Muscle spindle complexes in muscles around upper cervical vertebrae in the cat

Using Neck Muscle Afferentation to Control an Ongoing Limb Movement? Individual Differences in the Influence of Brief Neck Vibration

When preparing and executing goal-directed actions, neck proprioceptive information is critical to determining the relative positions of the body and target in space. While the contribution of neck proprioception for upper-limb movements has been previously investigated, we could not find evidence discerning its impact on the planning vs. online control of upper-limb trajectories. To investigate these distinct sensorimotor processes, participants performed discrete reaches towards a virtual target. On some trials, neck vibration was randomly applied before and/or during the movement, or not at all. The main dependent variable was the medio-lateral/directional bias of the reaching finger. The neck vibration conditions induced early leftward trajectory biases in some participants and late rightward trajectory biases in others. These different patterns of trajectory biases were explained by individual differences in the use of body-centered and head-centered frames of reference. Importantly, the current study provides direct evidence that sensory cues from the neck muscles contribute to the online control of goal-directed arm movements, likely accompanied by significant individual differences.

A Complex Intervention Integrating Prism Adaptation and Neck Vibration for Unilateral Neglect in Patients of Chronic Stroke: A Randomised Controlled Trial

Unilateral neglect in patients of chronic stroke reduces the quality of life and interferes with activities of daily living (ADL). This study aimed to investigate the effects of a complex rehabilitative programme that integrates prism adaptation (PA) and neck vibration (NV) for unilateral neglect in patients of chronic stroke. Thirty-six patients were randomised among the PA + NV group (Group A, n = 12), the NV-only group (Group B, n = 12), and the PA-only group (Group C, n = 12). The intervention was performed for 50 min/day, with five sessions per week, for 4 weeks. Albert's test and the Catherine Bergego Scale were used to measure the effects of each intervention on unilateral neglect, whereas the modified Barthel Index was used to assess the effect on ADL. All three groups exhibited a reduction in unilateral neglect and an improvement in activities of daily living after the intervention (p < 0.05). Notably, Group A (PA + NV) exhibited a significantly greater level of reduction in unilateral neglect than the other groups (p < 0.05); however, the improvement in ADL did not significantly vary across the three groups (p > 0.05). This novel complex intervention comprising PA + NV is recommended for the rehabilitation, in the clinical setting, of patients of chronic stroke with unilateral neglect.

Progressive recruitment of contralesional cortico-reticulospinal pathways drives motor impairment post stroke

KEY POINTS

Activation of the shoulder abductor muscles in the arm opposite a unilateral brain injury causes involuntary increases in elbow, wrist and finger flexion in the same arm, a phenomenon referred to as the flexion synergy. It has been proposed that flexion synergy expression is related to reduced output from ipsilesional motor cortex and corticospinal pathways. In this human subjects study, we provide evidence that the magnitude of flexion synergy expression is instead related to a progressive, task-dependent recruitment of contralesional cortex. We also provide evidence that recruitment of contralesional cortex may induce excessive activation of ipsilateral reticulospinal descending motor pathways that cannot produce discrete movements, leading to flexion synergy expression. We interpret these findings as an adaptive strategy that preserves low-level motor control at the cost of fine motor control.

ABSTRACT

A hallmark of hemiparetic stroke is the loss of fine motor control in the contralesional arm and hand and the constraint to a grouped movement pattern known as the flexion synergy. In the flexion synergy, increasing shoulder abductor activation drives progressive, involuntary increases in elbow, wrist and finger flexion. The neural mechanisms underlying this phenomenon remain unclear. Here, across 25 adults with moderate to severe hemiparesis following chronic stroke and 18 adults without neurological injury, we test the overall hypothesis that two inter-related mechanisms are necessary for flexion synergy expression: increased task-dependent activation of the intact, contralesional cortex and recruitment of contralesional motor pathways via ipsilateral reticulospinal projections. First, we imaged brain activation in real time during reaching motions progressively constrained by flexion synergy expression. Using this approach, we found that cortical activity indeed shifts towards the contralesional hemisphere in direct proportion to the degree of shoulder abduction loading in the contralesional arm. We then leveraged the post-stroke reemergence of a developmental brainstem reflex to show that anatomically diffuse reticulospinal motor pathways are active during synergy expression. We interpret this progressive recruitment of contralesional cortico-reticulospinal pathways as an adaptive strategy that preserves low-level motor control at the cost of fine motor control.

Using vertebral movement and intact paraspinal muscles to determine the distribution of intrafusal fiber innervation of muscle spindle afferents in the anesthetized cat

Increasing our knowledge regarding intrafusal fiber distribution and physiology of paraspinal proprioceptors may provide key insights regarding proprioceptive deficits in trunk control associated with low back pain and lead to more effective clinical intervention. The use of vertebral movement as a means to reliably stretch paraspinal muscles would greatly facilitate physiological study of paraspinal muscle proprioceptors where muscle tendon isolation is either very difficult or impossible. The effects of succinylcholine (SCh) on 194 muscle spindle afferents from lumbar longissimus or multifidus muscles in response to computer-controlled, ramp-and-hold movements of the L(6) vertebra were investigated in anesthetized cats. Paraspinal muscles were stretched by moving the L(6) vertebra 1.5-1.7 mm in the dorsal-ventral direction. Initial frequency (IF), dynamic difference (DD), their changes (∆) following SCh injection (100-400 μg kg(-1)), and post-SCh dynamic difference (SChDD) were measured. Muscle spindle intrafusal fiber terminations were classified as primary or secondary fibers as well as bag(1) (b(1)c), bag(2) (b(2)c), b(1)b(2)c, or chain (c) fibers. Intrafusal fiber subpopulations were distinguished using logarithmic transformation of SChDD and ∆IF distributions as established by previous investigators. Increases in DD indicate strength of b(1)c influence while increases in IF indicate strength of b(2)c influence. Out of 194 afferents, 46.9 % of afferents terminated on b(2)c fibers, 46.4 % on b(1)b(2)c fibers, 1 % on b(1)c fibers, and 5.7 % terminated on c fibers. Based on these intrafusal fiber subpopulation distributions, controlled vertebral movement can effectively substitute for direct tendon stretch and allow further investigation of paraspinal proprioceptors in this anatomically complex body region.

The thoracolumbar fascia: anatomy, function and clinical considerations

In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a 'hydraulic amplifier', assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine and the sacrotuberous ligament. This thoracolumbar composite (TLC) is in a position to assist in maintaining the integrity of the lower lumbar spine and the sacroiliac joint. The three-dimensional structure of the TLF and its caudally positioned composite will be analyzed in light of recent studies concerning the cellular organization of fascia, as well as its innervation. Finally, the concept of a TLC will be used to reassess biomechanical models of lumbopelvic stability, static posture and movement.

Ultrasound-guided insertion of intramuscular electrodes into suboccipital muscles in the non-human primate

The head-neck system is highly complex from a biomechanical and musculoskeletal perspective. Currently, the options for recording the recruitment of deep neck muscles in experimental animals are limited to chronic approaches requiring permanent implantation of electromyographic electrodes. Here, we describe a method for targeting deep muscles of the dorsal neck in non-human primates with intramuscular electrodes that are inserted acutely. Electrode insertion is guided by ultrasonography, which is necessary to ensure placement of the electrode in the target muscle. To confirm electrode placement, we delivered threshold electrical stimulation through the intramuscular electrode and visualized the muscle twitch. In one animal, we also compared recordings obtained from acutely- and chronically-implanted electrodes. This method increases the options for accessing deep neck muscles, and hence could be used in experiments for which the invasive surgery inherent to a chronic implant is not appropriate. This method could also be extended to the injection of pharmacological agents or anatomical tracers into specific neck muscles.

