The late facilitation in H-reflex recovery cycles in different pyramidal lesions

Abstract

H-reflex amplitudes were recorded after stimulation of the tibial nerve and different electrical stimuli in 18 normal persons and 26 patients showing pyramidal spasticity (8 spastic spinal paralysis, 6 spastic hemiparesis, 12 spinal lesions). A just subthreshold stimulus of the tibial nerve facilitated the H-reflex in spastic patients slightly after about 300 ms (up to 113%), following an early strong facilitation (10 ms) and a longer lasting depression (20-200ms). Similar postinhibitory facilitation was obtained in spastic patients after ipsilateral stimulation of the plantar surface and after direct stimulation of the dorsal columns. Conditioning by contralateral stimuli of the posterior tibial nerve caused a slight late facilitation in both normal and spastic patients. This late facilitation did not correlate significantly with the severity of spasticity, but it was more pronounced in cerebral pyramidal lesions than in spinal ones. It is assumed that this postinhibitory facilitation is probably generated as a spinal rhythm, similar to the clonus, and that it is modulated from supraspinal structures.