scholarly journals Evidence for Increased Activation of Persistent Inward Currents in Individuals With Chronic Hemiparetic Stroke

2008 ◽  
Vol 100 (6) ◽  
pp. 3236-3243 ◽  
Author(s):  
Jacob G. McPherson ◽  
Michael D. Ellis ◽  
C. J. Heckman ◽  
Julius P. A. Dewald
Keyword(s):  
Repeated Measures ◽  
Afferent Feedback ◽  
Joint Torque ◽  
Emg Activity ◽  
Tonic Vibration Reflex ◽  
Stretch Reflexes ◽  
Persistent Inward Currents ◽  
Inward Currents ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke

Despite the prevalence of hyperactive stretch reflexes in the paretic limbs of individuals with chronic hemiparetic stroke, the fundamental pathophysiological mechanisms responsible for their expression remain poorly understood. This study tests whether the manifestation of hyperactive stretch reflexes following stroke is related to the development of persistent inward currents (PICs) leading to hyperexcitability of motoneurons innervating the paretic limbs. Because repetitive volleys of 1a afferent feedback can elicit PICs, this investigation assessed motoneuronal excitability by evoking the tonic vibration reflex (TVR) of the biceps muscle in 10 awake individuals with chronic hemiparetic stroke and measuring the joint torque and electromyographic (EMG) responses of the upper limbs. Elbow joint torque and the EMG activity of biceps, brachioradialis, and the long and lateral heads of triceps brachii were recorded during 8 s of 112-Hz biceps vibration (evoking the TVR) and for 5 s after cessation of stimulation. Repeated-measures ANOVA tests revealed significantly ( P ≤ 0.05) greater increases in elbow flexion torque and EMG activity in the paretic as compared with the nonparetic limbs, both during and up to 5 s following biceps vibration. The finding of these augmentations exclusively in the paretic limb suggests that contralesional motoneurons may become hyperexcitable and readily invoke PICs following stroke. An enhanced tendency to evoke PICs may be due to an increased subthreshold depolarization of motoneurons, an increased monoaminergic input from the brain stem, or both.

scholarly journals Lower Extremity Motor Impairments in Ambulatory Chronic Hemiparetic Stroke: Evidence for Lower Extremity Weakness and Abnormal Muscle and Joint Torque Coupling Patterns

2017 ◽  
Vol 31 (9) ◽  
pp. 814-826 ◽  
Author(s):  
Natalia Sánchez ◽  
Ana Maria Acosta ◽  
Roberto Lopez-Rosado ◽  
Arno H. A. Stienen ◽  
Julius P. A. Dewald
Keyword(s):  
Lower Extremity ◽  
Degrees Of Freedom ◽  
Joint Torque ◽  
Motor Impairments ◽  
Lower Extremity Weakness ◽  
Joint Torques ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
Hip Extension ◽  
Flexion And Extension

Although global movement abnormalities in the lower extremity poststroke have been studied, the expression of specific motor impairments such as weakness and abnormal muscle and joint torque coupling patterns have received less attention. We characterized changes in strength, muscle coactivation and associated joint torque couples in the paretic and nonparetic extremity of 15 participants with chronic poststroke hemiparesis (age 59.6 ± 15.2 years) compared with 8 age-matched controls. Participants performed isometric maximum torques in hip abduction, adduction, flexion and extension, knee flexion and extension, ankle dorsi- and plantarflexion and submaximal torques in hip extension and ankle plantarflexion. Surface electromyograms (EMGs) of 10 lower extremity muscles were measured. Relative weakness (paretic extremity compared with the nonparetic extremity) was measured in poststroke participants. Differences in EMGs and joint torques associated with maximum voluntary torques were tested using linear mixed effects models. Results indicate significant poststroke torque weakness in all degrees of freedom except hip extension and adduction, adductor coactivation during extensor tasks, in addition to synergistic muscle coactivation patterns. This was more pronounced in the paretic extremity compared with the nonparetic extremity and with controls. Results also indicated significant interjoint torque couples during maximum and submaximal hip extension in both extremities of poststroke participants and in controls only during maximal hip extension. Additionally, significant interjoint torque couples were identified only in the paretic extremity during ankle plantarflexion. A better understanding of these motor impairments is expected to lead to more effective interventions for poststroke gait and posture.

