Convergence and interaction of neck and macular vestibular inputs on reticulospinal neurons

Extracellular recordings were obtained in decerebrate cats from neurons located in the inhibitory area of the medullary reticular formation, namely in the medial aspects of the nucleus reticularis gigantocellularis, magnocellularis and ventralis. Of 127 medullary reticular units examined, 77 were reticulospinal neurons antidromically identified following stimulation of the spinal cord at T12-L1; the remaining 50 neurons were not activated antidromically. Unit firing rate was analyzed under separate stimulation of macular vestibular, neck, or combined receptors by using sinusoidal rotations about the longitudinal axis at 0.026 Hz, 10 peak amplitude. Among the 127 reticular units, 84 (66.1%) responded with a periodic modulation of their firing rate to roll tilt of the animal and 93 (73.2%) responded to neck rotation. Convergence of macular and neck inputs was found in 71/127 (55.9%) reticular neurons; in these units, the gain as well as the sensitivity of the first harmonic of response corresponded on the average to 0.49 +/- 0.41, SD imp/s/deg and 5.10 +/- 4.27, SD %/deg for the neck responses and to 0.40 +/- 0.39, SD imp/s/deg and 3.90 +/- 3.80, SD %/deg for the macular responses, respectively. Most of the convergent reticular units were maximally excited by the direction of stimulus orientation, the first hormonic or responses showing an average phase lead of about +42.7 with respect to neck position and +24.9 with respect to animal position. Two populations of convergent neurons were observed. The first group of units (58/71, i.e. 81.7%) showed reciprocal ("out of phase") responses to the two inputs in that they were mainly excited during side-down neck rotation, but inhibited during side-down animal tilt. The remaining group of units (13/71, i.e. 18.3%) showed parallel ("in phase") responses to the two inputs and they were mainly excited by side-down neck rotation and animal tilt. The response characteristics of medullary reticular neurons to the combined neck and macular inputs, elicited during head rotation, closely corresponded to those predicted by a vectorial summation of the individual neck and macular responses. In particular, "out of phase" units displayed small amplitudes and large phase leads of the responses with respect to head position, when both types of receptors were costimulated. In contrast, "in phase" units displayed large amplitude and small phase leads during head rotation.(ABSTRACT TRUNCATED AT 400 WORDS)

Responses of medullary reticulospinal neurons to sinusoidal rotation of neck in the decerebrate cat

The electrical activity of 132 neurons located in the inhibitory area of the medullary reticular formation, namely, in the medial aspects of the nucleus reticularis gigantocellularis, magnocellularis and ventralis has been recorded in precollicular decerebrate cats during sinusoidal displacement of the neck. This was achieved by rotation of the body about the longitudinal axis of the animal, while maintaining the head stationary. In particular, 85 neurons were activated antidromically by stimulation of the spinal cord at T12 and L1, the remaining 47 units were not activated antidromically. Among these reticular neurons tested, 66 out of 85 (i.e. 77.6%) of the neurons that were, and 31 out of 47 (i.e. 66.0%) of the neurons that were not antidromically activated responded to slow neck rotation at the frequency of 0.026 Hz and at the peak amplitude of displacement of 10 degrees. The units influenced by neck rotation showed a periodic modulation of the firing rate in response to sinusoidal stimulation of neck receptors. In particular, 70 of 97 units (i.e. 72.2%) were excited during side-down neck rotation and depressed during side-up rotation, while 19 of 97 units (i.e. 19.6%) showed the opposite pattern. In both instances, the peak of the responses occurred with an average phase lead of +41 degrees for the extreme side-up or side-down neck displacement. The remaining 8 units (i.e. 8.2%) showed a prominent phase shift of the peak of their response relative to neck position. The proportion of units excited during side-down neck rotation were almost equally distributed throughout the whole rostro-caudal extent of the reticular structures explored. Responses to neck rotation were detectable at 0.25 degrees of peak displacement. The gain (imp./s/deg.) and the sensitivity (%/deg., i.e. percentage change of the mean firing rate per degree of displacement) in responses of reticulospinal neurons decreased by increasing the peak amplitude of neck rotation from 1 to 10 degrees at a frequency of 0.026 Hz. Therefore, the system did not behave linearly with respect to amplitude of stimulation. By increasing the frequency of stimulation from 0.008 to 0.32 Hz at the fixed amplitude of 10 degrees, the gain, sensitivity and phase lead of responses increased for frequencies of neck rotation above 0.051 Hz. Reticulospinal neurons may thus monitor changes in neck position as well as in velocity of neck rotation. Responses of reticulospinal neurons to neck rotation are discussed in relation to the responses to the same stimulus recently described of vestibulospinal neurons originating from the lateral vestibular nucleus.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of stimulation of vestibular and neck receptors on Deiters neurons projecting to the lumbosacral cord

