Novel concept for the epaxial/hypaxial boundary based on neuronal development.

Trunk muscles in vertebrates are classified as either dorsal epaxial or ventral hypaxial muscles. Epaxial and hypaxial muscles are defined as muscles innervated by the dorsal and ventral rami of spinal nerves, respectively. Each cluster of spinal motor neurons passing through dorsal rami innervates epaxial muscles, whereas clusters traveling on the ventral rami innervate hypaxial muscles. Herein, we show that some motor neurons exhibiting molecular profiles for epaxial muscles follow a path in the ventral rami. Dorsal deep-shoulder muscles and some body wall muscles are defined as hypaxial due to innervation via the ventral rami, but a part of these ventral rami has the molecular profile of motor neurons that innervate epaxial muscles. Thus, the epaxial and hypaxial boundary cannot be determined simply by the ramification pattern of spinal nerves. We propose that, although muscle innervation occurs via the ventral rami, dorsal deep-shoulder muscles and some body wall muscles represent an intermediate group that lies between epaxial and hypaxial muscles.

Age differences in arm-trunk coordination during trunk-assisted reaching.

Reaching for an object is a basic motor skill that requires precise coordination between elbow, shoulder and trunk motion. The purpose of this research study was to examine age-related differences in compensatory arm-trunk coordination during trunk-assisted reaching. To engage the arm and trunk, an older and younger group of participants were asked to (1) maintain a fixed hand position while flexing forward at the trunk [stationary hand task (SHT)] and (2) reach to a within-arm's reach target while simultaneously flexing forward at the trunk [reaching hand task (RHT)] (Raptis et al. in J Neurophysiol 97:4069-4078, 2007; Sibindi et al. in J Vestib Res 23:237-247, 2013). Both tasks were completed with eyes closed. Participants completed the two tasks with their dominant and non-dominant arms, and at both a fast and a preferred speed. On average, young and older participants performed in a similar manner in the SHT, such that they maintained their hand position by compensating for trunk movement with modifications of the elbow and shoulder joints. In the RHT, young and older participants had similar endpoint accuracy. This similarity in performance between young and older participants in the SHT and RHT tasks was observed regardless of the arm used or movement speed. However, for both tasks, movements in older adults were significantly more variable compared to younger adults as shown by the larger variability in arm-trunk coordination performance (gain scores) in the SHT and higher movement time variability in the RHT. Thus, results imply that older adults maintain their ability to coordinate arm and trunk movements efficiently during reaching actions but are not as consistent as younger adults.

Three-Dimensional Balance Training Using Visual Feedback on Balance and Walking Ability in Subacute Stroke Patients: A Single-Blinded Randomized Controlled Pilot Trial.

BACKGROUND: Trunk-activating exercises for balance are important because trunk weakness is relevant to the functional performance of individuals with stroke. This study aimed to explore the effects of three-dimensional balance training using visual feedback on balance and walking ability in subacute stroke patients. METHODS: Twenty-four participants with subacute stroke were randomly assigned to the experimental or control group. Each group underwent twenty sessions (30 min/day, 5 days/week for 4 weeks). Patients were assessed using the Berg balance scale, gait parameters (gait speed, cadence, step length, and double-limb support period) using GAITRite, and activity-specific balance confidence score, before and after the intervention. RESULTS: The three-dimensional balance training using visual feedback exhibited greater changes in the Berg balance scale, gait speed, cadence, step length, double-limb support period, and activity-specific balance confidence compared with the control group. Statistical analyses showed significant differences in Berg balance scale (P = .012; 95% CI, 2.585-6.415), gait speed (P = .001; 95% CI, .079-.155), cadence (P = .001; 95% CI, 1.622-4.392), step length (P = .003; 95% CI, 1.864-3.908), double-limb support period (P = .003; 95% CI, -3.259 to -0.761) and activity-specific confidence (P = .008; 95% CI, 6.964-14.036) between groups. CONCLUSION: Three-dimensional balance training using visual feedback may be more effective than conventional training in improving balance, walking ability, and activity-specific balance confidence in patients with subacute stroke.