Representation of Horizontal head-on-body position in the primate superior colliculus

Movement-related activity within the superior colliculus (SC) represents the desired displacement of an impending gaze shift. This representation must ultimately be transformed into position-based reference frames appropriate for coordinated eye-head gaze shifts. Parietal areas that project to the SC are modulated by the initial position of both the eye-re-head and head-re-body and SC activity is modulated by eye-re-head position. These considerations led us to investigate whether SC activity is modulated by the head-re-body position. We recorded activity from movement-related SC neurons while head-restrained monkeys performed a delayed-saccade task. Across blocks of trials, the horizontal position of the body was rotated under a space-fixed head to three to five different positions spanning +/-25 degrees . We observed a significant influence of body-under-head position on SC activity in 50/60 neurons. This influence was expressed predominantly as a linear gain field, scaling task-related SC activity without changing the location of the response field (linear gain fields explained >/=20% of the variance in neural activity in approximately 50% of our sample). Smaller nonlinear modulations were also observed in roughly 30% of our sample. SC activity was equally likely to increase or decrease as the body was rotated to the side of neuronal recording and we found no systematic relationship between the directionality or magnitude of the linear gain field with recording location in the SC. We conclude that a signal conveying head-re-body position is present in the SC. Although the functional significance remains open, our findings are consistent with the SC contributing to a displacement-to-position transformation for oculomotor control.

Posture and equilibrium in orthopedic and rheumatologic diseases

Posture and balance may be affected in many spine or lower-limb disorders. An extensive evaluation including clinical tests and movement analysis techniques may be necessary to characterize how rheumatologic or orthopedic diseases are related to static or dynamic changes in postural control. In lower limbs, unbalance may be related to a decreased stability following arthrosis or ligament injuries at knee or ankle levels, while hip lesions appear less associated with such troubles. Spinal diseases at cervical level are frequently associated with postural changes and impaired balance control, related to the major role of sensory inputs during stance and gait. At lower levels, changes are noticed in major scoliosis and may be related to pain intensity in patients with chronic low-back pain. Whatever the initial lesion and the affected level, improvement in clinical or instrumental tests following rehabilitation or brace wearing provides argument for a close relationship between rheumatologic or orthopedic diseases and related impairments in posture and balance control.

Neck muscle synergies during stimulation and inactivation of the interstitial nucleus of Cajal (INC)

The interstitial nucleus of Cajal (INC) is thought to control torsional and vertical head posture. Unilateral microstimulation of the INC evokes torsional head rotation to positions that are maintained until stimulation offset. Unilateral INC inactivation evokes head position-holding deficits with the head tilted in the opposite direction. However, the underlying muscle synergies for these opposite behavioral effects are unknown. Here, we examined neck muscle activity in head-unrestrained monkeys before and during stimulation (50 muA, 200 ms, 300 Hz) and inactivation (injection of 0.3 mul of 0.05% muscimol) of the same INC sites. Three-dimensional eye and head movements were recorded simultaneously with electromyographic (EMG) activity in six bilateral neck muscles: sternocleidomastoid (SCM), splenius capitis (SP), rectus capitis posterior major (RCPmaj.), occipital capitis inferior (OCI), complexus (COM), and biventer cervicis (BC). INC stimulation evoked a phasic, short-latency ( approximately 5-10 ms) facilitation and later ( approximately 100-200 ms) a more tonic facilitation in the activity of ipsi-SCM, ipsi-SP, ipsi-COM, ipsi-BC, contra-RCPmaj., and contra-OCI. Unilateral INC inactivation led to an increase in the activity of contra-SCM, ipsi-SP, ipsi-RCPmaj., and ipsi-OCI and a decrease in the activity of contra-RCPmaj. and contra-OCI. Thus the influence of INC stimulation and inactivation were opposite on some muscles (i.e., contra-OCI and contra-RCPmaj.), but the comparative influences on other neck muscles were more variable. These results show that the relationship between the neck muscle responses during INC stimulation and inactivation is much more complex than the relationship between the overt behaviors.

Head and neck position sense

Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or fails to be appropriately integrated in the CNS, errors in head position may occur, resulting in an inaccurate reference for HNPS, and conversely if neck proprioceptive information is inaccurate, then control of head position may be affected. The cerebellum and cortex also play a role in control of head position, providing feed-forward and modulatory influences depending on the task requirements. Position-matching tasks have been the most popular means of testing position sense in the cervical spine. These allow the appreciation of absolute, constant and variable errors in positioning and have been shown to be reliable. The results of such tests indicate that errors are relatively low (2-5 degrees). It is apparent that error is not consistently affected by age, a finding similar to studies undertaken in peripheral joints. Furthermore, the range of motion in which subjects are tested does not consistently affect accuracy in a predictable manner. However, it is evident that impairments in position sense are observed in individuals who have experienced whiplash-type injuries and individuals with chronic head and neck pain of non-traumatic origin (e.g. cervical spondylosis). While researchers advocate comprehensive retraining protocols, which include eye and neck motion targeting tasks and coordination exercises, as well as co-contraction exercises to reduce such impairments, some studies show that more general exercises and manipulation may be of benefit. Overall, there is limited information concerning the efficacy of treatment programmes.

Basic Science Research Related to Chiropractic Spinal Adjusting: The State of the Art and Recommendations Revisited

OBJECTIVE

The objectives of this white paper are to review and summarize the basic science literature relevant to spinal fixation (subluxation) and spinal adjusting procedures and to make specific recommendations for future research.

METHODS

PubMed, CINAHL, ICL, OSTMED, and MANTIS databases were searched by a multidisciplinary team for reports of basic science research (since 1995) related to spinal fixation (subluxation) and spinal adjusting (spinal manipulation). In addition, hand searches of the reference sections of studies judged to be important by the authors were also obtained. Each author used key words they determined to be most important to their field in designing their individual search strategy. Both animal and human studies were included in the literature searches, summaries, and recommendations for future research produced in this project.

DISCUSSION

The following topic areas were identified: anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system. A relevant summary of each topic area and specific recommendations for future research in each area were the primary objectives of this project.

CONCLUSIONS

The summaries of the literature for the 6 topic sections (anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system) indicated that a significant body of basic science research evaluating chiropractic spinal adjusting has been completed and published since the 1997 basic science white paper. Much more basic science research in these fields needs to be accomplished, and the recommendations at the end of each topic section should help researchers, funding agencies, and other decision makers develop specific research priorities.

An allometric analysis of the number of muscle spindles in mammalian skeletal muscles

An allometric analysis of the number of muscle spindles in relation to muscle mass in mammalian (mouse, rat, guinea-pig, cat, human) skeletal muscles is presented. It is shown that the trend to increasing number as muscle mass increases follows an isometric (length) relationship between species, whereas within a species, at least for the only essentially complete sample (human), the number of spindles scales, on average, with the square root rather than the cube root of muscle mass. An attempt is made to reconcile these apparently discrepant relationships. Use of the widely accepted spindle density (number of spindles g(-1) of muscle) as a measure of relative abundance of spindles in different muscles is shown to be grossly misleading. It is replaced with the residuals of the linear regression of ln spindle number against ln muscle mass. Significant differences in relative spindle abundance as measured by residuals were found between regional groups of muscles: the greatest abundance is in axial muscles, including those concerned with head position, whereas the least is in muscles of the shoulder girdle. No differences were found between large and small muscles operating in parallel, or between antigravity and non-antigravity muscles. For proximal vs. distal muscles, spindles were significantly less abundant in the hand than the arm, but there was no difference between the foot and the leg.

Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders

OBJECTIVE

To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients' symptoms and self-rated function.

DESIGN

A comparative group design, including a correlation design for the patient group.

SUBJECTS

Patients with chronic whiplash-associated disorders (n=37) and healthy subjects (n=41). The groups were matched for age and gender.

METHODS

All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and self-rated functioning and symptoms were studied by correlation and regression analyses.

RESULTS

The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity.

CONCLUSION

The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.

Trunk sway measures of postural stability during clinical balance tests in patients with chronic whiplash injury symptoms

STUDY DESIGN

Trunk sway occurring during clinical stance and gait tasks was compared between a group of subjects with a chronic whiplash injury, resulting from an automobile collision, and a normal collective.

OBJECTIVES

To examine if population specific trunk sway patterns for stance and gait could be identified for chronic whiplash injury patients.

SUMMARY OF BACKGROUND DATA

Our previous work has established that it is possible to identify specific patterns of stance and gait deficits for vestibular loss (both acute and compensated) patients and those with Parkinson's disease. Our question was whether it was possible to use the same stance and gait tasks to identify patterns of trunk sway differences with respect to those of healthy subjects and individuals with a chronic whiplash injury.

METHODS

Twenty-five subjects with history of whiplash injury and 170 healthy age-matched control subjects participated in the study. Trunk sway angular displacements in chronic whiplash patients were assessed for a number of stance and gait tasks similar to those of the Tinetti and Clinical Test of Sensory Interaction and Balance (CTSIB) protocols. We used a lightweight, easy-to-attach, body-worn apparatus to measure trunk angular displacements and velocities in the roll (lateral) and the pitch (forward-backward) planes.

RESULTS

Data analysis revealed several significant differences between the two groups. A pattern could be identified, showing greater trunk sway for stance tasks and for complex gait tasks that required task-specific gaze control such as walking up and down stairs. Trunk sway was less, however, for simple gait tasks that demanded large head movements but no task-specific gaze control, such as walking while rotating the head.

CONCLUSIONS

Subjects who have a chronic whiplash injury show a characteristic pattern of trunk sway that is different from that of other patient groups with balance disorders. Balance was most unstable during gait involving task-specific head movements which possibly enhance a pathologic vestibulo-cervical interaction.

Spinal reflex excitability changes after cervical and lumbar spinal manipulation: a comparative study

BACKGROUND CONTEXT

Spinal manipulation (SM) is a commonly employed nonoperative treatment modality in the management of patients with neck, low back or pelvic pain. One basic physiologic response to SM is a transient decrease in motoneuron activity as assessed using the Hoffmann reflex (H-reflex) technique. Previous research from our laboratory indicates that both SM with a high-velocity, low-amplitude thrust and mobilization without thrust produced a profound but transient attenuation of motoneuronal activity of the lumbosacral spine in asymptomatic subjects. To date, effects of cervical SM procedures on the excitability cervical motoneuron pools are unknown.

PURPOSE

The objective of this research was to a gain a more complete understanding of the physiologic effects of SM procedures on motoneuron activity, by comparing the effects of regional SM on cervical and lumbar motoneuron pool excitability.

STUDY DESIGN/SETTING

Maximal H-reflex amplitudes were recorded before and after SM in both the cervical and lumbar regions of asymptomatic subjects in two successive experimental sessions.

PATIENT SAMPLE

Asymptomatic, young healthy volunteers were used in this study.

OUTCOME MEASURES

Changes in flexor carpi radialis and gastrocnemius H-reflex amplitudes before and after SM procedures.

METHODS

H-reflexes recorded form the tibial and median nerves were evaluated before and after lumbar and cervical SM, respectively.

RESULTS

Both Lumbar and cervical SM produced a transient but significant attenuation of motoneuron excitability. The attenuation of the tibial nerve H-reflex amplitude was proportionately greater than that of the median nerve, which occurred after cervical SM.

CONCLUSIONS

SM procedures lead to transient suppression of motoneuron excitability, as assessed by the H-reflex technique. Lumbar spine SM appears to lead to greater attenuation of motoneuron activity compared with that of the cervical region. Thus, these two distinct regions of the spine may possess different responsiveness levels to spinal manipulative therapy.

Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study

Muscle spindle density is extremely high in the deep muscles of the human neck. However, there is a paucity of information regarding the morphology and immunoreactivity of these muscle spindles. The objective of this study was to investigate the intrafusal fiber content and to assess the myosin heavy chain (MyHC) composition of muscle spindles from human deep neck muscles. In addition to the conventional spindles containing bag(1), bag(2), and chain fibers (b(1)b(2)c spindle), we observed a number of spindles lacking bag(1) (b(2)c spindle) or bag(2) (b(1)c spindle) fibers. Both bag(1) and bag(2) fibers contained slow tonic MyHCs along their entire fiber length and MyHCI, MyHCIIa, embryonic, and alpha-cardiac MyHC isoforms along a variable length of the fibers. Fetal MyHC was present in bag(2) fibers but not in bag(1) fibers. Nuclear chain fibers contained MyHCIIa, embryonic, and fetal isoforms with regional variations. We also compared the present data with our previous results obtained from muscle spindles in human biceps brachii and the first lumbrical muscles. The allotment of numbers of intrafusal fibers and the MyHC composition showed some muscle-related differences, suggesting functional specialization in the control of movement among different human muscles.

Effect of neck pain on verticality perception: a cohort study

OBJECTIVE

To use the Rod-and-Frame Test (RFT) as a quantification of the perception of verticality in subjects with and without neck pain.

DESIGN

Cohort study comparing perception of verticality in symptomatic subjects with neck pain versus a control group.

SETTING

Both groups were selected from 2 urban chiropractic offices treating typical neuromusculoskeletal conditions from the general community in Canada.

PATIENTS

Nineteen subjects (11 women, 8 men) with uncomplicated mechanical neck pain and 17 (7 women, 10 men) asymptomatic subjects.

INTERVENTION

The RFT offers a noninvasive method of measuring spatial orientation or the perception of verticality. Studies of the RFT indicate that performance is reliable. The RFT requires subjects to set a luminescent rod to the true vertical in the presence and absence of a luminescent background frame.

MAIN OUTCOME MEASURE

The amount of rotation was measured and recorded by a dial on the back of the device.

RESULTS

Two-way analysis of variance showed statistically significant differences in judging vertical between symptomatic and asymptomatic subjects. Unpaired t tests for each test situation and the Tukey post hoc test showed statistical differences for both groups.

CONCLUSION

There may be a direct connection between the structures that provide internal cues for the body's ability to sense verticality and nociceptive influences affecting the afference of these structures. The overshoot of the symptomatic group could indicate the search for additional proprioceptive information.

Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain

OBJECTIVE

To investigate cervicocephalic kinesthetic sensibility (head repositioning accuracy to subjective straight ahead) in patients with chronic, nontraumatic cervical spine pain.

DESIGN

A prospective, 2-group, observational design.

SETTING

An outpatient chiropractic clinic in the United Kingdom.

PARTICIPANTS

Eleven patients (6 men, 5 women; mean age +/- standard deviation, 41.1 +/- 13.3 yr; range, 18-55 yr) with chronic, nontraumatic cervical spine pain (mean duration, 24 +/- 18 mo), with no evidence of cervical radiculopathy and/or myelopathy or any other neurologic disorder. Eleven asymptomatic, unimpaired volunteers (5 men, 6 women; mean age, 39.3 +/- 10.3 yr; range, 28-54 yr) with no history of whiplash or other cervical spine injury or pain served as controls.

