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At least 1,045 records · Page 58Linked to original sources
PubMed1995

Pupillometric analysis of the 'absent light reflex'.

OBJECTIVE: To measure the "absent light reflex" with an infrared pupillometer. SETTING: Intensive care unit of the Moffitt-Long Hospitals at the University of California-San Francisco. SUBJECTS: Three patients lacking a pupillary light reflex early in the postresuscitation period and a consecutive sample of comatose patients in the intensive care unit in whom clinical (penlight) examination demonstrated an absent light reflex. INTERVENTIONS: A portable infrared pupillometer was moved to the bedside of patients thought to have an absent light reflex, and a series of individual scans were averaged to detect the presence or absence of a light reflex. MAIN RESULTS: The study of patients in the intensive care unit was prompted by the observation of three postresuscitation patients whose pupillary light reflex was thought to be clinically absent but found to be present, although small, with infrared pupillometry. All patients in the intensive care unit with known brain death had an absent light reflex, whereas four of nine of those without brain death but with dilated nonreactive pupils had a small light reflex detectable by the infrared pupillometer. This reflex was characterized by a low maximum constriction velocity and low amplitude of constriction. CONCLUSION: Infrared pupillometry can sometimes reveal the presence of midbrain function that might otherwise be missed in paralyzed patients.

Adult↗
PubMed1998

Reassessment of H-reflex recovery curve using the double stimulation procedure.

We conducted two types of experiments to assess the validity of the H-reflex recovery test, using double stimulation to test soleus motoneuron pool excitability in healthy and spastic subjects. One type dealt with the mechanical effect of the conditioning H reflex on the ankle joint; the other type with the effect of change in reflex size. The mechanical effect was tested both with the ankle joint fixed (FX) and free to move (FR). Differences between FX and FR conditions commenced with relaxation of soleus muscle contraction by the conditioning H reflex. In the FR condition, abrupt facilitation occurred, and changed to marked depression. We conclude that specific facilitation and inhibition in the FR condition were secondary effects of group Ia inflows caused by the ankle extensor muscle stretching on relaxation. In some spastic patients as well as in controls, facilitation due to the mechanical effect in the FR condition was observed despite the FX condition. The effects of systematic changes on soleus H-reflex size were investigated at conditioning-test intervals of 80 ms, so as to avoid mechanical effects. When conditioning and test reflexes were the same size, the amount of recovery increased as the H-reflex size increased. Comparison of the relation between amount of recovery and H-reflex size, expressed as a percentage of Mmax, showed no significant difference between the two groups. We speculate that the stronger recovery of spasticity mentioned in previous literature may have resulted from the fact that relatively greater H reflexes were tested in those studies. In conclusion, the present study indicates that double stimulation is not appropriate for assessing spinal motoneuron pool "excitability increase" in spasticity.

Electric Stimulation↗
PubMed1989

Abnormal cough reflex in canine acrylamide neuropathy.

Coughing in response to irritation of the airways is a fundamental protective reflex that is dependent on rapidly adapting bronchopulmonary receptors and their vagal afferent fibers; reflex airway constriction, which is effected by vagomotor efferent fibers, usually accompanies coughing. Although dysfunction of vagally mediated cardiovascular and gastrointestinal reflexes is a well-documented complication of autonomic neuropathy, to date there have been no studies of the effect of peripheral autonomic failure on the cough reflex. In the study reported here, we examined the effect of acrylamide-induced neuropathy, a distal axonopathy, on the ventilatory and tracheomotor components of the cough reflex in conscious dogs. There was a reduction in the cough reflex in response to mechanical irritation of the large airways in the preclinical phase of the neuropathy, and the cough reflex was virtually abolished when the dogs had moderate neuropathy. Following withdrawal of the neurotoxin, there was a substantial recovery of the cough reflex in surviving animals. It is possible that the cough reflex may be reduced in patients with vagal neuropathy and that this might compromise protection of the airway.

Acrylamide↗
PubMed2006

Central auditory pathways mediating the rat middle ear muscle reflexes.

