Developmental morphometry and physiology of the rabbit vagus nerve

Intraoperative Neurophysiologic Testing of the Perigastric Vagus Nerve Branches to Evaluate Viability and Signals along Nerve Pathways during Gastrectomy

Purpose

The perigastric vagus nerve may play an important role in preserving function after gastrectomy, and intraoperative neurophysiologic tests might represent a feasible method of evaluating the vagus nerve. The purpose of this study is to assess the feasibility of neurophysiologic evaluations of the function and viability of perigastric vagus nerve branches during gastrectomy.

Materials and Methods

Thirteen patients (1 open total gastrectomy, 1 laparoscopic total gastrectomy, and 11 laparoscopic distal gastrectomy) were prospectively enrolled. The hepatic and celiac branches of the vagus nerve were exposed, and grabbing type stimulation electrodes were applied as follows: 10–30 mA intensity, 4 trains, 1,000 µs/train, and 5× frequency. Visible myocontractile movement and electrical signals were monitored via needle probes before and after gastrectomy. Gastrointestinal symptoms were evaluated preoperatively and postoperatively at 3 weeks and 3 months, respectively.

Results

Responses were observed after stimulating the celiac branch in 10, 9, 10, and 6 patients in the antrum, pylorus, duodenum, and proximal jejunum, respectively. Ten patients responded to hepatic branch stimulation at the duodenum. After vagus-preserving distal gastrectomy, 2 patients lost responses to the celiac branch at the duodenum and jejunum (1 each), and 1 patient lost response to the hepatic branch at the duodenum. Significant procedure-related complications and meaningful postoperative diarrhea were not observed.

Conclusions

Intraoperative neurophysiologic testing seems to be a feasible methodology for monitoring the perigastric vagus nerves. Innervation of the duodenum via the celiac branch and postoperative preservation of the function of the vagus nerves were confirmed in most patients.

Trial Registration

Clinical Research Information Service Identifier: KCT0000823

Vagal afferent activity and body temperature in 3 to 10-day-old and adult rats

This study examined the possible contribution of vagal stretch receptor activity to the increased power of the Hering-Breuer reflex in hyperthermia in rats during the early postnatal period. Experiments were performed on 10 anesthetized (pentobarbital 40 mg/kg, ip) 3 to 10-day-old (body weight of 16 ± 1 g; SE) and, for comparison, 18 adult Sprague-Dawley rats (body weight of 336 ± 35 g). Animals were tracheostomized and artificially ventilated with oxygen. The left vagus nerve was cut. In adult animals, single receptor fibers or a bundle of a few fibers were recorded using a bipolar stainless-steel electrode under mineral oil. In the young rats, a suction electrode filled with normal saline was used. Positive pressure of either 5 or 10 cmH2O was applied to the trachea when the respirator was turned off. The vagal activity was amplified and monitored on a storage oscilloscope for calculation of the frequency of vagal afferent activity during a given pressure application at different rectal temperatures (TR; range 28 to 42°C). In total, 30 and 31 sets of vagal activity in the young and adult rats, respectively, were analyzed. In all cases, an increase in tracheal pressure (PTR) from 5 to 10 cmH2O increased the frequency of vagal firing. The increase was greater in the adult versus the young animals; at 36°C the increase was 49 ± 11% and 16 ± 3% in the adult and young rats, respectively (P < 0.01). In all animals, vagal receptors showed temperature-sensitivity, but less so in the young than in the adult rats (P < 0.0004 and P < 0.003; for PTR of 5 and 10 cmH2O, respectively). In addition, the relationship between temperature-sensitivity and TR had significant slopes (P < 0.001 for both inflation pressures) in the adults but not in the young rats, indicating that in the latter the temperature-sensitivity of vagal receptors is independent of TR. These results imply that temperature-sensitivity of vagal receptors could have contributed to the increased power of the Hering-Breuer reflex in rats during the early postnatal period in the warmer environment.Key words: vagal receptors, temperature, Hering-Breuer reflex, young, adults, rats.

