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The effects of electroconvulsive shock on retinal activity.

Two experiments are reported examining the effects of electroconvulsive shock (ECS) on the electroretinogram (ERG) and the retinal oscillatory potentials (OPs) in the albino rat. Immediately after the induction of generalised seizure activity, both the ERG and the OPs were always preserved basically intact, despite minor alterations to their waveforms. In Experiment 1, it was found that small changes in amplitude of the ERG were recorded following ECS, but these were most likely artifactual. The only other notable finding was a temporary decrease in latency of the b-wave of the ERG. In Experiment 2, a slight overall attenuation in the amplitude of the OPs was observed. This was associated with a paradoxical decrease in the latencies of all three OP subcomponents similar to that found for the ERG b-wave. It is concluded that ECS does not interfere to any marked extent with either the transduction of the visual signal or its processing within the various retinal layers. This implies that the blockade of the afferent volley that occurs following ECS must be confined to the optic pathway or to the occipital cortex itself.

Animals↗

Pituitary adenomas: results of 684 surgically treated patients and review of the literature.

BACKGROUND: The outcome of patients with pituitary adenomas who were treated surgically with or without postoperative radiotherapy was analyzed. The purpose of this study was to determine the factors that strongly influence (A) tumor control, (B) the efficacy of surgery, and (C) radiotherapy based on the hormonal activity of adenomas and its invasion characteristics. METHODS: Between 1982-1996, 684 patients with the diagnosis of pituitary adenoma were operated on. The mean age was 38 years and the mean follow-up time was 40.5 months. A total of 516 patients who were followed for more than 1 year were studied to analyze the effect of treatment modalities and invasion characteristics on tumor control. There were 297 patients with prolactinomas, 118 patients with somatotropinomas, 45 with corticotropinomas, 17 with mixed adenomas, two with thyrotropinomas, and 205 with null cell adenomas. All patients were classified according to Hardy's modified radiological classification scheme and analyzed in invasive and noninvasive groups individually based on this classification system. In the early postoperative period, 230 of these patients were given conventional radiotherapy with a mean dose of 4400 cGy. The following factors were analyzed for prognostic significance in tumor control: the effects of surgery and radiotherapy based on tumor types and invasion characteristics, the existence of histologically proven invasion of the dura mater overlying the sellar floor, and the early results of topical bromocriptine application in macroprolactinoma patients. RESULTS: Overall surgical complications and mortality rate were similar to those of large series reported in the literature. Except for the invasive somatotropinomas and null cell adenomas, statistical analysis demonstrated the ineffectiveness of radiotherapy on tumor control. We did not detect any positive correlation between the recurrence rate and mean recurrence time or dural invasion of the sellar floor. Topical bromocriptine application seemed to improve tumor control in 21 selected macroprolactinoma patients. CONCLUSION: Conventional radiotherapy is not as effective as expected, considering its adverse effects. The increased side effects of radiotherapy in cases with supra-parasellar extension, especially to the optic pathway and hypothalamus, limit its benefits, which could be demonstrated only in invasive somatotropinomas and null cell adenomas. In contrast with our current beliefs, tumoral infiltration of the sellar dura mater is not a prognostic factor for recurrence and therefore should not be a criterion for radiotherapy after surgery. Topical application of bromocriptine into the sellar cavity after tumor removal seems to provide superior results compared with the conventional treatment modalities.

Adenoma↗

Photorefractive keratectomy for hyperopia: long-term nonlinear and vector analysis of refractive outcome.

