Distribution of recurrent inhibition in the human upper limb.

The distribution of homonymous and heteronymous recurrent inhibition among the motor nuclei innervating the main muscles of the human upper limb has been investigated in 25 healthy subjects. Homonymous recurrent inhibition was studied with a specially designed electrophysiological method with paired H-reflexes, previously described by Bussel & Pierrot-Deseilligny (1977), combined with a pharmacological study using a cholinergic agonist, the L-acetylcarnitine (Rossi & Mazzocchio 1991). These methods were used to investigate the Flexor Carpi Radialis (FCR), Extensor Carpi Radialis (ECR), Opponens Pollicis (OP) and Abductor Digiti Minimi (ADM) motor nuclei. In the Deltoid, Triceps, Flexor Carpi Ulnaris (FCU) and Extensor Carpi Ulnaris (ECU) motor nuclei in which it was impossible to evoke clearly distinguishable H-reflexes, homonymous recurrent inhibition was studied with the PSTH technique: homonymous recurrent inhibition was found in Deltoid, Triceps, FCR, FCU, ECR, ECU motor nuclei but not in OP and ADM motor nuclei. Heteronymous recurrent inhibition was studied with the PSTH technique in the Deltoid, Biceps, Triceps, FCR, ECR, FCU, ECU, Flexor Digitorum Communis (FDC), Extensor Digitorum Communis (EDC) motor nuclei as well as those innervating the intrinsic muscles of the hand. The following results were obtained: (1) motor neurones innervating muscles acting at digits do not receive any heteronymous recurrent inhibition; (2) motor neurones innervating muscles acting at the wrist give recurrent inhibition to motor nuclei of proximal muscles but do not receive any recurrent projections from the latter; and (3) motor neurones innervating proximal muscles (acting at shoulder or elbow) are interconnected by recurrent inhibition and receive heteronymous recurrent projections from some wrist muscles but not from intrinsic hand muscles.