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PubMed2002

Successful management of severe respiratory failure combining heliox with noninvasive high-frequency percussive ventilation.

Heliox has been shown to be beneficial in the management of different obstructive pulmonary disorders. High-frequency percussive ventilation has recently been advocated to treat lung injury in children with reduced lung compliance. We report our experience of combining heliox with noninvasive high-frequency percussive ventilation in a 5-yr-old boy with severe acute respiratory failure resulting from advanced cystic fibrosis lung disease. The dramatic improvement allowed stabilization and withholding of endotracheal intubation. We hypothesize that this approach improved gas exchange by enhancing molecular diffusion and by favoring laminar flow throughout the upper and lower airways. Further investigations should study the mechanisms of this noninvasive bimodal therapy.

Child, Preschool↗
PubMed1998

Posttraumatic cerebral ischemia after fluid percussion brain injury: an autoradiographic and histopathological study in rats.

OBJECTIVES: Mild-to-moderate reductions in local cerebral blood flow (ICBF) have been reported to occur in rats after moderate (1.7-2.2 atm) fluid percussion brain injury. The purpose of this study was to determine whether evidence for severe ischemia (i.e., mean ICBF < 0.25 ml/g/min) could be demonstrated after severe brain injury. In addition, patterns of indium-labeled platelet accumulation and histopathological outcome were correlated with the hemodynamic alterations. METHODS: Sprague-Dawley rats (n = 23), anesthetized with halothane and maintained on a 70:30 mixture of nitrous oxide:oxygen and 0.5% halothane, underwent normothermic (37 degrees C) parasagittal fluid percussion brain injury (2.4-2.6 atm). Indium-111-tropolone-labeled platelets were injected 30 minutes before traumatic brain injury (TBI), while 14C-iodoantipyrine was infused 30 minutes after trauma for ICBF determination. Sham-operated animals (n = 8) underwent similar surgical procedures but were not injured. For histopathological analysis, traumatized rats (n = 5) were perfusion-fixed 3 days after TBI. RESULTS: In autoradiographic images of indium-labeled platelets, abnormal platelet accumulation that was most pronounced overlying the pial surface was commonly associated with severe reductions in ICBF within underlying cortical regions 30 minutes after TBI. For example, within the lateral parietal cortex, ICBF was significantly reduced from 1.67 +/- 0.11 ml/g per minute (mean +/- standard error of the mean) in sham-operated animals to 0.23 +/- 0.03 ml/g per minute within the traumatized group. In addition to focal severe ischemia, moderate reductions in ICBF were detected throughout the traumatized hemisphere, including the frontal and occipital cortices, hippocampus, thalamus, and striatum. Mild decreases in ICBF were also observed throughout the contralateral cerebral cortex. At 3 days after severe TBI, histopathology demonstrated intracerebral and subarachnoid hemorrhage associated with cerebral contusion and selective neuronal necrosis. CONCLUSION: These data indicate that multiple cerebrovascular abnormalities, including subarachnoid hemorrhage, focal platelet accumulation, and severe ischemia, are important early events in the pathogenesis of cortical contusion formation after TBI. Injury severity is expected to be a critical factor in determining what therapeutic strategies are attempted in the clinical setting.

Animals↗
PubMed2002

Interleukin-1beta messenger ribonucleic acid and protein levels after fluid-percussion brain injury in rats: importance of injury severity and brain temperature.

