Experiencing the impossible and creativity: a targeted literature review

Previous work suggests that unexpected and surprising experiences (e.g., living in another culture or looking at surreal images) promotes creative thinking. This targeted literature review examines whether the inherent cognitive disruption associated with experiencing the seemingly impossible has a similar effect. Correlational and experimental research across six domains (entertainment magic, fantasy play, virtual reality and computer gaming, dreaming, science fiction/fantasy, and anomalous experiences) provided consistent support for the hypothesis. In addition, anecdotal evidence illustrated the possible impact that the creative output associated with each of these areas may have had on technology, science, and the arts. It is argued that impossible experiences are an important driver of creative thinking, thus accounting for reports of such experiences across the lifespan and throughout history. The theoretical and practical implications of this work are discussed, along with recommendations for future research.

Conjuring up creativity: the effect of performing magic tricks on divergent thinking

Research suggests that learning to perform magic tricks can promote both physical and psychological wellbeing. The current study extended this work by examining the impact of learning magic tricks on divergent thinking. A group of 10- to 11-year-old children completed Guilford’s Alternate Uses Test both before and after participating in either a magic-based, or art-based, activity. As predicted, compared to the art-based activity, the magic-based activity resulted in a significantly greater increase in both AUT Fluency and AUT Originality scores. Rosenberg’s Self-Esteem Scale and Dweck’s Implicit Theories of Intelligence Scale for Children was also completed after each activity, and participants’ self-esteem scores were higher after the art-based activity than the magic-based activity. In an exploratory aspect of the study, the AUT was re-administered to both groups three weeks later, and yielded no significant differences. The practical and theoretical implications of these findings are discussed, along with recommendations for future research.

Pedagogic prestidigitation: using magic tricks to enhance educational videos

Previous research suggests that magic tricks can be employed within an educational context to enhance attention, engagement, critical thinking and recall. This study builds on this work by examining the impact of incorporating magic tricks into an online educational video. Adult participants (N = 198) completed a need for cognition scale and then watched a video containing either several bespoke card tricks that had been specially devised to help tell the story of the Apollo Moon landings (Magic Video), or an almost identical video that did not contain any magic tricks (Control Video). All participants rated their levels of engagement, absorption and recall. Compared to the Control Video, the Magic Video was rated as significantly more interesting, informative and absorbing. There was no difference between the groups for recall. There was a positive correlation between participants’ need for cognition scores, and the degree to which they found the Magic Video interesting, and were willing to share it with others. The theoretical, methodological and practical implications of these results are discussed, along with recommendations for future work.

The effects of source expertise and trustworthiness on recollection: the case of vaccine misinformation

Designing effective communication strategies for correcting vaccines misinformation requires an understanding of how the target group might react to information from different sources. The present study examined whether erroneous inferences about vaccination could be effectively corrected by a perceived credible (i.e. expert or trustworthy) source. Two experiments are reported using a standard continued influence paradigm, each featuring two correction conditions on vaccine misinformation. Participants were presented with a story containing a piece of information that was later retracted by a perceived credible or not so credible source. Experiment 1 showed that providing a correction reduced participants' use of the original erroneous information, yet the overall reliance on misinformation did not significantly differ between the low- and high-expertise correction groups. Experiment 2 revealed that a correction from a high-trustworthy source decreased participants' reliance on misinformation when making inferences; nonetheless, it did not positively affect the reported intent to vaccinate one's child. Overall, source trustworthiness was more relevant than source expertise.

Conjuring cognition: a review of educational magic-based interventions

For hundreds of years, magic tricks have been employed within a variety of pedagogic contexts, including promoting science and mathematics, delivering educational messaging, enhancing scepticism about the paranormal, and boosting creative thinking for product design. This review examines this diverse body of work, focusing on studies that have assessed the impact of such interventions. Although the studies tended to yield positive outcomes, much of the work suffered from methodological shortcomings, including measuring the impact of interventions over a relatively short period of time, focusing on self-report measures and failing to employ control groups. The paper makes several recommendations for future study in the area, including assessing the longer-term impact of magic-based interventions, comparing these interventions to other types of pedagogic techniques, focussing on knowledge retention and behavioural outcomes, and collaborating with magicians to develop more impactful interventions.

Registered reports: an early example and analysis

The recent 'replication crisis' in psychology has focused attention on ways of increasing methodological rigor within the behavioral sciences. Part of this work has involved promoting 'Registered Reports', wherein journals peer review papers prior to data collection and publication. Although this approach is usually seen as a relatively recent development, we note that a prototype of this publishing model was initiated in the mid-1970s by parapsychologist Martin Johnson in the European Journal of Parapsychology (EJP). A retrospective and observational comparison of Registered and non-Registered Reports published in the EJP during a seventeen-year period provides circumstantial evidence to suggest that the approach helped to reduce questionable research practices. This paper aims both to bring Johnson's pioneering work to a wider audience, and to investigate the positive role that Registered Reports may play in helping to promote higher methodological and statistical standards.

Achieving the impossible: a review of magic-based interventions and their effects on wellbeing

Research has demonstrated that involvement with mainstream performing arts, such as music and dance, can boost wellbeing. This article extends this work by reviewing little-known research on whether learning magic tricks can have an equally beneficial effect. We first present an historic overview of several magic-based interventions created by magicians, psychologists and occupational therapists. We then identify the potential benefits of such interventions, and review studies that have attempted to systematically assess these interventions. The studies have mostly revealed beneficial outcomes, but much of the work is of poor methodological quality (involving small numbers of participants and no control group), and has tended to focus on clinical populations. Finally, we present guidelines for future research in the area, emphasizing the need for more systematic and better-controlled studies.