The activity of lateral vestibular nucleus (LVN) neurons, antidromically identified by stimulation of the spinal cord at T12 and L1, thus projecting to the lumbosacral segments of the spinal cord (IVS neurons), was recorded in precollicular decerebrate cats during rotation about the longitudinal axis either of the whole animal (labyrinth input) or of the body only while the head was kept stationary (neck input). Among the IVS neurons tested for vestibular stimulation, 76 of 129 units (i.e. 58.9%) responded to roll tilt of the animal at the standard parameters of 0.026 Hz, +/- 10 degrees. The gain and the sensitivity of the first harmonic responses corresponded on the average to 0.47 +/- 0.44, SD, impulses X s-1 X deg-1 and 3.24 +/- 3.15, SD, %/deg, respectively. As to the response patterns, 51 of 76 units (i.e. 67.1%) were excited during side-down and depressed during side-up tilt, whereas 15 (i.e. 19.7%) showed the opposite behavior. In both instances the peak of the responses occurred with an average phase lead of about +21.0 +/- 27.2, SD, deg with respect to the extreme side-down or side-up position of the animal. Moreover, the former group of units showed almost a twofold larger gain with respect to the latter group (t-test, p less than 0.05). Among the IVS neurons tested for neck stimulation, 75 of 109 units (68.8%) responded to neck rotation at the standard parameters. The gain and the sensitivity of the first harmonic responses corresponded on the average to 0.49 +/- 0.40, SD, impulses X s-1 X deg-1 and 3.30 +/- 3.42, SD, %/deg, respectively, thus being similar to the values obtained for the labyrinth responses. However, 59 of 75 units (i.e. 78.6%) were excited during side-up neck rotation and depressed during side-down neck rotation, while 8 of 75 units (i.e. 10.7%) showed the opposite pattern. In both instances the peak of the responses occurred with an average phase lead of +52.0 +/- 18.3, SD, deg for the extreme side-up or side-down neck displacements. Further, the former group of units showed a larger gain than the latter group. Histological controls indicated that 102 of 129 (i.e. 79.0%) IVS neurons tested for labyrinth stimulation and 86 of 109 (i.e. 78.9%) IVS neurons tested for neck stimulation were located in the dorsocaudal part of LVN, the remaining IVS neurons being located in the rostroventral part of LVN.(ABSTRACT TRUNCATED AT 400 WORDS)

Responses of medullary reticulospinal neurons to sinusoidal stimulation of labyrinth receptors in decerebrate cat

