
Erik NordhUmeå University | UMU · Department of Clinical Science - Neurosciences
Erik Nordh
Ass. Prof., M.D., Ph.D.
About
69
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Introduction
Additional affiliations
January 1991 - present
Publications
Publications (69)
Background:
Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash...
Background: An accurate identification of the injured nerve roots by EMG in patients with symptomatic CSD requires that the examined muscles are innervated by a single nerve root. In the present retrospective study, the authors address the question of whether such innervation of chosen muscles in the upper extremity can be identified. Methods: Scor...
Study design:
Prospective cohort study OBJECTIVE.: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.Summary of Background Data Many individuals report chronic pain in the orofacial region after whiplash traum...
Objective
Thermal quantitative sensory testing with the ‘Method-of-Limits’ is an established rationale for detection of small nerve fiber dysfunction, but adequate reference values are crucial for such evaluations, regardless of the underlying cause. This study assessed reference data for cold- (CPT) and warm- (WPT) perception thresholds at both pr...
Objectives:
We aimed to study the effect of deep brain stimulation (DBS) in the subthalamic nucleus (STN) and caudal zona incerta (cZi) on level of perceived voice tremor in patients with Parkinson disease (PD).
Study design:
This is a prospective nonrandomized design with consecutive patients.
Methods:
Perceived voice tremor was assessed in p...
Normal jaw function involves muscles and joints of both jaw and neck. A whiplash trauma may disturb the integrated jaw-neck sensory-motor function and thereby impair chewing ability, however, it is not known if such impairment is present shortly after a neck trauma or develops over time. The aim was to evaluate jaw function after a recent whiplash...
Objectives
The objective of this study was to examine swallowing function in patients with Parkinson's disease before and after caudal zona incerta deep brain (cZI DBS) surgery. The aims were to examine the effect of cZI DBS on swallowing safety regarding liquid and solid food, as well as to identify the effect of cZI DBS on body mass index (BMI) a...
Objectives:
The management of Parkinson's disease (PD) has been improved, but management of signs like swallowing problems is still challenging. Deep brain stimulation (DBS) alleviates the cardinal motor symptoms and improves quality of life, but its effect on swallowing is not fully explored. The purpose of this study was to examine self-reported...
Objective 61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences.
Methods The patients were assessed with the Tsui torticollis scale, Visual Analogue Scale (VAS) for pain and Fugl-Meyer scale for QoL. Evaluations were performed...
Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients.
To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception th...
Purpose
The present study aimed at comparing the effects of deep brain stimulation (DBS) treatment of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) on the proficiency in achieving oral closure and release during plosive production of people with Parkinson's disease.
Method
Nineteen patients participated preoperatively and 12 mont...
IMPORTANCE: Familial amyloid polyneuropathy, a lethal genetic disease caused by aggregation of variant transthyretin, induces progressive peripheral nerve deficits and disability. Diflunisal, a nonsteroidal anti-inflammatory agent, stabilizes transthyretin tetramers and prevents amyloid fibril formation in vitro.
OBJECTIVE: To determine the effect...
To investigate the effect of caudal zona incerta-deep brain stimulation (cZi-DBS) on word-level speech intelligibility in patients with Parkinson's disease, under both an optimal listening condition and a simulated more naturalistic listening condition.
Spoken single words were extracted from read samples collected from 10 bilaterally implanted pat...
There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study inv...
Previous findings, during chewing, that boluses of larger size and harder texture result in larger amplitudes of both mandibular and head-neck movements suggest a relationship between increased chewing load and incremental recruitment of jaw and neck muscles. The present report evaluated jaw (masseter and digastric) and neck [sternocleidomastoid (S...
Background: Identification of cortical areas is crucial for optimal motorcortex stimulation. This can be achieved by imaging with radiological and magnetic techniques, by electrophysiological recording/stimulation (NP), or by functional imaging (fMRI). The purpose of this pilot study was to elucidate the concordance between motor cortex mapping wit...
In patients with Parkinson's disease (PD), deep brain stimulation of the subthalamic nucleus (STN DBS) is well recognized in improving limb function, but the outcome on swallowing function has rarely been studied. The aim of this work was to evaluate the effect of STN DBS on pharyngeal swallowing function in patients with PD using self-estimation a...
Background:
Non-convulsive seizures (NCSZ) can be more prevalent than previously recognized among comatose neuro-intensive care patients. The aim of this study was to evaluate the frequency of NCSZ and non-convulsive status epilepticus (NCSE) in sedated and ventilated subarachnoid hemorrhage (SAH) patients.
