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Biomedical subjects

M M Mesulam

Publications and source records attributed to M M Mesulam.

At least 19 recordsLinked to original sources
PubMed1992

Differential laminar distribution of acetylcholinesterase and butyrylcholinesterase containing tangles in the cerebral cortex of Alzheimer's disease.

A sensitive histochemical method for the visualization of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity was used to determine the laminar distribution of cholinesterase-positive cortical tangles in Alzheimer's disease (AD). In many cortical areas AChE- and BChE-positive tangles displayed a completely overlapping distribution. In other areas the most superficial layers contained only AChE-positive tangles whereas the deepest layers contained only BChE-positive tangles. These observations suggest that some cholinesterase-positive tangles have a predominantly (if not exclusively) AChE-like reactivity whereas others have a reactivity that is predominantly BChE-like. The intermingling of AChE- and BChE-positive tangles in most cortical areas and layers suggests that there may also be a third population in which the two enzymes are equally prominent in the same tangle.

Acetylcholinesterase↗
PubMed1992

Cholinergic innervation of the human thalamus: dual origin and differential nuclear distribution.

The cholinergic innervation of the human thalamus was studied with antibodies against the enzyme choline acetyltransferase (ChAT) and nerve growth factor receptor (NGFr). Acetylcholinesterase histochemistry was used to delineate nuclear boundaries. All thalamic nuclei displayed ChAT-positive axons and varicosities. Only the medial habenula contained ChAT-positive perikarya. Some intralaminar nuclei (central medial, central lateral, and paracentral), the reticular nucleus, midline nuclei (paraventricular and reuniens), some nuclei associated with the limbic system (anterodorsal nucleus and medially situated patches in the mediodorsal nucleus) and the lateral geniculate nucleus displayed the highest density of ChAT-positive axonal varicosities. The remaining sensory relay nuclei and the nuclei interconnected with the motor and association cortex displayed a lower level of innervation. Immunoreactivity for NGFr was observed in cholinergic neurons of the basal forebrain but not in cholinergic neurons of the upper brainstem. The contribution of basal forebrain afferents to the cholinergic innervation of the human thalamus was therefore studied with the aid of NGFr-immunoreactive axonal staining. The anterior intralaminar nuclei, the reticular nucleus, and medially situated patches in the mediodorsal nucleus displayed a substantial number of NGFr-positive varicose axons, presumably originating in the basal forebrain. Rare NGFr-positive axonal profiles were also seen in many of the other thalamic nuclei. These observations suggest that thalamic nuclei affiliated with limbic structures and with the ascending reticular activating system are likely to be under particularly intense cholinergic influence. While the vast majority of thalamic cholinergic input seems to come from the upper brainstem, the intralaminar and reticular nuclei, and especially medially situated patches within the mediodorsal nucleus also appear to receive substantial cholinergic innervation from the basal forebrain.

Acetylcholine↗
PubMed1992

Cytoarchitecture and neural afferents of orbitofrontal cortex in the brain of the monkey.

The orbitofrontal cortex of the monkey can be subdivided into a caudal agranular sector, a transitional dysgranular sector, and an anterior granular sector. The neural input into these sectors was investigated with the help of large horseradish peroxidase injections that covered the different sectors of orbitofrontal cortex. The distribution of retrograde labeling showed that the majority of the cortical projections to orbitofrontal cortex arises from a restricted set of telencephalic sources, which include prefrontal cortex, lateral, and inferomedial temporal cortex, the temporal pole, cingulate gyrus, insula, entorhinal cortex, hippocampus, amygdala, and claustrum. The posterior portion of the orbitofrontal cortex receives additional input from the piriform cortex and the anterolateral portion from gustatory, somatosensory, and premotor areas. Thalamic projections to the orbitofrontal cortex arise from midline and intralaminar nuclei, from the anteromedial nucleus, the medial dorsal nucleus, and the pulvinar nucleus. Orbitofrontal cortex also receives projections from the hypothalamus, nucleus basalis, ventral tegmental area, the raphe nuclei, the nucleus locus coeruleus, and scattered neurons of the pontomesencephalic tegmentum. The non-isocortical (agranular-dysgranular) sectors of orbitofrontal cortex receive more intense projections from the non-isocortical sectors of paralimbic areas, the hippocampus, amygdala, and midline thalamic nuclei, whereas the isocortical (granular) sector receives more intense projections from the dorsolateral prefrontal area, the granular insula, granular temporopolar cortex, posterolateral temporal cortex, and from the medial dorsal and pulvinar thalamic nuclei. Retrograde labeling within cingulate, entorhinal, and hippocampal cortices was most pronounced when the injection site extended medially into the dysgranular paraolfactory cortex of the gyrus rectus, an area that can be conceptualized as an orbitofrontal extension of the cingulate complex. These observations demonstrate that the orbitofrontal cortex has cytoarchitectonically organized projections and that it provides a convergence zone for afferents from heteromodal association and limbic areas. The diverse connections of orbitofrontal cortex are in keeping with the participation of this region in visceral, gustatory, and olfactory functions and with its importance in memory, motivation, and epileptogenesis.