Mechanism of antinociceptive action of clonidine in nonmyelinated nerve fibres

Despite a large body of clinical evidence in favour of a local anesthetic effect of clonidine, the underlying mechanism has not yet been elucidated. In this study we have used the sucrose-gap method to measure the effects of clonidine on the electrophysiological properties of nonmyelinated nerve fibers in the rabbit vagus nerve. The results showed that clonidine enhanced the hyperpolarizing and reduced the depolarizing afterpotential that follow compound action potentials during electrical activity. We showed that summation of these afterpotentials shifts the membrane potential toward more negative values, thus creating a region of low safety conduction, where the local circuit currents might fail to depolarize the axonal membrane to the threshold value needed to open voltage-dependent Na(+) channels. Yohimbine did not reverse the inhibitory effects of clonidine on impulse propagation, indicating that the observed effects of clonidine relies on mechanisms not mediated by alpha(2)-adrenoceptors.

Preservation of the cervical vagus nerve in aged rats: morphometric and enzyme histochemical evidence

The vagus nerve trunk, sampled at a mid-cervical level, has been analysed quantitatively by light and electron microscopy principally with respect to the numbers and sizes of the myelinated and unmyelinated axon populations in Wistar rats of 4, 24 and 30 months. No significant differences in total myelinated axon numbers were seen over the age range in counts made on light microscope montages of the entire cross-section of the nerve. The overall histological organisation and appearance of the nerve trunk did not change with age but age-associated alterations in the ultrastructure of some myelinated fibres and their Schwann cells was seen. Unmyelinated axons and their associated Schwann cells rarely showed age-associated changes. The numbers of myelinated and unmyelinated axons per mm2 determined from electron micrographs were, however, slightly decreased but the ratio of myelinated to unmyelinated axons was approximately 1:4 at all ages. Measurements of myelinated fibres showed a small but significant increase in size between young and old animals. There was an increase in the thickness of the myelin sheath, a decrease in myelinated axon diameter and in the the g ratio. The diameter of unmyelinated axons decreased with age and the number of unmyelinated axons per Schwann cell unit increased. The numbers, diameters and thickness of the walls of the vagal microvessels remained unchanged. Quantitation by microdensitometry of the activity of NADH tetrazolium reductase and succinate dehydrogenase in longitudinal sections of the vagus indicated an increase in the activity of these two metabolic markers whilst an increase in the activity of cytochrome oxidase indicated that neuronal activity in the vagus was unimpaired in old age. It is concluded that the structure of the rat vagus nerve, and in particular of its predominantly unmyelinated axon population, is not significantly affected in old age.

Vagal nerve complex in normal development and sudden infant death syndrome

BACKGROUND

Although the pathogenesis of sudden infant death syndrome (SIDS) is not understood, one of the major hypotheses is that a subtle defect in respiratory circuitry is an important underlying factor. The vagus nerve is a critical component of respiratory control, but its neuroanatomic complexity has limited its investigation in human disease.

METHODS

Correlating developmental studies on different parts of the vagus nerve allows a more comprehensive assessment of its maturation process. Comparison of the normal developing vagus nerve with nerves examined in SIDS patients suggests alterations in the nucleus tractus solitarius and dorsal vagal nucleus as well as in the peripheral vagus nerve.

RESULTS AND CONCLUSIONS

The persistence of dendritic spines and lack of appropriate axonal growth implies delays in vagal maturation. Since nodose ganglia can be examined in vitro from autopsy material, perturbation to this system can be explored to evaluate further the mechanism involved in terminal vagal maturation. Although the reason for the delayed vagal maturation in SIDS is not apparent, the presence of astrogliosis in the region of the vagal nuclei is consistent with an exposure to hypoxic-ischemic events some time before death.

Delayed maturation of the vagus nerve in sudden infant death syndrome

Abnormalities of the respiratory control system have been implicated in the cause of death in sudden infant death syndrome (SIDS). The vagus nerve is a major component of the neural regulation of respiration. Ultrastructural quantitative morphometry of myelinated and unmyelinated fibers was performed on cervical vagus nerves taken from 30 SIDS victims and 29 age-matched controls between 1 and 9 months of age. In SIDS infants, more small and fewer large myelinated vagal fibers were found than in controls, suggesting that the vagus nerve in SIDS is relatively immature. Delayed vagal nerve maturation, together with delays in central nervous system myelination and dendritic development, indicates a neural developmental delay in SIDS, the cause of which is undetermined.

