- Complications
- Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy
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Lu Han, Nigel A. Calcutt, Xiajun Zhou
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Diabetes Metab J. 2024;48(6):1029-1046. Published online November 1, 2024
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DOI: https://doi.org/10.4093/dmj.2024.0614
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 Abstract
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- Measurement of the rate-dependent depression (RDD) of the Hoffmann (H) reflex, a technique developed over half a century ago, is founded on repeated stimulation of the H-reflex with tracking of sequentially evoked H-wave amplitudes in the resulting electromyogram. RDD offers insight into the integrity of spinal reflex pathways and spinal inhibitory regulation. Initially, RDD was predominantly utilized in the mechanistic exploration and evaluation of movement disorders characterized by spasticity symptoms, as may occur following spinal cord injury. However, there is increasing recognition that sensory input from the periphery is modified at the spinal level before ascending to the higher central nervous system and that some pain states can arise from, or be exaggerated by, disruption of spinal processing via a mechanism termed spinal disinhibition. This, along with the urgent clinical need to identify biological markers of pain generator and/or amplifier sites to facilitate targeted pain therapies, has prompted interest in RDD as a biomarker for the contribution of spinal disinhibition to neuropathic pain states. Current research in animals and humans with diabetes has revealed specific disorders of spinal GABAergic function associated with impaired RDD. Future investigations on RDD aim to further elucidate its underlying pathways and enhance its clinical applications.
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Citations
Citations to this article as recorded by  - Mechanisms of Different Motor Neurons in the Occurrence of Spasticity After Spinal Cord Injury: A Narrative Review
Han Gong, Ze-Yan Zhang, Zhi-Xuan Duan, Xin-Ao Mao, Yuan-Yuan Wu, Jia-Sheng Rao, Xiao-Xia Du
International Journal of Molecular Sciences.2025; 26(11): 5162. CrossRef
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