Neurobiological aspects of the pelvic floor muscles involved in defecation

Properties of Renshaw-like cells excited by recurrent collaterals of pudendal motoneurons in the cat

Although anatomical studies have indicated pudendal motoneurons to give off recurrent collaterals, they are not considered to make synapses onto interneurons, such as Renshaw cells, and rather terminate their own signals. No study till date has examined interneurons being driven by recurrent collaterals of pudendal motoneurons. Here, we aimed to investigate the existence of Renshaw cells driven by pudendal motoneurons along with the recurrent inhibition of the latter. Extracellular recordings were obtained from the ventral horn of the sacral spinal cord of anesthetized cats. Dorsal roots were sectioned, and motor axons were electrically stimulated. Renshaw-like cells driven by recurrent collaterals, with high-frequency firings at short latency discharge, were observed around Onuf's nucleus. However, the recurrent inhibitory post-synaptic potentials were not recorded by intracellular recordings from the pudendal motoneurons. In summary, we found Renshaw-like cells driven by pudendal motoneurons, but we could not identify the synaptic connection of these neurons.

Gastrointestinal dysfunction after spinal cord injury

The gastrointestinal tract of vertebrates is a heterogeneous organ system innervated to varying degrees by a local enteric neural network as well as extrinsic parasympathetic and sympathetic neural circuits located along the brainstem and spinal axis. This diverse organ system serves to regulate the secretory and propulsive reflexes integral to the digestion and absorption of nutrients. The quasi-segmental distribution of the neural circuits innervating the gastrointestinal (GI) tract produces varying degrees of dysfunction depending upon the level of spinal cord injury (SCI). At all levels of SCI, GI dysfunction frequently presents life-long challenges to individuals coping with injury. Growing attention to the profound changes that occur across the entire physiology of individuals with SCI reveals profound knowledge gaps in our understanding of the temporal dimensions and magnitude of organ-specific co-morbidities following SCI. It is essential to understand and identify these broad pathophysiological changes in order to develop appropriate evidence-based strategies for management by clinicians, caregivers and individuals living with SCI. This review summarizes the neurophysiology of the GI tract in the uninjured state and the pathophysiology associated with the systemic effects of SCI.

Investigating neurogenic bowel in experimental spinal cord injury: where to begin?

The devastating losses following traumatic spinal cord injury (SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evacuation difficulties, decreased anorectal sensation, fecal incontinence or some combination thereof. Furthermore, neurogenic bowel is one of the most prevalent comorbidities of SCI and is recognized by afflicted individuals and caregivers as a lifelong physical and psychological challenge that profoundly affects quality of life. The restoration of post-injury control of movement has received considerable scientific scrutiny yet the daily necessity of voiding the bowel and bladder remains critically under-investigated. Subsequently, physicians and caregivers are rarely presented with consistent, evidence-based strategies to successfully address the consequences of dysregulated voiding reflexes. Neurogenic bowel is commonly believed to result from the interruption of the supraspinal control of the spinal autonomic circuits regulating the colon. In this mini-review, we discuss the clinical challenges presented by neurogenic bowel and emerging pre-clinical evidence that is revealing that SCI also initiates functional remodeling of the colonic wall concurrent with a decrease in local enteric neurons. Since the enteric input to the colonic smooth muscle is the final common pathway for functional contractions of the colon, changes to the neuromuscular interface must first be understood in order to maximize the efficacy of therapeutic interventions targeting colonic dysfunction following SCI.

EMG characteristics of the external anal sphincter guarding reflex and effects of a unilateral ventral root avulsion injury in rhesus macaques ( Macaca mulatta)

The external anal sphincter (EAS) is important for the maintenance of bowel continence and may be compromised by a variety of neuropathic conditions. However, large animal models for the study of EAS functions have been sparse. The EAS guarding reflex was examined by electromyography (EMG) in neurologically intact rhesus macaques ( n = 6) and at 4-6 wk after a unilateral EAS denervation from an L6-S3 ventral root avulsion (VRA) injury ( n = 6). Baseline EAS EMG recordings were quiescent in all subjects, and evoked responses showed an initial large-amplitude EMG activity, which gradually returned to baseline within 1-2 min. At 4-6 wk postoperatively, the EAS guarding reflex showed a significantly reduced EMG response duration of 47 ± 15 s and area under the curve (AUC) of 0.198 ± 0.097 mV·s compared with the corresponding evoked EAS EMG duration of 102 ± 19 s and AUC of 0.803 ± 0.225 mV·s ( P < 0.05) in the control group. Detailed time- and frequency-domain analysis of the evoked EAS EMG responses for the first 40 s showed no difference between groups for the maximum amplitude but a significant decrease for the mean amplitude across the study period and an early AUC reduction for the first 10 s in the VRA injury group. Time-frequency analysis and power spectrum plots indicated decreased intensity and a narrower midrange of frequencies in the VRA injury group. We conclude that the EAS guarding reflex in rhesus macaques shows characteristic EMG features in control subjects and signs of partial target denervation after a unilateral L6-S3 VRA injury. NEW & NOTEWORTHY The external anal sphincter guarding reflex showed initial large-amplitude peaks and a gradual return to a quiescent baseline after a rectal probe stimulus in rhesus macaques. At 4-6 wk after a unilateral ventral root avulsion (VRA) injury, the electromyography duration, mean amplitude, and area under the curve measurements were decreased. Time-frequency analysis and power spectrum plots indicated decreased intensity and a narrowed midrange of frequencies in the VRA injury cohort.

