Influences of neck receptors on soleus motoneuron excitability in man

We studied the influence of the asymmetric tonic neck reflexes on the excitability of the human soleus motoneuronal pool by mapping the H amplitude as a function of rotation of the body relative to the fixed head. Eight normal adult volunteers were tested. On each subject 15 consecutive H reflexes were recorded from the right soleus muscle, for each of the following test position, 4 degrees, 8 degrees, 12 degrees, 16 degrees, as well as at the control position (0 degrees), both before and after each change in body position. Our results showed that the H reflex amplitude was progressively facilitated for contralateral rotation in respect to the recording side and conversely inhibited for ipsilateral rotation. The results indicate that neck receptors of one side enhance the excitability of the contralateral soleus motoneurons and depress the ipsilateral ones.     

Head deviation in progressive supranuclear palsy: enhanced vestibulo-collic reflex or loss of resetting head movements?

It is unclear how the torticollis occasionally observed in patients with progressive supranuclear palsy (PSP) relates to vestibulo-collic reflex mechanisms. We report here the results of vestibular evoked myogenic potentials (VEMPs) in a PSP patient with forced head deviation in the opposite direction of turning, leading to torticollis for a few seconds. As VEMPs were normal bilaterally we conclude that an enhanced vestibulo-collic reflex per se is not the cause of the torticollis in our patient. The abnormal head deviation induced by turning in some PSP patients is best explained by damage to reticular nuclei responsible for resetting eye and head saccades. When such mechanisms are defective, unopposed vestibulo-collic reflexes can lead to eye and head deviations in the opposite direction of body turns.     

The horizontal and vertical cervico-ocular reflexes of the rabbit

Horizontal and vertical cervico-ocular reflexes of the rabbit (HCOR, VCOR) were evoked by sinusoidal oscillation of the body about the vertical and longitudinal axes while the head was fixed. These reflexes were studied over a frequency range of 0.005–0.800 Hz and at stimulus amplitudes of± 10°. When the body of the rabbit was rotated horizontally clockwise around the fixed head, clockwise conjugate eye movements were evoked. When the body was rotated about the longitudinal axis onto the right side, the right eye rotated down and the left eye rotated up. The mean gain of the HCOR (eye velocity/body velocity) rose from 0.21 and 0.005 Hz to 0.27 at 0.020 Hz and then declined to 0.06 at 0.3 Hz. The gain of the VCOR was less than the gain of the HCOR by a factor of 2–3. The HCOR was measured separately and in combination with the horizontal vestibulo-ocular reflex (HVOR). These reflexes combine linearly. The relative movements of the first 3 cervical vertebrate during stimulation of the HCOR and VCOR were measured. For the HCOR, the largest angular displacement (74%) occurs between C₁ and C₂. For the VCOR, the largest relative angular displacement (45%) occurs between C₂ and C₃. Step horizontal clockwise rotation of the head and body (HVOR) evoked low velocity counterclockwise eye movements followed by fast clockwise (resetting) eye movements. Step horizontal clockwise rotation of the body about the fixed head (HCOR) evoked low velocity clockwise eye movements which were followed by fast clockwise eye movements. Step horizontal clockwise rotation of the head about the fixed body (HCOR + HVOR) evoked low velocity counterclockwise eye movements which werenot interrupted by fast eye clockwise movements. These data provide further evidence for a linear combination of independent HCOR and HVOR signals.     

Vestibulo-ocular reflex (VOR), cervico-ocular reflex (COR) and its interaction in active head movements

In normal adults the vestibulo-ocular reflex (VOR) and the cervico-ocular reflex (COR) were investigated during passive and active head or body movements, respectively. Sinusoidal rotations around the vertical axis of the body at frequencies of 0.05, 0.1, and 0.2s-1 and total amplitudes of 20 degrees, 40 degrees, 60 degrees, or 80 degrees were employed. The average eye deviations (Schlagfeld) during VOR were directed opposite to the direction of the head turning. During COR, however, slow eye deviations of higher amplitude were anticompensatory relative to the fixed head. During active head turnings the average eye deviations showed the same anticompensatory direction as in COR, but were still larger. The increased with stimulus amplitudes up to 60 degrees. At least a weak cervical nystagmus was elicited in all subjects, with its fast phases beating in the direction of the relative head movement. Its gain reached marked values up to 0.5, but only for peak stimulus velocities below 25%. The nystagmus gain during active head turnings was only slightly higher than during VOR. With higher stimulus velocities, large anticompensatory saccades appeared just before the change of stimulus direction; these are typical for active head movements, but were also found during COR.     