PURPOSE: To characterize the refractive changes after excimer laser photorefractive keratectomy for the correction of hyperopia over a follow-up up to 3 years and to assess refractive stability and changes in astigmatism. DESIGN: Noncomparative, nonrandomized, retrospective, interventional case series. PARTICIPANTS: Thirty-eight hyperopic eyes of 28 patients (age range, 33-62 years) with refraction in the range +1.00 to +8.00 diopters (D). Mean attempted correction was +3.33+/-0.98 D (range, +1.00 to +4.00 D). Data were compared to those from 216 eyes treated for myopia in the range -1.00 to -12.70 D. INTERVENTION: The hyperopic correction was made using an erodible mask inserted in the laser optical pathway to produce a circular ablation measuring 6.5 mm in diameter. An axicon was then used to create a blend transition zone from 6.5 mm up to 9.4 mm in diameter. Eyes were evaluated 3 to 11 times (5.5+/-2.4) over a 3- to 34-month follow-up (16.8+/-8.4 months). MAIN OUTCOME MEASURES: Vector analysis of refractive error, applying a nonlinear statistical model fitting the spherical equivalent, and the sphere component data. The fit parameters were the long-term error at stabilization (epsilon(infinity)), the amount of regression (epsilon0), being the difference of refractive errors immediately after surgery and at stabilization, and the time constant (T1/2) giving the temporal scale length by which the overcorrection halves (regression half-life). Cylinder was analyzed by a linear regression. RESULTS: The initial overcorrection was much larger after hyperopic treatments than myopic ones (epsilon0 = -3.26+/-0.35 D vs. +1.43+/-0.35 D), and it takes typically four times longer to regress (T1/2 = 3.30+/-0.91 months). Refractive stabilization is reached after more than 1 year, with a satisfactory refractive result. The hyperopic treatment induces a mean astigmatism of 1.00 D, which remains constant throughout the follow-up, and tends to be aligned along the with-the-rule meridian. CONCLUSIONS: The advantages of a reasonably well-designed algorithm to correct hyperopia (epsilon(infinity) = +0.20+/-0.23 D) are counterbalanced by the long time to refractive stabilization and by the induced astigmatism.

Adult↗

Detection and maturation of VEP albino asymmetry: an overview and a longitudinal study from birth to 54 weeks.

The genetic anomaly in albinism prevents adequate melanin metabolism within the fetal eye cup and stalk. This results in severe disruption of pre- and postnatal retinal development and the condition of abnormal temporal retinal projections. The obligate misrouting of retinal-geniculate-cortical projections in albinism can be detected in the topographical representation across the occiput of the visual evoked potential (VEP). Age-dependent misrouting detection methods are described which yield 100% detection rates with zero false positives across the life span. By combining appropriate state-defined neonatal recording procedures with the albino infant VEP test paradigm, the presence of aberrant optic pathway projections was observed in a 5-day-old full-term infant. Maximum asymmetry was observed within a long-latency window of the response which shifted during the postpartum period to shorter latencies. Longitudinal studies show two specific latency regions of significant VEP asymmetry. The first occurs within 40-70 ms after stimulus onset and remains constant across the age range. The second, more robust, cluster of asymmetry occurs within a longer latency window and shows an age-related shift towards shorter latencies. The decreasing latency of this asymmetry is concomitant with normal maturational changes of the evoked response. These results show that VEP misrouting can be extended to reliable albino diagnosis within the neonatal period and to the assessment of visual maturation.

Aging↗

The effects of electroconvulsive shock on the flash visual evoked potential in the rat.

The effects of electroconvulsive shock (ECS) on the flash visual evoked potential (FVEP) were studied in the awake albino rat. Immediately after the induction of generalised seizure activity, the FVEP was totally abolished although accidentally averaged rhythmic epileptiform activity was often present in the trace. During the second recording, a potential had reappeared but this response was suspected of being a superior colliculus FVEP masquerading as a cortical response. By the third recording, the genuine cortical FVEP had returned, albert with an abnormally large amplitude. The waveform subsequently remained significantly distorted although it had regained an approximately normal morphology within 6-7 min of the administration of ECS. It was not possible to identify the principal site of action of ECS but it was concluded that ECS may impact on activity generated at more than one location within the optic pathways. The present findings are compared with a number of previous animal and human studies where the FVEP was apparently preserved following ECS and attempts are made to explain the discrepancy in results. The relevance of the present findings for understanding the pathophysiology of electrical stunning and of the loss or impairment of consciousness during generalised epileptic seizures is also discussed.

