[A program of electromyographic study of suspected latent pyramidal insufficiency]. / Programma élektromiograficheskogo issledovaniia pri podozrenii na skrytuiu piramidnuiu nedostatochnost'.

One hundred patients with suspected latent pyramidal insufficiency associated with cerebral and upper spinal abnormalities of varying nature were studied using a special scheme of electromyographic examination. The latter included: assessment of the ratio of curves of tension-time of the central and motor responses of the muscles of the calf and the musculi pedis, determination of the severity of "low frequency depression" of the H-reflex of the musculus gastrocnemius as well as of the main characteristics of the late potential of the musculi plantaris. The electrophysiological signs of the subclinical stage of the pyramidal syndrome were detected in 47% of cases.

[Combined use of cutaneous electrostimulation of nerve fibers and electrogymnastics of the spine in painful vertebrogenic syndromes]. / Sochetannoe ispol'zovanie nakozhnoi élektrostimuliatsii nervnykh volokon i élektrogimnastiki pozvonochnika pri bolevykh vertebrogennykh sindromakh.

A combined use of acupunctural cutaneous electrostimulation of neural fibers and electrogymnastics of the vertebral column was tested in 40 patients with vertebral osteochondrosis accompanied by the muscle tonic or compression radical syndrome. Electrostimulation was performed bilaterally in the paravertebral areas at the level of the blocked motor segment, using series of impulses and achieving rhythmical flexing-unflexing movements of a small range in the damaged segment of the spinal column. Positive effect was obtained in all patients with the muscle tonic syndrome and in half the patients with the compression radical syndrome.

[Analgesic effect of high-frequency and acupuncture-like transcutaneous electric stimulation of nerve fibers in spinal osteochondrosis]. / O protivobolevom deistvii vysokochastotnoi i "akupunkturopodobnoi" nakozhnoi élektrostimuliatsii nervnykh volokkn pri osteokhondroze pozvonochnika.

Epicutaneous electrostimulation of nerve fibers was used in 192 patients with the neurologic manifestations of spinal osteochondritis in order to alleviate the pain syndrome. Two stimulation regimens were used: a high-frequency one (rectangular impulses of current with an 0.1-0.2 msec duration and a 70 Hz frequency and the intensity being subliminal for a motor response) and "acupuncture-like" a series consisting of seven impulses of the same duration and frequency with the repetition of three series in one second, the intensity of the irritant being over the motor response threshold). The occurrence of prolonged analgesia was shown to be approximately equal with both regimens and to depend significantly on the duration of the pain syndrome and the presence of the symptoms of the loss of spinal root function. There were several cases when after one of the regimens had failed, the pain was controlled by the alternative method of stimulation.

[Diagnosis of syndromes of nervous system lesions from ratios of the voltage-time curves of central and motor responses of the muscles of the leg and foot]. / Diagnostika sindromov porazhenii nervnoi sistemy po sootnosheniiu krivykh napriazheniia--vremeni tsentral'nykh i motornykh otvetov myshts goleni i stopy.

The study was conducted in two age groups of normal subjects (adolescents and youths aged 16-21 years and 24-40 year-old adults) and in three groups of patients: (1) with alpha-pyramidal deficiency; (2) with gamma-pyramidal syndrome, and (3) with syndromes of damage to the peripheral nervous system and the segmental apparatus of the spinal cord. Each group of those studied was shown to be characterized by peculiar correlations of the voltage-time curves of the central and motor responses of the musculus soleus and the muscles of the sole to electrical stimulation of the tibial nerve. The correlation of these curves is suggested to be used as an electrophysiological index for the diagnosis of the subclinical forms of the above syndromes.

[H-reflex of the flexor carpi radialis in healthy subjects and in nervous system pathology]. / H-refleks luchevogo sgibatelia kisti v norme i pri patologii nervnoi sistemy.

More than half of a series of healthy adults subjected to electrical stimulation of the median nerve from the wrist radial flexor showed not only the direct M-response but also H-reflex. The ratio of the maximal amplitudes of the H-reflex and M-potential (H max/M max) averaged 11.5 +/- 2.2%. In patients presenting a clinical picture of the pyramidal syndrome, the H-reflex was induced in all observations while the H max/M max was on the average 34.3 +/- 9.7%. In patients with a combination of conduction and segmental disturbances at the cervical level, the central response was absent in some studies whereas in others it had antidromal or reflex nature. All cases with polyneuropathies and median nerve impairments exhibited the absence of the late potential of the wrist radial flexor. A conclusion is drawn about the diagnostic value of the central response of the studied muscle.

