A Comparison of Methods to Assess the Excitability of Lower Motoneurones

ABSTRACT:The purpose of this investigation was to compare three methods of assessing the excitability of lower motoneurones—TA-reflex, H-reflex and F-wave—in 120 patients with spastic hemiparesis following a stroke. The H-reflex was recorded from the soleus muscle after submaximal electrostimulation of the tibial nerve. The T-Achilles (TA) reflex was recorded from the soleus muscle after percussion of the Achilles tendon. The F-wave was recorded in the distal limb muscles after supramaximal electrostimulation of the median, ulnar, fibular and tibial nerves. The patient’s healthy side was used as a control. The TA-reflex, H-reflex and F-wave showed increased amplitudes on the spastic side. All amplitude ratios: TA/M, H/M, Fmax/M and Fmean/M were increased. The H-reflex thresholds were decreased. The F-wave duration, persistence and number of phases were also increased on the spastic side. Despite clinically decreased muscle tone, there were no changes in TA or H-reflex parameters after treatment. On the other hand, F-wave parameters tended to normalize after treatment in all groups. In conclusion, the F-wave is a more sensitive method than the TA and H-reflexes in assessing the excitability of the lower motoneurone.

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Fatigue-incduced modulation of human soleus Hoffmann reflex under conditions of homosynaptic postactivation depression due to pair tibial nerve stimulation

Bulletin of Taras Shevchenko National University of Kyiv Series Biology ◽

10.17721/1728_2748.2017.74.55-59 ◽

2017 ◽

Vol 74 (2) ◽

pp. 55-59

Author(s):

O. Kolosova

Keyword(s):

Soleus Muscle ◽

Tibial Nerve ◽

Voluntary Contraction ◽

H Reflex ◽

Afferent Nerves ◽

Tibial Nerve Stimulation ◽

Static Contraction ◽

Conditioned Responses ◽

Postactivation Depression ◽

Stimulation Of

The purpose of our work was to investigate in detail the influence of pair stimulation of tibial nerve (n.tibialis) on human soleus H-reflex amplitude at rest and after long-lasting voluntary contraction of calf muscle (m.m. gastrocnemius-soleus), which caused the fatigue of soleus muscle. The method of H-reflex of soleus muscle was used. Test and conditioned responses (by pair stimulation of n. tibialis) were registered. Homosynaptic postactivation depression led to inhibition of H-reflex at rest. After fatiguing voluntary static contraction the amplitudes of test and conditioned soleus H-reflex were significantly reduced. Then both H-reflex amplitudes subsequently recovered. Soleus H-reflex inhibition might be due to the activation of the groups III and IV afferent nerves under the influence of mechanical and metabolic changes in the muscle.

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Electromyography in Disorders of Muscle Tone

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100037999 ◽

1987 ◽

Vol 14 (S3) ◽

pp. 501-505 ◽

Cited By ~ 22

Author(s):

Andrew Eisen

Keyword(s):

Muscle Tone ◽

Reciprocal Inhibition ◽

Blink Reflex ◽

H Reflex ◽

Physiological Basis ◽

Tendon Reflex ◽

F Wave ◽

Stiff Man Syndrome ◽

Voluntary Muscle Contraction ◽

Excitatory Drive

ABSTRACT:No single clinical electrophysiological test can evaluate disorders of muscle tone. These disorders, symptomatic of a variety of diseases have a multifactorial physiological basis. The several tests used are complimentary each aiming to study different aspects of spinal and supraspinal reflexes which become deranged. The H reflex and F wave (H max/M max and F max/M max ratios) measure motoneuron pool excitability in general. The tendon reflex includes spindle mechanisms bypassed by the H reflex and, with limitations, comparison of H max/M max and T max/M max yields information about the -y system. Tonic vibration of a tendon inhibits the H reflex from the same muscle. The TVR measures autogenous presynaptic inhibition exerted by the la afferents of the muscle. Recurrent inhibition via Renshaw cells is evaluated by studying the effect of collision on the H reflex. Reciprocal inhibition of the la afferents can be assessed by measuring H reflex change induced by stimulating la afferents from antagonists. Changes in the H reflex recovery cycle measure polysynaptic influences on spinal motoneuron excitability. Cutaneomuscular (flexor) reflexes measure poly- and oligosynaptic excitatory drive to spinal motoneurons and the blink reflex evaluates the excitatory drive to brainstem motoneurons. Long loop (segmental) responses can be evaluated by limb pertubation using a torque motor or electrical stimulation applied during voluntary muscle contraction. Finally needle electromyography is a more relevant test in several disorders of muscle tone such as the stiff-man syndrome and Isaacs' syndrome.

