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PubMed2006

Characterization of displaced white matter by brain tumors using combined DTI and fMRI.

In vivo white matter tractography by diffusion tensor imaging (DTI) has become a popular tool for investigation of white matter architecture in the normal brain. Despite some unresolved issues regarding the accuracy of DTI, recent studies applied DTI for delineating white matter organization in the vicinity of brain lesions and especially brain tumors. Apart from the intrinsic limitations of DTI, the tracking of fibers in the vicinity or within lesions is further complicated due to changes in diseased tissue such as elevated water content (edema), tissue compression and degeneration. These changes deform the architecture of the white matter and in some cases prevent definite selection of the seed region of interest (ROI) from which fiber tracking begins. We show here that for displaced fiber systems, the use of anatomical approach for seed ROI selection yields insufficient results. Alternatively, we propose to select the seed points based on functional MRI activations which constrain the subjective seed ROI selection. The results are demonstrated on two major fiber systems: the pyramidal tract and the superior longitudinal fasciculus that connect critical motor and language areas, respectively. The fMRI based seed ROI selection approach enabled a more comprehensive mapping of these fiber systems. Furthermore, this procedure enabled the characterization of displaced white matter using the eigenvalue decomposition of DTI. We show that along the compressed fiber system, the diffusivity parallel to the fiber increases, while that perpendicular to the fibers decreases, leading to an overall increase in the fractional anisotropy index reflecting the compression of the fiber bundle. We conclude that definition of the functional network of a subject with deformed white matter should be done carefully. With fMRI, one can more accurately define the seed ROI for DTI based tractography and to provide a more comprehensive, functionally related, white matter mapping, a very important tool used in pre-surgical mapping.

Anisotropy↗

PubMed1990

[MRI pathology of the globus pallidus in a patient with oculogyric crisis and tremor].

A 24-year-old woman developed occasional attacks of oculogyric crisis at the age of 18. She also suffered from postural tremor, dystonic gait, pyramidal tract signs, and peripheral nerve damages. No history of encephalitis was elicited. Nerve conduction velocity revealed decreased velocity and amplitude. Needle electromyography showed a neurogenic pattern. Sural nerve biopsy showed marked Wallerian degenerations. Muscle biopsy revealed small grouped atrophies. It was unlikely that she suffered from juvenile Parkinsonism, and we failed to obtain an evidence of neuronal intranuclear inclusion disease. Recently, Furumoto et al. reported a similar case who developed oculogyric crisis at the age of 12. So far, some authors have reported about changes of MRI image in the putamen and the substantia nigra in extrapyramidal movement disorders. However, few have paid attention to the changes of the pallidum. The most characteristic finding in the present case was the restoration of signal intensity of the globus pallidus on T2 weighted high-field MRI. It is known that pallidal damages produce dystonic disorders. However, the exact role which the pallidum played in pathogenesis of our patient's signs and symptoms is unknown at now.

Adult↗

PubMedDate not supplied

[The functional role of enhanced cellular excitability and synaptic efficiency in the neocortex during learning].

In experiments with noncurarized and unanaesthetized rabbits was recorded pyramidal tract response in the course of conditioning of direct stimulations of the two points of the cortical surface. The data obtained point to temporary specificity in manifestation of the membrane and synaptic plasticity, to participation of these mechanisms in the processes proceeding in both cortical representations of paired stimuli, and to predominantly undirected changes of a degree of their involvement in both cortical areas. At the early stage of conditioning were demonstrated all the characteristics of the dominant state developing at this stage, and at the late one those of differential conditioning. A conclusion is drown that the reinforcement through the membrane plasticity leads to initial dominant increase of cellular excitability. On the background of the latter by means of summation mechanism the conditions are created for excitation transmission from the sensory link of a new bond to its motor output. Underlined by the mechanisms of synaptic plasticity gradual reorganization of the excitatory and inhibitory connections to the output elements of conditioned response determines and consolidates specialized character of the elaborated reaction.

Animals↗

PubMed2001

Primary lateral sclerosis: further clarification.

