Neural connections in and around the cavernous sinus in rat, with special reference to cerebrovascular innervation

Unveiling the vulnerability of the human abducens nerve: insights from comparative cranial base anatomy in mammals and primates

The topographic anatomy of the abducens nerve has been the subject of research for more than 150 years. Although its vulnerability was initially attributed to its length, this hypothesis has largely lost prominence. Instead, attention has shifted toward its intricate anatomical relations along the cranial base. Contrary to the extensive anatomical and neurosurgical literature on abducens nerve anatomy in humans, its complex anatomy in other species has received less emphasis. The main question addressed here is why the human abducens nerve is predisposed to injury. Specifically, we aim to perform a comparative analysis of the basicranial pathway of the abducens nerve in mammals and primates. Our hypothesis links its vulnerability to cranial base flexion, particularly around the sphenooccipital synchondrosis. We examined the abducens nerve pathway in various mammals, including primates, humans (N = 40; 60% males; 40% females), and human fetuses (N = 5; 60% males; 40% females). The findings are presented at both the macroscopic and histological levels. To associate our findings with basicranial flexion, we measured the cranial base angles in the species included in this study and compared them to data in the available literature. Our findings show that the primitive state of the abducens nerve pathway follows a nearly flat (unflexed) cranial base from the pontomedullary sulcus to the superior orbital fissure. Only the gulfar segment, where the nerve passes through Dorello's canal, demonstrates some degree of variation. We present evidence indicating that the derived state of the abducens pathway, which is most pronounced in humans from an early stage of development, is characterized by following the significantly more flexed basicranium. Overall, the present study elucidates the evolutionary basis for the vulnerability of the abducens nerve, especially within its gulfar and cavernous segments, which are situated at the main synchondroses between the anterior, middle, and posterior cranial fossae-a unique anatomical relation exclusive to the abducens nerve. The principal differences between the pathways of this nerve and those of other cranial nerves are discussed. The findings suggest that the highly flexed human cranial base plays a pivotal role in the intricate anatomical relations and resulting vulnerability of the abducens nerve.

Delivery of immunoglobulin G antibodies to the rat nervous system following intranasal administration: Distribution, dose-response, and mechanisms of delivery

The intranasal route has been hypothesized to circumvent the blood-brain and blood-cerebrospinal fluid barriers, allowing entry into the brain via extracellular pathways along olfactory and trigeminal nerves and the perivascular spaces (PVS) of cerebral blood vessels. We investigated the potential of the intranasal route to non-invasively deliver antibodies to the brain 30 min following administration by characterizing distribution, dose-response, and mechanisms of antibody transport to and within the brain after administering non-targeted radiolabeled or fluorescently-labeled full length immunoglobulin G (IgG) to normal adult female rats. Intranasal [¹²⁵I]-IgG consistently yielded highest concentrations in the olfactory bulbs, trigeminal nerves, and leptomeningeal blood vessels with their associated PVS. Intranasal delivery also resulted in significantly higher [¹²⁵I]-IgG concentrations in the CNS than systemic (intra-arterial) delivery for doses producing similar endpoint blood concentrations. Importantly, CNS targeting significantly increased with increasing dose only with intranasal administration, yielding brain concentrations that ranged from the low-to-mid picomolar range with tracer dosing (50 μg) up to the low nanomolar range at higher doses (1 mg and 2.5 mg). Finally, intranasal pre-treatment with a previously identified nasal permeation enhancer, matrix metalloproteinase-9, significantly improved intranasal [¹²⁵I]-IgG delivery to multiple brain regions and further allowed us to elucidate IgG transport pathways extending from the nasal epithelia into the brain using fluorescence microscopy. The results show that it may be feasible to achieve therapeutic levels of IgG in the CNS, particularly at higher intranasal doses, and clarify the likely cranial nerve and perivascular distribution pathways taken by antibodies to reach the brain from the nasal mucosae.

Parasympathetic innervation of vertebrobasilar arteries: is this a potential clinical target?

