Differences between motor point and innervation zone locations in the biceps brachii. An exploratory consideration for the treatment of spasticity with botulinum toxin

BackgroundBotulinum toxin (BTX) acts on the neuromuscular junction which can be located by the innervation zone (IZ). Clinically, the motor point (MP) is homologous to the IZ and it is used as the injection site of BTX. Differences in the effectiveness of the application of BTX between MP and IZ locations have been determined.ObjectiveCompare the location of the MP obtained using electrical stimulation and the location of the IZ using a linear surface electrodes array on the biceps brachii muscle.MethodsThe biceps brachii muscle of twenty men was assessed. The MP was located using the torque measurement generated by electrical stimulation. The IZ was detected using a linear surface electrodes array.ResultsA difference between the MP and the IZ positions (75.8 vs. 86.5 mm, delta 10.7 mm; p = 0.003, post-hoc power 0.89) was observed.DiscussionThe magnitude of the difference between the MP and the IZ may be clinically relevant. The IZ location using surface electromyography as a guide to optimize BTX injection is proposed.     

Effect of innervation zones in estimating biceps brachii force-EMG relationship during isometric contraction

Measuring muscle forces in vivo is invasive and consequently indirect methods e.g., electromyography (EMG) are used in estimating muscular force production. The aim of the present paper was to examine what kind of effect the disruption of the physiological signal caused by the innervation zone has in predicting the force/torque output from surface EMG. Twelve men (age 26 (SD ±3) years; height 179 (±6) cm; body mass 73 (±6) kg) volunteered as subjects. They were asked to perform maximal voluntary isometric contraction (MVC) in elbow flexion, and submaximal contractions at 10%, 20%, 30%, 40%, 50% and 75% of the recorded MVC. EMG was measured from biceps brachii muscle with an electrode grid of 5 columns × 13 rows. Force-EMG relationships were determined from individual channels and as the global mean value. The relationship was deemed inconsistent if EMG value did not increase in successive force levels. Root mean squared errors were calculated for 3rd order polynomial fits. All subjects had at least one (4-52) inconsistent channel. Two subjects had inconsistent relationship calculated from the global mean. The mean root mean squared error calculated using leave one out method for the fits of the individual channels (0.33 ± 0.17) was higher (P < 0.001) than the error for the global mean fit (0.16 ± 0.08). It seems that the disruption of the physiological signal caused by the innervation zone affects the consistency of the force-EMG relationship on single bipolar channel level. Multichannel EMG recordings used for predicting force overcame this disruption.     

Distribution of innervation zone and muscle fiber conduction velocity in the biceps brachii muscle

The spatial distributions of muscle innervation zone (IZ) and muscle fiber conduction velocity (CV) were examined in nine healthy young male participants. High-density surface electromyography (EMG) was collected from the biceps brachii muscle when subjects performed isometric elbow flexions at 20% to 80% of the maximal voluntary contraction (MVC). A total of 9498 samples of IZs were identified and CVs were calculated using the Radon transform. The center and width of IZ sample distribution were compared within four different force levels and six medial to lateral electrode column positions using repeated measures ANOVA and multiple comparison tests. Significant shifts of IZ center were observed in the medial columns (Columns 5, 6, and 7) compared with the lateral columns (Columns 3 and 4) (p < 0.05). Similarly, significant differences in the IZ width were found in Column 7 and 8 compared to Column 3 (p < 0.05). In contrast, muscle CV was unaffected by column position. Instead, muscle CV was faster at 40% and 80% MVC compared to 20% MVC (p < 0.05). The findings of this study add further insights into the physiological properties of the biceps brachii muscle.     

Time course of stretching-induced changes in mechanomyogram and force characteristics

To evaluate the time-course of stretching-induced changes in mechanical properties of the muscle-tendon unit (MTU), 11 participants (age 22 ± 1 yr; body mass 77 ± 5 kg; stature 1.78 ± 0.05 m; mean ± SD) underwent tetanic electrical stimulations of the medial gastrocnemius muscle before and after (up to 2 h) stretching administration. During contractions, surface electromyogram (EMG), mechanomyogram (MMG) and force were recorded simultaneously. From MMG, peak-to-peak (p–p) and root mean square (RMS) were calculated during the on-phase and plateau phase of tetanic contraction, respectively. After stretching: (i) no differences were found in EMG parameters; (ii) MMG p–p and slope decreased (−16% and −10%, respectively; P < 0.05) and remained depressed for the entire recovery period; (iii) MMG RMS increased (+20%; P < 0.05), returning to pre-stretching values within 15 min; and (iv) peak force (pF), with its first (dF/dt) and second (d²F/dt²) derivative, decreased significantly by 32%, 35% and 54%, respectively, and remained depressed for the entire recovery period. The lack of MMG p–p and pF recovery could be ascribable to a reduced muscle force generating capacity due to persisting changes in viscoelastic characteristics of series elastic components. The early return of MMG RMS to pre-stretching values suggests that changes in viscoelastic parallel components recovered after few minutes.     