Primary lateral sclerosis (PLS) has been defined as a rare. Non-hereditary disease characterized by progressive spinobulbar spasticity, related to the exclusive involvement of precentral pyramidal neurons, with secondary pyramidal tract degeneration and a preservation of anterior horn motor neurons, the latter allowing PLS to be distinguish from amyotrophic lateral sclerosis (ALS). However, a clear distinction between the two diseases remains a subject of debate. With this in mind, we assessed patients with meeting the previously published criteria for PLS in a prospective, longitudinal study. At regular intervals, we analyzed various clinical and electrophysiological parameters in nine patients with a diagnosis of PLS. We made a deltoid muscle biopsy and PET study.Our results provide evidence that degeneration in PLS is not restricted to the upper motor neurons but also affects the lower motor neurons. The distinction between ALS and PLS is related to the degree and stability of lower motor neuron involvement. In view of the similarities with ALS, we consider that PLS may represent a slowly progressive syndrome closely related to this disease.

Adult↗

PubMed1975

The effects of motor cortical stimulation on the excitability of spinal motoneurons in man.

The pyramidal tract and particularly the direct cortico-motoneuronal components (DCM) have become increasingly important in the higher primates. Minimal single pulse precentral stimulation in man evokes EMG discharges from the contralateral hand muscles with a latency of 18-21 milliseconds. The excitability changes produced by such cortical stimulation on the upper limb H-reflex has been observed to include a short duration early facilitation probably corresponding to the DCM input and a later, longer lasting facilitation mediated by the same and probably other corticofugal projections. Potentiation of the H-reflex in the upper libs by means of postcentral excitation required much higher single pulse stimulus intensities and the changes in excitability produced on the spinal motoneurons could have been explained by physical extension of the stimulus current to the precentral region. Isometric contraction potentiated the H-reflex produced by combinations of precentral cortical and peripheral nerve stimulation but no direct evidence was found to support a possible transcortical basis for the V2 stretch reflex.

Electric Stimulation↗

PubMed2005

[Correlations between clinical course and investigation results of central conduction time of somatosensory potentials evoked from tibial nerves in patients with cervical myelopathy treated by surgery].

OBJECTIVE: The aim of study was to determine if abnormal somatosensory evoked potentials (SSEPs), specifically central conduction time (CCT) correlated with the degree of cervical myelopathy surgically treated or with clinical improvement following surgery. MATERIAL AND METHODS: Thirty patients (women, n=12 and men, n=18) with cervical myelopathy with neurological signs of cervical pyramidal tracts lesion and gait difficulties treated in 7-th Navy Hospital were studied. In our group in MR investigation we observed 26% discopathy, 56% cervical spondylosis and 43% cervical discopathy and spondylosis. Patients were treated surgically in cervical region. SSEP from tibial nerves data especially N22 to P40 interlatency (CCT) and basic everyday motional ability (by Dudek and Michno) were collected pre-operatively and 6-month after surgical treatment. RESULTS: Preoperatively, 43% (n=13) patients had normal values of CCT No patients had worsened CCT value after surgery. Six months after surgical treatment we observed abnormal in 13% (n=4) and normal values of CCT in 86% (n=26). In the second group we observed summary 60% (n=18) decrease of basic everyday motional ability. CONCLUSION: In 56% patients with cervical myelopathy abnormal SEP's from tibial nerve's abnormal CCT we observed. There is significant reduction of abnormalities SEP's from tibial nerve's after surgery. Abnormal SSEPs before the surgery correlates with the severity of myelopathy and improvement in SSEPs following surgery correlates strongly with clinical improvement.

Aged↗

PubMed2002

Preservation of directly stimulated muscle strength in hemiplegia due to stroke.