Animals↗

Preirradiation endocrinopathies in pediatric brain tumor patients determined by dynamic tests of endocrine function.

PURPOSE: To prospectively evaluate pediatric patients with localized primary brain tumors for evidence of endocrinopathy before radiotherapy (RT). METHODS AND MATERIALS: Seventy-five pediatric patients were evaluated with the arginine tolerance test and L-dopa test for growth hormone secretory capacity and activity; thyroid-stimulating hormone surge and thyrotropin-releasing hormone stimulation test for the hypothalamic-thyroid axis; the 1-microg adrenocorticotropin hormone (ACTH) and metyrapone test for ACTH reserve; and, depending on age, a gonadotropin-releasing hormone stimulation test to determine gonadotropin response. The study included 38 male and 37 female patients, age 1-21 years with ependymoma (n = 35), World Health Organization (WHO) Grade I-II astrocytoma (n = 18), WHO Grade III-IV astrocytoma (n = 10), craniopharyngioma (n = 7), optic pathway tumor (n = 4), and germinoma (n = 1). Seven patients receiving dexamethasone at the time of the evaluation were excluded from the final analysis. RESULTS: Of 68 assessable patient, 45 (66%) had evidence of endocrinopathy before RT, including 15 of 32 patients (47%) with posterior fossa tumors. Of the 45 patients, 38% had growth hormone deficiency, 43% had thyroid-stimulating hormone secretion abnormality, 22% had an abnormality in ACTH reserve, and 13% had an abnormality in age-dependent gonadotropin secretion. CONCLUSION: The incidence of pre-RT endocrinopathy in pediatric brain tumor patients is high, including patients with tumors not adjacent to the hypothalamic-pituitary unit. These data suggest an overestimation in the incidence of radiation-induced endocrinopathy. Baseline endocrine function should be determined for brain tumor patients before therapy. The potential for radiation-induced endocrinopathy alone cannot be used as an argument for alternatives to RT for most patients. Pre-RT endocrinopathy may be an early indicator of central nervous system damage that will influence the functional outcome unrelated to RT.

Adolescent↗

Treatment planning comparison of conventional, 3D conformal, and intensity-modulated photon (IMRT) and proton therapy for paranasal sinus carcinoma.

PURPOSE: To determine the potential improvements in patients with paranasal sinus carcinoma by comparing proton and intensity-modulated radiotherapy (IMRT) with conventional and conformal photon treatment planning techniques. METHODS AND MATERIALS: In 5 patients, comparative treatment planning was performed by comparing proton plans and related conventional, conformal, and IMRT photon plans. The evaluations analyzed dose-volume histogram findings of the target volumes and organs at risk (OARs, i.e., pituitary gland, optical pathway structures, brain, nontarget tissue). RESULTS: The mean and maximal doses, dose inhomogeneities, and conformity indexes for the planning target volumes were comparable for all techniques. Photon plans resulted in greater volumes of irradiated nontarget tissues at the 10-70% dose level compared with the corresponding proton plans. The volumes thereby increased by a factor of 1.3-3.1 for conventional, 1.1-3.8 for conformal, and 1.1-3.7 for IMRT. Compared with conventional techniques, conformal and IMRT photon treatment planning options similarly reduced the mean dose to the OARs. The use of protons further reduced the mean dose to the OARs by up to 65% and 62% compared with the conformal and IMRT technique, respectively. CONCLUSION: Compared with conventional treatment techniques, conformal RT and IMRT similarly enabled dose reductions to the OARs. Additional improvements were obtained using proton-based treatment planning modalities.

Humans↗

Imaging of sella and parasellar disease.