[Pathophysiology of spinal shock in man according to the results of stimulation electromyography]. / Patofiziologiia spinal'nogo shoka u cheloveka po dannym stimuliatsionnoi élektromiografii.

Electromyography was made in 5 patients with a clinical picture of spinal shock. Within the first 4 days of the disease the disappearance of T potential of the soleus muscle was accompanied by the decreased amplitude of its H reflex, the enhancement of the phenomenon of H reflex depression upon low-frequency stimulation and predominance of the reflex component in the central response of the medial muscles of the foot sole. During weeks 4 and 8 of the spinal shock, there disappeared not only T potential but also H reflex of the soleus muscle and the central response of the foot muscles. It is concluded that during acute total disconnection of the descending control there is a successive loss of the functions of gamma-motoneurons, interneurones that mediate the segmental (probably, presynaptic) inhibition, and of alpha-motoneurons.

[Neurophysiology of the pain syndrome in lumbar osteochondrosis]. / Neirofiziologiia bolevogo sindroma pri poiasnichnom osteokhondroze.

Data on the character of evoked central responses of the soleus and the anterior tibial muscles, as well as the minor muscles of the foot sole and patients with the so-called discogenic lumbar radiculitis are presented. In addition, results of treating this pathology by the method of anti-algetic supracutaneous electric stimulation are described. On the basis of comparing all the data it is concluded that of importance in the neurophysiological mechanism of the pain in lumbar osteochondrosis are not only hyperimpulsation alone the thin pain-conducting fibres, but also insufficient conduction of signals alone large-diameter afferent fibres, as well as weakening of the segmental inhibitory processes and deterioration of the functioning of the antinociceptive system.

[Analgesic cutaneous electrostimulation in diseases of the nervous system (technic and indications)]. / Protivobolevaia nakozhnaia élektrostimuliatsiia pri zabolevaniiakh nervnoi sistemy (metodika i pokazaniia).

In 76 patients with various pathologies of the nervous system accompanied with the pain syndrome, cutaneous electric stimulation was used for analgesia. The optimal effect was attained by proper positioning of the electrodes, use (as usual) of the monopolar method of the stimulation simultaneously in two sites, and maintenance of the definite parameters of the electric current (rectangular impulse duration 0.1 to 0.2 msec, frequency 60 to 70 o. p. s., current strengh 30 to 50 mA). A prolonged analgesic effect depended little on the disease entity: it was the duration of the pain syndrome that was the main factor predetermining the degree of the analgesic effect.

[Diagnosis of subclinical manifestations of the pyramidal syndrome by stimulation electromyography]. / Diagnostika subklinicheskikh proiavlenii piramidnogo sindroma metodami stimuliatsionnoi élektromiografii.

The studies were carried out on patients with cerebral and spinal pathology (transient disturbances of cerebral circulation, post-traumatic epilepsy, cervical myelopathy with segmental disorders, etc.). Despite the absence of the clinical manifestations of the pyramid syndrome most patients showed diversely directed shifts of the amplitude of the soleus muscle H-reflex, absence of the depression of this response on high-frequency stimulation, presence of the H-potential in the foot muscles, and an increase of the amplitude of the H-reflex (withdrawn by needle electrodes) of the anterior tibial muscle. It has been concluded that of greater diagnostic value for revealing subclinical forms of the pyramid-extrapyramid insufficiency are electrophysiological findings characterizing the state of the spinal inhibition mechanisms, rather than tests characterizing the level of the motor neuron activity.

[Subclinical forms of spinal disorders in discogenic lumbar radiculitis]. / Subklinicheskie formy spinal'nykh narushenii pri diskogennykh poiasnichnykh radikulitakh

In patients with discogenic lumbar radiculitis with a unilateral affection of L5 or S1 root motor and central responses of the medial group of plantar muscles were recorded. In S1 root pathology the central response consisted in 25% of the cases in repeated antidromal discharges, which testified to an increased excitability of the corresponding alpha-motoneurons. In patients with L5-radiculitis a predominance of the reflex component in the response was typical. Since this phenomenon was lacking in combined L5 and S1 root lesions, it was interpreted as a sign of a decreasing function of the segmental inhibitory interneurons.