Neocortical activation by electrical and chemical stimulation of the rat inferior colliculus: intra-collicular mapping and neuropharmacological characterization

Cholinergic cells in the tegmentum send branching projections to the inferior colliculus and the medial geniculate body

The pontomesencephalic tegmentum (PMT) provides cholinergic input to the inferior colliculus (IC) and the medial geniculate body (MG). PMT cells are often characterized as projecting to more than one target. The purpose of this study was to determine whether individual PMT cholinergic cells, (1) innervate the auditory pathways bilaterally via collateral projections to left and right auditory thalamus; or, (2) innervate multiple levels of the auditory pathways via collateral projections to the auditory thalamus and inferior colliculus. We used multiple retrograde tracers to identify individual PMT cells that project to more than one target. We combined the retrograde tracer studies with immunohistochemistry for choline acetyltransferase to determine whether the projecting cells were cholinergic. We found that individual PMT cells send branching axonal projections to two or more auditory targets in the midbrain and thalamus. The collateral projection pattern that we observed most frequently was to the ipsilateral IC and ipsilateral MG. Cells projecting to both MGs were somewhat less common, followed by cells projecting to the contralateral IC and ipsilateral MG. Both cholinergic and non-cholinergic cells contribute to each of these projection patterns. Less often, we found cells that project to one IC and both MGs; there was no evidence for non-cholinergic cells in this projection pattern. It is likely that collateral projections from PMT cells could have coordinated effects bilaterally and at multiple levels of the ascending auditory pathways.

Generalized cortex activation by the auditory midbrain: Mediation by acetylcholine and subcortical relays

The inferior colliculus (IC) is a critical component of the ascending projection system carrying auditory information from the brainstem to the forebrain. Recent evidence indicates that, in addition to its role in auditory processing, the IC can exert a generalized, modulatory effect on the forebrain by activating the neocortical electrocorticogram (ECoG). Given the sparse direct projections from the IC to the cortex, it appears that the effect of the IC to produce ECoG activation is indirect, mediated by one or several neuromodulatory systems that have diffuse access to the entire cortical mantle. However, the anatomical relays that permit the IC to influence cortical activity have not been elucidated. In the present experiments, electrical stimulation of the IC suppressed slow, large amplitude oscillations in the ECoG of urethane anesthetized rats, replacing them with higher-frequency cortical activation. This effect was blocked by the muscarinic receptor antagonist scopolamine (0.5-1.0 mg/kg, i.p.), suggestive of a critical role of acetylcholine (ACh) release. Consistent with this hypothesis, localized lidocaine infusions (2%, 1 microl) into the cholinergic basal forebrain complex strongly reduced ECoG activation elicited by IC stimulation. To identify additional relays between the IC and basal forebrain, the effects of lidocaine infusions into the superior colliculus, medial prefrontal cortex, midline thalamus, and dorsal raphe were also studied. Inactivation of the superior colliculus and dorsal raphe reduced IC-induced activation, while prefrontal cortex and thalamic infusions were ineffective. Concurrent basal forebrain and raphe inactivation produced effects similar to that of inactivation of the basal forebrain alone, suggesting that these two areas are arranged in series, rather than acting as independent, parallel pathways. These results suggest that the ability of the IC to induce ECoG activation is mediated, in large parts, by the basal forebrain cholinergic system. Consistent with anatomical evidence, the superior colliculus and dorsal raphe appear to provide important links to functionally connect the IC to the basal forebrain, allowing the IC to indirectly access the entire cortical mantle and enhance processing in neocortical networks.

Block-dependent sedation during epidural anaesthesia is associated with delayed brainstem conduction

BACKGROUND

Neuraxial anaesthesia produces a sedative and anaesthetic-sparing effect. Recent evidence suggests that spinal cord anaesthesia modifies reticulo-thalamo-cortical arousal by decreasing afferent sensory transmission. We hypothesized that epidural anaesthesia produces sensory deafferentation-dependent sedation that is associated with impairment of brainstem transmission. We used brainstem auditory evoked potentials (BAEP) to evaluate reticular function in 11 volunteers.

METHODS

Epidural anaesthesia was induced with 2-chloroprocaine 2%. Haemodynamic and respiratory responses, sensory block level, sedation depth and BAEP were assessed throughout induction and resolution of epidural anaesthesia. Sedation was evaluated using verbal rating score (VRS), observer's assessment alertness/sedation (OAA/S) score, and bispectral index score (BIS). Prediction probability (PK) was used to associate sensory block with sedation, as well as BIS with other sedation measures. Spearman's rank order correlation was used to associate block level and sedation with the absolute and interpeak BAEP latencies.

RESULTS

Sensory block level significantly predicted VRS (PK=0.747), OAA/S score (PK=0.748) and BIS. BIS predicted VRS and OAA/S score (PK=0.728). The latency of wave III of BAEP significantly correlated with sedation level (rho=0.335, P<0.01) and sensory block (rho=0.394, P<0.01). The other BAEP parameters did not change during epidural anaesthesia. Haemodynamic and respiratory responses remained stable throughout the study.

CONCLUSIONS

Sedation during epidural anaesthesia depends on sensory block level and is associated with detectable block-dependent alterations in the brainstem auditory evoked responses. Sensory deafferentation may reduce CNS alertness through mechanisms related to brainstem neural activity.