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Remediating Brain Instabilities in a Neurology Practice
Published in Hanno W. Kirk, Restoring the Brain, 2020
We cannot talk about the entity of “headache” in a chapter dedicated to the practice of clinical neurofeedback in a neurology specialty without expanding on this most common of complaints in medicine. The central pathophysiology of headache syndromes has a shared mechanism with arousal disorders38 and with myofascial head and neck pain disorders,39 accounting for frequent comorbidities. Headache invariably shows up in refractory extracranial disorders (e.g. autoimmune disease and chronic fatigue syndrome). Regardless of the association, chronic headache syndromes reflect an imminent or prevailing central dysregulation by whatever disease entity, effecting a consistent firing of afferents to the trigeminal complex (this largest of the cranial nerves serving a major sensory function to all anatomic structures above the shoulders, as well as providing motor efferents to the muscles of mastication). The spinal trigeminal nucleus, in particular, receives pain (and temperature) sensation from the head and facial structures and descends to the third cervical level, receiving nociceptive cervical afferents.40
Neural Control of Coughing And Sneezing
Published in Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop, Neural Control of the Respiratory Muscles, 2019
Roger Shannon, Donald C. Boiser, Bruce G. Lindsey
The respiratory areas of the nasal mucosa are innervated primarily by the trigeminal nerve. Electrical stimulation of branches of the trigeminal nerve (anterior ethmoidal, posterior nasal, and infraorbital) can produce sneeze-like responses (fictive sneeze).41,45 Trigeminal nerve afferents project onto second-order neurons in the spinal trigeminal nucleus.25 Although stimulation of trigeminal nerve afferents has an effect on the respiratory pattern of neurons (see below), anatomical and neurophysiological evidence suggests there are no direct afferent projections to medullary areas involved in the control of breathing.24,42 Histological findings showed nasal trigeminal afferent projections within the NPBM-KF,31 suggesting that “sneeze” receptors may act in part through the pneumotaxic center/pontine respiratory group. There have been no studies of the sneeze reflex evoked by specific physiological stimuli to determine the location in the trigeminal nucleus, characteristics, and specific projections of sneeze relay neurons to the DRG or BÖT/VRG. The use of repetitive air puffs in the nasal cavity to evoke sneeze shows promise as a specific physiological stimulus.39
Viscerosensory Processing in Nucleus Tractus Solitarii: Structural and Neurochemical Substrates
Published in I. Robin A. Barraco, Nucleus of the Solitary Tract, 2019
D.A. Ruggiero, V.M. Pickel, T.A. Milner, M. Anwar, K. Otake, E.P. Mtui, D. Park
Other cells were labeled in the ventral subolivary nucleus, nucleus pars α and ventral raphe. In the rostral dorsomedial medulla a small cell column was labeled in the periventricular gray and spatially segregated from unlabeled soma in the nucleus prepositus. Others extended into the dorsomedial reticular formation. NTS projection cells in the aforementioned columns were directly contiguous with those in lamina V-VII and X, respectively. Labeled cells in the spinal trigeminal nucleus caudalis pars zonale and paratrigeminal nucleus extended caudally into superficial laminae of the cervical dorsal horn.
Congenital alacrima
Published in Orbit, 2022
Zhenyang Zhao, Richard C. Allen
The neural regulation of lacrimal gland secretion comprises an afferent sensory arm and a parasympathetic dominant efferent arm. The afferent arm receives input from the nasal mucosa and ocular surface sensory fibers, which are composed of the polymodal nociceptors of the cornea.4 The stimulatory signal is processed in the spinal trigeminal nucleus and relayed to the superior salivary nucleus.5 The efferent arm originates from the superior salivary nucleus projecting to the pterygopalatine ganglion, initially through the greater superficial petrosal nerve, which later joins the deep petrosal nerve to form the vidian nerve before synapsing. The postganglionic fibers from the pterygopalatine ganglion provide parasympathetic innervation for the lacrimal gland.6 The same process regulates both reflex and basal tear secretion despite being different clinical concepts. This is supported by the observation that minimal basal tear secretion occurs without stimuli during sleep and under local or general anesthesia.7 Any interruptions along this pathway can lead to decreased tear production and alacrima.
Neck associated factors related to migraine in adolescents with painful temporomandibular disorders
Published in Acta Odontologica Scandinavica, 2021
Interestingly, compared with adolescents with only painful TMD, adolescents with both painful TMD and migraine seems to have greater associations among intensity of neck pain, a forward head posture, the number of active TrPs in the masticatory and cervical muscles, and intensity of the orofacial pain. Sensory afferent input from the regional masticatory and cervical muscle terminate in the trigeminocervical complex which is composed of the first and second cervical dorsal horns of the cervical spinal cord and the caudal part of the spinal trigeminal nucleus. Sustained and increased nociceptive input from headache and painful TMD may enhance interactions with the orofacial and neck pain intensity and the cervical and masticatory MFP and this may lead to positive feedback loop in the trigeminocervical complex. As mentioned above, a forward head posture could enhance this positive loop by increasing the cervical MFP.
Spinal cord involvement in Lewy body-related α-synucleinopathies
Published in The Journal of Spinal Cord Medicine, 2020
Raffaele Nardone, Yvonne Höller, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Cristina Florea, Kerstin Schwenker, Stefan Golaszewski, Leopold Saltuari, Eugen Trinka
The first relay stations of the pain system as well as parasympathetic and sympathetic pre- and postganglionic nerve cells in the lower brainstem, spinal cord, and coeliac ganglion has been investigated by using immunocytochemistry for α-synuclein, These examinations showed immunoreactive inclusions for the first time in spinal cord lamina I neurons. The lower portions of the spinal cord downwards of the fourth thoracic segment were mainly affected, while the spinal trigeminal nucleus was found to be virtually intact. An additional involvement of the parasympathetic preganglionic projection neurons of the vagal nerve, the sympathetic preganglionic neurons of the spinal cord, and the postganglionic neurons of the coeliac ganglion has been reported. The connections between these structures may explain their particular vulnerability. Lamina I neurons directly project upon sympathetic relay centers involved in the pain system; these, in turn, influence the parasympathetic regulation of the enteric nervous system.