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Biomedical subjects

C D Marsden

Publications and source records attributed to C D Marsden.

At least 883 records · Page 49Linked to original sources

Ballistic flexion movements of the human thumb.

1. In response to an auditory stimulus normal subjects made ballistic flexion movements of the top joint of the thumb against a lever attached to the spindle of a low-inertia electric motor. 2. Electromyographic (e.m.g.) activity was recorded from pairs of fine wire electrodes inserted into flexor pollicis longus and extensor pollicis longus, respectively the sole flexor and extensor of the joint. 3. Movements of 5 degrees, 10 degrees and 20 degrees were made from initial angles of 10 degrees, 20 degrees and 30 degrees flexion against torques of 0.04, 0.08 and 0.16 Nm. 4. The e.m.g. activity initiating such movements was characterized by a 'triphasic' pattern of sequential bursts of activity in the agonist (flexor pollicis longus), then in the antagonist (extensor pollicis longus), and then in the agonist again. 5. The duration of the first agonist and first antagonist bursts ranged from about 50 to 90 ms and there was no significant change of burst length in the different mechanical conditions. 6. In movements of differing angular distance, the rectified and integrated e.m.g. activity of the first agonist burst could be correlated with the distance moved. The rectified and integrated e.m.g. activity of the first antagonist burst could not be correlated with the distance moved. 7. Responses of the muscles to perturbations either before or during the ballistic movements were studied. Current in the motor could be altered so to extend the thumb ('stretch'), to allow it to accelerate ('release'), or to prevent further movement ('halt'). 8. Suitably timed stretch increased the e.m.g. activity of the first agonist burst while release decreased it. 9. There was a small response of the agonist to stretch or halt timed to act during the interval between the first two agonist bursts; the major response was an augmentation of the second agonist burst. 10. Stretch, timed to act between the first two agonist bursts which released the antagonist, diminished the activity of the first antagonist burst while halt virtually eradicated it in all but one subject. Release, at this time, which stretched the antagonist, increased the activity of the first antagonist burst. 11. It is concluded that the individual components of a ballistic movement are relatively fixed in duration and the amount of e.m.g. activity is altered within this time interval to produce the different forces required for fast movements of different amplitude. 12. Both agonist and antagonist muscles remain under some feed-back control during the entire course of a ballistic movement, but the amount of influence of fedd-back depends on the supraspinal command signal and the changes in the spindle during the course of the movement.

Electromyography↗

Effect of thumb anaesthesia on weight perception, muscle activity and the stretch reflex in man.

1. We have confirmed the results of Gandevia & McCloskey (1977) on the effect of thumb anaesthesia on perception of weights lifted by the thumb. Weights lifted by flexion feel heavier and weights lifted by extension feel lighter. 2. The change in size of the long-latency stretch reflex in flexor pollicis longus or extensor pollicis longus after thumb anaesthesia cannot explain the effect on weight perception by removal or augmentation of the background servo assistance to muscular contraction. 3. During smooth thumb flexion, thumb anaesthesia increases e.m.g. activity in flexor pollicis longus and extensor pollicis longus for any given opposing torque. 4. During smooth thumb extension the opposite occurs: e.m.g. activity in both extensor and flexor pollicis longus decreases. 5. Clamping the thumb at the proximal phalanx to limit movement solely to the interphalangeal joint reduces or abolishes the effect of anaesthesia on both weight perception and e.m.g. activity during both flexion or extension tasks. 6. Gandevia & McCloskey's findings on the distorting effects of thumb anaesthesia on weight perception cannot be used to support the hypothesis of an efferent monitoring system of the sense of effort. Our results emphasize the close functional relationship between cutaneous and joint afferent information and motor control.

Anesthesia, Local↗

beta-Adrenoreceptor antagonists in essential tremor.

Three different beta-adrenoreceptor antagonists--propranolol, sotalol, and atenolol--were compared in a double-blind study with placebo in nine patients with essential tremor. All three drugs produced an equal reduction in standing pulse rate but atenolol was less effective in reducing tremor than propranolol and sotalol. These results suggest that the reduction in tremor produced by beta-adrenoreceptor antagonists is mediated by an effect on peripheral beta 2-adrenoreceptors.

Adult↗

Primary writing tremor.

We describe a patient who complained of jerking of the right forearm on writing. Active pronation of his arm produced several beats of pronation/supination tremor. A burst of tremor also could be elicited by tendon taps to the volar surface of the wrist, to the finger extensors, and to pectoralis major, and by forcible supination of the wrist delivered by a torque motor. The subject's writing difficulty and tremor were temporarily abolished by partial motor point anaesthesia of pronator teres. We conclude that the tremor was caused by an abnormal response to muscle spindle input from pronator teres.

Adult↗

Relationship between plasma propranolol concentration and relief of essential tremor.

The relationship between plasma propranolol concentration and relief of essential tremor was examined in 11 patients during treatment with oral racemic propranolol in doses of 30 to 640 mg/day. Although propranolol decreased tremor in all 11 patients, the degree of improvement varied widely in individuals (mean 51%, range 25--90%), and was not related directly occurred at plasma propranolol concentrations below 20 ng/ml (0.077 mumol/l) and, in three others, below 40 ng/ml (0.154 mumol/l). It is concluded that the optimum response of essential tremor to propranolol is achieved at relatively low plasma propranolol levels, levels which are obtained by daily propranolol doses of 120--240 mg.

Adult↗

Cortical reflex myoclonus.

Three patients with a type of myoclonus produced by intention and somatosensory stimulation were studied with electrophysiologic techniques. Each jerk typically affected only a few contiguous muscles; agonist and antagonist muscles were activated simultaneously with a simple electromyographic (EMG) burst lasting 10 to 30 msec. Cranial nerve muscles were activated in an order indicating that the signal to produce the myoclonus traveled down the brainstem. In action-induced jerks a negative transient in the electroencephalogram (EEG) from the contralateral sensorimotor cortex consistently preceded the jerk with a fixed latency. In reflex-induced jerks this negative transient could be recognized as a component of the sensory evoked potential. The types of myoclonus are reviewed and it is argued that this type of myoclonus is mediated in cerebral cortex and that the negative transient represents a paroxysmal depolarization shift (PDS). The myoclonus may result from hyperactivity of a component of the long-latency stretch reflex.

Adult↗