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Results for “sensory function”

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PubMed2003

The 12 year prognosis of unilateral functional weakness and sensory disturbance.

BACKGROUND: Although the symptoms of unilateral "medically unexplained" or "functional" weakness and sensory disturbance present commonly to neurologists, little is known about their long term prognosis. OBJECTIVE: To determine the long term outcome of functional weakness and sensory disturbance. PATIENTS: A previously assembled cohort of 60 patients seen as inpatients by consultant neurologists in Edinburgh between 1985 and 1992 and diagnosed as having unilateral functional weakness or sensory disturbance. METHODS: Current symptoms, disability, and distress were assessed by postal questionnaire to the patients and their family doctors. RESULTS: Follow up data relating to mortality were obtained in 56 patients (93%) and to current diagnosis in 48 patients (80%). Patient questionnaire data were obtained in 42 patients (70%). The median duration of follow up was 12.5 years (range 9 to 16). Thirty five of the 42 patients (83%) still reported weakness or sensory symptoms, and the majority reported limitation of physical function, distress, and multiple other somatic symptoms. Twenty nine per cent had taken medical retirement. An examination of baseline predictors indicated that patients who had sensory symptoms had better functioning at follow up than those who had weakness. Only one patient had developed a neurological disorder which, in hindsight, explained the original presentation. Another patient had died of unrelated causes. CONCLUSIONS: Many patients assessed by neurologists with unilateral functional weakness and sensory symptoms as inpatients remain symptomatic, distressed, and disabled as long as 12 years after the original diagnosis. These symptoms are only rarely explained by the subsequent development of a recognisable neurological disorder in the long term.

Adult↗

PubMed2003

Results of the musculofascial lengthening technique for submuscular transposition of the ulnar nerve at the elbow.

BACKGROUND: In the absence of a randomized, prospective study comparing different surgical approaches for decompression of the ulnar nerve at the elbow, the choice of an approach relies on the individual surgeon's training and experience. The present report describes the results of a prospective, long-term evaluation of the musculofascial lengthening technique in a large series of patients. In these patients, the degree of ulnar nerve compression was staged with use of a numerical grading system that included measures of both motor and sensory function. METHODS: From 1985 through 1991, 121 consecutive patients (161 extremities) in whom the ulnar nerve was entrapped at the elbow were treated with surgical decompression with use of a musculofascial lengthening technique. In addition to the patient history and physical examination, measurements of sensory and motor function were obtained prospectively to permit staging of the severity of the compression by means of a grading scale. The preoperative and postoperative scores on this scale were evaluated. The mean duration of follow-up after surgery was 45.6 months. RESULTS: On the basis of traditional criteria, 105 limbs (65%) had an excellent result; thirty-seven (23%), a good result; six (4%), a fair result; twelve (7.5%), a failure; and one (0.5%), a recurrence. There was significant improvement in ulnar nerve function in terms of both the sensory (p < 0.001) and motor (p < 0.001) components of the grading scale. Comparisons of clinical subgroups revealed significant improvement in patients with diabetes, those with a Workers' Compensation claim, and those who had a severe degree of compression rather than a mild degree of compression. CONCLUSION: Surgical decompression of ulnar nerve entrapment at the elbow by means of a musculofascial lengthening technique was associated with an 88% rate of good to excellent results. The results of the present study demonstrate the feasibility of performing a statistical analysis of surgical results by using a numerical grading system to stage the degree of nerve compression. This method may be used to study different surgical techniques for the treatment of this common nerve compression syndrome.

Adolescent↗

PubMed2004

Results of the musculofascial lengthening technique for submuscular transposition of the ulnar nerve at the elbow.

