Serrao Mariano, Rossi Paolo, Parisi Leoluca, Perrotta Armando, Bartolo Michelangelo, Cardinali Patrizio, Amabile Giuseppe, Pierelli Francesco
Dipartimento di Neurologia e Otorinolaringoiatria, Università di Roma La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.
Clin Neurophysiol. 2003 Sep;114(9):1697-703. doi: 10.1016/s1388-2457(03)00132-9.
Electrical stimulation of the supraorbital nerve (SON) induces late reflex responses in the neck muscles; these responses are hypothesised to be polysynaptic reflexes participating in a defensive withdrawal retraction of the head from facial nociceptive stimuli. Such responses may extend to the proximal muscle of the arms.
(1) to investigate reflexes in the upper limb muscles (trigemino-spinal responses, TSR) and their relationship with trigemino-cervical responses (TCR); and (2) to identify the nociceptive component of such reflexes and their functional significance.
Reflex responses were registered from the semispinalis capitis and biceps brachii muscles after electrical stimulation of the SON in 12 healthy subjects. The sensory (ST), painful (PT) and reflex thresholds, the latency and area of the responses, the effect of heterotopic painful stimulation (HTP), the recovery cycle as well as the effect of the expected and unexpected stimuli were measured.
Stable reproducible TCR and TSR responses were identified at 2.5+/-0.4 x ST, which corresponded exactly to the PT in all the subjects. The TCR and TSR areas were markedly reduced after HTP. The recovery cycle of the TSR area was faster than that of the TCR. Repeated rhythmic stimulation failed to induce progressive reflex suppression.
These results confirm the nociceptive nature of the TCR and indicate that the biceps brachii response (TSR) has the same nocifensive significance as the posterior neck muscle responses. TCR and TSR are mediated different polysynaptic pathways The presence of trigemino-cervical-spinal responses in our study clearly indicates that there is a reflex interaction between nociceptive trigeminal afferents and both upper and lower cervical spinal cord motoneurons.
眶上神经（SON）电刺激可诱发颈部肌肉的迟发反射反应；这些反应被认为是多突触反射，参与头部对颜面部伤害性刺激的防御性退缩。此类反应可能会延伸至手臂的近端肌肉。
（1）研究上肢肌肉中的反射（三叉神经 - 脊髓反应，TSR）及其与三叉神经 - 颈反应（TCR）的关系；（2）确定此类反射的伤害性成分及其功能意义。
对12名健康受试者的眶上神经进行电刺激后，记录头半棘肌和肱二头肌的反射反应。测量感觉（ST）、疼痛（PT）和反射阈值、反应的潜伏期和面积、异位疼痛刺激（HTP）的效果、恢复周期以及预期和意外刺激的效果。
在2.5±0.4×ST时可识别出稳定可重复的TCR和TSR反应，这在所有受试者中与PT完全对应。HTP后TCR和TSR的面积显著减小。TSR面积的恢复周期比TCR的更快。重复的节律性刺激未能诱发渐进性反射抑制。
这些结果证实了TCR的伤害性本质，并表明肱二头肌反应（TSR）与后颈部肌肉反应具有相同的伤害防御意义。TCR和TSR由不同的多突触通路介导。我们研究中存在三叉神经 - 颈 - 脊髓反应，清楚地表明伤害性三叉神经传入纤维与上、下颈脊髓运动神经元之间存在反射相互作用。
