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Biomedical subjects

R Dengler

Publications and source records attributed to R Dengler.

167 records · Page 10Linked to original sources
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Membrane defects in paramyotonia congenita with and without myotonia in a warm environment.

Three patients with paramyotonia congenita and 3 control persons were biopsied for an in vitro investigation of the sarcolemmal membrane parameters and of the contractile properties of paramyotonic muscle. At 37 degrees C, paramyotonic muscle fibers had normal resting potentials, but on cooling to 27 degrees C they depolarized. Depolarization to -60 mV caused spontaneous activity, and further depolarization to -40 mV caused inexcitability. Depolarization could be prevented by the application of tetrodotoxin, a finding suggesting a defect in the Na channels. Analysis of the membrane current densities using voltage clamps with 3 microelectrodes revealed that in paramyotonic patients at 37 degrees C all component conductances were normal, except for a decreased Cl conductance in the patient who had myotonia in a warm environment. At 27 degrees C, the Na and Cl conductances were abnormally high. The K conductance was always normal. The results explain the clinical symptoms of weakness and paralysis. Potassium- and caffeine-contracture experiments gave normal results. The clinical symptom of paramyotonic stiffness, therefore, has not been explained by these studies.

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Botulinum toxin type A and EMG: a key to the understanding of chronic tension-type headaches?

BACKGROUND: The pathogenesis of chronic tension-type headache remains unclear, and the role of muscle tension is especially controversial. Botulinum toxin type A, a potent inhibitor of muscle tone, has been used to treat chronic tension-type headache. OBJECTIVE: To determine whether clinical response to treatment of chronic tension-type headache with Botox A parallels changes in resting muscle activity recorded through serial electromyography (EMG). METHODS: We randomly assigned eight patients with chronic tension-type headache to pericranial injection of 500 MU Botox A versus placebo (isotonic saline). RESULTS: At 6 and 12 weeks following treatment, there were no significant differences in clinical outcome between the placebo and the Botox A groups. This occurred despite EMG evidence of a reduction in resting muscle activity in the Botox A-treated patients. CONCLUSION: These results support the hypothesis that peripheral mechanisms such as increased muscle tone play, at most, a minor role in the pathophysiology of chronic tension-type headache.

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Inhibition of EMG activity in isometrically loaded agonist muscle preceding a rapid contraction.

It was recently suggested that a premotion silent period in isometrically loaded agonist muscle reflects transition process in switching motor program from an isometric to an isotonic condition. To test this hypothesis we investigated changes in EMG activity of a biceps muscle during motor preparatory phase in an entirely isometric paradigm. Five healthy volunteers produced rapid isometric elbow flexions superimposed on a slightly sustained contraction during self-paced and reaction time conditions. In addition to surface EMG, single motor units were recorded in agonist muscle prior to a rapid contraction. Silent period was found in responses of three out of five subjects, whereas inhibition of some but not all tonically active motor units was observed in all studied subjects prior to the phasic EMG burst. Inhibition of motor unit activity occurred more often in self-paced than reaction time contractions. Our results indicate that inhibition is not always powerful enough to produce a complete electrical silence, and weaker inhibitory effects were observed as a declining number of firing motor units. We conclude that the silent period or depression of the EMG activity is associated with changes in motor program from tonic to phasic muscle activation and is not merely a consequence of changes from an isometric to an isotonic condition.

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