Somatosensory temporal discrimination analysis reveals impaired processing in amyotrophic lateral sclerosis.

INTRODUCTION/AIMS: While amyotrophic lateral sclerosis (ALS) is primarily characterized as a motor system disorder, there is a growing body of evidence indicating sensory involvement. This study aimed to examine the hypothesis that somatosensory processing is impaired in ALS. METHODS: Study participants were ALS patients followed at the Neuromuscular Outpatient Unit, as well as healthy volunteers, from March 2021 to July 2023. The Medical Research Council (MRC) sum score was calculated for nine muscle groups bilaterally. The clinical status of patients was evaluated with the ALS Functional Rating Scale-Revised (ALSFRS-R) and the Penn Upper Motor Neuron core. Somatosensory temporal discrimination thresholds (STDTs) were recorded on the medial and lateral parts of both hands. Somatosensory cortex excitability was investigated with the paired somatosensory evoked potentials (SEP) paradigm in a subgroup. RESULTS: Increased STD values were detected in ALS patients compared to controls in both medial (107.66 ± 35 ms vs. 82.7 ± 32.5 ms, p = .001) and lateral (106.5 ± 34.5 ms vs. 82.9 ± 31.3 ms, p = .002) hands. There were no significant differences in STDTs among ALS patients across four regions (medial and lateral parts of the right and left hands). Amplitude ratios obtained from the paired-pulse SEP paradigm were approximately 1 for all interstimulus intervals (ISIs). STDTs did not show any correlations with motor findings or scales. DISCUSSION: Somatosensory processing appears to be compromised among ALS patients. The lack of correlation between impaired STDT and motor findings implies that it is a purely sensory deficit in ALS.

Maintained volitional activation of the muscle alters the cortical processing of proprioceptive afference from the ankle joint.

Cortical proprioceptive processing of intermittent, passive movements can be assessed by extracting evoked and induced electroencephalographic (EEG) responses to somatosensory stimuli. Although the existent prior research on somatosensory stimulations, it remains unknown to what extent ongoing volitional muscle activation modulates the proprioceptive cortical processing of passive ankle-joint rotations. Twenty-five healthy volunteers (28.8 ± 7 yr, 14 males) underwent a total of 100 right ankle-joint passive rotations (4° dorsiflexions, 4 ± 0.25 s inter-stimulus interval, 30°/s peak angular velocity) evoked by a movement actuator during passive condition with relaxed ankle and active condition with a constant plantarflexion torque of 5 ± 2.5 Nm. Simultaneously, EEG, electromyographic (EMG) and kinematic signals were collected. Spatiotemporal features of evoked and induced EEG responses to the stimuli were extracted to estimate the modulation of the cortical proprioceptive processing between the active and passive conditions. Proprioceptive stimuli during the active condition elicited robustly ∼26 % larger evoked response and ∼38 % larger beta suppression amplitudes, but ∼42 % weaker beta rebound amplitude over the primary sensorimotor cortex than the passive condition, with no differences in terms of response latencies. These findings indicate that the active volitional motor task during naturalistic proprioceptive stimulation of the ankle joint enhances related cortical activation and reduces related cortical inhibition with respect to the passive condition. Possible factors explaining these results include mechanisms occurring at several levels of the proprioceptive processing from the peripheral muscle (i.e. mechanical, muscle spindle status, etc.) to the different central (i.e. spinal, sub-cortical and cortical) levels.

Spatial arrangement of the whiskers of harbor seals (Phoca vitulina) compared to whisker arrangements of house mice (Mus musculus) and brown rats (Rattus norvegicus).

Whiskers (vibrissae) are important tactile sensors for most mammals. We introduce a novel approach to quantitatively compare 3D geometry of whisker arrays across species with different whisker numbers and arrangements, focusing on harbor seals (Phoca vitulina), house mice (Mus musculus) and Norway rats (Rattus norvegicus). Whiskers of all three species decrease in arclength and increase in curvature from caudal to rostral. They emerge from the face with elevation angles that vary linearly with dorsoventral position, and with curvature orientations that vary diagonally as linear combinations of dorsoventral and rostrocaudal positions. In seals, this diagonal varies linearly with horizontal emergence angles, and is orthogonal to the diagonal for rats and mice. This work provides the first evidence for common elements of whisker arrangements across species in different mammalian orders. Placing the equation-based whisker array on a CAD model of a seal head enables future mechanical studies of whisker-based sensing, including wake-tracking.

