Group II spindle fibres and afferent control of stance. Clues from diabetic neuropathy

Antonio Nardone, Marco Schieppati

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: Since patients with large-fibre neuropathy do not show abnormal body sway during stance, the hypothesis was tested that postural control is not impaired until myelinated fibres of medium size are affected. Methods: In 22 diabetic neuropathic patients and 13 normals, we recorded: (1) body sway area (SA), (2) stretch responses of soleus (Sol) and flexor digitorum brevis (FDB) to toe-up rotation of a platform, (3) Sol and FDB H reflex and FDB F wave, (4) conduction velocity (CV) of tibial, deep peroneal and sural nerve. In patients, detection thresholds for vibration, cooling (CDT), warming and heat-pain (HPDT) were assessed. Results: Body SA was increased in patients with respect to normals. Toe-up rotation elicited short- (SLR) and medium-latency (MLR) responses in Sol and FDB in all normals. In patients, SLR was absent in FDB and reduced in Sol, and MLR was delayed in both muscles; the FDB H reflex was absent. The CV of tibial nerve group II afferent fibres, as estimated from the afferent time of FDB MLR, was reduced in patients. All sensory detection thresholds were increased. Stepwise multiple regression showed that increased SA was explained by increased latency of MLR, decreased CV of group II fibres and augmented CDT and HPDT. Conclusions: Unsteadiness in diabetic neuropathy is related to alterations in medium-size myelinated afferent fibres, possibly originating from spindle secondary terminations.

Original languageEnglish
Pages (from-to)779-789
Number of pages11
JournalClinical Neurophysiology
Volume115
Issue number4
DOIs
Publication statusPublished - Apr 2004

Fingerprint

Diabetic Neuropathies
H-Reflex
Toes
Sensory Thresholds
Tibial Nerve
Sural Nerve
Peroneal Nerve
Vibration
Reaction Time
Hot Temperature
Pain
Muscles

Keywords

  • Diabetes
  • Group II fibre
  • Neuropathy
  • Stretch reflex
  • Sway

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems

Cite this

Group II spindle fibres and afferent control of stance. Clues from diabetic neuropathy. / Nardone, Antonio; Schieppati, Marco.

In: Clinical Neurophysiology, Vol. 115, No. 4, 04.2004, p. 779-789.

Research output: Contribution to journalArticle

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