Alteration of H-reflex amplitude modulation is a marker of impaired postural responses in individuals with incomplete spinal cord injury

Pion, Charlotte H.; Bolduc, Mélissa St-Pierre; Miranda, Zoé; MacMahon, Maureen; Barthélemy, Dorothy

doi:10.1007/s00221-021-06081-0

Cited by 5 publications

(3 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In spastic patients, the ascending sensory and descending supraspinal tracts are interrupted in different degrees. The decreased suppression of the stretch reflex and the delayed or reduced spinal reflex processing may contribute to impaired balance control [ 27 , 28 ]. Therefore, the worse the balance function of the spastic patients, the less the depression modulation of the H-reflex in the standing position.…”

Section: Discussionmentioning

confidence: 99%

Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

et al. 2021

View full text Add to dashboard Cite

Purpose. This study is aimed at exploring how soleus H-reflex change in poststroke patients with spasticity influenced by body position. Materials and Methods. Twenty-four stroke patients with spastic hemiplegia and twelve age-matched healthy controls were investigated. Maximal Hoffmann-reflex (Hmax) and motor potential (Mmax) were elicited at the popliteal fossa in both prone and standing positions, respectively, and the Hmax/Mmax ratio at each body position was determined. Compare changes in reflex behavior in both spastic and contralateral muscles of stroke survivors in prone and standing positions, and match healthy subjects in the same position. Results. In healthy subjects, Hmax and Hmax/Mmax ratios were significantly decreased in the standing position compared to the prone position (Hmax: p = 0.000 , Hmax/Mmax: p = 0.016 ). However, Hmax/Mmax ratios were increased in standing position on both sides in poststroke patients with spasticity (unaffected side: p = 0.006 , affected side: p = 0.095 ). The Hmax and Hmax/Mmax ratios were significantly more increased on the affected side than unaffected side irrespective of the position. Conclusions. The motor neuron excitability of both sides was not suppressed but instead upregulated in the standing position in subjects with spasticity, which may suggest that there was abnormal regulation of the Ia pathway on both sides.

show abstract

Section: Discussionmentioning

confidence: 99%

Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Electrical activity was recorded from the soleus (SOL) and TA muscles of both lower limbs. Details of the recording have been described elsewhere [ 20 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Quantitative electrophysiological assessments as predictive markers of lower limb motor recovery after spinal cord injury: a pilot study with an adaptive trial design

Huang

Meftah

Pion

et al. 2022

Spinal Cord Ser Cases

Self Cite

View full text Add to dashboard Cite

Study design Observational, cohort study. Objectives (1) Determine the feasibility and relevance of assessing corticospinal, sensory, and spinal pathways early after traumatic spinal cord injury (SCI) in a rehabilitation setting. (2) Validate whether electrophysiological and magnetic resonance imaging (MRI) measures taken early after SCI could identify preserved neural pathways, which could then guide therapy. Setting Intensive functional rehabilitation hospital (IFR). Methods Five individuals with traumatic SCI and eight controls were recruited. The lower extremity motor score (LEMS), electrical perceptual threshold (EPT) at the S2 dermatome, soleus (SOL) H-reflex, and motor evoked potentials (MEPs) in the tibialis anterior (TA) muscle were assessed during the stay in IFR and in the chronic stage (>6 months post-SCI). Control participants were only assessed once. Feasibility criteria included the absence of adverse events, adequate experimental session duration, and complete dataset gathering. The relationship between electrophysiological data collected in IFR and LEMS in the chronic phase was studied. The admission MRI was used to calculate the maximal spinal cord compression (MSCC). Results No adverse events occurred, but a complete dataset could not be collected for all subjects due to set-up configuration limitations and time constraints. EPT measured at IFR correlated with LEMS in the chronic phases (r = −0.67), whereas SOL H/M ratio, H latency, MEPs and MSCC did not. Conclusions Adjustments are necessary to implement electrophysiological assessments in an IFR setting. Combining MRI and electrophysiological measures may lead to better assessment of neuronal deficits early after SCI.

show abstract

“…Yet, one reasonable approach is exploring the neurophysiological reflex behavior, as such reflexes in principle reflect the spinal excitation level based on distinct readouts such as response rates and magnitudes ( Sandrini et al, 2005 ). Reflex studies may either apply innocuous stimuli, e.g., to study the impact of SCI on the H-reflex ( Lee et al, 2005 ; Knikou, 2008 ; Gómez-Soriano et al, 2018 ; Pion et al, 2021 ), or noxious stimuli to assess the effect of injured sensorimotor pathways on nociceptive withdrawal—also referred to as nocifensive—reflexes ( Lim et al, 2011 ; Linde et al, 2021 ). Previous clinical and preclinical studies on the effect of SCI on nocifensive reflexes revealed motor hyperresponsiveness and enlarged reflex receptive fields (RRF) ( Dimitrijevic and Nathan, 1968 ; Andersen et al, 2004 ; Biurrun Manresa et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Noxious radiant heat evokes bi-component nociceptive withdrawal reflexes in spinal cord injured humans—A clinical tool to study neuroplastic changes of spinal neural circuits

Franz

Heutehaus

Tappe‐Theodor

et al. 2023

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Investigating nocifensive withdrawal reflexes as potential surrogate marker for the spinal excitation level may widen the understanding of maladaptive nociceptive processing after spinal cord injury (SCI). The aim of this prospective, explorative cross-sectional observational study was to investigate the response behavior of individuals with SCI to noxious radiant heat (laser) stimuli and to assess its relation to spasticity and neuropathic pain, two clinical consequences of spinal hyperexcitability/spinal disinhibition. Laser stimuli were applied at the sole and dorsum of the foot and below the fibula head. Corresponding reflexes were electromyography (EMG) recorded ipsilateral. Motor responses to laser stimuli were analyzed and related to clinical readouts (severity of injury/spasticity/pain), using established clinical assessment tools. Twenty-seven participants, 15 with SCI (age 18–63; 6.5 years post-injury; AIS-A through D) and 12 non-disabled controls, [non-disabled controls (NDC); age 19–63] were included. The percentage of individuals with SCI responding to stimuli (70–77%; p < 0.001), their response rates (16–21%; p < 0.05) and their reflex magnitude (p < 0.05) were significantly higher compared to NDC. SCI-related reflexes clustered in two time-windows, indicating involvement of both A-delta- and C-fibers. Spasticity was associated with facilitated reflexes in SCI (Kendall-tau-b p ≤ 0.05) and inversely associated with the occurrence/severity of neuropathic pain (Fisher’s exact p < 0.05; Eta-coefficient p < 0.05). However, neuropathic pain was not related to reflex behavior. Altogether, we found a bi-component motor hyperresponsiveness of SCI to noxious heat, which correlated with spasticity, but not neuropathic pain. Laser-evoked withdrawal reflexes may become a suitable outcome parameter to explore maladaptive spinal circuitries in SCI and to assess the effect of targeted treatment strategies. Registration: https://drks.de/search/de/trial/DRKS00006779.

show abstract

Alteration of H-reflex amplitude modulation is a marker of impaired postural responses in individuals with incomplete spinal cord injury

Cited by 5 publications

References 48 publications

Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

Quantitative electrophysiological assessments as predictive markers of lower limb motor recovery after spinal cord injury: a pilot study with an adaptive trial design

Noxious radiant heat evokes bi-component nociceptive withdrawal reflexes in spinal cord injured humans—A clinical tool to study neuroplastic changes of spinal neural circuits

Contact Info

Product

Resources

About