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Biomedical subjects

R Mazzocchio

Publications and source records attributed to R Mazzocchio.

At least 19 recordsLinked to original sources
PubMed2006

Is the human masticatory system devoid of recurrent inhibition?

The aim of the present study was to investigate the existence or otherwise of a functional recurrent inhibitory system (Renshaw cell system) in the motoneurons that innervate human masticatory muscles. In a previous study, L: -acetylcarnitine (L: -Ac), a substance known to potentiate recurrent inhibition in humans was found to alter, in a specific way, the discharge variability, and the synchronous activity of motor units depending on the presence or absence of recurrent inhibition in the corresponding motoneuron pool. Using a similar paradigm, we have recorded the tonic discharge activity of motor unit pairs from the masseter muscle during voluntary isometric contraction while subjects were undergoing continuous intravenous saline (SAL, NaCl 0.9%) perfusion. Following a brief baseline-recording period, the subjects were given a test injection of either L: -Ac or isotonic saline (SAL) in a double blind manner. The variability, synchronization, and coherence between the motor unit discharges were analysed during three successive periods: pre-injection, during injection, and post-injection, each lasting 2-3 min. Neither L: -Ac nor SAL injection induced a significant change in the inter-spike interval (ISI) or the coefficient of variation of the ISIs in the motor units tested. There were also no significant changes in the pattern of synchronous activity or in the coherence, which reflects the common frequency content of the unit discharges. Reminiscent of what had been observed previously with motoneurons without recurrent inhibition in the Abductor Digitorum Minimi muscle, the lack of effects of L: -Ac injection on the firing behaviour of masseter motoneurons may suggest that classical Renshaw cell inhibition is lacking in this motoneuron pool.

Acetylcarnitine↗
PubMed2006

Changes in the recruitment curve of the soleus H-reflex associated with chronic low back pain.

OBJECTIVE: We investigated whether patients with chronic low back pain (CLBP) manifest changes in the excitability of the soleus H-reflex. METHODS: H-reflex stimulus-response curve was studied in 14 CLBP patients and 14 age-matched healthy subjects. H-threshold, H-maximum size, H-steepness and H-latency were determined for both legs. Homosynaptic depression (HD), following a train of H-reflexes, and presynaptic inhibition (PI) from flexor afferents onto soleus Ia afferents were also evaluated. RESULTS: H-threshold was significantly increased, H-size as a function of stimulus intensity was significantly different, and H-recruitment curve steepness was significantly lower in CLBP patients compared to healthy subjects. No significant difference in the amount of HD and PI of the H-reflex was found between the two groups. H-latency and Hmax/Mmax ratio was comparable between the subjects groups. CONCLUSIONS: In CLBP there is a reduced excitability of group Ia afferent fibres from the soleus muscle to which presynaptic factors do not seem to contribute and that presumably depend on changes in the peripheral sensory input. SIGNIFICANCE: Changes in H-reflex excitability may underlie a decrease in the gain of a peripheral sensor in CLBP. Estimation of soleus H-threshold and H-recruitment curve may contribute to the diagnostic evaluation of CLBP and may be used to monitor the efficacy of treatment.

Adult↗
PubMed2006

Recurrence quantification analysis of surface EMG detects changes in motor unit synchronization induced by recurrent inhibition.