Neural correlates of trait anxiety in sensory processing and distractor filtering.

Evidence suggests that trait anxiety relates to cognitive processing and behavior. However, the relationships between trait anxiety and sensory processing, goal-directed performance and sensorimotor function are unclear, particularly in a multimodal context. This study used electroencephalography to evaluate whether trait anxiety influenced visual and tactile event-related potentials (ERPs), as well as behavioral distractor cost, in a bimodal sensorimotor task. Twenty-nine healthy young adults completed the State-Trait Anxiety Inventory. Participants were directed to focus on either tactile or visual stimuli while disregarding the other modality, responding to target stimulus amplitude with a proportional grip. Previous research suggests that somatosensory N70 and visual P2 ERPs serve as markers of attentional relevance, with attention also impacting the visual P3 ERP. It was hypothesized that trait anxiety would modulate the ERPs susceptible to attentional modulation (tactile N70, visual P2 and P3) and not affect behavioral performance. Trait anxiety showed a large, significant interaction with attention for visual P3 latency in response to unimodal visual stimuli, with a positive relationship between P3 latencies and trait anxiety when attending toward the stimulus and negative when attending away. A large, positive main effect of trait anxiety on visual N1 amplitude for bimodal stimuli was also detected. As predicted, trait anxiety related to ERPs but not behavioral distractor cost. These findings suggest that trait anxiety modulates visual but not somatosensory processing correlates based on attention. The absence of overt behavioral performance effects suggests compensatory mechanisms may offset underlying differences in sensory processing.

Evaluation of somatosensory bedside testing and neurodynamics of the trigeminal nerve in craniofacial pain: A matched case-control study.

OBJECTIVE: The objective of this study was to investigate whether trigeminal somatosensory function and mechanosensitivity differ between groups with craniofacial neuropathic pain (CNP), non-neuropathic craniofacial pain (NNP), and healthy controls (HC). METHODS: Thirty-three participants were categorized into these groups, matched for age and sex. The study evaluated pain intensity, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and various trigeminal somatosensory tests, including vibration, pressure pain, thermal detection, cold pain, and neurodynamic tests of the trigeminal nerve. RESULTS: Cold pain thresholds differed significantly among the three groups CNP, NNP, and HC (p = .047). No difference was found in vibration detection, pressure pain threshold, and thermal detection. Trigeminal nerve mechanosensitivity was significantly different among the three groups (p = .03), particularly between groups CNP and HC (p = .01). CONCLUSION: Differences in aspects of trigeminal somatosensory function, including cold pain and trigeminal mechanosensitivity, exist between subjects with chronic craniofacial pain and HC. This implies that a clinical classification system for neuromusculoskeletal rehabilitation could be valuable in evaluating patients.

Tactile stimulation designs adapted to clinical settings result in reliable fMRI-based somatosensory digit maps.

Movement constraints in stroke survivors are often accompanied by additional impairments in related somatosensory perception. A complex interplay between the primary somatosensory and motor cortices is essential for adequate and precise movements. This necessitates investigating the role of the primary somatosensory cortex in movement deficits of stroke survivors. The first step towards this goal could be a fast and reliable functional Magnetic Resonance Imaging (fMRI)-based mapping of the somatosensory cortex applicable for clinical settings. Here, we compare two 3 T fMRI-based somatosensory digit mapping techniques adapted for clinical usage in seven neurotypical volunteers and two sessions, to assess their validity and retest-reliability. Both, the traveling wave and the blocked design approach resulted in complete digit maps in both sessions of all participants, showing the expected layout. Similarly, no evidence for differences in the volume of activation, nor the activation overlap between neighboring activations could be detected, indicating the general feasibility of the clinical adaptation and their validity. Retest-reliability, indicated by the Dice coefficient, exhibited reasonable values for the spatial correspondence of single digit activations across sessions, but low values for the spatial correspondence of the area of overlap between neighboring digits across sessions. Parameters describing the location of the single digit activations exhibited very high correlations across sessions, while activation volume and overlap only exhibited medium to low correlations. The feasibility and high retest-reliabilities for the parameters describing the location of the single digit activations are promising concerning the implementation into a clinical context to supplement diagnosis and treatment stratification in upper limb stroke patients.

