scholarly journals Perimenopausal women show modulation of excitatory and inhibitory neuromuscular mechanisms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Pesonen ◽  
Eija K. Laakkonen ◽  
Pekka Hautasaari ◽  
Pauliina Aukee ◽  
Vuokko Kovanen ◽  
...  
Keyword(s):  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Neuromuscular Control ◽  
Lower Limbs ◽  
Cortical Inhibition ◽  
Muscle Quality ◽  
Twitch Force ◽  
Peripheral Muscle ◽  
Increased Risk

Abstract Background Menopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are crucial, as they expose individuals to increased risk of falls. To elucidate some of the related neuromuscular mechanisms, we investigated cortical inhibition and peripheral muscle twitch force potentiation in women during the early and late stages of perimenopause. Methods Participants were 63 women aged 48–55 years categorized as early (EP, n = 25) or late (LP, n = 38) perimenopausal according to serum follicle-stimulating hormone (FSH) levels and menstrual diaries. EP women had an irregular menstrual cycle and FSH < 25 IU/L, while LP women had an irregular cycle and > 25 IU/L. We examined motor evoked potential (MEP) and silent period (SP) elicited by transcranial magnetic stimulation (TMS), in the tibialis anterior muscle at 20%, 40%, and 60% of maximal voluntary contraction (MVC) levels, and twitch force potentiation in plantar flexors. Results EP group showed a longer SP duration in 40% MVC condition and larger motor evoked potential amplitude in 20% MVC condition compared to the LP group. No group difference was detected in twitch force potentiation; however, it correlated negatively with FSH levels. Other factors, such as age, height, body mass index, or physical activity did not explain group differences. Conclusions Our preliminary results indicate subtle modulation in both TMS-induced inhibitory and excitatory mechanisms and twitch force potentiation in women already in the late perimenopausal stage. This suggests that the reduction of estrogens may have an accelerating role in the aging process of neuromuscular control.

A new concept in the electrophysiological evaluation of syringomyelia

2008 ◽  
Vol 8 (6) ◽  
pp. 517-523 ◽  
Author(s):  
Florian Roser ◽  
Florian H. Ebner ◽  
Marina Liebsch ◽  
Klaus Dietz ◽  
Marcos Tatagiba
Keyword(s):  
Evoked Potential ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Preoperative Assessment ◽  
Central Canal ◽  
Spinothalamic Tract ◽  
Specific Symptom ◽  
Electrophysiological Measurements

Object The current neurophysiological assessment of syringomyelia is inadequate. Early-stage syringomyelia is anatomically predisposed to affect decussating spinothalamic fibers that convey pain and sensation primarily. Silent periods have been proven to be a sensitive tool for detecting alterations in this pathway. Methods Thirty-seven patients with syringomyelia were included in this prospective study. Routine electrophysiological measurements were applied including somatosensory evoked potential (SSEP) and motor evoked potential (MEP) recordings for all extremities. The silent periods were recorded from the pollicis brevis muscle, and electrical stimuli were applied to the ipsilateral digiti II. To establish baseline values, the authors had 28 healthy controls undergo monitoring. Sensitivity and specificity values were statistically evaluated according to the main clinical symptoms (paresis, dissociative syndrome, and pain). Results All control individuals had normal silent periods in voluntarily activated muscle. In syringomyelia patients, the affected limb showed pathological silent periods with all symptoms (sensitivity 30–50%). Pain was the most specific symptom (90%), despite SSEP and MEP values that were within the normal range. Conclusions Silent period testing is a sensitive neurophysiological technique and an invaluable tool for preoperative assessment of syringomyelia. Silent periods are associated with early dysfunction of thin myelinated spinothalamic tract fibers, even when routine electrophysiological measurements still reveal normal values. Conduction abnormalities that selectively abolish the silent periods can distinguish between hydromyelia (a physiologically dilated central canal) and space-occupying syringomyelia.

scholarly journals Effects of desflurane and sevoflurane on somatosensory-evoked and motor-evoked potential monitoring during neurosurgery: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bingbing Xiang ◽  
Shulan Jiao ◽  
Yulong Zhang ◽  
Lu Wang ◽  
Yuting Yao ◽  
...  
Keyword(s):  
Evoked Potential ◽  
Controlled Trial ◽  
Motor Evoked Potential ◽  
Inhibitory Effect ◽  
Lower Limbs ◽  
Neurophysiological Monitoring ◽  
Dependent Manner ◽  
Clinical Trial Registry ◽  
Sevoflurane Group ◽  
Link Type

