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PubMed2000

The mechanical action of proprioceptive length feedback in a model of cat hindlimb.

Postural regulation is an important part of a variety of motor tasks, including quiet standing and locomotion. Muscle length feedback, both the autogenic length feedback arising from a muscle's own spindles, and heterogenic length feedback, arising from its agonists and antagonists, is a strong modulator of muscle force and well suited to postural maintenance. The effects of this reflex feedback on 3-D force generation and limb mechanics are not known. In this paper, we present a mechanical model for relating 3-D changes in cat hindlimb posture to changes in muscle lengths. These changes in muscle length are used to estimate changes in both intrinsic muscle force generation and muscle activation by length feedback pathways. Few muscles are found to have directly agonist mechanical actions, and most differ by more than 20 degrees. Endpoint force fields are largely uniform across the space investigated. Both autogenic and heterogenic feedback contribute to whole limb resistance to perturbation, autogenic pathways being most dramatic. Length feedback strongly reinforced a restoring force in response to endpoint displacement.

Animals↗
PubMed1981

Interlimb reflexes evoked in human arm muscles by ankle displacement.

Interlimb reflexes evoked by ankle displacements were studied in arm muscles of 6 normal subjects. EMGs from grastrocnemius (G), tibialis anterior (TA), biceps brachii (BB), and triceps brachii (TB) were amplified, rectified and low-pass filtered before recording. Averaging and Wiener filtering were used to detect changes in tonic EMG activity evoked by dorsiflexing or plantarflexing displacements of the ankle. A consistent pattern of response was observed in all subjects. In the leg muscles, the responses to stretch were consistent with previous reports. In the arm muscles, the response of TB was dominant. Dorsiflexing displacements of the ankle evoked a small excitation followed by a more marked decrease in TB activity but had no effect on BB. In contrast, plantarflexing displacements of the ankle resulted in a large, early period of excitation followed by a decreased level of activity in TB. A similar but smaller pattern of activity was observed in BB. It is notable that the TB responses to displacement were sizable, often modulating the tonic EMG activity by as much as 80%. Interlimb reflexes evoked by ankle displacement were larger and of shorter latency than those evoked by cutaneous electrical stimulation of the foot reported previously. This suggests that proprioceptive afferents may have stronger and more direct interlimb reflex connections than cutaneous afferents and may therefore play an important role in the coordination of movement.

Adult↗
PubMed1986

Penicillin epileptogenic focus in the rat: requisites for transcortical reflex triggering.

Epileptiform discharges elicited by natural or electrical stimulations, proprioceptive or cutaneous, were studied in the rat with an experimental acute focus induced by penicillin application in the motor area. EEG paroxystic spikes were easily triggered with restricted foci (0.5 to 1 mm2) located in the representation area of the stimulated region. However, despite the large overlap of sensory and motor cortical limb areas in the rat, EEG spikes, either spontaneous or triggered, were followed by muscular jerks only with much larger foci: at least 2 and 4 mm2, respectively, for anterior and posterior limb areas. Cutaneous stimulations were the most efficient in discharge production; however, discharges were triggered indifferently by muscular or cutaneous afferent fibers in about three-fourths of the cases. The temporal relation between EEG spike and myoclonic jerk were very close. A latency analysis (delay between triggered EEG spike and EMG response, parallel latency fluctuation of both phenomena, delay between spontaneous EEG spike and jerk) supported the hypothesis that a transcortical reflex mechanism, rather than a spinal excitability rebound, was involved in the jerk genesis. Iontophoretic ejection of penicillin within layers III-IV resulted in the development of electroclinical paroxysms. However, similar penicillin ejection within layer V, did not allow efferent discharge production. It is concluded that the involvement of a large surface or volume of cortical tissue is required to produce efferent discharges following EEG paroxysms. This observation is likely related to the unexpectedly wide representation of individual muscles at the motor cortical level.

