Local vibration induces changes in spinal and corticospinal excitability in vibrated and antagonist muscles.

Local vibration (LV) applied over the muscle tendon constitutes a powerful stimulus to activate the muscle spindle primary (Ia) afferents that project to the spinal level and are conveyed to the cortical level. This study aimed to identify the neuromuscular changes induced by a 30-min LV-inducing illusions of hand extension on the vibrated flexor carpi radialis (FCR) and the antagonist extensor carpi radialis (ECR) muscles. We studied the change of the maximal voluntary isometric contraction (MVIC, experiment 1) for carpal flexion and extension, motor-evoked potentials (MEPs, experiment 2), cervicomedullary motor-evoked potentials (CMEPs, experiment 2), and Hoffmann's reflex (H-reflex, experiment 3) for both muscles at rest. Measurements were performed before (PRE) and at 0, 30, and 60 min after LV protocol. A lasting decrease in strength was only observed for the vibrated muscle. The reduction in CMEPs observed for both muscles seems to support a decrease in alpha motoneurons excitability. In contrast, a slight decrease in MEPs responses was observed only for the vibrated muscle. The MEP/CMEP ratio increase suggested greater cortical excitability after LV for both muscles. In addition, the H-reflex largely decreased for the vibrated and the antagonist muscles. The decrease in the H/CMEP ratio for the vibrated muscle supported both pre- and postsynaptic causes of the decrease in the H-reflex. Finally, LV-inducing illusions of movement reduced alpha motoneurons excitability for both muscles with a concomitant increase in cortical excitability.NEW & NOTEWORTHY Spinal disturbances confound the interpretation of excitability changes in motor areas and compromise the conclusions reached by previous studies using only a corticospinal marker for both vibrated and antagonist muscles. The time course recovery suggests that the H-reflex perturbations for the vibrated muscle do not only depend on changes in alpha motoneurons excitability. Local vibration induces neuromuscular changes in both vibrated and antagonist muscles at the spinal and cortical levels.

Do soleus responses to transcutaneous spinal cord stimulation show similar changes to H-reflex in response to Achilles tendon vibration?

INTRODUCTION/PURPOSE: Recently, the use of transcutaneous spinal cord stimulation (TSCS) has been proposed as a viable alternative to the H-reflex. The aim of the current study was to investigate to what extent the two modes of spinal cord excitability investigation would be similarly sensitive to the well-known vibration-induced depression. METHODS: Fourteen healthy participants (8 men and 6 women; age: 26.7 ± 4.8 years) were engaged in the study. The right soleus H-reflex and TSCS responses were recorded at baseline (PRE), during right Achilles tendon vibration (VIB) and following 20 min of vibration exposure (POST-VIB). Care was taken to match H-reflex and TSCS responses amplitude at PRE and to maintain effective stimulus intensities constant throughout time points. RESULTS: The statistical analysis showed a significant effect of time for the H-reflex, with VIB (13 ± 5% of maximal M-wave (Mmax) and POST-VIB (36 ± 4% of Mmax) values being lower than PRE-values (48 ± 6% of Mmax). Similarly, TSCS responses changed over time, VIB (9 ± 5% of Mmax) and POST-VIB (27 ± 5% of Mmax) values being lower than PRE-values (46 ± 6% of Mmax). Pearson correlation analyses revealed positive correlation between H-reflex and TSCS responses PRE-to-VIB changes, but not for PRE- to POST-VIB changes. CONCLUSION: While the sensitivity of TSCS seems to be similar to the gold standard H-reflex to highlight the vibratory paradox, both responses showed different sensitivity to the effects of prolonged vibration, suggesting slightly different pathways may actually contribute to evoked responses of both stimulation modalities.

Cerebral Benefits Induced by Electrical Muscle Stimulation: Evidence from a Human and Rat Study.