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F-wave parameters for the tibial nerve in Miniature Dachshunds with and without naturally acquired thoracolumbar intervertebral disk herniation

American Journal of Veterinary Research ◽

10.2460/ajvr.81.5.422 ◽

2020 ◽

Vol 81 (5) ◽

pp. 422-427

Author(s):

Seiichi Okuno ◽

Kensuke Orito

Keyword(s):

Tibial Nerve ◽

Intervertebral Disk ◽

Disk Herniation ◽

Wave Parameters ◽

F Wave ◽

Intervertebral Disk Herniation

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Nerve Conduction Studies in Patients with Lumbosacral Radiculopathy Caused by Lumbar Intervertebral Disc Herniation

Advances in Orthopedics ◽

10.1155/2020/8882387 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Safa Yousif ◽

Ammar Ahmed ◽

Ahmed Abdelhai ◽

Afraa Musa

Keyword(s):

Nerve Conduction Study ◽

Nerve Conduction ◽

Tibial Nerve ◽

Motor Nerve ◽

H Reflex ◽

Nerve Conduction Studies ◽

Control Group ◽

Motor Nerve Conduction ◽

Lumbosacral Radiculopathy ◽

F Wave

Background. Nerve conduction studies (NCS) are electrodiagnostic tests used to evaluate peripheral nerves functions and aid in the assessment of patients with neuromuscular complaints. There is contrasting evidence concerning the use of NCS in the assessment of patients with lumbosacral radiculopathy. Objectives. This study was conducted to evaluate nerve conduction studies abnormalities in patients with lumbosacral radiculopathy and to find out their relation to abnormal physical examination findings. Materials and Methods. Twenty-seven patients with lumbosacral radiculopathy caused by L4/5 or L5/S1 intervertebral disc prolapse confirmed by magnetic resonance imaging (MRI) were recruited in the study. Twenty-five healthy subjects matched in age and sex served as control. Motor nerve conduction study bilaterally for both common peroneal and tibial nerves, F-wave for both nerves, and H-reflex had been conducted. Results. No significant difference was found in the motor nerve conduction study parameters (latency, amplitude, and conduction velocity) between the patients group and the control group. There was significant prolongation in H-reflex latency of both symptomatic and asymptomatic side in the patients group compared to the control group ( P < 0.05 ). Also, F-wave latencies (F minimum, F maximum, and F mean) of the tibial nerve were significantly prolonged ( P < 0.05 ) compared to control. Conclusion. Prolonged H-reflex latency was the commonest encountered abnormality in our study followed by F-wave latencies of the tibial nerve.

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Tibial nerve H-reflex and F-wave studies in patients with uremic neuropathy

Muscle & Nerve ◽

10.1002/mus.880030507 ◽

1980 ◽

Vol 3 (5) ◽

pp. 423-426 ◽

Cited By ~ 26

Author(s):

C. P. Panayiotopoulos ◽

G. Lagos

Keyword(s):

Tibial Nerve ◽

H Reflex ◽

F Wave

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Prolonged muscle inactivity and evaluation of peripheral neuromuscular features in patients hospitalized in Intensive Care Units

Hellenic Journal of Nursing Science ◽

10.24283/hjns.20192.13-14 ◽

2019 ◽

Vol 12 (2) ◽

pp. 50-64

Author(s):

George Elesnitsalis ◽

Ioannis Amiridis ◽

Dimitrios Patikas ◽

Ioanna Vekili ◽

Maria Vourvou

Keyword(s):

Intensive Care ◽

Critically Ill ◽

Conduction Velocity ◽

Soleus Muscle ◽

Critically Ill Patients ◽

Tibial Nerve ◽

H Reflex ◽

Apache Ii Score ◽

M Wave ◽

Stimulation Of

Introduction: Polyneuromyopathy constitutes a common complication in critically ill patients of the Intensive Care Unit (ICU) and in the last few years it appears to be identified as a syndrome detectable in the limbs and respiratory muscles. It is associated with the difficulties during weaning from mechanical ventilation. Aim: The present study investigates the reflective reaction of the soleus muscle following an electrical stimulation of the tibial nerve in intubated critically ill patients hospitalized in ICU with no medical history prior to their admission. Methods: Thirteen (13) patients who had been hospitalized for more than five (5) days and had a high APACHE II score (>15) and 13 age-matched control subjects were asked to participate in the present study on a volunteer basis. During the study, as reflective response parameters the range of the H-reflex and M-wave of the soleus muscle, as well as the conduction velocity of the tibial nerve, after electro-stimulation of the tibial nerve at the popliteal-fossa level, were assessed Results: Statistical analysis revealed significantly lower values in the ICU patients compared to healthy controls in both H-reflex range (p<0,049) and the M-wave range (p<0,041), as well as conduction velocity (p<0,001) of the tibial nerve. Conclusions: It is concluded that the reflective response of the soleus muscle as well as the tibial nerve’s conduction velocity are affected in critically ill patients hospitalized in ICU. The study of the above neurological parameters can provide further insights into the establishment and progress of polyneuromyopathy of critically ill patients in ICUs.

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