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Blood-brain barrier breach following cortical contusion in the rat.

Adult Fisher 344 rats were subjected to a unilateral impact to the dorsal cortex above the hippocampus at 3.5 m/second, resulting in a 2-mm cortical depression. This caused severe cortical damage and neuronal loss in hippocampus subfields CA1, CA3, and hilus. Breakdown of the blood-brain barrier (BBB) was assessed by injecting the protein horseradish peroxidase (HRP) 5 minutes prior to or at various times after injury (5 minutes, 1, 3, 6, and 12 hours, 1, 2, 5, and 10 days). Animals were killed 1 hour after HRP injection and brain sections were reacted with diaminobenzidine to visualize extravascular accumulation of the protein. Maximum staining occurred in animals injected with HRP 5 minutes prior to or 5 minutes after cortical contusion. Staining at these time points was observed in the ipsilateral cortex of the impact area and areas adjacent to it, as well as in the ipsilateral hippocampus. Some modest staining occurred in the dorsal contralateral cortex near the superior sagittal sinus. Cortical HRP staining gradually decreased at increasing time intervals postinjury. By 10 days, no HRP staining was observed in any area of the brain. In the ipsilateral hippocampus, HRP staining was absent by 3 hours postinjury and remained so at the 6- and 12-hour time points. Surprisingly, HRP staining was again observed in the ipsilateral hippocampus 1 and 2 days after cortical contusion, indicating a biphasic opening of the BBB following head trauma and a possible second wave of secondary brain damage days after the contusion injury. These data indicate that regions not initially destroyed by cortical impact, but evidencing BBB breach, may be accessible to neurotrophic factors administered intravenously both immediately and days after brain trauma.

Animals↗

Acoustically dependent latency shifts of BSER (wave V) in man.

The latencies of wave V in Brain Stem Evoked Responses (BSER) elicited by a set of acoustic transients were measured. The stimuli were produced by delivering pulses to two filters, arranged in series. The filters were set so that the maximum acoustic energy in the transients, i.e., filtered clicks, occurred at 0.5, 1, 2, 4, or 8 kHz. The filtered clicks were presented via earphones at a rate of 30/s at 20, 40, or 60 dB HL to ten subjects with normal hearing. The latencies of wave V varied systematically with center frequency of the filtered clicks when they were each at the same HL. Stimuli presented at 40 dB HL produced the greatest opportunity for relating stimulus frequency to latency. The latencies for a smaller set of responses to stimuli presented at 10/s were the same as those for the principal data taken at 30/s. The changes in latency of wave V due to frequency are similar to those observed by other investigators in whole-nerve responses recorded in man.

Acoustic Stimulation↗

Night terrors associated with thalamic lesion.

OBJECTIVE: To describe a case with night terrors (NT) symptomatic of a thalamic lesion. METHODS: Videopolysomnography and brain MRI were used to study a 48 year old woman with a recent onset of brief episodes, occurring exclusively during nocturnal sleep, where she suddenly sat up in bed, screamed and appeared to be very frightened. RESULTS: Videopolysomnography recorded an episode suggestive of NT. Sleep fragmentation with frequent brief arousals or microarousals was also evident mainly during slow wave sleep. The brain MRI showed increased T2 signal from the right thalamus suggestive of a low-grade tumor. CONCLUSIONS: Our case suggests that NT starting in adulthood can, rarely, be symptomatic of neurological disease, and warrant further investigation with MRI. SIGNIFICANCE: A thalamic dysfunction, disrupting at this level the arousal system, may play a role in provoking NT.

Arousal↗

Three-dimensional analysis of shear wave propagation observed by in vivo magnetic resonance elastography of the brain.

Dynamic magnetic resonance elastography (MRE) is a non-invasive method for the quantitative determination of the mechanical properties of soft tissues in vivo. In MRE, shear waves are generated in the tissue and visualized using phase-sensitive MR imaging methods. The resulting two-dimensional (2-D) wave images can reveal in-plane elastic properties when possible geometrical biases of the wave patterns are taken into account. In this study, 3-D MRE experiments of in vivo human brain are analyzed to gain knowledge about the direction of wave propagation and to deduce in-plane elastic properties. The direction of wave propagation was determined using a new algorithm which identifies minimal wave velocities along rays from the surface into the brain. It was possible to quantify biases of the elastic parameters due to projections onto coronal, sagittal and transversal image planes in 2-D MRE. It was found that the in-plane shear modulus is increasingly overestimated when the image slice is displaced from narrow slabs of 2-5cm through the center of the brain. The mean shear modulus of the brain was deduced from 4-D wave data with about 3.5kPa. Using the proposed slice positions in 2-D MRE, this shear modulus can be reproduced with an acceptable error within a fraction of the full 3-D examination time.