The sella and parasellar region may be affected by a variety of disease states. Diseases of this region often result in visual disturbances because of the proximity of the sella to the optic pathways and cranial nerves. Knowledge of the pathological conditions affecting the sella and surrounding structures is important for the orbital imager.

Aneurysm↗

Ontogeny of (D-Ala(2))-deltorphin I-like immunoreactive neurones in foetal rat brain.

Foetal rat brain from embryonic day (ED) 12-22 was immunohistochemically studied to describe the time of first appearance and further distribution patterns of (D-Ala(2))-deltorphin-I-immunoreactive (DADTI-IR) nerve elements. The primary antiserum used in this study was a polyclonal antibody against DADTI previously used in adult and postnatal rat brain mapping. DADTI-IR nerve elements first appeared in the neuroepithelium of ventral mesencephalon on ED 13. From there, positive cell bodies migrated towards the mantle layer until they invaded the whole ventral mesencephalic tegmentum. They then reached their definitive position, corresponding to a subpopulation of the A8, A9 and A10 dopaminergic neurones that had been constantly observed also in the adult age. From ED 15-17, DADTI-positive nerve fibres appeared in the medial forebrain bundle, the neostriatum anlage, the accumbens nucleus, the olfactory tubercle, the fasciculus retroflexus, and the prefrontal cortex. All these locations have also been found in adult rats. From ED 14 onwards, transient DADTI-IR somata and nerve fibres were observed in retinal neuroepithelium, optic pathways as far as the superior colliculus, CA3 hippocampal field, reticular formation in the medulla oblongata. All these locations gradually disappeared either before birth (medulla oblongata) or within the first 3 weeks after birth. These results suggest that the DADT-like molecule recognised by our antibody has during the embryonic development a regulatory function in neuronal growth and differentiation.

Analgesics, Opioid↗

[Neurofibromatosis 1: recommendations for management].

Twenty experts, members of a French medical network devoted to neurofibromatosis 1 have elaborated recommendations for the management of the disease. Bibliography was obtained through a Medline of articles from 1966 to 1999 for the terms neurofibromatosis, NF1, neurofibroma and from textbooks. A consensual document was written taking into account extracted data. An annual careful clinical examination is recommended except in cases with complications. Screening investigations are not recommended due to the rarity of complications, generally symptomatic and easily detected during the clinical follow-up. The only controversial exception might be magnetic resonance imaging for early detection of optic pathway gliomas in young children. A co-ordinated follow-up in specialised multidisciplinary centres, providing patients with a rational management, is recommended.

Adolescent↗

A centrifugally controlled circuit in the avian retina and its possible role in visual attention switching.

The isthmo-optic nucleus (ION) is the main source of efferents to the retina in birds. Isthmo-optic neurons project in topographical order on amacrine cells in the ventral parts of the retina, and a subclass of these known as proprioretinal neurons project onto the dorsal retina. We propose that, through the intermediary of the amacrine target cells, activity in the isthmo-optic pathway excites ganglion cells locally in the ventral retina but inhibits those in dorsal regions. This circuit would thereby mediate centrifugally controlled switches in attention between the dorsal retina, involved in feeding, and the more ventral parts, involved in scanning for predators. This hypothesis accounts for a wide range of disparate data from behavior, comparative anatomy, endocrinology, hodology, and neurophysiology.

Animals↗

Time-resolved study of the oxidation of ethanol by cerium(IV) using combined quick-XANES, UV-vis, and Raman spectroscopies.

Time-resolved X-ray absorption spectroscopy (Quick-XANES) has been combined with UV-vis and Raman spectroscopies to study the in situ reduction of Ce4+ to Ce3+ in ethanolic solution with a time resolution of ca. 4-5 s. For this purpose, a cam-driven oscillating double-crystal monochromator with a channel-cut crystal was combined with two spectrometers for UV-vis and Raman spectroscopies in a specialized cell which allows one to fit the optical pathways for all three spectroscopies individually. The results show that high-quality results can be obtained simultaneously, thus giving a detailed insight into the mechanisms of the investigated chemical reaction. The continuous release of nitrate and ethanol ligands from the initial Ce4+ into the solution finally leads to a trivalent cerium species which is only coordinated with water molecules after about 1800 s of reaction time.