BACKGROUND: Hemiplegia, or hemiparesis, severe impairment of purposeful activation of striated musculature, is the most conspicuous and often most disabling symptom of acute cerebrovascular lesions. Spontaneous improvement of voluntary strength may extend over many months. OBJECTIVE: In this archetypical upper motor neuron syndrome we wish to ascertain the degree of functional impairment due to direct contractile impairment of the affected striated musculature. DESIGN: Maximal tetanic muscle contraction was elicited by electrical stimulation applied directly to the tibialis anterior of the paretic and nonparetic limbs. Maximal forces of the normal limbs were compared with the afflicted limbs both early and late after vascular lesions of the pyramidal tract. Maximal voluntary force of foot dorsiflexion in the same limbs was also determined. Similar measurements were made in healthy control participants. SETTING: Acute hospital, rehabilitation, and outpatient units of a clinical research center. PATIENTS: Patients with unilateral stroke were studied a few or many weeks after the ictus. MAIN OUTCOME MEASURES: Comparison was made between contraction strengths induced by maximal tetanic electrical stimulation of the dysfunctional and contralateral unaffected muscles. Maximal voluntary strength of the foot dorsiflexion forces was also measured. RESULTS: Compared with the range of electrically evoked contractile force of tibialis anterior between the limbs of healthy participants, the directly elicited force in stroke-impaired tibialis anterior was not significantly impaired. CONCLUSIONS: Modes of exercise therapy focused primarily on direct strengthening of striated musculature, as in resistive exercise training, are strategically questionable. Whether other approaches may be more effective remains to be proved. The central disability of the upper motor neuron syndrome is failure of rapid coordinated adjustment of graded high-frequency motoneuron firing in purposeful complex synergies.

Acute Disease↗

PubMed1992

Mechanisms of supraspinal correction of scratching generator.

The influences of signals in descending systems on the parameters of scratching generator activity were studied on decerebrate immobilized cats. It was shown that phasic electric stimulation of descending systems evoked certain phase-dependent reorganization of the parameters of scratching generator efferent activity. Maximum increase in scratching cycle duration during electric stimulation of Deiters' nucleus, red nucleus and pyramidal tract is observed during stimulation in the first half of aiming phase. Stimulation in the second half of aiming phase and at the beginning of scratching jerk phase virtually does not change the scratching cycle duration. Maximum increase in scratching cycle duration during electric stimulation of the nucleus reticularis gigantocellularis is observed in the second half of aiming phase. Electric activation of descending pathways during aiming phase increases its intensity and decreases the intensity of scratching jerk phase. Activation of descending pathways during scratching jerk phase increases its intensity and virtually does not change the aiming phase intensity. Influences of electric activation of descending systems on scratching generator work reveal dependence on limb position. They are increased when the limb is deflected to the rear and are decreased during over-aimed position. Decerebellation leads to a decrease of scratching generator activity parameters rearrangement under influence of electric stimulation of the red nucleus and nucleus reticularis gigantocellularis, and to its increase during Deiters' nucleus stimulation. On the basis of these results the principles of supraspinal correction of scratching generator work are discussed.

Animals↗

PubMed1981

Transcortical reflexes and servo control of movement.

Sherrington proposed that the major role of proprioceptors is in processing afferent inputs generated by the active movements of the animal itself, and noted that the reflex effects of proprioceptive inputs are "mild." Current experimental results are consistent with the view that the major role of both segmental and transcortical proprioceptive reflexes is in small active movements and active postural stability, with muscle afferent inputs reducing "...errors of muscle length produced by fluctuating levels of motor discharge..." as stated by Goodwin and coworkers in 1978. Exteroceptive reflexes generate intense muscular responses and are of critical importance in prompt reprogramming essential for effective responses to environmental stimuli. Within the motor cortex (MI) there is a caudal region (MI/c) which receives exteroceptive cutaneous inputs and a rostral region (MI/r) which receives proprioceptive inputs. Transcortical reflexes mediated via pyramidal tract neurons (PTNs) of MI/r have properties which are analogous to segmental proprioceptive reflexes: changes of muscle length elicit PTN discharges which oppose the length change and so act to maintain stability. Furthermore, MI/r PTNs which are recruited earliest for small active movements are most sensitive to proprioceptive inputs. Data are not yet available concerning transcortical reflexes via MI/c during voluntary movement, but it is speculated that the cutaneous reflexes via MI/c might be functionally analogous to segmental cutaneous reflexes. Short-latency reflex responses also occur in postcentral (PoC) PTNs, and in this report we present results concerning the properties of PoC PTNs during active and passive movement. Caudal (area 2-5) PoC PTNs were similar to MI PTNs in that they often discharged prior to electromyogram (EMG) activity with active movement, and had different discharge frequencies with different steady state loads, but were unlike most MI PTNs in having the same changes of discharge with active and passive movement. Our finding of PoC discharge prior to movement onset, confirming that of Soso and Fetz in 1980, is discussed in connection with the concept of corollary discharge.

Afferent Pathways↗

PubMed2001

Corticospinal control of locomotor pathways generating extensor activities in the cat.

