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Recordings from over the posterior fossa following impulsive acceleration stimuli have shown short latency evoked potentials of presumed cerebellar origin. In this study, we investigated the effect of posture on these cerebellar evoked potentials (CEPs) and their relationship to postural reflexes recorded from the leg muscles evoked by the same stimuli. Nine healthy subjects were tested during lying (supine and prone), sitting and standing. Impulsive accelerations were applied at the mastoid and to truncal (both C7 and sternal) stimulation sites. The effect of vision, eyes open or closed, was investigated for all three stimuli. For the truncal stimuli, the effect of differing leaning conditions during standing was also recorded. CEP amplitudes were correlated for the three stimuli. For C7 stimulation during standing, both CEPs and postural reflexes scaled as the threat to postural stability increased. However, CEPs for all stimuli were present during lying, sitting and standing with amplitude and latency parameters mainly unaffected by posture or vision. In contrast, postural reflexes from the leg muscles were attenuated when not standing, with the effect being more marked for truncal stimuli. We conclude that CEPs evoked by axial and vestibular stimuli are not systematically gated by posture, in contrast to the reflex responses evoked by the same stimuli.

We report for the first time non‐invasively recorded ethanol (EtOH) induced changes in the spontaneous and evoked activity of the human cerebellum. We recorded electroencephalography (EEG), electro‐cerebellography (ECeG), lower limb electro‐myography (EMG), and posturography in a 64 year old adult male before and after oral ingestion of EtOH while standing at rest and in response to axial perturbation of the trunk. The a xial perturbation is known to give rise to a well‐defined postural reflex of likely brain‐stem origin in lower‐limb muscles accompanied by correlated short and long latency cerebral and cerebellar responses. The associated cerebellar response is of likely climbing fiber (CF) origin, characterized by post‐CF inhibition of the spontaneous Purkinje cell (PC) activity, non‐invasively manifest as pausing in the high‐frequency ECeG. In our case, EtOH reversibly attenuated the postural reflex and associated cerebral responses, whilst also causing an increase in the spontaneous high‐frequency ECeG and severely disrupting the post‐CF pausing of the ECeG in response to axial perturbation. The initial component of the CF response was unaffected, however, likely reflecting the afferent volley to the perturbation. These effects demonstrate that non‐invasive recordings of cerebellar electrophysiology are possible and can provide important pathophysiological insights.

We report the results of an experiment in which electrophysiological activity was recorded from the human cerebellum and cerebrum in a sample of 14 healthy subjects before, during and after a classical eye blink conditioning procedure with an auditory tone as conditional stimulus and a maxillary nerve unconditional stimulus. The primary aim was to show changes in the cerebellum and cerebrum correlated with behavioral ocular responses. Electrodes recorded EMG and EOG at peri‐ocular sites, EEG from over the frontal eye‐fields and the electrocerebellogram (ECeG) from over the posterior fossa. Of the 14 subjects half strongly conditioned while the other half were resistant. We confirmed that conditionability was linked under our conditions to the personality dimension of extraversion‐introversion. Inhibition of cerebellar activity was shown prior to the conditioned response, as predicted by Albus (1971). However, pausing in high frequency ECeG and the appearance of a contingent negative variation (CNV) in both central leads occurred in all subjects. These led us to conclude that while conditioned cerebellar pausing may be necessary, it is not sufficient alone to produce overt behavioral conditioning, implying the existence of another central mechanism. The outcomes of this experiment indicate the potential value of the noninvasive electrophysiology of the cerebellum. We report the results of an experiment in which electrophysiological activity was recorded from the human cerebellum and cerebrum in a sample of 14 healthy subjects before, during and after a classical eye‐blink conditioning procedure with an auditory tone as conditional stimulus and a maxillary nerve unconditional stimulus. The primary aim was to show changes in the cerebellum and cerebrum correlated with behavioural ocular responses.

The provision of written information is a low-cost and readily available intervention that has been found to reduce pain and anxiety in a variety of clinical settings. The current study was undertaken to determine if information provision may improve patients' experience during conventional electrodiagnostic studies. 128 participants were recruited from a tertiary teaching hospital who were referred for electrodiagnostic studies. They were randomized into 2 groups where the intervention group was provided with written information about the electrodiagnostic testing. Patients were invited to complete a questionnaire that included pain and anxiety using a visual analogue scale (VAS) following the testing. All participants underwent nerve conduction studies (NCS) whilst a subset also underwent subsequent needle electromyography (EMG). Those who received information had a statistically significant lower perception of anxiety during NCS, whilst only females who received information had a statistically significant lower perception of pain to both NCS and EMG. The provision of written information can reduce the degree of pain and anxiety experienced during electrodiagnostic testing. Improving patient comfort and tolerability during electrodiagnostic testing may have practical implications towards more reliable and accurate results obtained from such investigations that may in turn improve patient diagnosis and management.

