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Biomedical subjects

P Bawa

Publications and source records attributed to P Bawa.

At least 19 recordsLinked to original sources
PubMed2004

Bilateral responses of upper limb muscles to transcranial magnetic stimulation in human subjects.

Anatomical and behavioural work on primates has shown bilateral innervation of axial and proximal limb muscles, and contralateral control of distal limb muscles. The following study examined if a clear boundary exists between the distal and proximal upper limb muscles that are controlled contralaterally or bilaterally. The right motor cortical area representing the upper limb was stimulated, while surface EMG was recorded bilaterally from various upper limb muscles during rest and phasic voluntary contractions. Peak-to-peak amplitude of motor evoked potential (MEP) was measured for each muscle on both sides. The ratio R = (ipsilateral MEP: contralateral MEP) was calculated for seven pairs of muscles. For each of the seven pairs, R was less than 1.0, implying that for each muscle and subject, the contralateral control is stronger. The boundary where R changed from almost zero to a clearly measurable magnitude depended on the subject. Ipsilateral MEPs from trapezius and pectoralis could be recorded with a small background contraction from almost all subjects; on the other hand, in deltoid and biceps brachii, ipsilateral MEPs were observed only with bimanual phasic contractions. The forearm and hand muscles, in general, did not show any ipsilateral MEPs. Major differences between subjects lay in the presence or the absence of ipsilateral MEPs in biceps brachii and deltoid, without defining a sharp boundary between proximal and distal muscles.

Adult↗
PubMed2003

Properties of human motor units after prolonged activity at a constant firing rate.

The primary purpose of this study was to examine if there are changes in the intrinsic properties of spinal motoneurons after prolonged submaximal contractions. To do this, we assessed whether or not the synaptic drive to motoneurons needs to increase in order to maintain a constant firing rate of a motor unit. Recruitment of new units and an increase in total electromyographic (EMG) activity of the muscle of interest were taken as estimates of an increase in synaptic drive. Subjects were asked to maintain a constant firing rate of a clearly identifiable (targeted) motor unit from the first dorsal interosseous muscle for approximately 10 min, while surface EMG and force were recorded simultaneously. For the 60 units studied, the duration of the constant-firing-rate period ranged from 73 to 1,140 s (448 +/- 227 s; mean +/- SD). There was a significant increase ( t-test, p<0.001) in the magnitude of mean surface EMG, and DC force while the targeted motoneuron maintained a constant rate suggesting an increase in the net excitatory input to the motoneuron pool. Changes occurring simultaneously in other parameters, namely, variability in interspike interval, magnitude of force fluctuations, the duration of motor unit action potentials, and the median power frequency of surface EMG were also computed. The firing rates of 16 concurrently firing motoneurons, not controlled by the subject, remained constant. The key finding of this study is that after prolonged activity, a motoneuron requires a stronger excitatory input to maintain its firing rate. Additional results are indicative of significant changes in the characteristics of the synaptic inputs, changes at the neuromuscular junction (both pre- and postsynaptic regions) and the sarcolemma.

