Absence of Neuroplastic Changes in the Bilateral H-Reflex Amplitude following Spinal Manipulation with Activator IV.

Background and Objectives: Chiropractic spinal manipulation is an alternative medical procedure for treating various spinal dysfunctions. Great interest exists in investigating its neuroplastic effects on the central nervous system. Previous studies have found contradictory results in relation to the neuroplastic changes in the H-reflex amplitude as a response to manual spinal manipulation. The discrepancies could be partly due to differences in the unilateral nature of these recordings and/or the variable force exerted in manual techniques applied by distinct chiropractors. Concerning the latter point, the variability in the performance of manual interventions may bias the determination of the significance of changes in H-reflex responses derived from spinal manipulation. To investigate such responses, a chiropractic device can be used to provide more precise and reproducible results. The current contribution aimed to examine whether spinal manipulation with an Activator IV instrument generates neuroplastic effects on the bilateral H-reflex amplitude in dancers and non-dancers. Materials and Methods: A radiograph verified spinal dysfunction in both groups of participants. Since there were significant differences between groups in the mean Hmax values of the H-reflex amplitude before spinal intervention, an assessment was made of the possible dependence of the effects of spinal manipulation with Activator IV on the basal conditions. Results: Ten sessions of spinal manipulation with Activator IV did not cause statistically significant changes in the bilateral H-reflex amplitude (measured as the Hmax/Mmax ratio) in either group. Furthermore, no significant difference was detected in the effects of spinal manipulation between groups, despite their distinct basal H-reflex amplitude. Conclusions: Regarding the therapeutic benefits of a chiropractic adjustment, herein carried out with Activator IV, the present findings suggest that the mechanism of action is not on the monosynaptic H-reflex pathway. Further research is needed to understand the mechanisms involved.

Caudal-Rostral Progression of Alpha Motoneuron Degeneration in the SOD1G93A Mouse Model of Amyotrophic Lateral Sclerosis.

Mice with transgenic expression of human SOD1G93A are a widely used model of ALS, with a caudal-rostral progression of motor impairment. Previous studies have quantified the progression of motoneuron (MN) degeneration based on size, even though alpha (α-) and gamma (γ-) MNs overlap in size. Therefore, using molecular markers and synaptic inputs, we quantified the survival of α-MNs and γ-MNs at the lumbar and cervical spinal segments of 3- and 4-month SOD1G93A mice, to investigate whether there is a caudal-rostral progression of MN death. By 3 months, in the cervical and lumbar spinal cord, there was α-MN degeneration with complete γ-MN sparing. At 3 months, the cervical spinal cord had more α-MNs per ventral horn than the lumbar spinal cord in SOD1G93A mice. A similar spatial trend of degeneration was observed in the corticospinal tract, which remained intact in the cervical spinal cord at 3- and 4- months of age. These findings agree with the corticofugal synaptopathy model that α-MNs and CST of the lumbar spinal cord are more susceptible to degeneration in SOD1G93A mice. Hence, there is a spatial and temporal caudal-rostral progression of α-MN and CST degeneration in SOD1G93A mice.

Effects of Medications and Subthalamic Nucleus-Deep Brain Stimulation on the Cutaneous Silent Period in Patients With Parkinson's Disease.

