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PubMed2003

Clonus after human spinal cord injury cannot be attributed solely to recurrent muscle-tendon stretch.

Clonus, presented behaviorally as rhythmic distal joint oscillation, is a common pathology that occurs secondary to spinal cord injury (SCI) and other neurological disabilities. There are two predominant theories as to the underlying mechanism of clonus. The prevailing one is that clonus results from recurrent activation of stretch reflexes. An alternative hypothesis is that clonus results from the action of a central oscillator. We present evidence that the mechanism underlying clonus in individuals with SCI is not solely related to muscle stretch. We studied electromyography (EMG) of the soleus (SOL), medial gastrocnemius (MG), tibialis anterior (TA), medial and lateral hamstrings, vastus medialis, vastus lateralis, and rectus femoris from subjects with clinically complete and clinically incomplete SCI during stretch-induced ankle clonus, stepping, and non-weight-bearing standing. Clonic EMG of the SOL, MG, and TA occurred synchronously and were not consistently related to muscle-tendon stretch in any of the conditions studied. Further, EMG activity during stretch-induced ankle clonus, stepping, and non-weight-bearing standing had similar burst frequency, burst duration, silent period duration, and coactivation among muscles, indicating that clonic EMG patterns occurred over a wide range of kinematic and kinetic conditions, and thus proprioceptive inputs. These results suggest that the repetitive clonic bursts could not be attributable solely to immediate afferent feedback such as recurrent muscle stretch. However, these results support the theory that the interaction of central mechanisms and peripheral events may be responsible for clonus.

Adult↗

PubMed1996

Haptic cues for orientation and postural control in sighted and blind individuals.

Haptic cues from fingertip contact with a stable surface attenuate body sway in subjects even when the contact forces are too small to provide physical support of the body. We investigated how haptic cues derived from contact of a cane with a stationary surface at low force levels aids postural control in sighted and congenitally blind individuals. Five sighted (eyes closed) and five congenitally blind subjects maintained a tandem Romberg stance in five conditions: (1) no cane; (2,3) touch contact (< 2 N of applied force) while holding the cane in a vertical or slanted orientation; and (4,5) force contact (as much force as desired) in the vertical and slanted orientations. Touch contact of a cane at force levels below those necessary to provide significant physical stabilization was as effective as force contact in reducing postural sway in all subjects, compared to the no-cane condition. A slanted cane was far more effective in reducing postural sway than was a perpendicular cane. Cane use also decreased head displacement of sighted subjects far more than that of blind subjects. These results suggest that head movement control is linked to postural control through gaze stabilization reflexes in sighted subjects; such reflexes are absent in congenitally blind individuals and may account for their higher levels of head displacement.

Adult↗

PubMed1984

Central nervous sensitization and dishabituation of reflex action in an insect by the neuromodulator octopamine.

Habituation of excitatory synaptic inputs onto identified motor neurons of the locust metathoracic ganglion, driven electrically and by natural stimuli, was examined using intracellular recording. Rapid progressive reduction in amplitude of EPSPs from a variety of inputs onto fast-type motor neurons occurred. The habituated EPSPs were quickly dishabituated by iontophoretic release of octopamine from a microelectrode into the neuropilar region of presumed synaptic action. The zone within which release was effective for a given neuron was narrowly-defined. With larger amounts of octopamine applied at a sensitive site the EPSP became larger than normal, and in many instances action potentials were initiated by the sensitized response. Very small EPSPs onto a motor neuron, which were associated with proprioceptive feedback, and which were originally too small to be detected above the noise, were potentiated to a level of several mV by the iontophoresed octopamine. A DUM neuron (presumed to be octopaminergic) was found, whose direct stimulation was followed by a strong dishabituating and sensitizing action leading to spikes, of inputs to an identified flexor tibiae motor neuron. The action and its time course were closely similar to those evoked by octopamine iontophoresed into the neuropil in the region of synaptic inputs to the motor neuron. It is concluded that DUM (octopaminergic) neurons exert large potentiating actions on central neuronal excitatory synaptic transmission in locusts.