The electrical activity of 168 individual neurons located in the medullary reticular formation, namely, in the medial aspects of the nucleus reticularis gigantocellularis, magnocellularis, and ventralis, has been recorded in precollicular decerebrate cats during sinusoidal tilt about the longitudinal axis of the whole animal, leading to stimulation of labyrinth receptors. In particular, 93 neurons were activated antidromically by stimulation of the spinal cord at T12 and L1 (1RS neurons); the remaining 75 neurons were not activated antidromically (RF neurons). Among these medial reticular neurons tested, 64 of 93 (i.e., 69%) 1RS neurons and 49 of 75 (i.e., 65%) RF neurons responded to slow rotation of the animal at the standard frequency of 0.026 Hz and at the peak amplitude of displacement of 10 degrees. A periodic modulation of firing rate of the units was observed during the sinusoidal stimulus. In particular, 71 of 113 units (i.e., 63%) were excited during side-up and depressed during side-down tilt, whereas 24 of 113 units (i.e., 21%) showed the opposite behavior. In both instances, the peak of the responses occurred with an average phase lead of about +25 degrees with respect to the extreme side-up or side-down position of the animal. The remaining 18 units (i.e., 16%) showed a prominent phase shift of the peak of their response with respect to animal position. Within the explored region of the medulla, the proportion of units excited during side-up tilt was higher at caudal levels, whereas that of the units excited during side-down tilt was higher at rostral levels. Units displaying intermediate phase angle of the responses predominated at intermediate levels of the medulla. Responses to animal tilt were detectable at 1 degree of peak displacement. The gain (impulses x s-1 x deg-1) of the responses of reticulospinal neurons did not change by increasing the peak amplitude of tilt from 5 to 20 degrees at the fixed frequency of 0.026 Hz. This finding indicates that the system was relatively linear with respect to the amplitude of displacement. By varying the frequency of stimulation from 0.008 to 0.32 Hz at the fixed amplitude of 10 degrees, two populations of reticulospinal neurons were observed. In the first, the gain and the phase angle of response remained relatively unmodified against changes in frequencies: these positional responses were attributed to stimulation of macular receptors.(ABSTRACT TRUNCATED AT 400 WORDS)

Responses of locus coeruleus and subcoeruleus neurons to sinusoidal stimulation of labyrinth receptors

In precollicular decerebrate cats the electrical activity of 141 individual neurons located in the locus coeruleus-complex, i.e. in the dorsal (n = 41) and ventral parts (n = 67) as well as in the locus subcoeruleus (n = 33), was recorded during sinusoidal tilt about the longitudinal axis of the whole animal, leading to stimulation of labyrinth receptors. Some of these neurons showed physiological characteristics attributed to the norepinephrine-containing locus coeruleus neurons, namely, (i) a slow and regular resting discharge, and (ii) a typical biphasic response to fore- and hindpaw compression consisting of short impulse bursts followed by a silent period, which has been attributed to recurrent and/or lateral inhibition of the norepinephrine-containing neurons. Furthermore, 16 out of the 141 neurons were activated antidromically by stimulation of the spinal cord at T12 and L1, thus being considered coeruleospinal or subcoeruleospinal neurons. A large number of tested neurons (80 out of 141, i.e. 56.7%) responded to animal rotation at the standard frequency of 0.15 Hz and at the peak amplitude of 10 degrees. However, the proportion of responsive neurons was higher in the locus subcoeruleus (72.7%) and the dorsal locus coeruleus (61.0%) than in the ventral locus coeruleus (46.3%). A periodic modulation of firing rate of the units was observed during the sinusoidal stimulus. In particular, 45 out of the 80 units (i.e. 56.2%) were excited during side-up and depressed during side-down tilt (beta-responses), whereas 20 of 80 units (i.e. 25.0%) showed the opposite behavior (alpha-responses). In both instances, the response peak occurred with an average phase lead of about + 18 degrees, with respect to the extreme side-up or side-down position of the animal; however, the response gain (imp./s per deg) was, on average, more than two-fold higher in the former than in the latter group. The remaining 15 units (i.e. 18.7%) showed a prominent phase shift of this response peak with respect to animal position. Similar results were obtained from the subpopulation of locus coeruleus-complex neurons which fired at a low rate (less than 5.0 imp./s), as well as for the antidromically identified coeruleospinal neurons. The response gain of locus coeruleus-complex neurons, including the coeruleospinal neurons, did not change when the peak amplitude of tilt was increased from 5 degrees to 20 degrees at the fixed frequency of 0.15 Hz. This indicates that the system was relatively linear with respect to the amplitude of displacement.(ABSTRACT TRUNCATED AT 400 WORDS)

Skeletal muscle and nutritional assessment in chronic renal failure patients on a protein-restricted diet

BACKGROUND

The close relationship between protein-energy malnutrition and quality of life, morbidity and mortality, makes mandatory a careful evaluation of the nutritional status and muscle mass in chronic renal failure (CRF) patients.

