Changes in the Soleus H-reflex Test and Correlations between Its Results and Dynamic Magnetic Resonance Imaging Abnormalities in Patients with Hirayama Disease

Hirayama disease (HD) was first reported by the Japanese scholar Keizo Hirayama in 1959 (Hirayama et al., 1959). The aetiology of HD remains controversial. Currently, the main implicated mechanism is chronic cervical spinal cord ischaemia caused by microcirculatory disturbances in the territory of the anterior spinal artery during neck flexion (Hirayama, 2000; Hirayama, 2008). Because anterior horn cells are extremely vulnerable to ischaemia and a previous autopsy case of HD revealed confined necrosis in both the cervical anterior horn and ventral nerve root areas (Hirayama et al., 1987), HD is considered a neurological disease that involves only lower motor neurons (LMN) (e.g., anterior horn cells and ventral nerve roots) (Hirayama, 2008).

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