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1.
PLoS One ; 19(4): e0302214, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38669263

RESUMO

OBJECTIVE: Our aim was to determine the number and size parameters of EDB motor units in healthy young adults using MScanFit, a novel approach to motor unit number estimation (MUNE). Since variability in MUNE is related to compound muscle action potential (CMAP) size, we employed a procedure to document the optimal EDB electromyographic (EMG) electrode position prior to recording MUNE, a neglected practice in MUNE. METHODS: Subjects were 21 adults 21-44 y. Maximum CMAPs were recorded from 9 sites in a 4 cm2 region centered over the EDB and the site with the largest amplitude was used in the MUNE experiment. For MUNE, the peroneal nerve was stimulated at the fibular head to produce a detailed EDB stimulus-response curve or "MScan". Motor unit number and size parameters underlying the MScan were simulated using the MScanFit mathematical model. RESULTS: In 19 persons, the optimal recording site was superior, superior and proximal, or superior and distal to the EDB mid-belly, whereas in 3 persons it was proximal to the mid-belly. Ranges of key MScanFit parameters were as follows: maximum CMAP amplitude (3.1-8.5 mV), mean SMUP amplitude (34.4-106.7 µV), mean normalized SMUP amplitude (%CMAP max, 0.95-2.3%), largest SMUP amplitude (82.7-348 µV), and MUNE (43-103). MUNE was not related to maximum CMAP amplitude (R2 = 0.09), but was related to mean SMUP amplitude (R2 = -0.19, P = 0.05). CONCLUSION: The EDB CMAP was highly sensitive to electrode position, and the optimal position differed between subjects. Individual differences in EDB MUNE were not related to CMAP amplitude. Inter-subject variability of EDB MUNE (coefficient of variation) was much less than previously reported, possibly explained by better optimization of the EMG electrode and the unique approach of MScanFit MUNE.


Assuntos
Potenciais de Ação , Eletromiografia , Neurônios Motores , Músculo Esquelético , Humanos , Adulto , Masculino , Feminino , Músculo Esquelético/fisiologia , Neurônios Motores/fisiologia , Potenciais de Ação/fisiologia , Adulto Jovem , Nervo Fibular/fisiologia
2.
Front Physiol ; 14: 1137146, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37008017

RESUMO

This study examined methods for estimating the innervation zone (IZ) of a muscle using recorded monopolar high density M waves. Two IZ estimation methods based on principal component analysis (PCA) and Radon transform (RT) were examined. Experimental M waves, acquired from the biceps brachii muscles of nine healthy subjects were used as testing data sets. The performance of the two methods was evaluated by comparing their IZ estimations with manual IZ detection by experienced human operators. Compared with manual detection, the agreement rate of the estimated IZs was 83% and 63% for PCA and RT based methods, respectively, both using monopolar high density M waves. In contrast, the agreement rate was 56% for cross correlation analysis using bipolar high density M waves. The mean difference in estimated IZ location between manual detection and the tested method was 0.12 ± 0.28 inter-electrode-distance (IED) for PCA, 0.33 ± 0.41 IED for RT and 0.39 ± 0.74 IED for cross correlation-based methods. The results indicate that the PCA based method was able to automatically detect muscle IZs from monopolar M waves. Thus, PCA provides an alternative approach to estimate IZ location of voluntary or electrically-evoked muscle contractions, and may have particular value for IZ detection in patients with impaired voluntary muscle activation.

3.
Bioengineering (Basel) ; 10(4)2023 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-37106655

RESUMO

This study investigated electromyography (EMG)-force relations using both simulated and experimental approaches. A motor neuron pool model was first implemented to simulate EMG-force signals, focusing on three different conditions that test the effects of small or large motor units located more or less superficially in the muscle. It was found that the patterns of the EMG-force relations varied significantly across the simulated conditions, quantified by the slope (b) of the log-transformed EMG-force relation. b was significantly higher for large motor units, which were preferentially located superficially rather than for random depth or deep depth conditions (p < 0.001). The log-transformed EMG-force relations in the biceps brachii muscles of nine healthy subjects were examined using a high-density surface EMG. The slope (b) distribution of the relation across the electrode array showed a spatial dependence; b in the proximal region was significantly larger than the distal region, whereas b was not different between the lateral and medial regions. The findings of this study provide evidence that the log-transformed EMG-force relations are sensitive to different motor unit spatial distributions. The slope (b) of this relation may prove to be a useful adjunct measure in the investigation of muscle or motor unit changes associated with disease, injury, or aging.

