Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms. The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review.

Impact of non‐binding FDA guidances on primary endpoint selection in Alzheimer's disease trials

Introduction

The U.S. Food and Drug Administration (FDA)'s guidances help describe the agency's current thinking on regulatory issues and serve as a means of informal policymaking that is non‐binding. This study examines the impact of two guidance documents for Alzheimer's disease (AD) trials. The first guidance in 2013 encouraged the use of cognitive/functional endpoints, while the second in 2018 modified such recommendation.

Methods

Using pivotal trial data, we applied a regression discontinuity in time (RDiT) framework to examine trialist response to these guidance documents. Results were stratified by disease‐modifying therapy (DMT) status, and controlled for disease staging, FDA registration status, and trial phase.

Results

Among AD DMT trials, annual use of cognitive/functional composite endpoints significantly increased after the 2013 guidance (+12.9%, P < .001), and significantly decreased after the 2018 guidance (–19.9%, P = .022).

Discussion

Although guidance documents do not set new legal standards or impose binding requirements, our findings indicate they are broadly followed by AD trialists.

Turning Neural Prosthetics Into Viable Products

Academic researchers concentrate on the scientific and technological feasibility of novel treatments. Investors and commercial partners, however, understand that success depends even more on strategies for regulatory approval, reimbursement, marketing, intellectual property protection and risk management. These considerations are critical for technologically complex and highly invasive treatments that entail substantial costs and risks in small and heterogeneous patient populations. Most implanted neural prosthetic devices for novel applications will be in FDA Device Class III, for which guidance documents have been issued recently. Less invasive devices may be eligible for the recently simplified “de novo” submission routes. We discuss typical timelines and strategies for integrating the regulatory path with approval for reimbursement, securing intellectual property and funding the enterprise, particularly as they might apply to implantable brain-computer interfaces for sensorimotor disabilities that do not yet have a track record of approved products.

Biobank Continuity Management: A Survey of Biobank Professionals

Academic biobanks face challenges that call for continuity and disaster planning. However, current regulations do not require such planning, so it is unclear if and how biobanks have prepared themselves to deal with future crises. This exploratory study used mixed methods to understand the state of continuity planning in U.S. biobanks. It first reviewed the current state of regulatory and implementation requirements that drive and challenge continuity planning. A survey instrument was then developed and critiqued by a focus group of experienced practitioners in biobanking. The refined survey was disseminated to a targeted group of respondents employed at biobanks across the United States. Most respondents were associated with relatively mature biobanks in operation for more than 6 years and these typically had some form of continuity plan in place. More commonly, continuity planning was reported to be focused on countering natural disasters rather than organization- or personnel-related crises. Respondents identified their most common limitation to be financial resources affecting all phases of implementation. Although many respondents appeared to be aware of some guidance documents and standards for continuity planning, many reported that they did not use or reference them when constructing their biobank continuity plans. Furthermore, nearly 25% of surveyed biobanks did not have a continuity plan and 61% indicated concern in having a mandated continuity plan. Results suggested academic organizations would benefit from a continuity plan template and best practice guidelines for plan development and implementation.

Assessing the Benefit-Risk Profile for Pediatric Implantable Auditory Prostheses

BACKGROUND/AIMS

Children with congenital cochleovestibular abnormalities associated with profound hearing loss have few treatment options if cochlear implantation does not yield benefit. An alternative is the auditory brainstem implant (ABI). Regulatory authority device approvals currently include a structured benefit-risk assessment. Such an assessment, for regulatory purposes or to guide clinical decision making, has not been published, to our knowledge, for the ABI and may lead to the design of a research program that incorporates regulatory authority, family, and professional input.

METHODS

Much structured benefit-risk research has been conducted in the context of drug trials; here we apply this approach to device studies. A qualitative framework organized benefit (speech recognition, parent self-report measures) and risk (surgery- and device-related) information to guide the selection of candidates thought to have potential benefit from ABI.

RESULTS

Children with cochleovestibular anatomical abnormalities are challenging for appropriate assessment of candidacy for a cochlear implant or an ABI. While the research is still preliminary, children with an ABI appear to slowly obtain benefit over time. A team of professionals, including audiological, occupational, and educational therapy, affords maximum opportunity for benefit.

CONCLUSIONS

Pediatric patients who have abnormal anatomy and are candidates for an implantable auditory prosthetic require an individualized, multisystems review. The qualitative benefit-risk assessment used here to characterize the condition, the medical need, potential benefits, risks, and risk management strategies has revealed the complex factors involved. After implantation, continued team support for the family during extensive postimplant therapy is needed to develop maximum auditory skill benefit.

Incentivizing Quality in the Manufacture of Pharmaceuticals: Industry Views on Quality Metrics and Ratings

BACKGROUND

An increasing number of industry-wide quality breaches and consequential drug shortages have fueled interest in finding better ways to improve the manufacturing quality of pharmaceuticals. Quality metrics offer a way of focusing FDA inspectional resources by using risk-based paradigms and communicating the quality status of different companies to other stakeholders. This exploratory study investigated industry views related to the use of quality metrics and ratings to help advance these discussions.

METHODS

A 23-question survey engaged 2 separate populations of industry professionals: a panel of identified US industry experts (n = 110) and a broader population (n = 328) of professionals working primarily in southern California.

RESULTS

FDA metrics most valued by industry were warning letters and other observations, often characterized as "lagging" metrics. Respondents were generally hesitant to share information that would establish "leading" metrics, such as process performance measures that may warn of problems earlier. Ratings were recognized to incentivize higher quality by broadening stakeholder influence. However, concerns were identified related to the equity, misuse, or misunderstanding of the rating schemes and underlying metrics.

CONCLUSIONS

Industry is an important stakeholder in the development of metrics. The concerns of industry must be recognized and addressed if policies related to metrics and ratings are to be effective in building an industry-wide quality culture.

Management of Clinical Trial Agreements: Current Practices of Investigators in the United States

The clinical trial agreement (CTA) is a key but often underappreciated document governing the relationship between a study site and a sponsor. Previous anecdotal materials have suggested that investigators may not often be involved in the review or negotiation of the CTA and may attach little importance to it. To provide more systematic current information, survey methods were used to explore the level of engagement, knowledge, and perceptions of investigators in the United States. The survey was distributed to more than 700 investigators-university affiliated and nonaffiliated-and/or related study staff, of whom 167 responded. Most respondents identified that they did not manage the clinical trial agreement process but were actively engaged in its review. Most were encouraged by their institutions to participate. However, some respondents expressed concerns with regard to their satisfaction with the content of the CTA, particularly with respect to issues such as financial negotiations and payments, indemnification, and subject injury language. The majority of investigators either strongly agreed or agreed that it was important for the investigator to be actively involved in the CTA process. Data from this survey provide the first systematic look at the current practices of US investigators, possible issues, and areas for improvement from the investigator's point of view.

Percutaneous fiber-optic sensor for chronic glucose monitoring in vivo

We are developing a family of fiber-optic sensors called Sencils (sensory cilia), which are disposable, minimally invasive, and can provide in vivo monitoring of various analytes for several weeks. The key element is a percutaneous optical fiber that permits reliable spectroscopic measurement of chemical reactions in a nano-engineered polymeric matrix attached to the implanted end of the fiber. This paper describes its first application to measure interstitial glucose based on changes in fluorescence resonance energy transfer (FRET) between fluorophores bound to betacyclodextrin and Concanavalin A (Con A) in a polyethylene glycol (PEG) matrix. In vitro experiments demonstrate a rapid and precise relationship between the ratio of the two fluorescent emissions and concentration of glucose in saline for the physiological range of concentrations (0-500mg/dl) over seven weeks. Chronic animal implantation studies have demonstrated good biocompatibility and durability for clinical applications.