This review aims to summarise the contemporary evidence for the presence and function of the parasympathetic innervation of the cerebral circulation with emphasis on the vertebral and basilar arteries (the posterior cerebral circulation). We consider whether the parasympathetic innervation of blood vessels could be used as a means to increase cerebral blood flow. This may have clinical implications for pathologies associated with cerebral hypoperfusion such as stroke, dementia and hypertension. Relative to the anterior cerebral circulation little is known of the origins and neurochemical phenotypes of the parasympathetic innervation of the vertebrobasilar arteries. These vessels normally provide blood flow to the brainstem and cerebellum but can, via the Circle of Willis upon stenosis of the internal carotid arteries, supply blood to the anterior cerebral circulation too. We review the multiple types of parasympathetic fibres and their distinct transmitter mechanisms and how these vary with age, disease and species. We highlight the importance of parasympathetic fibres for mediating the vasodilatory response to sympathetic activation. Current trials are investigating the possibility of electrically stimulating the postganglionic parasympathetic ganglia to improve cerebal blood flow to reduce the penumbra following stroke. We conclude that although there are substantial gaps in our understanding of the origins of parasympathetic innervation of the vertebrobasilar arteries, activation of this system under some conditions might bring therapeutic benefits.

Neurochemical Characterization of Pterygopalatine Ganglion Branches in Humans

Background

Pterygopalatine ganglion (PPG) branches, seem to be involved in the pathophysiology of facial pain. The functions of these branches, including a recently discovered orbital branch, are not completely known but could be of clinical significance. This study was designed to characterize PPG branches through immunohistochemical stain and study their anatomy, specifically the orbital branches.

Methods

In a cadaver study of four specimens, the pterygopalatine fossa (PPF) was dissected out of its bony surroundings as a tissue block. Subsequently, cryostat sectioning of these blocks was performed. In one specimen the PPF was microscopically dissected. Recently discovered neural structures were identified, dissected out of the tissue block, and cryosectioned. All cryostat sectionings were immunohistochemically stained for protein gene product (PGP) 9.5, nitric oxide synthase (NOS), and tyrosine hydroxylase (TH).

Results

A recently discovered neural connection between the PPG and the ophthalmic nerve could be confirmed and classified as an orbital PPG branch. The connection stained throughout for PGP 9.5 and partially stained for NOS. In other orbital branches, both NOS and TH+ nerve fibers were found. The PPG contained NOS+ cells. TH labeling was also found in nerve fibers running through the PPG and the vidian nerve.

Conclusion

The recently discovered orbital PPG branch is of a mixed parasympathetic and sensory nature. In the other orbital branches, sympathetic fibers were shown as well. This knowledge may add to understanding the symptomatology and therapies of headache syndromes such as nerve block.

Cervical spinal cord stimulation improves neurological dysfunction induced by cerebral vasospasm

The effect of cervical spinal cord stimulation on the cerebral blood flow has been investigated both experimentally and clinically since 1986. Although the effect of the spinal cord stimulation on cerebral ischemia induced by cerebral vasospasm after subarachnoid hemorrhage has been investigated widely, neurological dysfunction induced by cerebral vasospasm and the effect of the spinal cord stimulation on neurological dysfunction have not been investigated so far. The aim of this study is to investigate the neurological dysfunction induced by cerebral vasospasm after subarachnoid hemorrhage and whether the spinal cord stimulation improves this neurological dysfunction or not in New Zealand albino rabbits. The animals were divided into sham and experiment groups: Sham group. Motor evoked potentials were recorded before experimental procedure was performed in this group. Just after, intracisternal saline was injected and 3 days later a stimulation electrode was placed in the cervical epidural space. Motor evoked potentials were recorded but electrical stimulation was not applied. Experiment group. Firstly, motor evoked potentials had been recorded before experimental procedure was performed in also this group. After then a stimulation electrode was placed in the cervical epidural space of the animals in which subarachnoid hemorrhage procedure was performed 3 days ago. Motor evoked potentials were recorded both before and after spinal cord stimulation. Motor evoked potential latencies and amplitudes did not change in the sham operation group. But, motor evoked potential latencies extended and the amplitudes decreased in the experiment group before spinal cord stimulation. Spinal cord stimulation improved the changes occurring in latencies and amplitudes in the experiment group. Spinal cord stimulation improves the neurological dysfunction induced by cerebral vasospasm and motor evoked potentials recording is a reliable electrophysiological method to detect cerebral vasospasm and to assess the effects of different treatments in cerebral vasospasm.