Interneuronal convergence of corticospinal and segmental pathways involved with the generation of extensor activities during locomotion was investigated in decerebrate and partially spinalized cats. L-dihydroxyphenylalanine (L-DOPA) was slowly injected until long-latency, long-lasting discharges could be evoked by the stimulation of contralateral flexor reflex afferents (coFRA) and the group I autogenetic inhibition was reversed to polysynaptic excitation in extensor motoneurons. Under these conditions, we stimulated in alternation the contralateral pyramidal tract (PT), group I afferents from knee and ankle extensor muscles, and both stimuli together. We did the same for the stimulation of PT and of coFRA. Clear polysynaptic EPSPs could be evoked from all three sources in 32 extensor motoneurons. Convergence was inferred from spatial facilitation, which occurred when the amplitude of the EPSPs evoked by the combined stimuli was notably larger than the algebraic sum of the EPSPs evoked by individual stimulation. Spatial facilitation was found between PT and extensor group I inputs in 30/59 tests (51%) in 20 motoneurons and in all cases (6/6) between PT and coFRA in six motoneurons. When fictive locomotion was induced with further injection of L-DOPA, PT descending volleys from the same stimulating site could reset the stepping rhythm by initiating bursts of activity in all extensors. These results indicate that at least some of the corticospinal fibers project onto interneurons shared by the coFRA and the polysynaptic excitatory group I pathways to extensors. The implications of such convergence patterns on the organization of the extensor "half-center" for locomotion are discussed.

Animals↗

PubMed1978

Conditioned changes of synaptic transmission in the motor cortex of the cat.

Intracellular recordings were made from 117 neurons in the motor cortex of anesthetized cats. The pyramidal tract (PT) and VL nucleus of thalamus were stimulated in order to activate the neurons from two directions. 1. PT cells were conditioned by antidromic trains (10--50 cps for 4--15 s) and by paired PT and VL stimuli with different intervals and sequences. The VL-EPSPs were examined before and after conditioning, to find differences in efficacy in giving rise to spikes. The conditioning procedures resulted in a remarkable facilitation of VL-EPSPs, manifesting itself as a significant rise of efficacy in generating spikes, a shortening of peak latency and in some cases, an enhancement of background firing. 2. In non-PT neurons the same conditioning procedures elicited heterosynaptic facilitation and a rise in firing activity. 3. Intracellularly injected square wave pulses also resulted in facilitation of VL-EPSPs. 4. Pairings of PT and VL stimuli were more effective than trains in evoking conditioned changes. 5. Plastic modifications were observed in the 13.7% of the neurons subjected to conditioning procedures. 6. The authors assume that synchronous activity of the pre- and postsynaptic neurons is a highly important condition for plastic changes in the efficacy of synaptic transmission.

Animals↗

PubMed1999

Dopaminergic modulation of transcallosal activity of cat motor cortical neurons.

The effects of dopamine (DA) and its antagonists on the transcallosal activity of pyramidal tract neurons (PTNs) and non-PTNs in the anesthetized cat motor cortex were studied with iontophoretic applications; dopamine, SCH 23390 (D1 antagonist), sulpiride (D2 antagonist) and haloperidol. Neuronal activity was recorded with a multi-barreled glass microelectrode. Transcallosal neuronal activity was evoked by stimulation of the contralateral motor cortex. The number of spikes thus activated was counted for the control and test conditions after application of each drug: (1) dopamine application decreased the number of spikes evoked by transcallosal stimulation; (2) application of SCH 23390, sulpiride and haloperidol restored these decreased spike numbers to the control level; (3) latency of neuronal response to transcallosal stimulation was not affected by the application of either DA, SCH 23390, sulpiride or haloperidol; and (4) there was no significant difference between PTNs and non-PTNs in the manner of response to DA and its antagonist applications. Our conclusion is that dopamine modulated the transcallosal neuronal response in the cat motor cortex in a suppressive manner. This fact suggested that interhemispheric neuronal communications could be subjected to suppressive modification by the dopaminergic system.

Action Potentials↗

PubMed1986

Dual mode of projections from the parietal to the motor cortex in the cat.