Neck muscles in the rhesus monkey. II. Electromyographic patterns of activation underlying postures and movements

Electromyographic (EMG) activity was recorded in < or = 12 neck muscles in four alert monkeys whose heads were unrestrained to describe the spatial and temporal patterns of neck muscle activation accompanying a large range of head postures and movements. Some head postures and movements were elicited by training animals to generate gaze shifts to visual targets. Other spontaneous head movements were made during orienting, tracking, feeding, expressive, and head-shaking behaviors. These latter movements exhibited a wider range of kinematic patterns. Stable postures and small head movements of only a few degrees were associated with activation of a small number of muscles in a reproducible synergy. Additional muscles were recruited for more eccentric postures and larger movements. For head movements during trained gaze shifts, movement amplitude, velocity, and acceleration were correlated linearly and agonist muscles were recruited without antagonist muscles. Complex sequences of reciprocal bursts in agonist and antagonist muscles were observed during very brisk movements. Turning movements of similar amplitudes that began from different initial head positions were associated with systematic variations in the activities of different muscles and in the relative timings of these activities. Unique recruitment synergies were observed during feeding and head-shaking behaviors. Our results emphasize that the recruitment of a given muscle was generally ordered and consistent but that strategies for coordination among various neck muscles were often complex and appeared to depend on the specifics of musculoskeletal architecture, posture, and movement kinematics that differ substantially among species.

Neck muscles in the rhesus monkey. I. Muscle morphometry and histochemistry

Morphometric methods were used to describe the musculotendinous lengths, fascicle lengths, pennation angles, and cross-sectional areas of neck muscles in adult Macaca mulatta monkeys. Additionally, muscles were frozen, sectioned, and stained for ATPase activity to determine fiber-type composition. Individual rhesus muscles were found to vary widely in their degree of similarity to feline and human muscles studied previously. Suboccipital muscles and muscles supplied by the spinal accessory nerve were most similar to human homologs, whereas most other muscles exhibited architectural specializations. Many neck muscles were architecturally complex, with multiple attachments and internal aponeuroses or tendinous inscriptions that affected the determination of their cross-sectional areas. All muscles were composed of a mixture of type I, IIa, and IIb fiber types the relative proportions of which varied. Typically, head-turning muscles had lower proportions of type II (fast) fibers than homologous feline muscles, whereas extensor muscles contained higher proportions of type II fibers. The physical and histochemical specializations described here are known to have a direct bearing on functional properties, such as force-developing capacity and fatigue-resistance. These specializations must be recognized if muscles are to be modeled accurately or studied electrophysiologically.

Real-time sonography to estimate muscle thickness: comparison with MRI and CT

PURPOSE

We investigated the feasibility of using real-time sonography to measure muscle thickness. Clinically, this technique would be used to measure the thickness of human muscles in which intramuscular microstimulators have been implanted to treat or prevent disuse atrophy.

METHODS

Porcine muscles were implanted with microstimulators and imaged with sonography, MRI, and CT to assess image artifacts created by the microstimulators and to design protocols for image alignment between methods. Sonography and MRI were then used to image the deltoid and supraspinatus muscles of 6 healthy human subjects.

RESULTS

Microstimulators could be imaged with all 3 methods, producing only small imaging artifacts. Muscle-thickness measurements agreed well between methods, particularly when external markers were used to precisely align the imaging planes. The correlation coefficients for sonographic and MRI measurements were 0.96 for the supraspinatus and 0.97 for the deltoid muscle. Repeated sonographic measurements had a low coefficient of variation: 2.3% for the supraspinatus and 3.1% for the deltoid muscle.

CONCLUSIONS

Real-time sonography is a relatively simple and inexpensive method of accurately measuring muscle thickness as long as the operator adheres to a strict imaging protocol and avoids excessive pressure with the transducer.

Recruitment properties of intramuscular and nerve-trunk stimulating electrodes

Functionally useful reanimation of paralyzed limbs generally requires reliable, finely graded control of muscle recruitment and force with minimal fatigue. We used force and electromyographic (EMG) recordings in combination with myofibrillar adenosine triphosphatase activity and glycogen depletion analysis to investigate the recruitment properties of intramuscular (IM) and nerve cuff (NC) stimulating electrodes implanted acutely or chronically in cat hindlimbs. Overall, 32 muscles were submaximally stimulated with current intensities producing approximately 20% of maximal twitch force using 330 ms trains of pulses at 20 and 40 pps. Both the glycogen-depletion and fatigue-test results were found to be difficult to interpret because NC stimulation resulted in surprisingly unstable recruitment during such trains. Fluctuations of force and M-waves within trains of identical stimuli were significantly greater for NC than for IM stimulation. NC stimulation produced much steeper recruitment curves and a reduced tetanus/twitch ratio compared to IM stimulation. IM stimulation produced more reliable and less fatigable recruitment of a mix of motor unit types that tended to be localized in neuromuscular compartments containing, or adjacent to, the IM electrode. We hypothesize that trains of submaximal stimulation applied through NC electrodes resulted in fluctuating recruitment because this electrode configuration magnifies the effects of refractoriness and small changes in axonal excitability during pulse trains.

Morphometry, histochemistry, and innervation of cervical shoulder muscles in the cat

Morphometric and histochemical methods were used to estimate the force-developing capabilities and fiber-type contents of four muscle complexes (rhomboideus, levator scapulae, trapezius, and sternomastoideus) that link the shoulder girdle to the skull and cervical vertebrae. Each complex contained at least two member muscles that were distinctive architecturally and often had specialized innervation patterns. Trapezius and sternocleidomastoideus were innervated by both cranial nerve XI and cervical spinal nerves. Glycogen depletion of trapezius suggested that the nerves derived from cervical roots might be entirely sensory. Muscles within each complex varied in physiological cross-sectional area from less than 0.1 cm2 to greater than 1 cm2. They showed differences in fiber-type composition that suggested specialized roles for different behaviors. The morphometric features of the cervical shoulder muscles suggest that they have considerable potential to produce head movements and should be incorporated into feline head-movement models.

Marked non-uniformity of fiber-type composition in the primate suboccipital muscle obliquus capitis inferior

Obliquus capitis inferior (OCI) is a monoarticular suboccipital muscle linking the transverse process of the atlas (C1) to the spinous process of the axis (C2). Histochemical analysis of fiber-type composition showed that the muscle has a marked gradient of fiber-type distribution in which type I fibers comprise 95-100% of fibers in the deepest region but less than 10% of fibers in the superficial layer. Step-like changes in fiber-type proportions occurred between groups of fascicles. In most instances the boundaries between these fascicles did not exhibit different perimysial features from those fascicles with similar fiber-type proportions. OCI contained large numbers of muscle spindles, which were concentrated in deep regions rich in type I fibers. The degree of nonuniformity in fiber-type distribution seen in OCI is unusually large when compared with patterns described in other primate muscles, and has implications for the way that the muscle is studied anatomically and physiologically.

