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PubMed2004

Deranged jaw-neck motor control in whiplash-associated disorders.

Recent findings of simultaneous and well coordinated head-neck movements during single as well as rhythmic jaw opening-closing tasks has led to the conclusion that 'functional jaw movements' are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. It can therefore be assumed that disease or injury to any of these joint systems would disturb natural jaw function. To test this hypothesis, amplitudes, temporal coordination, and spatiotemporal consistency of concomitant mandibular and head-neck movements during single maximal jaw opening-closing tasks were analysed in 25 individuals suffering from whiplash-associated disorders (WAD) using optoelectronic movement recording technique. In addition, the relative durations for which the head position was equal to, leading ahead of, or lagging behind the mandibular position during the entire jaw opening-closing cycle were determined. Compared with healthy individuals, the WAD group showed smaller amplitudes, and changed temporal coordination between mandibular and head-neck movements. No divergence from healthy individuals was found for the spatiotemporal consistency or for the analysis during the entire jaw opening-closing cycle. These findings in the WAD group of a 'faulty', but yet consistent, jaw-neck behavior may reflect a basic importance of linked control of the jaw and neck sensory-motor systems. In conclusion, the present results suggest that neck injury is associated with deranged control of mandibular and head-neck movements during jaw opening-closing tasks, and therefore might compromise natural jaw function.

Adult↗
PubMed1998

In vivo lactate editing with simultaneous detection of choline, creatine, NAA, and lipid singlets at 1.5 T using PRESS excitation with applications to the study of brain and head and neck tumors.

Two T2-independent J-difference lactate editing schemes for the PRESS magnetic resonance spectroscopy localization sequence are introduced. The techniques, which allow for simultaneous acquisition of the lactate doublet (1.3 ppm) and edited singlets upfield of and including choline (3.2 ppm), exploit the dependence of the in-phase intensity of the methyl doublet upon the time interval separating two inversion (BASING) pulses applied to its coupling partner after initial excitation. Editing method 1, which allows for echo times TE = n/J (n = 1, 2, 3, . . . . ), alters the BASING carrier frequency for each of two cycles so that, for one cycle, the quartet is inverted, whereas, for the other cycle, the quartet is unaffected. Method 2, which also provides water suppression, allows for editing for TE > 1/J by alternating, between cycles, the time interval separating the inversion pulses. Experimental results were obtained at 1.5 T using a Shinnar Le-Roux-designed maximum phase inversion pulse with a filter transition bandwidth of 55 Hz. Spectra were acquired from phantoms and in vivo from the human brain and neck. In a neck muscle study, the lipid suppression factor, achieved partly through the use of a novel phase regularization algorithm, was measured to be over 10(3). Spectra acquired from a primary brain and a metastatic neck tumor demonstrated the presence of lactate and choline signals consistent with abnormal spectral patterns. The advantages and limitations of the methods are analyzed theoretically and experimentally, and significance of the results is discussed.

Aspartic Acid↗
PubMed1995

Control of the head in response to tilt of the body in normal and labyrinthine-defective human subjects.

1. Head movement responses to discrete, unpredictable tilts of the trunk from earth upright were studied in normal and labyrinthine-defective (LD) subjects. Tilts of the seated, restrained trunk, were delivered in pitch and roll about head-centred axes and approximated raised cosine displacements with peak amplitudes of 20-30 deg and durations of 1.5-2 s. Subjects performed mental arithmetic with eyes closed or read earth-fixed text. 2. At the onset of tilt the head momentarily lagged behind the trunk because of inertia. Subsequently, head control varied widely with three broad types: (i) head relatively fixed to the trunk (in normal subjects and some patients); (ii) head unstable, falling in the direction of gimbal tilt (typical of acute patients for pitch motion); (iii) compensatory head movement in the opposite direction to gimbal tilt (observed consistently in normal subjects and in well-adapted patients). 3. EMG was well developed in subjects with compensatory head movement and consisted of an initial burst of activity at minimum latencies of 25-50 ms (means 72-108 ms), followed by a prolonged peak; both occurring in the 'side up' neck muscles, appropriate for righting the head. These muscles are shortened during the initial head lag so the responses cannot be stretch reflexes. In normal subjects their origin is predominantly labyrinthine but in patients they may be an 'unloading response' of the neck. 4. Head stability in space was superior with the visual task for all subjects but vision only partially compensated for labyrinthine signals in unstable patients. 5. Modelling the responses to tilt suggests that, in LD subjects, the short-latency burst could be driven by signals from the neck of the relative acceleration between head and trunk tilt. The longer latency EMG could be driven by a signal of head tilt in space. Normally, this signal is probably otolithic. In patients it could be synthesized from summing proprioceptive signals of position of head on trunk with trunk tilt.