Assembling a physical model helps students grasp human somatosensory pathways.

Mastering the complexity of the nervous system is essential for education programs in physiology, anatomy, and neuroscience. Students often struggle when learning somatosensory pathways, which convey information from sensory neurons to the somatosensory cortex in the brain. Active learning activities incorporating physical models have been shown to increase content comprehension as well as enjoyment of the learning process. Here, we present a three-dimensional physical model of somatosensory pathways constructed of durable, affordable, and widely available materials. In an upper level human physiology lab, students assembled the model and then used it to complete case study questions connecting damage to the spinal cord to resulting sensory deficits. This model-based activity was highly effective as indicated by significant increases in content knowledge and positive responses to survey questions on the effectiveness of the activity. This activity incorporates many evidence-based teaching practices that have been shown to increase engagement, inclusion, and mastery of content and provides an effective and fun way for students to learn a challenging topic.NEW & NOTEWORTHY This model-building activity for learning somatosensory neural pathways increases students' content knowledge and is an enjoyable way to learn a complex system. This activity adds to an ever-growing collection of evidence-based learning activities for human physiology courses.

The role of the Somatosensory system in the feeling of emotions: a neurostimulation study.

Emotional experiences deeply impact our bodily states, such as when we feel 'anger', our fists close and our face burns. Recent studies have shown that emotions can be mapped onto specific body areas, suggesting a possible role of the primary somatosensory system (S1) in emotion processing. To date, however, the causal role of S1 in emotion generation remains unclear. To address this question, we applied transcranial alternating current stimulation (tACS) on the S1 at different frequencies (beta, theta and sham) while participants saw emotional stimuli with different degrees of pleasantness and level of arousal. Results showed that modulation of S1 influenced subjective emotional ratings as a function of the frequency applied. While theta and beta-tACS made participants rate the emotional images as more pleasant (higher valence), only theta-tACS lowered the subjective arousal ratings (more calming). Skin conductance responses recorded throughout the experiment confirmed a different arousal for pleasant vs unpleasant stimuli. Our study revealed that S1 has a causal role in the feeling of emotions, adding new insight into the embodied nature of emotions. Importantly, we provided causal evidence that beta and theta frequencies contribute differently to the modulation of two dimensions of emotions - arousal and valence - corroborating the view of a dissociation between these two dimensions of emotions.

Cell-Type-Specific Expression of Leptin Receptors in the Mouse Forebrain.

Leptin is a hormone produced by the small intestines and adipose tissue that promotes feelings of satiety. Leptin receptors (LepRs) are highly expressed in the hypothalamus, enabling central neural control of hunger. Interestingly, LepRs are also expressed in several other regions of the body and brain, notably in the cerebral cortex and hippocampus. These brain regions mediate higher-order sensory, motor, cognitive, and memory functions, which can be profoundly altered during periods of hunger and satiety. However, LepR expression in these regions has not been fully characterized on a cell-type-specific basis, which is necessary to begin assessing their potential functional impact. Consequently, we examined LepR expression on neurons and glia in the forebrain using a LepR-Cre transgenic mouse model. LepR-positive cells were identified using a 'floxed' viral cell-filling approach and co-labeling immunohistochemically for cell-type-specific markers, i.e., NeuN, VGlut2, GAD67, parvalbumin, somatostatin, 5-HT3R, WFA, S100ß, and GFAP. In the cortex, LepR-positive cells were localized to lower layers (primarily layer 6) and exhibited non-pyramidal cellular morphologies. The majority of cortical LepR-positive cells were neurons, while the remainder were identified primarily as astrocytes or other glial cells. The majority of cortical LepR-positive neurons co-expressed parvalbumin, while none expressed somatostatin or 5-HT3R. In contrast, all hippocampal LepR-positive cells were neuronal, with none co-expressing GFAP. These data suggest that leptin can potentially influence neural processing in forebrain regions associated with sensation and limbic-related functions.

