Radiofrequency catheter ablation therapy in elderly patients with supraventricular tachycardia

In the present study, long-term and short-term rat preparations were used to develop a model for investigating external anal sphincter (EAS) reflexes in intact and spinal cord-injured (SCI) rats. In this model, EAS distension with an external probe elicits reflex contractions of the EAS in intact, unanesthetized animals. At 2 h after spinal cord transection, none of the lesioned animals displayed EAS EMG activity. In fact, once distended, the EAS was incapable of maintaining closure of the anal orifice. Over a period of 4 days, spinalized animals developed a hyperreflexia of the EAS response. By 48 h, the rectified, integrated EAS EMG was significantly elevated in comparison with nonlesioned controls (EAS hyperreflexia). In addition, the duration of the EAS EMG bursts in response to sphincter distension had significantly increased. At 6 weeks after injury, the EAS was significantly hyperreflexic as measured by EMG burst duration and burst area. As with intact animals, posttransection EAS reflexes were highly anesthesia sensitive. These studies indicate that (1) brief distension of the anal orifice is sufficient to evoke a physiologically relevant reflexive activation of the EAS in the rat, (2) the 2- to 24-h postinjury areflexia observed in these experiments may be a suitable model for the study of spinal shock, and (3) the observed EAS hyperreflexia after chronic SCI may represent the permanent effects of removing descending inhibitory circuits and segmental plasticity, making this reflex an appropriate measure of defecatory dysfunction after spinal cord injury.     

Age-dependent effects of muscle vibration and the Jendrassik maneuver on the patellar tendon reflex response

OBJECTIVE: To explore possible effects of aging on the excitability of spinal reflexes. DESIGN: Using a cross-sectional design, the influences of muscle vibration and the Jendrassik maneuver on patellar tendon reflex function were compared between 30 young adults and 15 older adults. SETTING: Motor control research laboratory. SUBJECTS: The young adults were volunteers of college age. The older adults (74.5 +/- 4.14 yr) were volunteers from the local community. All subjects were free of medications and neurological conditions that would affect normal neuromuscular responses. MAIN OUTCOME MEASURES: A force-time curve analysis of the patellar tendon reflex response was used to assess the inhibition and facilitation of spinal reflexes. In the experimental protocol to assess spinal reflex inhibition, 100 Hz vibration was applied to the right quadriceps muscle. In another experimental protocol, spinal reflex facilitation was assessed using the Jendrassik maneuver. To perform the Jendrassik maneuver, subjects were instructed to grasp their hands together and to pull as hard as possible while breathing normally. After a 2-second count, the tendon tap was delivered to the right leg and the subject was instructed to relax. In both experimental protocols, control patellar tendon reflexes were collected. RESULTS: Analysis of variance for reflex peak force revealed a significant 30% reduction in the amount of vibration-induced reflex inhibition with increasing age, and a similar 33% reduction in the amount of Jendrassik maneuver facilitation observed for the older adults as compared with the younger adults. CONCLUSION: These results support the hypothesis that inhibitory and excitatory influences acting on the alpha motoneuron pool are different in young and older adults.     

Stretch reflex and servo action in a variety of human muscles

1. In the long flexor of the thumb the latency of the stretch reflex and of other manifestations of servo action is some 45 msec, roughly double the latency of a finger jerk. 2. Tendon jerks are feeble or absent in the long flexor of the thumb even in subjects with brisk long-latency stretch reflexes in this muscle. This, and other facts, suggests that the nervous mechanism of the tendon jerk is different from that of the stretch reflex. 3. A muscle that has feeble tendon jerks may show a late component in the response to a tendon tap, with a latency similar to that of the long-latency stretch reflex. 4. On the hypothesis that the excess latency of the stretch reflex over that of a tendon jerk is because the stretch reflex employs a cortical rather than a spinal arc, the excess would be expected to be larger in magnitude for the long flexor of the big toe and smaller for the jaw closing muscles. This is confirmed, 5. An alternative hypothesis that the long latency of stretch reflexes in thumb and toe is because they are excited by slow-conducting afferents is made improbable by the finding that stretch reflexes with an equal or greater excess latency are also found in proximal arm muscles. 6. The long-latency stretch reflex in proximal muscles was seen most distinctly in a healthy subject who happened to have feeble or absent tendon jerks. In ordinary subjects there is often a large, short-latency, presumably spinal component of the stretch reflex in proximal muscles; and short-latency responses to halt and release are also seen, The significance of this spinal latency servo action in proximal muscles remains to be explored. 7. The Discussion argues that the available data on conduction time to and from the cerebral cortex are compatible with the hypothesis that the long-latency component of the stretch reflex uses a transcortical reflex arc, and that none of the experiments described in the present paper are inimical to this view.     

