Origins of Abnormal Excitability in Biceps Brachii Motoneurons of Spastic-Paretic Stroke Survivors

• Published in: Journal of neurophysiology Vol. 102; no. 4; pp. 2026 - 2038
• Main Authors: Mottram, Carol J, Suresh, Nina L, Heckman, C. J, Gorassini, Monica A, Rymer, William Z
• Format: Journal Article
• Language: English
• Published: United States Am Phys Soc 01-10-2009; American Physiological Society
• Subjects: Action Potentials; Aged; Elbow - physiopathology; Female; Functional Laterality; Humans; Male; Membrane Potentials; Middle Aged; Motor Neurons - physiology; Muscle Contraction - physiology; Muscle Spasticity - etiology; Muscle Spasticity - physiopathology; Paresis - etiology; Paresis - physiopathology; Stroke - complications; Synapses - physiology
• ISSN: 0022-3077; 1522-1598
• DOI: 10.1152/jn.00151.2009

1 Sensory Motor Performance Program, Rehabilitation Institute of Chicago;
2 Department of Physiology and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
3 Department of Biomedical Engineering and Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada
Submitted 20 February 2009;
accepted in final form 2 July 2009
ABSTRACT
Stroke survivors often exhibit abnormal motoneuron excitability, manifested clinically as spasticity with exaggerated stretch reflexes in resting muscles. We examined whether this abnormal excitability is a result of increased activation of intrinsic voltage-dependent persistent inward currents (PICs) or whether it is a result of enhanced synaptic inputs to the motoneuron. This distinction was made by recording firing rate profiles of pairs of motor units during isometric contractions of elbow flexor muscles. To estimate PIC amplitude, the discharge of the lower-threshold (reporter) motor unit of the pair was used to estimate the synaptic input to the higher-threshold (test) motor unit. The estimated synaptic input required to recruit the test unit was compared with the synaptic input when the test unit was derecruited ( F ) and this served as an estimate of the intrinsic (PIC) contribution to motoneuron firing. We found that PIC estimates were not larger in spastic-paretic motoneurons ( F = 4.0 ± 1.6 pps) compared with contralateral (4.6 ± 1.4 pps) and age-matched healthy control motoneurons (3.8 ± 1.7, all P > 0.1). Instead, following the voluntary contractions, the majority of lower-threshold motor units in spastic-paretic muscles (83%) exhibited spontaneous discharge, compared with 14% of contralateral and 0% of control motor units. Furthermore, there was strong co-modulation of simultaneously active units in spastic muscle. The presence of ongoing, correlated unit activity at "rest," coupled with firing behavior at recruitment unique to lower-threshold motor units in spastic muscles, suggested that firing changes are likely a result of a low-level depolarizing synaptic drive to the resting motoneuron pool.
Address for reprint requests and other correspondence: C. J. Mottram, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL 60611 (E-mail: c-mottram{at}northwestern.edu ).