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Hyper- and hypogravity alter posture in rats compensated on Earth for a vestibular asymmetry.

Head posture and neck muscle activity (EMGs) were examined in unilateral (UL) and bilateral (BL) vestibularly lesioned rats in hypergravity (1.7 g) and hypogravity (0 g) during parabolic flights. Compared with BL rats taken as control, the head and the body of UL deviated toward the lesion side at 0 g and toward the intact side at 1.7 g. Recorded in head fixed condition, left and right EMGs remained symmetrical in BL while UL rats displayed an asymmetry between left and right muscles at 1.7 g, but not at 0 g. These results demonstrate that an experimental otolithic asymmetry, compensated on Earth, can become unbalanced in altered gravity. Paradoxically, the utricular system appears to play a major role in that process.

Animals↗

Rib cage motion and muscle use in high tetraplegics.

In an attempt to assess the action of the sternocleidomastoid muscles on the human rib cage, we studied the pattern of rib cage motion in 2 patients with complete transection of the upper cervical cord. Measurements of rib cage motion were obtained with magnetometers and chest roentgenograms, and concentric needle electrodes were used to record the electromyograms (EMG) of various respiratory muscles. Spontaneous quiet breathing elicited a large amount of phasic inspiratory EMG activity not only in the sternocleidomastoids, but also in the trapezii, platysma, mylohyoid, and sternohyoid muscles. This pattern of muscle use was associated with substantial rib cage deformation. During spontaneous inspiration both patients showed a clear-cut decrease in lower rib cage transverse diameter, and they both had a cranial displacement of the sternum and an increase in upper rib cage anteroposterior diameter that was disproportionately larger than the increase in lower rib cage anteroposterior diameter. Radiographic measurements confirmed these deformations but also demonstrated that the upper rib cage transverse diameter increased rather than decreased with inspiration. These results indicate that: (1) Patients with high tetraplegia use many neck muscles in addition to the sternocleidomastoids to breathe; (2) The synchronous contraction of these muscles acts to pull the sternum cranially, expands the upper rib cage, and causes paradoxical inward displacement of the lateral walls of the lower rib cage; (3) As in dogs, the motion of the upper rib cage in humans is more tightly linked to the sternum than that of the lower rib cage.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Muscles↗

Different representations of inescapable noxious stimuli in the periaqueductal gray and upper cervical spinal cord of freely moving rats.

Previous work suggested that pain of distinct tissue origins was differentially represented in the midbrain periaqueductal gray (PAG). That is, persistent pain of deep origin (muscle, joint viscera) "activated" ventrolateral PAG neurons and triggered quiescence, hyporeactivity and vasodepression (i.e. passive emotional coping); whereas intermittent cutaneous pain "activated" lateral PAG neurons and triggered fight-flight (i.e. active emotional coping). Cutaneous noxious stimuli, if inescapable however, trigger a passive emotional coping reaction similar to that evoked by pain of deep origin. This raised the question--is it the behavioural significance (escapability versus inescapability) or the tissue origin (cutaneous versus deep) of the pain, that is represented in the PAG? In this study we used immediate-early-gene (c-Fos) expression to examine PAG and spinal activation patterns following "inescapable" (persistent) pain of cutaneous versus deep origin. It was found that selective activation of the ventrolateral PAG and passive emotional coping were evoked by an inescapable cutaneous noxious stimulus (i.e. clip of the neck), as well as by a deep noxious stimulus (i.e. neck muscle pain). In the upper cervical spinal cord, however, these noxious manipulations evoked distinct patterns of Fos expression which reflected the different patterns of primary afferent termination arising from skin versus muscle. The results suggest that whereas pain representation in the spinal cord accurately reflects tissue origin, pain representation in the PAG better reflects behavioural significance.

Animals↗

Determinants of nonsynostotic plagiocephaly: a case-control study.

