Biomedical subjects
Publications and source records attributed to R Linke.
A 14-year-old girl presented with the acute onset of gastrointestinal symptoms due to hypercalcaemia. Chest X-ray revealed osteolytic lesions in the ribs which in conjunction with a normal parathyroid hormone level raised the possibility of malignancy. Despite the absence of blast cells in her blood film, the bone marrow biopsy was diagnostic of acute lymphoblastic leukaemia. She responded well to treatment with pamidronate and chemotherapy.
UNLABELLED: Surgical Rehabilitation of Neuromuscular Swallowing Disorders with Special Regard to Cricopharyngeal Myotomy and Glottopexy. BACKGROUND: The surgical rehabilitation of patients with swallowing disorders caused by neuromuscular insufficiency with life-threatening aspiration presents a special challenge to the ENT-surgeon. METHODS: In a period of 5 years we decided on a surgical treatment in altogether 12 patients with paralytical dysphagia. In 6 patients we combined a cricopharyngeal myotomy with a complete closure of the glottis, in 5 patients we performed a sole cricopharyngeal myotomy. In another patient we restricted ourselves to glottopexy only. RESULTS: In all cases the dysphagia giving rise to the surgical intervention was regredient so far that the removal of the percutan endoscopic gastrostomy postsurgically was possible. 3 special cases are presented in detail. DISCUSSION: The main part of the therapy is the subtle and complete cricopharyngeal myotomy. Particulary good results are available with a combination of the latter with a reversible glottopexy. CONCLUSIONS: After the failure of conservative therapy the indication for a surgical treatment should be made on a large scale.
OBJECTIVE: To use pre- and postoperative CT density measurements to demonstrate changes achieved by Nd:YAG laser (1,064 nm) in protruded or extruded discs. BACKGROUND DATA: Nonendoscopic percutaneous laser disc decompression and nucleotomy (PLDN) with the Nd:YAG laser is an established minimal invasive treatment of discogenic pain syndromes in patients with bulging, protruded, or extruded intravertebral discs. Extremely high success rates involving improvement in the flow of cerebrospinal fluid in the dural sac and enhanced venous flow by MRI myelography are 80% lumbar, 86.5% cervical, and 98% thoracic spine. However, verification of reduced intradisc and intraspinal pressure by imaging procedures is difficult. METHODS: Twenty-one patients, four women and 17 men, with an average age of 43.67 (range, 24-59) were selected. The patients showed lumbar radicular pain syndromes with monosegmental disc protrusion or extrusion, and monoradicular clinical symptoms. Measurements were performed preoperatively and on postoperative day 1. RESULTS: The preoperative density measurements averaged 83.43, in agreement with the Houndsfield units (HU) described in the literature. Postoperatively, the reduction down to 66.33 HU had a statistical significance of p = 0.001 verified in the t test. Standardizing the measurements prior to laser irradiation to 100% produced an average 20% postoperative density reduction. CONCLUSION: PLDN with the Nd:YAG laser (1,064 nm) markedly reduces the postoperative density in protrusion and extrusion of intravertebral discs. The excellent therapeutic results achieved with this method in discogenic pain syndromes can be verified by imaging procedures.
Imaging of striatal dopamine transporter binding allows differentiation between patients with Parkinson's disease and controls. We investigated the use of this technique to monitor disease progression. We used N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (IPT) and single photon emission computed tomography (SPECT) to determine dopamine transporter function in eight patients with Parkinson's disease Hoehn and Yahr stage I to III over time. Patients were recruited from the movement disorder clinic and were studied at entry and after a follow-up period of 1 and 2 years. Specific striatal IPT binding was measured with a manual region of interest technique. At entry, all patients showed a reduction of striatal IPT uptake of approximately 50% compared to controls, with a mean striatum to background ratio of 3.61 +/- 0.72 (controls, 7.34 +/- 1.18). Putamen to background ratios were initially measured as 2.42 +/- 0.74 and caudate to background ratios as 5.00 +/- 0.73 (controls, 6.46 +/- 1.22 for putamen and 8.58 +/- 1.36 for caudate). Specific striatal IPT binding decreased by a mean of 6.6% in the first year and another 5.3% in the second year. Changes of specific IPT binding over time were similar in caudate and putamen. In patients with clinically asymmetric disease, differences between the rate of decline in the ipsilateral and contralateral sides could not be detected. The findings suggest that IPT SPECT can quantify the reduction of dopamine transporter binding over time. This technique seems to be a useful tool in monitoring the intra-individual progression of dopaminergic cell loss in patients with Parkinson's disease and may help to follow the effects of putative neuroprotective drugs in future clinical trials.