Animals↗

PubMed1989

The clinical use of dynamic posturography in the elderly.

We provide an overview of the clinical uses of dynamic posturography. Although the equipment described to perform this testing is expensive, the concepts, especially those for sensory organization, can be applied for +20.00. To apply the six sensory organization conditions, one merely needs some way to disrupt proprioceptive information by maintaining ankle angle and providing for visual conflict stimuli. We found that proprioceptive information can be disrupted easily by asking the patient to stand on a thick (4-inch) dense piece of foam rubber like that used in cushions for furniture. Visual stabilization conflict can be provided by having the patient wear a 19- to 20-inch Japanese lantern with a head-mounting system in the center so that the patient's movements do not reflect themselves in relative movements to the visual environment. With use of these two simple tools, the six sensory organization tests can be approximated in a clinical situation in a short time and can provide some relative information about a patient's postural control capabilities. With minor additional work, a quantitative measure of output that gives indications of the amount of anterior-posterior sway also can be provided. For elderly patients with a variety of problems ranging from general unsteadiness to frank vertigo, the risk of falling can be devastating, and it is important to provide a thorough investigation of the total balance system. The systematic investigation, qualitatively or quantitatively, of integration of sensory input and motor outputs provides a dimension that typically has been lacking in the routine "dizzy patient workup" for all ages but especially for elderly patients. Therefore, the application of the postural maintenance theory with the above-described procedures or variations in these procedures appears to have a great deal of clinical relevance in the evaluation of patients with gait and balance disorders. These types of evaluations represent an adjunct or addition to the evaluation of the vestibular system and the vestibulo-ocular reflexes and by no means should be considered a substitute for that traditional evaluation. It is the combination of information that can provide the clinician with a more global picture of the entire balance system and its functional capabilities.

Adult↗

PubMedDate not supplied

Spectral frequency analysis of dynamic balance in healthy and injured athletes.

Different neurophysiological circuits underlie the various frequencies of the body sway for the regulation of human upright posture. Servo-controlled platforms allowed experimental studies about latency responses after a sudden external disturbance but power frequency repartition during spontaneous dynamic equilibrium has rarely been examined. The purpose of the present study was to examine the zone of sway frequency assigned to proprioceptive afferences from muscular, articular and tendinous receptors in healthy and injured subjects standing on an unstable and minimal area. Dynamic balance conditions were realized by asking athletes to stand up on a seesaw (stabilometer). The recordings (stabilograms) were monitored by means of an accelerometer. Their power spectra were obtained by a fast Fourier transform process. A first study was conducted in order to specify the contribution of articular receptors of the ankle in the regulation of spontaneous dynamic equilibrium of five soccer players with unilateral injured ankle (IA). The balance parameters in lateral sways were measured in monopodal stance on the healthy ankle (HA) comparatively to IA. The stabilogram was longer (P < 0.05), the total energy of 2-20 Hz band (P < 0.01) higher in the IA (1074 +/- 111 mm and 53 +/- 8 V2) than in the HA (836 +/- 150 mm and 36 +/- 8 V2). A second study analyzed the contribution of knee articular receptors involved in the reflexes of antigravity extension. We assessed during bipodal stance the anteroposterior sways of five basketball players with injured knee (IK) and 3 with healthy knee (HK) in eyes-open and eyes-closed situations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1981

Unusual presentation of Charcot Marie-Tooth disease-incoordination with absent of minimal wasting-Report of 2 cases.

Two patients are reported presenting with incoordination mimicking cerebellar disease in the upper and lower limbs, ataxia of gait, absent tendon reflexes and little or no clinically detectable wasting. Motor conduction velocity in the upper limbs was substantially reduced in one patient whereas it was normal and slightly reduced in the other. It is concluded that in Charcot-Marie Tooth disease incoordination may mimic cerebellar disease and when this is so it is due to the association of varying degrees of proprioceptive deafferentation and a dyskinesia similar to that produced by familial (essential) tremor.

