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Modulation of spinal inhibitory reflex responses to cutaneous nociceptive stimuli during upper limb movement

Authors

  • Romildo Don,

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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  • Francesco Pierelli,

    1. Rehabilitation Unit, Polo Pontino-ICOT, University of Rome “La Sapienza”, Rome, Italy
    2. IRCCS Neuromed, Pozzilli (IS), Italy
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  • Alberto Ranavolo,

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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  • Mariano Serrao,

    1. Rehabilitation Unit, Polo Pontino-ICOT, University of Rome “La Sapienza”, Rome, Italy
    2. IRCCS Neuromed, Pozzilli (IS), Italy
    3. Rehabilitation Center, Policlinico Italia, Rome, Italy
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  • Massimiliano Mangone,

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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  • Marco Paoloni,

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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  • Angelo Cacchio,

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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  • Giorgio Sandrini,

    1. Department of Neurological Sciences, IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Pavia, Italy
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  • Valter Santilli

    1. Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, University of Rome “La Sapienza”, Piazzale Aldo Moro, 5 – 00185 Rome, Italy
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Dr R. Don, as above.
E-mail: romildodon@inwind.it

Abstract

In the present study we investigated the probability, latency and duration of the inhibitory component of the withdrawal reflex elicited by painful electrical stimulation of the index finger in humans. The stimulus consisted of a train of high-intensity pulses. The investigation was carried out in several upper limb muscles during isometric contractions of different strengths and during a motor sequence consisting of reaching, picking up and transporting an object. We used a new algorithm to detect and characterize the inhibitory reflex. The reflex was found in all muscles except the brachioradialis at all the isometric contraction strengths, and showed a distal-to-proximal gradient of latency and duration. Conversely, during movement the reflex probability was high (> 80%) in the anterior deltoid and triceps muscles during reaching, in the extensor carpi radialis muscle during transporting of the object, and in the first interosseous muscle during both picking up and transporting of the object. This modulation of inhibitory reflex transmission in the upper limb muscles suggests that the motor response is organized in such a way as to inhibit the overall ongoing motor task by interrupting motion during reaching and by releasing the object during transporting. This pattern of modulation appears to differ markedly from that previously reported for the excitatory component of the withdrawal reflex. Study of the nociceptive inhibitory reflexes during movement offers new and more profound insights into the functional anatomical organization of the spinal interneuronal network mediating sensory–motor integration.

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