4.
Bioengineering (Basel) ; 10(2)2023 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-36829711

RESUMO

A surface electromyography (EMG) analysis was performed in this study to examine central neural and peripheral muscle changes after a spinal cord injury (SCI). A linear electrode array was used to record surface EMG signals from the biceps brachii (BB) in 15 SCI subjects and 14 matched healthy control subjects as they performed elbow flexor isometric contractions from 10% to 80% maximum voluntary contraction. Muscle fiber conduction velocity (MFCV) and BB EMG-force relation were examined. MFCV was found to be significantly slower in the SCI group than the control group, evident at all force levels. The BB EMG-force relation was well fit by quadratic functions in both groups. All healthy control EMG-force relations were best fit with positive quadratic coefficients. In contrast, the EMG-force relation in eight SCI subjects was best fit with negative quadratic coefficients, suggesting impaired EMG modulation at high forces. The alterations in MFCV and EMG-force relation after SCI suggest complex neuromuscular changes after SCI, including alterations in central neural drive and muscle properties.

5.
Artigo em Inglês | MEDLINE | ID: mdl-36260575

RESUMO

This study presents a novel method to estimate a muscle's innervation zone (IZ) location from monopolar high density surface electromyography (EMG) signals. Based on the fact that 2nd principal component coefficients derived from principal component analysis (PCA) are linearly related with the time delay of different channels, the channels located near the IZ should have the shortest time delays. Accordingly, we applied a novel method to estimate a muscle's IZ based on PCA. The performance of the developed method was evaluated by both simulation and experimental approaches. The method based on 2nd principal component of monopolar high density surface EMG achieved a comparable performance to cross-correlation analysis of bipolar signals when noise was simulated to be independently distributed across all channels. However, in simulated conditions of specific channel contamination, the PCA based method achieved superior performance than the cross-correlation method. Experimental high density surface EMG was recorded from the biceps brachii of 9 healthy subjects during maximum voluntary contractions. The PCA and cross-correlation based methods achieved high agreement, with a difference in IZ location of 0.47 ± 0.4 IED (inter-electrode distance = 8 mm). The results indicate that analysis of 2nd principal component coefficients provides a useful approach for IZ estimation using monopolar high density surface EMG.


Assuntos
Contração Muscular , Músculo Esquelético , Humanos , Eletromiografia/métodos , Músculo Esquelético/fisiologia , Contração Muscular/fisiologia , Contração Isométrica/fisiologia , Braço
6.
Asian J Androl ; 25(1): 82-85, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35562126

RESUMO

This study investigated whether free prostate-specific antigen (fPSA) performs better than total PSA (tPSA) in predicting prostate volume (PV) in Chinese men with different PSA levels. A total of 5463 men with PSA levels of <10 ng ml-1 and without prostate cancer diagnosis were included in this study. Patients were classified into four groups: PSA <2.5 ng ml-1, 2.5-3.9 ng ml-1, 4.0-9.9 ng ml-1, and 2.5-9.9 ng ml-1. Pearson/Spearman's correlation coefficient (r) and receiver operating characteristic (ROC) curves were used to evaluate the ability of tPSA and fPSA to predict PV. The correlation coefficient between tPSA and PV in the PSA <2.5 ng ml-1 cohort (r = 0.422; P < 0.001) was markedly higher than those of the cohorts with PSA levels of 2.5-3.9 ng ml-1, 4.0-9.9 ng ml-1, and 2.5-9.9 ng ml-1 (r = 0.114, 0.167, and 0.264, respectively; all P ≤ 0.001), while fPSA levels did not differ significantly among different PSA groups. Area under ROC curve (AUC) analyses revealed that the performance of fPSA in predicting PV ≥40 ml (AUC: 0.694, 0.714, and 0.727) was better than that of tPSA (AUC = 0.545, 0.561, and 0.611) in men with PSA levels of 2.5-3.9 ng ml-1, 4.0-9.9 ng ml-1, and 2.5-9.9 ng ml-1, respectively, but not at PSA levels of <2.5 ng ml-1 (AUC: 0.713 vs 0.720). These findings suggest that the relationship between tPSA and PV may vary with PSA level and that fPSA is more powerful at predicting PV only in the ''gray zone'' (PSA levels of 2.5-9.9 ng ml-1), but its performance was similar to that of tPSA at PSA levels of <2.5 ng ml-1.


