Neurophysiological Changes Following Spinal Cord Lesions in Man

SUMMARY: A study has been made of the neurophysiological changes that follow spinal cord lesions in man. The Achilles tendon reflex (ATR) is used to estimate transmission in the la monosynaptic pathway, and the tonic vibration reflex (TVR) to estimate transmission in the la polysynaptic pathway to motoneurons. The inhibition of the H reflex by vibration is used as an estimate of presynaptic inhibition of the la monosynaptic pathway. Immediately following a complete lesion of the spinal cord presynaptic inhibition of the la monosynaptic pathway appears to be greatly increased. This enhanced inhibition may last several months but it eventually declines and in some instances becomes less than normal. Transmission in the la polysynaptic pathway is permanently abolished by a complete spinal lesion. A hypothesis is developed from these findings to explain the evolution of some of the clinical features that follow complete spinal lesions in man. Distinct differences are observed when the spinal lesion is incomplete. Transmission in the la polysynaptic pathway may be preserved and there may be no increase in presynaptic inhibition. These differences may depend upon the integrity of certain spinal long tracts which cannot be tested clinically.

[1]  M. Verrier,et al.  Studies on the receptor responsible for vibration induced inhibition of monosynaptic reflexes in man. , 1975, Journal of neurology, neurosurgery, and psychiatry.

[2]  P. Ashby,et al.  Segmental reflex pathways in spinal shock and spinal spasticity in man , 1974, Journal of neurology, neurosurgery, and psychiatry.

[3]  P. J. Delwaide,et al.  Human Monosynaptic Reflexes and Presynaptic Inhibition , 1973 .

[4]  P. Dietrichson.  The Role of the Fusimotor System in Spasticity and Parkinsonian Rigidity , 1973 .

[5]  D. Burke,et al.  Studies of the Reflex Effects of Primary and Secondary Spindle Endings in Spasticity , 1973 .

[6]  R. Mark,et al.  Renshaw Cell Activity in Normal and Spastic Man , 1973 .

[7]  J. Lance.  The reflex effects of muscle vibration. , 1973, Proceedings of the Australian Association of Neurologists.

[8]  D. Burke,et al.  Tonic vibration reflex in spasticity, Parkinson's disease, and normal subjects , 1972, Journal of neurology, neurosurgery, and psychiatry.

[9]  G. Eklund.  On muscle vibration in man; an amplitude-dependent inhibition, inversely related to muscle length. , 1971, Acta physiologica Scandinavica.

[10]  R. Johnston,et al.  The achilles tendon reflex and the H-response during and after tendon vibration. , 1971, Physical therapy.

[11]  E. Luschei,et al.  Relationship of firing patterns of units in face area of monkey precentral cortex to conditioned jaw movements. , 1971, Journal of Neurophysiology.

[12]  J. He,et al.  Electromyographic findings in lower extremities of patients with traumatic quadriplegia , 1971 .

[13]  D. Burke,et al.  Tonic vibration reflex in the cat. , 1971, Journal of neurophysiology.

[14]  P. Dietrichson.  PHASIC ANKLE REFLEX IN SPASTICITY AND PARKINSONIAN RIGIDITY , 1971, Acta neurologica Scandinavica.

[15]  L. Edström.  Selective changes in the sizes of red and white muscle fibres in upper motor lesions and Parkinsonism. , 1970, Journal of the neurological sciences.

[16]  L. Guttmann.  Spinal shock and reflex behaviour in man , 1970, Paraplegia.

[17]  O. Pompeiano,et al.  Inhibition of monosynaptic extensor reflex attributable to presynaptic depolarization of the group Ia afferent fibers produced by vibration of flexor muscle. , 1970, Archives italiennes de biologie.

[18]  P D Neilson,et al.  Presynaptic inhibition of the monosynaptic reflex by vibration , 1969, The Journal of physiology.

[19]  E. Diamantopoulos,et al.  Excitability of motor neurones in spinal shock in man. , 1967, Journal of neurology, neurosurgery, and psychiatry.

[20]  P. Matthews,et al.  The relative sensitivity to vibration of muscle receptors of the cat , 1967, The Journal of physiology.

