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The role of neurotrophins in the maintenance of the spinal cord motor neurons and the dorsal root ganglia proprioceptive sensory neurons.

The aim of this study was to approach the question of neuronal dependence on neurotrophins during embryonic development in mice in a way other than gene targeting. We employed amyogenic mouse embryos and fetuses that develop without any skeletal myoblasts or skeletal muscle and consequently lose motor and proprioceptive neurons. We hypothesized that if, in spite of the complete inability to maintain motor and proprioceptive neurons, the remaining spinal and dorsal root ganglia tissues of amyogenic fetuses still contain any of the neurotrophins, that particular neurotrophin alone is not sufficient for the maintenance of motor and proprioceptive neurons. Moreover, if the remaining spinal and dorsal root ganglia tissues still contain any of the neurotrophins, that particular neurotrophin alone may be sufficient for the maintenance of the remaining neurons (i.e., mostly non-muscle- and a few muscle-innervating neurons). To test the role of the spinal cord and dorsal root ganglia tissues in the maintenance of its neurons, we performed immunohistochemistry employing double-mutant and control tissues and antibodies against neurotrophins and their receptors. Our data suggested that: (a) during the peak of motor neuron cell death, the spinal cord and dorsal root ganglia distribution of neurotrophins was not altered; (b) the distribution of BDNF, NT-4/5, TrkB and TrkC, and not NT-3, was necessary for the maintenance of the spinal cord motor neurons; (c) the distribution of BDNF, NT-4/5 and TrkC, and not NT-3 and Trk B, was necessary for the maintenance of the DRG proprioceptive neurons; (d) NT-3 was responsible for the maintenance of the remaining neurons and glia in the spinal cord and dorsal root ganglia (possibly via TrkB).

Animals↗

The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception.

The effect of glenohumeral arthritis and subsequent total shoulder arthroplasty (TSA) on shoulder proprioception has not been evaluated previously. A prospective analysis of 20 consecutive patients with unilateral advanced glenohumeral arthritis who underwent TSA was undertaken. Shoulder proprioception testing for passive position sense and detection of motion was performed 1 week before surgery and 6 months after TSA. The presence of glenohumeral arthritis had a significant effect on position sense for all 3 planes tested (flexion, abduction, and external rotation). There were significant differences (P < .05) compared with the uninvolved shoulder and with a group of 20 age- and gender-matched subjects without a history of shoulder problems. Six months after TSA, position sense was significantly improved (P < .05) and was not significantly different from that in the contralateral shoulder or the comparison group. Detection of motion was also significantly worse in the arthritic group compared with that in the uninvolved contralateral side (P < .05). Six months after TSA, the sensitivity to detection of motion improved (P < .01) and was not significantly different than that in the uninvolved contralateral shoulder. In addition, the postoperative values for the involved shoulder were not significantly different than those in the age- and gender-matched comparison group. This study demonstrates a significant decrease in proprioceptive function in patients with advanced glenohumeral arthritis. After TSA, there was a marked improvement in proprioception.

Aged↗

PlexinA1 signaling directs the segregation of proprioceptive sensory axons in the developing spinal cord.

As different classes of sensory neurons project into the CNS, their axons segregate and establish distinct trajectories and target zones. One striking instance of axonal segregation is the projection of sensory neurons into the spinal cord, where proprioceptive axons avoid the superficial dorsal horn-the target zone of many cutaneous afferent fibers. PlexinA1 is a proprioceptive sensory axon-specific receptor for sema6C and sema6D, which are expressed in a dynamic pattern in the dorsal horn. The loss of plexinA1 signaling causes the shafts of proprioceptive axons to invade the superficial dorsal horn, disrupting the organization of cutaneous afferents. This disruptive influence appears to involve the intermediary action of oligodendrocytes, which accompany displaced proprioceptive axon shafts into the dorsal horn. Our findings reveal a dedicated program of axonal shaft positioning in the mammalian CNS and establish a role for plexinA1-mediated axonal exclusion in organizing the projection pattern of spinal sensory afferents.

Afferent Pathways↗

Direction-dependent integration of vision and proprioception in reaching under the influence of the mirror illusion.