Afferent Pathways↗
PubMed1992

Cholinergic innervation of the human striatum, globus pallidus, subthalamic nucleus, substantia nigra, and red nucleus.

The anatomical organization of cholinergic markers such as acetylcholinesterase, choline acetyltransferase, and nerve growth factor receptors was investigated in the basal ganglia of the human brain. The distribution of choline acetyltransferase-immunoreactive axons and varicosities and their relationship to regional perikarya showed that the caudate, putamen, nucleus accumbens, olfactory tubercle, globus pallidus, substantia nigra, red nucleus, and subthalamic nucleus of the human brain receive widespread cholinergic innervation. Components of the striatum (i.e., the putamen, caudate, olfactory tubercle, and nucleus accumbens) displayed the highest density of cholinergic varicosities. The next highest density of cholinergic innervation was detected in the red nucleus and subthalamic nucleus. The level of cholinergic innervation was of intermediate density in the globus pallidus and the ventral tegmental area and low in the pars compacta of the substantia nigra. Immunoreactivity for nerve growth factor receptors (NGFr) was confined to the cholinergic neurons of the basal forebrain and their processes. Axonal immunoreactivity for NGFr was therefore used as a marker for cholinergic projections originating from the basal forebrain (Woolf et al., '89: Neuroscience 30:143-152). Although the vast majority of striatal cholinergic innervation was NGFr-negative and, therefore, intrinsic, the striatum also contained NGFr-positive axons, indicating the existence of an additional cholinergic input from the basal forebrain. This basal forebrain cholinergic innervation was more pronounced in the putamen than in the caudate. The distribution of NGFr-positive axons suggested that the basal forebrain may also project to the globus pallidus but probably not to the subthalamic nucleus, substantia nigra, or red nucleus. The great majority of cholinergic innervation to these latter three structures and to parts of the globus pallidus appeared to come from cholinergic neurons outside the basal forebrain, most of which are probably located in the upper brainstem. These observations indicate that cholinergic neurotransmission originating from multiple sources is likely to play an important role in the diverse motor and behavioral affiliations that have been attributed to the human basal ganglia.

Acetylcholinesterase↗
PubMed1992

Differential cholinergic innervation within functional subdivisions of the human cerebral cortex: a choline acetyltransferase study.

The distribution of cholinergic fibers in the human brain was investigated with choline acetyltransferase immunocytochemistry in 35 cytoarchitectonic subdivisions of the cerebral cortex. All cortical areas and all cell layers contained cholinergic axons. These fibers displayed numerous varicosities and, on occasion, complex preterminal profiles arranged in the form of dense clusters. The density of cholinergic axons tended to be higher in the more superficial layers of the cerebral cortex. Several distinct patterns of lamination were identified. There were also major differences in the overall density of cholinergic axons from one cytoarchitectonic area to another. The cholinergic innervation of primary sensory, unimodal, and heteromodal association areas was lighter than that of paralimbic and limbic areas. Within unimodal association areas, the density of cholinergic axons and varicosities was significantly lower in the upstream (parasensory) sectors than in the downstream sectors. Within paralimbic regions, the non-isocortical sectors had a higher density of cholinergic innervation than the isocortical sectors. The highest density of cholinergic axons was encountered in core limbic structures such as the hippocampus and amygdala. These observations show that the cholinergic innervation of the human cerebral cortex displays regional variations that closely follow the organization of information processing systems.

Adult↗
PubMed1992

Overlap between acetylcholinesterase-rich and choline acetyltransferase-positive (cholinergic) axons in human cerebral cortex.