Animals↗
PubMed2003

Restoration of anterior cruciate ligament-hamstring reflex arc after anterior cruciate ligament reconstruction.

It has recently been emphasized that restoration of neuromuscular function contributes to dynamic stability of the anterior cruciate ligament (ACL) reconstructed knee. The existence of an ACL-hamstring reflex arc, one of the protective ligament-muscular pathways, has been revealed in normal human knees. Although reinnervation to the reconstructed ACL has been observed histologically, it remains unclear whether the ACL-hamstring reflex arc is reestablished. This study examined the existence of the ACL-hamstring reflex arc in ACL-reconstructed knees by analyzing the changes in the hamstring EMG elicited by electrical stimulation to the reconstructed ACL. The patellar tendon grafts transplanted as an ACL substitute in three patients were electrically stimulated via a bipolar wire electrode inserted arthroscopically. The surface EMG was monitored from the ipsilateral biceps femoris and semitendinosus. In two of the three patients the significantly increased EMG value of the biceps femoris was detected between 120 and 140 ms after the onset of electrical ACL stimulation. The increased EMG activity detected in the biceps femoris after the stimulation to the patellar tendon graft indicated reestablishment of the ACL-hamstring reflex arc in the ACL-reconstructed knee.

Adult↗
PubMed1991

Mechanical analysis of heterogenic inhibition between soleus muscle and the pretibial flexors in the cat.

1. The role of proprioceptive pathways linking the direct antagonists soleus (S) and tibialis anterior (TA) muscles in governing the mechanical properties of the ankle joint were studied in the decerebrate cat. Actions of these heterogenic pathways were compared with those between S and extensor digitorum longus (EDL), a muscle that also acts at the metatarsophalangeal joint. These neurally mediated interactions between S and either TA or EDL were studied by applying controlled length changes to the isolated tendons of pairs of these muscles and recording the resulting changes in force. The muscles were activated with the use of electrically evoked crossed-extension reflexes, flexion reflexes, and brain stem stimulation. 2. Heterogenic inhibition from TA or EDL onto S was well developed whether S was initially quiescent or activated by a crossed-extension reflex. The inhibition persisted for the duration of the stretch of TA or EDL. During a crossed-extension reflex, TA did not generate background force, but brief stretch reflexes could be obtained. During flexion reflexes, stretch reflexes in S were usually abolished, and heterogenic inhibition from S to TA was weak or absent. 3. The strength of the heterogenic inhibition onto S was dependent on the initial length and activation level of TA and EDL. Changes in flexor length or activation level per se did not alter the background force or strength of the stretch reflex in S. Even taking into account the variation of strength of inhibition with the initial state of the muscle of origin, the strength of the inhibition was stronger from TA to S than the other way around. 4. The contributions of heterogenic inhibition from TA and EDL to S were independent in the sense that these components summed linearly with each other and with the autogenic reflex in S. In addition, the magnitude of the inhibition from TA to S was proportional to the amplitude of stretch for low to intermediate levels of initial force in S. The inhibition appeared to affect the mechanical responses of S essentially as rapidly as the stretch reflex in this muscle. 5. The heterogenic inhibition from TA to S was reduced or abolished by intravenous injections of strychnine but unaffected by injections of picrotoxin or bicuculline. These results, together with the observation that the inhibition sums linearly with the stretch reflex, suggest that the mechanism of this heterogenic inhibition is glycinergic and postsynaptic and, therefore, may include Ia-disynaptic reciprocal inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

2-Amino-5-phosphonovalerate↗
PubMed1999

Disorders of proprioceptive responses in monkeys after cerebellar lesions: an analysis using the Denny-Brown Collection.

