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Neurophysiological Assessment of H-Reflex Alterations in Compressive Radiculopathy
1Department of Pathophysiology, The Second Faculty of Medicine, Charles University, Prague 5, Czech Republic. jakub.otahal@lfmotol.cuni.cz.
Physiological Research
|July 19, 2024
Summary
This study found significant differences in H-reflex recruitment curves between symptomatic and asymptomatic limbs in patients with unilateral S1 radiculopathy. The symptomatic side showed a decreased H-reflex slope and Hmax/Mmax ratio, aiding radiculopathy diagnosis.
Area of Science:
- Neuroscience
- Clinical Electrophysiology
- Orthopedics
Background:
- Compressive radiculopathy, particularly affecting the S1 nerve root, can alter neuromuscular function.
- Evaluating H-reflex recruitment curves provides insights into spinal cord and peripheral nerve excitability.
- Objective electrophysiological markers are needed to differentiate symptomatic from asymptomatic limbs in unilateral radiculopathy.
Purpose of the Study:
- To investigate changes in the H-reflex recruitment curve in unilateral S1 compressive radiculopathy.
- To compare H-reflex parameters between symptomatic and asymptomatic limbs.
- To assess the diagnostic utility of derived H-reflex parameters in lumbosacral radiculopathy.
Main Methods:
- Recruitment curves of the H-reflex and M-wave were analyzed in 24 patients with unilateral S1 radiculopathy.
- Participants had confirmed L5/S1 nerve root compression (disc protrusion, stenosis, or spondylolisthesis).
- Key parameters analyzed included M-wave and H-reflex threshold intensity, H-reflex slope, maximal H-reflex amplitude (Hmax), and Hmax/Mmax ratio.
Main Results:
- No significant difference in M-wave threshold intensity was found between symptomatic and asymptomatic limbs.
- A trend toward increased H-reflex threshold intensity was observed in the symptomatic limb.
- Significant findings included a decreased H-reflex slope and a markedly different maximal H-reflex amplitude on the symptomatic side. The Hmax/Mmax ratio was significantly reduced in the symptomatic limb.
Conclusions:
- H-reflex parameters, particularly the slope and Hmax/Mmax ratio, are sensitive indicators of altered neuromuscular function in unilateral S1 radiculopathy.
- These findings highlight the value of H-reflex recruitment curve analysis in neurological examinations for diagnosing lumbosacral radiculopathy.
- The observed differences can contribute to a more standardized and objective clinical assessment of unilateral radiculopathy.
