Dependency of human neck reflex responses on the bandwidth of pseudorandom anterior-posterior torso perturbations.

The vestibulocollic (VCR) and cervicocollic (CCR) reflexes are essential to stabilize the head-neck system and to deal with unexpected disturbances. This study investigates how neck reflexes contribute to stabilization and modulate with perturbation properties. We hypothesized that VCR and CCR modulate with the bandwidth of the perturbation and that this modulation is maintained across amplitudes and influenced by the eyes being open or closed. Seated subjects were perturbed in an anterior-posterior direction. The perturbations varied in bandwidth from 0.3 Hz to a maximum of 1.2, 2.0, 4.0, and 8.0 Hz, at three amplitudes, and with eyes open and closed. Frequency response functions of head kinematics and neck muscle EMG demonstrated substantial changes with bandwidth and vision and minor changes with amplitude, which through closed-loop identification were attributed to neural (reflexive) modulation. Results suggest that both reflexes were attenuated when perturbations exceeded the system's natural frequency, thereby shifting from a head-in-space to a head-on-trunk stabilization tendency. Additionally, results indicate that reflexive and mechanical stiffness marginally exceed the negative stiffness due to gravity; a stabilization strategy which minimizes effort. With eyes closed, reflexes were attenuated further, presumably due to a reduced ability to discriminate self-motion, driving the system to a head-on-trunk stabilization strategy at the highest bandwidth. We conclude that VCR and CCR modulate with perturbation bandwidth and visual feedback conditions to maintain head-upright posture, but are invariant across amplitude changes.

Dynamic head-neck stabilization and modulation with perturbation bandwidth investigated using a multisegment neuromuscular model.

The human head-neck system requires continuous stabilization in the presence of gravity and trunk motion. We investigated contributions of the vestibulocollic reflex (VCR), the cervicocollic reflex (CCR), and neck muscle co-contraction to head-in-space and head-on-trunk stabilization, and investigated modulation of the stabilization strategy with the frequency content of trunk perturbations and the presence of visual feedback. We developed a multisegment cervical spine model where reflex gains (VCR and CCR) and neck muscle co-contraction were estimated by fitting the model to the response of young healthy subjects, seated and exposed to anterior-posterior trunk motion, with frequency content from 0.3 up to 1, 2, 4 and 8Hz, with and without visual feedback. The VCR contributed to head-in-space stabilization with a strong reduction of head rotation (<8Hz) and a moderate reduction of head translation (>1Hz). The CCR contributed to head-on-trunk stabilization with a reduction of head rotation and head translation relative to the trunk (<2Hz). The CCR also proved essential to stabilize the individual intervertebral joints and prevent neck buckling. Co-contraction was estimated to be of minor relevance. Control strategies employed during low bandwidth perturbations most effectively reduced head rotation and head relative displacement up to 3Hz while control strategies employed during high bandwidth perturbations reduced head global translation between 1 and 4Hz. This indicates a shift from minimizing head-on-trunk rotation and translation during low bandwidth perturbations to minimizing head-in-space translation during high bandwidth perturbations. Presence of visual feedback had limited effects suggesting increased usage of vestibular feedback.

Dynamic head-neck stabilization in cervical dystonia.

BACKGROUND: Effective sensorimotor integration is essential to modulate (adapt) neck stabilization strategies in response to varying tasks and disturbances. This study evaluates the hypothesis that relative to healthy controls cervical dystonia patients have an impaired ability to modulate afferent feedback for neck stabilization with changes in the frequency content of mechanical perturbations. METHODS: We applied anterior-posterior displacement perturbations (110s) on the torso of seated subjects, while recording head-neck kinematics and muscular activity. We compared low bandwidth (0.2-1.2Hz) and high bandwidth (0.2-8Hz) perturbations where our previous research showed a profound modulation of stabilization strategies in healthy subjects. Cervical dystonia patients and age matched controls performed two tasks: (1) maintain head forward posture and (2) allow dystonia to dictate head posture. FINDINGS: Patients and controls demonstrated similar kinematic and muscular responses. Patient modulation was similar to that of healthy controls (P>0.05); neck stiffness and afferent feedback decreased with high bandwidth perturbations. During the head forward task patients had an increased neck stiffness relative to controls (P<0.05), due to increased afferent feedback. INTERPRETATION: The unaffected modulation of head-neck stabilization (both kinematic and muscular) in patients with cervical dystonia does not support the hypothesis of impaired afferent feedback modulation for neck stabilization.