A MEASURE OF PERIPHERAL-NERVE STIMULATION EFFICACY APPLICABLE TO H-REFLEX STUDIES

Background: When H-reflexes are recorded during movement in human subj ects, the stimulator current output is nor a good indicator of sensory stimulation efficacy because of unavoidable nerve movement relative t o the stimulus electrodes, Therefore, the M-wave amplitude has been us ed by researchers as an indicator of the efficacy of the stimulus, In this study we have examined the general validity of the hypothesis tha t the M-wave amplitude is directly proportional to the group I sensory afferent volley evoked by the stimulus, Methods: A nerve recording cu ff, stimulating electrodes, and EMG recording electrodes were implante d in cats. Nerve cuff recordings of centrally propagating volleys evok ed by electrical stimuli were directly compared to M-waves produced by the same stimuli. Compound action potentials (CAPs) recorded in the s ciatic nerve were compared with soleus M-waves during either tibial ne rve or soleus muscle nerve stimulation. CAPs in the ulnar nerve were c orrelated with flexor carpi ulnaris M-waves during ulnar nerve stimula tion, Results ald Conclusions: Our findings indicate that for mixed ne rve stimulation (e.g., tibial or ulnar nerve) the M-wave can be a reli able indicator of the centrally propagating sensory volley, Due to the high correlation between CAP and M-wave amplitude in these nerves, a small number of M-waves can give a good estimate of the size of the gr oup I sensory volley. On the other hand, when nerves with only partial ly overlaping fibre diameter populations are stimulated (e.g., the sol eus muscle nerve), the M-wave is not well correlated with the group I sensory volley and thus may not be used as a measure of the size of th e input volley for H-reflex studies.