OBJECTIVE: There has been a large increase in reported cases of nonsynostotic plagiocephaly in infants since the adoption of supine sleeping recommendations to prevent sudden infant death syndrome. The objective of this study was to identify and quantify the determinants of nonsynostotic plagiocephaly in infants. METHODS: One hundred infants who received a diagnosis of having nonsynostotic plagiocephaly were recruited as case patients and compared with 94 control subjects who were selected from a citywide database of infants. The infants all were aged between 2 and 12 months. Information concerning sociodemographic variables, obstetric factors, infant factors, and infant care practices was obtained by parental interview. RESULTS: Case patients were significantly more likely to be male (adjusted odds ratio [aOR]: 2.51; 95% confidence interval [CI]: 1.23-5.16), to be a firstborn (aOR: 2.94; 95% CI: 1.46-5.96), and to have been premature (aOR: 3.26; 95% CI: 1.02-10.47). In the first 6 weeks, they were more likely to have been sleeping in the supine position (aOR: 7.02; 95% CI: 2.98-16.53), not to have had the head position varied when put down to sleep (aOR: 7.11; 95% CI: 2.75-18.37), and to have had <5 minutes a day of tummy time (OR: 2.26; 95% CI: 1.03-5.00). Mothers of case patients were more likely to perceive their infants as less active (aOR: 3.23; 95% CI: 1.38-7.56), to have a developmental delay (aOR: 3.32; 95% CI: 1.01-10.85), and to have had a definite preferred head orientation at 6 weeks (aOR: 37.46; 95% CI: 8.44-166.32). Case mothers were more likely to have no or low educational qualifications (aOR: 5.61; 95% CI: 2.02-15.56), although they were more likely to have attended antenatal classes (aOR: 6.61; 95% CI: 1.59-27.47). CONCLUSIONS: Early identification of a preferred head orientation, which may indicate the presence of neck muscle dysfunction, may help prevent the development or further development of nonsynostotic plagiocephaly in infants. Plagiocephaly might also be prevented by varying the head position when putting the very young infant down to sleep and by giving supervised tummy time when awake.

Case-Control Studies↗

Effects of arm support or suspension on neck and shoulder muscle activity during sedentary work.

The aim of this study was to evaluate the effects on the levels on neck and shoulder muscular activity of ergonomic aids used to support or suspend the arm in different sitting postures, both with and without movement of the arm-hand. Ten skilled women workers performed a standardized simulated work cycle similar to assembling printed circuit boards, in different sitting postures with and without ergonomic aids. The elbow was supported by a loosely-mounted, padded plate. For suspension, a new device, the K-block, was used giving an adjustable, constant suspending force. Full-wave rectified, low-pass filtered, time-averaged and normalized EMG was used. Surface electrodes were applied over six neck and shoulder muscles. The results show that a reduction in the level of activity in neck and shoulder muscles can be obtained with either aid. The reduction, whether caused by suspension or support of the arm, was related to the sitting posture. Elbow support might be more efficient than arm suspension in a sitting posture with the whole spine flexed, while arm suspension might be more efficient when the trunk is inclined slightly backward. Elbow support and, particularly, arm suspension may thus be recommended as technical aids in sedentary assembly work for patients with easily elicited cervical spine and/or shoulder pain. It is also suggested that arm suspension may be used to improve ergonomic conditions at workplaces.

Adult↗

Effects of distance and gaze position on postural stability in young and old subjects.

Visual stabilization of posture is known to improve when the distance to target fixation decreases; this is attributed to increased angular size of retinal slip induced by body sway. At near distance, however, the eyes converge and efferent or afferent oculomotor signals could also be involved in posture stabilization. The goal of this study is to test whether the distance effect exists for both young and elderly and to test the role of vergence itself and of gaze position. Eighteen young (25.3 years) and 17 elderly (61.6 years) subjects were asked to fixate a target in quiet stance presented either at close (40 cm) or at far distance (200 cm); the vergence angle was 9 degrees and 2 degrees , respectively. For each distance, three gaze positions were studied straight-ahead (0 degrees ), 15 degrees up or down. We found a decrease in the surface of center of pressure (CoP), of standard deviation of antero-posterior and lateral body sway and of speed variance at near distance that occurs for both young and elderly. At far distance, the surface of CoP is smaller for 15 degrees up or down gaze in comparison with straight-ahead position, but at near distance there is no such gaze position effect. In an additional experiment, subjects fixated a target at far distance (200 cm) but prisms were used to cause the eyes to converge by an amount similar to that required for 40 cm viewing distance. The use of prisms decreased surface of CoP to values similar to those for natural near viewing distance. The effect of gaze position and of convergence (experiment with prisms) leads us to suggest that in addition to retinal slip, the ocular motor signals and perhaps related neck muscle activity are involved in postural stabilization. Finally, the elderly presented higher speed variance of CoP than the young subjects even though the surface itself was similar to adult values. We suggest that increment of speed variance is the first sign of senescence in postural control.