Crossed corticospinal facilitation between arm and trunk muscles in humans.

A voluntary contraction of muscles with one arm increases the excitability of corticospinal projections to the contralateral resting arm, a phenomenon known as crossed facilitation. Although many motor tasks engage simultaneous activation of the arm and trunk, interactions between corticospinal projections targeting these segments remain largely unknown. Using transcranial magnetic stimulation over the trunk representation of the primary motor cortex, we examined motor-evoked potentials (MEPs) in the resting erector spinae (ES) muscle when the contralateral arm remained at rest or performed 20% of isometric maximal voluntary contraction (MVC) into index finger abduction, thumb abduction, elbow flexion, and elbow extension. We found that MEP size in the ES increased during all voluntary contractions, with greater facilitation occurring during elbow flexion and index finger abduction. To further examine the origin of changes in MEP size, we measured short-interval intracortical inhibition (SICI) and cervicomedullary MEPs (CMEPs) in the ES muscle during elbow flexion and index finger abduction and when the arm remained at rest. Notably, SICI decreased and CMEPs remained unchanged in the ES during both voluntary contractions compared with rest, suggesting a cortical origin for the effects. Our findings reveal crossed facilitatory interactions between trunk extensor and proximal and distal arm muscles, particularly for elbow flexor and index finger muscles, likely involving cortical mechanisms. These interactions might reflect the different role of these muscles during functionally relevant arm and trunk movements. NEW & NOTEWORTHY Many of the tasks of daily life involve simultaneous activation of the arm and trunk. We found that responses in the erector spinae muscles evoked by motor cortical stimulation increased in size during elbow flexion and extension and during index finger abduction and thumb abduction. Crossed facilitation with the trunk was more pronounced during elbow flexion and index finger abduction. These results might reflect the different role of these muscles during arm and trunk movements.

Fall risk during opposing stance perturbations among healthy adults and chronic stroke survivors.

Studies examining recovery from SLIPS and TRIPS indicate higher incidence of falls during SLIPS than TRIPS however, differences in the recovery mechanisms during these opposing perturbations have not been examined. We therefore aimed to compare the reactive balance responses contributing to fall risk during SLIPS and TRIPS at comparable perturbation intensity among community-dwelling healthy adults and chronic stroke survivors. Younger adults (N = 11), age-matched adults (N = 11) and chronic stroke survivors (N = 12) were exposed to a single SLIP and TRIP through a motorized treadmill (16 m/s2, 0.20 m). Center of mass (COM) state stability was measured by recording COM position and velocity relative to base of support, i.e., D COM/BOS and X COM/BOS, respectively. Trunk and compensatory step kinematics were also recorded. During SLIPS, the incidence of falls among stroke survivors was greater than healthy adults (53.83% vs. 0%), however not for TRIPS. All groups showed higher change in postural stability from liftoff to touchdown during TRIPS than SLIPS. Among healthy adults higher change in D COM/BOS during TRIPS was accompanied by the ability to control trunk flexion at step touchdown and lower peak trunk velocity as compared with SLIPS, with no significant differences in compensatory step length between the perturbations (p > 0.05). Chronic stroke survivors increased compensatory step length during TRIPS versus SLIPS (p < 0.05) contributing to greater stability change. They were unable to control trunk excursion and peak trunk velocity as compared with the healthy adults leading to lower stability than healthy younger and age-matched adults during SLIPS and lower stability than younger adults during TRIPS. Difficulty in trunk control during SLIPS among all individuals and compensatory step length  among stroke survivors emphasizes higher fall risk for SLIPS than TRIPS among these populations.

The severity of chewing disorders is related to gross motor function and trunk control in children with cerebral palsy.

