Objective: To investigate changes in soleus H-reflex tests in patients with Hirayama disease (HD) and to analyse correlations between these changes and forward-shifting of the cervical cord during neck flexion.& para;& para;Methods: The amplitude of the soleus H-reflex with and without vibration on the Achilles tendon was recorded bilaterally in 81 HD patients and 34 controls to measure both the vibratory inhibition index (VII) and the H-max/M-max ratio. The maximum forward-shifting degree of cervical cord during neck flexion was measured using dynamic magnetic resonance imaging in all HD patients.& para;& para;Results: Significantly higher VII was recorded in 6/81 (7.4%) HD patients, along with abnormal H-max/M-max ratios in 5 of 6 cases. Compared to illness duration (r = 0.29-0.36, p < 0.05), the maximum forward-shifting degree of the cervical cord was more strongly correlated with both VII and the H-max/M-max ratio (r = 0.51-0.81, p < 0.05).& para;& para;Conclusions: HD patients may develop cervical spinal cord injury with disease progression, and these lesions may be more likely to occur in cases with relatively severe cervical-flexion structural abnormalities even during early stages.& para;& para;Significance: More caution should be taken when managing HD patients with severe cervical-flexion abnormalities because of the possible early occurrence of upper motor neuron lesions. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
[1]Fudan Univ, Huashan Hosp, Dept Orthoped, 12 Mid Wulumuqi Rd, Shanghai 200040, Peoples R China.
[2]SUNY Syracuse, Upstate Med Univ, Dept Phys Med & Rehabil, Syracuse, NY 10212 USA.
[3]Fudan Univ, Huashan Hosp, Dept Neurol, Shanghai 200040, Peoples R China.
[4]Fudan Univ, Peoples Hosp 5, Dept Orthoped, Shanghai 200240, Peoples R China.
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