And now for something completely different: Inattentional blindness during a Monty Python's Flying Circus sketch

Perceptual science has frequently benefited from studying illusions created outside of academia. Here, we describe a striking, but little-known, example of inattentional blindness from the British comedy series "Monty Python's Flying Circus." Viewers fail to attend to several highly incongruous characters in the sketch, despite these characters being clearly visible onscreen. The sketch has the potential to be a valuable research and teaching resource, as well as providing a vivid illustration of how people often fail to see something completely different.

Testing the implicit processing hypothesis of precognitive dream experience

Seemingly precognitive (prophetic) dreams may be a result of one's unconscious processing of environmental cues and having an implicit inference based on these cues manifest itself in one's dreams. We present two studies exploring this implicit processing hypothesis of precognitive dream experience. Study 1 investigated the relationship between implicit learning, transliminality, and precognitive dream belief and experience. Participants completed the Serial Reaction Time task and several questionnaires. We predicted a positive relationship between the variables. With the exception of relationships between transliminality and precognitive dream belief and experience, this prediction was not supported. Study 2 tested the hypothesis that differences in the ability to notice subtle cues explicitly might account for precognitive dream beliefs and experiences. Participants completed a modified version of the flicker paradigm. We predicted a negative relationship between the ability to explicitly detect changes and precognitive dream variables. This relationship was not found. There was also no relationship between precognitive dream belief and experience and implicit change detection.

The eyes don't have it: lie detection and Neuro-Linguistic Programming

Proponents of Neuro-Linguistic Programming (NLP) claim that certain eye-movements are reliable indicators of lying. According to this notion, a person looking up to their right suggests a lie whereas looking up to their left is indicative of truth telling. Despite widespread belief in this claim, no previous research has examined its validity. In Study 1 the eye movements of participants who were lying or telling the truth were coded, but did not match the NLP patterning. In Study 2 one group of participants were told about the NLP eye-movement hypothesis whilst a second control group were not. Both groups then undertook a lie detection test. No significant differences emerged between the two groups. Study 3 involved coding the eye movements of both liars and truth tellers taking part in high profile press conferences. Once again, no significant differences were discovered. Taken together the results of the three studies fail to support the claims of NLP. The theoretical and practical implications of these findings are discussed.

Impact of national guidelines on family history breast cancer surveillance

The breast cancer risk of women already under family history surveillance was accurately assessed according to national guidelines in an attempt to rationalize the service. Women attending two breast units in Glasgow between November 2003 and February 2005 were included. One thousand and five women under annual surveillance were assessed and had their relatives diagnoses verified. Four hundred and ninety-seven women were at significantly increased risk and eligible for follow-up. Five hundred and eight (50%) women attending were not eligible for family history surveillance, and 498 (98%) of these women accepted discharge. In conclusion, national guidelines have helped to more clearly define women who should undergo surveillance. This avoids unnecessary and potentially harmful routine investigations, and the service has been improved.

It's good to know: how treatment knowledge and belief affect the outcome of distant healing intentionality for arthritis sufferers

OBJECTIVE

This small-scale study explores the role of expectancy in response to distant healing by testing two hypotheses: 1) Participants aware of placement in the healing condition will report greater relief than those aware they are not receiving distant healing; 2) Participants who express belief in distant healing will report greater relief than those expressing disbelief.

METHODS

Sixty patients were recruited from a rheumatology outpatient clinic, and through online support networks and blogs. Participants were randomly allocated to one of four conditions, those in the healing condition received distant healing from self-reported healers, while participants in the control condition received no intervention. Half of the participants knew their treatment allocation and half were blinded. The primary outcome measures were the General Health Questionnaire (GHQ-12) and the Short-form McGill Pain Questionnaire. The Paranormal Belief Scale and a measure designed to assess belief in distant healing were given to determine if belief was correlated with healing outcomes.

RESULTS

Awareness of being a recipient of distant healing appeared to be associated with improved outcomes for those in the healing group. Medium to large improvements in GHQ scores (d=.76) and McGill Pain scores (d=.45) were calculated for the groups aware of their condition. Participants unaware that they were receiving healing showed no evidence of improved outcomes. Belief in healing did not have an effect on self-reported outcomes.

CONCLUSIONS

Improvements in reported pain and well-being appear to have been caused by knowledge of allocation in the distant healing condition rather than distant healing alone.

Judging a book by its cover: the unconscious influence of pupil size on consumer choice

Past research suggests that men perceive women with large pupils as especially attractive. We employed an innovative methodology to examine whether this effect influences consumer decision-making. A popular psychology book was published with two slightly different front covers. Both covers contained the same photograph of a woman; however, the woman's pupils on one cover were digitally enlarged. Readers indicated whether they were male or female, and whether they possessed the cover with small or large pupils. A significantly greater percentage of men than women had chosen the cover with the large pupils. None of the participants who attempted to guess the nature of the experiment was correct, suggesting that the influence exerted by pupil size was unconscious. These findings provide further support for the notion that people's judgments are unconsciously swayed by pupil size, and demonstrate that this effect operates in a real world setting.