scholarly journals Persistent Inward Currents Increase With The Level Of Voluntary Drive In Plantar Flexor Low-Threshold Motor Units

2020 ◽  
Author(s):  
Lucas B. R Orssatto ◽  
Karen Mackay ◽  
Anthony J Shield ◽  
Raphael L. Sakugawa ◽  
Anthony J. Blazevich ◽  
...  
Keyword(s):  
Motor Unit ◽  
Repeated Measures ◽  
Discharge Rate ◽  
Motor Units ◽  
Plantar Flexors ◽  
Force Output ◽  
Persistent Inward Currents ◽  
Gastrocnemius Medialis ◽  
Inward Currents ◽  
Maximal Discharge

This study tested the hypothesis that estimates of persistent inward currents (PICs) in the human plantar flexors would increase with the level of voluntary drive. Twenty-one participants volunteered for this study (29.2±2.6 years). High-density surface electromyograms were collected from soleus and gastrocnemius medialis during ramp-shaped isometric contractions to 10%, 20%, and 30% (torque rise of 2%/s and 30-s duration) of each participant's maximal torque. Motor units identified in all the contraction intensities were included in the paired-motor unit analysis to calculate delta frequency (ΔF) and estimate the PICs. Increases in PICs were observed from 10% to 20% (Δ=0.6 pps; p<0.001) and 20% to 30% (Δ=0.5 pps; p<0.001) in soleus, and from 10% to 20% (Δ=1.2 pps; p<0.001) but not 20% to 30% (Δ=0.09 pps; p=0.724) in gastrocnemius medialis. Maximal discharge rate increased for soleus and gastrocnemius medialis from 10% to 20% (respectively, Δ=1.75 pps, p<0.001; and Δ=2.43 pps, p<0.001) and 20% to 30% (respectively, Δ=0.80 pps, p<0.017; and Δ=0.92 pps, p=002). The repeated-measures correlation identified associations between ΔF and increases in maximal discharge rate for both soleus (r=0.64; p<0.001) and gastrocnemius medialis (r=0.77; p<0.001). An increase in voluntary drive tends to increase PIC strength, which has key implications for the control of force but also for comparisons between muscles or between studies when relative force levels might be different. These data indicate that increases in voluntary descending drive amplify PICs in humans and provide an important spinal mechanism for motor unit firing, and thus force output modulation.

Motor Unit Rotation in a Variety of Human Muscles

2009 ◽  
Vol 102 (4) ◽  
pp. 2265-2272 ◽  
Author(s):  
Parveen Bawa ◽  
Chantelle Murnaghan
Keyword(s):  
Motor Unit ◽  
Motor Units ◽  
Motor Command ◽  
Emg Activity ◽  
Persistent Inward Currents ◽  
Small Hand ◽  
Abductor Digiti Minimi ◽  
Inward Currents ◽  
Low Threshold ◽  
The Subject

The phenomena of substitution and rotation among motor units of a muscle were examined in seven different muscles. Intramuscular motor unit activity and surface electromyographic (EMG) activity were recorded from one of the following muscles: abductor digiti minimi, first dorsal interosseous, extensor digitorum communis, flexor and extensor carpi radialis, tibialis anterior, and soleus. The subject was asked to discharge a discernible unit at a comfortable constant or rhythmically (pseudosinusoidally) modulated rate with audio and visual feedback. Results are reported from a total of 42 sets of motor units from all seven muscles. We observed that when a subject fired a motor unit for a long period, an additional motor unit frequently started to discharge after a few minutes. When the subject was asked to keep activity down to one unit, very often it was Unit 1 that dropped and Unit 2 continued to fire. Whereas Unit 2 had fired for a few minutes, Unit 1 resumed firing without any conscious effort by the subject. If the subject was then asked to retain just one unit, it was Unit 2 that dropped. Rhythmic modulation of firing rate of a tonically firing unit showed that whereas the threshold of this unit increased, the threshold of a phasically discharging unit decreased substantially. The increase in threshold of a tonically discharging unit is suggested to arise from inactivation of Na+ and Ca2+ channels and the decrease in threshold of higher-threshold units is suggested to arise from an increase in persistent inward currents that may occur during prolonged contractions. Whether a unit stops or starts to fire is suggested to depend on a balance between the strength of the central motor command, persistent inward currents, and inactivation of voltage-gated channels. Such rotations among low-threshold motoneurons would ensure low-level sustained contractions to be viable not only in small hand muscles but also in larger limb muscles.