A biomechanical model of the human defecatory system to investigate mechanisms of continence

This article presents a method to fabricate, measure and control a physical simulation of the human defecatory system to investigate individual and combined effects of anorectal angle and sphincter pressure on continence. To illustrate the capabilities and clinical relevance of the work, the influence of a passive-assistive artificial anal sphincter (FENIX^TM) is evaluated. A model rectum and associated soft tissues, based on geometry from an anonymised computed tomography dataset, was fabricated from silicone and showed behavioural realism to the biological system and ex vivo tissue. Simulated stool matter with similar rheological properties to human faeces was developed. Instrumentation and control hardware were used to regulate injection of simulated stool into the system, automate balloon catheter movement through the anal canal, define the anorectal angle and monitor stool flow rate, intra-rectal pressure, anal canal pressure and puborectalis force. Studies were conducted to examine the response of anorectal angles at 80°, 90° and 100° with simulated stool. Tests were then repeated with the inclusion of a FENIX device. Stool leakage was reduced as the anorectal angle became more acute. Conversely, intra-rectal pressure increased. Overall inclusion of the FENIX reduced faecal leakage, while combined effects of the FENIX and an acute anorectal angle showed the greatest resistance to faecal leakage. These data demonstrate that the anorectal angle and sphincter pressure are fundamental in maintaining continence. Furthermore, it demonstrates that use of the FENIX can increase resistance to faecal leakage and reduce anorectal angles required to maintain continence. Physical simulation of the defecatory system is an insightful tool to better understand, in a quantitative manner, the effects of the anorectal angle and sphincter pressure on continence. This work is valuable in helping improve our understanding of the physical behaviour of the continence mechanism and facilitating improved technologies to treat severe faecal incontinence.

Neural pathways for colorectal control, relevance to spinal cord injury and treatment: a narrative review

STUDY DESIGN

Narrative review.

OBJECTIVES

The purpose is to review the organisation of the nerve pathways that control defecation and to relate this knowledge to the deficits in colorectal function after SCI.

METHODS

A literature review was conducted to identify salient features of defecation control pathways and the functional consequences of damage to these pathways in SCI.

RESULTS

The control pathways for defecation have separate pontine centres under cortical control that influence defecation. The pontine centres connect, separately, with autonomic preganglionic neurons of the spinal defecation centres and somatic motor neurons of Onuf's nucleus in the sacral spinal cord. Organised propulsive motor patterns can be generated by stimulation of the spinal defecation centres. Activation of the somatic neurons contracts the external sphincter. The analysis aids in interpreting the consequences of SCI and predicts therapeutic strategies.

CONCLUSIONS

Analysis of the bowel control circuits identifies sites at which bowel function may be modulated after SCI. Colokinetic drugs that elicit propulsive contractions of the colorectum may provide valuable augmentation of non-pharmacological bowel management procedures.

Electromyography of pelvic floor muscles

Pelvic floor muscles (PFM) are intimately involved in function of lower urinary tract, the anorectum and sexual functions, therefore their neural control transcends the primarily important somatic innervation of striated muscle, as they are directly involved in "visceral activity". Neural control of pelvic organs is affected by a unique co-ordination of somatic and autonomic motor nervous systems. Visceral and somatic sensory fibres supply sensory information from pelvic organs; their input influences through central integrative mechanisms also pelvic floor muscle activity. Anatomically, somatic afferent and efferent nerves of the sacral cord segments, reflexly integrated at the spinal cord and brainstem level, conduct neural control of PFM. The inputs from several higher centres influence the complex reflex control and are decisive for voluntary control, and for socially adapted behaviour related to excretory functions.

