Burke D, Adams R W, Skuse N F
Department of Neurology, Prince Henry Hospital, University of New South Wales, Sydney, Australia.
Brain. 1989 Apr;112 ( Pt 2):417-33. doi: 10.1093/brain/112.2.417.
The effects of a voluntary contraction on the H reflexes of various muscles were quantified to determine whether the reflex responses were sufficiently reproducible to be used in diagnostic studies. During a voluntary contraction, H reflexes could be recorded reliably from tibialis anterior and abductor pollicis brevis, but accurate identification of the onset of the H wave from the on-going background EMG required duplicate averages of multiple responses. During a contraction the H reflex could be obtained at lower stimulus intensities in the forearm flexor muscles than when relaxed, and a more clear separation of the H wave from the M wave was possible. The background contraction abolished the attenuation of reflex amplitude with increasing stimulus repetition rates, such that repetition rates of up to 4 Hz could be used without significant loss of reflex amplitude. There were only small and usually insignificant differences in the latency of the H reflex or its variability when elicited with the forearm muscles relaxed and when flexor carpi radialis was contracting steadily. The reflex latencies of abductor pollicis brevis, tibialis anterior and soleus were compared with F wave latencies for these muscles. The minimal F wave latencies were shorter than the H reflex latencies for abductor pollicis brevis (mean 2.2 ms) and tibialis anterior (mean 1.0 ms) but not for soleus. Comparison of the spread of F wave latencies (F max-F min) suggests that, for soleus, F waves are recorded only from the faster conducting motor units in the pool, presumably those less readily recruited in the H reflex. It was calculated that the distribution of motor conduction velocities responsible for the F waves of abductor pollicis brevis was 8.8 m.s-1. This value underestimates the likely distribution of motor conduction velocities for the thenar muscle by as much as 50%, consistent with the view that F waves rarely occur in slowly conducting motor units, the units of lowest threshold in reflex studies. It is concluded that, for many motoneuron pools, the H reflex and the F wave appear preferentially in different motoneurons, low and high threshold, respectively, and that reflex studies can provide information not available from somatosensory evoked potentials or F wave studies.
对自愿收缩对各种肌肉 H 反射的影响进行了量化,以确定反射反应是否具有足够的可重复性,可用于诊断研究。在自愿收缩期间,可以可靠地记录胫前肌和拇短展肌的 H 反射,但要从持续的背景肌电图中准确识别 H 波的起始,需要对多个反应进行重复平均。在收缩期间,与放松时相比,在前臂屈肌中以较低的刺激强度即可获得 H 反射,并且 H 波与 M 波之间的分离更清晰。背景收缩消除了随着刺激重复率增加而出现的反射幅度衰减,因此可以使用高达 4 Hz 的重复率而不会导致反射幅度显著损失。在前臂肌肉放松和桡侧腕屈肌稳定收缩时引出的 H 反射潜伏期或其变异性仅有微小差异,且通常不显著。将拇短展肌、胫前肌和比目鱼肌的反射潜伏期与这些肌肉的 F 波潜伏期进行了比较。拇短展肌(平均 2.2 毫秒)和胫前肌(平均 1.0 毫秒)的最小 F 波潜伏期短于 H 反射潜伏期,但比目鱼肌并非如此。F 波潜伏期范围(F max - F min)的比较表明,对于比目鱼肌,F 波仅从运动神经元池中的快速传导运动单位记录到,推测这些单位在 H 反射中较难被募集。经计算,负责拇短展肌 F 波的运动传导速度分布为 8.8 m.s-1。该值对比鱼际肌运动传导速度的可能分布低估了多达 50%,这与 F 波很少出现在慢传导运动单位(反射研究中阈值最低的单位)的观点一致。得出的结论是,对于许多运动神经元池,H 反射和 F 波分别优先出现在不同的运动神经元中,即低阈值和高阈值运动神经元,并且反射研究可以提供体感诱发电位或 F 波研究无法获得的信息。