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Alteration in sensory nerve function following electrical shock.

A study of the effects of electrical shock on peripheral nerve fibres is presented. Strength and duration of the applied shocks were similar to those encountered in a typical industrial electrical accident. The purpose of this study is: (i) to identify the electrophysiological and morphological change in nerve fibres after the application of electrical current shocks; (ii) to examine the ability of the peripheral nerve fibres to spontaneously regain function and; (iii) to demonstrate the usefulness of the sensory refractory spectrum as an additional technique in assessing the damage. Three groups of animals received twelve 4-ms electric field pulses of approximately 37 V/cm (n = 5), 75 V/cm (n = 9) and 150 V/cm (n = 6), respectively. Group 4 was a control group and received a direct application of 2 per cent lidocaine over the sciatic nerve for 30 min. Thermal effects of the shocks were negligible. The sensory refractory spectrum shows that electrical shock damage was mainly to the large, fast myelinated fibres and that higher field strengths do more damage. Also in a histological examination it was found that the more heavily shocked myelinated fibres had sustained more damage.

Action Potentials↗

Predicting global and specific neurological impairment with sensory-motor functioning.

The present study assessed the ability of the Dean-Woodcock Sensory-Motor Battery (DWSMB) to distinguish between normal subjects and neurologically impaired individuals. Scores from the subtests of the DWSMB for 250 normal and 250 neurologically impaired individuals were randomly assigned to two equal groups to allow for cross-validation. The DWSMB was able to correctly identify 92.8% of the cases, identifying 94.4% of the normal population and 91.2% of the neurologically impaired subjects. The cross-validation correctly identified 87.2% of the total cases, identifying 91.2% of the normal subjects and 83.2% of the neurologically impaired subjects. An additional discriminant analysis indicated that the DWSMB correctly identified the following cases: 44.9% cardio-vascular accidents, 66.7% multiple sclerosis, 40% seizures, 42% traumatic brain injuries, 62.7% dementia, and 54.5% Parkinson's disease. The results add to the validity of the DWSMB by providing evidence of its ability to differentiate between neurologically impaired and normal individuals.

Adolescent↗

A magnetic evaluation of peripheral nerve regeneration: II. The signal amplitude in the distal segment in relation to functional recovery.

Motor and sensory function in a healthy nerve is strongly related to the number of neuronal units connecting to the distal target organs. In the regenerating nerve the amplitudes of magnetically recorded nerve compound action currents (NCACs) seem to relate to the number of functional neuronal units with larger diameters regenerating across the lesion. The goal of this experiment was to compare the signal amplitudes recorded from the distal segment of a reconstructed nerve to functional recovery. To this end, the peroneal nerves of 30 rabbits were unilaterally transected and reconstructed. After 6, 8, 12, 20, and 36 weeks of regeneration time the functional recovery was studied based on the toe-spread test, and the nerve regeneration based on the magnetically recorded NCACs. The results demonstrate that the signal amplitudes recorded magnetically from the reconstructed nerves increase in the first 12 weeks from 0% to 21% of the amplitudes recorded from the control nerves and from 21% to 25% in the following 23 weeks. The functional recovery increases from absent to good between the 8th and the 20th week after the reconstruction. A statistically significant relation was demonstrated between the signal amplitude and the functional recovery (P < 0.001). It is concluded that the magnetic recording technique can be used to evaluate the quality of a peripheral nerve reconstruction and seems to be able to predict, shortly after the reconstruction, the eventual functional recovery.

Animals↗

Diabetic sensory neuropathy effect on ankle joint movement perception.

