Maisonobe T, Tankéré F, Lamas G, Soudant J, Bouche P, Willer J C, Fournier E
Federation of Clinical Neurophysiology, Hôpital Pitié-Salpêtrière-47, Bd. de l'Hôpital, 75013, Paris, France.
Brain Res. 1998 Nov 9;810(1-2):220-8. doi: 10.1016/s0006-8993(98)00953-6.
It has been shown that in patients in whom the central stump of the hypoglossal nerve has been anastomosed to the peripheral stump of a lesioned facial nerve, supraorbital nerve stimulation can elicit a short-latency reflex (12.5+/-0.6 ms; mean+/-S.D.) in facial muscles similar to the R1 disynaptic blink reflex response, but not followed by an R2 blink reflex component46. Thus in addition to replacing the facial neurons at peripheral synapses, these hypoglossal nerves contribute to a trigemino-hypoglossal reflex. The aim of this work was to study the type of reflex activities which can be elicited in both facial and tongue muscles by electrical stimulation of cutaneous (supraorbital nerve) or mucosal (lingual nerve) trigeminal (V) afferents in normal subjects. The results show that although stimulation of cutaneous V1 afferents elicits the well-known double component (R1-R2) blink reflex response in the orbicularis oculi muscles, it does not produce any detectable reflex response in the genioglossus muscle, even during experimental paradigms designed to facilitate the reflex activity. Conversely, stimulation of mucosal V3 afferents can elicit a single reflex response of the R1 type in the genioglossus muscle but not in the orbicularis oculi muscles, even during experimental paradigms designed to facilitate the reflex activity. These data are discussed in terms of two similar but separate circuits for the R1 responses of cutaneous (blink reflex) and mucosal (tongue reflex) origins. They suggest that in patients with hypoglossal-facial (XII-VII) nerve anastomosis, the short-latency trigemino-'hypoglossal-facial' reflex of the R1 blink reflex type observed in facial muscles following supraorbital nerve stimulation could be due to changes in synaptic effectiveness of the central connectivity within the principal trigeminal nucleus where both cutaneous and mucosal trigeminal afferents project.
已经表明，在舌下神经的中枢残端与受损面神经的外周残端进行吻合的患者中，眶上神经刺激可在面部肌肉中引发短潜伏期反射（12.5±0.6毫秒；平均值±标准差），类似于R1双突触眨眼反射反应，但之后没有R2眨眼反射成分46。因此，除了在外周突触处替代面神经神经元外，这些舌下神经还参与了三叉-舌下反射。这项工作的目的是研究在正常受试者中，通过电刺激皮肤（眶上神经）或黏膜（舌神经）三叉神经（V）传入神经，在面部和舌肌中可引发的反射活动类型。结果表明，尽管刺激皮肤V1传入神经会在眼轮匝肌中引发众所周知的双成分（R1 - R2）眨眼反射反应，但即使在旨在促进反射活动的实验范式中，它也不会在颏舌肌中产生任何可检测到的反射反应。相反，刺激黏膜V3传入神经可在颏舌肌中引发R1型单一反射反应，但在眼轮匝肌中则不会，即使在旨在促进反射活动的实验范式中也是如此。这些数据根据皮肤（眨眼反射）和黏膜（舌反射）起源的R1反应的两个相似但独立的回路进行了讨论。它们表明，在舌下-面神经（XII - VII）吻合的患者中，眶上神经刺激后在面部肌肉中观察到的R1眨眼反射类型的短潜伏期三叉-舌下-面神经反射可能是由于主要三叉神经核内中枢连接的突触效能发生了变化，皮肤和黏膜三叉神经传入神经都投射到该核。