MAIN OUTCOME MEASURES

Cervicocephalic kinesthetic sensibility was investigated by testing the ability of blindfolded participants to relocate accurately the head on the trunk, to a subjective straight-ahead position, after a near-maximal active movement of the head in the horizontal or vertical plane. The active cervical range of motion and the duration and intensity of neck pain were also recorded.

RESULTS

Mann-Whitney U testing indicated that the patient (P) group was no less accurate in head repositioning than the control (C) group for all movement directions except flexion (median global positioning error [95% confidence interval], P = 5.7 degrees [5.03-9.10], C = 4.2 degrees [3.17-5.32]; p <.05).

CONCLUSIONS

Nontraumatic neck pain patients show little evidence of impaired cervicocephalic kinesthetic sensibility. These results contrast with studies of chronic cervical pain patients in which the origin was not controlled or involved a cervical whiplash injury.

Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups: a possible effect of the cervicosympathetic and/or pressor reflex

OBJECTIVE

To determine whether a vectored adjustment of the atlas in patients identified as demonstrating signs of upper cervical joint dysfunction would cause lowering of blood pressure in comparison with resting controls.

DESIGN

Test 1: controlled clinical trial with a treatment (adjustment) group and a control (resting) group. Test 2: controlled clinical trial with subjects serving as their own controls.

SETTING

Private chiropractic practice.

PARTICIPANTS

Test 1: Forty established patients demonstrating signs of upper cervical subluxation/joint dysfunction and 40 established patients without such signs. Test 2: Thirty established patients demonstrating signs of upper cervical subluxation/joint dysfunction.

INTERVENTION

Specific, vectored upper cervical (atlas) adjustment or similarly positioned resting.

MAIN OUTCOME MEASURES

Prerest, postrest, and postadjustment systolic, diastolic, and pulse rates as recorded through use of a digital oscillometric sphygmomanometer.

RESULTS

In test 1, subjects receiving adjustment had a significant (P <.001) decrease in systolic blood pressure whereas resting subjects did not. Intergroup comparison of the treatment (adjustment) and control (resting) groups demonstrated a significant difference (P <.001). A greater pre/post drop in systolic pressure was associated with greater age and higher initial systolic pressure. In test 2, the pre/postrest change in systolic blood pressure was not significant. The systolic blood pressure changed significantly (P <.001) from postrest readings to postadjustment readings.

CONCLUSION

The results indicate that palpation and vectored atlas adjustment causes a significant decrease in systolic blood pressure in patients with putative upper cervical subluxation/joint dysfunction in comparison with resting controls. Similar results were also demonstrated when subjects acted as their own controls. The lack of randomization, blinding, and a manipulated control group are factors that weaken these findings. The sudden drop in systolic pressure is proposed to be due to stimulation of the cervicosympathetic reflex or moderation of muscle tone and elimination of the effects of the pressor reflex.

Response of muscle proprioceptors to spinal manipulative-like loads in the anesthetized cat

OBJECTIVE

The mechanisms underlying the benefits of spinal manipulation are not well understood. Neurophysiological mechanisms likely mediate its effects, at least in part, yet we know little about how the nervous system is affected by spinal manipulation. The purpose of the present study was to determine whether muscle spindles and Golgi tendon organs in paraspinal muscles respond to a mechanical load whose force-time profile is similar to that of a spinal manipulation.

METHODS

Experiments were performed on 10 anesthetized adult cats. The L6 dorsal root was isolated for electrophysiological recordings while the L6-L7 vertebrae and associated paraspinal tissues on one side of the vertebral column were left intact. Single unit recordings were obtained from 5 muscle spindles, 4 Golgi tendon organs, and 1 presumed Pacinian corpuscle afferent with receptive fields in paraspinal muscles. Loads were applied at the spinous process of the L6 vertebra through use of an electronic feedback control system. The load simulated the force-time profile of a spinal manipulation. Loads were applied in compressive and distractive directions and at 2 different angles (0 degrees and 45 degrees) with respect to the long axis of the vertebral column.

RESULTS

Golgi tendon organ afferent discharge frequency increased more to the impulse than to the preload during 13 of 15 spinal manipulations. Generally, the 4 Golgi tendon organ afferents became silent immediately at the end of each impulse. Similarly, muscle spindle discharge frequency increased more to the impulse than to the preload during 10 of 16 manipulations. Distractive manipulations loaded the spindles more effectively than compressive manipulations. After 7 of these 10 manipulations, muscle spindles became silent for 1.3 +/- 0.6 seconds (range, 0.1-4.3 seconds). Six of the 16 manipulations unloaded the muscle spindles. A presumed Pacinian corpuscle responded to the impulse of a manipulative-like load but not to loads with a slower force-time profile.

CONCLUSION

The data suggest that the high-velocity, short-duration load delivered during the impulse of a spinal manipulation can stimulate muscle spindles and Golgi tendon organs more than the preload. The physiologically relevant portion of the manipulation may relate to its ability to increase as well as decrease the discharge of muscle proprioceptors. In addition, the preload, even in the absence of the impulse, can change the discharge of paraspinal muscle spindles. Loading of the vertebral column during a sham manipulation may affect the discharge of paraspinal proprioceptors.

Influence of vibration to the neck, trunk and lower extremity muscles on equilibrium in normal subjects and patients with unilateral labyrinthine dysfunction

To investigate the role of proprioceptors of different skeletal muscles in postural control, in normal subjects and patients with unilateral labyrinthine dysfunction (ULD), the effect of vibration on these muscles was studied by postulography. The subjects comprised 59 normal subjects and 12 patients with ULD due to resection of acoustic tumours. Sagittal body sway was observed during vibration to the triceps surae, tibialis anterior and upper dorsal neck muscles. No significant change in sway was observed in the frontal plane in normal subjects. Significant differences between normal subjects and patients were found on stimulation of the muscle groups of triceps surae and biceps femoris during vibration. In patients with ULD, vibration to the dorsal neck muscles caused a deviation towards the diseased side. It can be speculated that the upper dorsal neck muscle plays an important role in maintaining the body balance in the frontal plane in patients with ULD. On the other hand, the lower extremity muscles, especially the muscles on the dorsal side of the body, play a significant role in adjusting the standing posture in the sagittal plane.

An in vivo preparation for investigating neural responses to controlled loading of a lumbar vertebra in the anesthetized cat

This paper describes a method for applying controlled loads to a lumbar vertebra while recording in vivo from primary afferents innervating the lumbar paraspinal tissues. Unlike the appendicular skeleton, the vertebral column poses a unique challenge for neurophysiological investigations. Distances between paraspinal tissues and the spinal cord are short. In addition, substantial removal of the paraspinal tissues to access the spinal roots or spinal cord appears necessary. The preparation described in this report takes advantage of the anatomical fact that the L6 dorsal root enters the spinal cord 2-2.5 vertebral segments rostral to its passage through the intervertebral foramina. This effectively lengthens the distance between the lumbar paraspinal tissues and central recording sites. The preparation has five unique features: (1) the L6 and L7 vertebrae remain intact; (2) lumbar paraspinal tissues and their attachments to the L6 and L7 vertebrae remain intact on one side of the vertebral column; (3) the intact L6 vertebra can be loaded at its spinous process; (4) the magnitude of the load applied at the L6 spinous process can be controlled with a feedback motor; (5) the direction of load relative to the long axis of the spine can be controlled. Using this preparation, single unit recordings were obtained from the L6 dorsal root during controlled loading of the L6 lumbar vertebra at its spinous process. The responses of two paraspinal muscle proprioceptors to vertebral loading are characterized in this report. With existing electrophysiological techniques this preparation can be used to study central processing of paraspinal inputs. By combining mechanical loading of the lumbar spine in the presence of inflammatory mediators this preparation can contribute to the understanding of the mechanisms by which interactions between mechanical and chemical stimuli likely produce low back pain.