OBJECTIVE: To determine if diabetic subjects with lower extremity cutaneous sensory neuropathy also have a loss of ankle joint movement perception. The strength of association between measurements of ankle joint movement perception and measures of cutaneous sensory function was also investigated. DESIGN: Diabetic subjects with and without sensory neuropathy and individuals without diabetes participated in this study. SETTING: All subjects were community-living individuals. PARTICIPANTS: Fifty-one subjects, ages 40 to 68. Seventeen of the 34 subjects with diabetes had significant distal sensory neuropathy as determined by cutaneous perception of mechanical vibration. All individuals without diabetes were volunteers from the community. Most subjects with diabetes were recruited through direct referral from their physicians. INTERVENTIONS: Ankle joint movement perception threshold (JMPT) was assessed using a device designed for this study. Cutaneous sensory function under both halluces was measured for vibration perception using a vibrometer and for touch-pressure perception using Semmes-Weinstein monofilaments. MAIN OUTCOME MEASURES: Ankle JMPTs (degrees) were compared to measurements of cutaneous vibration perception (volts) and touch-pressure perception (monofilaments force ratings). RESULTS: Diabetic subjects with cutaneous sensory neuropathy demonstrated a significant loss of ankle movement perception (p < .01). Correlation between JMPT and cutaneous sensory tests ranged from Spearman's rank r = .43 to .67. CONCLUSIONS: Although individuals with cutaneous sensory loss secondary to diabetic neuropathy also demonstrated loss of movement perception at the ankle, the relatively low explained variance between the two types of assessment (18% to 45%) indicates that the severity of ankle joint movement perception deficits cannot be directly implied from cutaneous sensory tests.

Adult↗

Restoration of sensibility in irreparable ulnar and median nerve lesions with use of sensory nerve transfer: long-term follow-up of 20 cases.

A prospective study was conducted to evaluate patient outcomes following sensory nerve transfer. Twenty patients with irreparable ulnar or median nerve lesions underwent the procedure. Nerve involvement was bilateral in 5 cases. The mean age of the patients at the time of surgery was 29 years. The mean paralysis time and the average length of follow-up were 59 and 78 months, respectively. Eighteen of 20 patients attended a sensory re-education program after surgery. Outcome was assessed objectively by functional sensory recovery testing and by the British Medical Research Council standards. Subjective outcome was assessed by a questionnaire. Two-point discrimination of less than 10 mm was achieved in 15 of 25 hands. The mean functional sensory recovery score was 83. Eighteen of 20 patients reported that the function of their hands improved after the procedure. Good or excellent results were associated with immediate transfer of the nerve, young age, and patients' attendance to the sensory re-education program after surgery. No differences were found between the recovery of ulnar and median nerves. Based on these results we suggest that sensory nerve transfer is a simple and reliable way of restoring sensibility to the hand with favorably comparable results over conventional nerve grafting in selected cases.

Adolescent↗

Deficits in orofacial sensorimotor function in Parkinson's disease.

Orofacial sensorimotor function was assessed in patients with Parkinson's disease and in age-matched controls. Tests were designed to assess sensory function, motor abilities, and the integration of sensory information for the performance of specific movements. Patients with Parkinson's disease and normal subjects both made more errors with increasing age; however, overall, patients with Parkinson's disease made significantly more errors in our tests than did normal subjects. Interestingly, patients with Parkinson's disease showed greater deficits in tests of sensory function and sensorimotor integration than in tests of motor function. These results suggest that one aspect of Parkinson's disease consists of complex deficits in the utilization of specific sensory inputs to organize and guide movements. The results are further discussed in relation to a proposed sensory gating or filtering schema of basal ganglia motor functioning.

Aged↗

Olvanil: more potent than capsaicin at stimulating the efferent function of sensory nerves.

The capsaicin analogue olvanil stimulated an increase in cutaneous blood flow when injected intradermally into the anaesthetised rabbit, as measured using a 133Xenon clearance method. Olvanil was found to be a 10-fold more potent vasodilator (on a molar basis) than capsaicin. The effect of both vasodilators was significantly inhibited by the calcitonin gene-related peptide (CGRP) receptor antagonist CGRP-(8-37). These findings suggest that olvanil stimulates the efferent function of cutaneous sensory nerves in a more potent manner than capsaicin. We therefore suggest that olvanil is a useful pharmacological tool for studying the activity of neuropeptides released from sensory nerves.

Anesthesia↗

[Evaluation of inferior alveolar nerve function with trigeminal somatosensory evoked potential during mandibular distraction osteogenesis in monkeys].

