PubMed Health⌕ Search

Biomedical subjects

L Thomander

Publications and source records attributed to L Thomander.

At least 19 recordsLinked to original sources
PubMed1993

Comorbid anxious signs and symptoms in major depression: impact on functional work capacity and comparative treatment outcomes.

Psychological distress is a driver both of direct and indirect health care costs. Depression compromises functional well-being, such as work productivity. Comorbid anxious features often complicate the recognition of depression and may herald a poor prognosis. We report the results of a cross-sectional naturalistic study to determine the impact of three interventions (no antidepressant, fluoxetine, or tricyclic antidepressant therapy) on relative risk of work days lost in 454 French outpatients with either major or minor depression. Most depressed patients also manifested anxious features (76% with a Hamilton Rating Scale for Anxiety score > or = 12). The presence of anxiety was related to the severity of depression, work absenteeism, and current social instability. Depression severity (Hamilton Rating Scale for Depression score > or = 26, including the contributions of anxious symptoms), psychiatric comorbidity, and psychomotor retardation best predicted continued work absenteeism. Patients with major depression were more likely to receive an antidepressant if they had a past history of depressive episodes and/or previous work disability. Patients with minor depression were less likely to receive drug therapy than patients with major depression, despite their current work disability. Among patients who received fluoxetine or a tricyclic antidepressant for at least 8 weeks, fluoxetine was associated with statistically significantly lower mean anxiety and depression scores and fewer work days missed.

Absenteeism↗
PubMed1990

Magnetic resonance in Bell's palsy.

The brain and the brain stem were investigated by magnetic resonance (MR) in 19 patients with complete acute peripheral facial palsy, diagnosed as Bell's palsy. Five patients with a median age of 57 years had changes on T2 weighted MR: One patient showed transient signal changes with increased signal intensity in the ipsilateral brain stem. Another patient had persisting abnormal signals both in the brain and the brain stem. Two patients presented regions of high signal intensity in the subcortical cerebral white matter and still another patient had increased signal intensity in the periventricular white matter. MR abnormalities anatomically related to the facial nerve or its nucleus were not demonstrated. The significance of the MR findings is not quite certain but the MR pattern in conjunction with the patient's high median age most likely indicate vascular disease.

Adult↗
PubMed1989

Elevated serum interferon levels in patients with Bell's palsy.

Serum interferon (IFN) levels were analyzed in patients with Bell's palsy to study the immune response in the disease. Serum samples from 91 patients were assayed for antiviral activity using a bioassay. The IFN levels in the serum were elevated in the acute and convalescent phases as compared with control subjects. The serum IFN-gamma levels were analyzed by radioimmunoassay in 32 of the patients: the IFN-gamma levels were alike in the acute and convalescent phases and the control subjects. Neutralization with specific antisera against IFN-alpha, -beta, and -gamma on 15 serum samples of 11 patients with elevated IFN activity showed a complex pattern that indicates that the antiviral activity was due to a mixture of IFNs and possibly also due to other factors. The elevated IFN levels indicate a low-grade antiviral response that may reflect the reactivation of a viral infection.

Adult↗
PubMed1989

Intrafascicular multi-unit recordings from the human infra-orbital nerve.

Intrafascicular micro-electrode recordings were made from the human infra-orbital nerve close to the infra-orbital foramen. The fascicular organization was studied and multi-unit activity from low-threshold mechanoreceptive afferents was recorded during tactile stimuli, vibration and facial movements. Attempts were also made to record C-fibre activity. Innervation zones corresponding to 66 fascicles were mapped with tactile stimuli on facial hairy skin and the red zone of the lip. Most of these fields were located on the upper lip, where they overlapped, indicating a high innervation density. The fields had a median size of 3.8 cm2. Skin indentation evoked dynamic on- and off-responses and a much less pronounced static discharge. The afferent double-peaked responses to an oscillating probe applied to the peri-oral region induced similar grouping of the EMG activity during sustained lip protrusion. Contraction of facial muscles and stretching of the skin evoked on- and off-responses, whereas the static discharge was less pronounced, especially during sustained stretching. The dynamic sensitivity to minor variations in contraction and stretching was high, and during normal facial movements, as in speech, there was a barrage of impulses originating from mechanoreceptors within large facial areas. Functional implications of these sensorimotor interactions are discussed. Sympathetic C-fibre activity, frequently seen in recordings from the supra-orbital nerve, was never encountered in the infra-orbital nerve recordings, indicating a lack of such fibres. Failure to detect afferent C-fibre activity could be explained by methodological difficulties.

