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Relander A, Jaakkola S, Virri H, Niemelä E, Vasankari T, Nuotio I, Airaksinen KEJ, Kiviniemi T. Fibrillatory wave amplitude and thromboembolic risk in non-anticoagulated patients with atrial fibrillation. Ann Med 2024; 56:2317362. [PMID: 38350436 PMCID: PMC10866044 DOI: 10.1080/07853890.2024.2317362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The benefit of oral anticoagulation in atrial fibrillation (AF) is well established for patients at elevated stroke risk, but less clear for those at intermediate risk. We investigated whether analysis of electrocardiogram (ECG) derived fibrillatory waves (F-waves) could help identify patients at risk for stroke and systemic embolism (SSE). METHODS The Finnish Cardioversion (FinCV) study included patients not on permanent anticoagulation therapy who underwent cardioversion for an acute AF episode. We identified 739 individuals with a valid ECG and complete follow-up data. The maximum amplitudes of the F-waves in leads II and V1 were manually measured from the pre-procedure ECG. Patients were categorized into fine and coarse F-wave groups. The optimal lead and amplitude threshold for grouping were found in an events per person-years analysis. SSE were identified from the patient medical records until either anticoagulation was prescribed, AF was deemed chronic, the patient had deceased, or the end of follow-up. RESULTS Overall 37 (5.0%) patients suffered SSE during the median follow-up time of 5.4 years (1.9-10.8). Measured from lead V1 the SSE rates per 100 person-years were 1.5 and 0.7 in fine and coarse F-wave groups, respectively. Fine F-waves were observed in 112 (15.2%). Baseline characteristics were similar between the groups. Fine F-wave predicted SSE in a competing risk analysis (SHR 2.34, 95%CI 1.12-4.87, p = .023). Analyses from lead II did not provide significant results. CONCLUSION Electrocardiographic F-wave amplitude may provide additional information on stroke risk in patients with paroxysmal AF and borderline indications or contraindications for anticoagulation.
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Affiliation(s)
- Arto Relander
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Samuli Jaakkola
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Hilla Virri
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Eelis Niemelä
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Tuija Vasankari
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Ilpo Nuotio
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Tuomas Kiviniemi
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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2
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Yang L, Chen X, Wu R. Afterdischarges in myotonic dystrophy type 1. Neurol Sci 2024; 45:735-740. [PMID: 37584878 DOI: 10.1007/s10072-023-07013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Electrodiagnostic testing is an important screening test for myotonic dystrophy type 1 (DM1). Although myotonic discharges are observed on electromyography in cases of DM1, it is difficult to distinguish DM1 from other myotonic disorders clinically. In the present study, afterdischarges, another type of pathological potential revealed by electrodiagnostic testing, were analyzed, and their role in distinguishing DM1 from other myotonic disorders was explored. METHODS Data from 33 patients with myotonic discharges on electromyography were analyzed retrospectively. According to gene testing, the patients were divided into DM1 (n = 20) and non-DM1 myotonia (n = 13) groups. Afterdischarges were investigated by retrospectively evaluating the electrodiagnostic findings of motor nerve conduction studies, F-waves, and repetitive nerve stimulations. RESULTS Afterdischarges were observed in 17 of the 20 patients with DM1, with an occurrence rate of approximately 85%. However, afterdischarges were absent in all patients with non-DM1 myotonia. There were significant differences in the occurrence rate between the two groups (P < 0.01). CONCLUSION Afterdischarges may serve as a suggestive role in clinical diagnosis of DM1. The discovery that DM1 can present with afterdischarges may pave a new way to study the pathogenesis of DM1.
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Affiliation(s)
- Li Yang
- Electromyography Room, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Xiuying Chen
- Electromyography Room, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
| | - Rui Wu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
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3
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Özyurt MG, Nascimento F, Brownstone RM, Beato M. On the origin of F-wave: involvement of central synaptic mechanisms. Brain 2024; 147:406-413. [PMID: 37796028 PMCID: PMC10834253 DOI: 10.1093/brain/awad342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023] Open
Abstract
Neurophysiological methods are used widely to gain information about motor neuron excitability and axon conduction in neurodegenerative diseases. The F-wave is a common biomarker used to test motor neuron properties in the diagnosis of neurological diseases. Although the origin of the F-wave is a subject of debate, the most widely accepted mechanism posits that the F-wave is generated by the backfiring of motor neurons stimulated antidromically from the periphery. In this study, we developed an ex vivo mouse sciatic nerve-attached spinal cord preparation with sensory axons severed. In this preparation, stimulation of the whole sciatic nerve or its tibial branch evoked responses with the electrophysiological signatures of F-waves. Manipulations of synaptic transmission by either removal of extracellular calcium or block of post-synaptic glutamate receptors abolished these responses. These results suggest that F-waves are mediated by spinal microcircuits activated by recurrent motor axon collaterals via glutamatergic synapses.
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Affiliation(s)
- M Görkem Özyurt
- Department of Neuroscience Physiology and Pharmacology (NPP), University College London, London WC1E 6BT, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Filipe Nascimento
- Department of Neuroscience Physiology and Pharmacology (NPP), University College London, London WC1E 6BT, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Robert M Brownstone
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Marco Beato
- Department of Neuroscience Physiology and Pharmacology (NPP), University College London, London WC1E 6BT, UK
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4
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Fidancı H, Öztürk İ, Buturak Ş, Yıldız M, Arlier Z. The effect of Jendrassik maneuver on the persistence of the peroneal nerve F-wave. Turk J Phys Med Rehabil 2023; 69:309-316. [PMID: 37674799 PMCID: PMC10478551 DOI: 10.5606/tftrd.2023.10931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/24/2022] [Indexed: 09/08/2023] Open
Abstract
Objectives This study investigated whether peroneal nerve F-wave persistence increased when the Jendrassik maneuver (JM) was performed, aiming to obtain information about the physiology of F-waves and JM. Patients and methods Thirty healthy individuals (HIs; 17 females, 13 males; mean age: 33.6±8.2 years; range, 23-50 years) were included in the prospective experimental study conducted between June 15, 2021, and December 15, 2021. Nerve conduction studies of peroneal, superficial peroneal, posterior tibial, and sural nerves were performed in one extremity of each HI. The peroneal nerve F-wave study was performed at rest (Study 1), during JM (Study 2), and after JM (Study 3). F-wave persistence of the peroneal nerve, maximum F-wave amplitude (ampF-wavemax), mean F-wave amplitude (ampF-wavemean), minimum F-wave latency, and the ratio of ampF-wavemean to maximum M amplitude (F/M ratio) were analyzed. Results The mean peroneal nerve F-wave persistence in Study 1, Study 2, and Study 3 was 28.7±23.9%, 52.3±32.1%, and 34.7±29.0%, respectively. F-wave persistence in Study 2 was higher compared to Studies 1 and 3 (p<0.001 and p<0.001, respectively). Moreover, ampF-wavemax, ampF-wavemean, and F/M ratio in Study 2 were higher than Studies 1 and 3 (p=0.026 and p=0.021 for ampF-wavemean; p=0.015 and p=0.003 for ampF-wavemax; p=0.033 and p=0.015 for F/M ratio, respectively). F-wave persistence in Study 2 was positively correlated with ampF-wavemax and ampF-wavemean (p<0.001, r= 0.717; p<0.001, r=0.786, respectively). Conclusion This study demonstrated that JM increased F-wave persistence and amplitude. Jendrassik maneuver may show its effect through motor neuron excitability.
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Affiliation(s)
- Halit Fidancı
- Department of Neurology, Division of Clinical Neurophysiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
| | - İlker Öztürk
- Department of Neurology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
| | - Şencan Buturak
- Department of Neurology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
| | - Mehmet Yıldız
- Department of Neurology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
| | - Zülfikar Arlier
- Department of Neurology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
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5
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Kurobe M, Suzuki T. Pain reduction method in recording F-waves from the vastus lateralis muscle. Muscle Nerve 2023; 67:236-238. [PMID: 36576113 DOI: 10.1002/mus.27780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/16/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION/AIMS Conventional recording of F-waves from the vastus lateralis muscle causes severe pain in some subjects. Thus, we aimed to investigate the effects of the stimulation frequency on pain and F-wave parameters when recording F-waves from this muscle and to develop a method for recording F-waves from the vastus lateralis muscle that causes minimal pain. METHODS The subject's femoral nerve was electrically stimulated at 0.5 or 0.2 Hz 30 times, while F-waves were recorded from the vastus lateralis muscle. Pain intensity was measured immediately using a visual analog scale. In addition, the visual analog scale, F-wave persistence, F-wave latency, and F/M amplitude ratio were compared between F-wave recordings with 0.5-Hz electrical stimulation and those with 0.2-Hz electrical stimulation. RESULTS Eleven healthy men participated in this study. The visual analog scale and F-wave persistence decreased when electrical stimulation at 0.2 Hz was applied compared with electrical stimulation at 0.5 Hz. DISCUSSION Electrical stimulation at 0.5 Hz increased pain due to temporal summation. However, electrical stimulation at 0.2 Hz did not cause temporal summation, suggesting reduced pain and excitability of the alpha motor neuron pool.
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Affiliation(s)
- Masataka Kurobe
- Department of Rehabilitation, Tanabe Central Hospital, Wakayama, Japan.,Department of Clinical Rehabilitation Research, Tanabe Central Hospital, Wakayama, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Osaka, Japan
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6
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Kaneko N, Sasaki A, Fok KL, Yokoyama H, Nakazawa K, Masani K. F-waves induced by motor point stimulation are facilitated during handgrip and motor imagery tasks. Exp Brain Res 2023; 241:527-37. [PMID: 36622384 DOI: 10.1007/s00221-022-06537-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
The F-wave is a motor response elicited via the antidromic firings of motor nerves by the electrical stimulation of peripheral nerves, which reflects the motoneuron pool excitability. However, the F-wave generally has low robustness i.e., low persistence and small amplitude. We recently found that motor point stimulation (MPS), which provides the muscle belly with electrical stimulation, shows different neural responses compared to nerve stimulation, e.g., MPS elicits F-waves more robustly than nerve stimulation. Here, we investigated whether F-waves induced by MPS can identify changes in motoneuron pool excitability during handgrip and motor imagery. Twelve participants participated in the present study. We applied MPS on their soleus muscle and recorded F-waves during eyes-open (EO), eyes-closed (EC), handgrip (HG), and motor imagery (MI) conditions. In the EO and EC conditions, participants relaxed with their eyes open and closed, respectively. In the HG, participants matched the handgrip force level to 30% of the maximum voluntary force with visual feedback. In the MI, they performed kinesthetic MI of plantarflexion at the maximal strength with closed eyes. In the HG and MI, the amplitudes of the F-waves induced by MPS were increased compared with those in the EO and EC, respectively. These results indicate that the motoneuron pool excitability was facilitated during the HG and MI conditions, consistent with findings in previous studies. Our findings suggest that F-waves elicited by MPS can be a good tool in human neurophysiology to assess the motoneuron pool excitability during cognitive and motor tasks.