OBJECTIVE: To assess sensory function of inferior alveolar nerve in monkeys with mandibular distraction osteogenesis by use of trigeminal somatosensory evoked potential (TSEP). METHOD: Seven young monkeys, 4 approximately 6 kg, were undergone a 13.5 mm bilateral or right-side mandibular lengthening with mandibular angle osteotomy and intraoral bone-born appliance. The inferior alveolar nerve function was assessed with TSEP before surgery, at the completion of distraction, and after four weeks of fixation. RESULTS: No significant differences in latencies and amplitudes of TSEP between the left and right inferior alveolar nerves before surgery. At the completion of distraction, latencies of TSEP showed significant elongation (P < 0.01, P < 0.001) and amplitudes also significantly decreased (P < 0.001). After four weeks of fixation, various degrees of TSEP recovery were identified. The latencies and the amplitude were slightly improved. CONCLUSIONS: Mandibular distraction osteogenesis affects sensory function of inferior alveolar nerves in studied monkeys evaluated with SEP, but recovery is observed four weeks after surgery.

Alveolar Process↗

Impairment and recovery of ipsilateral sensory-motor function following unilateral cerebral infarction.

After unilateral cerebral hemisphere stroke, resulting in contralateral arm symptoms but largely sparing higher cerebral function, ipsilateral arm function is generally considered to be unaffected. In this study, 8 subjects with acute unilateral cerebral infarction (confirmed by CT scan) and primarily motor deficits underwent 11 computerized and 6 clinical assessments between 11 days and 12 months poststroke, and were compared with 12 normal subjects. Computerized tests comprised 3 pursuit tracking tasks (preview-random, step and a combination of these), designed to measure different aspects of integrated sensory-motor (S-M) function, and 12 tasks aimed at breaking tracking into various sensory, perceptual and motor components (joint movement sense, visual resolution, object perception, static and dynamic visuospatial perception, range of movement, grip and arm strength, reaction time, speed, static and dynamic steadiness). The asymptomatic arm was impaired on all but one of the computerized tests throughout the 12-month period, although to a lesser degree than the symptomatic arm. Grip strength was marginally impaired initially. Incomplete neurological recovery was seen in the asymptomatic arm for all functions except strength, speed and steadiness, possibly indicating their resistance to improvement. Clinical assessment detected no asymptomatic arm impairment and only a mild transient deficit of higher mental function. Our data suggest that (1) all cerebral hemisphere areas involved in S-M functions can exert some degree of bilateral motor control; (2) ipsilateral influence is never greater than contralateral influence, and is usually considerably less; and (3) the proportion of ipsilateral to contralateral control is closely related to the degree of continuous sensory feedback required by the particular task. The mechanism and degree of ipsilateral dysfunction can be explained by a 3-tier cerebral model of S-M integration comprising a lower level of functions with high contralateral specificity (somatosensory and motor), a middle level of non-limb-specific partially lateralized functions (ideomotor praxis and visuospatial perception) and an upper level of global mental activities (intellect, alertness, etc.).

Adult↗

Sensory testing in the assessment of laryngeal sensation in patients with amyotrophic lateral sclerosis.

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease of unknown cause. Mortality in the population is frequently due to aspiration pneumonia. Although typically considered to be a disorder limited to motor neuron involvement, some investigators have indicated that decreased sensory function in ALS patients additionally contributes to the disease process. The objective of this study was to evaluate laryngopharyngeal sensation in the ALS population in order to quantify the range of sensory deficits and correlate any abnormalities with demographic data to determine which patients are at risk of having sensory deficits. METHODS: We examined the sensation of the larynx in 22 patients with ALS to determine whether a sensory deficit was present. After completion of a dysphagia questionnaire and medical history, patients underwent flexible endoscopic evaluation of swallowing with sensory testing (FEESST) to evaluate sensory function. Threshold values were determined and recorded for initiation of the adductor reflex. RESULTS: The results of the sensory and swallowing function assessments performed on 22 patients demonstrate abnormal sensation in 54.5% of the tested population. Asymmetric findings were noted in 75% of these patients. There was no correlation noted between the presence of sensory deficits and the severity or duration of the disease. CONCLUSIONS: Progressive dysphagia in the ALS population has typically been attributed to muscle weakness. This study points to the presence of sensory deficits in the larynx, which can further affect proper swallowing function.