Adult↗
PubMed1989

Facial nerve electroneurography with implanted electrodes. Experimental study in the rabbit.

Facial nerve function was evaluated with permanently implanted electrodes for registration of electroneurography in an experimental model. The test-retest reproducibility was analyzed under normal conditions, as well as after facial nerve section. The mean observed intraindividual variation obtained at different sessions was 4%. We believe that the method is well suited for studies of experimental facial palsy.

Animals↗
PubMed1989

Magnetic resonance imaging in patients with Bell's palsy.

Magnetic resonance imaging of the brain and the brain stem was performed in 18 patients with complete acute peripheral facial palsy and diagnosed as Bell's palsy. In five patients T2 weighted images revealed regions of high signal intensity in the cerebral white matter and/or in the brain stem. The changes indicate that in cases of Bell's palsy the central nervous system may be involved and the disease may be related to microvascular or demyelinating disorder.

Adolescent↗
PubMed1988

Sympathetic nerve fibers in peripheral sensory and motor nerves in the face of the rat.

Retrograde transport of horseradish peroxidase (HRP) has been used to investigate whether postganglionic neurons in the superior cervical ganglion send branches into various peripheral nerves in the rat. HRP was applied to the zygomatic branch of the facial nerve, the mental nerve, deep vibrissae nerves and to nerves in the tooth pulp. HRP-labeled neurons were consistently seen in the SCG in all types of experiments, except for the cases where HRP was applied to the tooth pulp.

Animals↗
PubMed1987

Tick-borne Borrelia infection in patients with Bell's palsy.

An enzyme-linked immunosorbent assay was applied to serum samples of 94 patients diagnosed as having Bell's palsy: they were studied throughout two consecutive years in an attempt to establish serologic evidence of a tick-borne spirochetal infection. A strain of Borrelia spirochetes, isolated from Swedish Ixodes ricinus ticks, was used as an antigen, and separate estimations of spirochetal IgG and IgM antibodies were made; serum samples with titers above the 95th-percentile level of 120 healthy individuals were considered positive. Thirteen percent of the patients' serum samples were IgG-positive, 3% were positive for IgM, and 3% were positive for both IgG and IgM. A twofold or greater increase of IgG titers was found in 6%. All the patients who were seropositive experienced the onset of palsy during the period from July to December.

Adult↗
PubMed1987

Specific and nonspecific regeneration of motor axons after sciatic nerve injury and repair in the rat.

The pattern of motor axon regeneration following unilateral sciatic nerve lesions (freezing or transection) was studied in adult rats. Transected nerves were repaired with epineurial or fascicular sutures. Four months after the lesion, the motor neuron cell body localization in the spinal cord of plantar or common peroneal nerve axons were examined bilaterally with retrograde transport of horseradish peroxidase. Motor neuron cell body localization was similar bilaterally after freezing, indicating that regenerating axons had reached their original peripheral innervation territory. However, after nerve transection, irrespective of whether epineurial or fascicular sutures were used, motor neuron cell body distribution on the operated side was abnormal with numerous labeled cell bodies located outside the area of the normal motor neuron pool. This finding indicates that after nerve transection the normal pattern of motor axon innervation is not restored even after fascicular nerve repair.

