In this episode of the Journal of Neurophysiology’s podcast series, coauthor Véronique Marchand-Pauvert discusses key findings from the team's published study, "Synaptic dynamics linked to widespread elevation of H-reflex before peripheral denervation in amyotrophic lateral sclerosis." The episode explores how an increased H-reflex—observed even without clear evidence of peripheral denervation—may reflect early synaptic changes in ALS. Marchand-Pauvert explains how this phenomenon appears widespread across different onset sites and may result from reduced inhibitory control over Ia afferent-motoneuron transmission. While its association with exaggerated reflexes and spasticity may limit diagnostic specificity, the H-reflex’s measurable nature makes it a promising biomarker in ALS clinical trials.   Synaptic dynamics linked to widespread elevation of H-reflex before peripheral denervation in amyotrophic lateral sclerosis Sina Sangari, Alexandra Lackmy-Vallee, Arnaud Preuilh, Iseline Peyre, Pierre-François Pradat, and Véronique Marchand-Pauvert Journal of Neurophysiology 2024 132:5, 1541-1560