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Taylor DN. The Neurophysiological Lesion: A Scoping Review. J Chiropr Med 2023; 22:123-130. [PMID: 37346242 PMCID: PMC10280090 DOI: 10.1016/j.jcm.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 04/03/2023] Open
Abstract
Objective The purpose of this study was to examine the extent of the literature on the neurophysiological lesion as referenced in functional neurology. Methods A literature search was performed within the period from 2010 to March 2021. Search terms included central sensitization, central sensitivity syndrome, nociplastic pain, cold hyperalgesia, heat hyperalgesia, mechanical hyperalgesia, dynamic mechanical allodynia, temporal summation, spatial summation, and descending inhibition. A qualitative synthesis summarized the research findings, including clinical conditions and effect of spinal manipulation. Results There were 30 studies, which included 7 high-level studies (meta-analysis or systematic reviews), 22 randomized controlled studies, and 1 scoping review. The findings suggest the existence of the changes in the central integrated state of a population of neurons with various disorders, experimentally induced stimulation, and treatment. The current literature suggests plasticity of the central integrative state (CIS) with the onset of pathologies and the changes in the CIS with different conservative nonpharmacologic treatments. Conclusions This review suggests changes in the resting state of the CIS of a population of neurons that exist in the physiologic lesion may change in response to various therapies, including manipulative therapy. The findings from this review provide support of the hypothesis that nonpharmacologic conservative care may affect the neurophysiological lesion. However, studies were heterogeneous and evidence was lacking in the translation of targeting the therapies to distinct neuronal areas for clinical outcomes to treat specific disease states.
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Affiliation(s)
- David N. Taylor
- Department of Clinical Sciences, Texas Chiropractic College, Pasadena, Texas
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Plasticity of the Central Nervous System Involving Peripheral Nerve Transfer. Neural Plast 2022; 2022:5345269. [PMID: 35342394 PMCID: PMC8956439 DOI: 10.1155/2022/5345269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
Peripheral nerve injury can lead to partial or complete loss of limb function, and nerve transfer is an effective surgical salvage for patients with these injuries. The inability of deprived cortical regions representing damaged nerves to overcome corresponding maladaptive plasticity after the reinnervation of muscle fibers and sensory receptors is thought to be correlated with lasting and unfavorable functional recovery. However, the concept of central nervous system plasticity is rarely elucidated in classical textbooks involving peripheral nerve injury, let alone peripheral nerve transfer. This article is aimed at providing a comprehensive understanding of central nervous system plasticity involving peripheral nerve injury by reviewing studies mainly in human or nonhuman primate and by highlighting the functional and structural modifications in the central nervous system after peripheral nerve transfer. Hopefully, it will help surgeons perform successful nerve transfer under the guidance of modern concepts in neuroplasticity.
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Dubois JD, Poitras I, Voisin JIA, Mercier C. Effect of pain on deafferentation-induced modulation of somatosensory evoked potentials. PLoS One 2018; 13:e0206141. [PMID: 30346981 PMCID: PMC6197665 DOI: 10.1371/journal.pone.0206141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/08/2018] [Indexed: 11/18/2022] Open
Abstract
There is a large body of evidence showing substantial sensorimotor reorganizations after an amputation. These reorganizations are believed to contribute to the development of phantom limb pain, but alternatively, pain might influence the plasticity triggered by the deafferentation. The aim of this study was to test whether pain impacts on deafferentation-induced plasticity in the somatosensory pathways. Fifteen healthy subjects participated in 2 experimental sessions (Pain, No Pain) in which somatosensory evoked potentials (SSEPs) associated with electrical stimulation of the ulnar nerve were assessed before and after temporary ischemic deafferentation induced by inflation of a cuff around the wrist. In the Pain session capsaicin cream was applied on the dorsum of the hand 30 minutes prior to cuff inflation. Results show that pain decreased the amplitude of the N20 (main effect of condition, p = 0.033), with a similar trend for the P25. Temporary ischemic deafferentation had a significant effect on SSEPs (main effect of time), with an increase in the P25 (p = 0.013) and the P45 amplitude (p = 0.005), together with a reduction of the P90 amplitude (p = 0.002). Finally, a significant time x condition interaction, reflecting state-dependent plasticity, was found for the P90 only, the presence of pain decreasing the reduction of amplitude observed in response to deafferentation. In conclusion, these results show that nociceptive input can influence the plasticity induced by a deafferentation, which could be a contributing factor in the cortical somatosensory reorganization observed in chronic pain populations.
