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Biomedical subjects

Timothy S Miles

Publications and source records attributed to Timothy S Miles.

At least 19 recordsLinked to original sources
PubMed2006

Organisation of common inputs to motoneuron pools of human masticatory muscles.

OBJECTIVE: To determine the pattern of organization of common inputs to the motoneuron pools of individual muscles in the masticatory system. METHODS: Six subjects bit on a rubber-coated wooden splint placed between the upper and lower incisor teeth. We recorded the surface electromyogram (EMG) of co-contracting masseter, temporalis and digastric muscles bilaterally during isometric jaw closing at 5%, 10%, 20% and 40% of maximal voluntary masseter EMG. RESULTS: The cross-correlograms of the EMGs of homologous muscle pairs indicate that there are common synaptic inputs to the motoneuron pools of the left and right masseter, and left and right digastric muscles, but not to left and right temporalis. The amplitude of the central peak in masseter and digastric correlograms increased with bite force. When the activity of ipsilateral muscle pairs was cross-correlated, central peaks were prominent for masseter-digastric and masseter-temporalis muscle pairs, and the peak amplitudes increased significantly with bite force. In contrast, no significant central peak was observed for temporalis-digastric muscle pairs at any level of voluntary biting. CONCLUSIONS: We conclude that there is synchronous modulation of input bilaterally to the masseter muscles and to the digastric muscles but not to the temporalis muscles. There is synchronous modulation of input to ipsilateral masseter-digastric and masseter-temporalis muscle pairs but not to temporalis and digastric muscles. SIGNIFICANCE: The extent of common input to motoneuron pools of muscles acting around a common joint varies for different muscle pairs, and is not simply a function of whether the muscles of the pair are synergists or antagonists.

Adult↗
PubMed2006

Impairments in precision grip correlate with functional measures in adult hemiplegia.

OBJECTIVE: Analysis of a precision grip-lift task provides measures to assess functional disability of the hand, but the correlation between these measures and accepted tests of motor function in stroke patients has not been established. METHODS: Seventeen subacute stroke patients were studied to compare parameters of a precision grip-lift task between the affected and unaffected side, and to correlate them with function. Functional impairment was assessed with the Action Research Arm Test and the Fugl-Meyer assessment, as well as grip strength and maximal finger-tapping speed. The grip force (GF) and load force (LF) were recorded as patients lifted a custom-built manipulandum. All measures were recorded on two separate occasions, at least 1 week apart. RESULTS: There was good reproducibility between testing sessions for the grip-lift and functional measures. The affected hand gripped the manipulandum for longer prior to lift-off than the unaffected hand, and the normal close temporal coupling between the rate of change of GF and LF during the lift was disrupted. These two measures correlated more highly with the ARAT than the FMA and, when combined with measures of grip strength and tapping speed, explained 71% of the variance of the ARAT. CONCLUSIONS: The grip-lift task is a sensitive measure of impaired dexterity following stroke and provides measures which correlate well with a commonly applied functional assessment scale. SIGNIFICANCE: This task may be used clinically to detect changes in the hemiplegic upper limb during rehabilitation and recovery.

Aged↗
PubMed2006

Experimental muscle pain does not affect fine motor control of the human hand.

Conditions known to cause hand pain, such as arthritis, are often accompanied by impaired dexterity. The aim of this study was to determine whether this association is coincident, or whether pain affects dexterity directly. In the first part of the study, several tests of dexterity based on pegboard skills were compared with a precision-grip-lift task: the correlations between the results of any of these tests were not significant at the 0.01 level. Nineteen subjects were then tested with a modified Purdue pegboard test and the precision grip-lift task, both without pain and during pain induced by injection of 5% hypertonic saline into the first dorsal interosseous muscle of the non-dominant hand. There was no significant difference in the performance of either task when the muscle was painful, indicating that acute experimental muscle pain does not affect dexterity.

Adolescent↗
PubMed2004

Effect of human grip strategy on force control in precision tasks.