Prospective surveillance of women with a family history of breast cancer: auditing the risk threshold

To evaluate current guidelines criteria for inclusion of women in special ‘breast cancer family history’ surveillance programmes, records were reviewed of women referred to Scottish breast cancer family clinics between January 1994 and December 2003 but discharged as at ‘less than ‘moderate’ familial risk’. The Scottish Cancer Registry was then interrogated to determine subsequent age-specific incidence of breast cancer in this cohort and corresponding Scottish population figures. Among 2074 women, with an average follow-up of 4.0 years, 28 invasive breast cancers were recorded up to December 2003, where 14.4 were expected, a relative risk (RR) of 1.94. Eleven further breast cancers were recorded between January 2004 and February 2006 (ascertainment incomplete for this period). The overall RR for women in the study cohort exceeded the accepted ‘cutoff’ level (RR=1.7) for provision of special counselling and surveillance. The highest RR was found for the age group 45–59 years and this group also generated the majority of breast cancers. The National Institute for Clinical Excellence (‘NICE’) guidelines appear to be more accurate than those of the Scottish Intercollegiate Guidelines Network (‘SIGN’) in defining ‘moderate’ familial risk, and longer follow-up of this cohort could generate an evidence base for further modification of familial breast cancer services.

Of two minds: Sceptic-proponent collaboration within parapsychology

The first author, a proponent of evidence for psychic ability, and the second, a sceptic, have been conducting a systematic programme of collaborative sceptic-proponent research in parapsychology. This has involved carrying out joint experiments in which each investigator individually attempted to mentally influence the electrodermal activity of participants at a distant location. The first two collaborations obtained evidence of 'experimenter effects', that is, experiments conducted by the proponent obtained significant results but those conducted by the sceptic did not. This paper describes a new collaborative study that attempted to replicate our previous findings and explore potential explanations for past results. The new study failed to replicate our previous findings. The paper investigates whether the results obtained in our initial studies may have been caused by a genuine psychic effect, and this third experiment failed to replicate this finding because some aspect of the study disrupted the production of that effect, or whether the results from our first two studies represented chance findings or undetected subtle artifacts, and the results obtained in the present study accurately reflect the absence of a remote detection of staring effect. The implications of this work are discussed, along with the benefits of conducting collaborative work for resolving disagreements in other controversial areas of psychology.

Belief in psychic ability and the misattribution hypothesis: a qualitative review

This paper explores the notion that people who believe in psychic ability possess various psychological attributes that increase the likelihood of them misattributing paranormal causation to experiences that have a normal explanation. The paper discusses the structure and measurement of belief in psychic ability, then reviews the considerable body of work exploring the relationship between belief in psychic ability, and academic performance, intelligence, critical thinking, probability misjudgement and reasoning, measures of fantasy proneness and the propensity to find correspondences in distantly related material. Finally, the paper proposes several possible directions for future research, including: the need to build a multi-causal model of belief; to address the issue of correlation versus causation; to resolve the inconsistent pattern of findings present in many areas; and to develop a more valid, reliable and fine-grained measure of belief in psychic ability.

Is it worth pursuing surgery for epilepsy in patients with normal neuroimaging?

OBJECTIVE

To determine whether it is worth pursuing surgery for the treatment of epilepsy in patients with normal neuroimaging.

METHODS

Two patient populations were studied: (1) 136 consecutive patients who were surgically treated; (2) 105 consecutive patients assessed with chronically implanted intracranial electrodes within the same period. Sixty patients belonged to both groups, and included all 21 patients who had normal neuroimaging.

RESULTS

There were no differences in the proportion of patients with favourable outcome between those with normal and those with abnormal neuroimaging, irrespective of whether intracranial recordings were required. Among the 19 operated patients with normal neuroimaging, 74% had a favourable outcome (Engel's seizure outcome grades I and II), and among the 93 patients with abnormal neuroimaging, 73% had favourable outcome (p = 0.96). In patients with temporal resections, 92% of the 13 patients with normal neuroimaging had a favourable outcome, whereas among the 70 patients with abnormal neuroimaging, 80% had a favourable outcome (p = 0.44). In patients with extratemporal resections, two of the six patients with normal neuroimaging had a favourable outcome, while 12 of the 23 patients with abnormal neuroimaging had a favourable outcome (p = 0.65). Among the 105 patients studied with intracranial electrodes, five suffered transitory deficits as a result of implantation, and two suffered permanent deficits (one hemiplegia caused by haematoma and one mild dysphasia resulting from haemorrhage).

CONCLUSIONS

It is worth pursuing surgery in patients with normal neuroimaging because it results in good seizure control and the incidence of permanent deficits associated with intracranial studies is low.

An investigation into alleged 'hauntings'

In cases of alleged hauntings, a large number of seemingly trustworthy witnesses consistently report experiencing unusual phenomena (e.g. apparitions, sudden changes in temperature, a strong sense of presence) in certain locations. The two studies reported here explored the psychological mechanisms that underlie this apparent evidence of 'ghostly' activity. The experiments took place at two locations that have a considerable reputation for being haunted-Hampton Court Palace (Surrey, England) and the South Bridge Vaults (Edinburgh, Scotland). Both studies involved participants walking around these locations and reporting where they experienced unusual phenomena. Results revealed significantly more reports of unusual experiences in areas that had a reputation for being haunted. This effect was not related to participants' prior knowledge about the reputation of these areas. However, the location of participants' experiences correlated significantly with various environmental factors, including, for example, the variance of local magnetic fields and lighting levels. These findings strongly suggest that alleged hauntings may not necessarily represent evidence for 'ghostly' activity, but could be, at least in part, the result of people responding to 'normal' factors in their surroundings.