Tonic cervical influences on eye nystagmus following hemilabyrinthectomy: immediate and plastic effects

In intact guinea pigs a passive horizontal rotation of the body about the fixed head induces compensatory ocular movements (cervico-ocular reflex). When the static neck deviation is maintained, a significant ocular displacement is observed. In acutely hemilabyrinthectomized animals, static body deviation towards the lesion side tonically alters eyenystagmus. It affects slow phase eye velocity and quick phase amplitude and frequency causing the eye to reach a less eccentric orbital position. Apart from such immediate influences, a plastic effect on eye nystagmus abatement is induced. In the animals restrained with no body-on-head deviation, abatement of nystagmus is delayed with respect to the animals restrained with 35° body deviation towards the lesion side. Thus the head position signal is not only a contributing factor for the correction of postural deficits but also influences the time course of the ocular balancing process following unilateral vestibular damage.     

Are Covert Saccade Functionally Relevant in Vestibular Hypofunction?

The vestibulo-ocular reflex maintains gaze stabilization during angular or linear head accelerations, allowing adequate dynamic visual acuity. In case of bilateral vestibular hypofunction, patients use saccades to compensate for the reduced vestibulo-ocular reflex function, with covert saccades occurring even during the head displacement. In this study, we questioned whether covert saccades help maintain dynamic visual acuity, and evaluated which characteristic of these saccades are the most relevant to improve visual function. We prospectively included 18 patients with chronic bilateral vestibular hypofunction. Subjects underwent evaluation of dynamic visual acuity in the horizontal plane as well as video recording of their head and eye positions during horizontal head impulse tests in both directions (36 ears tested). Frequency, latency, consistency of covert saccade initiation, and gain of covert saccades as well as residual vestibulo-ocular reflex gain were calculated. We found no correlation between residual vestibulo-ocular reflex gain and dynamic visual acuity. Dynamic visual acuity performance was however positively correlated with the frequency and gain of covert saccades and negatively correlated with covert saccade latency. There was no correlation between consistency of covert saccade initiation and dynamic visual acuity. Even though gaze stabilization in space during covert saccades might be of very short duration, these refixation saccades seem to improve vision in patients with bilateral vestibular hypofunction during angular head impulses. These findings emphasize the need for specific rehabilitation technics that favor the triggering of covert saccades. The physiological origin of covert saccades is discussed.     

Vestibulo-ocular reflex (VOR), cervico-ocular reflex (COR) and its interaction in active head movements

Summary In normal adults the vestibulo-ocular reflex (VOR) and the cervico-ocular reflex (COR) were investigated during passive and active head or body movements, respectively. Sinusoidal rotations around the vertical axis of the body at frequencies of 0.05, 0.1, and 0.2 s^–1 and total amplitudes of 20°, 40°, 60°, or 80° were employed.The average eye deviations (Schlagfeld) during VOR were directed opposite to the direction of the head turning. During COR, however, slow eye deviations of higher amplitude were anticompensatory relative to the fixed head. During active head turnings the average eye deviations showed the same anticompensatory direction as in COR, but were still larger. They increased with stimulus amplitudes up to 60°.At least a weak cervical nystagmus was elicited in all subjects, with its fast phases beating in the direction of the relative head movement. Its gain reached marked values up to 0.5, but only for peak stimulus velocities below 25°/s. The nystagmus gain during active head turnings was only slightly higher than during VOR.With higher stimulus velocities, large anticompensatory saccades appeared just before the change of stimulus direction; these are typical for active head movements, but were also found during COR.Supported by Sonderforschungsbereich Hirnforschung und Sinnesphysiologie (SFB 70) der Deutschen Forschungsgemeinschaft (DFG)     

