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Holland GR. Experimental trigeminal nerve injury. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 1996; 7:237-58. [PMID: 8909880 DOI: 10.1177/10454411960070030301] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The successful reinnervation of peripheral targets after injury varies with the axonal population of the nerve that is injured and the extent of the dislocation of its central component from the peripheral endoneurial tube. Larger-diameter axons such as those supplying mechanoreceptors recover more readily than narrower axons such as those supplying taste. A complex, bi-directional interaction between lingual epithelium and sprouting nerve results in the redifferentiation of taste buds after denervation. Dentin and the dental pulp provide a strong attraction to sprouting nerves and will become reinnervated from collateral sources if recovery of the original innervation is blocked. The most effective repair technique for transected lingual nerves is one which brings the cut ends together rather than one that provides a temporary bridge. Injuries can result in cell death in the trigeminal ganglion but only if the injury is severe and recovery is prevented. Lesser damage results in chromatolysis and the increased expression of neuropeptides. All nerve injuries bring about changes in the trigeminal nucleus. These occur as changes in receptive field and the incidence of spontaneously active neurons, effects which are consistent with the unmasking of existing afferents. These functional changes are short-lived and reversible. Morphologically, nerve injury results in terminal degeneration in the nuclei and an increased expression of the c-Fos gene and some neuropeptides. Only a chronic constriction injury induces behavioral changes. The adult trigeminal system retains considerable plasticity that permits it to respond successfully to nerve injury. Much remains to be learned about this response, particularly of the trophic factors that control peripheral recovery and the central response to more severe injuries.
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Affiliation(s)
- G R Holland
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA
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Abstract
(1) Although our knowledge on teeth and tooth nerves has increased substantially during the past 25 years, several important issues remain to be fully elucidated. As a result of the work now going on at many laboratories over the world, we can expect exciting new findings and major break-throughs in these and other areas in a near future. (2) Dentin-like and enamel-like hard tissues evolved as components of the exoskeletal bony armor of early vertebrates, 500 million years ago, long before the first appearance of teeth. It is possible that teeth developed from tubercles (odontodes) in the bony armor. The presence of a canal system in the bony plates, of tubular dentin, of external pores in the enamel layer and of a link to the lateral line system promoted hypotheses that the bony plates and tooth precursors may have had a sensory function. The evolution of an efficient brain, of a head with paired sense organs and of toothed jaws concurred with a shift from a sessile filter-feeding life to active prey hunting. (3) The wide spectrum of feeding behaviors exhibited by modern vertebrates is reflected by a variety of dentition types. While the teeth are continuously renewed in toothed non-mammalian vertebrates, tooth turnover is highly restricted in mammals. As a rule, one set of primary teeth is replaced by one set of permanent teeth. Since teeth are richly innervated, the turnover necessitates a local neural plasticity. Another factor calling for a local plasticity is the relatively frequent occurrence of age-related and pathological dental changes. (4) Tooth development is initiated through interactions between the oral epithelium and underlying neural crest-derived mesenchymal cells. The interactions are mediated by cell surface molecules, extracellular matrix molecules and soluble molecules. The possibility that the initiating events might involve a neural component has been much discussed. With respect to mammals, the experimental evidence available does not support this hypothesis. In the teleost Tilapia mariae, on the other hand, tooth germ formation is interrupted, and tooth turnover ceases after local denervation. (5) Prospective dental nerves enter the jaws well before onset of tooth development. When a dental lamina has formed, a plexus of nerve branches is seen in the subepithelial mesenchyme. Shortly thereafter, specific branches to individual tooth primordia can be distinguished. In bud stage tooth germs, axon terminals surround the condensed mesenchyme and in cap stage primordia axons grow into the dental follicle.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- C Hildebrand
- Department of Cell Biology, University of Linköping, Sweden
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Westrum LE, Henry MA. Contralateral degeneration in the cat spinal trigeminal nucleus following unilateral retrogasserian trigeminal rhizotomy. Neurosci Lett 1991; 121:143-6. [PMID: 1708472 DOI: 10.1016/0304-3940(91)90670-o] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Retrogasserian trigeminal rhizotomy was used to study the central projections and patterns of degeneration in the spinal trigeminal nucleus (STN). At survival times of 3-20 days, reduced silver stains show extensive degeneration throughout the ipsilateral STN and in addition, well delineated degeneration was identified in the periobex region of the contralateral STN that varied with survival time. The results suggest that primary afferents may contribute to this contralateral projection.
