Firing properties of muscle spindles supplying the intrinsic foot muscles of humans in unloaded and freestanding conditions.

We recently developed an approach for recording from muscle spindles in the intrinsic muscles of the foot in freestanding humans by inserting a tungsten microelectrode into the posterior tibial nerve behind the medial malleolus of the ankle. Here we characterize the behavior of muscle spindles in the small muscles of the foot in 1) seated subjects with the leg horizontal and the foot naturally plantarflexed and 2) standing subjects. In the first study, recordings were made from 26 muscle spindle afferents located within flexor digiti minimi brevis ( n = 4), abductor digiti minimi ( n = 3), quadratus plantae ( n = 3), plantar interossei ( n = 4), flexor digitorum brevis ( n = 3), dorsal interossei ( n = 2), and lumbricals ( n = 2), with one each supplying abductor hallucis, adductor hallucis, and flexor hallucis brevis. The identity of another two muscle afferents was unknown. The majority of the units were silent at rest, only seven (27%) being spontaneously active. Because of the anatomic constraints of the foot, some spindles supplying muscles acting on the toes responded to movements of one or more digits. In the second study, 12 muscle spindle afferents were examined during standing. The ongoing discharge of eight spindle afferents covaried with changes in the center of pressure during postural sway. We conclude that the majority of spindle endings in the small muscles of the foot are silent at rest, which may allow them to encode changes in conformation of the foot when it is loaded during standing. Moreover, these muscle spindle afferents can provide useful proprioceptive information during standing and postural sway. NEW & NOTEWORTHY We have characterized the firing properties of muscle spindles in the intrinsic muscles of the human foot for the first time. The majority of the spindle endings are silent in seated subjects, and most fire tonically during standing, their discharge covarying with center of pressure during postural sway. We conclude that spindle endings in the intrinsic muscles of the foot provide useful proprioceptive information during free standing.

Microneurography from the posterior tibial nerve: a novel method of recording activity from the foot in freely standing humans.

The posterior tibial nerve, located behind the medial malleolus of the ankle, supplies the intrinsic muscles of the foot and most of the skin of the sole. We describe a novel approach for recording from this nerve via a percutaneously inserted tungsten microelectrode and provide examples of recordings from presumed muscle spindle endings recorded in freely standing human subjects. The fact that the angular excursions of the ankle joint are small as the foot is loaded during the transition from the seated position to standing means that one can obtain stable recordings of neural traffic in unloaded, loaded, and freely standing conditions. We conclude that this novel approach will allow studies that will increase our understanding of the roles of muscle and cutaneous afferents in the foot in the control of upright posture. NEW & NOTEWORTHY We have performed the first microneurographic studies from the posterior tibial nerve at the ankle. Stability of the recording site allows one to record from muscle spindles in the intrinsic muscles of the foot as well as from cutaneous mechanoreceptors in the sole of the foot during the transition from seated to standing. This novel approach opens up new opportunities for studying the roles of muscle and cutaneous afferents in the foot in the control of upright stance.

Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome.

Parasympathetic function is important in the induction and maintenance of sleep. We examined whether nocturnal vagal modulation of heart rate is related to the poor sleep quality commonly reported in chronic fatigue syndrome (CFS). Heart rate (HR, as R-R intervals) was continuously monitored during sleep in 20 patients with CFS and 20 matched control subjects. Questionnaires assessed demographic information, symptoms, functional impairment, and subjective sleep quality. CFS was associated with more sleep problems in general and poorer subjective sleep quality on the study night (all p < 0.003), and reports of repeated awakening during the night were 7 times more likely compared to healthy subjects (p = 0.017). Time and frequency-domain parameters of HR variability during sleep were significantly lower in patients with CFS (all p < 0.006). Multiple regression analyses revealed that heart rate variability (HRV) parameters were the best predictors of subjective sleep measures. This study identified significant reductions in vagal modulation of heart rate during sleep in CFS. Low HRV strongly predicted sleep quality-suggesting a pervasive state of nocturnal sympathetic hypervigilance in CFS.

Effects of deep and superficial experimentally induced acute pain on skin sympathetic nerve activity in human subjects.

There is evidence in experimental animals that deep and superficial pain exert differential effects on cutaneous sympathetic activity. Skin sympathetic nerve activity (SSNA) was recorded from the common peroneal nerve of awake human subjects and injections of 0.5 ml hypertonic saline was made into the tibialis anterior muscle (causing a deep, dull ache) or 0.2 ml into the overlying skin (causing a sharp burning pain) at unexpected times. Both deep and superficial pain caused increases in SSNA immediately on injection and preceding the onset of pain for both muscle and skin pain (10.1 +/- 2.4 vs. 15.3 +/- 5.3 s; muscle versus skin, respectively). SSNA increases were short lasting (104.2 +/- 13.4 vs. 81.8 +/- 11.7 s; muscle versus skin pain) and did not follow muscle and skin pain profiles. Sweat release occurred following both intramuscular and subcutaneous injections of hypertonic saline. While muscle or skin pain invariably caused changes in skin blood flow as well as increases in sweat release, skin blood flow increased in females and decreased in males. We conclude that both acute muscle and skin pain cause an increase in SSNA, sweat release and gender-dependent changes in skin blood flow.

