Single unit recordings from muscle nerves in human subjects

The neural control of movement: a century of in vivo motor unit recordings is the legacy of Adrian and Bronk

In two papers dated 1928 to 1929 in The Journal of Physiology, Edgar Adrian and Detlev Bronk described recordings from motor nerve and muscle fibres. The recordings from motor nerve fibres required progressive dissection of the nerve until a few fibres remained, from which isolated single fibre activity could be detected. The muscle fibre recordings were performed in humans during voluntary contractions with an intramuscular electrode - the concentric needle electrode - that they describe for the first time in the second paper. They recognised that muscle fibres would respond to each impulse sent by the innervating motor neurone and that therefore muscle fibre recordings provided information on the times of activation of the motor nerve fibres which were as accurate as a direct record from the nerve. These observations and the description of the concentric needle electrode opened the era of motor unit recordings in humans, which have continued for almost a century and have provided a comprehensive view of the neural control of movement at the motor unit level. Despite important advances in technology, many of the principles of motor unit behaviour that would be investigated in the subsequent decades were canvassed in the two papers by Adrian and Bronk. For example, they described the concomitant motor neurones' recruitment and rate coding for force modulation, synchronisation of motor unit discharges, and the dependence of discharge rate on motor unit recruitment threshold. Here, we summarise their observations and discuss the impact of their work. We highlight the advent of the concentric needle, and its subsequent influence on motor control research.

Cancer survivors post-chemotherapy exhibit unimpaired short-latency stretch reflexes in the proximal upper extremity

Oxaliplatin (OX) chemotherapy can lead to long-term sensorimotor impairments in cancer survivors. The impairments are often thought to be caused by OX-induced progressive degeneration of sensory afferents known as length-dependent dying-back sensory neuropathy. However, recent preclinical work has identified functional defects in the encoding of muscle proprioceptors and in motoneuron firing. These functional defects in the proprioceptive sensorimotor circuitry could readily impair muscle stretch reflexes, a fundamental building block of motor coordination. Given that muscle proprioceptors are distributed throughout skeletal muscle, defects in stretch reflexes could be widespread, including in the proximal region where dying-back sensory neuropathy is less prominent. All previous investigations on chemotherapy-related reflex changes focused on distal joints, leading to results that could be influenced by dying-back sensory neuropathy rather than more specific changes to sensorimotor circuitry. Our study extends this earlier work by quantifying stretch reflexes in the shoulder muscles in 16 cancer survivors and 16 healthy controls. Conduction studies of the sensory nerves in hand were completed to detect distal sensory neuropathy. We found no significant differences in the short-latency stretch reflexes (amplitude and latency) of the shoulder muscles between cancer survivors and healthy controls, contrasting with the expected differences based on the preclinical work. Our results may be linked to differences between the human and preclinical testing paradigms including, among many possibilities, differences in the tested limb or species. Determining the source of these differences will be important for developing a complete picture of how OX chemotherapy contributes to long-term sensorimotor impairments.NEW & NOTEWORTHY Our results showed that cancer survivors after oxaliplatin (OX) treatment exhibited stretch reflexes that were comparable with age-matched healthy individuals in the proximal upper limb. The lack of OX effect might be linked to differences between the clinical and preclinical testing paradigms. These findings refine our expectations derived from the preclinical study and guide future assessments of OX effects that may have been insensitive to our measurement techniques.

Short-latency stretch reflexes depend on the balance of activity in agonist and antagonist muscles during ballistic elbow movements

The spinal stretch reflex is a fundamental building block of motor function, with a sensitivity that varies continuously during movement and when changing between movement and posture. Many have investigated task-dependent reflex sensitivity, but few have provided simple, quantitative analyses of the relationship between the volitional control and stretch reflex sensitivity throughout tasks that require coordinated activity of several muscles. Here, we develop such an analysis and use it to test the hypothesis that modulation of reflex sensitivity during movement can be explained by the balance of activity within agonist and antagonist muscles better than by activity only in the muscle homonymous with the reflex. Subjects completed hundreds of flexion and extension movements as small, pseudorandom perturbations of elbow angle were applied to obtain estimates of stretch reflex amplitude throughout the movement. A subset of subjects performed a postural control task with muscle activities matched to those during movement. We found that reflex modulation during movement can be described by background activity in antagonist muscles about the elbow much better than by activity only in the muscle homonymous to the reflex (P < 0.001). Agonist muscle activity enhanced reflex sensitivity, whereas antagonist activity suppressed it. Surprisingly, the magnitude of these effects was similar, suggesting a balance of control between agonists and antagonists very different from the dominance of sensitivity to homonymous activity during posture. This balance is due to a large decrease in sensitivity to homonymous muscle activity during movement rather than substantial changes in the influence of antagonistic muscle activity.NEW & NOTEWORTHY This study examined the sensitivity of the stretch reflexes elicited in elbow muscles to the background activity in these same muscles during movement and postural tasks. We found a heightened reciprocal control of reflex sensitivity during movement that was not present during maintenance of posture. These results help explain previous discrepancies in reflex sensitivity measured during movement and posture and provide a simple model for assessing their contributions to muscle activity in both tasks.

Recording and quantifying sympathetic outflow to muscle and skin in humans: methods, caveats and challenges

The development of microneurography, in which the electrical activity of axons can be recorded via an intrafascicular microelectrode inserted through the skin into a peripheral nerve in awake human participants, has contributed a great deal to our understanding of sensorimotor control and the control of sympathetic outflow to muscle and skin. This review summarises the different approaches to recording muscle sympathetic nerve activity (MSNA) and skin sympathetic nerve activity (SSNA), together with discussion on the issues that determine the quality of a recording. Various analytical approaches are also described, with a primary emphasis on those developed by the author, aimed at maximizing the information content from recordings of postganglionic sympathetic nerve activity in awake humans.

Motor unit recruitment in myopathy: The myopathic EMG reconsidered

Motor unit recruitment is abnormal in myopathies. We have addressed this subject by recording motor unit potentials (MUPs) using a standard concentric needle electrode in tibialis anterior muscles of clinically normal strength in a group of patients with myopathy (15 with myositis and 4 with facioscapulohumeral muscular dystrophy Type 1). In each recording site, a minimal voluntary contraction was sought in order to activate only 2 MUPs. At least 5 pairs of MUPs were recorded in each muscle. We analysed the recruitment rate of the first activated MUP and the mean consecutive difference (MCD) of firing frequency between the individual MUPs of each recruited pair. Results were compared with 30 healthy control subjects. In myopathy the first recorded MUs fired at similar rates to controls (8.2 vs 8.0 Hz, respectively), but the MCD of the firing rate difference between the first two recruited MUPs was less than in controls (median difference 1.78 Hz vs median difference 2.47 Hz, p = 0.02). This change suggests increased lower motor neuron excitability as a functional adaptation, since muscle strength was normal in the studied muscles. These findings are consistent with spinal cord adaptation to the functional changes associated with myopathic muscle disease, although a primary muscle fibre feedback sensing mechanism could also be involved.

Microneurography as a tool to study the function of individual C-fiber afferents in humans: responses from nociceptors, thermoreceptors, and mechanoreceptors

The technique of microneurography-recording neural traffic from nerves in awake humans-has provided us with unrivaled insights into afferent and efferent processes in the peripheral nervous system for over 50 years. We review the use of microneurography to study single C-fiber afferents and provide an overview of the knowledge gained, with views to future investigations. C-fibers have slowly conducting, thin-diameter, unmyelinated axons and make up the majority of the fibers in peripheral nerves (~80%). With the use of microneurography in humans, C-fiber afferents have been differentiated into discrete subclasses that encode specific qualities of stimuli on the skin, and their functional roles have been investigated. Afferent somatosensory information provided by C-fibers underpins various positive and negative affective sensations from the periphery, including mechanical, thermal, and chemical pain (C-nociceptors), temperature (C-thermoreceptors), and positive affective aspects of touch (C-tactile afferents). Insights from microneurographic investigations have revealed the complexity of the C-fiber system, methods for delineating fundamental C-fiber populations in a translational manner, how C-fiber firing can be used to identify nerve deficits in pathological states, and how the responses from C-fibers may be modified to change sensory percepts, including decreasing pain. Understanding these processes may lead to future medical interventions to diagnose and treat C-fiber dysfunction. NEW & NOTEWORTHY The technique of microneurography allows us to directly investigate the functional roles of single C-fiber afferents in awake human beings. Here we outline and discuss the current field of C-fiber research on this heterogeneous population of afferents in healthy subjects, in pathological states, and from a translational perspective. We cover C-fibers encoding touch, temperature, and pain and provide perspectives on the future of C-fiber microneurography investigations in humans.

Microneurography: how it started and how it works

In the first section, this historical review describes endeavors to develop the method for recording normal nerve impulse traffic in humans, designated microneurography. The method was developed at the Department of Clinical Neurophysiology of the Academic Hospital in Uppsala, Sweden. Microneurography involves the impalement of a peripheral nerve with a tungsten needle electrode. Electrode position is adjusted by hand until the activity of interest is discriminated. Nothing similar had previously been tried in animal preparations, and thus the large number of preceding studies that recorded afferent activity in other mammals did not offer pertinent methodological guidance. For 2 years, the two scientists involved in the research impaled their own nerves with electrodes to test various kinds of needles and explore different neural systems, all the while carefully watching for signs of nerve damage. Temporary paresthesiae were common, whereas enduring sequelae never followed. Single-unit impulse trains could be discriminated, even those originating from unmyelinated fibers. An explanation for the discrimination of unitary impulses using a coarse electrode is inferred based on the electrical characteristics of the electrode placed in the flesh and the impulse shapes, as discussed in the second section of this paper. Microneurography and the microstimulation of single afferents, combined with psychophysical methods and behavioral tests, have generated new knowledge particularly regarding four neural systems, namely the proprioceptive system, the cutaneous mechanoreceptive system, the cutaneous nociceptive system, and the sympathetic efferent system to skin structures and muscular blood vessels. Examples of achievements based on microneurography are presented in the final section.

Microneurography from the posterior tibial nerve: a novel method of recording activity from the foot in freely standing humans

The posterior tibial nerve, located behind the medial malleolus of the ankle, supplies the intrinsic muscles of the foot and most of the skin of the sole. We describe a novel approach for recording from this nerve via a percutaneously inserted tungsten microelectrode and provide examples of recordings from presumed muscle spindle endings recorded in freely standing human subjects. The fact that the angular excursions of the ankle joint are small as the foot is loaded during the transition from the seated position to standing means that one can obtain stable recordings of neural traffic in unloaded, loaded, and freely standing conditions. We conclude that this novel approach will allow studies that will increase our understanding of the roles of muscle and cutaneous afferents in the foot in the control of upright posture.

NEW & NOTEWORTHY We have performed the first microneurographic studies from the posterior tibial nerve at the ankle. Stability of the recording site allows one to record from muscle spindles in the intrinsic muscles of the foot as well as from cutaneous mechanoreceptors in the sole of the foot during the transition from seated to standing. This novel approach opens up new opportunities for studying the roles of muscle and cutaneous afferents in the foot in the control of upright stance.