Brain↗

Computerized tomographic scan and gunshot wounds of the head: indications and radiographic findings.

The authors document their experience with the computerized tomographic (CT) scanner for evaluating gunshot wounds of the head. Only those patients who were considered to be operative candidates and who were neurologically stable were scanned. In the postoperative period, patients who were not scanned preoperatively and those whose condition did not improve were also scanned. In the preoperative period the CT scanner is useful for identifying and localizing missile tracks, bony and metallic fragments, intra- and extraparenchymal hematomas, intracranial air, and brain swelling. In the postoperative period the CT scanner may demonstrate retained bone fragments, edema, brain abscess, and intracranial air. The limitations of the CT scan in evaluating gunshot wounds include an inability to define vascular lesions suchas traumatic aneurysms and post-traumatic spasm. Metallic scatter from missile fragments may render certain CT cuts uninterpretable. In addition, the CT scan may appear minimally abnormal in spite of immediate and irreversible injury caused by a shock wave transmitted to brain stem structures. The CT scanner has superceded angiography as a diagnostic tool for evaluating gunshot wounds of the head because it is noninvasive and rapid, allows visualization of the entire head, can resolve very small lesions that produce little or no mass effect, can help to determine the nature of intracranial lesions and may quantitate the amount of hemorrhage and edema. Because it enables physicians to visualize intracranial structures in three dimensions, the CT scan may precisely define missile tracks and contiguous lesions in a manner not heretofore possible with other diagnostic modalities. Thus, it is invaluable for the rational planning of surgical therapy.

Brain Injuries↗

[Kindling of rat epilepsy by intracerebroventricular injection of norfloxacin and ultrastructural changes of brain].

AIM: To study the toxic effects of norfloxacin (Nor) on EEG and ultrastructure of the brain. METHODS: EEG was recorded in the sensorimotor area of rat cortex after Nor 150 and 300 micrograms.kg-1 were injected into the right ventricle of the brain. RESULTS: Spike waves occurred, first at the ipsilateral side and then bilaterally. The seizure spike appeared at 168 +/- 129, 51 +/- 35 s, and 276 +/- 138, 118 +/- 65 s in the right and left cerebral cortices in 150 and 300 micrograms.kg-1 groups, respectively. The wave forms were variable, the wave amplitude and frequency increased gradually, accompanied with limb twitching. Neuron degeneration was seen in both cerebral hemispheres, hippocampus, and cerebellum 120 min after the i.c.v. of Nor 300 micrograms.kg-1: myeloid degeneration of Golgi complex, rough endoplasmic reticulum, and neuropils; swelling of cytoplasm; dissolution of nuclears and chromatin; necrosis of gliocytes and the appearance of changes in both the light and dark neurons, especially the dark ones. CONCLUSION: Rat brain was widely damaged after the kindling by Nor.

Animals↗

Audiologic presentation of vestibular schwannomas in neurofibromatosis type 2.

OBJECTIVE: The audiologic presentation of vestibular schwannoma (VS) associated with neurofibromatosis type 2 (NF2) has not been well characterized. The goal of this study was to investigate the audiologic features of NF2-associated VS and to determine their relationship to the size of the tumor. STUDY DESIGN: A retrospective case review. SETTING: Quaternary governmental medical research institute evaluating patients fitting specific criteria for ongoing clinical studies. PATIENTS: Audiologic and magnetic resonance imaging data were available for 40 patients (25 males, 15 females), with an average age of 32 years, who had been recruited for ongoing clinical and genetic studies of NF2. MAIN OUTCOME MEASURES: The audiologic profile and magnetic resonance imaging characteristic of tumor were retrospectively reviewed. RESULTS: The average size of the tumor at presentation was 7.26 +/- 16.58 cm3 and measured 1.2, 1.6, and 1.1 cm in the anterior/posterior, lateral/medial, and superior/inferior dimensions, respectively. An increase in lateral/medial size of the tumor most significantly correlated with deterioration in mid- (1,000-2,000 Hz) and high- (4,000-8,000 Hz) frequency hearing levels, elevated speech reception threshold, and prolonged auditory brain stem response waves III and V latency. CONCLUSIONS: Patients with NF2 demonstrate a more predictable audiologic profile for a given size tumor than has been previously described with spontaneous or sporadic VS.