BACKGROUND: Specific binding to dopamine transporters may serve as a tool to detect early loss of nigrostriatal dopaminergic neurons in patients with Parkinson's disease. OBJECTIVE: To determine striatal dopamine transporter binding using the cocaine analogue [I-123]N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chl orophenyl) tropane ([I-123]IPT) and single photon emission computed tomography. PATIENTS AND METHODS: We studied 9 control subjects (mean age, 58 years; range, 41-69 years) and 28 patients with early Parkinson's disease (Hoehn and Yahr stages I [n = 14] and II [n = 14] [symptom duration, <5 years]; mean age, 55.5 years; range, 36-71 years). Single photon emission computed tomography was performed 90 minutes after injection of 120 to 150 MBq of radioactive [I-123]IPT. RESULTS: Specific striatal [I-123] IPT binding (mean +/- SD) was significantly reduced in patients with early Parkinson's disease (ipsilateral striatum: 4.09+/-0.97; range, 2.46-6.40; contralateral striatum: 3.32+/-0.76; range, 1.80-5.13) compared with controls (left striatum: 7.28+/-0.94; range, 5.78-8.81; right striatum: 7.41+/-1.28; range, 5.58-9.44). IPT binding ratios (mean +/- SD) were significantly lower in patients with Hoehn and Yahr stage II (ipsilateral striatum: 3.47+/-0.75; contralateral striatum: 2.96+/-0.73) compared with those with Hoehn and Yahr stage I (ipsilateral striatum: 4.72+/-0.75; contralateral striatum: 3.69+/-0.61) (P<.001). The ipsilateral striatum of patients with Hoehn and Yahr stage I showed a significant mean+/-SD reduction of IPT binding (ipsilateral striatum: 4.72+/-0.75) compared with either right or left striatum of controls (P<.001). Only in 1 patient was IPT binding to the ipsilateral striatum (ratio, 6.40) higher than the lowest value observed in the striatum of a control subject (ratio, 5.58). CONCLUSIONS: Use of [I-123] IPT and single photon emission computed tomography demonstrates a reduction of dopamine transporter binding in patients with early Parkinson's disease. Significantly reduced IPT binding already observed in the ipsilateral striatum of patients with Hoehn and Yahr stage I demonstrates the potential of this method to detect preclinical disease.
The thalamic paralaminar nuclei that border the medial and ventral edges of the medial geniculate body, viz. the suprageniculate nucleus (SG), the posterior intralaminar nucleus (PIN), the medial division of the medial geniculate nucleus (MGm), and the peripeduncular nucleus (PP), are regarded as important extralemniscal relay nuclei for sensory stimuli and as an important link for the direct transmission of sensory stimuli to the amygdala. Each of these thalamic nuclei receives a unique pattern of afferent input but an unresolved question is, how each of these thalamic nuclei project to the amygdala and whether there are zones of convergence and/or non-overlapping regions within amygdaloid target nuclei. Small injections of PHA-L or Miniruby, which were made into single thalamic nuclei at different rostrocaudal levels, revealed a non-uniform distribution of anterogradely labeled axons within the amygdaloid complex. Injections into the SG, MGm, and rostral PIN predominantly labeled axons in the laterodorsal and lateroventral portions of the lateral nucleus of the amygdala (LA). Axons from the MGm were located rather in the dorsal part of the LA, whereas SG-derived axons were concentrated in the ventrolateral part of the LA. Injections into the PP labeled axons predominantly in the medial part of the LA, whereas after injections into the caudal PIN axons were seen in the entire LA. In addition, the PIN projects heavily to the anterior basomedial nucleus and medial division of the central nucleus, whereas this projection is virtually absent from the other thalamic nuclei. The lateral part of the central nucleus and the basal nucleus of the amygdala are spared by axons from the thalamic paralaminar nuclei. The present results suggest that, despite a considerable degree of convergence of the thalamoamygdaloid projection in the lateral nucleus, each thalamic nucleus plays a unique role in the transmission of sensory stimuli to the amygdala and in the modulation of intraamygdaloid circuits.