Abstract Background Better protection can be provided during neurosurgery due to the establishment of somatosensory-evoked potential (SEP) and motor-evoked potential (MEP) monitoring technologies. However, some studies have showed that inhaled halogenated anesthetics have a significant impact on neurophysiological monitoring. Methods A total of 40 consecutive patients undergoing neurosurgery were randomly assigned to two groups receiving inhaled anesthetics, either desflurane or sevoflurane. Multiples levels (concentrations of 0.3, 0.6 and 0.9) of anesthetics were administered at minimum alveolar concentration (MAC), and then the latencies and amplitudes of SEPs and MEPs were recorded. Results SEP and MEP signals were well preserved in patients who underwent neurosurgery under general anesthesia supplemented with desflurane or sevoflurane at concentrations of 0.3, 0.6 and 0.9 MAC. In each desflurane or sevoflurane group, the amplitudes of SEPs and MEPs decreased and the latencies of SEPs were prolonged significantly as the MAC increased (P < 0.05). The SEP latencies of both the upper and lower limbs in the desflurane group were significantly longer, and the SEP amplitudes were significantly lower than those in the sevoflurane group (P < 0.05). The MEP amplitudes in the desflurane group were significantly lower than those in the sevoflurane group (P < 0.05), only the amplitudes of the upper limbs at 0.3 MAC did not vary significantly. Conclusions SEPs and MEPs were inhibited in a dose-dependent manner by both desflurane and sevoflurane. At the same MAC concentration, desflurane appeared to have a stronger inhibitory effect than sevoflurane. All patients studied had normal neurological examination findings, hence, these results may not be applicable to patients with preexisting deficits. Trial registration The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR2100045504 (18/04/2021).

Supraspinal fatigue during intermittent maximal voluntary contractions of the human elbow flexors

2000 ◽  
Vol 89 (1) ◽  
pp. 305-313 ◽  
Author(s):  
Janet L. Taylor ◽  
Gabrielle M. Allen ◽  
Jane E. Butler ◽  
S. C. Gandevia
Keyword(s):  
Evoked Potential ◽  
Intermittent Exercise ◽  
Human Subjects ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Central Fatigue ◽  
Duty Cycles ◽  
Flexor Muscles ◽  
Elbow Flexor Muscles ◽  
Voluntary Contractions

Responses to transcranial magnetic stimulation in human subjects ( n = 9) were studied during series of intermittent isometric maximal voluntary contractions (MVCs) of the elbow. Stimuli were given during MVCs in four fatigue protocols with different duty cycles. As maximal voluntary torque fell during each protocol, the torque increment evoked by cortical stimulation increased from ∼1.5 to 7% of ongoing torque. Thus “supraspinal” fatigue developed in each protocol. The motor evoked potential (MEP) and silent period in the elbow flexor muscles also changed. The silent period lengthened by 20–75 ms (lowest to highest duty cycle protocol) and recovered significantly with a 5-s rest. The MEP increased in area by >50% in all protocols and recovered significantly with 10 s, but not 5 s, of rest. These changes are similar to those during sustained MVC. The central fatigue demonstrated by the torque increments evoked by the stimuli did not parallel the changes in the electromyogram responses. This suggests that part of the fatigue developed during intermittent exercise is “upstream” of the motor cortex.

scholarly journals Disparate kinetics of change in responses to electrical stimulation at the thoracic and lumbar level during fatiguing isometric knee extension

2020 ◽  
Vol 128 (1) ◽  
pp. 159-167 ◽  
Author(s):  
Callum G. Brownstein ◽  
Robin Souron ◽  
Nicolas Royer ◽  
Benjamin Singh ◽  
Thomas Lapole ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Evoked Potential ◽  
Isometric Exercise ◽  
Silent Period ◽  
Knee Extension ◽  
Lower Limbs ◽  
Evoked Responses ◽  
Time Points ◽  
Isometric Knee Extension ◽  
Kinetics Of

