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Abanoz Y, Gülen Abanoz Y, Gündüz A, Karadeniz D, Erdemir Kızıltan M. Long latency trigemino-cervical reflex in restless legs syndrome. Int J Neurosci 2024; 134:924-930. [PMID: 36533413 DOI: 10.1080/00207454.2022.2158826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 10/27/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The trigemino-cervical complex (TCC) seems under dopaminergic inhibitory control and the abnormalities of trigemino-cervical reflex (TCR) have been reported in disorders associated with the dopaminergic system and various pain disorders. If the inhibitory response in TCC is likely dopaminergic, we hypothesized that TCR, which has never been evaluated in restless legs syndrome (RLS) patients before, would be also abnormal. METHODS TCR was recorded from bilateral sternocleidomastoid and splenius capitis muscles in consecutive 15 drug-naive RLS patients and 16 age- and sex-matched healthy subjects. The right and left infraorbital branches of the trigeminal nerve were stimulated by percutaneous electrical stimulation separately. The presence rates, onset latencies, amplitudes, and durations of responses were measured and compared between patients with RLS and controls. RESULTS The presence rates, onset latencies and amplitudes of TCR responses were similar between RLS patients and controls, however, the durations of responses were bilaterally longer in RLS patients compared to healthy volunteers. CONCLUSIONS Hyperexcitability of TCR suggests defective sensory processing in the brainstem probably due to impairment of descending inhibitory dopaminergic system in RLS. The sensitization of TCC in RLS patients may also be a possible factor that might explain the association of RLS and pain disorders.
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Affiliation(s)
- Yasin Abanoz
- Department of Electroneurophysiology, Advanced Vocational School, Doğuş University, Istanbul, Turkey
| | - Yeşim Gülen Abanoz
- Department of Electroneurophysiology, Advanced Vocational School, Doğuş University, Istanbul, Turkey
| | - Ayşegül Gündüz
- Department of Neurology, School of Medicine, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Derya Karadeniz
- Department of Neurology, School of Medicine, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Meral Erdemir Kızıltan
- Department of Neurology, School of Medicine, İstanbul University-Cerrahpaşa, Istanbul, Turkey
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de Melo DLM, Comerlato EA, Pinheiro DS, Manzano GM. The feasibility and technical aspects of trigemino-cervical reflex elicitation in humans under general anesthesia. Clin Neurophysiol 2024; 161:173-179. [PMID: 38503202 DOI: 10.1016/j.clinph.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/10/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To analyze the feasibility, neurophysiological aspects, stimulation patterns, and topographic distribution of trigemino-cervical reflex (TCR) components in humans under general anesthesia. METHODS This prospective observational study enrolled 20 participants who underwent posterior fossa surgery, surgical proceduresin thecraniovertebral junction,or spinal cord surgery. TCR responses were simultaneously recorded in the sternocleidomastoid (SCM) and trapezius muscles after electrical stimulation of the supraorbital and infraorbital nerves. TCR responses were recorded preoperatively and intraoperatively using single-pulse and multipulse (trains of 2-7 electrical stimuli) stimulation, respectively. Two stimulus duration patterns were evaluated: 0.2-0.5 ms and 0.5-1.0 ms. RESULTS Intraoperatively, short- and long-latency TCR components were obtained in the SCM ipsilateral to the stimulation with variable recordability. Short-latency responses were the most commonly recorded components. A longer stimulus duration (0.5-1.0 ms) seems to favor the elicitation of TCR responses under general anesthesia. CONCLUSIONS Short-latency components recorded in the SCM ipsilateral to the stimulation could be regularly elicited under general anesthesia when a larger stimulus duration (0.5-1.0 ms) was applied. SIGNIFICANCE This is the first study to demonstrate the elicitation of TCR components in humans under general anesthesia. This neurophysiological technique can potentially optimize intraoperative neurophysiological monitoring during brainstem surgery.