Adaptation, Physiological↗

[Therapeutic outcome of spasmodic torticollis].

We investigated 117 patients with spasmodic torticollis who had visited us to seek for appropriate treatment in these 14 years. They were 71 men and 46 women, aged 44 +/- 14 (mean +/- SD) years, and suffered from this disorder during 4 +/- 5 years, maximum 26 years. Involuntary abnormal head positions, not only torticollis but also laterocollis and antero- or retrocollis, were contained in this study. Most of them were torticollis due to idiopathic focal dystonia. One or more courses of alcoholization therapy was accomplished in 82 patients who wished to be done. This therapy course consisted of about ten times totally of 99% ethanol injection to the motor point of two most hypertonic neck muscles, either side of the sternocleidomastoideus and the opposite side of the splenius in most cases, repeated every 2 or 3 weeks. One patient received as many as 98 times of this injection and resolved completely. Training to reinforce antagonistic muscles was also instructed. Twenty-one patients (26%) were resolved completely after this treatment. Fifty-four patients (66%) were ameliorated and satisfied partially, but 18 of them relapsed in 1 to 4 years after the treatment and were obliged to repeat one more course of this treatment. On the other hand, in five patients their torticollis improved under certain drug therapy alone. Sixteen patients (14%) gave up to continue the treatment within two months, and 14 patients (12%) dropped out before starting the therapy. This alcoholization therapy resulted in amelioration of torticollis in about 90% of the patients with a long effective period. Nevertheless, this alcohol injection is painful, and requires 5 to 6 months to be completed. In 2 patients who had already received many times of this injection, sudden hoarseness occurred one day immediately after the alcohol injection to the sternocleidomastoideus. This complication was presumably brought about by the unexpected infiltration of alcohol to the laryngeal area, located posterior to that muscle. They recovered in two months, but careful attention should be paid to the adverse effects. If botulinum toxin be available also in our country, we will be able to have another choice of therapy and the treatment of this disorder will become easier.

Adult↗

Induction of epileptic negative myoclonus by oxcarbazepine in symptomatic epilepsy.

Provocation of various seizure types including epileptic negative myoclonus and generalised atonic seizures is rarely observed in children treated with carbamazepine (CBZ). Provocation of the latter seizure types by oxcarbazepine (OXC) is not described in the literature. We report a four year-old boy with symptomatic epilepsy caused by left-sided cerebral atrophy of unknown origin who developed numerous daily drop attacks when exposed to OXC. Polygraphic analysis revealed secondary generalised precentral sharp-slow waves frequently associated with a silent period lasting for 100-150 ms in the electromyogram recorded from the deltoid and neck muscles. These seizures stopped promptly within 36 hours after discontinuation of OXC. This case demonstrates that OXC, similar to CBZ, can provoke epileptic negative myoclonus in some children with focal epilepsies. [Published with videosequences].

Anticonvulsants↗

Distribution of contacts from vestibulospinal axons on the dendrites of splenius motoneurons.