The cortico-cortical projection from area 5 to area 4 gamma was studied in anesthetized cats. Intracortical microstimulation of area 5 produced EPSPs in pyramidal tract (PT) cells in area 4 gamma. Such EPSPs were analysed in a total of 54 fast PT cells. The rising phase of these EPSPs was often composed of fast and slow components. Fast-rising EPSPs (fast component) were produced predominantly by stimulation within layer III of area 5 while slow-rising EPSPs (slow component) were evoked predominantly by stimulation within layer V of area 5. The amplitudes of the fast and slow components of EPSPs produced during repetitive stimulation within layers III and V of area 5 decreased and increased, respectively, with an increase in the stimulus frequency without any appreciable changes in their latency and time-to-peak. The slow component was much less influenced by membrane hyperpolarization than the fast component. Retrogradely labeled neurons were found not only in layer III but also in layer V of area 5 following HRP injection centered on superficial layers (I-III) of area 4 gamma. It is suggested that there are two groups of cortico-cortical neurons in layers III and V of area 5, which may make monosynaptic contact with the proximal and distal sites of fast PT cells in area 4 gamma, respectively.

Animals↗

PubMed1975

An alpha adrenergic mechanism in the ascending reticular activating system.

The effect of electrical stimulation of the mesencephalic reticular formation (MRF) on the pyramidal tract (PT) response to cortical stimulation in adult rats was examined with and without alpha adrenergic blocking agents and other chemicals, applied intravenously, intraperitoneally or topically to the exposed cerebral cortex. 1. By MRF stimulation, the initial component of the PT response (D wave) was not significantly altered but the later component (I waves) was initially facilitated and subsequently inhibited. 2. Intravenously applied alpha adrenergic blocking agents, phentolamine and phenoxybenzamine consistently blocked reticulo-cortical inhibition. The reticulo-cortical facilitation was significantly reduced by phentolamine but the effect of phenoxybenazmine was not consistent on this mechanism. Neither the PT response nor the effect of MRF stimulation on it was affected by propranolol or atropine. 3. Phentolamine or phenoxybenazmine, topically applied to the cortical surface, blocked the reticulo-cortical inhibition but did not alter the reticulo-cortical facilitation. 4. A monoamine oxidase inhibitor, iproniazid (i.p.), significantly potentiated the reticulo-cortical inhibition but the effect on the reticulocortical facilitation was not statistically significant. 5. These results suggest that the reticular inhibitory effect on the motor cortical activity is mediated through an alpha adrenergic mechanism and the receptor site is distributed in the cerebral cortex.

Administration, Topical↗

PubMed2006

Neuronal relays in double crossed pathways between feline motor cortex and ipsilateral hindlimb motoneurones.

Coupling between pyramidal tract (PT) neurones and ipsilateral hindlimb motoneurones was investigated by recording from commissural interneurones interposed between them. Near maximal stimulation of either the left or right PT induced short latency EPSPs in more than 80% of 20 commissural interneurones that were monosynaptically excited by reticulospinal tract fibres in the medial longitudinal fascicle (MLF). The EPSPs were evoked at latencies that were only 1-2 ms longer than those of EPSPs evoked from the MLF, compatible with a disynaptic coupling between PT fibres and these commissural interneurones. EPSPs evoked by PT stimulation were frequently associated with IPSPs which either followed or preceded the EPSPs. The latencies of the IPSPs (on average about 1 ms longer than latencies of the earliest EPSPs) indicated that they were mediated via single additional inhibitory interneurones. Records from a sample of nine commissural interneurones from a different population (with monosynaptic input from group I and/or II muscle afferents, and disynaptically excited from the MLF) suggest that actions of PT fibres on such interneurones are weaker because only four of them were excited by PT stimuli and at longer latencies. By demonstrating disynaptic coupling between PT neurones and commissural interneurones via reticulospinal fibres, the results provide a direct demonstration of trisynaptic coupling in the most direct pathways between PT neurones and ipsilateral motoneurones, and thereby strengthen the proposal that the double crossed pathways between PT neurones and ipsilateral motoneurones might be used to replace crossed actions of damaged PT neurones.

Animals↗

PubMed1990

Human T-lymphotropic virus type I (HTLV-I) and tropical spastic paraparesis or HTLV-I-associated myelopathy in Hawaii.