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Affiliation(s)
| | - Enio Alberto Comerlato
- Department of Clinical Neurophysiology. SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil
| | - Denise Spinola Pinheiro
- Department of Clinical Neurophysiology. Federal University of São Paulo, São Paulo, SP, Brazil
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Melo DLMD, Comerlato EA, Pinheiro DS, Manzano GM. Technical Aspects of Eliciting Trigeminocervical and Trigeminospinal Reflexes in Humans: A Scoping Review. J Clin Neurophysiol 2024; 41:379-387. [PMID: 38376940 DOI: 10.1097/wnp.0000000000001072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
SUMMARY This scoping review aims to summarize the technical strategies for obtaining trigeminocervical reflex (TCR) and trigeminospinal reflex (TSR) responses. Studies published on TCR or TSR elicitation in humans through electrical stimulation of trigeminal nerve branches were eligible for this scoping review. The data of interest included stimulation parameters, site of stimulation, recording parameters, and the feasibility of TCR and TSR elicitation, in healthy participants. Short-latency TCR responses were regularly obtained in both anterior and posterior neck muscles after electrical stimulation of the supraorbital and infraorbital nerves under voluntary muscle activation. However, without voluntary muscle activation, we found evidence of elicitation of short-latency TCR components only in the posterior neck muscles after supraorbital or infraorbital nerve stimulation. Long-latency TCR responses were regularly obtained in the anterior and posterior neck muscles in studies that evaluated this technique, regardless of the trigeminal branch stimulation or muscle activation status. Short-latency TSR components were not obtained in the included studies, whereas long-latency TSR responses were regularly recorded in proximal upper limb muscles. This scoping review revealed key heterogeneity in the techniques used for TCR and TSR elicitation. By summarizing all the methodological procedures used for TCR and TSR elicitation, this scoping review can guide researchers in defining optimized technical approaches for different research and clinical scenarios.
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Affiliation(s)
- Denise Lima Medeiros de Melo
- Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; and
| | - Enio Alberto Comerlato
- Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; and
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Cuenca-Martínez F, Herranz-Gómez A, Madroñero-Miguel B, Reina-Varona Á, La Touche R, Angulo-Díaz-Parreño S, Pardo-Montero J, del Corral T, López-de-Uralde-Villanueva I. Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Med 2020; 9:E2806. [PMID: 32872670 PMCID: PMC7565821 DOI: 10.3390/jcm9092806] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 01/22/2023] Open
Abstract
To assess neck disability with respect to jaw disability, craniocervical position, cervical alignment, and sensorimotor impairments in patients with temporomandibular disorders (TMD), a systematic review and meta-analysis of observational studies trials were conducted. The meta-analysis showed statistically significant differences in the association between neck disability and jaw disability (standardized mean difference (SMD), 0.72 (0.56-0.82)). However, results showed no significant differences for cervical alignment (SMD, 0.02 (-0.31-0.36)) or for the craniocervical position (SMD, -0.09 (-0.27-0.09)). There was moderate evidence for lower pressure pain thresholds (PPT) and for limited cervical range of motion (ROM). There was limited evidence for equal values for maximal strength between the patients with TMD and controls. There was also limited evidence for reduced cervical endurance and conflicting evidence for abnormal electromyographic (EMG) activity and motor control in TMD patients. Results showed a clinically relevant association between cervical and mandibular disability in patients with TMD. Regarding sensory-motor alterations, the most conclusive findings were observed in the reduction of PPT and cervical ROM, with moderate evidence of their presence in the patients with TMD. Lastly, the evidence on impaired motor control and cervical EMG activity in patients with TMD was conflicting.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Aida Herranz-Gómez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Beatriz Madroñero-Miguel
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Facultad de Medicina, Universidad CEU San Pablo, 28003 Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
| | - Tamara del Corral
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Ibai López-de-Uralde-Villanueva
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
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Martin AJ, Morales-Briceño H, Tchan M, Fung VSC. The Head Retraction Reflex in Niemann-Pick Type C: A Novel Diagnostic Clue. Mov Disord Clin Pract 2020; 7:543-547. [PMID: 32626799 DOI: 10.1002/mdc3.12976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023] Open
Abstract
Background The head retraction reflex (HRR) is characterized by the extension of the neck after percussion stimulation of the central facial region. It is either absent or habituates in normal individuals and can become exaggerated and persistent in certain pathological conditions, having been most commonly reported in hyperekplexia and stiff-person syndrome disorders. It has not, however, been reported in Niemann-Pick type C (NPC), a lipid storage disorder with a variety of neurologic and systemic manifestations. The diagnosis of NPC is often delayed because of the rarity of the condition and the subtlety of clinical signs. Cases We present 3 consecutive cases of genetically confirmed NPC with a pathological HRR, which was not present in controls. Neurophysiological analysis showed findings suggestive of myoclonus of brainstem origin. Conclusion We propose that the presence of a pathological HRR, an easily performed clinical test, may provide a clue to the diagnosis of NPC.
