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Observational Study
. 2024 Nov 13;42(5):451-456.
doi: 10.1097/WNP.0000000000001130.

Short-Latency Trigeminocervical Reflex Obtained Without Muscle Activation: Topographic Distribution and Methodological Approach

Denise Lima Medeiros de Melo  1 , Enio Alberto Comerlato  1 , Eduardo Santos Tavares  1 , Denise Spinola Pinheiro  2 , Gilberto Mastrocola Manzano  2
Affiliations
Observational Study

Short-Latency Trigeminocervical Reflex Obtained Without Muscle Activation: Topographic Distribution and Methodological Approach

Denise Lima Medeiros de Melo et al. J Clin Neurophysiol. .

Abstract

Purpose: Electrical stimulation of trigeminal nerve branches elicits early and late reflex responses in the cervical muscles, known as the trigeminocervical reflex (TCR). This study aimed to evaluate the neurophysiological aspects, stimulation patterns, and topographic distribution of short-latency TCR components in humans in the absence of voluntary muscle activation.

Methods: This prospective observational study included 30 participants. Trigeminocervical reflex responses were simultaneously recorded from the bilateral sternocleidomastoid, trapezius, and splenius capitis muscles (without voluntary muscle activation), after electrical stimulation of the supraorbital and infraorbital nerves. Two different stimulation protocols were evaluated: a 3 Hz stimulation protocol (using averaging) and a single-pulse stimulation protocol.

Results: Using a 3 Hz stimulation protocol, short-latency TCR responses were recorded in the sternocleidomastoid, trapezius, and splenius capitis muscles, ipsilateral and/or contralateral, but with variable recordability depending on the recording site. The most reliable response was obtained in ipsilateral sternocleidomastoid muscle. To the best of our knowledge, this is the first study to demonstrate the elicitation of short-latency TCR components in the sternocleidomastoid muscle in the absence of voluntary muscle activation in humans without craniocervical junction disorders or lower brainstem abnormalities.

Conclusions: The choice of an appropriate stimulation protocol is particularly relevant for recording short-latency TCR components, considering that the visualization of early or late responses seems to be facilitated by different stimulation methodologies.

Keywords: Brainstem reflexes; Trigeminal reflexes; Trigeminocervical reflex.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

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