Regulation of ciliary neurotrophic factor expression in myelin-related Schwann cells in vivo

Adult rat sciatic nerve is known to express high levels of ciliary neurotrophic factor (CNTF) mRNA and protein. Here we examine the cellular localization of CNTF protein and mRNA in peripheral nerve and the regulation of CNTF expression by peripheral axons. In intact nerve, CNTF immunoreactivity is found predominantly in the cytoplasm of myelin-related Schwann cells. After axotomy, CNTF immunoreactivity and mRNA levels fall dramatically and do not recover unless axons regenerate. This behavior is similar to the pattern of myelin gene expression in these nerves. We conclude that the expression of CNTF in Schwann cells depends on axon-Schwann cell interactions.

Absolute refractory period of human nerve fibres during postnatal myelination

In order to study the absolute refractory period of a given group of nerve fibres during development we measured absolute refractory periods and conduction velocities of motor fibres and the most excitable fibres in the human ulnar nerve of newborns, children and adults. In each group of nerve fibres absolute refractory period was not correlated to conduction velocity (i.e. fibre diameters) and was rather constant during development. However, absolute refractory period of the most excitable fibres was smaller than absolute refractory period of motor fibres independently of the subject's age. Thus, it appears that already at birth, absolute refractory period is characteristic for a given group of nerve fibres.

An electron microscope study of vagus nerve composition in the ferret

The total number of axons in the cervical and abdominal vagus nerves of the ferret was counted. The ratio of myelinated to non-myelinated, and afferent to efferent axons was determined. The fibre diameter spectrum of myelinated axons was measured. The total number of axons in the ferret cervical vagus is similar to other mammals (approximately 28,000); the majority of axons are afferent (approx. 24,000) and also the majority of axons are nonmyelinated (approx. 27,000). The dorsal abdominal trunk is about twice the size of the ventral trunk although both trunks have the same number of efferent axons. The abdominal vagal trunks are over 90% afferent.

Developmental morphometry of the vagus nerve in the opossum

Developmental morphology of the vagus nerve has been described for placental but not marsupial mammals such as the opossum which undergo even greater postnatal maturation. In the present study, the cervical vagus nerve of opossums from the seventh postnatal day to the adult were compared after 3% glutaraldehyde immersion, postfixation in osmium tetroxide and staining with uranyl acetate and lead citrate. At 7 days of age, axons were unmyelinated. Only 4 myelinated axons were present at the 25th postnatal day and by 50 days of age only 11% of adult values were reached. The number of Schwann cells increased from 105 at age 7 days up to 640 in the adult. The number of myelin lamellae surrounding the largest axons increased from 9 at 25 days up to 102 +/- 9 at adulthood. In the newborn kitten and rabbit, the number of myelinated vagal fibers comprised 10% (n = 326) and 18% (n = 653), respectively, of that reached in the adult animal. Comparable values are not obtained in the opossum until the 50th postnatal day.

Functional development of the parasympathetic innervation of the sino-auricular node in newborn rabbits, cats and guinea pigs

The effects of supramaximal vagus nerve stimulation on heart rate were studied in newborn rabbits, cats and guinea pigs. The analysis of the stimulus-effect curve revealed that the earlier proposed relationship: log If/IO = H.f (IO is the steady state PP-interval before and If during stimulation, f is the stimulus frequency, and H the slope of the line) accurately summarizes the relation in rabbits, while with minor deviations it also holds for newborn cats and guinea pigs. Thus, the vagus effect for each nerve and animal is characterized by the slope of the line, H. In rabbits and cats the vagus effect decreased during the first postnatal week to about 1/3 and 1/5 of the initial value at birth. Guinea pigs, however, did not show such a postnatal change of the vagus effect. In comparison with rabbits and cats these animals are born at a relatively late ontogenetic stage. Therefore, we hypothesized that the decrease in vagus effect is related to the stage of development and occurs mainly before birth in this species.