title: Trigeminal cardiac reflex: new thinking model about the definition based on a literature review.
abstract: Trigeminocardiac reflex (TCR) is a brainstem reflex that manifests as sudden onset of hemodynamic perturbation in blood pressure (MABP) and heart rate (HR), as apnea and as gastric hypermotility during stimulation of any branches of the trigeminal nerve. The molecular and clinical knowledge about the TCR is in a constant growth since 1999, what implies a current need of a review about its definition in this changing context. Relevant literature was identified through searching in PubMed (MEDLINE) and Google scholar database for the terms TCR, oculocardiac reflex, diving reflex, vasovagale response. The definition of the TCR varies in clinical as well as in research studies. The main difference applies the required change of MABP and sometimes also HR, which most varies between 10% and 20%. Due to this definition problem, we defined, related to actual literature, 2 major (plausibility, reversibility) and 2 minor criteria (repetition, prevention) for a more proper identification of the TCR in a clinical or research setting. Latest research implies that there is a need for a more extended classification with 2 additional subgroups, considering also the diving reflex and the brainstem reflex. In this review, we highlighted criteria for proper definition and classification of the TCR in the light of increased knowledge and present a thinking model to overcome this complexity. Further we separately discussed the role of HR and MABP and their variation in this context. As another subtopic we gave attention to is the chronic TCR; a variant that is rarely seen in clinical medicine.
authors: From the University of Basel, Switzerland (CM); The Houston Methodist Research Institute, Houston, Texas, USA (EG); Department of Anesthesia and Perioperative Medicine. University of Manitoba, Winnipeg, Canada (TC); Cardiology, St Anna Clinic, Luzern, Switzerland and University of Basel, Switzerland (PE); Department of Research, University of Southampton, United Kingdom (BS); and Academic Editor, Medicine (BS).
authors: C
authors: C
authors: Meuwly
authors: E
authors: E
authors: Golanov
authors: T
authors: T
authors: Chowdhury
authors: P
authors: P
authors: Erne
authors: B
authors: B
authors: Schaller
mesh_terms: D000208:Acute Disease; D001919:Bradycardia / Q000145:classification* / Q000503:physiopathology*; D002908:Chronic Disease; D006321:Heart; D006439:Hemodynamics; D006801:Humans; D059230:Reflex, Trigeminocardiac / Q000502:physiology*; D014276:Trigeminal Nerve / Q000378:metabolism
references: Acta Neurochir (Wien). 2006 Oct;148(10):1029-31; discussion 1031
references: 16944048
references: ScientificWorldJournal. 2010 Jul 20;10:1416-23
references: 20661534
references: Brain Res Brain Res Rev. 2004 Nov;46(3):243-60
references: 15571768
references: J Neurosurg Anesthesiol. 2006 Apr;18(2):163
references: 16628076
references: Mol Med. 2009 May-Jun;15(5-6):125-6
references: 19287512
references: J Neurosurg. 1999 Feb;90(2):215-20
references: 9950491
references: J Neurophysiol. 2009 Sep;102(3):1443-50
references: 19553488
references: J Oral Maxillofac Surg. 2011 Sep;69(9):2316-20
references: 21511380
references: J Neurosci Res. 2004 Jun 15;76(6):891-901
references: 15160400
references: Ann Plast Surg. 2015 Aug;75(2):213-8
references: 24374394
references: J Neurosurg Anesthesiol. 2007 Jul;19(3):203-4
references: 17592354
references: Ophthalmic Plast Reconstr Surg. 2011 Jan-Feb;27(1):e2-4
references: 20859241
references: J Cell Mol Med. 2009 Apr;13(4):644-7
references: 19438971
references: Expert Rev Cardiovasc Ther. 2010 Apr;8(4):509-12
references: 20397825
references: J Neurosurg Anesthesiol. 2009 Jul;21(3):187-95
references: 19542994
references: J Med Case Rep. 2011 Apr 15;5:149
references: 21496216
references: J Med Case Rep. 2012 Oct 30;6:372
references: 23110862
references: J Neurosurg Anesthesiol. 2008 Apr;20(2):131-5
references: 18362775
references: Neurosurgery. 1994 Mar;34(3):422-7; discussion 427-8
references: 8190216
references: J Clin Neurosci. 2010 May;17(5):641-4
references: 20188568
references: J Neurosurg Anesthesiol. 2015 Apr;27(2):136-47
references: 25602626
references: J Neurosurg Anesthesiol. 2014 Jan;26(1):86-7
references: 23686106
references: Can J Anaesth. 1991 Sep;38(6):696-9
references: 1914051
references: Clin Neurol Neurosurg. 2005 Oct;107(6):468-74
references: 16202819
references: Handchir Mikrochir Plast Chir. 2008 Aug;40(4):267-71
references: 18716987
references: J Neurosurg. 2012 Jun;116(6):1397-8; author reply 1398
references: 22462510
references: J Neurosurg Anesthesiol. 2014 Jan;26(1):91-2
references: 23887683
references: Surg Neurol Int. 2014 Mar 29;5:43
references: 24818050
references: Brain Res. 2007 May 29;1149:69-75
references: 17428450
references: J Med Case Rep. 2010 Nov 30;4:391
references: 21118536
references: Acta Neurochir (Wien). 2008 Sep;150(9):929-30; author reply 931
references: 18726064
references: Neurosurgery. 1988 Dec;23(6):745-8
references: 3265191
references: J Neurosurg. 2007 Jul;107(1):243; author reply 243-4
references: 17639902
references: Ophthalmologica. 2006;220(1):65-8
references: 16374051
references: Eur J Nucl Med Mol Imaging. 2006 Mar;33(3):384-5
references: 16374653
references: J Neurosurg Anesthesiol. 2011 Oct;23(4):379-80
references: 21908992
references: J Child Neurol. 2012 Feb;27(2):168-71
references: 21881008
references: Expert Rev Cardiovasc Ther. 2010 Jul;8(7):895-8
references: 20602549
references: Brain Res. 1977 Jan 7;119(2):305-26
references: 830389
references: Cerebrovasc Dis. 2004;18(3):179-88
references: 15273432
references: Nervenarzt. 2008 Jun;79(6):669-75
references: 18060379
references: ScientificWorldJournal. 2010 May 04;10:811-7
references: 20454763
references: JRSM Short Rep. 2012 Jan;3(1):6
references: 22299072
references: Neurol India. 2009 Jul-Aug;57(4):375-80
references: 19770535
references: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Aug;110(2):178-81
references: 20382052
references: Ophthalmologica. 2006;220(5):348
references: 16954716
references: Acta Anaesthesiol Taiwan. 2012 Dec;50(4):153-8
references: 23385037
references: Int J Oral Maxillofac Surg. 2012 Mar;41(3):389-93
references: 22240287
references: Acta Neurochir (Wien). 2008 Feb;150(2):157-60
references: 18080085
references: Clin Neurol Neurosurg. 2009 Feb;111(2):220
references: 18996640
references: J Neurosurg Anesthesiol. 2011 Jul;23(3):271-2
references: 21654337
references: Acta Neurochir (Wien). 2008 Jul;150(7):715-7; discussion 717-8
references: 18536994
references: Auton Neurosci. 2003 May 30;105(2):101-4
references: 12798206
references: J Neurol. 2004 Jun;251(6):658-65
references: 15311339
references: Acta Paediatr. 2002;91(3):307-12
references: 12022304
references: J Neurosurg Anesthesiol. 2005 Jan;17(1):45-8
references: 15632542