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Attenuation of acoustic and tactile startle responses of vitamin B-6 deficient rats.

Vitamin B-6 deficient rats exhibit changes in behavior, sensory function, and other nervous system abnormalities such as convulsive seizures and motor disturbances. Sensorimotor reactivity was evaluated quantitatively by measuring auditory and tactile startle responses in 12 week old female Long-Evans rats fed a diet devoid of added vitamin B-6 (DEF) or a control diet, either ad lib (AL-CON) or pair-fed to deficient rats (PF-CON). Deficiency was confirmed with a tryptophan-load test administered to a separate group of rats fed simultaneously according to the same protocol. At week 18, body weight and feed efficiency were different among groups (p less than 0.001), and were lowest in DEF. Amplitude of response to both acoustic and tactile stimuli was depressed in DEF compared to both control groups, which generally did not differ in response. This effect was seen most dramatically in responses to the acoustic stimulus (p = 0.034), and especially to the first presentation (p = 0.017). Latency to maximum response was not affected by diet. Possible mechanisms for this nervous system abnormality, not previously reported in vitamin B-6 deficiency, are discussed.

Animals↗

Evaluation of children and young adults with tethered spinal cord syndrome. Utility of spinal and scalp recorded somatosensory evoked potentials.

The diagnosis of tethered spinal cord syndrome should be considered in young patients with progressive orthopedic deformities, lower extremity weakness, urinary and fecal incontinence, low back pain, or combinations of these symptoms. Myelographic, computed tomographic, and urodynamic studies are useful for establishing a diagnosis, but contribute little to the evaluation of lower extremity sensory function or to the assessment of electrophysiologic impairment of the spinal cord itself. To determine the diagnostic usefulness of the somatosensory evoked potential after posterior tibial nerve stimulation (posterior tibial nerve somatosensory evoked potential) in tethered spinal cord syndrome, 22 consecutive patients with symptoms of tethered spinal cord syndrome (aged 18 months to 22 years) underwent recording of posterior tibial nerve somatosensory evoked potential; results were correlated with clinical, myelographic, and operative findings. In patients with clinical symptoms but no myelographically demonstrable lesions, posterior tibial nerve somatosensory evoked potentials were within normal limits, suggesting normal physiologic function. In patients with myelographically and operatively confirmed tethering dysraphic lesions, posterior tibial nerve somatosensory evoked potential was predictive of the level and laterality of the lesion. Similarly, ranking the severity of neurological impairment and extent of dysraphism at operation, as well as the extent of abnormality of posterior tibial nerve somatosensory evoked potential, revealed a significant (r = 0.81, p less than 0.001) correlation between clinical severity and posterior tibial nerve somatosensory evoked potential abnormalities. Postoperatively, in 8 patients, posterior tibial nerve somatosensory evoked potential also reflected improved function in relation to the level and type of dysraphic lesion present. These findings indicate that posterior tibial nerve somatosensory evoked potential is a sensitive indicator of neurophysiologic status in patients with tethered spinal cord, and is useful for determining the level of the conus medullaris, degree of spinal cord displacement, and severity of neurological impairment associated with this congenital disturbance of neuraxis formation. Recording of posterior tibial nerve somatosensory evoked potential is noninvasive and offers a more sensitive diagnostic tool than the clinical testing of sensation for detection of the development of neurologic deficits in patients with tethered cord syndrome.

Adolescent↗

The use of anterior Caspar plate fixation in acute cervical spine injury.

Optimal management of cervical cord injury in the presence of documented instability and/or compression of neural elements remains a controversial topic. Surgery and internal stabilization of cervical spine fracture/dislocations are effective and well accepted, but controversy exists on the relative merits of the anterior versus the posterior approach as well as the optimal timing of surgical intervention. We report our experience with the Caspar technique and instrumentation for anterior stabilization in 54 patients for acute cervical spine injury. Our series consists of 38 male and 16 female patients whose ages ranged from 16 to 68 years, with a mean age of 29.2 years. Thirty-two of these patients had complete neurological sensory/motor deficits at the time of presentation, eight were neurologically intact, and 14 had preservation of some motor and sensory function. All 54 patients had radiographic evidence of posterior instability as well as anterior disruption of either a vertebral body or intervertebral disk. We found that "early" intervention (less than 24 hours after injury) was performed frequently in the neurologically compromised patients. Twelve of the 22 patients undergoing surgery less than 24 hours after admission regained significant neurological function, with 13 of 22 developing postoperative complications. In the "delayed" group (surgery more than 24 hours after injury, mean 14.3 days), 14 patients experienced postoperative complications, with 15 of 24 demonstrating neurological improvement. The eight patients who were intact did uniformly well. There was no mortality during the follow-up. All 54 patients showed a solid fusion (clinically and radiologically) within 6 months of surgery. In two cases the plates had to be removed, without risking the fusion. Our experience suggests that although anterior cervical fusion and Caspar plating remain appropriate for patients with documented anterior compromise of the canal, it should not substitute for more traditional posterior stabilization procedures. Because this route has the potential for more serious complications, it should be reserved for the cases in which anterior decompression is deemed necessary or posterior fusion was unsuccessful. With appropriate selection of patients, no adverse effect of early surgery was demonstrated. In fact, neurologically compromised patients had the benefits of increased ease of patient care and early transfer to rehabilitation.