Action Potentials↗
PubMed2002

Responses of ankle extensor and flexor motoneurons to transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) of the motor cortex excites limb muscles of the contralateral side of the body. Reports of poorly defined, or a complete lack of systematic excitatory responses of soleus motoneurons compared with those of tibialis anterior (TA) motoneurons has led to the proposal that while all ankle flexor motoneurons receive strong corticomotoneuronal connections, very few soleus motoneurons do. In addition, the connections to these few motoneurons are weak. The nature of corticomotoneuronal connections onto these two motoneuron pools was re-evaluated in the following experiments. The leg area of the left motor cortex was stimulated with a large double-cone coil using Magstim 200, while surface electromyographic (EMG) and single motor unit (SMU) responses were recorded from soleus and TA muscles of healthy adult subjects. Under resting conditions, the onset (25-30 ms) and duration of concomitantly recorded short latency motor evoked potentials (MEPs) in surface EMG from both muscles were similar. The input-output relationships of the simultaneously recorded soleus and TA EMG responses showed much greater increases in TA MEPs compared with soleus MEPs with identical increases in stimulus intensity. Under resting and nonisometric conditions, a later peak with onset latency of approximately 100 ms was observed in soleus. During isometric conditions or with vibration of the TA tendon, the second soleus peak was abolished indicating reflex origin of this peak. Recordings from 42 soleus and 39 TA motor units showed clear response peaks in the peristimulus time histograms (PSTHs) of every unit. Two statistical tests were done to determine the onset and duration of response peaks in the PSTHs. With chi(2) test, the duration was 6.9 +/- 4.2 ms (mean +/- SD) for soleus and 5.1 +/- 2.1 ms for TA. Using the criterion of discerning a peak by bin counts being three SDs above background, the duration was 10.0 +/- 4.4 ms for soleus and 7.8 +/- 2.6 ms for TA. Results of these experiments do not suggest a lack of systematic corticomotoneuronal connections on soleus motoneurons when compared with those on TA, though some differences in the strengths of corticomotoneuronal connections onto the two pools do exist.

Adult↗
PubMed2001

Motor unit recruitment during lengthening contractions of human wrist flexors.

The purpose of this study was to revisit the question of recruitment of motor units during lengthening contractions because of conflicting views in the literature on this subject. Motor unit activity was recorded from the flexor carpi radialis muscle of four human subjects to compare the patterns of recruitment during lengthening and isometric contractions. Lengthening contractions were produced either when the subject voluntarily stopped opposing a background load or when an additional load was imposed on the already contracting muscle. In both cases, lengthening of the active muscle was produced at a variety of speeds, from quite slow to "as fast as possible." No differences in recruitment order were observed between isometric and lengthening contractions at any speed of lengthening contraction. It is concluded that all contractions in normal humans recruit motor units in an orderly fashion from small to large, according to the size principle of motor unit recruitment.

Adult↗
PubMed2000

Control of the wrist joint in humans.

As one considers changes in motor activity from lower mammals to higher primates, one of the major changes one observes lies in the cortical control of forelimb muscles. There has been a shift from disynaptic control of spinal motoneurons in, for example, the cat, to a greater and greater percentage of monosynaptic control of hand and forelimb motoneurons in the primate. In spite of the species and evolutionary changes in the synaptic connections of the corticospinal tract, it appears that the interneurons identified in the cat are retained in the monkey and human. These interneurons, under the influence of descending pathways, modulate the output of motoneuron pools. Perhaps the control of these interneurons has also changed towards finer control of movement, as has been suggested by recent studies in the monkey. Whether in cat or human, the recruitment pattern for motor units is the same; the change from disynaptic to monosynaptic connections has not changed the recruitment pattern of muscles. Differences in the recruitment patterns of muscles may lie in the finer control of inputs to motoneurons in the primate. This review seeks to integrate the current knowledge of the mechanisms involved in the motor control of the wrist joint and especially in the recruitment patterns of the muscles. These motor control mechanisms include the biomechanics of the wrist joint, recruitment patterns of wrist muscles, interneurons and spinal cord circuits in the cervical regions mediating the output of spinal motoneurons, and the supraspinal control of these muscles.

Biomechanical Phenomena↗
PubMed1999

Comparison of the depression of H-reflexes following previous activation in upper and lower limb muscles in human subjects.

