title: Startle responses after different stimulus modalities differ in stroke.
abstract: OBJECTIVE
  The auditory startle reaction (ASR) and startle reflex to somatosensory inputs (SSS) are stereotypical responses to sudden and unexpected stimuli, which are generated in the caudal brainstem reticular formation. Changes of ASR are relatively well known in stroke. Here, we aimed to investigate central pathways of SSS and plasticity changes of SSS circuits in different stages and localizations of stroke, by comparing with ASR.
  
  
  METHODS
  We prospectively included 39 patients with stroke between June 2009 and June 2013, and 23 age and gender-matched healthy subjects. ASR and SSS were recorded over orbicularis oculi, sternocleidomastoid, biceps brachii (BB), and abductor policis brevis muscles (APB) using surface electrodes.
  
  
  RESULTS
  There were supratentorial and infratentorial lesions in both acute and chronic stages. Overall, ASR probability was similar between groups (P=0.981). However, ASR probability was increased for BB and APB recordings on symptomatic sides of stroke patients with high amplitudes and long durations, most prominently on symptomatic sides of pontine strokes. Latencies and presence rates of SSS did not differ between any subgroups of stroke and healthy subjects.
  
  
  CONCLUSIONS
  ASR is facilitated in arm and hand muscles on symptomatic sides of stroke patients, whereas SSS did not show any significant changes according to stroke.
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, 34098 K.M. Pasa, Istanbul, Turkey.
authors.forename: Melis
authors.initials: M
authors.lastname: Sohtaoğlu
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, 34098 K.M. Pasa, Istanbul, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: E Kızıltan
authors.affiliation: Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, 34098 K.M. Pasa, 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, 34098 K.M. Pasa, Istanbul, Turkey.
authors.forename: Melda
authors.initials: M
authors.lastname: Bozluolçay
mesh_terms: D000161:Acoustic Stimulation; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D010812:Physical Stimulation; D011446:Prospective Studies; D013216:Reflex, Startle; D020521:Stroke / Q000503:physiopathology*
keywords: Accident vasculaire cérébral; Auditory startle reflex; Cerebrovascular disease; Maladie cérébrovasculaire; Réflexe de sursaut auditif; Réflexe de sursaut somatosensoriel; Somatosensory startle reflex; Stroke