Adult↗

[Breast areola and nipple sensitivity after reduction mammoplasty].

Considering the female breast to be a secondary sexual organ the sensibility of nipple and areola gains essentially in functional significance. This sensory function is impaired as well by reduction mammaplasty. Thus all different operation methods propagated in recent years have to be rated as to functional and esthetic results with regard to resection weight. The optimal operation method presupposes: 1. Satisfactory esthetic result, 2. optional reductional possibility up to subcutaneous mastectomy, 3. minor sensory impairment of nipple and areola.

Breast↗

Paramyxovirus infections alter certain functional properties in cultured sensory neurons.

Functional properties of cultured mouse dorsal root ganglion cells infected with paramyxoviruses have been studied using intracellular recording techniques. Mumps virus, which causes a persistent non-lytic infection, and Sendai virus, which causes an infection that leads to cell lysis after about a week were used. In the early phase of the infection (24-48 h) both viruses caused a reduction in the influx of calcium ions during the action potential, but did not alter resting membrane potential, action potential amplitude or input resistance. At later times functional properties became normal in mumps infected neurons. In contrast, Sendai virus infected neurons showed a reduction of action potential amplitude and input resistance at 48-72 h after infection, and finally there was also a reduction of membrane potential before the cells disintegrated. These results show that different paramyxovirus infections may cause different types of alterations in the functional properties of neurons. The reduced calcium influx resulting from mumps infection suggests that a non-lytic viral infection may have selective effects on important regulators of neuronal functions. Moreover, a lethal viral infection (Sendai) may influence specific membrane properties, such as calcium channel activation, several days prior to general structural and functional degeneration.

Action Potentials↗

[Repair and revision 9. Peripheral trigeminal nerve injury].

A review is given about long-term incidence of sensory disturbance in the areas of innervation of the n. trigeminus for different types of trauma and/or treatment. Diagnosis, clinical course and possible types of treatment are in addition reviewed. Regarding diagnosis, the outcome of a test on sensory function is not always related to the degree of nerve damage because methods differ in the type of afferent nerve fibers of which function is tested, and some specificity might occur in nerve damage, i.e. either thick or thin afferent fibers might be predominantly affected at a particular time. An initial quick testing of sensory function is recommended. This testing includes examining two sensory modalities, which are related to functioning of thick and thin afferent fibers respectively and which have a dichotomous yes/no outcome on the incidence of a pronounced sensory disturbance.

Humans↗

Sensibility deficiencies in the hands of children with spastic hemiplegia.

We evaluated 40 children with spastic hemiplegia due to cerebral palsy for sensory function and relative limb size in the affected and unaffected upper extremities. Sensory function of each limb was evaluated with respect to stereognosis (12 objects), two-point discrimination, and proprioception. Four size measurements of each limb were made: arm and forearm circumference and forearm and forearm-hand length. This study showed that 97% of the spastic limbs had a stereognosis deficit, 90% had a two-point discrimination deficit, and 46% had a proprioception deficit. Thus sensory deficits are the rule rather than the exception in children with spastic hemiplegia. Those children with severe stereognosis deficits had significantly smaller limbs in all four measurement parameters than the children with mild or moderate stereognosis deficits. In the preoperative evaluation of children with spastic hemiplegia, severe size discrepancy is a physical examination tool that can be used as a predictor of severe sensory deficits. This information is helpful for the hand surgeon in establishing realistic surgical goals.

Anthropometry↗

Large and small fibre type sensory dysfunction in patients with cancer.

