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PubMed1999

Facial canal decompression leads to recovery of combined facial nerve paresis and trigeminal sensory neuropathy: case report.

BACKGROUND: Trigeminal sensory neuropathy is often associated with facial idiopathic nerve paralysis (Bell's palsy). Although a cranial nerve viral polyneuropathy has been proposed as the usual cause, in many instances the etiology remains unclear. This case report of recovery of both trigeminal and facial neuropathy after surgical decompression of the facial nerve suggests an anatomic link. METHODS: A case of a 39-year-old woman presenting with recurrent unilateral facial paralysis is summarized. Her fifth episode, which did not spontaneously recover, was associated with retroorbital and maxillary pain as well as sensory loss in the trigeminal distribution. RESULTS: A middle cranial fossa approach for decompression of the lateral internal auditory canal, labyrinthine segment of the facial nerve and the geniculate ganglion was performed. The patient's pain and numbness resolved immediately postoperatively, and the facial paralysis improved markedly. CONCLUSION: This result implicates a trigeminal-facial reflex as hypothesized by others. It suggests that decompression of the facial nerve can lead to improvement in motor and sensory function as well as relief of pain in some patients with combined trigeminal and facial nerve dysfunction.

Adult↗

PubMed1996

A defect in nurturing in mice lacking the immediate early gene fosB.

Although expression of the Fos family of transcription factors is induced by environmental stimuli that trigger adaptive neuronal response, evidence that Fos family members mediate these responses is lacking. To address this issue, mice were generated with an inactivating mutation in the fosB gene. fosB mutant mice are profoundly deficient in their ability to nurture young animals but are normal with respect to other cognitive and sensory functions. The nurturing defect is likely due to the absence of FosB in the preoptic area, a region of the hypothalamus that is critical for nurturing. These observations suggest that a transcription factor controls a complex behavior by regulating a specific neuronal circuit and indicate that nurturing in mammals has a genetic component.

Animals↗

PubMed2003

Oxaliplatin-safety profile: neurotoxicity.

Oxaliplatin has become an integral part of various chemotherapy protocols, and in advanced colorectal cancer in particular. While oxaliplatin has only mild hematologic and gastrointestinal side effects, its dose-limiting toxicity is a cumulative sensory neurotoxicity that resembles that of cisplatin with the important difference of a more rapid and complete reversibility. The reversibility of neurotoxicity has been assured in long-term follow-up of patients who have received adjuvant oxaliplatin-based chemotherapy. In addition, oxaliplatin causes a very unique, but frequent, acute sensory neuropathy that is triggered or aggravated by exposure to cold but is rapidly reversible, without persistent impairment of sensory function. Various strategies have been proposed to prevent or treat oxaliplatin-induced neurotoxicity. The "Stop-and-Go" concept uses the reversibility of neurologic symptoms to aim at delivering higher cumulative oxaliplatin doses as long as the therapy is still effective. Several neuromodulatory agents such as calcium-magnesium infusions, antiepileptic drugs like carbamazepine or gabapentin, amifostine, alpha-lipoic acid, and glutathione have shown promising activity in prophylaxis and treatment of oxaliplatin-induced neurotoxicity. However, larger confirmatory trials are still lacking so that, to date, no evidence-based recommendation can be given for the prophylaxis of oxaliplatin-induced neurotoxicity. The predictability of neurotoxicity associated with oxaliplatin-based therapy should allow patients and doctors to develop strategies to manage this side effect in view of the individual patient's clinical situation.

Antineoplastic Agents↗

PubMed2004

The effects of motor neurone disease on language: further evidence.

It might sound surprising that Motor Neurone Disease (MND), regarded still by many as the very example of a neurodegenerative disease affecting selectively the motor system and sparing the sensory functions as well as cognition, can have a significant influence on language. In this article we hope to demonstrate that language dysfunction is not only a pronounced and well documented symptom in some MND patients but also that the study of language in MND can address interesting theoretical questions about the representation of language and conceptual knowledge in the brain. After a brief introduction delineating clinical and pathological features of the disease we discuss the evidence available in the literature for language dysfunction in MND. We then present linguistic data from our own study of seven patients with MND/dementia/aphasia syndrome focusing on the dissociation between noun and verb processing. To illustrate the clinical, neuropsychological and linguistic aspects of MND we describe in more detail the patient E.N., a pathologically confirmed case of MND/dementia. Finally, we attempt to characterise the nature of the linguistic impairment in MND in the light of current debates about the mechanisms underlying noun/verb dissociation.

