Segmental motoneuronal dysfunction is a feature of amyotrophic lateral sclerosis

Simon, NG; Lin, CSY; Lee, M; Howells, J; Vucic, S; Burke, D; Kiernan, MC

Segmental motoneuronal dysfunction is a feature of amyotrophic lateral sclerosis

Simon, NG Lin, CSY Lee, M

Howells, J Vucic, S Burke, D Kiernan, MC

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Publication Type:: Journal Article
Citation:: Clinical Neurophysiology, 2015, 126 (4), pp. 828 - 836
Issue Date:: 2015-01-01

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Field	Value	Language
dc.contributor.author	Simon, NG	en_US
dc.contributor.author	Lin, CSY	en_US
dc.contributor.author	Lee, M https://orcid.org/0000-0001-8872-9901	en_US
dc.contributor.author	Howells, J	en_US
dc.contributor.author	Vucic, S	en_US
dc.contributor.author	Burke, D	en_US
dc.contributor.author	Kiernan, MC	en_US
dc.date.available	2014-07-29	en_US
dc.date.issued	2015-01-01	en_US
dc.identifier.citation	Clinical Neurophysiology, 2015, 126 (4), pp. 828 - 836	en_US
dc.identifier.issn	1388-2457	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115578
dc.description.abstract	© 2014 International Federation of Clinical Neurophysiology. Objectives: There is accumulating evidence of dysfunction of spinal circuits in the pathogenesis of amyotrophic lateral sclerosis (ALS). Methods: The present study was undertaken to characterise the pathophysiological changes in segmental motoneuronal excitability in 28 ALS patients, using recruitment curves of the soleus H-reflex and M-wave, compared with clinical assessments of upper motor neuron (UMN) and lower motor neuron dysfunction. Results: H-reflex recruitment curves established that Hmax/Mmax and slope (Hθ/Mθ) ratios predicted clinical UMN dysfunction (p<0.001). Changes in Hθ/Mθ were driven by reduced Mθ. Assessment of Hmax/Mmax was similar in the ALS and control groups, and was affected by overlap of the H and M recruitment curves in ALS patients. Conclusion: Changes in the slope ratio (Hθ/Mθ) in ALS suggested that alterations in peripheral motor nerve excitability following UMN damage may affect the recorded H-reflex. Increased collision of reflex discharges with antidromically-conducted motor impulses may be exacerbated in ALS due to preferential loss of large-caliber α-motoneurones, which may explain the similarities in Hmax/Mmax between groups. Significance: Findings from the present study provide further insight into the pathophysiology of ALS, specifically the relative contributions of premotoneuronal and segmental motoneuronal dysfunction.	en_US
dc.relation.ispartof	Clinical Neurophysiology	en_US
dc.relation.isbasedon	10.1016/j.clinph.2014.07.029	en_US
dc.subject.classification	Neurology & Neurosurgery	en_US
dc.subject.mesh	Muscle, Skeletal	en_US
dc.subject.mesh	Motor Neurons	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Amyotrophic Lateral Sclerosis	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Neural Conduction	en_US
dc.subject.mesh	H-Reflex	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Segmental motoneuronal dysfunction is a feature of amyotrophic lateral sclerosis	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	126	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	09 Engineering	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	126	en_US

Abstract:

© 2014 International Federation of Clinical Neurophysiology. Objectives: There is accumulating evidence of dysfunction of spinal circuits in the pathogenesis of amyotrophic lateral sclerosis (ALS). Methods: The present study was undertaken to characterise the pathophysiological changes in segmental motoneuronal excitability in 28 ALS patients, using recruitment curves of the soleus H-reflex and M-wave, compared with clinical assessments of upper motor neuron (UMN) and lower motor neuron dysfunction. Results: H-reflex recruitment curves established that Hmax/Mmax and slope (Hθ/Mθ) ratios predicted clinical UMN dysfunction (p<0.001). Changes in Hθ/Mθ were driven by reduced Mθ. Assessment of Hmax/Mmax was similar in the ALS and control groups, and was affected by overlap of the H and M recruitment curves in ALS patients. Conclusion: Changes in the slope ratio (Hθ/Mθ) in ALS suggested that alterations in peripheral motor nerve excitability following UMN damage may affect the recorded H-reflex. Increased collision of reflex discharges with antidromically-conducted motor impulses may be exacerbated in ALS due to preferential loss of large-caliber α-motoneurones, which may explain the similarities in Hmax/Mmax between groups. Significance: Findings from the present study provide further insight into the pathophysiology of ALS, specifically the relative contributions of premotoneuronal and segmental motoneuronal dysfunction.

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http://hdl.handle.net/10453/115578