Adult↗

A combined study of tumor-related brain lesions by using magnetoencephalography and 1H magnetic resonance spectroscopic imaging. Technical note.

The purpose of this study was to localize pathological magnetic brain activities and to analyze metabolic alterations in functionally abnormal lesions by using magnetoencephalography (MEG) and (1)H magnetic resonance (MR) spectroscopy in patients with brain tumors. The authors studied 10 healthy volunteers and seven patients who harbored common brain tumors, namely astrocytic tumors and meningioma. In spontaneous MEG the pathological brain activities (slow waves, fast waves, and spikes) were localized using a single equivalent dipole model. After the results of MEG and (1)H MR spectroscopy were superimposed onto the corresponding MR images, the signal intensities of spectroscopically visible metabolites were analyzed in the regions in which the dipoles of the pathological activities were concentrated. Increased slow-wave activity was observed in four cases, and fast-wave or spike activity was significantly increased in one case each, respectively. These pathological activities were localized at almost the same cortical areas adjacent to the bulk of tumors, where mild reduction of N-acetyl aspartate (NAA) and slight accumulation of lactate consistently existed. Preserved and metabolically active cortical areas, which are indicated by residual NAA, might be able to generate pathological magnetic activities under lactic acidosis. Such an area could be understood as a border zone between normal brain tissue and brain tissue that has been seriously damaged by tumors or associated edema, which should be intensively treated. This combination of imaging techniques gives insight into functional as well as metabolic aspects of pathological brain conditions.

Journal Article↗

When Wiener filtering is less than optimal: a illustrative application to the brain stem evoked potential.

Wiener filtering as a means of improving the estimation of the wave form of the brain stem evoked potential (BSEP) is evaluated using both simulation and real signals. Where signal and noise overlap in the frequency domain, the performance of the filter is shown to be superior to signal averaging only at signal levels where the conventional approach already yields a working signal-to-noise ratio. It is concluded that, particularly given the computational overheads of Wiener filtering, the utility of the method must be doubted.

Acoustic Stimulation↗

[Effect of parenterally administered amino acids and protein hydrolysate on the electrical activity of brain structures].

Glycin, glutamic acid or casein hydrolysate induced high frequency and high voltage electrical waves in the brain-stem RF and often in the lateral hypothalamic nucleus and cortex. These changes were more obvious during feeding of the dogs. Sham feeding and parenteral administration of glucose or 0.9% solution of NaCl evoked responses different from the above ones. Gastric secretion stimulated by i.v. administration of nitrous substances by food was not directly related to the above responses either. The impulses responsible for the secretion seem to arise at another level of the brain.

Amino Acids↗

[Validity of early acoustically-evoked potentials in the diagnosis of brain death].

Brainstem acoustic evoked potentials (BAEP) in clinically proven brain death are already described in the literature. In most cases there were no reproducable BAEP or only wave I ipsilateral. In a few cases, shortly after the onset of brain death, wave I and a wave II ipsilateral have been detected. 40 Patients were examined during developing brain death and in brain death. Using an ipsilateral and contralateral montage (mastoid/vertex) four different patterns of BAEP in brain death could be distinguished: Wave I ipsilateral and wave II ipsilateral, reduced in amplitude and delayed in latency and a wave I-contralateral, Wave I ipsilateral and wave I-contralateral, Only wave I ipsilateral, No reproducable BAEP. In clinically not brain dead patients, three different patterns of BAEP are recorded which should be known in order to comment on the validity of the method in the diagnosis of brain death: Only wave I and a flat and late wave, only recordable using several reproductions and with a low rate of artefacts. Only wave I recordable while the patient is still breathing spontaneously (false positive results). Reversible loss of wave I. Ignoring the results, the BAEP may lead to false positive results in the diagnosis of brain death.

Brain Death↗

Normal brain stem auditory evoked potentials recorded in sleep apneics during waking and as a function of arterial oxygen saturation during sleep.

Brain stem auditory evoked potentials (BAEPs) can be utilized as an index of neuronal dysfunction at the level of the brain stem. These waves are known to be independent of level of arousal. In the present study, BAEPs (waves I-V) to monaural click stimulation were recorded during daytime waking and as a function of arterial oxygen saturation during nocturnal sleep in 6 subjects with obstructive sleep apnea syndrome. Normal conduction times were recorded in all 6 subjects during daytime waking. In addition, BAEPs remained stable in every case during sleep-related apneas when averaged over intervals of arterial oxygen saturation as low as 45-70% in one subject. Our data indicate that (1) the repetitive oxygen desaturation experienced during sleep in apneics had neither acute nor chronic, measurable effects on neurons which subserve the BAEP, and (2) a brain stem abnormality involving the structures which subserve the BAEP does not underly obstructive sleep apnea.

