Activity of primate putamen neurons is selective to the mode of voluntary movement: visually guided,self-initiated or memory-guided

Summary The aim of this report was to investigate the neural processes of movement initiation and control in which the basal ganglia play an essential role. Single-neuron activity was recorded in the putamen of monkeys performing learned arm movements initiated in three different modes: sensorially guided, internally-timed self-initiated and memory guided. There were no significant differences in the magnitude and timing of both prime mover and supporting muscle activity between the three modes of movement. Over half of the task-related neurons showed strong activity in one of the three modes of movement initiation, but were only slightly activated in the other two modes. No clear preference for a particular movement mode was evident in the population of putamen neurons as a whole. These results are consistent with the hypothesis that there are heterogeneous groups of neurons in the putamen, and that each group of neurons participates in retrieving a different kind of information required for movement based on either external sensory events or on internally stored information.     

Clinical reasoning for manual therapy management of tension type and cervicogenic headache

In recent years, there has been an increasing knowledge in the pathogenesis and better management of chronic headaches. Current scientific evidence supports the role of manual therapies in the management of tension type and cervicogenic headache, but the results are still conflicting. These inconsistent results can be related to the fact that maybe not all manual therapies are appropriate for all types of headaches; or maybe not all patients with headache will benefit from manual therapies. There are preliminary data suggesting that patients with a lower degree of sensitization will benefit to a greater extent from manual therapies, although more studies are needed. In fact, there is evidence demonstrating the presence of peripheral and central sensitization in chronic headaches, particularly in tension type. Clinical management of patients with headache needs to extend beyond local tissue-based pathology, to incorporate strategies directed at normalizing central nervous system sensitivity. In such a scenario, this paper exposes some examples of manual therapies for tension type and cervicogenic headache, based on a nociceptive pain rationale, for modulating central nervous system hypersensitivity: trigger point therapy, joint mobilization, joint manipulation, exercise, and cognitive pain approaches.     

Trigger Finger Release With Stepwise Preservation of the A1 Pulley: A Functional Pulley-Preserving Technique

The first annular (A1) pulley is an important structure of the hand, providing a biomechanical support to the metacarpophalangeal joint and maintaining joint stability and flexor tendon alignment. Albeit uncommon, disruption of this pulley can result in dislocation or ulnar drift of the digit, particularly pronounced in patients with rheumatoid arthritis. Despite this, the A1 pulley is commonly divided without reconstruction in trigger finger. Several annular pulley reconstructive techniques have been developed to preserve its function. However, development of recurrent triggering has been observed due to fibrosis, largely due to inadequate release of the pulley. We have developed a technique to increase the volume within the flexor sheath while preserving the A1 pulley by way of stepwise lengthening. This has enabled an increase in the diameter of the pulley to 4 times its original size. A prospective study was performed comprising 10 trigger finger releases with stepwise lengthening of the A1 pulley. In all patients, there were no complications, and good hand function was achieved with no recurrence of triggering at 6 weeks of follow-up. This technique can thus safely achieve trigger release without sacrifice of the function of the A1 pulley.     

Relationship among Cervical Spine Degeneration,Head and Neck postures,and Myofascial Pain in Masticatory and Cervical Muscles in Elderly with Temporomandibular Disorder

ObjectivesThe aim of the study was to verify associations among degenerative changes in the cervical spine, head and neck postures, and myofascial pain in the craniocervical musculature in elderly with myofascial temporomandibular disorders (TMDs).MethodsA total of 120 participants (mean age, 68.3 ± 7.5 years) were included: 45 participants had no signs of orofacial or cervical pain, 26 participants had myofascial TMD only (mTMD), and 49 participants had both myofascial TMD and cervical pain (cerTMD). Participants were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Cervical spine degeneration and head and neck postures were identified using the lateral cephalogram. Myofascial trigger points (TrPs) were evaluated in the temporalis, masseter, trapezius, sternocleidomastoid, sub-occipitalis, and splenius capitis muscles. Relationships among number of TrPs, head postures, and cervical degeneration were investigated using repeated-measure analysis of variance and Pearson’s correlation coefficient.ResultsThe cerTMD showed higher number of active TrPs in the masticatory and cervical muscles, greater forward head posture, and more severe degenerative changes in the cervical spine than mTMD did. The degenerative changes in each level of the cervical spine had complex interactions with head postures. Cervical degeneration, particularly at level of second to third vertebra appeared to be linked to the development of active TrPs in the masticatory and cervical muscles.ConclusionsThe results of this study demonstrated that degenerative changes in the cervical spine were related to altered head postures and the development of active TrPs in the craniocervical musculature in elderly with myofascial TMD.     

A critical overview of the current myofascial pain literature – January 2018

The majority of papers included in the quarterly review discuss various aspects of dry needling (DN), which continues to be of interest to researchers and clinicians. A study by Liu et al. is the first paper to examine the effects of DN of acetylcholine, esterase and receptors. The study provides support for the integrated trigger point hypothesis and for DN. A paper by Hightower and colleagues found an intriguing link between low magnesium levels in the drink water supply, vitamin D, and myofascial pain, cancer, tendon ruptures, and colon polyps. Contributions originated in the Brazil, China, Germany, Iran, India, Poland, South Korea, Spain, Taiwan, Turkey, and the US.     

Different hypersensitivities against homologous proteins of MGL_1304 in patients with atopic dermatitis

Background

Atopic dermatitis (AD) is exacerbated by sweating, and the skin of most patients with AD are resided by Malassezia (M.) fungi. Recently, MGL_1304 produced by Malassezia globosa was identified as the major histamine releasing antigen in human sweat.