Pseudoaneurysm of the popliteal artery following arthroscopic meniscectomy

The effect of the NMDA receptor antagonist D-2-amino-5-phosphonovalerate (APV) on classical conditioning of the flexion reflex in spinal cat was examined. Animals perfused intrathecally with artificial cerebral spinal fluid (CSF) containing APV exhibited flexion reflex potentiation during the conditioning period that was not significantly different from cats receiving artificial CSF alone. However, the APV group exhibited no signs of reflex potentiation during the 2.5 h retention period, in contrast to the CSF alone group. The results suggest that NMDA receptor activation plays a critical role in the induction of associative long-term potentiation of flexion reflexes in spinal cat.     

Effects of ketamine on somatosympathetic reflex discharges in cats

Effects of ketamine on somatosympathetic reflex discharges induced from sympathetic trunk with electrical stimulation of superficial peroneal nerve were investigated in 51 cats under anesthesia with urethane and alpha chloralose. These reflex discharges through spinal cord and medulla oblongata consist of two components, A and C reflexes, which are derived from somatic myelinated and unmyelinated afferent fiber respectively. Amplitudes of both A and C reflex potentials were depressed significantly after intravenous injection of ketamine 10 mg.kg-1. The maximum depression was observed 5 min after administration. In decerebrated cats with surgical transection at the midbrain, both A and C reflexes were also depressed after administration of the same dosages, and the maximum level of the depression was more profound than that in brain intact cats. After intrathecal injection of ketamine 1 mg.kg-1 to the lumbar spinal region, a slight depression of C reflex was found, but, dosages of 10 mg.kg-1 significantly depressed both A and C reflexes to the similar levels as those in iv injection to brain intact cats. The maximum depression was observed 30 min after administration. The depressive effects on both reflexes of intravenous ketamine 10 mg.kg-1 were not antagonized by naloxone 0.06 mg.kg-1 in brain intact cats. These results suggest that the suppressive effects of ketamine on somatosympathetic reflexes are caused by direct inhibition of medulla oblongata and spinal cord, whereas supra-midbrain regions may be activated by ketamine, and the effect of ketamine is predominant on medulla oblongata in this situation rather than on the spinal cord.     

Creating auxotrophic mutants in Methylophilus methylotrophus AS1 by combining electroporation and chemical mutagenesis

Examination of the superficial abdominal reflexes in patients thought to have idiopathic scoliosis has been considered possibly beneficial for deciding who should have magnetic resonance imaging to rule out syringomyelia. The purpose of this study was to determine what is normal for this examination. Thirty normal adolescents and 35 normal young adults underwent testing of the superficial abdominal reflexes and the patellar and Achilles deep tendon reflexes. Each test was repeated two times. Thirty-nine (60%) subjects had bilaterally equal abdominal reflexes. Nine (14%) subjects had asymmetric reflexes, and seven (11%) subjects had no reflex in at least one quadrant. No subjects had reflexes present on one side and absent on the other. Ten (15%) subjects had absence of the abdominal reflexes in all quadrants. Sixteen (25%) subjects had extinguishing of the reflex in at least one quadrant as the test was repeated. Eleven of these had asymmetric or partially absent reflexes initially. In contrast, the patellar and Achilles reflexes were more consistent. The patellar reflexes were bilaterally equal in 52 (85%), asymmetric in eight (13%), and absent in one (2%). The Achilles reflexes were bilaterally equal in 59 (97%), asymmetric in one (2%), and absent in one (2%). The finding of abdominal reflexes consistently present on one side and consistently absent on the other side did not occur in our normal subjects. This finding might warrant further workup if found in a patient with scoliosis. Other variations in abdominal reflex testing such as asymmetries, absent in some quadrants, and absent in all quadrants are fairly common in normal subjects.     