Recent models of multisensory integration predict differential weighting of information from different sensory modalities in different spatial directions. This direction-dependent weighting account suggests a heavier weighting for vision in the azimuthal (left-right) direction and a heavier weighting for proprioception in the radial (near-far) direction. Visually induced reaching errors, as demonstrated in previous 'mirror illusion' reaching experiments, should therefore be greater under visual-proprioceptive conflict in the azimuthal direction than in the radial direction. We report two experiments designed to investigate the influence of direction-dependent weighting on the visual bias of reaching movements under the influence of a mirror-illusion. In Experiment 1, participants made reaches straight forward, and showed terminal reaching errors that were biased by vision in both directions, but this bias was significantly greater in the azimuthal as compared to the radial direction. In Experiment 2, participants made reaches from right to left, and showed a significant bias only in the azimuthal direction. These results support the direction-dependent weighting of visual and proprioceptive information, with vision relatively more dominant in the azimuthal direction, and proprioception relatively stronger in the radial direction.

Adult↗

The effect of weight-bearing exercise with low frequency, whole body vibration on lumbosacral proprioception: a pilot study on normal subjects.

Patients with low back pain (LBP) often present with impaired proprioception of the lumbopelvic region. For this reason, proprioception training usually forms part of the rehabilitation protocols. New exercise equipment that produces whole body, low frequency vibration (WBV) has been developed to improve muscle function, and reportedly improves proprioception. The aim of this pilot study was to investigate whether weightbearing exercise given in conjunction with WBV would affect lumbosacral position sense in healthy individuals. For this purpose, twenty-five young individuals with no LBP were assigned randomly to an experimental or control group. The experimental group received WBV for five minutes while holding a static, semi-squat position. The control group adopted the same weightbearing position for equal time but received no vibration. A two-dimensional motion analysis system measured the repositioning accuracy of pelvic tilting in standing. The experimental (WBV) group demonstrated a significant improvement in repositioning accuracy over time (mean 0.78 degrees) representing 39% improvement. It was concluded that WBV may induce improvements in lumbosacral repositioning accuracy when combined with a weightbearing exercise. Future studies with WBV should focus on evaluating its effects with different types of exercise, the exercise time needed for optimal outcomes, and the effects on proprioception deficits in LBP patients.

Adult↗

Horizontal space misrepresentation in unilateral brain damage. I. Visual and proprioceptive-motor influences in left unilateral neglect.

Patients with unilateral neglect can misperceive horizontal distances in the contralesional space as being shorter than equivalent ipsilesional ones. We evaluated the visual and motor-proprioceptive components of space misrepresentation through a distance reproduction task performed both with and without visual guidance. Four groups of right brain damaged patients (neglect with hemianopia (N+H+), neglect with inferior quandrantanopia (N+Q+), neglect without hemianopia (N+H-) and patients without neglect or hemianopia (N-H-)) and one group of healthy controls (C) performed the line bisection task and reproduced horizontal distances either by setting the endpoints or by doubling the length of a line in the contralesional or ipsilesional space. The doubling length task was administered in three different conditions: (a) visuomotor (the patient draws the line in free vision); (b) visual (by sight the patient guides the examiner drawing the line); (c) proprioceptive-motor (the patient is blindfolded and manually inspects and extends the horizontal distance subtended by the line). Compared to C and N-H- patients, only N+H+ patients exhibited a significant ipsilesional shift in line bisection. N+H+ patients showed the most severe contralesional-overextension/ipsilesional-underextension asymmetry in the endpoint, visuomotor and visual line extension task. In the proprioceptive-motor condition no asymmetry was found and N+H- showed greater overextension on both sides of space. In N+H-, brain damage was mainly centered in central-frontal cortex and basal ganglia. These findings re-emphasize the relevance of damage to visual retinotopically organized representations of space in the genesis of horizontal space misrepresentation of neglect patients and suggest the possible association of a non-lateralized defective processing of proprioceptive-motor information with unilateral neglect.

Adult↗

Modality-specific organization for cutaneous and proprioceptive sense in human primary sensory cortex studied by chronic epicortical recording.

Modality specificity of human primary somatosensory cortex was studied by recording somatosensory evoked potentials (SEPs) from subdural electrodes in a patient with intractable focal motor seizure. A newly developed device was used for selectively activating proprioception. The spatial and temporal distributions of proprioception-related SEPs elicited by brisk passive flexion movement at the proximal interphalangeal (PIP) joint of the middle finger (4 degrees in 25 ms) were quite different from those to cutaneous sense evoked by electric stimulation of the digital nerve at the same site. It was for the first time demonstrated that proprioception-related SEPs following passive finger movement do not originate in area 3b, which was clearly activated by cutaneous stimulation, and that other sites at the sensorimotor cortex such as areas 2, 3a and 4 possibly contribute to the cortical processing of proprioception.

