Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1983 Jan;46(1):35–44. doi: 10.1136/jnnp.46.1.35

The behaviour of the long-latency stretch reflex in patients with Parkinson's disease

Jc Rothwell 1,2, Ja Obeso 1,2, Mm Traub 1,2, Cd Marsden 1,2
PMCID: PMC1027261  PMID: 6842198

Abstract

The size of the long-latency stretch reflex was measured in a proximal (triceps) and distal (flexor pollicis longus) muscle in 47 patients with Parkinson's disease, and was compared with that seen in a group of 12 age-matched normal control subjects. The patients were classified clinically into four groups according to the degree of rigidity at the elbow or tremor. Stretch reflexes were evaluated while the subject was exerting a small force against a constant preload supplied by a torque motor, and the size of the reflex response was measured as fractional increase over basal levels of activity. When stretches were given at random intervals by increasing the force exerted by the motor by a factor of 2 or 3, there was a clear trend for the more severely affected patients to have larger long latency responses in the triceps muscle, although there was no change in the size of the short-latency, spinal component of the response. In contrast, there was no change in the size of the long-latency response of the flexor pollicis longus in any group of patients with Parkinson's disease. Despite any differences in reflex size, the inherent muscle stiffness of both muscles appeared to be normal in all groups of patients with Parkinson's disease, since the displacement trajectory of the limb following the force increase was the same as control values in the short (25 ms) period before reflex compensation could intervene. In 20 of the patients and in seven of the control subjects, servo-controlled, ramp positional disturbances were given to the thumb. Up to a velocity of 300°/s, the size of the long-latency stretch reflex was proportional to the log velocity of stretch. This technique revealed, in both moderately and severely rigid patients, increases in the reflex sensitivity of the flexor pollicis longus, which had not been clear using step torque stretches alone. However, whether using ramp or step displacements, long latency stretch reflex gain was not closely related to rigidity; reflex size was within the normal range in many patients with severe rigidity. Enhanced long latency stretch reflexes thus contribute to, but may not be solely responsible for, rigidity in Parkinson's disease.

Full text

PDF
35

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrews C. J., Burke D., Lance J. W. The response to muscle stretch and shortening in Parkinsonian rigidity. Brain. 1972;95(4):795–812. doi: 10.1093/brain/95.4.795. [DOI] [PubMed] [Google Scholar]
  2. Burke D., Hagbarth K. E., Wallin B. G. Reflex mechanisms in Parkinsonian rigidity. Scand J Rehabil Med. 1977;9(1):15–23. [PubMed] [Google Scholar]
  3. Delwaide P. J., Schwab R. S., Young R. R. Polysynaptic spinal reflexes in Parkinson's disease. Neurology. 1974 Sep;24(9):820–827. doi: 10.1212/wnl.24.9.820. [DOI] [PubMed] [Google Scholar]
  4. Dietz V., Quintern J., Berger W. Electrophysiological studies of gait in spasticity and rigidity. Evidence that altered mechanical properties of muscle contribute to hypertonia. Brain. 1981 Sep;104(3):431–449. doi: 10.1093/brain/104.3.431. [DOI] [PubMed] [Google Scholar]
  5. Dufresne J. R., Soechting J. F., Tolosa E. S. Myotatic reflexes and the on-off effect in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1981 Apr;44(4):315–322. doi: 10.1136/jnnp.44.4.315. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Lee R. G., Tatton W. G. Long latency reflexes to imposed displacements of the human wrist: dependence on duration of movement. Exp Brain Res. 1982;45(1-2):207–216. doi: 10.1007/BF00235780. [DOI] [PubMed] [Google Scholar]
  7. Lee R. G., Tatton W. G. Motor responses to sudden limb displacements in primates with specific CNS lesions and in human patients with motor system disorders. Can J Neurol Sci. 1975 Aug;2(3):285–293. doi: 10.1017/s0317167100020382. [DOI] [PubMed] [Google Scholar]
  8. Marsden C. D., Merton P. A., Morton H. B. Is the human stretch reflex cortical rather than spinal? Lancet. 1973 Apr 7;1(7806):759–761. doi: 10.1016/s0140-6736(73)92141-7. [DOI] [PubMed] [Google Scholar]
  9. Marsden C. D., Merton P. A., Morton H. B., Rothwell J. C., Traub M. M. Reliability and efficacy of the long-latency stretch reflex in the human thumb. J Physiol. 1981 Jul;316:47–60. doi: 10.1113/jphysiol.1981.sp013771. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Marsden C. D., Merton P. A., Morton H. B. Servo action in human voluntary movement. Nature. 1972 Jul 21;238(5360):140–143. doi: 10.1038/238140a0. [DOI] [PubMed] [Google Scholar]
  11. Marsden C. D., Merton P. A., Morton H. B. Servo action in the human thumb. J Physiol. 1976 May;257(1):1–44. doi: 10.1113/jphysiol.1976.sp011354. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Vilis T., Cooke J. D. Modulation of the functional stretch reflex by the segmental reflex pathway. Exp Brain Res. 1976 Jun 18;25(3):247–254. doi: 10.1007/BF00234016. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES