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Inhibition and excitation of neck and shoulder muscles during unilateral electrical stimulation of the rat neostriatum.

Electrical stimulation of the caudate-putamen (Cd-Pt) in anesthetized adult male rats was used to determine the nature and extent of the control exerted by the Cd-Pt over the following neck and shoulder muscles: the trapezius, biventer cervicis, rectus capitis and scalenus dorsalis. Unilateral Cd-Pt stimulation resulted in a pattern of muscle responses marked by immediate inhibition of ipsilateral spontaneous activity and subsequent excitation of contralateral activity. Lesions of the substantia nigra pars reticulata blocked the excitation in 3 of the 4 muscles, while globus pallidus lesions had equivocal results. However, control ablations of the frontoparietal motor cortex, which blocked excitation in all muscles, and kainic acid lesions of the Cd-Pt, which had no effect on excitation, suggested that the excitation of muscle activity can only be attributed to the stimulation of corticofugal fibers passing through this region (i.e. the Cd-Pt). The inhibition of spontaneous activity does appear to be attributable to stimulation of the Cd-Pt.

Animals↗

Analgesic effect of electric stimulation of peripheral nerves with different electric frequencies using the formalin test.

Although electroacupuncture (EA) has been widely used to treat pain, the optimal frequency of EA therapy remains unclear. The study sought to determine the effect of different EA frequencies in a Sprague-Dawley (SD) rat model of pain. Electric stimulation (ES) at frequencies of 2 Hz, 15 Hz or 100 Hz was applied to the ipsilateral or contralateral sciatic nerve of the injected hindpaw of SD rats. Formalin (50 microl, 5%) was subcutaneously injected into the plantar surface of the left hindpaw to induce a nociceptive response. Behavior, including licking and biting, was observed to have two distinct periods, an early phase during the first 5 mins and a late phase from 21-35 mins after injection. The total biting or licking count served as an Indicator of nociceptive response. Our results indicate that ES of the ipsilateral sciatic nerve at a frequency of 2 Hz or 15 Hz reduced the nociceptive responses in both the early and the late phases of the formalin test, whereas ES at 2 Hz had greater antinociceptive effect than ES at 15 Hz in the early phase. No similar analgesic effect in the early phase was observed for ES at 100 Hz. Both pretreatment with ES at 2 Hz and naloxone (3 mg/kg, s.c.) produced a greater antinociceptive response in the late phase than when ES at 2 Hz was delivered immediately after formalin administration. In addition, ES of the neck muscle or contralateral sciatic nerve at a frequency of 2 Hz also decreased licking and biting activity in both phases. The results of this study indicate that different analgesic mechanisms are involved in the response to ES at frequencies of 2 Hz, 15 Hz and 100 Hz, and that ES at 2 Hz has a greater analgesic effect on formalin-induced nociceptive response, especially when it is delivered prior to the onset of pain. The analgesic effect of ES may be mediated via a central origin in the supraspinal level. These findings suggest that 2 Hz may be a good frequency selection for clinical EA applications in analgesia, and that pretreatment with EA at 2 Hz may be an effective method to treat post-operative pain.

Analgesia↗

Maximal isometric strength of the cervical musculature in 100 healthy volunteers.

STUDY DESIGN: A descriptive study involving maximal isometric strength measurements of the cervical musculature. OBJECTIVES: To determine the maximal isometric strength of the flexors and extensors and of the cervical musculature in 100 healthy volunteers (50 men and 50 women). SUMMARY OF BACKGROUND DATA: The literature contains only a few descriptive studies pertaining to strength levels of the cervical musculature. These studies include small subject populations, and measurement methods have demonstrated weak reliability. METHODS: Testing was carried out using strain-gauge technology on a neck muscle training apparatus. RESULTS: A reliability study demonstrated acceptable intraday and day-to-day values. Maximal isometric strength was approximately 20% to 25% higher in male subjects than female subjects in both flexion and extension from the third to the sixth decades. In the seventh decade, the women's strength levels surpassed values for men in both flexion and extension. Extension-flexion ratios were approximately 1.7 to 1 in both the men and women participants. The men demonstrated a significant decrease in maximal isometric strength with increasing age in both flexion and extension, whereas the women were able to maintain strength values in the ages tested. CONCLUSIONS: Men and women demonstrate impressive levels of muscular strength in the flexors and extensors of the cervical spine and can maintain these values until the seventh decade of life. Successful rehabilitation of the cervical musculature will require considerable resistance for sufficient stimulation of the cervical musculature.

Adult↗

Different sets of afferents are demonstrated by the fluorescent tracers fast blue and rhodamine.

The fluorescent retrograde tracers Rhodamine B Isothiocyanate (RITC) and Fast Blue (FB) were injected either into the thalamic nucleus rotundus or into the complexus neck muscle in pigeons. Both in the rotundal and the peripheral motor preparations RITC yielded a 3-5 times larger number of afferent ipsilateral neurones than FB. While RITC additionally labelled a large number of contralateral afferents, virtually no labelled cells were detected contralateral to the injection site using FB. This selective omission of the contralateral input with FB was identical for both neural systems despite differences in injection volume, survival time, and transport length. In the present case, this structure-specific sensitivity of FB would lead to the erroneous conclusion that contralateral afferents are virtually non-existent in the visual tectofugal and the peripheral motor system. Thus, these results make it likely that the choice for a certain tracer may lead to different connectional interpretations of a neural system. Although the mechanism for these structure-specific sensitivity differences are unknown, it is suggested that tracers with lower effectivity like FB may be unable to label afferent structures with fewer axon terminals.

Afferent Pathways↗

The pathways responsible for the characteristic head posture produced by lesions of the interstitial nucleus of Cajal in the cat.

(1) Experiments were performed in cats to examine effects of lesion of the interstitial nucleus of Cajal (INC) on head posture and the responsible pathway. Unilateral INC lesions resulted in lateral tilt of the head to the opposite side, and bilateral INC lesions resulted in dorsiflexion of the head as reported earlier. Such characteristic head posture was produced by successful kainic acid injections as well as by electrolytic lesions, suggesting that it was not due to damage of nerve fibers passing through the INC, but was produced most probably by damage of nerve cells in the INC. Electromyographic (EMG) recordings in unilateral INC-lesioned cats showed that activity was higher in the ipsilateral than in the contralateral major dorsal neck muscles (biventer, splenius, complexus, and rectus), and also higher in the contralateral than in the ipsilateral obliquus capitis caudalis muscle. The pattern of EMG activity was basically similar either when the cats presented typical head tilt or when their head was fixed to the frame at the stereotaxic plane. Characteristic head posture resulting from INC lesions seems consistent with the head posture produced by activation of these muscles. (2) Interruption of the medial and lateral vestibulospinal tracts did not significantly influence head tilt that had been produced by INC lesions. Characteristic head tilt was produced by INC lesions after cats had received bilateral labyrinthectomies, bilateral lesions of most of the vestibular nuclei, and bilateral aspiration of the cerebellar vermis and most of the lateral vestibular nuclei, indicating that typical head tilt can be produced without the vestibular nuclei and cerebellar vermis. (3) The medial longitudinal fasciculus (MLF) was interrupted at different levels to cut the major descending fibers from the INC. MLF interruption at the caudal midbrain produced typical head tilt, although MLF cut at the caudal pons and medulla was ineffective. Bilateral parasagittal cuts lateral to the MLF in the pons produced severe dorsiflexion of the head, and a subsequent unilateral INC lesion produced no further head tilt. These results suggest that fibers originating in the INC, removal of which is responsible for the typical head tilt, run through the MLF in the midbrain, and leave it in the pontine level.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Mechanisms controlling human head stabilization. I. Head-neck dynamics during random rotations in the horizontal plane.

1. Potential mechanisms for controlling stabilization of the head and neck include voluntary movements, vestibular (VCR) and proprioceptive (CCR) neck reflexes, and system mechanics. In this study we have tested the hypothesis that the relative importance of those mechanisms in producing compensatory actions of the head-neck motor system depends on the frequency of an externally applied perturbation. Angular velocity of the head with respect to the trunk (neck) and myoelectric activity of three neck muscles were recorded in seven seated subjects during pseudorandom rotations of the trunk in the horizontal plane. Subjects were externally perturbed with a random sum-of-sines stimulus at frequencies ranging from 0.185 to 4.11 Hz. Four instructional sets were presented. Voluntary mechanisms were examined by having the subjects actively stabilize the head in the presence of visual feedback as the body was rotated (VS). Visual feedback was then removed, and the subjects attempted to stabilize the head in the dark as the body was rotated (NV). Reflex mechanisms were examined when subjects performed a mental arithmetic task during body rotations in the dark (MA). Finally, subjects performed a voluntary head tracking task while the body was kept stationary (VT). 2. Gains and phases of head velocity indicated good compensation to the stimulus in VS and NV at frequencies < 1 Hz. Gains dropped and phases advanced between 1 and 2 Hz, suggesting interference between neural and mechanical components. Above 3 Hz, the gains of head velocity increased steeply and exceeded unity, suggesting the emergence of mechanical resonance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Electrical stimulation of rhesus monkey nucleus reticularis gigantocellularis. I. Characteristics of evoked head movements.

The nucleus reticularis gigantocellularis (NRG) receives monosynaptic input from the superior colliculus (SC) and projects directly to neck motor neuron pools. Neurons in NRG are well situated to play a critical role in transforming SC signals into head movement commands. A previous study of movements evoked by NRG stimulation in the primate reported a variety of ipsilateral and contralateral head movements with horizontal, vertical and torsional components. In addition to head movements, it was reported that NRG stimulation could evoke movements of the pinnae, face, upper torso, and co-contraction of neck muscles. In this report, the role of the rhesus monkey NRG in head movement control was investigated using electrical stimulation of the rostral portion of the NRG. The goal was to characterize head movements evoked by NRG stimulation, describe the effects of altering stimulation parameters, and assess the relative movements of the eyes and head. Results indicate that electrical stimulation in the rostral portion of the NRG of the primate can consistently evoke ipsilateral head rotations in the horizontal plane. Head movement amplitude and peak velocity depend upon stimulation parameters (primarily frequency and duration of stimulation trains). During stimulation-induced head movements the eyes counter-rotate (presumably a result of the vestibulo-ocular reflex: VOR). At 46 stimulation sites from two subjects the average gain of this counter-rotation was -0.38 (+/-0.18). After the end of the stimulation train the head generally continued to move. During this epoch, after electrical stimulation ceased, VOR gain remained at this reduced level. In addition, VOR gain was similarly low when electrical stimulation was carried out during active fixation of a visual target. These data extend existing descriptions of head movements evoked by electrical stimulation of the NRG, and add to the understanding of the role of this structure in producing head movements.

Animals↗

Efficacy of seven retrograde tracers, compared in multiple-labelling studies of feline motoneurones.

The labelling efficacies of 7 retrograde tracers were evaluated following cut nerve exposure or intramuscular injection into the serially compartmentalized neck muscle, biventer cervicis. Tested tracers included Fast Blue (FB), Fluorogold (FG), dextran conjugated to fluorescein (FD), dextran conjugated to rhodamine (Fluororuby (FR), 3000 and 10,000 MW), fluorescent latex microspheres, horseradish peroxidase coupled to colloidal gold, and 1,1'-dioctadecyl-3,3,3',3'-tetramethyl indocarbocyanine perchlorate (DiI). In 2 animals, horseradish peroxidase was also employed and spinal cords were processed for peroxidase activity to evaluate its effect on the appearance of cells labelled with fluorescent tracers. Four tracers, FB, FG, FD and FR, could be observed in motoneurones under the conditions of our study. FB and FG labelled comparable numbers of motoneurones following cut nerve exposure, but dissimilar numbers following intramuscular injection. FG diffused extensively following injection and was found in motoneurones not only in the appropriate ipsilateral segment but also adjacent ipsilateral and contralateral segments. Intramuscular injections of FB usually labelled fewer cells than cut nerve exposure, but evidence for spurious labelling following intramuscular injection could also be found. FD or FR labelled motoneurones following cut nerve exposure but not following intramuscular injection. The conjugated dextrans labelled more variable numbers of cells than FB or FG, but the labelled cells had similar patterns of distribution. The remaining tracers were ineffective as retrograde markers in our study, and the possible reasons for these failures are discussed.