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7
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Usui R, Mutsuga M, Narita Y, Tokuda Y, Terazawa S, Ito H, Uchida W, Inden Y, Murohara T, Usui A. Higher F-wave frequency associates with poor procedural success rate after Maze procedure. Gen Thorac Cardiovasc Surg 2022; 70:997-1004. [PMID: 35771344 DOI: 10.1007/s11748-022-01836-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Persistent atrial fibrillation (AF) causes atrial remodeling, which causes myocardial fibrosis and micro-reentry. Fibrosis may reduce wave voltage and micro-reentry may enhance the dominant frequency (DF) of the F-wave. We investigated whether the DF predicts procedural success by the Maze procedure. METHODS In 138 consecutive patients who underwent mitral valve surgery and a modified Cox-Maze III procedure for persistent AF in Nagoya University in 2002-2018, 96 (70%) were successfully cardioverted (group S); 42 had persistent or relapsed AF after surgery (group F). Patient data were compared between the groups. Cut-off values were determined by an ROC analysis and predictors of procedural success were evaluated. The DF was obtained from the F-wave of V1 by a high-speed Fourier analysis using the CEPAS software program. RESULTS Group F showed a significantly larger LA diameter, better LVEF, lower F-wave voltage, higher DF, and longer duration of AF. The cut-off values were as follows: LA diameter, 56 mm; EF, 64.5%; F-wave voltage, 0.13 mV; DF, 7.3 Hz; and duration of AF, 44 months. Each factor showed statistical significance in a univariate analysis; DF lost significance in the multivariate analysis. The higher (DF ≥ 7.3 Hz) and lower voltage group (≤ 0.13 mV) showed the worst procedural success rate (36%), while the lower DF (< 7.3 Hz) and higher voltage group (> 0.13 mV) showed a good rate (86%). CONCLUSIONS The DF of the F-wave is a useful predictor of procedural success after the Maze procedure in addition to the voltage of F-wave.
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Affiliation(s)
- Rena Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
| | - Masato Mutsuga
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Yuji Narita
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Yoshiyuki Tokuda
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Sachie Terazawa
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Hideki Ito
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Wataru Uchida
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Yasuya Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
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8
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Oguz-Akarsu E, Sirin NG, Artug T, Erbas B, Orhan EK, Idrisoğlu HA, Ketenci A, Baslo MB, Oge AE. Automatic detection of F-waves and F-MUNE in Two Types of Motor Neuron Diseases. Muscle Nerve 2022; 65:422-432. [PMID: 35020950 DOI: 10.1002/mus.27494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION/AIMS Motor unit number estimation by F-waves (F-MUNE) is an uncommonly used MUNE technique. The aim of this study was to analyze the sensitivity of F-MUNE values elicited with newly developed software in motor neuron diseases. METHODS F-waves were recorded by 300 submaximal stimuli from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) muscles of 35 patients with amyotrophic lateral sclerosis, 18 with previous poliomyelitis, and 20 controls. The software extracted the surface motor unit action potentials (sMUAP) and calculated the F-MUNE values. CMAP Scans were also recorded to obtain step% and MScanFit. RESULTS sMUAP amplitudes were higher and F-MUNE values were lower in both muscles of the patients than in controls. F-MUNE values were able to distinguish the patients from controls. Significant correlations were found between F-MUNE and MScanFit in patient groups. DISCUSSION The new F-MUNE software gave promising results in revealing motor unit loss caused by motor neuron diseases.
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Affiliation(s)
- Emel Oguz-Akarsu
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Neurology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Nermin Gorkem Sirin
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugrul Artug
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Izmir Democracy University, Izmir, Turkey
| | - Bahar Erbas
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Pharmacology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Halil Atilla Idrisoğlu
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysegul Ketenci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Baris Baslo
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Emre Oge
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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9
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Bunno Y, Suzuki T. Thenar Muscle Motor Imagery Increases Spinal Motor Neuron Excitability of the Abductor Digiti Minimi Muscle. Front Hum Neurosci 2021; 15:753200. [PMID: 34924979 PMCID: PMC8674616 DOI: 10.3389/fnhum.2021.753200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022] Open
Abstract
When a person attempts intended finger movements, unintended finger movement also occur, a phenomenon called “enslaving”. Given that motor imagery (MI) and motor execution (ME) share a common neural foundation, we hypothesized that the enslaving effect on the spinal motor neuron excitability occurs during MI. To investigate this hypothesis, electromyography (EMG) and F-wave analysis were conducted in 11 healthy male volunteers. Initially, the EMG activity of the left abductor digiti minimi (ADM) muscle during isometric opposition pinch movement by the left thumb and index finger at 50% maximal effort was compared with EMG activity during the Rest condition. Next, the F-wave and background EMG recordings were performed under the Rest condition, followed by the MI condition. Specifically, in the Rest condition, subjects maintained relaxation. In the MI condition, they imagined isometric left thenar muscle activity at 50% maximal voluntary contraction (MVC). During ME, ADM muscle activity was confirmed. During the MI condition, both F-wave persistence and the F-wave/M-wave amplitude ratio obtained from the ADM muscle were significantly increased compared with that obtained during the Rest condition. No difference was observed in the background EMG between the Rest and MI conditions. These results suggest that MI of isometric intended finger muscle activity at 50% MVC facilitates spinal motor neuron excitability corresponding to unintended finger muscle. Furthermore, MI may induce similar modulation of spinal motor neuron excitability as actual movement.
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Affiliation(s)
- Yoshibumi Bunno
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Osaka, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Osaka, Japan
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10
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Uncini A, Foresti C, Frigeni B, Storti B, Servalli MC, Gazzina S, Cosentino G, Bianchi F, Del Carro U, Alfonsi E, Piccinelli SC, De Maria G, Padovani A, Filosto M, Ippoliti L. Electrophysiological features of acute inflammatory demyelinating polyneuropathy associated with SARS-CoV-2 infection. Neurophysiol Clin 2021; 51:183-191. [PMID: 33685769 PMCID: PMC7891083 DOI: 10.1016/j.neucli.2021.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To assess whether patients with acute inflammatory demyelinating polyneuropathy (AIDP) associated with SARS-CoV-2 show characteristic electrophysiological features. Methods Clinical and electrophysiological findings of 24 patients with SARS-CoV-2 infection and AIDP (S-AIDP) and of 48 control AIDP (C-AIDP) without SARS-CoV-2 infection were compared. Results S-AIDP patients more frequently developed respiratory failure (83.3% vs. 25%, P = 0.000) and required intensive care unit (ICU) hospitalization (58.3% vs. 31.3%, P = 0.000). In C-AIDP, distal motor latencies (DMLs) were more frequently prolonged (70.9% vs. 26.2%, P = 0.000) whereas in S-AIDP distal compound muscle action potential (dCMAP) durations were more frequently increased (49.5% vs. 32.4%, P = 0.002) and F waves were more often absent (45.6% vs. 31.8%, P = 0.011). Presence of nerves with increased dCMAP duration and normal or slightly prolonged DML was elevenfold higher in S-AIDP (31.1% vs. 2.8%, P = 0.000);11 S-AIDP patients showed this pattern in 2 nerves. Conclusion Increased dCMAP duration, thought to be a marker of acquired demyelination, can also be oserved in critical illness myopathy. In S-AIDP patients, an increased dCMAP duration dissociated from prolonged DML, suggests additional muscle fiber conduction slowing, possibly due to a COVID-19-related hyperinflammatory state. Absent F waves, at least in some S-AIDP patients, may reflect α-motor neuron hypoexcitability because of immobilization during the ICU stay. These features should be considered in the electrodiagnosis of SARS-CoV-2 patients with weakness, to avoid misdiagnosis.
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Affiliation(s)
- Antonino Uncini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
| | - Camillo Foresti
- Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
| | - Barbara Frigeni
- Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
| | - Benedetta Storti
- Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
| | | | | | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia and IRCCS Mondino Foundation, Pavia, Italy
| | - Francesca Bianchi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano, Italy
| | - Ubaldo Del Carro
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano, Italy
| | | | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | | | - Alessandro Padovani
- Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Luigi Ippoliti
- Statistics Unit, Department of Economics, University "G. d'Annunzio", Pescara, Italy
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11
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Baudry S, Duchateau J. Changes in corticospinal excitability during the preparation phase of ballistic and ramp contractions. J Physiol 2021; 599:1551-1566. [PMID: 33481277 DOI: 10.1113/jp281093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/20/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Changes in corticospinal excitability prior to a contraction may depend on its characteristics, including the rate of torque development. This study compared the specific modulation of cortical and spinal excitability during the preparation phase (last 500 ms before contraction) of fast (ballistic) and ramp contractions of ankle dorsiflexors, using transcranial magnetic stimulation and peripheral nerve stimulation. The results indicate earlier changes at the cortical than at the spinal level during the preparation phase of both contraction types. However, these adjustments are delayed prior to ballistic relative to ramp contractions. This study suggests that the time course of change in cortical and spinal excitability during the preparation phase of a voluntary action is specific to the intended rate of torque development of the upcoming contraction. ABSTRACT The present study investigated cortical and spinal excitability during the preparation phase of ballistic (BAL) and ramp (RAMP) isometric contractions. To this end, young adults performed BAL and RAMP (1500 ms torque rise time) contractions, reaching a similar torque level, with the ankle dorsiflexor muscles. Transcranial magnetic stimulation of the motor cortex was randomly applied to record motor evoked potentials (MEP) in the tibialis anterior during the last 500 ms preceding the contraction (n = 16). Short-interval intracortical inhibition (SICI; n = 10) and spinal motor neurone excitability (F-wave occurrence; n = 8) were also assessed during this period. Data were averaged over 100 ms time windows beginning 500 ms prior to the onset of contractions. An increase in MEP amplitude and a decrease in SICI were observed from the 200-100 ms and 300-200 ms time windows prior to BAL and RAMP contractions (P < 0.05), respectively, with greater changes prior to RAMP than to BAL within the 300-200 ms time window (P < 0.05). F-wave occurrence, used to assess spinal motor neurone excitability, increased prior to RAMP (200-100 ms, P < 0.05) but not BAL contractions. Data obtained in a few participants during the last 100 ms confirmed a delayed and steeper rise in corticospinal excitability prior to BAL contractions. These results indicate earlier changes at the cortical than at the spinal level, with delayed changes prior to BAL contractions. This study suggests that the time course of change in cortical and spinal excitability during the preparation phase of a voluntary action is specific to the intended rate of torque development of the upcoming contraction.