Animals↗
PubMed1987

Immune complexes and complement components in Bell's palsy.

The serum levels of circulating immune complexes were studied in 63 patients and the complement system in 36 patients with Bell's palsy. The IgG-C1q and IgG-C3 containing immune complexes were analyzed by an enzyme-linked immunosorbent assay. The levels were found to be significantly elevated in the acute and convalescent stages of the palsy compared with controls. The total complement activity as determined by a CH50 assay and complement component C3 titrations also showed elevated values. The levels of C2 were not altered. The results indicate in Bell's palsy an inflammatory process and an antigen-antibody response which may be triggered by a viral antigen.

Adolescent↗
PubMed1986

Selective reinnervation of somatotopically appropriate muscles after facial nerve transection and regeneration in the neonatal rat.

The organization of the facial motor nucleus (FMN) has been examined after transection and regeneration of the facial nerve (FN) in neonatal and adult rats. In one series of experiments, horseradish peroxidase (HRP) was applied bilaterally to the superior or inferior buccal ramus 5 months after neonatal FN transection. In another series of experiments, wheat germ agglutinin-horseradish peroxidase conjugate was injected in selected vibrissae follicular muscles on both sides in animals surviving 5 months after FN transection at the neonatal or adult stage. The number and distribution of HRP-labeled cell bodies in the FMN after regeneration was compared with the contralateral side. On the uninjured side, labeled neurons were somatotopically organized. Ipsilateral to nerve injury the number of labeled cells was markedly reduced after neonatal nerve transection, but somatotopy was preserved. However, after nerve lesion at the adult stage, no significant loss of motoneurons occurred, but motor nucleus somatotopy was not maintained. Two alternative principal explanations are proposed for the re-establishment of the normal somatotopy after neonatal injury: that regenerating axons grow in a random fashion but inappropriate connections are subsequently eliminated or that regenerating axons of surviving neurons immediately follow a pathway leading to the appropriate muscle.

Aging↗
PubMed1986

Microelectrode recordings from the facial nerve in man.

Microneurographic recordings have for the first time been obtained from the human facial nerve trunk, close to its exit from the stylomastoid foramen. The aim was to search for evidence of an afferent or sympathetic component of the facial nerve at this level and to study the fascicular organization of motor fibres. Single unit discharges of motor axons were occasionally discerned, and all recordings showed multiunit motor impulses preceding the EMG activity of the appropriate facial muscles by about 5 ms during both blink reflexes and voluntary contractions. No evidence of low-threshold mechanoreceptive afferents was found. Electron microscopic studies at the level of recording showed unmyelinated axons but attempts to record nociceptive and sympathetic activity failed. However, deep facial pain evoked by intraneural stimulation suggested the presence of nociceptive afferents of non-cutaneous origin. Intrafascicular recording and stimulation showed that most fascicles were composed of motor axons innervating muscles within the whole ipsilateral half of the face.

Adult↗
PubMed1985

Vascular supply of the facial canal in the rat: a scanning electron microscopic study with the microcorrosive technique.

The vascularity of the facial canal in the rat was studied with the microcorrosive technique and scanning electron microscopy. The vascular casts thus created demonstrated the larger feeding vessels and the extrinsic vascular supply, but gave above all a good three-dimensional comprehension of the fine blood vessels within the nerve proper, the intrinsic vascular supply. The facial nerve is supplied by a rich anastomosing network of these fine blood vessels. Vascular loops and arteriovenous anastomoses are common, thus avoiding the creation of end-arterial systems. The blood vessels of the facial nerve also communicate widely with the rest of the temporal bone through small bony canals present in the lining of the facial canal. The architecture and distribution of the fine blood vessels are of great clinical interest, especially with regard to the etiology of idiopathic peripheral facial palsy, since it is at this level that the exchange of fluids, elecrolytes, and metabolites takes place.