Effects of regional stimulation using a miniature stimulator implanted in feline posterior biceps femoris

The effects of placement of a miniature implantable stimulator on motor unit recruitment were examined in the posterior head of cat biceps femoris. The implantable stimulator (13-mm long x 2-mm diameter) was injected either proximally near the main nerve branch, or distally near the muscle insertion, through a 12-gauge hypodermic needle. Glycogen-depletion methods were used to map the distribution of fibers activated by electrical stimulation. Muscle fibers were found to be depleted at most or all proximodistal levels of the muscle, but the density of depleted fibers varied transversely according to the stimulus strength and proximity of the device to the nerve-entry site. Thus, muscle cross sections often had a "patchy" appearance produced because different proportions of depleted fibers intermingled with undepleted fibers in different parts of the cross section. In other preparations, the force of muscle contraction was measured when stimuli of varying strengths were delivered by the stimulator positioned at the same proximal or distal sites within the muscle. Devices placed close to the nerve-entry site produced the greatest forces. Those placed more distally produced less force. As stimulus current and/or pulse width increased, muscle force increased, often in steps, until a maximum was reached, which was usually limited by the compliance voltage of the device to less than the force produced by whole nerve stimulation.

Long-term biocompatibility of a miniature stimulator implanted in feline hind limb muscles

Chronic foreign-body responses and muscular changes were examined following the implantation of active miniature stimulators into the hind limb muscles of cats for periods of up to three months. The radio-frequency (RF)-powered stimulators were injected into muscles through a 12-gauge hypodermic needle. The tissue responses around the active stimulators were compared histologically to those provoked by passive devices, broken glass, silicone tubing, polyester suture material coated with polybutylate, and two of the internal components of the stimulator (ferrite, integrated circuit chip). Active and passive stimulators produced similar, benign foreign-body reactions that resulted in an essentially identical fibrous capsule over time. The responses were similar to those produced by the internal components and the suture material, and were more modest than those produced by the broken glass. The capsule did not appear to interfere with the functionality of active devices because thresholds measured during the post-implantation survival period did not change significantly over time. Unexpectedly, the severity of the reaction differed significantly amongst the various target muscles. Medial gastrocnemius exhibited the most severe response, whereas tibialis anterior had the least reaction.

Feline caudofemoralis muscle. Muscle fibre properties, architecture, and motor innervation

Feline caudofemoralis (CF) is a promising preparation in which to study the properties of mammalian fast-twitch skeletal muscle, but little is known about its muscle fiber properties, architecture, and motor innervation. We used histochemical techniques to confirm that it contained predominantly type IIB fibers (95+/-2%, n=8, with six of eight muscles composed exclusively of type IIA and IIB fibers), but physiological experiments showed less fatiguability than for the type IIB component of medial gastrocnemius. This may be related to the surprisingly strong and regular recruitment of CF during repetitive tasks such as walking and trotting, which we demonstrated electromyographically. We measured muscle length over the anatomical range of motion for CF (approximately 0.6-1.2 L0) and estimated working length during walking and trotting (approximately 0.95-1.15 L0). The specific tension was similar to that of the exclusively slow-twitch soleus muscle (31.2+/-4.7 N/cm2 compared with 31.8+/-4.1 N/cm2; P>0.8). Single fiber dissections of CF revealed a series-fibered architecture with a mean of 2.3 fibers, each 2.5 cm long, required to span the fascicle length. We identified two neuromuscular compartments in CF by cutting one of the two nerve branches innervating CF and depleting the glycogen stores in the intact motor units. These compartments were in parallel and extended the length of the muscle; their electromyographic activity was similar during various natural behaviors. CF and gluteus maximus motoneurons were labeled concurrently with a combination of fluorescent, retrograde tracers including Fluororuby, Fluorogold and Fast Blue. The CF motor nucleus was located in L7-S1, overlapping and intermingling extensively with the nucleus of the adjacent gluteus maximus muscle. Distributions of CF motoneuron diameter revealed one large peak around 50-55 microm, with relatively few small-diameter (less than 35 microm) cells. Using estimates of the total number of fibers in three muscles and the estimated number of alpha-motoneurons for those same muscles, we calculated a mean innervation ratio of approximately 270, which is at the low end of the innervation ratios for type IIB motor units from other feline muscles and more similar to type IIA motor units. In general, CF appears to be a useful preparation in which to study the properties of fast-twitch muscle, but these properties may vary somewhat from type IIB fibers from different muscles.

Morphometry of human neck muscles

STUDY DESIGN

Cadaveric dissections were used to study muscle morphometry.

OBJECTIVE

To describe systematically the musculotendinous lengths, fascicle lengths, pennation angles, and physiologic cross-sectional areas of neck and shoulder muscles implicated in head movement.

SUMMARY OF BACKGROUND DATA

In previous studies of neck-muscle anatomy, researchers described only a subset of muscle features, often using crude or indirect methods. None used microdissected muscles to correct measured parameters for the presence of multiple fiber compartments, internal aponeuroses, or variations in fiber or sarcomere length required for qualitative models of force-generating capabilities.

METHODS

Muscle mass, pennation angle, fascicle length, and sarcomere length were measured in 14 neck muscles from 10 human cadavers. Architecturally complex muscles with multiple attachments were divided into subvolumes, and each subvolume was examined from both the superficial and deep surfaces, Internal aponeuroses were microdissected within muscles to characterize architectural specializations. Physiologic cross-sectional areas were calculated from the morphometric data.

RESULTS

The neck musculature was architecturally complex. Many muscles crossed two or more joints and had multiple attachments to different bones. In some, the presence of tendons and aponeuroses was associated with specializations in fascicle organization. Considerable interindividual variation was found in the number and location of tendinous insertions of the scalenes and longissimus capitis muscles. In addition, rhomboideus showed significant variations in its size and shape. The cross-sectional areas of neck muscles from large and small subjects did not scale proportionately with body height and weight, nor did individual muscles with widely varying cross-sectional areas (0.3-15.3cm2) scale from on subject to another.

CONCLUSIONS

The accuracy of morphometry can be improved by incorporating measurements made by microdissecting neck muscles. The presence of aponeurotic attachments can greatly shorten fascicle length; failure to identify such attachments can lead to underestimates of cross-sectional areas. Accuracy of a generalized model of the neck is also improved by normalizing sarcomere lengths in all muscles.

Shoulder and forelimb orientations and loading in sitting cats: implications for head and shoulder movement

A three-dimensional static analysis was carried out to characterize the effects of ground reaction forces propagated through different joints in the forelimb and shoulder of quietly sitting cats. Stereofluoroscopy, used to identify the orientations of bones, showed that the scapula is held in a parasagittal plane, with its vertebral border located dorsally to the spines of thoracic vertebrae. The forelimb is held with the elbow flexed. Loading on the elbow tended to flex and adduct the ulna, whereas loading on the glenohumeral joint tended to extend, adduct and internally rotate the humerus. Loading on the scapula was confined primarily to the sagittal plane and tended to rotate the vertebral border of the scapula caudally around the head of the humerus. This caudally-directed moment suggests that the static equilibrium of the feline scapula depends upon muscular forces directed cranially, presumably by way of attachments on the skull and cervical column. The differing arrangement of the shoulder-to-neck transition in cats and humans suggests caution in the use of feline models to represent some aspects of human head movement.