PURPOSE: The frequency of chewing disorders increases with decreasing level of gross motor function in children with cerebral palsy (CP). Besides its frequency, the severity of chewing disorders is also important. The aim of this study was to determine the relationship between chewing performance level and gross motor function, and trunk postural control in children with CP. MATERIALS AND METHODS: The study included 119 children with CP (age 2-10 years). Chewing performance level was determined by the Karaduman Chewing Performance Scale (KCPS). The Gross Motor Function Classification System (GMFCS) was used to determine the level of gross motor function. Segmental Assessment of Trunk Control (SATCo) was used to measure trunk control. RESULTS: Children with spastic CP with a median age of 4 years were evaluated, of which 50.4% were male. The percentages of patients classified to GMFCS levels I to V were 43.7%, 6.7%, 9.2%, 5.0%, and 35.3%, respectively. The median KCPS score was 3 (min = 0, max = 4). A good correlation was found between KCPS and GMFCS (p < .001, r = 0.70). Negative, excellent correlations between KCPS and SATCo static, SATCo active, and SATCo reactive postural controls were found (p < .001, r = -0.75, r = -0.77, r = -0.79; respectively). CONCLUSIONS: The severity of chewing disorders is related to the level of gross motor function and trunk postural control in children with CP. Clinical trial number: NCT03241160.

Teaching Adult Rats Spinalized as Neonates to Walk Using Trunk Robotic Rehabilitation: Elements of Success, Failure, and Dependence.

UNLABELLED: Robot therapy promotes functional recovery after spinal cord injury (SCI) in animal and clinical studies. Trunk actions are important in adult rats spinalized as neonates (NTX rats) that walk autonomously. Quadrupedal robot rehabilitation was tested using an implanted orthosis at the pelvis. Trunk cortical reorganization follows such rehabilitation. Here, we test the functional outcomes of such training. Robot impedance control at the pelvis allowed hindlimb, trunk, and forelimb mechanical interactions. Rats gradually increased weight support. Rats showed significant improvement in hindlimb stepping ability, quadrupedal weight support, and all measures examined. Function in NTX rats both before and after training showed bimodal distributions, with "poor" and "high weight support" groupings. A total of 35% of rats initially classified as "poor" were able to increase their weight-supported step measures to a level considered "high weight support" after robot training, thus moving between weight support groups. Recovered function in these rats persisted on treadmill with the robot both actuated and nonactuated, but returned to pretraining levels if they were completely disconnected from the robot. Locomotor recovery in robot rehabilitation of NTX rats thus likely included context dependence and/or incorporation of models of robot mechanics that became essential parts of their learned strategy. Such learned dependence is likely a hurdle to autonomy to be overcome for many robot locomotor therapies. Notwithstanding these limitations, trunk-based quadrupedal robot rehabilitation helped the rats to visit mechanical states they would never have achieved alone, to learn novel coordinations, and to achieve major improvements in locomotor function. SIGNIFICANCE STATEMENT: Neonatal spinal transected rats without any weight support can be taught weight support as adults by using robot rehabilitation at trunk. No adult control rats with neonatal spinal transections spontaneously achieve similar changes. The robot rehabilitation system can be inactivated and the skills that were learned persist. Responding rats cannot be detached from the robot altogether, a dependence develops in the skill learned. From data and analysis here, the likelihood of such rats to respond to the robot therapy can also now be predicted. These results are all novel. Understanding trunk roles in voluntary and spinal reflex integration after spinal cord injury and in recovery of function are broadly significant for basic and clinical understanding of motor function.

Referent control and motor equivalence of reaching from standing.