Adult↗

Achieving robust behavior by using proprioceptive activity patterns.

This paper proposes a new self-organizing, biologically-inspired control architecture for mobile robots consisting of a controller and a value system. The controller uses activity patterns of visual sensors to determine the motor commands, whereas the value system receives stimuli from proprioceptive sensors. This design decision is justified by the following arguments: (1) the feedback of proprioceptive sensory patterns is omnipresent in biological systems and has been widely neglected in control systems, (2) both components are significantly decoupled by using different sensory modalities, and (3) proprioceptive sensors operate more reliably and can be used more efficiently than visual sensors, such as pixels in a CCD camera. Practical experiments with the Khepera robot show that by using proprioceptive sensor values, the control architecture can adapt to different environments and yield very robust behavior with respect to, for example, sensor failures. Furthermore, the new control architecture can be easily enhanced by further components.

Feedback↗

Immunohistochemical analysis of mechanoreceptors in the human posterior cruciate ligament: a demonstration of its proprioceptive role and clinical relevance.

Although long-term studies report successful results with total knee arthroplasty (TKA), performed with or without posterior cruciate ligament (PCL) retention, controversy exists as to which is preferable in regard to patient outcome and satisfaction. The possible proprioceptive role of the PCL may account for a more normal feeling of the arthroplasty. Although the PCL has been examined using various histological techniques, immunohistochemical techniques are the most sensitive for neural elements. Therefore an immunohistochemical study was designed to determine the patterns of innervation, the morphological types of the proprioceptors, and their immunohistochemical profile. During TKA, samples were obtained from 22 osteoarthritic PCLs and subjected to immunohistochemical analysis with mouse monoclonal antibodies against neurofilament protein (NFP), S100 protein (S100P), epithelial membrane antigen (EMA), and vimentin (all present in neuromechanoreceptors). Three normal PCLs from cadaveric specimens were also obtained and analyzed for comparison. Five types of sensory corpuscles were observed in both the normal and the arthritic PCLs: simple lamellar, Pacini-like, Ruffini, Krause-like, and morphologically unclassified. Their structure included a central axon, inner core, and capsule in lamellar and Pacini corpuscles and variable intracorpuscular axons and periaxonal cells in the Ruffini and Krause-like corpuscles. The immunohistochemical profile showed the central axon to have NFP immunoreactivity, periaxonal cells to have S100P and vimentin immunoreactivity, and the capsule to have EMA and vimentin immunoreactivity. Nerve fibers and free nerve endings displayed NFP and S100P immunoreactivity. The immunohistochemical profile of the PCL sensory corpuscles is almost identical to that of cutaneous sensory corpuscles. Some prior histological studies of the PCL reported Golgi-like mechanoreceptors, and others found encapsulated corpuscles but no Golgi-like structures. This report determined the innervation of the PCL by the more sensitive immunohistochemical means, revealing four major types of encapsulated mechanoreceptors. The plentiful and varied types of encapsulated mechanoreceptors found in even the arthritic PCL suggests a rich proprioceptive role. It is controversial as to whether preservation of the PCL at TKA improves postoperative proprioception. Our findings tend to support those clinical reports of improved proprioception after PCL-retaining versus PCL-substituting TKAs. The presence of many and varied types of mechanoreceptors may account for the improved stair climbing reported in patients with PCL-retaining TKA and may contribute to patient satisfaction and a more normal feeling after TKA.

Arthroplasty, Replacement, Knee↗

Proprioceptive impairment in knee osteoarthritis.

Proprioception, the perception of limb position in space, is derived from afferent signals originating primarily from musculotendinous and joint receptors. Proprioception is critical to the maintenance of joint stability. Studies have demonstrated that proprioception is less accurate in patients with knee osteoarthritis versus elderly control subjects, in healthy older versus younger subjects, and in the setting of other conditions affecting the knee including anterior cruciate ligament deficiency and hypermobility syndrome. Possible pathways between proprioceptive inaccuracy, knee osteoarthritis, and related knee disorders are described.

Animals↗

Introduction of a neurotrophin-3 transgene into muscle selectively rescues proprioceptive neurons in mice lacking endogenous neurotrophin-3.