How to construct and move a cat's neck

Extensive information has been accumulated over the past several years about the head-neck sensory-motor system, in particular that relating to cats. Using still x-ray and cineradiographic analysis, the skeletal geometry of head-neck posture in three dimensions--when an animal is resting, actively orienting, or locomoting--is described. From these descriptions, cervical, vertebral, and craniocervical joint biomechanics for all three rotational dimensions are quantified. These behavioral data on muscle and skeletal movements have been incorporated in a biomechanical, functional anatomical model of the head-neck movement system. Individual as well as groups of neck muscles have been measured in detail and their kinematics determined. The role of a number of these muscles will be described for several reflex and voluntary behavioral contexts, including muscle co-contractions. Having established how each movement is accomplished, the neuronal sensory-motor reflex basis of head-neck system stabilization in space is addressed. The vestibular system is largely responsible for acquisition and maintenance of upright posture. The bilateral semicircular canals (horizontal, anterior, posterior) and otoliths (sacculus, utriculus) feed information differentially to specific neck muscles: these connections are reviewed with regard to the origin of the reflex are from each receptor to its destination of specific muscles. Behavioral data from normal animals, and from animals whose vestibular receptor systems are selectively lesioned, will be reviewed to complement the functional interpretation of the sensory-motor transformations. Finally, the requirements for space-time coordinated cat head-neck movements will be synthesized, based on biomechanics, muscle kinematics, canal/otolith connectivity, and selective lesion experiments.

Distribution of motoneurons supplying feline neck muscles taking origin from the shoulder girdle

A combination of fluorescent retrograde tracers and horseradish peroxidase (HRP) was used to compare the spinal distributions of motoneurons supplying shoulder muscles with attachments to the skull and cervical spinal cord that suggest a significant role in head movement. Two muscles, the rhomboideus and the levator scapulae, were innervated by multiple segmental nerve bundles that entered the muscles at different rostrocaudal locations. Motoneurons that were labelled retrogradely from rhomboideus nerve bundles formed a single, long column in the ventral horn from C4 to C6, lateral to previously studied motor nuclei supplying deep neck muscles. When different tracers were used to differentiate motoneurons supplying specific nerve bundles, discrete subnuclei could be identified that were organized in a rostrocaudal sequence corresponding to the rostrocaudal order of the nerve bundles. Levator scapulae motoneurons formed a second elongate column immediately lateral to the rhomboidues motor nucleus. Three other muscles, that trapezius, sternomastoideus, and cleidomastoideus, were supplied by cranial nerve XI. Labelled motoneurons from these muscles formed a single column from the spinomedullary junction to middle C6. Within this column, the three motor nuclei supplying the sternomastoideus, cleidomastoideus, and trapezius were laminated mediolaterally. Sternomastoideus and cleidomastoideus motoneurons were confined to upper cervical segments, whereas trapezius motoneurons were found from C1 to C6. In C1 and C6, the motoneuron column was located centrally in the gray matter, but, between C2 and C5, the column lay on the lateral wall of the ventral horn in a position dorsolateral to motor nuclei supplying the rhomboideus and the deeper neck muscles. The findings in this study suggest that descending and propriospinal systems responsible for coordinating head movement may have to descend as far caudally as C6 if they are to project onto muscles controlling the mobility of the lower neck.

Effect of neck posture on patterns of activation of feline neck muscles during horizontal rotation

The electromyographic (EMG) patterns of neck muscles were recorded during whole-body horizontal rotation in head-free, alert cats and head-restrained, decerebrate cats. In some trials the cervical column of the animal was oriented vertically, whereas in others it was oriented more horizontally. In alert cats making head movements that compensated for the motion of the platform, neck muscles with modulated patterns of activity could be divided into a subset whose individual EMG patterns changed significantly when the neck posture was altered (including longissimus capitis, obliquus capitis superior and scalenus anterior) and a subset whose individual EMG patterns were invariant regardless of neck posture (including obliquus capitis inferior, levator scapulae and complexus). In head-restrained, decerebrate cats, electromyograms from all implanted muscles were modulated similarly in phase with the platform position. Changing the orientation of the neck had little effect upon these EMG patterns evoked by the horizontal vestibulocollic reflex. One decerebrate cat with strong extensor tone was tested further under head-free conditions. There was very little compensatory head movement, but individual neck muscles displayed patterns of activity that were more similar to those observed in alert, head-free animals.

A novel method to identify migration of small implantable devices

A histologic method has been developed to assess the migration of chronically-implanted intramuscular devices. Bullet-shaped glass devices with varying tip configurations and glass-encapsulated microstimulators of a similar size were loaded with the fluorescent tracer Procion Yellow dissolved in molten glucose. Dissolution of the hardened glucose soon after contact with body fluids released the Procion Yellow, which binds irreversibly to local tissues, thereby marking the initial site of implantation with a localized fluorescent spot. After survival times of 2-7 weeks, histologic analysis usually showed a close physical relationship between the fluorescent spot and the connective-tissue capsule from which the device was extracted. In one case, migration of a sharply pointed device from the deep surface of an implanted muscle was recognized by differences in the location of the dye spot and the site of explantation from nearby fascia. Results suggested that this method could measure migratory distances as small as 5-10 mm.

Effect of neck posture on the activation of feline neck muscles during voluntary head turns

1. To determine whether neck posture affects the usage of neck muscles during a specific motor task, we recorded the electromyographic (EMG) patterns of neck muscles in four cats, which made horizontal, head-turning movements to fixate eccentrically placed targets. In some trials, the cervical column was oriented vertically whereas in other trials, the cervical column was oriented more horizontally. 2. During horizontal head movements, five muscles (obliquus capitis inferior, splenius, levator scapulae, complexus, and biventer cervicis) displayed activation patterns that were consistent from cat to cat and did not change when the cats adopted a different neck posture. Most of these muscles are large, superficial muscles that attach to the skull and span many cervical joints. 3. Posturally dependent patterns of activation were observed in five other neck muscles (semispinalis cervicis, longissimus capitis, levator scapulae ventralis, scalenus anterior, and obliquus capitis superior). Most of these muscles lie deeper and more laterally within the neck musculature and generally span fewer cervical joints than the muscles that displayed invariant patterns of activation. 4. These results suggest that the set of invariantly activated muscles may compose part of a basic motor program that is triggered during head movements in the horizontal plane. This motor program appears to be modified by the selective activation of ancillary muscles, which are recruited in a manner related to the neck posture. The deep positioning of the ancillary muscles may permit them to regulate the mobility of the cervical column and to adjust the net muscular force applied across the neck to the skull. Organizing the motor output in this manner might simplify the task of computing the appropriate patterns of neck-muscle activation.

Organization of single motor units in feline sartorius

1. We depleted single motor units in feline sartorius muscles of glycogen by stimulating their motoneurons intracellularly. We mapped the intramuscular distribution of depleted fibers by inspecting histological cross-sections throughout the length of sartorius. 2. We selected ten depleted motor units for detailed study and quantitative analysis. Nine motor units were located in the anterior head of sartorius. One was located in a muscle whose distal half appeared to have been damaged some time before the acute experiment. A single motor unit was located in the medial head of sartorius. 3. Five motor units were composed of fast-twitch glycolytic (FG) muscle fibers, two of fast-twitch oxidative glycolytic (FOG) muscle fibers, and three of slow-twitch oxidative (SO) muscle fibers. Estimates of the numbers of depleted fibers in motor units of anterior sartorius indicated that FG motor units were larger (mean 566 fibers) than FOG and SO motor units (SO mean 190, FOG mean 156 fibers). The SO motor unit in the damaged muscle had 550 fibers. One motor unit depleted in the medial head of sartorius had 270 fibers with FG profiles. 4. Muscle fibers belonging to each anterior motor unit were never distributed throughout the whole cross-section of anterior sartorius at any proximodistal level. Furthermore, fibers were distributed nonuniformly along the proximodistal axis of the muscle. In most muscles at least a few depleted fibers were found at all proximodistal levels. However, in one normal muscle and the damaged muscle, depleted fibers were confined to the proximal end. 5. The fibers in the medial motor unit were confined to a strip that did not extend across the whole cross-section of the muscle head. Fibers within this strip were scattered quite evenly from origin to insertion. This medial FG motor unit occupied a smaller territory and contained fewer fibers than anterior motor units of the same histochemical type. 6. These results show that sartorius motor units are not distributed uniformly in the mediolateral plane; those in anterior sartorius were distributed asymmetrically in the proximodistal axis as well. This finding has important functional implications for the way in which we model force development and transmission in sartorius and other long muscles.