Precise coding of ankle angle and velocity by human calf muscle spindles

Human standing balance control requires the integration of sensory feedback to produce anticipatory, stabilizing ankle torques. However, the ability of human triceps surae muscle spindles to provide reliable sensory feedback regarding the small, slow ankle movements that occur during upright standing has recently come under question. We performed microneurography to directly record axon potentials from single muscle spindle afferents in the human triceps surae during servo-controlled movement of the ankle joint. To simulate movements of the ankle while standing, we delivered random 90-s dorsiflexion/plantar flexion oscillations of the ankle joint, with a peak-to-peak amplitude of 0.7° and frequency content below 0.5Hz. In roughly half of the trials (46%), participants held a low-level, near-isometric contraction of the triceps surae muscles. We demonstrate that afferent activity in a population of muscle spindles closely reflects ankle movements at frequencies and amplitudes characteristic of human standing. Four out of five soleus spindles, and three out of seven gastrocnemius spindles coded for at least a single frequency component of anteroposterior ankle rotation. Concatenating within muscles, coherence was significantly greater for soleus spindles at all stimulus frequencies. Voluntary contraction of the parent muscle reduced spindle sensitivity, but only significantly near the mean power frequency of the stimulus (∼0.3Hz). In conclusion, these results provide direct evidence that triceps surae muscle spindles are potentially capable of providing important sensory feedback for the control of human standing balance.

Motoneuron firing in amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis is an inexorably progressive neurodegenerative disorder involving the classical motor system and the frontal effector brain, causing muscular weakness and atrophy, with variable upper motor neuron signs and often an associated fronto-temporal dementia. The physiological disturbance consequent on the motor system degeneration is beginning to be well understood. In this review we describe aspects of the motor cortical, neuronal, and lower motor neuron dysfunction. We show how studies of the changes in the pattern of motor unit firing help delineate the underlying pathophysiological disturbance as the disease progresses. Such studies are beginning to illuminate the underlying disordered pathophysiological processes in the disease, and are important in designing new approaches to therapy and especially for clinical trials.

Decoding of the spike timing of primary afferents during voluntary arm movements in monkeys

Understanding the mechanisms of encoding forelimb kinematics in the activity of peripheral afferents is essential for developing a somatosensory neuroprosthesis. To investigate whether the spike timing of dorsal root ganglion (DRG) neurons could be estimated from the forelimb kinematics of behaving monkeys, we implanted two multi-electrode arrays chronically in the DRGs at the level of the cervical segments in two monkeys. Neuronal activity during voluntary reach-to-grasp movements were recorded simultaneously with the trajectories of hand/arm movements, which were tracked in three-dimensional space using a motion capture system. Sixteen and 13 neurons, including muscle spindles, skin receptors, and tendon organ afferents, were recorded in the two monkeys, respectively. We were able to reconstruct forelimb joint kinematics from the temporal firing pattern of a subset of DRG neurons using sparse linear regression (SLiR) analysis, suggesting that DRG neuronal ensembles encoded information about joint kinematics. Furthermore, we estimated the spike timing of the DRG neuronal ensembles from joint kinematics using an integrate-and-fire model (IF) incorporating the SLiR algorithm. The temporal change of firing frequency of a subpopulation of neurons was reconstructed precisely from forelimb kinematics using the SLiR. The estimated firing pattern of the DRG neuronal ensembles encoded forelimb joint angles and velocities as precisely as the originally recorded neuronal activity. These results suggest that a simple model can be used to generate an accurate estimate of the spike timing of DRG neuronal ensembles from forelimb joint kinematics, and is useful for designing a proprioceptive decoder in a brain machine interface.

Population coding of forelimb joint kinematics by peripheral afferents in monkeys

Various peripheral receptors provide information concerning position and movement to the central nervous system to achieve complex and dexterous movements of forelimbs in primates. The response properties of single afferent receptors to movements at a single joint have been examined in detail, but the population coding of peripheral afferents remains poorly defined. In this study, we obtained multichannel recordings from dorsal root ganglion (DRG) neurons in cervical segments of monkeys. We applied the sparse linear regression (SLiR) algorithm to the recordings, which selects useful input signals to reconstruct movement kinematics. Multichannel recordings of peripheral afferents were performed by inserting multi-electrode arrays into the DRGs of lower cervical segments in two anesthetized monkeys. A total of 112 and 92 units were responsive to the passive joint movements or the skin stimulation with a painting brush in Monkey 1 and Monkey 2, respectively. Using the SLiR algorithm, we reconstructed the temporal changes of joint angle, angular velocity, and acceleration at the elbow, wrist, and finger joints from temporal firing patterns of the DRG neurons. By automatically selecting a subset of recorded units, the SLiR achieved superior generalization performance compared with a regularized linear regression algorithm. The SLiR selected not only putative muscle units that were responsive to only the passive movements, but also a number of putative cutaneous units responsive to the skin stimulation. These results suggested that an ensemble of peripheral primary afferents that contains both putative muscle and cutaneous units encode forelimb joint kinematics of non-human primates.

Motor unit firing in amyotrophic lateral sclerosis and other upper and lower motor neurone disorders

OBJECTIVE

Motor unit recruitment order and firing rate was investigated in healthy subjects, and in small numbers of patients 50years ago. We aimed to investigate firing rate in different disorders, testing the same target muscle with normal strength, to evaluate possible application in diagnosing upper motor neuron (UMN) lesion.

METHODS

We studied motor unit firing in the tibialis anterior muscle in six groups of subjects; normal subjects (n=45), patients with amyotrophic lateral sclerosis (ALS) (n=36), primary lateral sclerosis (PLS) (n=21), progressive muscular atrophy (PMA) (n=14), various upper motor neurone lesions (n=16) and polyneuropathy (n=42). In all these subjects the tibialis anterior muscle was of normal strength. Motor units were recruited during slight contraction in order to study 2-5 motor units at each recording site, using a standard concentric needle electrode, so that 20-22 motor units were recorded in each muscle. We analysed the coefficient of variation (CV) for amplitude, area, duration and firing rate in these motor units, and the correlation between motor unit potential size and recruitment order.

RESULTS

The mean MU firing rate in this task was similar in each group. No recruitment order was disclosed within the limits of the study task. The CV of firing rate was decreased in UMN and PLS groups. ALS patients with marked spasticity showed a lower CV of motor unit firing rate. The CV of amplitude, area and duration was similar between groups.