An in vivo method for studying afferent fibre activity from cervical paravertebral tissue during vertebral motion in anaesthetised cats

We describe a method for characterizing and studying afferent input to the central nervous system arising from deep axial structures of the neck during defined cervical vertebral movement. Multiple or single unit recordings of afferent activity arising from identified receptive fields in these tissues can now be studied in situ while simultaneously inducing 'natural' stimulation of mechanoreceptors during well defined movements of the intact vertebral column. When combined with existing strategies for extracellular and intracellular recordings of neurones, the methods described here will allow in vivo investigation of the central effects of functionally identified afferents innervating identified receptive fields located in deep paravertebral tissues during a variety of discrete movements of individual vertebra. This has particular importance in determining the relative role that afferents innervating specific axial tissues have on identified neurones in the central nervous system. It will allow determination of the 'bias' of input to projection cells, such as 'hyperconvergent' neurones, during natural movement. Furthermore, it will allow investigation of their role in the control of somatic and autonomic reflex behaviour.

Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury

OBJECTIVE

To investigate cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury.

DESIGN

A 2-year review of consecutive patients admitted to the emergency unit after whiplash injury.

SETTING

An otorhinolaryngology department.

PATIENTS AND SUBJECTS

Twenty-seven consecutive patients with diagnosed whiplash injury (14 men and 13 women, mean age, 33.8yrs [range, 18 to 66yrs]). The controls were healthy subjects without a history of whiplash injury.

MAIN OUTCOME MEASURES

Oculomotor function was tested at 2 months and at 2 years after whiplash injury. The ability to appreciate both movement and head position was studied. Active range of cervical motion was measured. Subjective intensity of neck pain and major medical symptoms were recorded.

RESULTS

Active head repositioning was significantly less precise in the whiplash subjects than in the control group. Failures in oculomotor functions were observed in 62% of subjects. Significant correlations occurred between smooth pursuit tests and active cervical range of motion. Correlations also were established between the oculomotor test and the kinesthetic sensibility test.

CONCLUSION

The results suggest that restricted cervical movements and changes in the quality of proprioceptive information from the cervical spine region affect voluntary eye movements. A flexion/extension injury to the neck may result in dysfunction of the proprioceptive system. Oculomotor dysfunction after neck trauma might be related to cervical afferent input disturbances.

Spatiotemporal response properties of cerebellar Purkinje cells to neck displacement

The activity of 184 Purkinje cells and 58 unidentified neurons located within the cerebellar anterior vermis was recorded in decerebrate cats during wobble of the body under a fixed head. This stimulus induced a neck displacement of constant amplitude (2.5 degrees) whose direction rotated at the constant velocity of 56.2 degrees/s on the horizontal plane, both in the clockwise and counterclockwise directions. It was then possible to evaluate the spatiotemporal characteristics of unit responses to neck displacement in the vertical planes; 131 of 184 Purkinje cells (71%) and 35 of 58 unidentified cells (60%) responded to clockwise and/or counterclockwise rotations. In particular, among the responsive units, 44% of the Purkinje cells and 37% of the unidentified cells showed an equal amplitude modulation during clockwise and counterclockwise rotations. These units are expected to show a maximal response sensitivity for neck displacement in a preferred direction, a null response for perpendicularly oriented stimuli and a constant temporal phase (narrowly tuned neurons). In 28% of the Purkinje cells and 40% of the unidentified cells, responses of different amplitudes were observed during clockwise and counterclockwise rotations. These neurons should display a preferred direction of response to neck displacement, lack of null response directions and a temporal phase changing with the stimulus direction (broadly tuned neurons). Finally, 27% of the Purkinje cells and 23% of the unidentified cells responded only to wobble in the clockwise or counterclockwise direction (unidirectional units). This behavior predicts equal sensitivities for all the directions of neck displacement and a response phase changing linearly with the direction of neck displacement. A maximal sensitivity vector (Smax), aligned with the preferred direction of the neuron, was evaluated for the bidirectional narrowly tuned and broadly tuned units. Its amplitude and temporal phase corresponded to the response characteristics expected for stimuli in the preferred direction of the cell. Smax directions were distributed over the horizontal plane. Most of them, however, were closer to the pitch than to the roll axis and pointed towards the animal's tail. Among pitch-related Purkinje cells, the temporal phase of Smax was small with a predominance of phase lags; phase leads of rather large amplitude were usually observed for roll-related Purkinje cells. The possibility that the recorded population of units coded the direction of neck displacement was tested by assuming that each cell gave a vectorial contribution related to its response properties and that the vectorial sum of such contributions represented the outcome of the population code. Dynamic body-to-head displacements in four different directions were simulated and for each direction 12 population vectors were evaluated at regular intervals of the stimulus cycle. The direction of the population vector was related to that of the stimulus, but the correspondence was close only for the pitch direction. Moreover, the amplitude of the population vector depended upon the direction of the stimulus, being larger for pitch than for roll displacements. Due to the efferent connections of the explored cerebellar region, the neuronal signals generated by the Purkinje cell population are probably transferred to the spinal cord, where they may differentially affect the amplitude and the spatial properties of the neck reflexes according to the direction of neck displacement.

Ability to reproduce head position after whiplash injury

STUDY DESIGN

A two-group design with repeated measures.

OBJECTIVES

To determine if there is loss of the ability to reproduce target position of the cervical spine individuals who have sustained a whiplash injury.

SUMMARY OF BACKGROUND DATA

The ability to sense position is a prerequisite for functional movement. Injury may have a deleterious effect on this ability, resulting in inaccurate positioning of the head and neck with respect to the body coordinates and to the environment.

METHODS

Eleven subjects with history of whiplash injury (age, 42 +/- 8.7 years) and 11 age-matched asymptomatic subjects (age, 43 +/- 3.1 years) participated in the study. Effects of whiplash injury on the ability to replicate a target position of the head were assessed. Maximum rotation of the neck and ability to reproduce the target angle were measured using a standard cervical range-of-motion device. Subjects' perception of "neutral" position was also assessed.

RESULTS

Analysis of variance indicated the whiplash subjects were less accurate in reproducing the target angle than were control subjects. These whiplash subjects tended to overshoot the target. In addition, the subjects in the whiplash group were often inaccurate in their assessment of neutral position.

CONCLUSIONS

Subjects who have experienced a whiplash injury demonstrate a deficit in their ability to reproduce a target position of the neck. These data are consistent with the hypothesis that these subjects possess an inaccurate perception of head position secondary to their injury. This study has implications for the rehabilitation of individuals with whiplash injury.

Encapsulated sensory receptors within intraorbital skeletal muscles of a camel

BACKGROUND

The occurrence of encapsulated sensory receptors in extrinsic ocular muscles differs among and within orders of mammals. Beyond indications that neuromuscular and neurotendinous spindles are present in extraocular muscles of the family Camilidae, little is known of their distributional characteristics. In fact there appear to be no distribution maps for any animal that show both major types of encapsulated muscle receptor in a full set of intraorbital skeletal muscles.