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Affiliation(s)
- Jean-Daniel Dubois
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada
- Department of Rehabilitation, Laval University, Pavillon Ferdinand-Vandry, Quebec City, Québec, Canada
| | - Isabelle Poitras
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada
- Department of Rehabilitation, Laval University, Pavillon Ferdinand-Vandry, Quebec City, Québec, Canada
| | - Julien I. A. Voisin
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada
- Department of Rehabilitation, Laval University, Pavillon Ferdinand-Vandry, Quebec City, Québec, Canada
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada
- Department of Rehabilitation, Laval University, Pavillon Ferdinand-Vandry, Quebec City, Québec, Canada
- * E-mail:
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Fisher KM, Lilak A, Garner J, Darian-Smith C. Extensive somatosensory and motor corticospinal sprouting occurs following a central dorsal column lesion in monkeys. J Comp Neurol 2018; 526:2373-2387. [PMID: 30014461 DOI: 10.1002/cne.24491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/16/2023]
Abstract
The corticospinal tract (CST) forms the major descending pathway mediating voluntary hand movements in primates, and originates from ∼nine cortical subdivisions in the macaque. While the terminals of spared motor CST axons are known to sprout locally within the cord in response to spinal injury, little is known about the response of the other CST subcomponents. We previously reported that following a cervical dorsal root lesion (DRL), the primary somatosensory (S1) CST terminal projection retracts to 60% of its original terminal domain, while the primary motor (M1) projection remains robust (Darian-Smith et al., J. Neurosci., 2013). In contrast, when a dorsal column lesion (DCL) is added to the DRL, the S1 CST, in addition to the M1 CST, extends its terminal projections bilaterally and caudally, well beyond normal range (Darian-Smith et al., J. Neurosci., 2014). Are these dramatic responses linked entirely to the inclusion of a CNS injury (i.e., DCL), or do the two components summate or interact? We addressed this directly, by comparing data from monkeys that received a unilateral DCL alone, with those that received either a DRL or a combined DRL/DCL. Approximately 4 months post-lesion, the S1 hand region was mapped electrophysiologically, and anterograde tracers were injected bilaterally into the region deprived of normal input, to assess spinal terminal labeling. Using multifactorial analyses, we show that following a DCL alone (i.e., cuneate fasciculus lesion), the S1 and M1 CSTs also sprout significantly and bilaterally beyond normal range, with a termination pattern suggesting some interaction between the peripheral and central lesions.
