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Influence de la proprioception cranio-faciale sur le contrôle postural et la stabilisation du regard

Abstract : Balance control requires integration of information arising from somesthetic (proprioceptive and exteroceptive), vestibular and visual systems. These sensorial afferences converge on vestibular nuclei of the brainstem in which they are integrated, and induce motor-reflex responses, leading to compensatory movements of the body (vestibulo-spinal reflex) and eyes (vestibulo-ocular reflex). The possibility that cranio-facial proprioception, through trigeminal afferences, could contribute to postural control and gaze stabilisation, has been discussed for many years. The weight of cranio-facial proprioception upon postural control and gaze stabilisation has been evaluated, by inducing several experimental modifications of cranio-facial proprioception, according to three protocols. Trigeminal proprioception modification was induced by an experimental modification of dental occlusion and by an unilateral anaesthesia of the mandibular nerve. Postural control and gaze stabilisation quality decreased either when dental occlusion was not in centric relation condition (neuromuscular equilibrium) or when a part of trigeminal afferences is inhibited by unilateral anaesthesia of the mandibular nerve. Postural control accuracy increased when dental occlusion was set in centric relation position. The role of sensorial afferences upon postural control and gaze stabilisation appeared to be essential in these three protocols. These results suggest on one hand connections between trigeminal afferences and vestibular nuclei and on the other hand, their connections with oculo-motor nerve nuclei (oculomotor nerve, trochlear nerve and abducens nerve) and vestibulo-spinal pathways. Any modification of trigeminal afferences could thus have repercussions upon balance control. Consequently, an experimental modification of a part of somato-sensory afferences, not related to support structures (lower legs), might influence the fine regulation of postural control. Therefore, a postural control and gaze stabilisation increment would be possible through modifications of cranio-facial proprioception.
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Pierre Gangloff. Influence de la proprioception cranio-faciale sur le contrôle postural et la stabilisation du regard. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2002. Français. ⟨NNT : 2002NAN10228⟩. ⟨tel-01748626⟩

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