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PubMed1995

Vestibular function test anomalies in patients with chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) is distinguished by the new onset of debilitating fatigue that lasts at least 6 months, concomitant with other symptoms to be described later. Many CFS patients complain of disequilibrium, yet the exact type of the balance dysfunction and its function and its location (peripheral vs. central) have not been described. Herein we report results of vestibular function testing performed on 11 CFS patients. These results revealed no predominant pattern of abnormalities. Patients typically performed below average in dynamic posturography testing, with a significant number of falls in the tests requiring subjects to depend heavily on the vestibular system. One patient had abnormal caloric testing, while 3 had abnormally low earth vertical axis rotation (EVA) gains at the higher frequencies tested. As a group, the average gain of EVA was significantly lower than normals in the 0.1 - 1.0 Hz range (p < 0.05). In earth horizontal axis rotation, the CFS group had a higher than normal bias value for the optokinetic (OKN) and eyes open in the dark conditions (p < 0.05), but had normal scores during visual vestibular reflex testing. Five of the 11 subjects had an abnormal OKN bias build up over the course of the run, equal to or actually exceeding the 60 degrees/s target velocity by as much as 14 degrees/s. Altogether, these results are more suggestive of central nervous system deficits than of peripheral vestibular disfunction.

Adult↗
PubMed1977

[Pathomechanisms of cervical headaches].

Various types of disorders of the cervical region may produce headache. In many of these increased tension of the neck musculature plays an important role. The following mechanisms underlying headache are described and differentiated: 1. Headache due to faulty muscle pattern (stereotype) resulting in overstrain of the upper fixators of the shoulder girdle (upper part of the m.trapezius and levator scapulae); faulty respiration with the aid of the upper auxillary muscles even at rest is pointed out. 2. A forward drawn head position producing static overstrain in the posterior neck muscles and compensatory retroflexion of the cranio-cervical junction resulting in blockage in this region. 3. Anteflexion and ligament pain mainly due to faulty position at work and jolting. 4. Static disturbance in the frontal plain due to obliquity producing asymmetrical strain in the neck musculature. 5. Increased muscular tension due to psychological stress. 6. Blockage in the regions of the cervical spine, shoulder girdle and upper ribs with reflex muscular spasm. 7. Reflex spasm of the neck musculature in visceral disorders causing in addition blockage of the cervico-thoracic junction (heart, gall bladder). 8. Pain arising from the posterior arch of the atlas (here described for the first time). 9. Headache due to vertebral artery involvement. The type of headache seems to be determined rather by the individual mode of reaction than by the mechanism underlying it. As a rule a combination of mechanisms is actually found.

Atlanto-Occipital Joint↗
PubMed2003

Foot-sole reflex receptive fields for human withdrawal reflexes in symmetrical standing position.

Human withdrawal-reflex receptive fields were assessed in 10 healthy subjects during standing with even support on both legs. Two electrical-stimulus intensities (1.2 and 2.2 times the pain threshold, PTh) were used. The painful stimuli were delivered in random order to 12 positions distributed over the foot sole. Tibialis anterior (TA), soleus (SO), vastus lateralis (VL), semitendinosus (ST), and iliopsoas (IL) reflexes were recorded. Further, the vertical force was recorded and the center or pressure (CoP) was assessed in the frontal and sagittal planes on both legs. Reflexes were observed at both intensities with the strongest reflexes at the high intensity. Around the ankle joint, SO reflexes dominated, which is in contrast to previous observations for subjects sitting. An unloading of the limb was found on the stimulated leg associated with a simultaneous loading of the contralateral leg. The shift in load was most pronounced for stimulation of the heel. The flexors ST and IL also had strong reflexes with reflex patterns correlated to the pattern of unloading. The shift in vertical force was accomplished by a move of the CoP in the anterior direction on the stimulated limb (contraction of SO), which simultaneously caused a small movement of the CoP in the lateral direction. In the present standing conditions, the ankle extensor played a dominant role in the withdrawal pattern in contrast to previous studies during sitting, relaxed conditions.

Adult↗
PubMed1983

Reflex responses of human thigh muscles to non-noxious sural stimulation during stepping.

An investigation of reflex responses of leg muscles to sural stimulation during stepping was performed on human subjects. Non-noxious electrical stimulation applied during the swing phase or the latter half of the stance phase produced a mixed increase and decrease of EMG activity in the hamstring muscles. No response or very weak response was observed when the same stimulus was applied during either quiet standing or various levels of constant voluntary effort at varying hip and knee joint angles.

Adult↗
PubMed1996

Is perilymphatic pressure altered in tinnitus?