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Affiliation(s)
- Karen M Fisher
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California
| | - Alayna Lilak
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California
| | - Joseph Garner
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California
| | - Corinna Darian-Smith
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California
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Sehle A, Büsching I, Vogt E, Liepert J. Temporary deafferentation evoked by cutaneous anesthesia: behavioral and electrophysiological findings in healthy subjects. J Neural Transm (Vienna) 2016; 123:473-80. [PMID: 26983925 DOI: 10.1007/s00702-016-1537-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 02/28/2016] [Indexed: 01/31/2023]
Abstract
Motor function and motor excitability can be modulated by changes of somatosensory input. Here, we performed a randomized single-blind trial to investigate behavioral and neurophysiological changes during temporary deafferentation of left upper arm and forearm in 31 right-handed healthy adults. Lidocaine cream was used to anesthetize the skin from wrist to shoulder, sparing the hand. As control condition, on a different day, a neutral cream was applied to the same skin area. The sequence (first Lidocaine, then placebo or vice versa) was randomized. Behavioral measures included the Grating Orientation Task, the Von Frey hair testing and the Nine-hole-peg-test. Transcranial magnetic stimulation was used to investigate short-interval intracortical inhibition, stimulus response curves, motor evoked potential amplitudes during pre-innervation and the cortical silent period (CSP). Recordings were obtained from left first dorsal interosseous muscle and from left flexor carpi radialis muscle. During deafferentation, the threshold of touch measured at the forearm was significantly worse. Other behavioral treatment-related changes were not found. The CSP showed a significant interaction between treatment and time in first dorsal interosseous muscle. CSP duration was longer during Lidocaine application and shorter during placebo exposure. We conclude that, in healthy subjects, temporary cutaneous deafferentation of upper and lower arm may have minor effects on motor inhibition, but not on sensory or motor function for the adjacent non-anesthetized hand.
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Affiliation(s)
- Aida Sehle
- Kliniken Schmieder Allensbach, Lurija Institut, Zum Tafelholz 8, 78476, Allensbach, Germany.
| | - Imke Büsching
- Kliniken Schmieder Allensbach, Lurija Institut, Zum Tafelholz 8, 78476, Allensbach, Germany
| | - Eva Vogt
- Kliniken Schmieder Allensbach, Lurija Institut, Zum Tafelholz 8, 78476, Allensbach, Germany
| | - Joachim Liepert
- Kliniken Schmieder Allensbach, Lurija Institut, Zum Tafelholz 8, 78476, Allensbach, Germany
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Moustafa IM, Diab AA. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial. Rheumatol Int 2015; 35:1163-74. [DOI: 10.1007/s00296-015-3248-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
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Ende-Henningsen B, Henningsen H. Neurobiologische Grundlagen der Plastizität des Nervensystems. NeuroRehabilitation 2010. [DOI: 10.1007/978-3-642-12915-5_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Influence of topical anaesthesia on the corticomotor response to tongue training. Arch Oral Biol 2009; 54:696-704. [DOI: 10.1016/j.archoralbio.2009.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 04/04/2009] [Accepted: 04/13/2009] [Indexed: 11/21/2022]
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Haavik Taylor H, Murphy BA. Altered cortical integration of dual somatosensory input following the cessation of a 20 min period of repetitive muscle activity. Exp Brain Res 2006; 178:488-98. [PMID: 17136532 DOI: 10.1007/s00221-006-0755-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2006] [Accepted: 10/08/2006] [Indexed: 11/30/2022]
Abstract
The adult human central nervous system (CNS) retains its ability to reorganize itself in response to altered afferent input. Intracortical inhibition is thought to play an important role in central motor reorganization. However, the mechanisms responsible for altered cortical sensory maps remain more elusive. The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a period of repetitive contractions. To achieve this, the dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was utilized in 14 subjects. SEPs were recorded following median and ulnar nerve stimulation at the wrist (1 ms square wave pulse, 2.47 Hz, 1x motor threshold). SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25 and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves. There was a significant increase in the MU/M + U ratio for both cortical SEP components following the 20 min repetitive contraction task, i.e. the N20-P25 complex, and the P22-N30 SEP complex. These cortical ratio changes appear to be due to a reduced ability to suppress the dual input, as there was also a significant increase in the amplitude of the MU recordings for the same two cortical SEP peaks (N20-P25 and P22-N30) following the typing task. No changes were observed following a control intervention. The N20 (S1) changes may reflect the mechanism responsible for altering the boundaries of cortical sensory maps, changing the way the CNS perceives and processes information from adjacent body parts. The N30 changes may be related to the intracortical inhibitory changes shown previously with both single and paired pulse TMS. These findings may have implications for understanding the role of the cortex in the initiation of overuse injuries.