Anomia↗

PubMedDate not supplied

Dysphagia in the patient with a tracheostomy: six cases of inappropriate cuff deflation or removal.

Patients with tracheostomy tubes have altered motor and sensory functions that may decrease their swallowing efficiency. Failure to recognize disorders in deglutition may result in dangerous complications including aspiration and death. Assessment of dysphagia is especially important in the patient transferred from the intensive care unit to the ward--where resources are less abundant. We present six cases in which cuff deflation or change of tracheostomy tube were undertaken without documented swallowing assessment. In these cases each patient was found to be aspirating and required the cuff to be reinflated, or a cuffed tube to be reinstated when assessed by the multidisciplinary team. Dysphagia management in the patient with a tracheostomy should be approached from a multidisciplinary point of view so that appropriate decisions can be made regarding changes in management and the decannulation process.

Adult↗

PubMed1999

Chiropractic rehabilitation of a patient with S1 radiculopathy associated with a large lumbar disk herniation.

OBJECTIVE: To describe the nonsurgical treatment of acute S1 radiculopathy from a large (12 x 12 x 13 mm) L5-S1 disk herniation. CLINICAL FEATURES: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. His symptoms began 5 days before the initial visit and progressed despite nonsteroidal anti-inflammatory drugs and analgesic medication. An absent left Achilles reflex, left S1 dermatome hypesthesia, and left gastrocnemius/soleus weakness was noted. Magnetic resonance imaging demonstrated a large L5-S1 disk herniation. INTERVENTION AND OUTCOME: Initial treatment of this patient included McKenzie protocol press-ups to reduce and centralize symptoms, nonloading exercise for cardiovascular fitness, and lower leg isotonic exercises to prevent atrophy. Counseling was provided to reduce abnormal illness behavior risk. Later, flexion distraction and side-posture manipulation were provided to improve joint function. Sensory motor training, trunk stabilization exercises, and trigger point therapy were also used. He returned to modified work 27 days after symptom onset. A follow-up, comparative magnetic resonance imaging (MRI) study was unchanged. He was discharged as symptomatic (zero rating on both the Oswestry and numerical pain scales) after 50 days and 20 visits, although the left S1 reflex remained absent. Reassessment 169 days later revealed neither significant symptoms nor lifestyle restrictions. CONCLUSION: This case demonstrates the potential benefit of a chiropractic rehabilitation strategy by use of multimodal therapy for lumbar radiculopathy associated with disk herniation.

Adult↗

PubMed2002

Determination and quantification of pharmacological, physiological, or behavioral manipulations on ensembles of simultaneously recorded neurons in functionally related neural circuits.

The present report describes methods for evaluating the impact of physiological, pharmacological or behavioral manipulations on simultaneously recorded single neurons within a functional sensory network of the awake, freely moving rat. Surgical techniques were developed to implant a subcutaneous electrode at the base of a single facial whisker (mystacial vibrissae) so that uniform electrical stimuli could be routinely delivered to a discrete region of the whisker pad in the awake and freely moving animal. Multi-channel extracellular recording was used to monitor the spike train activity from ensembles of single neurons in whisker-related regions of the thalamus and neocortex. Algorithms were developed to verify the stability of individual cell recordings during extended experimental sessions. Additional analysis procedures and criteria were established for identifying and evaluating the treatment-specific changes in single neuron discharge patterns that are likely to occur under these experimental conditions. Finally, analyses for evaluating the impact of experimental manipulations on sensory representations distributed over populations of neurons are discussed. The development of these techniques has provided us with the means to investigate the influence of systemically administered drugs or broadly projecting monoamine pathways on single neurons and local circuits within primary sensory networks of the awake or anesthetized mammalian brain.

Action Potentials↗

PubMed2003

A double-lumen intrathecal catheter for studies of modulation of spinal opiate tolerance.

Studies of spinal opioid tolerance frequently employ a spinal infusion model in which a single-lumen intrathecal (IT) catheter is connected to an osmotic mini pump. We have modified this model by developing a double-lumen catheter system that permits continuous delivery of the toleragen to the IT space and allows for examination of the effects of concurrent IT drug administration without interruption of the ongoing infusion. The catheter is constructed of two pieces of PE10 tubing fused to the lumens of a dual-lumen catheter (8 cm) with one PE10 tube used as an infusion line connected to an osmotic pump and the other for injection. The catheter is inserted through the cisterna magna. Most implanted rats (66 out of 73) showed full recovery of motor and sensory function without detectable neurological deficit. The profile of the tolerance development and the response to drug manipulation using the double-lumen catheter are similar to previous findings in the spinal infusion model which used a single-lumen catheter. Most importantly, we demonstrate that concurrent probe drug testing and/or concurrent drug treatment can be achieved without interruption of spinal infusion of morphine. Using the double-lumen catheter model expands the range of possibility for studies of spinal opiate tolerance and spinal drug delivery.