Adaptation, Physiological↗
PubMed1992

Effect of Gz forces and head movements on cervical erector spinae muscle strain.

A portable surface-integrated EMG (IEMG) device was used to investigate the strain caused by low and high Gz forces and head movements on the cervical erector spinae muscles during flight missions. The obtained IEMG activities were normalized by comparing them with activities representing maximal voluntary contraction (MVC) of the cervical erector spinae muscles in each subject. The muscular strain increased with increasing Gz forces and head movements. Under +7.0 Gz the mean muscular strain was 5.9-fold compared with +1.0 Gz and was 37.9% of the MVC. In some individuals, the muscular tolerance (100% of the MVC) was ipsilaterally reached already under +4.0 Gz with concomitant movements and twisted positions of the head. Pilots are susceptible to acute neck injury when the protection afforded by their neck muscles is insufficient.

Adult↗
PubMedDate not supplied

Changes in neck electromyography associated with meningeal noxious stimulation.

OBJECTIVE: To determine if the activity of jaw and neck muscles in a rat model is influenced by the application of small-fiber irritant mustard oil to meningeal/dural vascular tissues. DESIGN: Controlled animal experiment. SETTING: University neurophysiology laboratory. INTERVENTIONS: Applications of mineral oil (vehicle control) and mustard oil to exposed meningeal/dural vascular tissues. MAIN OUTCOME MEASURE: Electromygraphic (EMG) recordings from deep suboccipital muscles, bilaterally, and the left trapezius and left masseter muscles. RESULTS: Mineral oil evoked no EMG responses in any muscles. The incidences of mustard oil-evoked EMG increases were 100%, 100%, 89% and 78% for left deep neck, right deep neck, left trapezium and left masseter muscles, respectively. The durations of EMG responses were (mean +/- SD) 19.2 +/- 6.6 min, 17.3 +/- 7.5 min, 14.5 +/- 6.8 min and 12.7 +/- 8.5 min, respectively. CONCLUSIONS: These results document that meningeal/dural vascular irritation leads to sustained and reversible activation of neck and jaw muscles that may be related to the clinical occurrence of muscular tension and pain associated with certain types of headaches, particularly migraine.

Animals↗
PubMed1978

Effect of load disturbances during centrally initiated movements.

1. We have investigated the relative contributions of mechanical and reflex mechanisms in generating the forces produced by the neck muscles when loads were unexpectedly applied during centrally programmed head movements in monkeys. These movements, subserved by muscles well endowed with muscle spindles, are part of the coordinated eye-head response to the appearance of a stimulus in the animal's visual field. Our preparation was a chronically vestibulectomized monkey trained to make a visual discrimination. 2. Two procedures were used to evaluate the torque generated by the neck musculature when an unexpected load disturbance was applied: first, by surgically interrupting the afferent loop subserving the reflex action (section of cervical dorsal roots) and second, by building a mathematical model of the head-neck system and carrying out a process of simulation. 3. Our results indicated that the compensatory torque of reflex origin stimulated by the application of an opposing force was less than 10--30% of that required for perfect compensation, and the larger fraction of the observed compensation was due to the mechanical properties (inertial, viscous, and elastic) of the neck musculature. The combined action of reflex and mechanical processes never completely compensated for the disturbance.

