Single subthalamic nucleus deep brain stimuli inhibit the blink reflex in Parkinson's disease patients

© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved.The disordered output from the basal ganglia to the pontine tegmentum nuclei is considered responsible for a number of abnormalities in brainstem reflexes in patients with Parkinson's disease. One of the most conspicuous of these abnormalities is the reduced inhibition of the blink reflex by a prepulse stimulus. The circuit of prepulse inhibition involves structures and fibre groups that can be reached by stimuli applied through the electrodes implanted in the subthalamic nucleus for deep brain stimulation (STNDBS). In seven Parkinson's disease patients we examined whether single STNDBS induced prepulse effects on the blink reflex and how they compared with the effects induced by single auditory and somatosensory stimuli. Prepulse inhibition was determined by measuring the percentage inhibition induced in the R2 component of the orbicularis oculi response to supraorbital nerve stimuli. The inter-stimuli intervals (ISI) between the prepulse and the supraorbital nerve stimuli were 0 to 30 ms and 100 ms for single STNDBS and 100 ms for auditory and somatosensory modalities. The results obtained with acoustic and somatosensory stimuli were compared with those obtained from a group of 20 age-matched healthy subjects. Single STNDBS induced significant inhibition of the R2 in all patients at ISIs between 10 and 30 ms, with a mean percentage inhibition of 94% at the ISI of 30 ms. On the contrary, significant inhibition by auditory or somatosensory stimuli was induced in only two out of the seven patients. The mean percentage inhibition at the ISI of 100 ms was 37% for auditory and 40% for somatosensory stimuli, well below reference limits for prepulse inhibition in control subjects (61%). Single STNDBS induces significant prepulse inhibition of the blink reflex in Parkinson's disease patients who have abnormally reduced auditory and somatosensory prepulse effects. This finding helps define the prepulse circuit in humans and the eventual site of its dysfunction in Parkinson's disease.This work was in part accomplished thanks to grant P1040970 from FIS. J.C. has received a scholarship from the non-government Calouste Gulbenkian Foundationinfo:eu-repo/semantics/publishedVersio

Differential responses of spinal motoneurons to fatigue induced by short-lasting repetitive and isometric tasks

[Abstract] Compared to isometric activities, the neural basis of fatigue induced by repetitive tasks has been scarcely studied. Recently, we showed that during short-lasting repetitive tasks at the maximal possible rate (finger tapping for 10 and 30 s), tapping rate and maximal voluntary contraction (MVC) force decrease at the end of finger tapping. We also observed larger silent periods (SP) induced by transcranial magnetic stimulation during MVC post finger tapping. However, if SP were induced by cervicomedullary stimulation (CMS) they remained unchanged. This suggested a supraspinal origin of fatigue for repetitive tasks. Nevertheless, CMS SP only partially explore spinal excitability; therefore, to evaluate a spinal origin of fatigue it is essential to know the features of the CMS-evoked potentials (CMEP). Herein, we evaluated (n = 15) the amplitude of the CMEP during MVC executed immediately (no gap) after a short-lasting finger tapping task; we also evaluated the compound muscle action potential (CMAP) so that the amplitude of the CMEP was expressed as a function of the CMAP amplitude. Indices of fatigue obtained during finger tapping were compared with those obtained during short-lasting maximal isometric tasks. While indices of excitability increased initially in both tasks, they decreased with the isometric task only when the task was prolonged to 30 s. We suggest that the inability to maintain increased levels of spinal excitability during task execution is a neurophysiological mark of fatigue. Our results suggest that the origin of fatigue induced by brief and fast repetitive tasks is not spinal.Galicia. Consellería de Educación; 2007/000140-

Reply to the commentary on Luis et al. "spontaneous plugging of the horizontal semicircular canal with reversible canal dysfunction and recovery of vestibular evoked myogenic potentials"

info:eu-repo/semantics/acceptedVersio

A loud auditory stimulus overcomes voluntary movement limitation in cervical dystonia