Adolescent↗

PubMed1993

Cerebral cortical evoked potentials elicited by cat intercostal muscle mechanoreceptors.

Intercostal muscle afferents discharge in response to changes in intercostal muscle mechanics and have spinal and brain stem projections. It was hypothesized that intercostal muscle mechanoreceptors also project to the sensorimotor cortex. In cats, the proximal muscle branch of an intercostal nerve was used for electrical stimulation. The mechanical stimulation was stretch of an isolated intercostal space. The sensorimotor cortex was mapped with a surface ball electrode. Primary cortical evoked potentials (CEP) were found in area 3a of the sensorimotor cortex with mechanical and electrical stimulation. The CEP was elicited with the smallest stretch amplitude used, 50 microns. The CEP response showed little increase beyond 300-microns stretch. The CEP elicited by 50-microns stretch suggests an initial cortical activation by intercostal muscle spindles. The minimal increase in CEP amplitude with stretch > 300 microns suggests that the CEP response is primarily due to muscle spindle recruitment. The increase in amplitude beyond this stretch may be due to recruitment of tendon organs. These results demonstrate a short-latency projection of intercostal muscle mechanoreceptors to the sensorimotor region of the cerebral cortex. This cortical activation may be involved in respiratory sensations and/or transcortical reflex responses to changes in respiratory muscle mechanics.

Animals↗

PubMed1975

Optic organ and cervical proprioceptors in maintenance of body equilibrium.

Two experiments were made on the functional correlation between the optic organ and the cervical proprioceptors in maintenance of body equilibrium. Experiment I: The effects of weak and strong electric stimulation of the deep nuchal muscles on changes in optokinetic nystagmus and optokinetic after-nystagmus were examined in adult non-albino rabbits with binocular vision. Experiment II: Experiment I was repeated on rabbits with monocular vision giving optokinetic stimulation moving from the side of the blindfolded eye to that of the open eye and applying only weak electric stimulation to the neck muscles. The results obtained were as follows: (1) Experiment I: Weak electric stimulation of the deep nuchal muscles of rabbits with binocular vision tended to promote optokinetic nystagmus with either no significant change or decrease in optokinetic after-nystagmus. Strong electric stimulation had the opposite effects, i.e., it tended to inhibit optokinetic nystagmus and activate optokinetic after-nystagmus. It also produced abnormal optokinetic nystagmus, such as the inversion phenomenon of optokinetic nystagmus and "optokinetic nystagmus firing". (2) Experiment II: Weak electric stimulation of the deep nuchal muscles of rabbits with monocular vision had similar effects to those in experiment I, but promotion of optokinetic nystagmus was less obvious, while activation of optokinetic after-nystagmus was more marked. In addition, the inversion phenomenon of optokinetic nystagmus developed even on weak electric stimulation. From these results the following conclusions were drawn: (1) The cervical proprioceptors can function in two mechanisms causing promotion and break down of equilibrium of the optokinetic system. (2) The cervical proprioceptors, as an organ of equilibrium, can exert two different actions on the optokinetic eye reflexes, i.e., they can promote optokinetic nystagmus and inhibit optokinetic after-nystagmus.

Animals↗

PubMed2001

Selective processing of vestibular reafference during self-generated head motion.

The vestibular sensory apparatus and associated vestibular nuclei are generally thought to encode head-in-space motion. Angular head-in-space velocity is detected by vestibular hair cells that are located within the semicircular canals of the inner ear. In turn, the afferent fibers of the vestibular nerve project to neurons in the vestibular nuclei, which, in head-restrained animals, similarly encode head-in-space velocity during passive whole-body rotation. However, during the active head-on-body movements made to generate orienting gaze shifts, neurons in the vestibular nuclei do not reliably encode head-in-space motion. The mechanism that underlies this differential processing of vestibular information is not known. To address this issue, we studied vestibular nuclei neural responses during passive head rotations and during a variety of tasks in which alert rhesus monkeys voluntarily moved their heads relative to space. Neurons similarly encoded head-in-space velocity during passive rotations of the head relative to the body and during passive rotations of the head and body together in space. During all movements that were generated by activation of the neck musculature (voluntary head-on-body movements), neurons were poorly modulated. In contrast, during a task in which each monkey actively "drove" its head and body together in space by rotating a steering wheel with its arm, neurons reliably encoded head-in-space motion. Our results suggest that, during active head-on-body motion, an efferent copy of the neck motor command, rather than the monkey's knowledge of its self-generated head-in-space motion or neck proprioceptive information, gates the differential processing of vestibular information at the level of the vestibular nuclei.

