Physiological tremor enhanced by manoeuvres affecting the segmental stretch reflex.

Abstract

In view of recent evidence that physiological tremor can be enhanced by positive feedback via the segmental stretch reflex, several manoeuvres and procedures were employed to enhance the finger and hand tremor of healthy subjects--the purpose being to determine if tremorogenic effects, at least in part, are due to increase efficacy of the stretch reflex servo. Mechanical events during tremor (and during voluntary or electrically induced muscle twitches) were recorded together with EMG activity from wrist and finger flexor muscles and discharges from primary spindle endings in these muscles. Physiological tremor can be enhanced not only by manoeuvres which increase the gain of segmental stretch reflexes (Jendrassik manoeuvre) but also by manoeuvres which increase the contrast in spindle firing during stretch versus shortening phases of tremor, thus enhancing reflex modulation. Effects of the latter type can be achieved by procedures which alter mechanical twitch properties of extrafusal fibres (isoproterenol infusions and fatigue) and by procedures which involve application of spindle stimuli acting preferentially during stretch phases of tremor movements (muscle vibrations). Physiological tremor, which can be temporarily enhanced by an externally applied muscle perturbation, also becomes accentuated by those small "pseudo-myoclonic" jerks which occur in all normal subjects attempting to perform slow, smooth movements.