Demonstration of PACAP-immunoreactive intrapineal nerve fibers in the golden hamster (Mesocricetus auratus) originating from the trigeminal ganglion

By using immunohistochemistry, a network of nerve fibers containing pituitary adenylate-cyclase activating polypeptide (PACAP) was demonstrated in the pineal gland of the golden hamster, a photoperiodic species often used in pineal and circadian rhythm research. The nerve fibers are present in the capsule from where they permeate into the pineal perivascular spaces and parenchyma. Immuno-electron microscopy showed the PACAPergic nerve terminals, with clear transmitter vesicles, to terminate in the interstitial spaces between the pinealocytes or in the perivascular spaces. Some of the PACAPergic nerve terminals made synapse-like contacts with the pinealocytes. The origin of the PACAP-containing nerve fibers innervating the pineal gland of the hamster was investigated by combined retrograde tracing with fluorogold and immunohistochemistry for PACAP. A 2% fluorogold solution was injected iontophoretically into the superficial pineal gland and the animals were allowed to survive for 1 wk. After perfusion fixation of the rats, the location of the tracer was investigated in the brain, the parasympathetic sphenopalatine, and otic ganglia, as well as in the sensory trigeminal ganglia. The tracer was found in perikarya of all the investigated ganglia. However, co-localization with PACAP was found only in the trigeminal ganglion.

Origin of PACAP-immunoreactive nerve fibers innervating the subarachnoidal blood vessels of the rat brain

The subarachnoidal cerebral blood vessels of the rat are innervated by nerve fibers containing different neuropeptides, e.g. pituitary adenylatecyclase activating polypeptide (PACAP). PACAP dilates brain arterioles and immunohistochemical studies of the rat have indicated that PACAP binds to a VPAC1-receptor in the cerebral vasculature of this species. We have investigated the perikaryal origin of the nerve fibers innervating the subarachnoidal blood vessels of the rat by combined retrograde tracing with Fluorogold and immunohistochemistry. The in vivo neuronal retrograde tracings were done by injection of 2% Fluorogold in water into the subarachnoidal space in the area of the middle cerebral artery. The retrograde transported tracer was detected by use of an antibody against Fluorogold. One week after the injections, the animals were vascularly perfused with Stephanini's fixative and labeled perikarya were found bilaterally in the trigeminal, sphenopalatine, and otic ganglia. The retrograde Fluorogold tracings were combined with immunohistochemistry for PACAP using a mouse monoclonal antibody and the biotinylated tyramide amplification system. Double labeled perikarya containing both Fluoro-gold and PACAP were found predominantly in the trigeminal ganglion, and only rarely in the otic and sphenopalatine ganglion. Summarizing, our retrograde tracings combined with immunohistochemistry indicate that the perikarya in the trigeminal ganglion are the main origin of PACAPergic nerve fibers projecting to the cerebral vasculature of the rat.

PACAP-containing intrapineal nerve fibers originate predominantly in the trigeminal ganglion: a combined retrograde tracing- and immunohistochemical study of the rat

Pituitary adenylate-cyclase activating polypeptide (PACAP) is a neuropeptide originally isolated from the hypothalamus and located in many neuronal systems in both the central and peripheral nervous system. PACAP is also found in nerve fibers innervating the pineal gland, where it stimulates the secretion of the pineal hormone, melatonin, by binding to specific PACAP-receptors located on the cell membrane of the pinealocyte. In this study we have investigated the origin of PACAP-containing nerve fibers innervating the rat pineal gland by combined retrograde tracing with Fluorogold and immunohistochemistry for PACAP. A solution of 2% Fluorogold was injected iontophoretically into the superficial pineal gland of Wistar rats, and the animals were allowed to survive for 1 week. After perfusion fixation of the rats, the location of the tracer was investigated in the brain and the sphenopalatine, otic, and trigeminal ganglia. The tracer was found in all the investigated ganglia. However, colocalization with PACAP was predominantly found in the trigeminal ganglion and only occasionally in the sphenopalatine and otic ganglia. Due to the stimulatory function of PACAP on pineal melatonin secretion, the PACAP-containing neurons of this ganglion could be considered a subset of the parasympathetic nervous system. The presence of neurons with a parasympathetic function in a ganglion that has been considered a purely sensory ganglion, is a new concept in neuroanatomy.