Physical exercise (EX) is well established for its positive impact on brain health. However, conventional EX may not be feasible for certain individuals. In this regard, this study explores electromyostimulation (EMS) as a potential alternative for enhancing cognitive function. Conducted on both human participants and rats, the study involved two sessions of EMS applied to the quadriceps with a duration of 30 min at one-week intervals. The human subjects experienced assessments of cognition and mood, while the rats underwent histological and biochemical analyses on the prefrontal cortex, hippocampus, and quadriceps. Our findings indicated that EMS enhanced executive functions and reduced anxiety in humans. In parallel, our results from the animal studies revealed an elevation in brain-derived neurotrophic factor (BDNF), specifically in the hippocampus. Intriguingly, this increase was not associated with heightened neuronal activity or cerebral hemodynamics; instead, our data point towards a humoral interaction from muscle to brain. While no evidence of increased muscle and circulating BDNF or FNDC5/irisin pathways could be found, our data highlight lactate as a bridging signaling molecule of the muscle-brain crosstalk following EMS. In conclusion, our results suggest that EMS could be an effective alternative to conventional EX for enhancing both brain health and cognitive function.

Understanding Antidiabetic Potential of Oligosaccharides from Red Alga Dulse Devaleraea inkyuleei Xylan by Investigating α-Amylase and α-Glucosidase Inhibition.

In this study, the α-glucosidase (maltase-glucoamylase: MGAM) and α-amylase inhibitory properties elicited by xylooligosaccharides (XOSs) prepared from dulse xylan were analysed as a potential mechanism to control postprandial hyperglycaemia for type-2 diabetes prevention and treatment. Xylan was purified from red alga dulse powder and used for enzymatic hydrolysis using Sucrase X to produce XOSs. Fractionation of XOSs produced xylobiose (X2), ß-(1→3)-xylosyl xylobiose (DX3), xylotriose (X3), ß-(1→3)-xylosyl-xylotriose (DX4), and a dulse XOS mixture with n ≥ 4 xylose units (DXM). The different fractions exhibited moderate MGAM (IC50 = 11.41-23.44 mg/mL) and α-amylase (IC50 = 18.07-53.04 mg/mL) inhibitory activity, which was lower than that of acarbose. Kinetics studies revealed that XOSs bound to the active site of carbohydrate digestive enzymes, limiting access to the substrate by competitive inhibition. A molecular docking analysis of XOSs with MGAM and α-amylase clearly showed moderate strength of interactions, both hydrogen bonds and non-bonded contacts, at the active site of the enzymes. Overall, XOSs from dulse could prevent postprandial hyperglycaemia as functional food by a usual and continuous consumption.

Can motor imagery balance the acute fatigue induced by neuromuscular electrical stimulation?

PURPOSE: The combination of motor imagery (MI) and neuromuscular electrical stimulation (NMES) can increase the corticospinal excitability suggesting that such association could be efficient in motor performance improvement. However, differential effect has been reported at spinal level after MI and NMES alone. The purpose of this study was to investigate the acute effect on motor performance and spinal excitability following MI, NMES and combining MI and NMES. METHODS: Ten participants were enrolled in three experimental sessions of MI, NMES and MI + NMES targeting plantar flexor muscles. Each session underwent 60 imagined, evoked (20% MVC) or imagined and evoked contractions simultaneously. Before, immediately after and 10 min after each session, maximal M-wave and H-reflex were evoked by electrical nerve stimulation applied at rest and during maximal voluntary contraction (MVC). RESULTS: The MVC decreased significantly between PRE-POST (- 12.14 ± 6.12%) and PRE-POST 10 (- 8.1 ± 6.35%) for NMES session, while this decrease was significant only between PRE-POST 10 (- 7.16 ± 11.25%) for the MI + NMES session. No significant modulation of the MVC was observed after MI session. The ratio Hmax/Mmax was reduced immediately after NMES session only. CONCLUSION: The combination of MI to NMES seems to delay the onset of neuromuscular fatigue compared to NMES alone. This delay onset of neuromuscular fatigue was associated with specific modulation of the spinal excitability. These results suggested that MI could compensate the neuromuscular fatigue induced acutely by NMES until 10 min after the combination of both modalities.