Animals↗
PubMed1984

Evidence for a sympathetic component in motor branches of the facial nerve: a horseradish peroxidase study in the cat.

The retrograde transport of horseradish peroxidase (HRP) was used to examine the location of sympathetic ganglion cells with axons in facial motor branches of the cat. Large numbers of HRP-labeled neurons were observed in the rostro-anterior part of the superior cervical ganglion. In addition, some labeled neurons were found in the cervical sympathetic trunk, the accessory cervical, middle cervical and stellate ganglia.

Adrenergic Fibers↗
PubMed1984

An HRP study of the central course of sensory intermediate and vagal fibers in peripheral facial nerve branches in the cat.

Previous studies have shown that sensory fibers of intermediate and vagal nerve origin are present in facial nerve branches to the mimetic muscles in the cat. In the present study the central course of these fibers has been examined by transganglionic transport of horseradish peroxidase (HRP). In some of these experiments the facial nerve proper was transected central to the site of HRP application. In this way, the central course of the vagal fibers could be studied separately. For comparison HRP-conjugated wheat germ agglutinin was injected into the geniculate ganglion, revealing the central course of the entire afferent component of the intermediate nerve. The results show that labeled sensory intermediate nerve fibers, at their level of entrance in the brainstem, form a tract at the dorsal margin of the spinal trigeminal tract (5T). While some fibers ascend from this level to terminate in the main sensory trigeminal nucleus, and a few fibers terminate in the rostral part of the solitary tract nucleus, the majority take a descending course. The main site of termination for these descending fibers is in the medial part of the C2 dorsal horn. Terminal labeling is also seen in the ventrolateral part of the cuneate nucleus (CUN) and in a small area of gray substance between CUN and trigeminal nucleus caudalis. After entering the brainstem some sensory vagal fibers project to the trigeminal nucleus interpolaris and to an interstitial nucleus within the 5T, but the larger part joins the descending tract of intermediate nerve fibers. These descending vagal fibers have a terminal distribution pattern similar to the intermediate nerve fibers.

Afferent Pathways↗
PubMed1984

A procedure for studying the organization of peripheral nerves with horseradish peroxidase demonstrated on the facial and hypoglossal nerves in the rat.

The intraaxonal transport of horseradish peroxidase, applied to the proximal stump of different transected hypoglossal and facial nerve branches, was used to label fibers in the hypoglossal main trunk and in the intratemporal portion of the facial nerve in the rat. By using tetramethylbenzidine as a substrate, numerous heavily labeled fibers are obtained. In longitudinal sections the arrangement of fibers can be studied for long distances. From these sections, sites of specific interest can be further examined in transverse-like reconstructions of the nerve. Thus, the procedure described offers a convenient way of analyzing the intrinsic organization of peripheral nerves.

Animals↗
PubMed1983

Uptake and transport of exogenous macromolecules from the tongue to the facial nerve complex in the rat.

According to a current theory about the pathogenesis of Bell's palsy, the motorfibers of the facial nerve are affected by a viral neuropathy, transmitted to the facial nerve via the axons of the chorda tympani nerve. We have used horseradish peroxidase (HRP) to test to what extent and under what conditions uptake and transport of macromolecules can take place from the tongue. When HRP was applied directly onto the mucosa, no labeling was observed. However, when applied to localized superficial lesions of the epithelium or injected into the tongue, HRP is transported retrogradely to the geniculate and trigeminal ganglia, superior salivatory and hypoglossal nuclei. Injection of HRP resulted in many more labelled cells as well as fiber labeling in the peripheral nerves, in the solitary and spinal trigeminal nuclei. The findings show that even after a minor-superficial lesion in the tongue, exogenous macromolecules are taken up and transported to the intratemporal portion of the facial nerve as well as other cranial nerves. These findings are compatible with the theory that Bell's palsy is a neuropathy caused by neurotropic viruses spread via the chorda tympani.

Animals↗