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Affiliation(s)
- Stéphane Baudry
- Laboratory of Applied Biology, Research Unit in Applied Neurophysiology, ULB-Neurosciences Institute (UNI), Faculty for Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Jacques Duchateau
- Laboratory of Applied Biology, Research Unit in Applied Neurophysiology, ULB-Neurosciences Institute (UNI), Faculty for Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Yamamoto Y, Shigematsu H, Kawaguchi M, Hayashi H, Takatani T, Tanaka M, Okuda A, Kawasaki S, Masuda K, Suga Y, Tanaka Y. Tetanic stimulation of the peripheral nerve augments motor evoked potentials by re-exciting spinal anterior horn cells. J Clin Monit Comput 2021; 36:259-270. [PMID: 33420971 DOI: 10.1007/s10877-020-00647-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Tetanic stimulation of the peripheral nerve, immediately prior to conducting transcranial electrical stimulation motor evoked potential (TES-MEP), increases MEP amplitudes in both innervated and uninnervated muscles by the stimulated peripheral nerve; this is known as the remote augmentation of MEPs. Nevertheless, the mechanisms underlying the remote augmentation of MEPs remain unclear. Although one hypothesis was that remote augmentation of MEPs results from increased motoneuronal excitability at the spinal cord level, the effect of spinal anterior horn cells has not yet been investigated. We aimed to investigate the effect of tetanic stimulation of the peripheral nerve on spinal cord anterior horn cells by analyzing the F-wave. We included 34 patients who underwent elective spinal surgeries and compared the changes in F-waves and TES-MEPs pre- and post-tetanic stimulation of the median nerve. F-wave analyses were recorded by stimulating the median and tibial nerves. TES-MEPs and F-wave analyses were compared between baseline and post-tetanic stimulation time periods using Wilcoxon signed-rank tests. A significant augmentation of MEPs, independent of the level corresponding to the median nerve, was demonstrated. Furthermore, F-wave persistence was significantly increased not only in the median nerve but also in the tibial nerve after tetanic stimulation of the median nerve. The increased F-wave persistence indicates an increase of re-excited motor units in spinal anterior horn cells. These results confirm the hypothesis that tetanic stimulation of the peripheral nerve may cause remote augmentation of MEPs, primarily by increasing the excitability of the anterior horn cells.
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Affiliation(s)
- Yusuke Yamamoto
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Hideki Shigematsu
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan.
| | | | | | - Tsunenori Takatani
- Division of Central Clinical Laboratory, Nara Medical University, Nara, Japan
| | - Masato Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Akinori Okuda
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Sachiko Kawasaki
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Keisuke Masuda
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Yuma Suga
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan
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Saxena A, Sehgal S, Jangra MK. Effectiveness of Neurodynamic Mobilization versus Conventional Therapy on Spasticity Reduction and Upper Limb Function in Tetraplegic Patients. Asian Spine J 2020; 15:498-503. [PMID: 33059433 PMCID: PMC8377221 DOI: 10.31616/asj.2020.0146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/28/2020] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN The study employed a pre- and post-test experimental design. PURPOSE This study was designed to assess the effect of neurodynamic mobilization of the median nerve on upper limb spasticity in tetraplegic patients. OVERVIEW OF LITERATURE Spasticity is a common and potentially disabling and bothersome complication in patients with spinal cord lesion; this disorder can negatively influence the quality of life by restricting the patient's ability to perform activities of daily living. Neural mobilization is currently used for reducing the spasticity in individuals with neurological disorders. METHODS Twenty subjects with traumatic spinal cord injury (level C5-C8) and upper limb spasticity in the finger and wrist flexors were enrolled. They were randomly allocated to two different groups using a computer-generated randomization schedule: group I comprised the neurodynamic mobilization group (n=11) and group II was the conventional therapy group (n=9); the subjects were administered therapy for 5 days every week for a period of 4 weeks. Upper limb spasticity was assessed using the Modified Ashworth Scale for wrist and finger flexors; F-wave amplitude, latency, and F-wave/M-wave amplitude ratio (F/M ratio) were examined using the F-wave scores of the median nerve; and upper limb function was determined using the Capabilities of Upper Extremity (CUE) Questionnaire. RESULTS After 4 weeks of intervention, between-group comparisons showed a significant difference in the pre-intervention and postintervention scores on the Modified Ashworth Scale score for wrist flexors (-1.64±0.67), Modified Ashworth Scale score for finger flexors (-1.00±0.63), F-wave amplitude (-154.09±220.86), F/M ratio (-0.18±0.24), and CUE scores (17.82±13.49). CONCLUSIONS These results suggest that neurodynamic mobilization of the median nerve may be effective for upper limb spasticity control and upper limb functional improvement in tetraplegic patients.
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Affiliation(s)
- Akanksha Saxena
- Department of Physiotherapy, Maharishi Markandeshwar University, Mullana, India
| | - Stuti Sehgal
- Division of Neurology, Department of Physiotherapy, Indian Spinal Injuries Center-Institute of Rehabilitation Sciences, New Delhi, India
| | - Mandeep Kumar Jangra
- Division of Cardiothoracic & Pulmonary Disorders, Department of Physiotherapy, Maharishi Markandeshwar University, Mullana, India
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Takahara T, Yamaguchi H, Seki K, Onodera S. Sensory gating and suppression of subjective peripheral sensations during voluntary muscle contraction. BMC Neurosci 2020; 21:41. [PMID: 33003995 PMCID: PMC7528260 DOI: 10.1186/s12868-020-00592-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the somatosensory evoked potentials (SEPs) amplitude decreases. This depression of sensory input during voluntary muscle contraction has been demonstrated by many studies using electrophysiological methods. However, the association between the electrophysiological response of the sensory system during sustained muscle contraction and subjective peripheral sensation (SPS) is still unclear. The aim of this study was to investigate changes in spinal excitability, SEPs, and SPS during voluntary muscle contraction. RESULTS The appearance rate of the F-wave was significantly higher during muscle contraction than rest, whereas no significant difference was observed in F-wave latency between muscle contraction and rest. Furthermore, the P25 amplitude of SEPs was significantly lower during muscle contraction than rest, whereas the N20 amplitude of SEPs exhibited no significant differences. The SPS was significantly lower during muscle contraction than rest CONCLUSIONS: We conclude that sensory gating, which is found in the P25 component of SEPs during muscle contraction, is one of the neurophysiological mechanisms underlying the suppression of SPS.
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Affiliation(s)
- Terumasa Takahara
- Department of Sport Social Management, KIBI International University, 8 Igamachi, Takahashi, Okayama, 716-8508, Japan.
| | - Hidetaka Yamaguchi
- Department of Sport Social Management, KIBI International University, 8 Igamachi, Takahashi, Okayama, 716-8508, Japan
| | - Kazutoshi Seki
- Department of Human Health and Wellbeing, University of Marketing and Distribution Science, Kobe. 3-1 Gakuen-Nishimachi, Nishi-ku, Kobe, Hyogo, 651-2188, Japan
| | - Sho Onodera
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
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15
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Wang ZL, Liu M, Cai Z, Ding Q, Hu Y, Cui L. A prospective study on split-hand index as a biomarker for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:574-583. [PMID: 32608275 DOI: 10.1080/21678421.2020.1779299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the practical diagnostic utility of split-hand index (SI) values calculated from F-wave persistence (SIFP) and the F/M amplitude ratio (SIF/M) for differentiating patients with amyotrophic lateral sclerosis (ALS) from other conditions. Methods: This prospective study recruited consecutive patients from Peking Union Medical College Hospital, China, between June 2019 and December 2019. Patients 18-80 years old who had clinical neuromuscular symptoms affecting the upper limbs and required electrophysiological examinations to aid diagnosis were eligible. Compound muscle action potentials (CMAPs) and F-waves recorded from the abductor pollicis brevis (APB), first dorsal interosseous muscle (FDI), and abductor digiti minimi (ADM) were examined. SIFP and SIF/M were calculated as: SI = (APB × FDI)/ADM. The sensitivity and specificity of SIFP and SIF/M in differentiating ALS from non-ALS conditions were derived using receiver operating characteristic (ROC) curves. Results: A total of 309 participants, comprising 91 (29.4%) with ALS and 218 (70.6%) with other neuromuscular disorders, were enrolled after 54 were excluded. SIFP was significantly reduced and SIF/M increased in the ALS group compared with the non-ALS group (p < 0.001). By ROC curve analysis, an SIFP cutoff of 73.3 showed 85.7% sensitivity and 80.7% specificity for differentiating ALS from non-ALS. SIF/M and SICMAP showed lower sensitivity (67% and 75.8%, respectively, p < 0.001) than SIFP for ALS diagnosis. SIFP and SIF/M combined did not outperform SIFP alone. Conclusion: SIFP could be a sensitive, noninvasive neurophysiological diagnostic marker for ALS patients with affected upper limbs. In particular, an SIFP value of 73.3 might be the optimal cutoff for diagnosing ALS.
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Affiliation(s)
- Zhi-Li Wang
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and
| | - Zhengyi Cai
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and
| | - Youfang Hu
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China, and.,Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
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Abstract
Purpose: In physical therapy for post-stroke patients, we often experience cases in which unpleasant emotions cause abnormal muscle tonus. Previously, we suggested that the magnitude of spinal motor neuron excitability was correlated with the grade of muscle tonus. Therefore, spinal motor neuron excitability was considered to be a useful index to evaluate the influence of unpleasant emotions on muscle tonus. In this study, we investigated whether unpleasant emotions evoked by visual stimuli affected the excitability of spinal motor neurons.Materials and Methods: The F-waves, an indicator of spinal motor neuron excitability, were measured in 19 healthy adult volunteers. Firstly, for the rest trial, F-waves were measured during relaxation to determine the baseline of spinal motor neuron excitability. Following the rest trial, the unpleasant trial was conducted in which F-waves were measured while the subjects viewed an unpleasant picture for 1 min. After the unpleasant trial, F-waves were measured during relaxation. For the control condition, F-waves were measured while the subjects viewed a neutral picture instead of the unpleasant picture. The recorded F-wave data were analysed for persistence and the F/M amplitude ratio.Results: Persistence and the F/M amplitude ratio were significantly greater during the unpleasant trial than during the rest trial. In the control condition, there was no significant difference in persistence and the F/M amplitude ratio compared with the three trials.Conclusions: Our findings indicate that unpleasant emotions may affect spinal motor neuron excitability. Therefore, learning how to control emotions should be important aspect of physical therapy.