The middle ear muscle (MEM) reflexes function to protect the inner ear from intense acoustic stimuli and to reduce acoustic masking. Sound presented to the same side or to the opposite side activates the MEM reflex on both sides. The ascending limbs of these pathways must be the auditory nerve fibers originating in the cochlea and terminating in the cochlear nucleus, the first relay station for all ascending auditory information. The descending limbs project from the motoneurons in the brainstem to the MEMs on both sides, causing their contraction. Although the ascending and descending pathways are well described, the cochlear nucleus interneurons that mediate these reflex pathways have not been identified. In order to localize the MEM reflex interneurons, we developed a physiologically based reflex assay in the rat that can be used to determine the integrity of the reflex pathways after experimental manipulations. This assay monitored the change in tone levels and distortion product otoacoustic emissions within the ear canal in one ear during the presentation of a reflex-eliciting sound stimulus in the contralateral ear. Preliminary findings using surgical transection and focal lesioning of the auditory brainstem to interrupt the MEM reflexes suggest that MEM reflex interneurons are located in the ventral cochlear nucleus.

Acoustic Stimulation↗
PubMed2003

Identification of spinal neurons involved in the urethrogenital reflex in the female rat.

The urethrogenital (UG) reflex is a spinal sexual reflex that consists of autonomic and somatic nerve activity and vaginal, uterine, and anal sphincter contractions. The UG reflex is under tonic descending inhibition by neurons in the region of the nucleus paragigantocellularis (nPGi). The location of spinal neurons activated by the UG reflex was examined in the female rat using the immediate early gene, c-fos. In addition, the descending inputs from the nPGi onto fos-activated neurons was examined using the anterograde tracer biotin dextran amine injected into the nPGi. The UG reflex resulted in a significant increase in fos-positive nuclei in segments T12-S1, compared with experimental controls in which the UG reflex was not activated. Spinal circuits involved in the UG reflex include neurons relaying afferent information from the pudendal sensory nerve, in the dorsal horn and medial cord of L5-S1. Efferent output includes preganglionic neurons located in the lateral gray of L5-S1 and lateral and medial gray of T13-L2. Spinal interneurons involved in the UG reflex were found close to the preganglionic neurons and in the dorsal horn and intermediate and medial gray of T12-S1. NPGi inputs were found primarily on the autonomic efferents and interneurons in the medial and intermediate gray. These studies demonstrate multisegmental spinal circuits activated with the UG reflex and demonstrate that the descending inhibition from the nPGi is by means of preganglionic and somatic efferents and spinal interneurons closely associated with the efferent output.

Anal Canal↗
PubMed2005

Medial olivocochlear reflex interneurons are located in the posteroventral cochlear nucleus: a kainic acid lesion study in guinea pigs.

The medial olivocochlear (MOC) reflex arc is probably a three-neuron pathway consisting of type I spiral ganglion neurons, reflex interneurons in the cochlear nucleus, and MOC neurons that project to the outer hair cells of the cochlea. We investigated the identity of MOC reflex interneurons in the cochlear nucleus by assaying their regional distribution using focal injections of kainic acid. Our reflex metric was the amount of change in the distortion product otoacoustic emission (at 2f(1)-f(2)) just after onset of the primary tones. This metric for MOC reflex strength has been shown to depend on an intact reflex pathway. Lesions involving the posteroventral cochlear nucleus (PVCN), but not the other subdivisions, produced long-term decreases in MOC reflex strength. The degree of cell loss within the dorsal part of the PVCN was a predictor of whether the lesion affected MOC reflex strength. We suggest that multipolar cells within the PVCN have the distribution and response characteristics appropriate to be the MOC reflex interneurons.

Acoustic Stimulation↗
PubMed1975

Area specific reflexes from normal and supernumerary hindlimbs of Xenopus laevis.