Tropical spastic paraparesis or human T-lymphotropic virus type I (HTLV-I)-associated myelopathy is a degenerative encephalomyelopathy with pyramidal tract dysfunction affecting the lower extremities. It is associated with HTLV-I infection and found primarily in the Caribbean region and in southwestern Japan. Five cases of tropical spastic paraparesis (or HTLV-I-associated myelopathy) in Hawaii are reported. All five patients were born in Hawaii; four are women. Each of the patients has parents who were from HTLV-I-endemic areas of Japan. Two of these patients had serum antibodies to HTLV-I. Five of six of the spouses and children of the seropositive patients were also seropositive. Viral cultures of lymphocytes from both seropositive patients and two of the three seropositive children were positive for HTLV-I. None of the five patients had a history of antecedent blood transfusion, multiple sexual partners, or intravenous drug use. There is no evidence of adult T-cell leukemia or lymphoma in any of the patients or their families. Given the increasing seroprevalence of HTLV-I in the United States, clinicians need to be alert to new cases of this disorder.

Back Pain↗

PubMed2002

Longitudinal study of motor recovery after stroke: recruitment and focusing of brain activation.

BACKGROUND AND PURPOSE: The goal of this study was to characterize cortical reorganization after stroke and its relation with the site of the stroke-induced lesion and degree of motor recovery using functional MRI (fMRI). METHODS: Fourteen stroke patients with an affected upper limb were studied longitudinally. Three fMRI sessions were performed over a period of 1 to 6 months after stroke. Upper limb recovery, Wallerian degeneration of the pyramidal tract, and responses to transcranial magnetic stimulation were assessed. RESULTS: Two main patterns of cortical reorganization were found. Pattern 1 was focusing, in which, after initial recruitment of additional ipsilateral and contralateral areas, activation gradually developed toward a pattern of activation restricted to the contralateral sensorimotor cortex in 9 patients. Five patients were found to have pattern 2, persistent recruitment, in which there was an initial and sustained recruitment of ipsilateral activity. Occurrence of recruitment or focusing seemed to depend mainly on whether the primary motor cortex (M1) was lesioned; persistent recruitment was observed in 3 of 4 patients with M1 injury, and focusing was seen in 8 of 10 patients with spared M1. These patterns had no relation to the degree of recovery; in particular, focusing did not imply recovery. However, there was a clear relation between the degree of recovery and the degree of Wallerian degeneration. CONCLUSIONS: These results suggest that ipsilateral recruitment after stroke corresponds to a compensatory corticocortical process related to the lesion of the contralateral M1 and that the process of compensatory recruitment will persist if M1 is lesioned; otherwise, it will be transient.

Adaptation, Physiological↗

PubMed1989

[Clinical characteristics of infarction of the corona radiata adjacent to the body of the lateral ventricle].

Fifty-three patients with infarction of the corona radiata adjacent to the body of the lateral ventricle were clinically evaluated in order to determine the clinical characteristics of this infarction and localization of the pyramidal tract in this area, as well as its somatotopy and etiology. Clinical characteristics included the following: (1) this type of infarction was observed in 9.1% of all patients with cerebral infarction; (2) although 81.1% of the patients of this type had clear consciousness and neuropsychological symptoms in some patients; (3) motor paralysis usually occurred in the upper limbs; (4) monoplegia occurred in 13.2% of patients, with monoplegia of upper and lower limbs being associated with infarction of the anterior and posterior portion, respectively, of the corona radiata adjacent to the body of the lateral ventricle; (5) pure motor hemiplegia was observed in 45.3% of patients; (6) facial paralysis and dysarthria were observed in 54.7% and 58.5% of patients, respectively, and the incidence of these symptoms was the highest in the infarction of the anterior portion of the corona radiata; (7) sensory disturbance, which was usually recognized as a mild subjective feeling of abnormality and localized to the limbs, was reported by 47.2% of patients; (8) risk factors included hypertension, diabetes and high hematocrit and triglyceride levels; (9) arteriosclerosis was often noted in areas between the siphon of the internal carotid artery and the main stem of the anterior and middle cerebral arteries; (10) 64.2% of patients were able to conduct independent activities of daily life (ADL) 1 month after the onset of the disease and more marked paralysis remained in the infarction of the middle portion than in the anterior or posterior portion.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Infarction↗