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Affiliation(s)
- Chieko Onigata
- Clinical Physical therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Yoshibumi Bunno
- Clinical Physical therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan.,Graduate School of Health Sciences, Graduate School of Kansai, University of Health Sciences, Osaka, Japan
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17
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Aoyama T, Kaneko F, Ohashi Y, Kohno Y. Neural mechanism of selective finger movement independent of synergistic movement. Exp Brain Res 2019; 237:3485-3492. [PMID: 31741000 DOI: 10.1007/s00221-019-05693-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
Muscle synergy is important for simplifying functional movement, which constitutes spatiotemporal patterns of activity across muscles. To execute selective finger movements that are independent of synergistic movement patterns, we hypothesized that inhibitory neural activity is necessary to suppress enslaved finger movement caused by synergist muscles. To test this hypothesis, we focused on a pair of synergist muscles used in the hand opening movement, namely the index finger abductor and little finger abductor (abductor digiti minimi; ADM), and examined whether inhibitory neural activity in ADM occurs during selective index finger abduction/adduction movements and/or its imagery using transcranial magnetic stimulation and F-wave analysis. During the index finger adduction movement, background EMG activity, F-wave persistence, and motor evoked potential (MEP) amplitude in ADM were elevated. However, during the index finger abduction movement, ADM MEP amplitude remained unchanged despite increased background EMG activity and F-wave persistence. These results suggest that increased spinal excitability in ADM is counterbalanced by cortical-mediated inhibition only during selective index finger abduction movement. This assumption was further supported by the results of motor imagery experiments. Although F-wave persistence in ADM increased only during motor imagery of index finger abduction, ADM MEP amplitude during motor imagery of index finger abduction was significantly lower than that during adduction. Overall, our findings indicate that cortical-mediated inhibition contributes to the execution of selective finger movements that are independent of synergistic hand movement patterns.
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Affiliation(s)
- Toshiyuki Aoyama
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-gun, Ibaraki, Japan.
| | - Fuminari Kaneko
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yukari Ohashi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-gun, Ibaraki, Japan
| | - Yutaka Kohno
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-gun, Ibaraki, Japan
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Wang ZL, Cui L, Liu M, Zhang K, Liu S, Ding Q, Hu Y. Reassessment of Split-Leg Signs in Amyotrophic Lateral Sclerosis: Differential Involvement of the Extensor Digitorum Brevis and Abductor Hallucis Muscles. Front Neurol 2019; 10:565. [PMID: 31191446 PMCID: PMC6548849 DOI: 10.3389/fneur.2019.00565] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/13/2019] [Indexed: 12/11/2022] Open
Abstract
Background: The muscle patterns involved in the “split-leg” syndrome of amyotrophic lateral sclerosis (ALS) remains controversial. We sought to evaluate and reassess the pattern of the extensor digitorum brevis (EDB) and the abductor hallucis (AH) muscles' involvement in split-leg syndrome in ALS. Methods: We recruited 60 consecutive patients with ALS and 25 healthy controls (HCs). Compound muscle action potentials (CMAPs) and F-waves were recorded over the EDB and AH muscles in all subjects. For comparison, we classified patients into two categories based on the presence or absence of lower limbs symptoms. Results: The EDB/AH CMAP amplitude ratio was significantly reduced in patients with affected legs (0.33 ± 0.21, P = 0.007), whereas patients with unaffected legs had a ratio similar to that of the HCs. The EDB/AH ratios for the F-wave latencies, mean F-wave amplitude, mean F/M amplitude ratio, and the persistence of the total repeater F-wave shapes (index Freps) of the EDB-AH, were significantly increased in the affected leg group, whereas the EDB/AH ratio for F-wave persistence was significantly reduced. These findings indicated a greater loss of lower motor neurons (LMNs) innervating the EDB and dysfunction of spinal motoneurons innervating the EDB. In the unaffected leg group, the EDB, but not the AH, F-wave latencies, mean and maximal F/M amplitude ratios, and index Freps were significantly altered. Receiver operating characteristic curve analysis suggested that the EDB F-wave latencies, mean F/M amplitude ratios, and index Freqs (area under the curve [AUC] > 0.8) more strongly differentiated patients with ALS from the HCs compared to the EDB/AH CMAP amplitude ratio (AUC = 0.61). Notably, the EDB maximal F-wave latency and index Freqs reliably differentiated patients with unaffected legs (HCs), with AUCs of 0.83 (95% CI 0.76–0.91) and 0.81 (95% CI 0.72–0.89), sensitivities of 76 and 78%, and specificities of 76 and 78%, respectively. Conclusions: These results suggest preferential EDB compared to AH involvement in the split-leg syndrome of ALS. The EDB maximal F-wave latency and index Freqs robustly differentiated patients with ALS from HCs, which might facilitate an earlier identification of ALS.
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Affiliation(s)
- Zhi-Li Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Kang Zhang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuangwu Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Youfang Hu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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19
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Wang ZL, Cui L, Liu M, Zhang K, Liu S, Ding Q. Split-Hand Syndrome in Amyotrophic Lateral Sclerosis: Differences in Dysfunction of the FDI and ADM Spinal Motoneurons. Front Neurosci 2019; 13:371. [PMID: 31133773 PMCID: PMC6517473 DOI: 10.3389/fnins.2019.00371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
The F-wave test allows for the non-invasive assessment of spinal motoneuron excitability. We investigated the difference in spinal motoneuron dysfunction between the first dorsal interosseous (FDI) and abductor digit minimi (ADM) muscles by investigating F-waves and to assess the contribution of spinal mechanisms to split-hand syndrome in patients with amyotrophic lateral sclerosis (ALS). Sixty-five consecutive ALS patients and twenty age- and gender-matched healthy controls (HCs) were enrolled. Motor nerve conduction studies and F-waves were performed bilaterally on median and ulnar nerves in all subjects. HCs revealed prominently longer F-wave latencies, lower chronodispersion, mean F-wave amplitude, and mean and maximal F/M amplitude ratio (P < 0.001) in the FDI compared to the ADM. However, no significant differences in almost all F-wave parameters between the FDI and ADM were observed in ALS patients with affected hands except the minimal and mean F-wave latency. These data suggest that excitability is greatly changed in the spinal motoneurons innervating the FDI. Furthermore, the mean F-wave amplitude (r = 0.454, P = 0.002) of the FDI was significantly correlated with the FDI/ADM CMAP amplitude ratio in ALS patients with affected hands but not of the ADM. Our findings suggested that the dysfunction of spinal motoneurons between the FDI and ADM was different in ALS, and spinal motoneuron dysfunction was associated with development of the split-hand phenomenon.
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Affiliation(s)
- Zhi-Li Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Neurosciences Center, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Kang Zhang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuangwu Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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20
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Iskra DA, Kovalenko AP, Koshkarev MA, Frunza DN. [Combination of central and peripheral muscle relaxants in the treatment of post-stroke spasticity]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:51-57. [PMID: 32207718 DOI: 10.17116/jnevro201911912251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To study the electromiographic (EMG) parameters and to evaluate the therapeutic efficacy of a combination of central (baclofen, baclosan) and peripheral (incobotulotoxinA, xeomin) muscle relaxants in the treatment of post-stroke spasticity (PSS). MATERIAL AND METHODS Ninety-six patients with PSS of upper and lower limbs were divided into 2 groups: the first group (n=56) was treated with xeomin and the second (n=40) received combined therapy of xeomin and baclofen. Xeomin was administered according to the pattern of spasticity. The total dosage reached 800 U. Baclofen was used orally in a dose of 10 mg 3 times a day. The scales of paresis and spasticity assessment (MRCS, MAS and Tardieu), activity and participation of patients in everyday life (Bartel, Rankin, Rivermead mobility Index, comfortable walking test, LASIS) were used. EMG and transcranial magnetic stimulation (TMS) were performed. M-response, H-reflex, F-wave, central conduction time were determined. The total duration of the study was 120 days. Patients were assessed at 4 points. RESULTS AND CONCLUSION Potentiation of peripheral and central muscle relaxants and prolongation of the effect of xeomin was revealed (it was expressed in the reduction of the number of injection sessions from 7-8 to 5-6). The use of xeomin in a total dosage of up to 800 U has shown its efficacy and safety for the treatment of spasticity of the upper and lower limbs. The results of EMG and TMS shed a light on the mechanisms of the therapeutic effect of combined (xeomin+baclosan) and monotherapy (xeomin) spasticity.
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Affiliation(s)
- D A Iskra
- Kirov Medical-Military Academy, St-Petersburg, Russia
| | - A P Kovalenko
- Kirov Medical-Military Academy, St-Petersburg, Russia
| | - M A Koshkarev
- Branch N 5 Vishnevsky 3th Central Military Clinical Hospital, Sergiev Posad, Russia
| | - D N Frunza
- Kirov Medical-Military Academy, St-Petersburg, Russia
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21
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Abstract
PURPOSE Motor imagery, the process of imagining a physical action, has been shown to facilitate the excitability of spinal anterior horn cells. In the acute phase after a stroke, the excitability of spinal anterior horn cells is significantly reduced, which leads to motor deficits. This loss of movement can be prevented by increasing the excitability of spinal anterior horn cells immediately following an injury. Motor imagery is an effective method for facilitating the excitability of spinal anterior horn cells in patients with impaired movement; however, the optimal duration for motor imagery is unclear. MATERIALS AND METHODS To investigate time-dependent changes in spinal anterior horn cell excitability during motor imagery, healthy adult participants were recruited to measure the F-wave, an indicator of anterior horn cell excitability. F-waves were measured from participants at baseline, during motor imagery, and post-motor imagery. During motor imagery, participants imagined isometric thenar muscle activity at 50% maximum voluntary contraction for 5 min. F-waves were measured at 1, 3, and 5 min after beginning motor imagery and analysed for persistence and F/M amplitude ratio. RESULTS Persistence and F/M amplitude ratios at 1- and 3-min after motor imagery initiation were significantly greater than at baseline. The persistence and F/M amplitude ratio at 5-min after motor imagery initiation, however, was comparable to baseline levels. CONCLUSION Therefore, 1 to 3 min of motor imagery is likely sufficient to facilitate the excitability of spinal anterior horn cells.
