[논문]H-Reflex und F-Welle im M. soleus des Menschen

Krott, Hugo M.; Jacobi, Hans M.; Busse, Merita J.

doi:10.1007/bf00316771

H-Reflex und F-Welle im M. soleus des Menschen
H-reflex and F-wave in the soleus muscle of man

Zeitschrift für Neurologie, v.199 no.4, 1971년, pp.332 - 343

Krott, Hugo M. , Jacobi, Hans M. , Busse, Merita J.

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SummarySecondary responses of the soleus muscle were elicited by electrical intranerval stimulation of the tibial nerve using needle electrodes, 15–25 μ in diameter at the tip. Surface electrodes and intramuscular wire electrodes were used for recording. Two potentials with latencies longer than that of the direct response could be elicited in the soleus muscle, corresponding in magnitude to the stimulus: 1. An H-reflex with stimuli smaller than those required for a direct M-response; 2. A polyphasic F-wave varying in form from stimulus to stimulus, displaying a latency more variable (SD ± 1.4 msec) and by 3.4 msec longer than that of the H-reflex. The average duration of the F-wave was about 2.8 msec shorter than that of the H-wave. Contrary to the H-reflex, the F-wave could not be facilitated post-tetanically. The F-wave of the m. soleus has the same characteristics as those previously reported for the smal muscles of hand and foot. In order to determine the location of the tip of the needle electrode within the nerve, mechanically induced responses of mechanoreceptors of the soleus muscle were recorded. It was not possible to distinguish F-waves from H-reflexes when stimuli were applied through a skin electrode or through needle electrodes adjacent to the nerve. In contrast to the monosynaptic H-reflex, the F-wave of the soleus muscle becomes apparent upon supramaximal stimulation of nerve fibres of slower conduction velocities and higher thresholds than Ia volleys. Differences in conduction velocities of the respective fibre population and in their synaptic transmission would result in a polysynaptic reflex response (Magladery and McDougal, 1950). The polysynaptic interconnections of spinal interneurons would explain the longer and more variable latency of the F-wave although facilitation of the F-wave was not obtained. Our results do not exclude the possibility of recurrent discharges being involved in the F-wave of the soleus muscle.

Abstract

ZusammenfassungEs wurden bei 10 gesunden Erwachsenen mit bipolarer intranervaler Nadelstimulation (Semimikroelektroden) des N. tibialis im M. soleus neben dem Muskelpotential reflektorische Muskelantworten ausgelöst und mit Oberflächensowie Drahtelektroden abgeleitet. Durch unterschiedlich starke elektrische Reize von einer für das direkte Muskelpotential (M) infra- bis supramaximalen Intensität konnten im M. soleus zwei Spätpotentiale unterschieden werden: 1. Bei inframaximaler Intensität ein H-Reflex mit reizabhängigem reziprokem Amplitudenverhalten gegenüber der M-Antwort, 2. bei supramaximaler Intensität eine von Reiz zu Reiz wechselnd polyphasische F-Welle mit einer um 3,4 msec längeren und inkonstanten (SD ± 1,4 msec) Latenz. Die Dauer der F-Welle war im Mittel um 2,8 msec kürzer als die des H-Potentials. Im Gegensatz zum H-Reflex ließ sich die F-Welle posttetanisch nicht fazilitieren.Mit Oberflächenreizung oder paranervaler Nadelstimulation gelang die Differenzierung von H-Reflexen und F-Wellen im M. soleus nicht. Zum Beweis für die Lage der Nadelelektroden an Ia-Fasern im N. tibialis wurden nach mechanischer Reflexauslösung Afferenzen aus Mechanoreceptoren des M. soleus abgeleitet. Durch simultane Ableitung des M. tibialis anterior und der Plantarmuskeln wurde ein Flexor-Reflex ausgeschlossen.Im Unterschied zum niederschwelligen monosynaptischen H-Reflex entsteht die F-Welle des M. soleus bei supramaximaler Reizintensität über langsamer leitende Fasern mit höherer Reizschwelle als die der Fasergruppe Ia; die F-Welle ist eine dem erregten Faserspektrum entsprechende polysynaptische Reflexantwort, wie Magladery u. McDougal 1950 vermuteten. Die polysynaptische Verschaltung der Interneurone erklärt die längere und weniger konstante Latenz der F-Welle gegenüber dem H-Reflex. Ob in der F-Welle des M. soleus eine Rückschlagwelle enthalten ist (Dawson u. Merton, 1956) muß nach unseren Ergebnissen offenbleiben.

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H-Reflex und F-Welle im M. soleus des Menschen
H-reflex and F-wave in the soleus muscle of man

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H-Reflex und F-Welle im M. soleus des Menschen H-reflex and F-wave in the soleus muscle of man

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H-Reflex und F-Welle im M. soleus des Menschen
H-reflex and F-wave in the soleus muscle of man