OBJECTIVE: Posttraumatic temperature manipulations have been reported to significantly influence the inflammatory response to traumatic brain injury (TBI). The purpose of this study was to determine the temporal and regional profiles of messenger ribonucleic acid (mRNA) expression and protein levels for the proinflammatory cytokine interleukin-1beta (IL-1beta), after moderate or severe TBI. The effects of posttraumatic hypothermia (33 degrees C) or hyperthermia (39.5 degrees C) on these consequences of TBI were then determined. METHODS: Male Sprague-Dawley rats underwent fluid-percussion brain injury. In the first phase of the study, rats were killed 15 minutes or 1, 3, or 24 hours after moderate TBI (1.8-2.2 atmospheres), for reverse transcription-polymerase chain reaction analysis. Other groups of rats were killed 1, 3, 24, or 72 hours after moderate or severe TBI (2.4-2.7 atmospheres), for protein analysis. In the second phase, rats underwent moderate fluid-percussion brain injury, followed immediately by 3 hours of posttraumatic normothermia (37 degrees C), hyperthermia (39.5 degrees C), or hypothermia (33 degrees C), and were then killed, for analyses of protein levels and mRNA expression. Brain samples, including cerebral cortex, hippocampus, thalamus, and cerebellum, were dissected and stored at -80 degrees C until analyzed. RESULTS: The findings indicated that mRNA levels were increased (P < 0.05) as early as 1 hour after TBI and remained elevated up to 3 hours after moderate TBI. Although both moderate and severe TBI induced increased levels of IL-1beta (P < 0.05), increased protein levels were also noted in remote brain structures after severe TBI. Posttraumatic hypothermia attenuated IL-1beta protein levels, compared with normothermia (P < 0.05), although the levels remained elevated in comparison with sham values. In contrast, hyperthermia had no significant effect on IL-1beta levels, compared with normothermic values. Posttraumatic temperature manipulations had no significant effect on IL-1beta mRNA levels. CONCLUSION: Injury severity determines the degree of IL-1beta protein level elevation after TBI. The effects of posttraumatic hypothermia on IL-1beta protein levels (an important mediator of neurodegeneration after TBI) may partly explain the established effects of posttraumatic temperature manipulations on inflammatory processes after TBI.

Animals↗
PubMedDate not supplied

High-frequency percussive ventilation with systemic heparin improves short-term survival in a LD100 sheep model of acute respiratory distress syndrome.

We undertook an assessment of high-frequency percussive ventilation (HFPV) and systemic heparin on survival in our LD100 sheep model of smoke/burn-induced acute respiratory distress syndrome (ARDS). This was a prospective controlled outcomes study in a large animal critical care laboratory. ARDS was induced in 13 sheep by a combination of 48 cotton smoke breaths and 40% full-thickness cutaneous burn (LD100) followed by mechanical ventilation (15 ml/kg tidal volume). After meeting ARDS criteria (PaO2/FiO2 < 200), the sheep were divided into high-frequency percussive ventilation (HFPV; n = 7) or volume-controlled mechanical ventilation (VCMV; n = 6) groups. Both groups received systemic heparin to achieve an ACT 180-300 seconds. HFPV was managed with the Volumetric Diffusive Respiration Ventilator (Percussionaire Corp., Sandpoint, ID). The VCMV group was managed with up to 10 ml/kg tidal volume. Arterial blood gases and ventilator settings were monitored every 6 hours after onset of ARDS. HFPV did not affect sheep hemodynamics. Survival 84 hours after smoke and burn injury was significantly greater in the HFPV (7/7, 100%) compared with the VCMV group (3/6, 50%, P < .05). PaCO2 was significantly greater in VCMV group at 36, 48, and 72 hours after smoke and burn injury. PaO2/FiO2 after 36 hours of smoke and burn injury in the HFPV group was improved compared with the VCMV group, but no statistical difference was found. In the VCMV group, peak airway pressure was decreased to 19.7 +/- 2.2 cm H2O at 36 hours from 29 +/- 2.8 at 24 hours as the tidal volume changed from 15 ml/kg to 10 ml/kg and then gradually increased to 39 +/- 5.6 cm H2O at 72 hours. In the HFPV group, peak inspiratory pressure kept constant at a level of 30 cmH2O. In our smoke/burn-induced LD100 sheep model of ARDS, volume-controlled mechanical ventilation with systemic heparin achieved a 50% survival whereas HFPV with systemic heparin achieved 100% survival at 60 hours after the onset of ARDS.

Animals↗
PubMed1979

Comparative trial of manual and mechanical percussion technique with gravity-assisted bronchial drainage in patients with cystic fibrosis.

Chest physiotherapy still remains one of the most important aspects in the treatment of chest complications of cystic fibrosis. A mechanical device that allows the patient with cystic fibrosis to do his own chest physiotherapy will be of great benefit if it is as effective as manual percussion. 14 patients with cystic fibrosis using mechanical and manual percussion physiotherapy were studied by measuring sputum volumes, and FEV and FVC. Results with mechanical percussor were as good as with the manual percussor and, therefore, it would be reasonable for the older patient to use the former on his own.

Adolescent↗
PubMed1989

Recovery of impaired endothelium-dependent relaxation after fluid-percussion brain injury in cats.