Myosin heavy chain composition of muscle spindles in human biceps brachii.

Data on the myosin heavy chain (MyHC) composition of human muscle spindles are scarce in spite of the well-known correlation between MyHC composition and functional properties of skeletal muscle fibers. The MyHC composition of intrafusal fibers from 36 spindles of human biceps brachii muscle was studied in detail by immunocytochemistry with a large battery of antibodies. The MyHC content of isolated muscle spindles was assessed with SDS-PAGE and immunoblots. Four major MyHC isoforms (MyHCI, IIa, embryonic, and intrafusal) were detected with SDS-PAGE. Immunocytochemistry revealed very complex staining patterns for each intrafusal fiber type. The bag(1) fibers contained slow tonic MyHC along their entire fiber length and MyHCI, alpha-cardiac, embryonic, and fetal isoforms along a variable part of their length. The bag(2) fibers contained MyHC slow tonic, I, alpha-cardiac, embryonic, and fetal isoforms with regional variations. Chain fibers contained MyHCIIa, embryonic, and fetal isoforms throughout the fiber, and MyHCIIx at least in the juxtaequatorial region. Virtually each muscle spindle had a different allotment of numbers of bag(1), bag(2) and chain fibers. Taken together, the complexity in intrafusal fiber content and MyHC composition observed indicate that each muscle spindle in the human biceps has a unique identity.     

Estimate of M-wave changes in human biceps brachii during continuous stimulation.

The purpose of the present study was to validate the capability of new fatigue indexes (in the time and frequency domain) applied to experimental recordings and thus, to test some assumptions made in previous simulations. The indexes were applied to M-waves detected non-invasively from human m.biceps brachii during repetitive slightly above threshold stimulations. It was found that distance between the motor point and middle of the end-plate region could be relatively large. Under identical conditions (signals detected by monopolar electrodes and high-pass filtered at 1 Hz), the relative changes of the indexes obtained in electrophysiological experiments and simulations were similar. Changes of the intracellular action potential profile during fatigue used in the simulations were consequently supposed to be close to the actual ones for the muscle analyzed. When the high-pass cut-off frequency was higher than 1 Hz, the sensitivity of the index in the time domain was higher, while that in the frequency domain was lower. If the normalizing spectral moment was of higher order, the sensitivity of the spectral index could be even 150-times greater than that of the fatigue indexes traditionally used. Thus, the spectral index promises high capability to assess fatigue during functional electrical stimulation.     

Studies of human antagonistic muscles after rupture of the tendon of biceps brachii

The fibre type ratio and the cross sectional areas of fibres were studied in triceps brachial muscle after rupture of tendon of the biceps brachial muscle in man. On the healthy and injured sides of the m. triceps brachii, the mean value of type 1 fibres was 51.9% and 52.4%, respectively. The mean cross sectional area of fibre on the two sides of the triceps muscle varied considerably among individuals without any significant correlation to injury of the biceps tendon.     

Histochemical characteristics of the muscle fibers of the biceps and triceps brachii muscles in human ontogeny

By means of morphometrical and histochemical methods for revealing myosin ATPase and SDG activity development of various types of muscle fibers (MF) has been studied in the postmortem material, using m. biceps and m. triceps brachii in human ontogenesis. The flexors and extensors have features in common in the dynamics of the MF maturation, and some distinctive peculiarities. The appearance of histochemical distinctions between the MF takes place on the 5th-6th months of the intrauterine development. Morphofunctional specialization begins with formation of tonic fibers. During the 1st-2nd years phasic fibers form. A relative amount of fast MF in both muscles increases at the age of 11-12 years. The dynamics of final specialization of the MF is connected with stages of sexual maturation. The first stage of the sexual maturation (about 14 years of age) is connected with decrease in the relative amount of the MF of glycolytic type of energy supply and corresponding increase in the number of oxidative type structures. From 15-17 years of age a final differentiation begins, it is connected with an intensive transversal growth of all the MF and distinguish of thick glycolytic MF. The m. biceps brachii has a relatively greater amount of oxidative fibers, and the m. triceps brachii, glycolytic ones. The transversal section area of the MF in the m. triceps brachii exceeds that of the m. biceps brachii, beginning from the 7th month of the intrauterine development up to 14 years of age. The investigation performed does not reveal any anticipating development either in the flexors or in the extensors. The differentiating processes in the m. biceps and m. triceps brachii occur nearly simultaneously.     