Characterisation of Bioactive Peptides from Red Alga Gracilariopsis chorda.

In this study, we studied the bioactive peptides produced by thermolysin hydrolysis of a water-soluble protein (WSP) from the red alga Gracilariopsis chorda, whose major components are phycobiliproteins and Ribulose-1,5-bisphosphate carboxylase-oxygenase (RuBisCo). The results showed that WSP hydrolysate exhibited significantly higher ACE inhibitory activity (92% inhibition) compared to DPP-IV inhibitory activity and DPPH scavenging activity. The phycobiliproteins and RuBisCo of G. chorda contain a high proportion of hydrophobic (31.0-46.5%) and aromatic (5.1-46.5%) amino acid residues, which was considered suitable for the formation of peptides with strong ACE inhibitory activity. Therefore, we searched for peptides with strong ACE inhibitory activity and identified two novel peptides (IDHY and LVVER). Then, their interaction with human ACE was evaluated by molecular docking, and IDHY was found to be a promising inhibitor. In silico analysis was then performed on the structural factors affecting ACE inhibitory peptide release, using the predicted 3D structures of phycobiliproteins and RuBisCo. The results showed that most of the ACE inhibitory peptides are located in the highly solvent accessible α-helix. Therefore, it was suggested that G. chorda is a good source of bioactive peptides, especially ACE-inhibitory peptides.

Complete lung agenesis caused by complex genomic rearrangements with neo-TAD formation at the SHH locus.

During human organogenesis, lung development is a timely and tightly regulated developmental process under the control of a large number of signaling molecules. Understanding how genetic variants can disturb normal lung development causing different lung malformations is a major goal for dissecting molecular mechanisms during embryogenesis. Here, through exome sequencing (ES), array CGH, genome sequencing (GS) and Hi-C, we aimed at elucidating the molecular basis of bilateral isolated lung agenesis in three fetuses born to a non-consanguineous family. We detected a complex genomic rearrangement containing duplicated, triplicated and deleted fragments involving the SHH locus in fetuses presenting complete agenesis of both lungs and near-complete agenesis of the trachea, diagnosed by ultrasound screening and confirmed at autopsy following termination. The rearrangement did not include SHH itself, but several regulatory elements for lung development, such as MACS1, a major SHH lung enhancer, and the neighboring genes MNX1 and NOM1. The rearrangement incorporated parts of two topologically associating domains (TADs) including their boundaries. Hi-C of cells from one of the affected fetuses showed the formation of two novel TADs each containing SHH enhancers and the MNX1 and NOM1 genes. Hi-C together with GS indicate that the new 3D conformation is likely causative for this condition by an inappropriate activation of MNX1 included in the neo-TADs by MACS1 enhancer, further highlighting the importance of the 3D chromatin conformation in human disease.

Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach.

INTRODUCTION: Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared. METHODS: Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography. RESULTS: MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only. CONCLUSION: Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.

Does partial activation of the neuromuscular system induce cross-education training effect? Case of a pilot study on motor imagery and neuromuscular electrical stimulation.

INTRODUCTION: Cross education defines the gains observed in the contralateral limb following unilateral strength training of the other limb. The present study questioned the neural mechanisms associated with cross education following training by motor imagery (MI) or submaximal neuromuscular electrical stimulation (NMES), both representing a partial activation of the motor system as compared to conventional strength training. METHODS: Twenty-seven participants were distributed in three groups: MI, NMES and control. Training groups underwent a training program of ten sessions in two weeks targeting plantar flexor muscles of one limb. In both legs, neuromuscular plasticity was assessed through maximal voluntary isometric contraction (MViC) and triceps surae electrophysiological responses evoked by electrical nerve stimulation (H-reflexes and V-waves). RESULTS: NMES and MI training improved MViC torque of the trained limb by 11.3% (P < 0.001) and 13.8% (P < 0.001), respectively. MViC of the untrained limb increased by 10.3% (P < 0.003) in the MI group only, accompanied with increases in V-waves on both sides. In the NMES group, V-waves only increased in the trained limb. In the MI group, rest H-reflexes increased in both the trained and the untrained triceps suraes. CONCLUSION: MI seems to be effective to induce cross education, probably because of the activation of cortical motor regions that impact the corticospinal neural drive of both trained and untrained sides. Conversely, submaximal NMES did not lead to cross education. The present results emphasize that cross education does not necessarily require muscle activity of the trained limb.