Action Potentials↗

PubMed2004

The role of multisensor data fusion in neuromuscular control of a sagittal arm with a pair of muscles using actor-critic reinforcement learning method.

In this study, we consider the role of multisensor data fusion in neuromuscular control using an actor-critic reinforcement learning method. The model we use is a single link system actuated by a pair of muscles that are excited with alpha and gamma signals. Various physiological sensor information such as proprioception, spindle sensors, and Golgi tendon organs have been integrated to achieve an oscillatory movement with variable amplitude and frequency, while achieving a stable movement with minimum metabolic cost and coactivation. The system is highly nonlinear in all its physical and physiological attributes. Transmission delays are included in the afferent and efferent neural paths to account for a more accurate representation of the reflex loops. This paper proposes a reinforcement learning method with an Actor-Critic architecture instead of middle and low level of central nervous system (CNS). The Actor in this structure is a two layer feedforward neural network and the Critic is a model of the cerebellum. The Critic is trained by the State-Action-Reward-State-Action (SARSA) method. The Critic will train the Actor by supervisory learning based on previous experiences. The reinforcement signal in SARSA is evaluated based on available alternatives concerning the concept of multisensor data fusion. The effectiveness and the biological plausibility of the present model are demonstrated by several simulations. The system showed excellent tracking capability when we integrated the available sensor information. Addition of a penalty for activation of muscles resulted in much lower muscle coactivation while keeping the movement stable.

Algorithms↗

PubMed1993

Parallel processing of proprioceptive information in the terminal abdominal ganglion of the crayfish.

The processing of proprioceptive information from the exopodite-endopodite chordotonal organ in the tailfan of the crayfish Procambarus clarkii (Girard) is described. The chordotonal organ monitors relative movements of the exopodite about the endopodite. Displacement of the chordotonal strand elicits a burst of sensory spikes in root 3 of the terminal ganglion which are followed at a short and constant latency by excitatory postsynaptic potentials in interneurones. The afferents make excitatory monosynaptic connections with spiking and nonspiking local interneurones and intersegmental interneurones. No direct connections with motor neurones were found. Individual afferents make divergent patterns of connection onto different classes of interneurone. In turn, interneurones receive convergent inputs from some, but not all, chordotonal afferents. Ascending and spiking local interneurones receive inputs from afferents with velocity thresholds from 2-400 degrees/s, while nonspiking interneurones receive inputs only from afferents with high velocity thresholds (200-400 degrees/s). The reflex effects of chordotonal organ stimulation upon a number of uropod motor neurones are weak. Repetitive stimulation of the chordotonal organ at 850 degrees/s produces a small reduction in the firing frequency of the reductor motor neurone. Injecting depolarizing current into ascending or non-spiking local interneurones that receive direct chordotonal input produces a similar inhibition.

Animals↗

PubMed1990

Phrenic afferents and ventilatory control.