Assuntos
Antígeno Prostático Específico , Neoplasias da Próstata , Masculino , Humanos , Próstata , População do Leste Asiático , Neoplasias da Próstata/diagnóstico , Curva ROC
7.
J Electromyogr Kinesiol ; 63: 102637, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35176686

RESUMO

The spatial distributions of muscle innervation zone (IZ) and muscle fiber conduction velocity (CV) were examined in nine healthy young male participants. High-density surface electromyography (EMG) was collected from the biceps brachii muscle when subjects performed isometric elbow flexions at 20% to 80% of the maximal voluntary contraction (MVC). A total of 9498 samples of IZs were identified and CVs were calculated using the Radon transform. The center and width of IZ sample distribution were compared within four different force levels and six medial to lateral electrode column positions using repeated measures ANOVA and multiple comparison tests. Significant shifts of IZ center were observed in the medial columns (Columns 5, 6, and 7) compared with the lateral columns (Columns 3 and 4) (p < 0.05). Similarly, significant differences in the IZ width were found in Column 7 and 8 compared to Column 3 (p < 0.05). In contrast, muscle CV was unaffected by column position. Instead, muscle CV was faster at 40% and 80% MVC compared to 20% MVC (p < 0.05). The findings of this study add further insights into the physiological properties of the biceps brachii muscle.


Assuntos
Contração Isométrica , Músculo Esquelético , Braço , Eletromiografia , Humanos , Contração Isométrica/fisiologia , Masculino , Contração Muscular/fisiologia , Fibras Musculares Esqueléticas/fisiologia , Músculo Esquelético/fisiologia
8.
Spinal Cord ; 60(3): 199-209, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34172926

RESUMO

STUDY DESIGN: This is a cross-sectional descriptive study. OBJECTIVES: To quantify differences in hand muscle morphology between persons with cervical spinal cord injury (SCI) and uninjured adults. SETTING: The study was performed at the Guangdong Work Injury Rehabilitation Hospital. METHODS: We quantified hand muscle cross-sectional area (CSA), thickness, and echo intensity (EI) in 18 persons with subacute to chronic SCI and 23 controls using ultrasound imaging. RESULTS: Mean SCI abductor pollicis brevis (APB), abductor digiti minimi (ADM), and first dorsal interosseous (FDI) CSA were ~26%, 43%, and 37% smaller than the control means, the deficit in the APB being less than the ADM (P < 0.05). Muscle thickness was also smaller after SCI, but deficits in ADM (31%) and FDI (20%) thickness were less than the CSA deficits (P < 0.05). In five SCI persons, APB CSA and/or opponens pollicis (OP) thickness were normal despite complete motor paralysis. Mean longitudinal image EI was 40% higher in the OP and 15% higher in the flexor pollicis brevis (FPB) after SCI (P < 0.05), suggesting denervation-induced infiltration of fat and fibrous tissues. OP EI was related to OP thickness (r = -0.6, P = 0.007, n = 18). Mean axial image EI was 10% higher in the APB and ADM after SCI (P < 0.05). There were no significant correlations between muscle morphological properties and clinical features in the SCI participants. CONCLUSION: Our results indicate significant SCI atrophy and elevated EI that are muscle dependent.


Assuntos
Medula Cervical , Traumatismos da Medula Espinal , Adulto , Medula Cervical/diagnóstico por imagem , Eletromiografia/métodos , Mãos/diagnóstico por imagem , Mãos/fisiologia , Humanos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico por imagem , Ultrassonografia
9.
J Neuroeng Rehabil ; 16(1): 73, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186009