Mechanism of action of nonachlazin on nervous regulation of coronary circulation

In experiments on cats and dogs under general anesthesia nonachlazine, a new antianginal agent, depressed the reflex decrease of the blood flow to the coronary arteries (electromagnetic recording). Nonachlazine also depressed the reflex decrease of the blood flow in the system of common carotic artery, and the pressure vasomotor reflexes. During recording the tonic and reflex activity in the heart sympathetic nerves nonachlazine proved to selectively inhibit the vasoconstrictor impulses from Adelta-afferent fibers of the spinal nerves, that is it influenced the vasomotor component of the "primary" pain reaction. This mechanism could underlie the block by nonachlazine of the pain syndrome during the heart ischemia disease.     

Changes in the excitability of soleus muscle short latency stretch reflexes during human hopping after 4 weeks of hopping training

Changes in the excitability of the human triceps surae muscle short latency stretch reflexes were investigated in six male subjects before and after 4 weeks of progressive two-legged hopping training. During the measurements the subjects performed 2-Hz hopping with: preferred contact time (PCT) and short contact time. The following reflex parameters were examined before and after the training period: the soleus muscle (SOL) Hoffmann-reflex (H-reflex) at rest and during hopping, the short latency electromyogram (EMG) components of the movement induced stretch reflex (MSR) in SOL and medial gastrocnemius muscle (MG), and the EMG amplitude of the SOL and MG tendon reflexes (T-reflexes) elicited at rest. The main results can be summarized as follows: the SOL T-reflex had increased by about 28% (P < 0.05) after training while the MG T-reflex was unchanged; the SOL MSR (always evident) and the MG MSR (when observable) did not change in amplitude with training, and before training the SOL H-reflex in both hopping situations was significantly depressed to about 40% of the reference value at standing rest (P < 0.05). After training the H-reflex during PCT hopping was no longer depressed. As the value of the measured mechanical parameters (the total work rate, joint angular velocity and the ankle joint work rate) was unchanged after training in both hopping situations, the reflex changes observed could not be ascribed to changes in the movement pattern. To explain the observed changes, hypotheses of changes in the excitability of the stretch reflex caused by the training were taken into consideration and discussed.     

Assessment of spasticity in hemiplegic cerebral palsy. II: Distal lower-limb reflex excitability and function

A clinical method for measuring the stretch reflex threshold and gain of muscles acting across the ankle joint in children with congenital hemiplegia is described. The stretch reflexes of all limbs were velocity-dependent. Hemiparetic limbs were not necessarily spastic compared with non-paretic limbs, suggesting that the term 'spastic hemiplegia' should be used more selectively and emphasis be placed on the heterogeneity of the hemisyndromes of childhood. Abnormal motor control, planning and dexterity, the hemipostures and plastic (non-electrical) muscle changes may be more important measures of impairment than reflex excitability. A general scheme for assessing reflex excitability and available treatments applicable to all types of cerebral palsy is proposed.     

Autonomic hyperreflexia in a pregnant paraplegic patient. Case report

BACKGROUND AND OBJECTIVES: Pregnant patients with spinal cord injuries are predisposed to autonomic hyperreflexia, which if unrecognized or untreated can lead to death. Hypertension occurring in laboring patients at risk for autonomic hyperreflexia must be managed aggressively. METHODS: Epidural anesthesia can safely control autonomic hyperreflexia during labor and delivery, but because spinal cord impaired patients lack sensory and motor function below the level of injury, it is difficult to determine the dermatomal spread of epidural anesthesia by the usual methods. This difficulty is highlighted by the following case, reporting an epidural that failed during labor, with the subsequent development of autonomic hyperreflexia. RESULTS: Previously, autonomic hyperreflexia occurring in pregnant patients (undergoing surgical procedures) was treated with intravenous antihypertensive agents. During labor, however, titrating these agents to coincide with uterine contractions is difficult. In this case, epidural anesthesia was repeated and the autonomic hyperreflexia resolved. CONCLUSIONS: Autonomic hyperreflexia can develop in unanesthetized laboring paraplegic patients (failed epidural) but it can be successfully managed with adequate epidural anesthesia.     