To clarify the role of muscle-derived neurotrophin-3 (NT-3) in the development of sensory neurons, we generated transgenic mice selectively overexpressing NT-3 in skeletal muscles under the control of a myogenin promoter (myo-NT-3 mice). The myo-NT-3 transgene was then bred into an NT-3 null mutant (-/-) line to generate myo-NT-3, NT-3(-/-) mice in which NT-3 was expressed in muscles, but not elsewhere. Transient overexpression of NT-3 in developing muscles increased the number of proprioceptive neurons as well as the density of both their central and peripheral projections, resulting in more Ia afferents in spinal cord and more spindles (end organs of Ia afferents) in muscles. NT-3 expression restricted to muscles was sufficient to secure the development of proprioceptive neurons and their central and peripheral projections in myo-NT-3, NT-3(-/-) mice. The loss of nonproprioceptive neurons observed in NT-3(-/-) mice was not reversed by the transgene, suggesting that these neurons are regulated by NT-3 from sources other than muscle. We conclude that target-derived rather than intraganglionic NT-3 is preeminent in supporting the development of proprioceptive neurons. The level of NT-3 in developing muscles may be the principal factor determining the number of proprioceptive neurons in dorsal root ganglions and spindles in skeletal muscles of adults.

Afferent Pathways↗

The role of proprioception in action recognition.

This study aimed at evaluating the role of proprioception in the process of matching the final position of one's limbs with an intentional movement. Two experiments were realised with the same paradigm of conscious recognition of one's own limb position from a distorted position. In the first experiment, 22 healthy subjects performed the task in an active and in a passive condition. In the latter condition, proprioception was the only available information since the central signals related to the motor command were likely to be absent. The second experiment was realised with a deafferented patient who suffers from a complete haptic deafferentation, including loss of proprioception. The results first argue in favour of a dominant role of proprioception in action recognition, but they also stress the possible role of central signals. The process of matching the final position of one's limbs with an intended movement and thus of action recognition would be achieved through a comparison process between the predicted sensory consequences of the action, which are stored in its internal model, and the actual sensory consequences of that action.

Adult↗

The effect of intraarticular anesthesia and elastic bandage on elbow proprioception.

Twenty uninjured male volunteers were studied to characterize normal elbow proprioception and to investigate the effect of applying an elastic bandage to the extremity and injection of an intraarticular anesthetic. A modified Biodex dynamometer was used to study position sense and detection of motion. In part 1 of the study position sense was tested by flexing the elbow to a predetermined angle, returning to the starting position, and then asking the subject to identify that angle. In part 2 detection of motion was tested by asking the subject to disengage the apparatus by pressing a stop button when movement was detected. The testing conditions in part 1 and part 2 were repeated after the elbow was wrapped with an elastic bandage and again after an intraarticular injection of 3 cc 1% lidocaine with the bandage removed. Ten additional subjects underwent testing of both elbows to examine the effect of arm dominance. Mean position sense was within 3.3 degrees+/-1.3 degrees of the actual angle in trials without an elastic bandage or an anesthetic. A significant improvement in position sense was observed (2.2 degrees+/-1.2 degrees) after an elastic bandage was applied (P < .004). No significant difference was seen in position sense after lidocaine was injected. The mean threshold for detection of motion in trials without an elastic bandage or an anesthetic was 4.21 degrees+/-1.56 degrees. No significant differences were seen in detection of motion observed with the elastic bandage or intraarticular anesthetic. No significant differences were seen between dominant and nondominant extremities for both position sense and detection of motion. The application of an elastic bandage improved position sense, suggesting that tactile cues from cutaneous or other extraarticular receptors may play a role in elbow proprioception. Intraarticular anesthesia, however, had little effect, suggesting that intracapsular receptors play a lesser role in elbow proprioception. The determination of proprioceptive qualities for the normal elbow can aid in the understanding of elbow function and provide a basis for defining its role in elbow dysfunction.

Adult↗

Intact proprioception and control of labour pain during epidural analgesia.

BACKGROUND: Accurate proprioception is critical while walking, yet an ambulatory epidural regimen that provides adequate analgesia for labour while simultaneously preserving proprioceptive input has not been described. METHODS: Sixty primigravidae in established labour received bupivacaine 15 mg (15 ml of 0.1% w/v) and fentanyl 100 micrograms through a lumbar epidural catheter. Clinical assessment of dorsal column sensory function included: vibration sense, distal proprioception and the Romberg test, and were all performed before catheter insertion and 30 min after the study bolus. Sensory modalities were also tested compared to an unblocked dermatome. Pain was scored on a 0-10 cm visual analogue scale (VAS) before and 30 min after induction. Intensity of the motor block was tested using a modified Bromage score (grade 1-6). RESULTS: The study bolus provided reliable analgesia with 43 parturients attaining a VAS pain score of zero. Mean duration of analgesia was 67.5 min (SD 22.85). All parturients retained the ability to perform a partial knee bend while standing (grade 6). No mothers exhibited impaired distal proprioception, altered vibration sense or a positive Romberg sign. CONCLUSION: This study confirms that the addition of lumbar epidural fentanyl 100 micrograms to 15 mg of epidural bupivacaine provides good control of labour pain with no motor block and establishes that this combination preserves dorsal column sensory function.

