A reappraisal of long‐latency abdominal muscle reflexes in patients with propriospinal myoclonus
Identifieur interne : 000164 ( Istex/Corpus ); précédent : 000163; suivant : 000165A reappraisal of long‐latency abdominal muscle reflexes in patients with propriospinal myoclonus
Auteurs : Samar S. Ayache ; Rechdi Ahdab ; Pierre Brugières ; Jean-François Ejzenbaum ; François-Jérôme Authier ; Gilles Fénelon ; Jean-Pascal LefaucheurSource :
- Movement Disorders [ 0885-3185 ] ; 2011-08-01.
English descriptors
Abstract
We report 3 patients with typical clinical and electrophysiological characteristics of propriospinal myoclonus propagating from a thoracic spine generator.
In these patients, the pattern of recruitment of long‐latency electromyographic reflexes in abdominal muscles was studied in response to various stimuli.
Abdominal reflex latency varied from 60 to 140 ms depending on stimulus location. Latency increased from magnetic stimulation of the thoracic spine to electrical stimulation of the supraorbital nerve, electrical stimulation of the median nerve, and magnetic stimulation of the motor cortex.
Long‐latency abdominal reflex jerks are probably controlled by the brain stem to propriospinal system projections in patients with propriospinal myoclonus. The stereotyped pattern of recruitment of these reflexes could be of clinical utility to differentiate organic propriospinal myoclonus from psychogenic or mimicked jerks. © 2011 Movement Disorder Society
Url:
DOI: 10.1002/mds.23645
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ISTEX:D93E3A3838034AB13AD5BA5E3F5BDA0427CAC158Le document en format XML
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myoclonus</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Copyright © 2011 Movement Disorder Society</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. 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href="file:MDS.MDS23645.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="1"></count><count type="referenceTotal" number="25"></count><count type="wordTotal" number="3094"></count></countGroup><titleGroup><title type="main" xml:lang="en">A reappraisal of long‐latency abdominal muscle reflexes in patients with propriospinal myoclonus<link href="#fn1"></link></title><title type="short" xml:lang="en">Brief Report</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Samar S.</givenNames><familyName>Ayache</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Rechdi</givenNames><familyName>Ahdab</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Pierre</givenNames><familyName>Brugières</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Jean‐François</givenNames><familyName>Ejzenbaum</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af5 #af6"><personName><givenNames>François‐Jérôme</givenNames><familyName>Authier</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Gilles</givenNames><familyName>Fénelon</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1 #af2 #af5" corresponding="yes"><personName><givenNames>Jean‐Pascal</givenNames><familyName>Lefaucheur</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email normalForm="jean-pascal.lefaucheur@hmn.aphp.fr">jean‐pascal.lefaucheur@hmn.aphp.fr</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Service de Physiologie—Explorations Fonctionnelles, Hôpital Henri Mondor, APHP, Créteil, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>EA 4391, Faculté de Médecine de Créteil, Université Paris‐Est‐Créteil, Créteil, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Service de Neuroradiologie, Hôpital Henri Mondor, APHP, Créteil, France</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="FR" type="organization"><unparsedAffiliation>Service de Neurologie, Hôpital Henri Mondor, APHP, Créteil, France</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="FR" type="organization"><unparsedAffiliation>Centre de référence des maladies rares neuromusculaires, Hôpital Henri Mondor, APHP, Créteil, France</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="FR" type="organization"><unparsedAffiliation>INSERM U955‐E10, Université Paris‐Est‐Créteil, Créteil, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">abdominal muscles</keyword><keyword xml:id="kwd2">electromyography</keyword><keyword xml:id="kwd3">fiber tracking</keyword><keyword xml:id="kwd4">propriospinal myoclonus</keyword><keyword xml:id="kwd5">reflex</keyword></keywordGroup><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23645:MDS_23645_sm_suppinfofigure1"></mediaResource><caption>Figure e‐1. Surface EMG recordings in orbicularis oculi (O Oc), abductor digiti minimi (Abd dm), intercostalis (T2 and T5 levels), rectus abdominis (T8, T10, and T12 levels), iliopsoas (Ilio ps), and tibialis anterior (Tib ant) muscles obtained from patient 2, showing slow rostral and caudal spreading from a T8 generator of the spontaneous myoclonus and the reflex EMG bursts to motor cortex or supraorbital nerve stimulation. Oblique lines are drawn from jerk onset at different myelomeres to highlight the propagation pattern.