The systemic injection of L-Acetylcarnitine (L-Ac) induces a reversible increase in recurrent inhibition. In addition, L-Ac potentiation of recurrent inhibition has been found to increase the synchronous activity of single motor units, as detected by traditional linear analysis in the time domain. This result has been recently confirmed using a nonlinear method based on the analysis of embedded determinism (%DET) extracted from the surface EMG. The present study aimed at testing the general applicability of RQA methodology, as a viable tool for assessing motor unit synchronization, by extending the analysis of surface EMG, as revealed by changes in %DET induced by L-Ac, to many upper and lower limb muscles and to muscles that are not easily studied by needle electrodes, such as the orbicularis oculi. Subjects performed brief periods of tonic contractions, alternated to periods of rests to avoid muscle fatigue. Pharmacological enhancement of recurrent inhibition was obtained by a short-lasting intravenous injection of L-Ac. Control experiments were performed replacing L-Ac injection with saline injection. The average %DET showed a significant increase during L-Ac injection in the deltoid, biceps brachii, extensor carpi radialis, while no effect was observed in the opponens pollicis and abductor digiti minimi for the upper limb muscles. Similarly, the average %DET showed a significant increase during L-Ac injection in the quadriceps, soleus, and tibialis anterior, while no effect was observed in the abductor hallucis for the lower limb muscles. RQA of orbicularis oculi muscle activity showed no increase in %DET during L-Ac injection in analogy to what found in the intrinsic muscles of the hand and foot, known to be devoid of recurrent inhibition. The presence or absence of drug-induced increase in motor unit synchronization agrees with the known distribution of recurrent inhibition in the various motor nuclei. The overall significance of these findings is the potential application of RQA methodology as a reliable and independent tool for generally assessing motor unit synchronization from surface EMG under strictly controlled experimental condition.

Acetylcarnitine↗
PubMed2006

Motor unit synchronous firing as revealed by determinism of surface myoelectric signal.

Information on motor strategies can be extracted from the surface electromyogram (EMG) by non-linear methods. The percentage of determinism (%DET) obtained from recurrence quantification analysis (RQA) may be a sensitive variable to detect synchronous motor unit behaviour. The purpose of the present study was to validate this methodology by comparing it with an established technique estimating the degree of synchronization of pairs of voluntary activated motor units from the correlation of their firing in the time-domain. Single motor unit activity was recorded in extensor carpi radialis (ECR) muscle by pairs of tungsten microelectrodes inserted into the muscle belly. Cross-correlation analysis was performed in order to determine synchronization peak area by computing synchronous impulse probability. Surface EMG activity was recorded in parallel by electrodes placed over the skin of the same muscle and %DET was used as a measure of synchronous activity. The %DET appeared to be a valid measure of synchronization yielding results comparable to those obtained with cross-correlation analysis. Increases in %DET (t = 64.59, P < 0.0001) highly correlated (r2 = 0.70, P = 0.0013) with pharmacologically induced increases in the synchronization activity of pairs of ECR motor units (t = 8.71, P < 0.0001). RQA may be used as an alternative methodology for testing synchronous motor unit behaviour from surface EMG under physiological and pathological conditions.

Acetylcarnitine↗
PubMed2005

Changes in coordination of postural control during dynamic stance in chronic low back pain patients.

The human postural system operates on the basis of integrated information from three independent sources: vestibular, visual and somatosensory. It is conceivable that a derangement of any of these systems will influence the overall output of the postural system. The peripheral proprioceptive system or the central processing of proprioceptive information may be altered in chronic low back pain (CLBP). We therefore investigated whether patients with CLBP exhibited an altered postural control during quiet standing. Dynamic posturography was performed by 12 CLBP patients and 12 age-matched controls. Subject's task was to stand quietly on a computer-controlled movable platform under six sensory conditions that altered the available visual and proprioceptive information. While the control of balance was comparable between the two groups across stabilized support surface conditions (1-3), CLBP patients oscillated much more than controls in the anterior-posterior (AP) direction in platform sway-referenced conditions (4-6). Control experiments ruled out that increased sway was due to pain interference. In CLBP patients, postural stability under challenging conditions is maintained by an increased sway in AP direction. This change in postural strategy may underlie a dysfunction of the peripheral proprioceptive system or the central integration of proprioceptive information.

Adaptation, Physiological↗
PubMed2005

Cortico-motoneuronal output to intrinsic hand muscles is differentially influenced by static changes in shoulder positions.

