Late component of trigemino-cervical reflex: changes according to age and gender
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ORIGINAL ARTICLE
Late component of trigemino-cervical reflex: changes according to age and gender Meral E. Kızıltan 1 & Ayşegül Gündüz 1 Received: 1 August 2019 / Accepted: 6 January 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Trigemino-cervical reflex (TCR) is a protective reflex which is elicited by the stimulation of any branch of the trigeminal nerve. After infraorbital stimulation, an early and late components have been described. The aim of this study was to find out whether there are age- or gender-related changes in the long-latency (RII) component of TCR. Method We included consecutive 53 healthy subjects (20 men, 37.7%) who had normal neurological examination. The mean age was 45.1 ± 14.3 years (age range 18–75 years). TCR was recorded simultaneously from bilateral sternocleidomastoid (SCM) and splenius capitis (SC) muscles with surface electrodes after stimulating right or left infraorbital branch of the trigeminal nerve, separately. We compared latency, amplitude, and duration according to gender and age. Results The amplitudes of SC responses were significantly higher in women compared to men. The duration of SCM response was significantly longer in subjects above the age of 50 years compared to younger patients. The latency of the SC response was significantly delayed above the age of 40 years. Conclusion There are age- and gender-related changes in TCRs probably due to changes in the motoneurons of the SC and SCM muscles. Keywords Trigemino-cervical reflex . Age . Gender
Introduction Trigemino-cervical reflex (TCR), which is a protective reflex was first described by Sartucci et al. in 1986 [1]. It is elicited by the stimulation of the supraorbital or infraorbital branch of trigeminal nerve and recorded on both sternocleidomastoid (SCM) and/or posterior neck muscles [2]. After supraorbital nerve (SON) stimulation, a response with a mean latency of 50 ms was elicited [3]. The authors also used a glabellar tap which elicited earlier responses [3]. Ertekin et al. [2] also showed stimulation of the supraorbital and infraorbital branches of the trigeminal nerve had different reflexive effects on the posterior neck muscles. The authors described a stable, very early-latency,
* Ayşegül Gündüz [email protected] 1
Department of Neurology, Cerrahpaşa School of Medicine, IUC, Istanbul, Turkey
positive wave with a high amplitude (RI) after maximal stimulation of the infraorbital nerve (ION), which could never be detected by stimulation of the SON, whereas the third component (RIII) of the TCR was always evoked after SON stimulation, but only evoked after lowthreshold stimulation of the ION. A consecutive study revealed the presence of a similar reflex response on biceps brachii muscle [4]. All these studies disclosed an interaction between the trigeminal sensory afferents and the neck or proximal upper extremity muscles. Elderly adults show an age-related decline in sensory systems and a reduced ability to adapt to changes in their environment to maintain balance [5, 6
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