Methods:
Retrospective study at a univ...
Laryngeal hypokinesia is a common symptom in Parkinson's disease (PD) that affects quality of life. Deep brain stimulation (DBS) is well recognized as a complementary method for treatment of motor symptoms in PD but the outcomes on patients' control over phonatory alternation have yet not been clearly elucidated. The present study examined the effe...
The purpose of the present study was to examine whether there was a negative effect of caudal Zona Incerta deep brain stimulation (cZI DBS) on pharyngeal swallowing function in Parkinson's patients (PD). There are no former reports including swallowing and cZI DBS.
Eight patients (aged 49-71 years; median 62) were evaluated pre- and post-operativel...
The differential diagnosis of patients with idiopathic parkinsonism is difficult, especially early in the course of the disease. External anal sphincter electromyography (EAS-EMG) has been reported to be of value in the differential diagnosis between Parkinson's disease (PD) and multiple system atrophy (MSA). Patients with MSA are reported to have...
Patients with transthyretin amyloidosis (ATTR) polyneuropathy, a hereditary fatal disease, often report defects in both thermal perception and autonomic nervous system function as their first clinical symptoms. While elevated thermal perception thresholds (TPT) for cold and warmth only recently have been shown as an early marker of small nerve fibe...
The hypokinetic dysarthria observed in Parkinson's disease (PD) affects the range, speed, and accuracy of articulatory gestures in patients, reducing the perceived quality of speech acoustic output in continuous speech. Deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) and of the caudal zona incerta (cZi-DBS) are current surgical tr...
Deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD) affects speech inconsistently. Recently, stimulation of the caudal zona incerta (cZi-DBS) has shown superior motor outcomes for PD patients, but effects on speech have not been systematically investigated. The aim of this study was to compare the e...
To evaluate the reproducibility of quantitative sensory testing (QST), performed with the method-of-limits (MLI) at different test intervals, by assessing the inter- and intra-individual variation of thermal cold (CT) and warm (WT) perception thresholds, and of thermal cold- (CPT) and heat pain (HPT) thresholds.
QST with the MLI was performed in 38...
Peripheral nerve injures are common and often result in impaired functional recovery. The majority of injuries involve the arm and/or the hand. The traditional treatment for peripheral nerve injuries is repair by using microsurgical techniques, either by primary nerve suture or nerve graft, but research to find more successful methods that could im...
Transthyretin amyloid neuropathy of type 1 (Swedish–Portuguese type) is an autosomally inherited progressive disease with a Val30Met mutation, causing generalized sensory-motor polyneuropathy. Quantitative sensory testing (QST) quantifies thermal threshold changes in patients with manifest general polyneuropathy, but its applicability at an early c...
The current problem finding reliable and objective methods for evaluating results after peripheral nerve repair is a challenge when introducing new clinical techniques. The aim of this study was to obtain reference material and to evaluate the applicability of different tests used for clinical assessment after peripheral nerve injuries. Fifteen pat...
Findings that jaw-opening/-closing relies on both mandibular and head movements suggest that jaw and neck muscles are jointly activated in jaw function. This study tested the hypothesis that rhythmic jaw activities involve an active repositioning of the head, and that head fixation can impair jaw function. Concomitant mandibular and head-neck movem...
Several studies have indicated changes in sensation and/or pain sensitivity among women across the menstrual cycle, but the pattern of the changes varies considerably. One reason for the reported discrepancies could reside in lack of biochemical definition of menstrual cycle phase. The aim was to quantify temperature and temperature pain thresholds...
We have previously introduced a new concept for natural jaw function suggesting that "functional jaw movements" are the result of coordinated jaw and neck muscle activation, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. Thus, jaw function requires a healthy state of both the jaw and the nec...
Despite fairly good return of motor function, patients who have amputated hands reimplanted demonstrate poor sensory recovery and severe cold intolerance, two variables that are difficult to quantify reliably. In this study we wanted to find out if there is a correlation between morphological findings of sensory and sympathetic reinnervation and cl...
Previous studies of spatial and temporal coordination between human mandibular and head-neck movements during single as well as rhythmic jaw opening-closing tasks suggest that these movements are regulated by central nervous commands common for jaw and neck muscles. The present study evaluated the spatiotemporal consistency of concomitant mandibula...
Previous finding of concomitant mandibular and head movements during jaw function suggest a functional relation between the human jaw and neck regions. This study examined the temporal coordination between mandibular and head-neck movements during maximal jaw opening-closing tasks, at fast and slow speed. Twenty-four healthy individuals, median age...