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Affiliation(s)
- Yoshibumi Bunno
- a Graduate School of Health Sciences , Graduate School of Kansai University of Health Sciences , Osaka , Japan.,b Clinical Physical Therapy Laboratory, Faculty of Health Sciences , Kansai University of Health Sciences , Osaka , Japan
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Zheng C, Liang J, Nie C, Zhu Y, Lu F, Jiang J. F-waves of peroneal and tibial nerves in the differential diagnosis and follow-up evaluation of L5 and S1 radiculopathies. Eur Spine J 2018; 27:1734-43. [PMID: 29948325 DOI: 10.1007/s00586-018-5650-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/12/2018] [Accepted: 06/01/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate F-wave as a method to identify a specific root lesion of L5 or S1 and to quantitatively evaluate the severity and progression of motor root lesions in lumbosacral radiculopathies (LR). METHODS Both peroneal and tibial F-waves were performed bilaterally in 142 patients with unilateral L5 or S1 radiculopathies and 37 controls along with Medical Research Council (MRC) evaluation, and soleus H-reflexes were tested bilaterally in 78 of these 142 cases. Both F-wave and MRC were re-evaluated approximately 1 year after initial examination in 65 patients. RESULTS Abnormal peroneal F-waves were found in 34 patients with L5 radiculopathy (34/67, 50.7%) along with normal tibial F-waves and soleus H-reflexes in all tested cases. By contrast, 27 patients with S1 radiculopathy presented abnormal tibial F-waves (27/76, 36.0%) along with normal peroneal F-waves in all 76 cases and abnormal soleus H-reflexes in 38 of 47 (80.9%) cases. There were significant differences in involved side F-duration among different MRC scales in both radiculopathy groups (P < 0.05). Follow-up analysis demonstrated slow progression of both F-wave abnormalities and muscle weakness in patients undergoing conservative treatment (P < 0.05). CONCLUSIONS Comparisons of F-waves between the same nerve on both sides and between peroneal and tibial nerves in the same leg may clearly increase the validity of F-waves for evaluating a specific motor root lesion of L5 or S1. Furthermore, a quantitative comparison of F-waves may provide additional information on the severity of individual root lesions and their progression even in the early stages of disease. These slides can be retrieved under Electronic Supplementary Material.
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Takahara T, Yamaguchi H, Seki K, Murata M, Onodera S. Effect of circulatory system response to motor control in one-sided contractions. Eur J Appl Physiol 2018; 118:1773-1780. [PMID: 29869712 DOI: 10.1007/s00421-018-3907-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/29/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to clarify the effect one-sided skeletal muscle contraction has on the circulatory system, spinal α-motoneuron excitability, and somatosensory-system-evoked potential. METHOD Nine healthy males maintained tension at 10, 20, and 30% of maximal voluntary contraction in static gripping in right hand. Heart rate, ln high frequency (HF), blood pressure (BP), F-wave, and somatosensory-evoked potential (SEP) were recorded during gripping task. BP, F-wave and SEP were recorded from left hand (contralateral side from contracting side). RESULT AND CONCLUSION There were significant main effects of contractions strength on heart rate (0%: 68.2 ± 6.8 bpm, 10%: 67.6 ± 7.4 bpm, 20%: 69.7 ± 8.5 bpm, 30%: 73.7 ± 9.3 bpm, F3.24=9.18, P < 0.01), systolic BP (0%: 127.7 ± 15 mmHg, 10%: 136.2 ± 13.5 mmHg, 20%: 136.2 ± 13.5 mmHg, 30%: 140.0 ± 17.1 mmHg, F3.24=23.93, P < 0.01), diastolic BP (0%: 69.3 ± 8.5 mmHg, 10%: 76.9 ± 11.1 mmHg, 20%: 79.9 ± 12.5 mmHg, 30%: 86.2 ± 14 mmHg, F3.24=17.09, P < 0.01), and F-wave appearance rate (0%: 29.7 ± 15.6%, 10%: 39.3 ± 20.5%, 20%: 47.5 ± 22.9%, 30%: 55.2 ± 21.8%, F3.24=14.04, P < 0.01). For the ln HF (0%: 5.9 ± 0.6, 10%: 6.3 ± 0.9, 20%: 6.3 ± 1.3, 30%: 6.0 ± 1.0, F3.24=2.43, P = 0.08), F-wave latency (0%: 29.6 ± 1.7 ms, 10%: 26.9 ± 2.1 ms, 20%: 26.5 ± 3.6 ms, 30%: 26.9 ± 2.3 ms, F3.24=0.11, P = 0.96), F-wave amplitude (0%: 2.0 ± 0.9%, 10%: 2.2 ± 0.9%, 20%: 2.3 ± 0.7%, 30%: 2.8 ± 1.1%, F3.24=2.80, P = 0.06), and N20 amplitude (0%: 3.9 ± 1.7 µV, 10%: 3.7 ± 1.7 µV, 20%: 3.9 ± 1.7 µV, 30%: 3.9 ± 1.8 µV, F3.24=0.61, P = 0.62), between the conditions. We conclude that regulation of the circulatory system and motor system has a limited effect on sensory input.
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Affiliation(s)
- Terumasa Takahara
- Department of Sport Social Management, KIBI International University, 8 Igamachi, Takahashi, Okayama, 716-8508, Japan.
| | - Hidetaka Yamaguchi
- Department of Sport Social Management, KIBI International University, 8 Igamachi, Takahashi, Okayama, 716-8508, Japan
| | - Kazutoshi Seki
- Department of Human Health and Wellbeing, University of Marketing and Distribution Science, Kobe. 3-1 Gakuen-Nishimachi, Nishi-ku, Kobe, Hyogo, 651-2188, Japan
| | - Megumi Murata
- KIBI International University of Japan Health Welfare Laboratory, 8 Igamachi, Takahashi, Okayama, 716-8508, Japan
| | - Sho Onodera
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
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Nakanishi K, Tanaka N, Kamei N, Kotaka S, Ochi M, Adachi N. Evidence that impaired motor conduction in the bilateral ulnar and tibial nerves underlies cervical spondylotic amyotrophy in patients with unilateral deltoid muscle atrophy. Spine Surg Relat Res 2018; 2:23-29. [PMID: 31440642 PMCID: PMC6698543 DOI: 10.22603/ssrr.2017-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/02/2017] [Indexed: 11/05/2022] Open
Abstract
Introduction The clinical entity of cervical spondylotic amyotrophy (CSA) is characterized by severe muscle atrophy in the upper extremities with insignificant sensory deficits in patients with cervical spondylosis. However, the pathogenesis of CSA is still unclear. Methods We assessed electrophysiological motor conduction through the corticospinal tract and ulnar and tibial nerves, which do not supply the deltoid or biceps muscles, of 18 patients with CSA, 12 patients with compressive cervical myelopathy, and 18 control subjects with cervical spondylotic radiculopathy. Motor evoked potentials following transcranial magnetic stimulation and M-waves and F-waves following electrical stimulation were measured from the bilateral abductor digiti minimi muscles (ADMs) and abductor hallucis muscles (AHs). The peripheral conduction time (PCT) was calculated from the latencies of the CMAPs and F-waves as follows: (latency of CMAPs + latency of F-waves - 1) / 2. The central motor conduction time (CMCT) was calculated by subtracting the PCT from the onset latency of the MEPs. Results The M-wave (M) latency and minimum F-wave (Fmin) latency from the ADM, and Fmin-M latency from the ADM/AH were significantly longer in the CSA group than in the other groups, on both the affected (p = 0.000-0.007) and unaffected sides (p = 0.000-0.033). F-wave persistence from the bilateral ADMs was significantly lower in the CSA group than in the other groups (p = 0.000-0.002). Among the CSA patients, there were no significant differences in these parameters between the affected and unaffected sides. The CMCT showed no significant differences between the CSA and control groups, but significant differences between the CSA and CCM groups (p = 0.000-0.004). Conclusions CSA patients with unilateral deltoid muscle atrophy had subclinical impairments of lower motor neurons and/or peripheral axons in the ulnar nerve, and subclinical impairments of peripheral axons in the tibial nerve. These motor impairments may have originally existed in these individuals before the onset of CSA.
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Affiliation(s)
- Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuhiro Tanaka
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Naosuke Kamei
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Kotaka
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Fang J, Cui L, Liu M, Guan Y, Ding Q, Shen D, Li D, Tai H. A Retrospective Study of the Characteristics and Clinical Significance of A-Waves in Amyotrophic Lateral Sclerosis. Front Neurol 2017; 8:515. [PMID: 29033889 PMCID: PMC5625027 DOI: 10.3389/fneur.2017.00515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022] Open
Abstract
A-wave was observed in patients with motor neuron disease (1). However, data on the characteristics and clinical significance of A-waves in patients with amyotrophic lateral sclerosis (ALS) have been scarce. The F-wave studies of 83 patients with ALS and 63 normal participants which were conducted previously at the Department of Neurology in Peking Union Medical College Hospital were retrospectively reviewed to determine the occurrence of A-waves in ALS. A-waves occurred more frequently in ALS patients than in normal controls. For the median and peroneal nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were comparable between the ALS patients and normal controls. For the ulnar and tibial nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were significantly increased in the ALS patients compared with those of the normal participants. Disease progression rate was slower in the ALS patients with A-waves (0.73 ± 0.99) than that in the ALS patients without A-waves (0.87 ± 0.55, P = 0.007). No correlations were found between the amplitudes of F-waves with A-waves and those of A-waves in the ulnar nerves (r = 0.423, P = 0.149). No correlations were found between the persistence of F-waves with A-waves and the persistence of A-waves in the ulnar nerves as well (r = 0.219, P = 0.473). The occurrence of A-waves may indicate dysfunction of lower motor neurons and possibly imply a relatively slower degenerative process.