Fundamentals of neurogastroenterology: basic science

The focus of neurogastroenterology in Rome II was the enteric nervous system (ENS). To avoid duplication with Rome II, only advances in ENS neurobiology after Rome II are reviewed together with stronger emphasis on interactions of the brain, spinal cord, and the gut in terms of relevance for abdominal pain and disordered gastrointestinal function. A committee with expertise in selective aspects of neurogastroenterology was invited to evaluate the literature and provide a consensus overview of the Fundamentals of Neurogastroenterology textbook as they relate to functional gastrointestinal disorders (FGIDs). This review is an abbreviated version of a fuller account that appears in the forthcoming book, Rome III. This report reviews current basic science understanding of visceral sensation and its modulation by inflammation and stress and advances in the neurophysiology of the ENS. Many of the concepts are derived from animal studies in which the physiologic mechanisms underlying visceral sensitivity and neural control of motility, secretion, and blood flow are examined. Impact of inflammation and stress in experimental models relative to FGIDs is reviewed as is human brain imaging, which provides a means for translating basic science to understanding FGID symptoms. Investigative evidence and emerging concepts implicate dysfunction in the nervous system as a significant factor underlying patient symptoms in FGIDs. Continued focus on neurogastroenterologic factors that underlie the development of symptoms will lead to mechanistic understanding that is expected to directly benefit the large contingent of patients and care-givers who deal with FGIDs.

5-Hydroxytryptamine2C receptors on pudendal motoneurons innervating the external anal sphincter

The aim of this study was to determine the localization of 5-hydroxytryptamine2C (5-HT2C) receptors on the motoneurons innervating the external anal sphincter (EAS) of male rats. Motoneurons were retrogradely labeled after percutaneous intramuscular injection of Fluorogold (FG) into the EAS. Using fluorescent immunohistochemistry, FG-positive EAS motoneurons that were immunoreactive for the 5-HT2C receptor (5-HT2C-IR) were targeted for specific examination with widefield microscopy or confocal laser scanning microscopy with spectral separation. Widefield microscopy revealed distributions of FG-positive EAS motoneurons in the L5-S1 gray matter corresponding to the dorsomedial cell group. 5-HT2C-IR positive cells were distributed in the intermediolateral cell column and the ventral horn. Ventral horn 5-HT2C-IR labeling included the dorsomedial cell group as well as the dorsolateral, ventromedial and ventrolateral areas. Confocal analysis of FG-positive EAS motoneurons and 5-HT2C-IR positive motoneuron profiles adjacent to EAS motoneurons that were not labeled with FG but presumably innervate the bulbospongiosus muscle confirmed that EAS motoneurons were immunopositive for the 5-HT2C receptor. These data suggest that previously identified descending serotonergic immunopositive fibers observed terminating on EAS motoneurons might mediate their input through the activation of 5-HT2C receptors.

Descending pathways modulating the spinal circuitry for ejaculation: effects of chronic spinal cord injury

Sexual dysfunction is a common complication in men with chronic spinal cord injury. In particular, ejaculation is severely compromised or absent and the resulting infertility issues are important to this group of predominantly young men. To investigate the neural circuits and descending spinal pathways involved in ejaculation, animal models have been developed in normal and spinal cord-injured preparations. Primarily through studies in rats, spinal ejaculatory circuits have been described including (i) autonomic circuits at the thoracolumbar and lumbosacral levels mediating the emission phase of ejaculation, (ii) somatic circuits at the lumbosacral level controlling the expulsion phase of ejaculation through sequential and rhythmic contraction of perineal striated muscles (e.g. bulbospongiosus), and (iii) a proposed ejaculatory pattern generator in the lumbar cord. Midthoracic incomplete chronic spinal cord injury has revealed the dependency of spinal ejaculatory circuits on bilateral spinal pathways from the brainstem via modulation of pudendal motor neuron reflexes and pudendal nerve autonomic fibers. Accordingly, sensory input from the dorsal nerve of the penis, required to trigger the ejaculatory response in animals and humans, is no longer inhibited from the lateral paragigantocellularis nucleus in the ventrolateral medulla. This inhibitory effect, likely presynaptic through a serotonergic pathway, is thought to be necessary to provide the rhythmic, bursting, and sequential contractions of the perineal muscles during ejaculation. Chronic lateral hemisection injury, which severs half of the descending lateral funiculus-located pathways, results in new functional connections of the pudendal reflex inhibitory and pudendal sympathetic activation pathways across the midline, above and below the lesion, respectively. Clinical correlations in spinal cord-injured men have demonstrated the validity of the rodent animal for the study of ejaculatory dysfunction after chronic injury.

