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Changes in the H-reflex amplitude with different characteristics of the preceding conditioned stimulus.

The post-stimulus inhibition of the H-reflex was studied in human subjects with the following experimental sets: Presentation of a pair of stimuli, with intensity of the conditioned stimulus, S1, of 30% Hmax, and with varying intensities of the test stimulus, S2, from threshold to maximal values. Varying intensity of S1 from threshold values, 30% Hmax, 50% Hmax, and varying intensity of S2 from threshold to maximal values, for the H2-reflex-curve to be obtained. Varying intensity of S1 from 0.9 to 1.15-1.20 threshold and constant intensity of S2 of 30-40% Hmax. In the first two experiments the curve "intensity of S1/H2-reflex amplitude" at different intensities of S1 and different delays of S2 has been investigated. In the third experiment the H2-reflex recovery with diminishing the S1 to subthreshold values has been investigated. The results have shown: H2-reflex was strongly suppressed even with threshold values of S1. H2-reflex-curve after a conditioned stimulus was significantly lower to the H-reflex-curve after a single stimulus. The recovery of the H-reflex amplitude after S1 was observed with subthreshold values of S1. The possible role of the presynaptic inhibition for the suppression of the H1-reflex with the presentation of a pair of stimuli has been considered.

Adult↗

Reflex facilitation by remote contraction: topographic aspects.

This study compares the facilitation of various lower limb reflex arcs brought about by a selective contraction of a well-defined upper limb muscle group in able-bodied healthy subjects. Quantitatively (results expressed as a percentage of maximal motor response), the quadriceps tendon reflex is facilitated more than the soleus and biceps femoris tendon reflexes. The time course of facilitation is similar for the 3 reflexes and exhibits 3 distinct phases. Electrically induced reflexes in the quadriceps are facilitated as much as the tendon jerk but only during the 2nd phase. Complementarily, the effects of contraction of different upper limb muscle groups on a single lower limb reflex (quadriceps tendon jerk) were also investigated. This reflex is facilitated more (especially in the 2nd phase) by contraction of thenar muscle than by that of deltoid muscles and more by wrist extensors than wrist flexors. Differences in facilitation are only apparent when the effects are quantified. They depend on the segmental level of the reflex under test (more marked proximally than distally) and on the conditioning muscle group; both facts must be taken into consideration in the interpretation of the functional role of remote contraction.

Female↗

Masseter reflex potentials in olivo-ponto-cerebellar atrophy.

We recorded masseter reflex potentials to examine the correlation between the masseter reflex and the muscle stretch reflexes of limbs in 19 patients with olivo-ponto-cerebellar atrophy (OPCA). The patients were subdivided into hyper- (n = 5), normo- (n = 7) and hypo- (n = 7) reflexia groups according to the degrees of the conventional deep tendon jerks in the upper limbs. The masseter reflex potentials, elicited by tapping the chin with a reflex hammer, were recorded from the bilateral masseters using a pair of surface electrodes. The latency of the potentials in the hyporeflexia was significantly longer than in the other groups, while the amplitude of those in the hyperreflexia group was significantly higher than in the other groups. These results indicate that in patients with OPCA the magnitude and latency of the masseter reflex correlates with the status of the muscle stretch reflexes of the limbs in contrast with Friedreich's ataxia where the masseter reflex has been reported to be normal or hyperactive despite hyporeflexia in the limbs.

Adult↗

Tone and reflex development before term.

The evolution of tone and reflexes from 25 weeks postmenstrual age (gestational age plus chronologic age) to term in a population of 42 surviving infants is described. The infants were born in 1983 at the Johns Hopkins Hospital, had birth weights less than 1300 g, were examined weekly until neonatal intensive care unit discharge, and did not develop cerebral palsy. Lower-extremity flexor tone was first detectable at 29 weeks post-menstrual age by the popliteal angle and heel to ear maneuvers. Flexor tone, recoil, and hyperreflexia were all noted 2 to 3 weeks earlier in the lower extremities (33 to 35 weeks) than in the upper extremities (35 to 37 weeks). Hip tone (35 to 37 weeks) followed knee flexor tone, but preceded shoulder tone (37 to 38 weeks). Trunk tone on ventral suspension emerged closer to term (36 to 40 weeks), and more than half of infants evaluated at term continued to demonstrate head lag when pulled to sitting position. The emergence of the primitive and pathologic reflexes reflects (both in timing and pattern) the evolution of tone: development of the reflexes in the lower extremities precedes that of those in the upper extremities, and development of the distal reflexes precedes that of the proximal. Maturation of tone, deep tendon reflexes, pathologic reflexes, and primitive reflexes occurs in an orderly, sequential manner, with a well-defined pattern: caudocephalad (lower extremities to upper extremities) and centripetal (distal to proximal).