</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23645:MDS_23645_sm_suppinfofigure2"></mediaResource><caption>Figure e‐2. Diffusion tensor imaging with fiber‐tracking of the spinal cord at cervical level. Fiber‐tracking reconstruction showed fiber loss in the posterior lemniscal pathways in patient 1 (126 fibers on the right and 143 fibers on the left), but was normal in patient 2 (285 fibers on the right and 228 fibers on the left) according to our control values. DTI was acquired with a 16‐direction, single‐shot, spin‐echo echoplanar sequence, according to the following parameters: repetition time (TR): 3550 ms; echo time (TE): 62 ms, field of view (FOV): 250×250 mm2, section thickness: 2 mm, voxel size: 2×2×2 mm; b values: 0 and 1000 s/mm2, and 60 sections covering the whole cervical spinal canal. DTI‐based color maps and fiber tracking were generated by using the TrackVis freeware (version 0.4.2; MGH, Boston, Mass, USA). Tracking was performed in both retrograde and anterograde directions from an initial region of interest situated at the level of the thoracic spinal cord drawn on Fraction Anisotropy (FA) color maps. The propagation was terminated when it reached a voxel with FA < 0.08 or when the angle between two consecutive steps was greater than 50.</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23645:MDS_23645_sm_suppinfofigure3"></mediaResource><caption>Figure e‐3. Representation of the neural pathways presumably involved in long‐latency abdominal muscle reflexes to supraorbital nerve stimulation (in green), median nerve stimulation (in purple), and motor cortex stimulation (in blue). Blink reflex studies have showed that supraorbital nerve stimulation activates short sensory afferent fibers (from the face) and then cells in the trigeminal sensory nuclei that project to the bulbar reticular formation. The circuit recruited by median nerve stimulation in addition to that recruited by supraorbital nerve stimulation is indicated as a purple dotted line (and contributes to a 25‐ms increase in reflex latency, since the latency of cortical evoked potentials to median nerve stimulation at the wrist is about 20 ms and the conduction time for the descending volley from cortex to brainstem could be about 5 ms). The circuit recruited by motor cortex stimulation in addition to that recruited by median nerve stimulation is indicated as a blue dotted line (and contributes to a 30‐ms increase in reflex latency, since the latency of abdominal motor evoked potential (MEP) to cortical stimulation is about 20 ms and the difference in the conduction time for ascending sensory volleys between abdominal and wrist origin could be about 10 ms). A thoracic spine generator and the propriospinal pathways (red line and arrows) are presumably the common system involved in the spreading of the reflex responses to the three conditions of stimulation as in the spontaneous propagation of propriospinal myoclonus (PSM). Abdominal reflex latency was shorter following thoracic spine stimulation than supraorbital nerve stimulation (not shown). This is not consistent with a descending control from the brainstem that should logically produce longer reflex latencies to spinal than trigeminal stimulation. Therefore, one may suggest that intraspinal loops involving the propriospinal system could also contribute to the generation of abdominal reflexes in PSM (not shown). However, a simple segmental circuit mediated by proprioceptive afferents from the abdominal muscles (triggered by MEP‐associated muscle twitches) is not conceivable because the difference in latency between the abdominal MEPs and reflex responses is not the same following cortical and thoracic magnetic stimulation (120 and 55 ms, respectively).</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23645:MDS_23645_sm_suppinfotable1"></mediaResource><caption>Table e‐1. Literature data regarding reflex responses elicited in abdominal wall muscles of patients with propriospinal myoclonus in response to mechanical or electrical sensory stimuli</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background:</title><p>We report 3 patients with typical clinical and electrophysiological characteristics of propriospinal myoclonus propagating from a thoracic spine generator.</p></section><section xml:id="abs1-2"><title type="main">Methods:</title><p>In these patients, the pattern of recruitment of long‐latency electromyographic reflexes in abdominal muscles was studied in response to various stimuli.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>Abdominal reflex latency varied from 60 to 140 ms depending on stimulus location. Latency increased from magnetic stimulation of the thoracic spine to electrical stimulation of the supraorbital nerve, electrical stimulation of the median nerve, and magnetic stimulation of the motor cortex.