Economic considerations of the use of new anesthetics: a comparison of propofol, sevoflurane, desflurane, and isoflurane

Cost control in anesthesia is no longer an option; it is a necessity. New anesthetics have entered the market, but economic differences in comparison to standard anesthetic regimens are not exactly known. Eighty patients undergoing either subtotal thyroidectomy or laparoscopic cholecystectomy were randomly divided into four groups, with 20 patients in each group. Group 1 received propofol 1%/sufentanil, Group 2 received desflurane/sufentanil, Group 3 received sevoflurane/sufentanil, and Group 4 received isoflurane/sufentanil (standard anesthesia) for anesthesia. A fresh gas flow of 1.5-2 L/min and 60% N2O in oxygen was used for maintenance of anesthesia, and atracurium was given for muscle relaxation. Concentrations of volatile anesthetics, propofol, and sufentanil were varied according to the patient's perceived need. Isoflurane, desflurane, and sevoflurane consumption was measured by weighing the vaporizers with a precision weighing machine. Biometric data, time of surgery, and time of anesthesia were similar in the four groups. Times for extubation and stay in the postanesthesia care unit (PACU) were significantly longer in the isoflurane group. Use of sufentanil and atracurium did not differ among the groups. Propofol patients required fewer additional drugs in the PACU (e.g., antiemetics), and thus showed the lowest additional costs in the PACU. Total (intra- and postoperative) costs were significantly higher in the propofol group ($30.73 per patient; $0.24 per minute of anesthesia). The costs among the inhalational groups did not differ significantly (approximately $0.15 per minute of anesthesia). We conclude that in today's climate of cost savings, a comprehensive pharmacoeconomic approach is needed. Although propofol-based anesthesia was associated with the highest cost, it is doubtful whether the choice of anesthetic regimen will lower the costs of an anesthesia department. IMPLICATIONS: Cost analysis of anesthetic techniques is necessary in today's economic climate. Consumption of the new inhaled drugs sevoflurane and desflurane was measured in comparison to a standard anesthetic regimen using isoflurane and an IV technique using propofol. Propofol-based anesthesia was associated with the highest costs, whereas the costs of the new inhaled anesthetics sevoflurane and desflurane did not differ from those of a standard, isoflurane-based anesthesia regimen.     

Effect of isoflurane and sevoflurane on evoked potentials and EEG

Evoked potentials and EEG are used to monitor the central nervous system and the depth of anesthesia in anesthetized patients. In this study, we examined EEG, VEP, SEP and ABR at various concentrations of isoflurane or sevoflurane, and evaluated the influence of volatile agents and their usefulness for the monitoring of the depth of anesthesia. With increasing concentrations of isoflurane and sevoflurane, AE (frequency which account for 80% of total voltage) showed dose-related reduction and EEG showed a trend toward a slower wave and higher amplitude. With increasing concentrations of isoflurane and sevoflurane, P100 of VEP showed a significant dose-related reduction in its amplitude and increase in its latency. So we could not record P100 at the level of the anesthesia of 1.0 MAC with 66% N2O. N20 of SEP can be easily recorded at any depth of anesthesia. And the trend showed consistent dose-related changes in amplitude and latency. With increasing concentrations of isoflurane and sevoflurane, wave III and V of ABR increased significantly in latency, but the changes were very small. In conclusion, the effect of isoflurane and that of sevoflurane on evoked potentials and EEG are similar with each other and with other volatile agents. SEP is the most consistent and reliable factor to monitor the depth of anesthesia neurophysiologically.     

The grasp reflex of the foot and related phenomena in the absence of other reflex abnormalities following cerebral commissurotomy

The grasp reflex of the foot and related pheonomena were examined in six subjects with no abnormalities of deep tendon or plantar (and related) reflexes 6 to 10 years after cerebral comissurotomy. In all subjects they were more marked on the same side as the more damaged hemisphere. These tonic phenomena seem to be facillitated by sitting and standing postures. Practical and theoretical implications of the tonic foot responses in the absence of similar phenomena of the hand are discussed.     