Selective innervation of lamina I projection neurones that possess the neurokinin 1 receptor by serotonin-containing axons in the rat spinal cord

Axons containing serotonin descend from brainstem to spinal cord and are thought to contribute to stimulation-produced and opioid analgesia, partly by a direct inhibitory action of serotonin on projection neurones. The density of serotoninergic innervation is highest in lamina I, which contains many nociceptive projection neurones. Two sets of anatomical criteria have been used to classify lamina I projection neurones: somatodendritic morphology and presence or absence of the neurokinin 1 receptor. To test whether the strength of serotoninergic innervation of lamina I projection neurones was related to morphology or neurokinin 1 receptor expression, we used confocal microscopy to determine the density of serotoninergic contacts on 60 cells retrogradely labelled from the caudal ventrolateral medulla. The contact density on neurones with the neurokinin 1 receptor was variable, with some cells receiving heavy input and others having few contacts. However, on average they received significantly more contacts (5.64 per 1000 microm(2) plasma membrane +/- 0.47, S.E.M.) than neurones which lacked the receptor (2.49 +/- .36). Among the neurokinin 1 neurones, serotoninergic innervation density was not related to morphology. Since the majority of serotoninergic boutons in lamina I of rat spinal cord do not appear to form synapses, we carried out electron microscopy on three heavily innervated neurokinin 1 receptor-immunoreactive projection neurones. Symmetrical synapses were found at 89% of serotoninergic contacts. These results indicate that serotoninergic innervation of lamina I projection neurones in the rat spinal cord is related to expression of neurokinin 1 receptors, but not to morphology, and that (at least on heavily innervated neurones) most serotonin-containing boutons which are in contact form synapses.

MOR-1-immunoreactive neurons in the dorsal horn of the rat spinal cord: evidence for nonsynaptic innervation by substance P-containing primary afferents and for selective activation by noxious thermal stimuli

A direct action of mu-opioid agonists on neurons in the spinal dorsal horn is thought to contribute to opiate-induced analgesia. In this study we have investigated neurons that express the mu-opioid receptor MOR-1 in rat spinal cord to provide further evidence about their role in nociceptive processing. MOR-1-immunoreactive cells were largely restricted to lamina II, where they comprised approximately 10% of the neuronal population. The cells received few contacts from nonpeptidergic unmyelinated afferents, but many from substance P-containing afferents. However, electron microscopy revealed that most of these contacts were not associated with synapses. None of the MOR-1 cells in lamina II expressed the neurokinin 1 receptor; however, the mu-selective opioid peptide endomorphin-2 was present in the majority (62-82%) of substance P axons that contacted them. Noxious thermal stimulation of the foot induced c-Fos expression in approximately 15% of MOR-1 cells in the medial third of the ipsilateral dorsal horn at mid-lumbar level. However, following pinching of the foot or intraplantar injection of formalin very few MOR-1 cells expressed c-Fos, and for intraplantar formalin injection this result was not altered significantly by pretreatment with systemic naloxone. Although these findings indicate that at least some of the neurons in lamina II with MOR-1 are activated by noxious thermal stimulation, the results do not support the hypothesis that the cells have a role in transmitting nociceptive information following acute mechanical or chemical noxious stimuli.

Should needle localization breast biopsy give way to the new technology; the advanced breast biopsy instrumentation

Between July 1995 and June 1997, 114 consecutive women underwent 118 breast biopsies for nonpalpable lesions. A limited procedure room and local anesthesia were used in 96.5 per cent of patients. Intravenous access was not established in 95 per cent of patients. Oral diazepam was given to 51 per cent of patients. Needle localization technique was used with a success rate of 97.5 per cent and average operative time of 18 minutes. Breast carcinoma was found in 29 (24.6 per cent) biopsies. A review of 99 of the 118 mammograms showed only 45 per cent of the lesions being amenable to the new technology, the advanced breast biopsy instrumentation. Advantages of the needle localization include short operative time; supine position for the patient; easy access to control bleeding; ability to choose a cosmetic site for the skin incision; minimal tissue removal before reaching the lesion; ability to maintain a sterile field; and applicability to almost any mammographic lesion identified, whether single or multiple. Disadvantages include the need for a separate procedure to place the wire and potential of missing the lesion in 2.5 per cent, requiring additional surgery.

GABAergic neurons that contain neuropeptide Y selectively target cells with the neurokinin 1 receptor in laminae III and IV of the rat spinal cord

Neuropeptide Y (NPY) is contained in a population of GABAergic interneurons in the spinal dorsal horn and, when administered intrathecally, can produce analgesia. We previously identified a strong monosynaptic link between substance P-containing primary afferents and cells in lamina III or IV with the neurokinin 1 (NK1) receptor. Because some of these cells belong to the spinothalamic tract, they are likely to have an important role in pain mechanisms. In this study, we used confocal microscopy to examine the input to lamina III/IV NK1 receptor-immunoreactive neurons from NPY-containing axons. All of the cells studied received a dense innervation from NPY-immunoreactive axons, and electron microscopy revealed that synapses were often present at points of contact. Most NPY-immunoreactive boutons were also GABAergic, which supports the suggestion that they are derived from local neurons. The association between NPY-containing axons and NK1 receptor-immunoreactive neurons was specific, because postsynaptic dorsal column neurons (which were located in laminae III-V but did not possess NK1 receptors) and lamina I neurons with the NK1 receptor received significantly fewer contacts from NPY-immunoreactive axons. In addition, the NK1 receptor-immunoreactive lamina III/IV cells received few contacts from nitric oxide synthase-containing axons (which belong to a different population of GABAergic dorsal horn neurons). The NPY-containing axons appeared to be targeted to the NK1 receptor-immunoreactive neurons themselves rather than to their associated substance P-immunoreactive inputs. The dense innervation of these cells by NPY-containing axons suggests that they may possess receptors for NPY and that activation of these receptors may contribute to NPY-mediated analgesia.