It has been understood since the late 1800s that the diaphragm has significant sensory innervation. The role of phrenic afferents in the control of breathing, however, has been obscure. The phrenic nerve has been shown to contain a full array of afferent fibers. However, proprioceptive (group 1 fibers) afferents are few compared to postural muscles or the intercostals. The diaphragm, unlike the inspiratory intercostal muscles, has a small complement of spindle afferents and not all of these spindles are supplied with fusorial fibers. Reduced spindle afferents under gamma control help to explain previous studies of the diaphragm that have failed to reveal autogenic facilitation, that is, a reflex-mediated increase in drive during inspiratory loading. Nevertheless, some clinical studies have revealed increased activation of the diaphragm when its length is reduced. Group 1 fibers, which are predominantly tendon organ afferents in the diaphragm, have been shown to have a phasic inhibitory function. A reduction in this inhibition brought about by a reduction in diaphragmatic length during lung inflation may explain the increased diaphragmatic activation reported in clinical studies. Phrenic afferents have been shown to have multiple spinal and supraspinal projections. Recent studies have explored the ventilatory effects of thin fiber afferents (group III and IV fibers) in the phrenic nerve. Stimulation of these afferents has been shown both to inhibit and excite ventilation. These afferents arise from polymodal receptors that respond to both mechanical and chemical stimulation. Activation of these receptors may occur in a variety of conditions and the ventilatory response may be determined by the specific receptor activated.

Animals↗

PubMed1999

[Dysautonomia in Guillain-Barré syndrome].

About 20% of all GBS patients have symptoms of dysautonomia: labile hypertension, orthostatic hypotension, sinustachycardia or sinus arrest. This rate rises to 75% in patients with tetraplegia. Proprioceptive loss predicts dysautonomia independently from the severity of weakness. It is frequently responsible for dysautonomia. The afferent limb of cardiovascular regulation contains more myelinated fibers than the sympathetic and parasympathetic efferences, which determine the common classification of dysautonomia. The frequence of mixed sympathetic and parasympathetic hyperactivity is hard to explain by efferent lesions. Afferent conduction block releases the sympathetic efference of the baroreceptor reflex. The resulting catecholamine excess explains hypertension, tachycardia, ECG-changes and hyperglycemia. Norepinephrine sensitizes left ventricular stretch receptors. They induce cardiovascular depression and neurocardiogenic syncope which has a temporal behaviour similar to the blood pressure variations of GBS. Conduction block of sinoatrial stretch receptors causes inappropriate secretion of ADH and renin. Dysbalance between myelinated and unmyelinated afferents which decrease and increase heart rate may cause parasympathetic hyperactivity, as exemplified by pulmonary stretch receptors that are stimulated by artificial ventilation. Wrong afferent feedback is responsible for many cardiovascular instabilities in GBS. Blockade of misguided efferent reactions is an attractive therapeutical approach.

Autonomic Nervous System↗

PubMed1995

[Highlights in the subject of low frequency-high intensity TENS (review)].

Transcutaneous electrical neural stimulation (l.f.-h.i. TENS), employed in dentistry, allows masticatory muscles relaxation, temporary clearance of muscular and periodontal proprioceptive input and even oro-facial pain relief. The mechanisms involved in this type of stimulation are not entirely clarified. According to the most recent neurophysiological researches, the authors describe several l.f.-h.i. TENS. action modalities. Some of them are well known such as the gate control theory, the endogenous antinociceptive system activation, the metabolic recovery of the muscular tissue and the unloading reflex. Other mechanisms, instead, are less known such as hypnosis and stress analgesia, exteroceptive suppression and counterirritation (DNIC). Some hypothetical mechanisms are also considered such as endogenous inhibition and sympathetic activity reduction.

Acupuncture Analgesia↗

PubMed2006

Role of gravity-based information on the orientation and localization of the perceived body midline.

The present study focused on the influence of gravity-based information on the orientation and localization of the perceived body midline. The orientation was investigated by the rolling adjustment of a rod on the subjects' Z-axis and the localization by the horizontal adjustment of a visual dot as being straight ahead. Experiment 1 investigated the effect of the dissociation between the Z-axis and the direction of gravity by placing subjects in roll tilt and supine postures. In roll tilt, the perception of the body midline orientation was deviated in the direction of body tilt and the perception of its localization was deviated in the opposite direction. In the supine body orientation, estimates of the Z-axis and straight-ahead remained veridical as when the body was upright. Experiment 2 highlighted the relative importance of the otolithic and tactile information using diffuse pressure stimulation. The estimation of body midline orientation was modified contrarily to the estimation of its localization. Thus, subjects had no absolute representation of their egocentric space. The main hypothesis regarding the dissociation between the orientation and localization of the body midline may be related to a difference in the integration of sensory information. It can be suggested that the horizontal component of the vestibulo-ocular reflex (VOR) contributed to the perceived localization of the body midline, whereas its orientation was mainly influenced by tactile information.