BACKGROUND: In the absence of a randomized, prospective study comparing different surgical approaches for decompression of the ulnar nerve at the elbow, the choice of an approach relies on the individual surgeon's training and experience. The present report describes the results of a prospective, long-term evaluation of the musculofascial lengthening technique in a large series of patients. In these patients, the degree of ulnar nerve compression was staged with use of a numerical grading system that included measures of both motor and sensory function. METHODS: From 1985 through 1991, 121 consecutive patients (161 ex-tremities) in whom the ulnar nerve was entrapped at the elbow were treated with surgical decompression with use of a musculofascial lengthening technique. In addition to the patient history and physical examination, measurements of sensory and motor function were obtained prospectively to permit staging of the severity of the compression by means of a grading scale. The preoperative and postoperative scores on this scale were evaluated. The mean duration of follow-up after surgery was 45.6 months. RESULTS: On the basis of traditional criteria, 105 limbs (65%) had an excellent result; thirty-seven (23%), a good result; six (4%), afair result; twelve (7.5%), a failure; and one (0.5%), a recurrence. There was significant improvement in ulnar nerve function in terms of both the sensory (p < 0.001) and motor (p < 0.001) components of the grading scale. Comparisons of clinical subgroups revealed significant improvement in patients with diabetes, those with a Workers' Compensation claim, and those who had a severe degree of compression rather than a mild degree of compression. CONCLUSIONS: Surgical decompression of ulnar nerve entrapment at the elbow by means of a musculofascial lengthening technique was associated with an 88% rate of good to excellent results. The results of the present study demonstrate the feasibility of performing a statistical analysis of surgical results by using a numerical grading system to stage the degree of nerve compression. This method may be used to study different surgical techniques for the treatment of this common nerve compression syndrome.

Contraindications↗

PubMed1996

The effects of antiepileptic drugs on cognition in normal volunteers.

The effects of antiepileptic drugs on cognitive function in 48 healthy volunteers were assessed using event-related potentials (ERP) and the Attention Index included in the Wechsler Memory Scale, revised edition (WMS-R). The study was conducted over 1 week, using a double-blind design. Four drugs, carbamazepine (CBZ), phenytoin (PHT), valproate (VPA) and zonisamide (ZNS) were tested. Using an auditory oddball task, ERP measurements were made under two conditions with different tone intensities: Condition 1 used 70 db SPL; and Condition 2 used 30 db SPL. Results showed that CBZ prolonged target N1 and P3 latencies in Condition 1, and reduced frequent N1 amplitude in Condition 2, which suggests that CBZ may cause a change in sensory memory and prolong stimulus evaluation time. It is suggested that under a low stimulus intensity level, the sensory function itself was affected. Phenytoin was found to prolong target N1 latency in Condition 2, which also indicates a change in the sensory memory function. However, VPA did not significantly affect ERP components, except for the shortened frequent N1 latency, which could not be explained due to the limited information. It was found that ZNS augmented P3 amplitude in Condition 2, and reduced scores on the Attention Index. It is suggested that the augmentation of P3 amplitude was caused by the reduction of processing negativity as a result of the detrimental effect of ZNS on subjects' attention. However, the apparent difference between the ERP and behavioral indices suggests that caution should be exercised in assessing the results obtained only from ERP measurements.

Adult↗

PubMed1978

Memory effects and sensory integration: an examination of sensory modality translation models of intersensory functioning.

The sensory modality of a task and the modality of a retroactive interfering activity were systematically covaried in order to test Connolly and Jones' and Pick's translation models of intersensory functioning. Forty 10-year-old boys and girls were asked to recall distance and location cues of length under intrasensory and intersensory task conditions (visual and kinesthetic). Visual and kinesthetic interpolated activities were used in an attempt to provide modality specific interference with the recall of length under the various sensory task conditions. Results of the data analyses provided no support for the Connolly and Jones model of modality specific storage with translation. Rather, the findings of the study were interpreted as supportive of Pick's hypothesis which emphasizes the coding of stimulus information (regardless of modality of input) into a form specific to whatever modality is specialized for detection of the information.

Child↗

PubMed1980

Immunohistochemical localization of enkephalin in rat forebrain.