We investigated whether shoulder position influenced the recruitment properties of the abductor digiti minimi muscle (ADM) and first dorsal interosseous muscle (FDI). ADM and FDI motor evoked potentials (MEPs) in response to transcranial magnetic stimulation (TMS) were obtained in seven healthy volunteers at two different static positions of the shoulder joint (30 degrees adduction vs 30 degrees abduction) while the arm was passively supported at shoulder level (90 degrees in the horizontal plane) and the elbow joint was fixed at 90 degrees . ADM and FDI voluntary activity was also examined during (1) externally paced finger abductions at 2 Hz in the two different shoulder positions (EMG(ADM) and EMG(FDI) was back-averaged time-locked to the end of finger abduction) and (2) maximal voluntary abduction of the little finger and the index finger. Maximal EMG power and force were analysed in the two shoulder positions. H-reflexes from ADM and FDI were also obtained in two subjects. The ADM stimulus-response curve to TMS showed that the slope and plateau level were significantly reduced with the shoulder at 30 degrees abduction. In contrast, the FDI stimulus-response curve to TMS was not influenced by shoulder position. The back-averaged EMG(ADM) showed a significant decrease in peak amplitude and area with the shoulder at 30 degrees abduction, while no change in EMG(FDI) was observed under the same condition. Similarly, maximal EMG(ADM) and force exertion by the little finger were significantly reduced with the shoulder at 30 degrees abduction, while no such effect was observed for FDI. ADM H-reflex, but not FDI, was also decreased with shoulder abduction. These results indicate that the corticospinal pathway to ADM is less accessible to TMS and to voluntary command when the shoulder is placed at 30 degrees abduction. In contrast, activation of FDI, whether by TMS or by volition, is not influenced by shoulder position. This finding suggests that there are differences in the corticospinal innervation to ADM and FDI, possibly due to the different role of these muscles in hand function.

Adult↗
PubMed2005

Force estimation processing as a function of the input--output relationship of the corticospinal pathway in humans.

Static changes of the shoulder joint from 30 degrees adduction (ANT) to 30 degrees abduction (POST) in the horizontal plane reduce the gain of the input--output relationship of the corticospinal pathway to the abductor digiti minimi (ADM) muscle [F. Ginanneschi et al. (2005)Exp. Brain Res., 161, 374--382]. The present study examined force estimation under conditions in which the input--output relationship of the corticospinal innervation to ADM was modified by changing shoulder position as above. The input--output relationship was studied using transcranial magnetic stimulation. Estimates of force were assessed using a matching procedure; subjects first matched a target level (10--40% of maximum) on a screen by applying a reference (Ref) isometric contraction of ADM and then they reproduced the same level of force without visual feedback by a test contraction (Test). When Ref and Test contractions were performed at either ANT or POST (i.e. the same input--output), the respective force levels were closely matched. In contrast, when the Test and Ref were performed in POST and ANT, respectively (i.e. different input--output), subjects exerted more force than required. Errors were in the opposite direction when the Test and Ref were in ANT and POST, respectively. The present results suggest that the process of force estimation is based on the effort : tension ratio which is a direct function of the corticomotoneuronal input--output relationship. This notion may contribute to explaining the pathophysiology of central fatigue.

Adult↗
PubMed2004

Changes in corticomotor excitability of hand muscles in relation to static shoulder positions.