Amidines↗

Cervical epidural steroid injection for cervicobrachialgia.

Fifty patients with chronic resistant cervicobrachialgia were randomly divided into two groups. Twenty-five patients (group A) were treated with cervical epidural steroid/lidocaine injections and 17 patients (group B) were treated with steroid/lidocaine injections into the posterior neck muscles. Another eight patients from group B were excluded from the study because they had started the process of litigation of insurance claims and their subjective analysis of pain relief might therefore not be trustworthy. One to three injections were administered at 2-week intervals according to the clinical response. All patients continued their various pre-study treatments: non-steroidal anti-inflammatory drugs, non-opioid analgesics and physiotherapy. Pain relief was evaluated by the visual analogue scale 1 week after the last injection and then 1 year later. One week after the last injection we rated pain relief as very good and good in 76% of the patients in group A, as compared to 35.5% of the patients in group B. One year after the treatment 68% of the group A patients still had very good and good pain relief, whereas only 11.8% of group B patients reported this degree of pain relief. These differences were statistically significant. We failed to achieve significant improvement of tendon reflexes or of sensory loss in both groups, but the increase in the range of motion, the fraction of patients who were able to decrease their daily dose of analgesics, and recovery of the capacity for work were significantly better in group A. We encountered no complications in either group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing.

Surface electrical stimulation is currently used in therapy for swallowing problems, although little is known about its physiological effects on neck muscles or swallowing. Previously, when one surface electrode placement was used in dysphagic patients at rest, it lowered the hyolaryngeal complex. Here we examined the effects of nine other placements in normal volunteers to determine 1) whether movements induced by surface stimulation using other placements differ, and 2) whether lowering the hyolaryngeal complex by surface electrical stimulation interfered with swallowing in healthy adults. Ten bipolar surface electrode placements overlying the submental and laryngeal regions were tested. Maximum tolerated stimulation levels were applied at rest while participants held their mouths closed. Videofluoroscopic recordings were used to measure hyoid bone and subglottic air column (laryngeal) movements from resting position and while swallowing 5 ml of liquid barium, with and without stimulation. Videofluoroscopic recordings of swallows were rated blind to condition using the National Institutes of Health-Swallowing Safety Scale. Significant (P < 0.0001) laryngeal and hyoid descent occurred with stimulation at rest. During swallowing, significant (P <or= 0.01) reductions in both the larynx and hyoid bone peak elevation occurred during stimulated swallows. The stimulated swallows were also judged less safe than nonstimulated swallows using the National Institutes of Health-Swallowing Safety Scale (P = 0.0275). Because surface electrical stimulation reduced hyolaryngeal elevation during swallowing in normal volunteers, our findings suggest that surface electrical stimulation will reduce elevation during swallowing therapy for dysphagia.

Adult↗

Visual and oculomotor responses induced by neck vibration in normal subjects and labyrinthine-defective patients.