Labyrinth and neck reflex modification of the tonic vibration reflex in the decerebrate cat

The interaction between tonic labyrinth or neck reflexes and the tonic vibration reflex acting on the medial head of triceps in the decerebrate cat is described. Medial triceps was isotonically loaded and reflex actions were measured as changes in muscle length. Natural stimulation of the receptors giving rise to tonic labyrinth or neck reflexes can either enhance or diminish the size of a pre-existing tonic vibration reflex. It is also shown that descending activity from either the labyrinth or neck reflex systems can completely suppress the tonic vibration reflex, whereas the tonic vibration reflex was never observed to suppress an established labyrinth or neck reflex.     

Studies of parkinsonian movement: 2. Initiation of fast voluntary eye movement during postural disturbance

Delay in initiation of rapid voluntary eye movements (saccades) in brady-kinetic parkinsonian patients and normal subjects was recorded with and without postural disturbances (rotation of the body and head).
Parkinsonian patients as a group exhibited longer delays in the initiation of saccades. The delay increased during postural disturbance in both the patients and the normal subjects.
The study failed to substantiate the hypothesis that postural reflexes interfere with the initiation of voluntary movement in Parkinsonism.     

Flexor reflexes in chronic spinal cord injury triggered by imposed ankle rotation

Hypersensitivity of the flexor reflexes to input from force-sensitive muscle afferents may contribute to the prevalence and severity of muscle spasms in patients with spinal cord injuries. In the present study, we triggered flexor reflexes with constant-velocity ankle movements into end-range dorsiflexion and plantarflexion positions in 8 individuals with spinal cord injuries. We found that all 8 subjects had coordinated increases in flexion torque at the hip and ankle following externally imposed plantarflexion movements at the ankle. In addition, end-range dorsiflexion movements also triggered flexor reflexes in 3 subjects, although greater loads were required to trigger such reflexes using dorsiflexion movements (compared to plantarflexion movements). These three-joint reflex torque patterns triggered by ankle movement were broadly comparable to flexion withdrawal responses elicited by electrocutaneous stimuli applied to a toe, although the amplitude of the torque response was generally lower. We conclude that excitation of muscle and joint-related afferents induced by end-range movements may be responsible for exaggerated flexion reflex responses in spinal cord injury.     

Modulation of flexor carpi radialis H reflex by lateral tilts in man

Static vestibular influences on upper limb flexor tone were studied in man by analyzing the changes in flexor carpi radialis H reflex area with lateral tilting of the longitudinal body axis. Ten healthy volunteers and 2 labyrinthine defective patients were tested in an experimental situation designed to minimize all afferent inputs except vestibular ones. Each subject was seated on a chair which could be tilted laterally to the left or the right from the vertical. Head and trunk were fixed upright, upper and lower limbs in half-flexed position and forearm in an intermediate position between supination and pronation. Lateral tilting was applied at random from the vertical (0 degrees control position) to left and right (4 degrees, 8 degrees, 12 degrees, 16 degrees, 20 degrees test positions). Each test position was followed by a return to 0 degrees and in each control and test position 20 consecutive H reflexes were recorded. The data observed in the normal subjects showed flexor tone inhibition in the arm which was tilted downwards and facilitation in the contralateral arm. These findings suggest that in man, like in animals, labyrinth reflexes act asymmetrically and in the opposite direction to neck reflexes.     

The participation of forelimb flexors in labyrinth and neck reflexes in the decerebrate cat

The reflex behaviour of triceps and biceps brachii was assessed by EMG recordings during natural labyrinth or neck stimulation. Labyrinth reflexes resulting from changes in head position are antagonistic to those resulting from changes in neck position. Reflexes recorded from biceps were reciprocal to those recorded in ipsilateral triceps and symmetrical to those from contralateral triceps. A scheme of labyrinth and neck reflexes involving forelimb flexors is presented.     