Artificial embodiment displaces cortical neuromagnetic somatosensory responses.

Integrating artificial limbs as part of one's body involves complex neuroplastic changes resulting from various sensory inputs. While somatosensory feedback is crucial, plastic processes that enable embodiment remain unknown. We investigated this using somatosensory evoked fields (SEFs) in the primary somatosensory cortex (S1) following the Rubber Hand Illusion (RHI), known to quickly induce artificial limb embodiment. During electrical stimulation of the little finger and thumb, 19 adults underwent neuromagnetic recordings before and after the RHI. We found early SEF displacement, including an illusion-brain correlation between extent of embodiment and specific changes to the first cortical response at 20 ms in Area 3b, within S1. Furthermore, we observed a posteriorly directed displacement at 35 ms towards Area 1, known to be important for visual integration during touch perception. That this second displacement was unrelated to extent of embodiment implies a functional distinction between neuroplastic changes of these components and areas. The earlier shift in Area 3b may shape extent of limb ownership, while subsequent displacement into Area 1 may relate to early visual-tactile integration that initiates embodiment. Here we provide evidence for multiple neuroplastic processes in S1-lasting beyond the illusion-supporting integration of artificial limbs like prostheses within the body representation.

Time varying characteristic in somatosensory evoked potentials as a biomarker of spinal cord ischemic-reperfusion injury in rat.

Spinal cord ischemic-reperfusion injury (SCIRI) could occurs during surgical procedures without detection, presenting a complex course and an unfavorable prognosis. This may lead to postoperative sensory or motor dysfunction in areas innervated by the spinal cord, and in some cases, permanent paralysis. Timely detection of SCIRI and immediate waring can help surgeons implement remedial intervention to prevent irreversible spinal cord injury. Therefore, it is crucial to develop a precise and effective method for early detection of SCIRI. This study utilized rat models to simulate intraoperative SCIRI and employed somatosensory evoked potentials (SEP) for continuous monitoring during surgery. In this study, SEP signal changes were examined in six groups with varying severities of SCIRI and one normal control group. SEP signal changes were examined during operations in different groups and correlated with postoperative behavioral and histopathological data. The result demonstrated specific changes in SEP signals during SCIRI, termed as time-varying characteristics, which are associated with the duration of ischemia and subsequent reperfusion. Time-varying characteristics in SEP could potentially serve as a new biomarker for the intraoperative detection of SCIRI. This finding is significant for clinical surgeons to identify and guide early intervention of SCIRI timely. Additionally, this measurement is easily translatable to clinical application.

Somatosensory profile in individuals with duchenne muscular dystrophy: A quantitative sensory testing (QST) study.

OBJECTIVE: This study aimed to quantify somatosensory profiles in individuals with Duchenne muscular dystrophy (DMD). METHODS: We included 28 participants with genetically confirmed DMD (aged 8-17 years), 14 with chronic pain (DMD-CP), and 14 without pain (DMD-NP), compared to 13 healthy controls (HC) matched for age and sex. Three quantitative sensory testing (QST) modalities were examined: pressure pain threshold (PPT), temporal summation of pain (TSP) and conditioned pain modulation (CPM). Characteristics related to chronic pain, fatigue, psychological distress, and health-related quality of life were assessed using questionnaires. RESULTS: Decreased PPTs were found in both DMD cohorts across body areas commonly affected by pain (rectus femoris, medial gastrocnemius, paraspinal muscles, upper trapezius), as well as in a less frequently affected remote area (thenar eminence), compared to HCs (p < 0.001). The DMD-CP group exhibited greater TSP compared to HCs (p = 0.025). There were no differences in CPM effects between DMD groups and HCs. No differences were detected in all QST measures between DMD-CP and DMD-NP. SIGNIFICANCE: This study is the first to explore the somatosensory profile in DMD. Preliminary evidence suggests that generalized hyperalgesia may be a common feature in DMD regardless of pain status. QST measures appear to not distinguish individuals with chronic pain from those without and thus are not recommended for assessing pain in DMD or guiding treatment.