Motor actions may result from central changes in the referent body configuration, defined as the body posture at which muscles begin to be activated or deactivated. The actual body configuration deviates from the referent configuration, particularly because of body inertia and environmental forces. Within these constraints, the system tends to minimize the difference between these configurations. For pointing movement, this strategy can be expressed as the tendency to minimize the difference between the referent trajectory (RT) and actual trajectory (QT) of the effector (hand). This process may underlie motor equivalent behavior that maintains the pointing trajectory regardless of the number of body segments involved. We tested the hypothesis that the minimization process is used to produce pointing in standing subjects. With eyes closed, 10 subjects reached from a standing position to a remembered target located beyond arm length. In randomly chosen trials, hip flexion was unexpectedly prevented, forcing subjects to take a step during pointing to prevent falling. The task was repeated when subjects were instructed to intentionally take a step during pointing. In most cases, reaching accuracy and trajectory curvature were preserved due to adaptive condition-specific changes in interjoint coordination. Results suggest that referent control and the minimization process associated with it may underlie motor equivalence in pointing. NEW & NOTEWORTHY: Motor actions may result from minimization of the deflection of the actual body configuration from the centrally specified referent body configuration, in the limits of neuromuscular and environmental constraints. The minimization process may maintain reaching trajectory and accuracy regardless of the number of body segments involved (motor equivalence), as confirmed in this study of reaching from standing in young healthy individuals. Results suggest that the referent control process may underlie motor equivalence in reaching.

Syncopation affects free body-movement in musical groove.

One of the most immediate and overt ways in which people respond to music is by moving their bodies to the beat. However, the extent to which the rhythmic complexity of groove-specifically its syncopation-contributes to how people spontaneously move to music is largely unexplored. Here, we measured free movements in hand and torso while participants listened to drum-breaks with various degrees of syncopation. We found that drum-breaks with medium degrees of syncopation were associated with the same amount of acceleration and synchronisation as low degrees of syncopation. Participants who enjoyed dancing made more complex movements than those who did not enjoy dancing. While for all participants hand movements accelerated more and were more complex, torso movements were more synchronised to the beat. Overall, movements were mostly synchronised to the main beat and half-beat level, depending on the body-part. We demonstrate that while people do not move or synchronise much to rhythms with high syncopation when dancing spontaneously to music, the relationship between rhythmic complexity and synchronisation is less linear than in simple finger-tapping studies.

Variations of Cords of Brachial Plexus and Branching Pattern of Nerves Emanating From Them.

Brachial plexus is complex network of nerves, formed by joining and splitting of ventral rami of spinal nerves C5, C6, C7, C8, and T1 forming trunks, divisions, and cords. The nerves emerging from trunks and cords innervate the upper limb and to some extent pectoral region. Scanty literature describes the variations in the formation of cords and nerves emanating from them. Moreover, the variations of cords of brachial plexus and nerves emanating from them have iatrogenic implications in the upper limb and pectoral region. Hence study has been carried out. Twenty-eight upper limbs and posterior triangles from 14 cadavers fixed in formalin were dissected and rare and new variations of cords were observed. Most common variation consisted of formation of posterior cord by fusion of posterior division of upper and middle trunk and lower trunk continued as medial cord followed by originating of 2 pectoral nerves from anterior divisions of upper and middle trunk. Other variations include anterior division of upper trunk continued as lateral cord and pierced the coracobrachialis, upper and middle trunk fused to form common cord which divided into lateral and posterior cords, upper trunk gave suprascapular nerve and abnormal lateral pectoral nerve and formation of median nerve by 3 roots. These variations were analyzed for diagnostic and clinical significance making the study relevant for surgeons, radiologists in arresting failure patients and anatomists academically in medical education.

[THE METHOD CHOICE OF OPERATIVE INTERVENTION IN PATIENTS WITH POSTTRAUMATIC DEFECTS OF COVERING TISSUES OF TRUNK AND EXTREMITIES].