In this study Fourier analysis was applied to condensed images of gastric emptying with the aim of evaluating the amplitude and frequency of gastric contractions as well as gastric emptying in patients with various well-defined disorders. In 15 controls, 65 patients with progressive systemic sclerosis (PSS), 41 patients with diabetes mellitus type I (DM), 12 patients with pyloric stenosis and 9 patients who had undergone gastric surgery, gastric emptying was determined after ingestion of a semi-solid test meal. In addition, condensed images were generated to evaluate the amplitude and frequency of gastric contractions by means of Fourier analysis. In PSS and DM patients, gastric emptying and contraction amplitudes were significantly reduced (P<0.01). Patients with pyloric stenosis displayed regular peristalsis but significantly delayed emptying (P<0.01). Patients who had undergone gastric surgery showed normal or rapid gastric emptying associated with decreased amplitudes (P<0.01). The frequency of gastric contractions in the patient groups was not different from that in controls. This study showed Fourier analysis of condensed images to be a rapid and feasible approach for the evaluation of gastric contractions. Depending on the underlying disorder, gastric emptying and peristalsis showed both corresponding and discrepant findings. Data on gastric contractions provided additional information compared with results obtained by conventional emptying studies. Therefore, both parameters should be routinely assessed to further improve characterisation of gastric dysfunction by scintigraphy.
Imaging the presynaptic dopamine transporter with cocaine analogues and single-photon emission tomography (SPET) has proven to be a potential diagnostic tool for classifying the extent and degree of dopaminergic nerve cell loss. For correct interpretation of scan results, however, knowledge of the intra-/interobserver variation of data evaluation is mandatory. Iodine-123 labelled N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(chlorophenyl)tropane ([123I]IPT) SPET data of 10 controls and 30 parkinsonian patients with varying degrees of reduced IPT binding were analysed twice by an expert (intraobserver) and once by a less experienced physician in training (interobserver). For semiquantitative evaluation of specific IPT binding, ratios between total striatum, caudate and putamen and a background region were calculated. No significant differences were observed for either the intra- or the interobserver analyses. Variation was lower in controls than in the patient group. Overall variation indices were below 5%. Variation in interobserver results was only slightly higher than that in intraobserver results. The intra-/interobserver results showed highly significant correlations (r = 0.99). The intraclass correlation was higher than 0.9 for all evaluations. Our results indicate that the specific presynaptic striatal dopamine transporter binding assessed with IPT-SPET may be reproducibly analysed by the same and different observers in controls as well as in patients with varying degrees of reduced binding.
BACKGROUND: The origin of subjective tinnitus is not really known yet. It is possible to investigate the function of outer hair cells by means of the distortion products of otoacoustic emissions (DPOAE). METHODS: DPOAE of 56 patients were analysed in a prospective study (tinnitus without any loss of hearing n = 34; hearing loss with a maximum of 35 dB and tinnitus n = 22). There was always a normal tympanogram and in no case a conductive hearing loss. The relation of the primary tones f2/f1 was 1.22, the levels of the primary tones were 70 dB. RESULTS: DPOAE-amplitudes were reduced distinctly in both groups of patients. But there was no general difference and no difference at the frequency of tinnitus between the ear with tinnitus and the contralateral ear (no hearing loss) or there was a small reduction related to the normal ear (distinct hearing loss). DPOAE-amplitudes did not change in patients without hearing loss after a treatment with Pentoxifylline i.v., also not at the frequency of tinnitus, although there was a subjective reduction of tinnitus. In patients with hearing loss DPOAE-amplitudes enhanced like the improvement of hearing threshold at the frequency of tinnitus. CONCLUSIONS: The low DPOAE-amplitudes are a sign of damaged outer hair cells of the patients. But there is a symmetry of the DPOAE-amplitudes and there is no change of DPOAE after a therapy with Pentoxifylline i.v. in patients without hearing loss.
Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by complex behaviour during REM sleep. The aetiology of this disorder is still unknown, but a recent study showed an association between RBD and Parkinson's disease. We therefore studied striatal postsynaptic dopamine D2 receptor density with [123I](S)-2-hydroxy-3-iodo-6-methoxy-(1-ethyl-2-pyrrolidinylmethyl ) benzamide ([123I]IBZM) and the striatal presynaptic dopamine transporter with (N)-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorop henyl) tropane ([123I]IPT) using single-photon emission computed tomography (SPECT) in patients with idiopathic RBD. We compared the [123I]IPT-SPECT results of five patients with polysomnographically confirmed idiopathic RBD with the [123I]IPT-SPECTs of seven age- and sex-matched controls without a history of sleep disorders, and of 14 patients with Parkinson's disease (Hoehn and Yahr stage I). All RBD patients had significantly reduced striatal [123I]IPT binding compared with the controls (RBD: right, 2.94 +/- 0.32, left, 3.03 +/- 0.41; controls: right, 4.41 +/- 0.17, left, 4.34 +/- 0.21; P = 0.003), but significantly higher striatal [123I]IPT binding compared with the striatum contralateral to the symptomatic body side of the Parkinson's disease patients (Parkinson's disease: ipsilateral, 3.17 +/- 0.36, P = 0.298; contralateral, 2.51 +/- 0.31, P = 0.019). Uptake of [123I]IBZM was not significantly different in the RBD group compared with the controls. This study demonstrates that [123I]IPT-SPECT is a useful diagnostic tool in RBD and that reduced striatal dopamine transporters may be a pathophysiological mechanism of idiopathic RBD. (Results are given as mean +/- standard deviation.)
Thalamic nuclei adjacent to the medial geniculate body play a pivotal role in processing of sensory stimuli during emotional situations. These nuclei, which include the suprageniculate nucleus (SG), the posterior intralaminar nucleus (PIN), the peripeduncular nucleus (PP) and the medial division of the medial geniculate body (MGm), project to both cortex and amygdala, but target areas and the extent of the projection of individual nuclei are not known yet. The aim of the present study was to analyze the contribution of individual nuclei to the cortical projection with modern sensitive tracing techniques. Small injections of Miniruby or PHA-L were made into single thalamic nuclei. All thalamic nuclei have in common a projection into the upper portion of layer I of the temporal aspect of the cortical mantle. Furthermore, SG, PIN, MGm and PP each demonstrated a convergent projection to lower layer III and to layer IV of the ectorhinal and visceral cortex. Only MGm projects to layer VI of primary auditory and temporal association cortices. Within the perirhinal cortex zones of convergence and divergence exist. The present results demonstrate a differential thalamocortical projection of single thalamic nuclei to those cortical areas which are involved in the transmission of sensory signals to the amygdala via the thalamocortico-cortical pathway and to the hippocampus via the entorhinal cortex. The thalamic nuclei are thus in a position to activate the amygdala and to modulate the information flow of the thalamocortico-cortical pathway to both amygdala and hippocampus.
The indications for cranioplasty after decompressive craniectomy are cosmetic repair and, mainly, restoration of cerebral protection. Although neurological improvement after cranioplasty is repeatedly noted, the reasons for this still remain unclear. Few observations concerning the impact of CSF hydrodynamic and/or atmospheric pressure were published during the last decades. Relevant data concerning the cerebrovascular reserve capacity and cerebral glucose metabolism before and after cranioplasty have been lacking until now. To gain further insight, the present study was undertaken to investigate the impact of cranioplasty on indices of cerebral blood flow regulation and metabolism. Thirteen patients in whom extensive craniectomies had been performed underwent a meticulous study of blood flow velocities in the middle cerebral artery (MCA) and extracranial internal carotid artery (ICA), as assessed by transcranial Doppler (TCD) ultrasonography during postural maneuvers (supine and sitting positions) and during stimulation with 1 g of acetazolamide for the interpretation of cerebrovascular reserve (CVR) capacity. Twelve patients underwent 18-fluorodesoxyglucose positron emission tomography. These measurements were made before and 7 days after cranioplasty. Cranioplasty improved preoperative differences in MCA blood flow velocities when comparing the injured with the noninjured hemisphere. Similarly, cranioplasty resolved decreases in extracranial ICA blood flow in the injured hemisphere that were induced by postural changes, which was a constant finding prior to this procedure. More strikingly, however, the CVR capacity, which was severely impaired in both hemispheres, significantly increased after the procedure. Metabolic deficits, which were observed in the injured as compared with the noninjured hemisphere, were found to improve after reimplantation of the skull bone flap. Cranioplasty appears to affect postural blood flow regulation, CVR capacity, and cerebral glucose metabolism markedly. Thus, early cranioplasty is warranted to facilitate rehabilitation in patients after decompressive craniectomy.
