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Biomedical subjects

N F Skuse

Publications and source records attributed to N F Skuse.

At least 19 recordsLinked to original sources
PubMed1994

Myogenic potentials generated by a click-evoked vestibulocollic reflex.

Electromyograms (EMGs) were recorded from surface electrodes over the sternomastoid muscles and averaged in response to brief (0.1 ms) clicks played through headphones. In normal subjects, clicks 85 to 100 dB above our reference (45 dB SPL: close to perceptual threshold for normal subjects for such clicks) evoked reproducible changes in the averaged EMG beginning at a mean latency of 8.2 ms. The earliest potential change, a biphasic positive-negativity (p13-n23), occurred in all subjects and the response recorded from over the muscle on each side was predominantly generated by afferents originating from the ipsilateral ear. Later potentials (n34, p44), present in most but not all subjects, were generated bilaterally after unilateral ear stimulation. The amplitude of the averaged responses increased in direct proportion to the mean level of tonic muscle activation during the recording period. The p13-n23 response was abolished in patients who had undergone selective section of the vestibular nerve but was preserved in subjects with severe sensorineural hearing loss. It is proposed that the p13-n23 response is generated by activation of vestibular afferents, possibly those arising from the saccule, and transmitted via a rapidly conducting oligosynaptic pathway to anterior neck muscles. Conversely, the n34 and p44 potentials do not depend on the integrity of the vestibular nerve and probably originate from cochlear afferents.

Acoustic Stimulation↗
PubMed1991

Task-dependent changes in the responses to low-threshold cutaneous afferent volleys in the human lower limb.

1. In seven human subjects who were standing without support the sural nerves were stimulated electrically using trains of non-painful stimuli (five pulses at 300 Hz), designed to activate afferents from cutaneous mechanoreceptors. The reflex effects of the stimulus train on different muscles of the ipsilateral and contralateral legs were sought in post-stimulus averages of rectified EMG. Changes in the pattern of reflex influence were investigated when the subjects maintained different postures. 2. Clear reflex responses were seen in ipsilateral tibialis anterior, soleus, biceps femoris and vastus lateralis, but only when the muscles were actively contracting. In each muscle, inhibition was the dominant reflex response within the first 100 ms. In four of the seven subjects, reflex changes were detectable in the contralateral tibialis anterior and soleus, the peak-to-peak modulation within the first 200 ms being 25-50% of that for the homologous ipsilateral muscle. 3. When subjects attempted to stand on a tilted platform, an unstable platform or on one leg with the other flexed, different combinations of muscles were active, involving both flexors and extensors or predominantly flexors or predominantly extensors. In each posture the reflex effects were demonstrable only in the active muscles. 4. With ipsilateral tibialis anterior, there were task-dependent changes in the short-latency components of the EMG response, approximately 60 ms and 80 ms after the stimulus. When seated performing voluntary contractions these components were difficult to define, and when standing on a platform tilted toe-up they were small. When the ipsilateral leg was flexed or when standing on an unstable base, these early components were more prominent in each subject. With contralateral tibialis anterior, the dominant reflex pattern was inhibition when seated and contracting voluntarily, and facilitation during bipedal stance tilted toe-up. These changes in reflex pattern could not be explained by different levels of background contraction. 5. It is concluded that cutaneous mechanoreceptors of the foot have widespread reflex actions on muscles throughout both limbs, particularly the ipsilateral limb, and that the reflex pattern in different muscles and within a single muscle may change dependent on the task that the subject is undertaking. These task-dependent changes indicate plasticity in the expression of cutaneous reflex activity, affecting both short-latency spinal as well as long-latency pathways.

Adult↗
PubMed1990

The distribution of muscle weakness in upper motoneuron lesions affecting the lower limb.

To determine the distribution of weakness in the lower limb after upper motoneuron lesions the strength of 8 muscle groups was measured. Four groups of patients were studied: 22 control subjects, 16 patients with unilateral leg paresis, 4 patients with severe unilateral paralysis and 5 patients with paraparesis. In the testing posture (seated), patients with cerebral upper motoneuron lesions showed no selective loss of power in flexors or extensors on the contralateral side. Gravitational torques were included in the measurements. However, proximal muscles (acting at hip and knee) were significantly less severely affected than more distal muscles (acting at ankle and hallux). At any particular joint, physiological flexors and extensors were affected equally in both the hemiparetic and paraparetic subjects. As in the upper limb (Colebatch and Gandevia, 1989), the strength of muscles on the clinically unaffected side was reduced compared with control subjects, although no muscle groups were especially affected.