Results of 242 patients treatment, suffering the trunk and extremities covering tissues defects, which have had occur as a consequence of mechanical injury in a 2008 ­ 2016 yrs period, were analyzed. There were 697 оperative interventions performed, of them 492 (70.6%) ­ aiming to restore the tissues injured. The choice of method of the correcting intervention and the tissues defects covering have depended upon the wound dimension and depth, as well as peculiarities of hemodynamics in the area injured. Application of differentiated approach to choice of method for the wound surfaces closure, which were created as a consequence of mechanical injury, have had permitted to achieve satisfactory results in 98.75% of patients.

A cutaneous positioning system.

Our previous work revealed that torso cutaneous information contributes to the internal representation of the torso and plays a role in postural control. Hence, the aims of this study were to assess whether posture could be manipulated by patterns of vibrotactile stimulation and to determine whether resulting modified postures were associated with specific and consistent spatial attitudes. Ten healthy young adults stood in normal and Romberg stances with six vibrating actuators positioned on the torso in contact with the skin over the anatomical locations corresponding to left and right external oblique, internal oblique and erector spinae muscles at the L4/L5 vertebrae level. A 250-Hz tactile vibration was applied for 5 s either at a single location or consecutively at each location in clockwise or counterclockwise sequences. Kinematic analysis of the body segments indicated that postural responses observed in response to single and sequential stimulation patterns were similar, while the center of pressure remained unaltered in any situations. Moreover, torso inclinations followed rectilinear-like path segments chartered by stimuli loci during sequential stimulations. Comparison of torso attitudes with previous results obtained with co-vibration patterns of the same duration showed that torso inclination amplitudes are equivalent for single (one location) and co-vibration (pairs of locations) patterns inducing the same directional effect. Hence, torso cutaneous information exhibits kinesthetic properties, appears to provide a map of upper body spatial configuration, and could assume the role of an internal positioning system for the upper body.

Fast gaze reorientations by combined movements of the eye, head, trunk and lower extremities.

Large reorientations of the line of sight, involving combined rotations of the eyes, head, trunk and lower extremities, are executed either as fast single-step or as slow multiple-step gaze transfers. In order to obtain more insight into the mechanisms of gaze and multisegmental movement control, we have investigated time-optimal gaze shifts (i.e. with the instruction to move as fast as possible) during voluntary whole-body rotations to remembered targets up to 180° eccentricity performed by standing healthy humans in darkness. Fast, accurate, single-step movement patterns occurred in approximately 70 % of trials, i.e. considerably more frequently than in previous studies with the instruction to turn at freely chosen speed (30 %). Head-in-space velocity in these cases was significantly higher than during multiple-step transfers and displayed a conspicuously regular bell-shaped profile, increasing smoothly to a peak and then decreasing slowly until realignment with the target. Head-in-space acceleration was on average not different during reorientations to the different target eccentricities. In contrast, head-in-space velocity increased with target eccentricity due to the longer duration of the acceleration phase implemented during trials to more distant targets. Eye saccade amplitude approached the eye-in-orbit mechanical limit and was unrelated to eye/head velocity, duration or target eccentricity. Overall, the combined movement was stereotyped such that the first two principal components accounted for data variance almost up to gaze shift end, suggesting that the three mechanical degrees of freedom under consideration (eye-in-orbit, head-on-trunk and trunk-in-space) are on average reduced to two kinematic degrees of freedom (i.e. eye, head-in-space). Synchronous EMG activity in the anterior tibial and gastrocnemius muscles preceded the onset of eye rotation. Since the magnitude and timing of peak head-in-space velocity were scaled with target eccentricity and because head-on-trunk and trunk-in-space displacements were on average linearly correlated, we propose a separate controller for head-in-space movement, whereas the movement of the eye-in-space may be, in contrast, governed by global, i.e. gaze feedback. The rapid progression of the line of sight can be sustained, and the reactivation of the vestibulo-ocular reflex would be postponed, until gaze error approaches zero only in association with a strong head-in-space neural control signal.

Effects of support surface stability on feedback control of trunk posture.

