Pj Harrison

Differential control of the scapulothoracic muscles in humans

The control of the scapulothoracic muscles trapezius (Tr) and serratus anterior (SA) has been examined in normal human subjects. Electromyographic recordings were made from the SA and Tr muscles (upper trapezius UTr, lower trapezius LTr) using surface electrodes placed bilaterally. Magnetic stimulation of the motor cortex and electrical stimulation of peripheral nerves were used to examine their descending and reflex control. The average optimal site of cortical stimulation was found to be the same for SA, UTr and LTr (an approximate centre of gravity of −0.6 cm, 3.7 cm where the centre of gravity is expressed as the mean anterio‐posterior position, the mean medio‐lateral position). Some asymmetry in the cortical representation of UTr was found in each individual tested. Magnetic stimulation evoked bilateral MEPs in Tr (latency contralateral (c) UTr 8.5 ± 1.6 ms, ipsilateral (i) UTr 19.0 ± 2.7 ms) but only contralateral responses were evoked in SA (11.2 ± 2.6 ms). Electrical stimulation of the long thoracic nerve at two sites was used to examine homonymous and heteronymous reflexes of SA, while electrical stimulation of cervical nerve of C3/4 was used to examine the heteronymous reflexes of Tr. Ipsilateral SA H reflexes were evoked at a latency of 9.9 ± 0.8 ms (proximal site) and 10.8 ± 1.2 ms (distal site). No group I reflexes were evoked from SA to its contralateral homologue. No group I reflexes were evoked between Tr and SA. Finally, cross‐correlation of activity from the Tr muscle pairs and the SA muscle pair revealed that the motoneurones of the Tr muscles share some common presynaptic input whereas there was no detectable common presynaptic input to the SA muscle pair. This study extends and consolidates knowledge regarding the neural control of trapezius and for the first time explores the neural control of SA. The study demonstrates a contrasting bilateral control of Tr and SA. These patterns of connections are discussed in relation to the contrasting bilateral functional roles of these muscles.

South-east Asian ovalocytosis and the cryohydrocytosis form of hereditary stomatocytosis show virtually indistinguishable cation permeability defects

The hereditary stomatocytoses are a group of dominantly inherited conditions in which the osmotic stability of the red cell is compromised by abnormally high cation permeability. This report demonstrates the very marked similarities between the cryohydrocytosis form of hereditary stomatocytosis and the common tropical condition south‐east Asian ovalocytosis (SAO). We report two patients, one showing a novel cryohydrocytosis variant (Ser762Arg in SLC4A1) and a case of SAO. Both cases showed a mild haemolytic state with some stomatocytes on the blood film, abnormal intracellular sodium and potassium levels which were made markedly abnormal by storage of blood at 0°C, increased cation ‘leak’ fluxes at 37°C and increased Na+K+ pump activity. In both cases, the anion exchange function of the mutant band 3 was destroyed. Extensive electrophysiological studies comparing the cation leak and conductance in Xenopus laevis oocytes expressing the two mutant genes showed identical patterns of abnormality. These data are consistent with the cryohydrocytosis form of hereditary stomatocytosis and we conclude that the cation leak in SAO is indistinguishable from that in cryohydrocytosis, and that SAO should be considered to be an example of hereditary stomatocytosis.

Stretch reflexes in human abdominal muscles

Homonymous and heteronymous reflex connections of the abdominal muscles were investigated by the application of a tap to the muscle belly and observation of surface electromyographic responses. Reflex responses of the following abdominal muscles were investigated both ipsilateral and contralateral to the tap: rectus abdominis (RA), external oblique (EO) and internal oblique (IO). Reflexes were evoked in each of the homonymous muscles with latencies and estimated conduction velocities compatible with being evoked by Ia muscle afferents and having a monosynaptic component. Short latency heteronymous excitatory reflex connections were also observed in muscles on both ipsilateral and contralateral sides in response to the same stimulus. The latencies of the crossed responses were only marginally longer than responses evoked in the respective ipsilateral muscle. Moreover, the reflexes evoked in the IO muscle from ipsilateral and contralateral IO muscle afferents were of comparable amplitude, as were those reflexes evoked in ipsilateral and contralateral EO and RA muscles when tapping IO. These similarities in the reflex characteristics on the ipsilateral and contralateral sides suggest that abdominal muscle afferents activate similar pathways to muscles on both sides of the body. It follows that if the homonymous stretch reflex of abdominal muscles have a monosynaptic component, then a similar monosynaptic pathway activates synergistic motoneurones, not only ipsilaterally but also contralaterally.

Stretch Reflexes in the Rectus Abdominis Muscle in Man

The spinal reflex circuitry of the rectus abdominis (RA) muscle in man was investigated by the application of a mechanical tap to the muscle. Electromyographic recordings were made in ten healthy subjects, performing a series of manoeuvres, using pairs of surface electrodes placed bilaterally. The reflex responses elicited largely depended on the amount of tonic (postural) activity of the trunk. When standing in the upright position, no reflex activity was recorded in response to the tap. Reflex activity due to mechanical tap was readily recorded when the muscle became tonically active. Moderate, backward trunk extension introduced short‐latency reflexes at 18.8 ± 1.9 ms (mean ± S.D.) ipsilaterally and 20.8 ± 1.8 ms contralaterally. Excitatory reflex activity of longer latency was also recorded contralaterally in all subjects (latency 45.1 ± 4.3 ms) and ipsilaterally in five of the ten subjects (latency 47.2 ± 2.6 ms). Vibration of the tapped muscle produced a reduction in the amplitude of the early reflex responses, whilst increasing the amplitude of the late responses. Moreover, the early reflexes were facilitated by the Jendrassik manoeuvre. Such observations are consistent with the early responses being mediated, at least partly, monosynaptically, and the late responses being of polysynaptic nature. This implies that muscle spindle afferents from rectus abdominis monosynaptically activate motoneurones contralaterally.

Functional modulation of shoulder girdle stability.

We have previously reported that electrical stimulation of the ulnar nerve at group I strength evokes reflex excitation of the trapezius muscle in normal human subjects. In the present study this reflex has been evoked while subjects were performing a number of different tasks. When subjects performed a task involving a high degree of manual dexterity, the reflex was larger. On the other hand, when subjects performed a task that can be achieved with virtually no movement of the hand or wrist musculature, the reflex does not appear to show any task dependency. These results support the view that in delicate tasks of the hand, such compensatory reflexes are more important than in basic mechanisms such as lifting an object. The functional consequences of these findings and their significance in relation to the possibility that these task-related reflex gain changes produce intention tremor is discussed.

Platelet activation responses in vitro to human mast cell activation

Mast cells are thought to play an important role in atherogenesis and plaque rupture, but their role in the subsequent platelet activation and thrombus formation is unclear. Tryptase positive cells (KU812T+) were established from the KU812 cell line as an in vitro model of human mast cells and used to study the effect of mast cell activation on human platelets. Overnight incubation of KU812T+ with IgE and subsequent challenge with anti‐IgE caused the release of heparinoid substances which inhibited 1 μg/ml collagen‐induced platelet aggregation. KU812T+ challenged with compound 48/80 produced a releasate that had no apparent heparinoid content but caused full platelet aggregation. These findings showed that, although activation of KU812T+ via FcɛR1 partially abrogated collagen‐induced platelet aggregation, activation of the C5a receptor signalling pathway, by compound 48/80, caused the release of potent platelet‐activating substances. This cell culture model offers a unique insight into the role of platelet–mast cell interactions in arterial thrombogenesis.