When conditioning-testing (C-T) stimuli are applied to Ia afferents to elicit H-reflexes, the test reflex is abolished immediately following the conditioning reflex. As the C-T interval is increased, the test response slowly begins to recover, taking several hundred milliseconds to attain control values. The time course of this recovery is known as the H-reflex recovery curve. H-reflex recovery curves were compared using surface EMG and single motor unit activities in lower limb soleus and upper limb flexor carpi radialis (FCR) muscles in seven healthy human subjects. Under rest conditions, the recovery of H-reflexes and single motor unit activity was slow for soleus; the recovery was not complete even in 1 s. In comparison, the recovery was very fast for FCR motor units, occurring in 200-300 ms. The effects of rate of stimulation (0.1-10.0 imp/s) were also examined on the magnitude of H-reflex responses. The reflex response declined with increasing rate of stimulation, the decline being slightly greater in soleus than in FCR. When these phenomena were examined with voluntary facilitation of the spinal cord, the time of recovery shortened and the effect of stimulus rate also diminished. Changes with background facilitation were greater in FCR than in soleus. The differences between the two muscles are attributed mainly to differences in presynaptic inhibition in the two spinal segments, and/or to the differences in dynamics of the transmitter release in terminals of Ia afferents synapsing with slow soleus motoneurons and those synapsing with the fast FCR motoneurons.

Adult↗
PubMed1999

Reduced short and long latency reflexes during voluntary tracking movement of the human wrist joint.

In six healthy human subjects we compared changes in the strength of Hoffmann (H), short latency (30-55 ms) and long latency (55-100 ms) stretch reflexes of flexor carpi radialis (FCR) muscle during movement and isometric contractions. In one set of experiments, stretches were imposed to the wrist during voluntarily tracked sinusoidal movement and during matched isometric contractions to compare short and long latency stretch reflex responses. In the second set, H-reflexes were compared during similar matched conditions. All reflexes decreased significantly (P < 0.05) during the voluntary tracking movement. The H-reflex was reduced during the wrist flexion, on average, by 33% of its value obtained during the isometric condition. Compared with their values during isometric conditions, the short latency stretch reflex and long latency stretch reflex during movement were reduced by 52 and 40%, respectively. From the pattern changes of the stretch reflexes and the H-reflex, a movement-induced presynaptic inhibition combined with pronounced muscle spindle unloading is proposed to play an important role in decreasing the strength of the stretch reflexes during the tracking task as compared with a matched isometric contraction.

Adult↗
PubMed1997

Synaptic connections from large afferents of wrist flexor and extensor muscles to synergistic motoneurones in man.

Short-latency excitatory Ia reflex connections were determined between pairs of human wrist flexor and extensor muscles. Spindle Ia afferents were stimulated by either tendon tap or electrical stimulation. The activity of voluntarily activated single motor units was recorded intramuscularly from pairs of wrist flexor or extensor muscles. Cross-correlation between stimuli and the discharge of the motor units provided a measure of the homonymous or heteronymous excitatory input to a motoneurone. Homonymous motoneurone facilitation was generally stronger than that of the heteronymous motoneurones. The principal wrist flexors, flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU), were tightly connected through a bidirectional short-latency reflex pathway. In contrast, the extensor carpi ulnaris (ECU) and the extensor carpi radialis (ECR) did not have similar connections. ECU motoneurones received no short-latency excitatory Ia input from the ECR. ECR motoneurones did receive excitatory Ia input from ECU Ia afferents; however, its latency was delayed by several milliseconds compared with other heteronymous Ia excitatory effects observed. The wrist and finger extensors were linked through heteronymous Ia excitatory reflexes. The reflex connections observed in humans are largely similar to those observed in the cat, with the exception of heteronymous effects from the ECU to the ECR and from the extensor digitorum communis (EDC) to the ECU, which are present only in humans. The differences in the reflex organization of the wrist flexors versus the extensors probably reflects the importance of grasping.

Adult↗
PubMed1997

Omeprazole for severe reflux esophagitis in children.

