Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T14:14:20.840Z Has data issue: false hasContentIssue false

Reciprocal Inhibition in Hemiplegia: Correlation with Clinical Features and Recovery

Published online by Cambridge University Press:  18 September 2015

Yasuyuki Okuma
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary
Robert G. Lee*
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary
*
Department of Clinical Neurosciences. Universily of Calgary. 3330 Hospital Drive N.W., Calgary. Alberta. Canada T2N 4N1
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Previous reports have described changes in reciprocal la inhibition in hémiplégie patients, but correlations between the amount of la inhibition and the clinical deficits have not been well established.

Methods:

We studied reciprocal inhibition between ankle flexors (tibialis anterior) and extensors (soleus) in 16 hemiplegic patients at various stages following a stroke and in 26 control subjects. The amount of disynaptic la inhibition was determined from the short latency suppression of the soleus or tibialis anterior H-reflexes by conditioning stimulation of the antagonistic muscle nerves.

Results:

Disynaptic la inhibition from peroneal nerve afférents to soleus motoneurones was increased in patients who showed good recovery of function with mild spasticity. However, it was not changed, or even sometimes diminished, in patients who made a poor recovery and had more marked extensor spasticity. In patients where serial recordings were obtained there was an increase in la inhibition during the recovery period following stroke. la inhibition to the tibialis anterior motoneurones tended to be greater in the poor recovery patients with marked spasticity than in the good recovery patients. The late (Dl) inhibition, presumably due to presynaptic inhibition, was decreased in the patients, although consistent correlations between the amount of this inhibition and the clinical features were not clearly demonstrated.

Conclusions:

Changes in excitability of la inhibitory pathways can be correlated with some of the clinical features seen in hemiplegia. Increased la inhibition of soleus motoneurones during recovery may be a mechanism to compensate for loss of descending motor commands.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

References

1.Lee, RG, Boorman, G.Upper motoneurone syndrome: clinical aspects and treatment. In: Berardelli, A, Benecke, R, Manfredi, M, Marsden, CD, eds. Motor Disturbances II. Academic press, 1990: 333345.Google Scholar
2.Baldissera, F, Hultborn, H, Illert, M.Integration in spinal neuronal systems. In: Brooks, VB, ed. Handbook of Physiology, section 1, The Nervous System, Vol.2, Motor Control. Bethesda: American Physiological Society, 1981: 509595.Google Scholar
3.Mizuno, Y, Tanaka, R, Yanagisawa, N.Reciprocal group I inhibition on triceps surae motoneurones in man. J Neurophysiol 1971; 34: 10101017.CrossRefGoogle Scholar
4.Tanaka, R.Reciprocal la inhibition during voluntary movements in man. Exp Brain Res 1974; 21: 529540.CrossRefGoogle Scholar
5.Yanagisawa, N, Tanaka, R, Ito, Z.Reciprocal la inhibition in spastic hemiplegia of man. Brain 1976; 99: 555574.CrossRefGoogle Scholar
6.Yanagisawa, N.Reciprocal reflex connections in motor disorders in man. In: Desmedt, JE, ed. Progress in Clinical Neurophysiology, vol. 8, Spinal and Supraspinal Mechanisms of Voluntary Motor Control and Locomotion. Basel: Kargar, 1980, 129141.Google Scholar
7.Pierrot-Deseilligny, E, Morin, C, Bergego, C, Tancov, N.Pattern of group I fiber connections from ankle flexor and extensor muscles in man. Exp Brain Res 1981; 42: 337350.Google Scholar
8.Shindo, M, Harayama, H, Kondo, K, Yanagisawa, N, Tanaka, R.Changes in reciprocal la inhibition during voluntary contraction in man. Exp Brain Res 1984; 53: 400408.CrossRefGoogle Scholar
9.Crone, C, Hultborn, H, Jespersen, B.Reciprocal la inhibition from the peroneal nerve to soleus motoneurones with special reference to the size of the test reflex. Exp Brain Res 1985; 59: 418422.CrossRefGoogle Scholar
10.Crone, C, Hultborn, H, Jespersen, B, Nielsen, J.Reciprocal la inhibition between ankle flexors and extensors in man. J Physiol 1987; 389: 163185.CrossRefGoogle Scholar
11.Crone, C, Hultborn, H, Mazieres, L, et al. Sensitivity of monosynaptic test reflexes to facilitation and inhibition as a function of the test reflex size: a study in man and the cat. Exp Brain Res 1990; 81: 3545.CrossRefGoogle Scholar
12.Boorman, G, Hulliger, M, Lee, RG.Tako, K, Tanaka, R.Reciprocal la inhibition in patients with spinal spasticity. Neurosci Lett 1991; 127: 5760.CrossRefGoogle Scholar
13.Medical Research Council. Aids to the examination of the peripheral nervous system. Memorandum No.45 London: HMSO, 1976, 12.Google Scholar
14.Ashworth, B.Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 1964; 192: 540542.Google ScholarPubMed
15.Ashby, P, Wiens, M.Reciprocal inhibition following lesions of the spinal cord in man. J Physiol 1989: 414: 145157.CrossRefGoogle ScholarPubMed
16.Kagamihara, Y, Tanaka, R.Reciprocal inhibition upon initiation of voluntary movement. Neurosci Lett 1985; 55: 2327.CrossRefGoogle ScholarPubMed
17.Tanaka, R.Spinal cord circuits in man – with a special reference to the reciprocal la inhibitory pathway. In: Ellingson, RJ, Murray, NMF, Halliday, AM, eds. The London symposia (EEG Suppl 39): Elsevier, 1987; 6771.Google Scholar
18.Hagbarth, KE.Microneurography and applications to issues of motor control: Fifth annual Stuart Reiner memorial lecture. Muscle & Nerve 1993; 16: 693705.CrossRefGoogle Scholar
19.Delwaide, PJ.Human monosynaptic reflexes and presynaptic inhibition. An interpretation of spastic hyperreflexia. In: Desmedt, JE, ed. New Developments in Electromyography and Clinical Neurophysiology, vol.3, Human Reflexes, Pathophysiology of Motor systems, Methodology of Human Reflexes. Basel: Karger, 1973; 508522.Google Scholar
20.Burke, D, Hagbarth, KE, Lofstedt, L, Wallin, G.The responses of human muscle spindle endings to vibration of non-contracting muscles. J Physiol 1976; 261: 673693.CrossRefGoogle ScholarPubMed
21.Hultborn, H, Meunier, S, Morin, C, Pierrot-Deseilligny, E.Assessing changes in presynaptic inhibition of la fibers: a study in man and the cat. J Physiol 1987; 389: 729756.CrossRefGoogle ScholarPubMed
22.Faist, M, Mazevet, D, Dietz, V, Pierrot-Deseilligny, E.A quantitative assessment of presynaptic inhibition of la afferents in spastics. Differences in hemiplegics and paraplegics. Brain 1994; 117: 14491455.CrossRefGoogle Scholar