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Affiliation(s)
- Andrew J Martin
- Movement Disorders Unit, Neurology Department Westmead Hospital Westmead New South Wales Australia.,Sydney Medical School University of Sydney, Sydney New South Wales Australia
| | - Hugo Morales-Briceño
- Movement Disorders Unit, Neurology Department Westmead Hospital Westmead New South Wales Australia
| | - Michel Tchan
- Movement Disorders Unit, Neurology Department Westmead Hospital Westmead New South Wales Australia
| | - Victor S C Fung
- Movement Disorders Unit, Neurology Department Westmead Hospital Westmead New South Wales Australia.,Sydney Medical School University of Sydney, Sydney New South Wales Australia
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E Kızıltan M, Gündüz A. Late component of trigemino-cervical reflex: changes according to age and gender. Neurol Sci 2020; 41:1759-1764. [PMID: 32006124 DOI: 10.1007/s10072-020-04242-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Trigemino-cervical reflex (TCR) is a protective reflex which is elicited by the stimulation of any branch of the trigeminal nerve. After infraorbital stimulation, an early and late components have been described. The aim of this study was to find out whether there are age- or gender-related changes in the long-latency (RII) component of TCR. METHOD We included consecutive 53 healthy subjects (20 men, 37.7%) who had normal neurological examination. The mean age was 45.1 ± 14.3 years (age range 18-75 years). TCR was recorded simultaneously from bilateral sternocleidomastoid (SCM) and splenius capitis (SC) muscles with surface electrodes after stimulating right or left infraorbital branch of the trigeminal nerve, separately. We compared latency, amplitude, and duration according to gender and age. RESULTS The amplitudes of SC responses were significantly higher in women compared to men. The duration of SCM response was significantly longer in subjects above the age of 50 years compared to younger patients. The latency of the SC response was significantly delayed above the age of 40 years. CONCLUSION There are age- and gender-related changes in TCRs probably due to changes in the motoneurons of the SC and SCM muscles.
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Affiliation(s)
- Meral E Kızıltan
- Department of Neurology, Cerrahpaşa School of Medicine, IUC, Istanbul, Turkey
| | - Ayşegül Gündüz
- Department of Neurology, Cerrahpaşa School of Medicine, IUC, Istanbul, Turkey.
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Noreña AJ, Fournier P, Londero A, Ponsot D, Charpentier N. An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock. Trends Hear 2019; 22:2331216518801725. [PMID: 30249168 PMCID: PMC6156190 DOI: 10.1177/2331216518801725] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Acoustic shocks and traumas sometimes result in a cluster of debilitating symptoms, including tinnitus, hyperacusis, ear fullness and tension, dizziness, and pain in and outside the ear. The mechanisms underlying this large variety of symptoms remain elusive. In this article, we elaborate on the hypothesis that the tensor tympani muscle (TTM), the trigeminal nerve (TGN), and the trigeminal cervical complex (TCC) play a central role in generating these symptoms. We argue that TTM overuse (due to the acoustic shock), TTM overload (due to muscle tension), and ultimately, TTM injury (due to hypoxia and "energy crisis") lead to inflammation, thereby activating the TGN, TCC, and cortex. The TCC is a crossroad structure integrating sensory inputs coming from the head-neck complex (including the middle ear) and projecting back to it. The multimodal integration of the TCC may then account for referred pain outside the ear when the middle ear is inflamed and activates the TGN. We believe that our model proposes a synthetic and explanatory framework to explain the phenomena occurring postacoustic shock and potentially also after other nonauditory causes. Indeed, due to the bidirectional properties of the TCC, musculoskeletal disorders in the region of the head-neck complex, including neck injury due to whiplash or temporomandibular disorders, may impact the middle ear, thereby leading to otic symptoms. This previously unavailable model type is experimentally testable and must be taken as a starting point for identifying the mechanisms responsible for this particular subtype of tinnitus and its associated symptoms.