Child Development↗

Latency of the acoustic reflex in eighth-nerve tumor.

We evaluated acoustic reflex morphologic features in four subjects with confirmed, unilateral acoustic neuroma. All four subjects showed marked reduction in absolute reflex amplitude and alteration in the reflex amplitude-intensity function in the ear with the eighth-nerve disorder. The early, fast-rising component of the normal reflex was also typically absent in the ears with tumor. Interaural latency comparisons were made in three ways. At equal reflex sensation levels and equal reflex sound pressure levels, latency ws substantially delayed in the ear with the eighth-nerve disorder. At equivalent reflex amplitudes, however, latency was equivalent in normal ears and ears with eighth-nerve disorder. Results suggest that delayed onset of the acoustic reflex in subjects with eighth-nerve disorder may reflect amplitude and wave-form morphologic effects rather than a latency prolongation per se.

Adult↗

Quantitative relations between hypertonia and stretch reflex threshold in spastic hemiparesis.

The relative contributions of variations in stretch reflex threshold and total joint stiffness to changes in stretch-evoked torque were assessed in the spastic elbow muscles of 14 hemiparetic spastic subjects. For a given subject, variations in torque, measured after a constant angular deflection, were mediated largely by changes in stretch reflex threshold, rather than by changes in reflex stiffness. Between-subject comparisons were sensitive to stiffness differences between limbs, but reflex thresholds were still broadly correlated with torque magnitude, suggesting that reductions in stretch reflex threshold are uniformly present in spastic muscles. These findings, coupled with the apparent similarity of reflex stiffness estimates in voluntarily activated spastic and normal muscles, suggest that the central disturbance in spasticity is a reduction in the threshold of the stretch reflex, without a significant enhancement of reflex gain.

Adult↗

Stretch reflex dynamics in spastic elbow flexor muscles.

Previous studies of stretch reflexes in patients with spastic hypertonia have emphasized the dynamic character of stretch reflex output. In contrast, our own studies of stretch reflex dynamics in spastic elbow flexor muscles of 14 hemiparetic human subjects have shown that stretch-evoked torque displays a relatively weak dependence on stretch velocity, and there is generally no preferential enhancement of dynamic as compared with static reflex output. Moreover, stretch reflex dynamics are broadly similar in voluntarily activated spastic and normal elbow flexor muscles. These findings support our hypothesis that spastic hypertonia results primarily from a decrease in stretch reflex threshold. The strong velocity dependence of stretch-evoked electromyographic activity in initially inactive spastic muscles could be due to a decrease in reflex threshold with increasing stretch velocity, rather than an abnormal velocity-dependent increase in stretch reflex responsiveness.

Adult↗

The neural substrate for the pupillary light reflex in the pigeon (Columba livia).

The neural substrate of the pupillary light reflex in the pigeon was investigated using anatomical, stimulation, and lesion techniques. In birds, as in mammals, the sphincter pupillae muscle (which constricts the iris) is innervated by cells in the ciliary ganglion (Pilar and Tuttle, '82). These cells are in turn innervated by cells in the Edinger-Westphal nucleus (EW) (Cowan and Wenger, '68; Narayanan and Narayanan, '76; Lyman and Mugnaini, '80). The efferent link of the pupillary light reflex must therefore involve cells in EW. To study the central course of this reflex pathway, injections of horseradish peroxidase (HRP) were placed in EW. These injections labeled cells in a number of regions including a contralateral pretectal nucleus, area pretectalis (AP). Only a limited number of cells in AP project to EW. Injections of tritiated amino acids into AP labeled a discrete region of the contralateral EW. This projection is confined to a dorsolateral region of caudal EW and overlies the somata of approximately 100 cells. Tritiated proline was injected into the eye, and the results confirmed an earlier report (Reperant, '73) that AP receives retinal input from the contralateral eye. Immunohistochemical studies demonstrated fibers in AP that stained positively for substance-P-like, enkephalin-like and tyrosine-hydroxylase-like immunoreactivity. Injections of HRP were placed in AP to examine the retinal ganglion cells mediating the reflex. Cells with an average diameter of approximately 14 microns (5-25 microns range) were labeled and averaged approximately 6 microns greater in diameter than the retinal ganglion cells (mean = 7.3 microns) labeled by an optic chiasm injection. The cells labeled by AP injections were distributed unevenly throughout the retina with a higher concentration in the central and temporal retina and a paucity in the red field and fovea. Our results demonstrate that AP receives input from a distinct subpopulation of large retinal ganglion cells that comprises a very small percentage of the total population of retinal ganglion cells. Unilateral lesions of AP abolished the pupillary light reflex in the eye contralateral to the lesion; stimulation of AP elicited pupilloconstriction in the eye contralateral to the stimulation site. These results delineate the central course of the pupillary light reflex pathway in the pigeon and identify the retinal ganglion cells that subserve this reflex. They show that, at every point in the pathway, only a few cells mediate this simple reflex.(ABSTRACT TRUNCATED AT 400 WORDS)

Afferent Pathways↗

Soleus H-reflex inhibition during gait initiation in Parkinson's disease.