METHODS

Nutritional and skeletal muscle data were obtained from 28 nondiabetic patients with severe CRF (glomerular filtration rate, GFR < 15 mL min-1) on conservative treatment. Of them, 14 (8 males, 4 females) were on a conventional low-protein (0.6 g kg-1 body weight) diet (LPD) and 14 (8 males, 4 females) were on a very low-protein (0.3 g kg-1 body weight) diet supplemented with essential amino acids and ketoacids (Ketodiet); 28 healthy sex- and age-matched subjects served as controls. We evaluated biochemistry, anthropometry, bioelectrical impedance vector analysis, and three noninvasive tests investigating some skeletal muscle features: (a) myoelectrical fatigue phenomenon was studied using a surface electromyography technique that provides data on conduction velocity (CV), median frequency of power spectrum (MDF) and average rectified value (ARV) of myofibre action potential, at 15 and 35 Hz stimulation frequency; (b) muscle oxidative metabolism was studied by serum lactate following aerobic exercise; and (c) muscle strength of the legs was studied using an isokinetic exercise test at two different angular velocities (60 degrees and 180 degrees s-1).

RESULTS

No difference between patients and controls was detected regarding CV, MDF and ARV, at 35 and 15 Hz testing. Serum lactate was higher in patients than in controls at 1, 5, 10 and 30 min recovery. A decreased knee extension and flexion strength was detected in CRF patients both at low (60 degrees s-1) and at high (180 degrees s-1) angular velocity; muscle strength deficit negatively correlated to serum albumin (r = -0.52, P < 0.01), but no relationship was found with protein intake or residual renal function. No difference was found between LPD and Ketodiet patients regarding the studied muscular tests as well as the anthropometry and bio-impedance data.

CONCLUSIONS

Implementation of a proper dietary regimen, including severe restriction of protein intake can preserve lean body mass and nutritional status of advanced CRF patients. Skeletal muscle shows unchanged sarcolemma excitability but abnormal oxidative metabolism and reduced segmental strength. Regular physical activity and a close clinical and dietary monitoring should be recommended for the predialysis patient care.

Convergence and interaction of neck and macular vestibular inputs on locus coeruleus and subcoeruleus neurons

Extracellular recordings were obtained in precollicular decerebrate cats from 90 neurons located in the noradrenergic area of the dorsal pontine tegmentum, namely in the dorsal (LCd, n = 24) and the ventral part (LC alpha, n = 40) of the locus coeruleus (LC) as well as in the locus subcoeruleus (SC, n = 26). Among these units of the LC complex, 13 were coerulospinal (CS) neurons antidromically identified following stimulation of the spinal cord at T12-L1. Some of these neurons showed the main physiological characteristics of the norepinephrine (NE)-containing LC neurons, i.e., a slow and regular resting discharge and a typical biphasic response to fore- and hindpaw compression consisting of a short burst of excitation followed by a period of quiescence, due, in part at least, to recurrent and/or lateral inhibition. Unit firing rate was analyzed under separate stimulation of macular vestibular, neck, or combined receptors by using sinusoidal rotation about the longitudinal axis at 0.15 Hz, +/- 10 degrees peak amplitude. Among the 90 LC-complex neurons, 60 (66.7%) responded with a periodic modulation of their firing rate to roll tilt of the animal and 67 (74.4%) responded to neck rotation. Convergence of macular and neck inputs was found in 52/90 (57.8%) LC-complex neurons; in these units, the gain and the sensitivity of the first harmonic of the response corresponded on the average to 0.34 +/- 0.45, SD, impulses.s-1.deg-1 and 3.55 +/- 2.82, SD, %/deg for the neck responses and to 0.23 +/- 0.29, SD, impulses.s-1.deg-1 and 3.13 +/- 3.04, SD, %/deg for the macular responses. In addition to these convergent units, 8/90 (8.9%) and 15/90 (16.7%) LC-complex units responded to selective stimulation either of macular or of neck receptors only. These units displayed a significantly lower response gain and sensitivity to animal tilt and neck rotation with respect to those obtained from convergent units. Most of the convergent LC-complex units were maximally excited by the direction of stimulus orientation, the first harmonic of responses showing an average phase lead of about +31.0 degrees with respect to neck position and +17.6 degrees with respect to animal position. Two populations of convergent neurons were observed. The first group of units (43/52, i.e., 82.7%) showed reciprocal ("out of phase") responses to the two inputs; moreover, most of these units were excited during side-down neck rotation, but inhibited during side-down animal tilt.(ABSTRACT TRUNCATED AT 400 WORDS)