Influence of the paraventricular nucleus and oxytocin on the retrograde stain of pubococcygeus muscle motoneurons in male rats

Lumbosacral cord motoneurons innervating the pubococcygeus muscle (Pcm) at the pelvic floor of male rats were analyzed. We showed previously that these motoneurons participate in sexual functions and are sensitive to fluctuations of systemic androgen and estrogen. Though estrogen receptors have not been identified in Lamina IX at these spinal areas, the release of oxytocin from the paraventricular nucleus of the hypothalamus (PvN) has been found to control pelvic sexual physiology. We therefore worked on the hypothesis that steroid hormones in the PvN induce the release of oxytocin at the lumbosacral level to modulate the function of Pcm motoneurons. Four experiments were developed, and results were observed with the retrograde staining of motoneurons with horseradish peroxidase. Data indicated that morphometric parameters of Pcm motoneurons were significantly reduced after castration or blocking of the steroids at the PvN site, or following complete transection of the spinal cord at the T8 level. In each case, the reduction of the stain was recovered after intrathecal treatment with oxytocin. Thus, present results show that Pcm motoneurons respond to spinal oxytocin. The conclusive model that we propose is that steroids stimulate the PvN, causing the nucleus to release oxytocin at the level of the lumbosacral spinal cord, and the release of the peptide regulates the spread of the stain of Pcm motoneurons. This work also shows that motoneurons distal to a transected area in the spinal cord could respond to exogenous oxytocin, an important finding for the research of spinal cord lesioned subjects.

Mechanisms involved in the neural construction of a body-centered reference axis for extrapersonal directed movements. A hypothesis

To localize objects in space, it is necessary to refer them to a set of coordinates that serve as a frame of reference. Advances in molecular aspects of evolutionary developmental biology reveal how axial coordinates are established in embryos. But we do not yet know how axes of reference are constructed by adult animals. The characteristics of epaxial musculature, spinal connectivity, and organization at the cortical level are reviewed. Although endowed with muscle spindles, epaxial muscles lack the monosynaptic but possess the tonic component of the stretch reflex. Motoneurons of epaxial muscles are devoid of recurrent inhibition and do not show crossed disynaptic inhibition. At motorsensory cortex (MSC), regions corresponding to the body axis receive somatosensory signals that always extend across the midline. Visual and vestibular input also converge in the zone corresponding to the body axis. This region is also endowed with a large number of callosal fibers that, by connecting the two halves of the body axis, may allow them to function and behave as a unity. In contrast, somatic signals from distal extremities are discrete, confined only to the contralateral MSC, and show short latency of responses. They do not receive either telereceptive or vestibular input. We propose that limb movements directed to extrapersonal space take place within a reference frame in which one of the axes is the result of integration at the MSC of telereceptive, proprio and somatosensory signals from the body. Vestibular input signals the effect of the force of gravity, providing directionality to the axis.

Descending spinal projections from the rostral gigantocellular reticular nuclei complex

Electrophysiological and physiological studies have suggested that the ventral medullary gigantocellular reticular nuclei (composed of the gigantocellular ventralis and pars alpha nuclei as well as the adjacent lateral paragigantocellular nucleus; abbreviated Gi-LPGi complex) provide descending control of pelvic floor organs (Mackel [1979] J. Physiol. (Lond.) 294:105-122; Hubscher and Johnson [1996] J. Neurophysiol. 76:2474-2482; Hubscher and Johnson [1999] J. Neurophysiol. 82:1381-1389; Johnson and Hubscher [1998] Neuroreport 9:341-345). Specifically, this complex of paramedian reticular nuclei has been implicated in the inhibition of sexual reflexes. In the present study, an anterograde fluorescent tracer was used to investigate direct descending projections from the Gi-LPGi complex to retrogradely labeled pudendal motoneurons (MN) in the male rat. Our results demonstrated that, although a high density of arborizations from Gi-LPGi fibers appears to be in close apposition to pudendal MNs, this relationship also applies to other MNs throughout the entire spinal cord. The Gi-LPGi also projects to spinal autonomic regions, i.e., both the intermediolateral cell column and the sacral parasympathetic nucleus, as well as to regions of the intermediate gray, which contain interneurons involved in the organization of pelvic floor reflexes. Lastly, throughout the length of the spinal cord, numerous neurons located primarily in laminae VII-X, were retrogradely labeled with Fluoro-Ruby after injections into the Gi-LPGi. The diffuse descending projections and arborizations of this pathway throughout the spinal cord suggest that this brainstem area is involved in the direct, descending control of a variety of spinal activities. These results are in contrast with our observations of the discrete projections of the caudal nucleus raphe obscurus, which target the autonomic and somatic MNs involved specifically in sexual and eliminative functions (Hermann et al. [1998] J. Comp. Neurol. 397:458-474).