Linear dimensional change of heat-cured acrylic resin complete dentures after reline and rebase

BACKGROUND: Mivazerol (MIV) is an alpha 2-adrenoceptor agonist designed to prevent adverse cardiac outcome in perioperative patients. The present study was undertaken to determine whether the hyperdynamic state observed at emergence from halothane (HAL) anesthesia in rats could be modulated by MIV and to explore the mode of action of MIV under such conditions. METHODS: Male Sprague Dawley rats were anesthetized with 1% HAL and assisted for respiration (N2O-O2: 70-30%). MIV 2.2-15.3 micrograms.kg-1.h-1 i.v. was infused 30 min before withdrawal of anesthesia and compared for heart rate (HR) and systolic arterial blood pressure (SAP) to control animals treated with saline. In some experiments, animals were pretreated with intrathecal pertussis toxin (T2 level, 0.5 microgram, 7 d), or i.v. rauwolscine (0.34 mg/kg, 5 min) or were bilaterally stellectomized (30 min) prior to withdrawal of HAL. RESULTS: Increases in HR (65 bpm, +20%) and in SAP (25 mmHg, +26%) were observed immediately upon discontinuation of HAL and remained constant for at least 30 min. The increase in HR was abolished by removal of the stellate ganglia. MIV dose-dependently inhibited the increase in HR from 4.8 micrograms.kg-1.h-1 (68% reduction, P < 0.05) without affecting HR or SAP during anesthesia. Inhibition of HR increase was of 98% at 15.3 micrograms.kg-1.h-1. This effect was abolished by rauwolscine, and partially (50%) inhibited by pertussis toxin pre-treatment. CONCLUSION: These results demonstrate that withdrawal of HAL anesthesia in the rat produces a sustained increase in HR due to activation of the sympathetic system and that MIV inhibits this tachycardia via activation of alpha 2-adrenoceptors located at least in part in the spinal cord.     

Long latency postural reflexes are under supraspinal dopaminergic control

Scaling of posturally stabilizing long latency (LL) reflexes in tibialis anterior muscles induced by "toe-up" rotational perturbations is abnormal in standing patients with Parkinson's disease. To investigate the contribution of dopaminergic pathways to abnormal scaling, we studied LL reflexes in 22 patients with selective hypodopaminergic syndromes: 10 psychiatric patients taking chronic neuroleptic medication (7 with mild parkinsonism), 8 patients with young-onset Parkinson's disease, and 4 patients with MPTP-induced parkinsonism. Results were compared with those of 10 healthy controls. Stimuli consisted of (a) 10 serial (predictable) perturbations of 4 degrees amplitude, (b) 10 serial (predictable) perturbations of 10 degrees amplitude, and (c) 20 randomly mixed (unpredictable) perturbations of either 4 or 10 degrees amplitude. In normal subjects, LL reflex amplitudes were adapted to match predictable variations in stimulus size, whereas under unpredictable conditions a "default" response emerged that anticipated the 10 degrees perturbation. LL reflex scaling under predictable conditions was intact in patients with neuroleptic-induced parkinsonism and young-onset Parkinson's disease, but the large default LL response under unpredictable conditions was absent. In patients with MPTP-induced parkinsonism, LL reflex scaling was absent during both predictable and unpredictable conditions. We conclude that abnormal scaling of posturally stabilizing LL reflexes is related to decreased supraspinal dopaminergic influence.     

The efficacy of epinephrine test doses during spinal anesthesia in volunteers: implications for combined spinal-epidural anesthesia

Epinephrine test doses may be administered during combined spinal-epidural anesthesia to determine intravascular placement of epidural catheters. This study was designed to determine systolic blood pressure (SBP) and heart rate (HR) responses to intravenous injection of epinephrine (15 microg) during spinal anesthesia. Twelve volunteers received three spinal anesthetics (lidocaine 100 mg, tetracaine 15 mg, and bupivacaine 15 mg) in a randomized, double blind, cross-over fashion. Epinephrine was administered prior to spinal anesthesia (control), 30 min after injection of spinal anesthesia, and at regression of sensory block to T-10. SBP was measured with a radial arterial catheter and HR with an electrocardiogram. Positive responses were defined as peak increase in SBP > or = 15 mm Hg or HR > or = 20 bpm after injection of epinephrine. Compared with control, peak SBP responses decreased by a mean of 12 mm Hg during spinal anesthesia with tetracaine and bupivacaine (P < 0.05). Peak HR responses decreased by 11 bpm during all three spinal anesthetics (P < 0.05). Incidences of detection of intravenous injection by positive SBP and HR responses ranged from 50% to 100% and were not significantly affected by spinal anesthesia. Spinal anesthesia reduces hemodynamic responses to intravenous epinephrine injection but is unlikely to reduce detection by positive SBP and HR criteria.     