Background Patients with cervical dystonia (CD) present with an impaired performance of voluntary neck movements, which are usually slow and limited. We hypothesized that such abnormality could involve defective preparation for task execution. Therefore, we examined motor preparation in CD patients using the StartReact method. In this test, a startling auditory stimulus (SAS) is delivered unexpectedly at the time of the imperative signal (IS) in a reaction time task to cause a faster execution of the prepared motor programme. We expected that CD patients would show an abnormal StartReact phenomenon. Methods Fifteen CD patients and 15 age matched control subjects (CS) were asked to perform a rotational movement (RM) to either side as quick as possible immediately after IS perception (a low intensity electrical stimulus to the II finger). In randomly interspersed test trials (25%) a 130 dB SAS was delivered simultaneously with the IS. We recorded RMs in the horizontal plane with a high speed video camera (2.38 ms per frame) in synchronization with the IS. The RM kinematic-parameters (latency, velocity, duration and amplitude) were analyzed using video-editing software and screen protractor. Patients were asked to rate the difficulty of their RMs in a numerical rating scale. Results In control trials, CD patients executed slower RMs (repeated measures ANOVA, p<0.10−5), and reached a smaller final head position angle relative to the midline (p<0.05), than CS. In test trials, SAS improved all RMs in both groups (p<0.10−14). In addition, patients were more likely to reach beyond their baseline RM than CS (χ2, p<0.001) and rated their performance better than in control trials (t-test, p<0.01). Conclusion We found improvement of kinematic parameters and subjective perception of motor performance in CD patients with StartReact testing. Our results suggest that CD patients reach an adequate level of motor preparation before task execution

Assessment of trunk flexion in arm reaching tasks with electromyography and smartphone accelerometry in healthy human subjects

Reproducció del document publicat a: https://doi.org/10.1038/s41598-021-84789-3Trunk stability is essential to maintain upright posture and support functional movements. In this study, we aimed to characterize the muscle activity and movement patterns of trunk flexion during an arm reaching task in sitting healthy subjects and investigate whether trunk stability is affected by a startling acoustic stimulus (SAS). For these purposes, we calculated the electromyographic (EMG) onset latencies and amplitude parameters in 8 trunk, neck, and shoulder muscles, and the tilt angle and movement features from smartphone accelerometer signals recorded during trunk bending in 33 healthy volunteers. Two-way repeated measures ANOVAs were applied to examine the effects of SAS and target distance (15 cm vs 30 cm). We found that SAS markedly reduced the response time and EMG onset latencies of all muscles, without changing neither movement duration nor muscle recruitment pattern. Longer durations, higher tilt angles, and higher EMG amplitudes were observed at 30 cm compared to 15 cm. The accelerometer signals had a higher frequency content in SAS trials, suggesting reduced movement control. The proposed measures have helped to establish the trunk flexion pattern in arm reaching in healthy subjects, which could be useful for future objective assessment of trunk stability in patients with neurological affections.This work was supported in part by a fellowship from “La Caixa” Foundation (ID 100010434) with fellowship code LCF/BQ/DE18/11670019, in part by the Secretaria d’Universitats i Recerca de la Generalitat de Catalunya under Grant GRC 2017 SGR 01770, in part by the Agencia Estatal de Investigación, the Spanish Ministry of Science, Innovation and Universities, and the European Regional Development Fund under Grant RTI2018 098472-B-I00, in part by the CERCA Program/Generalitat de Catalunya, in part by H2020-ERA-NET Neuron under Grant AC16/00034, in part by La Marató de TV3 2017 under Grant 201713.31, and in part by Premi Beca “Mike Lane” 2019—Castellers de la Vila de Gràcia

Quantitative evaluation of trunk function and the StartReact effect during reaching in patients with cervical and thoracic spinal cord injury

