Medium- and long-latency responses to displacements of the ankle joint in patients with spinal and central lesions.

In order to elucidate further the possible pathways and the functional significance of long-loop reflexes we recorded short-, medium- and long-latency responses from leg muscles in 27 patients with spinal lesions, 20 patients with central lesions of the internal capsule or cerebral hemisphere, and in 18 control patients with frontal or occipital lesions without motor or sensory disturbances. Our normal population included 50 subjects, who were age and sex matched to the patients. The mean latency of the long-latency response (LL) in the anterior tibial muscle was significantly delayed in patients with spinal (164.5 msec) and central lesions (145.1 msec) compared to control patients (123.5 msec) and the normals (125.3 msec). This delay of LL could be observed in patients who exhibited only motor or sensory disturbances or a combination of both. The medium-latency response (ML) was absent in 47% of the records in patients with spinal lesions, mainly on the side which was clinically more affected. Its latency was normal if the response occurred. The integral of the LL response was enlarged in patients with spinal or central lesions, but was also enlarged in the control group. The results indicate that the ML response is segmental, but that its amplitude is modulated by supraspinal structures. The LL response probably corresponds to a transcortical 'reflex.'