Behavior of the H-reflex in humans following mechanical perturbation or injury to rostral spinal cord
- PMID: 8874394
- DOI: 10.1002/(SICI)1097-4598(199611)19:11<1373::AID-MUS1>3.0.CO;2-9
Behavior of the H-reflex in humans following mechanical perturbation or injury to rostral spinal cord
Abstract
In humans H-reflexes are suppressed during early spinal shock. In animals rostral cord injury results in loss of segmental reflexes within seconds. If H-reflexes persist under general anesthesia, can they be used to monitor the integrity of the rostral cord? In part I of this study, we recorded H-reflexes intraoperatively in 25 patients to elucidate general anesthesia effect. In 23 subjects, H-reflexes were consistently elicited, and within +/- 13% of the normalized group mean amplitude. In part II, we recorded H-reflexes in 31 patients during spinal cord surgery to elucidate H-reflex behavior immediately following rostral spinal cord injury. In 6, abrupt suppression of the H-reflex coincided with cord injury. In 4 of 6, suppression was transient and less than 50% of baseline; none of these patients developed neurological deficits. In 2, suppression exceeded 90% and persisted throughout surgery; both patients developed profound deficits. We conclude that (1) the H-reflex can be consistently elicited under general anesthesia in most patients, (2) rostral cord injury rapidly suppresses the H-reflex, and (3) the degree and duration of H-reflex suppression reflects the severity of the injury.
Similar articles
-
Operant conditioning of H-reflex increase in spinal cord--injured rats.J Neurotrauma. 1999 Feb;16(2):175-86. doi: 10.1089/neu.1999.16.175. J Neurotrauma. 1999. PMID: 10098962
-
Spinal motoneuron excitability after acute spinal cord injury in humans.Neurology. 1996 Jul;47(1):231-7. doi: 10.1212/wnl.47.1.231. Neurology. 1996. PMID: 8710084
-
[Descending modulation of the reflex reactions of the spinal motor neurons in human spinal cord damage].Neirofiziologiia. 1988;20(1):105-13. Neirofiziologiia. 1988. PMID: 3380204 Russian.
-
Intraoperative applications of the H-reflex and F-response: a tutorial.J Clin Monit Comput. 2006 Aug;20(4):267-304. doi: 10.1007/s10877-006-9036-x. Epub 2006 Jul 1. J Clin Monit Comput. 2006. PMID: 16816892 Review.
-
Mechanisms underlying the recovery of lower urinary tract function following spinal cord injury.Prog Brain Res. 2006;152:59-84. doi: 10.1016/S0079-6123(05)52005-3. Prog Brain Res. 2006. PMID: 16198694 Review.
Cited by
-
Suprasegmental neurophysiological monitoring with H reflex and TcMEP in spinal surgery. Transient loss due to hypotension. A case report.Clin Neurophysiol Pract. 2016 Sep 16;1:54-57. doi: 10.1016/j.cnp.2016.09.001. eCollection 2016. Clin Neurophysiol Pract. 2016. PMID: 30214960 Free PMC article.
-
Distributed stimulation increases force elicited with functional electrical stimulation.J Neural Eng. 2018 Apr;15(2):026001. doi: 10.1088/1741-2552/aa9820. J Neural Eng. 2018. PMID: 29099387 Free PMC article.
-
The Relationship between Trans-Lesional Conduction, Motor Neuron Pool Excitability, and Motor Function in Dogs with Incomplete Recovery from Severe Spinal Cord Injury.J Neurotrauma. 2017 Nov 1;34(21):2994-3002. doi: 10.1089/neu.2017.5012. Epub 2017 Jun 16. J Neurotrauma. 2017. PMID: 28462632 Free PMC article.
-
The onset of hyperreflexia in the rat following complete spinal cord transection.Spinal Cord. 2008 Dec;46(12):798-803. doi: 10.1038/sc.2008.49. Epub 2008 Jun 10. Spinal Cord. 2008. PMID: 18542097 Free PMC article.
-
Nitrous oxide can enhance the hypnotic effect, but not the suppression of spinal motor neuron excitability by propofol in humans.J Anesth. 2006;20(3):173-8. doi: 10.1007/s00540-006-0394-9. J Anesth. 2006. PMID: 16897235 Clinical Trial.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