The distribution of acetylcholinesterase-rich axons was compared to that of choline acetyltransferase-positive (cholinergic) axons in 28 major cytoarchitectonic divisions of the adult human cerebral cortex. Acetylcholinesterase-rich as well as choline acetyltransferase-positive cortical axons contained multiple varicosities. Each type of axon was more densely distributed in limbic-paralimbic regions of the brain. In all the cortical areas that were examined, the two markers displayed laminar and regional distribution patterns that were indistinguishable from each other. A method that allowed the concurrent visualization of both reaction products demonstrated that acetylcholinesterase and choline acetyltransferase were colocalized in the same axon. These observations show that there is probably a complete correspondence between choline acetyltransferase-positive and acetylcholinesterase-rich axons and that the acetylcholinesterase reaction can be used as a specific marker for cortical cholinergic axons in the adult human brain.

Acetylcholine↗
PubMed1992

A one-step cobalt-ferrocyanide method for histochemical demonstration of acetylcholinesterase activity in central nervous system tissue.

We introduce a one-step histochemical method with cobalt as the precipitating agent for ferrocyanide for the light microscopic demonstration of acetylcholinesterase activity. This method was used to demonstrate acetylcholinesterase in normal cortical fibers and neurons, as well as pathological elements such as plaques and tangles. This procedure can also be easily combined with immunohistochemical methods that use diaminobenzidine as a chromogen.

Acetylcholinesterase↗
PubMed1992

Diminished curiosity in patients with probable Alzheimer's disease as measured by exploratory eye movements.

Clinical accounts of Alzheimer's disease (AD) suggest that some patients exhibit markedly diminished curiosity and initiative early in the course of their illness. Such behavioral changes are extremely difficult to measure experimentally. We studied one aspect of curiosity by measuring exploratory eye movements in response to provocative visual stimuli in 12 patients with probable AD and 10 matched controls. Subjects viewed slides, each of which contained an incongruous or irregular figure paired with a congruous or regular one. Unlike controls, who spent significantly more time viewing the incongruous stimuli, AD patients distributed their viewing time equally and spent significantly less time than controls looking at the novel stimuli. Additionally, when presented with picture slides containing an unexpected element, AD patients exhibited diminished visual exploration overall and decreased attention to the incongruous part. Further analyses suggest that the results cannot be adequately explained by a general decline in cognition or by problems with ocular motility or directing visual attention. We conclude that AD patients exhibit diminished curiosity which can be measured by the study of exploratory eye movements.

Aged↗
PubMed1992

Neuropsychological aspects of dementia of motor neuron disease: a report of two cases.

We describe the neuropsychological data from two cases of dementia of motor neuron disease. In both cases, a gradually progressive presenile dementia began prior to the development of motor neuron disease involving predominantly bulbar musculature. These data, along with the neuropathologic findings available in one case, suggest that dementia of motor neuron disease differs from that of Alzheimer's disease (AD). Both patients displayed major alterations of personality and comportment. Neuropsychological test results revealed marked attention deficits, particularly on tasks requiring sustained effort and on those requiring ability to shift from one line of thinking to another. Confrontation naming, verbal fluency, insight, and judgment also showed extensive impairment. By contrast, verbal and nonverbal memory remained intact after several years of illness. This pattern is quite different from that seen in AD, where memory deficits are salient.

Aged↗
PubMed1991

Acetylcholinesterase-rich neurons of the human cerebral cortex: cytoarchitectonic and ontogenetic patterns of distribution.

Layers 3 and 5 of the adult human cerebral cortex contain a very large number of pyramidal neurons that express intense acetylcholinesterase (AChE) enzymatic activity and AChE-like immunoreactivity. The density of these neurons is high in motor, premotor, and neocortical association areas but quite low in paralimbic cortex. These AChE-rich neurons are located predominantly within layer 3 in the premotor and association cortex, within layer 5 in the non-isocortical components of the paralimbic cortex, and are equally prominent in layers 3 and 5 in the motor cortex. Almost all Betz cells in the motor cortex and up to 80% of layer 3 pyramidal neurons in some parts of the association neocortex yield an AChE-rich staining pattern. The existence of a specific laminar and cytoarchitectonic distribution suggests that the AChE-rich enzymatic pattern of these neurons is selectively regulated. The AChE-rich enzymatic reactivity of the layer 3 and layer 5 neurons is not detectable during early childhood, becomes fully established during adulthood, and does not show signs of decline during advanced senescence in mentally intact individuals. The AChE activity (or enzyme synthesis) in these neurons is therefore held in check for several years during infancy and childhood and begins to be expressed at a time when the more advanced motor and cognitive skills are also being acquired. The absence of immunostaining with an antibody to choline acetyltransferase suggests that these AChE-rich neurons are not cholinergic. The regional distribution of these AChE-rich neurons does not parallel the regional variations of cortical cholinergic innervation. Whereas the AChE-rich pyramidal neurons of layers 3 and 5 almost certainly represent one subgroup of cholinoceptive cortical neurons, their AChE-rich enzymatic pattern is probably also related to a host of non-cholinergic processes that may include maturational changes and plasticity in the adult brain.