RESUMO

BACKGROUND: High density surface electromyography (EMG) can be used to estimate muscle innervation zones (IZ). The objective of this study was to compare the differences in the distribution of the biceps brachii (BB) IZ derived from voluntary contractions (VC) and electrical stimulation (ES) of the musculocutaneous nerve. METHODS: Surface EMG signals were recorded from the medial and lateral BB with two 64-channel high density electrode matrices in eight healthy men. The surface EMG was recorded at different percentages of the maximal voluntary contraction (MVC) force (20-100% MVC) and at different percentages of the current needed to elicit a maximal M-wave (20-100% Imax). The IZs of the medial and lateral BB were identified from the EMG signals and expressed as a row number within a given medial-lateral column. RESULTS: ES current intensity had no significant effect on the group mean IZ location (p > 0.05). However, The IZ during VC was located more proximally with increasing force (p < 0.05), likely due to muscle shortening. The position of the IZ varied slightly (by up to ~ 8 mm) in a medial-lateral direction under both contraction types, but this spatial effect was not significant. The IZ during ES and weak VC (20, 40% MVC) was similar (p > 0.05), but was more proximal in the latter than the former during 60-100% MVC (p < 0.05). CONCLUSION: ES can be used to detect spatial differences in IZ location free of the confounding effects of muscle shortening and recruitment order of different sized motor units. The method may prove beneficial for locating the IZ in patients who lack voluntary control of their musculature.


Assuntos
Eletromiografia/métodos , Músculo Esquelético/inervação , Adulto , Braço , Estimulação Elétrica , Humanos , Contração Isométrica/fisiologia , Masculino , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Adulto Jovem
10.
Front Physiol ; 9: 1587, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30559674

RESUMO

The purpose of this study was to better understand changes in motor unit electrophysiological properties in people with chronic stroke based on concentric needle electromyography (EMG) and single fiber EMG recordings. The first dorsal interosseous (FDI) muscle was studied bilaterally in eleven hemiparetic stroke subjects. A significant increase in mean fiber density (FD) was found in the paretic muscle compared with the contralateral side based on single fiber EMG (1.6 ± 0.2 vs. 1.3 ± 0.1, respectively, P = 0.003). There was no statistically significant difference between the paretic and contralateral sides in most concentric needle motor unit action potential (MUAP) parameters, such as amplitude (768.7 ± 441.7 vs. 855.0 ± 289.9 µV), duration (8.9 ± 1.8 vs. 8.68 ± 0.9 ms) and size index (1.2 ± 0.5 vs. 1.1 ± 0.3) (P > 0.18), nor was there a significant difference in single fiber EMG recorded jitter (37.0 ± 9.6 vs. 39.9 ± 10.6 µs, P = 0.45). The increase in FD suggests motor units of the paretic FDI have enlarged due to collateral reinnervation. However, sprouting might be insufficient to result in a statistically significant change in the concentric needle MUAP parameters. Single fiber EMG appears more sensitive than concentric needle EMG to reflect electrophysiological changes in motor units after stroke. Both single fiber and concentric needle EMG recordings may be necessary to better understand muscle changes after stroke, which is important for development of appropriate rehabilitation strategies. The results provide further evidence that motor units are remodeled after stroke, possibly in response to a loss of motoneurons.

11.
Med Sci Monit ; 24: 7570-7576, 2018 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-30352050

RESUMO

BACKGROUND The aim of this study was to assess the passive stiffness of the medial and lateral gastrocnemius (MG and LG), Achilles tendon (AT), and plantar fascia (PF) at different ankle and knee positions. MATERIAL AND METHODS Stiffness was assessed using a portable hand-held device (MyotonPRO). In 30 healthy participants (15 males, 15 females) with the knee fully extended or flexed 90°, stiffness of the MG, LG, AT, and PF was measured at 50° plantar flexion, 0° (neutral position), and 25° dorsiflexion (not for AT) of the ankle joint by passive joint rotation. RESULTS With the knee fully extended, passive dorsiflexion caused significant increase in muscle stiffness (P<0.001), whereas AT and PF stiffness increased with passive ankle dorsiflexion regardless of knee position (P<0.001). Increased stiffness was observed in MG compared to LG (P<0.001) and at the 3-cm site of AT compared to the 6-cm site (P<0.05). Stiffness was greater in LG compared to MG at -50° plantar flexion (P<0.001) and was greater in MG compared to LG at 25° dorsiflexion (P<0.05). Stiffness of AT increased in a distal-to-proximal pattern: 0 cm >3 cm >6 cm (P<0.001). CONCLUSIONS Stiffness assessed by use of the MyotonPRO was similar assessments using other techniques, suggesting that the MyotonPRO is capable of detecting the variations in stiffness of MG, LG, AT, and PF at different ankle and knee positions.