Current descriptions of the organization of synapses on the dendritic trees of spinal motoneurons indicate that the inputs are arranged in several patterns: some are widely distributed; some are distributed to proximal dendrites; others are distributed based on the trajectory of the dendrites. However, the principles governing the organization of synapses on spinal motoneurons remain poorly defined. Our goal was to extend the descriptions of the distribution of synapses, identified by their source, on the dendritic trees of spinal motoneurons. We combined anterograde and intracellular staining techniques in cats to determine the distribution of contacts between excitatory axons from the rostral aspect of the descending vestibular nucleus and the dendrites of motoneurons supplying a dorsal neck muscle, splenius. In five of five motoneurons, the contacts were preferentially distributed on dendrites medial to the soma. This qualitative observation was confirmed by using Monte Carlo methods. The results from this analysis showed that the distribution of contacts can be explained not by the overall distribution of the dendritic membrane area but rather by a systematic innervation of the medial regions of the dendritic trees (P < 0.02). Despite this selectivity, there was no additional bias in the distribution of contacts to proximal vs. distal dendrites. By concentrating excitatory synapses in a restricted region of the dendritic tree, the actions of vestibulospinal connections on neck motoneurons may be increased as a result of a greater probability of activating persistent inward currents on the dendrites.

Animals↗

Quantification of sensory trick impact on tremor amplitude and frequency in 60 patients with head tremor.

Head tremor with an obvious head deviation is the typical clinical picture of tremulous cervical dystonia (TCD), whereas head tremor without any significant head deviation allows for the differential diagnosis of dystonic head tremor (DHT) as well as essential head tremor (EHT). Clinical and polyelectromyographic (poly-EMG) studies have shown a suppression of dystonic muscle activity in patients with TCD performing a maneuver called geste antagonistique. The effect of these trick maneuvers on head tremor has not been investigated in patients with DHT and EHT. We studied the impact of sensory trick maneuvers on head tremor amplitude and frequency clinically by using the tremor subscore of the Tsui scale and by means of computer-based accelerometry in 60 patients with head tremor as their major disorder. Based on clinical data (modified Tsui scale: rating of spontaneous head deviation [rotation + lateroflexion + ante-/retroflexion]), pharmacologic response of tremor (propranolol, primidone, or alcohol), family history (postural hand tremor in first-degree relatives), and poly-EMG findings (reciprocal inhibition in neck muscles during voluntary head rotation), 34 patients were diagnosed as having TCD, 14 were classified as having DHT, and 12 patients were diagnosed as having EHT. Using a clinical rating scale, head tremor amplitudes showed a significant decrease compared with baseline during the performance of sensory trick maneuvers in patients with TCD and DHT, but not in patients with EHT. This clinically observed effect was accompanied by a significant reduction in the mean peak power of the dominant frequency in patients with TCD (decrease by 83%, p = 0.0001) and DHT (decrease by 90%, p = 0.01), but not in patients with EHT (decrease by 6%, p = 0.6). Head tremor frequencies showed no significant changes in relation to the trick maneuvers. We conclude that a significant reduction of head tremor amplitude during a sensory trick maneuver is a useful quantitative criterion to distinguish TCD and DHT from EHT.

Adrenergic beta-Antagonists↗

Axonal pathways and projection levels of anterior semicircular canal nerve-activated vestibulospinal neurons in cats.

Using collision tests of orthodromically and antidromically generated spikes, we studied the axonal pathways, axonal projection levels, and soma location of anterior semicircular canal (AC) nerve-activated vestibulospinal neurons in decerebrate cats. AC nerve-activated vestibulospinal neurons (n=74) were mainly located in the ventral portion of the lateral vestibular nuclei and the rostral portion of the descending vestibular nucleus, which is consistent with previous studies. Of these neurons, 15% projected through the ipsilateral (i-) lateral vestibulospinal tract (LVST), 74% projected through the medial vestibulospinal tract (MVST), and 11% projected through the contralateral (c-) LVST. The vast majority (78%) of AC nerve-activated vestibulospinal neurons were activated antidromically only from the cervical segment of the spinal cord; 15% of neurons were activated from the T1 segment and only one neuron was activated from the L3 segment. AC nerve-activated vestibulospinal neurons may primarily target the neck muscles and thus contribute to the vestibulocollic reflex. Most of the c-LVST neurons were also activated antidromically from the oculomotor nucleus, suggesting that they are closely related to the control of combined eye-head movements.