[21]  E. Diamantopoulos,et al.  Excitability of spinal motor neurones in normal subjects and patients with spasticity, Parkinsonian rigidity, and cerebellar hypotonia. , 1967, Journal of neurology, neurosurgery, and psychiatry.

[22]  M. Takamori.  H reflex study in upper motoneuron diseases , 1967, Neurology.

[23]  J. Lance,et al.  Tonic and phasic spinal cord mechanisms in man , 1966 .

[24]  P. Matthews,et al.  The reflex excitation of the soleus muscle of the decerebrate cat caused by vibration applied to its tendon , 1966, The Journal of physiology.

[25]  A. Lundberg,et al.  Inhibition of transmission to primary afferents by electrical stimulation of the brain stem. , 1966, Archives italiennes de biologie.

[26]  J. Lance,et al.  Differential effects on tonic and phasic reflex mechanisms produced by vibration of muscles in man. , 1966, Journal of neurology, neurosurgery, and psychiatry.

[27]  W. Landau,et al.  Fusimotor Function: Part I. Spinal Shock of the Cat and the Monkey , 1963 .

[28]  W. Landau,et al.  Fusimotor Function: Part III. The Spastic Monkey , 1963 .

[29]  W. Landau,et al.  Fusimotor Function: Part II. Evidence of Fusimotor Depression in Human Spinal Shock , 1963 .

[30]  R. Joynt,et al.  Motoneuron resting potentials in spinal shock. , 1962, The American journal of physiology.

[31]  M SATO,et al.  Response of Pacinian corpuscles to sinusoidal vibration , 1961, The Journal of physiology.

[32]  M. Clare,et al.  The plantar reflex in man, with special reference to some conditions where the extensor response is unexpectedly absent. , 1959, Brain : a journal of neurology.

[33]  G. McCouch,et al.  Sprouting as a cause of spasticity. , 1958, Journal of neurophysiology.

[34]  L. Kirstein.  [Spasticity and rigidity]. , 1953, Nordisk medicin.

[35]  J. Brobeck.  The Integrative Action of the Nervous System , 1948, The Yale Journal of Biology and Medicine.

[36]  D. P. Lloyd.  CONDUCTION AND SYNAPTIC TRANSMISSION OF THE REFLEX RESPONSE TO STRETCH IN SPINAL CATS , 1943 .

[37]  E. Liddell.  THE INFLUENCE OF EXPERIMENTAL LESIONS OF THE SPINAL CORD UPON THE KNEE-JERK , 1936 .

[38]  E. Liddell.  SPINAL SHOCK AND SOME FEATURES IN ISOLATION-ALTERATION OF THE SPINAL CORD IN CATS , 1934 .

[39]  T. Ruch,et al.  RECIPROCAL CHANGES IN REFLEX ACTIVITY OF THE FORE LIMBS INDUCED BY POST-BRACHIAL "COLD-BLOCK" OF THE SPINAL CORD , 1934 .

[40]  E. Liddell,et al.  THE INFLUENCE OF EXPERIMENTAL LESIONS OF THE SPINAL CORD UPON THE KNEE-JERK. I.—ACUTE LESIONS , 1930 .

[41]  G. Riddoch.  THE REFLEX FUNCTIONS OF THE COMPLETELY DIVIDED SPINAL CORD IN MAN, COMPARED WITH THOSE ASSOCIATED WITH LESS SEVERE LESIONS , 1917 .

[42]  W. Smith.  The Integrative Action of the Nervous System , 1907, Nature.

[43]  K. Hagbarth,et al.  The Effect of Muscle Vibration in Normal Man and in Patients with Motor Disorders , 1973 .

[44]  H. E. Johnson,et al.  Electromyographic findings in lower extremities of patients with traumatic quadriplegia. , 1971, Archives of physical medicine and rehabilitation.

[45]  R. Herman,et al.  The myotatic reflex. Clinico-physiological aspects of spasticity and contracture. , 1970, Brain : a journal of neurology.

[46]  P. Zapata.  Peripheral and central factors in the pathophysiology of spinal shock. , 1966, Acta physiologica latino americana.

[47]  A. van Harreveld.  On Spinal Shock. , 1940, Proceedings of the National Academy of Sciences of the United States of America.