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Do soleus responses to transcutaneous spinal cord stimulation show similar changes to H-reflex in response to Achilles tendon vibration?

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Abstract

Introduction/purpose

Recently, the use of transcutaneous spinal cord stimulation (TSCS) has been proposed as a viable alternative to the H-reflex. The aim of the current study was to investigate to what extent the two modes of spinal cord excitability investigation would be similarly sensitive to the well-known vibration-induced depression.

Methods

Fourteen healthy participants (8 men and 6 women; age: 26.7 ± 4.8 years) were engaged in the study. The right soleus H-reflex and TSCS responses were recorded at baseline (PRE), during right Achilles tendon vibration (VIB) and following 20 min of vibration exposure (POST-VIB). Care was taken to match H-reflex and TSCS responses amplitude at PRE and to maintain effective stimulus intensities constant throughout time points.

Results

The statistical analysis showed a significant effect of time for the H-reflex, with VIB (13 ± 5% of maximal M-wave (Mmax) and POST-VIB (36 ± 4% of Mmax) values being lower than PRE-values (48 ± 6% of Mmax). Similarly, TSCS responses changed over time, VIB (9 ± 5% of Mmax) and POST-VIB (27 ± 5% of Mmax) values being lower than PRE-values (46 ± 6% of Mmax). Pearson correlation analyses revealed positive correlation between H-reflex and TSCS responses PRE-to-VIB changes, but not for PRE- to POST-VIB changes.

Conclusion

While the sensitivity of TSCS seems to be similar to the gold standard H-reflex to highlight the vibratory paradox, both responses showed different sensitivity to the effects of prolonged vibration, suggesting slightly different pathways may actually contribute to evoked responses of both stimulation modalities.

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Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CCC:

Concordance correlation coefficient

H-reflex:

Hoffmann reflex

Mat H:

Associated M-wave amplitude when recording an H-reflex

Mmax :

Maximal M-wave

POST-VIB:

Measurements performed after prolonged vibration

PRE:

Measurements performed at baseline

SOL:

Soleus

TA:

Tibialis anterior

TSCS:

Transcutaneous spinal cord stimulation

VIB:

Measurements performed during vibration exposure

VL:

Vastus Lateralis

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Author information

Authors and Affiliations

  1. Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, 42023, Saint-Etienne, France

    Anders Gravholt, Clara Pfenninger & Thomas Lapole

  2. C3S Laboratory (Culture, Sport, , Health and Society; EA 4660), Department Sport & Performance, University of Franche-Comté, Besançon, France

    Sidney Grospretre

  3. Laboratoire INSERM U1093, Université de Bourgogne, Faculté des Sciences du Sport (UFR Staps), BP 27877, 21078, Dijon, France

    Alain Martin

Authors
  1. Anders Gravholt
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  2. Clara Pfenninger
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  3. Sidney Grospretre
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  4. Alain Martin
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  5. Thomas Lapole
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Contributions

In accordance with CRediT taxonomy: Conceptualization: AG, CP, SG, AM, TL; Methodology: AG, CP, SG, AM, TL; Formal analysis and investigation: AG, CP, TL; Writing—original draft preparation: AG, TL; Writing—review and editing: AG, CP, SG, AM, TL; Funding acquisition: TL; Resources: AG, CP, TL; Supervision: TL. In accordance with submission guidelines: AG, CP, SG, AM, TL conceived and designed the study, AG and CP conducted experiments. AG and TL conducted initial analysis of data. AG and TL wrote first draft of manuscript. All authors contributed to secondary and final draft(s) of manuscript. All authors read and approved of the submitted manuscript.

Corresponding author

Correspondence to Thomas Lapole.

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Conflict of interest

None of the authors declare any conflict of interest—No funding was receiving for this study.

Additional information

Communicated by Andrew Cresswell.

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Appendices

Appendix 1

Here we present data concerning the right Tibialis Anterior muscle.

For the five chosen responses, the Generalized Estimation Equation showed a significant effect of time for the right TA H-reflex (Figs. 2 and 5A; P < 0.001), with VIB but not POST-VIB values being significantly lower than PRE-values (P < 0.001 and P = 0.18, respectively). Mean values for PRE, VIB and POST-VIB were 10 ± 1, 4 ± 1, and 9 ± 1% of Mmax, respectively. At the same time, right TA Mat H did not change over time (Fig. 6; P = 0.87). Similarly, to the H-reflex, right TA TSCS responses changed over time (Fig. 5B; P < 0.001), VIB but not POST-VIB values being significantly lower than PRE-values (P < 0.001 and P = 0.25, respectively). Mean values for PRE, VIB and POST-VIB were 19 ± 6, 14 ± 2, and 17 ± 1% of Mmax, respectively.

