Muscle Pain and Muscle Spindles

Muscle pain is a common symptom associated with, for example, myofascial syndrome, fibromyalgia and polymyalgia rheumatica. Many diseases of the muscle tissue are, however, completely or nearly painless such as polymyositis and inclusion body myositis. Thus, a mere inflammation cannot be the cause of muscle pain. In needle electromyography (EMG), the insertion of a needle electrode causes pain but further advancement is usually painless. However, there are small spots of muscle tissue where sudden pain is elicited with the needle. In EMG, these ‘active spots’ are observed to produce spontaneous activity in the form of end plate noise and spikes (EPSs). End plate noise is elicited at the neuromuscular junction of α, β or γ motor neuron. EPSs are action potentials of γ or β motor units. Muscle spindles are the main nociceptors in muscle tissue, both in healthy muscle and in diseases with muscle pain by inflammation of the muscle spindles. Multiple possible mechanisms of muscle pain exist. Polymyalgia rheumatica may have interstitial pain and possibly pain associated with muscle spindle capsules. Delayed onset muscle soreness may reflect both interstitial muscle pain caused by minor injuries and pain generated in mildly inflamed muscle spindles

A rare type of fibrillation-like EMG activity

Non peer reviewe

Electromyography of the muscle spindle

In needle electromyography, there are two spontaneous waveforms, miniature end plate potentials and "end plate spikes", appearing usually together. Miniature end plate potentials are local, non-propagating postsynaptic waves, caused by spontaneous exocytosis of acetylcholine in the neuromuscular junction. The prevailing hypothesis states that "end plate spikes" are propagated postsynaptic action potentials of muscle fibers, caused by presynaptic irritation of the motor nerve or nerve terminal. Using several small concentric needle electrodes in parallel with the muscle fibers, most "end plate spikes" are strictly local or propagating for 2-4 mm. At the end plate zone, there are miniature end plate potentials without "end plate spikes". Local "end plate spikes" are junctional potentials of intrafusal gamma neuromuscular junctions of the nuclear bag fibers, and propagated "end plate spikes" are potentials of nuclear chain muscle fibers of muscle spindles. Miniature end plate potentials without "end plate spikes" at the end plate zone derive from alpha neuromuscular junctions. These findings contrast with the prevailing hypothesis. The history of observations and different hypotheses of the origin of end plate spikes are described.Peer reviewe

Optimal digital filters for analyzing the mid-latency auditory P50 event-related potential in patients with Alzheimer's disease

Background: Filtering is an effective pre-processing technique for improving the signal-to-noise ratio of ERP waveforms. Filters can, however, introduce substantial distortions into the time-domain representations of ERP waveforms. Inappropriate filter parameters may lead to the presence of statistically significant but artificial effects, whereas true effects may appear as insignificant. New method: The present study aimed to determine the optimal digital filters for analyzing the auditory P50 component in patients with Alzheimer's disease. To provide evidence of the optimal filter settings, different high-pass and low-pass filters were applied to ERP waveforms obtained from a conditioning testing paradigm. The results facilitate practical recommendations for selection of filters that maximize the signal-to-noise ratio of the P50 components without introducing significant distortions. Results: The present study confirms that filter parameters have a significant effect on the amplitude and gating measures of the P50 component. Setting the high-pass cut-off at 0.1 Hz and the low-pass cut-off at 90Hz (or above) is recommended for P50 component analyses. Comparison with existing methods: The majority of ERP studies on sensory gating report using high-pass filters with 10-Hz cut-offs to measure P50 suppression. Such a high cut-off appeared to induce significant distortions into the ERP waveforms; thus, the authors advise against using these excessive high-pass cut-offs. Conclusions: Filtering broadband signals, such as ERP signals, necessary results in time-domain distortions. However, by adjusting the filter parameters carefully according to the components of interest, it is possible to minimize filter artifacts and obtain more easily interpretable ERP waveforms. (C) 2016 Elsevier B.V. All rights reserved.Peer reviewe

Infancy and early childhood maturation of neural auditory change detection and its associations to familial dyslexia risk

