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Temporal facilitation of spastic stretch reflexes following human spinal cord injury

机译:暂时性促进人脊髓损伤后痉挛性伸展反射

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摘要

Recent evidence suggests that alterations in ionic conductances in spinal motoneurones, specifically the manifestation of persistent inward currents, may be partly responsible for the appearance of hyperexcitable reflexes following spinal cord injury (SCI). We hypothesized that such alterations would manifest as temporal facilitation of stretch reflexes in human SCI. Controlled, triangular wave, ankle joint rotations applied at variable velocities (30–120 deg s−1) and intervals between stretches (0.25–5.0 s) were performed on 14 SCI subjects with velocity-dependent, hyperexcitable plantarflexors. Repeated stretch elicited significant increases in plantarflexion torques and electromyographic (EMG) activity from the soleus (SOL) and medial gastrocnemius (MG). At higher velocities (≥ 90 deg s−1), reflex torques declined initially, but subsequently increased to levels exceeding the initial response, while mean EMG responses increased throughout the joint perturbations. At lower velocities (≤ 60 deg s−1), both joint torques and EMGs increased gradually. Throughout a range of angular velocities, reflex responses increased significantly only at intervals ≤ 1 s between stretches and following at least four rotations. Ramp-and-hold perturbations used to elicit tonic stretch reflexes revealed significantly prolonged EMG responses following one or two triangular stretches, as compared to single ramp-and-hold excursions. Post hoc analyses revealed reduced reflex facilitation in subjects using baclofen to control spastic behaviours. Evidence of stretch reflex facilitation post-SCI may reflect changes in underlying neuronal properties and provide insight into the mechanisms underlying spastic reflexes.
机译:最近的证据表明,脊髓运动神经元中离子电导的改变,特别是持续的内向电流的表现,可能部分归因于脊髓损伤(SCI)后出现过度兴奋性反射。我们假设这种改变将表现为人类SCI的舒张反射的时间促进。对14名SCI受试者进行速度可变,过度兴奋的可变速度(30–120 deg s -1 )和伸展间隔(0.25–5.0 s)的受控三角波,踝关节旋转flex屈肌。反复的拉伸引起比目鱼肌(SOL)和腓肠肌内侧(MG)的足底屈曲扭矩和肌电图(EMG)活性显着增加。在较高的速度下(≥90度s -1 ),反射扭矩最初下降,但随后增加到超过初始响应的水平,而平均EMG响应在整个关节扰动中都增加了。在较低的速度(≤60度s -1 )下,关节扭矩和EMG均逐渐增加。在整个角速度范围内,反射响应仅在拉伸之间的间隔≤1 s且至少旋转四次后才显着增加。与单次斜拉保持偏移相比,用于引起强直性伸缩反射的斜拉保持扰动显示,在进行一次或两次三角拉伸后,EMG反应显着延长。事后分析显示,使用巴氯芬控制痉挛行为的受试者的反射促进作用降低。 SCI后伸展反射促进的证据可能反映了潜在神经元特性的变化,并为痉挛反射的潜在机制提供了见识。

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