Plantar cutaneous afferents normalize the reflex modulation patterns during stepping in chronic human spinal cord injury

J Neurophysiol. 2010 Mar;103(3):1304-14. doi: 10.1152/jn.00880.2009. Epub 2009 Dec 30.

Abstract

Plantar cutaneous afferent transmission is critical for recovery of locomotion in spinalized animals, whereas a phase-dependent reflex modulation is apparent during fictive or real locomotion. In nine people with a chronic spinal cord injury (SCI) the effects of foot sole stimulation on the soleus H-reflex and tibialis anterior (TA) flexion reflex modulation patterns during assisted stepping were established on different days. The soleus H-reflex was elicited by posterior tibial nerve stimulation followed by a supramaximal stimulus 100 ms after the test H-reflex to control for movement of recording electrodes. The flexion reflex was evoked by sural nerve stimulation with a 30-ms pulse train, recorded from the ipsilateral TA muscle, and elicited at 1.2- to twofold the reflex threshold. During assisted stepping, spinal reflexes were conditioned by percutaneous stimulation of the ipsilateral metatarsals at threefold perceptual threshold with a 20-ms pulse train delivered at 9- to 11-ms conditioning-test intervals. Stimuli were randomly dispersed across the step cycle, which was divided into 16 equal bins. The conditioned soleus H-reflex was significantly facilitated at midstance and depressed during midswing when compared with the unconditioned soleus H-reflex recorded during stepping. Foot sole stimulation induced a significant facilitation of the long-latency TA flexion reflex before, during, and after stance-to-swing transition when compared with the unconditioned long-latency TA flexion reflex during stepping. This study provides evidence that plantar cutaneous afferents remarkably influence the soleus H-reflex and TA flexion reflex modulation patterns during stepping and support that actions of plantar cutaneous afferents onto spinal interneuronal circuits engaged in locomotion are manifested in a phase-dependent manner in chronic SCI subjects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Chronic Disease
  • Data Interpretation, Statistical
  • Female
  • Foot / innervation*
  • H-Reflex / physiology*
  • Humans
  • Locomotion / physiology*
  • Male
  • Middle Aged
  • Nerve Net / physiology
  • Neurons, Afferent / physiology*
  • Skin / innervation*
  • Spinal Cord Injuries / physiopathology*
  • Young Adult