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Affiliation(s)
- L E Westrum
- Department of Neurological Surgery, University of Washington, Seattle 98195
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Abstract
The presence, distribution and origin of substance P (SP), neuropeptide Y (NPY), and CGRP-immunoreactive axons in rat iris were investigated in whole mount preparations, with special respect to the localization of the "classical" adrenergic and cholinergic ground plexuses. SP-IR fibres are distributed parallel to the pupillary margin in the sphincter muscle, and in an irregular plexus in the dilator muscle. The distribution of CGRP-IR fibres was similar to this. Both SP- and CGRP-IR elements originated from the Gasserian ganglion. Following electrocoagulation of the ophthalmic nerve, both SP- and CGRP-IR nerves completely disappeared, while in the caudal nucleus of the trigeminal nerve a substantial decrease of the immunoreactivity was found. NPY-IR fibres have also been demonstrated in the anterior uvea, displaying a pattern similar to that of the adrenergic nerves. In the sympathectomized iris, there was a marked decreased in the density of NPY-IR fibres indicating that NPY most likely coexists with the classical sympathetic neurotransmitter, noradrenalin in the sympathetic nerve supply deriving from the superior cervical ganglion. 1 month after sympathectomy, there was an increase in the density (and possibly also in the number) of both SP- and CGRP-IR fibres in the denervated iris. Subsequent immuno-electron microscopic analysis has demonstrated that both SP- and CGRP-IR fibres are unmyelinated axons, embedded in a common Schwann cell cytoplasm together with a number of axons devoid of immunoreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C Vereczkey
- Department of Anatomy, Albert Szent-Györgyi Medical University, Szeged, Hungary
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Henry MA, Westrum LE. Central representation of dental structures in the kitten, including projections to the mesencephalic trigeminal nucleus. Somatosens Mot Res 1990; 7:447-62. [PMID: 2291377 DOI: 10.3109/08990229009144719] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Horseradish peroxidase (HRP) was injected into either a single maxillary or a single mandibular primary (deciduous) cuspid tooth of 8- to 10-week-old kittens. The large apex of the primary cuspid allowed for some leakage of the HRP from the pulpal chamber to the periodontal ligament (PDL). Thus, the injection procedure resulted in the application of HRP to the PDL as well as to the pulpal tissues. The transganglionic transport of HRP resulted in discrete terminal fields within the spinal trigeminal nucleus (STN) and the main sensory nucleus (MSN). These projections were clearly somatotopically organized within the STN, but less so within MSN. Within pars oralis (PO) and pars interpolaris (PI), mandibular cuspid dental structures (MdCDS) were represented in a dorsal position relative to the maxillary cuspid dental structures (MxCDS), whereas within pars caudalis (PC) and the adjacent reticular formation the somatotopic representation was not dorsoventral, but rather mediolateral, with the MdCDS represented more medially than the MxCDS. Areas of overlap between MxCDS and MdCDS were found within MSN and to a lesser degree within the superficial laminae of PC. In addition, the fiber pathway leading to labeled somata in the mesencephalic trigeminal (Mes V) nucleus was clearly identified. The majority of the fibers traced to the Mes V nucleus exited the spinal trigeminal tract at the level of the transition from PO to the MSN and traversed the nuclear region in a position dorsal to and separate from the trigeminal motor tract. As in STN, fibers within the caudal Mes V tract appeared to be somatotopically organized, with the fibers from the MdCDS generally more dorsal than the ones from the MxCDS. Labeled fibers, some with terminal arbors, were also identified in close association with the trigeminal motor tract. The findings show a complex pattern of central representation in the immature feline central nervous system for deciduous dental structures.
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Affiliation(s)
- M A Henry
- Department of Neurological Surgery, School of Medicine, University of Washington, Seattle 98195
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Kapadia SE, LaMotte CC. Deafferentation-induced alterations in the rat dorsal horn: I. Comparison of peripheral nerve injury vs. rhizotomy effects on presynaptic, postsynaptic, and glial processes. J Comp Neurol 1987; 266:183-97. [PMID: 2830320 DOI: 10.1002/cne.902660205] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Light microscopical degeneration and ultrastructural alterations in the rat spinal dorsal horn were studied following either cutting of the sciatic nerve or rhizotomy at L4 and L5; survival time for both procedures was 3 weeks. Fink-Heimer silver methods showed minimal degeneration of afferent central processes after sciatic section, and limited ultrastructural changes were present. Both rhizotomy and nerve section resulted in degenerating terminals. Most were swollen and electron lucent, with loss of vesicles; some electron-dense terminals were present, particularly after rhizotomy. Both procedures also produced significant degeneration of postsynaptic dendrites and soma, evidenced by either increases in electron density, or loss of organelles and cavitation, or accumulation of osmiophilic floccular material. Glial processes frequently were expanded and extended to engulf single degenerating terminals and dendrites, or terminal-dendrite units; in other cases glial tongues separated terminals from their postsynaptic dendrite. Glial processes often wrapped around degenerating profiles or groups of profiles in several layers, sometimes forming complex labyrinths. These results confirm past descriptions of pre- and postsynaptic changes resulting from peripheral nerve section, but newly reveal that dendritic destruction and increased glial activity are also significant following rhizotomy. Documentation of these changes is relevant for studies of reorganization following nerve and spinal cord damage, as well as providing an ultrastructural basis for evaluation of effects of neurotoxins that affect primary afferents, as described in a companion paper.