OBJECT: The indications for cranioplasty after decompressive craniectomy are cosmetic repair and, mainly, restoration of cerebral protection. Although neurological improvement after cranioplasty is repeatedly noted, the reasons for this remain unclear. Few observations concerning the impact of cerebrospinal fluid hydrodynamic and/or atmospheric pressure have been published during the last decades. Relevant data concerning the cerebrovascular reserve (CVR) capacity and cerebral glucose metabolism before and after cranioplasty have been lacking until now. To gain further insight, this study was undertaken to investigate the impact of cranioplasty on indices of cerebral blood flow regulation and metabolism. METHODS: Thirteen patients in whom extensive craniectomies had been performed underwent a meticulous study of blood flow velocities in the middle cerebral artery (MCA) and extracranial internal carotid artery (ICA), as assessed by transcranial Doppler ultrasonography during postural maneuvers (supine and sitting positions) and during stimulation with 1 g of acetazolamide for the interpretation of CVR capacity. Twelve patients underwent 18-fluorodeoxyglucose positron emission tomography. These measurements were obtained before and 7 days after cranioplasty. Cranioplasty improved preoperative differences in MCA blood flow velocities when comparing those in the injured with those in the uninjured hemisphere. Similarly, cranioplasty resolved decreases in extracranial ICA blood flow in the injured hemisphere that were induced by postural changes, which was a constant finding prior to this procedure. More strikingly, however, the CVR capacity, which was severely impaired in both hemispheres, increased significantly after the procedure. Metabolic deficits, which were observed in the injured hemisphere, were found to improve after reimplantation of the skull bone flap. CONCLUSIONS: Cranioplasty appears to affect postural blood flow regulation, CVR capacity, and cerebral glucose metabolism markedly. Thus, early cranioplasty is warranted to facilitate rehabilitation in patients after decompressive craniectomy.
UNLABELLED: Evaluation of therapies for parkinsonism by dopamine receptor SPECT requires a reproducible, optimized quantitation technique. This study presents a new, objective, automated technique for semiquantitative analysis of dopamine receptor density, as applied to the differential diagnosis of parkinsonism. METHODS: Dopamine receptor density measured by 123I-iodobenzamide (IBZM) SPECT was retrospectively analyzed in nonidiopathic parkinsonism (NIPS), in Parkinson's disease (PD), and in healthy volunteers (n = 19, 38, and 13, respectively). A mean template was created from coregistered control studies. Registration errors were assessed using studies with simulated binding deficits. Patient studies were registered to the mean template, and striatal binding was calculated from a corresponding map of 3-dimensional regions of interest (ROIs). The striatal binding ratio and deficits determined by voxelwise comparison with the normal template were investigated and tested with various 3-dimensional ROI sizes and positions. Separation of patient groups was determined by tscore after automatically processing all studies. Results were compared with manual ROI analyses. RESULTS: The automatic method was completely reproducible in 64 of 70 cases. The best diagnostic discriminator was the minimum binding ratio of the 2 striatal nuclei, with the following values: NIPS, 1.33+/-0.13; PD, 1.50+/-0.12; healthy volunteers, 1.49+/-0.08 (+/-SD). The deficit size from voxelwise analysis was: NIPS, 20.5+/-8.2 mL; PD, 9.5+/-8.3; healthy volunteers, 8.9+/-6.0 (+/-SD). The accuracy, measured by receiver operating characteristic areas, was 0.85+/-0.05, 0.77+/-0.06, and 0.80+/-0.06 (+/-SE) for the optimal predictor (automated) and 2 blinded observers (manual), respectively. CONCLUSION: A new 3-dimensional, automated technique has been developed to semiquantitate receptor density that dramatically improves reproducibility. The optimal diagnostic discriminator of parkinsonism determined by the automatic technique has good accuracy compared with the manual technique.
We report a patient with left temporal lobe epilepsy and a left parietal angioma, in whom ictal SPECT showed hyperperfusion in a spontaneous and an electrically-induced, non-habitual focal seizure. A SPECT investigation during an habitual seizure originating in the left temporal lobe showed a left temporal hyperperfusion. Electrical stimulation of the parietal cortex adjacent to the location of a previously resected angioma using subdural electrodes resulted in a non-habitual seizure beginning with a unilateral somatosensory aura. Ictal SPECT of this seizure demonstrated contralateral central hyperperfusion. We conclude from our findings that ictal SPECT hyperperfusion reflects the activation of symptomatogenic cortex, which can be induced by both epileptic discharge and electrical stimulation.