Assuntos
Tendão do Calcâneo/fisiologia , Fasciíte Plantar/fisiopatologia , Músculo Esquelético/fisiologia , Adulto , Tornozelo , Articulação do Tornozelo/fisiologia , Feminino , , Voluntários Saudáveis , Humanos , Joelho , Articulação do Joelho/fisiologia , Masculino , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
12.
Muscle Nerve ; 58(5): 735-737, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29981247

RESUMO

INTRODUCTION: This study performed motor unit number estimation (MUNE) of the abductor hallucis (AH) muscle from 16 healthy control participants on the basis of the compound muscle action potential (CMAP) scan. METHODS: Muscle responses to electrical stimuli ranging from subthreshold to supramaximal intensity were recorded, and MUNE was determined from a model of the responses (MScanFit program). RESULTS: The average CMAP amplitude and MUNE of the AH for the right and left sides combined were 19.6 ± 0.75 mV and 127 ± 5 (mean ± SE), respectively. DISCUSSION: Findings of the study provide useful information about the motor unit number of the AH. Muscle Nerve 58: 735-737, 2018.


Assuntos
Potenciais de Ação/fisiologia , Neurônios Motores/fisiologia , Músculo Esquelético/fisiologia , Adulto , Biofísica , Estimulação Elétrica , Eletromiografia , Feminino , Lateralidade Funcional , Voluntários Saudáveis , Humanos , Masculino , Reprodutibilidade dos Testes
14.
Muscle Nerve ; 57(1): E60-E69, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28621464

RESUMO

INTRODUCTION: Excitability properties of motor nerves to different muscles are different, but the explanation is uncertain. We characterized motor axon excitability properties to the medial gastrocnemius (MG) in 27 adults, and made comparisons with the peroneal nerve to the tibialis anterior (TA) and median nerve to the abductor pollicis brevis (APB) in 10 subjects. METHODS: Recordings of multiple excitability properties were made using threshold tracking, stimulating the nerves at the wrist or knee. RESULTS: Threshold electrotonus and superexcitability differed between nerves (APB>MG>TA axons) that may reflect differences in fast K+ conductance. APB axons had larger S2 accommodation and undershoot than TA and MG axons, indicating greater slow K+ conductance. TA axons demonstrated greater accommodation during hyperpolarizing currents than MG and APB axons, suggestive of greater inwardly rectifying current. DISCUSSION: Inherent differences in several conductances underlie nerve differences in excitability, presumably related to muscle or motoneuron properties. Muscle Nerve 57: E60-E69, 2018.


Assuntos
Axônios/fisiologia , Neurônios Motores/fisiologia , Músculo Esquelético/inervação , Adulto , Estimulação Elétrica , Feminino , Mãos/inervação , Humanos , Joelho/fisiologia , Masculino , Nervo Mediano/fisiologia , Nervo Fibular/fisiologia , Canais de Potássio/fisiologia , Punho/fisiologia , Adulto Jovem
15.
J Neurophysiol ; 117(2): 684-691, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-27852734

RESUMO

After human spinal cord injury (SCI), motoneuron recruitment and firing rate during voluntary and involuntary contractions may be altered by changes in motoneuron excitability. Our aim was to compare F waves in single thenar motor units paralyzed by cervical SCI to those in uninjured controls because at the single-unit level F waves primarily reflect the intrinsic properties of the motoneuron and its initial segment. With intraneural motor axon stimulation, F waves were evident in all 4 participants with C4-level SCI, absent in 8 with C5 or C6 injury, and present in 6 of 12 Uninjured participants (P < 0.001). The percentage of units that generated F waves differed across groups (C4: 30%, C5 or C6: 0%, Uninjured: 16%; P < 0.001). Mean (±SD) proximal axon conduction velocity was slower after C4 SCI [64 ± 4 m/s (n = 6 units), Uninjured: 73 ± 8 m/s (n = 7 units); P = 0.037]. Mean distal axon conduction velocity differed by group [C4: 40 ± 8 m/s (n = 20 units), C5 or C6: 49 ± 9 m/s (n = 28), Uninjured: 60 ± 7 m/s (n = 45); P < 0.001]. Motor unit properties (EMG amplitude, twitch force) only differed after SCI (P ≤ 0.004), not by injury level. Motor units with F waves had distal conduction velocities, M-wave amplitudes, and twitch forces that spanned the respective group range, indicating that units with heterogeneous properties produced F waves. Recording unitary F waves has shown that thenar motoneurons closer to the SCI (C5 or C6) have reduced excitability whereas those further away (C4) have increased excitability, which may exacerbate muscle spasms. This difference in motoneuron excitability may be related to the extent of membrane depolarization following SCI. NEW & NOTEWORTHY: Unitary F waves were common in paralyzed thenar muscles of people who had a chronic spinal cord injury (SCI) at the C4 level compared with uninjured people, but F waves did not occur in people that had SCI at the C5 or C6 level. These results highlight that intrinsic motoneuron excitability depends, in part, on how close the motoneurons are to the site of the spinal injury, which could alter the generation and strength of voluntary and involuntary muscle contractions.


