Mercan Metin, Kuruoğlu Reha
Department of Neurology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye.
Department of Neurology, Gazi University Faculty of Medicine, Ankara, Türkiye.
Front Neurol. 2024 Nov 19;15:1462882. doi: 10.3389/fneur.2024.1462882. eCollection 2024.
This study aimed to investigate the physiological and anatomical factors influencing the flexor carpi radialis (FCR) H-reflex and to establish reference values for FCR H-reflex parameters in relation to these factors.
The FCR H-reflexes, elicited by median nerve stimulation, were assessed in 80 healthy individuals both at rest and during isometric voluntary contraction (IVC). Multiple linear regression analyses were performed with H-reflex parameters as the dependent variables, while age, gender, height, arm length, and weight were included as independent variables.
The FCR H-reflex was recorded bilaterally in nearly all healthy individuals (76 out of 80) during IVC, while it could be obtained in only 35% (28 out of 80) of these individuals at rest. During IVC, the maximum H-reflex amplitude (Hmax) and its ratio to the maximum M-response amplitude (Hmax/Mmax ratio) were significantly increased ( < 0.001). However, there were no changes in H-reflex latency, latency difference, conduction velocity (HRCV), or amplitude ratio ( > 0.05). In both conditions, age and arm length were the most important factors affecting H-reflex latency ( < 0.001), while HRCV was influenced only by age ( < 0.01). Women exhibited shorter H-reflex latencies ( < 0.01), and both Hmax amplitude and Hmax/Mmax ratio were higher in women during IVC ( < 0.05). The H-reflex amplitude ratio during IVC showed a tendency to decrease with age ( < 0.05).
These findings suggest that FCR H-reflexes are more reliably elicited during IVC, and that both physiological and anatomical factors should be considered when assessing H-reflex abnormalities.
本研究旨在探讨影响桡侧腕屈肌（FCR）H反射的生理和解剖因素，并建立与这些因素相关的FCR H反射参数的参考值。
对80名健康个体在静息状态和等长自主收缩（IVC）期间进行正中神经刺激诱发的FCR H反射评估。以H反射参数作为因变量进行多元线性回归分析，同时将年龄、性别、身高、臂长和体重作为自变量纳入分析。
几乎所有健康个体（80例中的76例）在IVC期间双侧均可记录到FCR H反射，而在静息状态下只有35%（80例中的28例）个体能够记录到。在IVC期间，最大H反射波幅（Hmax）及其与最大M波反应波幅的比值（Hmax/Mmax比值）显著增加（<0.001）。然而，H反射潜伏期、潜伏期差值、传导速度（HRCV）或波幅比值无变化（>0.05）。在两种状态下，年龄和臂长是影响H反射潜伏期的最重要因素（<0.001），而HRCV仅受年龄影响（<0.01）。女性的H反射潜伏期较短（<0.01），在IVC期间女性的Hmax波幅和Hmax/Mmax比值均较高（<0.05）。IVC期间的H反射波幅比值有随年龄降低的趋势（<0.05）。
这些发现表明，在IVC期间FCR H反射更容易可靠引出，并且在评估H反射异常时应同时考虑生理和解剖因素。