Alternate grip strategies are often used for object manipulation in individuals with sensorimotor deficits. To determine the effect of grip type on force control, ten healthy adult subjects were asked to grip and lift a small manipulandum using a traditional precision grip (lateral pinch), a pinch grip with the fingers oriented downwards (downward pinch) and a "key grip" between the thumb and the side of the index finger. The sequence of grip type and hand used was varied randomly after every ten lifts. Each of the three grips resulted in different levels of force, with the key grip strategy resulting in the greatest grip force and the downward pinch grip using the least amount of grip force to lift the device. Cross-correlation analysis revealed that the ability to scale accurately the rate of grip force and load force changes was lowest in the downward pinch grip. This was also associated with a more variable time-shift between the two forces, indicating that the precise anticipatory control when lifting an object is diminished in this grip strategy. There was a difference between hands across all grips, with the left non-dominant hand using greater grip force during the lift but not the hold phase. Further, in contrast with the right hand, the left hand did not reduce grip force during the lift or the hold phase over the ten lifts, suggesting that the non-dominant hand did not quickly learn to optimise grip force. These findings suggest that the alternate grip strategies used by patients with limited fine motor control, such as following stroke, may partly explain the disruption of force control during object manipulation.

Adult↗
PubMed2004

Do alternate methods of analysing motor evoked potentials give comparable results?

This study assessed the reliability of alternate methods of analysis of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS). We recorded two sets of MEPs (Time 1 and Time 2) at the optimal scalp sites for both the right first dorsal interosseous (FDI) and flexor carpi ulnaris (FCU) at two different stimulation intensities in 10 healthy subjects. MEP magnitude was determined in each of the following three ways: the mean peak-to-peak amplitude and area of the 20 individual responses; the amplitude and area of the ensemble averaged waveform; and the amplitude and area of the maximal response. There was no significant difference in amplitude or area for either muscle using any of the three methods between Time 1 and 2. However, the ensemble average (area and amplitude) was significantly smaller that the mean MEP, and the maximal MEP amplitude was significantly larger. Intraclass correlation analysis demonstrated that reliability of MEP measures over time was poor regardless of method. Reliability was similar between methods for FDI, but FCU had lower reliability values for the mean and ensemble average methods than the maximal method.

Adult↗
PubMed2004

Control of human mandibular posture during locomotion.

Mandibular movements and masseter muscle activity were measured in humans during hopping, walking and running to determine whether reflexes contribute to the maintenance of jaw position during locomotion. In initial experiments, subjects hopped so that they landed either on their toes or on their heel. Landing on the toes provoked only small mandibular movements and no reflex responses in the masseter electromyogram (EMG). Landing on the heels with the jaw muscles relaxed caused the mandible to move vertically downwards relative to the maxilla, and evoked a brisk reflex response in the masseter at monosynaptic latency. Neither this relative movement of the mandible nor the reflex was seen when the teeth were clenched: hence the reflex is not the result of vestibular activation during head movement. The same variables were measured in a second series of experiments while subjects stood, walked and ran at various speeds and at various inclinations on a treadmill. During walking, the vertical movements of the head and therefore the mandible were slow and small, and there was no tonic masseter EMG or gait-related activity in the jaw-closing muscles. When subjects ran, the vertical head and jaw movement depended on the running speed and the inclination of the treadmill. Landing on the heels induced larger movements than landing on the toes. About 10 ms after each foot-strike, the mandible moved downwards relative to the maxilla, thereby stretching the jaw-closing muscles and activating them at segmental reflex latency. This caused the mandible to move back upwards. The strength of the reflex response was related to the speed and amplitude of the vertical jaw movement following landing. It is concluded that, during walking, the small, slow movements of the mandible relative to the maxilla are subthreshold for stretch reflexes in the jaw muscles: i.e. the mandible is supported by visco-elasticity of the soft tissues in the masticatory system. However, the brisker downward movements of the mandible after heel-landing during hopping and running evoke segmental reflex responses which contribute to the active maintenance of the posture of the mandible. This is a unique demonstration of how a stretch reflex operates to maintain posture under entirely natural conditions.

Adolescent↗
PubMed2003

Differential modulation of tremor and pulsatile control of human jaw and finger by experimental muscle pain.