CONCLUSIONS

These results in tibialis anterior indicate that physiological modulation of lower motor neuron (LMN) firing rate is decreased in patients with lower limb spasticity. The variability of MU discharges tends to be greater in diseases affecting the LMN.

SIGNIFICANCE

These results suggest that, notwithstanding the simplicity of the task we have used, the physiological variability of motor unit firing may be a useful variable in assessing UMN involvement in motor system disorders.

Firing patterns of spontaneously active motor units in spinal cord-injured subjects

Involuntary motor unit activity at low rates is common in hand muscles paralysed by spinal cord injury. Our aim was to describe these patterns of motor unit behaviour in relation to motoneurone and motor unit properties. Intramuscular electromyographic activity (EMG), surface EMG and force were recorded for 30 min from thenar muscles of nine men with chronic cervical SCI. Motor units fired for sustained periods (>10 min) at regular (coefficient of variation ≤ 0.15, CV, n =19 units) or irregular intervals (CV>0.15, n =14). Regularly firing units started and stopped firing independently suggesting that intrinsic motoneurone properties were important for recruitment and derecruitment. Recruitment (3.6 Hz, SD 1.2), maximal (10.2 Hz, SD 2.3, range: 7.5-15.4 Hz) and derecruitment frequencies were low (3.3 Hz, SD 1.6), as were firing rate increases after recruitment (~20 intervals in 3 s). Once active, firing often covaried, promoting the idea that units received common inputs.Half of the regularly firing units showed a very slow decline (>40 s) in discharge before derecruitment and had interspike intervals longer than their estimated after hyperpolarisation potential (AHP) duration (estimated by death rate and breakpoint analyses). The other units were derecruited more abruptly and had shorter estimated AHP durations. Overall, regularly firing units had longer estimated AHP durations and were weaker than irregularly firing units, suggesting they were lower threshold units. Sustained firing of units at regular rates may reflect activation of persistent inward currents, visible here in the absence of voluntary drive, whereas irregularly firing units may only respond to synaptic noise.

The scapholunate interosseous ligament afferent proprioceptive pathway: a human in vivo experimental study

PURPOSE

To examine the afferent pathways of the scapholunate interosseous ligament (SLIL)-generated stimuli and their contribution to the overall carpal proprioception.

METHODS

We examined 5 selected patients with preganglionic global root avulsion, confirmed by previous brachial plexus exploration, during the initial stage of carpal arthrodesis surgery. Despite their anesthetic-flail extremity, both the distal axon and the ganglionic cell were intact and able to transfer afferent stimuli. We placed electrodes subcutaneously over the adjacent areas of the ulnar, median, and radial nerves at the elbow region and performed an intraoperative neurophysiologic study. We studied the homologous sensory action potentials (SAPs) generated at the wrist in relaxation, flexion, extension, radial deviation, and ulnar deviation positions at each nerve and repeated them in 2 stages. The first took place with the SLIL intact and the second with the SLIL lacerated. The noise from the rest of the wrist elements was digitally eliminated.

RESULTS

After the SLIL laceration, SAP intensities recorded at the median nerve in every wrist position were reduced. The radial and ulnar nerves showed differences of lesser degrees between the recorded SAP intensities before and after the ligament sectioning in every carpal position, with only the radial nerve following a specific pattern. The SAP intensity recorded at the median nerve in every carpal motion after the SLIL laceration was similar to the SAP intensity at relaxation with the SLIL intact, whereas recordings of various intensities were present for the radial and ulnar nerves.

CONCLUSIONS

The SLIL generates proprioceptive stimuli at every wrist position. The main innervation of the whole SLIL derives from the anterior interosseous nerve; a partial contribution of the posterior interosseous nerve focused on the dorsal subregion of the ligament may also be present.

NeuPSIG guidelines on neuropathic pain assessment

This is a revision of guidelines, originally published in 2004, for the assessment of patients with neuropathic pain. Neuropathic pain is defined as pain arising as a direct consequence of a lesion or disease affecting the somatosensory system either at peripheral or central level. Screening questionnaires are suitable for identifying potential patients with neuropathic pain, but further validation of them is needed for epidemiological purposes. Clinical examination, including accurate sensory examination, is the basis of neuropathic pain diagnosis. For more accurate sensory profiling, quantitative sensory testing is recommended for selected cases in clinic, including the diagnosis of small fiber neuropathies and for research purposes. Measurement of trigeminal reflexes mediated by A-beta fibers can be used to differentiate symptomatic trigeminal neuralgia from classical trigeminal neuralgia. Measurement of laser-evoked potentials is useful for assessing function of the A-delta fiber pathways in patients with neuropathic pain. Functional brain imaging is not currently useful for individual patients in clinical practice, but is an interesting research tool. Skin biopsy to measure the intraepidermal nerve fiber density should be performed in patients with clinical signs of small fiber dysfunction. The intensity of pain and treatment effect (both in clinic and trials) should be assessed with numerical rating scale or visual analog scale. For future neuropathic pain trials, pain relief scales, patient and clinician global impression of change, the proportion of responders (50% and 30% pain relief), validated neuropathic pain quality measures and assessment of sleep, mood, functional capacity and quality of life are recommended.

Motor unit behavior during clonus

Medial gastrocnemius surface electromyographic activity and intramuscular electromyographic activity were recorded from six individuals with chronic cervical spinal cord injury to document the recruitment order of motor units during clonus. Four subjects induced clonus that lasted up to 30 s while two subjects induced clonus that they actively stopped after 1 min. Mean clonus frequency in different subjects ranged from 4.7 to 7.0 Hz. Most of the 166 motor units recorded during clonus (98%) fired once during each contraction but at slightly different times during each cycle. Other motor units fired during some clonus cycles (1%) or in bursts (1%). When 59 pairs of units were monitored over consecutive clonus cycles (n = 5-89 cycles), only 8 pairs of units altered their recruitment order in some cycles. Recruitment reversals only occurred in units that fired close together in the clonus cycle. These data demonstrate that orderly motor unit recruitment occurs during involuntary contractions of muscles paralyzed chronically by cervical spinal cord injury, providing further support for the importance of spinal mechanisms in the control of human motor unit behavior.