Animals↗
PubMed1996

Spatial coordination by descending vestibular signals. 2. Response properties of medial and lateral vestibulospinal tract neurons in alert and decerebrate cats.

Spatial response properties of medial (MVST) and lateral (LVST) vestibulospinal tract neurons were studied in alert and decerebrate cats during sinusoidal angular rotations of the whole body in the horizontal and many vertical planes. Of 220 vestibulospinal neurons with activity modulated during 0.5-Hz sinusoidal rotations, 200 neurons exhibited response gains that varied as a cosine function of stimulus orientation and phases that were near head velocity for rotation planes far from the minimum response plane. A maximum activation direction vector (MAD), which represents the axis and direction of rotation that maximally excites the neuron, was calculated for these neurons. Spatial properties of secondary MVST neurons in alert and decerebrate animals were similar. The responses of 88 of 134 neurons (66%) could be accounted for by input from one semicircular canal pair. Of these, 84 had responses consistent with excitation from the ipsilateral canal of the pair (13 horizontal, 27 anterior, 44 posterior) and 4 with excitation from the contralateral horizontal canal. The responses of the remaining 46 (34%) neurons suggested convergent inputs. The activity of 38 of these was significantly modulated by both horizontal and vertical rotations. Twelve neurons (9%) had responses that were consistent with input from both vertical canal pairs, including 9 cells with MADs near the roll axis. Thirty-two secondary MVST neurons (24%) had type II yaw and/or roll responses. The spatial response properties of 18 secondary LVST neurons, all studied in decerebrate animals, were different from those of secondary MVST neurons. Sixteen neurons (89%) had type II yaw and/or roll responses, and 12 (67%) appeared to receive convergent canal pair input. Convergent input was more common on higher-order vestibulospinal neurons than on secondary neurons. These results suggest that MVST and LVST neurons and previously reported vestibulo-ocular neurons transmit functionally different signals. LVST neurons, particularly those with MADs close to the roll axis, may be involved in the vestibular-limb reflex. The combination of vertical and ipsilateral horizontal canal input on many secondary MVST neurons suggests a contribution to the vestibulocollic reflex. However, in contrast to most neck muscles, very few neurons had maximum vertical responses near pitch.

Animals↗
PubMed2005

Inflammatory focal myositis of the sternomastoid muscle: is there an absolute indication for biopsy? A case report and review of the literature.

Focal myositis is a localised inflammatory process affecting skeletal muscles belonging to the pathological group of inflammatory pseudo tumours of soft tissue that includes myositis ossificans, proliferative myositis and nodular pseudosarcomatous fasciitis. Very rarely, it may affect one of the neck muscles and present as a neck lump, in which case both the clinical and pathological picture can mimic a sarcoma. We describe a case of focal myositis of the sternocleidomastoid muscle, present a review of this rare condition and debate the necessity of biopsy.

Adult↗
PubMed2001

Head movement properties during voluntary rapid jaw movement in humans.

The purpose of this study was to determine whether the start of the synchronized head movement during mandibular movement is evoked by the peripheral reflexes following mandibular movement (i.e. stretch or trigemino-neck reflexes), or, alternatively, is started by pre-programmed central command. Head movement accompanying voluntary rapid jaw opening movement was studied using accelerometers fixed to the upper and lower incisors, as well as electromyographs (EMGs) of the neck muscles. The direction of head acceleration at the upper incisor was towards head extension at the beginning of jaw opening movement in 89.2% of all trials, opposite to the direction of lower jaw acceleration. The onset of head acceleration was later than that of the lower jaw acceleration by averages of 6.2-10.7 ms, and the onset of electromyographic activities of the sternocleidomastoid (SCM) muscle preceded that of head acceleration by an average of 12.5-24.3 ms. These findings suggest that head movement during mandibular movement is not started by peripheral reflexes but by pre-programmed central commands. This may be relevant to muscular discomfort in the neck and shoulder regions of patients with stomatognathic disorders.

Acceleration↗
PubMed1984

Gaze changing behaviour in head restrained monkey.