Quantitative sensory testing was used to assess the prevalence of sensory dysfunction in patients with cancer, carefully screened for other risk factors for neuropathy. Large fibre type sensory function was evaluated using vibration threshold (VT) determinations while small fibre type sensory function was assessed by thermal threshold (TT) determinations. Mean VT and TT were significantly elevated in the toes but not the fingers of cancer patients. VT elevations in the toes occurred in 31% of cancer patients and in 6% of control subjects. TT elevations in the toes occurred in 43% of cancer patients and 4% of control subjects. Based on these findings it is concluded that large and small fibre type sensory dysfunction is much more common in carefully screened cancer patients than in control subjects. This sensory dysfunction is most likely to represent a neuropathy related directly or indirectly associated with cancer.

Adult↗

Modulation of lymphocyte function by sensory neuropeptides.

Neuropeptides present in the peripheral nervous system (PNS) and central nervous system (CNS) modify diverse functions of human, murine and guinea pig mononuclear leukocytes in vitro and in vivo by receptor-mediated mechanisms. Both stimulatory and inhibitory effects on lymphocytes and macrophages have been demonstrated for different neuropeptides in vitro at concentrations which are similar to those in the circulation and in tissues. The dissociation constant (KD) for the binding of a neuropeptide to its lymphocyte receptor is within the range of concentrations that evoke lymphocyte responses critical to immunity and hypersensitivity. The receptor-mediated interactions of diverse neuropeptides with immunocompetent cells provide one mechanism through which the PNS may influence localized immune responses and the CNS may alter systemic immunity.

Animals↗

Management of diabetic neuropathy.

The only strategy shown to be consistently beneficial in the treatment of diabetic neuropathy is meticulous control of blood glucose. The largest study of the effects of glycemic control on progression of neuropathy was the Diabetes Control and Complications Trial, which enrolled 1,500 patients. Meticulous control of blood glucose by multiple injections or continuous subcutaneous infusion both delayed the onset of neuropathy and slowed its progression. A weakness of this and other studies of the effect of glycemic control is that they used surrogate measures of improvement (or slowing of progression) of neurologic function. Most used sensory and motor nerve conduction studies and some used vibration perception thresholds. Whether such measures correlate reliably with neuropathy symptom scores, neurologic examination, quality-of-life measures, neuropathic complications (foot ulcers and amputation), and mortality remains controversial. Also, most studies of tight glycemic control do not address the complications of more intensive therapy, among them severe hypoglycemia. Severe hypoglycemia can precipitate acute painful neuropathy, and it markedly increases axonal degeneration in experimental diabetic neuropathy. Finally, all studies have been confined to patients with mild neuropathy; some patients had no clinical evidence of neuropathy. Whether benefit can accrue to patients with more advanced neuropathy is not known. The most physiologic means of achieving glycemic control is through pancreas transplantation; this can result in significant improvement in clinical and electrophysiologic measures of motor and sensory function and slightly improve autonomic function. Strategies to reduce the metabolic consequences of hyperglycemia on nerves and to enhance axonal regeneration are needed to supplement careful glycemic control. Aldose reductase inhibitors hold promise for reducing metabolic nerve injury, but further study is needed.

Aldehyde Reductase↗

Developmental neurotoxicity after toluene inhalation exposure in rats.

Rats were exposed to 1200 ppm or 0 ppm toluene (CAS 108-88-3) for 6 h per day from day 7 of pregnancy until day 18 postnatally. Developmental and neurobehavioral effects in the offspring were investigated using a test battery including assessment of functions similar to those in the proposed OECD TG for Developmental Neurotoxicity Study, i.e., physical development, reflex ontogeny, motor function, motor activity, sensory function, and learning and memory. The exposure did not cause maternal toxicity or decreased viability of the offspring. Lower birth weight, delayed ontogeny of reflexes, and increased motor activity in the open field was registered in the exposed offspring. Impaired cognitive function was revealed in the exposed female offspring at the age of 3.5 months, i.e., they used more time to locate the hidden platform in the Morris water maze after platform relocation. The difference was not related to poorer swimming capabilities, because swim speeds were similar to control values. The results show that exposure to 1200 ppm toluene during brain development caused long-lasting developmental neurotoxicity in rats.

Administration, Inhalation↗