The soleus H-reflex excitability during gait initiation was investigated in Parkinson's disease. Eleven patients participated in this study. Patients stepped forward as soon as the start signal flashed. Soleus H-reflex was evoked from the trailing leg 100, 300, or 600 msec after the start signal. The electromyographic activity in the soleus muscle immediately before evoking the H-reflex and the ankle joint motion were recorded. The soleus H-reflex was inhibited 300 msec after the start signal. The amount of the soleus H-reflex inhibition was inversely correlated with the Hoehn and Yahr stage; Items 14, 29, and 31 of the Unified Parkinson's Disease Rating Scale; and the delay of the onset of the ankle dorsiflexion from the start signal. In contrast, the amount of electromyographic activity immediately before evoking the H-reflex was not significantly correlated with those measures but was significantly correlated with Item 22 of the Unified Parkinson's Disease Rating Scale. Those findings indicate that the amount of soleus H-reflex inhibition during gait initiation depends on the severity of the disease. Abnormality of descending command may be related to the severity-dependent H-reflex inhibition.

Adult↗

The H-reflex as a tool in neurophysiology: its limitations and uses in understanding nervous system function.

The Hoffmann reflex (H-reflex) is extensively used as both a research and clinical tool. The ease with which this reflex can be elicited in several muscles throughout the body makes it an attractive tool. This review discusses some of the important limitations in using the H-reflex. In particular, the inaccurate but widely held assumptions that the H-reflex (1). represents the monosynaptic reflex of the Ia afferent onto homonymous motoneurons, and (2). can be used to measure motoneuronal excitability are addressed. The second part of this review explores the utility of the H-reflex as a neural probe in neurophysiology and motor control research. Applications ranging from the investigation of the functional organization of neural circuitry to the study of adaptive plasticity in spinal structures in health and disease suggest that the H-reflex will continue to be an extensively used tool in motor control neurophysiology.

Animals↗

Perioral reflexes in orofacial dyskinesia and spasmodic dysphonia.

In order to assess the clinical utility of trigemino-facial reflexes in lower facial muscles, we studied perioral reflexes to mechanical and electrical stimulation in 13 patients with spasmodic dysphonia and orofacial dyskinesia and in 7 healthy subjects. Mechanical stimulation of the upper lip of all patients and electrical stimulation of the infraorbital nerve of patients with orofacial dyskinesia elicited larger perioral reflexes than in controls. In the majority of patients, hyperexcitable perioral reflexes were accompanied by increased gain of the blink reflex. In 4 patients, however, trigemino-facial reflexes were enhanced selectively in either the perioral muscles or orbicularis oculi. Our findings suggest that the quantitative assessment of perioral reflexes may provide information about the excitability of brainstem interneurons in cranial dystonia that is complementary to blink reflex studies.

Blinking↗

H reflex latency in the healthy elderly.

The purpose of this study was to evaluate prospectively and analyze the relationship of tibial nerve H reflex latency to age, sex, leg length, and skin temperature in a large healthy elderly population. The H reflex was recorded bilaterally in 92% of 103 carefully screened individuals aged 60-88 years. The mean H reflex latency was 30.8 (SD = 2.6) and 30.7 (SD = 2.6) ms for right and left legs, respectively. A high correlation (r = 0.55, P < 0.05) was present between H reflex latency and leg length. No significant correlation existed for H reflex latency and age. The upper normal limit for the difference between right and left H reflex latencies was 1.8 ms. This limit is greater than that reported in the literature for younger individuals due to a larger standard deviation. These findings suggest that aging increases the between-leg variability of H reflex latency in individuals. This greater difference must be taken into account when using side-to-side H reflex latency comparison to detect unilateral pathology in the elderly.

Aged↗

Functionally complex muscles of the cat hindlimb. IV. Intramuscular distribution of movement command signals and cutaneous reflexes in broad, bifunctional thigh muscles.