METHOD

Serial histological sections of all skeletal muscles from one orbit of an adult, one-humped camel (Camelus dromedarius) were examined for encapsulated receptors.

RESULTS

Encapsulated receptors were apparent in all the intraorbital skeletal muscles. Muscle spindles outnumbered tendon organs in the fleshy part of each muscle. For all muscles, spindles were most abundant in the half of the muscle near the origin; levator palpebrae superioris had a more even distribution of spindles along its length than did extraocular muscles. These longitudinal patterns of distribution for muscle spindles related in a general way to the nerve entry zone. Tendon organs occurred anywhere along a muscle's length, but they tended to be more frequent on either side of the major concentration of muscle spindles. Both types of encapsulated receptors were generally located nearer the perimeter than the center of cross sections through muscles.

CONCLUSIONS

Encapsulated receptors of classic appearance are plentiful and have distinctive configurations within intraorbital skeletal muscles of the adult dromedary. When analyzed in conjunction with other studies, the present data give rise to testable explanations for the variability among genera in the number of encapsulated receptors in extraocular muscles.

Distribution of motoneurons supplying dorsal and ventral suboccipital muscles in the feline neck

A combination of retrograde tracers was used to compare the relative distributions of motoneurons supplying the ventral and lateral suboccipital muscles, rectus capitis anterior (RCA), and rectus capitis lateralis (RCL), with those supplying dorsal muscles, including rectus capitis posterior muscles (RCP), complexus (CM), and the medial head of obliquus capitis superior (OCS). Three of the tracers, horseradish peroxidase, fluororuby, and fluorescein-conjugated dextran, were applied to cut nerve ends. Fast blue was applied by intramuscular injection, and fluorogold was delivered both by injection and by cut nerve exposure. Motoneurons supplying RCA and RCL were clustered on the medial wall of the ventral horn in a restricted region defined previously as the commissural nucleus. Labelled cells supplying RCL were confined to the C1 segment, but those supplying RCA were distributed from C1 to rostral C4. Motoneurons supplying RCA tended to lie more dorsomedially than those supplying RCL, but there was substantial overlap between the two populations. Motoneurons supplying dorsal muscles had a separate, more ventral distribution. RCP motoneurons were located primarily in the ventromedial nucleus, but a small proportion of cells was found in the white matter of the ventral funiculus or the gray matter surrounding the central canal. Motoneurons supplying CM and OCS were located dorsomedially to the RCP cell population. These results suggest that neck motoneurons are arranged according to a "musculotopic" pattern in which dorsal muscles have the most ventral locations, and progressively more lateral and then ventral muscles are layered dorsomedially along the medial wall of the ventral horn.

Characteristics of saccades induced by neck torsions: a re-examination in the normal guinea pig

Torsion of the neck relative to the fixed head results in several reflexes involving the eyes, the neck and the body. One of these reflexes, the cervico-ocular reflex, has been described as having a small gain in the normal animal. However, when the body of a guinea pig is moved relative to the fixed head with a ramp-like velocity profile, saccades are systematically elicited in the direction of body movement. We re-examined the characteristics of this reflex in the normal guinea pig and demonstrated that: (1) it occurs mainly in the range of high velocity body movements; (2) the latency of the saccades is shorter than previously suspected; (3) the saccades are triggered at specific positions relative to the starting and ending positions of rotation, revealing some degree of flexibility in the reflex. We hypothesize that these saccades of nuchal origin are under the control of the same neuronal circuit as visually triggered saccades and quick phases of vestibular nystagmus. Thus, this nuchal reflex may fundamentally subserve orienting behaviour in normal animal.

Morphometry and histoenzymology of the hamster tenuissimus and its muscle spindles

Muscle spindles and extrafusal fibers in the tenuissimus muscle of mature golden Syrian hamsters were studied morphologically and quantitatively using several light microscopic techniques. Muscle spindles were identified in serial-transverse frozen-sections of whole muscles stained with hematoxylin and eosin. Five tenuissimus muscles were examined from origin to insertion, and the locations of individual receptors were plotted in camera-lucida reconstructions. Spindles were found in proximity to the main neurovascular bundle in the central core of each muscle. A range of 16-20 receptors was noted per muscle. The mean muscle spindle index (the total number of spindles per gram of muscle weight) was 503 and the average spindle length was 7.5 mm. Oxidative enzyme and myosin adenosine-triphosphatase (ATPase) staining profiles were also evaluated in the intrafusal and extrafusal fibers in each muscle. Even numbers of type I and type IIA extrafusal fibers were distributed homogeneously throughout all muscle cross-sections. Histochemical staining patterns varied along the lengths of the three intrafusal fiber types. Nuclear chain fibers possessed staining properties similar to the type IIA extrafusal fibers and exhibited no regional variations. Bag1 fibers displayed staining variability, particularly when treated for myosin ATPase under acid preincubation conditions. Some spindles were isolated under darkfield illumination and then either treated with 7-nitrobenz-2-oxa-1,3-diazole (NBD)-phallacidin to detect filamentous actin by fluorescence microscopy, or prepared for conventional scanning electron microscopy (SEM). By fluorescence microscopy, a registered actin banding-pattern was observed in the sarcomeres of the intrafusal fibers, and variations in the intensity of banding were noted amongst different fibers. SEM revealed punctate sensory nerve endings that adhered intimately to the surfaces of underlying intrafusal fibers in the equatorial and juxtaequatorial regions. By transmission electron microscopy (TEM) these endings appeared crescent-shaped and were enveloped by external laminae. Each profile contained numerous mitochondria and cytoskeletal organelles. The high spindle density observed in this muscle suggests that the hamster tenuissimus may function in hindlimb proprioception.

Central projections of cervical primary afferent fibers in the guinea pig: an HRP and WGA/HRP tracer study

The central course and the projections of the first and the second cervical dorsal root ganglia and of suboccipital muscle primary afferent fibers in the guinea pig were studied by means of anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase (WGA/HRP) or aqueous solution of horseradish peroxidase (HRP). Injections of WGA/HRP into the second cervical dorsal root ganglion produced labeling in the dorsal and ventral horns. Within the spinal cord, the largest amount of HRP reaction product was found within the lateral third of the substantia gelatinosa and within the central cervical nucleus. The main area of termination in the medulla was the external cuneate nucleus. However, HRP reaction product was also found within the medial and inferior vestibular nuclei, cell group x, the perihypoglossal nuclei, the nucleus of the solitary tract, and the nucleus of the spinal trigeminal tract. Descending fibers could be detected as caudal as spinal segment T5. Injections of WGA/HRP into the first cervical dorsal root ganglion produced heavy terminal label within the central cervical nucleus but not within the substantia gelatinosa. Again, the external cuneate nucleus was the main area of termination within the medulla. Label could not be observed within the vestibular nuclear complex or within the spinal trigeminal nucleus. Injections of aqueous HRP into the suboccipital muscles produced heavy transganglionic label within the central cervical nucleus, whereas the substantia gelatinosa totally lacked terminal label. Ascending proprioceptive fibers reached the external cuneate nucleus and group x. Scanty projections could be detected within the vestibular nuclei as well as within the perihypoglossal nuclei except for the nucleus prepositus hypoglossi. Label was absent in the spinal trigeminal nucleus.