The effect of a moderate level of fluid-percussion brain injury on acetylcholine-induced cerebral arteriolar vasodilation was examined for 12 hours after trauma in anesthetized cats equipped with cranial windows. The cats were then perfused with aldehydes, and the pial arteries were prepared for electron microscopy. Immediately after brain injury, the normal vasodilator response to topical application of acetylcholine was converted to vasoconstriction. By 4 hours after trauma, the ability of small pial arterioles (diameters less than 100 microns) to dilate after acetylcholine application had returned to the pretrauma level and was observed to be normal at both 8 and 12 hours after trauma (p less than 0.05). The vasodilator response of large caliber arterioles (diameters greater than or equal to 100 microns) at 4, 8, and 12 hours after injury was reduced relative to the pretrauma response but was significantly improved relative to their response at 30 minutes after trauma (p less than 0.05). Moreover, the response of large vessels at 4, 8, and 12 hours in injured animals was equal to that observed in noninjured control animals assessed at 4, 8, and 12 hours after window implantation. At 12 hours after injury, the ultrastuctural characteristics of both large and small vessels resembled their preinjury state. These data suggest that the impairment of acetylcholine-induced endothelium-dependent relaxation observed in cats after fluid-percussion brain injury is not irreversible but returns to normal (small arterioles) or exhibits significant recovery (large arterioles) within 4 hours after injury.

Acetylcholine↗
PubMed1978

Myokymia, muscle hypertrophy and percussion "myotonia" in chronic recurrent polyneuropathy.

Three unusual features were observed in a patient with chronic relapsing polyneuropathy: myokymia, muscle hypertrophy, and prolonged contraction in response to muscle percussion. Low nerve conduction velocity and conduction block were demonstrated in all motor nerves tested, indicating a demyelinating peripheral neuropathy. Myokymia was caused by spontaneous motor unit activity which was shown to originate in peripheral nerves, since it persisted after nerve block and was abolished by regional curarization. Muscle hypertrophy was attributed to increased peripheral nerve activity, and the prolonged contraction of muscle in response to direct percussion was attributed to irritability of intramuscular nerve terminals.

Adult↗
PubMed2004

Tumor necrosis factor alpha expression and protein levels after fluid percussion injury in rats: the effect of injury severity and brain temperature.

OBJECTIVE: Tumor necrosis factor alpha (TNFalpha) is elevated in some models of traumatic brain injury (TBI). However, it is unclear how TNFalpha messenger ribonucleic acid (mRNA) expression and protein levels are affected by injury severity and posttraumatic temperature modification. This study determined the regional and temporal profile of TNFalpha levels after moderate and severe TBI and assessed the effects of posttraumatic hypothermia or hyperthermia on this proinflammatory cytokine. METHODS: Adult male Sprague-Dawley rats were subjected to sham procedures (no injury), moderate fluid-percussion TBI (1.8-2.2 atm), or severe fluid-percussion TBI (2.4-2.6 atm). After 1 to 72 hours of survival, animals were killed, and brain samples, cerebrospinal fluid, and serum were harvested for enzyme-linked immunosorbent assay quantification of TNFalpha levels. In a subsequent study, a 3-hour period of posttraumatic hypothermia (33 degrees C) or hyperthermia (39.5 degrees C) was applied, followed by immediate killing and cytokine assay. Another group was subjected to moderate TBI (1.8-2.2 atm), followed by killing at 15 minutes or at 1, 3, or 24 hours for TNFalpha reverse transcriptase-polymerase chain reaction analysis. RESULTS: A significant increase in TNFalpha mRNA and protein levels in cellular lysates of injured cortex and ipsilateral hippocampus was noted by 1 hour after TBI; it was sustained to 3 hours, followed by a rapid decline. Increased injury severity was associated with increased protein levels at remote injury sites and in the injured cerebral cortex at 72 hours. Posttraumatic hypothermia significantly reduced TNFalpha mRNA expression in the hippocampus compared with that in normothermic rats. In contrast, no temperature effects on TNFalpha protein levels were documented. CONCLUSION: Rapid and marked increase in TNFalpha mRNA expression and protein levels follows moderate and severe TBI. Injury severity and posttraumatic temperature play a modest but significant role on TNFalpha expression and protein levels. These findings suggest that the effects of posttraumatic temperature on histopathological and behavioral outcome primarily may involve secondary mediators that do not operate directly through their effect on TNFalpha.

Animals↗
PubMed1996

Continuous multiparametric monitoring of brain activities following fluid-percussion injury in rats: preliminary results.

