Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy

Measurement of the rate-dependent depression (RDD) of the Hoffmann (H) reflex, a technique developed over half a century ago, is founded on repeated stimulation of the H-reflex with tracking of sequentially evoked H-wave amplitudes in the resulting electromyogram. RDD offers insight into the integri...

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Main Authors: Lu Han, Nigel A. Calcutt, Xiajun Zhou
Format: Article
Language:English
Published: Korean Diabetes Association 2024-11-01
Series:Diabetes & Metabolism Journal
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Online Access:http://e-dmj.org/upload/pdf/dmj-2024-0614.pdf
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author Lu Han
Nigel A. Calcutt
Xiajun Zhou
author_facet Lu Han
Nigel A. Calcutt
Xiajun Zhou
author_sort Lu Han
collection DOAJ
description Measurement of the rate-dependent depression (RDD) of the Hoffmann (H) reflex, a technique developed over half a century ago, is founded on repeated stimulation of the H-reflex with tracking of sequentially evoked H-wave amplitudes in the resulting electromyogram. RDD offers insight into the integrity of spinal reflex pathways and spinal inhibitory regulation. Initially, RDD was predominantly utilized in the mechanistic exploration and evaluation of movement disorders characterized by spasticity symptoms, as may occur following spinal cord injury. However, there is increasing recognition that sensory input from the periphery is modified at the spinal level before ascending to the higher central nervous system and that some pain states can arise from, or be exaggerated by, disruption of spinal processing via a mechanism termed spinal disinhibition. This, along with the urgent clinical need to identify biological markers of pain generator and/or amplifier sites to facilitate targeted pain therapies, has prompted interest in RDD as a biomarker for the contribution of spinal disinhibition to neuropathic pain states. Current research in animals and humans with diabetes has revealed specific disorders of spinal GABAergic function associated with impaired RDD. Future investigations on RDD aim to further elucidate its underlying pathways and enhance its clinical applications.
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spelling doaj-art-34ced94676824643963b49efc927f1b52024-11-29T06:51:01ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872024-11-014861029104610.4093/dmj.2024.06142897Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic NeuropathyLu Han0Nigel A. Calcutt1Xiajun Zhou2 Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China Department of Pathology, University of California San Diego, La Jolla, CA, USA Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaMeasurement of the rate-dependent depression (RDD) of the Hoffmann (H) reflex, a technique developed over half a century ago, is founded on repeated stimulation of the H-reflex with tracking of sequentially evoked H-wave amplitudes in the resulting electromyogram. RDD offers insight into the integrity of spinal reflex pathways and spinal inhibitory regulation. Initially, RDD was predominantly utilized in the mechanistic exploration and evaluation of movement disorders characterized by spasticity symptoms, as may occur following spinal cord injury. However, there is increasing recognition that sensory input from the periphery is modified at the spinal level before ascending to the higher central nervous system and that some pain states can arise from, or be exaggerated by, disruption of spinal processing via a mechanism termed spinal disinhibition. This, along with the urgent clinical need to identify biological markers of pain generator and/or amplifier sites to facilitate targeted pain therapies, has prompted interest in RDD as a biomarker for the contribution of spinal disinhibition to neuropathic pain states. Current research in animals and humans with diabetes has revealed specific disorders of spinal GABAergic function associated with impaired RDD. Future investigations on RDD aim to further elucidate its underlying pathways and enhance its clinical applications.http://e-dmj.org/upload/pdf/dmj-2024-0614.pdfdiabetic neuropathieselectrophysiologyh-reflexneuralgianeural inhibition
spellingShingle Lu Han
Nigel A. Calcutt
Xiajun Zhou
Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
Diabetes & Metabolism Journal
diabetic neuropathies
electrophysiology
h-reflex
neuralgia
neural inhibition
title Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
title_full Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
title_fullStr Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
title_full_unstemmed Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
title_short Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
title_sort rate dependent depression of the hoffmann reflex practical applications in painful diabetic neuropathy
topic diabetic neuropathies
electrophysiology
h-reflex
neuralgia
neural inhibition
url http://e-dmj.org/upload/pdf/dmj-2024-0614.pdf
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AT nigelacalcutt ratedependentdepressionofthehoffmannreflexpracticalapplicationsinpainfuldiabeticneuropathy
AT xiajunzhou ratedependentdepressionofthehoffmannreflexpracticalapplicationsinpainfuldiabeticneuropathy