BACKGROUND: Severe esophagitis is a rare complication of gastroesophageal reflux in children. In adults, omeprazole therapy of severe erosive esophagitis has become the gold standard short-term treatment of the disease. In children, data on its use are limited, and problems about the dosage are unresolved. The aim of this study was to evaluate the efficacy of a simplified, body-weight-based daily dosage of omeprazole in children with severe esophagitis. METHODS: Ten children (median age 75.6 months; range 25-109 months) with severe esophagitis were prospectively investigated. All patients were evaluated by endoscopy, histology, and 24-h pH-metry study before and after 3 months of omeprazole. The starting dose of omeprazole was 20 mg as a single daily dose in children weighing less than 30 kg, and 40 mg daily for those weighing over 30 kg. RESULTS: A significant improvement in all the children was demonstrated after 3 months of treatment by clinical, endoscopic, and pH-metry assessment. However, histologic study failed to show significant improvement of both inflammatory and hyperplastic findings. Relapse occurred in six of 10 patients after discontinuation of therapy. CONCLUSIONS: Omeprazole is effective in the short-term treatment of severe oesophagitis in children. The daily dose of the drug could be easily based on the body weight. The persistence of histologic features of esophagitis in spite of clinical and endoscopic healing could be an indicator of poor outcome.

Anti-Ulcer Agents↗
PubMed1997

Computer simulation of the responses of human motoneurons to composite 1A EPSPS: effects of background firing rate.

Two compartmental models of spinal alpha motoneurons were constructed to explore the relationship between background firing rate and response to an excitatory input. The results of these simulations were compared with previous results obtained from human motoneurons and discussed in relation to the current model for repetitively firing human motoneurons. The morphologies and cable parameters of the models were based on two type-identified cat motoneurons previously reported in the literature. Each model included five voltage-dependent channels that were modeled using Hodgkin-Huxley formalism. These included fast Na+ and K+ channels in the initial segment and fast Na+ and K+ channels as well as a slow K+ channel in the soma compartment. The density and rate factors for the slow K+ channel were varied until the models could reproduce single spike AHP parameters for type-identified motoneurons in the cat. Excitatory synaptic conductances were distributed along the equivalent dendrites with the same density described for la synapses from muscle spindles to type-identified cat motoneurons. Simultaneous activation of all synapses on the dendrite resulted in a large compound excitatory postsynaptic potential (EPSP). Brief depolarizing pulses injected into a compartment of the equivalent dendrite resulted in pulse potentials (PPs), which resembled the compound EPSPs. The effects of compound EPSPs and PPs on firing probability of the two motoneuron models were examined during rhythmic firing. Peristimulus time histograms, constructed between the stimulus and the spikes of the model motoneuron, showed excitatory peaks whose integrated time course approximated the time course of the underlying EPSP or PP as has been shown in cat motoneurons. The excitatory peaks were quantified in terms of response probability, and the relationship between background firing rate and response probability was explored. As in real human motoneurons, the models exhibited an inverse relationship between response probability and background firing rate. The biophysical properties responsible for the relationship between response probability and firing rate included the shapes of the membrane voltage trajectories between spikes and nonlinear changes in PP amplitude during the interspike interval at different firing rates. The results from these simulations suggest that the relationship between response probability and background firing rate is an intrinsic feature of motoneurons. The similarity of the results from the models, which were based on the properties of cat motoneurons, and those from human motoneurons suggests that the biophysical properties governing rhythmic firing in human motoneurons are similar to those of the cat.

Cell Membrane↗
PubMed1996

Activation of midlumbar neurones by afferents from anterior hindlimb muscles in the cat.

1. It has been suggested that a group of interneurones located in the midlumbar segments of the spinal cord might play a role in switching from the stance to swing phases of the step cycle during locomotion. We have further examined the input to these neurones from proprioceptive afferents to test whether the connections to these cells are consistent with this role. 2. Electrical stimulation of group I and group II afferents in branches of the femoral nerve which supply iliopsoas, the major hip flexor muscle, excited a large majority of intermediate zone midlumbar interneurones which receive input from quadriceps group II afferents. The central latencies and properties of the EPSPs indicate that both group I and group II afferents from iliopsoas make monosynaptic connections with many midlumbar interneurones. 3. Group II afferents from both the ankle flexor tibialis anterior and the digit dorsiflexor extensor digitorum longus excited midlumbar interneurones. Similarly, they were also excited by group II afferents from both of the two main anatomical divisions of the sartorius muscle. 4. The frequent and potent excitation of midlumbar neurones from group I and II afferents in iliopsoas suggests that they may be excited at the end of the stance phase of the step when these muscles are stretched. This possibility is discussed in relation to recent work on the functional control of the step cycle.