Journal Article↗

Correlational analysis of proteins and nonmetallic nanoparticles in a deep-nulling microscope.

We present a method for label-free microscopic analysis of nonmetallic nanoparticles such as biopolymers or technical polymers diffusing freely in an aqueous environment. We demonstrate the principal feasibility of the approach with first measurements of 20-200 nm sized polystyrene spheres and of the approximately 10 nm protein complex Photosystem I (PS I) of Thermosynechococcus elongatus. The approach is based on the combination of a microscope setup with a deep-nulling interferometer for measuring minute refractive index changes or absorptions in the focal area of the microscope. It is possible to obtain transient nulls in a microscope setup on the order of 10(-5), corresponding to optical pathway differences of less than 0.6 nm and to stabilize the nulls to about 5.10(-4). With this level of stabilization it is possible to perform a fast (1 s) correlational analysis of aqueous solutions containing the protein complex PS I or 20 nm spheres and to detect in real time single diffusional transits of larger nanospheres through the focal area of the microscope. A modulated heating of the samples in the microscope focus is not necessary for detection. The interferometer correlation data correspond well to conventional two-photon excited fluorescence correlation (FCS) data measured in the same setup, providing evidence that the detection volumes are of a similar size (approximately 200 nm). We also conducted first nulling experiments using coherent near-field sources of about 30 nm diameter. Theoretical considerations indicate that this combination with nanometric near-field sources will even allow label-free single-protein analysis.

Bacterial Proteins↗

Continuous monitoring of the stimulated area in multifocal ERG.

INTRODUCTION: Multifocal electroretinography (MF-ERG) is widely used in the detection of local retinal dysfunction. However, the position of the stimulus on the retina and the stability of fixation are usually not directly accessible. Thus, devices have been designed for a continuous fundus visualization during recording. METHODS: MF-ERGs were recorded with a RetiScan system connected to two different Scanning-laser ophthalmoscopes (SLOs) that use either a red (633 nm) or green (415 nm) laser for stimulation, and a VERIS 4 system connected to a piggyback stimulator prototype that added the stimulus to the optical pathway of the SLO by means of a wavelength-sensitive mirror. Fundus visualization was achieved with the infrared lasers of the SLOs (780 and 835 nm). RESULTS: The most extensive study so far with a green laser stimulus in a cat model of retinal degeneration demonstrated the capability of the device to detect retinal landmarks and the different stages of degeneration. Also, the advantages of exactly reproducible stimulus positioning for averaging within and comparison between disease groups became apparent. The results with the same setup in transgenic mice suggest a pure cone origin of the responses. In humans, recordings show that fixation is sufficiently good in most subjects. It is not clear yet whether red or green laser stimulation (or both) is preferable. The results with the prototype were very similar to the MF-ERGs obtained with a standard CRT screen. CONCLUSIONS: All three devices allowed us to record MF-ERGs with continuous fundus monitoring. Although further refinements are necessary, it is obvious that fundus controlled methods will improve the reliability of MF-ERG in future research on glaucoma, transplantation studies, and evaluation of gene therapy.

Journal Article↗

Changes in pattern reversal evoked potentials during menstrual cycle.