We examined whether the recruitment properties of the corticospinal pathway to intrinsic hand muscles are influenced by variations of the shoulder joint angle. Abductor digiti minimi (ADM) motor evoked potentials (MEPs) in response to transcranial magnetic stimulation were examined during different static positions of the shoulder joint in the horizontal plane from 30 degrees adduction to 30 degrees abduction with respect to the neutral position at 0 degrees, while elbow and wrist joints were constrained statically at 90 degrees and 180 degrees respectively. We found that 30 degrees abduction of the shoulder significantly depressed MEP size and prolonged MEP latency in comparison with 30 degrees shoulder adduction. The neutral shoulder angle position (at 0 degrees ) significantly reduced MEP size but had no effect on MEP latency in comparison with 30 degrees shoulder abduction. The input-output relationship between MEP size and stimulus intensity was sigmoidal. The plateau value and maximum slope were significantly lower at 30 degrees abduction than at 30 degrees adduction of the shoulder. However, the threshold value did not differ significantly between the two positions. To differentiate excitability changes at cortical versus subcortical sites, intracortical inhibition (ICI) and intracortical facilitation (ICF) were assessed using a paired-magnetic pulse paradigm. A significant decrease in ICF was observed after changing shoulder position from 30 degrees adduction to 30 degrees abduction. In contrast, no variation in the amount of ICI occurred in relation to the same changes in shoulder position. ADM F-waves elicited by electrical stimulation of the ulnar nerve at the wrist were significantly decreased at 30 degrees shoulder abduction in comparison with 30 degrees adduction. A similar pattern was observed in one subject in whom the H-reflex could be exceptionally elicited in ADM. We conclude that shoulder position influences the recruitment efficiency (gain) of the corticospinal volleys to motoneurons of intrinsic hand muscles. It is proposed that activity of peripheral receptors signalling static shoulder position influences corticomotor excitability of hand muscles both at the cortical and at the spinal level. This modulation may be functionally relevant when reaching to grasp objects.

Action Potentials↗
PubMed2004

Kinematically specific interhemispheric inhibition operating in the process of generation of a voluntary movement.

Unilateral hand movements are accompanied by a transient decrease in corticospinal (CS) excitability of muscles in the opposite hand. However, the rules that govern this phenomenon are not completely understood. We measured the amplitude of motor evoked potentials (MEP) in the left first dorsal interosseus (FDI) elicited by transcranial magnetic stimulation (TMS) of the primary motor cortex in order to assess CS excitability changes that preceded eight possible combinations of unilateral and bilateral index finger movements with different right hand positions. Left FDI MEP amplitude (MEP(Left FDI)) increased when this muscle acted as an agonist and tended to decrease when it was an antagonist. Additionally, MEP(Left FDI) decreased substantially before right index finger abduction (a movement mediated by the right FDI) when both hands were lying flat (a movement mirroring left index finger abduction) but not when the right hand was turned at 90 degrees or flat with the palm up. Therefore, CS excitability of the resting FDI was differentially modulated depending on the direction of the opposite index finger movement, regardless of muscles engaged in the task. These results indicate that inhibitory interactions preceding unilateral finger movements are determined by movement kinematics possibly to counteract the default production of mirror motions.

Adult↗
PubMed2003

Effect of chemically activated fine muscle afferents on spinal recurrent inhibition in humans.

OBJECTIVE: To test the hypothesis that 'metabolites released during fatiguing muscle contractions excite group III-IV muscle nociceptive afferents, inhibiting homonymous motoneurones via Renshaw cells,' by recording changes in recurrent inhibition of soleus motoneurones when high-threshold, small-diameter afferents (group III-IV fibres) from the same muscle were tonically activated. METHODS: Experiments were performed in 7 healthy subjects at rest and during weak isometric voluntary contraction of the soleus muscle. Muscle nociceptive afferents were activated by local standardized injection of levo-ascorbic acid. Renshaw cells were orthodromically activated by a conditioning H reflex and the resulting recurrent inhibition of the soleus motoneurones was assessed by a subsequent test H reflex. An additional H reflex of the same size as the test reflex was used to assess motoneurone excitability. RESULTS: At rest, muscle nociceptive stimulation produced transient facilitation of both test H and reference H reflexes. Under weak voluntary contraction, muscle nociceptive stimulation produced long-lasting extra-inhibition and extra-facilitation of the test reflex and reference reflex respectively, the time course of which closely resembled that of the subjective muscle pain curve. CONCLUSIONS: Discharge of putative group III-IV muscle afferents facilitated homonymous recurrent inhibition. The filtering property of recurrent inhibition may contribute to limit motoneurone activity during muscle pain and/or adapt motoneurone firing rate to the modified contractile properties of motor units as muscle fatigue developed.