2-Amino-5-phosphonovalerate↗

PubMed2002

Cytokines and neuro-immune-endocrine interactions: a role for the hypothalamic-pituitary-adrenal revolving axis.

Cytokines, peptide hormones and neurotransmitters, as well as their receptors/ligands, are endogenous to the brain, endocrine and immune systems. 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. Interplay between the immune, nervous and endocrine systems is most commonly associated with the pronounced effects of stress on immunity. The hypothalamic-pituitary-adrenal (HPA) axis is the key player in stress responses; it is well established that both external and internal stressors activate the HPA axis. Cytokines are chemical messengers that stimulate the HPA axis when the body is under stress or experiencing an infection. This review discusses current knowledge of cytokine signaling pathways in neuro-immune-endocrine interactions as viewed through the triplet HPA axis. In addition, we elaborate on HPA/cytokine interactions in oxidative stress within the context of nuclear factor-kappaB transcriptional regulation and the role of oxidative markers and related gaseous transmitters.

Animals↗

PubMed1999

Qualitative research methods in otorhinolaryngology.

OBJECTIVE: Qualitative research methods explore the character and meaning of human phenomena. The methodology is unfamiliar to most clinicians, not only because of the different techniques and the type of studied issues, but also because of important differences regarding terminology and criteria for evaluating qualitative studies. This paper aims at discussing the potential contribution of qualitative methods to otorhinolaryngological research in general, and to describe a specific method with an otologic application in detail. METHOD: In order to explore different disturbing sound phenomena and coping strategies in patients with manifest tympanic membrane retractions, individual semi-structured interviews were performed. The transcripts were systematically analyzed by coding, categorizing, and interpreting the content of the text. The extracted themes, categories, and patterns were summarized. RESULTS: The method proved useful when exploring empirically known but non-measurable sound disturbances. Moreover, the findings provided further support for an alternative pathogenic theory suggesting the patient's playing an active role in the development of tympanic membrane retractions. CONCLUSIONS: Used as a complement to quantitative methods, qualitative methods offer a means for exploring the patient's experiences and role in the development, therapy, and prevention of disease. Otorhinolaryngology involves disorders of sensory functions such as hearing, equilibrium, smell and taste, as well as the vital functions of breathing and eating. The related symptoms might be experienced and coped with very differently depending on individual interpretations, fear of severe disease, etc. Furthermore, the clinician's and the patient's perspectives of symptoms and expectations regarding treatment may differ, which has implications for information, planning of therapy, and quality assessment in health care. There is no lack of study questions, but rather a lack of experience of alternative and pertinent methods.

Auditory Perception↗

PubMed2003

Taste responsiveness and diet preference in autoimmune MRL mice.

One of the most profound behavioural deficits in lupus-prone MRL-lpr mice is blunted responsiveness to sweet solutions. Given the systemic nature of autoimmune/inflammatory disease, it was not clear whether impaired taste sensitivity or motivated response to palatable food underlie this deficit. The present study compares response rates of MRL-lpr mice (which develop disease early), congenic MRL +/+ mice (which develop disease later in life) and non-autoimmune Swiss Webster (SW) mice to different tastes and diets. Healthy SW mice showed the highest responsiveness to palatable stimulation throughout the study. Conversely, the preference for palatable solutions progressively declined in MRL-lpr mice as the disease developed. No differences between the two MRL substrains were seen in responsiveness to quinine or saline, suggesting that blunted responsiveness to palatable solutions cannot be accounted for by reduced taste sensory function (hypogeusia). In addition, changes in response rates to palatable solutions were associated with systemic upregulation of pro-inflammatory cytokines. With a new cohort of mice fed on carbohydrate-rich and fat-rich diets, we also examined whether reduced sucrose intake in MRL-lpr mice can be accounted for by a reduced craving for carbohydrates. Contrary to this expectation, diseased MRL-lpr mice preferred carbohydrate-rich food while consuming a food mass comparable to controls. These results further support the hypothesis that the onset of lupus-like disease alters motivated behaviour, independent of changes in neurologic function and food metabolism.