Two area specific reflexes elicited by natural stimulation of different regions of the hindlimbs of Xenopus laevis have been identified. Light or intense mechanical stimulation of the foot evokes reflex activity in the ipsilateral knee flexor nerve; moderate pressure applied to the calf evokes reflex activity predominantly in the ipsilateral knee extensor nerve. The reflex responses have been recorded electrophysiologically to overcome the limitations of behavioral observations for determining the presence of activity in particular muscles. Normal area specific reflexes are elicited in the normal ipsilateral hindlimb by stimulation of grafted supernumerary hindlimbs innervated either by hindlimb (lumbar) or by non-limb (thoracic) spinal cord segments. The area specific reflexes can be elicited only if the limb is grafted to a host younger than stage 54-55 of Nieuwkoop and Faber ('56), the stage at which reflex movements are first observed behaviorally. Abnormal reflex responses are evoked by stimulation of supernumerary limbs innervated by either thoracic or lumbar segments when the limb buds are grafted to older larvae. Supernumerary forelimbs grafted at early stages and innervated by either thoracic or lumbar spinal cord segments generally fail to elicit area specific reflex responses in the normal hindlimb. Single-unit recordings of afferent fibers supplying the normal and supernumerary hindlimbs show that each limb receives a separate nerve supply. No evidence for branched afferent fibers has been found. The implications of these results for theories of neuronal specification are discussed, particularly the hypothesis that peripheral tissues are able to specify the central actions of afferent fibers that innervate them.

Animals↗
PubMed2002

Brainstem reflexes: electrodiagnostic techniques, physiology, normative data, and clinical applications.

An overview is provided on the physiological aspects of the brainstem reflexes as they can be examined by use of clinically applicable neurophysiological tests. Brainstem reflex studies provide important information about the afferent and efferent pathways and are excellent physiological tools for the assessment of cranial nerve nuclei and the functional integrity of suprasegmental structures. In this review, the blink reflex after trigeminal and nontrigeminal inputs, corneal reflex, levator palpebrae inhibitory reflex, jaw jerk, masseter inhibitory reflex, and corneomandibular reflex are discussed. Following description of the recording technique, physiology, central pathways, and normative data of these reflexes, including an account of the recording of recovery curves, the application of these reflexes is reviewed in patients with various neurological abnormalities, including trigeminal pain and neuralgia, facial neuropathy, and brainstem and hemispherical lesions. Finally, simultaneous electromyographic recording from the orbicularis oculi and the levator palpebrae muscles is discussed briefly in different eyelid movement disorders.

Blinking↗
PubMed1991

Hering-Breuer reflex in young asthmatic children.

The aim of this study was to assess if the Hering-Breuer reflex could be provoked in young children. Thirty asthmatic children with a mean age of 5.3 years and 18 healthy children with a mean age of 7.0 years were studied. The presence of the reflex was indicated by prolongation of the spontaneous expiratory time following application of continuous positive airways pressure (CPAP). The occurrence of the reflex was then related to age, compliance of the respiratory system (Crs) measured by weighted spirometry, functional residual capacity (FRC) determined by helium gas dilution, and the change in lung volume resulting from the application of CPAP. The asthmatic children in whom the Hering-Breuer reflex was observed tended to be younger (P less than 0.01) and the reflex was present in those children of both groups who had more compliant lungs (P less than 0.05). The FRC was not different in asthmatic children with and without the Hering-Breuer reflex, but healthy children in whom the reflex was present tended to have smaller lung volumes. The change in lung volume resulting from application of CPAP was significantly greater in those children of both groups in whom the reflex was present (P less than 0.01 asthmatics, P less than 0.02 healthy children). We conclude that the Hering-Breuer reflex may be provoked in young children.

Asthma↗
PubMed2002

Effects of different anesthetics on the paired-pulse depression of the h reflex in adult rat.

Hyperreflexia is a common feature of spinal cord injury (SCI), and changes in reflex excitability have been reported to be useful in assessing treatments in animal models of cord damage. However, spinal reflexes are known to be dependent on anesthetic level. As a preliminary to its use in SCI, the excitability of the Hoffman reflex (H reflex) has been assessed under several commonly used anesthetics. The H reflex was recorded in the distal foot muscles (dorsal interossei) of adult rats, while the lateral plantar nerve was stimulated. Five different anesthetics were used: ketamine, halothane, Nembutal, Etomidate, and Saffan. Recording and stimulating electrodes were inserted directly through the skin to minimize the surgical procedure for each experiment, allowing repeated recording to be made in the same animal on a weekly basis. Suppression of the H reflex was tested using twin-pulse stimulation. Halothane and ketamine produced suppression of the H response when interpulse intervals were shortened to less than 1 s. The H-reflex suppression profiles recorded under Etomidate, Saffan, and Nembutal anesthesia were less sensitive to the stimulation rate, with little reduction until intervals were 200 ms or less. The suppression profiles of halothane and ketamine resemble that seen in unanesthetized humans, whereas that under the other anesthetics tried here resembles that observed in spinal-cord-injured animals. The results suggest a preferential action of some anesthetics on descending pathways involved in reflex modulation and the importance of assessing reflex excitability under anesthetics such as ketamine or halothane.

