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Cutaneous silent periods - Part 1: Update on physiological mechanisms.

Markus Kofler1, A A Leis2, Josep Valls-Solé3

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|January 30, 2019
PubMed
Summary

The cutaneous silent period (CSP) measures muscle response to nociceptive stimuli, offering insights into human physiology and neurophysiology. Understanding CSP principles is key for its clinical use in diagnosing conditions.

Keywords:
Cutaneous silent periodExteroceptive reflexProtective reflexReviewSpinal reflex

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Area of Science:

  • Neurophysiology
  • Human Physiology
  • Clinical Neurophysiology

Background:

  • Exteroceptive electromyographic modulation of voluntary muscle activity is crucial in human physiology.
  • The cutaneous silent period (CSP) is a well-established nociceptive EMG suppression.
  • CSP is mediated at the spinal level by A-delta afferents.

Purpose of the Study:

  • To critically review the literature on cutaneous silent period (CSP) testing.
  • To cover stimulation and recording techniques, physiological principles, and involved neural pathways.
  • To provide a foundation for understanding CSPs in clinical neurophysiology.

Main Methods:

  • Literature survey of applied stimulation and recording techniques.
  • Review of physiological principles, including fiber types and spinal circuitry.
  • Examination of supraspinal modulation, neurotransmitters, and pharmacology of CSPs.

Main Results:

  • CSP is a robust and reproducible nociceptive EMG suppression.
  • The review synthesizes current knowledge on CSP mechanisms and influencing factors.
  • Understanding CSP principles is fundamental for clinical application.

Conclusions:

  • CSP testing is of significant interest in normal and pathological human physiology.
  • A thorough understanding of CSP principles is essential for valid clinical neurophysiology.
  • This review serves as a foundation for the clinical application of CSPs.