Showing papers by "David Burke published in 1983"

The afferent volleys responsible for spinal proprioceptive reflexes in man

Abstract: 1. To define the neural volleys responsible for the Achilles tendon jerk and the H reflex, muscle afferent activity was recorded using micro-electrodes inserted percutaneously into appropriate fascicles of the tibial nerve in the popliteal fossa.2. The response of soleus muscle afferents to tendon percussion consisted of a dispersed volley, starting 3.5-7.0 ms after percussion, increasing to a peak over 6.5-11.0 ms, and lasting 25-30 ms, depending on the strength of percussion. Electrical stimuli to the sciatic nerve at a level adequate to evoke an H reflex but subthreshold for the M wave produced a more synchronized volley, the fastest fibres of which had conduction velocities of 62-67 m/s, and the slowest 36-45 m/s.3. The wave of acceleration produced by percussion subthreshold for the ankle jerk spread along the skin at over 150 m/s. Midway between the bellies of the gastrocnemii it consisted of a damped oscillation with four to five separate phases and maximum amplitude approximately one-twentieth of that recorded on the Achilles tendon.4. With ten primary spindle endings, tendon percussion subthreshold for the ankle jerk elicited two to five spike discharges per tap, the shortest interspike intervals being 4-7 ms. Tendon percussion elicited single discharges from two Golgi tendon organs, and altered the discharge pattern of a single secondary spindle ending. The degree of dispersion of the multi-unit muscle afferent volley can be explained by the pattern of discharge of primary spindle endings.5. Percussion on the Achilles tendon evoked crisp afferent volleys in recordings from nerve fascicles innervating flexor hallucis longus, tibialis posterior, the intrinsic muscles of the foot and the skin of the foot. Electrical stimuli delivered to the tibial nerve in the popliteal fossa at a level sufficient for the H reflex of soleus produced either a volley in muscle afferents from the intrinsic muscles of the foot or a volley in cutaneous afferents from the foot.6. For comparable stimuli in the two positions, the H reflex was inhibited but the Achilles tendon jerk enhanced when the ankle was dorsiflexed from 105 degrees to 90 degrees .7. The duration of the rise times of the excitatory post-synaptic potentials (e.p.s.p.s) produced in soleus motoneurones by electrical stimulation, and by tendon percussion subthreshold for the H reflex and the ankle jerk respectively, was estimated from post-stimulus time histograms of the discharge of voluntarily activated single motor units in soleus. The mean e.p.s.p. rise times were 1.9 ms for electrical stimulation and 6.6 ms for tendon percussion. There was evidence that the duration of the electrically evoked e.p.s.p. was curtailed by an inhibitory post-synaptic potential (i.p.s.p.) of only slightly longer latency than the e.p.s.p.8. The mechanically induced and electrically induced afferent volleys are not homogeneous volleys in group I a afferents from triceps surae. The afferent volleys differ in so many respects that it is probably invalid to compare the H reflex and tendon jerk as a measure of fusimotor activity. It is suggested that neither reflex can be considered a purely monosynaptic reflex.

Muscle spindle discharge in response to contraction of single motor units.

Abstract: 1. In human subjects, microelectrode recordings were made from 25 muscle spindle afferents and two tendon organ afferents coming from muscles innervated by the peroneal nerve. 2. Stimulation at low intensity through the recording microelectrode activated efferent axons innervating motor units in close proximity to the muscle spindle or tendon organ. There was a clear alteration in the discharge of 17 afferents (15 muscle spindle, 2 tendon organ) in response to twitch contractions that involved only one, two, or three motor units. With three other afferents there was a less overt but statistically significant alteration in discharge rate by the twitch contraction of a single motor unit. 3. The sensitivity of 21 receptors (20 spindles, 1 tendon organ) to twitch contractions of anatomically close motor units was contrasted with their sensitivity to twitches of more remote motor units in the muscle. In no instance was the sensitivity to the contraction of remote motor units greater than that to the contraction of local motor units stimulated through the microelectrode; with remote stimulation many units usually had to be activated before the resulting twitch contraction altered the discharge of an afferent. 4. It is concluded that muscle spindles as well as tendon organs can play a role in monitoring the activity of motor units anatomically close to the receptor.

Convergence in the somatosensory pathway between cutaneous afferents from the index and middle fingers in man.

Abstract: Average short-latency cerebral potentials were recorded from the parietal scalp to mechanical stimulation of the index and middle fingers and to electrical stimulation of the digital nerves in normal subjects. The early components of the cerebral potential, representing the arrival of the afferent volley at the sensorimotor cortex, were studied during stimulation of the fingers separately and together. When strong or moderate stimuli were used there was a suppressive interaction between the afferent input from the two fingers with either electrical or mechanical stimulation. During simultaneous stimulation of both fingers the size of the early component of the cerebral potential was less than predicted by simple addition of the potentials produced by stimulation of the fingers individually. When very weak stimuli, close to the level necessary for detection by the subject, the input from the two fingers produced additive or facilitatory interactions in the early components of the cerebral potential. These results suggest that there is convergence between the afferent inputs from the index and middle fingers along the somatosensory pathway. At levels of stimulation comparable to those which produced facilitation in the electrophysiological studies, simultaneous stimulation to both fingers was detected significantly more frequently than would be expected from the detection of stimulation to individual fingers.

Tarsal tunnel syndrome and peripheral neuropathy in rheumatoid disease

Abstract: Thirty patients with classical or definite rheumatoid disease (RD) with foot pain and radiologically demonstrated erosions were studied electrodiagnostically to ascertain the frequency of the tarsal tunnel syndrome and peripheral neuropathy. Four patients (13.3%) had evidence of the tarsal tunnel syndrome. The electrical abnormalities were mild and unassociated with specific clinical features. Two patients (6.6%) had evidence of sensory peripheral neuropathy. There may be an appreciable frequency of clinically unsuspected tarsal tunnel syndrome in RD.

The effect of warning and prior instruction on short-latency cerebral potentials produced by muscle afferents in man.

Abstract: This study examined the effect of a warning and of prior instruction on the early components of the cerebral potential produced by stimulation of the left posterior tibial nerve at the ankle. Early components of this potential are dominated by the activity in muscle afferents from the small muscles of the foot. In 50% of presentations, the stimulus to the posterior tibial nerve was preceded by an auditory cue. In some sequences subjects were required to move toes on the left foot immediately the stimulus was detected. Although subjects responded more rapidly to shocks which were preceded by a warning there was no statistically significant effect of the warning on the amplitude or latency of the early components of the muscle afferent cerebral potential. Prior instruction to respond to the stimulus also failed to change the cerebral potentials. This study suggests that the ability to respond more rapidly to "warned" stimuli is due to events "upstream" of the sensorimotor cortex rather than to enhancement of the volley arriving at the cortex.