Recent observations in man of concomitant mandibular and head movements during single maximal jaw-opening/-closing tasks suggest a close functional relationship between the mandibular and the head-neck motor systems. This study was aimed at further testing of the hypothesis of a functional integration between the human jaw and neck regions. Spatiot...
Human mandibular movements in space are the result of combined motions of the mandible and the head-neck. They can be simultaneously monitored by an optoelectronic recording technique via markers at different locations on the mandible and on the head. Markers can be attached to the teeth or to the facial skin. Mandibular movements relative to the h...
To test the hypothesis of a functional relationship between the human mandibular and cranio-cervical motor systems, head-neck movements during voluntary mandibular movements were studied in 10 healthy young adults, using a wireless optoelectronic system for three-dimensional (3D) movement recording. The subjects, unaware of the underlying aim of th...
This study evaluated the applicability of skin- and teeth-attached reflex markers fixed to the mandible and the head for optoelectronic recording of chewing movements. Markers were attached to the upper and lower incisors and to the skin on the forehead, the bridge of the nose, the tip of the nose and the chin in seven subjects. Chewing movements w...
The combined effect of posteroventral pallidotomy and optimal medical treatment was assessed in 22 patients with levodopa sensitive Parkinson's disease.
Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly assessments performed preoperatively and four and 12 months after operation....
This paper describes and evaluates the digital MacReflex system for wireless recording of movements in three dimensions. Up to seven high resolution infra-red sensitive CCD video cameras with electronic shutters register the positions of maximally 40 stroboscopically illuminated retro-reflective tape markers. The system is equipped with real-time v...
The analysis of multidimensional neurophysiological data poses difficulties for the scientist in understanding the often complex inherent data relations. This is particularly the case when neuromuscular cell discharge parameters are to be related to body segment movement characteristics in freely behaving animals or humans. The understanding of suc...
The complexity of the movements and muscle attachments between head, neck and mandible in man implies the existence of close functional relationships between the corresponding motor systems (see Figure 1A). Recent kinesiographic studies by our group have revealed concomitant head-neck movements during different voluntary jaw movement tasks (Nordh,...
Analyses of movement-related nerve discharge characteristics are usually performed on data obtained from experiments involving spatially restricted motor tasks. In reduced preparations, the muscular action often comprises only one or two dimensions, and in behavioural studies of animals or humans, the motor task is often stereotyped and spatially l...
This paper reports a study of speech articulator movement using a video-based system for tracking and recording movement in three dimensions, the MacReflex. The system is non-invasive, there is no hazardous radiation or electromagnetic field, and there are no wires that might impede movement by the subject. The facility is installed at the faculty...
Single-unit activity was recorded with needle electrodes in eighteen muscle spindle afferents (eleven primaries, seven secondaries) from finger extensor muscles in the radial nerve of awake human subjects. The discharge rate of the afferents was determined during precisely controlled voluntary movements. The subjects performed a standardized visual...
The impulse discharge in single afferent units was recorded in waking human subjects. Tungsten needle electrodes were percutaneously inserted in the left radial nerve, and activity in muscle spindle afferents from the extensor muscles of the forearm were studied while the subjects remained relaxed. Thirty-six spontaneously discharging single units...
An extensive review of the well documented experimental and clinical findings related to trigeminal neuralgia shows, that it is possible to set up an unifying theory for trigeminal neuralgia, which would explain most clinical features of the disease and also would be congruent with several other theories that have previously been presented. Thus, t...
1. Single unit activity of muscle spindle afferents from finger extensor muscles was recorded in the radial nerve of waking human subjects. The mean discharge rate of the afferent units was determined while the receptor related finger was held at fixed angular positions of the metacarpo-phalangeal joint. 2. During a visual tracking task the subject...
The activity of human spindle afferents from finger extensor muscles has been studied during voluntary position holding at two finger positions, to disclose any explicit monitoring of muscle length. The results indicate that, taken as groups, neither primary nor secondary afferents show explicit position responses during active position tracking. T...
A system has been developed for off-line analysis of discharge characteristics of continuously firing nerve cells. The programs, which are mainly written in FORTRAN IV, determine mean firing rates, variability and other parameters of the impulse activity, and construct interspike interval histograms. They are run under time-sharing on a small labor...
1. Afferent activity of 111 single units from the glabrous skin area was recorded percutaneously in the median nerve of human subjects, using tungsten electrodes. 2. The majority of the units (103) were classified as low-threshold mechano-sensitive units belonging to one of the four categories previously described: rapidly adapting with small recep...