Distribution of motoneurons supplying dorsal and ventral suboccipital muscles in the feline neck

A combination of retrograde tracers was used to compare the relative distributions of motoneurons supplying the ventral and lateral suboccipital muscles, rectus capitis anterior (RCA), and rectus capitis lateralis (RCL), with those supplying dorsal muscles, including rectus capitis posterior muscles (RCP), complexus (CM), and the medial head of obliquus capitis superior (OCS). Three of the tracers, horseradish peroxidase, fluororuby, and fluorescein-conjugated dextran, were applied to cut nerve ends. Fast blue was applied by intramuscular injection, and fluorogold was delivered both by injection and by cut nerve exposure. Motoneurons supplying RCA and RCL were clustered on the medial wall of the ventral horn in a restricted region defined previously as the commissural nucleus. Labelled cells supplying RCL were confined to the C1 segment, but those supplying RCA were distributed from C1 to rostral C4. Motoneurons supplying RCA tended to lie more dorsomedially than those supplying RCL, but there was substantial overlap between the two populations. Motoneurons supplying dorsal muscles had a separate, more ventral distribution. RCP motoneurons were located primarily in the ventromedial nucleus, but a small proportion of cells was found in the white matter of the ventral funiculus or the gray matter surrounding the central canal. Motoneurons supplying CM and OCS were located dorsomedially to the RCP cell population. These results suggest that neck motoneurons are arranged according to a "musculotopic" pattern in which dorsal muscles have the most ventral locations, and progressively more lateral and then ventral muscles are layered dorsomedially along the medial wall of the ventral horn.

Efficacy of seven retrograde tracers, compared in multiple-labelling studies of feline motoneurones

The labelling efficacies of 7 retrograde tracers were evaluated following cut nerve exposure or intramuscular injection into the serially compartmentalized neck muscle, biventer cervicis. Tested tracers included Fast Blue (FB), Fluorogold (FG), dextran conjugated to fluorescein (FD), dextran conjugated to rhodamine (Fluororuby (FR), 3000 and 10,000 MW), fluorescent latex microspheres, horseradish peroxidase coupled to colloidal gold, and 1,1'-dioctadecyl-3,3,3',3'-tetramethyl indocarbocyanine perchlorate (DiI). In 2 animals, horseradish peroxidase was also employed and spinal cords were processed for peroxidase activity to evaluate its effect on the appearance of cells labelled with fluorescent tracers. Four tracers, FB, FG, FD and FR, could be observed in motoneurones under the conditions of our study. FB and FG labelled comparable numbers of motoneurones following cut nerve exposure, but dissimilar numbers following intramuscular injection. FG diffused extensively following injection and was found in motoneurones not only in the appropriate ipsilateral segment but also adjacent ipsilateral and contralateral segments. Intramuscular injections of FB usually labelled fewer cells than cut nerve exposure, but evidence for spurious labelling following intramuscular injection could also be found. FD or FR labelled motoneurones following cut nerve exposure but not following intramuscular injection. The conjugated dextrans labelled more variable numbers of cells than FB or FG, but the labelled cells had similar patterns of distribution. The remaining tracers were ineffective as retrograde markers in our study, and the possible reasons for these failures are discussed.

Facial input to neck motoneurons: trigemino-cervical reflexes in the conscious and anaesthetised cat

Cutaneous facial inputs influencing head movement were examined in the conscious and anaesthetised cat. EMG recordings were made in neck muscles of conscious, unrestrained cats in which an unexpected light cutaneous stimulus was applied to the glabrous skin of the planum nasale (PN). These observations established that head aversion movements were associated with synchronised activation of both deep and superficial dorsal neck muscles. In anaesthetised cats in which activity in the motoneurons of the large dorsal neck muscles was examined, mechanical stimulation of the PN or electrical stimulation of the infraorbital nerve (ION) produced a short latency, reflex activation. The reflex could be elicited by excitation of low threshold, rapidly conducting fibres in the ION. Intracellular recording from neck motoneurons showed that there is a short latency, probably disynaptic, excitatory pathway from low threshold nerves in the ION to neck motoneurons, but discharge of neck motoneurons occurred several milliseconds later, presumably as a result of activity in a longer multisynaptic pathway.

Sagittal-plane mobility of the cat cervical spine

The present study was conducted to evaluate the nature of sagittal-plane motion across cervical vertebral joints and to identify the centers of rotation for each joint in anaesthetized cats X-rayed in a range of head-neck postures. Relative positions of adjacent pairs of vertebrae were assessed by constructing transparent templates for each vertebra that could be overlaid onto different X-rays, and then by digitizing the locations of three markers attached at a distance from each template. The finite centers of rotation for each joint were estimated using a rigid-body method. The errors associated with the estimates were quantified further by using a method in which the positions of digitized markers were fitted to concentric circles using a least-squares approach. The center of rotation between the skull and C1 was located at the cranial articular facets between the two bones. The center of rotation between C1 and C2 was situated near the tip of the odontoid process close to the site of attachment of the transverse ligaments. Centers of rotation for the other cervical vertebral joints were located in the region of the intervertebral disc. A similar range of values was obtained for centers of rotation when extended or flexed postures were used for the calculations, suggesting that the centers of rotation may not move markedly throughout a range of sagittal-plane rotations of approximately 90 degrees at the skull-C1 joint and about 15-30 degrees at the other cervical joints. These results showed that all cervical joints rotated during sagittal-plane motion. A minimal representation of the musculoskeletal mechanics of the feline neck probably requires multiple segments, each corresponding to a single vertebral bone.

In-series fiber architecture in long human muscles

The fiber architecture of adult human sartorius and gracilis muscles was examined using a combination of fiber microdissections and histological methods. Intact fibers were dissected from fascicles of muscle strips that were digested in nitric acid. All of these fibers terminate intrafascicularly by tapering to a fine strand at one or both ends. They measure 4-20 cm after correction for shrinkage. Systematic dissections of 1 cm long blocks sampled at intervals along the muscle length suggest that tapered fiber endings occur at all locations along the muscle but are most common centrally; here they accounted for up to 14% of dissected fibers in each block. Transverse sections of muscle confirm that fiber profiles with small diameters occur at all levels of the muscle but are especially common in sections more than 5 cm from its origin or insertion. The architectural arrangement demonstrated here suggests that long human muscles, like muscles in other species, are composed of relatively short, in-series fibers. This has many implications for the neural activation and force-developing behavior of these muscles that must be considered when paralyzed muscles are reanimated using electrical stimulation. Further, it may predispose long muscles to certain types of neuromuscular damage and dysfunction.