OBJECTIVES: We sought to evaluate whether the cutaneous silent period (CSP) could be an electrophysiological indicator reflective of the effects of therapy for Parkinson's disease (PD), including anti-PD medications or deep brain stimulation (DBS). MATERIAL AND METHODS: We recorded the CSP in 43 patients with PD prior to and following the administration of medication during a pre-DBS evaluation (30 cases) and the "on" and "off" states of subthalamic nucleus DBS (13 cases). The CSP was elicited from the abductor pollicis brevis muscle by an electrical stimulation of the index finger that was 2, 4, and 15 times stronger than the sensory threshold (ST). We measured changes in latencies, including the onset, duration, and end of CSP, and waveform scores from 0 to 3. The correlation between the CSP score and unified PD rating score part III (UPDRS-III) also was assessed. RESULTS: The onset latency and duration of CSP were significantly different between high- (15ST) and low-strength stimulations (2ST and 4ST). However, there were no significant latency changes (onset, duration, end of CSP) before and after receiving medication, or during the on and off state of the DBS. Anti-PD medications substantially increased the CSP waveform score only in the 4ST state. However, the waveform score significantly increased in all stimuli states during the DBS-on state. Both medication and the DBS-on state decreased the UPDRS-III. Nevertheless, there was no statistically significant correlation between the UPDRS-III and CSP waveform scores. CONCLUSION: Different onset latencies and the duration of CSP between low- and high-strength stimuli support the hypotheses proposing two different reflex pathways. Despite being independent from the UPDRS-III, the CSP may be an electrophysiological indicator reflective of the changes in inhibitory activity to the spinal α-motoneuron in response to anti-PD medications and DBS.

Diabetes Mellitus-Related Dysfunction of the Motor System.

Although motor deficits in humans with diabetic neuropathy have been extensively researched, its effect on the motor system is thought to be lesser than that on the sensory system. Therefore, motor deficits are considered to be only due to sensory and muscle impairment. However, recent clinical and experimental studies have revealed that the brain and spinal cord, which are involved in the motor control of voluntary movement, are also affected by diabetes. This review focuses on the most important systems for voluntary motor control, mainly the cortico-muscular pathways, such as corticospinal tract and spinal motor neuron abnormalities. Specifically, axonal damage characterized by the proximodistal phenotype occurs in the corticospinal tract and motor neurons with long axons, and the transmission of motor commands from the brain to the muscles is impaired. These findings provide a new perspective to explain motor deficits in humans with diabetes. Finally, pharmacological and non-pharmacological treatment strategies for these disorders are presented.

Effects of vibration on cutaneous silent period.

Suppression of an ongoing muscle contraction following noxious digital stimulation is called cutaneous silent period (CSP) which is under the influence of several physiological factors. In this study, we aimed to evaluate the influence of group Ia afferents on the cutaneous silent period (CSP) by applying 2-min vibration. CSP was obtained from abductor pollicis brevis muscle after stimulating index finger. The recordings were repeated three times-before, during and after vibration-which was applied over the tendon of flexor carpi radialis muscle. Onset latency, duration and magnitude of total CSP, inhibitory phases I1 and I2, and of the long-loop reflex were measured and compared. Suppression indices of CSP, I1 and I2 increased significantly during and after vibration, indicating significantly less exteroceptive EMG suppression outlasting the time of vibration. Vibration also caused mild shortening of I2 end latency (p = 0.048) and I2 duration (p = 0.019). Our findings indicate that vibration exerts a powerful influence on CSPs and causes reduction in the magnitude of exteroceptive EMG suppression during and after vibration. Although vibration is known to activate Ia afferents, we cannot exclude contribution of other afferents, e.g. mechanoreceptors, as well as pre- or postsynaptic inhibitory effects on ensuing interneurons, or enhanced vibration-related excitatory influence.

Aging and Strength Training Influence Knee Extensor Intermuscular Coherence During Low- and High-Force Isometric Contractions.