Animals↗

PubMed2001

FMRFamide-related peptides in potato cyst nematodes.

This study presents data demonstrating the presence of FMRFamide-related peptides (FaRPs) in potato cyst nematodes (PCN). Five transcripts of FaRP encoding genes, designated gpflp-1 to gpflp-5, were characterised using RACE. In terms of ORFs, gpflp-1 was 444 base pairs (bp) long and coded for four copies of the FaRP, PF3 (KSAYMRFamide) whilst gpflp-2 was 309 bp long and encoded one copy of the peptide, KNKFEFIRFamide. gpflp-3 (420 bp) Encoded two copies of KHEYLRFamide (AF2) and the genes gpflp-4 and gpflp-5 encoded a total of 11 FaRPs, most of which are novel to PCN. FMRFamide-related peptide (FaRP)-like immunoreactivity was observed in both PCN species, Globodera pallida and Globodera rostochiensis, using an antiserum raised against the invertebrate peptide, FMRFamide. Immunopositive neurones were found throughout the central nervous system in the ventral and dorsal nerve cords and the circumpharyngeal and perianal nerve rings. Reactive neurones were also present peripherally, innervating the highly muscular pharynx with a nerve net and ring-like structures. Positive immunostaining was also observed in neurones running toward the stylet protractor muscles and/or the anterior sensory apparatus. This study implicates a role for FaRPs in feeding, host penetration and sensory function of PCN. This is the first study to characterise FaRP encoding genes from a plant-parasitic nematode using a targeted PCR based RACE approach and further underlines the importance and diversity of this neuropeptide group in the phylum Nematoda.

Amino Acid Sequence↗

PubMed2000

Innovations in neuropsychological assessment using event-related brain potentials.

Historically, clinicians have utilized evoked potentials for evaluating sensory functions and neuropsychological tests for evaluating cognitive functions. However, the clinical implementation of event-related brain potentials (ERPs), an on-line index of cognitive processing, remains to be developed fully. We describe a new method for assessing language functions using neuropsychological tests that are formatted for computer presentation with simultaneous ERP recordings. From its inception, there have been two major objectives of this ERP language assessment research. Practically, we have sought to develop assessment techniques that would enable clinicians to evaluate the language functions of individuals with limited behavioral and communicative abilities. Conceptually, we have endeavored to increase the precision of neuropsychological testing through the development of measures that are sensitive to readily identifiable and objective neural responses. This article summarizes the issues central to the development of ERP assessment techniques, reviews recent normative studies with healthy individuals, and suggests some future avenues of research in this area.

Brain↗

PubMed2002

Reaction times and anticipatory skills of karate athletes.

Two experiments were conducted to investigate the reaction times (RTs) and anticipation of karate athletes. In Experiment 1, choice RTs and simple RTs were measured with two types of stimuli. One was videotaped scenes of opponent's offensive actions, which simulated the athletes' view in real situations, and the other was static filled circles, or dots. In the choice RT task, participants were required to indicate as soon as possible whether the offensive actions would be aimed at the upper or middle level of their body, or the dot was presented either at a higher or a lower position. In the simple RT task, they were required to respond as soon as possible when the offensive action started from a static display of the opponent's ready stance, or a dot appeared on the display. The results showed significant differences between the karate athletes and the novices in the choice RT task, the difference being more marked for the video stimuli than for the dot stimuli. There was no significant difference in simple RT between the two groups of participants, for either type of stimuli. In Experiment 2, the proportions of correct responses (PCRs) were measured for video stimuli which were cut off at the seventh frame from the onset of the opponent's offensive action. The athletes yielded significantly higher PCRs than the novices. Collectively the results of the two experiments demonstrate the superior anticipatory skills of karate athletes regarding the target area of an opponent's attack (Scott, Williams, & Davids, Studies in perception and action II: Posters presented at the VIIth International conference on Event Perception and Action, Erlbaum, Hillsdale, NJ, 1993, p. 217; Wiiliams & Elliot, Journal of Sport & Exercise Psychology 21 (1999) 362), together with their advantage over novices in non-specific sensory functions (e.g., vertical discrimination).

Adult↗

PubMed2001

Effects of temporal gaps between successive fixation targets on discrimination performance and evoked brain activity.