This study aimed to examine the interactions of visual, vestibular, proprioceptive, and tactile sensory manipulations and sitting on either a stable or an unstable surface on mediolateral (ML) trunk sway. Fifteen individuals were measured. In each trial, subjects sat as quiet as possible, on a stable or unstable surface, with or without each of four sensory manipulations: visual (eyes open/closed), vestibular (left and right galvanic vestibular stimulation alternating at 0.25 Hz), proprioceptive (left and right paraspinal muscle vibration alternating at 0.25 Hz), and tactile (minimal finger contact with object moving in the frontal plane at 0.25 Hz). The root mean square (RMS) and the power at 0.25 Hz (P25) of the ML trunk acceleration were the dependent variables. The latter was analyzed only for the rhythmic sensory manipulations and the reference condition. RMS was always significantly larger on the unstable than the stable surface. Closing the eyes caused a significant increase in RMS, more so on the unstable surface. Vestibular stimulation significantly increased RMS and P25 and more so on the unstable surface. Main effects of the proprioceptive manipulation were significant, but the interactions with surface condition were not. Finally, also tactile manipulation increased RMS and P25, but did not interact with surface condition. Sensory information in feedback control of trunk posture appears to be reweighted depending on stability of the environment. The absolute effects of visual and vestibular manipulations increase on an unstable surface, suggesting a relative decrease in the weights of proprioceptive and tactile information.

Enhancement of anticipatory postural adjustments in older adults as a result of a single session of ball throwing exercise.

The aim of the study was to investigate the role of short-term training in improvement of anticipatory postural adjustments (APAs) and its effect on subsequent control of posture in older adults. Nine healthy older adults were exposed to self-initiated and predictable external perturbations before and after a single training session consisting of throwing a medicine ball. EMG activity of eight trunk and leg muscles and ground reaction forces were recorded before and immediately after the training session. Muscle onsets and center of pressure displacements were analyzed during the anticipatory and compensatory phases of postural control. The training involving throwing of a medicine ball resulted in enhancement of the generation of APAs seen as significantly early onsets of leg and trunk muscle activity prior to the bilateral arm flexion task. Significantly early activation of postural muscles observed prior to the predictable external perturbation, the task that was not a part of training, indicates the transfer of the effect of the single training session. The observed training-related improvements of APAs suggest that APA-focused rehabilitation could be effective in improving postural control, functional balance, mobility, and quality of life in the elderly.

Visual influences on postural and manual interpersonal coordination during a joint precision task.

We investigated whether the interpersonal postural coordination that occurs during a joint supra-postural, manual precision task is driven by the constraints of the task, or, instead results from visual entrainment to the movements of a co-actor. Participants were instructed to coordinate their finger movements under conditions where participants could see others' whole-body movements or could only see the results of the other's actions. Participants' finger and torso movements were recorded. Coordination was quantified using cross-recurrence quantification analysis measures. Interpersonal coordination was enhanced by, although it did not depend entirely upon, visual information about the co-actor's body movements.

Time disparity sensitive behavior and its neural substrates of a pulse-type gymnotiform electric fish, Brachyhypopomus gauderio.

Roles of the time coding electrosensory system in the novelty responses of a pulse-type gymnotiform electric fish, Brachyhypopomus, were examined behaviorally, physiologically, and anatomically. Brachyhypopomus responded with the novelty responses to small changes (100 µs) in time difference between electrosensory stimulus pulses applied to different parts of the body, as long as these pulses were given within a time period of ~500 µs. Physiological recording revealed neurons in the hindbrain and midbrain that fire action potentials time-locked to stimulus pulses with short latency (500-900 µs). These time-locked neurons, along with other types of neurons, were labeled with intracellular and extracellular marker injection techniques. Light and electron microscopy of the labeled materials revealed neural connectivity within the time coding system. Two types of time-locked neurons, the pear-shaped cells and the large cells converge onto the small cells in a hypertrophied structure, the mesencephalic magnocellular nucleus. The small cells receive a calyx synapse from a large cell at their somata and an input from a pear-shaped cell at the tip of their dendrites via synaptic islands. The small cells project to the torus semicircularis. We hypothesized that the time-locked neural signals conveyed by the pear-shaped cells and the large cells are decoded by the small cells for detection of time shifts occurring across body areas.