Physiological characteristics of low-threshold mechanoreceptors in joints, muscle and skin in human subjects

1. The development of microneurography, in which an insulated tungsten microelectrode is inserted into an accessible peripheral or cranial nerve in awake human subjects, has allowed detailed analyses of the signalling capacities of single mechanoreceptive afferents from the skin, muscles and joints. For example, we know much about how the two classes of rapidly adapting (Meissner and Pacinian) and two classes of slowly adapting (Merkel and Ruffini) cutaneous mechanoreceptors encode forces applied normal or tangential to the skin of the hand and the similarities and differences in glabrous versus non-glabrous skin (and receptors associated with hairs). We also know about stretch- and force-sensitive endings in muscle (the muscle spindle and Golgi tendon organ, respectively) and how they behave during passive or active movements or during isometric contractions. In addition, we have characterized the firing properties of mechanoreceptors in the joint capsules of the fingers. However, we know little about sensory nerves in the periosteum, other than that nociceptors and Pacinian corpuscles exist. 2. In addition to studies on the physiology of sensory endings in human subjects, microstimulation through the recording microelectrode has revealed how the brain deals with the sensory information conveyed by a single afferent. From this work, we know that there is specificity in the sensory channels: electrical stimulation of a single Meissner or Pacinian corpuscle generates frequency dependent illusions of 'flutter' or 'vibration', whereas microstimulation of a single Merkel afferent can produce a percept of 'pressure' and stimulation of a single joint afferent can evoke a sensation of 'joint rotation'. Interestingly, the input from a single Ruffini ending in the skin cannot be perceived and the same is true of muscle spindle afferents. So, where does this leave us with osseoperception from the mouth? Given that the periodontal receptors in the vicinity have been lost, which mechanoreceptive endings could encode forces applied to a bone-implanted prosthesis? 3. Meissner and Merkel endings have very small receptive fields and respond only to local forces. Pacinian corpuscles have an exquisite sensitivity to brisk mechanical events and could respond to such stimuli transmitted through the bone to a remote receptor, but would not be able to encode sustained forces. Ruffini endings also respond to forces applied remote to the receptive field and, unlike the Pacinian corpuscles, respond in a sustained fashion, but would their signals be perceived? Like muscle spindles, it is possible that the coactivation of many Ruffini endings could provide meaningful information. Finally, as we have seen, the input from a single joint receptor can be perceived, but they mostly respond at the limits of joint rotation, so it is unlikely that any associated with the temporomandibular joint could contribute to osseoperception.

Microneurography: how the technique developed and its role in the investigation of the sympathetic nervous system

A historical review is given of the development of microneurography and its application for studies of sympathetic nerve activity in humans.

Subtypes of nociceptive units in the rat temporomandibular joint

Response properties of nociceptors in the rat's temporomandibular joint (TMJ) were investigated using an in vitro TMJ-nerve preparation. Recordings were obtained from 33 nociceptive units that responded to mechanical, chemical, and/or thermal stimuli. According to both characteristics of nociceptors and afferent fibers, nociceptive units in the TMJ area were classified into the following four subtypes: Adelta-high-threshold mechanonociceptor (HTM) (12.1%), Adelta-polymodal nociceptor (POLY) (36.4%), C-HTM (12.1%), and C-POLY (39.4%). The mean mechanical threshold of the Adelta units was significantly lower than that of the C units. Bradykinin increased the discharge of Adelta- and C-POLY units. No significant differences of thermal thresholds between Adelta and C units were found. The percentage of Adelta units was 47.2% and of C units was 52.8%, respectively. In the TMJ area, POLY units were predominant (75.8%), suggesting that inflammatory reactions can easily evoke pain sensation.

Position sensitivity of human muscle spindles: single afferent and population representations

The representation of joint position at rest and during movement was investigated in 44 muscle spindle primary afferents originating from the extensor carpi radialis brevis (ECRb) and extensor digitorum (ED) of normal human subjects. Position sensitivity was estimated for each afferent, and 43 of 44 were position sensitive. In each trial, six sequential ramp-and-hold movements (2-6 degrees, 2 degrees/s, total 24 degrees) flexed the relaxed wrist, beginning from the angle at which the afferent was just recruited. Joint position was represented by three specific features of afferent firing patterns: the steady-state firing rate during the 4-s hold period between ramps, the initial burst at the beginning of each ramp, and the ramp increase in firing rate later in the movement. The position sensitivity of the initial burst (1.27 +/- 0.90 pps/degree, mean +/- SD) was several times higher than that of the hold period (0.40 +/- 0.30 pps/degree) and not different from that of the ramp increase in firing rate (1.36 +/- 0.68 pps/degree). The wrist position sensitivities of ECRb and ED afferents were equivalent, as were their recruitment angles and angular ranges of position sensitivity. Muscle spindle afferents, both individually and as a population, were shown to represent static joint position via the hold rate and the initial burst. Afferents were recruited over the entire 110 degree range of wrist positions investigated; however, the angular range over which each feature represented joint position was extremely limited (approximately 15 degrees). The population response, based on the summed activity of the 43 afferents, was monotonically related to joint position, and it was strongly influenced by the afferent recruitment pattern, but less so by the position sensitivities of the individual afferents.