The role of the biceps brachii in shoulder elevation.

The biceps brachii is a bi-articular muscle affecting motion at the shoulder and elbow. While its' action at the elbow is well documented, its role in shoulder elevation is less clear. Therefore, the purpose of this project was to investigate the influence of shoulder and elbow joint angles on the shoulder elevation function of the biceps brachii. Twelve males and 18 females were tested on a Biodex dynamometer with the biceps brachii muscle selectively stimulated at a standardized level of voltage. The results indicated that both shoulder and elbow joint angles influence the shoulder joint elevation moment produced by the biceps brachii. Further analysis revealed that the elevation moment was greatest with the shoulder joint at 0 degrees and the elbow flexed 30 degrees or less. The greatest reduction in the elevation moment occurred between shoulder angles of 0 degrees and 30 degrees . The shoulder elevation moment was near zero when shoulder elevation reached or exceeded 60 degrees regardless of elbow angle. These results clarify the role of the biceps in shoulder elevation, as a dynamic stabilizer, and suggest that it is a decelerator of the arm during the throwing motion.     

Remarkable heterogeneity in myosin heavy-chain composition of the human young masseter compared with young biceps brachii

Adult human jaw muscles differ from limb and trunk muscles in enzyme-histochemical fibre type composition. Recently, we showed that the human masseter and biceps differ in fibre type pattern already at childhood. The present study explored the myosin heavy-chain (MyHC) expression in the young masseter and biceps muscles by means of gel electrophoresis (GE) and immuno-histochemical (IHC) techniques. Plasticity in MyHC expression during life was evaluated by comparing the results with the previously reported data for adult muscles. In young masseter, GE identified MyHC-I, MyHC-IIa MyHC-IIx and small proportions of MyHC-fetal and MyHC-α cardiac. Western blots confirmed the presence of MyHC-I, MyHC-IIa and MyHC-IIx. IHC revealed in the masseter six isomyosins, MyHC-I, MyHC-IIa, MyHC-IIx, MyHC-fetal, MyHC α-cardiac and a previously not reported isoform, termed MyHC-IIx'. The majority of the masseter fibres co-expressed two to four isoforms. In the young biceps, both GE and IHC identified MyHC-I, MyHC-IIa and MyHC-IIx. MyHC-I predominated in both muscles. Young masseter showed more slow and less-fast and fetal MyHC than the adult and elderly masseter. These results provide evidence that the young masseter muscle is unique in MyHC composition, expressing MyHC-α cardiac and MyHC-fetal isoforms as well as hitherto unrecognized potential spliced isoforms of MyHC-fetal and MyHC-IIx. Differences in masseter MyHC expression between young adult and elderly suggest a shift from childhood to adulthood towards more fast contractile properties. Differences between masseter and biceps are proposed to reflect diverse evolutionary and developmental origins and confirm that the masseter and biceps present separate allotypes of muscle.     

Mechanomyographic amplitude and mean power frequency versus torque relationships during isokinetic and isometric muscle actions of the biceps brachii.

The purpose of this investigation was to determine the mechanomyographic (MMG) amplitude and mean power frequency (MPF) versus torque (or force) relationships during isokinetic and isometric muscle actions of the biceps brachii. Ten adults (mean +/- SD age = 21.6 +/- 1.7 years) performed submaximal to maximal isokinetic and isometric muscle actions of the dominant forearm flexors. Following determination of isokinetic peak torque (PT) and the isometric maximum voluntary contraction (MVC), the subjects randomly performed submaximal step muscle actions in 10% increments from 10% to 90% PT and MVC. Polynomial regression analyses indicated that MMG amplitude increased linearly with torque during both the isokinetic (r2 = 0.982) and isometric (r2 = 0.956) muscle actions. From 80% to 100% of isometric MVC, however, MMG amplitude appeared to plateau. Cubic models provided the best fit for the MMG MPF versus isokinetic (R2 = 0.786) and isometric (R2 = 0.940) torque relationships, although no significant increase in MMG MPF was found from 10% to 100% of isokinetic PT. For the isometric muscle actions, however, MMG MPF remained relatively stable from 10% to 50% MVC, increased from 50% to 80% MVC, and decreased from 80% to 100% MVC. The results demonstrated differences in the MMG amplitude and MPF versus torque relationships between the isokinetic and isometric muscle actions. These findings suggested that the time and frequency domains of the MMG signal may be useful for describing the unique motor control strategies that modulate dynamic versus isometric torque production.     