Administration, Inhalation↗
PubMed1993

Neural mechanisms that contribute to cyclical modulation of the soleus H-reflex in walking in humans.

The amplitude of the Hoffmann reflex (H-reflex) of the human soleus muscle is modulated in a cyclical way during walking. This paper addresses two questions associated with the neural mechanisms that might generate this modulation: (1) Does the amplitude of the H-reflex simply rise and fall as a function of the background excitability of the soleus motoneuron pool? (2) Is the modulation of the H-reflex dependent on events associated with activation of the antagonist muscle? The amplitude of the soleus H-reflex was compared under three conditions: natural walking, walking without activating the tibialis anterior muscle, and walking with activation of the soleus muscle in the swing phase. Human subjects were able to perform these three tasks with minimal training. The results indicated that the soleus H-reflex remained very depressed in the swing phase of walking, even when a voluntary contraction of the soleus muscle was superimposed during this time. Moreover, the presence of tibialis anterior activity had a very minor effect on the amplitude of the soleus H-reflex during walking. It is concluded that modulation of the soleus H-reflex is not simply a reflection of the background excitability of the motoneuron pool, and the modulation is not dependent on activation of the antagonist muscle. Other more powerful mechanisms are acting to modulate the reflex, most likely presynaptic inhibition of the primary afferents.

H-Reflex↗
PubMed1993

Jaw-jerk reflex activity in relation to various clenching tasks in man.

In order to investigate whether the mandibular stretch (jaw-jerk) reflex is modulated in a task-dependent manner, jaw-jerk reflexes were elicited in eight subjects during clenching with unilateral and bilateral tooth support, respectively. The reflexes were examined in the electromyographic (EMG) activity recorded by means of surface electrodes and were elicited by means of small transient jaw displacements at a constant value of 80 microns. Low levels of background EMG were applied ranging from 1 to 30% maximal voluntary contraction (MVC) as controlled by means of visual feedback. Linear relationships were observed between reflex amplitude and level of background EMG. The slope in these relationships served as a measure of reflex gain. For the masseter as well as the anterior temporal muscles, the reflex gain, averaged over both sides, was larger during clenching with unilateral tooth support than with bilateral tooth support (P < 0.05). Furthermore, the gain was larger on the side without tooth support during unilateral clenching and larger on the side without visual feedback of elevator muscle activity during bilateral clenching. It can be concluded that the jaw-jerk reflex is modulated to subserve the stabilization of the mandible, with the reflex sensitivity being larger the more that alternative stabilizing factors such as mechanical tooth contact, visual feedback and feedback from periodontal pressure receptors around the teeth are lacking. The reflex modulation may be of functional importance in stabilizing the mandible during its movement in the chewing process, as the food is predominantly placed unilaterally between the antagonistic teeth during individual chewing cycles.

Adolescent↗
PubMed1975

The mode of action of 5-hydroxytryptophan in facilitating a stretch reflex in the spinal cat.