Myoclonus After Cardiac Arrest did not Correlate with Cortical Response on Somatosensory Evoked Potentials.

PURPOSE: Myoclonus after anoxic brain injury is a marker of significant cerebral injury. Absent cortical signal (N20) on somatosensory evoked potentials (SSEPs) after cardiac arrest is a reliable predictor of poor neurological recovery when combined with an overall clinical picture consistent with severe widespread neurological injury. We evaluated a clinical question of if SSEP result could be predicted from other clinical and neurodiagnostic testing results in patients with post-anoxic myoclonus. METHODS: Retrospective chart review of all adult patients with post-cardiac arrest myoclonus who underwent both electroencephalographic (EEG) monitoring and SSEPs for neuroprognostication. Myoclonus was categorized as "non-myoclonic movements," "myoclonus not captured on EEG," "myoclonus without EEG correlate," "myoclonus with EEG correlate," and "status myoclonus." SSEP results were categorized as all absent, all present, N18 and N20 absent bilaterally, and N20 only absent bilaterally. Cox proportional hazards with censoring was used to evaluate the association of myoclonus category, SSEP results, and confounding factors with survival. RESULTS: In 56 patients, median time from arrest to either confirmed death or last follow up was 9 days. The category of myoclonus was not associated with SSEP result or length of survival. Absence of N20 s or N18 s was associated with shorter survival (N20 hazard ratio [HR] 4.4, p = 0.0014; N18 HR 5.5, p < 0.00001). CONCLUSIONS: Category of myoclonus did not reliably predict SSEP result. SSEP result was correlated with outcome consistently, but goals of care transitioned to comfort measures only in all patients with present peripheral potentials and either absent N20 s only or absence of N18 s and N20 s. Our results suggest that SSEPs may retain prognostic value in patients with post-anoxic myoclonus.

Molecular Mechanisms Underlying the Generation of Absence Seizures: Identification of Potential Targets for Therapeutic Intervention.

Understanding the molecular mechanisms underlying the generation of absence seizures is crucial for developing effective, patient-specific treatments for childhood absence epilepsy (CAE). Currently, one-third of patients remain refractive to the antiseizure medications (ASMs), previously called antiepileptic drugs (AEDs), available to treat CAE. Additionally, these ASMs often produce serious side effects and can even exacerbate symptoms in some patients. Determining the precise cellular and molecular mechanisms directly responsible for causing this type of epilepsy has proven challenging as they appear to be complex and multifactorial in patients with different genetic backgrounds. Aberrant neuronal activity in CAE may be caused by several mechanisms that are not fully understood. Thus, dissecting the causal factors that could be targeted in the development of precision medicines without side effects remains a high priority and the ultimate goal in this field of epilepsy research. The aim of this review is to highlight our current understanding of potential causative mechanisms for absence seizure generation, based on the latest research using cutting-edge technologies. This information will be important for identifying potential targets for future therapeutic intervention.

Brain Encoding of Naturalistic, Continuous, and Unpredictable Tactile Events.

Studies employing EEG to measure somatosensory responses have been typically optimized to compute event-related potentials in response to discrete events. However, tactile interactions involve continuous processing of nonstationary inputs that change in location, duration, and intensity. To fill this gap, this study aims to demonstrate the possibility of measuring the neural tracking of continuous and unpredictable tactile information. Twenty-seven young adults (females, 15) were continuously and passively stimulated with a random series of gentle brushes on single fingers of each hand, which were covered from view. Thus, tactile stimulations were unique for each participant and stimulated fingers. An encoding model measured the degree of synchronization between brain activity and continuous tactile input, generating a temporal response function (TRF). Brain topographies associated with the encoding of each finger stimulation showed a contralateral response at central sensors starting at 50 ms and peaking at ∼140 ms of lag, followed by a bilateral response at ∼240 ms. A series of analyses highlighted that reliable tactile TRF emerged after just 3 min of stimulation. Strikingly, topographical patterns of the TRF allowed discriminating digit lateralization across hands and digit representation within each hand. Our results demonstrated for the first time the possibility of using EEG to measure the neural tracking of a naturalistic, continuous, and unpredictable stimulation in the somatosensory domain. Crucially, this approach allows the study of brain activity following individualized, idiosyncratic tactile events to the fingers.

