Jusić A, Baraba R, Bogunović A
Department of Neurology, University of Zagreb, Croatia.
Electromyogr Clin Neurophysiol. 1995 Dec;35(8):471-8.
The systematic analyses of secondary muscle potentials of H-reflex and F-wave type were done in multicentric study. The examinations were carried out in healthy volunteers with 9 muscles analysed on the legs and 9 on the lower arms and hands. The H-reflex potential was found regularly in thigh muscles (vastus medialis 100%, biceps femoris 97%, semitendinosus 93%). Less frequently but still with high incidence it appeared in posterior lower leg muscles (soleus 93%, caput mediale gastrocnemii 73%). In anterior tibial muscle and extensor digitorum brevis it did not appear at all. Only exceptionally it was found in short peroneal muscle (3%) and occasionally, only on proximal nerve stimulation, in flexor hallucis brevis. The similar distribution pattern was found in lower arm and hand muscles with analysis on both sides. In flexor digitorum superficialis (73-70%) and flexor carpi radialis (73-57%) the percentage of H-potential muscles was the highest, in flexor carpi ulnaris (47-40%) lesser but still remarkable. Brachioradialis (37-30%) and extensor digitorum communis (27-27%) percentage decreased further. The even more distal, pronator quadratus (21-20%) and abuctor digiti minimi (17-17%) presented as muscles with low incidence of H-reflex positivity. In extensor indicis proprius (3%) the lowest H-potential incidence was found and in opponens pollicis no H-potential at all. F-waves if evaluated as "F-frequency" follow the similar distribution pattern. The lowest "F-frequency" was found on the legs in anterior tibial, short peroneal and extensor digitorum brevis muscles. In the last one more than one half of stimuli failed to evoke the F-potential. Those are the muscles in which H-potentials almost never appeared. The highest "F-frequency" was recorded in thigh, posterior lower leg muscle and flexor hallucis brevis. Some of the examinees displayed in almost all examined muscles H-potential (6 of 30), the others (9 of 30) had it in neither one or in a single muscle. It looks like as if a kind of H-reflex or F-wave individuals exist. If the H- or F-potentials distribution pattern got projected on the homunculus in quadrupedal position the following idea appears. The thigh muscles, the plantar flexors of the feet and hand and finger flexors are first of all tonic muscles mostly involved in standing or holding. The extensors of the foot/toes, respectively of hand/fingers interrupt phasically the sustained action of standing by lifting the foot/hand from the ground. The muscles with mostly tonic function produce much H-reflexes, transitional forms or at least F-wave with high "F-frequency". Is that a kind of phylogenetical remnants, better developed in the motorically less differentiated legs? Have the H-reflex muscles if compared with F-wave muscles different motor units structure? Have they different motoneurons, with different liability to produce recurrent discharges?
在多中心研究中对H反射和F波类型的继发性肌肉电位进行了系统分析。对健康志愿者进行了检查，分析了腿部的9块肌肉以及下臂和手部的9块肌肉。H反射电位在大腿肌肉中经常出现（股内侧肌100%，股二头肌97%，半腱肌93%）。在小腿后部肌肉中出现频率较低但仍有较高发生率（比目鱼肌93%，腓肠肌内侧头73%）。在胫骨前肌和趾短伸肌中根本不出现。仅在极少数情况下在腓骨短肌中发现（3%），偶尔仅在近端神经刺激时在拇短屈肌中发现。在下臂和手部肌肉中两侧分析时发现了类似的分布模式。在指浅屈肌（73 - 70%）和桡侧腕屈肌（73 - 57%）中H电位肌肉的百分比最高，在尺侧腕屈肌（47 - 40%）中较低但仍很显著。肱桡肌（37 - 30%）和指总伸肌（27 - 27%）的百分比进一步降低。更靠远端的旋前方肌（21 - 20%）和小指展肌（17 - 17%）表现为H反射阳性发生率低的肌肉。在示指固有伸肌中发现H电位发生率最低（3%），在拇对掌肌中根本没有H电位。如果将F波评估为“F频率”，则遵循类似的分布模式。在腿部，胫骨前肌、腓骨短肌和趾短伸肌的“F频率”最低。在最后一块肌肉中，超过一半的刺激未能引出F电位。这些就是几乎从未出现H电位的肌肉。“F频率”最高的记录出现在大腿、小腿后部肌肉和拇短屈肌中。一些受检者在几乎所有检查的肌肉中都有H电位（30人中的6人），另一些人（30人中的9人）在任何一块肌肉中都没有或仅在一块肌肉中有H电位。似乎存在一种H反射或F波个体。如果将H或F电位的分布模式投影到四足动物体位的运动小人图上，就会出现以下想法。大腿肌肉、足部和手部及手指的跖屈肌首先是主要参与站立或握持的紧张性肌肉。足部/脚趾的伸肌，分别是手部/手指的伸肌，通过将足部/手部从地面抬起，阶段性地中断站立的持续动作。具有主要紧张性功能的肌肉产生许多H反射、过渡形式或至少具有高“F频率”的F波。这是一种系统发育残留吗？在运动分化程度较低的腿部发育得更好？与F波肌肉相比，具有H反射的肌肉有不同的运动单位结构吗？它们有不同的运动神经元，产生反复放电的倾向不同吗？