Three-dimensional scleral search coil eye movement recordings were obtained in five normal subjects and four patients with absent vestibular function, during unilateral vibration of the neck in the supine position. The purpose of the experiments was to investigate any role played by eye movements in the illusion that a small fixation target, viewed in an otherwise dark room, moves when vibration is applied to the neck (propriogyral illusion). Vibration was applied to the right dorsal neck muscles in three visual conditions: total darkness, fixating a light-emitting diode (LED) in an otherwise totally dark room and LED fixation in the normally lit room. Normal subjects reported that during vibration, with LED fixation in an otherwise dark room, the target appeared to move predominantly leftwards and patients reported a predominantly downward movement. Eye movements were consistently elicited in all subjects. In normal subjects there was a slow-phase eye movement predominantly to the right, interrupted by nystagmic quick phases in the opposite direction, whereas in the patients slow phases were predominantly upward with quick phases downward. Eye movements were larger in the dark but the velocity of the initial slow-phase component (<200 ms) did not change with visual conditions. Mean latencies of the eye movements were typically 80 ms but in individual trials could be as short as 40- 60 ms. The eye movements were considerably larger in the patients (e.g. mean cumulative slow-phase displacement in the dark 12 degrees vs 2 degrees; maximum velocity ca. 5 degrees /s vs 1 degrees /s). These results indicate that the propriogyral illusion is secondary to vibration-induced eye movements, presumably mediated by the cervico-ocular reflex (COR). The difference in direction of the illusion and eye movements in the patients may be related to a predominant enhancement of the vertical COR, secondary to the prominent exposure to vertical retinal slippage experienced by these patients during daily activities such as locomotion.

Adult↗

[Muscle-tendon echography in acute cervical sprain traumas. Preliminary results].

Acute cervical sprain traumas can be divided into simple and severe, depending on the presence of organic lesions which can be documented by conventional radiologic techniques. Persistent painful symptomatology of the nape and the precise localization of pain, led us to suspect the presence of organic lesions due to tearing of the neck muscles in 94 patients who had suffered a simple cervical sprain. To demonstrate these post-traumatic lesions, the patients were subjected to US examinations of both the nape and the muscles at the base of the neck. In 13 cases (13.8%) muscular tearing lesions were demonstrated, which were characterized by hypoechoic lacunae (6 cases), by hyperechoic stripes (5 cases), and by muscular hernia (1 case); in 1 case, partial disconnection of a muscular insertion was demonstrated. Thus, we believe muscle-tendon US to be a valuable technique for both diagnostic and nosologic purposes, for the method allows simple cervical sprain to be discriminated from sprains which are complicated by organic muscular lesions. We suggest that the cervical sprain traumas where a muscular lesion due to tearing can be demonstrated be defined as "complex" traumas.

Adolescent↗

Neck, trunk and limb muscle responses during postural perturbations in humans.

This study examined the EMG onsets of leg, trunk, and neck muscles in 10 standing human subjects in response to support surface anterior and posterior translations, and to plantar and dorsiflexion rotations. The objective of the study was to test the hypothesis that the responses radiating upward from distal leg muscles represent part of a large ascending synergy encompassing axial muscles along the entire length of the body. If these responses are not ascending, then the muscles of the neck, and possibly the trunk, can be independently activated by vestibular, proprioceptive or visual inputs. We analysed the timing of postural muscle responses within and between body segments in order to determine whether they maintained a consistent temporal relationship under translational and rotational platform movement paradigms. Our results did not strongly support an ascending pattern of activation in all directions of platform perturbation. Temporal differences between activation patterns to platform perturbations in the forward or backward directions were revealed. In response to posterior platform translations we observed an ascending pattern of muscle responses along the extensor surface of the body. In addition, responses elicited in the neck flexor and abdominal muscles occurred as early as those of the stretched ankle muscles. This pattern of upward radiation from stretched ankle muscles was not as clear for anterior platform displacements, where early neck flexor muscle responses were observed during the ascending sequence on the flexor surface of the body. Platform rotations caused fewer responses in the neck and upper trunk muscles than translations, and all muscles responses occurred simultaneously rather than sequentially. Probable differences in the stimulation of vestibular and neck proprioceptive inputs and the mechanical demands of the rotation and translation paradigms are discussed.

Adult↗

Systemic carnitine deficiency with peripheral nerve involvement morphological and biochemical study.