Decoding motor imagery loaded on steady-state somatosensory evoked potential based on complex task-related component analysis.

BACKGROUND AND OBJECTIVE: Motor Imagery (MI) recognition is one of the most critical decoding problems in brain- computer interface field. Combined with the steady-state somatosensory evoked potential (MI-SSSEP), this new paradigm can achieve higher recognition accuracy than the traditional MI paradigm. Typical algorithms do not fully consider the characteristics of MI-SSSEP signals. Developing an algorithm that fully captures the paradigm's characteristics to reduce false triggering rate is the new step in improving performance. METHODS: The idea to use complex signal task-related component analysis (cTRCA) algorithm for spatial filtering processing has been proposed in this paper according to the features of SSSEP signal. In this research, it's proved from the analysis of simulation signals that task-related component analysis (TRCA) as typical method is affected when the response between stimuli has reduced correlation and the proposed algorithm can effectively overcome this problem. The experimental data under the MI-SSSEP paradigm have been used to identify right-handed target tasks and three unique interference tasks are used to test the false triggering rate. cTRCA demonstrates superior performance as confirmed by the Wilcoxon signed-rank test. RESULTS: The recognition algorithm of cTRCA combined with mutual information-based best individual feature (MIBIF) and minimum distance to mean (MDM) can obtain AUC value up to 0.89, which is much higher than traditional algorithm common spatial pattern (CSP) combined with support vector machine (SVM) (the average AUC value is 0.77, p < 0.05). Compared to CSP+SVM, this algorithm model reduced the false triggering rate from 38.69 % to 20.74 % (p < 0.001). CONCLUSIONS: The research prove that TRCA is influenced by MI-SSSEP signals. The results further prove that the motor imagery task in the new paradigm MI-SSSEP causes the phase change in evoked potential. and the cTRCA algorithm based on such phase change is more suitable for this hybrid paradigm and more conducive to decoding the motor imagery task and reducing false triggering rate.

Restoring transient connectivity during development improves dysfunctions in fragile X mice.

Early-generated circuits are critical for the maturation of cortical network activity and the formation of excitation/inhibition (E/I) balance. This process involves the maturation of specific populations of inhibitory neurons. While parvalbumin (PV)-expressing neurons have been associated with E/I impairments observed in neurodevelopmental disorders, somatostatin-expressing (SST) neurons have recently been shown to regulate PV neuron maturation by controlling neural dynamics in the developing cortex. SST neurons receive transient connections from the sensory thalamus, yet the implications of transient connectivity in neurodevelopmental disorders remain unknown. Here, we show that thalamocortical connectivity to SST neurons is persistent rather than transient in a mouse model of Fragile X syndrome. We were able to restore the transient dynamics using chemogenetics, which led to the recovery of fragile X-associated dysfunctions in circuit maturation and sensory-dependent behavior. Overall, our findings unveil the role of early transient dynamics in controlling downstream maturation of sensory functions.

Qualitative somatosensory evaluation of recipient and donor sites of subepithelial connective tissue grafts: a preliminary study.

