Electrophysiological assessment of the cranial reflexes

Electrophysiological assessment methods play a key role in the diagnosis of various neurological disorders. Electrophysiological evaluation of cranial reflexes is particularly valuable for neurologists. This article provides an overview of electrophysiological evaluation methods for cranial reflexes, which are most commonly used in clinical practice. They provide objective assessment of the functional integrity of nervous system structures that make up the cranial reflex arc, identify the level and, in some cases, the nature of disease, as well as pathophysiological mechanisms of central and peripheral nervous system disorders. We describe the instruments and main approaches to analysing the results for the standard blink reflex, blink reflex with prepulse inhibition, blink reflex with paired stimuli and recovery curve evaluation, reflex inhibition of the levator palpebrae superioris, jaw jerk reflex, and reflex inhibition (cutaneous silent period) of the masseter muscle.

Fatigue-induced modulation of human soleus H-reflex in conditions of pair tibial nerve stimulation in untrained and trained people

Monosynaptic reflex indices peculiarities, concerned with adaptative reactions to the long-term physical exercise, might add new data about mechanisms of human nervous system plasticity. The objective of the research was to investigate the influence of fatigue on human soleus H (Hoffmann) reflex in conditions of pair stimulation of tibial nerve with inter stimulus interval 500 m sin tenun trained people (age: M = 25,3, SE = 1,6 years) and ten trained athletes (age: M = 20,5, SE = 0,5 years). H-reflex study was performed using neurodiagnostic complex Nicolet Biomedical Viking Select (Viasys Health care, USA) at rest: before and after long-lasting isometric voluntary contraction of calf muscle, which caused the soleus muscle fatigue; the muscle force was equal to 75 % of maximal voluntary contraction. Test and conditioned responses (by means of stimulation with first and second impulses from pair) were registered. Homosynaptic postactivation depression (HPAD), associated with pair stimulation of tibial nerve, led to 56 % and 51 % inhibition of H-reflex in untrained and trained people at rest, respectively (p < 0,05). After fatiguing voluntary contraction the amplitudes of test and conditioned soleus H-reflex were both reduced approximately in half. Then both H-reflex amplitudes subsequently recovered, more rapidly in trained people. Soleus H-reflex inhibition might be due to the activation of the groups III and IV afferent nerves under the influence of mechanical and metabolic changes in the muscle. It was also found that HPAD H-reflex inhibition intensity increased by 20 % in untrained people and by 15 % in trained ones at 90 s after fatiguing voluntary contraction (p < 0,05). It is assumed that complex influence of fatigue and homosynaptic postactivation depression was more pronounced in untrained people in comparison with trained ones. It can be ascribed to athletes adaptation to the long-term physical exercise.

Reflex response to airway occlusion in human inspiratory muscles when recruited for breathing and posture

Briefly occluding the airway during inspiration produces a short-latency reflex inhibition in human inspiratory muscles. This occlusion reflex seems specific to respiratory muscles; however, it is not known whether the reflex inhibition has a uniform effect across a motoneuron pool when a muscle is recruited concurrently for breathing and posture. In this study, participants were seated and breathed through a mouthpiece that occluded inspiratory airflow for 250 ms at a volume threshold of 0.2 liters. The reflex response was measured in the scalene and sternocleidomastoid muscles during 1) a control condition with the head supported in space and the muscles recruited for breathing only, 2) a postural condition with the head unsupported and the neck flexors recruited for both breathing and to maintain head posture, and 3) a large-breath condition with the head supported and the volume threshold raised to between 0.8 and 1.0 liters to increase inspiratory muscle activity. When normalized to its preocclusion mean, the reflex response in the scalene muscles was not significantly different between the large-breath and control conditions, whereas concomitant recruitment of these muscles for posture control reduced the reflex response by half compared with the control condition. A reflex response occurred in sternocleidomastoid when it contracted phasically as an accessory muscle for inspiration during the large-breath condition. These results indicate that the occlusion reflex does not produce a uniform effect across the motoneuron pool and that afferent inputs for this reflex most likely act via intersegmental networks of premotoneurons rather than at a motoneuronal level. NEW & NOTEWORTHY In this study, we investigated the effect of nonrespiratory activity on the reflex response to brief sudden airway occlusions in human inspiratory muscles. We show that the reflex inhibition in the scalene muscles was not uniform across the motoneuron pool when the muscle was recruited concurrently for breathing and postural control. The reflex had a larger effect on respiratory-driven motoneurons than those recruited to maintain head posture.