Responses of locus coeruleus and subcoeruleus neurons to sinusoidal neck rotation in decerebrate cat

The electrical activity of 99 neurons located in the locus coeruleus-complex, namely in the dorsal (n = 26) and the ventral part of the locus coeruleus (n = 46) as well as the locus subcoeruleus (n = 27), has been recorded in precollicular decerebrate cats during sinusoidal displacement of the neck. This was achieved by rotation of the body about the longitudinal axis of the animal, while maintaining the head stationary. A proportion of these neurons showed some of the main physiological characteristics attributed to the noradrenergic locus coeruleus neurons, i.e. (i) a slow and regular resting discharge, and (ii) a typical biphasic response to fore and hindpaw compression consisting of short bursts of impulses followed by a period of quiescence, due at least in part to recurrent or lateral inhibition of the corresponding neurons. Moreover, 14 out of the 99 neurons were activated antidromically by stimulation of the spinal cord at T12 and L1, thus being considered as coeruleo- or subcoeruleospinal neurons. Among these locus coeruleus-complex neurons tested, 73 out of 99 (i.e. 73.7%) responded to neck rotation at the standard frequency of 0.15 Hz and at the peak amplitude of displacement of 10 degrees. In particular 40 of 73 units (i.e. 54.8%) were excited during side-down neck rotation and depressed during side-up rotation, while 18 of 73 units (i.e. 24.7%) showed the opposite pattern. In both instances the peak of the responses occurred with an average phase lead of +34.2 degrees for the extreme side-down or side-up neck displacement; however, the response gain (impulses/s per deg) was on the average more than two-fold higher in the former than in the latter group of units. The remaining 15 units (i.e. 20.5%) showed phase angle values which were intermediate between those of the two main populations. As to the coeruleo or subcoeruleospinal neurons, 11 of 14 units (78.6%) responded to the neck input, the majority (nine of 11 units, i.e. 81.8%) being excited during side-down neck rotation. Within the explored region, the proportion of responsive units was higher in the locus subcoeruleus (85.2%) than in the locus coeruleus, both dorsal and ventral (69.4%). Moreover, units located in the former structure showed on the average a response gain higher than that found in the latter structures. Similar results were also obtained from the population of locus subcoeruleus-complex neurons which fired at a low rate (less than or equal to 5.0 impulses/s).(ABSTRACT TRUNCATED AT 400 WORDS)

Changes on EMG activation in healthy subjects and incomplete SCI patients following a robot-assisted locomotor training

The aim of this study was to understand and measure the lower limbs muscular activation patterns both in healthy and spinal cord injured (SCI) subjects during robot-assisted locomotor exercise. Electromyographic (EMG) activity of four leg's muscles (rectus and biceps femoris, tibialis anterioris and gastrocnemius) was recorded and analyzed at two different percentages of body weight support, three stepping velocities and three different modalities. SCI subjects were recorded also after four weeks training to evaluate the effectiveness of lower limb robot-assisted rehabilitative treatment. A multi-factor ANOVA on the integrated muscle activity (IEMG) parameters both in healthy and SCI subjects was performed. Higher muscular activities both in healthy subjects and SCI patients were found during the exercises using the "DGO active" modality and higher stepping velocities. A significant increased bilateral muscular activity was observed in each SCI subject after the rehabilitation treatment. The method proposed to analyze EMG data provides a quantitative description of the lower limb muscular recruitment and can contribute to identify the optimal rehabilitation treatment's conditions.

FES-cycling training in spinal cord injured patients

Among the objectives of spinal cord injury (SCI) rehabilitation, (i) prevention of bony, muscular and joint trophism and (ii) limitation of spastic hypertone represent important goals to be achieved. The aim of this study is to use functional electrical stimulation (FES) to activate pedaling on cycle-ergometer and analyse effects of this technique for a rehabilitation training in SCI persons. Five spinal cord injured subjects were recruited and underwent a two months FES-cycling training. Our results show an increase of thigh muscular area and endurance after the FES-cycling training, without any increase of spasticity. This approach, which is being validated on a larger pool of patients, represents a potential tool for improving the rehabilitation outcome of complete and incomplete SCI persons.