Tinnitus is characterized by the continuous or intermittent auditory perception of various sounds (buzzing, whistling, etc.) in the absence of any external stimulus. Perilymphatic hyperpressure is one of the numerous mechanisms which could hypothetically be involved in tinnitus generation. In the present experiment, perilymphatic pressure was measured indirectly using the tympanic membrane displacement technique. Twenty-five tinnitus patients were investigated at 10, 15 and 20 dB above the acoustic reflex threshold with ipsilateral stimulation. The variables Vi (inward tympanic displacement), Vm (mean tympanic displacement) and their variations according to stimulus level were compared between tinnitus sufferers and age-matched or hearing-matched controls. Tympanic displacement was measured in sitting and supine positions so as to evaluate cochlear aqueduct patency. No systemic changes in response occurred in tinnitus patients, except at a high stimulation level, perhaps due to hearing impairment.

Adult↗
PubMed1984

Spinal reflex alterations as a function of intensity and frequency of vibration applied to the feet of seated subjects.

Sensorimotor system performance is known to be altered by vibration applied locally to tendons and muscles or to the whole body. The present study is an attempt to determine the influence of vibration amplitude, acceleration, and frequency on the excitability of the motoneurons as evaluated by the amplitude of electrically induced spinal reflex response in man. The results show that a vibration applied to the legs of a seated subject (S) decreased the reflex response. The effect is directly related to the vibration intensity. The reflex amplitude is minimal in the 10-30 Hz range. At constant acceleration, the depressive effect decreased beyond 20-30 Hz while, at constant displacement amplitude, the reflex inhibition was almost constant throughout the frequency range of 20-60 Hz. These observations suggest that the diminution of the reflex response is mainly related to the amplitude of the vibration, regardless of the frequency. The results are interpreted in light of current knowledge of the effect of locally applied vibration on muscle tendons. The marked inhibition observed in the 10-30 Hz range, even with moderate intensity, suggests that particular attention should be devoted to avoid vibration in that frequency range in vehicles in order to prevent alteration of the performance of sensorimotor systems.

Adolescent↗
PubMed1987

Vestibular compensation evaluated by rotation tests and posturography.

In patients with unilateral vestibular hypofunction (UVH), compensation plays an indispensable role in reorganizing and returning to normal the vestibulo-ocular reflex (VOR) and the vestibulospinal reflex (VSR). These compensatory and adaptive processes, however, may have an independent course because the results for VOR are nontransferable to VSR. Discordance between results of rotation tests (evaluating the compensation for the VOR) and posturographic (PG) results (evaluating compensation for the VSR) are observed in 50% of the patients with UVH. The complaint of "instability" shows correlation with abnormal PG data. Accordingly, a thorough evaluation of a patient with UVH has to include information about the VSR as it can be provided by PG.

Humans↗
PubMed1987

Cardiovascular reflexes in multiple sclerosis.

Cardiovascular autonomic function was studied in 50 patients with multiple sclerosis using 5 simple non-invasive tests: the heart rate responses to the Valsalva manoeuvre, deep breathing and standing, and the blood pressure responses to standing and sustained handgrip. Abnormalities of one or more tests were found in 37 subjects. There was a variable distribution of abnormalities with most occurring in the heart rate response to deep breathing and the blood pressure response to sustained handgrip. This pattern contrasts with that in diabetics and probably reflects the scattered central pathological lesions of multiple sclerosis.

Adult↗
PubMedDate not supplied

[Statocyst regulation of the heart and statokinetic reflexes in the crab, Hemigrapsus sanguineus, during linear acceleration].

In experiments on the shore crab H. sanguineus studies have been made of the effect of variable longitudinal acceleration during swinging (for 15--30 min) upon cardiac activity and gravitational reflexes. High sensitivity of gravitational receptors of the canal statocyst to the effect of acceleration was demonstrated. Removal of the statocysts increases the frequency and amplitude of cardiac contractions as revealed by ECG recording. Changes in stato-kinetic coordinations cause both the disorder of overturning reactions and the disorder of reciprocal inhibition in antagonistic muscles of the dactylopodite. Statocyst regulation of skeletal muscles and heart is presumably realised via contralateral inhibitory canal which is sensitive to linear accelerations.

Acceleration↗
PubMedDate not supplied

The cervico-ocular reflex of normal human subjects in response to transient and sinusoidal trunk rotations.

We used the magnetic search coil technique to measure the horizontal cervico-ocular reflex (COR) of 8 subjects in response to transient or sinusoidal (0.1-1.0 Hz) trunk rotations while their heads were firmly immobilized. Although we were able to resolve eye rotations of < 0.05 degrees, the COR was hardly measurable (gain was always < 0.07). This finding, made with the most precise measurement technique used to date, suggests that the COR makes a negligible contribution to the stability of gaze in normal subjects during natural activities.