We used the Denny-Brown Research Collection to study in detail the reflex responses of monkeys after ablation of the anterior lobe, posterior lobe or the entire cerebellum. The Collection includes written, film and histological records, and photographs of the brain at autopsy. Large cerebellar ablations severely suppress proprioceptive responses, thereby significantly impairing the capacity to stand, walk, and hop. Cutaneous reflexes are also impaired, although more selectively, permitting expression of normally suppressed responses such as magnet reactions and tactile avoiding responses. Enhancement (release) of responses to truncal cutaneous stimulation, along with suppression of opposing proprioceptive responses, leads to postures of persistent flexion. Large cerebellar lesions also interfere with reflex responses mediated by visual and vestibular systems. More limited cerebellar ablations have similar, but less severe effects.

Animals↗
PubMed1992

Peripheral and central delays in the cortical projections from human truncal muscles. Rapid central transmission of proprioceptive input from the hand but not the trunk.

In contrast to the cortical connections to and from the muscles of the hand, the transmission of an afferent volley from the intercostal muscles to the cerebral cortex takes approximately 10 ms longer than it takes a cortical motor volley to reach the muscle. This disparity in afferent and efferent cortical transmission times could be due to a slower peripheral conduction velocity of intercostal muscle afferents or a slower afferent conduction within the central nervous system. The present study derived peripheral and central conduction times for the truncal muscles from the onsets of the mechanically evoked intercostal and abdominal spinal reflexes and the onsets of the cortical sensory potentials. Mean latencies of the ipsilateral intercostal and abdominal reflexes (evoked and recorded in the mid-clavicular line) were 11.9 +/- 0.7 (SEM) ms and 13.7 +/- 0.9 ms, respectively; calculated peripheral conduction velocities were 69.4 +/- 4.1 m/s and 56.2 +/- 2.3 m/s (assuming equal velocities for the sensory and motor axons and an intraspinal delay of 1 ms). Central sensory conduction time (spinal cord to cortex) was calculated by subtracting the peripheral conduction times for the intercostal and abdominal afferents (5.5 +/- 0.3 ms and 6.4 +/- 0.4 ms) from the onsets of the cortical sensory potentials (19.4 +/- 0.8 ms and 25.3 +/- 12.3 ms); central sensory conduction times (14.2 +/- 1.7 ms and 18.6 +/- 2.3 ms) were 8-11 ms longer than central motor conduction times. These results demonstrate that peripheral conduction velocities of intercostal and abdominal afferents are not slow, and that, when compared with the extremities, there is a relatively long central conduction time for proprioceptive information from the trunk to the cerebral cortex.

Adult↗
PubMed2005

Functional sparing of intrafusal muscle fibers in muscular dystrophies.

In a previous study, we showed that patients with muscular dystrophies (MDs) perceive passive movements, experience sensations of illusory movement induced by muscle tendon vibration, and have proprioceptive-regulated sways in response to vibratory stimulation applied to the neck and ankle muscle tendons. These findings argue for preserved proprioceptive functions of muscle spindles. However, it is unclear whether the function of intrafusal muscle fibers is spared, i.e., whether they retain their ability to contract when submitted to a fusimotor drive. To answer this question, we analyzed the effects of reinforcement maneuvers (mental computation and the Jendrassik maneuver) that are known to increase muscle spindle sensitivity via fusimotor drive in healthy subjects. Nine patients with different MDs participated in the study. Reinforcement maneuvers increased both the mean amplitude of the Achilles tendon reflex (187 +/- 52.9% of the mean control amplitude) and the sensitivity of muscle spindle afferents to imposed movements of the ankle. The same reinforcement maneuvers failed to alter the amplitude of the Hoffmann reflex in the triceps surae muscle. These results suggest that the intrafusal muscle fibers preserve their contractile abilities in slowly progressive MDs. The reasons for a differential impairment of intrafusal and extrafusal muscle fibers and the clinical implications of the present results are discussed.

Achilles Tendon↗
PubMedDate not supplied

Rehabilitation outcomes of patients who have developed Guillain-Barré syndrome.