Resting tremor is seen in both the limbs and in the trigeminal motor system. These rhythmical perturbations are the result of alternating activation of antagonistic muscles, and these increase in amplitude during slow, voluntary movements. In the present study, we examined the effect of experimental muscle pain on finger and jaw tremor. The tremor in the mandible and in the middle finger was measured on separate occasions, at rest and during two constant-velocity movements. Pain was then induced by the infusion of hypertonic saline into a jaw-closing muscle (masseter) or into a finger extensor muscle (extensor digitorum longus, EDL). During masseter pain, the power at the peak tremor frequency of the mandible decreased significantly both when the jaw was at rest and during voluntary jaw movements at two velocities. In contrast, pain in EDL resulted in a significant increase in the power of finger tremor only during the two speeds of voluntary movement. No change in the peak tremor frequency was seen in either the finger or the jaw during pain. The most likely explanation for these data is that muscle pain tonically modulates the amplitude of the outputs from the central "pulsatile control" generators that drive the alternating activation of antagonistic muscles which produce tremor at rest and during movements. This modulation is in the opposite direction for systems controlling jaw and hand, suggesting a specific interaction of the nociceptive afferents with separate central oscillators.

Adult↗
PubMed2003

Is the long-latency stretch reflex in human masseter transcortical?

A long-latency stretch reflex (LLSR) has been described in the human masseter muscle, but its pathway remains uncertain. To investigate this, the excitability of corticomotoneuronal (CM) cells projecting to masseter motoneurons during the LLSR was assessed with transcranial magnetic stimulation (TMS). A facilitated response to TMS would be evidence of a LLSR pathway that traverses the motor cortex. Surface electromyogram electrodes were placed over the left or right masseter, and subjects ( n=10) bit on bars with their incisor teeth at 10% of maximal electromyographic activity (EMG). Servo-controlled displacements were imposed on the lower jaw to evoke a short- and long-latency stretch reflex in masseter. TMS intensity was just suprathreshold for a response in contralateral masseter. Trials consisted of: (1) stretch alone, (2) TMS alone, and (3) TMS with a preceding conditioning stretch at varied conditioning-testing (C-T) intervals chosen to combine TMS with the short-latency stretch reflex (3 ms, 5 ms) and the LLSR (23-41 ms). Masseter EMG was rectified and averaged. With TMS alone, mean (+/- SE) MEP area above baseline was 56+/-9%. The area of masseter MEPs above baseline in the C-T trials was calculated from each EMG average following subtraction of the response to stretch alone. Conditioning muscle stretch had no significant effect on masseter MEPs evoked by TMS with any C-T interval (ANOVA; P=0.90). In addition, subjects were unable to modify the SLSR or LLSR by voluntary command. It is concluded that the long-latency stretch reflex in the masseter does not involve the motor cortex and is not influenced by "motor set".

Adult↗
PubMed2003

Prolonged peripheral nerve stimulation induces persistent changes in excitability of human motor cortex.

This study sought to determine whether prolonged peripheral nerve stimulation was effective in inducing persistent "plastic" changes in the excitability of the human motor cortex. The amplitude of the electromyographic response evoked in resting intrinsic hand muscles by focal transcranial magnetic stimulation (TMS) was taken as an index of motor cortical excitability. Twelve subjects were stimulated with each of three protocols, one of which was given on each of three separate occasions. The protocols consisted of various schedules of electrical stimulation of the radial and ulnar nerves or the motor point of the first dorsal interosseous muscle (FDI), or stimulation of FDI motor point paired with low-frequency TMS. Amplitudes of TMS-elicited motor evoked potentials (MEPs) were measured before peripheral stimulation and for 2 h after stimulation. The data from one subject were unusable. In every other subject, all three protocols induced a prolonged, significant facilitation of MEPs in at least some of the three intrinsic hand muscles used. In some instances, MEPs were not enlarged and occasionally were significantly depressed. Different protocols based on peripheral afferent stimulation can induce plastic changes in the organisation of the motor cortex that persist for at least 2 h.

Adult↗
PubMed2003

Responses of single motor units in human masseter to transcranial magnetic stimulation of either hemisphere.