Objective: We investigated early maturation of the infant mismatch response MMR, including mismatch negativity (MMN), positive MMR (P-MMR), and late discriminative negativity (LDN), indexing auditory discrimination abilities, and the influence of familial developmental dyslexia risk. Methods: We recorded MMRs to vowel, duration, and frequency deviants in pseudo-words at 0, 6, and 28 months and compared MMRs in subgroups with vs. without dyslexia risk, in a sample overrepresented by risk infants. Results: Neonatal MMN to the duration deviant became larger and earlier by 28 months; MMN was elicited by more deviants only at 28 months. The P-MMR was predominant in infancy; its amplitude increased by 6 and decreased by 28 months; latency decreased with increasing age. An LDN emerged by 6 months and became larger and later by 28 months. Dyslexia risk affected MMRs and their maturation. Conclusions: MMRs demonstrate an expected maturational pattern with 2-3 peaks by 28 months. The effects of dyslexia risk are prominent but not always as expected. Significance: This large-scale longitudinal study shows MMR maturation with three age groups and three deviants. Results illuminate MMR's relation to the adult responses, and hence their cognitive underpinnings, and help in identifying typical/atypical auditory development in early childhood. (c) 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Muscle activity and acute stress in fibromyalgia

Background: Fibromyalgia (FM) patients are likely to differ from healthy controls in muscle activity and in reactivity to experimental stress. Methods: We compared psychophysiological reactivity to cognitive stress between 51 female FM patients aged 18 to 65 years and 31 age- and sex-matched healthy controls. They underwent a 20-minute protocol consisting of three phases of relaxation and two phases of cognitive stress. We recorded surface electromyography normalized to maximum voluntary muscle contraction (%EMG), the percentage of time with no muscle activity (EMG rest time), and subjective pain and stress intensities. We compared group reactivity using linear modelling and adjusted for psychological and life-style factors. Results: The FM patients had a significantly higher mean %EMG (2.2 % vs. 1.0 %, p <0.001), pain intensity (3.6 vs. 0.2, p <0.001), and perceived stress (3.5 vs. 1.4, p <0.001) and lower mean EMG rest time (26.7 % vs. 47.2 %, p <0.001). In the FM patients, compared with controls, the pain intensity increased more during the second stress phase (0.71, p = 0.028), and the %EMG decreased more during the final relaxation phase (-0.29, p = 0.036). Within the FM patients, higher BMI predicted higher %EMG but lower stress. Leisure time physical activity predicted lower %EMG and stress and higher EMG rest time. Higher perceived stress predicted lower EMG rest time, and higher trait anxiety predicted higher pain and stress overall. Conclusions: Our results suggest that repeated cognitive stress increases pain intensity in FM patients. FM patients also had higher resting muscle activity, but their muscle activity did not increase with pain. Management of stress and anxiety might help control FM flare-ups.Peer reviewe

Transient behavior of photorefractive gratings in a polymer

The transient behavior of photorefractive gratings in the polymer composite poly(N-vinyl carbazole) (PVK), 2,4,7-trinitro-9-fluorenone (TNF), and N,N-diethyl-para-nitroaniline (EPNA) doped with various amounts of 4-(diethylamino)benzaldehyde diphenylhydrazone (DEH) is presented. The influence on the hole drift mobility due to the change in the trap density induced by DEH, was directly measured. (C) 1995 American Institute of Physics

Real-world efficacy of bezlotoxumab for prevention of recurrent Clostridium difficile infection: a retrospective study of 46 patients in five university hospitals in Finland

Reports on real-world experience on efficacy of bezlotoxumab (BEZ) has been lacking thus far. We retrospectively studied the efficacy and safety of BEZ in preventing the recurrence of Clostridium difficile infection (CDI) in five university hospitals in Finland. Seventy-three percent of our 46 patients remained free of recurrence in the following 3 months and the performance remained as 71% effective also among immunocompromised patients. In severe CDI, BEZ prevented recurrence in 63% of cases. From our study patients, 78% had three or more known risk factors for recurrence of CDI. Eight of our patients were waiting for fecal microbiota transplantation but after stopping the antibiotics that were continued to prevent recurrence of CDI and after receiving BEZ, all remained free of recurrence and did not need the procedure. Success with BEZ as an adjunctive treatment in preventing recurrence of CDI in high-risk patients may be rated as high. Among a subgroup of our patients, those already evaluated to be in need of fecal microbiota transplantation, BEZ seems to be an alternative option.</p