Aging is associated with reduced maximum force production and force steadiness during low-force tasks, but both can be improved by training. Intermuscular coherence measures coupling between two peripheral surface electromyography (EMG) signals in the frequency domain. It is thought to represent the presence of common input to alpha-motoneurons, but the functional meaning of intermuscular coherence, particularly regarding aging and training, remain unclear. This study investigated knee extensor intermuscular coherence in previously sedentary young (18-30 years) and older (67-73 years) subjects before and after a 14-week strength training intervention. YOUNG and OLDER groups performed maximum unilateral isometric knee extensions [100% maximum voluntary contraction (MVC)], as well as force steadiness tests at 20 and 70% MVC, pre- and post-training. Intermuscular (i.e., EMG-EMG) coherence analyses were performed for all (three) contraction intensities in vastus lateralis and medialis muscles. Pre-training coefficient of force variation (i.e., force steadiness) and MVC (i.e., maximum torque) were similar between groups. Both groups improved MVC through training, but YOUNG improved more than OLDER (42 ± 27 Nm versus 18 ± 16 Nm, P = 0.022). Force steadiness did not change during 20% MVC trials in either group, but YOUNG demonstrated increased coefficient of force variation during 70% MVC trials (1.28 ± 0.46 to 1.57 ± 0.70, P = 0.01). YOUNG demonstrated greater pre-training coherence during 20% and 70% MVC trials, particularly within the 8-14 Hz (e.g., 20%: 0.105 ± 0.119 versus 0.016 ± 0.009, P = 0.001) and 16-30 Hz (20%: 0.063 ± 0.078 versus 0.012 ± 0.007, P = 0.002) bands, but not during 100% MVC trials. Strength training led to increases in intermuscular coherence within the 40-60 Hz band during 70% MVC trials in YOUNG only, while OLDER decreased within the 8-14 Hz band during 100% MVC trials. Age-related differences in intermuscular coherence were observed between young and older individuals, even when neuromuscular performance levels were similar. The functional significance of intermuscular coherence remains unclear, since coherence within different frequency bands did not explain any of the variance in the regression models for maximum strength or force steadiness during 20 and 70% MVC trials.

The Complexity of H-wave Amplitude Fluctuations and Their Bilateral Cross-Covariance Are Modified According to the Previous Fitness History of Young Subjects under Track Training.

The Hoffmann reflex (H-wave) is produced by alpha-motoneuron activation in the spinal cord. A feature of this electromyography response is that it exhibits fluctuations in amplitude even during repetitive stimulation with the same intensity of current. We herein explore the hypothesis that physical training induces plastic changes in the motor system. Such changes are evaluated with the fractal dimension (FD) analysis of the H-wave amplitude-fluctuations (H-wave FD) and the cross-covariance (CCV) between the bilateral H-wave amplitudes. The aim of this study was to compare the H-wave FD as well as the CCV before and after track training in sedentary individuals and athletes. The training modality in all subjects consisted of running three times per week (for 13 weeks) in a concrete road of 5 km. Given the different physical condition of sedentary vs. athletes, the running time between sedentary and athletes was different. After training, the FD was significantly increased in sedentary individuals but significantly reduced in athletes, although there were no changes in spinal excitability in either group of subjects. Moreover, the CCV between bilateral H-waves exhibited a significant increase in athletes but not in sedentary individuals. These differential changes in the FD and CCV indicate that the plastic changes in the complexity of the H-wave amplitude fluctuations as well as the synaptic inputs to the Ia-motoneuron systems of both legs were correlated to the previous fitness history of the subjects. Furthermore, these findings demonstrate that the FD and CCV can be employed as indexes to study plastic changes in the human motor system.

A distinct functional distribution of α and γ motoneurons in the rat trigeminal motor nucleus.