The patient, a 31-year-old woman, suffered from a weakness of the proximal muscles which subsequently worsened involving the spinal and neck muscles. During the hospitalization, the patient displayed a "burning feet" syndrome. Lab tests showed a moderate increase in CPK, Aldolase, SGPT, SGOT, lactic and pyruvic acids. Needle EMG was interpreted as "myopathic" but a marked reduction of sensitive action potentials was also detected. Muscle biopsy showed neutral lipid accumulation in muscle fibers, many small angular fibers, probably denervated ones were also evident. A liver biopsy showed fatty accumulation in hepatocytes. Free carnitine was extremely reduced in muscle and liver and just below normal level in plasma while there was a tenfold elevation of long-chain carnitine esters in plasma too. The mechanism by which carnitine deficiency can cause both neural and muscular alterations and in particular the role of carnitine in glucose metabolism is discussed.

Adult↗

Neck and shoulder muscle activity and thorax movement in singing and speaking tasks with variation in vocal loudness and pitch.

The aim of this study was to examine respiratory phasing and loading levels of sternocleidomastoideus (STM), scalenus (SC), and upper trapezius (TR) muscles in vocalization tasks with variation in vocal loudness and pitch. Eight advanced singing students, aged 22 to 28 years, participated. Surface electromyographic (EMG) activity was recorded from STM, SC, and TR. Thorax movement was detected by two strain gauge sensors placed around the upper (upper TX) and lower (lower TX) thorax. A glissando and simplified singing and speaking tasks were performed. Sustained vowels /a:-i-ae-o:/ were sung in a glissando from lowest to highest pitch (mixed voice/falsetto) back to lowest pitch and in short singing sequences at comfortable, low, and high pitches. The same vowels were spoken softly and loudly for about the same length. The subjects inhaled between the vowels. It was concluded that the inspiratory phased STM and SC muscles produced a counterforce to compression of upper TX at high pitches in glissando. STM and SC were activated to higher levels during phonation than in inhalation. As breathing demands were reduced, STM and SC activity was lowered and the respiratory phasing of peak amplitude changed to inhalation. TR contributed to exhalation in demanding singing with long breathing cycles, but it was less active in singing tasks with short breathing cycles and was essentially inactive in simplified speaking tasks.

Adult↗

Botulinum toxin A for the treatment of chronic neck pain.

A clinical study tested the therapeutic efficacy of Botulinum toxin A (BTXA) when injected into symptomatic neck muscles after one injection session. Patients with chronic neck pain were randomly assigned to receive either a high dose of an active treatment or an injection of the same volume of normal saline. Patients were compared for 4 months using a comprehensive set of outcome measures that included the Neck Pain and Disability Scale (Spine 24 (1999) 1290) and pressure algometry (Arch Phys Med Rehabil 67 (1986) 406; Pain 30 (1987) 115; Clin J Pain 2 (1987) 207). Analyses were consistent in showing significant benefits from the injection session; however, the effects were not specific to the group treated with BTXA. Both treatment and control groups showed a significant decline in pain and disability across time and an increased ability to withstand pressure on trigger points. The heavy incidence of adverse events in the treatment group may partly explain the absence of a treatment effect specific to BTXA. The results show that a single dose treatment without physical therapy is not effective for chronic neck pain.

Adult↗

Localization of Trichinella spiralis in muscles of commercial and parasitologic interest in pork.

Trichinellosis is widespread around the world with different representatives of the genus Trichinella found in almost every continent. In Argentina the main source of transmission for the disease to humans is pig meat infected with Trichinella spiralis. The object of this work was to determine the distribution of Trichinella larvae in fresh meat cuts which are sold for human consumption and in the muscles traditionally used for the disease diagnosis at meat-packing plants. Cranial muscles to the last rib showed more Trichinella spiralis larvae than those with a caudal location (p < 0.01). No significant differences were found (p > 0.05) between bilateral left and right muscles. Significant larval concentrations were found in the neck muscles, even in carcasses with a low parasitic load; these muscles are used to prepare cold meats (boston butt). Commercial cuts of meat had a substantial larval burdens in animals experimentally infected with 500 to 5,000 Trichinella spiralis larvae, with parasite burdens similar to infection levels in muscles evaluated at the meat packing plant.

Animals↗