Functional and isokinetic assessment of muscle strength in patients with idiopathic inflammatory myopathies

OBJECTIVE

To assess muscle strength in patients with idiopathic inflammatory myopathies (IIM) using neuromuscular scales and isokinetic testing.

METHODS

Muscle function was evaluated in 27 IIM patients being followed at the Rheumatology Unit of the University of Pisa using: (i) a modified version of the grading system used to assess Duchenne dystrophy, (ii) the four-stage grading system of Henriksson and Sandstedt, (iii) an isokinetic muscle strength test (Kin Com, Chatanooga) and (iv) the Health Assessment Questionnaire (HAQ).

RESULTS

The neuromuscular scales showed normal or only mildly impaired muscle strength in 60% (Duchenne scale) and 80% (Henriksson and Sandstedt scale) of the patients, respectively, whereas isokinetic testing detected moderate to severe reductions in muscle strength in almost 70% of the patients. No correlations were observed between muscle strength and disease activity, therapy, age at evaluation and disease duration. There was a correlation between the results of the HAQ and neuromuscular testing, but not the isokinetic test.

CONCLUSIONS

Although less easy and more expensive to administer, isokinetic testing appears to be a more sensitive instrument than the standard neuromuscular tests for assessing muscle function in IIM patients. In particular, it can detect small reductions in muscle strength.

An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results

The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

Responses of locus coeruleus neurons to convergent neck and vestibular inputs

The locus coeruleus (LC) complex, located in the dorsolateral pontine tegmentum, is composed of noradrenergic and self-inhibitory adrenoceptive neurons, which project to broad regions of the brain, including the spinal cord. Experiments were performed in decerebrate cats to find out whether units which had the physiological characteristics of noradrenergic neurons (i.e., a slow and regular resting discharge and a typical response to a noxious stimulus consisting of a short burst of excitation followed by a silent period), received a convergent input from both labyrinth and neck receptors. Among 90 LC-complex units, 13 of which could be identified antidromically as coeruleospinal (CS) neurons following electrical stimulation of the spinal cord at T12-L1, 52 (57.8%) responded to roll tilt of the animal and neck rotation at 0.15 Hz, +/- 10 degrees. The responses were particularly related to the extreme animal and neck displacements. Most of these convergent neurons (43/52, i.e., 82.7%) showed reciprocal ('out of phase') responses to the two inputs, while only a few units (9/52, i.e., 17.3%) showed parallel ('in phase') responses. Moreover, the majority of the 'out of phase' units showed an increased discharge during side-up animal tilt and side-down neck rotation. These predominant response patterns were just opposite to those of the vestibulospinal (VS) neurons projecting to the same segments of the spinal cord. The response characteristics of the LC-complex neurons to combined neck and vestibular inputs elicited during head rotation usually corresponded to those predicted by a vectorial summation of the individual neck and labyrinth responses, as shown for the VS neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

Labyrinthine influences on locus coeruleus neurons

The locus coeruleus (LC) complex, located in the dorsolateral pontine tegmentum, is composed principally of noradrenergic neurons, which project to broad regions of the CNS, including the spinal cord. Experiments were performed in precollicular decerebrate cats to ascertain whether units histologically identified within the LC complex, and having the physiological characteristics of noradrenergic neurons, would respond to sinusoidal stimulation of labyrinth receptors. Among 141 LC complex neurons, 16 of which could be activated antidromically by stimulation of the spinal cord at T12-L1, 80 (i.e. 56.7%) responded to roll tilt of the animal at 0.15 Hz, +/- 10 degrees. The responses were particularly related to the extreme animal displacements, thus being attributed to stimulation of macular utricular receptors. The proportion of responsive units, and also the average gain of the responses, were higher in the LCd and the subcoerular (subLC) area than in the LCa. Moreover in the same structures the majority of units showed a beta-pattern of response (excitation during side-up tilt), which contrasted with the predominant alpha-pattern (excitation during side-down tilt) displayed by the previously recorded vestibulospinal neurons projecting to the same segments of the spinal cord. The role that the noradrenergic coeruleospinal neurons exert in the dynamic control of posture during the vestibulospinal reflexes is discussed.

