Electromyography and clinical neurophysiology
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Electromyogr Clin Neurophysiol · Jan 2010
Phase relation changes between the firings of alpha and gamma-motoneurons and muscle spindle afferents in the sacral micturition centre during continence functions in brain-dead human and patients with spinal cord injury.
1. Single-nerve fibre action potentials (APs) were recorded with 2 pairs of wire electrodes from lower sacral nerve roots during surgery in patients with spinal cord injury and in a brain-dead human. Conduction velocity distribution histograms were constructed for afferent and efferent fibres, nerve fibre groups were identified and simultaneous impulse patterns of alpha and gamma-motoneurons and secondary muscle spindle afferents (SP2) were constructed. ⋯ It is conceivable that the mutual inhibitory action of detrusor and external bladder sphincter has the capacity to recover, if the functional neuronal organization of the sacral micturition center is improved in the direction of more stable phase relations between the firings of neurons and neuronal ensembles by natural coordinated afferent inputs from continence organs, supraspinal neurons, and functionally connected neuronal networks. For supraspinal control and improvement of neuronal organization some kinds of bulbo-spinal-bulbo pathways have to exist or to be reconstructed by regeneration. 7. It will be shown in a following article that the sacral micturition centre can be repaired after spinal cord injury by a functional reorganization and limited regeneration of the human spinal cord by administering coordination dynamics therapy.