Spinal cord neural organization controlling the urinary bladder and striated sphincter

The storage and elimination of urine requires the coordination of activity between the autonomic nervous system (thoracolumbar sympathetic and sacral parasympathetic divisions) controlling the urinary bladder and urethra and the lumbosacral somatic motoneurons innervating the striated sphincter and pelvic floor muscles. These three efferent systems involved in the control of lower urinary tract function receive segmental sensory information from various visceral organs and the perineum, as well as inputs from supraspinal regions. Ascending and descending connections between the various spinal segments levels and supraspinal regions provide the reflex substrates participating in normal bladder continence and micturition reflexes. Many of the actions of descending and segmental reflexes are mediated by excitatory and inhibitory sacral spinal interneurons located within the region of the parasympathetic preganglionic autonomic neurons and the sphincter ventral horn motoneurons. This review will: (1) discuss the basic organization and spinal elements of the reflex pathways subserving continence and micturition; (2) describe features of the identified sacral interneuronal circuitry contributing to the control of the bladder and sphincter function; and (3) discuss how changes in the control of these reflex pathways and neurons may contribute to abnormal patterns of bladder and sphincter function commonly observed following spinal cord injury.

Development of androgen receptor and p75(NTR) mRNAs and peptides in the lumbar spinal cord of the gerbil

Development of sex differences in the spinal cord appears to be largely under the control of androgen and although neurotrophins may also have a role. Spinal cords of male and female neonatal gerbils (postnatal days 1, 5, 7, 10, 23) and adult gerbils (postnatal day 150) were examined to determine the relative temporal expression of androgen receptor (AR) and the low-affinity neurotrophin receptor (p75) mRNAs within the spinal nucleus of the bulbocavernosus (SNB) and dorsolateral nucleus (DLN). Furthermore, prepubertal male gerbils were placed into one of six gonadal hormone treatment groups at weaning: Either sham castrate, castrated with gonadal hormone replacement, or castrated without gonadal hormone replacement. Ten weeks later gerbils were aldehyde-perfused, spinal cords removed and processed for presence of AR and p75 immunoreactivity (ir) in motoneurons of the SNB and DLN. During neonatal development, there were significant increases in androgen receptor mRNA within the SNB and DLN. In the SNB, the increase in androgen receptor mRNA preceded the increase in p75 mRNA. Peripubertally, significantly more SNB than DLN motoneurons contained AR- and p75-ir. These data demonstrate that AR expression occurs along the same developmental time frame as the development of the SNB and DLN and the organizational effects of androgens on their development continues through puberty in the male gerbil.

Non-linear membrane properties of sacral sphincter motoneurones in the decerebrate cat

1. Responses to pudendal afferent stimulation and depolarizing intracellular current injection were examined in sacral sphincter motoneurones in decerebrate cats. 2. In 16 animals examined, 2-10 s trains of electrical stimulation of pudendal afferents evoked sustained sphincter motoneurone activity lasting from 5 to >50 s after stimulation. The sustained response was observed in: 11 animals in the absence of any drugs; two animals after the intravenous administration of 5-hydroxytryptophan (5-HTP; <= 20 mg kg-1); one animal in which methoxamine was perfused onto the ventral surface of the exposed spinal cord; and two animals following the administration of intravenous noradrenergic agonists. 3. Extracellular and intracellular recordings from sphincter motoneurones revealed that the persistent firing evoked by afferent stimulation could be terminated by motoneurone membrane hyperpolarization during micturition or by intracellular current injection. 4. Intracellular recordings revealed that 22/40 sphincter motoneurones examined displayed a non-linear, steep increase in the membrane potential in response to depolarizing ramp current injection. The mean voltage threshold for this non-linear membrane response was -43 +/- 3 mV. Five of the 22 cells displaying the non-linear membrane response were recorded prior to the administration of 5-HTP; 17 after the intravenous administration of 5-HTP (<= 20 mg kg-1). 5. It is concluded that sphincter motoneurones have a voltage-sensitive, non-linear membrane response to depolarization that could contribute to sustained sphincter motoneurone firing during continence.

Fertility ratio in male rats: effects after denervation of two pelvic floor muscles

Fertility ratio is defined here as the proportion of females that a male can impregnate after a constant period of in-polygyny living. This ratio was investigated in male rats after denervation of two pelvic floor muscles, the pubococcygeus and iliococcygeus. Denervation was carried out by transecting the somatomotor branch of the pelvic nerve. The lesion did not modify the sexual behavior of males or their overall fertility, but decreased the weight of the ejaculated seminal plug. Consequently, the number of days living in cohabitation to induce pregnancy was increased in lesioned males (approximately 13 days) compared with intact and sham animals (approximately 5 days). These results showed that the fertility ratio was optimal when intact/sham males cohabited with females for two consecutive estrous cycles, but that lesioned males needed up to four cycles to induce most pregnancies. Two hypotheses are raised by our results. The first is that pelvic floor denervation decreases the forceful tension required to expel the semen from the prostatic urethra to the vagina, then an incomplete seminal plug is expelled. The second is that denervation cut afferent fibers that reflexively promote the continence of the semen deposited in the prostatic urethra during seminal emission, allowing some to leak out before ejaculation. The latter hypothesis can also explain the recovery of the fertility ratio in lesioned males. It could be a compensatory mechanism mediated by the pudendal nerve supply to the coccygeus muscle, the other pelvic floor muscle.