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Affiliation(s)
- Jia Fang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuzhou Guan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Dawei Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hongfei Tai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Imajo Y, Kanchiku T, Suzuki H, Yoshida Y, Funaba M, Nishida N, Fujimoto K, Taguchi T. Effects of differences in age and body height on normal values of central motor conduction time determined by F-waves. J Spinal Cord Med 2017; 40:181-187. [PMID: 26832330 PMCID: PMC5430475 DOI: 10.1080/10790268.2015.1117193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To investigate the effect on central motor conduction time (CMCT) based on the relationship between age and height in normal subjects. DESIGN Retrospective study. METHODS One hundred and ninety nine normal subjects (107 men and 92 women; mean age 39.0 ± 16.4 years; mean height 164.5 ± 8.8 cm) participated in the study. The approximate ages of subjects were as follows: 82 (20-29 years old), 32 (30-39 years old), 32 (40-49 years old), 28 (50-59 years old), and 25 (≧60 years old). The heights of 9, 49, 79, 53, and 9 subjects were <150 cm, 150-160 cm, 160-170 cm, 170-180 cm, and >180 cm, respectively. CMCT- abductor digiti minimi (ADM) and abductor hallucis (AH) were calculated by subtracting the peripheral motor conduction time (PMCT) from the onset latency of motor evoked potentials (MEPs) evoked by transcranial magnetic stimulation. PMCT was calculated from the latencies of the compound muscle action potentials (CMAPs) and F-waves as follows: (latency of CMAPs + latency of F-waves -1)/2. OUTCOME MEASURES CMCT-ADM and CMCT-AH. RESULTS The normative values were 5.2 ± 0.8 ms and 11.8 ± 1.3 ms for CMCT-ADM and CMCT-AH, respectively. CMCT-ADM was not significantly correlated with age (P = 0.196) and body height (P = 0.158). CMCT-AH had significantly positive, linear correlations with age and body height (CMCT-AH = 0.014 × age + 10.971, P = 0.011, R = 0.179 and CMCT-AH = 0.026 × body height + 7.158, P = 0.010, R = 0.182). CONCLUSIONS We suggest normative values of 3.2-7.2 ms in CMCT-ADM for subjects exerting slight effort on ADM regardless age and body height. CMCT-AH had significantly positive, linear correlations with age and body height.
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Affiliation(s)
- Yasuaki Imajo
- Correspondence to: Yasuaki Imajo, Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1–1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
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Mayo M, DeForest BA, Castellanos M, Thomas CK. Characterization of Involuntary Contractions after Spinal Cord Injury Reveals Associations between Physiological and Self-Reported Measures of Spasticity. Front Integr Neurosci 2017; 11:2. [PMID: 28232792 PMCID: PMC5299008 DOI: 10.3389/fnint.2017.00002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 01/16/2017] [Indexed: 12/02/2022] Open
Abstract
Correlations between physiological, clinical and self-reported assessments of spasticity are often weak. Our aims were to quantify functional, self-reported and physiological indices of spasticity in individuals with thoracic spinal cord injury (SCI; 3 women, 9 men; 19–52 years), and to compare the strength and direction of associations between these measures. The functional measure we introduced involved recording involuntary electromyographic activity during a transfer from wheelchair to bed which is a daily task necessary for function. High soleus (SL) and tibialis anterior (TA) F-wave/M-wave area ratios were the only physiological measures that distinguished injured participants from the uninjured (6 women, 13 men, 19–67 years). Hyporeflexia (decreased SL H/M ratio) was unexpectedly present in older participants after injury. During transfers, the duration and intensity of involuntary electromyographic activity varied across muscles and participants, but coactivity was common. Wide inter-participant variability was seen for self-reported spasm frequency, severity, pain and interference with function, as well as tone (resistance to imposed joint movement). Our recordings of involuntary electromyographic activity during transfers provided evidence of significant associations between physiological and self-reported measures of spasticity. Reduced low frequency H-reflex depression in SL and high F-wave/M-wave area ratios in TA, physiological indicators of reduced inhibition and greater motoneuron excitability, respectively, were associated with long duration SL and biceps femoris (BF) electromyographic activity during transfers. In turn, participants reported high spasm frequency when transfers involved short duration TA EMG, decreased co-activation between SL and TA, as well as between rectus femoris (RF) vs. BF. Thus, the duration of muscle activity and/or the time of agonist-antagonist muscle coactivity may be used by injured individuals to count spasms. Intense electromyographic activity and high tone related closely (possibly from joint stabilization), while intense electromyographic activity in one muscle of an agonist-antagonist pair (especially in TA vs. SL, and RF vs. BF) likely induced joint movement and was associated with severe spasms. These data support the idea that individuals with SCI describe their spasticity by both the duration and intensity of involuntary agonist-antagonist muscle coactivity during everyday tasks.
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Affiliation(s)
- Meagan Mayo
- The Miami Project to Cure Paralysis, University of Miami Miami, FL, USA
| | | | | | - Christine K Thomas
- The Miami Project to Cure Paralysis, University of MiamiMiami, FL, USA; Department of Neurological Surgery, University of MiamiMiami, FL, USA; Department of Physiology and Biophysics, University of MiamiMiami, FL, USA
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Kanbayashi T, Yamauchi T, Miyaji Y, Sonoo M. Investigation of anodal stimulation and its implications for F-wave examinations. Muscle Nerve 2016; 56:51-56. [PMID: 27784125 DOI: 10.1002/mus.25450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Recent studies have shown that stimulation occurs at the anode of stimulating electrodes instead of anodal block. This phenomenon may be a pitfall in F-wave examinations. METHODS Subjects included 10 healthy volunteers. Their ulnar nerve was stimulated at the wrist with the cathode placed distally. Antidromic impulses were evaluated using mixed nerve action potential (MNAP) at the elbow. RESULTS Anodal stimulation occurred for both sensory and motor fibers at 22 mm proximal to the anode, on average, which may theoretically shorten the F-wave latency by about 0.8 ms. Displacement of the anode away from the nerve made anodal stimulation less likely. In contrast, displacement of the cathode away from the nerve lowered the threshold for anodal stimulation, a newly found interaction between cathode and anode. CONCLUSIONS In this work we identified detailed features of anodal stimulation and potential influence on F-wave examinations. Muscle Nerve 56: 51-56, 2017.
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Affiliation(s)
- Takamichi Kanbayashi
- Department of Neurology, Teikyo University School of Medicine,Kaga 2-11-1, Itabashi-ku, Tokyo, 1738605, Japan
| | | | - Yosuke Miyaji
- Department of Neurology, Teikyo University School of Medicine,Kaga 2-11-1, Itabashi-ku, Tokyo, 1738605, Japan
| | - Masahiro Sonoo
- Department of Neurology, Teikyo University School of Medicine,Kaga 2-11-1, Itabashi-ku, Tokyo, 1738605, Japan
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Lee EB, Lee YY, Lee JM, Son SM, Hwang SK, Kwon S, Kim SY. Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children. Korean J Pediatr 2016; 59:271-5. [PMID: 27462356 PMCID: PMC4958705 DOI: 10.3345/kjp.2016.59.6.271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/22/2015] [Accepted: 11/09/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.
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Affiliation(s)
- Eung-Bin Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Yun Young Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Su Min Son
- Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea
| | - Su-Kyeong Hwang
- Department of Pediatrics, Kyungpook National University Children's Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Soonhak Kwon
- Department of Pediatrics, Kyungpook National University Children's Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sae Yoon Kim
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
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Fang J, Cui L, Liu M, Guan Y, Li X, Li D, Cui B, Shen D, Ding Q. Differences in F-Wave Characteristics between Spinobulbar Muscular Atrophy and Amyotrophic Lateral Sclerosis. Front Aging Neurosci 2016; 8:50. [PMID: 27014057 PMCID: PMC4783393 DOI: 10.3389/fnagi.2016.00050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/25/2016] [Indexed: 12/13/2022] Open
Abstract
There is limited data on the differences in F-wave characteristics between spinobulbar muscular atrophy (SBMA) and lower motor neuron dominant (LMND) amyotrophic lateral sclerosis (ALS). We compared the parameters of F-waves recorded bilaterally from the median, ulnar, tibial, and deep peroneal nerves in 32 SBMA patients, 37 patients with LMND ALS, and 30 normal controls. The maximum F-wave amplitudes, frequencies of giant F-waves, and frequencies of patients with giant F-waves in all nerves examined were significantly higher in the SBMA patients than in the ALS patients and the normal controls. The mean F-wave amplitude, maximum F-wave amplitude, frequency of giant F-waves, and frequency of patients with giant F-waves in the median and deep peroneal nerves were comparable between the ALS patients and normal controls. Giant F-waves were detected in multiple nerves and were often symmetrical in the SBMA patients compared with the ALS patients. The number of nerves with giant F-waves seems to be the most robust variable for differentiation of SBMA from ALS, with an area under the curve of 0.908 (95% CI: 0.835–0.982). A cut-off value of the number of nerves with giant F-waves (≥3) for diagnosing SBMA showed high sensitivity and specificity: 85% sensitivity and 81% specificity vs. ALS patients. No significant correlations were found between the pooled frequency of giant F-waves and disease duration in the SBMA (r = 0.162, P = 0.418) or ALS groups (r = 0.107, P = 0.529). Our findings suggested that F-waves might be used to discriminate SBMA from ALS, even at early stages of disease.
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Affiliation(s)
- Jia Fang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijing, China; Neuroscience Center, Chinese Academy of Medical SciencesBeijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Yuzhou Guan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Xiaoguang Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Dawei Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Bo Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China
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Fang J, Cui L, Liu M, Guan Y, Li X, Li D, Cui B, Shen D, Ding Q. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis. Front Hum Neurosci 2016; 10:99. [PMID: 27014030 PMCID: PMC4780404 DOI: 10.3389/fnhum.2016.00099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/23/2016] [Indexed: 12/01/2022] Open
Abstract
This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P < 0.05), index repeating neuron (RN; P < 0.001), and index repeater F-waves (Freps; P < 0.001) significantly differed between the APB and the ADM in the NC participants. For the hands of the ALS patients that lacked detectable wasting or weakness and exhibited either no or mild impairment of discrete finger movements, significantly reduced F-wave persistence (P < 0.001), increased index RN (P < 0.001), and increased index Freps (P < 0.001) were observed in APB in comparison with the normal participants, with relatively normal ADM F-wave parameters. For the hands of ALS patients that exhibited wasting and weakness, the mean F-wave amplitude (P < 0.05), the F/M amplitude ratio (P < 0.05), F-wave persistence (P < 0.001), index RN (P < 0.05), and index Freps (P < 0.05) significantly differed between APB and ADM. The differences in the dysfunction of motoneurons innervating APB and ADM are unique manifestations in ALS patients. The F-wave persistence (P = 0.002), index RN (P < 0.001), and index Freps (P < 0.001) in the APB seemed to differentiate ALS from the NCs more robustly than the ADM/APB Compound muscle action potential (CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders.