Effects of roll tilt of the animal and neck rotation on different size vestibulospinal neurons in decerebrate cats with the cerebellum intact

In decerebrate cats with the cerebellum intact we recorded the activity of lateral vestibulospinal neurons projecting to lumbosacral segments of the spinal cord (IVS neurons) and related the resting discharge, as well as the response characteristics of these neurons to roll tilt of the animal and neck rotation, with the cell size inferred from the conduction velocity of the corresponding axons. A slight negative correlation was found between resting discharge rate and conduction velocity of the whole population of IVS neurons responsive and unresponsive to animal tilt and neck rotation, so that the faster the conduction velocity, the lower was the unit discharge at rest. This correlation, however, was found only for the dorsocaudal LVN neurons, which contributed to the majority of IVS units, but not for the rostroventral LVN neurons. Moreover, it affected the units unresponsive but not those responsive to vestibular stimulation; the opposite, however, occurred for the units tested to neck stimulation. These findings indicate that the static properties of the IVS neurons can only in part be related to cell size. If we consider the IVS neurons responsive to roll tilt of the animal (76 neurons) and neck rotation (75 neurons) at the standard parameters of 0.026 Hz, +/- 10 degrees, no significant correlation was found between gain (impulses X s-1 X deg-1) of the labyrinth or neck responses and conduction velocity of the axons. Thus, due to the presence of slight negative relation between resting discharge and conduction velocity of the axons, larger neurons exhibited a greater percentage modulation (sensitivity) to the labyrinth and neck inputs than smaller neurons; this correlation involved particularly the dcLVN neurons. These findings suggest that the afferent pathways driven during dynamic stimulation of labyrinth and neck receptors produce an higher number or density of synaptic contacts on IVS neurons of increasing size. No significant differences in the means of resting discharge, conduction velocity, gain and sensitivity were found between all the IVS units responding to labyrinth and neck inputs. These findings indicate that the effectiveness of the two inputs was almost comparable and did not vary in different units as a function of cell size. The IVS neurons were mainly excited during side-down animal tilt and side-up neck rotation. Although these neurons showed the same spectrum of conduction velocity as those displaying the opposite response patterns, the response gains of the predominant populations of units were on the average higher than those obtained from the remaining populations of units.(ABSTRACT TRUNCATED AT 400 WORDS)

Cholinergic brainstem sites for gain control of vestibulospinal reflexes in cats

Decerebrate cats were injected with carbachol into the locus coeruleus (LC) or with carbachol or bethanechol into the dorsal pontine reticular formation (pRF) of one side; recordings were made of the tonic contraction of forelimb extensor muscles of both sides and of their responses to sinusoidal roll tilt of the animal. Both drugs had similar effects when injected into the pRF: a decrease in the tonic contraction of limb extensors and a greatly enhanced amplitude and gain with slightly decreased phase lead in the responses to animal tilt of the forelimb extensor, triceps brachii, ipsilateral to the side of injection. Injected into the LC, carbachol produced a response opposite to the above: it increased the tonic contraction of limb extensors ipsilateral to the side of injection, but decreased the amplitude and gain of the EMG responses of limb extensor muscles to labyrinth stimulation induced by sinusoidal tilt. These findings did not depend on changes in posture since they were still observed when postural EMG activity was maintained constant by appropriate changes in static stretch of the muscle. Moreover, the magnitude of the effects increased in a dose-dependent manner. Results suggest that cholinergic activation of dorsal pRF neurons through muscarinic receptors increases the background discharge of medullary inhibitory reticulospinal (RS) system neurons, thus increasing their modulatory influence. Further, it is postulated that cholinergic activation of LC neurons would cause them to inhibit this tonic facilitatory drive by the pRF. Common to both sites of carbachol injection is the increase in phase lag of the EMG response of limb extensors to animal tilt.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma exchange for polyradiculoneuropathy following kidney transplantation: a case report

We describe a case of polyradiculoneuropathy (PRN) following living donor kidney transplantation, without clinical evidence of preexisting infection. In this study plasma exchange treatment resulted 6 days later in improvement in extremity weakness and paresthesias in the upper and lower extremities. Total neurological recovery was obtained 3 months after the onset of symptoms.