Cells in laminae III and IV of the rat spinal cord that possess the neurokinin-1 receptor and have dorsally directed dendrites receive a major synaptic input from tachykinin-containing primary afferents

Many neurons with cell bodies in laminae III or IV of the spinal dorsal horn possess the neurokinin 1 receptor and have dorsal dendrites that arborize in the superficial dorsal horn. We have performed a confocal microscopic study to determine whether these cells receive inputs from substance P-containing primary afferents. All neurons of this type received contacts from substance P-immunoreactive axons, and in most cases the contacts onto dorsal dendrites were very numerous. A great majority (90-100%) of substance P-immunoreactive varicosities in contact with these cells were also immunoreactive with antibody to calcitonin gene-related peptide, indicating that they were of primary afferent origin. The density of contacts from substance P-immunoreactive varicosities onto these cells was significantly higher than that seen on cholinergic neurons in lamina III (which do not possess the receptor). Electron microscopy revealed that synapses were present at points of contact between substance P-immunoreactive boutons and dorsal dendrites of cells with the neurokinin 1 receptor. Some cells of this type belong to the spinothalamic tract, and we therefore examined neurons with cell bodies in laminae III or IV that possessed the neurokinin 1 receptor and were labeled retrogradely after thalamic injection of cholera toxin B subunit. These cells also received contacts from substance P-immunoreactive axons on their dorsal dendrites. The results of this study indicate that neurons of this type are a major target for substance P-containing primary afferents.

An ultrastructural study of the glycine transporter GLYT2 and its association with glycine in the superficial laminae of the rat spinal dorsal horn

The glycine transporter GLYT2 is present in axonal boutons throughout the spinal cord, and its laminar distribution matches that of glycine-enriched axons, which are presumed to be glycinergic. In order to determine whether boutons which possess GLYT2 are glycine-enriched, we have carried out pre-embedding immunocytochemistry with antibody raised against GLYT2, and combined this with post-embedding detection of glycine, in the rat. GLYT2 immunoreactivity was present in boutons which formed symmetrical axodendritic, axosomatic or axoaxonic synapses, and was often seen in peripheral axons of type II synaptic glomeruli. One hundred and fifty GLYT2-immunoreactive boutons were analysed quantitatively, and in 142 (94.6%) of these the density of gold particles representing glycine-like immunoreactivity exceeded the background level (over presumed glutamatergic boutons) by at least a factor of two. Within immunoreactive boutons, the GLYT2 reaction product was associated with the plasma membrane, but often appeared as discrete clumps and was generally excluded from the region of the active sites of synapses. These results confirm that GLYT2 is associated with glycine-enriched axonal boutons in the superficial dorsal horn. They also suggest that GLYT2 is unevenly distributed on the plasma membrane of these boutons, and raise the possibility that it may be excluded from synaptic clefts.

The mu-opioid receptor (MOR1) is mainly restricted to neurons that do not contain GABA or glycine in the superficial dorsal horn of the rat spinal cord

The mu-opioid receptor MOR1 is present on primary afferent axons and a population of neurons in the superficial dorsal horn of the rat spinal cord. In order to determine which types of neuron possess the receptor we carried out pre-embedding immunocytochemistry with antibody to MOR1 and combined this with a post-embedding method to detect GABA and glycine in the rat. MOR1 immunoreactivity was seen on many small neurons in lamina II and a few in the dorsal part of lamina III. Although immunostaining was mainly restricted to the cell bodies and dendrites of these neurons, in some cases it was possible to see their axons, and a few of these entered lamina III. One hundred and thirty-nine MOR1-immunoreactive cells were tested with GABA and glycine antibodies, and the great majority of these (131 of 139; 94%) were not GABA or glycine immunoreactive, while the remainder showed GABA but not glycine immunoreactivity. These results suggest that most of the cells in the superficial dorsal horn which possess MOR1 are excitatory interneurons. They support the hypothesis that part of the action of mu-opioid agonists, such as morphine, involves the inhibition of excitatory interneurons which convey input from nociceptors to neurons in the deep dorsal horn, thus interrupting the flow of nociceptive information through polysynaptic pathways in the spinal cord.

Colocalization of GABA, glycine, and their receptors at synapses in the rat spinal cord

To determine whether GABA and glycine can act as cotransmitters at synapses in the rat spinal cord, we have compared the ultrastructural distribution of GABAA-receptor beta 3 subunit with that of the glycine receptor-associated protein gephyrin and combined this with postembedding detection of GABA and glycine. We also used a dual-immunofluorescence method to confirm that gephyrin was associated with the glycine-receptor alpha 1 subunit throughout the cord. GABAA beta 3-subunit immunoreactivity was restricted primarily to synapses, and at a majority of these synapses the presynaptic axon was GABA-immunoreactive. Many synapses showed both GABAA beta 3 and gephyrin immunoreactivity, and at most of these synapses GABA and glycine were enriched in the presynaptic axon. These results strongly support the idea that cotransmission by GABA and glycine occurs in the spinal cord.