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Affiliation(s)
- Jia Fang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China; Neuroscience Center, Chinese Academy of Medical SciencesBeijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Yuzhou Guan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Xiaoguang Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Dawei Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Bo Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Qingyun Ding
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
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Bunno Y, Suzuki T, Iwatsuki H. Motor imagery muscle contraction strength influences spinal motor neuron excitability and cardiac sympathetic nerve activity. J Phys Ther Sci 2016; 27:3793-8. [PMID: 26834354 PMCID: PMC4713793 DOI: 10.1589/jpts.27.3793] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/17/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the changes in spinal motor neuron
excitability and autonomic nervous system activity during motor imagery of isometric
thenar muscle activity at 10% and 50% maximal voluntary contraction (MVC). [Methods] The
F-waves and low frequency/high frequency (LF/HF) ratio were recorded at rest, during motor
imagery, and post-trial. For motor imagery trials, subjects were instructed to imagine
thenar muscle activity at 10% and 50% MVC while holding the sensor of a pinch meter for
5 min. [Results] The F-waves and LF/HF ratio during motor imagery at 50% MVC were
significantly increased compared with those at rest, whereas those during motor imagery at
10% MVC were not significantly different from those at rest. The relative values of the
F/M amplitude ratio during motor imagery at 50% MVC were significantly higher than those
at 10% MVC. The relative values of persistence and the LF/HF ratio during motor imagery
were similar during motor imagery at the two muscle contraction strengths. [Conclusion]
Motor imagery can increase the spinal motor neuron excitability and cardiac sympathetic
nerve activity. Motor imagery at 50% MVC may be more effective than motor imagery at 10%
MVC.
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Affiliation(s)
- Yoshibumi Bunno
- Graduate School of Health Sciences, Graduate School of Aomori University of Health and Welfare, Japan; Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Toshiaki Suzuki
- Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Hiroyasu Iwatsuki
- Graduate School of Health Sciences, Graduate School of Aomori University of Health and Welfare, Japan
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Abstract
A specific feature of motor unit (MU) firing behaviour is rhythmic trains of single discharges at low rate resulting from the prolonged motoneuronal afterhyperpolarization. However, some MUs exhibit occasional doublets with uniquely short interspike intervals (2.5-20.0 ms). Motoneuronal delayed depolarization is commonly accepted to be doublet underlying mechanism. Apart from doublets, much scarcer MU triple discharges were described, but their mechanisms are disputable. The aim of the present study was to analyse MU triplet firing origin in healthy humans. MU triple discharges occasionally arising during gentle voluntary muscle contractions were compared with those arising in axons during motor nerve stimulation. Firing pattern was analysed in 109 MUs of four muscles: the tibialis anterior, the flexor carpi ulnaris, the abductor pollicis brevis, and the abductor digiti minimi. Our findings present evidence that during voluntary contractions two kinds of MU triplet firing can be occasionally observed: "true" motoneuronal triplets (interspike intervals of 3.6-17.3 ms) with the delayed depolarization as the possible underlying mechanism and axonal triple discharges including the M-response and F-wave. The findings can be useful not only for understanding mechanisms of the very rare motoneuronal firing in healthy humans but also for estimation of pathological triplet firing origin.
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Affiliation(s)
- Lydia P Kudina
- Institute for Information Transmission Problems (Kharkevich Institute), Russian Academy of Sciences, 19, Bol'shoi Karetnyi pereulok, Moscow, Russia, 127994.
| | - Regina E Andreeva
- Institute for Information Transmission Problems (Kharkevich Institute), Russian Academy of Sciences, 19, Bol'shoi Karetnyi pereulok, Moscow, Russia, 127994
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Bunno Y, Onigata C, Suzuki T. Excitability of spinal motor neurons during motor imagery of thenar muscle activity under maximal voluntary contractions of 50% and 100. J Phys Ther Sci 2015; 27:2775-8. [PMID: 26504291 PMCID: PMC4616092 DOI: 10.1589/jpts.27.2775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/03/2015] [Indexed: 01/13/2023] Open
Abstract
[Purpose] We often perform physical therapy using motor imagery of muscle contraction to
improve motor function for healthy subjects and central nerve disorders. This study aimed
to determine the differences in the excitability of spinal motor neurons during motor
imagery of a muscle contraction at different contraction strengths. [Subjects] We recorded
the F-wave in 15 healthy subjects. [Methods] In resting trial, the muscle was relaxed
during F-wave recording. For motor imagery trial, subjects were instructed to imagine
maximal voluntary contractions of 50% and 100% while holding the sensor of a pinch meter,
and F-waves were recorded for each contraction. The F-wave was recorded immediately after
motor imagery. [Results] Persistence and F/M amplitude ratio during motor imagery under
maximal voluntary contractions of 50% and 100% were significantly higher than that at
rest. In addition, the relative values of persistence, F/M amplitude ratio, and latency
were similar during motor imagery under the two muscle contraction strengths. [Conclusion]
Motor imagery under maximal voluntary contractions of 50% and 100% can increase the
excitability of spinal motor neurons. Differences in the imagined muscle contraction
strengths are not involved in changes in the excitability of spinal motor neurons.
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Affiliation(s)
- Yoshibumi Bunno
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Japan ; Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Chieko Onigata
- Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Japan ; Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
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Naseri M, Petramfar P, Ashraf A. Effect of Motor Imagery on the F-Wave Parameters in Hemiparetic Stroke Survivors. Ann Rehabil Med 2015; 39:401-8. [PMID: 26161346 PMCID: PMC4496511 DOI: 10.5535/arm.2015.39.3.401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/09/2014] [Indexed: 12/03/2022] Open
Abstract
Objective To assess the effect of motor imagery, as a rehabilitation method in stroke, on F-wave parameters that undergo changes during upper motor neuron involvement. Methods Twenty-one fully conscious hemiparetic stroke survivors with a completely plegic hand (power 0/5) and a minimum interval of 72 hours since stroke were recruited into this study. The mean F-wave latency, amplitude, and persistence in the median and ulnar nerves were measured in both the affected and non-affected sides at rest and in the paretic hand during a mental task. Comparison was made between data from the affected hand and the non-affected hand as well as between data from the affected hand at baseline and during motor imagery. Results Patients had significantly different F-wave persistence between the affected and non-affected sides (paired t-test, p<0.001). Motor imagery could improve F-wave persistence in both the investigated nerves (paired t-test, p=0.01 for ulnar nerve and p<0.001 for median nerve) and F-response amplitude in the median nerve (paired t-test, p=0.01) of the affected limb. Conclusion The amplitude and persistence of F-wave were improved during motor imagery, representing F-wave facilitation. This result suggests that motor imagery can restore motor neuron excitability, which is depressed after stroke.
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Affiliation(s)
- Mahshid Naseri
- Department of Physical Medicine and Rehabilitation and Shiraz Burn Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Department of Neurology, Shiraz University of Medical, Shiraz, Iran
| | - Alireza Ashraf
- Department of Physical Medicine and Rehabilitation and Shiraz Burn Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
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Kotan S, Kojima S, Miyaguchi S, Sugawara K, Onishi H. Depression of corticomotor excitability after muscle fatigue induced by electrical stimulation and voluntary contraction. Front Hum Neurosci 2015; 9:363. [PMID: 26150781 PMCID: PMC4472998 DOI: 10.3389/fnhum.2015.00363] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/08/2015] [Indexed: 11/13/2022] Open
Abstract
In this study, we examined the effect of muscle fatigue induced by tetanic electrical stimulation (ES) and submaximal isometric contraction on corticomotor excitability. Experiments were performed in a cross-over design. Motor-evoked potentials (MEPs) were elicited by transcranial magnetic stimulation (TMS). Corticomotor excitability was recorded before and after thumb opposition muscle fatigue tasks, in which 10% of the maximal tension intensity was induced by tetanic ES or voluntary contraction (VC). The participants were 10 healthy individuals who performed each task for 10 min. Surface electrodes placed over the abductor pollicis brevis (APB) muscle recorded MEPs. F- and M-waves were elicited from APB by supramaximal ES of the median nerve. After the tetanic ES- and VC tasks, MEP amplitudes were significantly lower than before the task. However, F- and M-wave amplitudes remained unchanged. These findings suggest that corticospinal excitability is reduced by muscle fatigue as a result of intracortical inhibitory mechanisms. Our results also suggest that corticomotor excitability is reduced by muscle fatigue caused by both VC and tetanic ES.
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Affiliation(s)
- Shinichi Kotan
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Kazuhiro Sugawara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
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Takemi M, Masakado Y, Liu M, Ushiba J. Sensorimotor event-related desynchronization represents the excitability of human spinal motoneurons. Neuroscience 2015; 297:58-67. [PMID: 25839147 DOI: 10.1016/j.neuroscience.2015.03.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/06/2015] [Accepted: 03/19/2015] [Indexed: 11/22/2022]
Abstract
Amplitudes of mu and beta (7-26Hz) oscillations measured by electroencephalography over the sensorimotor areas are suppressed during motor imagery as well as during voluntary movements. This phenomenon is referred to as event-related desynchronization (ERD) and is known to reflect motor cortical excitability. The increased motor cortical excitability associated with ERD during hand motor imagery would induce a descending cortical volley to spinal motoneurons, resulting in facilitation of spinal motoneuronal excitability. Therefore, in the present study, we tested the association of ERD during motor imagery with the excitability of spinal motoneurons in 15 healthy participants. Spinal excitability was tested using the F-wave recorded from the right abductor pollicis brevis muscle. The F-wave results from antidromic activation of spinal motoneurons and is induced by peripheral nerve stimulation. Participants performed 5s of motor imagery of right thumb abduction following 7s of rest. The right median nerve was stimulated at wrist level when the ERD magnitude of the contralateral hand sensorimotor area exceeded predetermined thresholds during motor imagery. The results showed ERD magnitude during hand motor imagery was associated with an increase in F-wave persistence, but not with the response average of F-wave amplitude or F-wave latency. These findings suggest that the ERD magnitude may be a biomarker representing increases in the excitability of both cortical and spinal levels.