The electromyographic activity of neck muscles and head torque were recorded in the alert, head-fixed rhesus monkeys together with the horizontal component of eye movements during pursuit movements, scanning movement and vestibular stimulation in darkness. A strong correlation between head torque and the horizontal component of eye position was demonstrated during these three different experimental situations. These conjugate head and eye movements are accompanied by a specific change in the timing of neck neuromuscular activation.

Acoustic Stimulation↗
PubMed1989

Eye movements induced by microinjection of GABA agonist in the rat substantia nigra pars reticulata.

Injection of muscimol (GABA agonist) in the substantia nigra pars reticulata (SNr) of the alert rat induced a continual repetition of fast eye movements to the contralateral side, each of which was followed by a slow returning movement. The fast eye movements were similar to spontaneous saccades. Larger saccades were accompanied by contralateral neck muscle activity. We suggest that the SNr plays an important role in control of eye movements in the rat.

Animals↗
PubMed1995

Effect of MLF transection on the vertical vestibulocollic reflex in decerebrate cats.

1. In the cat, motoneurons supplying biventer cervicis, complexus and rectus capitis posterior receive disynaptic input from the posterior semicircular canals and from the contralateral anterior canal via the medial vestibulospinal tract (MVST). Disynaptic excitation from the ipsilateral anterior canal reaches these motoneurons via the lateral vestibulospinal tract. 2. We hypothesized that if the MVST has a unique role in the production of the vertical vestibulocollic reflex (VCR) in these muscles then interruption of this tract by transection of the medial longitudinal fasciculus (MLF) would change the VCR responses. Specifically, response vector orientations would shift toward the plane of the ipsilateral anterior canal, and response gains would drop at high frequencies. 3. We lesioned the MLF bilaterally and observed no substantial effect on neck-muscle responses. Response vector orientations did not shift systematically toward a single plane, nor was there a consistent decrease in response gains at high frequencies. 4. As in the horizontal VCR, there is no unique contribution from MVST neurons; parallel pathways must play an important role in the vertical VCR.

Animals↗
PubMed1990

Neck and shoulder muscle activity during work with different cash register systems.

Levels of neck and shoulder myoelectric activity (EMG) were recorded in eight female cashiers during work with different cash register systems. Static, median and peak levels of load were determined, and comparisons were made between conventional keyboard operation and operation with horizontal scanner, vertical scanner and pen reader respectively, and between sitting and standing work postures. Each complete transaction (33 articles) lasted 74-166 s (mean 104 s). Cash register operation, regardless of register system, caused static load (mean) in the thoracic erector spinae at 4.1-6.2 TAMP% (Time-Averaged Myoelectrical Potential), in the infraspinatus at 2.9-5.8 TAMP%, and in the trapezius at 2.8-3.8 TAMP%. The cervical erector spinae and levator scapulae were very low in activity (0.6-1.3 TAMP% at the static load). Except for the left infraspinatus during scanner and pen reader operation, the median loads were low. Mean peak loads never exceeded 27.4 TAMP%. When the cashier was standing, the muscle activity at all levels of load was lower than when sitting, e.g., the left infraspinatus mean static load was 3.7 TAMP% (standing) and 5.4 TAMP% (sitting) (p less than or equal to 0.001). Differences were found between the cash register systems at median and peak loads. Work with scanners and pen reader caused, in ranking order, higher loads than conventional keyboard operation in the trapezius, infraspinatus and thoracic erector spinae. However, the main problem seems to be the repetitive handling of merchandise and the constant static load regardless of cash register system used.

Adult↗
PubMed2001

Trapped in the neutral zone: another symptom of whiplash-associated disorder?