Adolescent↗
PubMed1989

The effects of voluntary contraction on the H reflex of human limb muscles.

The effects of a voluntary contraction on the H reflexes of various muscles were quantified to determine whether the reflex responses were sufficiently reproducible to be used in diagnostic studies. During a voluntary contraction, H reflexes could be recorded reliably from tibialis anterior and abductor pollicis brevis, but accurate identification of the onset of the H wave from the on-going background EMG required duplicate averages of multiple responses. During a contraction the H reflex could be obtained at lower stimulus intensities in the forearm flexor muscles than when relaxed, and a more clear separation of the H wave from the M wave was possible. The background contraction abolished the attenuation of reflex amplitude with increasing stimulus repetition rates, such that repetition rates of up to 4 Hz could be used without significant loss of reflex amplitude. There were only small and usually insignificant differences in the latency of the H reflex or its variability when elicited with the forearm muscles relaxed and when flexor carpi radialis was contracting steadily. The reflex latencies of abductor pollicis brevis, tibialis anterior and soleus were compared with F wave latencies for these muscles. The minimal F wave latencies were shorter than the H reflex latencies for abductor pollicis brevis (mean 2.2 ms) and tibialis anterior (mean 1.0 ms) but not for soleus. Comparison of the spread of F wave latencies (F max-F min) suggests that, for soleus, F waves are recorded only from the faster conducting motor units in the pool, presumably those less readily recruited in the H reflex. It was calculated that the distribution of motor conduction velocities responsible for the F waves of abductor pollicis brevis was 8.8 m.s-1. This value underestimates the likely distribution of motor conduction velocities for the thenar muscle by as much as 50%, consistent with the view that F waves rarely occur in slowly conducting motor units, the units of lowest threshold in reflex studies. It is concluded that, for many motoneuron pools, the H reflex and the F wave appear preferentially in different motoneurons, low and high threshold, respectively, and that reflex studies can provide information not available from somatosensory evoked potentials or F wave studies.

Adult↗
PubMed1989

Maintenance of visual fixation using a reaction-time task.

The VEP to pattern reversal was recorded in eight healthy subjects who were instructed to fixate on a central LED in the stimulating screen. The LED could be extinguished at irregular intervals approximately once every 10 s and the subjects were then required to re-light it as rapidly as possible in a reaction-time task. In the first series of recordings subjects were reminded verbally to maintain visual fixation throughout the averaging sequences. When the reaction-time paradigm was used to maintain visual fixation, the VEP was slightly less variable in latency but otherwise identical to that recorded when the subjects maintained visual fixation on a constantly illuminated LED. In a separate series of 8 consecutive averaging runs, subjects were given the reaction-time task but no verbal reminders. VEP parameters differed from those in the first series when verbal reminders had been given. There was no correlation between VEP parameters and the reaction time or its variability in individual subjects or in the group. The reaction-time task is a satisfactory means for ensuring accurate visual fixation but does not obviate the need to provide subjects with verbal encouragement to maintain full attention.

Evoked Potentials, Visual↗
PubMed1986

The refractory period of the visual evoked potential produced by pattern reversal in multiple sclerosis.

Refractoriness of the visual evoked potential to pattern-reversal stimulation has been studied using a light-emitting diode stimulator, the effect on a test P100 of a conditioning pattern reversal being determined for conditioning-test intervals of 20 ms, 50 ms and 100 ms. In 20 normal subjects, the latency of the test P100 was increased by a mean of 9.8% (SD 5.0%) with the 20-ms interval, 5.8% (SD 6.6%) with the 50-ms interval, and 2.8% (SD 4.7%) with the 100-ms interval. Patients with clinically definite multiple sclerosis were divided into 3 groups based on the latency of P100 in the conventional VEP: within 2 SD of the normal mean (7 patients), plus 3-6 SD (7 patients), and greater than 10 SD (7 patients), representing normal, mildly abnormal and grossly abnormal latencies, respectively. Only 4 patients had "abnormal" results in the conditioning-test paradigm, 2 of whom were in the "grossly abnormal" group and 1 in each of the other two groups. The prolongation in latency tended to be greater the longer the control P100. The conditioning-test paradigm did not reveal evidence of a significantly prolonged refractory period of demyelinated axons in the optic nerve, and did not assist in the identification of changes "typical of demyelination" in patients with normal or mildly abnormal control P100s. It is concluded that testing the refractoriness of the VEP may not enhance the diagnostic yield of the VEP in multiple sclerosis.

Brain↗
PubMed1984

Reproducibility of the visual evoked potential using a light-emitting diode stimulator.

