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.

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.

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Background:Musculoskeletal models served to analyze head-neck motion and injury during automotive impact. Although muscle activation is known to affect the kinematic response, a model with properly validated muscle contributions does not exist to date. The goal of this study was to enhance a musculoskeletal neck model and to validate passive properties, muscle moment arms, maximum isometric strength, and muscle activity.Methods: A dynamic nonlinear musculoskeletal model of the cervical spine with 48 degrees of freedom was extended with 129 bilateral muscle segments. The stiffness of the passive ligamentous spine was validated in flexion/extension, lateral bending, and axial rotation. Instantaneous joint centers of rotation were validated in flexion/extension, and muscle moment arms were validated in flexion/extension and lateral bending. A linearized static model was derived to predict isometric strength and muscle activation in horizontal head force and axial rotation tasks.Results: The ligamentous spine stiffness, instantaneous joint centers of rotation, muscle moment arms, cervical isometric strength, and muscle activation patterns were in general agreement with biomechanical data. Taking into account equilibrium of all neck joints, isometric strength was strongly reduced in flexion (46 %) and axial rotation (81 %) compared to a simplified solution only considering equilibrium around T1-C7, while effects were marginal in extension (3 %).Conclusions: For the first time, isometric strength and muscle activation patterns were accurately predicted using a neck model with full joint motion freedom. This study demonstrates that model strength will be overestimated particularly in flexion and axial rotation if only muscular moment generation at T1-C7 is taken into account and equilibrium in other neck joints is disregarded.

Botulinum toxin (BoNT) injections in the dystonic muscles is the preferred treatment for Cervical Dystonia (CD), but the proper identification of the dystonic muscles remains a challenge. Previous studies showed decreased 8–14 Hz autospectral power in the electromyography (EMG) of splenius muscles in CD patients. Cumulative distribution functions (CDF’s) of dystonic muscles showed increased CDF10 values, representing increased autospectral powers between 3 and 10 Hz, relative to power between 3 and 32 Hz. In this study, we evaluated both methods and investigated the effects of botulinum toxin. Intramuscular EMG recordings were obtained from the splenius, semispinalis, and sternocleidomastoid muscles during standardized isometric tasks in 4 BoNT-naïve CD patients, 12 BoNT-treated patients, and 8 healthy controls. BoNT-treated patients were measured 4–7 weeks after their last BoNT injections and again after 11–15 weeks. We found significantly decreased 8–14 Hz autospectral power in splenius muscles, but not in the semispinalis and sternocleidomastoid muscles of CD patients when compared to healthy controls. CDF10 analysis was superior in demonstrating subtle autospectral changes, and showed increased CDF10 values in all studied muscles of CD patients. These results did not change significantly after BoNT injections. Further studies are needed to investigate the origin of these autospectral changes in dystonia patients, and to assess their potential in muscle selection for BoNT treatment.