Hormonal changes that occur during the menstrual cycle of women influence the visual function of females. Estrogen is reported to cause a decrease in the visual transmission time by increasing the sensitivity of receptors in the optic pathways to dopamine. The aim of this study was to search if pattern reversal evoked potentials (PRVEPs) changed during the different phases of the menstrual cycle. PRVEPs of both eyes of 30 healthy women were recorded in 4 different phases of the menstrual cycle, namely, menstrual, follicular, ovulatory and luteal. The highest mean PRVEP latency and the lowest mean P100 amplitude were recorded during the menstrual phase. The mean PRVEP latency recorded during the ovulatory phase (when estrogen level rises to 3-5 times that of other phases' without an increase in progesterone levels) was statistically significantly shorter than that of other phases' (p<0.05). Although not statistically significant, the mean P100 amplitude recorded during the ovulatory phase was higher than the other phases. Looking at these results, sex steroids seemed to affect the generation of PRVEPs. The significant decrease in PRVEP latencies when estrogen levels peaked was thought to be due to facilitating effect of estrogen on the neural transmission of the visual pathways.

Adolescent↗

Heterogeneous patterns of oligodendroglial differentiation in the forebrain of the opossum Didelphis marsupialis.

The differentiation of oligodendrocytes in the forebrain of the opossum (Didelphis marsupialis) has been studied by the immunohistochemical identification of 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) and by the autoradiographic detection of the uptake of 3H-thymidine. CNPase is expressed early in oligodendroglia somata and fibre sheaths (myelin) in the forebrain and its persistence in the cell bodies is regionally heterogeneous, being ephemeral in cells within the optic pathway, supraoptic decussation, and posterior commissure, of intermediate duration in the mamillo-thalamic fascicle, and stria medullaris, and long-lasting in other diencephalic and in telencephalic tracts. In the cerebral cortex, most CNPase+ cells have small somata and multiple processes (types I and II). CNPase-expressing oligodendrocytes are also regionally heterogeneous in terms of proliferative capability, which could not be detected in forebrain tracts or diencephalon, but has appeared in a small proportion of cells in the neocortical white matter and in the fimbria. Our findings provide additional evidence in favour of the heterogeneity of oligodendrocytes.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗

MfERG waveform characteristics in the RS1h mouse model featuring a 'negative' ERG.

Several retinal disorders lead to a relatively greater attenuation of the b-wave compared to the a-wave of the electroretinogram (ERG), a constellation called 'negative' ERG. To determine the waveform characteristics of multifocal ERGs (mfERGs) and their dependence on recording parameters in such a case, we studied the Rs1h(-/Y) mouse, the model for x-linked juvenile retinoschisis. mfERGs were recorded with a VERIS 4 system connected to a piggyback stimulator prototype that added the stimulus to the optical pathway of a HRA scanning-laser ophthalmoscope (SLO) by means of a wavelength-sensitive mirror. Real-time fundus visualization was achieved with the infrared laser of the SLO (835 nm). High-pass filter settings and the time interval used by the 'artefact removal' feature were varied to study their influence on the waveform. The mfERG in the Rs1h(-/Y) mouse had a 'negative' shape. However, the high-pass filter setting had to be lowered from the usual 10 Hz down to about 2 Hz in order to obtain that result, otherwise the negative shape was lost and mainly a positive peak remained. Similarly, a short time interval used by the 'artefact removal' feature also removed the negative shape. The Rs1h(-/Y) mouse was found to be a valuable model of diseases with a 'negative' waveform shape also in mfERG. Our results underline the importance of a lower high-pass filter cutoff frequency when recording mfERGs in such disorders. In addition, if the 'artefact removal' feature is used, it should be verified that it doesn't distort the waveform shape.

Animals↗

Visual information processing by intracerebral retinal transplants in rats.

We have developed a simple system involving the implantation of retinae over the midbrain of rodents to examine whether, in a clearly defined system such as the primary optic pathway, it is possible to re-create circuits lost as a result of injury or developmental disorder. For much of the work, immature rat hosts have been used, in part to maximise optimal conditions and to provide a baseline for similar transplants in adults. In this review we summarise the sequence of studies that has led us to the conclusion that transplanted retinae are capable not only of differentiating and responding to light but also of relaying luminance information to visual centres of the host brain where appropriate behavioural responses are elaborated.

Animals↗