Action Potentials↗

An identified interneuron contributes to aspects of six different behaviors in Aplysia.

Previous results have indicated that the bilateral cerebral interneuron CC5 mediates the pedal artery shortening that is a component of defensive withdrawal responses involving the head. Current studies suggest that CC5 contributes to aspects of at least six different behaviors: locomotion, head turning, defensive head withdrawal, local tentacular withdrawal, rhythmic feeding, and head lifting. In addition to receiving input from mechanoreceptors in the head, CC5 receives synaptic input during fictive locomotor and feeding programs. Firing of CC5 produces widespread monosynaptic or polysynaptic actions in all ganglia in the animal. CC5 excites presumptive motor neurons for the neck, and its activity can contract neck muscles. The pedal artery shortener motor neuron (PAS), a key excitatory follower cell of CC5, fires during ipsilateral head turning, head withdrawal, tentacle withdrawal, feeding, and locomotion. For all behaviors, except locomotion and biting, responses of PAS were eliminated by cutting the ipsilateral-pleural connective, which interrupts the only direct connection of CC5 to the ipsilateral PAS. The data suggest that CC5 is a multifunctional interneuron that plays different roles during different behaviors. The neuron appears to be involved in producing coordinated movements of the head, involving both somatic and visceral muscles. For some behaviors, or for certain aspects of behaviors, CC5 appears to act as an individual command-like neuron; for other behaviors, CC5 appears to act more as an element of a distributed circuit and is neither necessary nor sufficient for any aspects of the behavior.

Abdomen↗

The morphology, physiology and function of suboesophageal neck motor neurons in the honeybee.

We report some of the neural and muscular circuitry that allows honeybees to control head movements. We studied neck motor neurons with cell bodies in the suboesophageal ganglion, axons in the first cervical nerve (IK1) and terminals in neck muscles 44 and 51 (muscle classification: Snodgrass in Smithsonian Misc Coll 103:1-120, 1942). We show that muscle 44 actually comprises five separate bundles of muscle fibres (subunits), while muscle 51 is split into two subunits. Eight motor neurons innervate muscles 44 and 51. Two motor neurons have cell bodies in the ventral-median cell body group (one innervates a subunit in muscle 44, the other a subunit in muscle 51). One motor neuron has a ventrally located contralateral cell body (innervating a subunit in muscle 44) and five have laterally located ipsilateral cell bodies. Of the five lateral cells, one innervates a subunit in muscle 51, three selectively innervate subunits in muscle 44 and one co-innervates a subunit in muscle 44 with the contralateral cell. Extracellular recordings revealed three types of visually driven, direction-selective cell-types in each IK1 tuned for leftward, rightward and downward motion over the eyes. The spatiotemporal tuning of the units is similar to that of other visual interneurons in the bee brain.

Action Potentials↗

Effects on performance, tissue integrity, and metabolism of vitamin E supplementation for beef heifers fed a diet that contains gossypol.