Fiber content and myosin heavy chain composition of muscle spindles in aged human biceps brachii.

The present study investigated potential age-related changes in human muscle spindles with respect to the intrafusal fiber-type content and myosin heavy chain (MyHC) composition in biceps brachii muscle. The total number of intrafusal fibers per spindle decreased significantly with aging, due to a significant reduction in the number of nuclear chain fibers. Nuclear chain fibers in old spindles were short and some showed novel expression of MyHC alpha-cardiac. The expression of MyHC alpha-cardiac in bag1 and bag2 fibers was greatly decreased in the A region. The expression of slow MyHC was increased in nuclear bag1 fibers and that of fetal MyHC decreased in bag2 fibers whereas the patterns of distribution of the remaining MyHC isoforms were generally not affected by aging. We conclude that aging appears to have an important impact on muscle spindle composition. These changes in muscle spindle phenotype may reflect an age-related deterioration in sensory and motor innervation and are likely to have an impact in motor control in the elderly.     

Skeletal muscle bioenergetics: a comparative study of mitochondria isolated from pigeon pectoralis, rat soleus, rat biceps brachii, pig biceps femoris and human quadriceps

The metabolism of mitochondria isolated from five functionally different skeletal muscles is compared. Data for a single ectothermic preparation are also reported. The mitochondria were prepared in yields of 44+/-7% from 50 to 100 mg muscle. The muscle content of mitochondrial protein ranged between 2 and 40 g kg(-1). Twelve specific activities of key enzymes and metabolic systems were determined, 10 of these in functional assays with respiratory measurements. The specific activities of glutamate dehydrogenase, alpha-glycerophosphate dehydrogenase, and exo-NADH oxidase differed considerably among muscle sources. Seven specific activities, including very central reactions, showed low among-muscle variation. The activity of ATP synthesis, for instance, was 1.0-1.3 mmol min(-1) g(-1) mitochondrial protein, 25 degrees C. In vitro data were extrapolated to in vivo conditions of the muscles. The calculated rates of respiration and ATP synthesis were in accordance with reported tissue activities. Pigeon pectoralis mitochondria showed a unique cytochrome spectrum and a respiratory chain activity that might effect simultaneous carbohydrate and fatty acid respiration. In mitochondria from the other muscles, the respiratory chain activity balanced the carbohydrate oxidation capacity. In all muscles, the respiratory capacity exceeds that needed for oxidative phosphorylation. This may secure maximal mitochondrial ATP synthesis during maximal work rates and high cellular [Ca(2+)].     

The expression of the skeletal muscle force-length relationship in vivo: A simulation study

The force-length relationship is one of the most important mechanical characteristics of skeletal muscle in humans and animals. For a physiologically realistic joint range of motion and therefore range of muscle fibre lengths only part of the force-length curve may be used in vivo, i.e. only a section of the force-length curve is expressed. A generalised model of a mono-articular muscle-tendon complex was used to examine the effect of various muscle architecture parameters on the expressed section of the force-length relationship for a 90° joint range of motion. The parameters investigated were: the ratio of tendon resting length to muscle fibre optimum length (L_TR:L_F·OPT) (varied from 0.5 to 11.5), the ratio of muscle fibre optimum length to average moment arm (L_F·OPT:r) (varied from 0.5 to 5), the normalised tendon strain at maximum isometric force (c) (varied from 0 to 0.08), the muscle fibre pennation angle (θ) (varied from 0° to 45°) and the joint angle at which the optimum muscle fibre length occurred (φ). The range of values chosen for each parameter was based on values reported in the literature for five human mono-articular muscles with different functional roles. The ratios L_TR:L_F·OPT and L_F·OPT:r were important in determining the amount of variability in the expressed section of the force-length relationship. The modelled muscle operated over only one limb at intermediate values of these two ratios (L_TR:L_F·OPT=5; L_F·OPT:r=3), whether this was the ascending or descending limb was determined by the precise values of the other parameters. It was concluded that inter-individual variability in the expressed section of the force-length relationship is possible, particularly for muscles with intermediate values of L_TR:L_F·OPT and L_F·OPT:r such as the brachialis and vastus lateralis. Understanding the potential for inter-individual variability in the expressed section is important when using muscle models to simulate movement.     

