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Differential activation of nerve fibers with magnetic stimulation in humans.

BACKGROUND: Earlier observations in our lab had indicated that large, time-varying magnetic fields could elicit action potentials that travel in only one direction in at least some of the myelinated axons in peripheral nerves. The objective of this study was to collect quantitative evidence for magnetically induced unidirectional action potentials in peripheral nerves of human subjects. A magnetic coil was maneuvered to a location on the upper arm where physical effects consistent with the creation of unidirectional action potentials were observed. Electromyographic (EMG) and somatosensory evoked potential (SEP) recordings were then made from a total of 20 subjects during stimulation with the magnetic coil. RESULTS: The relative amplitudes of the EMG and SEP signals changed oppositely when the current direction in the magnetic coil was reversed. This effect was consistent with current direction in the coil relative to the arm for all subjects. CONCLUSION: A differential evocation of motor and sensory fibers was demonstrated and indicates that it may be possible to induce unidirectional action potentials in myelinated peripheral nerve fibers with magnetic stimulation.

Action Potentials↗

Neuronal interactions mediated by neurally evoked changes in the extracellular potassium concentration.

Neuronal interactions mediated by alteration of the extracellular K+ concentration [K+]o occur between populations as well as among single neurones in very restricted regions. The interactions mediated by K+ ions may range from low efficacy ones (in which the effects of increased [K+]o around the non-active cells can be recorded only after massive activity of a large population of neurones) to very effective interactions (in which a single action potential in a neurone is sufficient to produce a depolarization of several mV in a second one). Such efficient K+-mediated interactions cannot be unequivocally distinguished by shape, amplitude or time course from postsynaptic responses induced by chemical or electrotonic synapses. We review here experiments which demonstrate various levels of interactions mediated by changes in potassium ion concentration. The giant axons (Gax) and non-giant axons from the central nervous system of the cockroach Periplaneta americana were used. The types of interactions discussed are: pathological interactions among populations of neurones induced by the convulsant drug picrotoxin; restricted and limited interactions which are the consequence of the combination of the special geometry of Gaxs and increases in extracellular K+; and finally, local and efficient interactions among Gaxs which are postulated to be mediated by K+ ions. The experiments described in this review, as well as others, demonstrate that the extracellular spaces in the CNS serve as predetermined pathways for K+-mediated neuronal communication. When the extracellular space between two adjacent neurones is very small, the K+-mediated interaction may resemble the PSPs of chemical or electrotonic synapses. It is possible that because of this resemblance, other K+-mediated interactions in the CNS have not been identified as such.

Abdomen↗

Co-ordinating interneurones of the locust which convey two patterns of motor commands: their connexions with flight motoneurones.

1. Some flight motoneurones receive two superimposed rhythms of depolarizing synaptic potentials when the locust is not flying; a slow rhythm which is invariably linked to the expiratory phase of ventilation, and a fast rhythm with a period of about 50 ms which is similar to the wingbeat period in flight. 2. By recording simultaneously from groups of motoneurones, the synaptic potentials which underly these rhythms have been revealed in 30 flight motoneurones in the three thoracic ganglia. The inputs occur in elevator motoneurones and some depressors but are of lower amplitude in the latter. The inputs have not been found in leg motoneurones. 3. The rhythmic depolarizations are usually subthreshold but sum with sensory inputs to evoke spikes in flight motoneurones at intervals equal to or multiples of the wingbeat period in flight. 4. Both rhythms originate in the metathoracic ganglion and are mediated by the same interneurones. They can be adequately explained by supposing that there are two symmetrical interneurones which each make widespread connexions with left and right flight motoneurones in the three ganglia. 5. The slow rhythm is coded in the overall burst of interneurone spikes during expiration and the fast rhythm in the interval between the spikes of a burst.

Action Potentials↗

Electrophysiological tests of the hearing organ in Hashimoto's disease.

Thyroid gland diseases resulting from an autoimmunological process may influence the hearing organ. The aim of this study was to assess peripheral and central parts of the hearing organ in children with Hashimoto's thyroiditis. Thirty children (mean age 14.9 years) with Hashimoto's thyroiditis were examined. Patients were euthyroid, and presented high blood concentration of antithyroperoxidase (ATPO) antibodies. Pure tone audiometry, tympanometry, otoacoustic emissions (DPOAEs), and brain auditory evoked potentials (BAEPs) were performed. None of the patients had any complaints about hearing acuity; pure tone audiometry, tympanometry, and DPOAEs were normal in all patients. There were considerable disturbances in auditory nerve and brainstem neural conduction in BAEPs. There was positive correlation between the blood concentration of ATPOA and the extent of the disturbances in the central part of the hearing organ. One should consider the possible presence of subclinical Hashimoto's encephalopathy affecting the central part of the auditory organ.

Adolescent↗

Central nervous system control of heat acclimation adaptations: an emerging paradigm.

