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M G Fehlings

Publications and source records attributed to M G Fehlings.

80 records · Page 5Linked to original sources

Motor and somatosensory evoked potentials recorded from the rat.

An accurate neurophysiological technique that is able to monitor both the sensory and motor tracts of the spinal cord is required to assess patients with injury or other lesions of the cord, and for the evaluation of experimental studies of cord injury. We have recorded and characterized the motor and somatosensory evoked potentials (MEPs and SSEPs) from 20 normal rats and from 16 rats with cord lesions. MEPs were elicited by applying constant current anodal stimuli to the sensorimotor cortex (SMC) with the responses recorded from microelectrodes in the spinal cord at T10 (MEP-C) and from a bipolar electrode placed on the contralateral sciatic nerve (MEP-N). SSEPs were elicited by stimulating the sciatic nerve and were recorded from the cord at T10 and the contralateral SMC. The MEP-C consisted of an initial D wave (mean latency 1.21 +/- 0.12 msec and 4 subsequent I waves, 11-14). The D wave was elicited at stimulation frequencies exceeding 100 Hz. The initial positive wave of the MEP-N (mean latency 3.09 +/- 0.19 msec) was followed by several slower components which were attenuated by repetition rates exceeding 8.2 Hz. The grand mean SSEP consisted of 7 peaks. Sectioning of the dorsal columns abolished the SSEP but spared the MEP. Complete cord transection abolished both the MEP and SSEP. These experiments demonstrate that the combined recording of MEPs and SSEPs is an accurate and easily performed method of monitoring the functional integrity of the rat cord, and suggest that this technique would be of value in patients, especially those undergoing operative treatment of spinal lesions.

Animals↗

Cavernous hemangioma of Meckel's cave. Case report.

A case of a cavernous hemangioma located within Meckel's cave and involving the gasserian ganglion is described in a patient presenting with facial pain and a trigeminal nerve deficit. Although these lesions have been reported to occur in the middle fossa, this is believed to be the first case of such a vascular malformation arising solely from within Meckel's cave.

Adult↗

The effect of direct-current field on recovery from experimental spinal cord injury.

Recent work has indicated that direct-current (DC) fields may promote recovery after acute spinal cord injury. In the present experiments, the therapeutic value of an applied DC field was studied in 40 rats with clip compression injuries of the cord at C7-T1. The rats were randomly allocated to one of four groups including 10 rats each: two groups received a 17-gm cord injury and two groups a 53-gm injury. One group at each injury severity received implantation of a treatment (14 microA) DC stimulator and the other group a control (0 microA) stimulator. Clinical neurological function was assessed weekly by the inclined-plane technique. At 8 weeks after injury, motor and somatosensory evoked potentials (MEP's and SSEP's) were recorded, and the axonal tracer horseradish peroxidase (HRP) was introduced into the cord at T-6. The total number of HRP-labeled cells was counted in every sixth coronal section through the brain stem and motor cortex. All outcome parameters were assessed blindly. In the 17-gm group, there were no significant differences in any outcome measure between control and treated rats. In contrast, in the 53-gm group, the inclined-plane scores, the amplitude of the MEP's, and the number of labeled cells in the red nucleus, raphé nuclei, and vestibular nuclei were greater in treated than in control rats. These data strongly indicate that an applied DC field can produce functional neurological and anatomical improvement in rats with acute spinal cord injuries.

Animals↗

Assessment of spinal cord injury by counting corticospinal and rubrospinal neurons.