Animals↗
PubMed1996

Comparison of peripheral Ia and corticomotoneuronal composite EPSPs in human motoneurons.

The effects of excitatory inputs arising from Ia afferent and corticomotoneuronal volleys on repetitively firing flexor carpi radialis (FCR) motoneurons were compared in normal human subjects. Peripheral (Ia) volleys were produced by transcutaneous electrical stimulation of the median nerve and by mechanical taps to the FCR tendon. Transcranial magnetic stimulation (TMS) was used to activate the corticomotoneuronal pathway. The duration of the excitatory response peaks measured from peri-stimulus time histograms (PSTHs) and the time course of the response trajectories were both taken to reflect the shapes of the underlying composite excitatory postsynaptic potentials (EPSP)s acting upon that motoneuron. The duration of excitatory response peaks for the H-reflex and the first sub-peak (SP1) of the motor unit's response to TMS were similar and were typically less than those arising from tendon taps. The response trajectories, which measure the excitability of the motoneuron during different phases of the afterhyperpolarization, overlapped for H-reflex and SP1 responses, but were different for tendon tap inputs. Our results indicate that the SP1 response of a motoneuron to TMS input and its response to near-synchronous Ia afferent activation are mediated by composite EPSPs with similar rise times. We suggest that a similar spatial distribution of synaptic boutons for both Ia and corticomotoneuronal input to motoneurons innervating FCR is likely.

Adult↗
PubMed1995

Excitability of human upper limb motoneurones during rhythmic discharge tested with transcranial magnetic stimulation.

1. The activity of thirty-one single motor units (SMUs) was recorded from forearm and hand muscles of three volunteers. The excitability of the rhythmically firing motoneurones supplying these SMUs was examined after voluntary discharge using transcranial magnetic stimulation (TMS). 2. The magnetic stimulus was delivered either at a fixed delay (range: 1-60 ms) after SMU discharge (triggered mode) or at random with respect to voluntary SMU discharge (random mode). Post-stimulus time histograms (PSTHs) of responses to 50-100 stimuli were constructed for each experimental condition. 3. In the triggered mode, the probability of response to TMS progressively decreased as the spike-to-stimulus interval was shortened. Shortening of the interval also resulted in redistribution of responses within the different subpeaks characterizing the short-latency response of motor units to TMS: the relative response probability of the first subpeak decreased with the shorter spike-to-stimulus intervals. 4. In the triggered mode, the probability of SMU responding to TMS was significantly higher when the firing rate of the motor unit was increased from a slow rate (< 10 impulses s-1) to a faster rate (> 12 impulses s-1), irrespective of the spike-to-stimulus interval. In contrast, in the random mode, the response probability was greater at the slower discharge rate. 5. The higher excitability of motoneurones at the fast rate in the triggered mode is consistent with findings in cat motoneurones suggesting a shallower after-hyperpolarization, but other mechanisms could contribute. Furthermore, our results suggest that there is an asymptotic recovery in the excitability of slow firing motoneurones towards the end of the interspike interval.

Adult↗
PubMed1995

Nonlinear behaviour of human motoneurons.

