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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1993 Jul;56(7):776–781. doi: 10.1136/jnnp.56.7.776

Soleus H-reflex tests and clinical signs of the upper motor neuron syndrome.

J H Koelman 1, L J Bour 1, A A Hilgevoord 1, G J van Bruggen 1, B W Ongerboer de Visser 1
PMCID: PMC1015059  PMID: 8331353

Abstract

Soleus H-reflex tests are used for elucidating pathophysiological mechanisms in motor control. The cumulative vibratory inhibition of the soleus H-reflex, the ratio of the reflex to direct muscle potential (H to M ratio) and the recovery curve of the soleus H-reflex were studied in 38 patients with varying signs of the upper motor neuron syndrome for a possible relation with clinical features. The results were compared with those obtained from a group of healthy volunteers. The magnitude of vibratory inhibition decreased with increase of hypertonia. The H to M ratio increased as the activity of the tendon reflex was enhanced and correlated to a lesser degree with muscle tone. Both the H to M ratio and late facilitation of the soleus H-reflex recovery curve were elevated in clonus. The findings suggest that alterations in the results of soleus H-reflex tests relate to specific clinical features of the upper motor neuron syndrome. Possible pathophysiological implications are discussed.

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Selected References

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  1. ASHWORTH B. PRELIMINARY TRIAL OF CARISOPRODOL IN MULTIPLE SCLEROSIS. Practitioner. 1964 Apr;192:540–542. [PubMed] [Google Scholar]
  2. Ashby P., Verrier M., Lightfoot E. Segmental reflex pathways in spinal shock and spinal spasticity in man. J Neurol Neurosurg Psychiatry. 1974 Dec;37(12):1352–1360. doi: 10.1136/jnnp.37.12.1352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ashby P., Verrier M. Neurophysiologic changes in hemiplegia. Possible explanation for the initial disparity between muscle tone and tendon reflexes. Neurology. 1976 Dec;26(12):1145–1151. doi: 10.1212/wnl.26.12.1145. [DOI] [PubMed] [Google Scholar]
  4. Burke D., Ashby P. Are spinal "presynaptic" inhibitory mechanisms suppressed in spasticity? J Neurol Sci. 1972 Mar;15(3):321–326. doi: 10.1016/0022-510x(72)90073-1. [DOI] [PubMed] [Google Scholar]
  5. De Gail P., Lance J. W., Neilson P. D. Differential effects on tonic and phasic reflex mechanisms produced by vibration of muscles in man. J Neurol Neurosurg Psychiatry. 1966 Feb;29(1):1–11. doi: 10.1136/jnnp.29.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dohrmann G. J., Nowack W. J. Relationship between various clinical signs in lesions of the descending motor system (a statistical study). Dis Nerv Syst. 1974 Aug;35(8):375–377. [PubMed] [Google Scholar]
  7. Gassel M. M. A critical review of evidence concerning long-loop reflexes excited by muscle afferents in man. J Neurol Neurosurg Psychiatry. 1970 Jun;33(3):358–362. doi: 10.1136/jnnp.33.3.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gillies J. D., Lance J. W., Neilson P. D., Tassinari C. A. Presynaptic inhibition of the monosynaptic reflex by vibration. J Physiol. 1969 Nov;205(2):329–339. doi: 10.1113/jphysiol.1969.sp008968. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hagbarth K. E., Eklund G. The effects of muscle vibration in spasticity, rigidity, and cerebellar disorders. J Neurol Neurosurg Psychiatry. 1968 Jun;31(3):207–213. doi: 10.1136/jnnp.31.3.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hagbarth K. E., Wallin G., Löfstedt L., Aquilonius S. M. Muscle spindle activity in alternating tremor of Parkinsonism and in clonus. J Neurol Neurosurg Psychiatry. 1975 Jul;38(7):636–641. doi: 10.1136/jnnp.38.7.636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hayat A. Factorial analysis of specific parameters in spasticity. Electromyogr Clin Neurophysiol. 1979 Nov-Dec;19(6):541–553. [PubMed] [Google Scholar]
  12. Hultborn H., Meunier S., Morin C., Pierrot-Deseilligny E. Assessing changes in presynaptic inhibition of I a fibres: a study in man and the cat. J Physiol. 1987 Aug;389:729–756. doi: 10.1113/jphysiol.1987.sp016680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Iles J. F., Roberts R. C. Presynaptic inhibition of monosynaptic reflexes in the lower limbs of subjects with upper motoneuron disease. J Neurol Neurosurg Psychiatry. 1986 Aug;49(8):937–944. doi: 10.1136/jnnp.49.8.937. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. MAGLADERY J. W., TEASDALL R. D., PARK A. M., LANGUTH H. W. Electrophysiological studies of reflex activity in patients with lesions of the nervous system. I. A comparison of spinal motoneurone excitability following afferent nerve volleys in normal persons and patients with upper motor neurone lesions. Bull Johns Hopkins Hosp. 1952 Oct;91(4):219–passim. [PubMed] [Google Scholar]
  15. Matthews P. B. Evidence from the use of vibration that the human long-latency stretch reflex depends upon spindle secondary afferents. J Physiol. 1984 Mar;348:383–415. doi: 10.1113/jphysiol.1984.sp015116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Olsen P. Z., Diamantopoulos E. Excitability of spinal motor neurones in normal subjects and patients with spasticity, Parkinsonian rigidity, and cerebellar hypotonia. J Neurol Neurosurg Psychiatry. 1967 Aug;30(4):325–331. doi: 10.1136/jnnp.30.4.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ongerboer de Visser B. W., Bour L. J., Koelman J. H., Speelman J. D. Cumulative vibratory indices and the H/M ratio of the soleus H-reflex: a quantitative study in control and spastic subjects. Electroencephalogr Clin Neurophysiol. 1989 Aug;73(2):162–166. doi: 10.1016/0013-4694(89)90196-x. [DOI] [PubMed] [Google Scholar]
  18. Panizza M., Lelli S., Nilsson J., Hallett M. H-reflex recovery curve and reciprocal inhibition of H-reflex in different kinds of dystonia. Neurology. 1990 May;40(5):824–828. doi: 10.1212/wnl.40.5.824. [DOI] [PubMed] [Google Scholar]
  19. Schieppati M. The Hoffmann reflex: a means of assessing spinal reflex excitability and its descending control in man. Prog Neurobiol. 1987;28(4):345–376. doi: 10.1016/0301-0082(87)90007-4. [DOI] [PubMed] [Google Scholar]
  20. Taylor S., Ashby P., Verrier M. Neurophysiological changes following traumatic spinal lesions in man. J Neurol Neurosurg Psychiatry. 1984 Oct;47(10):1102–1108. doi: 10.1136/jnnp.47.10.1102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Van Boxtel A. Differential effects of low-frequency depression, vibration-induced inhibition, and posttetanic potentiation on H-reflexes and tendon jerks in the human soleus muscle. J Neurophysiol. 1986 Mar;55(3):551–568. doi: 10.1152/jn.1986.55.3.551. [DOI] [PubMed] [Google Scholar]
  22. Yap C. B. Spinal segmental and long-loop reflexes on spinal motoneurone excitability in spasticity and rigidity. Brain. 1967 Dec;90(4):887–896. doi: 10.1093/brain/90.4.887. [DOI] [PubMed] [Google Scholar]

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