Adolescent↗

Long-term results of transplantations to repair median, ulnar, and radial nerve lesions by a microsurgical interfascicular autogenous cable graft technique.

A comprehensive analysis of 187 patients (78 median, 86 ulnar, and 23 radial nerve lesions) treated by an interfascicular autogenous nerve grafting technique is presented. After a follow-up of at least 18 months good motor recovery was achieved in 72% of median nerve lesions, 77% of ulnar nerve lesions, and 57% of radial nerve lesions. Good functional sensory recovery was found in 36% of median, 45% of ulnar, and 48% of radial nerve lesions. It appears by multivariate analysis that the results obtained generally were better in younger patients, in patients with a shorter preoperative delay, and in cases with a shorter transplant.

Adolescent↗

Evaluation and management of children with sacral agenesis.

Sacral agenesis is a rare congenital anomaly of the lower vertebral column which usually produces lower urinary tract dysfunction. Sixteen children with varying degrees of sacral agenesis and urinary symptoms were extensively evaluated. The neurologic lesion varied from no denervation to a complete loss of sacral motor and sensory function. The treatment instituted was individualized and based on specific urodynamic and radiologic findings. Overall, 12 of the 16 children (75%) achieved continence. Clues to the diagnosis including symptoms, physical findings, and the relationship to maternal diabetes are discussed.

Abnormalities, Multiple↗

Matching to sample, blood pressure and hormonal effects of chronic enalapril in baboons.

Sensory and behavioral performance of three normotensive and one renovascular hypertensive baboon was tested before, during and following chronic oral dosing with the angiotensin converting enzyme (ACE) inhibitor enalapril. Performance measurements during a five-color simultaneous matching to sample task were obtained during enalapril dosing of 0.18 and 0.61 mg/kg/day, and vehicle. Each dose was administered for 21 consecutive days preceded and followed by 14 baseline and recovery periods, respectively. BP from awake animals as well as serum ACE activity were measured. Systolic BPs decreased by a maximum of 6-8% (8 mmHg). ACE activity was decreased in a dose-dependent fashion by 54.01% and 81.63% for 0.18 mg/kg and 0.61 mg/kg doses, respectively. At 0.61 mg/kg, the duration of simple key-press motor behavior increased by 15% in the first week and then progressively returned to baseline levels. Systematic changes in choice reaction times or color discrimination accuracy were not observed. Although the renovascular hypertensive baboon displayed greater hypotension and ACE inhibition, behavioral effects were not significantly different from normotensive baboons. The present study extends to sensory functions the lack of adverse behavioral side-effects of enalapril.

Animals↗

Reaction time during cocaine versus alcohol withdrawal: longitudinal measures of visual and auditory suppression.

Visual and auditory stimulus discrimination tasks, analogous to those used in the Reitan-Klove Sensory Perceptual Examination, were performed by 12 cocaine-dependent and 5 alcohol-dependent patients after 1 week, 3 weeks, and 3 months of verified abstinence. Sixteen control subjects, who were not substance-dependent, performed the same tasks after comparable intervals. During each task, either visual or auditory stimuli were presented in the left, in the right, or in both sensory fields. A simple key press was made to discriminate these conditions. Cocaine-dependent patients responded more slowly than control subjects during both tasks. The reaction-time slowing persisted across all three sessions, spanning a 3-month period of abstinence. There were no significant differences between the cocaine-dependent and control groups in response accuracy. In the context of other findings, these findings are interpreted as reflecting an enduring effect of prior cocaine dependence on motor as opposed to sensory functioning.

Acoustic Stimulation↗

A comparison of lateral peristriate and striate neocortical ablations in the rat.

