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R A Maselli

Publications and source records attributed to R A Maselli.

30 records · Page 2Linked to original sources
PubMed1993

Analysis of anticholinesterase-induced neuromuscular transmission failure.

To define the underlying mechanism of neuromuscular transmission failure induced by anticholinesterases, we simultaneously performed surface recordings of compound muscle action potentials (CMAPs) and intracellular recordings of miniature end-plate potentials (MEPPs), miniature end-plate current (MEPCs), and end-plate potential (EPPs) in rat diaphragms exposed in vitro to 1 x 10(-4) to 2 x 10(-2) mmol/L neostigmine methylsulfate. At low concentrations of neostigmine, repetitive stimulation of the phrenic nerve resulted in decrement followed by complete recuperation of CMAP amplitudes. This bimodal pattern was associated with maximal end-plate depolarization at the beginning of the stimulation period, increased MEPP amplitudes, and prolonged time constants of MEPC decays. Higher concentrations of neostigmine resulted in a unimodal decline of amplitudes of CMAPs and EPPS, reduced MEPP amplitudes, and a double exponential time course of MEPC decays. These results indicate that low concentrations of anticholinesterases impaired neuromuscular transmission by producing transient depolarization of the end-plate region. Higher concentrations induced desensitization and direct blockade of the end-plate receptor channel, probably in its open conformation.

Action Potentials↗
PubMed1993

Neuromuscular transmission in amyotrophic lateral sclerosis.

The functional and structural characteristics of the neuromuscular junction were studied in anconeus muscle biopsies of 10 patients with amyotrophic lateral sclerosis (ALS). Intracellular recordings revealed decreased amplitudes of miniature endplate potentials (MEPPs). The MEPP frequencies were highly variable in ALS patients but the average MEPP frequency was not different from that of control patients. The mean quantal content of endplate potentials (m), the mean quanta available for immediate release (n), and the mean quantal stores (N) were all decreased. In contrast, the mean probability of quantal release (p) was normal and the mean probability of quantal store release (P) was surprisingly high at the majority of ALS endplates. Histologic evidence of denervation and small or absent nerve terminals were observed in all ALS patients. These functional and structural abnormalities of the neuromuscular junction may explain the fatigability and the electromyographic evidence of impaired neuromuscular transmission often encountered in ALS patients.

Acetylcholine↗
PubMed1992

In vitro microelectrode study of neuromuscular transmission in a case of botulism.

We performed in vitro microelectrode studies in the anconeus muscle biopsy of a 6-week-old infant intoxicated with Clostridium botulinum toxin B. The most striking abnormalities were the severe reduction of the endplate potential (EPP) quantal content and the marked variability of EPP latencies. The increased variability was often limited to a "single quantum" component of the EPP. Neither the amplitudes nor the frequencies of spontaneous miniature endplate potentials (MEEPs) were decreased. However, there was a wide range of amplitudes and frequencies of MEPPs. This unique combination of electrophysiologic findings indicates a severe presynaptic failure of neuromuscular transmission, which appears to result from an impairment of the process of synaptic vesicle release taking place after the stimulus induced influx of calcium into the motor nerve terminals.

Biopsy↗
PubMed1992

Neuromuscular transmission as a function of motor unit size in patients with prior poliomyelitis.

We studied neuromuscular transmission in 16 patients with prior poliomyelitis by measuring single fiber electromyographic (SFEMG) jitter. This was compared with 3 indirect methods of assessing reinnervation: SFEMG fiber density, macro EMG, and the presence of fiber type grouping on muscle biopsy. In patients with acute poliomyelitis before the age of 10, there was a positive correlation between the extent of neuromuscular transmission impairment, demonstrated by increased SFEMG jitter, and the enlargement of the motor unit, as indicated by increased fiber density, increased macro EMG signals, and fiber type grouping on muscle biopsy. However, there was no correlation between any of these parameters and the presence or absence of new symptoms of weakness. These findings suggest that impaired neuromuscular transmission is most common in patients with prior poliomyelitis whose motor units have been maximally enlarged by axonal sprouting, but is independent of the presence or absence of new symptoms of weakness.