Corticospinal excitability is altered similarly following concentric and eccentric maximal contractions.

PURPOSE: To examine corticospinal excitability and neuromuscular function following the completion of eccentric (ECC) or concentric (CON) maximal exercises of same mechanical work. METHODS: Ten males (29.9 ± 11.8 years) performed maximal isokinetic knee extensor contractions in four experimental sessions. The two first sessions (one in ECC and one in CON) ended with a dynamic peak torque loss of 20%. The work completed in each contraction type was then achieved in the other contraction type. Neuromuscular function- maximal voluntary isometric contraction (MVIC), voluntary activation level (VAL), potentiated doublet (Dt), M-wave- and corticospinal excitability- motor evoked potential (MEP) amplitude and silent period (SP)-were assessed in the vastus lateralis (VL) and rectus femoris (RF) muscles at 20% MVIC before and immediately after exercise. RESULTS: To lose 20% of dynamic peak torque subjects performed 1.8 times more work in ECC than CON (P = 0.03), inducing a non-different decline in MVIC (P = 0.15). VAL dropped after the ECC sessions only (- 8.5 ± 6.7%; all P < 0.027). Only, the CON session featuring the greatest work affected Dt amplitude (- 9.4 ± 23.8%; P = 0.047). In both muscles, MEP amplitude decreased (all P < 0.001) and MEP SP stayed constant (all P > 0.45), irrespective of contraction type (all P > 0.15). CONCLUSION: Same-work maximal ECC and CON exercises induced similar fatigue level but from different origins (preferentially central for ECC vs peripheral for CON). Yet, net corticospinal excitability did not depend on contraction type.

Spinal plasticity with motor imagery practice.

KEY POINTS: While a consensus has now been reached on the effect of motor imagery (MI) - the mental simulation of an action - on motor cortical areas, less is known about its impact on spinal structures. The current study, using H-reflex conditioning paradigms, examined the effect of a 20 min MI practice on several spinal mechanisms of the plantar flexor muscles. We observed modulations of spinal presynaptic circuitry while imagining, which was even more pronounced following an acute session of MI practice. We suggested that the small cortical output generated during MI may reach specific spinal circuits and that repeating MI may increase the sensitivity of the spinal cord to its effects. The short-term plasticity induced by MI practice may include spinal network modulation in addition to cortical reorganization. ABSTRACT: Kinesthetic motor imagery (MI) is the mental simulation of a movement with its sensory consequences but without its concomitant execution. While the effect of MI practice on cortical areas is well known, its influence on spinal circuitry remains unclear. Here, we assessed plastic changes in spinal structures following an acute MI practice. Thirteen young healthy participants accomplished two experimental sessions: a 20 min MI training consisting of four blocks of 25 imagined maximal isometric plantar flexions, and a 20 min rest (control session). The level of spinal presynaptic inhibition was assessed by conditioning the triceps surae spinal H-reflex with two methods: (i) the stimulation of the common peroneal nerve that induced D1 presynaptic inhibition (HPSI response), and (ii) the stimulation of the femoral nerve that induced heteronymous Ia facilitation (HFAC response). We then compared the effects of MI on unconditioned (HTEST ) and conditioned (HPSI and HFAC ) responses before, immediately after and 10 min after the 20 min session. After resting for 20 min, no changes were observed on the recorded parameters. After MI practice, the amplitude of rest HTEST was unchanged, while HPSI and HFAC significantly increased, showing a reduction of presynaptic inhibition with no impact on the afferent-motoneuronal synapse. The current results revealed the acute effect of MI practice on baseline spinal presynaptic inhibition, increasing the sensitivity of the spinal circuitry to MI. These findings will help in understanding the mechanisms of neural plasticity following chronic practice.

