No abstract

Facet joints are implicated as a major source of neck and low-back pain. Both cervical and lumbar facet syndromes have been described in the medical literature. Biomechanical studies have shown that lumbar and cervical facet-joint capsules can undergo high strains during spine-loading. Neuroanatomic studies have demonstrated free and encapsulated nerve endings in facet joints as well as nerves containing substance P and calcitonin gene-related peptide. Neurophysiologic studies have shown that facet-joint capsules contain low-threshold mechanoreceptors, mechanically sensitive nociceptors, and silent nociceptors. Inflammation leads to decreased thresholds of nerve endings in facet capsules as well as elevated baseline discharge rates. Recent biomechanical studies suggest that rear-end motor-vehicle impacts give rise to excessive deformation of the capsules of lower cervical facet joints. Still unresolved is whether this stretch is sufficient to activate nociceptors in the joint capsule. To answer this question, recent studies indicate that low stretch levels activate proprioceptors in the facet-joint capsule. Excessive capsule stretch activates nociceptors, leads to prolonged neural afterdischarges, and can cause damage to the capsule and to axons in the capsule. In instances in which a whiplash event is severe enough to injure the joint capsule, facet capsule overstretch is a possible cause of persistent neck pain.

Cervical facet joints have been implicated as a major source of pain after whiplash injury. We sought to identify facet joint capsule receptors in the cervical spine and quantify their responses to capsular deformation. The response of mechanosensitive afferents in C5-C6 facet joint capsules to craniocaudal stretch (0.5 d s ) was examined in anaesthetized adult goats. Capsular afferents were characterized into Group I11 and IV based on their conduction velocity. Two-dimensional strains across the capsules during stretch were obtained by a stereoimaging technique and finite element modeling. 17 (53%) Group I11 and 14 (56%) Group IV afferents were identified with low strain thresholds of 0.107 f 0.033 and 0.100 f 0.046. A subpopulation of low-strain-threshold afferents had discharge rate saturation at the strains of 0.388 f 0.121 (n = 9, Group 111) and 0.341 k 0.159 (n = 9, Group IV). Two (8%) Group IV units responded only to high strains (0.460 k 0.170). 15 (47%) Group I11 and 9 (36%) Group IV units could not be excited even by noxious capsular stretch. Simple linear regressions were conducted with capsular load and principal strain as independent variables and neural response of low-strain-threshold afferents as the dependent variable. Correlation coefficients (R2) were 0.73 f 0.1 1 with load, and 0.82 f 0.12 with principal strain. The stiffness of the C W 6 capsules was 16.8 f 11.4 N/mm. Our results indicate that sensory receptors in cervical facet joint capsules are not only capable of signaling a graded physiological mechanical stimulus, but may also elicit pain sensation under excessive deformation.

Visual evoked potential-based brain–computer interfaces (BCIs) have been widely investigated because of their easy system configuration and high information transfer rate (ITR). However, the uncomfortable flicker or brightness modulation of existing methods restricts the practical interactivity of BCI applications. In our study, a flicker-free steady-state motion visual evoked potential (FF-SSMVEP)-based BCI was proposed. Ring-shaped motion checkerboard patterns with oscillating expansion and contraction motions were presented by a high-refresh-rate display for visual stimuli, and the brightness of the stimuli was kept constant. Compared with SSVEPs, few harmonic responses were elicited by FF-SSMVEPs, and the frequency energy of SSMVEPs was concentrative. These FF-SSMVEPs evoked “single fundamental peak” responses after signal processing without harmonic and subharmonic peaks. More stimulation frequencies could thus be selected to elicit more responding fundamental peaks without overlap with harmonic peaks. A 40-target online SSMVEP-based BCI system was achieved that provided an ITR up to 1.52 bits per second (91.2 bits/min), and user training was not required to use this system. This study also demonstrated that the FF-SSMVEP-based BCI system has low contrast and low visual fatigue, offering a better alternative to conventional SSVEP-based BCIs.

An abundance of protein gene product 9.5 reactive nerve fibers indicates an extensive innervation of the cervical facet joint capsules. The presence of substance P and calcitonin gene-related peptide reactive nerve fibers in a population of these lends credence to cervical facet joint capsules as a key source of neck pain.