Suboccipital muscles in the cat neck: morphometry and histochemistry of the rectus capitis muscle complex

The morphometry, histochemistry, and biomechanical relationships of rectus capitis muscles were examined in adult cats. This family of muscles contained six members on the dorsal, ventral, and lateral aspects of the upper cervical vertebral column. Three dorsal muscles (rectus capitis posterior major, medius, and minor) formed a layered complex spanning from C1 and C2 to the skull. Rectus capitis posterior major was composed predominantly of fast fibers, but the other two deeper muscles contained progressively higher proportions of slow fibers. One ventral muscle, rectus capitis anterior major, was architecturally complex. It originated from several cervical vertebrae and appeared to be divided into two different heads. In contrast, rectus capitis anterior minor and rectus capitis lateralis were short, parallel-fibered muscles spanning between the skull and C1. The ventral muscles all had nonuniform distributions of muscle-fiber types in which fast fibers predominated. Dorsal and ventral muscle groupings usually had cross-sectional areas of 0.5 cm2 or more, reflecting a potential capacity to generate maximal tetanic force in excess of 9 N. Biomechanical analyses suggested that one muscle, rectus capitis lateralis, had its largest moment in lateral flexion, whereas the other muscles had large, posturally dependent moment arms appropriate for actions in flexion-extension. The observation that most rectus muscles have relatively large cross-sectional areas and high fast-fiber proportions suggests that the muscles may have important phasic as well as postural roles during head movement.

Neuromuscular organization of feline anterior sartorius: II. Intramuscular length changes and complex length-tension relationships during stimulation of individual nerve branches

The feline anterior sartorius is a long strap-like muscle composed of short muscle fibers. Nerve branches that enter this muscle contain the axons of motor units whose constituent muscle fibers are distributed asymmetrically within the muscle. In the present study, twitch and tetanic isometric contractions were evoked by stimulating individual nerve branches while muscle force was recorded and intramuscular length changes were monitored optically by the movement of reflective markers on the muscle. Contractions elicited by stimulating the parent nerve produced little change in the positions of the surface markers. Contractions elicited by stimulating the proximally or distally directed nerve branches caused the muscle to shorten at the end closest to the nerve branch and lengthen at the opposite end. Some muscles were supplied by a centrally directed nerve branch whose stimulation produced variable effects: in some cases a portion of the muscle shortened whereas the rest lengthened, but in other cases, the positions of the surface markers showed little change. The intramuscular length changes produced by stimulating single nerve branches were greater during isometric contractions at short whole-muscle lengths than at long whole-muscle lengths. The twitch and tetanic length-tension relationships obtained by stimulating the individual nerve branches were not congruent with the length-tension relationship produced when the parent nerve was stimulated. At short whole-muscle lengths, stimulation of a single nerve branch generated only a small fraction of the force that could be generated by the muscle when the parent nerve was stimulated. As whole-muscle length increased, an increased fraction of total muscle force could be generated by stimulating a single nerve branch. The results suggest that a complex relationship between passive and active elements contributes to the total muscle force and depends on the distribution of active and passive muscle units throughout the muscle.

Electromyographic studies of neck muscles in the intact cat. I. Patterns of recruitment underlying posture and movement during natural behaviors

Natural head movements in alert, unrestrained cats were studied using video-filming, videofluoroscopy and electromyographic (EMG) recording methods. In each cat, up to sixteen neck muscles or neck-muscle compartments were implanted with recording electrodes. Patterns of muscle recruitment were examined during systematically-selected behavioral epochs in which the cat held a range of stationary postures, and when it performed volitional and exploratory behaviors such as flexion-extension or turning, grooming, eating, or headshaking. Patterns of muscular activity were interpreted with reference to simultaneous video images of head and neck movements. In separate, videofluoroscopic analysis, flexion-extension movements were examined to gain insight into the underlying movements of the skull and cervical vertebrae. These and other movements were found commonly to depend upon changes in joint angles between lower as well as upper cervical joints. Stationary postures in which the neck was held vertically were consistently associated with tonic EMG activity in only two long dorsal muscles, biventer cervicis and occipitoscapularis. Less consistent activity was also present in dorsal intervertebral muscles crossing lower cervical joints. When the neck was held horizontally, the long dorsal muscles increased their EMG activity and moderate activity was also recorded in deeper intervertebral and suboccipital muscles. When flexion-extension occurred around upper cervical joints, greatest activity was recorded in rectus capitis posterior and complexus, but when it involved the lower cervical joints, large changes in EMG activity could also be detected in biventer cervicis, occipitoscapularis, and the intervertebral muscles crossing lower cervical joints. During specialized, sagittal-plane movements such as grooming, well-defined patterns of synergy could be recognized that varied according to the degree of involvement of upper and lower cervical joint-sets. Movements in the horizontal plane were associated with EMG activity in a largely different subset of neck muscles including splenius, longissimus capitis and obliquus capitis inferior. The levels of EMG activity during flexion-extension or turning movements were much lower than those observed during other more vigorous behaviors, such as head shaking. Some neck muscles, such as clavotrapezius and sternomastoideus, could only be recruited during forceful or ballistic head movements. Results showed that the patterns of muscular activation were linked not only to the speed and trajectory of the movements of the skull, but also to the kinematics of the motion occurring across different parts of the cervical column.

Electromyographic studies of neck muscles in the intact cat. II. Reflexes evoked by muscle nerve stimulation

Short-latency reflexes were studied in the neck muscles of four alert cats following electrical stimulation of nerves supplying biventer cervicis (BC), splenius (SP) or rectus capitis posterior (RCP). Reflexes were assessed by comparing levels of EMG activity of muscles before and after each stimulus, as the cats lapped milk, licked their paws or walked on a treadmill. When BC or SP nerves were stimulated at 1.5-4 times threshold (T) for their motor axons, no short-latency heteronymous reflexes could be identified in most neck muscles. However, stimulation of RCP nerves produced inhibitory effects as early as 3-4 ms in the ipsilateral BC, CM, and SP muscles and 6 ms in contralateral BC. At stimulus strengths above 4xT, a more complex pattern of inhibitory or excitatory effects was observed in CM, SP and the intervertebral muscle spinalis dorsi. The reflex effects were attenuated or abolished by partial or complete C1 dorsal rhizotomy (2 cats). Cervicocollic reflex data may need to be reevaluated to consider the possible effects of disinhibition rather than excitation in short-latency reflex pathways.

Neuromuscular organization of feline anterior sartorius: I. Asymmetric distribution of motor units

The neuromuscular organization of feline anterior sartorius was examined using three experimental approaches. First, the branching pattern of the nerve supplying anterior sartorius was inspected in muscles taken from a large number of feline cadavers. All muscles were found to be supplied by two major nerve branches, one directed proximally and the other directed distally, and most muscles (42/51) had a third distinct branch that entered the muscle centrally. Second, the motoneuronal populations supplying the three nerve branches were investigated by electrophysiological techniques. Motoneurons that supplied axons to the distally-directed branch did not appear to have collaterals in more proximally-located branches. In contrast, other motoneurons supplying the proximally-directed branch also appeared to supply axon collaterals to the centrally-directed branch. This result suggested that the motoneuronal population of the distally-directed branch was largely separate from that supplying the proximally- and centrally-directed branches. Third, the motor unit territories supplied by different nerve branches were mapped using glycogen-depletion methods. Muscle fibers supplied by the distally-directed nerve branch were mostly distributed to the medial portion of anterior sartorius, whereas the fibers supplied by the other two branches were generally found more anteriorly. Further, the muscle fibers supplied by an individual nerve branch were present in greater numbers at the end of the muscle closest to the entry point of that branch. Thus, the motor units supplied by discrete nerve branches were found to be distributed asymmetrically within anterior sartorius, but were arranged neither strictly in-parallel nor strictly in-series.