1. Intravenous injection of 5-hydroxytryptophan (5-HTP) excites discharges of gamma motoneurones to extensor muscles of the hind limbs of decerebrate spinal cats and this occurs with a short latency (1-2 min). 2. 5-HTP also facilitates the stretch reflex in the spinal cat but, in contrast, there is a latency of about 10 min with a maximum action after 20 min. 3. Facilitation of the stretch reflex by 5-HTP still occurs when the gamma loop has been opened by cutting all ventral roots supplying the muscle. Thus excitation of gamma motoneurones by 5-HTP is not required for facilitation of the stretch reflex. 4. A possible contribution to the stretch reflex from the increased discharge of gamma motoneurones has been assessed. Selectively removing gamma activity rarely altered the reflex response to stretch and in only 3 out of 15 spinal cats could we conclude that gamma discharges contributed towards facilitation of the stretch reflex by 5-HTP; 5; Methysergide (0.25 mg/kg) blocked completely the facilitation of the stretch reflex caused by 5-HTP in the spinal cat but only partially antagonised the reflex in the decerebrate cat, even when injected intra-arterially close to the lumbar spinal cord. 6. Lysergic acid diethylamide (LSD) was found to mimic the actions of 5-HTP. It facilitated the stretch reflex and excited extensor gamma motoneurones in the spinal animal.

5-Hydroxytryptophan↗
PubMed1996

Reduced stretch-reflex sensitivity after exhausting stretch-shortening cycle exercise.

The stretch-shortening cycle (SSC) is an effective and natural form of muscle function but, when repeated with sufficient intensity or duration, it may lead to muscle damage and functional defects. A reduced tolerance to impact has been reported, which may be partly attributed to a reduced stretch-reflex potentiation. The aim of the present study was to examine the influence of SSC-induced metabolic fatigue and muscle damage on the efficacy of stretch reflexes, as judged by the electromyograph (EMG) response of two shank muscles (lateral gastrocnemius LG, soleus SOL) to controlled ramp stretches. These EMG responses were recorded before and immediately after exhausting SSC-type leg exercise and 2 h, 2 days and 4 days later. Serum concentrations of creatine kinase ([CK]), myoglobin and lactate were measured repetitively along the protocol. Two maximal vertical drop jumps and counter-movement jumps were performed after each reflex test. The exhausting SSC-type exercise induced an immediate reduction (P < 0.05) with a delayed short-term recovery of the LG peak-to-peak reflex amplitude. This was not accompanied by significant changes in the reflex latency. The drop jump performance remained slightly but significantly reduced (P < 0.05) until the 2nd day postexercise. Peak [CK] appeared for all the subjects on the 2nd day, suggesting the presence of muscle damage. The increase in [CK] between the 2nd h and the 2nd day postexercise was found to be negatively related (P < 0.001) to the relative changes in the drop jump height. Furthermore, a significant relationship (P < 0.05) was found between recovery of the stretch reflex in LG and the decrease of [CK] between the 2nd and the 4th day. These findings support the hypothesis of a reduced stretch-reflex sensitivity. While the exact mechanisms of the reflex inhibition remain unclear, it is emphasized that the delayed recovery of the reflex sensitivity could have resulted from the progressive inflammation that develops in cases of muscle damage.

Adult↗
PubMed1989

Measurement of tendon reflexes by surface electromyography in normal subjects.

A simple method for measuring the tendon reflexes was developed. A manually operated, electronic reflex hammer was applied that enabled measurement of the strength of tendon taps. Reflex responses were recorded by surface electromyography. Stimulus-response relations and latencies of tendon reflexes in the biceps, triceps, quadriceps and triceps surae were examined in 40 healthy subjects. A characteristic relation between stimulus strength and response amplitude was found which could be described by an empirical function. Latencies of both arm and leg reflexes were linearly related to the height of the subjects. Variations of reflex amplitudes within and between subjects were comparable with previous results obtained with more complicated techniques. Although repeatability of measurement of the amplitude is limited by the variability of reflexes, significant agreement was found between repeated measurements. Most reflex amplitudes were diminished during repeated examination after a short interval. Both measurement and clinical examination showed the frequent occurrence of left-right asymmetry of reflex amplitudes. These left-right differences were reproducible to a significant degree on repeated measurements after more than 2 years.

Adult↗
PubMed1990

Reliability of the clinical and electromyographic examination of tendon reflexes.