The lateral sellar nerve plexus and its connections in humans

OBJECT

The aim of the present study was to elucidate the systematic topography of the lateral sellar (cavernous sinus [CS]) nerve plexus and its connections in humans.

METHODS

Seven specimens of human CS and adjacent regions were dissected in steps and stained as whole-mount preparations by using a sensitive acetylcholinesterase method. Another specimen was frozen, cut on a frontal plane, and stained for acetylcholinesterase. The human CS contains an extensive nerve plexus with small ganglia. The plexus is composed of a main part, the lateral sellar plexus proper, which is located around the abducent nerve and medial to the ophthalmic nerve, and a lateral extension just underneath the outermost layer of the lateral CS wall, which is located lateral to the trochlear and ophthalmic nerves. The lateral sellar plexus is connected to the internal carotid nerve, the pterygopalatine ganglion, and the trigeminal ganglion. From the lateral sellar plexus, nerve branches run along the oculomotor, trochlear, ophthalmic, and abducent nerves into the orbit. In addition, the lateral sellar plexus has multiple connections with nerves located around the internal carotid artery. The presence of connections between the lateral sellar plexus and functionally defined neural structures suggests that the plexus receives sympathetic, parasympathetic, and sensory contributions.

CONCLUSIONS

The plexus may distribute nerve subpopulations to several targets, including cerebral arteries and orbital structures. The presence of a mixed nerve plexus that projects to a variety of targets indicates that injury or disease in the CS may result in a variety of symptoms.

Innervation of cerebral blood vessels: morphology, plasticity, age-related, and Alzheimer's disease-related neurodegeneration

The light microscopical and ultrastructural morphology of the innervation of the major cerebral arteries and pial vessels is described, including the origins of the different groups of nerve fibres and their characteristic neurotransmitter phenotype. Species and region specific variations are described and novel data regarding the parasympathetic innervation of cerebral vessels are presented. The dynamic nature, or plasticity, of cerebrovascular innervation is emphasized in describing changes affecting particular subpopulations of neurons during normal ageing and in Alzheimer's disease. The molecular controls on plasticity are discussed with particular reference to target-associated factors such as the neurotrophins and their neuronal receptors, as well as extracellular matrix related factors such as laminin. Hypotheses are presented regarding the principal extrinsic and intrinsic influences on plasticity of the cerebrovascular innervation.

Cavernous sinus ganglia are sources for parasympathetic innervation of cerebral arteries in rat

Retrograde tracing and immunohistochemistry was used in rats to investigate whether the ganglia in the cavernous sinus contribute to cerebrovascular innervation. The cavernous sinus ganglia in rat include the cavernous part of the pterygopalatine ganglion (PGC) and small cavernous ganglia (CG). The tracers, fluorogold and fast blue, were applied to the middle cerebral artery in eight rats. After 1 to 4 days, the cavernous sinuses were dissected out and studied as whole mount preparations and sections. A moderate number of labeled neurons were visible in the ipsilateral PGC and CG. Furthermore, fibers in the cavernous nerve plexus and abducens nerve were labeled, suggesting that the pathway from the cavernous sinus ganglia to the cerebral arteries runs through the cavernous plexus and then retrogradely along the abducens nerve to the internal carotid artery. Selected sections were immunohistochemically stained for the cholinergic marker, vesicular acetylcholine transporter (VAChT). Most cells in the PGC and CG were VAChT-immunoreactive, some of which also contained tracer. It is concluded that in rat, the cavernous sinus ganglia, consisting of the PGC and small CG, contribute to parasympathetic cerebrovascular innervation and that the cavernous nerve plexus and abducens nerve are involved in the pathway from these ganglia to the cerebral arteries.