The CCC showed no correlation between the evolution of right TA H-reflex and TSCS responses over time (CCC = 0.003 [−0.09;0.09]). Pearson correlation analyses revealed no correlation between right TA H-reflex and TSCS responses PRE-to-VIB changes (Fig. 7; R = 0.32, P = 0.26).

Fig. 5
figure 5

Boxplots showing right tibialis anterior (TA) H-reflex (A) and TSCS (B) responses at baseline (PRE), during right Achilles tendon vibration (VIB) and after prolonged exposure to vibration (POST-VIB). Responses are expressed as a percentage of right TA Mmax. *Denotes significant differences when compared to PRE

Full size image
Fig. 6
figure 6

Boxplots showing right tibialis anterior (TA) associated M-wave (Mat H) during H-reflex responses at baseline (PRE), during right Achilles tendon vibration (VIB) and after prolonged exposure to vibration (POST-VIB). Responses are expressed as a percentage of right TA Mmax, respectively

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Fig. 7
figure 7

Pearson correlation plots between right TA PRE-to-VIB changes in H-reflex and TSCS responses amplitude (i.e., absolute changes expressed in percentage of Mmax). The red line is the correlation, the black an identity slope (i.e., where y = x)

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Appendix 2

Here we present the results section if one were to include every stimulation utilized in the present study. Notice how the CCC changes dramatically, while all other tests remain somewhat similar to the other analysis. The CCC is, coincidentally also the only statistical test that concerns the full dataset and includes the within-subject variation, not a mean value of x stimulations. One should be aware of the greater variation when interpreting the results in both result sections.

The Generalized Estimation Equation showed a significant effect of time for the right SOL H-reflex (Fig. 8A; P < 0.001), with VIB and POST-VIB values being significantly lower than PRE-values (P < 0.001 and P = 0.003, respectively). Mean values for PRE, VIB and POST-VIB were 48 ± 5, 13 ± 5, and 36 ± 4% of Mmax, respectively. At the same time, right SOL Mat H did not change over time (Fig. 9A; P = 0.69). Similarly, to the H-reflex, right SOL TSCS responses changed over time (Fig. 8B; P < 0.001), VIB and POST-VIB values being significantly lower than PRE-values (P < 0.001) and POST-VIB values being greater than VIB values (P < 0.001). Mean values for PRE, VIB and POST-VIB were 43 ± 5, 10 ± 4, and 25 ± 4% of Mmax, respectively. No effect of time was observed for the responses of the left VL (Fig. 9B; P = 0.13).

Fig. 8
figure 8

Boxplots showing right soleus (SOL) H-reflex (A) and TSCS (B) responses at baseline (PRE), during right Achilles tendon vibration (VIB) and after prolonged exposure to vibration (POST-VIB). Responses are expressed as a percentage of right soleus Mmax. *Denotes significant differences when compared to PRE. #Denotes significant difference when compared to VIB

Full size image
Fig. 9
figure 9

Boxplots showing right soleus (SOL) associated M-wave during H-reflex recordings (A) and left vastus lateralis (VL) TSCS (B) responses at baseline (PRE), during right Achilles tendon vibration (VIB) and after prolonged exposure to vibration (POST-VIB). Responses are expressed as a percentage of right SOL and left VL Mmax, respectively

Full size image

The CCC showed a non-existent correlation between the evolution of right SOL H-reflex and TSCS responses over time (CCC = 0.10 [0.05;0.16]). Yet, Pearson correlation analyses revealed significant correlation between right SOL H-reflex and TSCS responses PRE-to-VIB changes (r = 0.82, P < 0.001; Fig. 10A), and for PRE- to POST-VIB changes (r = 0.54, P = 0.047; Fig. 10B).

Fig. 10
figure 10

Pearson correlation plots between right SOL PRE-to-VIB changes (A) as well as between PRE- to POST-VIB changes (B) in H-reflex and TSCS responses amplitude (i.e., absolute changes expressed in percentage of Mmax). The red line is the correlation, the black an identity slope (i.e., where y = x)

Full size image

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Gravholt, A., Pfenninger, C., Grospretre, S. et al. Do soleus responses to transcutaneous spinal cord stimulation show similar changes to H-reflex in response to Achilles tendon vibration?. Eur J Appl Physiol 124, 1821–1833 (2024). https://doi.org/10.1007/s00421-023-05406-x

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