Acetylcholinesterase↗
PubMed1991

Electron microscopic localization of cholinesterase activity in Alzheimer brain tissue.

Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity was localized by electron microscopic enzyme cytochemistry in cortex from Alzheimer brains and brains from non-demented cases. In the tangle-rich medial temporal cortex of the Alzheimer brain, most of the neuronal AChE was associated with neurofibrillary tangles. These structures also contained BChE activity. In normal neurons AChE activity was found in the rough endoplasmic reticulum, nuclear envelope and Golgi apparatus. Little BChE activity was noted in normal cortex. In neuritic plaques, AChE and BChE activity was associated mostly with the amyloid, but also with the neuritic component.

Acetylcholinesterase↗
PubMed1991

Immunocytochemical demonstration of axonal and perikaryal acetylcholinesterase in human cerebral cortex.

The adult human neocortex contains a dense net of axons and perikarya which yield an acetylcholinesterase-rich enzymatic reaction pattern in histochemical experiments. We employed a monoclonal antibody to human acetylcholinesterase and a method for the concurrent visualization of histochemical and immunohistochemical reaction-products to explore the relationship between immunological and enzymatic markers of acetylcholinesterase. We observed that the cortical axons and perikarya with a histochemically determined acetylcholinesterase-rich enzymatic activity also contain acetylcholinesterase-like immunoreactivity. This was especially informative for the intracortical acetylcholinesterase-rich perikarya of layers III and V since these neurons require prolonged incubations for histochemical detection and since they are not conspicuous in other animal species. The availability of a reliable immunohistochemical method makes it possible to investigate the distribution of the acetylcholinesterase enzyme molecule independent of its enzymatic activity.

Acetylcholinesterase↗
PubMed1991

Broca's aphasia following damage to Wernicke's area. For or against traditional aphasiology?

Classic aphasiology has been challenged by studies that have employed cranial computed tomography to test predicted anatomic-behavioral correlations. We treated a patient who developed a classic Broca's aphasia but whose computed tomographic scan revealed damage to Wernicke's area, thus seeming to contradict the principles of traditional aphasiology. However, subsequent information obtained by magnetic resonance imaging, intracarotid amobarbital (Amytal) testing, and electrophysiologic studies, including cortical stimulation, demonstrated that the brain-behavior correlations in this patient can be understood in terms of the formulations of traditional aphasiology.

Adult↗
PubMed1991

Frontal lobe dysfunction following infarction of the left-sided medial thalamus.

We treated a 62-year-old woman who developed a dramatic change in personality and behavior following a discrete left-sided medial thalamic infarction involving the dorsomedial nucleus. Neuropsychological testing demonstrated severe impairment of complex executive behaviors that are usually associated with frontal lobe function. Electroencephalography and single-photon emission computed tomography strongly implicated dysfunction of the ipsilateral frontal lobe. This case further supports a functional and physiologic thalamofrontal linkage as part of a broader cerebral network modulating complex human behavior.

Brain Diseases↗
PubMed1991

Right hemisphere advantage for evaluating emotional facial expressions.

The ability to evaluate the intensity of emotional facial expressions was investigated in patients undergoing the intracarotid sodium amytal procedure. It was found that when the hemisphere non-dominant for language (usually right) was anesthetized, the patients' ratings of the intensity of emotional expressions in photographs were lower than baseline ratings of these expressions. Such an effect was not seen with anesthetization of the hemisphere dominant for language (usually left). Ratings of shades of gray (which served as control stimuli) showed no such effect. The findings are interpreted in terms of a right hemisphere superiority in the perception and evaluation of emotional expression.

Adolescent↗