The intersubject and intrasubject reproducibility of the VEP was evaluated using two different methods of producing pattern reversal--a mirror/projector system and a light-emitting diode (LED) system. Intersubject reproducibility was determined in 100 normal subjects (50 males, 50 females). Ten subjects were studied on ten different occasions over 11 months to establish intrasubject reproducibility. The two methods gave comparable results. It is concluded that the mirror/projector system has no advantages over the LED system, which is cheaper, more robust and more convenient. Most of the intersubject variability was found to be due to subject variables and it is concluded that technical improvements are unlikely to reduce further the variability of the test. A variability in the latency of P100 of up to 7.7 ms was recorded in the serial studies on the ten subjects, indicating that in longitudinal studies on patients, changes in latency must exceed 9-10 ms to be significant. With both stimulus systems, there were significant sex-related differences in latency (P50 and P100 but not N70) and amplitude (N70-P100). The extent of the difference was such that the upper limit of normal latency for P100 (2.5-3 SD from the mean) was 4.2-4.7 ms longer for males than females-a value which exceeds 1 SD. Separate control values for males and females are advisable whichever method is used to produce pattern reversal.

Adolescent↗
PubMed1982

Interactions between cutaneous and muscle afferent projections to cerebral cortex in man.

In order to demonstrate interactions between cutaneous and muscle afferent volleys in the ascending somatosensory pathways, different nerves of the lower limb were stimulated together in a conditioning-test paradigm, the changes in the earliest component of the cerebral potential evoked by the test stimulus being taken to indicate such an interaction. It was first confirmed that the cerebral potential evoked by stimulation of the posterior tibial nerve at the ankle is derived from muscle afferents in the mixed nerve and has shorter latencies than the cerebral potential evoked by purely cutaneous volleys in the sural nerve (see Burke et al. 1981). Complete suppression of the cerebral potential evoked by stimulation of muscle or cutaneous afferents was produced by conditioning volleys in a different nerve or in a different fascicle of the same nerve. The major factors determining the degree of suppression were found to be the relative sizes of the conditioning and test volleys and their timing, rather than whether the volleys were of cutaneous or muscular origin. It is concluded that the transmission of cutaneous or muscle afferent volleys to cortex can be profoundly altered in normal subjects by conditioning activity. The possibility that normal background afferent activity can similarly modify afferent transmission has implications for diagnostic studies, particularly when they are performed under non-standard conditions, such as in the operating theatre or intensive care unit. It is also concluded that, although a subject may perceive cutaneous paraesthesiae when the posterior tibial nerve is stimulated at the ankle, there may be no cutaneous component to the evoked cerebral potential.

Adult↗
PubMed1981

The irrelevance of fusimotor activity to the Achilles tendon jerk of relaxed humans.

In two normal subjects the sciatic nerve was blocked completely using concentrated lidocaine. The muscle afferent and reflex electromyographic responses to reproducible percussion of the Achilles tendon were recorded while the blocks developed. The intensity of percussion was sufficient to produce an Achilles tendon jerk in one subject when at rest and in the other during reinforcement. The block did not alter the muscle afferent response to tendon percussion in either subject. It is concluded that background fusimotor activity is not a prerequisite for the tendon jerk and that, during complete relaxation, there may be no significant fusimotor drive directed to the triceps surae. The varying ease with which tendon jerks can be elicited in different normal subjects or in different muscles of the same subject appears to be related not to fusimotor activity but to differences in the "central excitability state."

Achilles Tendon↗
PubMed1981

Dependence of the Achilles tendon reflex on the excitability of spinal reflex pathways.

Muscle afferent activity from the triceps surae was recorded during experimentally induced alterations in amplitude of the Achilles tendon jerk. No changes in the neural afferent response to tendon percussion or in the background level of neural activity occurred when the reflex response was altered by discomfort, distraction, changes in attention, or changes in the rate of tendon percussion. Reinforcement of the Achilles tendon jerk by forceful contraction of the forearm muscles did not alter the relationship between intensity of the tendon tap and amplitude of the evoked neural afferent volley. Nevertheless, such maneuvers lowered the reflex threshold and raised reflex sensitivity so that a smaller afferent volley was required to produce a tendon jerk, and an increase in the afferent volley produced a disproportionately greater increase in reflex electromyographic activity than would have occurred at rest. Reinforcement maneuvers potentiated the H-reflex but did not alter the electrically induced afferent volley or the background level of neural activity. It is concluded that these changes in reflex responsiveness occurred through intrinsic spinal mechanisms independent of the fusimotor system.

Achilles Tendon↗
PubMed1980

Anticipation and fusimotor activity in preparation for a voluntary contraction.