External anal sphincter hyperreflexia following spinal transection in the rat

In the present study, long-term and short-term rat preparations were used to develop a model for investigating external anal sphincter (EAS) reflexes in intact and spinal cord-injured (SCI) rats. In this model, EAS distension with an external probe elicits reflex contractions of the EAS in intact, unanesthetized animals. At 2 h after spinal cord transection, none of the lesioned animals displayed EAS EMG activity. In fact, once distended, the EAS was incapable of maintaining closure of the anal orifice. Over a period of 4 days, spinalized animals developed a hyperreflexia of the EAS response. By 48 h, the rectified, integrated EAS EMG was significantly elevated in comparison with nonlesioned controls (EAS hyperreflexia). In addition, the duration of the EAS EMG bursts in response to sphincter distension had significantly increased. At 6 weeks after injury, the EAS was significantly hyperreflexic as measured by EMG burst duration and burst area. As with intact animals, posttransection EAS reflexes were highly anesthesia sensitive. These studies indicate that (1) brief distension of the anal orifice is sufficient to evoke a physiologically relevant reflexive activation of the EAS in the rat, (2) the 2- to 24-h postinjury areflexia observed in these experiments may be a suitable model for the study of spinal shock, and (3) the observed EAS hyperreflexia after chronic SCI may represent the permanent effects of removing descending inhibitory circuits and segmental plasticity, making this reflex an appropriate measure of defecatory dysfunction after spinal cord injury.

M. levator ani in the rat: does it really lift the anus?

BACKGROUND

There is a good deal of confusion about the denomination of the pelvic floor muscles of the rat in the literature. By carefully dissecting and observing tail and visceral movements and pressure measurements in the vagina, rectum, and urethra during electrical stimulation, we studied the anatomy and function of the different muscles and searched for similarities with the human anatomy.

RESULTS

We found some degree of similarity between the M. pubococcygeus and M. iliococcygeus muscles in both species. The M. levator ani in the rat resembles in gross anatomy the M. puborectalis in man, but the insertion and function are different. More specifically, stimulation of the M. levator ani led to only a negligible pressure rise in the rectum and no lifting of the rectum or anus.

CONCLUSIONS

The M. pubococcygeus and the M. iliococcygeus share similarities with their homologues in the human. The M. levator ani, which is present only in the male rat, reveals some anatomical resemblance with the human M. puborectalis but has a different insertion and function. Because it does not lift the anus during contraction, its denomination as M. levator ani seems unjustified. Because of its principal sexual function, its fixation to the bulbus, and its sensitivity to testosterone, naming this muscle M. bulbocavernosus dorsalis would indeed seem more logical.

Electrophysiological evidence for the nomenclature of the pudendal nerve and sacral plexus in the male rat

Surgical microscopy and electrophysiological techniques were used to standardize the nomenclature for the pudendal nerve and sacral plexus according to their somatic axonal composition in the male rat. We conclude that the pudendal nerve is the segment running from the L6-S1 trunk to the sacral plexus, carrying efferent fibers to the coccygeus, internal obturator, ventral and dorsal bulbospongiosus, ischiocavernosus, external anal sphincter, and external urethral sphincter muscles, and afferent fibers from the penis, prepuce, scrotum, and ventral-proximal tail. The sacral plexus is the complex formed by the bridge-like structure connecting the pudendal nerve with the lumbosacral trunk, and two nerve branches emerging from it, one innervating the proximal half of the scrotal skin, and the other innervating the muscles at the base of the penis known as the motor branch. These branches are only considered as a part of the sacral plexus because they integrate axons from both the lumbosacral trunk and pudendal nerve. The gross anatomy of the pudendal nerve and sacral plexus has a main organization that was observed in 70% of cases, whereas the remaining 30% occurred in two variants. This nomenclature is appropriate to describe the pudendal nerve and sacral plexus in studies that involve them being lesioned or electrophysiologically analysed. A main additional finding was that two large afferent branches innervate the scrotum, one the proximal half and the other the distal half. As mentioned above, the proximal branch belongs to the sacral plexus, whereas the distal branch belongs to the pudendal nerve because all its axons travel to the cord via this nerve. Since stimulation or even manipulation of the scrotal branches resulted in the secretion of semen containing spermatozoa, it is suggested that scrotal afferents are involved in some way in the ejaculatory process, a topic that deserves further research.

Anorectal angle enhances faecal continence

This study was performed with an in vitro model to assess the relative importance of sphincter pressure and anorectal angulation in maintaining faecal continence. Water and semisolid material were infused separately into porcine intestine compressed by an inflatable cuff until leakage was observed. Angulation of the bowel with respect to the cuff was 180 degrees and then 90 degrees. With water, holdback pressure was independent of angulation. In contrast, when semisolid material was used, angling the bowel to 90 degrees increased holdback pressure by at least 100 per cent. Measurements taken in solid tubes demonstrated that both a restriction in the tube and an unconstricted 90 degrees bend produced a resistance to flow of the semisolid material which was dependent on flow rate. These data suggest that liquid is retained in the rectum by occlusion pressure alone, whereas the retention of semisolid material is enhanced by angulation.