The role of the central nervous system (CNS) in the control of human heat acclimation (HA) and HA adaptations at the ultrastructural and biochemical level are not well described, although empirical evidence demonstrates that the hypothalamus adjusts thermoregulation subsequent to 8-14 days of exercise in a hot environment. Therefore, numerous investigations and concepts are presented in this paper that 1) describe plausible mechanisms for the development and CNS control of physiological adaptations and enhanced performance during heat acclimation, 2) include adaptations of neuron morphology and biochemical pathways, 3) account for situations in which homeostatic control during exercise in heat is inadequate, and 4) describe applications to other phenomena in physiology and medicine. The resulting paradigm incorporates information storage, temperature-sensitive neurons in the brain, and neural plasticity.

Acclimatization↗

Prefrontal control of the amygdala.

Accumulating evidence indicates that phobic and posttraumatic anxiety disorders likely result from a failure to extinguish fear memories. Extinction normally depends on a new learning that competes with the original fear memory and is driven by medial prefrontal cortex (mPFC) projections to the amygdala. Although mPFC stimulation was reported to inhibit the central medial (CEm) amygdala neurons that mediate fear responses via their brainstem and hypothalamic projections, it is unclear how this inhibition is generated. Because the mPFC has very sparse projections to CEm output neurons, the mPFC-evoked inhibition of the CEm is likely indirect. Thus, this study tested whether it resulted from a feedforward inhibition of basolateral amygdala (BLA) neurons that normally relay sensory inputs to the CEm. However, our results indicate that mPFC inputs excite rather than inhibit BLA neurons, implying that the inhibition of CEm cells is mediated by an active gating mechanism downstream of the BLA.

Amygdala↗

[Dualist nature of cutaneous pain. Review of the literature].

The double nature of the cutaneous pain is evident since the peripheral level, projecting in different structures of the central nervous system. In certain levels their ways converge, in other ones they diverge. Their characteristics appear since the stimulation, going beyond through different properties of receptive fields, and reaching particular associated responses. They seem also different in the ways of blocking and have interactions between them and with the dorsal column and lemniscal system, that conveys the sensibility of fine touch.

Animals↗

Regional anaesthesia in the elderly: a clinical guide.

The number of elderly patients presenting for anaesthesia and surgery has increased exponentially in recent years. Regional anaesthesia is frequently used in elderly patients undergoing surgery. Although the type of anaesthesia (general versus regional anaesthesia) has no substantial effect on perioperative morbidity and mortality in any age group; it intuitively makes sense that elderly patients would benefit from regional anaesthesia because they remain minimally sedated throughout the procedures and awaken with excellent postoperative pain control. However, a multitude of factors influence the outcome, such as the type, duration and invasiveness of the operation, co-existing medical and mental status of the patient and the skill and expertise of the anaesthesiologist and surgeon. These factors make it difficult to decide if and when one technique is equivocally better than another. Thus, it is more important to optimise the overall management of the patient during the perioperative period and, in most cases, it is the quality of the anaesthetic administered rather than the type of anaesthetic which is most important. Sedatives used for regional anaesthesia in the elderly should be short acting, easy to administer, have a low adverse effect profile and high safety margin. Midazolam, lorazepam, ketamine, propofol and low-dose opioids have been successfully used for sedation in the elderly. Aging affects the pharmacokinetics and pharmacodynamics of local anaesthetics, composition and characteristics of tissues and organs within the body, and physiological functions of the body. Changes in the systematic absorption, distribution and clearance of local anaesthetics lead to an increased sensitivity, decreased dose requirement and a change in the onset and duration of action in the elderly. Decreases in neural population, neural conduction velocity and inter-Schwann cell distance can lead to an increased sensitivity to local anaesthetics in the elderly. The addition of an opioid and epinephrine (adrenaline) has been shown to be useful in central neuraxial blockade. Epinephrine also can prolong the duration of peripheral nerve blocks. However, caution must be exercised as epinephrine has the potential for causing ischaemic neurotoxicity in peripheral nerves. Regional anaesthesia appears to be safe and beneficial in elderly patients; however, every anaesthetic administered must be assessed on a case-by-case basis and particular consideration should be given to the health status of the patient, the operation being performed and the expertise of the anaesthesiologist.

Aged↗

Pruritus. Current concepts in pathogenesis and treatment.

Pruritus is an unpleasant sensation that provokes an urge to scratch. Many stimuli (notably histamine) are able to induce pruritus. The neural conduction of the itch sensation from the free unmyelinated nerve endings to the central nervous system mainly occurs on unmyelinated C fibres and the anterolateral spinothalamic tract. Pruritus is a common symptom in many skin or systemic diseases, but very little is known about the mechanism of the condition. Treatment evaluation is difficult; many methods do not evaluate the pruritus, but only the scratching, which is a consequence of pruritus. A number of asymptomatic treatments are only partially effective and we know little about their mechanism of action. Antihistamines remain the treatment of first choice for pruritus without known cause, but generally give incomplete relief. Whenever possible it is best to treat the underlying disease.