An in vitro temporomandibular joint-nerve preparation for pain study in rats

A novel in vitro TMJ-nerve preparation was developed to quantitatively study peripheral sensory mechanisms of temporomandibular joint (TMJ). The TMJ region on one side (including mandibular head, disc, retrodiscal tissue and mandibular fossa) of adult Wistar albino rats was excised together with the auriculo-temporal nerve. The block was preserved in a modified Krebs-Henseleit solution saturated with O(2)/CO(2) (95/5%) gas mixture. Using a calibrated von Frey type apparatus, mechanical noxious stimulation was applied directly to various sites within the TMJ region. In addition, thermal and chemical noxious stimuli were also attempted. Stable recordings of single unit activities from the auriculo-temporal nerve could be obtained for as long as 5 h, which was sufficient to analyze the response properties of the TMJ units to various stimuli. This new preparation would be useful for investigating TMJ peripheral sensory mechanisms, especially pain, and potentially makes it possible to reveal neural mechanisms of temporomandibular arthralgia, a syndrome that has recently shown an increased incidence in clinical dentistry.

Spontaneous motor unit behavior in human thenar muscles after spinal cord injury

Our first aim was to characterize spontaneous motor unit activity in thenar muscles influenced by chronic cervical spinal cord injury. Thenar surface electromyography (EMG), intramuscular EMG, and abduction and flexion forces were recorded. Subjects were instructed to relax for 2 min. Units still firing after 10 s were considered spontaneously active. Two distinct patterns of spontaneous unit activity were recorded. Units either fired tonically at a mean frequency of 6.1 HZ or were active sporadically (2.2 HZ). Stimuli (e.g., light touch of nearby skin) were then used to influence tonic spontaneous unit activity. Most stimuli produced a change in firing frequency, usually a temporary increase, but sometimes unit frequency decreased or new activity was initiated. Inputs to these motoneurons clearly make important contributions to changes in unit activity. However, the difficulty that subjects had in stopping unit activity, and the initiation of activity when subjects relaxed, suggest that the source of spontaneity may be the motoneuron itself.

The role of motor unit rate modulation versus recruitment in repeated submaximal voluntary contractions performed by control and spinal cord injured subjects

The relative roles of motor unit firing rate modulation and recruitment were evaluated when individuals with cervical spinal cord injury (SCI) and able-bodied controls performed a brief (6 s), 50% maximal voluntary contraction (50% MVC; target contraction) of triceps brachii every 10 s until it required maximal effort to achieve the target force. Mean (+/-SD) endurance times for SCI and control subjects were 34+/-26 and 15+/-5 min, respectively, at which point significant reductions in maximal triceps force had occurred. Twitch occlusion analysis in controls indicated that force declines resulted largely from peripheral contractile failure. In SCI subjects, triceps surface EMG and motor unit potential amplitude declined in parallel suggesting failure at axon branch points and/or alterations in muscle membrane properties. The force of low threshold units, measured by spike-triggered averaging, declined in SCI but not control subjects, suggesting that higher threshold units fatigued in controls. Central fatigue was also obvious after SCI. Mean (+/-SD) MVC motor unit firing rates declined significantly with fatigue for control (24.6+/-7.1 to 17.3+/-5.1Hz), but not SCI subjects (25.9+/-12.7 to 20.1+/-9.7Hz). Unit firing rates were unchanged during target contractions for each subject group, but with the MVC rate decreases, units of SCI and control subjects were activated intensely at endurance time (88% and 99% MVC rates, respectively). New unit recruitment also maintained the target contractions although it was limited after SCI because many descending inputs to triceps motoneurons were disrupted. This resulted in sparse EMG, even during MVCs, but allowed the same unit to be recorded throughout. These EMG data showed that both unit recruitment and rate modulation were important for maintaining force during repeated submaximal intermittent contractions of triceps brachii muscles performed by SCI subjects. Similar results were found for control subjects. Muscles weakened by SCI may therefore provide a useful model in which to directly study motor unit rate modulation and recruitment during weak or strong voluntary contractions.

Postural after-contractions in man attributed to muscle spindle thixotropy

1. It is an old observation that non-volitional arm abduction movements accompanied by a sensation of arm lightness often occur as an after-effect following forceful voluntary arm abductor contractions against a restraint. In the present study we have tested the hypothesis that such non-volitional, so-called 'postural after-contractions' are tonic reflex responses to an enhanced resting discharge in primary muscle spindle afferents which in turn is a consequence of thixotropy-dependent enhanced stiffness of intrafusal muscle fibres. 2. Results obtained in ten volunteers show that the arm abductor after-contraction phenomenon in man is most readily evoked by a type of conditioning procedure which in various respects mimics the procedure proven in animal experiments to be particularly effective in producing thixotropy-dependent excitation of primary spindle endings. 3. It is also shown that changes in arm abductor intramuscular temperature affect the strength of the after-contractions in a direction predicted by the thixotropy hypothesis. 4. Attention is drawn to several similarities between the after-contraction phenomenon with accompanying sensory illusions and the tonic reflex responses and illusions that can be induced when primary spindle endings are excited by muscle vibration. 5. The results support our hypothesis that postural after-contractions are induced by activity in primary muscle spindle afferents as a consequence of thixotropic properties of intrafusal muscle fibres. Central excitability changes following the conditioning voluntary effort may contribute to the phenomenon.

Distinct patterns of motor unit behavior during muscle spasms in spinal cord injured subjects

Surface electromyograms (EMG) and force were recorded during repeated involuntary spasms of paralyzed triceps surae muscles of four men with chronic cervical spinal cord injury. The firing rates of 78 medial gastrocnemius (MG) motor units also were recorded intramuscularly with tungsten microelectrodes. Spasms typically involved a relatively rapid rise, then a more gradual fall in triceps surae EMG and torque. Motor unit firing rates either increased and then decreased with the spasm intensity (54%) or were relatively constant (26%), firing mainly at 2-10 Hz. The remaining units (20%) produced trains that included one or several doublets. Mean peak spasm firing rates were 18 +/- 9 Hz (mean +/- SD) for rate modulated units and 11 +/- 10 Hz for units with little or no rate modulation. Some motor units fired at rates comparable with those recorded previously during maximum voluntary contractions performed by intact subjects. Others fired at rates below the minimum usually seen when normal units are first recruited (< 6 Hz). Doublets (interspike interval < 10 ms) often repeated every 123-333 ms, or were interspersed in trains firing at low steady rates (< 11 Hz). This study shows that rate coding for many motor units appears to be similar whether descending motor input is intact or whether it has been reduced severely by spinal cord injury. In contrast, rate modulation in other units appears to depend mainly on voluntary motor commands.