Thyrotropin-releasing hormone (TRH) and CNS regulation of anorectal motility in the rat

The effect of thyrotropin-releasing hormone (TRH) upon anorectal motility was investigated in acute male rat preparations. Micromolar doses of TRH were intrathecally (i.t.) infused at the L6 spinal level at a rate of 1 microliter/min over 8 min. TRH infusions in 1.0-1000 microM concentrations elicited biphasic, dose-dependent anorectal contractions as measured by a rectal manometer. The 100 microM dose yielded the most significant increase in contractions over the greatest period of time. Atropine, administered as a pretreatment (100 micrograms s.c.), blocked contractions normally produced by i.t. infusion of TRH (1000 microM). Intravenous infusions of atropine (10 micrograms) through a jugular catheter immediately blocked anorectal contractions produced by i.t. infusion of 100 microM TRH. Sectioning of the hypogastric nerve, which supplies sympathetic innervation to the colon and internal anal sphincter, did not significantly affect contractions induced by 100 microM TRH applied intrathecally. Disruption of the major pelvic ganglion fibers, however, completely abolished the contractions induced by 100 microM TRH, either through the interruption of preganglionic parasympathetic fibers in the pelvic nerve, or by disrupting postganglionic fibers. These findings extend the role of TRH in the regulation of defecatory behaviors.

Caudal medullary pathways to lumbosacral motoneuronal cell groups in the cat: evidence for direct projections possibly representing the final common pathway for lordosis

The nucleus retroambiguus (NRA) projects to distinct brainstem and cervical and thoracic cord motoneuronal cell groups. The present paper describes NRA projections to distinct motoneuronal cell groups in the lumbar enlargement. Lumbosacral injections of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) were made to localize and quantify the retrogradely labeled neurons in the caudal medullary lateral tegmentum. These injections were combined with spinal hemisections to distinguish between neurons having ipsi-or contralaterally descending axons. The NRA-lumbosacral fibers descend almost exclusively contralaterally, but neurons in areas surrounding the NRA project mainly ipsilaterally. In an anterograde tracing study, injections of WGA-HRP or tritiated leucine were made in the region of the NRA to determine the NRA targets in the lumbosarcral cord. Hemisections in C2 made it possible to distinguish between NRA projections and projections from neurons in the adjoining lateral tegmentum. The results show delicate NRA projections to distinct lumbosacral motoneuronal cell groups innervating specific hindlimb muscles (iliopsoas, adductors, and hamstrings) as well as axial muscles (medial longissimus and proximal tail muscles). The projection is bilateral, with a contralateral predominance. Ipsilaterally terminating fibers are derived from NRA neurons whose axons cross the midline at the level of the obex, descend through the contralateral spinal white matter, and recross at the level of termination. A conceptual description is presented in which the periaqueductal gray-NRA-lumbosacral projections form the final common pathway for lordosis in the cat.

Motoneurons dorsolateral to the central canal innervate perineal muscles in the Mongolian gerbil

The Mongolian gerbil provides a model in which sexually dimorphic areas in the hypothalamus are correlated with sociosexual behaviors such as scent marking and male copulatory behavior. To extend this model, investigations were conducted to determine whether sexually dimorphic areas existed in the spinal cord that could be relevant to male sexual behavior. The focus of these investigations was the perineal muscles associated with the penis. Therefore, this research identified the spinal motoneurons that innervate the bulbocavernosus, levator ani, anal sphincter, and ischiocavernosus muscles of Mongolian gerbils. The motoneuron pool that innervates the bulbocavernosus, levator ani, and anal sphincter was designated the spinal nucleus of the bulbocavernosus (SNB), as for other species of rodents. The motoneuron pool innervating the ischiocavernosus was identified as the dorsolateral nucleus, again, to be consistent with the designation for other rodents. The motoneurons of the gerbil SNB were distributed dorsolateral to the central canal in the lumbosacral transition zone of the spinal column. These motoneurons are located in the region classically defined as area X of the spinal cord. The number of SNB motoneurons was sexually dimorphic, with male gerbils having about five times as many SNB motoneurons as do female gerbils. The size of SNB motoneurons was also sexually dimorphic. The SNB motoneurons of males were 1.5 times larger than the SNB motoneurons of females. The effects of adult castration on the male SNB were also studied. After castration, the size, but not the number, of SNB motoneurons in males was significantly decreased. This decrease was prevented by testosterone treatment. The percentage of calcitonin gene-related peptide (CGRP)-immunoreactive SNB motoneurons was also affected by adult castration. The percentage of CGRP-immunoreactive motoneurons was significantly decreased after adult castration. Again, this decrease was reversed by testosterone treatment. These findings suggest that the SNB of gerbils is sexually dimorphic and is sensitive to circulating levels of gonadal steroids. The unique placement of the SNB motoneurons suggests that an alternative laminar organizational scheme may be necessary for Mongolian gerbil.