1. Multi-unit and single-unit recordings were made of muscle spindle afferent activity from the pretibial muscles of human subjects who were initially relaxed. The muscles were subjected to a stretching perturbation of 1 s duration, occurring irregularly, on average once every 5 s. In test sequences, an auditory or visual warning was provided 1 . 06 s before some of the perturbations. Subjects were required to oppose every perturbation by contracting the receptor-bearing muscle as rapidly as possible. 2. Following the warning all subjects sometimes tensed the receptor-bearing muscle unintentionally in preparation for the perturbation. In these contractions, the discharge of a spindle ending accelerated only if the contraction strength exceeded the ending's threshold for activation, established in control voluntary contractions performed under isometric conditions. 3. When the receptor-bearing muscle did not contract in the interval between warning and perturbation, there was no detectable change in the multi-unit recordings of spindle activity or in recordings from twelve of thirteen single spindle afferents. The thirteenth spindle afferent discharged prior to the perturbation in the absence of detectable e.m.g. in response to (only) three of twenty-three warning stimuli. However, this ending had been so responsive during isometric voluntary contractions that a contraction level at which it did not respond could not be established, and it is suggested that the findings with this ending resulted from its low threshold rather than from selective activation of the fusimotor system. 4. When subjects were warned of the perturbations, the dynamic response of spindle endings to the perturbations was not increased in size or altered in latency. 5. The motor response to perturbations without warning generally contained only long-latency (volitional) e.m.g. activity occurring 107--200 ms after the onset of the perturbation. When a warning was given, short-latency (reflex) e.m.g. activity was also recorded, beginning 46--76 ms after the onset of the perturbation. 6. It is concluded that anticipation of the need to contract a muscle does not result in selective activation of fusimotor neurones in preparation for the contraction. The change in stretch reflex gain that occurs as a result of 'anticipation' occurs through a central process which does not involve the fusimotor system.

Acoustic Stimulation↗
PubMed1979

Voluntary activation of spindle endings in human muscles temporarily paralysed by nerve pressure.

1. In normal human subjects, the afferent activity from muscle spindle endings in the pretibial muscles was recorded while a pressure block was applied to the peroneal nerve proximally in the popliteal fossa. 2. In five of ten blocks, spindle activity increased in attempted isometric voluntary contractions when the receptor-bearing muscles were completely paralysed. In the remaining five blocks, voluntary effort still increased spindle activity when maximum voluntary power was reduced by more than 90%, but the ability to activate spindles voluntarily was lost with or slightly before block of the last motor units. When the ability to activate spindle endings in an attempted voluntary contraction was lost sympathetic efferent fibres remained unblocked. 3. It is concluded that the fusimotor effects seen during a voluntary contraction are mediated by myelinated fibres of small calibre which probably innervate intrafusal structures exclusively (gamma fusimotor fibres). There is no necessity to postulate that skeleto-fusimotor (beta) fibres are responsible for the tight 'alpha-gamma co-activation' seen in man during voluntary contractions.

Humans↗
PubMed1979

The regularity of muscle spindle discharge in man.

1. The variability of discharge of thirty-nine muscle spindle afferents from the pretibial muscles of normal human subjects was determined for spike train sequences recorded with the ankle joint fixed in 25 degrees plantar flexion, during further stretch and during graded voluntary contractions of the receptor-bearing muscle. 2. In non-contracting muscles with the ankle joint in 25 degrees plantar flexion, a sustained discharge was maintained by twenty-four of the thirty-nine endings. The mean discharge frequency for the active endings was 11.1 Hz (range 4.8--22.1 Hz), the mean coefficient of variation 0.073 (range 0.021--0.183). With further stretch, the discharge of endings maintaining frequencies below 10--12 Hz became more regular. For endings maintaining higher frequencies, changes in the coefficient of variation were small and occurred in either direction. All secondary endings maintained a highly regular discharge, but, at these frequencies, there was no statistically significant difference in the variability of primary and secondary endings. 3. It is considered that these findings are comparable to those of Matthews & Stein (1969) for de-efferented feline spindle endings, and support the view that there is no functionally effective background fusimotor drive to non-contracting muscles of normal human subjects. 4. A voluntary contraction sufficient to accelerate a spindle ending invariably decreased the regularity of its afferent discharge. During voluntary contractions, coefficients of variation up to 0.345 were recorded. However, coefficients as low as 0.1 were not uncommon, and thus the absence of fusimotor drive cannot necessarily be inferred from a regular afferent discharge pattern. 5. With contractions of different strength, the increase in the coefficient of variation did not parallel the increase in discharge frequency. It is concluded that not all fusimotor influences acting on a spindle ending are translated into variability, and that measurements of the variability of discharge do not accurately reflect the level of fusimotor drive. 6. The discharge frequency of some spindle endings decreased slightly in some contractions and this was accompanied by an increase in the variability of discharge. It is suggested that contracting extrafusal muscle fibres can modulate the discharge pattern of spindle endings and contribute to the variability of discharge during a voluntary contraction. 7. In contracting muscles the irregular fusimotor-driven spindle discharge contained a 'hidden' periodicity, but this was not as extensive as has been reported for the cat. No such periodicity could be demonstrated for spindle endings in non-contracting human muscles.