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Affiliation(s)
- Arnaud J Noreña
- 1 Aix-Marseille Université, UMR CNRS 7260, Laboratoire Neurosciences Intégratives et Adaptatives-Centre Saint-Charles, Marseille, France
| | - Philippe Fournier
- 1 Aix-Marseille Université, UMR CNRS 7260, Laboratoire Neurosciences Intégratives et Adaptatives-Centre Saint-Charles, Marseille, France
| | - Alain Londero
- 2 Service ORL et CCF, Hôpital Européen G. Pompidou, Paris, France
| | - Damien Ponsot
- 3 Académie de Lyon-Lycée Germaine Tillion, Sain-Bel, France
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Eriksson PO, Zafar H, Backén M. Instant reduction in postural sway during quiet standing by intraoral dental appliance in patients with Whiplash associated Disorders and non-trauma neck pain. Arch Oral Biol 2018; 97:109-115. [PMID: 30384151 DOI: 10.1016/j.archoralbio.2018.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study tested the hypothesis that modulation of jaw sensorimotor control by intraoral dental appliance can reduce postural sway during quiet standing and hence improve standing balance, in patients with whiplash associated disorders (WAD) and non-trauma neck pain. DESIGN Postural sway during quiet standing with feet together was examined in 54 WAD patients (40 females) and 10 non-trauma patients (8 females) using wireless 3D movement recording technique. Recordings were performed alternating without and with intraoral dental appliance, and with closed eyes and open eyes, respectively. In this protocol the participants served as their own controls. A reference group of 30 healthy subjects (17 females) was also recorded. Each recording lasted 120 s, followed by 3-5 min of rest. Speed, acceleration and perimeter of postural sway area were documented. RESULTS In the patients, but not in the healthy group, the intraoral dental appliance instantly and significantly reduced standing postural sway in recordings with closed and open eyes. CONCLUSIONS The prompt reduction in standing postural sway from intervention by intraoral dental appliance i.e. improved standing balance, suggests a potent effect on the postural control system by modulation of the jaw sensorimotor system, probably involving reflex transmission. The result opens for new insight into mechanisms behind postural control and the pathophysiology of balance disorders, and adds to the knowledge on plasticity of the nervous system. It may help developing new procedures for assessment and management of impaired balance in WAD and non-trauma neck pain patients.
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Affiliation(s)
- Per-Olof Eriksson
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Hamayun Zafar
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia.
| | - Mattias Backén
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Informatics, County Council of Västerbotten, Umeå, Sweden
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Neurophysiological studies on atypical parkinsonian syndromes. Parkinsonism Relat Disord 2017; 42:12-21. [DOI: 10.1016/j.parkreldis.2017.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/14/2017] [Accepted: 06/24/2017] [Indexed: 01/31/2023]
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Doeltgen SH, Young J, Bradnam LV. Anodal Direct Current Stimulation of the Cerebellum Reduces Cerebellar Brain Inhibition but Does Not Influence Afferent Input from the Hand or Face in Healthy Adults. THE CEREBELLUM 2017; 15:466-74. [PMID: 26283524 DOI: 10.1007/s12311-015-0713-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The cerebellum controls descending motor commands by outputs to primary motor cortex (M1) and the brainstem in response to sensory feedback. The cerebellum may also modulate afferent input en route to M1 and the brainstem. OBJECTIVE The objective of this study is to determine if anodal transcranial direct current stimulation (tDCS) to the cerebellum influences cerebellar brain inhibition (CBI), short afferent inhibition (SAI) and trigeminal reflexes (TRs) in healthy adults. METHODS Data from two studies evaluating effects of cerebellar anodal and sham tDCS are presented. The first study used a twin coil transcranial magnetic stimulation (TMS) protocol to investigate CBI and combined TMS and cutaneous stimulation of the digit to assess SAI. The second study evaluated effects on trigemino-cervical and trigemino-masseter reflexes using peripheral nerve stimulation of the face. RESULTS Fourteen right-handed healthy adults participated in experiment 1. CBI was observed at baseline and was reduced by anodal cerebellar DCS only (P < 0.01). There was SAI at interstimulus intervals of 25 and 30 ms at baseline (both P < 0.0001), but cerebellar tDCS had no effect. Thirteen right-handed healthy adults participated in experiment 2. Inhibitory reflexes were evoked in the ipsilateral masseter and sternocleidomastoid muscles. There was no effect of cerebellar DCS on either reflex. CONCLUSIONS Anodal DCS reduced CBI but did not change SAI or TRs in healthy adults. These results require confirmation in individuals with neurological impairment.
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Affiliation(s)
- Sebastian H Doeltgen
- Swallowing Rehabilitation Research Laboratory, School of Health Sciences, Flinders University, Adelaide, Australia
- Department of Speech Pathology and Audiology, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Jessica Young
- Swallowing Rehabilitation Research Laboratory, School of Health Sciences, Flinders University, Adelaide, Australia
- Department of Speech Pathology and Audiology, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Lynley V Bradnam
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia.
- Discipline of Physiotherapy, School of Health Sciences, Flinders University, Adelaide, Australia.