Eye movements in patients with absent voluntary horizontal gaze

Despite the complete absence of horizontal saccades, two patients with pontine gliomas had horizontal reflex eye movements within a range of +/- 20 degrees. The gain (peak eye velocity/peak stimulus velocity) and phase of the vestibulo-ocular reflex were normal, but the optokinetic gain was decreased. The latency, accuracy, and peak velocity of vertical saccades were normal. Apparently the voluntary gaze centers in the pontine reticular formation are not crucial for generating horizontal vestibular or vertical saccadic eye movements.     

Abnormality of vergence latency in children with vertigo

Abstract. It is well known that vergence movements are important for distance appreciation, depth vision and stereopsis. Moreover, vergence movements are very probably used by the CNS during head and body motion to adjust the gain of the vestibulo-ocular reflex (VOR) according to the viewing distance. A recent clinical study of Anoh-Tanon et al. suggested that vertigo in children with normal vestibular function could be associated with abnormal vergence clinically assessed. The purpose of this study was to test this hypothesis with objective vergence eye movement recordings. We examined the latency of vergence, saccades and combined movements in twelve children with the complaint of vertigo but without vestibular abnormality. Convergence and saccades combined with convergence or with divergence had abnormally long latencies (relative to normal children of matched age). In contrast, divergence and isolated saccades showed only mild latency increase relative to normals. Lengthening of latency could be due to impaired cortical control. Orthoptic vergence training reduced all latencies; however, even the reduced latency of vergence and of combined movements was still abnormal. The improvement after orthoptic vergence training could be due to increased visual attention, although such mechanism cannot eliminate completely the initiation deficit of vergence movements. Objective eye movement recordings are thus useful for a diagnosis and treatment of children with vertigo.     

Semicircular canal occlusion causes permanent VOR changes

We measured the guinea pig horizontal vestibulo-ocular reflex (hVOR) to high acceleration impulsive head rotations following a unilateral lateral semicircular canal (LSCC) occlusion. We found a significant hVOR deficit for rotations toward the side of the occluded LSCC and this deficit did not show systematic changes over 3 months. We considered the LSCC nerve was still functional as shown by the normal appearance of the crista of the LSCC ampulla and also electrical stimulation of the LSCC. We conclude that the VOR during angular acceleration in response to high acceleration shows no adaptive plasticity following a unilateral LSCC occlusion.     

Trigeminocervical reflexes elicited by stimulation of the infraorbital nerve: head retraction reflex.

In the current study, the effects of stimulation of the infraorbital nerve (ION) on the trigeminocervical reflexes (TCRs), recorded from the posterior neck muscles, was investigated and the results were compared with the results recorded by stimulation of the supraorbital nerve (SON). TCRs obtained by stimulation of the ION was evaluated as the electrophysiologic counterpart of the head retraction reflex. Twenty normal control subjects, 10 men and 10 women, were enrolled in the study. The SON and the ION were stimulated by using a bipolar surface electrode. Results were recorded by using either concentric needle electrodes inserted into the semispinalis capitis muscle at the level of the third or fourth cervical vertebra or by surface electrodes placed at the C3 and C7 vertebrae on the midline. It was found that stimulation of the supraorbital and infraorbital branches of the trigeminal nerve had different reflexive effects on the posterior neck muscles. A stable positive (or negative-positive) wave, with a very early latency and high amplitude was always recorded after maximal stimulation of the ION, which could never be detected by stimulation of the SON. The C3 response of the TCR, evoked by SON stimulation was always evoked, by stimulation of the ION, at a low threshold. These findings suggest that the head retraction reflex is composed of two phases: inhibitory and excitatory. The early, fixed positive wave represents the general inhibition of the cranial and neck muscles, just before withdrawal of the face and head, from unexpected stimuli, which precedes the dense C3 response, demonstrating activation of the posterior neck muscles.     