Corticospinal excitability changes following downhill and uphill walking.

Locomotor exercise may induce corticospinal excitability and/or cortical inhibition change in the knee extensors. This study investigated whether the mode of muscle contraction involved during a locomotor exercise modulates corticospinal and intracortical responsiveness. Eleven subjects performed two 45-min treadmill walking exercises in an uphill (+ 15%) or a downhill (- 15%) condition matched for speed. Maximal voluntary isometric torque (MVIC), voluntary activation level (VAL), doublet (Dt) twitch torque, and M-wave area of the knee extensors were assessed before and after exercise. At the same time-points, motor-evoked potential (MEP), cortical silent period (CSP), and short-interval cortical inhibition (SICI) were recorded in the vastus lateralis (VL) and rectus femoris (RF) muscles. After exercise, uphill and downhill conditions induced a similar loss in MVIC torque (- 9%; p < 0.001), reduction in VAL (- 7%; p < 0.001), and in M-wave area in the VL muscle (- 8%; p < 0.001). Dt twitch torque decreased only after the downhill exercise (- 11%; p < 0.001). MEP area of the VL muscle increased after the downhill condition (p = 0.007), with no change after the uphill condition. MEP area of the RF muscle remained stable after exercises. CSP and SICI did not change in the two conditions for both muscles. Downhill walking induces an increase in MEP area of the VL muscle, with no change of the CSP duration or SICI ratio. The eccentric mode of muscle contraction during a locomotor exercise can modulate specifically corticospinal excitability in the knee extensors.

Impact of stimulation frequency on neuromuscular fatigue.

PURPOSE: The aim of the present study was to examine the frequency effects (20 Hz and 100 Hz) on neuromuscular fatigue using stimulation parameters favoring an indirect motor unit recruitment through the afferent pathway. METHODS: Nineteen subjects were divided into two groups: 20 Hz (n = 10) and 100 Hz (n = 9). The electrical stimulation session consisted of 25 stimulation trains (20 s ON/20 s OFF, pulse width: 1 ms) applied over the tibial nerve and delivered at an intensity evoking 10% maximal voluntary isometric contraction (MVIC). Before and after these protocols, MVIC was assessed, while neural changes were evaluated by the level of activation (VAL) and muscle changes were evaluated by the twitch associated with the maximal M-wave (Pt). For all stimulation trains, the real and the theoretical values of the torque-time integral (TTIr and TTIth, respectively) were calculated. The TTIr/TTIth ratio of the first train was calculated to evaluate the presence of extra torque. RESULTS: The main results showed a similar decrease in MVIC torque after both protocols accompanied by neural and muscle changes, as evidenced by the decrease in VAL and Pt. TTIr values across the 20-Hz trains remained constant, whereas they significantly decreased during the 100-Hz stimulation trains. The relative MVIC decrease was negatively correlated with TTIr/TTIth. CONCLUSION: Results give evidence of an identical neuromuscular fatigue development between protocols, while lower stimulation frequency permitted preservation of a given torque level during the stimulation trains. The negative correlation between this fatigue development and TTIr/TTIth suggests that extra torque production induces greater voluntary torque losses.

Neuromuscular and electromechanical properties of ultra-power athletes: the traceurs.