The effects of striate, lateral peristriate and sham ablations upon the post-operative reacquisition of visual discriminations were studied in two experiments. The results of Experiment 1 indicated that lesions restricted to the lateral peristriate neocortex rendered the rat incapable of resolving an oblique stripe discrimination. Seven of the 9 rats with striate ablations were unable to form the discrimination. The histological findings indicated that the deficit following lateral peristriate injury was not due to interruption of the geniculostriate system. However, the behavioral impairment in destriate rats corresponded to the degree of unintentional injury in lateral peristriate neocortex, but not medial peristriate tissue. In Experiment 2, the effects of these lesions were studied upon the post-operative reacquisition of either a non-reversal or reversal of a preoperatively acquired brightness discrimination. Animals with striate damage demonstrated considerable savings on the non-reversed brightness discrimination, and they acquired the reversal at a rate equal to that seen in animals with sham ablations. Rats with peristriate ablations showed no savings on the non-reversed brightness habit, and they required more extensive training than both the striate and sham groups on the reversal. These findings suggest that the frequently reported loss of a preoperative brightness habit following large posterior neocortex ablations is due to damage in the lateral peristriate neocortex rather than damage of the geniculostriate system. These results, taken with other literature, suggest an important role of the lateral peristriate neocortex in visuospatial sensory function.

Animals↗

The syntax of immune-neuroendocrine communication.

There is now overwhelming evidence that cytokines, peptide hormones and neurotransmitters, as well as their receptors, are endogenous to the brain, endocrine and immune systems. Here, Edwin Blalock discusses how these shared ligands and receptors are used as a common chemical language for communication within and between the immune and neuroendocrine systems. Such communication suggests an immunoregulatory role for the brain and a sensory function for the immune system. A clearer understanding of this circuitry is dramatically altering our understanding of physiology and may profoundly affect the treatment of human disease.

Animals↗

Subclinical VEP abnormalities in patients on chronic deferoxamine therapy: longitudinal studies.

As deferoxamine (DFO) appeared to have certain toxic effects on the sensory pathways in some of our patients on nightly subcutaneous deferoxamine (DFO) for transfusion-dependent anemia, treatment was stopped in all of these patients to obtain a comprehensive baseline assessment of sensory function. Visual evoked potentials (VEPs) were studied in all patients; the 77 described in this report all had normal ophthalmological examinations. Abnormally prolonged VEP latencies were found in 21%. The patients remained off DFO for 2-6 months, and most of those with abnormal VEPs who were retested showed improvement in their VEPs over this period with the VEPs returning to within normal range in half the cases; two showed no change. Since restarting DFO, VEP latencies in 10 of these patients have increased again beyond normal limits, as have the VEPs in 7 who had previously normal VEPs. Although most of the 77 patients have VEPs that are currently normal and stable while on DFO, a significant sub-group have abnormal VEPs that appear sensitive to the administration of DFO and may reflect a vulnerability to DFO neurotoxicity. These data suggest that the VEPs can detect subclinical toxic effects of DFO on the visual system and should be considered as a monitor for patients receiving chronic DFO therapy.

Deferoxamine↗

Expression of somatostatin receptor 3 mRNA in the motorneurones of the rat spinal cord, and the sensory neurones of the spinal ganglia.

At least five different types of somatostatin receptors (SSTRs): SSTR1-5 have been recently cloned. Here, we report the distribution of somatostatin receptor 3 (SSTR3) mRNA in spinal cord and spinal ganglia by in situ hybridization. We demonstrate the presence of this transcript in motorneurones of the spinal cord and other motor nuclei of the brain stem, and in the sensory neurones of the spinal ganglia. These data suggest a role for SSTR3 in motor and sensory functions.

Animals↗

Calcitonin gene-related peptide (CGRP) in the female rat urogenital tract.

CGRP-immunoreactivity was found throughout the female rat urogenital tract by specific radioimmunoassay, and shown to be present in nerve fibres by immunocytochemistry. The highest concentrations of CGRP-like immunoreactivity were found in the urinary tract, with lower levels in regions of the genitalia. Chromatographic analysis of bladder and vaginal extracts on Sephadex G-50 columns and HPLC revealed at least three CGRP-immunoreactive peaks. The major peak emerged in the same position as synthetic rat CGRP. CGRP nerve fibres were associated mainly with blood vessels, non-vascular smooth muscle, squamous epithelium and uterine and cervical glands, and were particularly abundant in the ureter and bladder. CGRP-immunoreactivity was depleted by neonatal treatment with capsaicin and after surgical section of pelvic and/or hypogastric nerves. Immunocytochemistry demonstrated that depletion occurred predominantly in the mucosal layer of the urogenital tract. These findings indicate a sensory function for most of the CGRP-immunoreactive nerves in the rat urogenital tract.