Adult↗
PubMed2001

Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy.

BACKGROUND: Needle EMG may be negative in mild or predominantly sensory lumbosacral radiculopathies. In such cases, an increase in the latency of the soleus H-reflex is a useful diagnostic criterion for establishing sensory fiber compromise at the S1 root level. However, if clinical signs of radicular involvement are lacking, the latency of the H-reflex is normal. We therefore studied the recruitment curve of the soleus H-reflex to investigate whether a change in the electrical threshold for eliciting the H-reflex might be a more sensitive criterion for detecting subclinical S1 root dysfunction. METHODS: Clinical and electrophysiological findings from 26 patients with chronic back pain and radiculopathy were compared with data obtained from 40 healthy subjects. RESULTS: An increase in the mean H-reflex threshold was the only abnormal electrophysiological finding in patients with no clinical sign of root injury (58%). A decrease in the mean H-reflex amplitude and a prolongation of H-reflex latency was observed in patients with radicular signs (42%). In both patients groups, F-wave and needle EMG studies were normal. No radiological evidence of S1 root compression was found. CONCLUSIONS: The study of the recruitment curve of the soleus H-reflex may be usefully associated to F-wave and needle EMG studies to detect possible S1 root dysfunction in mild lumbosacral radiculopathies. An increase in H-threshold may be the earliest abnormality in the absence of focal neurological signs.

Journal Article↗
PubMed2000

Abnormalities of the soleus H-reflex in lumbar spondylolisthesis: a possible early sign of bilateral S1 root dysfunction.

Using routine electrodiagnostic procedures, the authors searched for physiologic evidence of nerve root compromise in patients with chronic mechanical perturbation to the lumbar spine. They examined 37 patients with spondylolisthesis and various degrees of degenerative changes in the lumbar canal. Clinical and neurophysiologic findings were compared with data obtained from 36 healthy persons. The soleus H-reflex appeared to be a sensitive indicator of sensory fiber compromise at the S1 root level, because changes correlated well with the focal sensory signs and preceded clinical and electromyographic signs of motor root involvement. When these occurred, the clinical findings were consistent with a more severe nerve root deficit and with radiographic evidence of neural compression. The greater sensitivity of the soleus H-reflex may be related to the pathophysiologic events that occur at the lesion site.

Adult↗
PubMed1999

Peripheral neuropathy associated with anti-myelin basic protein antibodies in a woman vaccinated with rubella virus vaccine.

Active immunisation with rubella vaccine has not been commonly associated with neurological complications. We report the case of a 23-year-old woman who developed a mild, distal demyelinating neuropathy after immunisation with the live attenuated RA 27/3 rubella strain. Post-immunisation immunologic studies carried over 24 months showed the presence of antibodies to the RV proteins, particularly to the capsid antigen, and to the myelin basic protein (MBP). A similarity between a C antigen motif and a sequence of the MBP was found by computer analysis. The cross-reactivity was confirmed by immunising mice with a synthetic peptide derived from the MBP, which developed a strong humoral response to RV and MBP. This finding raises the possibility that a virus-induced immune response could lead to an autoaggressive reaction responsible for demyelination.

Adult↗
PubMed1999

Aspecific inflammatory lesion (histiocytosis?) simulating intramedullary astrocytoma. Case report.