Discrete localization of enkephalin immunoreactive sites in the rat forebrain was undertaken using animals with and without colchicine pretreatment. Both the immunofluorescence and unlabeled PAP antibody techniques were employed using antisera directed against methionine-enkephalin. We have found several areas of enkephalin fiber and cell localizations not previously described, as well as confirming the results of other researchers. Thus, we found large amounts of perikaryal enkephalin immunoreactivity in the lateral septal nucleus, bed nucleus of the stria terminalis, the preoptic nuclei, the ventral premammillary nucleus, prelateral mammillary nucleus, the medial mammillary nucleus, paraventricular nucleus, the periventricular, ventromedial, dorsomedial and posterior nuclei of the hypothalamus, the arcuate nucleus, and the ventral nucleus of the lateral geniculate body. High concentrations of immunoreactive neuronal fibers not immediately associated with enkephalin perikarya were seen in the nucleus accumbens, medial forebrain bundle, globus pallidus, mammillothalamic tract, the subthalamic nucleus, and the caudal portion of the zona incerta. Many of the areas presented in this study correspond with areas known to exert some regulation over neuroendocrine function as well as various motor and sensory functions. Nuclei with high immunoreactive fiber content also correspond in many instances with areas reported to have high concentrations of opiate receptors. Possible enkephalin-containing tracts and the relationships of enkephalin-containing cells in fiber bundles are also pointed out.

Animals↗

PubMed1986

Opiate blockade inhibits saccharin intake and blocks normal preference acquisition.

Recent evidence indicates a close connection between oral sensory function and opioid effects on feeding. Not only is gustatory motivation influenced by opiate drugs but apparently gustatory stimuli can also activate central opiate receptor systems. In 3 experiments we studied the effect of opiate receptor blockade on drinking motivated by the sweet taste of saccharin. Experiment 1 established a dose-response function for inhibition of intake by naloxone (NAL) in short (60 min) 2-bottle tests. This experiment demonstrated the extreme sensitivity of nondeprived, nonstressed animals to NAL and estimated the MED50 at less than 0.1 mg/kg (SC), well below the threshold for effects due to illness or general motor disturbance. Experiment 2 further demonstrated that NAL's effectiveness depends on saccharin concentration. In particular, the lowest NAL dose studied was effective near the threshold for saccharin preference but not at higher concentrations. These data suggest that endogenous opioid systems may be activated by taste stimuli in a graded fashion. Finally, experiment 3 showed that the typical acquisition of preference for a moderate saccharin concentration can be effectively blocked by daily pre-test NAL injection. Together these experiments further demonstrate the close functional relationship between opioid systems and gustatory sensory systems.

Animals↗

PubMed1989

Relationships between a neuronal buccal population and the peribuccal regions in Aplysia: an electrophysiological study.

1. The relationships between Aplysia buccal neurons projecting the cerebral ganglion (L cells) and peribuccal regions were studied by electrophysiological techniques. 2. Stimulation of the cerebral upper labial (UL) and anterior tentacular (AT) nerves produced excitatory postsynaptic potentials in L cells. 3. Sixteen cells out of 24 were found possess an axonal branch in the labial branch of the AT nerve, 1 out of 8 in the UL nerve. 4. These axonal branches did not show any direct motor or sensory function in "reduced" preparations. 5. A modulatory function for the axonal projections and a sensory role for the synaptic relationships are hypothesized.

Action Potentials↗

PubMed2004

Sustained blockade of brain AT1 receptors before and after focal cerebral ischemia alleviates neurologic deficits and reduces neuronal injury, apoptosis, and inflammatory responses in the rat.

In the present study, we investigate whether a long-term blockade of brain AT1 receptors in male Wistar rats before and after ischemic injury exerts neuroprotective effects and modulates apoptosis and inflammatory responses, which are associated with the post-ischemic progression of brain damage. The AT1 receptor antagonist irbesartan was continuously infused intracerebroventricularly using osmotic minipumps over a 5-day period before and for 3 or 7 days after middle cerebral artery occlusion (MCAO) for 90 minutes. Neurologic status was evaluated daily, starting 24 hours after MCAO. After MCAO (3 and 7 days), brains were removed for the measurement of infarct size and immunohistochemical evaluation of apoptosis and accumulation of reactive microglia and macrophages. Treatment with irbesartan before ischemia improved motor functions, whereas post-ischemic treatment improved sensory functions. Blockade of brain AT1 receptors reduced the infarct size on days 3 and 7 after MCAO. In the peri-infarct cortex, irbesartan treatment decreased the number of apoptotic cells on day 3 and attenuated the invasion of activated microg-lia and macrophages on days 3 and 7 after ischemia. Long-term blockade of brain AT1 receptors improves the recovery from cerebral ischemia. Antiapoptotic mechanisms and inhibition of post-ischemic inflammation are involved in the AT1 receptor blockade-induced neuroprotective effects in ischemic brain tissue.