Spasticity in rats with sacral spinal cord injury

We have investigated sacral spinal cord lesions in rats with the goal of developing a rat model of muscular spasticity that is minimally disruptive, not interfering with bladder, bowel, or hindlimb locomotor function. Spinal transections were made at the S2 sacral level and, thus, only affected the tail musculature. After spinal transection, the muscles of the tail were inactive for 2 weeks. Following this initial period, hypertonia, hyperreflexia, and clonus developed in the tail, and grew more pronounced with time. These changes were assessed in the awake rat, since the tail is readily accessible and easy to manipulate. Muscle stretch or cutaneous stimulation of the tail produced muscle spasms and marked increases in muscle tone, as measured with force and electromyographic recordings. When the tail was unconstrained, spontaneous or reflex induced flexor and extensor spasms coiled the tail. Movement during the spasms often triggered clonus in the end of the tail. The tail hair and skin were extremely hyperreflexive to light touch, withdrawing quickly at contact, and at times clonus could be entrained by repeated contact of the tail on a surface. Segmental tail muscle reflexes, e.g., Hoffman reflexes (H-reflexes), were measured before and after spinalization, and increased significantly 2 weeks after transection. These results suggest that sacral spinal rats develop symptoms of spasticity in tail muscles with similar characteristics to those seen in limb muscles of humans with spinal cord injury, and thus provide a convenient preparation for studying this condition.     

Heart rate response and perceived exertion during twenty consecutive karate sparring matches

This study investigated the changes in heart rate (HR) and perceived exertion ratings (RPE) of 20 consecutive karate sparring matches each of 2 minutes duration. The resting and maximal HR (HRmax) responses to the maximal treadmill test were 69.8 +/- 2.9 beats.min-1 and 198.5 +/- 8.2 beats.min-1, respectively. The resting HR before the 20 sparring matches was 83.5 +/- 11.3 beats min-1. The mean HR during the 20 sparring matches was 191.8 +/- 9.4 beats.min-1 which was equal to 96.7 +/- 4.2% of HRmax. At the end of the 20 sparring matches, the mean RPE obtained was 19 +/- 2. The results of this study suggest that the subjects could continue the 20 sparring matches for about 40 minutes at the intensity close to the HRmax.     

Characteristics of locomotor control in children with cerebral palsy

The typical features of electromyographical (EMG) recordings from children with cerebral palsy (CP) consist of a coactivation of antagonistic leg muscles during the stance phase, a low and tonic activation of extensor EMG, and enhanced stretch reflex excitability with short latency. This characteristic reflex pattern is suggested to reflect an arrested normal maturation. The strong similarity between the walking pattern of CP children (8-16 years of age) and the reflex pattern during the process of learning to walk (7-10 months of age) lets us draw the following conclusion. During normal maturation a close parallelism exists between the control of group I afferent inhibition with the suppression of mono/oligosynaptic stretch reflexes and group II afferent facilitation with the increase of polysynaptic (mainly extensor) EMG responses. This maturation depends on supraspinal control, and does not occur in CP children. In adult patients with a supraspinal lesion, a regression to this early reflex pattern takes place.     

123I-MIBG myocardial scintigraphy in diabetic patients: relationship with 201Tl uptake and cardiac autonomic function

The purpose of this study is to investigate the effects of aging on the human stretch reflexes. The EMG and torque responses of the stretch reflex of the wrist flexors were evoked by ramp-and-hold mechanical perturbations. The stretch reflexes were recorded at seven test conditions with different stretch velocity and muscle preload. The test results from young and older healthy adult subjects were compared. In average, the absolute amplitude of the short-latency (20-40 ms) EMG (recorded from flexor carpi radialis) reflex response was significantly lower in the older group. If the data were normalized and expressed in percentage of the maximal voluntary EMG activity, however, this group difference was not significant. There was no change in the reflex gain of the short-latency reflex with aging. For the long-latency (50-90 ms) EMG reflex response, both the normalized amplitude and the reflex gain were significantly enhanced with aging, probably through supraspinal mechanisms. There was no significant difference in the threshold velocity for the evoked EMG reflexive activities between age groups. There were also no changes in the reflexive wrist flexion torque with aging. These results suggested that the number of motor units recruited during the stretch reflex activity declined with aging although the percentage of motor units recruited was not affected by aging. It is concluded that the central regulating mechanisms of the spinal motoneuron excitability are not compromised by aging. The automatic gain compensation phenomenon is also preserved with aging.