Severe head injury can result in a high mortality rate or irreversible brain damage. One technique used to induce traumatic brain injury (TBI) is exposure of the brain to fluid percussion pressure while monitoring the increase in intracranial pressure (ICP). Since brain injury is a multifactorial, pathological, time-dependent state, the multiparametric monitoring approach was adopted for studying fluid percussion effects on the rat brain. A multiprobe assembly (MPA) connected to the brain in vivo (right hemisphere) enabled the simultaneous monitoring of CBF, NADH redox state, extracellular K+, Ca2+, H+ levels as well as DC potential, ECoG and ICP. The animal was connected to the monitoring system and exposed to TBI after a recuperation period of at least 3 hours after the end of the operation. Two typical responses to TBI were recorded in our preliminary experiments. When severe injury was induced, ischemic depolarization (ID) developed, whereas mild or moderate injury led to repetitive spreading depression (SD) cycles. The relationship between the ID and SD observed under TBI is important to the understanding of the mechanism of brain injury. ICP before injury was between 2-6 mm Hg and increased to 20-22 mm Hg 2-3 minutes after the ID. After severe head injury, ICP remained high and in some cases increased to critical values causing death of these animals. Some animals developed seizures at various stages after the TBI. Hyperbaric oxygenation was used as a therapeutic tool to treat severely injured animals. These preliminary results suggest that it is feasible and practical to use the MPA approach for monitoring the brain after TBI.

Brain Injuries↗
PubMed1975

An auditory-motor percussion test for differential diagnosis of children with communication difficulties.

Experience with children who have communication difficulties, are often hard to reach, and present severe barriers to treatment and testing led to the development of an auditory-motor percussion test designed to help distinguish children who show organicity from those who do not. Results of a normative study of 144 children tested in settings for the normal child and 84 in settings for disturbed children supported the hypothesis that the presence of structural alteration in the central nervous system is probable if subject (aged 4 to 7) is unable to tap a rhythmic tonal pattern. With the use of simple percussion instruments in a special method for administering the new procedure, the test can be used as an alert to hidden neurological damage in children over 4 and inaccessible to traditional testing.

Adolescent↗
PubMed1981

Oxidative metabolic activity of cerebral cortex after fluid-percussion head injury in the cat.

To assess the metabolic and vascular effects of head trauma, fluid-percussion pressure waves were transmitted to the brains of anesthetized, paralyzed, and artificially ventilated cats. Changes in the redox state of cytochrome a,a3, and relative local blood volume were measured in situ by dual-wavelength reflection spectrophotometry of the cortical surface viewed through an acrylic cranial window implanted within the closed skull. Initial fluid-percussion impacts of 0.5 to 2.8 atm peak pressure produced consistent transient oxidation of cytochrome a,a3 and increases of cortical blood volume. These changes occurred despite the presence of transient posttraumatic hypotension i some cases. Also, impact-induced alterations of vascular tone occurred, independent of the presence or absence of transient hypertension in the posttraumatic period. These data demonstrate that hypoxia does not play a role in the immediate posttraumatic period in cerebral cortex, and are consistent with the idea that after injury there is increased cortical energy conservation. These data also support the concept that head trauma alters the relationship of metabolism and cerebral circulation in the period immediately after injury.

Animals↗
PubMed1991

Evaluation of brain-stem dysfunction following severe fluid-percussion head injury to the cat.

The degree of brain-stem dysfunction associated with high-level fluid-percussion injury (3.0 to 3.8 atm) was investigated in anesthetized cats. Measurements were made of the animals' intracranial pressure (ICP) pressure-volume index (PVI), far-field brain-stem auditory evoked responses (BAER's), and cerebral blood flow (CBF). The animals were classified into two groups based on the severity of neuropathological damage to the brain stem after trauma: Group 1 had mild intraparenchymal and subarachnoid hemorrhages and Group 2 had severe intraparenchymal and subarachnoid hemorrhages. The ICP values in Group 1 were insignificantly lower than those in Group 2, while the PVI values in Group 2 were clearly lower (p less than 0.05). Immediately after the injury, peaks II, III, and IV of the BAER's demonstrated a transitory and marked suppression. One Group 1 and two Group 2 animals showed the disappearance of peak V. In Group 1, the latencies of peak II, III, and IV gradually increased until 60 to 150 minutes postinjury, then returned to 95% of baseline value at 8 hours; however, the animals in Group 2 showed poor recovery of latencies. Two hours after brain injury, the CBF decreased to 40% of the preinjury measurement in both groups (p less than 0.001). In contrast to Group 2, the CBF in Group 1 returned to 86.8% of the preinjury measurement by 8 hours following the injury. Changes in PVI, BAER, and CBF correlated well with the degree of brain-stem injury following severe head injury. These data indicate that high-level fluid-percussion injury (greater than 3.0 atm) is predominantly a model of brain-stem injury.