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Affiliation(s)
- S E Kapadia
- Section of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06510
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Henry MA, Westrum LE, Johnson LR, Canfield RC. Ultrastructure of degenerative changes following ricin application to feline dental pulps. JOURNAL OF NEUROCYTOLOGY 1987; 16:601-11. [PMID: 3501003 DOI: 10.1007/bf01637653] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The ultrastructure of degenerative changes within the ipsilateral trigeminal ganglion, and partes caudalis and interpolaris of the spinal trigeminal nucleus in the cat is described following the application of the potent toxin ricin to the tooth pulps of unilateral maxillary and mandibular posterior teeth, including the cuspids. Survival times ranged from 6 to 10 days. Typical changes identified within the ipsilateral trigeminal ganglion included myelin fragmentation and 'compartmentalization' of the axoplasm of medium-sized myelinated axons, while small myelinated and unmyelinated axons underwent a more variable response ranging from electron-lucent to electron-dense changes. The affected cell body was characterized by the presence of swollen, electron-lucent mitochondria, a reduction of cytoplasmic ribosomes and a filamentous hyperplasia. Other changes often included an eccentric nucleus and satellite cell proliferation. Degenerative changes often occurred in isolated elements surrounded by normal profiles, suggesting specificity of ricin within the trigeminal ganglion. Changes within brainstem axons showed both an electron-dense and a lucent, fragmenting type of axonal alteration. Terminal changes ranged from electron-dense to lucent and also included filamentous hyperplasia and 'hyperglycogenesis'. The altered axonal knobs contained round synaptic vesicles that were presynaptic to dendritic profiles and postsynaptic to terminals containing flattened synaptic vesicles. The above brainstem alterations were identified specifically in the following areas: ventrolateral, medial and dorsomedial pars interpolaris; the ventrolateral and mid-dorsal to dorsomedial areas of the marginalis and outer substantia gelatinosa layers of pars caudalis; and in ventral pockets corresponding to lamina V of the medullary dorsal horn. Dense alterations within terminals containing flattened synaptic vesicles that are typically presynaptic to primary afferents in these areas were rare findings, but along with vacuolization of dendritic profiles suggest a trans-synaptic effect possibly due to the exocytosis of ricin. The results are discussed in relation to different reports of dental projections and with regards to patterns of transganglionic degeneration.
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Affiliation(s)
- M A Henry
- Dental Occlusion and Facial Pain Center, University of Florida, Gainesville 32610
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Wahnschaffe U, Bartsch U, Fritzsch B. Metamorphic changes within the lateral-line system of Anura. ANATOMY AND EMBRYOLOGY 1987; 175:431-42. [PMID: 3495204 DOI: 10.1007/bf00309679] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The metamorphic loss of lateral-line organs, lateral-line nerves and second order lateral-line neurons was examined in two Anuran species. At the onset of metamorphic climax, terminals within the lateral-line neuropil showed accumulation of glycogen-like granules. Neither the lateral-line nerve nor the organs or the nerve terminals inside the organs displayed any sign of degeneration at this stage. A few second order neurons exhibited accumulations of chromatin into conspicuous masses. These cells were partially or completely engulfed by phagocytes. At mid-metamorphosis all lateral-line organs were lost. The proximal parts of the lateral-line nerve fibers entering the rhombencephalic alar plate showed signs of degeneration. Within the lateral-line neuropil, pre- and some postsynaptic elements exhibited the flocculent type of degeneration or, to a lesser extent, the dark type of degeneration. Second order lateral-line neurons underwent an electron-dense or electron-lucent type of degeneration and were taken up by phagocytes. At the end of metamorphic climax the distal parts of the lateral-line nerves showed numerous dark degenerating fibers inside an intact myelin sheath. Within the lateral-line neuropil, numerous dark degenerating presynaptic elements were found next to some elements showing flocculent degeneration. Fewer degenerating second order neurons were found in the alar plate. They showed predominantly the dark type of degeneration. In contrast to earlier reports, our data suggest that the degenerative metamorphic changes observed in the present study are initiated in all parts of the lateral-line system simultaneously, and lead to the complete loss of all lateral-line organs and nerves and presumably all second order lateral-line neurons as well.