The objective of this study was to determine associations between early variables (requirement for ventilator support, anemia, indicators of abnormal peripheral nerve function (proprioception, vibratory, fine touch/pinprick, deep-tendon reflexes, cranial nerve involvement, dysautonomia, electrodiagnostic findings), plasmapheresis, age, and gender) and outcome variables (length of acute hospitalization, length of inpatient rehabilitation, Functional Independence Measure (FIM) Rasch converted scores, and acute and rehabilitation charges) in Guillain Barré Syndrome (GBS). The design of the study was a retrospective case review of 39 GBS admissions (as defined by National Institute of Neurologic Disorders and Stroke clinical criteria) to an inpatient rehabilitation unit at a university tertiary care rehabilitation center during a three-year period. The average length of stay for 39 patients requiring transfer to the inpatient rehabilitation unit (40% of all acute care GBS admissions) was 34 days in acute care and 26 days in rehabilitation. The average adjusted charges for inpatient rehabilitation (1993 dollars) was $31,636.28. Those who required ventilator support before rehabilitation v those who did not had an admission mean FIM Rasch converted motor score of 26.6 v a score of 38.3 (P = 0.0469), gained only 10.3 points on their FIM Rasch converted motor score v 27.7 points (P = 0.0001), and had a mean acute length of stay of 66.2 days v 19.3 days (P = 0.0029). Patients requiring ventilator support were more likely to have dysautonomia (P = 0.0009). Thirty-one of 39 patients with GBS (79%) had anemia. No correlation was found between hematocrit or hemoglobin and motor function recovery as assessed via the Rasch transformed FIM motor scores. There was an association between autonomic dysfunction and an increased acute care length of stay (P = 0.0325) and total length of hospital stay (P = 0.0203). Cranial nerve dysfunction resulted in an increase in the acute care length of stay (P = 0.0266), the total length of hospital stay (P = 0.0123), and adjusted hospital charges while undergoing inpatient rehabilitation (P = 0.0235). For patients with GBS necessitating admission to inpatient rehabilitation, the requirement of prior ventilator support most strongly predicts an extended length of stay for inpatient rehabilitation.

Adolescent↗
PubMed1991

Motor compensatory reactions following a forward fall in subjects with unilateral abolition of the triceps-surae H reflex.

The electromyograms of the right and left soleus and tibialis anterior muscles of 6 subjects with unilateral abolition of Achilles tendon reflex due to S1 radiculitis were recorded during a forward fall involving stepping to recover balance. Each subject took part in two series of experiments, one in which the step was performed with the unaffected leg and a second in which the affected leg was used. A unilateral deficiency of peripheral proprioceptive afferents affected ankle muscles EMG activities bilaterally, except for the EMG activity of the soleus of the starting foot. The tibialis anterior of both the affected and the unaffected side, showed either a normal pattern (i.e. a phasic contraction after soleus contraction stopped), or an early contraction. On the stance side, the early contraction was associated with a depressed soleus EMG activity. Some abnormal motor patterns could be due to the ipsilateral deficiency of the Ia inhibitory projection from soleus to tibialis anterior. The presence of abnormal patterns on the unaffected side indicates that the motor activity in one lower limb can be modified by a loss of peripheral afference in the contralateral limb. This suggests that crossed pathways between lower limbs are involved in balance recovery movement.

Achilles Tendon↗
PubMed1982

Spinocerebellar degeneration secondary to chronic intestinal malabsorption: a vitamin E deficiency syndrome.

Two adults are described who developed a progressive neurological disorder more than 20 years after the onset of chronic fat malabsorption. The clinical features included dysarthria, cerebellar ataxia, and prominent proprioceptive loss with depressed or absent tendon reflexes. Serum vitamin E was undetectable in both cases. One patient improved clinically and electrophysiologically after oral therapy with vitamin E. The findings in these patients were similar to those in others recently reported with vitamin E deficiency associated with biliary atresia. Electrophysiological observations suggested that the human deficiency state parallels that found neuropathologically in vitamin E-deficient animals.