Adult↗
PubMed1983

Evaluation of skin vasomotor reflexes by using laser Doppler velocimetry.

We used a laser Doppler velocimeter for measurement of skin blood flow in 63 healthy control subjects and in patients with dysautonomias. We measured vasoconstrictor responses to inspiratory gasp, standing, Valsalva maneuver, and cold stimulus. An abnormal profile was defined in terms of the percentage of abnormal test results, the results of individual tests, and the alterations in the shape of the recorded response. These measurements of vasomotor function may permit the diagnosis of focal abnormalities of peripheral nerve sympathetic failure.

Adolescent↗
PubMed1994

Autorotation test abnormalities of the horizontal and vertical vestibulo-ocular reflexes in panic disorder.

Patients with panic disorder often describe dizziness as a disturbing symptom, with more severe episodes reported than in other psychiatric populations. Nineteen patients diagnosed as having a panic disorder were tested for vestibulo-ocular (VOR) abnormalities with the Vestibular Autorotation Test (VAT), a computerized test of the high-frequency (2 to 6 Hz) VOR. The patients were unselected for the presence or absence of balance disorders. Results showed VOR abnormalities, relative to a normal population, in the horizontal and/or vertical VORs of all 19 patients. Vestibulo-ocular reflex asymmetries were commonly present. Because the VAT tested the VOR over a frequency range encountered during common daily activities, the observed abnormalities could result in a perceptually moving visual field (oscillopsia). We hypothesize that the resulting experience of a visual-vestibular disturbance--perhaps in a biologically or psychologically predisposed individual--is catastrophically misinterpreted, leading to more bodily symptoms and anxiety. These could then contribute to more misinterpretation in a positive feedback sense, ultimately leading to a panic attack.

Adult↗
PubMed2001

Effect of a reduced base of support in standing and balance training on the soleus H-reflex.

The present study provides evidence that a reflex at the segmental level can adapt over a two hour experiment in a functionally appropriate manner in response to a balance training task. Subjects (N=9) received soleus (S) H-reflexes in blocks of seven trials while free standing on a normal base-of-support (NBOS) and while standing on a plafform with a reduced base-of-support (RBOS) in the sagittal plane. During the RBOS condition, the H-reflex served as a postural perturbation. Subjects were instructed to suppress the H-reflex when it was evoked, as an attempt to maintain a balanced state. Background EMG from the S and tibialis anterior muscles, the S M-wave, and stimulus current were maintained at a constant level during the experiment. Subjects initially received a block of NBOS trials, followed by 4 RBOS blocks (training), a second NBOS block, four additional RBOS blocks, and a third NBOS block with the protocol repeated on three different days (D1, D2 and D3) within the same week. The S H/M ratio was depressed 9% upon standing on the RBOS. With training the S H/M ratio decreased by 22% on Dl, 18% on D2 and 6% on D3. The ratio between the H-reflex and background S EMG (H-reflex gain) decreased 10% on D1, 40% on D2 and 23% on D3 when the first NBOS and first RBOS blocks were compared. Due to a slight increase in the S EMG across blocks, the H-reflex gain decreased considerably more across blocks than the H/M ratio. Although the S H/M ratio underwent an 7% decrease from D1 to D3, the differences were not significant. Individually, however, six of the nine subjects decreased their H/M ratios from 12-42% across days. The results may reflect the inception of longer-term adaptations of the segmental stretch reflex system.

Adaptation, Physiological↗
PubMed1992

The dynamics of spatial orientation during complex and changing linear and angular acceleration.

The dynamics of spatial orientation perception were examined in a series of experiments in which a total of 43 subjects were passively exposed to various combinations of linear and angular acceleration during centrifuge runs. Perceptual effects during deceleration were much stronger than effects during acceleration. The dynamics of spatial orientation perception differed substantially from changes in the vestibulo-ocular reflex (VOR). VOR was fairly well predicted by a current model, but our experiments revealed perceived change in attitude (roll, pitch, yaw tilt position in space) and perceived angular velocity in space that was not reflected by parallel changes in the plane or magnitude of the VOR. This series of experiments establishes several facts concerning spatial orientation perception beyond the predictive domain of any current model. New concepts are needed and several are suggested to deal with changing reactions to complex combinations of linear and angular accelerations.

Acceleration↗
PubMed1996

Anticipatory responses to a self-applied load in normal subjects and hemiparetic patients.

