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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| Language: | English |
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Korean Diabetes Association
2024-11-01
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| 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. |
| format | Article |
| id | doaj-art-34ced94676824643963b49efc927f1b5 |
| institution | Kabale University |
| issn | 2233-6079 2233-6087 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| 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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