OBJECTIVES: The subepithelial connective tissue graft (SCTG) plus coronal advanced flap is commonly evaluated by clinical parameters, but potential sensory changes (patients' perception of painful or painless sensations) need to be further explored. This preliminary study aimed to qualitatively evaluate the somatosensory profile of recipient and palatal donor sites of SCTG. MATERIALS AND METHODS: Sensory tests were applied at SCTG recipient and donor sites at baseline, after 3 and 6 months. A single calibrated examiner applied Douleur Neuropathique 4 questionnaire (DN4), qualitative sensory test (QualST), discriminating the areas as hypersensitive, hyposensitive or normosensitive, and two-point acuity test. Descriptive statistics, non-parametric Kruskal Wallis test for QualST evaluation and ANOVA for Two-point test (p < 0.05) were used. RESULTS: QualST revealed that recipient areas presented no significant differences in tactile, pressure and thermal tests. Brush test revealed hyposensitivity after 3 months (p = 0.03). In donor areas, only thermal evaluation showed a significant difference (p = 0.01), being hypersensitive after 3 months and hyposensitive after 6 months. At baseline, all evaluations in recipient and donor areas were normosensitive. According to DN4, no patient reported pain in recipient and donor sites. Non-painful sensory perception was reported as numbness in recipient (3.14% of patients) and donor (18.4%) areas. No significant differences were found for two-point acuity test values. CONCLUSIONS: Somatosensory variations were observed in donor and recipient areas using qualitative tests, with no detection of painful sensations, only non-painful sensations of numbness and electric shock. CLINICAL RELEVANCE: This preliminary study demonstrated that alterations of hypo- and hypersensitivity may occur in donor and recipient areas of gingival grafts. However, when present, these alterations were non-painful and did not impact oral functions. CLINICAL REGISTRATION: ReBEC #RBR-7zz3b6p.

Altered muscle fibre activation in an antagonistic muscle pair due to perturbed afferent feedback caused by blood flow restriction.

PURPOSE: This study aimed to better understand the coping strategy of the neuromuscular system under perturbed afferent feedback. To this end, the neuromechanical effects of transient blood flow restriction (BFR) compared to atmospheric pressure were investigated in an antagonistic muscle pair. METHODS: Perceived discomfort and neuromechanical parameters (torque and high-density electromyography) were recorded during submaximal isometric ankle dorsiflexion before, during and after BFR. The tibialis anterior and gastrocnemius lateralis muscles were studied in 14 healthy young adults. RESULTS: Discomfort increased during BFR and decreased to baseline level afterwards. The exerted torque and the co-activation index remained constant, whereas the EMG signal energy increased significantly during BFR. Coherence analysis of the delta band remained constant, whereas the alpha band shows an increase during BFR. Median frequency and muscle fibre conduction velocity showed a positive trend during the first minutes of BFR before significantly decreasing. Both parameters exceeded baseline values after cuff deflation. CONCLUSION: Perturbed afferent feedback leads to altered neuromechanical parameters. We assume that increased central drive is required to maintain force output, resulting in changed muscle fibre activity. Glycolytic fast-switch fibres are only active for a short time due to oxygen deprivation and hyperacidity, but fatigue effects predominate in the long term.

Reduction of the acquisition time needed to obtain somatosensory evoked potentials by estimation of the required averaging sweep count by an algorithm.

Somatosensory evoked potentials are frequently acquired by stimulation of the median or tibial nerves (mSEPs and tSEPs) for intraoperative monitoring of sensory pathways. Due to their low amplitudes it is common practice to average 200 or more sweeps to discern the evoked potentials from the background EEG. The aim of this study was to investigate if an algorithm designed to determine the lowest sweep count needed to obtain reproducible evoked potentials in each patient significantly reduces the median necessary sweep count to under 200. 30 patients undergoing spinal surgery at the Department of Neurosurgery were included in the study. Beginning with a sweep count of 200 an algorithm was designed to determine the lowest sweep count that yielded reproducible evoked potentials in each patient. By this algorithm the minimal sweep count was determined in 15 patients for mSEPs and in 15 patients for tSEPs. The required sweep count was below 200 in 14 of 15 patients for mSEPs (93.3%) with a mean sweep count of 56 ± 51. For tSEPs the sweep count was below 200 in 11 of 15 patients (73.3%) with a mean sweep count of 106 ± 70 (mean ± SD). The calculated mean time to average the potentials could thereby be reduced from 48.8s to 13.7s for mSEPs and from 48.8s to 25.9s for tSEPs. The proposed algorithm allowed sweep count and acquisition time reduction in roughly 90% of all patients for mSEPs and in 70% of all patients for tSEPs.