Optokinetic eye and head movements in the unrestrained cat

Eye and head movements of the unrestrained and alert cat were measured with the search coil technique. Optokinetic responses were elicited by a moving random dot pattern. With the head free, slow phase gaze velocity (SPGV) during optokinetic nystagmus (OKN) was not faster than slow phase eye velocity (SPEV) with the head fixed neither with binocular nor with monocular stimulation. Cats with the head free also showed a directional asymmetry of SPGV during monocular stimulation with higher gain values for slow phases from temporal to nasal as compared to slow phases from nasal to temporal. Eye, head and body movements contributed to SPGV to a varying degree. Although SPGV remained rather constant (comparable to the head-fixed condition), the relative contributions of head velocity and eye velocity could fluctuate strongly. During the resetting saccades, the head ended its fast phase later than the eye (102 ± 46 ms). During this period, the eye compensated the remaining part of the fast phase of the head and simultaneously executed an already new slow phase of gaze. It is discussed whether the cerebellar flocculus might provide a system to achieve constant gaze during OKN.     

Motor functions: associated primitive reflex profiles

The results of reflex/motor activity interactions in 177 normal infants are evaluated. The asymmetrical tonic neck reflex, tonic labyrinthine reflex-supine, and Moro reflexes were assessed for each child at birth and at intervals up to 12 months. Ages of rolling prone to supine, rolling supine to prone, and sitting alone were elicited from parents. The effects of the primitive reflexes on early motor activity were assessed, and statistically significant correlations were demonstrated between decreased reflex activity and the emergence of motor milestones. The distinctive association of reflex activity with motor function suggests the interaction of several reflexes (a primitive reflex profile) rather than the influence of isolated reflex activity. Such patterns support the hypothesis that decreasing primitive reflex activity is associated with the onset of volitional motor activity in normal infants.     

Identification and assessment of factors contributing to variability of the jaw jerk

Unlike limb monosynaptic reflexes, the jaw jerk reflex (JJR) is extremely variable. We studied 35 healthy adults to determine the relative contributions of extrinsic and intrinsic factors underlying this variability. Each subject sat in a dental chair with his head and chin securely stabilized. Chin taps, delivered by a solenoid-driven plunger, were quantified with a piezo-transducer. The reflex response was recorded from surface electrodes over the right masseter muscle. A nasal thermistor signalled phases of respiration. Five of the 35 subjects had no reflex when relaxed, but during 15° neck extension or voluntary contraction of the platysma muscle, a JJR appeared. The amplitude of the reflex varied considerably from trial to trial in all but one subject. A small component of this variability was due to minute changes in tap force despite head and chin stabilization and stimulus uniformity. Mean amplitudes of the reflex tended to increase with increases in tap force, but variability was large indicating intrinsic fluctuations in motoneuron excitability. Voluntary contraction of the platysma muscle and 15° neck extension reliably enhanced the reflex. The JJR showed negligible respiratory modulation during quiet breathing. The reflex's variability in and among subjects precludes the use of the JJR as an index of masseteric motoneuron excitability. Our findings suggest that branchial motoneurons innervating the masticatory muscles receive far more diverse and fluctuating inputs than do somatic motoneurons innervating limb muscles.     

Tonic neck reflexes on upper limb flexor tone in man

The asymmetric tonic neck reflexes on upper limbs in man have been studied by analyzing the changes in flexor carpi radialis H-reflex amplitude following body rotation around the longitudinal axis with a stationary head. In eight normal subjects 15 consecutive H-reflexes were recorded from the right flexor carpi radialis muscle at each test position. The tested body rotation angles were 4, 8, 12, 16, and 20 degrees both to the right side and to the left side. Before and after each test position 15 H-reflexes were recorded at 0 degrees. The linear correlation coefficient r, computed by plotting the H-reflex amplitudes against the relevant body rotation angles, was significant in all the subjects. The FCR H-reflex amplitude increased with contralateral body rotation (i.e., ipsilateral head rotation) and decreased with ipsilateral body rotation (i.e., contralateral head rotation). It has been suggested that these findings, which are opposite to those observed in animal experiments, are the consequence of the acquired antigravity function of upper limb flexor muscles in man.