Reflex interactions during whole head-and-body tilts are modified by age in humans

We have demonstrated that lower limb extensor muscle response to tibial nerve stimulation is significantly facilitated by whole head-and-body tilt in the forward direction. Our aim was to examine whether this reflex interaction is influenced by age. Reflexes were elicited in lower limb muscles by electrical stimulation (ES) of the right tibial nerve. We compared reflexes during supported stance (ESalone) and sudden forward tilting of the whole head-and-body (Tilt+ES) between 10 healthy subjects aged 66 +/- 4 years and 13 subjects aged 27 +/- 3 years. In young subjects the area of response evoked in the ipsilateral vastus lateralis (iVL) was significantly increased by 74% during Tilt+ES as compared with ESalone (p < 0.05). Moreover, the latency of contralateral VL and soleus muscle responses (cVL and/or cSO) was significantly shorter by 61 ms during Tilt+ES than ESalone (p < 0.01). In contrast, older subjects showed no significant increase in the excitability of iVL muscle response and cVL and/or cSO muscle responses during Tilt+ES as compared with ESalone, despite the application of similar intensity of ES and head acceleration as in young subjects. Our findings showed that the interaction between ES-evoked and tilt-evoked responses in lower limb extensor muscles is modified with age, which suggests modifications of sensorimotor integration involved in balance control.