Similarities between the muscle synergies associated with the flexion reflex and locomotion in reduced preparations have suggested that spinal circuits subserving these two motor tasks might share common interneurons. To test this hypothesis in functionally complex muscles, we studied the interaction between low-threshold cutaneous afferents and the locomotor central pattern generator (CPG) during treadmill locomotion in awake, intact cats. Electrical stimuli were delivered via implanted nerve cuff electrodes at all phases of locomotion, and EMGs were recorded from fourteen intramuscular subregions in eight bifunctional thigh muscles (adductor femoris, biceps femoris, caudofemoralis, gracilis, semimembranosus, semitendinosus, tensor fasciae latae, and tenuissimus). In addition, the EMG patterns recorded during locomotion were compared with those recorded during two other centrally driven rhythmical behaviors, scratching and paw shaking, to determine whether the functional relationships among these intramuscular subregions were fixed or task dependent. Four of the five broad, bifunctional muscles studied (biceps femoris, gracilis, semimembranosus, and tensor fasciae latae) had functional subunits that could be differentially activated in one or more of the three movements studied; adductor femoris was consistently uniformly activated despite its distributed skeletal attachments. The pattern of recruitment of the intramuscular functional subunits was movement-specific. The locomotor CPG and cutaneous reflex pathways both similarly subdivided some bifunctional muscles, but not others, into intramuscular subregions. The results of the present study confirm that some combinations of muscle subregions and cutaneous nerves constitute simple reciprocal categories of flexors and extensors, as described originally by Sherrington (1910). "Typical" low threshold excitatory or inhibitory reflex responses were produced in muscles or muscle subregions that were recruited as "net" flexors of extensors, respectively. However, muscles with complex activation patterns during walking often had very individualized, complex reflex responses during locomotion that did not conform to the background locomotion synergies. All of the reflex responses observed were mediated by low threshold cutaneous afferents. These data indicate that there are multiple, low threshold, excitatory and inhibitory cutaneous reflex pathways that have highly specialized connections with flexor and extensor muscles and even their intramuscular subregions. It is also clear that the premotoneuronal circuits mediating these cutaneous reflex effects are not necessarily synonymous with those of the locomotor CPG. These two systems do interact powerfully, however, suggesting some convergence. The nature of the convergence between the CPG and the many independent subsets of spinal interneurons mediating cutaneous reflexes is specialized and muscle subregion-specific.

Afferent Pathways↗

H-reflexes in masseter and temporalis muscles in man.

In contrast with limb muscles, studies on H-reflexes in the trigeminal system are scarce. The present report aimed at reevaluating the responses obtained in the masseter and temporalis muscles after electrical stimulation of their nerves. Twenty-four subjects participated in the experiments. The reflexes were elicited in the masseter and temporal muscles by monopolar stimulation and recorded using surface electrodes. Stimulation of the masseteric nerve evoked an M-response in the masseter and an H-reflex in both the masseter and the temporal muscles. In contrast with the masseter muscle, where the homonymous H-reflex disappeared at higher stimulation intensities, the heteronymous temporal H-reflex remained and reached a plateau. Simultaneous stimulation of the masseteric and deep temporal nerves resulted in an M-response and an H-reflex in both the masseter and temporal muscles. Increasing stimulus intensitites led to disappearance of the H-reflex in both muscles. The results were compared with those obtained by others on limb muscles. As in these muscles, the presence of heteronymous H-reflexes in the jaw muscles can be used in future studies of motoneuronal excitability.

Adult↗

Excitatory amino acid receptors in the caudal ventrolateral medulla mediate a vagal cardiopulmonary reflex in the rat.

The importance of the caudal ventrolateral medulla (CVLM) in mediating vagal cardiopulmonary (Bezold-Jarisch reflex) reflex activity was studied in urethane-anaesthetized rats. Unilateral electrolytic lesion of the CVLM markedly attenuated Bezold-Jarisch reflex responses (hypotension and bradycardia) elicited by intravenous injections of 5-HT. Bilateral lesion of the CVLM virtually abolished the reflex responses. Microinjection of the excitatory amino acid (EAA) receptor antagonist kynurenate (KYN), but not the inactive analogue xanthurenate, into the CVLM markedly attenuated the reflex responses to 5-HT. The N-methyl-D-aspartate (NMDA) receptor antagonist, MK-801 also markedly attenuated reflex activity. Furthermore, lesions, KYN and MK-801 all tended to elevate resting blood pressure and to reduce resting heart rate. These findings support the hypothesis that the CVLM is an important medullary locus mediating cardiovascular reflex integration and that an EAA synapse in the CVLM is important in the cardiopulmonary reflex arc.

Animals↗

Functional organization of the nociceptive withdrawal reflexes. II. Changes of excitability and receptive fields after spinalization in the rat.

