Modulation of H-Reflex Depression with Paired-Pulse Stimulation in Healthy Active Humans

Preeti D Oza, Shauna Dudley-Javoroski, Richard K Shields, Preeti D Oza, Shauna Dudley-Javoroski, Richard K Shields

Abstract

Depression of the Hoffman reflex (H-reflex) is used to examine spinal control mechanisms during exercise, fatigue, and vibration and in response to training. H-reflex depression protocols frequently use trains of stimuli; this is time-consuming and prevents instantaneous assessment of motor neuronal excitability. The purpose of this study was to determine if paired-pulse H-reflex depression is reproducible and whether paired-pulse stimulation adequately estimates the depression induced by the more traditional ten-pulse train. H-reflexes were elicited via ten-pulse trains at 0.1, 0.2, 1, 2, and 5 Hz in ten neurologically intact individuals on two separate days. We measured the depression elicited by the second pulse (H2) and the mean depression elicited by pulses 2-10 (Hmean). H2 was consistent at all frequencies on both days (r2 = 0.97, p < 0.05, and ICC(3,1) = 0.81). H2 did not differ from Hmean (p > 0.05). The results indicate that paired-pulse H-reflex depression has high between-day reliability and yields depression estimates that are comparable to those obtained via ten-pulse trains. Paired-pulse H-reflex depression may be especially useful for studies that require rapid assessment of motor neuronal excitability, such as during exercise, fatigue, and vibration, or to establish recovery curves following inhibition.

Figures

Figure 1
Figure 1
Representative example of 10-pulse H-reflex trains elicited at 0.1 Hz, 0.2 Hz, 1 Hz, 2 Hz, and 5 Hz. 0.1(a) Hz and 0.1(b) Hz were delivered at the start and end of the experimental protocol.
Figure 2
Figure 2
Normalized H2 amplitude at each frequency on the two experimental days. No difference in H2 existed between days at any frequency (all p > 0.05). ∗ = 1 Hz, 2 Hz, and 5 Hz significantly different from 0.1 Hz and 0.2 Hz (p < 0.05).
Figure 3
Figure 3
Normalized amplitude of H2 and the average of the H-reflex train (pulses 2–10, Hmean) at each frequency. No difference existed between H2 and Hmean at any frequency (all p > 0.05). ∗ = 1 Hz, 2 Hz, and 5 Hz significantly different from 0.1 Hz and 0.2 Hz (p < 0.05).
Figure 4
Figure 4
Correlation between M1 (the M-wave accompanying H1) and M2 (the M-wave accompanying H2) on the two experimental days for all subjects.

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