UNLABELLED: The objective of this prospective study was to determine the extent to which the levels of thyroid-stimulating hormone (TSH) influence the uptake of FDG by thyroid carcinoma tumors METHODS: Ten patients with follicular (n = 7) or papillary (n = 3) thyroid carcinoma underwent FDG PET during TSH suppression (<0.05 microU/mL) and TSH stimulation (>22 microU/mL) within an average interval of 42 d (range, 28-73 d). The findings were evaluated by visual criteria. In addition, a tumor-to-background ratio (TBR) was determined for 17 lesions that were visualized. RESULTS: In 15 of 17 lesions with positive FDG uptake, TSH stimulation was associated with an increase in the TBR from 3.85 +/- 2.53 (mean +/- SD) to 5.84 +/- 4.84, corresponding to an average increase of 63.1% (P < 0.001). Determination of absolute counting rates indicated that this increase was the result of a decrease in FDG metabolism in the background together with an increase in the tumor tissue. No relationship was found between the presence or absence of iodine storage capacity (5 versus 12/17 lesions) and increase in FDG accumulation. Seven of 10 patients had additional iodine-positive metastases that showed no accumulation of FDG. CONCLUSION: Most locally recurrent and metastatic follicular and papillary thyroid carcinomas exhibited a significant increase in FDG uptake on TSH stimulation. In 3 of 10 patients, TSH stimulation resulted in either detection of new lesions or classification of the FDG uptake pattern as typical for malignancy. These findings suggest that FDG uptake in recurrent and metastatic thyroid carcinoma depends on the TSH level. Therefore, we recommend that PET examinations be performed in patients with thyroid carcinoma under TSH stimulation and follow-up examinations be performed under identical TSH conditions to prevent erroneous interpretation.
Chronic application of morphine leads to the development of tolerance towards several of its effects, e.g., analgesia or respiratory depression. Simultaneously, however, sensitization arises which becomes apparent in behavioral tests as increased locomotion or increased self-application. A human correlate for the latter may be the increasing craving for opioids in addicts. To identify brain areas involved in these long-lasting processes, we studied the expression of the transcription factor c-fos by in situ hybridization in rat brain as a marker for changes in gene expression after single or repeated morphine applications in the animals. The only c-fos signal that exceeded background after a single dose of morphine (50 mg/kg) was a diffuse expression in the lateral septum. In contrast, repeated dosage twice daily for 10 days and ascending from 10 to 50 mg/kg resulted in a sharply delineated morphine-induced c-fos synthesis in the dorsomedial and lateral striatum, lateral septum, medial mammillary nuclei, anterior thalamus and, in part masked by a high background due to injection stress, in the cingulate cortex. Most of these areas belong to the limbic system or are closely associated with it. The c-fos response was inducible by morphine in pretreated animals for up to 8 weeks after finishing the repeated application scheme. Retrograde tracing studies revealed that the dorsomedial part of the striatum, which was strongly labeled with the c-fos probe, received inputs from limbic as well as from motoric parts of the thalamus and cortex. Therefore, the sensitization of morphine-induced c-fos expression in parts of the striatum seems to correlate with the locomotor effects of repeated morphine application, whereas the observed sensitization in several limbic brain areas might reflect emotional phenomena like increased self-administration in rats or drug craving in humans.
The aim of the present study was to identify synaptic contacts from axons originating in the superior colliculus with thalamic neurons projecting to the lateral nucleus of the amygdala. Axons from the superior colliculus were traced with the anterograde tracers Phaseolus vulgaris leucoagglutinin or the biotinylated and fluorescent dextran amine "Miniruby." Thalamo-amygdaloid projection neurons were identified with the retrograde tracer Fluoro-Gold. Injections of Fluoro-Gold into the lateral nucleus of the amygdala labeled neurons in nuclei of the posterior thalamus which surround the medial geniculate body, viz. the suprageniculate nucleus, the medial division of the medial geniculate body, the posterior intralaminar nucleus, and the peripeduncular nucleus. Anterogradely labeled axons from the superior colliculus terminated in the same regions of the thalamus. Tecto-thalamic axons originating from superficial collicular layers were found predominantly in the suprageniculate nucleus, whereas axons from deep collicular layers were detected in equal density in all thalamic nuclei surrounding the medial geniculate body. Double-labeling experiments revealed an overlap of projection areas in the above-mentioned thalamic nuclei. Electron microscopy of areas of overlap confirmed synaptic contacts of anterogradely labeled presynaptic profiles originating in the superficial layers of the superior colliculus with retrogradely labeled postsynaptic profiles of thalamo-amygdaloid projection neurons. These connections may represent a subcortical pathway for visual information transfer to the amygdala.