Adult↗

Proprioceptive sensitivity and performance in anterior cruciate ligament-deficient knee joints.

We studied the performance and proprioception of the knee joint in a group of non-reconstructed anterior cruciate ligament (ACL)-deficient (n=20) patients and compared them with a group of ACL-reconstructed patients (n=18) and a group of healthy controls (n=20). Each patient was scored according to Lysholm and Tegner and was then asked to subjectively evaluate the performance of the injured knee and the degree of retropatellar discomfort. The knee joint laxity was measured. The performance was assessed based on the performance in a triple jump test and a one-leg one-step leap test. The proprioception in the knee was measured as the threshold when passive movement was detected and as the ability to reproduce a flexion angle from a start position of 60 degrees of flexion or from full extension of the knee. All tests were performed on both legs. The scoring systems and the subjective evaluation showed significant differences between the reconstructed and the non-reconstructed patients. No significant difference in knee joint laxity was found between the two groups. In the triple jump test and the one-step leap test, both groups performed significantly worse on the leg with the injured knee joint than on the non-injured leg. The proprioceptive tests showed decreased ability to recognize and reproduce a prior angle from a start position of 60 degrees. The threshold to detection of passive movement with the injured knee was significantly increased in both groups of patients. No difference was found between the dominant and non-dominant knee in the control group. When reproduction of the same angles started from full extension, the groups did not differ. These data show that decreased performance and changes in the proprioception of the knee joint accompany ACL rupture.

Adult↗

Sympathetic nerve activity does not reduce proprioceptive acuity in humans.

AIM: Proprioception is essential in coordinating body segments and controlling muscles to perform movements. Animal studies have reported reduced muscle spindle sensitivity in jaw muscles during stimulation of sympathetic nerves. A stress-induced distortion of proprioception has been suggested that could lead to reduced fine control of movement and inefficient muscle use. The present study investigated whether increased muscle sympathetic activation alter human proprioception. METHOD: Movement detection thresholds of the right ankle were determined in eight healthy subjects, before and during two conditions known to increase muscle sympathetic activity (MSA); a cold pressor test (CPT) and oral glucose ingestion (GLUC). RESULTS: During a cold pressor test plasma noradrenaline (NA) and mean arterial pressure (MAP) increased significantly, compared with baseline (Ps<0.01), whereas the movement thresholds were unchanged (Ps>>0.05). After GLUC plasma NA and MAP increased significantly, compared with baseline (Ps<0.05). The movement threshold into flexion decreased (P=0.022), whereas into extension there was no change (P=0.28). The most prominent increase of plasma NA corresponded with a reduced movement detection threshold, suggesting increased muscle spindle sensitivity. CONCLUSION: The present findings contradict previous reports from animal studies and the hypothesis that sympathetic nerve activity reduces proprioceptive acuity.

Adult↗

[Proprioceptive capacities of the knee joint with and without endoprosthesis].

PURPOSE OF THE STUDY: To compare the proprioceptive abilities of total knee arthroplasty patients and a control group. METHOD: In a knee arthroplasty patient group of 28 and in 25 healthy volunteers the proprioceptive function was examined. To measure the proprioceptive function the motion analysis system with reflecting markers was chosen. In each patient 16 measurements from different starting points in different joint positions with and without visual controlling were performed. RESULTS: The results demonstrated significant differences between the patients and volunteers independent of the starting point, the joint position and the visual controlling. Also the comparison with the 30 and 60 degree position showed significant differences. In the patient group were not shown significant values comparing the starting position, the visual controlling and the comparison with the healthy leg. CLINICAL RELEVANCE: Knee arthroplasty conducts to loss of proprioception in the operated and healthy leg. Visual controlling can not solve these problems. The worst results were achieved in 60 degrees position. The starting position can not influence the results.

Aged↗

Shoulder proprioception in baseball pitchers.

We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation.

Adolescent↗