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Abstract
INTRODUCTION The purpose of this study was to determine whether F-waves reveal electrophysiological features of anterior horn cells in polio survivors. METHODS Forty-three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F-waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE). RESULTS A significant increase in abnormally stereotyped ("repeater") F-waves and a reduction of F-wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F-waves had a negative correlation with MUNE. CONCLUSIONS These trends in F-wave persistence and repeater F-waves after motor unit loss are characteristic findings in polio survivors. Repeater F-waves are a sign of motor unit pathology.
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Affiliation(s)
- Akiko Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan
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Abstract
BACKGROUND F waves are late electrophysiological responses to antidromic activation of motor neurons and are used to evaluate the conduction along the whole length of peripheral nerves. We aimed to determine the diagnostic efficacies of minimum median nerve F-wave latency (FWL) and median-to-ulnar nerve F-wave latency difference (FWLD) on carpal tunnel syndrome (CTS). MATERIALS AND METHODS The electrophysiological studies consisted of sensory and motor nerve conduction and F-wave studies of the median and ulnar nerves. The best cut-off points of minimum median nerve FWL and FWLD for the diagnosis of CTS were detected for the whole study group and for different height subgroups (Group 1: 150-159 cm, Group 2: 160-169 cm, and Group 3: over 170 cm). The diagnostic efficacies of minimum median nerve FWL and FWLD were calculated for the whole CTS group and for the mild CTS group, separately. RESULTS The best cut-off point of minimum median nerve FWL on the diagnosis of CTS was determined as 24.60 ms for the whole group. It was 23.90 ms for Group 1, 24.80 ms for Group 2, and 28.40 ms for Group 3. The usage of these stratified cut-off points yielded a higher total diagnostic efficacy rate than single cut-off point usage (79.9% vs 69%, respectively; P=0.02). The best cut-off point of FWLD on the diagnosis of CTS was 0.80 ms for the whole group. It was 0.55 ms for Group 1, 0.30 ms for Group 2, and 0.85 ms for Group 3. Both the single cutoff point usage and the stratified chart usage for FWLD had equal diagnostic efficacy (85.1%). In the mild CTS group, diagnostic efficacy was 55.5% for minimum median nerve FWL and 78.8% for FWLD (P=0.0001). CONCLUSION Median-to-ulnar nerve FWLD yields a higher diagnostic efficacy than minimum median nerve FWL on the diagnosis of CTS. However, the sensitivities of both parameters are not satisfactory for the extremities with mild CTS, which compose the main group having diagnostic challenge.
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Affiliation(s)
- Murat Alemdar
- Sakarya University Education and Research Hospital, Sakarya, Turkey
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Mondelli M, Aretini A. Low sensitivity of F-wave in the electrodiagnosis of carpal tunnel syndrome. J Electromyogr Kinesiol 2014; 25:247-52. [PMID: 25561074 DOI: 10.1016/j.jelekin.2014.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 11/26/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Previous studies showed "F-wave inversion" (F-INV) as a sensitive method in the electrodiagnosis of early stage of carpal tunnel syndrome (CTS). This study aimed at evaluating the sensitivity and specificity of F-wave and nerve conduction velocity (NCV) testing in CTS. METHODS We consecutively enrolled 244 cases and 108 controls. F-waves analysis included: Fwave minimum and mean latencies, F-wave persistence and chronodispersion, mean-F/CMAP amplitude ratio, F-INV. Specificity and sensitivity of F-waves parameters were calculated in the whole sample of CTS patients and by grouping the patients according to CTS severity. Multivariate logistic regression was also performed using F-INV as a dependent variable. RESULTS In the whole sample the sensitivity of F-mean-INV and of median-ulnar NCV comparative testing was 50.8% and 93.7%, respectively. F-INV sensitivity dropped to 8% in CTS early stage. F-INV could be predicted only by distal motor latency of the median nerve. The sensitivity of all F-wave parameters increased only in the most severe stages of CTS. CONCLUSIONS This study does not confirm the electrodiagnostic usefulness of F-INV in early stage of CTS. All F-wave parameters, including F-INV, are much less sensitive than conventional NCV in CTS electrodiagnosis. F-wave does not add further useful information specifically related to CTS.
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Bunno Y, Yurugi Y, Onigata C, Suzuki T, Iwatsuki H. Influence of motor imagery of isometric opponens pollicis activity on the excitability of spinal motor neurons: a comparison using different muscle contraction strengths. J Phys Ther Sci 2014; 26:1069-73. [PMID: 25140099 PMCID: PMC4135200 DOI: 10.1589/jpts.26.1069] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/23/2014] [Indexed: 12/05/2022] Open
Abstract
[Purpose] This study aimed to determine the differences in the excitability of spinal
motor neurons during motor imagery of a muscle contraction at different contraction
strengths. [Methods] We recorded the F-wave in 15 healthy subjects. First, in a trial at
rest, the muscle was relaxed during F-wave recording. Next, during motor imagery, subjects
were instructed to imagine maximum voluntary contractions of 10%, 30%, and 50% while
holding the sensor of a pinch meter, and F-waves were recorded for each contraction.
F-waves were recorded immediately and at 5, 10, and 15 min after motor imagery. [Results]
Both persistence and F/M amplitude ratios during motor imagery under maximum voluntary
contractions of 10%, 30%, and 50% were significantly higher than that at rest. In
addition, persistence, F/M amplitude ratio, and latency were similar during motor imagery
under the three muscle contraction strengths. [Conclusion] Motor imagery under maximum
voluntary contractions of 10%, 30%, and 50% can increase the excitability of spinal motor
neurons. The results indicated that differences in muscle contraction strengths during
motor imagery are not involved in changes in the excitability of spinal motor neurons.
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Affiliation(s)
- Yoshibumi Bunno
- Graduate School of Health Sciences, Graduate School of Aomori University of Health and Welfare: 58-1 Mase, Hamadate, Aomori 030-8505, Japan
| | - Yuko Yurugi
- Graduate School of Health Sciences, Graduate School of Aomori University of Health and Welfare: 58-1 Mase, Hamadate, Aomori 030-8505, Japan
| | - Chieko Onigata
- Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Toshiaki Suzuki
- Clinical Physical Therapy Laboratory, Faculty of Health Sciences, Kansai University of Health Sciences, Japan
| | - Hiroyasu Iwatsuki
- Graduate School of Health Sciences, Graduate School of Aomori University of Health and Welfare: 58-1 Mase, Hamadate, Aomori 030-8505, Japan
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Nowicki M, Baum P, Kosacka J, Stockinger M, Klöting N, Blüher M, Bechmann I, Toyka KV. Effects of isoflurane anesthesia on F-waves in the sciatic nerve of the adult rat. Muscle Nerve 2014; 50:257-61. [PMID: 24347162 DOI: 10.1002/mus.24150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 12/10/2013] [Accepted: 12/11/2013] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Nerve conduction studies provide insights into the functional consequences of axonal and myelin pathology in peripheral neuropathies. We investigated whether isoflurane inhalation anesthesia alters F-wave latencies and F-persistence in the sciatic nerve of adult rats. METHODS Ten rats were investigated at 3 different isoflurane concentrations followed by ketamine-xylazine injection anesthesia. To assess F-wave latencies, a stimulation paradigm was chosen to minimize H-reflex masking of F-waves. RESULTS F-wave persistence rates were reduced with 3.5% isoflurane concentration at 4 and 10 Hz supramaximal stimulation and marginally reduced with 2.5% isoflurane when compared with ketamine-xylazine. F-wave amplitudes decreased progressively with rising stimulus frequency in all types of anesthesia and most at 3.5% isoflurane concentration. CONCLUSIONS The type of anesthesia and the stimulus repetition rate have an impact on some F-wave parameters. Higher isoflurane concentrations and repetition rates are not recommended in experimental studies using rat neuropathy models where F-waves are of interest.
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Affiliation(s)
- Marcin Nowicki
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
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Abstract
The responsiveness of the human central nervous system can change profoundly with exercise, injury, disuse, or disease. Changes occur at both cortical and spinal levels but in most cases excitability of the motoneuron pool must be assessed to localize accurately the site of adaptation. Hence, it is critical to understand, and employ correctly, the methods to test motoneuron excitability in humans. Several techniques exist and each has its advantages and disadvantages. This review examines the most common techniques that use evoked compound muscle action potentials to test the excitability of the motoneuron pool and describes the merits and limitations of each. The techniques discussed are the H-reflex, F-wave, tendon jerk, V-wave, cervicomedullary motor evoked potential (CMEP), and motor evoked potential (MEP). A number of limitations with these techniques are presented.
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Affiliation(s)
- Chris J McNeil
- Neuroscience Research Australia Randwick, NSW, Australia ; School of Health and Exercise Sciences, University of British Columbia Kelowna, BC, Canada
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Hirose H, Suzuki T, Shimada T. Excitability of Spinal Motor Neuron Function after the Transcutaneous Electrical Stimulation (TES) in Healthy Subjects - F-wave Study. J Jpn Phys Ther Assoc 2006; 9:17-20. [PMID: 25792946 DOI: 10.1298/jjpta.9.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Accepted: 11/26/2005] [Indexed: 11/23/2022]
Abstract
To clarify the excitability of spinal motor neuron function after transcutaneous electrical stimulation (TES), we investigated the F-wave before and after TES. Fourteen healthy volunteers with a mean age of 23.4 years were studied. TES was applied to the flexor hallucis brevis (FHB) for 15 minutes. F-wave and M-wave were recorded from the FHB after tibial nerve stimulation at the ankle before TES, just after TES, 10, 20 and 30 minutes after TES. TES evoked full flexion of the great toe. F-wave was analyzed for the amplitude ratio of F/M, latency and duration. The amplitude ratio of F/ M was 3.1% before TES, 1.4% just after TES, 1.6% 10 minutes after, 1.9% 20 minutes after and 1.7% 30 minutes after TES. Each amplitude ratio of F/M after TES was significantly lower than that before TES (p<0.05). There was no statistically significant difference in the latency and the duration. These results suggest that the excitability of spinal motor neuron function after TES to muscles under this condition was reduced in healthy subjects.
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Affiliation(s)
- Hiroaki Hirose
- Department of Physical Therapy, Kansai Vocational College of Medicine, Osaka 558-0011, Japan
| | - Toshiaki Suzuki
- Research Center of Neurological Diseases, Kansai College of Oriental Medicine, Osaka 590-0482, Japan
| | - Tomoaki Shimada
- Division of Health Sciences, Kobe University Graduate School of Medicine, Hyogo 654-0142, Japan
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