We studied 12 patients with Parkinson’s disease (PD): 6 with postural instability (Hoehn and Yahr Stage 3) and 6 without (Stage 2 or 2.5), using a quantitative test based on the clinical pull test. Their findings were compared with those for 12 healthy controls. The patients on their usual medications were pulled either forwards or backwards at the level of the shoulders and asked not to take a step in a series of five trials. Acceleration was monitored for the upper trunk, sacrum, and both tibias. EMG was measured in soleus and tibialis anterior (TA) muscles in all and for thigh and truncal muscles in a subgroup. A target of 0.2 g trunk acceleration was used, but smaller perturbations were used in very unstable patients. All the Stage 3 patients lost balance in at least one trial for the posterior perturbations but none for the anterior ones. None of the Stage 2 patients lost balance. There was increased tonic EMG and agonist activity but no difference in EMG onset or initial force production compared to healthy controls. For posterior perturbations, there were two related disorders that separated the PD patients from controls. There was a significantly higher ratio of sacral-to-applied acceleration and both PD groups showed reduced knee acceleration and shortened latency, more so for the Stage 3 group. The increased sacral-to-C7 acceleration ratio was correlated with the tonic level of activation of the hamstrings (HS), quadriceps, and lumbar paraspinal muscles (PS), while the tibial acceleration latency was also correlated with the level of tonic PS activation. We also found that the size of balance responses, 0–200 ms post-perturbation, correlated significantly with the level of tonic activation in nearly all the muscles studied. We confirmed that PD patients show greater instability posteriorly than anteriorly to applied perturbations. Our findings support increasing axial and limb rigidity as the cause of the impaired pull test rather than postural bradykinesia and suggest that tonic truncal and thigh muscle activation may be an important underlying cause.

The ocular vestibular evoked myogenic potential (oVEMP) is a relatively new method used to assess otolith-ocular pathways in humans. When elicited using air-conducted (AC) sound stimulation, the oVEMP is thought to reflect mostly saccular activation. However, it has been recently suggested that utricular afferents may also contribute to the AC evoked oVEMP. While previous frequency tuning studies of the AC evoked oVEMP report predominately high frequency sensitivity (>400 Hz), few have included the lower frequencies (<200 Hz) at which it has been proposed the utricle is most sensitive. In this study, ten normal subjects were stimulated with AC sound delivered unilaterally using headphones over frequencies from 50 to 1,200 Hz at a near constant A-weighted intensity of 120 dB peak sound pressure level. For AC stimulation, the oVEMP demonstrated maximum amplitudes around 600 Hz, with a second, smaller peak occurring around 100 Hz. The AC evoked oVEMP tuning has two peaks, a dominant one consistent with excitation of the saccule and a smaller one consistent with excitation of the utricle.

We studied the short-latency (SL) effects of postural perturbations produced by impulses applied over the spine of the C7 vertebra or the sternum (“axial impulses”) in 12 healthy subjects. EMG recordings were made bilaterally from the triceps brachii, biceps brachii, soleus, and tibialis anterior muscles, and unilaterally from the deltoid, forearm flexors, forearm extensors, and first dorsal interosseous (FDI) muscles. Sternal impulses evoked short-latency responses in the biceps when subjects leaned posteriorly to support approximately 12% of their body weight with the arms, but these responses were only modestly larger than for isometric contraction of the arms (26.3 vs. 14.7%). In contrast, clear excitatory responses could be evoked in the deltoid, triceps, forearm muscles, and FDI when leaning anteriorly to support similar amounts of body weight. These responses were significantly larger than during isometric contraction. The deltoid (42.5%) and triceps (44.7%) had the largest responses in supported anterior lean and onset latencies increased distally in this condition (mean 31.8 ms in deltoid to 53.7 ms in FDI). There was a disproportionate delay between the forearm muscles and FDI. For both directions of lean, postural reflex responses normally present in the legs were severely attenuated. SL upper limb excitatory responses were bigger in proximal muscles as well as larger and more widespread for anterior axial perturbations compared to posterior axial perturbations when using the arms to support body weight. Our findings also provide further evidence of a role for reticulospinal pathways in mediating these rapid postural responses to accelerations of the trunk.