Biopsy↗
PubMed1992

Single motor unit H-reflex in motor neuron disorders.

The latency fluctuation of single motor unit potentials (MUPH) in the H-reflex is greater than the latency fluctuation of MUPs in the direct (MUPM) and recurrent (MUPF) responses. This has been attributed to the variability in the impulse generation at the site of nerve stimulation, and to the variation in the synaptic delay at the anterior horn cell. We studied the latency fluctuation of single motor unit H-reflex in patients with motor neuron disorders (MND) in comparison with normal subjects. The mean jitter of the H-reflex was 264.3 +/- 17.8 microseconds (mean +/- SEM) in 30 MUPH recorded from 10 patients with ALS, 302.7 +/- 25.2 microseconds in 16 MUPH from 6 patients with chronic motor neuron diseases, as compared with 137.4 +/- 7.3 microseconds in 34 MUPH recorded from 10 normal subjects. This difference, which persisted even after the correction for the latency variation of MUPM, cannot be explained on the basis of an enhanced reciprocal inhibition. Thus, the increased latency fluctuation of the single motor unit H-reflex in patients with MND may reflect changes in the motoneuron pool excitability that may be secondary to altered intrinsic electrophysiological properties of motoneurons, or to an abnormal temporal and spatial summation of synaptic inputs on motoneurons.

Amyotrophic Lateral Sclerosis↗
PubMed1991

Analysis of the organophosphate-induced electromyographic response to repetitive nerve stimulation: paradoxical response to edrophonium and D-tubocurarine.

We studied the mechanism underlying acute organophosphate intoxication (OPI) through in-vivo and in-vitro electrophysiologic studies in rats injected with diisopropylfluorophosphate. Intoxicated rats showed weakness, repetitive compound muscle action potentials (CMAPs) in response to a single stimulus, and decremental response to repetitive nerve stimulation that was most pronounced at the second CMAP. The decrement was worsened with the administration of edrophonium, and was completely reversed by D-tubocurarine. In-vitro microelectrode studies showed no reduction in the amplitude of miniature endplate potentials (MEPPs) or in the quantal content of end-plate potentials (EPPs). However, the half-decay times of MEPPs and EPPs were significantly prolonged. Trains of stimuli induced sustained end-plate depolarization via a "staircase phenomenon" of summation of prolonged EPPs, which was enhanced by edrophonium and abolished by D-tubocurarine. These results indicate that sustained end-plate depolarization can directly account for the decrement and weakness in acute OPI.

Animals↗
PubMed1991

Inflammation at the neuromuscular junction in myasthenia gravis.

To better define the pathogenic mechanisms in the antibody-mediated autoimmune disease myasthenia gravis (MG), we analyzed the morphology and electrophysiology of the neuromuscular junction in anconeus muscle biopsy specimens from eight patients with MG and seven control subjects. There were inflammatory cells at the neuromuscular junction in seven of the eight biopsies from MG patients. The endplate index (length of the postsynaptic membrane divided by the length of the apposed presynaptic membrane) was abnormally reduced in all the MG patients, and fiber type grouping, suggestive of reinnervation, was present in six of the eight MG patients. Intracellular recording revealed diminished amplitude of miniature endplate potentials and miniature endplate currents in the MG patients compared with the controls. The time constant of decay of miniature endplate currents did not differ from that of controls, suggesting no change in mean channel open time of the acetylcholine receptor. The endplate receptor sensitivity to iontophoretically applied acetylcholine was also decreased in MG patients compared with controls. The quantal content of neurally evoked endplate potentials was reduced in six of the eight MG patients, demonstrating abnormal presynaptic function as well. The presence of inflammatory cells at the neuromuscular junctions of limb muscles in MG reconciles an apparent disparity between the animal model of MG, experimental autoimmune myasthenia gravis, and the human disease. This study also demonstrates a frequent presynaptic component to the abnormal neuromuscular transmission in MG.

Action Potentials↗
PubMed1989

Comparison of sympathetic skin response with quantitative sudomotor axon reflex test in diabetic neuropathy.