The types of neuron in spinal dorsal horn which possess neurokinin-1 receptors

In order to provide further information about the types of spinal neuron which possess neurokinin-1 receptors, we have carried out pre-embedding immunocytochemistry on sections of rat lumbar spinal cord with an antiserum raised against a synthetic peptide corresponding to part of the sequence of the receptor, and combined this with post-embedding immunocytochemistry to detect GABA and glycine. Numerous neuronal cell bodies showing neurokinin-1 receptor-immunoreactivity were seen in lamina I, laminae III-VI, the lateral spinal nucleus and the area around the central canal. Most of the cells observed in lamina III were small and had relatively restricted dendritic trees which could often not be followed into lamina II, however some larger cells in laminae III and IV had dendrites which extended through lamina II and into lamina I. Cells of the latter type are likely to represent a major target of substance P released from small-diameter primary afferents in the superficial dorsal horn. The great majority (255 out of 283) of spinal neurons which possessed neurokinin-1 receptor-immunoreactivity, including all of those in lamina I, were not GABA- or glycine-immunoreactive, however a few cells in the deep part of the dorsal horn and the lateral spinal nucleus and several cells near the central canal were GABA-immunoreactive, and some of these were also glycine-immunoreactive. These results suggest that substance P acts through neurokinin-1 receptors mainly on excitatory neurons within the spinal cord.

Awake patient monitoring to determine the need for shunting during carotid endarterectomy

BACKGROUND

The indications for shunt placement to prevent cerebral ischemia during carotid endarterectomy have been controversial. Some investigators have recommended empiric shunting for patients presumed to be at higher risk for cerebral ischemia with a recent stroke or severe stenosis or occlusion of the contralateral internal carotid artery.

METHODS

Carotid endarterectomy was performed in 81 cases with cervical block anesthetic, monitoring the awake patient for the development of cerebral ischemia (unresponsiveness or paralysis) during carotid clamping. The need for shunting (based on awake response) was compared in patients with the arbitrarily defined empiric indications for shunting (n = 29) versus those who did not have such clinical or anatomic findings (n = 52).

RESULTS

Cerebral ischemia requiring shunting was observed in five (17.2%) of 29 cases with the defined indications for empiric shunting. This was not different than the need for shunting in the control group where cerebral ischemia was seen in eight (15.4%) of 52 cases. No intraoperative neurologic events occurred in any case, but one (1.2%) patient suffered a postoperative transient ischemia attack and another (1.2%) had a postoperative stroke.

CONCLUSIONS

Empiric clinical or anatomic indications for shunting were not reliable predictors of cerebral ischemia that developed during carotid clamping in this study. Awake patient monitoring during carotid endarterectomy with regional anesthetic allowed prompt, accurate identification of patients with cerebral ischemia who would clearly benefit from placement of a shunt.

Ultrastructural evidence of axonal shearing as a result of lateral acceleration of the head in non-human primates

The concept of shearing of axons at the time of non-impact injury to the head was first suggested in the middle of this century. However, no experimental model of diffuse axonal injury (DAI) has provided morphological confirmation of this concept. Evidence from experiments on invertebrate axons suggests that membrane resealing after axonal transection occurs between 5 and 30 min after injury. Thus, ultrastructural evidence in support of axonal shearing will probably only be obtained by examination of very short-term survival animal models. We have examined serial thin sections from the corpus callosum of non-human primates exposed to lateral acceleration of the head under conditions which induce DAI. Tearing or shearing of axons was obtained 20 and 35 min after injury, but not at 60 min. Axonal fragmentation occurred more frequently at the node/paranode but also in the internodal regions of axons. Fragmentation occurred most frequently in small axons. Axonal shearing was associated with dissolution of the cytoskeleton and the occurrence of individual, morphologically abnormal membranous organelles. There was no aggregation of membranous organelles at 20 and 35 min but small groups did occur in some axons at 60 minutes. We suggest that two different mechanisms of injury may be occurring in non-impact injury to the head. The first is shearing of axons and sealing of fragmented axonal membranes within 60 min. A second mechanism occurs in other fibres where perturbation of the axon results in axonal swelling and disconnection at a minimum of 2 h after injury.

Differences in the fatty acid composition of the grey and white matter of different regions of the brains of patients with Alzheimer's disease and control subjects

In the present study, a comparison was made of the fatty acid composition of the grey and white matter of the frontal, parietal and parahippocampal regions of post-mortem brains of patients who had died with Alzheimer's disease (n = 15) and control postmortem subjects (n = 10). Diagnosis of Alzheimer-type disease was based on the presence of senile plaques and neurofibrillary tangles in post-mortem sections. Several highly significant and specific differences were observed between the two groups. Adrenic acid (22:4 n-6) was three to four times higher in the grey matter but lower in the white matter in each of the three regions in the Alzheimer brains than in the control group. These alterations were compensated by reciprocal changes in 18:0 in the grey matter and 16:1 fatty acids in the white matter. There was no significant difference in the proportion of other fatty acids, including those of the n-6 and n-3 series, in either the grey or the white matter of any of the three regions of the two groups, except for a higher proportion of 22:6 n-3 in the parietal white matter in the Alzheimer patients. There was no significant relationship between the levels of the individual fatty acids and age at death. It is suggested that the alterations in the fatty acid composition observed in the brains of Alzheimer patients may be caused by an aberration in the system by which essential fatty acids are transported into the brain.