We report an exceptional case of aspecific inflammatory lesion of the thoracic spinal cord simulating an intramedullary glial tumor. Patient history was characterized by progressive spastic paraparesis with urinary incontinence; MR imaging (T4-T5) showed an enhancing intrinsic mass lesion. Myelotomy enabled partial resection of grayish astrocytoma-like tissue. Only light microscope examination was possible and disclosed aspecific inflammatory tissue composed of eosinophils, lymphocytes and histiocytes. After the operation, the patient improved promptly and no further therapy was administered. Control MRI after four months, one year and two years showed complete disappearance of the intramedullary mass lesion and the patient remained clinically stable with no other signs of disease. Since electron microscopic as well as immunohistochemical studies were not available, a definitive histological diagnosis was not possible. However on the basis of some clinical similarities with cases of isolated histiocytosis X of the CNS reported in the literature, we suggest that a diagnosis of isolated intramedullary eosinophilic granuloma could be reasonable.

Astrocytoma↗
PubMed1997

A method for potentiating Renshaw cell activity in humans.

Owing to the introduction of a special electrophysiological method [3] it has been possible to study spinal recurrent inhibition in humans. The method, however, is indirect and, being based on an H reflex technique, can only be tested in motor nuclei from which a large monosynaptic response can be obtained. We have developed a complementary method by which pharmacological stimulation of Renshaw cells is obtained [6]. It exploits the central cholinergic properties of L-acetylcarnitine [18], a substance which most likely acts potentiating the synaptic drive of the motoneurone collaterals [7], known to be the main source of excitation of Renshaw cells [15,20]. The use of L-acetylcarnitine has allowed to establish the validity of the original methodology [6] and to confirm the presence of recurrent inhibition, tested either by the H reflex technique [11-13] or, if not possible, by the PSTH technique and/or rectified averaged EMG analysis [1,4], in many limb motor nuclei. Thus, it can be expected that L-acetylcarnitine may be used as an independent means for identifying changes in motoneuronal activity related or attributed to the influence of Renshaw cells.

Acetylcarnitine↗
PubMed1997

Involvement of spinal recurrent inhibition in spasticity. Further insight into the regulation of Renshaw cell activity.

Changes in the excitability of the soleus H-reflex are were studied after oral administration of L-acetylcarnitine, a cholinomimetic substance, in eight healthy control subjects and 23 spastic patients presenting with slowly progressive paraparesis (n = 10), a cord lesion (n = 9) and a cerebral lesion (n = 4). Changes in the amount of recurrent inhibition of soleus motor neurons at rest were also estimated in order to assess the level of activity of Renshaw cells before and after L-acetylcarnitine administration. Recurrent inhibition elicited by a conditioning reflex discharge (H1) was assessed by a subsequent test reflex (H'). Four patients lacked an H' reflex. In approximately 50% of the remaining patients, recurrent inhibition was normal, while in the other half there was evidence of reduced or absent inhibitory activity at rest. Pooling the data relative to the effect of L-acetylcarnitine on the H-reflex in relation to the strength of recurrent inhibition disclosed that the ratio of peak-to-peak amplitude values of the maximum H reflex to maximum M wave responses (Hmax:Mmax) was reduced in all the cases in which the recurrent inhibition at rest was normal, while such a reduction was never observed in the patients in whom recurrent inhibition was found to be decreased at rest. In the former cases, the size of the H' reflex evoked by the same conditioning H1 discharge was further depressed after L-acetylcarnitine, pointing to a potentiating effect of the drug on Renshaw cells; in the latter cases no such effect was seen. A significant decrease in the mean Hmax:Mmax ratio after L-acetylcarnitine intake was also seen in the healthy control subjects. Possible changes in the amount of presynaptic inhibition on Ia terminals on soleus motor neurons after L-acetylcarnitine were ruled out. It is proposed that the differential effect of the drug on the H-reflex excitability is directly related to the level of Renshaw cell activity, a reduction of which probably follows a lesion interrupting reticulo-spinal pathways with tonic facilitatory influences on Renshaw cells. These findings support the hypothesis that Renshaw cell excitability is set via cortico-reticulo-spinal systems.

Acetylcarnitine↗