Motor unit forces and recruitment patterns after cervical spinal cord injury

Force was measured from triceps brachii motor units in individuals with chronic cervical spinal cord injury (SCI) and in able-bodied (A-B) control subjects using spike-triggered averaging (175 and 48 units, respectively). Eleven percent of units from the SCI population generated normal electromyograms (EMGs) but exerted no measurable force, 65% generated force comparable to the control data, while 24% were stronger than usual. Weak units probably reflect disuse. Muscle shortening, densely innervated territories, and polyphasic EMG potentials suggested strong units resulted from intact axons sprouting to reinnervate denervated muscle. Many units from SCI subjects had faster than normal contraction times (CTs). The force and CT distributions from the SCI and A-B populations differed significantly. Motor units of SCI subjects were recruited in order of increasing force output and increasing contraction time. Chronic cervical SCI therefore seems to alter the expected triceps brachii motor unit force-speed relations.

Efferent responses to twitch tests used in identifying human muscle afferents

The response of a muscle afferent to the mechanical stimulus produced by a twitch contraction of the receptor-bearing muscle is an important test for differentiating between muscle spindle endings and Golgi tendon organs. The present study demonstrates that active alpha-motor axons can behave in a similar manner to spindle afferents, presumably responding not to the mechanical event per se, but reflexly to the change in afferent discharge created by the mechanical event. alpha-Motor axons were unequivocally identified during microneurography using spike-triggered averages of EMG. Caution is required when the twitch test is utilized to assist in the classification of muscle afferents during an intentional or unintentional voluntary contraction.

Microneurography and applications to issues of motor control: Fifth Annual Stuart Reiner Memorial Lecture

Among the hypotheses regarding fusimotor functions based on earlier animal experiments some are inconsistent, others are in conformity with microneurographic observations in man. The human data provide evidence against the following two theories: (1) the length follow-up servo theory; and (2) the theory that fusimotor neurons can be selectively activated to produce spindle sensitization and stretch reflex reinforcements. The human data support the theory of alpha-gamma coactivation. In particular, in the early phase of isometric voluntary contractions fusimotor-driven afferent spindle activity assists in autogenetic activation of alpha motoneurons and in reciprocal relaxation of antagonists. As muscle fatigue develops, the autogenetic reflex drive via the fusimotor route declines. The fusimotor bias during contraction provides for maintenance of spindle sensitivity to minute perturbations and for load-compensating reflex adjustments to such perturbations. Reflex overcorrections may lead to uncontrollable oscillations of the type seen in enhanced physiological tremor.

Changes in motoneurone firing rates during sustained maximal voluntary contractions

Tungsten micro-electrodes have been used to record the electrical activity of single motor units in the human adductor pollicis during maximal voluntary contractions. The potentials were characteristic of those from single muscle fibres. In brief maximal contractions, the firing rates of over 200 motor units were obtained from five normal subjects. Four subjects had a similar range (mean 26.4 +/- 6.5 Hz) while the fifth was slightly higher (35 +/- 7.4 Hz). When maximal voluntary force was sustained for 40-120 s, there was a progressive decline in the range and mean rate of motor-unit discharge. In the first 60 s, mean rates fell from about 27 Hz to 15 Hz. There was some evidence to suggest that those units with the highest initial frequencies changed rate most rapidly. It is suggested that this decline in motor unit discharge rates is not responsible for force loss, but that it may enable effective modulation of voluntary strength by rate coding to continue during fatigue.

Efferents and afferents in an intact muscle nerve: background activity and effects of sural nerve stimulation in the cat

1. The background activity was observed in gamma and alpha efferent fibres and in group I and II fibres innervating the muscle gastrocnemius lateralis or medialis. The reflex effects of ipsilateral and contralateral sural nerve stimulations on the muscle efferents were analysed together with their consequences upon the afferents of the same muscle. The observations were made in the decerebrated cat without opening the neural loops between the muscle and the spinal cord.2. The multi-unit discharges of each category of fibres were obtained, on line, by an original electronic device (Joffroy, 1975, 1980) that sorted the action potentials from the whole electrical activity of a small branch of gastrocnemius lateralis or medialis nerve according to the direction and velocity of propagation of the potentials.3. The small nerve may be regarded as a representative sample of different functional groups of fibres conducting faster than 12 m.sec(-1) and supplying gastrocnemius muscles.4. Some gamma efferents were always tonically firing except when a transient flaccid state developed. Usually the alpha efferents were silent, probably because the muscle was fixed close to the minimal physiological length.5. Separate and selective stimulations of Abeta, Adelta and C fibres of ipsilateral and contralateral sural nerve showed that each group could induce the excitation of gamma neurones. The reciprocal inhibition period of alpha efferents during a flexor reflex was only once accompanied by a small decrease in gamma-firing.6. The reflex increase of over-all frequency of gamma efferents resulted from an increased firing rate of tonic gamma neurones and from the recruitment of gamma neurones previously silent. When the gamma efferents in the small nerve naturally occurred in two subgroups, the slower-conducting subgroup (mainly composed of tonic gamma axons) was activated before the faster-conducting subgroup (mostly composed by gamma axons with no background discharge). Some rare exceptions were found, however.7. The selective activation of gamma efferents could be obtained with short-and low-frequency stimulation. When, with stronger stimulations, gamma-alpha co-activation was observed, the onset of the gamma-firing increase preceded by 100-600 msec that of the alpha discharge in the small nerve. Likewise, the onset of the gamma-efferent response preceded the increase of over-all electromyographic activity of the whole triceps muscle but only by 10-100 msec. The discrepancy could be due to the soleus alpha motoneurones being activated earlier than the alpha-motoneurones of gastrocnemius muscle, according to the size principle. In only one experiment, the alpha-firing onset preceded the gamma-firing increase.8. Stimulations of ipsilateral or contralateral nerve, whatever the alpha or gamma reflex patterns, always led to increased firing rates of group I and II fibres of the small nerve. The origins of the discharge of group I and II muscle afferents and the excitation mechanisms of the receptors involved are considered. Some aspects of the mechanism of the reflex control of movement are discussed in the light of these results.