Main trajectories of nerves that traverse and surround the tympanic cavity in the rat

To guide surgery of nerves that traverse and surround the tympanic cavity in the rat, anatomical illustrations are required that are topographically correct. In this study, maps of this area are presented, extending from the superior cervical ganglion to the otic ganglion. They were derived from observations that were made during dissections using a ventral approach. Major blood vessels, bones, transected muscles of the tongue and neck and supra and infrahyoid muscles serve as landmarks in the illustrations. The course of the mandibular, facial, glossopharyngeal, vagus, accessory and hypoglossal nerves with their branches, and components of the sympathetic system, are shown and discussed with reference to data available in the literature. Discrepancies in this literature can be clarified and new data are presented on the trajectories of several nerves. The course of the tympanic nerve was established. This nerve originates from the glossopharyngeal nerve, enters the tympanic cavity, crosses the promontory, passes the tensor tympani muscle dorsally, and continues its route intracranially to the otic ganglion as the lesser petrosal nerve after intersecting with the greater petrosal nerve. Auricular branches of the glossopharyngeal and of the vagus nerve were noted. We also observed a pterygopalatine branch of the internal carotid nerve, that penetrates the tympanic cavity and courses across the promontory.

Morphology of the walls of the cavernous sinus of Cebus apella (tufted capuchin monkey)

The morphology of the dura mater and its relationship with the structures of the cavernous sinus were analyzed in five tufted capuchin monkeys (Cebus apella) using histological sections, showing that the walls of the cavernous sinus of this species are similar to those of other primates, including man. Except for the medial wall of the cavernous sinus, the remaining walls consist of two distinct dura mater layers. The deep layer of the lateral wall of the cavernous sinus is contiguous to the sheath of the oculomotor, trochlear and ophthalmic nerves. Arterioles, venules, venous spaces, neuronal bodies and nervous fiber bundles are found on this lateral wall.

Increased expression of Ca2+-sensitive K+ channels in the cerebral microcirculation of genetically hypertensive rats: evidence for their protection against cerebral vasospasm

The Ca2+-sensitive K+ channel (K(Ca) channel) plays a key role in buffering pressure-induced constriction of small cerebral arteries. An amplified current through this channel has been reported in vascular smooth muscle cells obtained from hypertensive animals, implying that the expression or properties of K(Ca) channels may be regulated by in vivo blood pressure levels. In this study, we investigated this hypothesis and its functional relevance by comparing the properties, expression levels, and physiological role of K(Ca) channels in cerebral resistance arteries from normotensive and genetically hypertensive rats. Whole-cell patch-clamp experiments revealed a 4.7-fold higher density of iberiotoxin-sensitive K(Ca) channel current at physiological membrane potentials in spontaneously hypertensive rat (SHR) compared with Wistar-Kyoto (WKY) rat cerebrovascular smooth muscle cells (n = 18 and 21, respectively). However, additional single-channel analysis in detached patches showed similar levels of unitary conductance, voltage, and Ca2+ sensitivity in K(Ca) channels from WKY and from SHR membranes. In contrast, Western analysis using an antibody directed against the K(Ca) channel alpha-subunit revealed a 4.1-fold increase in the corresponding 125-kD immunoreactive signal in cerebrovascular membranes from SHR compared with WKY rats. The functional impact of this enhanced K(Ca) channel expression was assessed in SHR and WKY rat pial arterioles, which were monitored by intravital microscopy through in situ cranial windows. Progressive pharmacological block of K(Ca) channels by iberiotoxin (0.1 to 100 nmol/L) dose-dependently constricted pial arterioles from SHR and WKY rats (n = 6 to 8). The arterioles in SHR constricted 2- to 4-fold more intensely, and vasospasm occurred in some vessels. These data provide the first direct evidence that elevated levels of in situ blood pressure induce K(Ca) channel expression in cerebrovascular smooth muscle membranes. This homeostatic mechanism may critically regulate the resting tone of cerebral arterioles during chronic hypertension. Furthermore, the overexpression of distinct K+ channel types during specific cardiovascular pathologies may provide for the upregulation of novel disease-specific membrane targets for vasodilator therapies.