Antipruritics↗

Effects of disulfide bond reduction on the excitatory and inhibitory postsynaptic responses of Aplysia ganglion cells.

Three kinds of the cholinoceptive neurons, nicotinic depolarizing (D)-, nicotinic hyperpolarizing (H)-, and muscarinic H-tyes, as well as two other kinds of neurons, GABA H- and dopamine H-types, were identified in Aplysia abdominal ganglion, and the effects of disulfide bond reduction and reoxidation on their postsynape acetylcholine-induced responses of both nicotinic types (D- and H-) were depressed by reducing the disulfide bonds with dithiothreitol (DTT) and restored by reoxidizing with 5, 5' -dithiobis-(2-nitrobenzoic acid): (DTNB), whereas the responses of the muscarinic H-, GABA H-, and dopamine H-cells were not affected at all by either DTT or DTNB. In contrast to the results obtained from the electroplax, the cholinergic receptors in our preparation showed neither the activation by hexamethonium nor the augmentation of decamethonium-induced responses after reduction of disulfide bonds. In addition, our preparation did not demonstrate the long-lasting responses to bromoaTT-induced depression of the nicotinic responses was studied on the dose-response curves; the mode of receptor inhibition was rather complexed, being neither type of competitive nor non-competitive. We concluded that the disulfide bond is a crucial element in both types of nicotinic receptors (D and H), and that this bond is related to the activation process of the receptors regardless of their ionic specificities.

Acetylcholine↗

Barosensory neurons in the ventrolateral medulla in rabbits and their responses to various afferent inputs from peripheral and central sources.

In 55 anesthetized and paralyzed adult rabbits, 161 spontaneously active neurons which responded to electrical stimulation of A-fibers of the aortic nerve were found within the ventrolateral medulla (VLM). They were termed barosensory VLM neurons, since the aortic nerve A-fibers were considered to consist exclusively of afferents from arterial baroreceptors. Forty percent of barosensory VLM neurons tested (49/123) were activated antidromically by stimulation of the dorsolateral funiculus indicating that they send descending bulbospinal projections. Spontaneous discharges of barosensory VLM neurons were invariably inhibited by stimulation of aortic nerve A-fibers. Ninety-three percent of 80 neurons tested also responded to stimulation of aortic nerve C-fibers, a mixture of barosensory and nonbarosensory afferents. Natural stimulation of carotid sinus baroreceptors by an intravenous injection of phenylephrine in 19 vagotomized rabbits with aortic nerves disrupted inhibited spontaneous activity of all the 50 barosensory VLM neurons tested. By contrast, pharmacological stimulation of right or left carotid body chemoreceptors by close arterial injection of NaCN into the carotid sinus augmented activity of 93% of barosensory VLM neurons tested (41/44). The neuronal response was always greater to stimulation of chemoreceptors in the contralateral carotid sinus. Seven out of 8 barosensory VLM neurons tested (88%) were orthodromically excited by stimulation of the posterior hypothalamic area. In 74% of the 97 neurons examined in 29 vagotomized animals, a distinct respiratory-related rhythm, locked to that of phrenic nerve activity, was discerned. Thus, spontaneous activity of barosensory VLM neurons is inhibited by afferent inputs from aortic and carotid sinus baroreceptors, but is excited by incoming signals from carotid body chemoreceptors and the posterior hypothalamic area. It is also subject to the influence of the central mechanism generating the respiratory rhythm.

Afferent Pathways↗

Neural substrates for reflex salivation induced by taste, mechanical, and thermal stimulation of the oral region in decerebrate rats.

In order to investigate the neural mechanisms of reflex salivary secretion, experiments were carried out on anesthetized, decerebrate rats from which the volumes of submandibular salivary secretion and the efferent discharges in the preganglionic parasymapathetic fibers innervating the submandibular gland were recorded. Salivary secretion was induced by either infusing a taste solution, or an aliquot of hot water (45-55 degrees C) into the oral cavity, or by pinching the frontal parts of the oral region with a pair of forceps. The reflex salivation induced by noxious thermal and mechanical stimuli was markedly reduced by lesioning either the caudal (VC), or the interpolar (VI) trigeminal sensory nuclei. Taste-elicited salivary secretion was significantly reduced by lesioning the nucleus of the tractus solitarius (NTS). Of 43 preganglionic parasympathetic fibers sampled, 27 responded to both noxious mechanical and thermal stimulation of the oral region, and to electrical stimulation of the VC. Ten fibers responded only to taste stimulation and to electrical stimulation of the NTS. The remaining 6 fibers responded to both taste and noxious thermal stimulation of the oral region. These fibers responded well to NTS stimulation, but gave only a slight response to VC stimulation. These results suggest that two distinct neural pathways exist which mediate reflex salivation in the lower brain stem of the rat, i.e., the taste pathway via the NTS and the nociceptive pathway via the trigeminal sensory nuclei.

Animals↗