Assessment of a Newly Recognized Association

Blanc, Jean‐Jacques; L’heveder, G.; Mansourati, Jacques; Tea, Say Hak; Guillo, P.; Mabin, D

doi:10.1161/01.cir.95.11.2548

Cited by 29 publications

(11 citation statements)

References 10 publications

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“…This is contrary to the hypothesis (Blanc et al. 1997) that chronic denervation of the sternocleidomastoid muscles with aging interrupts normal integration of neck muscle proprioception and carotid baroreceptor information, leading to excessive responses to CSM and an increased risk of syncope. Our results suggest that the previously reported association between sternocleidomastoid denervation and CSH in older adults (Blanc et al.…”

Section: Discussionmentioning

confidence: 99%

“…Our results suggest that the previously reported association between sternocleidomastoid denervation and CSH in older adults (Blanc et al. 1997) may be coincidental, rather than causal, and highlight the need for further research to identify the pathophysiological mechanisms underlying CSH.…”

Section: Discussionmentioning

confidence: 99%

“…1997) of sternocleidomastoid denervation contributing to CSH in older adults. This discrepancy may partly reflect the different methodology employed in the previous study, whereby sternocleidomastoid raw EMG was qualified based on physician observation as “normal” or “abnormal – moderate or severe,” and not subjected to quantitative evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Loss of this central integration due to sternocleidomastoid denervation might lead to hypersensitive responses during daily activities, such as neck turning, as well as during CSM (Blanc et al. 1997). This led to the first description of sternocleidomastoid electromyographic abnormalities in elderly patients with CSH (Blanc et al.…”

Section: Introductionmentioning

confidence: 99%

“…This led to the first description of sternocleidomastoid electromyographic abnormalities in elderly patients with CSH (Blanc et al. 1997). It was suggested that chronic denervation of the sternocleidomastoid muscles with aging interrupts normal integration of neck muscle proprioception and carotid baroreceptor information, leading to excessive responses to CSM and an increased risk of syncope.…”

Section: Introductionmentioning

confidence: 99%

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Carotid sinus hypersensitivity: block of the sternocleidomastoid muscle does not affect responses to carotid sinus massage in healthy young adults

et al. 2017

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The arterial baroreflex is crucial for short‐term blood pressure control – abnormal baroreflex function predisposes to syncope and falling. Hypersensitive responses to carotid baroreflex stimulation using carotid sinus massage (CSM) are common in older adults and may be associated with syncope. The pathophysiology of this hypersensitivity is unknown, but chronic denervation of the sternocleidomastoid muscles is common in elderly patients with carotid sinus hypersensitivity (CSH), and is proposed to interfere with normal integration of afferent firing from the carotid baroreceptors with proprioceptive feedback from the sternocleidomastoids, producing large responses to CSM. We hypothesized that simulation of sternocleidomastoid “denervation” using pharmacological blockade would increase cardiovascular responses to CSM. Thirteen participants received supine and tilted CSM prior to intramuscular injections (6–8 mL distributed over four sites) of 2% lidocaine hydrochloride, and 0.9% saline (placebo) in contralateral sternocleidomastoid muscles. Muscle activation was recorded with electromyography (EMG) during maximal unilateral sternocleidomastoid contraction both pre‐ and postinjection. Supine and tilted CSM were repeated following injections and responses compared to preinjection. Following lidocaine injection, the muscle activation fell to 23 ± 0.04% of the preinjection value (P < 0.001), confirming neural block of the sternocleidomastoid muscles. Cardiac (RRI, RR interval), forearm vascular resistance (FVR), and systolic arterial pressure (SAP) responses to CSM did not increase after lidocaine injection in either supine or tilted positions (supine: ΔRRI −72 ± 31 ms, ΔSAP +2 ± 1 mmHg, ΔFVR +4 ± 4%; tilted: ΔRRI −20 ± 13 ms, ΔSAP +2 ± 2 mmHg, ΔFVR +2 ± 4%; all P > 0.05). Neural block of the sternocleidomastoid muscles does not increase cardiovascular responses to CSM. The pathophysiology of CSH remains unknown.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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