Distribution of motoneurons supplying cat sartorius and tensor fasciae latae, demonstrated by retrograde multiple-labelling methods

Sartorius (SART) and tensor fasciae latae (TFL) in the cat hindlimb are functionally heterogeneous muscles with regions that differ in their skeletal actions and electromyographic recruitment during normal activity. The topographical organization of motoneurons supplying different regions of SART or TFL has been investigated by exposing cut nerve branches supplying different peripheral territories to a combination of retrograde tracers, including Fast Blue (FB), Fluorogold (FG), and horseradish peroxidase (HRP). Motoneurons supplying medial, central, and anterior regions of SART were intermixed extensively throughout a single columnar nucleus located in the ventrolateral part of segments L4 and L5. With this column, motoneurons supplying medial SART tended to lie more rostrally than those supplying anterior regions, but the gradient was modest and showed some cat-to-cat variation. Two major branches entered anterior SART at different proximodistal levels. When these two branches were exposed to different tracers, most motoneurons contained a single tracer; only a few double-labelled cells were apparent. The labelling suggests that anterior SART may contain two separate, in-series divisions of motor units. In TFL, motoneurons supplying nerve branches to posterior, central, and anterior parts of the muscle were intermingled indiscriminately in a single ventrolateral cell column in L6 and rostral L7. These results suggest that topographical organization in lumbar motor nuclei does not always reflect the highly ordered biomechanical and functional specialization evident in the peripheral organization of the muscles themselves.

Distribution of motoneurons supplying dorsal suboccipital and intervertebral muscles in the cat neck

Multiple labelling methods were used to examine the topographical organization of motoneurons supplying the suboccipital muscles, rectus capitis posterior (RCP) and obliquus capitis inferior (OCI); the intervertebral muscles, spinalis dorsi (SD) and semispinalis cervicis (SSC); and the dorsal extensor biventer cervicis (BC). Muscle nerves were isolated, cut, and exposed in the same animal to one of three different retrograde tracers, Fluorogold, Fast Blue, and horseradish peroxidase. Motoneurons supplying suboccipital muscles were found to be located in the rostral two cervical segments. The RCP motor nucleus was confined to C1 and the caudal brainstem, whereas the OCI nucleus usually originated in mid-C1 and extended caudally as far as mid-C2. Most motoneurons supplying OCI and SD were concentrated in the deepest part of the ventral horn, but some cells were found in the commissural region, the contralateral ventral horn, the dorso-medial aspect of the ipsilateral ventral horn, and the ventromedial white matter. Cells supplying the functional extensor RCP were intermingled with those supplying the turning muscle OCI, although a gradient in mediolateral distribution was detected. Motoneurons supplying the intervertebral muscles SD and SSC were found caudal to C3. Within the ventral horn, they occupied locations similar to those occupied by suboccipital motoneurons in C1 and C2. The cell column for intervertebral motoneurons was just medial to that of BC and some cells supplying SD and SSC were found in the territory occupied by BC motoneurons. Motoneurons supplying intervertebral and suboccipital muscles had unimodal diameter spectra, and most cells had mean equivalent diameters smaller than 35 microns.

Topography in the phrenic motoneuron nucleus demonstrated by retrograde multiple-labelling techniques

A combination of retrograde tracing methods was employed to distinguish populations of motoneurons supplying different motor unit territories in the feline diaphragm. The compatibility of the tracers--horseradish peroxidase, fast or true blue, diamidino yellow, and fluorogold--was first assessed by applying the different tracers concurrently to separate cut branches of hindlimb and neck muscle nerves. On the basis of these initial observations fast blue, fluorogold, and horseradish peroxidase were chosen to compare the distribution of motoneurons whose axons ran in different primary branches of the phrenic nerve. Motoneurons with different target territories were extensively intermixed throughout most of the phrenic motor nucleus. However, motoneurons innervating the sternal and medial costal part of the diaphragm were distributed more densely in the rostral part of the phrenic motor pool, whereas motoneurons serving the lateral costal part were concentrated more caudally. Crural motoneurons were intermingled with costal motoneurons in the middle and caudal portions of the nucleus. Motoneurons within the phrenic nucleus are distributed in clusters. Such clusters commonly contained motoneurons labelled from two or more primary branches. Thus, the highly ordered topography of muscle units in the diaphragm is not mirrored by the intraspinal distribution of phrenic motoneurons.

Muscle-fiber architecture, innervation, and histochemistry in the diaphragm of the cat

Previous anatomical descriptions of the diaphragm have contained several contradictory findings. To validate and extend the previous work, diaphragmatic architecture, histochemistry, and end-plate distribution were examined by use of a combination of anatomical methods, including fiber microdissections, cholinesterase staining, and enzyme histochemistry. Microdissections showed that muscle-fiber fascicles throughout the diaphragm contain both long fibers that run from origin to insertion and shorter fibers with intrafascicular terminations. Fibers with intrafascicular terminations were particularly common in the costal diaphragm, where they accounted for the majority of sampled fibers. The heterogeneity of fiber length was reflected in the pattern of end-plate banding. Cholinesterase studies showed that fiber fascicles in cat and kitten diaphragms were crossed by two to four end-plate bands distributed in discontinuous arrays across the width of the muscle. A similar pattern of multiple banding was also demonstrated in the adult and neonatal dog. However, rat and rabbit diaphragms had only a single, continuous end-plate band. Histochemical studies of fiber types in different parts of the feline diaphragm showed that costal, crural, and sternal subregions had similar overall proportions of fiber types. However, type SO (slow oxidative) fibers were distributed more densely on the thoracic than the abdominal surface of costal and crural, but not sternal subregions. Type SO fibers were also concentrated in fiber fascicles bordering the esophageal hiatus.

Motor unit territories supplied by primary branches of the phrenic nerve

Recent studies have demonstrated that, under certain circumstances, the diaphragm does not contract as a homogeneous unit. These observations suggest that motor units may not be randomly distributed throughout the muscle but confined to localized subvolumes. In the present study, electromyographic (EMG) and glycogen depletion methods were combined to investigate the organization of motor units supplied by the primary branches of the phrenic nerve in the cat. Four primary branches are generally present, one branch to the crus and three branches to the sternocostal region. The gross motor-unit territory of each of the four phrenic primary branches was determined by stimulating each nerve separately, while recording from nine EMG electrodes distributed over the hemidiaphragm. Stimulation of the crural branch evoked activity in the ipsilateral crus, whereas stimulation of each of the remaining branches evoked activity in discrete but overlapping areas of the sternocostal diaphragm. A more precise analysis of the distribution and borders of the motor territories was obtained by mapping regions depleted of muscle glycogen due to stimulation of each primary branch for 90 min. Glycogen depletion results closely matched the EMG findings of a localized distribution of motor units served by single primary branches. Stimulation of the crural branch typically caused depletion of the ipsilateral crus, whereas the sternocostal branches each served a striplike compartment. In the majority of cases, the borders of the sternocostal compartments were relatively abrupt and consisted of a 1- to 2-mm transition zone of depleted and nondepleted fibers. These studies demonstrate that motor unit territories of the primary branches of the phrenic nerve are highly delineated. This compartmentalization provides the central nervous system with the potential for a more precise regional motor control of costal and crural diaphragm than previously suspected.