Instability of the cervical spine following whiplash trauma has been demonstrated in a number of studies. We hypothesized that, in patients with whiplash-associated disorder, rotation of the head would be accompanied by an earlier onset of neck muscle activity to compensate for intrinsic instability. The aim of the study was to examine the range of motion (RoM) of the cervical spine and the onset and activity of the sternocleidomastoid (SCM) muscles during axial rotation, in healthy control subjects and in patients with chronic whiplash-associated disorder. Forty-eight control subjects (42% male) and 46 patients (33% male) with chronic whiplash-associated disorder (symptoms lasting longer than 3 months) were examined. Cervical axial RoM differed significantly (P = 0.0001) between the groups, with the whiplash patients showing lower values (83 degrees +/- 30 degrees) than the healthy controls (137 degrees +/- 19 degrees). The whiplash patient group showed no evidence of the predicted earlier activation of SCM muscles. Many patients never reached the point in the RoM where SCM muscle activity rises steeply, as it does in the healthy controls (the 'elastic zone'), and their movements remained mostly within the region of low muscle activity (the 'neutral zone'). The whiplash patients appeared either unable or unwilling to drive the cervical spine into this region of high muscle activity, possibly because they were restricted by existing pain or fear of pain.

Adult↗
PubMedDate not supplied

Postural control responses sitting on unstable board during visual stimulation.

Concerning with the relation of vection induced by the optokinetic stimulation and the body movement, especially we attended to the neck joint movement, which counteracted to the shoulder movement. Then, we analyzed the mechanisms of the sitting postural control by using the seesaw board. By the optokinetic stimulation through the head mounted display (H.M.D.), the vection was leaded, and it affected to the sway of the body on the seesaw board. In this experiment, we found that the movement of upper part of body except for the head was the same direction to the seesaw board but the head moved out of phase to the seesaw board. This phenomenon will be suggested that the unstable condition of sway is balanced by the counter swing of head and the neck muscle tonus is controlled by acting of the vestibulo-collic reflex.

Adult↗
PubMed1994

Myogenic potentials generated by a click-evoked vestibulocollic reflex.

Electromyograms (EMGs) were recorded from surface electrodes over the sternomastoid muscles and averaged in response to brief (0.1 ms) clicks played through headphones. In normal subjects, clicks 85 to 100 dB above our reference (45 dB SPL: close to perceptual threshold for normal subjects for such clicks) evoked reproducible changes in the averaged EMG beginning at a mean latency of 8.2 ms. The earliest potential change, a biphasic positive-negativity (p13-n23), occurred in all subjects and the response recorded from over the muscle on each side was predominantly generated by afferents originating from the ipsilateral ear. Later potentials (n34, p44), present in most but not all subjects, were generated bilaterally after unilateral ear stimulation. The amplitude of the averaged responses increased in direct proportion to the mean level of tonic muscle activation during the recording period. The p13-n23 response was abolished in patients who had undergone selective section of the vestibular nerve but was preserved in subjects with severe sensorineural hearing loss. It is proposed that the p13-n23 response is generated by activation of vestibular afferents, possibly those arising from the saccule, and transmitted via a rapidly conducting oligosynaptic pathway to anterior neck muscles. Conversely, the n34 and p44 potentials do not depend on the integrity of the vestibular nerve and probably originate from cochlear afferents.

Acoustic Stimulation↗
PubMed1976

Lipid storage myopathies. A review of metabolic defect and of treatment.

Various cases of lipid storage myopathies have been described. The biochemical defect could be determined in only some of these cases. The syndromes identified to date are as follows: carnitine deficiency (type I lipid storage myopathy), carnitine-palmityltransferase (CPT) deficiency and pyruvate-decarboxylase deficiency. In the last two diseases the vacuolization in muscle is not marked. The case of a 10 year old carnitine deficient patient with a history of insidious muscle weakness in the proximal limb and neck muscles is presented. The patient was treated with oral carnitine and a medium chain triglyceride diet for 18 months and her clinical status has remained improved. In other lipid storage patients prednisone treatment resulted in improvement. In cases of suspected lipid storage myopathy the following studies are indicated: 1) examination of ketone bodies in serum and urine during fasting, long chain and medium chain triglyceride diets; 2) serum triglyceride and serum carnitine; 3) study on fresh muscle and fibroblasts with labeled substrates, biochemical determination of carnitine and CPT in muscle.

Adult↗