Animals↗

Regional cerebral metabolic rate for glucose in beagle dogs of different ages.

Regional cerebral metabolic rates for glucose (rCMRglc) were studied in unanesthetized Beagle dogs in five age groups. Significant age-related differences did not occur in the cingulate, pyriform or visual cortices, cerebellar flocculus, corpus callosum, or cerebellar white matter. However, age-related decrements were apparent in 15 of the 22 brain regions examined. The apparent time course of age effect on rCMRglc varied among the brain regions. Most regions had significantly lower rCMRglc at 6 years than at 1 year. Decrements of more than 25% were seen in the mammillary bodies, pons, hippocampus, superior colliculus, basis of the midbrain, temporal cortex, geniculate bodies, caudate nucleus, and superior frontal gyrus. There were no age differences in rCMRglc at 10-12 years compared with 6 years. Senescence-associated decrements (after 6 years) were noted in only 5 regions: the frontal and temporal cortices, mammillary bodies, and areas involved in sensory functions. The results indicate that rCMRglc in the adult Beagle brain declines by midlife, and continues to decline in some brain regions through senescence.

Age Factors↗

Replantation of the radial side of the hand in the rhesus monkey: anatomical and functional aspects. A preliminary study to composite tissue allografting.

Before human hand transplantation can even be considered, an appropriate research model must be studied in a non-human primate. The first ray of the hand, augmented with a radial forearm flap, was chosen as a functional composite tissue graft. Four technically successful replantation of the radial unit have been carried out. One monkey died on the first post-operative day due to cardiac arrythmia. Normal wound healing occurred in the other three animals. In three monkeys, functional sensory and motor recovery was almost complete. The monkeys were able to pick up small particles of food with the index finger and thumb. It is suggested that this model could be used for allogeneic composite tissue transplantation in a non-human primate.

Animals↗

The results of secondary microsurgical repair of ulnar nerve injury.

110 patients with injuries to the ulnar nerve were assessed, on average, 12.7 (3-20) years after secondary repair. 89 were male and 21 female, with a mean age of 27.9 years. Most of the nerve lesions were sharp (63) or blunt (41) injuries. Division was total in 76 cases and most were at the forearm level. The average delay from the injury to the operation was 10.1 (1-48) months. Secondary repair was performed in 34 cases and fascicular grafting in 76 cases. The mean graft length was 5.4 (1-30) cm. Four factors of motor and sensory function were assessed and the quantitative evaluation was compared with the MRC classification. Useful results were obtained in only 51.8% and poor in 30.9%. The age of the patient, the width of contusion, the pre-operative delay, and the level of the injury influenced the results significantly.

Adolescent↗

The results of secondary repair of 254 digital nerves.

95 patients with 254 completely divided digital nerves were reviewed, on average, 12.4 (5-20) years after repair. There were 47 sharp and 48 blunt injuries. 45 injuries were at the level of the palm of the hand and 50 more distally. Secondary epineurial suture was used in 53, fascicular grafting in 37 and fascicular suture in five. Four sensory factors were assessed and evaluated quantitatively. Useful sensory function was recovered in 79.5% of the nerves operated on with epineurial or fascicular suture and in 56.3% with fascicular grafting.

Adolescent↗

The validation of measures of outcome following suture of divided peripheral nerves supplying the hand.

Erik Moberg pioneered the idea of validating measures of sensory function following peripheral nerve suture by correlating their results with those of functional tests. However it is important that powerful prior variables (age at suture, time elapsed since suture and delay between injury and suture) be controlled. Failure to do this may result in spurious correlations, as illustrated by analysis of two sets of data, one collected by the author and the other given in the classic paper of Onne (1962).

Adolescent↗

Neurophysiological consequences of acute exposure to methylpyridines.

A series of neurophysiological tests was performed on Long-Evans hooded rats treated with either 2-, 3-, or 4-methylpyridine at dosages of 100 mg/kg, approximately one-half the ip LD50. The tests contained measures of sensory function (paired pulse flash evoked potentials, pattern reversal evoked potentials, and brainstem auditory evoked responses) and cerebral excitability (pentylenetetrazol seizures and hippocampal afterdischarges). In general, rats treated with 2- and 3-methylpyridine were more affected than those treated with 4-methylpyridine. The changes observed were in many ways similar to those seen following administration of depressant compounds: increased latency of evoked potentials and increased latency to PTZ seizures. Not all findings, however, were consistent with previously observed patterns of central nervous system depression.

Animals↗