Assuntos
Potencial Evocado Motor/fisiologia , Neurônios Motores/fisiologia , Traumatismos da Medula Espinal/patologia , Adulto , Axônios/fisiologia , Medula Cervical/patologia , Estimulação Elétrica , Eletromiografia , Feminino , Humanos , Masculino , Condução Nervosa/fisiologia , Estatísticas não Paramétricas , Adulto Jovem
16.
Front Hum Neurosci ; 9: 569, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26557068

RESUMO

This study presents a frequency analysis of surface electromyogram (EMG) signals acquired by a linear electrode array from the biceps brachii muscles bilaterally in 14 hemiparetic stroke subjects. For different levels of isometric contraction ranging from 10 to 80% of the maximum voluntary contraction (MVC), the power spectra of 19 bipolar surface EMG channels arranged proximally to distally along the muscle fibers were examined in both paretic and contralateral muscles. It was found that across all stroke subjects, the median frequency (MF) and the mean power frequency (MPF), averaged from different surface EMG channels, were significantly smaller in the paretic muscle compared to the contralateral muscle at each of the matched percent MVC contractions. The muscle fiber conduction velocity (MFCV) was significantly slower in the paretic muscle than in the contralateral muscle. No significant correlation between the averaged MF, MPF, or MFCV vs. torque was found in both paretic and contralateral muscles. However, there was a significant positive correlation between the global MFCV and MF. Examination of individual EMG channels showed that electrodes closest to the estimated muscle innervation zones produced surface EMG signals with significantly higher MF and MPF than more proximal or distal locations in both paretic and contralateral sides. These findings suggest complex central and peripheral neuromuscular alterations (such as selective loss of large motor units, disordered control of motor units, increased motor unit synchronization, and atrophy of muscle fibers, etc.) which can collectively influence the surface EMG signals. The frequency difference with regard to the innervation zone also confirms the relevance of electrode position in surface EMG analysis.

17.
Front Hum Neurosci ; 9: 329, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26089791

RESUMO

Cerebral palsy (CP) is a permanent disorder caused by a lesion to the developing brain that significantly impairs motor function. The neurophysiological mechanisms underlying motor impairment are not well understood. Specifically, few have addressed whether motoneuron or peripheral axon properties are altered in CP, even though disruption of descending inputs to the spinal cord may cause them to change. In the present study, we have compared nerve excitability properties in seven adults with CP and fourteen healthy controls using threshold tracking techniques by stimulating the median nerve at the wrist and recording the compound muscle action potential over the abductor pollicis brevis. The excitability properties in the CP subjects were found to be abnormal. Early and late depolarizing and hyperpolarizing threshold electrotonus was significantly larger (i.e., fanning out), and resting current-threshold (I/V) slope was smaller, in CP compared to control. In addition resting threshold and rheobase tended to be larger in CP. According to a modeling analysis of the data, an increase in leakage current under or through the myelin sheath, i.e., the Barrett-Barrett conductance, combined with a slight hyperpolarization of the resting membrane potential, best explained the group differences in excitability properties. There was a trend for those with greater impairment in gross motor function to have more abnormal axon properties. The findings indicate plasticity of motor axon properties far removed from the site of the lesion. We suspect that this plasticity is caused by disruption of descending inputs to the motoneurons at an early age around the time of their injury.