Reproducció del document publicat a: https://doi.org/10.1088/1741-2552/ac19d3Objective. Impaired trunk stability is frequent in spinal cord injury (SCI), but there is a lack of quantitative measures for assessing trunk function. Our objectives were to: (a) evaluate trunk muscle activity and movement patterns during a reaching task in SCI patients, (b) compare the impact of cervical (cSCI) and thoracic (tSCI) injuries in trunk function, and (c) investigate the effects of a startling acoustic stimulus (SAS) in these patients. Approach. Electromyographic (EMG) and smartphone accelerometer data were recorded from 15 cSCI patients, nine tSCI patients, and 24 healthy controls, during a reaching task requiring trunk tilting. We calculated the response time (RespT) until pressing a target button, EMG onset latencies and amplitudes, and trunk tilt, lateral deviation, and other movement features from accelerometry. Statistical analysis was applied to analyze the effects of group (cSCI, tSCI, control) and condition (SAS, non-SAS) in each outcome measure. Main results. SCI patients, especially those with cSCI, presented significantly longer RespT and EMG onset latencies than controls. Moreover, in SCI patients, forward trunk tilt was accompanied by significant lateral deviation. RespT and EMG latencies were remarkably shortened by the SAS (the so-called StartReact effect) in tSCI patients and controls, but not in cSCI patients, who also showed higher variability. Significance. The combination of EMG and smartphone accelerometer data can provide quantitative measures for the assessment of trunk function in SCI. Our results show deficits in postural control and compensatory strategies employed by SCI patients, including delayed responses and higher lateral deviations, possibly to improve sitting balance. This is the first study investigating the StartReact responses in trunk muscles in SCI patients and shows that the SAS significantly accelerates RespT in tSCI, but not in cSCI, suggesting an increased cortical control exerted by these patients.This work was developed in the framework of the joint project 'Biomedical signal interpretation to study motor impairment, neurological disorders and novel personalised neurorehabilitation therapies', between the Fundación Institut Guttmann and the Institute for Bioengineering of Catalonia. This work was supported in part by a fellowship from 'La Caixa' Foundation (ID 100010434) with fellowship code LCF/BQ/DE18/11670019, in part by the Secretaria d'Universitats i Recerca de la Generalitat de Catalunya under Grant GRC 2017 SGR 01770, in part by the Agencia Estatal de Investigación, the Spanish Ministry of Science, Innovation and Universities, and the European Regional Development Fund under Grant RTI2018 098472-B-I00, in part by the CERCA Program/Generalitat de Catalunya, in part by H2020-ERA-NET Neuron under Grant AC16/00034, in part by La Marató de TV3 2017 under Grant 201713.31, and in part by Premi Beca 'Mike Lane' 2019—Castellers de la Vila de Gràcia. The authors declare no competing interests

The effects of auditory startle and nonstartle stimuli on step initiation in Parkinson's disease

[Abstract] Background. Auditory external cues enhance step initiation in Parkinson's disease (PD) patients. We wanted to explore whether a startle reaction has a comparable effect on step initiation in PD. Methods. Thirteen PD patients and 13 aged-matched controls participated in this study. Electromyography pattern and onset toe-off time during a step initiation task were recorded in response to three different stimuli: a visual imperative stimulus; visual stimulus simultaneous with a nonstartle auditory stimulus and with a startle auditory stimulus. Results. In all subjects, onset of tibialis anterior was faster in the startle auditory condition, compared with the nonstartle auditory condition. However, in the patient group, there was no difference in onset of soleus and toe-off between the startle and nonstartle conditions. Conclusions. Startle reaction in PD patients demonstrates a disordered coupling between the anticipatory postural adjustments that initiate the weight shift and the movement to initiate toe-off during step initiation.Ministerio de Ciencia e Innovación; PSI2008-0317

Central nervous system physiology

This is the second chapter of the series on the use of clinical neurophysiology for the study of movement disorders. It focusses on methods that can be used to probe neural circuits in brain and spinal cord. These include use of spinal and supraspinal reflexes to probe the integrity of transmission in specific pathways; transcranial methods of brain stimulation such as transcranial magnetic stimulation and transcranial direct current stimulation, which activate or modulate (respectively) the activity of populations of central neurones; EEG methods, both in conjunction with brain stimulation or with behavioural measures that record the activity of populations of central neurones; and pure behavioural measures that allow us to build conceptual models of motor control. The methods are discussed mainly in relation to work on healthy individuals. Later chapters will focus specifically on changes caused by pathology

The Effects of Startle and Non-Startle Auditory Stimuli on Wrist Flexion Movement in Parkinson's Disease

[Abstract] Startle stimuli lead to shorter reaction times in control subjects and Parkinson's disease (PD) patients. However, non-startle stimuli also enhance movement initiation in PD. We wanted to examine whether a startle-triggered movement would retain similar kinematic and EMG-related characteristics compared to one induced by a non-startle external cue in PD patients. In this study we investigated the electromyography pattern and the reaction time during a wrist flexion movement in response to three different stimuli: a visual imperative stimulus; visual stimulus simultaneous with a non-startle auditory stimulus and with a startle auditory stimulus. Ten PD patients and ten aged matched controls participated in this study. The reaction times were faster for startle and non-startle stimuli in comparison with the visual imperative stimulus, in both patients and control subjects. The startle cue induced a faster reaction than the non-startle cue. The electromyography pattern remained unchanged across the conditions. The results suggest that the startle reaction effect for upper limb movements are unimpaired in PD patients and has different characteristics than the effect of non-startle stimuli.Ministerio de Ciencia e Innovación; DEP2011-2246