Animals↗
PubMed1996

Combined fetal neural transplantation and nerve growth factor infusion: effects on neurological outcome following fluid-percussion brain injury in the rat.

This study was designed to evaluate the histological and behavioral impact of fetal neural transplantation with and without neurotrophin infusion in rats subjected to traumatic brain injury using a clinically relevant model of lateral fluid-percussion brain injury. Adult male Sprague-Dawley rats received lateral fluid-percussion brain injury of moderate severity (2.1-2.3 atm). Twenty-four hours after injury, minced fetal cortical grafts (E16) were stereotactically transplanted into the site of injury cavity formation (in 32 rats). Ten control animals received injections of saline. A third group of 29 animals that received transplants also underwent placement of a miniosmotic pump (immediately after transplantation) to continuously infuse nerve growth factor (NGF) directly into the region of graft placement for the duration of the experiment. A fourth group of eight animals underwent transplantation of fetal cortical cells that had been dissociated and placed in suspension. Animals were evaluated at 72 hours, 1 week, and 2 weeks after injury for cognitive function (using the Morris water maze), posttraumatic motor dysfunction, and transplant survival and morphology (using Nissl and modified Palmgren's silver staining techniques). Robust survival of whole-tissue transplants was seen in 65.5% of animals and was not increased in animals receiving NGF infusion. Animals receiving transplants of cell suspension had no surviving grafts. Brain-injured animals receiving transplants showed significant cognitive improvements compared with controls at the 2-week evaluation. Significantly improved memory scores were seen at all evaluation times in animals receiving both NGF and transplants compared with injured controls and compared with animals receiving transplants alone at the 72-hour and 1-week evaluations. Neurological motor function scores were significantly improved in animals receiving transplants alone and those receiving transplants with NGF infusion. Histological evaluation demonstrated differentiation of grafted cells, decreased glial scarring around transplants when compared with control animals, and the presence of neuronal fibers bridging the interface between graft and host. This study demonstrates that fetal cortical cells transplanted into the injured cortex of the adult rat can improve both posttraumatic cognitive and motor function and interact with the injured host brain.

Analysis of Variance↗
PubMed2004

Effects of hyperbaric oxygen therapy on cerebral oxygenation and mitochondrial function following moderate lateral fluid-percussion injury in rats.

OBJECT: In the current study, the authors examined the effects of hyperbaric O2 (HBO) following fluid-percussion brain injury and its implications on brain tissue oxygenation (PO2) and O2 consumption (VO2) and mitochondrial function (redox potential). METHODS: Cerebral tissue PO2 was measured following induction of a lateral fluid-percussion brain injury in rats. Hyperbaric O2 treatment (100% O2 at 1.5 ata) significantly increased brain tissue PO2 in both injured and sham-injured animals. For VO2 and redox potential experiments, animals were treated using 30% O2 or HBO therapy for 1 or 4 hours (that is, 4 hours 30% O2 or 1 hour HBO and 3 hours 100% O2). Microrespirometer measurements of VO2 demonstrated significant increases following HBO treatment in both injured and sham-injured animals when compared with animals that underwent 30% O2 treatment. Mitochondrial redox potential, as measured by Alamar blue fluorescence, demonstrated injury-induced reductions at 1 hour postinjury. These reductions were partially reversed at 4 hours postinjury in animals treated with 30% O2 and completely reversed at 4 hours postinjury in animals on HBO therapy when compared with animals treated for only 1 hour. CONCLUSIONS: Analysis of data in the current study demonstrates that HBO significantly increases brain tissue PO2 after injury. Nonetheless, treatment with HBO was insufficient to overcome injury-induced reductions in mitochondrial redox potential at 1 hour postinjury but was able to restore redox potential by 4 hours postinjury. Furthermore, HBO induced an increase in VO2 in both injured and sham-injured animals. Taken together, these data demonstrate that mitochondrial function is depressed by injury and that the recovery of aerobic metabolic function may be enhanced by treatment with HBO.

Animals↗
PubMed2000

A common perceptual space for harmonic and percussive timbres.