The cerebrovascular response to experimental lateral head acceleration

A number of microvascular changes, such as the development of astrocyte lucency, increased endothelial pit/vesicle activity, development of crater like lesions, and endothelial microvilli have been reported after injury to the brain. Lateral head acceleration in the non-human primate, however, still provides the best experimental model for human diffuse axonal injury. No attempt has yet been made to document the spatial extent or time course of the microvascular response to acceleration injury to the head. We have examined the brains of baboons 1, 4, 6, and 12 h and 7 days after acceleration injury to the head to analyse the microvascular response. In the experimental animals there was a short-term rise in intracranial pressure followed by a long-term resolution, and a reduction in both mean arterial blood pressure and cerebral perfusion pressure which, however, never dropped below 75% of baseline for more than 5 min after injury in any animal. We found evidence for extravasation of blood in a small number of blood vessels in all parts of the brain. Interendothelial tight junctions are not disrupted. Pit/vesicle activity rises in the 1st h in the occipital cortex, but not until 4 h in the frontal cortex, and remains elevated for at least 7 days. There is little change in the thalamus. Development of microvilli is most rapid in the frontal cortex with peak values at 1 h, but slower in the thalamus and occipital cortex where peak values are only obtained at 6 h. Highest numbers of microvilli occur in parasagittal regions of the brain.(ABSTRACT TRUNCATED AT 250 WORDS)

The isolation and characterization of high-density-lipoprotein subfractions containing apolipoprotein E from human plasma

1. Plasma high-density lipoprotein (HDL) was separated by heparin-Sepharose affinity chromatography into a non-bound, apolipoprotein E-poor, and a bound, apolipoprotein E-rich, fraction through the binding effect of Mn2+ in the column buffer. 2. The application of a series of elution buffers in which the concentration of Mn2+ was progressively replaced by Mg2+ resulted in the separation of the bound HDL into five subfractions. 3. Each subfraction migrated a different distance on gradient-gel electrophoresis. Three of the subfractions had RF (relative migration compared with BSA) values within the range of HDL2b. One subfraction contained largely HDL2a, with some material in the regions of HDL2b and HDL3a, and one subfraction spanned the RF regions of HDL2a, HDL3a and HDL3b. 4. The number of molecules, per HDL particle, of cholesteryl ester, non-esterified cholesterol and phospholipid increased with particle size, whereas triacylglycerol passed through a maximum and the number of amino acid residues remained approximately the same. 5. Apolipoprotein (apo) A-I was the major apoprotein in all five subfractions, but the latter differed appreciably in their contents of apo A-II and apo E. 6. The major fatty acid component of each subfraction was linoleic acid, with moderate amounts of C16:0 and C18:1 fatty acids and a smaller content of C18:0, C20:4,n-6 and C22:6,n-3, with no significant difference in composition between the subfractions. 7. This paper provides the first description of a method for the isolation of three subfractions of HDL2b together with other subfractions in quantities that are sufficient for further analytical or metabolic studies.

Changes in the choroid plexus, responses by intrinsic epiplexus cells and recruitment from monocytes after experimental head acceleration injury in the non-human primate

We have examined, by scanning and transmission electron microscopy, morphological changes in the choroid plexus of the lateral ventricles of the non-human primate brain after lateral head acceleration. We demonstrate passage of plasma and blood cells either through tears in blood vessels and the choroidal epithelium, or through the cells of the choroidal epithelium, 20 min after injury, together with morphological changes in that epithelium. At 3 and 4 h small cells with a reniform nucleus accumulate in the connective tissue core of the choroid plexus. We suggest that these are monocytes. At 6 and 12 h cells can be seen in enlarged intercellular spaces within the choroidal epithelium. These cells possess surface ruffles and we suggest that they are monocytes differentiating into macrophages and epiplexus cells. Further evidence for transepithelial migration of monocytes/macrophages is obtained at 7 days. However, at 28 days all blood has been removed from the surface of the choroid plexus and epiplexus cells possess an appearance typical of that in uninjured animals. The possible sources of epiplexus cells are discussed with reference to studies of responses after brain insult and of development. We have obtained no evidence in support of emperipolesis by monocytes through the choroidal epithelium. We suggest that monocytes/macrophages migrate, via an intercellular route, to differentiate into epiplexus cells, thus providing additional numbers of epiplexus cells after head injury.

Localisation of calcium ions and calcium-ATPase activity within myelinated nerve fibres of the adult guinea-pig optic nerve

There is no published description of the distribution of free Ca2+, nor of the distribution of Ca(2+)-ATPase activity associated with the maintenance of low axoplasmic Ca2+ concentrations, in normal central myelinated nerve fibres. We have used the oxalate-pyroantimonate technique to localise free Ca2+, together with the lead-citrate technique to localise Ca(2+)-ATPase activity within myelinated fibres from the adult guinea-pig optic nerve. Pyroantimonate precipitate occurred within the axoplasm at nodes of Ranvier and the internode, at areas of myelin disruption, within Schmidt-Lanterman incisures (SLI) and glial paranodal loops. But precipitate was absent from the axoplasm beneath SLI and at the paranode. Ca(2+)-ATPase activity was localised in axonal smooth endoplasmic reticulum (SER), the outer membrane of mitochondria, the nodal axolemma, the glial membranes of the paranodal loops, the SLI and the external aspect of the myelin sheath. We have demonstrated large domains within the axons of CNS fibres where calcium is present or absent. Moreover, we have shown that, where calcium is absent, there is localisation of Ca(2+)-ATPase activity, which would serve to remove calcium from the adjacent axoplasm. Our results are compared with information obtained from PNS fibres and some differences of distribution discussed.