Distribution of motoneurons supplying dorsal suboccipital and intervertebral muscles in the cat neck

Multiple labelling methods were used to examine the topographical organization of motoneurons supplying the suboccipital muscles, rectus capitis posterior (RCP) and obliquus capitis inferior (OCI); the intervertebral muscles, spinalis dorsi (SD) and semispinalis cervicis (SSC); and the dorsal extensor biventer cervicis (BC). Muscle nerves were isolated, cut, and exposed in the same animal to one of three different retrograde tracers, Fluorogold, Fast Blue, and horseradish peroxidase. Motoneurons supplying suboccipital muscles were found to be located in the rostral two cervical segments. The RCP motor nucleus was confined to C1 and the caudal brainstem, whereas the OCI nucleus usually originated in mid-C1 and extended caudally as far as mid-C2. Most motoneurons supplying OCI and SD were concentrated in the deepest part of the ventral horn, but some cells were found in the commissural region, the contralateral ventral horn, the dorso-medial aspect of the ipsilateral ventral horn, and the ventromedial white matter. Cells supplying the functional extensor RCP were intermingled with those supplying the turning muscle OCI, although a gradient in mediolateral distribution was detected. Motoneurons supplying the intervertebral muscles SD and SSC were found caudal to C3. Within the ventral horn, they occupied locations similar to those occupied by suboccipital motoneurons in C1 and C2. The cell column for intervertebral motoneurons was just medial to that of BC and some cells supplying SD and SSC were found in the territory occupied by BC motoneurons. Motoneurons supplying intervertebral and suboccipital muscles had unimodal diameter spectra, and most cells had mean equivalent diameters smaller than 35 microns.

Responses of locus coeruleus neurons to labyrinth and neck stimulation

The electrical activity of a large population of locus coeruleus (LC)-complex neurons, some of which were antidromically activated by stimulation of the spinal cord at T12-L1, was recorded in precollicular decerebrate cats during labyrinth and neck stimulation. Some of these neurons showed physiological characteristics attributed to norepinephrine (NE)-containing LC neurons, i.e., (i) a slow and regular resting discharge; (ii) a typical biphasic response to compression of the paws consisting of short impulse bursts followed by a silent period, which was attributed to recurrent and/or lateral inhibition of the corresponding neurons; and (iii) a suppression of the resting discharge during episodes of postural atonia, associated with rapid eye movements (REM), induced by systemic injection of an anticholinesterase, a finding which closely resembled that occurring in intact animals during desynchronized sleep. Among the neurons tested, 80 of 141 (i.e., 56.7%) responded to the labyrinth input elicited by sinusoidal tilt about the longitudinal axis of the whole animal at the standard parameters of 0.15 Hz, +/- 10 degrees, and 73 of 99 (i.e., 73.7%) responded to the neck input elicited by rotation of the body about the longitudinal axis at the same parameters, while maintaining the head stationary. A periodic modulation of firing rate of the units was observed during the sinusoidal stimuli. In particular, most of the LC-complex units were maximally excited during side-up tilt of the animal and side-down neck rotation, the response peak occurring with an average phase lead of about +17.9 degrees and +34.2 degrees with respect to the extreme animal and neck displacements, respectively. Similar results were also obtained from the antidromically identified coeruleospinal (CS) neurons. The degree of convergence and the modalities of interaction of vestibular and neck inputs on LC-complex neurons were also investigated. In addition to the results described above, the LC-complex neurons were also tested to changing parameters of stimulation. In particular, both static and dynamic components of single unit responses were elicited by increasing frequencies of animal tilt and neck rotation. Moreover, the relative stability of the phase angle of the responses evaluated with respect to the animal position in most of the units tested at increasing frequencies of tilt allowed the conclusion to attribute these responses to the properties of macular ultricular receptors. This conclusion is supported by the results of experiments showing that LC-complex neurons displayed steady changes in their discharge rate during static tilt of the animal.(ABSTRACT TRUNCATED AT 400 WORDS)

Vestibular neurones in the parieto-insular cortex of monkeys (Macaca fascicularis): visual and neck receptor responses

1. One hundred and fifty-two vestibularly activated neurones were recorded in the parieto-insular vestibular cortex (PIVC) of four awake Java monkeys (Macaca fascicularis): sixty-two were tested systematically with visual stimulation and seventy-nine were tested with various somatosensory stimuli. With very few exceptions all vestibular neurones tested responded to visual and somatosensory stimulation, therefore being classified as polymodal vestibular units. 2. A most effective stimulus for all fifty-eight visually activated PIVC units was movement of a large structured visual pattern in an optimal direction. From forty-four units responsive to a horizontally moving optokinetic striped drum, twenty-nine were activated with optokinetic movement in the opposite direction to the activating vestibular stimulus ('synergistic' response), thirteen were activated optokinetically and vestibularly in the same direction ('antagonistic' responses) and two were biphasic. The gain of the optokinetic response to sinusoidal stimulation (average 0.28 (impulses s-1) (deg s-1)-1 at 0.2 Hz, 56 deg amplitude) was in a range similar to that of the vestibular gain at low frequencies. At 1 Hz some units only showed weak optokinetic responses or none at all, but the vestibular response was still strong. 3. With different 'conflicting' or 'enhancing' combinations of optokinetic and vestibular stimulation no generalized type of interaction was observed, but the responses varied from nearly 'algebraic' summation to no discernible changes in the vestibular responses by additional optokinetic stimuli. With all visual-vestibular stimulus combinations the responses to the vestibular stimulus remained dominant. 4. The optokinetic preferred direction was not related to gravitational coordinates since the optokinetic responses were related to the head co-ordinates and remained constant with respect to the head co-ordinates at different angles of steady tilt. 5. Almost all PIVC units were activated by somatosensory stimulation, whereby mainly pressure and/or movement of neck and shoulders (bilateral) and movement of the arm joints elicited vigorous responses. Fewer neurones were activated by lightly touching shoulders/arms or neck, by vibration and/or pressure to the vertebrae, pelvis and legs. 6. A most effective somatosensory stimulus was sinewave rotation of the body with head stationary. The gain of this directionally selective neck receptor response was in the range of vestibular stimulation. Interaction of vestibular and neck receptor stimulation was either of a cancellation or facilitation type.(ABSTRACT TRUNCATED AT 400 WORDS)

Central distribution of cervical primary afferents in the rat, with emphasis on proprioceptive projections to vestibular, perihypoglossal, and upper thoracic spinal nuclei

The projections of primary afferents from rostral cervical segments to the brainstem and the spinal cord of the rat were investigated by using anterograde and transganglionic transport techniques. Projections from whole spinal ganglia were compared with those from single nerves carrying only exteroceptive or proprioceptive fibers. Injections of horseradish peroxidase (HRP) or wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) were performed into dorsal root ganglia C2, C3, and C4. Free HRP was applied to the cut dorsal rami C2 and C3, greater occipital nerve, sternomastoid nerve, and to the C1/2 anastomosis, which contains afferents from suboccipital muscles and the atlanto-occipital joint. WGA-HRP injections into ganglia C7 and L5 were performed for comparative purposes. Injections of WGA-HRP or free HRP into rostral cervical dorsal root ganglia and HRP application to C2 and C3 dorsal rami produced labeling in dorsal and ventral horns at the level of entrance, the central cervical nucleus, and in external and main cuneate nuclei. From axons ascending to pontine and descending to upper thoracic spinal levels, medial collaterals were distributed to medial and descending vestibular, perihypoglossal and solitary nuclei, and the intermediate zone and Clarke's nucleus dorsalis in the spinal cord. Lateral collaterals projected mainly to the trigeminal subnucleus interpolaris and to lateral spinal laminae IV and V. Results from HRP application to single peripheral nerves indicated that medial collaterals were almost exclusively proprioceptive, whereas lateral collaterals were largely exteroceptive with a contribution from suboccipital proprioceptive fibers. WGA-HRP injections into dorsal root ganglia C7 and L5 failed to produce significant labeling within vestibular and periphypoglossal nuclei, although they demonstrated classical projection sites within the brainstem and spinal cord. The consistent collateralisation pattern of rostral cervical afferents along their whole rostrocaudal course enables them to contact a variety of precerebellar, vestibulospinal, and preoculomotor neurons. These connections reflect the well-known significance of proprioceptive neck afferents for the control of posture, head position, and eye movements.