The goal of a series of listening tests was to better isolate the principal dimensions of timbre, using a wide range of timbres and converging psychophysical techniques. Expert musicians and nonmusicians rated the timbral similarity of three sets of pitched and percussive instruments. Multidimensional scaling analyses indicated that both centroid and rise time comprise the principal acoustic factors across all stimulus sets and that musicians and nonmusicians did not differ significantly in their weighting of these factors. Clustering analyses revealed that participants also categorized percussive and, to a much lesser extent, pitched timbres according to underlying physical-acoustic commonalties. The findings demonstrate that spectral centroid and rise time represent principal perceptual dimensions of timbre, independent of musical training, but that the tendency to group timbres according to source properties increases with acoustic complexity.

Adolescent↗
PubMed1986

Elaboration of a standard procedure for the measurement of vibration emitted by percussive tools--application to breakers.

The Association Française de Normalisation (AFNOR) is preparing a standard on the exposure assessment of vibration from percussive tools. Therefore, a test code was developed for the measurement of vibration from percussive tools under laboratory conditions. The handle vibration from six different breakers, among which three tools were of "antivibration design," was measured with the following energy absorption methods: hydraulic base, steel shot, actual breaking of concrete, AFNOR concrete block, pointed chisel embedded in concrete. The last four methods were applied with breakers held by three successive operators. In addition, the first two were used with tools mounted in a rig which held them vertically and loaded them with a vertical downforce. The results indicated that the steel shot method was preferable although it gave 20% lower vibration results than those recorded for the actual breaking of concrete. It has the advantages of yielding consistent results with low scatter and being simple and cheap. Since difficulties have been experienced during the use of a pneumatic rig with breakers of antivibration design conception, the shot method should be applied with human operators.

Humans↗
PubMed2000

[Dynamics of mitotic index of buckwheat root meristems, developing from seeds subjected to percussive wave treatment].

A method of percussive wave treatment of seeds, promoting activization of physiological processes in plants, was proposed. The influence of physical treatment on cell nuclei and phytohormones was investigated. We examined dynamics of mitotic indices (MI) of the root meristems of buckwheat seedlings 48-58 h after the treatment. The seeds were treated with pressures of 11, 23, 29 MPa. The synchrony of cell divisions was estimated according to the augmentation of maximum MI versus average MI. The maximum and the average MI of control seedlings was 9.6 and 8.1%, resp. After the treatment with the pressure of 11 MPa the average MI increased by 2.6 times, and synchrony raised by 50%. After the treatment by the pressure of 23 MPa the average value of MI did not change versus the control, but the synchrony enhanced by 2.8 times. After the treatment of the pressure of 29 MPa the average MI decreased by 31%, the synchrony increased by 33%. Examination of phase indexes allowed to reveal the damage of cytotomy, transition to metaphase, and mitotic apparatus formation. The MI of root meristems of the test seedling aged 8 days topped the control by 21, 156 and 20%. So, the pressure of 11 MPa promoted MI increase in 2 days, and those of 23 and 29 MPa in 8 days. The investigation of hormone balance allowed to detect a raising level of abscisic acid. Its influence on the plant growth depends on the content of zeatin. A hypothetical model of plant reaction mechanism was proposed, based on the obtained results. A momentary pressing in the percussive wave was a stressor, promoting the accumulation of ABA and "growth rest", that changed for an active growth induced by zeatin.

Fagopyrum↗
PubMed1989

[Reflex responses in the trapezius muscle after percussion of various parts of the body].

In a Group of 20 healthy subjects and 16 patients with different central motor disorders a reflexological investigation was made in the upper part of the trapezius muscle. The reflex responses were produced by percussion with a reflex hammer on several sites on the head, trunk and upper extremities and identified as excitatory and inhibitory modulations of recorded EMG activity resulting from the stimulus, after averaging of 50 responses. In the group of healthy subjects after percussion of the chin, upper lip, cheek, mastoid process, back of the skull, the processus spinosus of vertebras C7 and Th12 and both sides of the volar area of the wrist, reflex responses with a short and long latency were recorded. In the group of patients with central motor disorders the reflexological finding was different, depending on the type of central disorder. On the side of spastic hemiparesis after a hemispheric ischaemic cerebrovascular lesion only responses with a short latency were recorded. In patients with parkinsonism mostly only reflex responses with a long latency were elicited. In patients with the dystonic form of torticollis spastica a side asymmetry was found. The results of the investigation provided evidence of reflex connections of remote parts of the body with trapezius muscle in healthy subjects and of the incidence of specific deviations of reflex responses in this muscle in patients with various central lesions. This is important in the differential diagnosis of central motor disorders.

Adult↗