Neurogenic switching: a hypothesis for a mechanism for shifting the site of inflammation in allergy and chemical sensitivity.

Neurogenic switching is proposed as a hypothesis for a mechanism by which a stimulus at one site can lead to inflammation at a distant site. Neurogenic inflammation occurs when substance P and other neuropeptides released from sensory neurons produce an inflammatory response, whereas immunogenic inflammation results from the binding of antigen to antibody or leukocyte receptors. There is a crossover mechanism between these two forms of inflammation. Neurogenic switching is proposed to result when a sensory impulse from a site of activation is rerouted via the central nervous system to a distant location to produce neurogenic inflammation at the second location. Neurogenic switching is a possible explanation for systemic anaphylaxis, in which inoculation of the skin or gut with antigen produces systemic symptoms involving the respiratory and circulatory systems, and an experimental model of anaphylaxis is consistent with this hypothesis. Food-allergy-iducing asthma, urticaria, arthritis, and fibromyalgia are other possible examples of neurogenic switching. Neurogenic switching provides a mechanism to explain how allergens, infectious agents, irritants, and possibly emotional stress can exacerbate conditions such as migraine, asthma, and arthritis. Because neurogenic inflammation is known to be triggered by chemical exposures, it may play a role in the sick building syndrome and the multiple chemical sensitivity syndrome. Thus neurogenic switching would explain how the respiratory irritants lead to symptoms at other sites in these disorders

Neurogenic inflammation and sensitivity to environmental chemicals.

Neurogenic inflammation as a pathway distinct from antigen-driven, immune-mediated inflammation may play a pivotal role in understanding a broad class of environmental health problems resulting from chemical exposures. Recent progress in understanding the mediators, triggers, and regulation of neurogenic inflammation is reviewed. Evidence for and speculations about a role for neurogenic inflammation in established disorders such as asthma, rhinitis, contact dermatitis, migraine headache, and rheumatoid arthritis are presented. The sick building syndrome and multiple chemical sensitivity syndrome have been defined as clinical entities in which exposure to chemical inhalants gives rise to disease. Current data on the existence of chemical irritant receptors in the airway and skin are discussed; neurogenic inflammation arising from stimulation of chemical irritant receptors is a possible model to explain many of the aspects of chemical sensitivities

Shared Bimanual Tasks Elicit Bimanual Reflexes During Movement

Previous research has suggested distinct predictive and reactive control mechanisms for bimanual movements compared with unimanual motion. Recent studies have extended these findings by demonstrating that movement corrections during bimanual movements might differ depending on whether or not the task is shared between the arms. We hypothesized that corrective responses during shared bimanual tasks recruit bilateral rapid feedback mechanisms such as reflexes. We tested this hypothesis by perturbing one arm as subjects performed uni- and bimanual movements. Movements were made in a virtual-reality environment in which hand position was displayed as a cursor on a screen. During bimanual motion, we provided cursor feedback either independently for each arm (independent-cursor) or such that one cursor was placed at the average location between the arms (shared-cursor). On random trials, we applied a 40 N force pulse to the right arm 100 ms after movement onset. Our results show that while reflex responses were rapidly elicited in the perturbed arm, electromyographic activity remained close to baseline levels in the unperturbed arm during the independent-cursor trials. In contrast, when the cursor was shared between the arms, reflex responses were reduced in the perturbed arm and were rapidly elicited in the unperturbed arm. Our results thus suggest that when both arms contribute to achieving the task goal, reflex responses are bilaterally elicited in response to unilateral perturbations. These results agree with and extend recent suggestions that bimanual feedback control might be modified depending on task context