18.
Clin Neurophysiol ; 125(10): 2070-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24680197

RESUMO

OBJECTIVE: Indirect evidence suggests that lateralized changes in motoneuron behavior post-stroke are potentially due to a depolarizing supraspinal drive to the motoneuron pool, but the pathways responsible are unknown. In this study, we assessed vestibular evoked myogenic potentials (VEMPs) in the neck muscles of hemispheric stroke survivors with contralesional spasticity to quantify the relative levels of vestibular drive to the spastic-paretic and contralateral motoneuron pools. METHODS: VEMPs were recorded from each sternocleidomastoid muscle in chronic stroke survivors. Side-to-side differences in cVEMP amplitude were calculated and expressed as an asymmetry ratio, a proxy for the relative amount of vestibular drive to each side. RESULTS: Spastic-paretic VEMPs were larger than contralateral VEMPs in 13/16 subjects. There was a strong positive relationship between the degree of asymmetry and the severity of spasticity in this subset of subjects. Remaining subjects had larger contralateral responses. CONCLUSION: Vestibular drive to cervical motoneurons is asymmetric in spastic stroke survivors, supporting our hypothesis that there is an imbalance in descending vestibular drive to motoneuron pools post-stroke. We speculate this imbalance is a consequence of the unilateral disruption of inhibitory corticobulbar projections to the vestibular nuclei. SIGNIFICANCE: This study sheds new light on the underlying mechanisms of post-stroke spasticity.


Assuntos
Neurônios Motores/fisiologia , Espasticidade Muscular/fisiopatologia , Tratos Piramidais/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Núcleos Vestibulares/fisiopatologia , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Músculo Esquelético/fisiopatologia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/complicações , Sobreviventes
19.
Motor Control ; 17(3): 283-97, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23761424

RESUMO

Few examined the contribution of neural and muscular deficits to weakness in the same stroke subject. We determined maximal voluntary contraction (MVC) and 50 Hz torques, activation (twitch interpolation), electromyographic (EMG) amplitude and antagonist coactivation, and muscle volume using magnetic resonance imaging (MRI) of the dorsiflexors bilaterally in 7 chronic stroke subjects (40-67 y). Recordings of MVC and 50 Hz torque were also done in 7 control subjects (24-69 y) without stroke. The MVC torque was smaller in the contralesional than ipsilesilesional limb (29.8 ± 21.3 Nm vs. 42.5 ± 12.0 Nm, p = .04), and was associated with deficits in activation (r2 = .77) and EMG amplitude (r2 = .71). Antagonist coactivation percentage was not significantly different between limbs. Muscle volume, 50 Hz torque, and specific torque (50Hz torque/muscle volume) were also not different between sides. The concept that atrophy is commonplace after stroke is not supported by the results. Our findings indicate that dorsiflexor weakness in mobile stroke survivors is not explained by atrophy or reduced torque generating capacity suggesting an important role for central factors.


Assuntos
Contração Muscular/fisiologia , Debilidade Muscular/fisiopatologia , Músculo Esquelético/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Sobreviventes , Caminhada/fisiologia , Adulto , Idoso , Estudos de Casos e Controles , Doença Crônica , Estimulação Elétrica/métodos , Eletromiografia/métodos , Potencial Evocado Motor/fisiologia , Feminino , Marcha/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Músculo Esquelético/patologia , Atrofia Muscular/fisiopatologia , Acidente Vascular Cerebral/complicações , Torque
20.
Aging Dis ; 3(2): 156-63, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22724076

RESUMO

Muscle pull and weight-bearing are key mechanical determinants of bone geometry which is an important feature of bone strength that declines with adult aging. However, the relative importance of these determinants in young and old adults has not been evaluated systematically. To differentiate the influence of each type of mechanical loading we compared humeral and femoral bone shaft geometry and cross-sectional area (CSA) of the arm and thigh muscles in young and old men. Contiguous transverse MRI (Siemens 1.5T) scans of the arm and thigh were made in 10 young men (21.9 ± 1.0 years) and 10 old men (78.1 ± 4.9 years). Image analysis yielded total (TA), cortical (CA) and medullary (MA) CSA of the humeral and femoral shafts, as well as muscle CSA of the corresponding regions of the arm and thigh. Humeral CA was significantly greater in the young, whereas humeral and femoral MA were significantly greater in the older group. Significant correlations were found between arm muscle CSA and humeral CA (r = 0.73); between thigh muscle CSA and femoral CA (r = 0.69); and between body mass and femoral CA (r = 0.63) and TA (r = 0.55). Moderate correlations between muscle CSA and CA suggest that muscle pull is an important determinant of bone geometry. The significant difference observed between young and old in humeral, but not femoral CA, and the correlation between body mass and femoral, but not humeral cortical area, suggests that weight-bearing attenuates bone loss associated with adult aging.

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