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Segmental motor neuron dysfunction in amyotrophic lateral sclerosis: Insights from H reflex paradigms

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dc.contributor.authorCastro, José
dc.contributor.authorOliveira Santos, Miguel
dc.contributor.authorSwash, Michael
dc.contributor.authorCarvalho, Mamede
dc.date.accessioned2024-02-21T16:16:11Z
dc.date.available2024-02-21T16:16:11Z
dc.date.issued2024
dc.description© 2024 Wiley Periodicals LLC.pt_PT
dc.description.abstractIntroduction/aims: In amyotrophic lateral sclerosis (ALS), the role of spinal interneurons in ALS is underrecognized. We aimed to investigate pre- and post-synaptic modulation of spinal motor neuron excitability by studying the H reflex, to understand spinal interneuron function in ALS. Methods: We evaluated the soleus H reflex, and three different modulation paradigms, to study segmental spinal inhibitory mechanisms. Homonymous recurrent inhibition (H'RI ) was assessed using the paired H reflex technique. Presynaptic inhibition of Ia afferents (H'Pre ) was evaluated using D1 inhibition after stimulation of the common peroneal nerve. We also studied inhibition of the H reflex after cutaneous stimulation of the sural nerve (H'Pos ). Results: Fifteen ALS patients (median age 57.0 years), with minimal signs of lower motor neuron involvement and good functional status, and a control group of 10 healthy people (median age 57.0 years) were studied. ALS patients showed reduced inhibition, compared to controls, in all paradigms (H'RI 0.35 vs. 0.11, p = .036; H'Pre 1.0 vs. 5.0, p = .001; H'Pos 0.0 vs. 2.5, p = .031). The clinical UMN score was a significant predictor of the amount of recurrent and presynaptic inhibition. Discussion: Spinal inhibitory mechanisms are impaired in ALS. We argue that hyperreflexia could be associated with dysfunction of spinal inhibitory interneurons. In this case, an interneuronopathy could be deemed a major feature of ALS.pt_PT
dc.description.sponsorshipThis work was funded by the project “Spinal circuitry in Motor Neuron Disease: Changes in Spinal and Corticospinal Mechanisms in Amyotrophic Lateral Sclerosis and its variants” (sponsored by Biogen Inc).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMuscle Nerve. 2024 Mar;69(3):303-312pt_PT
dc.identifier.doi10.1002/mus.28035pt_PT
dc.identifier.eissn1097-4598
dc.identifier.issn0148-639X
dc.identifier.urihttp://hdl.handle.net/10451/62780
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/10974598pt_PT
dc.subjectH reflexpt_PT
dc.subjectAmyotrophic lateral sclerosispt_PT
dc.subjectSegmental motor neuronpt_PT
dc.subjectSpinal cord physiologypt_PT
dc.subjectSpinal interneuronspt_PT
dc.titleSegmental motor neuron dysfunction in amyotrophic lateral sclerosis: Insights from H reflex paradigmspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage312pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage303pt_PT
oaire.citation.titleMuscle & Nervept_PT
oaire.citation.volume69pt_PT
person.familyNameCastro
person.familyNameOliveira Santos
person.familyNameSwash
person.familyNamede Carvalho
person.givenNameJosé
person.givenNameMiguel
person.givenNameMichael
person.givenNameMamede
person.identifier.ciencia-id7C1E-6635-38C2
person.identifier.ciencia-idB511-DD32-12D7
person.identifier.orcid0000-0001-8984-475X
person.identifier.orcid0000-0002-8290-0410
person.identifier.orcid0000-0002-8717-8914
person.identifier.orcid0000-0001-7556-0158
person.identifier.scopus-author-id57217474349
person.identifier.scopus-author-id7101990692
person.identifier.scopus-author-id7101893769
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication35b00efd-7239-4c95-be75-9792af2c1633
relation.isAuthorOfPublicationeab02009-54a9-4518-8b22-9426433cea69
relation.isAuthorOfPublicationc6014014-de11-4f31-ac1a-096c54052517
relation.isAuthorOfPublicationdd7f55d4-c2b5-4fd2-9bd1-a9542a62f58f
relation.isAuthorOfPublication.latestForDiscovery35b00efd-7239-4c95-be75-9792af2c1633

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