Adult↗

PubMed1992

[Vestibular studies: current status, prospects].

Equilibrium is based on gaze stabilization. Clinical examinations currently test, individually the three components involved in equilibrium: vestibular, visual and proprioception. New investigations are being developed to test equilibrium dynamic conditions. After briefly reviewing vestibular physiology, under the authors discuss the various tests of vestibular function and equilibrium.

Eye Movements↗

PubMed2004

Neuromuscular aspects of osteoarthritis: a perspective.

Osteoarthritis (OA) represents failure of the diarthrodial joint and may be due to a primary abnormality in any of the tissues of the joint, e.g. articular cartilage, subchondral bone, synovium, periarticular muscle, or sensory nerves whose termini lie within the joint. Neuropathic arthropathy, due to severe sensory neuropathy, causes severe and rapid breakdown of joints. We have shown that interruption of sensory input from the ipsilateral hind limb strikingly accelerates progression of OA after anterior cruciate ligament transection in the dog; a clinical correlate exists in humans with diabetic neuropathy who sustain even minor joint trauma. Knee OA in humans is accompanied by defects in proprioception, although it is not clear whether the neurological abnormality is primary or a consequence of intra-articular pathology. The magnitude of the load on a joint and, especially, the rate of impulsive loading, influence development of OA. It is relevant, therefore, that quadriceps weakness may precede development of knee OA in some people, insofar as this may diminish the effectiveness of protective muscular reflexes and thereby increase deleterious joint loading. Individuals vary with respect to how they load their joints, perhaps because of genetic differences in central program generators.

Animals↗

PubMed2006

Effects produced in human arm and forearm motoneurones after electrical stimulation of ulnar and median nerves at wrist level.

Effects of electrical stimulation of ulnar and median nerves at wrist level were investigated in post-stimulus time histograms (PSTHs) of single motor units from both flexors and extensors in human arm and forearm. Stimulation of ulnar nerve produced late (mean extra time-after monosynaptic group Ia excitation-10.7 +/- 0.1 ms) high-threshold (>1.2 x motor threshold, MT) excitation, which was not reproduced by purely cutaneous stimulation, in all the investigated motor nuclei except in Extensor Carpi Radialis. Stimulation of median nerve, and of the skin of fingers II and III (at palmar side level), produced short latency inhibition (mean extra time 3.8 +/- 0.3 ms), which was most often truncated or followed by late excitation (mean extra time 11.8 +/- 0.3 ms); both effects were of low threshold (0.8 x MT). Short latency inhibition was very strong, and late excitation was rare and weak in almost all the investigated motor units except in those supplying flexors in forearm, in which the main effect was the late facilitation (stronger than in other motoneurones). Since extra time was not more than 13 ms, it is suggested that the late effects may be mediated through spinal pathways, at least during their 3-5 first ms. Based on the electrophysiological results and on the anatomical characteristics of ulnar and median nerves, it is assumed that ulnar-induced late high-threshold peak in PSTHs might reflect group II excitation in spinal motoneurones, and median-induced modifications in motor unit discharge, mainly cutaneous control of motoneurone discharge. Since the central delay of median-induced inhibition is longer the more caudal the motoneurone, inhibitory propriospinal-like interneurones are supposed to mediate cutaneous inhibitory control from hand upon muscles in arm and forearm. Potential roles of proprioceptive and cutaneous control from hand to more proximal musculature, provided by ulnar and median nerve, respectively, during precise hand movements are discussed.

Adult↗