</p></section><section xml:id="abs1-4"><title type="main">Conclusions:</title><p>Long‐latency abdominal reflex jerks are probably controlled by the brain stem to propriospinal system projections in patients with propriospinal myoclonus. The stereotyped pattern of recruitment of these reflexes could be of clinical utility to differentiate organic propriospinal myoclonus from psychogenic or mimicked jerks. © 2011 Movement Disorder Society</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Relevant conflicts of interest/financial disclosures:</b> Nothing to report.</p><p>Full financial disclosures and author roles can be found in the online version of this article</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>A reappraisal of long‐latency abdominal muscle reflexes in patients with propriospinal myoclonus</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Brief Report</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>A reappraisal of long‐latency abdominal muscle reflexes in patients with propriospinal myoclonus</title></titleInfo><name type="personal"><namePart type="given">Samar S.</namePart><namePart type="family">Ayache</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Physiologie—Explorations Fonctionnelles, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><affiliation>EA 4391, Faculté de Médecine de Créteil, Université Paris‐Est‐Créteil, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rechdi</namePart><namePart type="family">Ahdab</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Physiologie—Explorations Fonctionnelles, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><affiliation>EA 4391, Faculté de Médecine de Créteil, Université Paris‐Est‐Créteil, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Brugières</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Neuroradiologie, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean‐François</namePart><namePart type="family">Ejzenbaum</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Service de Neurologie, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">François‐Jérôme</namePart><namePart type="family">Authier</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centre de référence des maladies rares neuromusculaires, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><affiliation>INSERM U955‐E10, Université Paris‐Est‐Créteil, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gilles</namePart><namePart type="family">Fénelon</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Service de Neurologie, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean‐Pascal</namePart><namePart type="family">Lefaucheur</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Service de Physiologie—Explorations Fonctionnelles, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><affiliation>EA 4391, Faculté de Médecine de Créteil, Université Paris‐Est‐Créteil, Créteil, France</affiliation><affiliation>Centre de référence des maladies rares neuromusculaires, Hôpital Henri Mondor, APHP, Créteil, France</affiliation><affiliation>Service Physiologie, Explorations Fonctionnelles, Hôpital Henri Mondor, 51 avenue de Lattre de Tassigny, 94010 Créteil cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-08-01</dateIssued><dateCaptured encoding="w3cdtf">2010-06-09</dateCaptured><dateValid encoding="w3cdtf">2010-12-28</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="references">25</extent><extent unit="words">3094</extent></physicalDescription><abstract>We report 3 patients with typical clinical and electrophysiological characteristics of propriospinal myoclonus propagating from a thoracic spine generator.</abstract><abstract>In these patients, the pattern of recruitment of long‐latency electromyographic reflexes in abdominal muscles was studied in response to various stimuli.</abstract><abstract>Abdominal reflex latency varied from 60 to 140 ms depending on stimulus location. Latency increased from magnetic stimulation of the thoracic spine to electrical stimulation of the supraorbital nerve, electrical stimulation of the median nerve, and magnetic stimulation of the motor cortex.</abstract><abstract>Long‐latency abdominal reflex jerks are probably controlled by the brain stem to propriospinal system projections in patients with propriospinal myoclonus. The stereotyped pattern of recruitment of these reflexes could be of clinical utility to differentiate organic propriospinal myoclonus from psychogenic or mimicked jerks. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles can be found in the online version of this article</note><subject lang="en"><genre>keywords</genre><topic>abdominal muscles</topic><topic>electromyography</topic><topic>fiber tracking</topic><topic>propriospinal myoclonus</topic><topic>reflex</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="journal">journal</genre><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Figure e‐1. Surface EMG recordings in orbicularis oculi (O Oc), abductor digiti minimi (Abd dm), intercostalis (T2 and T5 levels), rectus abdominis (T8, T10, and T12 levels), iliopsoas (Ilio ps), and tibialis anterior (Tib ant) muscles obtained from patient 2, showing slow rostral and caudal spreading from a T8 generator of the spontaneous myoclonus and the reflex EMG bursts to motor cortex or supraorbital nerve stimulation. Oblique lines are drawn from jerk onset at different myelomeres to highlight the propagation pattern. - Figure e‐2. Diffusion tensor imaging with fiber‐tracking of the spinal cord at cervical level. Fiber‐tracking reconstruction showed fiber loss in the posterior lemniscal pathways in patient 1 (126 fibers on the right and 143 fibers on the left), but was normal in patient 2 (285 fibers on the right and 228 fibers on the left) according to our control values. DTI was acquired with a 16‐direction, single‐shot, spin‐echo echoplanar sequence, according to the following parameters: repetition time (TR): 3550 ms; echo time (TE): 62 ms, field of view (FOV): 250×250 mm2, section thickness: 2 mm, voxel size: 2×2×2 mm; b values: 0 and 1000 s/mm2, and 60 sections covering the whole cervical spinal canal. DTI‐based color maps and fiber tracking were generated by using the TrackVis freeware (version 0.4.2; MGH, Boston, Mass, USA). Tracking was performed in both retrograde and anterograde directions from an initial region of interest situated at the level of the thoracic spinal cord drawn on Fraction Anisotropy (FA) color maps. The propagation was terminated when it reached a voxel with FA < 0.08 or when the angle between two consecutive steps was greater than 50. - Figure e‐3. Representation of the neural pathways presumably involved in long‐latency abdominal muscle reflexes to supraorbital nerve stimulation (in green), median nerve stimulation (in purple), and motor cortex stimulation (in blue). Blink reflex studies have showed that supraorbital nerve stimulation activates short sensory afferent fibers (from the face) and then cells in the trigeminal sensory nuclei that project to the bulbar reticular formation. The circuit recruited by median nerve stimulation in addition to that recruited by supraorbital nerve stimulation is indicated as a purple dotted line (and contributes to a 25‐ms increase in reflex latency, since the latency of cortical evoked potentials to median nerve stimulation at the wrist is about 20 ms and the conduction time for the descending volley from cortex to brainstem could be about 5 ms). The circuit recruited by motor cortex stimulation in addition to that recruited by median nerve stimulation is indicated as a blue dotted line (and contributes to a 30‐ms increase in reflex latency, since the latency of abdominal motor evoked potential (MEP) to cortical stimulation is about 20 ms and the difference in the conduction time for ascending sensory volleys between abdominal and wrist origin could be about 10 ms). A thoracic spine generator and the propriospinal pathways (red line and arrows) are presumably the common system involved in the spreading of the reflex responses to the three conditions of stimulation as in the spontaneous propagation of propriospinal myoclonus (PSM). Abdominal reflex latency was shorter following thoracic spine stimulation than supraorbital nerve stimulation (not shown). This is not consistent with a descending control from the brainstem that should logically produce longer reflex latencies to spinal than trigeminal stimulation. Therefore, one may suggest that intraspinal loops involving the propriospinal system could also contribute to the generation of abdominal reflexes in PSM (not shown). However, a simple segmental circuit mediated by proprioceptive afferents from the abdominal muscles (triggered by MEP‐associated muscle twitches) is not conceivable because the difference in latency between the abdominal MEPs and reflex responses is not the same following cortical and thoracic magnetic stimulation (120 and 55 ms, respectively). - Table e‐1. Literature data regarding reflex responses elicited in abdominal wall muscles of patients with propriospinal myoclonus in response to mechanical or electrical sensory stimuli - </note><subject><genre>article-category</genre><topic>Brief Report</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1759</start><end>1762</end><total>4</total></extent></part></relatedItem><identifier type="istex">D93E3A3838034AB13AD5BA5E3F5BDA0427CAC158</identifier><identifier type="DOI">10.1002/mds.23645</identifier><identifier type="ArticleID">MDS23645</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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