Adult↗
PubMed1995

Projection of jaw-muscle spindle afferents to the caudal brainstem in rats demonstrated using intracellular biotinamide.

Intracellular staining with biotinamide was used to study the axonal projection and synaptic morphology of rat jaw-muscle spindle afferents. Intracellular recordings in the mesencephalic trigeminal nucleus (Vme) were identified as spindle afferent responses by their increased firing during stretching of the jaw-elevator muscles. Biotinamide-stained axon collaterals with boutons were found in the trigeminal motor nucleus (Vmo), Vme, the region dorsal to Vmo including the supratrigeminal region, the dorsomedial portion of the trigeminal principal sensory nucleus, and the dorsomedial part of the rostral spinal trigeminal subnucleus oralis. Additional, previously undescribed projections of jaw-muscle spindle afferents were found to the dorsomedial portion of the caudal spinal trigeminal subnucleus oralis (Vodm), the dorsomedial part of the spinal trigeminal subnucleus interpolaris (Vidm), the caudal parvicellular reticular formation, laminae IV and V of the spinal trigeminal subnucleus caudalis (Vc), and the dorsal division of the medullary reticular field. Labeled spindle boutons in Vodm formed predominately axodendritic synapses. Some of these boutons received presynaptic inputs from unlabeled P-type boutons containing clear, spherical, or flattened vesicles. In Vidm, labeled collaterals and boutons were densely clustered into glomerular-like structures. Labeled boutons in Vidm made axodendritic, axosomatic, and axoaxonic synapses and received synaptic contacts from unlabeled boutons containing clear, spherical, or flat and pleomorphic vesicles. Unlabeled presynaptic boutons in Vidm occasionally contained dense core vesicles. Labeled boutons in Vc mainly formed synaptic contacts with large diameter dendrites. This projection of jaw-muscle spindle afferents to caudal brainstem regions may play a significant role in masticatory-muscle stretch reflexes and in the integration of trigeminal proprioceptive information and its transmission to higher centers.

Afferent Pathways↗
PubMed2001

Hand trajectory invariance in reaching movements involving the trunk.

Movements of different body segments may be combined in different ways to achieve the same motor goal. How this is accomplished by the nervous system was investigated by having subjects make fast pointing movements with the arm in combination with a forward bending of the trunk that was unexpectedly blocked in some trials. Subjects moved their hand above the surface of a table without vision from an initial position near the midline of the chest to remembered targets placed within the reach of the arm in either the ipsi- or contralateral workspace. In experiment 1, subjects were instructed to make fast arm movements to the target without corrections whether or not the trunk was arrested. Only minor changes were found in the hand trajectory and velocity profile in response to the trunk arrest, and these changes were seen only late in the movement. In contrast, the patterns of the interjoint coordination substantially changed in response to the trunk arrest, suggesting the presence of compensatory arm-trunk coordination minimizing the deflections from the hand trajectory regardless of whether the trunk is recruited or mechanically blocked. Changes in the arm interjoint coordination in response to the trunk arrest could be detected kinematically at a minimal latency of 50 ms. This finding suggests a rapid reflex compensatory mechanism driven by vestibular and/or proprioceptive afferent signals. In experiment 2, subjects were required, as soon as they perceived the trunk arrest, to change the hand motion to the same direction as that of the trunk. Under this instruction, subjects were able to initiate corrections only after the hand approached or reached the final position. Thus, centrally mediated compensatory corrections triggered in response to the trunk arrest were likely to occur too late to maintain the observed invariant hand trajectory in experiment 1. In experiment 3, subjects produced similar pointing movements, but to a target that moved together with the trunk. In these body-oriented pointing movements, the hand trajectories from trials in which the trunk was moving or arrested were substantially different. The same trajectories represented in a relative frame of reference moving with the trunk were virtually identical. We conclude that hand trajectory invariance can be produced in an external spatial (experiment 1) or an internal trunk-centered (experiment 3) frame of reference. The invariance in the external frame of reference is accomplished by active compensatory changes in the arm joint angles nullifying the influence of the trunk motion on the hand trajectory. We suggest that to make a transition to the internal frame of reference, control systems suppress this compensation. One of the hypotheses opened to further experimental testing is that the integration of additional (trunk) degrees of freedom into movement is based on afferent (proprioceptive, vestibular) signals stemming from the trunk motion and transmitted to the arm muscles.