Segmental trunk control acquisition and reaching in typically developing infants.

This study explored the influence of an external support at the thoracic and pelvic level of the trunk on the success of reaching, postural stability and reaching kinematics while infants reached for a toy. Seventeen infants (4-6 months) were clustered into two groups according to their trunk control assessed with the Segmental Assessment of Trunk Control. Major differences were seen between groups with pelvic support, whereas with thoracic support, all infants showed similar quality reaching behaviors. With the external pelvic support, infants who had acquired trunk control in the lumbar region were more accurate in their reaching movements (less movement time, improved straightness of reach, less movement units and increased path length per movement unit) and were more stable (decreased trunk and head displacement) during a reach than infants who had only acquired trunk control in the thoracic region. These results support the hypothesis that trunk control influences the quality of reaching behavior.

Long-term results of endoscopic sympathetic block using the Lin-Telaranta classification.

BACKGROUND: Endoscopic thoracic sympathectomy has been used successfully in the treatment of blushing, excessive sweating, and social phobia. However, the adverse effects of endoscopic thoracic sympathectomy are more severe and frequent than the adverse effects of endoscopic sympathetic block (ESB). The use of different blocking levels for different indications in ESB according to the Lin-Telaranta classification further decreases the postoperative adverse effects. However, there are few data on the long-term results of ESB performed using the Lin-Telaranta classification. METHODS: Ninety-five patients (55 men, 40 women) were interviewed by before the surgery using our routine questionnaire, and the same questionnaire was answered postoperatively by the patients. In addition, a long-term follow-up questionnaire was sent to all patients whose address was known. Forty-seven patients (24 men, 23 women) answered to this questionnaire. The Davidson brief social phobia scale and the Liebowitz quality of life scale were used. Patients were divided to 3 categories: category 1, patients with sweating problems; category 2, patients with blushing; and category 3, and patients with symptoms other than sweating or blushing. RESULTS: Among patients in category 1, social phobia decreased from 12.43 to 6.71 (p = 0.004), in category 2 from 13.97 to 7.69 (p < 0.001), and in category 3 from 13.18 to 9.64 (p = 0.007) during long-term follow-up. Among patients with severe sweating problems preoperatively, sweating decreased from 2.50 to 1.29 (p = 0.003) among patients in category 1 and from 1.86 to 1.16 (p < 0.001) among patients in category 2. Among patients with unbearable blushing, blushing decreased from 4 to 1.80 (p < 0.001). CONCLUSIONS: Patients got a clear help from ESB performed using the Lin-Telaranta classification to treat blushing, excessive sweating, and social phobia with and without physical symptoms. In addition, compensatory sweating increased only slightly.

Stress-induced modulation of nociceptive responses in the rat anterior cingulate cortex.

In the limbic system, the anterior cingulate cortex (ACCX) is one of the key areas involved in the close association between pain and emotion. However, neuronal changes in ACCX nociceptive responses after stress conditioning have not yet been quantitatively investigated. We investigated the modulation of nociceptive responses in the ACCX neurons following restraint stress in rats. The present study demonstrated that stress-conditioning enhanced excitatory nociceptive responses in the ACCX following tail stimuli in the mid-term (7 days). Short-term (3 days) and long-term (21 days) of stress conditioning did not affect these responses significantly. Nociceptive responses evoked by other sites of the body (nose, back and four paws) stimulation were not changed by stress-conditioning, indicating that neural information from the tail is important for emotional system modulation. It is suggested that the emotional/affective part of the pain sensation is strongly modified by stress through neuroplasticity in the ACCX.