We studied the response to axial taps (mini-perturbations) of a group of 13 healthy older subjects (mean age 63 ± 12 years, 7 females, 6 males), 12 of whom were also studied using larger applied (macro-) perturbations requiring active postural responses. The mini-perturbation consisted of a brief impulsive force produced by a mini-shaker applied to the trunk at the level of the shoulders and anteriorly at the upper sternum which was perceived as a tap. Acceleration, force platform, and EMG measurements were made. The average peak accelerations for the mini-perturbations were 108 mG (anterior) and − 78.9 mG (posterior). Responses overall were very similar to those previously reported for younger subjects: the perturbation evoked short latency responses in leg muscles, modulated by degree and direction of lean, and were largest for the muscle most relevant for the postural correction. The increases in the amplitude for the main agonist were greater than the increase in tonic activity. With both anterior and posterior lean, co-contraction responses were present. The size of the EMG response to the mini-perturbations correlated with the corresponding earliest EMG responses (0–100, 100–200 ms intervals) to the larger postural perturbations, timing which corresponds to balance responses. The balance responses evoked by the larger imposed postural perturbations may, therefore, receive a contribution through the reflex pathway mediating the axial tap responses, whose efferent limb appears to be the reticulospinal tract.

We studied the short-latency (SL) postural effects of axial impulses in 11 subjects (22 ± 2 years old). Recordings were made bilaterally from soleus and tibialis anterior (TA) muscles. We confirmed that with leaning anteriorly and posteriorly, reflex EMG increases occurred in both muscle groups at short latency following brief perturbations applied over C7 or the sternum (soleus mean latencies 57.5 and 66.4 ms; TA mean 51.7 and 55.4 ms, respectively). While the size of the SL reflexes was affected by the direction of lean when standing we found that light touch did not affect the amplitudes or latencies significantly. We investigated the presence of SL responses in the upper limb muscle triceps brachii during an isometric contraction and when the arm muscles had a direct role in supporting approximately 40% of the body weight. Similar levels of tonic EMG activity occurred in triceps in both conditions but significantly larger SL reflexes occurred when used posturally compared to the isometric contraction (23.0 vs 3.3%) while the reverse occurred for SL responses in soleus and TA, which were significantly attenuated. The responses were present with the head in the neutral position but with head rotation were larger contralateral to the direction of rotation. Calculations based upon the relative latencies suggest that the pathway responsible is not the corticospinal tract. We conclude that axially evoked SL postural reflexes are unaffected by light tactile input but are present in upper limb muscles when used for postural support. We propose that the pathway mediating these responses is the reticulospinal tract.

This study concerned the effects of brisk perturbations applied to the shoulders of standing subjects to displace them either forwards or backwards, our aim being to characterise the responses to these disturbances. Subjects stood on a force platform, and acceleration was measured at the level of C7, the sacrum and both tibial tuberosities. Surface EMG was measured from soleus (SOL), tibialis anterior (TA), the hamstrings (HS), quadriceps (QUAD), rectus abdominis (RA) and lumbar paraspinal (PS) muscles. Trials were recorded for each of four conditions: subjects’ eyes open (reference) or closed and on a firm (reference) or compliant surface. Observations were also made of voluntary postural reactions to a tap over the deltoid. Anterior perturbations (mean C7 acceleration 251.7 m g ) evoked activity within the dorsal muscles (SOL, HS, PS) with a similar latency to voluntary responses to shoulder tapping. Responses to posterior perturbations (mean C7 acceleration −240.4 m g ) were more complex beginning, on average, at shorter latency than voluntary activity (median TA 78.0 ms). There was activation of TA, QUAD and SOL associated with initial forward acceleration of the lower legs. The EMG responses consisted of an initial phasic discharge followed by a more prolonged one. These responses differ from the pattern of automatic postural responses that follow displacements at the level of the ankles, and it is unlikely that proprioceptive afferents excited by ankle movement had a role in the initial responses. Vision and surface properties had only minor effects. Perturbations of the upper trunk evoke stereotyped compensatory postural responses for each direction of perturbation. For posterior perturbations, EMG onset occurs earlier than for voluntary responses.