The corticobulbar inputs to single masseter motoneurons from the contra- and ipsilateral motor cortex were examined using focal transcranial magnetic stimulation (TMS) with a figure-of-eight stimulating coil. Fine-wire electrodes were inserted into the masseter muscle of six subjects, and the responses of 30 motor units were examined. All were tested with contralateral TMS, and 87 % showed a short-latency excitation in the peristimulus time histogram at 7.0 +/- 0.3 ms. The response was a single peak of 1.5 +/- 0.2 ms duration, consistent with monosynaptic excitation via a single D- or I1-wave volley elicited by the stimulus. Increased TMS intensity produced a higher response probability (n = 13, paired t test, P < 0.05) but did not affect response latency. Of the remaining motor units tested with contralateral TMS, 7 % did not respond at intensities tested, and 7 % had reduced firing probability without any preceding excitation. Sixteen of these motor units were also tested with ipsilateral TMS and four (25 %) showed short-latency excitation at 6.7 +/- 0.6 ms, with a duration of 1.5 +/- 0.3 ms. Latency and duration of excitatory peaks for these four motor units did not differ significantly with ipsilateral vs. contralateral TMS (paired t tests, P > 0.05). Of the motor units tested with ipsilateral TMS, 56 % responded with a reduced firing probability without a preceding excitation, and 19 % did not respond. These data suggest that masseter motoneurons receive monosynaptic input from the motor cortex that is asymmetrical from each hemisphere, with most low threshold motoneurons receiving short-latency excitatory input from the contralateral hemisphere only.

Adult↗
PubMed2003

Age and sex differences in human motor cortex input-output characteristics.

Stimulus-response curves for motor evoked potentials (MEPs) induced in a hand muscle by transcranial magnetic stimulation (TMS) were constructed for 42 subjects with the aim of identifying differences related to age and sex. There was no effect of age on the resting threshold to TMS, the maximal amplitude of the MEP that could be evoked (MEP(max)) or the maximal slope of the stimulus-response curve. However, higher stimulus intensities were required to achieve both MEP(max) and the maximal slope in the older subjects. The trial-to-trial variability of MEPs was greater in the older subjects, particularly at intensities near threshold. There was a significant interaction between age, threshold and trial-to-trial variability of MEP amplitude. Overall, MEP variability fell markedly as stimulus intensity increased above threshold but less rapidly in older than in younger subjects. Females tended to have larger MEP variability than males, but age and threshold were much stronger modulators than sex. These differences in input-output characteristics are likely to be due either to a decreased number of spinal motoneurones being activated synchronously in older subjects, or to the activation of the same number of motoneurones in a less synchronous manner, leading to phase cancellation in the surface electromyogram.

Adult↗
PubMed2003

Pulsatile control of the human masticatory muscles.

Spectral analysis of jaw acceleration confirmed that the human mandible 'trembles' at a peak frequency around 6 Hz when held in its rest position and at other stationary jaw openings. The 6 Hz tremor increased during very slow movements of the mandible, but other lower-frequency peaks became prominent during more rapid jaw movements. These lower-frequency peaks are likely to be the result of asymmetries in the underlying, voluntarily produced, 'saw-tooth' movements. In comparison, finger tremor at rest and during slow voluntary movements had a mean peak frequency of about 8 Hz: this frequency did not change during rhythmical finger flexion and extension movements, but the power of the tremor increased non-linearly with the speed of the movement. The resting jaw tremor was weakly coherent with the activity of the masseter and digastric muscles at the tremor frequency in about half the subjects, but was more strongly coherent during voluntary movements in all subjects. The masseter activity was at least 150 deg out of phase with the digastric activity at the tremor frequency (and at all frequencies from 2.5-15 Hz). The alternating pattern of activity in antagonistic muscles at rest and during slow voluntary movements supports the idea that the masticatory system is subject to pulsatile control in a manner analogous to that seen in the finger.

Fingers↗
PubMed2003

Postural stability of the human mandible during locomotion.

Movements of the head and of the mandible relative to the head were measured in human subjects walking and running on a treadmill at various speeds and inclinations. A miniature magnet and piezo-electric accelerometer assembly was mounted on the mandibular incisors, and a Hall-effect sensor along with a second accelerometer mounted on a maxillary incisor along a common vertical axis. Signals from these sensors provided continuous records of vertical head and mandible acceleration, and relative jaw position. Landing on the heel or on the toe in different forms of locomotion was followed by rapid deceleration of the downward movement of the head and slightly less rapid deceleration of the downward movement of the mandible, i.e., the mandible moved downwards relative to the maxilla, then upwards again to near its normal posture within 200 ms. No tooth contact occurred in any forms of gait at any inclination. The movement of the mandible relative to the maxilla depended on the nature and velocity of the locomotion and their effects on head deceleration. The least deceleration and hence mandibular displacement occurred during toe-landing, for example, during "uphill" running. The maximum displacement of the mandible relative to the head was less than 1mm, even at the fastest running speed. The mechanisms that limit the vertical movements of the jaw within such a narrow range are not known, but are likely to include passive soft-tissue visco-elasticity and stretch reflexes in the jaw-closing muscles.