PURPOSE: Practising a power-type activity over years can shape the neuromuscular profile of athletes. This study aimed at comparing the neuromuscular profile of a non-trained group (NT, n = 10) to power athletes practising Parkour (= traceurs, group PK, n = 11), an activity consisting of jumping obstacles mostly in an urban landscape. METHODS: Maximal isometric plantar flexion force (MVC) and rate of torque development (RTD) were evaluated, and neuromuscular function of triceps surae muscles was assessed and compared between groups through the analysis of evoked potentials from posterior tibial nerve stimulation. RESULTS: PK group exhibited higher MVC force (131.3 ± 8.7 Nm) than NT (110.4 ± 9.6 Nm, P = 0.03) and higher RTD (489.1 ± 93 Nm/s) than NT (296.9 ± 81 Nm/s). At a nervous level, this greater performance was related to a greater voluntary activation level (PK: 96.8 ± 3.6%; NT: 91.5 ± 7.7%; P = 0.02) and soleus V-wave amplitude (P = 0.03), and a lower antagonist co-activation (P = 0.02) and rest soleus spinal excitability (PK Hmax/Mmax: 0.32 ± 0.13; NT: 0.58 ± 0.17; P < 0.001). At a muscular level, PK group exhibited higher mechanical twitch amplitude (PK: 13.42 ± 3.52 Nm; NT: 9.86 ± 4.38 Nm; P = 0.03) and electromechanical efficiency (P = 0.04). CONCLUSIONS: The greater maximal force production capacity of traceurs compared to untrained was underlain by nervous factors, such as greater descending command and greater ability to modulate the spinal excitability, but also by muscular factors such as greater excitation-contraction coupling efficiency. The high eccentric loads that characterize Parkour training may have led traceurs to exhibit such neuromuscular profile.

Production and characterization of cowpea protein hydrolysate with optimum nitrogen solubility by enzymatic hydrolysis using pepsin.

BACKGROUND: Cowpea is a source of low-cost and good nutritional quality protein for utilization in food formulations in replacement of animal proteins. Therefore it is necessary that cowpea protein exhibits good functionality, particularly protein solubility which affects the other functional properties. The objective of this study was to produce cowpea protein hydrolysate exhibiting optimum solubility by the adequate combination of hydrolysis parameters, namely time, solid/liquid ratio (SLR) and enzyme/substrate ratio (ESR), and to determine its functional properties and molecular characteristics. RESULTS: A Box-Behnken experimental design was used for the experiments, and a second-order polynomial to model the effects of hydrolysis time, SLR and ESR on the degree of hydrolysis and nitrogen solubility index. The optimum hydrolysis conditions of time 208.61 min, SLR 1/15 (w/w) and ESR 2.25% (w/w) yielded a nitrogen solubility of 75.71%. Protein breakdown and the peptide profile following enzymatic hydrolysis were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and size exclusion chromatography. Cowpea protein hydrolysate showed higher oil absorption capacity, emulsifying activity and foaming ability compared with the concentrate. CONCLUSION: The solubility of cowpea protein hydrolysate was adequately optimized by response surface methodology, and the hydrolysate showed adequate functionality for use in food. © 2016 Society of Chemical Industry.

New evidence of corticospinal network modulation induced by motor imagery.

Motor imagery (MI) is the mental simulation of movement, without the corresponding muscle contraction. Whereas the activation of cortical motor areas during MI is established, the involvement of spinal structures is still under debate. We used original and complementary techniques to probe the influence of MI on spinal structures. Amplitude of motor-evoked potentials (MEPs), cervico-medullary-evoked potentials (CMEPs), and Hoffmann (H)-reflexes of the flexor carpi radialis (FCR) muscle and of the triceps surae muscles was measured in young, healthy subjects at rest and during MI. Participants were asked to imagine maximal voluntary contraction of the wrist and ankle, while the targeted limb was fixed (static condition). We confirmed previous studies with an increase of FCR MEPs during MI compared with rest. Interestingly, CMEPs, but not H-reflexes, also increased during MI, revealing a possible activation of subcortical structures. Then, to investigate the effect of MI on the spinal network, we used two techniques: 1) passive lengthening of the targeted muscle via an isokinetic dynamometer and 2) conditioning of H-reflexes with stimulation of the antagonistic nerve. Both techniques activate spinal inhibitory presynaptic circuitry, reducing the H-reflex amplitude at rest. In contrast, no reduction of H-reflex amplitude was observed during MI. These findings suggest that MI has modulatory effects on the spinal neuronal network. Specifically, the activation of low-threshold spinal structures during specific conditions (lengthening and H-reflex conditioning) highlights the possible generation of subliminal cortical output during MI.