A bimanual loading task was studied in eight right-handed normal subjects and nine hemiparetic patients in order to detect anticipatory adjustments and to analyse the reflex and voluntary, responses induced by the perturbation. The left forearm (or the impaired side in patients) was flexed at approximately 90 degrees and free to rotate in a vertical sagittal plane. It was held to resist a load (2-3 kg) dropped either by an experimenter (control situation), or by the subject himself with no visual control (self-applied situation). The load was dropped from the right hand by normal subjects and from the unimpaired hand by hemiparetic patients. The initial distance the load fell was 0.05-0.35 m. The elbow movements of the limb receiving the load were recorded with a linear accelerometer at the wrist, a potentiometer at the elbow and via the EMG signals from flexor muscles. Normal subjects always made an anticipatory flexion movement prior to the impact in the self-applied situation, but not in the control situation. The anticipatory flexion of hemiparetic patients was slower and longer. The amplitude of the anticipatory flexion at the time of impact and its duration were correlated with the mass of the load and the initial distance between the two hands in both groups. The anticipatory flexion reduced the distance through which the load fell and thus its kinetic energy at impact. The impact induced a brisk extension which was always smaller in the self-applied situation for a given kinetic energy. In normal subjects, the amplitude of the monosynaptic reflex (MSR) following the impact in flexor muscles was usually greater in the self-applied situation, but its gain was either reduced or unchanged. The gain of the functional stretch reflex (FSR) was consistently reduced in the self-applied situation. Depression of the FSR gain occurred in only two hemiparetic patients who had the best recovered motor function. Anticipation always ended up minimizing the perturbation following different motor strategies. The normal subjects fell into two groups. One group adjusted the anticipatory forearm flexion to correct the extension disturbance as fast as possible; the second group relied on an accurate adjustment of the final position. Hemiparetic patients showed idiosyncratic intermediate behavior.

Adult↗
PubMed1996

Functional modulation of the human flexion and crossed extension reflexes by body position.

The effects of body position on the electrically evoked flexion (FR) and crossed extension reflexes (CER) were investigated in humans. The FR area in the ipsilateral tibialis anterior muscle was significantly smaller during sitting than supported stance by 36% (P < 0.01). In contrast, the excitability of extensor muscles on both sides was enhanced in standing. For instance, twice as many subjects manifested a response in the ipsilateral vastus lateralis (VL) and the contralateral VL and/or soleus muscles (i.e. the CER) in standing than sitting. The FR and CER modulation observed seems to be dictated by the difference in functional demand between sitting and supported stance.

Adult↗
PubMed1984

Sympathetic vasoconstrictor nerve function in alcoholic neuropathy.

The peripheral sympathetic vasomotor nerve function was investigated in 18 male chronic alcoholics admitted for intellectual impairment or polyneuropathy. By means of the local 133Xenon washout technique, the sympathetic veno-arteriolar axon-reflex was studied. This normally is responsible for a 50% decrease in tissue blood flow, when the ankle is lowered 40 cm below heart level in the supine individual. The patients with moderate to severe polyneuropathy, taken as a group, did not differ significantly from the group of patients with no or only mild polyneuropathy, although a lesser response was seen (18% and 48% decrease respectively). However, in three patients with moderate neuropathy, and in one patient with no signs of neuropathy, this veno-arteriolar reflex was absent, indicating dysfunction of the peripheral sympathetic adrenergic nerve fibres. The three patients also showed a lesser degree of arteriolar constriction during 45 degrees passive head-up tilt, although none developed symptoms of orthostatic hypotension. Anhidrosis of the feet was found in only three patients. This study lends support to the view that individual differences in the susceptibility to the deleterious effect of alcohol comprise not only the peripheral sensory and motor nerve fibres, but also the thin pseudomotor and vasomotor nerves.

Adult↗
PubMed1982

Apparent instrument horizon deflection during and immediately following rolling maneuvers.

There have been recent reports by pilots of apparent visual bending or bowing of instrument horizons during and immediately following ascending rolling maneuvers in the F-14 aircraft. The present study investigates the probability that normal reflex actions may partially account for the illusions cited in these reports. The results of this study suggest that the vestibulo-ocular reflex (VOR) can produce an apparent deflection of the instrument horizon (actually an apparent flicking back and forth) during and after roll maneuvers involving high peak angular velocities. This perceptual aberration could disturb a pilot attempting to use his instrument horizon and could lead him to suspect instrument malfunction. The reported distortions of the instrument horizon could be the result of the VOR, which tends to stabilize the eye relative to the Earth during angular acceleration of the head, and therefore reflexly displaces the eye relative to objects such as flight instruments that move with the head.

Acceleration↗