The reliability of clinical examination of the tendon reflexes was examined by studying inter-observer agreement. Twenty patients were examined by three neurologists. The briskness of the tendon reflexes in arms and legs was scored on a nine-point scale. In 28% of the 160 examined reflexes the observations disagreed 2 scale units or more. Disagreement on the presence of asymmetry occurred in 45% of the 80 reflex pairs. In 15% one observer judged a reflex pair to be symmetrical while another observer found asymmetry of at least 2 scale units. In a second experiment clinical observation of apparently asymmetrical quadriceps reflexes was compared with measurement by surface electromyography. A significant, semi-logarithmic relationship was found between clinical scores and measured reflex amplitudes. Measured reflex asymmetry always agreed with clinical asymmetry, and the magnitudes of right-left amplitude differences were correlated with the magnitude of clinically observed asymmetry. The bedside examination of tendon reflexes is subject to considerable inter-observer disagreement.

Adult↗
PubMed1980

Sympathetic activity in the recto-rectal reflex of the guinea pig.

In the guinea pig, defecation is controlled by the myenteric plexus, whose activity is modulated by the sacral spinal and supraspinal centers. The purpose of this study is to clarify the control of defecation reflex by sympathetic nerves. The propulsive contractions of the rectum produced by rectal distension (recto-rectal excitatory reflex response) were abolished after transection of the Th 13 and/or L 4 segment. This response was reproduced again after removal of the lumbar segments (L1--4), division of the lumbar dorsal roots (L1--4), the lumbar splanchnic nerves or lumbar colonic nerves (LCN). The frequency of efferent discharges of LCN was increased slightly by rectal distension and remarkably increased after Th 13 and/or L 4 transection. Thus, there occurs during the recto-rectal reflex not only mucosal intrinsic reflex and sacral excitatory reflex via the pelvic nerves but also a lumbar inhibitory reflex via the colonic nerves, whose center may be located in the upper lumbar segments. But, the activity of the inhibitory center was depressed by the supraspinal center, so that an excitatory reflex is produced more dominantly than an inhibitory one in normal animals. All these extrinsic reflexes coordinate the activity of the myenteric plexus in defecation reflex.

Action Potentials↗
PubMed1976

The peristaltic reflex: an analysis of the nerve pathways and their pharmacology.

The enteric reflexes in isolated segments of the distal colon and rectum of the guinea-pig were studied by applying localized distensions and recording the consequent changes in circular muscle activity, and by recording tension changes in the circular muscle during the propulsion of a bolus in vitro. Lesions of the wall of the colon were made to locate nerve pathways involved in the reflexes and pharmacological tests were applied to investigate the natures of transmitters released and the types of receptors involved. Distension produced a transient contraction of the circular muscle on the oral side and sustained relaxation on the anal side. Both reflexes were nerve-mediated. They were elicited in segments deprived of mucosa and submucosa. Interruption of Auerbach's plexus, but not interruption of the submucosal plexus, prevented their conduction. The ascending excitatory reflex was partly blocked by hyoscine and was also partly blocked by methysergide or by making the preparation tachyphylactic to the excitatory action of 5-hydroxytryptamine. The ascending excitatory pathways apparently involve neurons releasing a 5-HT-like transmitter as well as cholinergic neurons. The descending inhibitory reflex was not antagonized by hyoscine, guanethidine, methysergide or mepyramine. It is assumed that the inhibitory neurons activated in this reflex are identical with the non-cholinergic, non-adrenergic, enteric inhibitory neurons found throughout the intestine. If both the ascending excitatory and descending inhibitory reflexes acted simultaneously on the same area of circular muscle, the inhibitory response tended to dominate. Pellets of faeces, covered by a thin layer of resin, were introduced into the oral ends of isolated segments of colon. They were propelled analwards at speeds of 0.5-1.6 mm/s. Tension records showed that the pellets were preceded by relaxation and followed by a ring of contraction. The propulsion was blocked by both hyoscine and methysergide. Descending waves of contraction were also observed in empty segments of colon. These occurred spontaneously or were initiated by stretch. They did not occur in the presence of hyoscine or tetrodotoxin. It is postulated that three factors may contribute to propulsion in the guinea-pig distal colon: ascending excitatory reflexes which evoke contractions above a bolus; descending inhibitory reflexes which cause relaxations below; and contractions which, once set up in the circular muscle, travel in an anal direction.

Animals↗