and slowing of half-relaxation time were always significantly less when only part rather than all of the muscles was fatigued. The part of the paralyzed muscles that was activated was also relatively fatigue resistant compared with control single thenar motor units. Thus, a reversal of recruitment order from fatigable to fatigue-resistant units cannot explain the extreme fatigability of paralyzed muscles. Use of submaximal stimulation during functional electrical stimulation may therefore help to reduce muscle fatigue because it recruits the more fatigue-resistant units.

Adult↗

Patterns of pathological firing in human motor units.

Modulation of motor unit firing rates can change muscle force production. Motor unit firing rates are often reduced during voluntary contractions of muscles influenced by disorders such as stroke or multiple sclerosis, while higher firing rates are typical of muscles innervated by a reduced number of motoneurones. An expanded range of motor unit firing rates is characteristic of disorders in which damage to various systems and neurons occur. Most neuromuscular disorders result in an increase in motor unit discharge variability, in part due to a higher incidence of doublets. In spinal cord injured subjects, long lasting involuntary contractions are common. This activity may reflect persistent inward currents that are revealed due to a lack of (voluntary) inhibition. Some of these changes in motor unit behaviour may actually work to enhance muscle force rather than to reduce it.

Electrophysiology↗

Corticospinal transmission after voluntary contractions.

Transmastoid stimulation in human subjects evokes a single descending volley in corticospinal axons. Electromyographic (EMG) responses to transmastoid stimuli measured in the relaxed elbow flexor muscles after a maximal voluntary contraction (MVC) are depressed by approximately 50% compared to prior to the MVC. The depression recovers over 2 min. Responses can also be depressed in the relaxed muscle after submaximal contractions and when measured during weak contractions after an MVC. The depression may reflect a decrease in efficacy at the corticospinal-motoneuronal synapse. If so, an activity-dependent decrease in the effectiveness of cortical drive to the motoneurones could affect the control of many voluntary movements.

Elbow↗