Abdomen↗
PubMed2000

Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans.

Anterior cruciate ligament (ACL)-deficient knees have impaired proprioception, and, although mechanoreceptors have been found in the ACL, the existence of a reflex elicited from these receptors has not been directly demonstrated in humans. In eight patients that underwent knee arthroscopy and had no sign of ACL disease, thin wire electrodes were inserted into the proximal and mid parts of the ACL. Postoperatively, the sensory nerve fibers inside the ACL were stimulated electrically while motor activity in the knee muscles was recorded using electromyography. In seven of the eight patients, a muscular contraction of the semitendinosus muscle could be elicited with stimulus trains consisting of at least two stimuli. The latency was 95 +/- 35 ms. Stimulation during isometric contraction of either extensor or flexor muscles elicited a short, complete inhibition of the muscle activity in the contracting muscles. The latency of the inhibitory responses was 65 +/- 20 ms in the semitendinosus muscle and 70 +/- 15 ms in the rectus femoris muscle.

Adult↗
PubMed2003

Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases.

Leprosy is one of the most common diseases of the peripheral nerves. In some cases there is only neural involvement without skin changes (neuritic form). The neuropathy has often a distal stocking and glove distribution with thermal and pinprick anesthesia and preservation of proprioception. There is no weakness, the tendon reflexes may be preserved and sometimes the nerves are thickened. We reported 17 patients with a predominantly small-fiber polyneuropathy due to leprosy. All patients had distal temperature and pain anesthesia with different individual variations. The tendon reflexes were normal in seven patients and in eight there was thickening of the nerves. The nerve conduction was normal in three patients. Sural nerve biopsy consisted of: 1) inflammatory infiltrates, 2) vacuolated "foamy" cells, 3) fibrosis of endoneurium, perineurium, and epineurium, 4) partial or total loss of nerve fibers, 5) large number of bacilli. We concluded that in countries where leprosy is frequent, nerve biopsy is an obligatory procedure in patients with predominantly small-fiber polyneuropathy.

Adult↗
PubMed2001

Neurological and psychological symptoms after the severe acute neuroborreliosis.

The purpose of this study was to delineate distant neurological and neuropsychological effects of severe neuroborreliosis. A group of 33 patients (12 men and 21 women) were selected for the study. Every patient had suffered from severe meningitis, meningoencephalitis or meningopolyradiculoneuritis due to neuroborreliosis in the chronic form of the illness. Standardised medical interview, physical examination and a series of neuropsychological tests (WAIS-R, BDI, BENTON-BENDER, DUM) were performed. In the clinical history, 36.4% of the patients complained of headache, 27.3% of subjective memory distortions; 33.3% of the patients suffered from sleeplessness. The neurological examination showed that 36.4% of the patients experienced such cerebellum integrity disturbances as abnormalities in gait and coordination or even mild ataxia. 21.2% of the patients experienced dysfunction in the proprioceptive pathways, 9% asymmetry in deep tendon reflexes (DTR's), 27.3% disturbances in the sensory responses. The examination showed, however, no muscular strength abnormalities. Half of the patients had slight depression. Psychological tests indicated that 21.2% of the patients had problems in thinking process and experienced memory impairment. 36.4% of the patients had significant organic damage in the central nervous system. The results of this study suggest the existence of long-lasting consequences of acute neuroborreliosis, which can significantly influence the quality of life of patients.

Adult↗