Spatial distribution of surface action potentials generated by individual motor units in the human biceps brachii muscle

This study analyses the spatial distribution of individual motor unit potentials (MUPs) over the skin surface and the influence of motor unit depth and recording configuration on this distribution. Multichannel surface (13 × 5 electrode grid) and intramuscular (wire electrodes inserted with needles of lengths 15 and 25 mm) electromyographic (EMG) signals were concurrently recorded with monopolar derivations from the biceps brachii muscle of 10 healthy subjects during 60-s isometric contractions at 20% of the maximum torque. Multichannel monopolar MUPs of the target motor unit were obtained by spike-triggered averaging of the surface EMG. Amplitude and frequency characteristics of monopolar and bipolar MUPs were calculated for locations along the fibers’ direction (longitudinal), and along the direction perpendicular (transverse) to the fibers. In the longitudinal direction, monopolar and bipolar MUPs exhibited marked amplitude changes that extended for 16–32 mm and 16–24 mm over the innervation and tendon zones, respectively. The variation of monopolar and bipolar MUP characteristics was not symmetrical about the innervation zone. Motor unit depth had a considerable influence on the relative longitudinal variation of amplitude for monopolar MUPs, but not for bipolar MUPs. The transverse extension of bipolar MUPs ranged between 24 and 32 mm, whereas that of monopolar MUPs ranged between 72 and 96 mm. The mean power spectral frequency of surface MUPs was highly dependent on the transverse electrode location but not on depth. This study provides a basis for the interpretation of the contribution of individual motor units to the interference surface EMG signal.     

Architectural and histochemical analysis of the biceps brachii muscle of the horse.

The biceps brachii of horses is a complex muscle subdivided into two heads which may subserve distinct functions. The lateral head contains a large percentage of type I myofibers. This region is largely composed of short fibers (5-7 mm long) arranged in a pinnate fashion and heavily invested with connective tissue. The medial head contains fewer type I fibers and is composed of relatively longer myofibers (15-20 mm long), also arranged in a pinnate fashion but less heavily invested with connective tissue. It is hypothesized that the lateral muscle head of biceps brachii contributes to the postural role of the muscle in the forelimb passive stay apparatus. The medial head, with its longer fibers and generally fast fiber population may be most important during dynamic activity such as walking, trotting and running.     

Motor unit synchronization in FDI and biceps brachii muscles of strength-trained males

Motor unit (MU) synchronization is the simultaneous or near-simultaneous firing of two MUs which occurs more often than would be expected by chance. The present study sought to investigate the effects of exercise training, muscle group, and force level, by comparing the magnitude of synchronization in the biceps brachii (BB) and first dorsal interosseous (FDI) muscles of untrained and strength-trained college-aged males at two force levels, 30% of maximal voluntary contraction (MVC) and 80% MVC. MU action potentials were recorded directly via an intramuscular needle electrode. The magnitude of synchronization was assessed using previously-reported synchronization indices: k′, E, and CIS. Synchronization was significantly higher in the FDI than in the BB. Greater synchronization was observed in the strength-trained group with CIS, but not with E or k′. Also, synchronization was significantly greater at 80% MVC than at 30% MVC with E, but only moderately greater with CIS and there was no force difference with k′. Synchronization prevalence was found to be greater in the BB (80.1%) than in the FDI (71.5%). Thus, although the evidence is a bit equivocal, it appears that MU synchronization is greater at higher forces, and greater in strength-trained individuals than in untrained subjects.     

Acoustic myography reflects force changes during dynamic concentric and eccentric contractions of the human biceps brachii muscle.

The relationship between acoustic myography (AMG), electromyography (EMG) and force during submaximal dynamic contractions was examined in the biceps brachii muscles of eight healthy males (aged 17-26 years). Different weights were lifted and lowered at a constant speed, using a wall pulley system, to perform concentric and eccentric contractions, respectively. Integrated AMG (iAMG) and integrated EMG (iEMG) activity both increased linearly with force during concentric (iAMG r = 0.94; iEMG r = 0.99) and eccentric (iAMG r = 0.90; iEMG r = 0.94) contractions. The slopes of the concentric regression lines were significantly different from the eccentric slopes (P less than 0.01) for both iAMG and iEMG with concentric contractions showing greater levels of activity. The results indicated that AMG can be used to detect changes in force during dynamic contractions which has important implications for the use of AMG in rehabilitation. The differences in iAMG activity between concentric and eccentric contractions are discussed in relationship to the origin of the AMG signal.