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Nardone R, Höller Y, Orioli A, Brigo F, Christova M, Tezzon F, Golaszewski S, Trinka E. Trigemino-cervical-spinal reflexes after traumatic spinal cord injury. Clin Neurophysiol 2015; 126:983-6. [PMID: 25270243 DOI: 10.1016/j.clinph.2014.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/20/2014] [Accepted: 08/29/2014] [Indexed: 10/24/2022]
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Bradnam L, Barry C. The role of the trigeminal sensory nuclear complex in the pathophysiology of craniocervical dystonia. J Neurosci 2013; 33:18358-67. [PMID: 24259561 PMCID: PMC6618800 DOI: 10.1523/jneurosci.3544-13.2013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 12/15/2022] Open
Abstract
Isolated focal dystonia is a neurological disorder that manifests as repetitive involuntary spasms and/or aberrant postures of the affected body part. Craniocervical dystonia involves muscles of the eye, jaw, larynx, or neck. The pathophysiology is unclear, and effective therapies are limited. One mechanism for increased muscle activity in craniocervical dystonia is loss of inhibition involving the trigeminal sensory nuclear complex (TSNC). The TSNC is tightly integrated into functionally connected regions subserving sensorimotor control of the neck and face. It mediates both excitatory and inhibitory reflexes of the jaw, face, and neck. These reflexes are often aberrant in craniocervical dystonia, leading to our hypothesis that the TSNC may play a central role in these particular focal dystonias. In this review, we present a hypothetical extended brain network model that includes the TSNC in describing the pathophysiology of craniocervical dystonia. Our model suggests the TSNC may become hyperexcitable due to loss of tonic inhibition by functionally connected motor nuclei such as the motor cortex, basal ganglia, and cerebellum. Disordered sensory input from trigeminal nerve afferents, such as aberrant feedback from dystonic muscles, may continue to potentiate brainstem circuits subserving craniocervical muscle control. We suggest that potentiation of the TSNC may also contribute to disordered sensorimotor control of face and neck muscles via ascending and cortical descending projections. Better understanding of the role of the TSNC within the extended neural network contributing to the pathophysiology of craniocervical dystonia may facilitate the development of new therapies such as noninvasive brain stimulation.
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Affiliation(s)
- Lynley Bradnam
- Applied Brain Research Laboratory, Centre for Neuroscience
- Effectiveness of Therapy Group, Centre for Clinical Change and Healthcare Research, School of Medicine, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Christine Barry
- Applied Brain Research Laboratory, Centre for Neuroscience
- Department of Anatomy and Histology School of Medicine, and
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Sohn JH, Choi HC, Kim CH. Differences between episodic and chronic tension-type headaches in nociceptive-specific trigeminal pathways. Cephalalgia 2013; 33:330-9. [PMID: 23297379 DOI: 10.1177/0333102412461889] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The trigeminal nociceptive system plays a pivotal role in the pathophysiology of tension-type headaches (TTH). OBJECTIVE This study investigated and compared nociceptive-specific trigeminal pathways in patients with episodic and chronic TTH (ETTH and CTTH, respectively) using the nociceptive blink reflex (nBR) and nociceptive trigeminocervical reflex (nTCR). METHODS We recorded nBR and nTCR in patients with ETTH and CTTH, and healthy controls using concentric electrodes and subsequently compared the threshold (i.e. sensory, pain) and parameters of reflex (i.e. the R2 component of the nBR and the late responses of the nTCR). RESULTS Women with ETTH ( N = 40) and CTTH ( N = 32) and age-matched controls ( N = 40) were recruited. CTTH patients displayed significantly lower amplitude and area under the curve (AUC) values of the R2 component for the nBR compared with those displayed by ETTH patients and controls ( P < 0.05). Moreover, the amplitude and AUC of the R2 component was negatively correlated with the frequency of headaches, whereas the latency of the R2 component for the nBR was positively correlated with the frequency and duration of headaches in the TTH groups ( P < 0.05). However, no significant differences in the late response parameters (i.e. latency, duration, amplitude, or AUC) were noted between the groups in terms of the nTCR. CONCLUSIONS R2 suppression associated with CTTH suggests decreased brainstem excitability. This may be the result of excessive descending inhibitory influences.
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Affiliation(s)
- Jong Hee Sohn
- Department of Neurology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea.
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Stanton G. The Human Auriculo–Cervical Reflex. Med Acupunct 2012. [DOI: 10.1089/acu.2011.0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gary Stanton
- Department of Medicine, Neurology Service, Emerson Hospital, Concord, MA
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Bartolo M, Serrao M, Perrotta A, Tassorelli C, Sandrini G, Pierelli F. Lack of trigemino-cervical reflexes in progressive supranuclear palsy. Mov Disord 2008; 23:1475-9. [DOI: 10.1002/mds.22039] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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