Spinal and supraspinal mechanisms affecting torque development at different joint angles.

INTRODUCTION: We examined the neural mechanisms responsible for plantar flexion torque changes at different joint positions. METHODS: Nine subjects performed maximal voluntary contractions (MVC) at 6 ankle-knee angle combinations [3 ankle angles (dorsiflexion, anatomic position, plantar flexion) and 2 knee angles (flexion, full extension)]. Neural mechanisms were determined by V-wave, H-reflex (at rest and during MVC), and electromyography during MVC (RMS), normalized to the muscle compound action potential (V/Msup, Hmax/Mmax, Hsup Msup and RMS/Msup) and voluntary activation (VA), while muscle function was assessed by doublet amplitude. RESULTS: MVC and doublet amplitude were significantly lower at plantar flexion (P < 0.01), while VA was significantly lower at dorsiflexion and full knee extension (P < 0.05). V/Msup and RMS/Msup were significantly lower at knee extension (P < 0.01), while Hsup/Msup was not affected by joint angle. CONCLUSIONS: These results indicate that joint positions leading to muscle lengthening produce reduced neural drive, due mainly to supraspinal mechanisms.

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale.

BACKGROUND: Sonographic evaluation of the fetal conus medullaris (CM) level is not reproducible. The objectives of this study were to determine the normal position of the fetal CM during pregnancy as well as the normal intradural filum terminale (FT) length and to evaluate their use in detecting tethered cord. METHODS: This is a prospective evaluation of normal singleton pregnancies examined by sonography from 17 weeks of gestation to term. Each sonographer had to identify the top of the first sacral vertebra (S1) to measure the distance between it and the conus extremity (CM-S1 distance). The intradural FT distance was measured with 5- to 8-MHz probes. RESULTS: 194 consecutive pregnant women were included. The CM and intradural FT were demonstrated clearly in 164 (84%) cases. The mean CM-S1 distance was 20.6 mm (range 0.5-42). The mean intradural FT distance was 27.9 mm (range 6.6-49.3). Linear regression analysis showed a significant association between both those distances and gestational age (p < 0.05). In cases of tethered cord, the mean CM-S1 distance and the mean intradural FT distance were both below the 5th percentile. CONCLUSION: Prenatal evaluation of the CM and the intradural FT is feasible and reproducible and seems useful in detecting tethered cord.

Fetal phenotype associated with the 22q11 deletion.

The 22q11 deletion syndrome is one of the most common human microdeletion syndromes, with a wide spectrum of abnormalities. The fetal phenotype associated with the 22q11 deletion is poorly described in the literature. A national retrospective study was performed from 74 feto-pathological examinations. The objectives were to evaluate the circumstances of the 22q11 deletion diagnosis and to describe fetal anomalies. Post mortem examinations were performed after 66 terminations of pregnancy and eight fetal deaths. The series included nine fetuses from the first trimester, 55 from the second trimester, and ten from the third trimester. A 22q11 FISH analysis was recommended for 57 fetuses after multidisciplinary prenatal diagnostic counseling and for 17 fetuses by a fetal pathologist. Conotruncal heart defects were the most common anomalies (65 fetuses), followed by thymus defects (62 fetuses), and malformations of the urinary tract (25 fetuses). This study identified several unusual and severe features rarely described in the literature. Neurological abnormalities were described in ten fetuses, with seven neural tube defects and five arhinencephalies. This series also included lethal malformations: two hypoplastic left heart syndromes, two bilateral renal agenesis, and one tracheal agenesis. Genetic analysis for a 22q11 deletion is usually indicated when a congenital conotruncal heart and/or thymus defect is detected, but might also be useful in case of other lethal or severe malformations that initially led to the termination of pregnancy.