This paper describes an objective, quantifiable technique for assaying the degree of severity of spinal cord injury. Twenty-one rats underwent a C7-T1 laminectomy: 12 received a C8 spinal cord clip compression injury with forces of either 2.3, 16.9 or 53.0 g; 4 had cord transection at C8, and 5 had no cord lesion. Postoperative clinical neurological assessment was performed by the inclined plane method. At 4 weeks, the spinal cord-injured rats underwent a T10 transection and insertion of a Gelfoam pledget impregnated with horseradish peroxidase (HRP). HRP was similarly administered to 9 normal rats. Longitudinal sections of the spinal cord encompassing the injury site were stained with Luxol fast blue, and coronal sections from the cerebrum and midbrain were processed for HRP reactivity with tetramethylbenzidine. Labelled corticospinal and rubrospinal neurons were counted in every 6th section to derive a cortical score (CS) and a red nucleus score (RNS) for each animal. The CS reflected the extent of the pathological changes at the site of cord injury and the ln CS decreased linearly with increasing injury severity (P less than 0.0001). In contrast, the RNS was only reduced in animals with severe (53.0 g) cord injuries (P less than 0.0006). The degree of preservation of the dorsal columns including the corticospinal tracts at the injury site correlated with the CS, whereas the RNS was related to the degree of preservation of the lateral columns. Counts of rubrospinal neurons, but not corticospinal neurons, correlated closely (r = 0.96, P less than 0.001) with the inclined plane results, suggesting the importance of non-pyramidal tracts in controlling gross motor function. Thus, counting corticospinal and rubrospinal neurons is an objective, reliable test of the severity of experimental spinal cord injury.

Animals↗

Motor evoked potentials recorded from normal and spinal cord-injured rats.

A need exists for an accurate neurophysiological technique that monitors the motor tracts of the cord in patients with spinal cord injury or other cord lesions and for the evaluation of experimental models of cord injury. We have recorded and characterized the motor evoked potentials (MEPs) from 10 normal rats and from 10 rats with the following cord lesions at C-8: 4 animals with complete cord transection and 6 with clip compression injury: 2 at 56.0 g, 2 at 20.0 g, and 2 at 1.5 g. MEPs were elicited by applying constant current anodal stimuli to the sensorimotor cortex with the responses recorded from microelectrodes in the spinal cord at T-10. The MEP consisted of an initial D wave (mean latency, 1.22 +/- 0.09 ms) and 4 subsequent I waves, I1 to I4. The D wave was elicited at stimulation frequencies exceeding 100 Hz, consistent with the hypothesis that it results from direct pyramidal cell excitation. The 56.0-g clip compression injuries and the cord transections abolished the MEP distal to the lesion, whereas the 20.0- and 1.5-g injuries resulted in a latency shift and amplitude decrement of the MEP peaks. These experiments suggest that the recording of MEPs will be an extremely useful and accurate method of monitoring the functional integrity of the cord, of value in patients with cord injury.

Animals↗

The relationships among the severity of spinal cord injury, motor and somatosensory evoked potentials and spinal cord blood flow.

To characterize the changes in axonal function in the motor and somatosensory tracts of the cord after spinal cord injury (SCI) and to correlate these changes with spinal cord blood flow (SCBF), the relationships among the severity of SCI, motor and somatosensory evoked potentials (MEPs and SSEPs) and SCBF were examined. Fifteen rats received a 1.5 g (n = 5), 20 g (n = 5) or 56 g (n = 5) clip compression injury of the cord at C8. SCBF at the injury site was measured by the hydrogen clearance technique 35 min before and 30 min after SCI. Concomitantly MEPs from the cord at T10 (MEP-C) and from the sciatic nerve (MEP-N) and SSEPs were recorded. A linear relationship (r = -0.89, P less than 0.002) was found between the severity of SCI and the reduction in SCBF at the injury site. Linear discriminant analysis revealed that both the MEP (P less than 0.0001) and SSEP (P less than 0.003) were significantly related to the severity of SCI. Furthermore, the amplitude of the MEP (r = 0.65, P less than 0.0001) and SSEP (r = 0.58, P less than 0.001) was significantly correlated with the posttraumatic SCBF. Multiple regression revealed that both the severity of cord injury and the degree of posttraumatic ischemia were significantly related to axonal dysfunction after SCI. While the MEP was more sensitive to injury than the SSEP, the SSEP more accurately distinguished between mild and moderate severities of cord injury. Axonal conduction in the motor and somatosensory tracts of the cord was significantly correlated with the reduction in posttraumatic SCBF and, therefore, these data provide quantitative evidence linking posttraumatic ischemia to axonal dysfunction following acute cord injury. Furthermore, this study validates the hypothesis that the combined recording of MEPs and SSEPs is an accurate technique to assess the physiological integrity of the cord after injury.

Animals↗