title: Trigemino-cervical reflex in spinal cord injury.
abstract: Abnormal enhancement of polysynaptic brainstem reflexes has been previously reported in patients with spinal cord injury (SCI). We aimed to investigate trigemino-cervical reflex (TCR) in SCI since it may reflect alterations in the connections of trigeminal proprioceptive system and cervical motoneurons. Consecutive 14 patients with SCI and 16 healthy subjects were included in this study. All patients were in the chronic phase. TCR was recorded over sternocleidomastoid (SCM) and splenius capitis (SC) muscles by stimulation of infraorbital nerve. We measured onset latency, amplitudes and durations of responses and compared between groups. We obtained stable responses over both muscles after one sided stimulation in healthy volunteers whereas probability of TCR was decreased in patients over both SCM (78.6% vs. 100%, p=0.050) and SC (71.4% vs. 100%, p=0.022). The absence of TCR was related to use of oral baclofen (≥50mg/day). However, when present, responses of SCI group had higher amplitudes and were more persistent. We demonstrated that TCR probability was similar to healthy subjects in SCI patients who used no or low dose oral baclofen. But it had higher amplitudes and longer durations. It was not obtained in only two patients who used oral baclofen more than 50mg/day.
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: draysegulgunduz@yahoo.com.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Gündüz
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Uzun
authors.affiliation: Department of Physical Therapy and Rehabilitation, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Nurettin İrem
authors.initials: Nİ
authors.lastname: Örnek
authors.affiliation: Department of Physical Therapy and Rehabilitation, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Ünalan
authors.affiliation: Department of Physical Therapy and Rehabilitation, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Şafak Sahir
authors.initials: ŞS
authors.lastname: Karamehmetoğlu
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Meral E
authors.initials: ME
authors.lastname: Kızıltan
mesh_terms: D000328:Adult; D001418:Baclofen / Q000494:pharmacology; D016022:Case-Control Studies; D004558:Electric Stimulation; D005260:Female; D018755:GABA Agonists / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D009333:Neck / Q000294:innervation; D012018:Reflex; D013116:Spinal Cord / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014276:Trigeminal Nerve / Q000503:physiopathology*
chemical_list: D018755:GABA Agonists; D001418:Baclofen
keywords: Baclofen; Brainstem reflexes; Spasticity; Spinal cord injury; Spinal trauma; Trigemino-cervical reflex