Abstract
IntroductionThe Blink Reflex Test (BRT) is a neurophysiological examination used for evaluation of brainstem reflex circuits. MRI is the most precise modality for evaluation of MS lesion anatomy. Our study objective was to investigate how the functional results of the neurophysiological BRT relate to the anatomy of MS lesions in routine MRI studies.Methods65 MS patients underwent the BRT within 2 months of a brain MRI showing demyelinating lesions.Results The overall sensitivity of the BRT was 90.8%, while in patients with at least one brainstem lesion and no brainstem lesions it was 91.4% and 90%, respectively.Discussion The presence of brainstem lesions does not significantly affect BRT sensitivity. This points to the influence of supratentorial MS lesions on the BRT. Gender, age, disease duration, type of MS, acuteness of an MS event and whether MS diagnosis was recent or not were not variables affecting the results.
Highlights
The Blink Reflex Test (BRT) is a neurophysiological examination used for evaluation of brainstem reflex circuits
The Blink Reflex Test (BRT) [1,2,3] is a neurophysiological examination in which unilateral electrical stimulation of the nerve trunks of the supraorbital branches of the trigeminal nerve in the forehead produces the afferent volley of a reflex, the efferent loop of which leads via the facial nerves to bilateral contraction of the orbicularis oculi muscles
In the 35 patients with at least one brainstem lesion, the sensitivity of the BRT was Se=91.4%, while 8.6%
Summary
The Blink Reflex Test (BRT) is a neurophysiological examination used for evaluation of brainstem reflex circuits. The Blink Reflex Test (BRT) [1,2,3] is a neurophysiological examination in which unilateral electrical stimulation of the nerve trunks of the supraorbital branches of the trigeminal nerve in the forehead produces the afferent volley of a reflex, the efferent loop of which leads via the facial nerves to bilateral contraction of the orbicularis oculi muscles. The R1 response is synchronous and does not habituate [5,6,7,8] since it is oligosynaptic [9] It involves the main sensory nucleus of V [4,5,10,11] in the lateral midpontine and lower pontine regions and the ipsilateral facial nucleus (the intermediate subnucleus [5,12,13,14]). The R2 response is asynchronous because its central loop consists of a polysynaptic chain [4,5,15,16] with fibers 1) descending in the nucleus of the spinal tract of V from the pons to the caudal medulla before ascending ipsilaterally to reach the facial nucleus and produce the ipsilateral R2 response and 2)
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