Gamma-motoneurons (γMNs) play a crucial role in regulating isometric muscle contraction. The slow jaw-closing during mastication is one of the most functional isometric contractions, which is developed by the rank-order recruitment of alpha-motoneurons (αMNs) in a manner that reflects the size distribution of αMNs. In a mouse spinal motor nucleus, there are two populations of small and large MNs; the former was identified as a population of γMNs based on the positive expression of the transcription factor estrogen-related receptor 3 (Err3) and negative expression of the neuronal DNA-binding protein NeuN, and the latter as that of αMNs based on the opposite pattern of immunoreactivity. However, the differential identification of αMNs and γMNs in the trigeminal motor nucleus (TMN) remains an assumption based on the size of cell bodies that were retrogradely stained with HRP. We here examined the size distributions of αMNs and γMNs in the dorsolateral TMN (dl-TMN) by performing immunohistochemistry using anti-Err3 and anti-NeuN antibodies. The dl-TMN was identified by immunopositivity for vesicular glutamate transporter-1. Immunostaining for choline acetyltransferase and Err3/NeuN revealed that the dl-TMN is composed of 65% αMNs and 35% γMNs. The size distribution of αMNs was bimodal, while that of γMNs was almost the same as that of the population of small αMNs, suggesting the presence of αMNs as small as γMNs. Consistent with the size concept of motor units, the presence of smaller jaw-closing αMNs was coherent with the inclusion of jaw-closing muscle fibers with smaller diameters compared to limb muscle fibers.

Effect of streptozotocin-induced diabetes on motoneurons and muscle spindles in rats.

This study examined the alterations in the number and size of motoneurons innervating the medial gastrocnemius (MG) and biceps femoris (BF) motor nuclei in diabetic rats (12 or 22 weeks after injection of streptozotocin) and age-matched controls using retrograde labeling technique. Additionally, morphological alterations of muscle spindles in BF and MG muscles were tested. Significantly fewer labeled MG motoneurons were found in 12- and 22-week diabetic rats as compared with age-matched control animals. In contrast, the number of BF motoneurons was preserved in each group. Compared to control animals, the ratio of larger motoneurons of MG and BF muscle were decreased at 12 weeks, and smaller MG motoneurons were drastically decreased at 22 weeks. Moreover, MG muscle spindle showed reduction of its number and increase of intrafusal muscle fibers; however, BF muscle spindles showed little or no difference from control animals. We conclude that there is an early loss of alpha motoneurons for both MG and BF muscles followed by a later loss of gamma motoneurons in MG muscle in diabetic animals. Moreover, loss of gamma motoneuron might induce atrophy of MG muscle spindles.

Ultrastructural Analysis of GABA- and Glycine-Immunoreactive Nerve Terminals on Jaw-Closing and Jaw-Opening Motoneurons in the Rat / 대한해부학회지

Previous studies have shown that inhibitory synaptic inputs are different between in spinal and trigeminal motor systems and activities of jaw closing and opening alpha motoneurons are different during a chewing cycle. This study examined the distribution of inhibitory synapses made on masseter and digastric motoneurons by using retrograde tracing of wheat germ agglutinin conjugated to horseradish peroxides (WGA-HRP) combined with postembedding immunogold labeling on serial ultrathin sections.Many boutons IR (immunoreactive) to GABA and/or glycine were found to appose on two kinds of motoneurons, which were containing pleomorphic vesicles (a mixture of round, oval and flattened vesicles) and exhibited symmetrical synaptic contacts on the somata. Packing density and synaptic covering % were higher in digastric than in masseter motoneurons. Of 703 boutons apposing on 12 masseter motoneurons, 6.08+/-3.51, 29.67+/-8.89 and 17.78+/-5.22% were IR to GABA only, glycine only, and both GABA and glycine, respectively. Of 637 boutons apposing on 11 digastric motoneurons, 6.37+/-4.64, 19.74+/-8.25 and 12.01+/-5.38% were IR to GABA only, glycine only, and both GABA and glycine, respectively. Proportions of glycine IR boutons were higher than that of GABA IR boutons in both masseter and digastric motoneurons. Packing density and proportion of boutons IR to GABA and/or glycine were higher in jaw closing than in jaw opening motoneurons (packing density, 12.03+/-1.58 vs 10.28+/-2.99; proportion of IR boutons, 53.54+/-8.94% vs 38.12+/-9.38% in jaw closing and opening motoneurons, respectively). These results provide ultrastructural evidence that GABA and glycine act as important neurotransmitters for modulation of jaw movement and that proportion of inhibitory synapses is higher in jaw closing than in jaw opening motoneurons.