SALSA - a sectional aerosol module for large scale applications

"The sectional aerosol module SALSA is introduced. The model has been designed to be implemented in large scale climate models, which require both accuracy and computational efficiency. We have used multiple methods to reduce the computational burden of different aerosol processes to optimize the model performance without losing physical features relevant to problematics of climate importance. The optimizations include limiting the chemical compounds and physical processes available in different size sections of aerosol particles; division of the size distribution into size sections using size sections of variable width depending on the sensitivity of microphysical processing to the particles sizes; the total amount of size sections to describe the size distribution is kept to the minimum; furthermore, only the relevant microphysical processes affecting each size section are calculated. The ability of the module to describe different microphysical processes was evaluated against explicit microphysical models and several microphysical models used in air quality models. The results from the current module show good consistency when compared to more explicit models. Also, the module was used to simulate a new particle formation event typical in highly polluted conditions with comparable results to more explicit model setup.""The sectional aerosol module SALSA is introduced. The model has been designed to be implemented in large scale climate models, which require both accuracy and computational efficiency. We have used multiple methods to reduce the computational burden of different aerosol processes to optimize the model performance without losing physical features relevant to problematics of climate importance. The optimizations include limiting the chemical compounds and physical processes available in different size sections of aerosol particles; division of the size distribution into size sections using size sections of variable width depending on the sensitivity of microphysical processing to the particles sizes; the total amount of size sections to describe the size distribution is kept to the minimum; furthermore, only the relevant microphysical processes affecting each size section are calculated. The ability of the module to describe different microphysical processes was evaluated against explicit microphysical models and several microphysical models used in air quality models. The results from the current module show good consistency when compared to more explicit models. Also, the module was used to simulate a new particle formation event typical in highly polluted conditions with comparable results to more explicit model setup.""The sectional aerosol module SALSA is introduced. The model has been designed to be implemented in large scale climate models, which require both accuracy and computational efficiency. We have used multiple methods to reduce the computational burden of different aerosol processes to optimize the model performance without losing physical features relevant to problematics of climate importance. The optimizations include limiting the chemical compounds and physical processes available in different size sections of aerosol particles; division of the size distribution into size sections using size sections of variable width depending on the sensitivity of microphysical processing to the particles sizes; the total amount of size sections to describe the size distribution is kept to the minimum; furthermore, only the relevant microphysical processes affecting each size section are calculated. The ability of the module to describe different microphysical processes was evaluated against explicit microphysical models and several microphysical models used in air quality models. The results from the current module show good consistency when compared to more explicit models. Also, the module was used to simulate a new particle formation event typical in highly polluted conditions with comparable results to more explicit model setup."Peer reviewe

Meta-analysis fine-mapping is often miscalibrated at single-variant resolution

Funding Information: We acknowledge all the participants and researchers of the 23 biobanks that have contributed to the GBMI. Biobank-specific acknowledgments are included in the Data S3 . We thank H. Huang, A.R. Martin, B.M. Neale, Y. Okada, K. Tsuo, J.C. Ulirsch, Y. Wang, and all the members of Finucane and Daly labs for their helpful feedback. M.K. was supported by a Nakajima Foundation Fellowship and the Masason Foundation . H.K.F. was funded by NIH grant DP5 OD024582 . Publisher Copyright: © 2022 The Author(s)Meta-analysis is pervasively used to combine multiple genome-wide association studies (GWASs). Fine-mapping of meta-analysis studies is typically performed as in a single-cohort study. Here, we first demonstrate that heterogeneity (e.g., of sample size, phenotyping, imputation) hurts calibration of meta-analysis fine-mapping. We propose a summary statistics-based quality-control (QC) method, suspicious loci analysis of meta-analysis summary statistics (SLALOM), that identifies suspicious loci for meta-analysis fine-mapping by detecting outliers in association statistics. We validate SLALOM in simulations and the GWAS Catalog. Applying SLALOM to 14 meta-analyses from the Global Biobank Meta-analysis Initiative (GBMI), we find that 67% of loci show suspicious patterns that call into question fine-mapping accuracy. These predicted suspicious loci are significantly depleted for having nonsynonymous variants as lead variant (2.7×; Fisher's exact p = 7.3 × 10−4). We find limited evidence of fine-mapping improvement in the GBMI meta-analyses compared with individual biobanks. We urge extreme caution when interpreting fine-mapping results from meta-analysis of heterogeneous cohorts.Peer reviewe