Long latency reflexes of the median nerves in healthy adults

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Winkel, A
Cook, M
Roberts, L
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2023
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Abstract

Introduction/Aims: Long latency reflexes (LLRs) are late responses in nerve conduction studies seen after peripheral nerve stimulation during submaximal muscle contraction. They follow a short latency reflex, also known as the H reflex, and are thought to involve transcortical pathways, providing a measure of proximal nerve and central conduction. For this reason, they have been evaluated in several central nervous system diseases, but reference values are not widely published and are mostly based on old studies with very small numbers of participants. Therefore, in this work we aim to provide comprehensive reference values for LLR testing. Methods: LLRs were tested in a cohort of 100 healthy participants, testing the median nerve bilaterally. Results: Mean latencies for short latency reflex (SLR), LLR1, LLR2, and LLR3 were 27.00, 38.50, 47.60, and 67.34 milliseconds, respectively. The allowable side-to-side difference was approximately 3 to 4 milliseconds. No significant sex-related differences were seen. Height correlated moderately with the SLR latency, but only weakly with LLR1, LLR2, and LLR3. Discussion: This work provides normal LLR values for comparison with future studies in disease. The technique used may allow for improved evaluation of central nervous system or proximal peripheral nerve disorders.

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Muscle & Nerve

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© 2023. This is the peer reviewed version of the following article: Winkel, A, Cook, M, Roberts, L. Long latency reflexes of the median nerves in healthy adults. Muscle & Nerve. 2023, which has been published in final form at https://doi.org/10.1002/mus.27981. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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This publication has been entered in Griffith Research Online as an advanced online version.

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Subject

Neurology and neuromuscular diseases

Biological sciences

Biomedical and clinical sciences

long latency reflexes

median nerve

nerve conduction studies

neuropathy

neurophysiology

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Winkel, A; Cook, M; Roberts, L, Long latency reflexes of the median nerves in healthy adults, Muscle & Nerve, 2023

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