Adolescent↗

Altered mechanisms of motor-evoked potential generation after transient focal cerebral ischemia in the rat: implications for transcranial magnetic stimulation.

We recently demonstrated that a long-lasting transmission defect in cortical synapses caused motor dysfunction after brief middle cerebral artery (MCA) occlusion in the rat despite rapid recovery of axons. In this experimental study, we have examined the impact of differential recovery of synapses and axons on generation of motor-evoked potentials (MEP) recorded from contralateral paralyzed and ipsilateral unaffected muscles, to gain insight into mechanisms of MEPs recorded from stroke patients by transcranial magnetic stimulation (TMS). MEPs generated by focal electrical stimulation of the forelimb area of motor cortex were simultaneously recorded from the brain stem, contra- and ipsilateral forelimb and contralateral hindlimb muscles in rats subjected to transient MCA occlusion. The effect of ischemia on cortical activity and axonal conduction was differentially studied by proximal or distal occlusion of the MCA. Regional cerebral blood flow changes in the forelimb area were monitored by laser-Doppler flowmetry during ischemia and reperfusion. In addition, synaptic transmission within the forelimb area of motor cortex was examined by intracellular and extracellular recording of potentials generated by stimulation of the premotor area. No MEP response was recorded during ischemia. Upon reperfusion: (i) motor axons readily regained their excitability and cortical stimulation caused successive pyramidal volleys (recorded as D waves from the brain stem) and a MEP from contralateral paralytic muscles although synaptic activation of motor pathways was not feasible; (ii) the amplitude of pyramidal volley was increased; (iii) MEPs with a longer latency were recorded from the ipsilateral forelimb. In conclusion, differential recovery of synapses and axons after ischemia may account for some previously unexplained findings (such as preserved MEPs in paralysed muscles) observed in cortical stimulation studies of stroke patients.

Animals↗

[The effect of etimizol on the excitability and spontaneous super-slow activity of the structures of the rabbit brain].

Spontaneous superslow electrical brain activity and its changes were studied in acute experiments on curarized rabbits after administration of etimysol in doses of 1.0, 1.5 and 2.5 mg/kg. The effect of the drug persisted for three hours. Two oscillation phases were recorded in the medial group of mesencephalic reticular nuclei and the lateral nucleus of the hypothalamus: a short positive phase and a prolonged negative one. In other brain structures only negative waves were recorded. A significant functional rearrangement of correlative connections of brain structures took place in 90 minutes after the drug administration. The factor analysis showed that the most subtle connections were preserved in the neocortex and the dorsal hippocampus.

Animals↗

Effect of islet transplantation on neuroelectrophysiological abnormalities in diabetic inbred Lewis rats: comparison of primary versus secondary prevention.

BACKGROUND: Neuroelectrophysiological abnormalities in diabetes indicate nervous function failure. Restoration of euglycemia by islet transplantation may prevent or reverse these abnormalities. METHODS: Pancreatic islets were transplanted in inbred Lewis rats after 15 days (Ta12, primary prevention) or 8 months (Tb12, secondary prevention) from streptozotocin-induced diabetes. Transplanted and control (normal and diabetic) rats were followed for a total period of 12 months. Metabolic parameters, somato-sensory, brain-stem auditory, and visual evoked potentials were determined at the beginning and at the end of the study and before transplantation for secondary prevention. RESULTS: The metabolic parameters in transplanted animals were similar to those of normal animals. Ta12 and normal group somato-sensory conduction velocities did not vary and were always significantly higher than those of diabetic animals. By contrast, Tb12 group conduction velocities showed only a partial improvement, values lying between those of diabetic and normal rats. Brain-stem auditory (waves I, II, and III) latencies in Ta12 group were similar to those of normal rats and significantly lower than those of diabetic animals (wave I: P<0.01; waves II and III: P<0.05). Tb12 group wave I and II latency values remained altered (P<0.005 and P<0.01 versus normal values respectively). Visual evoked potentials-P1 wave latencies in transplanted rats were always higher than those of normal and diabetic animals. CONCLUSIONS: After primary prevention, central and peripheral neurological alterations were abolished. After secondary prevention, transplantation beneficial effects were partial, occurring mainly at peripheral level. These results highlight the importance of early transplantation to prevent hyperglycemia-dependent neuroelectrophysiological alterations.