The influence of initial posture on the sit-to-stand movement

Head movements, ground reaction forces and electromyographic activity of selected muscles were recorded simultaneously from two subjects as they performed the sit-to-stand manouevre under a variety of conditions. The influence of initial leg posture on the magnitude of the various parameters under investigation was examined first. A preferred initial leg posture resulted in smaller magnitudes of head movement and ground reaction forces. EMG activity in some muscles, trapezius and erector spinae, decreased, while in others, quadriceps and hamstrings, it increased in the preferred leg posture. The decreases seen correlate with reductions in head movement observed. The effect of inhibiting habitual postural adjustments of the head and neck, by comparing "free" and "guided" movements was also examined. In guided movements there are significant reductions in head movement, ground reaction forces and EMG activity in trapezius, sternomastoid and erector spinae. It would appear that both initial leg posture and the abolition of habitual postural adjustment have a profound influence on the efficiency of the sit-to-stand manouevre. This preliminary study high-lights the practical importance of head posture in the diagnosis and treatment of movement disorders, as well as in movement education.

Responses of locus coeruleus and subcoeruleus neurons to sinusoidal neck rotation in decerebrate cat

The electrical activity of 99 neurons located in the locus coeruleus-complex, namely in the dorsal (n = 26) and the ventral part of the locus coeruleus (n = 46) as well as the locus subcoeruleus (n = 27), has been recorded in precollicular decerebrate cats during sinusoidal displacement of the neck. This was achieved by rotation of the body about the longitudinal axis of the animal, while maintaining the head stationary. A proportion of these neurons showed some of the main physiological characteristics attributed to the noradrenergic locus coeruleus neurons, i.e. (i) a slow and regular resting discharge, and (ii) a typical biphasic response to fore and hindpaw compression consisting of short bursts of impulses followed by a period of quiescence, due at least in part to recurrent or lateral inhibition of the corresponding neurons. Moreover, 14 out of the 99 neurons were activated antidromically by stimulation of the spinal cord at T12 and L1, thus being considered as coeruleo- or subcoeruleospinal neurons. Among these locus coeruleus-complex neurons tested, 73 out of 99 (i.e. 73.7%) responded to neck rotation at the standard frequency of 0.15 Hz and at the peak amplitude of displacement of 10 degrees. In particular 40 of 73 units (i.e. 54.8%) were excited during side-down neck rotation and depressed during side-up rotation, while 18 of 73 units (i.e. 24.7%) showed the opposite pattern. In both instances the peak of the responses occurred with an average phase lead of +34.2 degrees for the extreme side-down or side-up neck displacement; however, the response gain (impulses/s per deg) was on the average more than two-fold higher in the former than in the latter group of units. The remaining 15 units (i.e. 20.5%) showed phase angle values which were intermediate between those of the two main populations. As to the coeruleo or subcoeruleospinal neurons, 11 of 14 units (78.6%) responded to the neck input, the majority (nine of 11 units, i.e. 81.8%) being excited during side-down neck rotation. Within the explored region, the proportion of responsive units was higher in the locus subcoeruleus (85.2%) than in the locus coeruleus, both dorsal and ventral (69.4%). Moreover, units located in the former structure showed on the average a response gain higher than that found in the latter structures. Similar results were also obtained from the population of locus subcoeruleus-complex neurons which fired at a low rate (less than or equal to 5.0 impulses/s).(ABSTRACT TRUNCATED AT 400 WORDS)

Proprioception in the neck

Proprioception in the neck was investigated in normal human subjects. Three experiments studied rotation of the head about a vertical axis on the body. Accuracy of pointing, thresholds for detection of passive movement, and control of fine movement were tested. Comparison of the accuracy of pointing at the big toe with the nose and with the arm, showed a smaller scatter of angular misalignments when pointing with the arm. However, the arm pointed systematically off target. Pointing at the target toe by turning the head was not significantly more accurate than aligning the nose and toe by turning the chair and body with the head fixed. The highest threshold found for the detection of the direction of passive movement of the head relative to the body was 1.4 degrees angular displacement. Thresholds were highest at the slowest angular velocity and dropped as angular velocity increased. When the head was turned on the body thresholds were lower than when the body was turned and the head held still. Control of fine angular movements of the head and of the distal phalanx of the right thumb were compared by measuring subjects' accuracy in guiding a cursor through a path on a computer screen by turning the head or moving the thumb. The thumb was found to be better controlled than the head.

Synaptic connections between spinal motoneurons and dorsal root ganglion cells in the cat

Light- and electron-microscopical horseradish peroxidase (HRP) studies have been employed in conjunction with a degeneration study in order to clarify the origin and axonal passage of afferent synaptic terminals in cat dorsal root ganglia. After injection of HRP into ganglia (C3) without involvement of the ventral roots and spinal nerves, a few ipsilateral spinal ventral horn neurons (C3) were retrogradely labeled with HRP. The labeled neurons were localized in the dorsomedial and the ventromedial nuclei. Following ventral rhizotomy of C3, the afferent terminals in the ganglia (C3) anterogradely degenerated and contained accumulated and disintegrated neurofilaments, depleted, aggregated and enlarged synaptic vesicles. Subsequent to an HRP and wheat germ agglutinin (WGA)-HRP-mixture injection into the dorsal neck or suboccipital muscles, many spinal motoneurons (C3) were labeled retrogradely with an HRP mixture. On the other hand, the afferent synaptic terminals in ganglia contained the membrane-bound and electron-dense bodies which were anterogradely labeled with an HRP mixture in addition to the normal synaptic elements. The present findings strongly suggest that some spinal motoneurons send their axon collaterals to the dorsal root ganglia, in which the terminals of the axon collaterals directly synapse with the dorsal root ganglion cells.

Distribution of sensory receptors in the flexor carpi radialis muscle of the cat

The structures and distribution of encapsulated muscle receptors were examined in serial transverse sections of flexor carpi radialis in the adult cat. Four types of receptors (muscle spindles, Golgi tendon organs, paciniform, and Pacinian corpuscles) were identified. Their structures resembled those encountered in other limb muscles. Pacinian corpuscles were rare and occurred only in the external fascial coat of the muscle near its origin. The other three receptor types were distributed in an uneven but consistent pattern throughout the muscle. As noted previously (Gonyea and Ericson, '77), spindles were largely confined to a deep muscle region comprising less than 20% of the muscle volume, located directly between the long tendon of origin and the tendon of insertion. This region contains the largest proportion of type SO muscle fibers (Gonyea and Ericson, '77). Tendon organs and paciniform corpuscles were concentrated along the tendons that lined the spindle-rich muscle region. This region appeared to be composed of extrafusal fibers that were shorter and of more oblique pinnation than those in other regions. The localization of muscle receptors to the "oxidative" core of the muscle in its direct line of pull may have functional implications for afferent input to the spinal cord which are discussed. In addition, the possibility is raised that there are more paciniform corpuscles in flexor carpi radialis (and possibly other muscles) than previously thought.