Angiotensin II Type 1 Receptor Blockers↗

PubMed2002

Brain research in functional gastrointestinal disorders.

The current understanding is that functional gastrointestinal disorders (FGIDs) result from dysregulation of the bidirectional communication between the gut and the brain (i.e., the brain-gut axis), modulated by various psychosocial and environmental factors (i.e., the biopsychosocial model). This concept has led to a growing interest in the research of brain function in relation to gut motor and sensory function. Brain research on the mechanisms that are involved in the generation of gastrointestinal symptoms includes studies of the gut response to brain stimulation with technique such as transcranial magnetic stimulation or studies of the brain response to gut stimulation by cortical evoked potentials, positron emission tomography, and functional magnetic resonance imaging. Studies using these techniques have shown that visceral/gut sensation involves activation of several brain regions that are associated with various brain functions, including sensation, cognition, and affect. The complexity of the brain response to visceral stimulation and the multidetermined nature of FGIDs make studies of brain function in FGID patients difficult and demands great caution in interpreting their results. Nevertheless, brain research in FGIDs is an emerging field and suggests that patients with irritable bowel syndrome differ from healthy subjects in the way that their brain response to visceral (e.g., rectal) distention. These studies emphasize the role of the central nervous system in conducting and processing visceral signals and suggest that alteration in brain processes involving perception and affective responses might be key factors in the pathogenesis of functional gastrointestinal symptoms.

Autonomic Nervous System↗

PubMed1991

A method for evaluating the selectivity of electrodes implanted for nerve simulation.

The scale of stimulating electrodes possible for use in functional electrical stimulation to restore motor and sensory function is rapidly approaching that of individual neurons. Although the electrodes may approach the dimensions of single nerve cells, it is unclear if the region of excitation elicited by each electrode will be correspondingly small. Previous techniques for evaluating this have either been tedious or have lacked the resolution necessary. This paper describes a method that uses the refractory interaction of the compound action potentials elicited by a stimulus pulse pair, along with high-resolution recording of those potentials, to achieve measurements of the selectivity of stimulation down to the scale of a few axon diameters. The feasibility of this technique is demonstrated in sciatic nerves of frogs (Rana Catesbiana) acutely implanted with a sapphire electrode array.

Action Potentials↗

PubMed2006

Language and the aging brain: patterns of neural compensation revealed by functional brain imaging.

Human aging brings with it declines in sensory function, both in vision and in hearing, as well as a general slowing in a variety of perceptual and cognitive operations. Yet in spite of these declines, language comprehension typically remains well preserved in normal aging. We review data from functional magnetic resonance imaging (fMRI) to describe a two-component model of sentence comprehension: a core sentence-processing area located in the perisylvian region of the left cerebral hemisphere and an associated network of brain regions that support the working memory and other resources needed for comprehension of long or syntactically complex sentences. We use this two-component model to describe the nature of compensatory recruitment of novel brain regions observed when healthy older adults show the same success at comprehending sentences as their younger adult counterparts. We suggest that this plasticity in neural recruitment contributes to the stability of language comprehension in the aging brain.

Aged↗

PubMed1997

Progressive posttraumatic myelomalacic myelopathy: treatment with untethering and expansive duraplasty.

