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We present results from a study of the 6-to 12-Hz force tremor in relation to motor unit (MU) firing synchrony. Our experimental observations from 32 subjects, 321 contractions, and 427 recorded MUs reveal that tremor is accompanied by corresponding, in-phase MU rhythms that are additional to the ones at the MU intrinsic firing rates. This rhythmical synchrony is widespread and has a uniform strength that ranges from near zero to very large (MU/MU coherence > 0.50) in different contractions. Both the synchrony and the tremor are suppressed during ischemia, and this strongly suggests an involvement of spindle feedback in their generation. Furthermore, in the presence of substantial synchrony, the tremor enhancement, relative to the minimal tremor of ischemia, reflects the strength of the synchrony. Theoretical considerations based on these observations indicate that the muscle force signal is expected to show 1) frequency components in the band of the firing rates of the last-recruited, large MUs, and 2) because of the synchronized MU rhythms, an additional, distinct component with a size reflecting the strength of synchrony. Furthermore, synchronized MU rhythms, with frequencies in the 6- to 12-Hz range, are expected to arise from self-oscillations in the monosynaptic stretch reflex loop, due primarily to the associated muscle delay (several tens of milliseconds). Our results therefore reveal the parallel action of two tremor mechanisms, one of which involves MU synchrony probably caused by loop action. Clearly, the results on the synchrony and its impact also apply to other possible generators of tremor synchrony, including supraspinal ones.

In quasi-sinusoidal (0.5-3.0 Hz) voluntary muscle contractions, we studied the 6- to 10-Hz motor unit (MU) firing synchrony and muscle force oscillation with emphasis on their neural substrate and relation to rhythmical motor control. Our analyses were performed on data from 121 contractions of a finger muscle in 24 human subjects. They demonstrate that coherent 6- to 10-Hz components of MU discharges coexist with carrier components and coherent modulation components underlying the voluntary force variations. The 6- to 10-Hz synchrony has the frequency of the tremor synchrony in steady contractions and is also widespread and in-phase. Its strength ranges from very small to very large (MU/MU coherence >0.50) among contractions; moreover, it is not related to the contraction parameters, in accord with the notion of a distinct 6- to 10-Hz synaptic input to the MUs. Unlike the coherent MU modulations and the voluntary force variations, the in-phase 6- to 10-Hz MU components are suppressed or even eliminated during ischemia, while the respective force component is drastically reduced. These findings agree with the widely assumed supraspinal origin of the MU modulations, but they also strongly suggest a key role for muscle spindle feedback in the generation of the 6- to 10-Hz synaptic input. They therefore provide important information for the study of generators of the 6- to 10-Hz rhythm which subserves the postulated rhythmical control and is manifested as force and movement components. Moreover, they argue for a participation of oscillating spinal stretch reflex loops in the rhythm generation, possibly in interaction with supraspinal oscillators.

Muscle tremors reflect rhythmical motor unit (MU) activities. Therefore, the MU firing patterns and synchrony determine the properties of the parkinsonian force tremor (FT) and the neurogenic components of associated limb tremors. They may also be indicative of the neural mechanisms of tremor genesis which to date remain uncertain. We examined these MU behaviours during isometric contractions of a finger muscle in 19 parkinsonian subjects. Our results reveal that the parkinsonian FT is abnormally large. Like the physiological FT, it is accompanied by in-phase rhythms in all MU activities. However, there exist two important differences. Firstly, the synchrony during the parkinsonian FT is stronger than the normal one and therefore contributes to the FT enhancement. Secondly, the synchronous MU components partly represent rhythmical sequences of spike doublets and triplets whose incidences directly reflect the differences of the MU firing rates to the FT frequency. According to our analyses, the latter frequency coincides with the MU recruitment rate. Consequently, the numerous mediumand small-sized active MUs contribute rhythmical twitch doublets and triplets, i.e. large force pulses, to the parkinsonian FT. The impact of this effect on the FT amplitude is found to predominate over the impact of the augmented synchrony. Importantly, apart from the rule governing the occurrence of doublets/triplets, the mean interspike intervals within such spike events are fairly fixed around 50 ms. Such regularities in MU activities may reflect properties of the neural input underlying the FT, and thus represent a basis for more focused studies of the generator(s) of parkinsonian tremors.

The firing behavior of motor units (MUs) of the first dorsal interrosseus muscle of the hand was examined during both constant-force and varying-force (sinusoidal or broadband random variations) isometric contractions in healthy adults. The emphasis was on the analysis of MU synchrony with an efficient and sensitive method. In static contractions, widespread and strong MU firing correlations, with the MUs in phase, were present at the frequency of muscle tremor, when the tremor was regular (narrowband) and large. MU correlations could also exist in contractions where the tremor of a subject was irregular (broadband) overall, but they were generally weak. These correlations were at the frequency of the subject's regular tremor, and the corresponding distinct tremor component was sometimes discernible within the broad tremor-band. In contrast, the MUs did not show any such correlations in the case of purely irregular and small tremor. On the basis of these observations, it is concluded that the rhythms in the force contributions of the last- recruited, large MUs, which fire near their threshold rate, compose the broadband frequency content of physiological muscle tremor in every contraction. Within this band, there is an additional distinct tremor component when MU correlations are present. For widespread and strong MU correlations, this component dominates and constitutes the observed regular tremor. In dynamic contractions, the firing of all MUs was modulated in the frequency band of both the sinusoidal and the complex variations of the force. The MU modulations showed a time-lead over the force variations and were strongly correlated both to these variations and among themselves. Thus widespread and strong correlations of MU firing modulations seem to provide a mechanism for generation of time-varying voluntary force, under general dynamic conditions. Finally, when regular tremor was present in dynamic contractions, widespread and fairly strong MU correlations also existed at the tremor frequency. It is concluded that at least two mechanisms can cause widespread MU synchrony, and they can act in parallel. They involve two types of correlated inputs to the alpha-motoneurons (presumably from the muscle spindles and the cortex), whose effects combine at the level of the membrane potential of the cells.

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Survivors of critical illness exhibited a high prevalence of obstructive sleep-disordered breathing and poor sleep architecture at hospital discharge, which slightly improved 6 months later, indicating that reversible factors are partly responsible for these abnormalities.