The present study compared the fatigue-induced change of matched-amplitude thoracic evoked potential (TMEP) and lumbar evoked potential (LEP) following electrical stimulation. Ten participants performed a 3 × 3 min isometric knee extension contraction separated by 4 min of recovery at the level of EMG required to produce 50% maximal voluntary contraction (MVC) force at baseline. The TMEP and LEP were evoked during the ongoing contraction at baseline and every minute into the fatiguing protocol and during recovery. Both responses were also assessed during a transcranial magnetic stimulation (TMS) evoked silent period to elicit a TMS-TMEP and TMS-LEP to assess responses without the confounding influence of descending drive. The results displayed disparate kinetics of the TMS-TMEP and TMS-LEP throughout the fatiguing protocol. The TMS-TMEP was reduced at all time points during exercise ( P < 0.001), whereas the TMS-LEP was reduced at 2 min into set 1 and 1 min into sets 2 and 3 ( P ≤ 0.04). TMS-LEPs were higher than the TMS-TMEPs at most time points ( P ≤ 0.04). No change was observed in the TMEP or LEP. When evoked during the silent period, the reduction in TMEP is greater than the LEP during fatiguing isometric exercise. The disparate kinetics of change suggest that differential mechanisms are responsible for evoked responses to thoracic and lumbar stimulation. More research is required to identify the mechanisms responsible for the TMEP and LEP before precise inferences can be made on what fatigue-induced changes in these variables reflect. NEW & NOTEWORTHY Assessing spinal excitability using lumbar stimulation when measuring responses in lower limbs has been suggested as an alternative method that could circumvent the issues associated with thoracic stimulation. The present study compared responses to the two types of stimuli throughout a fatiguing protocol and demonstrated that lumbar evoked responses differ substantially from thoracic responses when measured in the absence of voluntary drive. These findings suggest that different mechanisms are responsible for evoked responses to thoracic and lumbar stimuli.

The effect of acetaminophen ingestion on cortico-spinal excitability

2013 ◽  
Vol 91 (2) ◽  
pp. 187-189 ◽  
Author(s):  
Alexis R. Mauger ◽  
James G. Hopker
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Sodium Currents ◽  
Cortical Silent Period ◽  
Voltage Gated ◽  
Spinal Excitability

Acetaminophen (ACT) facilitates the inhibition of voltage-gated calcium and sodium currents, which may effect cortico-spinal excitability. Twelve subjects ingested acetaminophen or a placebo and underwent transcranial magnetic stimulation to assess the motor evoked potential (MEP), and cortical silent period (CSP). ACT significantly increased MEP response (P > 0.05) but had no effect on CSP (P > 0.05). This indicates that ACT increases MEP and should be controlled for in studies where these measures are of interest.

Direct corticospinal pathways contribute to neuromuscular control of perturbed stance

2006 ◽  
Vol 101 (2) ◽  
pp. 420-429 ◽  
Author(s):  
Wolfgang Taube ◽  
Martin Schubert ◽  
Markus Gruber ◽  
Sandra Beck ◽  
Michael Faist ◽  
...  
Keyword(s):  
Magnetic Stimulation ◽  
Evoked Potential ◽  
Cortical Excitability ◽  
Motor Evoked Potential ◽  
Neuromuscular Control ◽  
H Reflex ◽  
Compensatory Response ◽  
Long Latency Responses ◽  
Long Latency ◽  
Posterior Translation

The antigravity soleus muscle (Sol) is crucial for compensation of stance perturbation. A corticospinal contribution to the compensatory response of the Sol is under debate. The present study assessed spinal, corticospinal, and cortical excitability at the peaks of short- (SLR), medium- (MLR), and long-latency responses (LLR) after posterior translation of the feet. Transcranial magnetic stimulation (TMS) and peripheral nerve stimulation were individually adjusted so that the peaks of either motor evoked potential (MEP) or H reflex coincided with peaks of SLR, MLR, and LLR, respectively. The influence of specific, presumably direct, corticospinal pathways was investigated by H-reflex conditioning. When TMS was triggered so that the MEP arrived in the Sol at the same time as the peaks of SLR and MLR, EMG remained unaffected. Enhanced EMG was observed when the MEP coincided with the LLR peak ( P < 0.001). Similarly, conditioning of the H reflex by subthreshold TMS facilitated H reflexes only at LLR ( P < 0.001). The earliest facilitation after perturbation occurred after 86 ms. The TMS-induced H-reflex facilitation at LLR suggests that increased cortical excitability contributes to the augmentation of the LLR peaks. This provides evidence that the LLR in the Sol muscle is at least partly transcortical, involving direct corticospinal pathways. Additionally, these results demonstrate that ∼86 ms after perturbation, postural compensatory responses are cortically mediated.

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