Patients with progressive posttraumatic myelomalacic myelopathy (PPMM), or tethered cord syndrome, present with symptoms and signs similar to those observed in case of progressive posttraumatic cystic myelopathy, that is, sensorimotor function deterioration, local and/or radicular pain, increased spasticity, increased autonomic dysreflexia, and sphincter dysfunction. The authors investigated surgical outcomes of untethering combined with expansive duraplasty. Forty patients with PPMM who presented with functional deterioration underwent untethering of the spinal cord and nerve roots with an expansive duraplasty. Meticulous dissections of adhesions on the dorsal and lateral aspects of the spinal cord and nerve roots were performed. Intraoperative ultrasonography was used to detect the presence of a confluent cyst and to assess the success of untethering. After surgery, the patients were treated using a protocol that involved frequent turning for 48 hours and subsequently mobilization. Preoperative magnetic resonance (MR) imaging, with and without administration of a contrast agent, was obtained in all patients, except one patient who underwent immediate and delayed computerized tomography (CT) myelography. The mean follow-up period was 3 years (range 20-57 months) for the 36 patients available for follow-up review. Spinal cord tethering was observed in all patients preoperatively. Trauma was the most common cause of this pathology, accounting for 31 of the 40 cases. Preoperative MR imaging did not demonstrate tumor recurrence in the group of five patients who had undergone an initial operation for tumor excision. The interval between the causative event and the operation was less than 5 years in half of the patients (20 of 40), with the longest interval lasting up to 37 years. Motor function deterioration was the most frequent manifestation; it was present in 31 of 40 patients. Improvements in motor function, autonomic dysreflexia, pain, sphincter dysfunction, and sensory function were found during the most recent follow-up examination in 79%, 75%, 62%, 50%, and 43% of the patients, respectively. Two patients experienced retethering of the spinal cord and one underwent a second operation. Surgical untethering and expansive duraplasty, followed by postoperative position rotation to avoid retethering, provide symptomatic relief for patients with PPMM.

Adolescent↗

PubMed1975

[Neurological aspects of nerve transplantation].

Neurological aspects of nerve-grafting are discussed. Methods designed for quantification of the pre-and the postoperative neurologicalsyhdromes ("index of integral function") and for the selective description of sensory impairment ("index of sensibility") are presented. These methods may facilitate the comparison of results of different investigators. The rate of positive results could possibly be raised if patients could be operated earlier. Considerable improvement can be expected only, when nervegrafting takes place as soon as possible, at the latest six months after injury. Grafting is no longer recommendable, when 12 months or more have passed even when only sensory recovery is aimed at. The reason is that reduction of sensory functions usually causes less impairment than vegetative and trophic changes which may occur as sequelae of the operation.

Adolescent↗

PubMed1992

Ultrastructural identification of trigeminal nerve endings in the rat cornea and iris.

Trigeminal nerve terminals in the rat cornea and iris were ultrastructurally identified using anterograde tracing with Phaseolus vulgaris-leukoagglutinin (PHA-L). Electron microscopic immunohistochemistry was used to demonstrate the presence and localization of calcitonin gene-related peptide (CGRP) in cornea and iris. In the cornea and iris, nerve fibers were labelled with PHA-L throughout the stroma. Labelling was most obvious within varicosities, densely packed with mainly clear and a few granular vesicles and containing dark mitochondria. Numerous fibers in the stroma of cornea and iris were CGRP-positive. CGRP-positive staining was most intense within varicosities, containing mainly clear and incidentally granular vesicles and dark mitochondria, similar to the structures labelled with PHA-L. CGRP-positive varicosities packed with mainly clear and few granular vesicles also were demonstrated in fibers adjacent to the sphincter and dilator muscles of the iris. In the corneal epithelium, small terminals containing vesicles were CGRP-positive. Trigeminal nerve fibers innervating the rat cornea and iris contained numerous varicosities packed with vesicles. These areas are CGRP-positive, so it can be implied that CGRP is released from these varicosities as a response to triggering impulses. This agrees with the hypothesis that in addition to their afferent function, sensory fibers also exert an efferent modulating function.

Animals↗

PubMed1990

Morphological and electrophysiological study of the effects of cisplatin and ORG.2766 on rat spinal ganglion neurons.