We conducted an experiment for 112 d with yearling beef heifers to evaluate the effects of cottonseed meal (CSM) fed with various concentrations of vitamin E on hematological and tissue components. Heifers were assigned randomly to four treatments, with eight heifers per treatment. The treatments consisted of the following dietary supplements: 1) CON, based on soybean meal with 30 IU vitamin E/kg; 2) GOS, based on CSM with 30 IU vitamin E/kg; 3) G+2E, based on CSM with 2,000 IU vitamin E x animal(-1) x d(-1); and 4) G+4E, based on CSM with 4,000 IU vitamin E x animal(-1) x d(-1). Supplements based on CSM provided 4.5 g of free and 50.5 g of total gossypol x animal(-1) x d(-1). The total gossypol present in the supplements was 29.1% of the negative isomer (-) and 70.9% of the positive isomer (+). Blood samples were collected at the start of the experiment and every 2 wk thereafter up to 16 wk. There was a time x treatment interaction (P<.01) for plasma alpha-tocopherol ( alpha-T) concentration; however, feeding gossypol did not decrease plasma alpha-T. Weight gain, retinol palmitate, retinol, beta-carotene (beta-C), hemoglobin, and hematocrit were not affected by treatment. Erythrocyte osmotic fragility (EOF) increased (P<.05) in gossypol-fed animals; however, vitamin E supplementation lowered EOF (P<.05). Heifers fed the supplements GOS, G+2E, and G+4E had greater (P<.01) plasma (-)-, (+)-, and total gossypol than heifers fed CON from Collection 2 to the end of the experiment. There was a treatment effect (P<.05) on vitamin E and gossypol concentrations in different tissues, with no effect (P>.05) for trace minerals (Cu, Zn, Fe, and Se). Vitamin E concentration in tissue increased with increased dietary supplementation of vitamin E. In heart and neck muscle, (-)-gossypol was greater (P<.05) than (+)-gossypol, but the reverse was true for liver. Gossypol decreased in vitro lipid peroxidation of liver homogenate in tissues. Gossypol deposition in tissue was liver > heart > muscle. In summary, gossypol from CSM did not decrease concentrations of antioxidant vitamins, including alpha-T, vitamin A, and beta-C, or have any detrimental effect on performance of beef heifers.

Alkaline Phosphatase↗

Injuries in the sport of luge. Epidemiology and analysis.

We undertook this study to determine the types and frequency of injuries sustained in the sport of luge. Before this study, no data were available in the medical literature on luge injuries. We performed a retrospective analysis between the years 1985 and 1992 using data obtained from the athlete injury and illness report forms at the US Training Center Sports Medicine Clinic in Lake Placid, New York. During the 7 years examined, 1043 athletes took 57,244 track runs and sustained 407 injuries. The risk of sustaining an injury was 0.39 per person per year, and the risk of an injury causing the loss of more than 1 day of practice was 0.04 per person per year. Contusions were the major injury (51%), followed by strains (27%). Strains of the neck muscles and contusions of extremities, especially the hands, were characteristic injuries sustained by athletes. The most serious injuries were concussions (2%) and fractures (3%). Crashes were responsible for 64% of injuries. Luge appears to be a relatively safe sport with injury rates comparable with recreational alpine skiing.

Adolescent↗

Bulbar myoclonus without palatal myoclonus. A hypothesis on pathophysiology.

A 40-year-old woman with myoclonic contractions bilaterally in the infrahyoid neck muscles, especially in the left cricothyroid muscle, was presented and successfully treated with botulinum toxin injections. The patient had a wide, aberrant vessel curving into the left dorsolateral reticular formation of the medulla oblongata. Based on our observations, we propose that symptomatic bulbar and palatal myoclonus is caused by pathology in the dorsolateral reticular formation, and not by inferior olivary dysfunction as is currently thought.

Adult↗

Horizontal space misrepresentation in unilateral brain damage. II. Eye-head centered modulation of visual misrepresentation in hemianopia without neglect.

We used a visual distance reproduction task (endpoint task) to evaluate horizontal space representation in two left brain damaged (LBD) and three right brain damaged (RBD) patients with contralateral homonymous hemianopia and no neglect. All patients were examined in the chronic phase of the stroke and were aware of their visual field defect. Along with contralesional deviation in the line bisection task, all patients estimated size (Landmark task) and distances in the contralesional space as being longer than equivalent size and distances located in the ipsilesional space. Misreproduction of distances was abolished or reduced when the task was performed in the ipsilesional head-centred space with the head turned contralesionally. This finding points out that misrepresentation of horizontal space linked to hemianopia can be modulated by combined proprioceptive input from eye and neck muscles. The pattern of misrepresentation found in chronic hemianopic patients is opposite to the one described in chronic neglect patients with concomitant hemianopia. These different patterns of space misrepresentation are the likely consequence of the presence, in hemianopics, and the absence, in neglect patients with hemianopia, of compensatory strategies based on the non-retinotopic and multimodal coding of spatial positions falling in the retinotopically organised blind field.

Adult↗