Characterization of the tendon vibration reflex response in hemi-spastic stroke individuals

The objective of our study was to assess the role of persistent inward currents, or PICs, on the excitability of motoneurons innervating spastic muscle in hemi-spastic stroke individuals. This was accomplished by examining the effects of tonic vibration applied to the tendon of the biceps brachii muscle. The elicited TVR (tonic vibration reflex) provides a useful way to assess the degree of excitability of spinal neurons in spastic syndromes, and it has additional features that may signify the presence of PICs in spastic motoneurons. We applied sinusoidal stretches of varied duration to the biceps tendon of two hemi-spastic stroke individuals and one neurologically intact individual. We recorded the resulting TVR response from electromyographic(EMG) signals obtained from the biceps as well as force recorded at the wrist. The results of our preliminary study show that the initial rise of the TVR force response as well as the force magnitude are generally greater in spastic muscle, perhaps a marker of motoneuron excitability. Additionally, a shorter vibration duration was sufficient to evoke a response on the spastic side of our tested stroke subjects. However, the key marker of PICs the decay of the force response as well as sustained after-discharge did not exhibit clear differences. Our present data suggests that motoneurons innervating spastic muscle are more readily activated, and thus exhibit increased excitability, which could possibly be a function of greater depolarization, without a change in PIC magnitude. Our data does not rule out the possibility of subthreshold activation of the PIC resulting in enhanced motoneuron depolarization.