Fiber architecture and histochemistry in the cat neck muscle, biventer cervicis

1. Biventer cervicis (BC) is an anatomically complex muscle that is divided by tendinous inscriptions into five in-series compartments of motor units. We have analyzed the fiber architecture and fiber-type composition of these different compartments using microdissection and histochemical methods. 2. BC narrows as it runs rostrally, but its in-series compartments have similar cross-sectional areas. The tapered shape of BC comes about because tendinous inscriptions and the tendon of insertion are oriented obliquely and muscle fibers attach in a progressively offset fashion from the medial to the lateral muscle edge. 3. Individual compartments of BC differ from one another in their architecture. The rostral two compartments (1 and 2) contain fibers of similar length that run between two plates of tendinous tissue. Compartments 3 and 4 are divided into two or three in-parallel subvolumes whose fiber bundles differ in their lengths and sites of attachment. Compartment 5 is the most variable in its structure. In some cats it is separated from compartment 4 by a tendinous inscription, but in other cats, it blends with a dorsomedial part of compartment 4 to form a single subvolume. 4. The relative lengths of fibers in different compartments were analyzed when the head and neck were held in different postures. Fibers in rostromedial regions were stretched more effectively when the head was flexed at suboccipital joints, and appeared to be less sensitive to movements at lower cervical joints. Movements across lower cervical joints produced substantial length changes in caudolateral parts of BC. 5. Muscle fibers of different histochemical types were not distributed evenly within each muscle compartment. Slow, oxidative (SO) fibers accounted for the majority of fibers near the nuchal midline but for only 30%-45% of fibers in lateral muscle regions. Proportions of fast, glycolytic (FG) fibers were greatest in lateral regions. Fast, oxidative-glycolytic (FOG) fibers were distributed quite uniformly throughout each compartment. 6. The specialized architecture of BC may shape its physiological capabilities. The complex internal structures of different compartments may alter the length-tension properties of BC.(ABSTRACT TRUNCATED AT 400 WORDS)

Compartmentalization of motor units in the cat neck muscle, biventer cervicis

1. The neck muscle biventer cervicis is supplied by five separate nerve bundles that originate from segments C2-C5 and enter the muscle at different rostrocaudal levels. We have used the glycogen-depletion method to investigate the distribution of muscle fibers supplied by each nerve bundle and also the extent of motor-unit territories supplied by single motoneurons in the C3 segment. 2. Prolonged intermittent stimulation of each nerve bundle produced glycogen depletion in a compartment of muscle fibers that ran only a fraction of the whole-muscle length. The depleted compartment was separated by tendinous inscriptions from adjacent, serially arranged compartments that were supplied by different nerve bundles. Thus the muscle was divided into five in-series compartments, arranged in the same rostrocaudal sequence as the nerves by which they were supplied. 3. Six fast, glycolytic (FG) and five fast, oxidative-glycolytic (FOG) motor units were depleted by repetitive intracellular stimulation of their antidromically identified motoneurons in the C3 segment. The fibers of each motor unit were confined to a striplike subvolume whose cross-sectional area was only 20-40% of that for the whole compartment in which it was located. Single motor units contained an average of 408 extrafusal fibers (range: 262-582 fibers), and these were distributed with an average density of 20 fibers/mm2 in cross sections through their motor domains. No significant differences were found between the numbers or densities of fibers in FG and FOG motor units. 4. The specialized in-series organization of compartments has functional implications because the forces generated by one compartment of motor units must be transmitted through other in-series compartments of muscle fibers rather than directly onto skeletal attachments. The confined distribution of muscle fibers belonging to a single motor unit suggests that an additional level of organization may exist within individual compartments. The implications of these features for the physiological behavior and neural control of biventer cervicis are discussed.

Cross-correlation of EMG reveals widespread synchronization of motor units during some slow movements in intact cats

It is commonly assumed that the motor units comprising a single mammalian muscle will be recruited asynchronously at subtetanic firing rates to produce smoothly modulated force output. However, electromyograms from certain neck muscles, recorded by implanted bipolar "patch" electrodes having large contacts, often exhibited a rhythmic clustering of spike activity whose patterns suggested that motor-unit firing was synchronized both within and across muscles. We have developed a computerized processing system that digitizes EMG activity and calculates auto- and cross-correlation products of selected segments. The presence or absence of synchronization caused by neural mechanisms can be identified and differentiated from that due to the rhythmicity of the behavior itself (e.g. shaking) or due to cross-talk, according to the shapes of the resultant correlograms. These methods have so far been applied to the study of hindlimb and neck muscle EMG during various natural motor behaviors, but they provide a general, quantitative tool for the study of an important aspect of motor control that may be overlooked by conventional sampling and smoothing techniques.

Distribution and innervation of short, interdigitated muscle fibers in parallel-fibered muscles of the cat hindlimb

The cat hindlimb contains several long, biarticular strap muscles composed of parallel muscle fascicles that attach to short tendons. Three of these muscles--sartorius, tenuissimus, and semitendinosus--were studied by dissecting individual gold-stained fibers and determining the surface distribution of acetylcholinesterase-stained end-plate zones. In each muscle, fascicles were composed of muscle fibers that ran only part of the fascicle length and tapered to end as fine strands that interdigitated with other tapering fibers within the muscle mass. Most muscle fibers measured 2-3 cm in length. Fascicles of muscle fibers were crossed by short transverse bands of endplates (1 mm wide by 1-5 mm long) that were spaced at fairly regular intervals from the origin to the insertion of the muscle. The endplate pattern suggested that the fiber fascicles were organized into multiple longitudinal strips. In the sartorius, the temporospatial distribution of electromyographic (EMG) activity evoked by stimulating fine, longitudinal branches of the parent nerve confirmed that each strip was selectively innervated by a small subset of the motor axons. These axons appeared to distribute their endings throughout the entire length of the fascicles, providing for synchronous activation of their in-series fibers.

The innervation of tandem muscle spindles in the cat neck

Patterns of innervation were examined in tandem muscle spindles teased from silver-stained muscles of the cat neck. Each tandem spindle was composed of two or more encapsulated receptors linked in series by a shared bag2 fiber. In most tandem spindles, two different types of encapsulation were identified according to differences in their intrafusal fiber content. One type, the b1b2c unit, contained typical bag1, bag2, and chain fibers and was structurally similar to single spindles described in other cat muscles. Each b1b2c unit contained a single primary sensory ending and 1-6 secondary endings. Fusimotor innervation was supplied by many axons. Some fusimotor axons ended in trail ramifications on bag2 and chain fibers, others ended in plates on the bag1 or long chain fiber. The other type of tandem encapsulation, the b2c unit, had only bag2 and chain fibers in its intrafusal fiber bundle. The b2c unit was usually supplied by only one sensory axon that ended on the nucleated part of the intrafusal fiber bundle. This single ending had a more variable terminal morphology than the primary ending in b1b2c units. A few b2c units (3/49) were also supplied by a secondary ending. The fusimotor innervation of the b2c unit was relatively simple. A single pole of the b2c unit was usually supplied by only one to three axons, all ending in trail ramifications. No plate endings were found in b2c units. These morphological specializations suggest that b1b2c and b2c units in tandem spindles differ in both their transductive and fusimotor mechanisms. Thus, the tandem spindle is a specialized structure that may provide additional proprioceptive information beyond that available from single muscle spindles.