Brainstem motoneuron pools that are selectively resistant in amyotrophic lateral sclerosis are preferentially enriched in parvalbumin: evidence from monkey brainstem for a calcium-mediated mechanism in sporadic ALS

Some brainstem motoneuron groups appear more resistant to the process of neurodegeneration in ALS (for example, oculomotor, trochlear, and abducens nuclei) than others (for example, trigeminal, facial, ambiguus, and hypoglossal nuclei). The possibility that the differential presence of the calcium-chelating protein parvalbumin might underlie this difference in vulnerability was examined immunohistochemically as a way to determine whether a calcium-mediated mechanism might be involved in ALS. In normal monkey brainstem, we found that the abundance of parvalbumin-containing neurons in the oculomotor, trochlear, and abducens nuclei was approximately 90% of the abundance of choline acetyltransferase (CHAT)-containing motoneurons. In contrast, the abundance of parvalbumin-containing neurons in the other brainstem motor nuclei innervating skeletal muscle (trigeminal, facial, ambiguus, and hypoglossal) was only about 30-60% of the abundance of CHAT-containing motoneurons. Since some of these motoneuron pools contain nonmotoneuron internuclear neurons that might be parvalbumin-containing, we also carried out double-label studies to specifically determine the percentage of cholinergic motoneurons that contained parvalbumin in each of these motoneuron pools. We found that 85-100% of the oculomotor, trochlear, and abducens motoneurons were parvalbumin-containing. In contrast, only 20-30% of the trigeminal, facial, ambiguus, and hypoglossal motoneurons were parvalbumin-containing. These results raise the possibility that motoneuron death in sporadic ALS is related to some defect that promotes cytosolic calcium accumulation in motoneurons. This excess calcium entry may promote cell death via an excitotoxic pathway. Motoneurons rich in parvalbumin may resist the deleterious effects of this putative calcium gating defect because they are better able to sequester the excess calcium.

Physiology and mechanics of rat levator ani muscle: evidence for a sexual function

The levator ani (LA) of male rodents is a classic model tissue for the study of hormone-muscle interactions, although its functions remain unknown. Recordings during copulation from chronic electromyographic (EMG) electrodes in the LA and bulbospongiosus (BS) revealed that EMG activity in the LA and BS was tightly coordinated. The LA was not active during noncopulatory behaviors, including the 1-min interval surrounding defecation. Electrical stimulation of the LA motor nerves increased penile bulb pressure. Increases in penile bulb pressure following BS nerve stimulation were markedly attenuated after LA denervation and were reduced further by LA removal. Stimulation of the LA nerve yielded insignificant changes in rectal pressure. Perineal motion analysis demonstrated that the LA acts upon the penile bulb and the surrounding BS exclusively. Apparently the rodent LA muscle is an active component in a highly coordinated neuromuscular system augmenting penile erection and, contrary to its name, is most unlikely to participate in alimentary function.

Pelvic floor muscles response to graded rectal distension and cutaneous stimulation

The responses of the external ani sphincter (EAS) and the levator ani (LA) muscles to graded rectal distension and to cutaneous and genital stimulation were examined in 25 cats of either sex. The animals were anesthetized with sodium pentobarbital (30 mg/kg, intraperitoneal) and then tested in two positions: with hindlimbs extended and with hindlimbs flexed simulating the straining position. Graded rectal distension was performed at two speeds: 1 and 10 sec. Basal levels of activity in the EAS were higher in the straining than in the extended position (P less than 0.005). The EAS responded to rapid rectal distension with inhibition of its activity. When changed to the straining position significant increases in muscular activity were observed after 35 cc of balloon insufflation (P less than 0.005). In the same muscle, slow distension produced an initial decrease in activity followed by significant increases after insufflation of 40 cc in the extended position and of 30 cc in the straining position. Basal activity in the LA was similar in both positions tested. The main effects of rectal distension in this muscle were increases in activity, significant only after high volumes of air inflation in the straining position (P less than 0.0001). Cutaneous stimulation disclosed a receptive field that was widespread for the EAS, extending over lumbosacral dermatomes (L3-S2), but greatly restricted for the LA. Responses to vaginal and cervical stimulation were more reliably obtained from the LA (P less than 0.001). These differences indicate that the EAS and LA muscles of the cat correspond with distinct, although related neural circuits.