The sympathetic skin response (SSR), the quantitative sudomotor axon reflex test (Q-SART), and cardiac beat-to-beat variability with respiration as measured by the expiratory/inspiratory ratio (E/I ratio) were studied in 39 patients with diabetic neuropathy of whom 33 also had one or more symptoms of autonomic involvement. In the lower extremities 87% of the patients with an absent SSR had an abnormal Q-SART (P less than 0.001), and 81% of patients with the SSR present had a normal Q-SART (P less than 0.02). The E/I ratio was abnormal in all but one of 23 patients with an absent SSR in the foot, and a normal E/I ratio was present only in those patients (n = 7) with the SSR present in hand and foot, and in an eighth patient who had SSR absent in the foot and present in the hand. A similar correlation was found between the E/I ratio and the Q-SART in the foot, although 4 of 25 patients with an abnormal foot Q-SART had a normal E/I ratio. We conclude that the concordance of results of the SSR and Q-SART supports the combined use of these tests to uncover early distal sympathetic failure in diabetic neuropathy.

Adult↗
PubMed1989

Effects of a monoclonal anti-acetylcholine receptor antibody on the avian end-plate.

1. The effects of anti-acetylcholine receptor (AChR) monoclonal antibodies (mAbs) 370 and 132A on miniature end-plate potentials (MEPPs) and end-plate currents (EPCs) in the posterior latissimus dorsi muscle of adult chickens were investigated. 2. After incubation of the electrophysiological preparation with mAb 370 (5-50 micrograms/ml), which blocks both agonist (carbamylcholine) and alpha-bungarotoxin (alpha-BTX) binding and induces a hyperacute form of experimental autoimmune myasthenia gravis (EAMG), MEPP and EPC amplitudes were irreversibly reduced. 3. This effect was not associated with any significant change in the time constant describing EPC decay (tau EPC), current reversal potential, or the voltage dependence of tau EPC. The tau EPC at -80 mV was 5.9 +/- 0.6 ms before incubation with mAb 370 (50 micrograms/ml) and 6.0 +/- 0.9 ms afterwards. Current reversal potential was -3.9 +/- 0.4 mV before mAb incubation and -4.8 +/- 1.5 mV afterwards. The change in membrane potential required to produce an e-fold change in tau EPC was 128 +/- 2.3 mV before antibody incubation compared to 125 +/- 6.6 mV after incubation. 4. A second anti-AChR mAb, 132A (50 micrograms/ml), which is capable of inducing the classically described form of EAMG without blocking agonist or alpha-BTX binding, or inducing hyperacute EAMG, produced no significant change in MEPP amplitude, EPC amplitude, tau EPC or EPC reversal potentials. 5. The mAb 370 (50 micrograms/ml) induced a partially reversible decrease of the quantal content of the neurally evoked end-plate potential (EPP). This effect was not observed with mAb 132A, (+)tubocurarine (10(-7)-10(-5) g/ml) or an irrelevant anti-oestrogen receptor mAb. 6. These data suggest that the rapid onset of weakness observed in chicken hatchlings after the injection of mAb 370 (Gomez & Richman, 1983) can be attributed to a combined effect of a block of acetylcholine (ACh)-induced ion channel activity in the postsynaptic membrane and a reduction of the neurally evoked release of acetylcholine from the nerve terminal.

Action Potentials↗
PubMed1988

Episodic nocturnal wanderings in non-epileptic young patients.

Twelve patients, aged 19 to 29 years, presented with episodic nocturnal wanderings characterized by stereotyped frequent attacks of screaming, ambulation, and complex automatisms during sleep. The attacks ranged in frequency from two or three per year to several per night and were often associated with semi-purposeful violent and even life-threatening behavior. None of the patients had a history of seizures; three had a history of prior parasomnias and four had family members with a history of parasomnia. Polysomnographic and daytime electroencephalographic (EEG) investigations showed potentially epileptiform activity in four patients. Recorded episodes were not accompanied by ictal EEG activity. Anticonvulsant medication reduced or eliminated the attacks in all of the nine treated patients. The pathophysiology of the disorder is uncertain.

Adult↗