ESTIMATES OF PERSISTENT INWARD CURRENTS INCREASE WITH THE LEVEL OF VOLUNTARY DRIVE IN LOW-THRESHOLD MOTOR UNITS OF PLANTAR FLEXOR MUSCLES

2021 ◽  
Author(s):  
Lucas B R Orssatto ◽  
Karen Mackay ◽  
Anthony James Shield ◽  
Raphael Luiz Sakugawa ◽  
Anthony John Blazevich ◽  
...  
Keyword(s):  
Motor Unit ◽  
Repeated Measures ◽  
Discharge Rate ◽  
Motor Units ◽  
Plantar Flexors ◽  
Force Output ◽  
Persistent Inward Currents ◽  
Gastrocnemius Medialis ◽  
Inward Currents ◽  
Maximal Discharge

This study tested if estimates of persistent inward currents (PICs) in the plantar flexors would increase with the level of voluntary drive. High-density surface electromyograms were collected from soleus and gastrocnemius medialis of 21 participants during ramp-shaped isometric contractions to 10%, 20%, and 30% (torque rise and decline of 2%/s and 30-s duration) of each participant's maximal torque. Motor units identified in all the contraction intensities were included in the paired-motor unit analysis to calculate delta frequency (ΔF) and estimate the PICs. ΔF is the difference in discharge rate of the control unit at the time of recruitment and de-recruitment of the test unit. Increases in PICs were observed from 10% to 20% (Δ=0.6 pulse-per-second, pps; p<0.001) and 20% to 30% (Δ=0.5pps; p<0.001) in soleus, and from 10% to 20% (Δ=1.2pps; p<0.001) but not 20% to 30% (Δ=0.09pps; p=0.724) in gastrocnemius medialis. Maximal discharge rate increased for soleus and gastrocnemius medialis from 10% to 20% (respectively, Δ=1.75pps, p<0.001; and Δ=2.43pps, p<0.001) and 20% to 30% (respectively, Δ=0.80pps, p<0.017; and Δ=0.92pps, p=002). The repeated-measures correlation identified associations between ΔF and increases in maximal discharge rate for soleus (r=0.64; p<0.001) and gastrocnemius medialis (r=0.77; p<0.001). An increase in voluntary drive tends to increase PIC strength, which has key implications for the control of force but also for comparisons between muscles or studies when relative force levels are different. Increases in voluntary descending drive amplify PICs in humans and provide an important spinal mechanism for motor unit discharging, and thus force output modulation.

The NIH Stroke Scale Lacks Validity in Chronic Hemiparetic Stroke

2015 ◽  
Vol 96 (10) ◽  
pp. e35
Author(s):  
Heather Tanksley Peters ◽  
Susan White ◽  
Stephen Page
Keyword(s):  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke

scholarly journals Biomechanical parameters of the elbow stretch reflex in chronic hemiparetic stroke

2018 ◽  
Vol 237 (1) ◽  
pp. 121-135 ◽  
Author(s):  
Jacob G. McPherson ◽  
Arno H. A. Stienen ◽  
Brian D. Schmit ◽  
Julius P. A. Dewald
Keyword(s):  
Stretch Reflex ◽  
Biomechanical Parameters ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke
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