Planning and executing of action in real-world conditions require continuous sensory input from many modalities. At the same time, sensory functions depend on reafferent and efference-copy information flow as imposed by motor actions. We studied how a specific oculomotor task influences afferent visual processing. Twenty healthy adults performed visually guided saccades. Between the offset of a fixation light and the onset of a new visual target a temporal gap of a duration of about 200 ms was introduced. This time structure is known from previous studies to elicit saccades at express latencies. In a control condition, 'no gap' was used. During eye movements one of four visual patterns with different orientations was presented, triggered by the horizontal electro-oculogram. We analyzed discrimination performance and the simultaneously recorded multichannel EEG activity. In the gap condition, shorter saccadic latencies were accompanied by significant more correct perceptual judgments. However, brain activity, as quantified by global field power, evoked component latency and topographical descriptors (centers of gravity or centroids) were not affected by the gap. This contrasts the notion that parieto-occipital areas are the most important sites of sensorimotor integration. Furthermore, the presence of a visual masking stimulus did not degrade discrimination performance, demonstrating that local retinal afterimages were not used for perceptual decisions. We conclude that intra-saccadic visual processing is influenced by pre-saccadic events. Under the short-time constraints prevalent in the saccadic task, fixation target cues are not only used for motor planning but also influence the visibility of visual patterns presented during the eye movement.

Adult↗

PubMed1999

Early establishment of lesion-insensitive mature barrelettes corresponding to upper lip vibrissae in developing mice.

Vibrissae are tactile sense organs on the face of non-human mammals, and build up topographical representations in the brainstem trigeminal sensory nucleus called barrelettes. In the present study, we examined postnatal development of barrelettes corresponding to upper lip vibrissae by cytochrome oxidase (CO) histochemistry. At nuclear regions corresponding to upper lip vibrissae, a few segregated barrelettes first appeared at postnatal day 2 (P2), and segregation became clear for most upper lip barrelettes at P4. Compared with major barrelettes corresponding to mystacial vibrissae on the snout, the development of segregated pattern formation for upper lip barrelettes was retarded by 1-2 days. When vibrissa-related patterns were examined 5 days after infraorbital nerve transection, upper lip barrelettes became obscure in all mice lesioned at P1 and P2. Lesion-insensitive upper lip barrelettes first emerged in a few mice lesioned at P3 (33%), and the percentage attained 100% at P6. This temporal transition from lesion-sensitive to lesion-insensitive barrelettes was 3 days ahead of mystacial barrelettes. Therefore, upper lip barrelettes achieve rapid development within a narrow time frame during the first postnatal week. The early and rapid establishment of lesion-insensitive, mature barrelettes can be interpreted as suggesting the importance of oral sensory function in neonatal life.

Aging↗

PubMed1997

Use of nitrous oxide to dissociate the non-specific and specific components of the human auditory N1.

The components of the N1 are thought to be related to sensory functioning (Components 1 and 2) and arousal (Component 3). To provide direct evidence for the involvement of Component 3 in arousal, we hypothesized that it should be more sensitive to the anesthetic gas nitrous oxide (N2O) than Component 1. Using the technique of selective adaptation, 30 blocks of 5 tones were presented at 1 min intervals to 9 subjects who breathed air, 25% and 35% N2O. As hypothesized, the amplitude of Component 3 was significantly reduced in a dose-dependent manner by N2O, but the amplitude of Component 1 was not, although the latter showed some evidence of a decrease at 25% N2O.

Adult↗

PubMed2000

Region-specific decline in the expression of metabotropic glutamate receptor 7 mRNA in rat brain during aging.

Age-dependent changes in the expression of group III metabotropic glutamate receptors (mGluR4 and mGluR7) were studied by quantitative in situ hybridization using male Fisher 344 rats 3, 12 and 25 months of age. Results indicate an early decrease in mGluR7 mRNA level in several cortical areas including the frontal, parietal and temporal cortices. In the hippocampus, mGluR7 mRNA levels decreased in the CA1 region and the lower blade of the dentate gyrus. Moreover, significant decrease was found in the laterodorsal thalamic nucleus at 12 months of age. Other regions such as the caudate putamen and nucleus accumbens showed no age-related changes in mGluR7 mRNA levels. Analysis of emulsion autoradiograms revealed a 36% decrease of mGluR7 mRNA in Purkinje neurons in the 12-month-old group and a 48% decline in the 25-month-old group as compared to the 3-month-old group. A substantial decrease in mGluR4 mRNA level was found in the granule cell layer of the cerebellum during aging. The difference between the young and aged groups exceeded 35%. These region-specific decreases may have important implication in some of the age-related changes in cognitive, motor and/or sensory functions.

Aging↗