The microvascular response to stretch injury in the adult guinea pig visual system

In a variety of brain injury models, both reactive axonal change and microvascular abnormalities occur. Development of a stretch injury model in the guinea pig optic nerve has allowed for the characterization of the early axonal response to injury. In this same model, we have now attempted to characterize those morphologic changes occurring in the visual system microvasculature after injury. Thirty adult guinea pigs were subjected to axonal stretch injury and killed at posttraumatic survival periods ranging from 10 minutes to 14 days. Twenty animals were examined by scanning electron microscopy (SEM) for the detection of posttraumatic changes in the surface morphology of the microvasculature, and 10 animals were processed for transmission electron microscopy (TEM) analysis. Through this approach, increased pit vesicle activity and formation of endothelial microvilli were recognized within 10 minutes of injury. Pit vesicle activity returned to control levels by 2 hours. The formation of endothelial microvilli was widespread, affecting the microvessels in both the stretched and unstretched optic nerves and in the chiasm. The greatest response developed most slowly in the stretched nerve, and it was faster but less marked in the unstretched nerve and chiasm. Microvilli were more numerous in larger vessels. Related astrocytic swelling/lucency was not apparent until 6 hours after injury. The astrocyte response was less marked than that documented after brain injury. The results of this investigation demonstrate a widespread microvascular response to stretch injury of the guinea pig optic nerve. Comparison with the documented responses to traumatic brain injury indicates different rates of response to different types of insult.

Reduced postprandial skeletal muscle blood flow contributes to glucose intolerance in human obesity

While it is well accepted that the disposal of an oral glucose load (OGL) occurs primarily in skeletal muscle, the mechanisms by which this occurs are not completely elucidated. Glucose uptake (GU) in skeletal muscle follows the Fick principal, such that GU equals the products of the arteriovenous glucose difference (AVGd) across and the blood flow (BF) into muscle. It is widely believed that in the postprandial period both insulin and glucose increase GU by increasing the AVGd; however, a role for increments in BF in the disposal and tolerance of an OGL has not been established. To investigate this issue, whole body GU (isotope dilution), leg GU (leg balance technique), leg BF, and cardiac index (CI) were measured after an overnight fast and over 180 min after an OGL (1 g/kg) in 8 lean (ln) and 8 obese (ob) subjects [mean +/- SEM age, 36 +/- 2 vs. 37 +/- 2 yr (P = NS) and 60 +/- 1 vs. 99 +/- 5 kg (P less than 0.01), respectively]. Serum glucose levels were higher in the ob than in the ln subjects between 100 and 160 min, indicating reduced glucose tolerance. Fasting and post-OGL serum insulin levels were 2- to 3-fold higher in ob vs. ln at all times, indicating insulin resistance. Peak (40-80 min) incremental whole body GU above baseline was 32% lower in ob vs. ln, (P less than 0.05). Peak femoral AVGd was not different between ob and ln (0.55 +/- 0.16 vs. 0.66 +/- 0.14 mmol/L; P = NS). Peak leg BF increased 36% over baseline in ln (0.328 +/- 0.052 to 0.449 +/- 0.073 L/min; P less than 0.05), while ob subjects displayed no change in leg BF from baseline. Consequently, peak leg GU was 44% lower in ob vs. ln (P less than 0.05). CI increased 24% from baseline at 60 min in ln (P less than 0.05), but was unchanged in ob. In summary, after an OGL 1) femoral AVGd increases in both ln and ob subjects, but skeletal muscle BF and CI increase in ln only; 2) since peak femoral AVGd values were similar in ln and ob, differences in peak leg GU and (by inference) whole body GU are largely due to reduced BF to insulin-sensitive tissues; and 3) hemodynamics play an important role in the physiological disposal of an OGL, and therefore, hemodynamic defects can potentially contribute to reduced glucose tolerance and insulin resistance.

The effect of clomipramine treatment on plasma lipoproteins and high density lipoprotein subfractions in healthy subjects

The effect of clomipramine on plasma lipoproteins, including high density lipoprotein (HDL) subfractions in five healthy males was investigated. The concentrations of total plasma cholesterol and low density lipoprotein cholesterol decreased slightly while that of total HDL-cholesterol showed a small increase, giving a decrease (p less than 0.05) in the ratio of total plasma cholesterol to HDL-cholesterol. The level of HDL2-cholesterol increased (p less than 0.01) with clomipramine treatment while there was no significant change in the concentration of HDL3-cholesterol. Gradient gel electrophoresis showed that administration of the drug was associated with an increase in the relative concentration of HDL2a as well as of HDL2b and a decrease in that of HDL3b/3c. The plasma concentration of apolipoprotein (Apo) A-I showed a small but insignificant increase. These changes in lipoprotein profile are characteristic of those associated with a decrease in coronary risk.