Inhibition and synchronisation of tremor induced by a muscle twitch

The effects of a muscle twitch on the tremor of the extensor indicis muscle and of the tibial anterior muscle have been recorded in 14 patients with essential tremor and in 10 patients with Parkinson's disease. The muscle twitch evoked by the electrical stimulation of the motor nerve inhibits the tremor and synchronises it. The mean duration of the inhibition is 92.1 +/- 6.8 ms for essential tremor and 183.0 +/- 16.8 ms for Parkinsonian tremor. This inhibitory phase lasts longer when the muscle twitch is induced during the second half of the Parkinsonian tremor cycle. The effects of voluntary contraction and of unloading suggest that inhibition and resetting of the tremor can be attributed to the autogenic mechanism induced by Ib fibres discharges. The presence of a rhythmic inhibition in the cycle of Parkinsonian tremor accounts for the longer duration of the inhibitory phase. In practice, these techniques aid the diagnosis of tremor in these two conditions, for example they assist the identification of low frequency essential tremor and of postural tremor in Parkinson's disease.

Fusimotor activity in masseter nerve of the cat during reflex jaw movements

1. Unit recordings have been made from the central ends of filaments of the masseter nerve in lightly anaesthetized cats. Evidence is presented to show that fusimotor activity may be distinguished from alpha motor activity. 2. During reflex cyclic movements induced by intra-oral stimulation, two distinct patterns of fusimotor firing emerged. One type of unit increased firing at the beginning and sustained this with little modulation throughout the movements. The other type was strongly modulated approximately in parallel with the alpha motor activity. 3. By comparison with records of jaw elevator spindle afferents under similar conditions, it was deduced that the sustained type of action was due to dynamic fusimotor neurones while the modulated type was due to static fusimotor neurones. 4. The patterns of fusimotor activity seen in these rhythmic movements under light anaesthesia agree well with the patterns deduced from spindle recordings in the conscious cat during mastication. 5. The results emphasize the importance of looking beyond a simple hypothesis of 'alpha-gamma co-activation' to explain fusimotor function. It is proposed that tonic dynamic fusimotor activity is set at the beginning of a movement to determine the incremental sensitivity of primary endings to stretch. The static fusimotor fibres are activated principally during shortening to help keep both primary and secondary endings active.

Recurrent inhibition of individual Ia inhibitory interneurones and disinhibition of their target alpha-motoneurones during muscle stretches

The effects of ramp stretches applied to triceps surae muscle on the discharge patterns of single Ia inhibitory interneurones, monosynaptically invaded from various nerves, were studied in either decerebrate or anesthetized cats. Interneurones which received direct excitatory Ia input from the stretched muscle exhibited augmented activity both during the dynamic and static phase of stretch, which was, however, interrupted by a transient inhibitory influence during the dynamic phase of stretch. The influences on Ia inhibitory interneurones, monosynaptically invaded from hamstring or tibial nerve, were exclusively inhibitory. These stretch-induced inhibitions were better demonstrable in decerebrate than in anesthetized preparations. The timing of the discharge patterns of additionally recorded Renshaw cells during stretch, and the disappearance or reduction of the above described inhibitory effects after administration of DHE, strongly support the idea that these inhibitory actions are caused by Renshaw inhibition. In Ia inhibitory interneurones, monosynaptically activated from the antagonistic peroneal nerve, stretch induced also pronounced inhibitory effects, which were most probably caused by mutual inhibition between Ia inhibitory interneurones. The suppression of agonistic Ia inhibitory interneurone activity below the tonic resting activity corresponded to an enhancement of the monosynaptic reflex amplitude of the antagonistic motoneurone pool. The findings suggest that normal orthodromic activation of Renshaw cells, and consequently the recurrent inhibition of the Ia inhibitory interneurones, is predominantly linked with rapid phasic, rather than slow tonic, motoneuronal firing. The functional role of this mechanism for the performance of rapidly alternating movements and the damping of ballistic agonist contractions is discussed.

Muscle spindle activity in man during voluntary fast alternating movements

Single unit activity in primary spindle afferent nerve fibres from finger and foot flexors was recorded with tungsten microelectrodes inserted into the median and peroneal nerves of healthy subjects. During voluntary fast alternating finger and foot movements, simulating the tremor of Parkinsonism, two types of discharges were seen in the Ia afferent fibres: (1) stretch responses occurring during the flexor relaxation phases, and (2) discharges occurring during the flexor contraction phases. Contrary to the stretch responses the spindle contraction discharges could be eliminated by a partial lidocaine block of the muscle nerve proximal to the recording site, indicating that they resulted from fusimotor activation of intrafusal fibres. On the basis of the temporal relations between the beginning and end of individual EMG-bursts, the start of the spindle contraction discharges and the latency of the stretch reflex in the muscles concerned, the following conclusions were drawn: the recurrent extrafusal contractions in movements of this type are initiated by the fast direct alpha route, but individual contraction phases generally last long enough to be influenced subsequently by the coactivated fusimotor loop through the spindles. It is postulated that this gamma loop influence during alternating movements helps to keep flexor and extensor muscles working in a regular reciprocal fashion with contractions adjusted in strength to the external loads.