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Zhu PC, Thureson-Klein A, Klein RL. Exocytosis from large dense cored vesicles outside the active synaptic zones of terminals within the trigeminal subnucleus caudalis: a possible mechanism for neuropeptide release. Neuroscience 1986; 19:43-54. [PMID: 2431353 DOI: 10.1016/0306-4522(86)90004-7] [Citation(s) in RCA: 170] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
It has been hypothesized that chemical interactions between neurons in the central nervous system can occur in the absence of well defined synaptic complexes, but morphological correlates have been difficult to find. The present study demonstrates exocytotic release from large (70-130 nm) dense cored vesicles at structurally nonspecialized areas along the plasmalemma of structurally different categories of terminals and occasionally from dendrites and axons within the neuropil of the trigeminal subnucleus caudalis. In rats, the marginal (lamina I) and substantia gelatinosa (lamina II) layers contain the central terminals of primary afferent fibers from the infraorbital nerve that supply the skin and whiskers (vibrissae). Different types of interneurons are also present and may modify the input being relayed to higher centers. While exocytotic profiles were present in control animals, they increased significantly (P less than 0.01) on the ipsilateral side 1-24 h after a unilateral skin lesion in the vibrissae area. A second increase (P less than 0.001) occurred 14-15 days after the lesion. Virtually all examples of large vesicle exocytosis were observed at structurally nonspecialized sites while those at the active synaptic zones involved small clear vesicles. Substance P-like immunofluorescence, present in controls and on the ipsilateral side during the first 6 days, subsequently declined until 4 weeks after surgery when some recovery was noted. The increase in large vesicle exocytosis and the decrease in substance P are interpreted to reflect functional adjustments of different neurons in response to the lesion. The exocytosis involving large dense cored vesicles may serve to deliver transmitters and/or neuropeptide modulators to appropriate receptors in a wider area than release into a specialized synaptic cleft would allow.
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Arvidsson J. Transganglionic degeneration in vibrissae innervating primary sensory neurons of the rat: a light and electron microscopic study. J Comp Neurol 1986; 249:392-403. [PMID: 3734162 DOI: 10.1002/cne.902490306] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Previous studies have shown that transection of peripheral branches of primary sensory neurons leads to light microscopical degeneration argyrophilia and ultrastructural changes in the central termination areas of these neurons. This type of degeneration has been termed transganglionic degeneration (TGD). In the present experiments TGD has been studied specifically in neurons innervating the rat vibrissae at the light and electron microscopic levels. Light microscopically, small amounts of degeneration argyrophilia are observed in the magnocellular zone of the trigeminal subnucleus caudalis at 8-14 days survival. At longer survival times there are substantial amounts of degeneration in this area. At the ultrastructural level the first signs of TGD are observed at 6 days survival, when some terminals show a small increase in electron density, loss of synaptic vesicles, and mitochondrial disintegration. Terminals showing a more advanced increase in electron density become common at 8 days survival, but few of them are still left at 14 days survival. Neurofilamentous terminals appear in small numbers 8-14 days postoperatively. Various forms of degeneration in myelinated axons are observed from 8 days survival and are common also at 80 days survival. Electron-dense axons are rather unfrequent, but more or less disrupted myelin sheaths containing disintegrated axoplasmic remnants and empty areas are common as well as extremely expanded myelin sheaths. Glial cells containing axonal and myelin debris are seen from 8 days survival and become a more common finding at longer survivals. A most striking finding 8-10 days postoperatively is a complex relationship between glial cells and less darkened terminals, indicating phagocytosis before reaching an entirely darkened state. The findings clearly show that peripheral nerve transection leads to severe central alterations in a population of mechanoreceptor neurons innervating the vibrissae of the adult rat.
