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Updated: Dec 10, 2025

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Sex differences in soleus muscle H-reflex and V-wave excitability
Goncalo V Mendonca1,2, Pedro Pezarat-Correia1,2, André D Gonçalves1
1Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.
New Findings:
What is the central question of this study? How do H-reflex and V-wave excitability compare between men and women engaging in similar levels of physical activity? What is the main finding and its importance? H-reflex excitability is lower in women than in men because of their greater level of antagonist co-activation during sustained plantar flexion isometric exercise. In addition, supraspinal drive is similar between men and women independently of their differences in H-reflex excitability and antagonist muscle co-activation.
Abstract:
We compared H-reflex and V-wave excitability between men and women engaging in similar levels of physical activity. We also explored whether differences in antagonist muscle co-activation between sexes might partially explain sexual dimorphism in the excitability of the H-reflex and V-wave. Fifty-seven young participants were included (29 men: 21.7 ± 2.3 years; 28 women: 22.4 ± 3.3 years). Soleus M- and H-recruitment curves were constructed on a tonic background muscle activation. V-waves were elicited during maximal voluntary contraction (MVC). Besides being stronger than women, men achieved greater Hmax /Mmax values and presented a steeper slope of the ascending limb of the H-reflex recruitment curve (P < 0.05). The current intensity required to elicit Hmax was lower for men (P < 0.05). The co-activation of the tibialis anterior muscle during the sustained plantar flexions was greater in women (ratio between tibialis and soleus normalized EMG: 20.5 vs. 8.3%, P < 0.05). Covariance analysis showed that sexual dimorphism in H-reflex excitability was dissipated when controlling for antagonist co-activation. V-wave normalized amplitude was similar between sexes even after controlling for the effects of Hmax /Mmax and antagonist co-activation as covariates. Thus, women exhibit lower H-reflex excitability than men and this is dependent on their higher level of antagonist muscle co-activation. While sex differences in antagonist co-activation persist during MVCs, this is not the case for V-wave normalized amplitude. Thus, although the efficacy of the transmission between Ia afferent fibres to α-motoneurons is lower in women because of a greater level of antagonist co-activation, our findings are consistent with similar supraspinal drive between sexes.
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