Effects of deep and superficial experimentally induced acute pain on muscle sympathetic nerve activity in human subjects.

Human studies conducted more than half a century ago have suggested that superficial pain induces excitatory effects on the sympathetic nervous system, resulting in increases in blood pressure (BP) and heart rate (HR), whereas deep pain is believed to cause vasodepression. To date, no studies have addressed whether deep or superficial pain produces such differential effects on muscle sympathetic nerve activity (MSNA). Using microneurography we recorded spontaneous MSNA from the common peroneal nerve in 13 awake subjects. Continuous blood pressure was recorded by radial arterial tonometry. Deep pain was induced by intramuscular injection of 0.5 ml hypertonic saline (5%) into the tibialis anterior muscle, superficial pain by subcutaneous injection of 0.2 ml hypertonic saline into the overlying skin. Muscle pain, with a mean rating of 4.9 +/- 0.8 (S.E.M.) on a 0-10 visual analog scale (VAS) and lasting on average 358 +/- 32 s, caused significant increases in MSNA (43.9 +/- 10.0%), BP (5.4 +/- 1.1%) and HR (7.0 +/- 2.0%) - not the expected decreases. Skin pain, rated at 4.9 +/- 0.6 and lasting 464 +/- 54 s, also caused significant increases in MSNA (38.2 +/- 12.8%), BP (5.1 +/- 2.1%) and HR (5.6 +/- 2.0%). The high-frequency (HF) to low-frequency (LF) ratio of heart rate variability (HRV) increased from 1.54 +/- 0.25 to 2.90 +/- 0.45 for muscle pain and 2.80 +/- 0.52 for skin pain. Despite the different qualities of deep (dull and diffuse) and superficial (burning and well-localized) pain, we conclude that pain originating in muscle and skin does not exert a differential effect on muscle sympathetic nerve activity, both causing an increase in MSNA and an increase in the LF:HF ratio of HRV. Whether this holds true for longer lasting experimental pain remains to be seen.

Selective activation of muscle and skin nociceptors does not trigger exaggerated sympathetic responses in spinal-injured subjects.

STUDY DESIGN: Measurement of sympathetic effector organ responses to selective activation of muscle and skin nociceptors below lesion in spinal cord-injured (SCI) subjects. OBJECTIVES: To test whether selective noxious stimulation below lesion causes exaggerated sympathetic responses in human SCI. SETTING: Prince of Wales Medical Research Institute, Australia. METHODS: Twelve subjects (C5-T10, ASIA A-C), none of whom had sensation below the lesion, were included in the study. Selective stimulation of muscle or cutaneous nociceptors was produced by bolus injection of hypertonic (5%) saline into the tibialis anterior muscle or overlying skin and compared with non-noxious electrical stimulation of the abdominal wall. Cutaneous vasoconstrictor (photoelectric plethysmography) and sudomotor (skin conductance) responses, in addition to respiration, heart rate and continuous arterial pressure were monitored. RESULTS: Electrical stimulation of the abdominal wall caused a significant increase in arterial pressure (31.8+/-6.1%). Conversely, intramuscular or subcutaneous injection of hypertonic saline caused no significant changes in blood pressure (-3.0+/-2.4%; -1.4+/-3.4%) heart rate, skin blood flow or sweat release. CONCLUSIONS: While hypertonic saline injected into muscle or skin induces strong pain, cutaneous vasoconstriction and sweat release in able-bodied subjects, we saw no evidence of exaggerated sympathoexcitation when these same noxious stimuli were delivered below lesion in subjects with SCI. This suggests that certain types of somatic noxious input may not trigger autonomic dysreflexia, and questions the concept that any painful stimuli originating below lesion can reliably trigger dysreflexia.

Buffer exchange using size exclusion chromatography, countercurrent dialysis, and tangential flow filtration: Models, development, and industrial application.

There are three major methods for buffer exchange of proteins at industrial scale: size exclusion chromatography (SEC), tangential flow filtration (TFF), and countercurrent dialysis (CCD). In order to determine the optimal technology for a given process, a study was done to compare these technologies on a technological and economic basis. This comparison required that new mathematical models be developed which enable the common features of each unit operation to be directly compared. The new concept of a diavolume equivalent for SEC, defined as the inverse of the fractional loading, was also introduced to aid in this comparison. Variables that were examined for each unit operation included range of buffer exchange, dilution of protein solution, yield, buffer requirements, total operating time, throughput, plant space, capital, raw materials, and labor costs. It was found that TFF and CCD have a greater range of buffer exchange than SEC. TFF also provides the advantage that concentration of the protein can readily be accomplished in the same step. For processes of equal batch size and yield, TFF and CCD also provide a two- to five- fold improvement in each of the remaining variables. The major economic advantage in using TFF and CCD over SEC is the decreased plant size required for manufacturing and thus the longer term use of existing facilities. Situations where SEC (or CCD) would be favored over TFF are when protein denaturation occurs in TFF but does not occur in SEC. (c) 1995 John Wiley & Sons, Inc.