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Affiliation(s)
- Heidi Haavik Taylor
- Human Neurophysiology and Rehabilitation Laboratory, Department of Sport and Exercise Science, Tamaki Campus, University of Auckland, Auckland, New Zealand.
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Pandin P, Salengros JC, d'Hollander A, Tchekap C, Vandesteene A. Somatosensory evoked potentials as an objective assessment of the sensory median nerve blockade after infraclavicular block. Can J Anaesth 2006; 53:67-72. [PMID: 16371611 DOI: 10.1007/bf03021529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Median nerve somatosensory evoked responses (MnSSER) alterations were compared to clinical tests (cold and pinprick) variations, in 20 ASA I adult patients following infraclavicular block obtained with 40 mL ropivacaine 0.5% to assess first, the difference of time course of the respective electrophysiological and clinical signs, and second, the objectivity and the reproducibility of MnSSER changes. CLINICAL FEATURES Four MnSSER derivations (Erb's point; cutaneous projection of peripheral end of brachial plexus; posterior neck at C6 level, frontal and controlateral parietal scalp) were monitored and recorded for retrospective analysis. Continuous data acquisition were started before ropivacaine injection (baseline) and maintained for 30 min thereafter. Every three minutes after ropivacaine injection, cold and pinprick tests were performed in the hand median nerve cutaneous supply zone and were assessed using a sensory visual score (varying from 0-10). Data were compared using analysis of variance. Although MnSSER values were stable during baseline period, after ropivacaine administration, severe progressive amplitude depressions of selected MnSSER were detected in every patient. While clinical cold and pinprick tests became positive (score > 8) only 15.8 +/- 1.2 min and 20.1 +/- 1.8 min respectively after ropivacaine administration, the mean time to observe the earliest MnSSER 20% amplitude decrease at Erb's point derivation was reduced to 5.6 +/- 1.1 min (P < 0.01). CONCLUSION Selected MnSSER amplitude reduction indicates objectively the onset of median nerve anesthesia following infraclavicular brachial plexus block before the appearance of clinical signs.
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Affiliation(s)
- Pierre Pandin
- Department of Anesthesiology and Intensive Care, Erasmus Hospital, Lennik Drive 808, B-1070 Brussels, Belgium.
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Bretzner F, Drew T. Changes in Corticospinal Efficacy Contribute to the Locomotor Plasticity Observed After Unilateral Cutaneous Denervation of the Hindpaw in the Cat. J Neurophysiol 2005; 94:2911-27. [PMID: 16014797 DOI: 10.1152/jn.00254.2005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We used microwire electrodes chronically implanted into the hindlimb representation of the motor cortex as well as into the pyramidal tract to test the hypothesis that the corticospinal system contributes to the locomotor plasticity that is observed after cutaneous denervation of the cat hindpaw. A total of 23 electrodes implanted into the motor cortex in three cats trained to walk on a treadmill produced phase-dependent, short-latency, twitch responses in hindlimb flexor and extensor muscles during locomotion. After a unilateral cutaneous denervation of the hindpaw, the cats showed transient deficits in locomotion, including a dragging of the hindpaw along the treadmill belt during the swing phase. This deficit rapidly recovered over the course of a few days. The recovery of locomotion was accompanied by an increase in the magnitude of the responses evoked in different muscles by the cortical stimulation at all 23 cortical sites. Response magnitude increased rapidly within the first 1–2 wk postdenervation before attaining a plateau at ≥3 wk. In two cats, for which detailed information was obtained, response magnitude in the knee flexor, semitendinosus (St), was increased by >250% at 14/18 sites (mean increase = 1,235%). Increased responses in the St to stimulation were also observed at two of the four pyramidal tract sites after the denervation but were relatively smaller (max = 593%) than those evoked by the cortical stimulation. We suggest that the denervation produces changes in both cortical and spinal excitability that, together, produce a change in corticospinal efficacy that contributes to the recovery of locomotor function.
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