Eleven- to 12-wk-old rats were treated twice a week with cisplatin/saline or with cisplatin plus ORG.2766 during 12.5 wk. Cisplatin and ORG.2766 were administered at a final concentration of 0.04 mg/ml (i.p.) and 10 micrograms/ml (s.c.), respectively. Control animals were treated with saline. In this period the cisplatin-treated animals developed a peripheral neuropathy resulting in impairment of sensory functions. Estimates of the motor (MNCV) and sensory (SNCV) nerve conduction velocity were made after 0, 7.5, 10, and 12.5 wk. It appeared that the MNCV of the control, cisplatin-, and cisplatin plus ORG.2766-treated rats increased from 50 to 59 m/s. In contrast, the SNCV of the cisplatin-treated rats decreased significantly (P less than 0.001) from 63 to 56 m/s, whereas that of the control animals increased from 62 to 84 m/s. Rats which received cisplatin plus ORG.2766 showed an increase in SNCV up to control levels. After 12.5 wk the animals were perfused with a mixture of 1% paraformaldehyde and 1.25% glutaraldehyde in 0.05 M phosphate buffer. At the level of L5 and L6, 5 mm of spinal cord tissue and three dorsal root ganglia were removed and processed for electron microscopy. With the point-counting method the volume fraction (v/v) of somata and myelin in spinal ganglia was estimated. No significant change in the volume fraction of somata of the control (0.42), cisplatin (0.33)-, and cisplatin plus ORG.2766 (0.39)-treated rats was found. The same held true for the volume fraction of myelin of the control (0.53), cisplatin (0.59)-, and cisplatin plus ORG.2766 (0.58)-treated rats. In addition, the number of lysosomes per 100 microns 2 was estimated in spinal ganglion neurons and in spinal cord motor neurons of a total of 120 randomly chosen neurons. It was found that the number of lysosomes in the spinal ganglion neurons of the control animals was lower (10 per 100 microns 2) than in cisplatin-treated (30 per 100 microns 2) and in cisplatin plus ORG.2766-treated rats (28 per 100 microns 2) (P less than 0.05). No difference was observed in the number of lysosomes between cisplatin- and cisplatin plus ORG.2766-treated rats. The number of lysosomes in spinal cord tissue of cisplatin-treated rats (2.4 per 100 microns 2) did not differ from controls (0.1 per 100 microns 2) and from cisplatin plus ORG.2766-treated rats (0.8 per 100 microns 2).(ABSTRACT TRUNCATED AT 400 WORDS)

Adrenocorticotropic Hormone↗

PubMed1984

Clinical assessment of midazolam for induction of anesthesia.

Intravenous midazolam was tried as a hypnotic agent for induction of anesthesia in 63 surgical patients. Three dosages were used: 0.2, 0.3 and 0.4 mg/kg body weight. Indices of induction, changes of vital parameters, incidence of apnea and side effects and the duration of the drug effect on central nervous system functions were evaluated. No significant differences were observed between the effects of the different doses of midazolam on the cardiac and respiratory parameters. The drug provided a satisfactory degree of sleep in all patients of maximal intensity at three minutes but anesthetic induction was not achieved in several patients of each dose group (overall failure rate 11%). A short-lasting apnea was seen in 13% of the patients and seemed not related to the administered dose of midazolam. The awareness of the surroundings was satisfactorily obtunded by the anti-recall effect of the drug. The sedative effects of midazolam on central nervous system functions lasted fairly long. Indeed, mental arousal, sensory functions and muscle tone still had not returned to preinjection values 20 min after midazolam administration. A reliable relationship between dose of midazolam and intensity of cerebral depressive effect was not evident.

Adolescent↗

PubMed1999

Minimally invasive stereotactically-guided extirpation of brain stem cavernoma with the aid of electrophysiological methods.

The surgical extirpation of brain stem cavernomas always includes a risk of neurological deficits. To minimize the risk of deficits and control the motor and sensory function intraoperative monitoring of SEP and MEP seems to be helpful. The high density of motor and sensory fibers within the brain stem makes bilateral intraoperative monitoring necessary. The following case demonstrates a stereotactically-guided supratentorial, transventricular approach for extirpation of a brain stem cavernoma. Sensory and motoric functions were observed by transcranial recording of SEP's and by transcranial stimulation of motor cortex.

Adult↗