The effects of inhibitory controls triggered by heterotopic noxious stimuli on a jaw reflex evoked by perioral stimuli in man.

Electromyographic recordings (EMGs) were made from the active masseter muscle of the inhibitory reflex evoked by application of electrical stimuli to the skin of the upper lip in 11 human subjects. In control sequences, the reflex had a mean latency and duration of 41 +/- 1.7 and 44 +/- 2.6 ms, respectively. The magnitude of the reflex (measured by integration of the EMG) was significantly reduced by the application of cold (3 degrees C) or hot (47-48 degrees C) but not warm (38-46 degrees C) water to a hand or foot. The strongest stimuli (3 or 48 degrees C) produced mean reductions of the reflex magnitude in the range of 62-85%. These effects occurred regardless of whether the background activity in the masseter was raised or lowered during the application of the thermal stimuli. Thus, activity in nociceptive nerves from widespread areas of the body can modulate jaw reflexes in man by exerting an influence on the reflex pathway at a point before the motor neurones. This may involve the system of 'diffuse noxious inhibitory controls', which have been shown to depress limb flexion reflexes and neuronal activity in the spinal dorsal horn and trigeminal nuclear complex.