Action Potentials↗
PubMed1978

Recruitment order of human spindle endings in isometric voluntary contractions.

1. The responses of twenty-two spindle endings in the anterior tibial and toe extensor muscles of human subjects were studied during isometric voluntary contractions of the receptor-bearing muscle with the ankle joint fixed in 25 degrees plantar flexion.2. The discharge of eighteen endings accelerated in voluntary contractions when the contraction strength exceeded a threshold level which differed for different endings but was reproducible for the same ending.3. With contractions of slow onset the latency to spindle acceleration varied with the speed of onset of the contraction. Endings with a background discharge were often unloaded by contractions until the contraction strength exceeded the threshold for activation of the ending.4. No correlation was found between the sensitivity of a spindle to external length changes and its ease of activation in a voluntary contraction. For two spindle endings with a background discharge there was no change in either discharge frequency or the regularity of spindle discharge during contractions which were below the threshold for activation of the endings. It is concluded that the threshold for activation of a spindle ending in an isometric voluntary contraction is determined by its fusimotor innervation, and that fusimotor neurones probably have a recruitment order, much as do skeletomotor neurones.5. Once activated, the discharge of spindle endings fluctuated with changes in skeletomotor activity but the relationship for some endings contained non-linearities. Such non-linearities were not as apparent in multi-unit recordings from a number of spindle endings in the contracting muscle. It is concluded that the fusimotor drive to a muscle is proportional to the skeletomotor drive to the muscle, and that skeletomotor and fusimotor neurones are subjected to similar if not identical descending command signals. From the work of Evarts (1968), it seems likely that these command signals are related more to desired muscle force than to desired muscle length.

Action Potentials↗
PubMed1977

A micro-electrode study of peripheral neuropathy in man. Part 1. Responses to single graded stimuli.

Multi-unit micro-electrode recording were obtained from sensory fascicles of the sural and median nerves of 12 control subjects and of 28 patients with peripheral neuropathy. Spontaneous activity and mass responses to mechanical and electrical stimuli were examined. Mechanoreceptor function appeared normal but there was a reduced number of responsive receptors in peripheral neuropathy. The electrical activation threshold of nerve fibres of all conduction velocities was increased in neuropathy and a greater number of fibres needed to be activated for preception to occur. Clinical sensory impairment was associated with a reduction in size of the initial compound action potential of the maximal evoked neurogram and with dispersion of fibre responses. Pathological slowing of fibre conduction velocity was demonstrated in demyelinating neuropathy but in most cases of axomal degeneration the changes in velocity could have been due either to a reduced number of fast conducting fibres, or to conduction block. No changes were observed in C-fibre activity in these patients.

Adult↗
PubMed1977

A micro-electrode study of peripheral neuropathy in man. Part 2. Responses to conditioning stimuli.

Surface, needle and micro-electrode recordings were obtained from sensory nerves of patients with various types of peripheral neuropathy. Changes in amplitude and conduction velocity of nerve action potentials were measured after a single conditioning stimulus and after tetanic stimulation for 2 min. In patients with hereditary forms of axonal degeneration (AD), recovery processes of nerve fibres of all conduction velocities were normal; in acquired forms of AD fibres with conduction velocity less than 30 m/sec had greater and more prolonged post-tetanic depression than control nerves of similar conduction velocity. Where neuropathy was associated with segmental demyelination (SD), fibres of all conduction velocities had prolonged recovery processes after both single and tetanic stimulation. The changes were especially marked at higher skin temperature, and were greater than the changes seen in nerves with acquired forms of AD. Finally, 2 sural nerves were studied during the process of Wallerian degeneration after a biopsy had been obtained proximally, and recovery processes did not change during the period of degeneration. Perceptual abnormalities were similar in AD and SD. It is suggested that changes in recovery processes of nerve fibres with segmental demyelination or regeneration after injury contribute to the perceptual abnormalities which occur in clinically encountered peripheral neuropathies.

Action Potentials↗