When ramp-and-hold currents are injected into a motoneuron of an anesthetized cat, the motoneuron responds with a high initial firing rate (dynamic phase), which then adapts to a lower steady-state firing rate. The firing rates during the dynamic and the steady-state phases are linearly related to the rate of change and the magnitude of the injected current, respectively. In human subjects, where inputs to the motoneurons are not accessible, force parameters are used to describe motoneuron behaviour. Population responses of human motoneurons, measured in terms of gross electromyographic (EMG) activity, increase linearly with the magnitude and the rate of change of force. No study has attempted to examine the question of linearity of single motor units during the dynamic as well as the steady-state phases. The following study recorded single motor unit and EMG activities simultaneously from the flexor carpi radialis muscle in human subjects completing ramp-and-hold force trajectories. Although the results confirmed the linear relationship between EMG activities and the rate and magnitude of the force, a nonlinear activity pattern was observed between the single motor unit firing and the force parameters, suggesting that recruitment must be responsible for the linear behaviour of EMG activity. Comparisons of different background activity levels on the firing patterns of a given motor unit, as well as comparisons of two simultaneously recorded units, further supported nonlinear response patterns of single motor units.

Adult↗
PubMed1995

Responses of human motoneurons to Ia inputs: effects of background firing rate.

The effects of synchronous Ia volleys on the firing probability of repetitively firing human motoneurons were examined at fast and slow firing rates. Ia afferents of either the median or the posterior tibial nerve were stimulated, while single motor unit activity was recorded from the homonymous muscles. Motoneuron responses to the Ia inputs were quantified by measurement of the magnitude of the short latency excitatory peak in peristimulus time histograms (PSTHs). When the stimuli were given at random with respect to the times of motor unit spikes, the magnitude of the PSTH peak (response probability) was significantly lower at a faster firing rate. In the "triggered" mode of stimulation, stimuli were given at various known times during the interspike interval. In this mode the response probability to the input increased monotonically as the stimuli were delivered progressively later during the interspike interval. The response probability at a fixed delay with respect to the triggering spike was higher at the faster firing rate. The results obtained with the two modes of stimulation are not in contradiction and both may be explained by the nature of membrane voltage trajectories and ionic conductances during the interspike interval described for repetitively firing cat motoneurons.

Adult↗
PubMed1994

Recruitment order of motoneurons during functional tasks.

The recruitment order of motoneurons of first dorsal interosseous (1DI) muscle has been shown to be the same during either isometric abduction or flexion of the index finger. However, it is not known whether this stereotyped recruitment is the same for all functional tasks. This question was addressed by using the 1DI muscle, which contributes to many functional tasks involving the hand and fingers. Single motor units and surface electromyographic activity were recorded from 1DI in three human subjects. Each subject performed tasks of abduction of the index finger, rotation to unscrew a threaded knob and pincer to close a spring-loaded clip. The same motor units were activated for each of the three tasks, providing no evidence for the existence of task groups. The order of recruitment of pairs of selected motor units was the same for each of the three tasks.

Adult↗
PubMed1994

Lymphocytic gastritis: a positive relationship with celiac disease.

Lymphocytic gastritis is characterized by lymphocytic infiltration of the surface and pit epithelium. Its cause has not been established, but an association with Helicobacter pylori infection or celiac disease has been suggested. We evaluated the histologic features of both gastric and duodenal biopsy specimens from 245 consecutive children and adolescents, and found chronic gastritis in 60 children and celiac disease in 25. Chronic gastritis was associated with H. pylori infection in 36 children and with celiac disease in 15. Lymphocytic gastritis was found in nine children with celiac disease. Children with lymphocytic gastritis had a mean of 40.64 lymphocytes per 100 epithelial cells, compared with a mean of 3.92 lymphocytes per 100 epithelial cells in children with H. pylori-associated gastritis and 5.15 lymphocytes in normal control subjects. Immunohistochemical studies showed that the intraepithelial lymphocytes in lymphocytic gastritis were T cells. No child with lymphocytic gastritis had serologic evidence of past H. pylori infection. We conclude that lymphocytic gastritis in children is associated with celiac disease. Dyspeptic symptoms are frequent; the endoscopic appearance is not characteristic.

Adolescent↗