Silent period in upper limb muscles after noxious cutaneous stimulation in man.

We studied the effect of electrical stimulation of the C5-C8 dermatomes on voluntary electromyographic activity (EMG) recorded from the ipsilateral first dorsal interosseus (FDI), abductor digiti minimi, flexor and extensor carpi, triceps brachii, biceps brachii, and orbicularis oculi muscles of healthy humans. Finger stimulation (C6-C8) produced an EMG inhibition (silent period, SP), which progressively decreased in duration from distal to proximal muscles; in the biceps it induced a slight facilitation and in the orbicularis oculi muscle, it had no effect. Stimulation of the C5 dermatome induced no response in either distal or proximal muscles. Only high-intensity stimuli evoked clear silent periods. The threshold for evoking an SP was almost double that required for sensory action potentials, 3.25 times the sensory threshold, and decidedly above the pain threshold. An indirect estimation of the conduction velocity of SP afferent fibres placed them in the A-delta group of myelinated fibres. In double-shock experiments, used to study the recovery cycle of the SP in the FDI muscle after finger stimulation, neither low- nor high-intensity conditioning stimuli delivered 100-500 ms before the test stimulus changed test SPs. Experiments designed to evaluate motoneuronal excitability showed that in relaxed FDI muscle, finger stimulation markedly reduced the F wave at the 50 ms time interval, the time when the SP normally occurs. Our findings demonstrate that the activation of A-delta afferents from the fingers inhibits the C7-T1 motoneurons postsynaptically, through an oligosynaptic spinal circuit. We propose that the strong inhibitory effect exerted by noxious cutaneous stimuli on all distal muscles may contribute to a defence action which is specific for the human upper limb.

[1]  J. Kimura,et al.  Disorder of interneurons in Parkinsonism. The orbicularis oculi reflex to paired stimuli. , 1973, Brain : a journal of neurology.

[2]  B. W. Ongerboer de Visser,et al.  Cutaneous silent period in masseter muscles: a clinical and electrodiagnostic evaluation. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[3]  G. Baumgartner,et al.  The effect of nociceptive cutaneous stimuli on human motoneurons. , 1973, Brain : a journal of neurology.

[4]  M. Illert,et al.  Distribution of recurrent inhibition in the cat forelimb. , 1989, Progress in brain research.

[5]  E. Pierrot-Deseilligny,et al.  Pattern of propriospinal‐like excitation to different species of human upper limb motoneurones. , 1991, The Journal of physiology.

[6]  J C Rothwell,et al.  Effect of digital nerve stimuli on responses to electrical or magnetic stimulation of the human brain. , 1992, The Journal of physiology.

[7]  D Bowsher,et al.  Intracranial stimulation of the trigeminal nerve in man. II. Reflex responses. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[8]  A. Rossi,et al.  Distribution of recurrent inhibition in the human upper limb. , 1993, Acta physiologica Scandinavica.

[9]  S. Pullman,et al.  Silent period induced by cutaneous stimulation. , 1991, Electroencephalography and clinical neurophysiology.

[10]  R. Eccles,et al.  Synaptic actions in motoneurones by afferents in which may evoke the flexion reflex , 1959 .

[11]  R. Sumino,et al.  Reflex organization of cat masticatory muscles. , 1968, Journal of neurophysiology.

[12]  D. Walk,et al.  Effects of cutaneous stimulation on ipsilateral and contralateral motoneuron excitability: an analysis using H reflexes and F waves. , 1993, Electromyography and clinical neurophysiology.

[13]  J. Desmedt Motor control mechanisms in health and disease , 1983 .

[14]  A. Berardelli,et al.  Masseter inhibitory reflex in movement disorders. Huntington's chorea, Parkinson's disease, dystonia, and unilateral masticatory spasm. , 1991, Electroencephalography and clinical neurophysiology.

[15]  D. Burke,et al.  Reflex responses in active muscles elicited by stimulation of low-threshold afferents from the human foot. , 1992, Journal of neurophysiology.

[16]  D. Mclellan The electromyographic silent period produced by supramaximal electrical stimulation in normal man , 1973, Journal of neurology, neurosurgery, and psychiatry.

[17]  M. Manfredi,et al.  Recovery cycle of the masseter inhibitory reflex in man , 1984, Neuroscience Letters.

[18]  I. A. Boyd,et al.  Composition of peripheral nerves , 1968 .

[19]  J. Willer Nociceptive flexion reflexes as a tool for pain research in man. , 1983, Advances in neurology.

[20]  A. McComas,et al.  Cutaneous reflexes in small muscles of the hand , 1973, Journal of neurology, neurosurgery, and psychiatry.

[21]  B W Ongerboer de Visser,et al.  Human reflexes and late responses. Report of an IFCN committee. , 1994, Electroencephalography and clinical neurophysiology.

[22]  M. Kofler,et al.  The silent period in pure sensory neuronopathy , 1992, Muscle & nerve.