Stimulus point distribution in deep or superficial peroneal nerve for treatment of ankle spasticity

Shinji Kubota, Shigeo Tanabe, Kenichi Sugawara, Yoshihiro Muraoka, Norihide Itoh, Yoshikiyo Kanada

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Objectives: To develop effective electrical stimulation treatment to reduce spasticity, we examined the optimal stimulus point of the common peroneal nerve. Materials and Methods: The locations of selective stimulus points for the deep peroneal nerve or superficial peroneal nerve fiber were examined in 25 healthy subjects in both legs (50 legs) using the ratio of the tibialis anterior (TA) to the peroneus longus (PL) M-wave amplitude (TA/PL ratio). In addition, we measured reciprocal Ia inhibition in ten healthy subjects. The amount of inhibition was determined from short-latency suppression of the soleus (Sol) H-reflex by conditioning stimuli to the deep or superficial peroneal nerve. The paired t-test was used for statistical analysis. Results: The mean TA/PL ratio during deep peroneal nerve stimulation was significantly different from superficial peroneal nerve stimulation (p < 0.001). The mean stimulus point for the deep peroneal nerve was located 7 ± 5 mm distal and 3 ± 6 mm anterior from the distal edges of the head of fibula and was markedly different from the stimulus point for the superficial peroneal nerve (20 ± 7 mm distal and 12 ± 8 mm posterior). During deep peroneal nerve stimulation, the mean conditioned H-reflex was depressed to 83.8 ± 10.7% of the unconditioned value of the H-reflex. In contrast, during superficial peroneal nerve stimulation, the mean conditioned H-reflex increased to 105.3 ± 5.2%. These values were significantly different (p < 0.001). Conclusions: In the present study, we revealed a stimulus area of the deep peroneal nerve. Also, we observed the inhibitory effects of stimulation upon the deep peroneal nerve at individual stimulus point. Our results appear to indicate that localized stimulation of the deep peroneal nerve is more useful for the reduction of ankle spasticity.

    Original languageEnglish
    Pages (from-to)251-255
    Number of pages5
    JournalNeuromodulation
    Volume16
    Issue number3
    DOIs
    Publication statusPublished - 2013 May

    Fingerprint

    Peroneal Nerve
    Ankle
    H-Reflex
    Therapeutics
    Classical Conditioning
    Leg
    Healthy Volunteers
    Fibula
    Nerve Fibers
    Electric Stimulation

    Keywords

    • Deep peroneal nerve
    • peripheral nerve stimulation
    • reciprocal Ia inhibition
    • spasticity
    • superficial peroneal nerve

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine
    • Neurology
    • Clinical Neurology

    Cite this

    Stimulus point distribution in deep or superficial peroneal nerve for treatment of ankle spasticity. / Kubota, Shinji; Tanabe, Shigeo; Sugawara, Kenichi; Muraoka, Yoshihiro; Itoh, Norihide; Kanada, Yoshikiyo.

    In: Neuromodulation, Vol. 16, No. 3, 05.2013, p. 251-255.

    Research output: Contribution to journalArticle

    Kubota, Shinji ; Tanabe, Shigeo ; Sugawara, Kenichi ; Muraoka, Yoshihiro ; Itoh, Norihide ; Kanada, Yoshikiyo. / Stimulus point distribution in deep or superficial peroneal nerve for treatment of ankle spasticity. In: Neuromodulation. 2013 ; Vol. 16, No. 3. pp. 251-255.
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    abstract = "Objectives: To develop effective electrical stimulation treatment to reduce spasticity, we examined the optimal stimulus point of the common peroneal nerve. Materials and Methods: The locations of selective stimulus points for the deep peroneal nerve or superficial peroneal nerve fiber were examined in 25 healthy subjects in both legs (50 legs) using the ratio of the tibialis anterior (TA) to the peroneus longus (PL) M-wave amplitude (TA/PL ratio). In addition, we measured reciprocal Ia inhibition in ten healthy subjects. The amount of inhibition was determined from short-latency suppression of the soleus (Sol) H-reflex by conditioning stimuli to the deep or superficial peroneal nerve. The paired t-test was used for statistical analysis. Results: The mean TA/PL ratio during deep peroneal nerve stimulation was significantly different from superficial peroneal nerve stimulation (p < 0.001). The mean stimulus point for the deep peroneal nerve was located 7 ± 5 mm distal and 3 ± 6 mm anterior from the distal edges of the head of fibula and was markedly different from the stimulus point for the superficial peroneal nerve (20 ± 7 mm distal and 12 ± 8 mm posterior). During deep peroneal nerve stimulation, the mean conditioned H-reflex was depressed to 83.8 ± 10.7{\%} of the unconditioned value of the H-reflex. In contrast, during superficial peroneal nerve stimulation, the mean conditioned H-reflex increased to 105.3 ± 5.2{\%}. These values were significantly different (p < 0.001). Conclusions: In the present study, we revealed a stimulus area of the deep peroneal nerve. Also, we observed the inhibitory effects of stimulation upon the deep peroneal nerve at individual stimulus point. Our results appear to indicate that localized stimulation of the deep peroneal nerve is more useful for the reduction of ankle spasticity.",
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    AU - Kubota, Shinji

    AU - Tanabe, Shigeo

    AU - Sugawara, Kenichi

    AU - Muraoka, Yoshihiro

    AU - Itoh, Norihide

    AU - Kanada, Yoshikiyo

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    AB - Objectives: To develop effective electrical stimulation treatment to reduce spasticity, we examined the optimal stimulus point of the common peroneal nerve. Materials and Methods: The locations of selective stimulus points for the deep peroneal nerve or superficial peroneal nerve fiber were examined in 25 healthy subjects in both legs (50 legs) using the ratio of the tibialis anterior (TA) to the peroneus longus (PL) M-wave amplitude (TA/PL ratio). In addition, we measured reciprocal Ia inhibition in ten healthy subjects. The amount of inhibition was determined from short-latency suppression of the soleus (Sol) H-reflex by conditioning stimuli to the deep or superficial peroneal nerve. The paired t-test was used for statistical analysis. Results: The mean TA/PL ratio during deep peroneal nerve stimulation was significantly different from superficial peroneal nerve stimulation (p < 0.001). The mean stimulus point for the deep peroneal nerve was located 7 ± 5 mm distal and 3 ± 6 mm anterior from the distal edges of the head of fibula and was markedly different from the stimulus point for the superficial peroneal nerve (20 ± 7 mm distal and 12 ± 8 mm posterior). During deep peroneal nerve stimulation, the mean conditioned H-reflex was depressed to 83.8 ± 10.7% of the unconditioned value of the H-reflex. In contrast, during superficial peroneal nerve stimulation, the mean conditioned H-reflex increased to 105.3 ± 5.2%. These values were significantly different (p < 0.001). Conclusions: In the present study, we revealed a stimulus area of the deep peroneal nerve. Also, we observed the inhibitory effects of stimulation upon the deep peroneal nerve at individual stimulus point. Our results appear to indicate that localized stimulation of the deep peroneal nerve is more useful for the reduction of ankle spasticity.

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    KW - reciprocal Ia inhibition

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    KW - superficial peroneal nerve

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