The spatial organization of the cutaneous input to hindlimb withdrawal reflexes was studied in spinalized, decerebrated, unanesthetized rats. Reflex activity in plantar flexors of the digits, pronators of the foot, dorsiflexors of the digits, and/or the ankle and flexors of the knee was recorded with electromyographic techniques for up to 12 h after spinalization. Graded mechanical (pinch) and thermal stimulation (CO2 laser) of the skin were used. Reflexes were absent ("spinal shock") during approximately 10-20 min after spinalization. The reflex thresholds for pinch and CO2 laser stimulation then decreased considerably during the following 5-8 h. After this time, even mild pressure (less than 0.1 N/mm2) on the skin was sufficient to evoke a reflex in most muscles. During the period from about 0.5-3 h after spinalization, the nociceptive receptive field of each muscle usually corresponded to the area of the skin withdrawn by the muscle. Maximal responses were evoked from the area of the receptive field maximally withdrawn. During this period, responses to innocuous pinch were evoked mainly from the most sensitive area of the receptive fields. Concomitant with the decrease in reflex thresholds, the nociceptive receptive fields expanded for all muscles, often to include areas of the skin not withdrawn by the muscles. For most muscles, reflexes on tactile stimuli were eventually elicited from the entire receptive fields. The receptive fields for thermonociceptive and mechanonociceptive inputs were similar in most muscles. The interossei muscles were exceptional in that they responded very weakly to thermal stimulation. It is concluded that there are neuronal networks in the spinal cord that translate cutaneous nociceptive and tactile input into a withdrawal. However, the control exerted by descending pathways is necessary to maintain a functionally adequate excitability in these reflex pathways and an appropriate size for their receptive fields.

Animals↗

Vestibulo-spinal response modification as determined with the H-reflex during the Spacelab-1 flight.

Our laboratory at the Johnson Space Center has employed the H-reflex recorded from the soleus muscle as a method of monosynaptic reflex testing in conjunction with vertical linear acceleration to assess modification of utriculo-saccular function induced through prolonged exposure to microgravity. It was hypothesized that exposure to free fall would reduce the necessity for postural reflexes in the major leg muscles, and that postural modification would reflect a change, not in the peripheral vestibular organs, but more centrally. This postural adjustment would reflect a sensory motor rearrangement where otolith receptor input was reinterpreted to provide an environmentally appropriate response. In addition to the H-reflex (which was the only inflight measurement), vestibulo-spinal EMG from the gastrocnemius, and self-motion reports were obtained in response to a sudden earth vertical fall. Preflight, inflight and postflight motion sickness reports were also recorded, and related to the H-reflex data. The results indicated that early inflight H-reflex amplitude was similar to that recorded preflight, but that measurements obtained later in the flight (day seven) did not show a change in potentiation as a function of the different drop to shock intervals. Immediate postflight H-reflex response in three of the four astronauts tested showed a rebound effect. Postflight gastrocnemius EMG in response to the sudden fall did not show a significant change from preflight values. However, one crewman who was tested early postflight did show an increase in EMG activity in response to the sudden fall. This immediate postflight effect returned to baseline rapidly. Self-motion perception obtained inflight suggested that the early inflight drops were perceived like those preflight. Drops later inflight were described as sudden, fast, hard and translational in nature. Immediately postflight the drops were perceived like those late inflight, and the astronauts said that they did not feel as though they were falling, rather the floor came up to meet them. Post hoc peak H-reflex amplitude, both preflight and postflight was related to inflight space motion sickness.

Humans↗

The gastroauricular phenomenon and related vagus reflexes.

Eight lesser known reflexes were grouped together because of their anatomical and physiological relationship. In all of them a branch of the vagus nerve forms a bridge between a circumscribed area of the skin, mostly the external auditory meatus, and an internal organ, namely the stomach, esophagus, lungs, heart, uterus, and some male and female sex organs. The eight reflexes are: (1) Gastroauricular phenomenon (Gaph) (Engel, 1922) in man; (2) Auricular phenomenon (Malherbe, 1958) in man; (3) Pulmonoauricular phenomenon (Deutsch, 1919) in man; (4) Auriculogenital reflex (Bradford, 1937) in cat; (5) Auriculouterine reflex (Vasiliu, 1932) in women; (6) Oculocardiac reflex (Aschner, 1967) in man; (7) Kalchschmidt's reflex in cattle (1956); and (8) Coughing attack with heartburn (Berlin, 1959) in man. The organs involved are either effector or receptor organs. The six reflexes observed in man are of diagnostic significance. Attention is also drawn to analogous reflexes in which the meningeal branch of the vagus is involved.

Animals↗