Animals↗

Sleep-wave activity of a delta sleep-inducing peptide analog correlates with its penetrance of the blood-brain barrier.

Delta sleep-inducing peptide (DSIP) significantly increases delta wave electrical activity in the brain of rats after intraperitoneal (i.p.) injection. Rats (n = 10) were peripherally injected with DSIP and [D-Ala4]DSIP-NH2 during the dark portion of a 12-h light/dark cycle prior to recording of epidural encephalographic (EEG) wave forms. Administration of [D-Ala4]DSIP-NH2, an analog that enters the brain after peripheral administration more readily than the parent DSIP molecule, resulted in significantly more delta waves than DSIP together with a highly significant amount of theta activity. DSIP was found to significantly increase EEG output in the delta range when compared with controls. In addition, the DSIP analog significantly decreased locomotor activity, whereas DSIP itself was without effect. These findings strongly support the controversial concepts that peripherally injected peptides can reach the brain and that DSIP compounds can increase sleep activity.

Animals↗

Effects of electrical stimulation on intracranial pressure and systemic arterial blood pressure in cats. Part I: Stimulation of brain stem.

It has been suggested that brain stem activity is involved in the occurrence of pressure waves. Different sites in the brain stem were activated by electrical stimulation in cats anaesthetized with sodium pentobarbital, to produce an increase in intracranial pressure (ICP) similar to the pressure waves. Then the effect of artificial ventilation on the occurrence of the pressure wave-like response produced under spontaneous respiration was examined since Lundberg's A-waves appear even in artificial ventilation, and B-waves are effaced during artificial ventilation. This results in a brain stem map of ICP and systemic arterial blood pressure (BP) produced by electrical stimulation during spontaneous respiration. Stimulation of the rostral medullary reticular formation produced a rise in ICP and BP in association with a change in the rhythm of the spontaneous respiration; with artificial ventilation, stimulation produced a rise in BP but ICP kept almost at the same level. However, the rise in ICP that was produced by stimulation of the caudal medullary reticular formation during spontaneous respiration also occurred with a depressor response of BP during controlled ventilation. The pressure wave-like responses could be classified, therefore, into two types. One was the response seen during both spontaneous and controlled ventilation, which we designated the 'alpha' wave. The other was the response seen only during spontaneous ventilation, the 'beta' wave. These observations suggest that the origins of A- and B-waves may be related to those of 'alpha' and 'beta' waves, respectively.

Animals↗

The relationship between loudness intensity functions and the click-ABR wave V latency.

OBJECTIVE: To assess the relationship of loudness growth and the click-evoked auditory brain stem response (ABR) wave V latency-intensity function (LIF) in listeners with normal hearing or cochlear hearing loss. The effect of hearing loss configuration on the intensity functions was also examined. DESIGN: Behavioral and electrophysiological intensity functions were obtained using click stimuli of comparable intensities in listeners with normal hearing (Group I; n = 10), and cochlear hearing loss of flat (Group II; n = 10) or sloping (Group III; n = 10) configurations. Individual intensity functions were obtained from measures of loudness growth using the psychophysical methods of absolute magnitude estimation and production of loudness (geometrically averaged to provide the measured loudness function), and from the wave V latency measures of the ABR. RESULTS: Slope analyses for the behavioral and electrophysiological intensity functions were separately performed by group. The loudness growth functions for the groups with cochlear hearing loss approximated the normal function at high intensities, with overall slope values consistent with those reported from previous psychophysical research. The ABR wave V LIF for the group with a flat configuration of cochlear hearing loss approximated the normal function at high intensities, and was displaced parallel to the normal function for the group with sloping configuration. The relationship between the behavioral and electrophysiological intensity functions was examined at individual intensities across the range of the functions for each subject. A significant relationship was obtained between loudness and the ABR wave V LIFs for the groups with normal hearing and flat configuration of cochlear hearing loss; the association was not significant (p = 0.10) for the group with a sloping configuration of cochlear hearing loss. CONCLUSION: The results of this study established a relationship between loudness and the ABR wave V latency for listeners with normal hearing, and flat cochlear hearing loss. In listeners with a sloping configuration of cochlear hearing loss, the relationship was not significant. This suggests that the click-evoked ABR may be used to estimate loudness growth at least for individuals with normal hearing and those with a flat configuration of cochlear hearing loss. Predictive equations were derived to estimate loudness growth for these groups. The use of frequency-specific stimuli may provide more precise information on the nature of the relationship between loudness growth and the ABR wave V latency, particularly for listeners with sloping configurations of cochlear hearing loss.

Acoustic Stimulation↗