Acceleration↗
PubMed2003

Magnetic stimulation of motor and somatosensory cortices suppresses perception of ulnar nerve stimuli.

Magnetic stimulation of sensorimotor cortex interferes with the detection of electro-cutaneous stimulation. However, it is uncertain whether this interference is due to activation of the somatosensory or the motor cortex. Here, transcranial magnetic stimuli (TMS) were delivered separately over somatosensory and motor cortex contralateral to the right ulnar nerve in 12 subjects. In separate trials, TMS were given 100 ms before and 20 ms after 60 ms trains of electro-cutaneous ulnar nerve stimuli, and their effect on the subjective perception of peripheral stimuli was assessed. TMS of both motor and somatosensory cortex interfered with the perception of afferent stimuli when given before or after stimulation of the ulnar nerve. Perception was more strongly suppressed by motor cortex stimulation than by somatosensory cortex stimulation, when given before or after the peripheral stimulus. A similar proportion of errors was induced by sensory cortex stimulation between the two stimulus timing intervals. This study suggests that the inhibition of the afferent volley is unlikely to be the result of antidromic activation of thalamocortical connections or corticospinal gating. A phenomenon akin to sensory masking is the most plausible explanation for much of the suppression of sensory perception by stimulation of the motor or somatosensory cortex. The more powerful suppressive effect of motor cortex stimulation may be due to multiple mechanisms.

Adult↗
PubMed2003

Suppression of motor evoked potentials in a hand muscle following prolonged painful stimulation.

Earlier investigations have shown that stimulation of peripheral afferent nerves induces prolonged changes in the excitability of the human motor cortex. The present study compared the effect of experimental pain and non-painful conditioning stimulation on motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in the relaxed first dorsal interosseous (FDI) and flexor carpi ulnaris (FCU) muscles. The MEPs were measured in 10 healthy subjects, and stimulus-response curves were generated before and after each of four stimulation paradigms conducted in random order on separate occasions: (a) control; (b) "dual stimulation" consisting of electrical stimulation of the FDI motor point paired with TMS; (c) painful infusion of hypertonic saline in the FDI muscle; and (d) pain combined with dual stimulation. There were no significant changes in FDI MEPs following the control paradigm, and dual stimulation induced an increase in the FDI MEPs only inconsistently. In contrast, the painful stimulation and the combined pain and dual stimulation paradigms were followed by significant suppression of the FDI MEPs at higher stimulus intensities. No changes were observed in the FCU MEPs following the four paradigms. In two additional subjects, the responses evoked in FDI by direct stimulation of the descending corticospinal tracts were significantly depressed following painful stimulation of the FDI, although the ulnar-evoked M-waves remained constant. It is concluded that muscle pain is followed by a period with profound depression of MEPs amplitudes in the resting muscle, but that these changes are at least in part due to a lasting depression of the excitability of the motoneurones in the spinal cord. Hence, painful stimulation differs from non-painful, repetitive stimulation, which facilitates the corticomotor pathway.

Adult↗
PubMed2003

Frequency-dependent, bi-directional plasticity in motor cortex of human adults.

OBJECTIVE: To determine whether the plastic changes induced in human motor cortex by afferent stimulation depend on stimulus frequency. METHODS: Transcranial magnetic stimulation was used to examine changes in corticospinal excitability in 20 subjects before and after combined peripheral (motor point) and central stimulation. Peripheral stimuli were given as either low frequency (3 Hz) or high frequency (30 Hz) trains. RESULTS: Low frequency stimulation induced prolonged depression of corticospinal excitability, while high frequency stimulation induced prolonged facilitation. These effects persisted for approximately 40-50 min after stimulation ceased. CONCLUSIONS: Corticospinal plasticity induced by dual peripheral and central stimulation is bi-directionally-modifiable in the adult human, with the direction of change being frequency-dependent. SIGNIFICANCE: Therapies using peripheral stimulation to alter human motor cortex excitability could be tailored to exploit the differential effects of stimulus frequency on the direction of the excitability change.

Adolescent↗