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Ling EA, Wong WC, Yick TY, Leong SK. Ultrastructural changes in the dorsal motor nucleus of monkey following bilateral cervical vagotomy. JOURNAL OF NEUROCYTOLOGY 1986; 15:1-15. [PMID: 3711939 DOI: 10.1007/bf02057900] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The neurons of the dorsal motor nucleus (DMN) of the monkey (Macaca fascicularis) were of two main types: small (13 X 8 micron) and medium-sized (20 X 13 micron). The latter, which were the predominant form, contained a pale oval nucleus surrounded by organelle-rich cytoplasm. Between one and three long principal dendrites per section profile arose from each of the somata. Both axosomatic and axodendritic synapses were seen on these cells although the latter were more common. No structural changes were noted in the DMN 1-3 days after bilateral cervical vagotomy. Some of the dendrites of the medium-sized axotomized vagal neurons appeared darkened 5-10 days after the operation. With longer surviving intervals, i.e. 21 and 28 days after operation, darkened dendrites were more commonly seen and the cytoplasmic density of these dendrites was dramatically enhanced. Their mitochondria were pale and some of them also showed vesiculation. Both normal and degenerating axon terminals were seen to form synaptic contacts with the darkened dendrites. The degenerating axon terminals were characterized by the clumping of their round agranular vesicles. Both darkened dendrites and degenerating axon terminals were phagocytosed by hypertrophied astrocytes and activated microglial cells. Blood elements infiltrating into the DMN were a possible source for some of the neural macrophages. It was concluded from the present study that the dendrites of the vagal neurons were the first structures to degenerate in axotomy and these were subsequently removed by glial elements. Degenerating axon terminals on the darkened dendrites could represent endings of the central processes of peripheral vagal ganglion cells that had undergone transganglionic degeneration after damage to their peripheral processes.
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Henry MA, Westrum LE, Johnson LR. Light- and electron-microscopic localization of primary dental afferents to medullary dorsal horn (pars caudalis). SOMATOSENSORY RESEARCH 1986; 3:291-307. [PMID: 3490680 DOI: 10.3109/07367228609144589] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Light-microscopic (LM) and ultrastructural (electron-microscopic, or EM) identification of primary dental afferents to medullary dorsal horn (MDH) was demonstrated in the cat following injections of horseradish peroxidase (HRP) into pulpal chambers of unilateral maxillary and mandibular posterior teeth, including the cuspids. Use of a new osmication protocol improved and simplified the EM localization of reaction product within the brain stem terminals. LM examination showed that the projection pattern varied between the different levels of MDH. At caudal levels, the labeling was primarily confined to a narrow band consisting of a dense projection to the dorsomedial portion of laminae I and superficial II and a less intense projection to lamina V. The pattern to rostral levels became increasingly more dense and extensive within these same laminae. LM examination of the tooth apex region showed that a limited spread to the periodontal ligament occurred in some cases. EM investigation of the ipsilateral MDH demonstrated reaction product in terminals with synaptic vesicles that are presynaptic to small and medium-sized dendrites. Labeled axonal endings in close association with cell bodies were also observed. No labeled structures were identified in the contralateral MDH. Some of the reaction product found with EM was below the LM limit of resolution, and thus ultrastructural investigation is necessary for a complete analysis of any pathway when using HRP.
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Abstract
Toxic ricin was used to study the central distribution of dental afferents in the cat. Following intrapulpal ricin injections ganglion cell degeneration is seen in the II and III ganglion divisions. Central argyrophilic degeneration occurs in the dorsal portion of all ipsilateral trigeminal nuclei. Ventral degeneration is seen in the pars interpolaris and pars caudalis. No contralateral degeneration was observed. The results are discussed with regard to previous studies of the central location of dental afferents.
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The reaction of primary sensory neurons to peripheral nerve injury with particular emphasis on transganglionic changes. Brain Res 1985; 357:27-46. [PMID: 2412661 DOI: 10.1016/0165-0173(85)90006-2] [Citation(s) in RCA: 142] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper reviews light- and electron microscopic, histochemical and physiological evidence which demonstrate that peripheral nerve injury in mammals is followed by profound structural and functional changes in the central terminals of the affected primary sensory neurons. Available evidence indicates that at least some of these so-called transganglionic changes are the result of ganglion cell degeneration and death, although other mechanisms are probably in effect as well. Existing data suggest that this ganglion cell death does not effect all types of ganglion cells equally, but do not permit a clearcut answer to the question of which kinds of ganglion cells are affected more than others. Results from studies with microtubule inhibitors and antibodies to nerve growth factor are compatible with the notion that depletion of retrogradely transported trophic factors is involved in the production of certain transganglionic changes. This issue needs further examination, however. Physiological studies indicate marked alterations in certain primary afferent synaptic connections after peripheral nerve lesions. So far, these changes have not been satisfactorily correlated with the structural changes induced by similar lesions. Further studies on the structural and functional response of primary sensory neurons to peripheral nerve injury are likely to contribute to the understanding of the frequent failure to regain normal sensory functions after peripheral nerve lesions in man, as well as of the basic aspects of lesion-induced changes in general in the peripheral and central nervous system.
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