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Contralateral acoustic suppression of transient evoked otoacoustic emissions--activation of the medial olivocochlear system.

Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes from the superior olivary complex ending at outer hair cells. Activation of medial olivocochlear system (MOCS) alters the cochlear output decreasing the travelling wave within cochlea. Stimulation of MOCS provides protection against moderate levels of noise, encoding noise signals as well as selecting hearing attention. Activation of MOCS can be performed using contralateral acoustic stimulation. The principal result of presentation of contralateral acoustic stimulation during screening of transient evoked otoacoustic emission (TEOAE) is an attenuation of the TEOAE amplitude. Thirty-eight ears were examined in this study: twenty-eight ears from 14 normal-hearing adults and 10 patients with unilateral deafness. Healthy subjects were exposed to contralateral broad-band noise of various intensities (40, 30, 20 and 10 dB SL), as well as 30 dB SL pure tone stimulation (1 kHz and 4 kHz). A decrease of TEOAE amplitudes during contralateral stimulation with 40 and 30 dB SL broad-band noise and pure tones was established. This effect was a result of MOCS activation. A greater intensity of contralateral stimulation evoked greater decrease of TEOAE amplitude; stimulation with broad-band noise caused greater attenuation than with pure tone stimulation. Contralateral stimulation of deaf ears in the group with unilateral deafness was also performed. Statistically significant difference between TEOAE amplitude before and during contralateral stimulation was not established. This circumstance explains that activation of MOCS and consequent reduction of outer hair cells motility is very possibly caused by contralateral acoustic stimulation. Apart from studying physiological significance of efferent auditory system, results of this and similar studies can be used for production of hearing aids improving speech discrimination in noisy environment.

Acoustic Stimulation↗

Reflex coronary vasoconstriction caused by gallbladder distension in anesthetized pigs.

BACKGROUND: Gallbladder distension in anesthetized pigs reflexly increases heart rate and arterial pressure by means of afferent vagal pathways and efferent sympathetic mechanisms. The effect of such distension on the coronary circulation is unknown. The present study was undertaken to determine whether gallbladder distension primarily causes reflex changes in left circumflex blood flow. METHODS AND RESULTS: In 21 pigs anesthetized with sodium pentobarbitone (16) or alpha-chloralose (5), left circumflex blood flow was measured with an electromagnetic flowmeter. A balloon positioned within the gallbladder was distended with volumes of Ringer's solution equal to the volumes of bile previously withdrawn (mean vol: 62 mL; mean gallbladder pressure: 12 mm Hg). Heart rate and arterial pressure were kept constant by atrial pacing and by a pressurized reservoir connected to the left femoral artery. Gallbladder distension always caused a decrease in circumflex blood flow. In 6 of the 16 sodium pentobarbitone-anesthetized pigs, this decrease was graded by step increments of distension. In 5 of these 16 pigs, the decrease in circumflex blood flow was not affected by atropine. In 10 of these 16 pigs, including those given atropine, the response was not affected by propranolol but was abolished by subsequently giving phentolamine. Cervical vagotomy abolished the coronary vasoconstriction in the remaining 6 pigs. In the 5 alpha-chloralose-anesthetized pigs, the response was not significantly affected by cutting the splanchnic nerves but was abolished by subsequent cervical vagotomy. CONCLUSIONS: The present study showed that innocuous distension of the gallbladder in anesthetized pigs caused a reflex coronary vasoconstriction that involved efferent sympathetic mechanisms related to alpha-adrenoceptors and afferent vagal pathways.

Adjuvants, Anesthesia↗

Effect of efferent-induced changes on acoustical reflex.

The efferent auditory pathway is known to alter the cochlear electrical properties, at low stimulus levels. This study aims to identify the effect of activation of the efferent auditory pathway through contralateral wide- and narrow-band noise at high sound levels. Acoustical reflex threshold and acoustical reflex amplitude (at ART + 10 dB) were obtained at three frequencies (500 Hz, 1 kHz, 2 kHz) in 60 normally hearing subjects, in the presence and absence of contralateral wide-and narrow-band noise (centred around reflex activating stimuli) at 30 dB SL. Results showed a consistent reduction in amplitude, and an increase in threshold, for 1- and 2-kHz tones in the presence of contralateral wideband but not narrow-band noise. Results are discussed with reference to the electrical properties of the cochlea, and the response properties of the efferent auditory pathway and cochlear nucleus.

Adolescent↗

Binocularity in the little owl, Athene noctua. I. Anatomical investigation of the thalamo-Wulst pathway.

The efferent projections from the visual thalamus to the Wulst were studied in the little owl, Athene noctua. Cells of origin were identified by retrograde labeling after injections of wheat-germ-agglutinin-conjugated horseradish peroxidase into the Wulst. The labeled-cell distribution was correlated with the distribution of anterogradely labeled retinal terminals as revealed by intraocular injections of horseradish peroxidase. The results demonstrated a bilateral thalamofugal visual pathway ascending from the nucleus dorsolateralis anterior thalami (DLA). Projections from the visual thalamus to the Wulst showed a specific and orderly pattern, and retrogradely labeled cells of DLA were distributed equally, in a complementary fashion, on both sides of the brain, with a small region of overlap. Retinal termination fields in DLA largely overlapped relay neurons projecting to either Wulst, although the overlap was not complete. Despite differences in the organization of avian and mammalian visual pathways, which reflect their separate evolutionary origins, similarities between the DLA in the little owl and the lateral geniculate nucleus in mammals suggest that, during evolution similar selective pressures for binocularity led to a similar morphological organization.

Animals↗

Reduction of high-frequency network oscillations (ripples) and pathological network discharges in hippocampal slices from connexin 36-deficient mice.

Recent evidence suggests that electrotonic coupling is an important mechanism for neuronal synchronisation in the mammalian cortex and hippocampus. Various types of network oscillations have been shown to depend on, or be sharpened by, gap junctions between inhibitory interneurones or excitatory projection cells. Here we made use of a targeted disruption of the gene coding for Cx36, a recently discovered neuronal gap junction subunit, to analyse its role in hippocampal network behaviour. Mice lacking Cx36 are viable and lack obvious morphological or behavioural abnormalities. Stimulation of afferent and efferent fibre pathways in hippocampal slices revealed a largely normal function of the synaptic circuitry, including tetanically evoked network oscillations. Spontaneous sharp waves and ripple (approximately 200 Hz) oscillations, however, occurred less frequently in slices from Cx36 -/- mice, and ripples were slightly slower than in littermate controls. Moreover, epileptiform discharges elicited by 4-aminopyridine were attenuated in slices from Cx36 -/- mice. Our findings indicate that Cx36 plays a role in the generation of certain forms of network synchronisation in the hippocampus, namely sharp wave-ripple complexes and hypersynchronous epileptiform discharges.

4-Aminopyridine↗

[Central nervous control of erection].

Penile erection is caused by a change of the activity of efferent autonomic pathways to the erectile tissues and of somatic pathways to the perineal striated muscles. The sympathic outflow is mainly antierectile, the sacral parasympathic outflow is proerectile and the pudendal outflow, through contraction of the perineal striated muscles, enhances an erection already present. Spinal neurones controlling erection are activated by afferents from the genitals. It is likely that these primary afferents do not directly stimulate the spinal sympathetic, parasympathetic and somatic nuclei, but do through spinal interneurones. This spinal network is able of integrating information from periphery to elicit reflexive erections. It also receives supraspinal descending pathways from pons and hypothalamic nuclei, among the latter, the paraventricular nucleus and the medial preoptic area. These structures are likely involved to regulate penile erection in more integrated and coordinated responses occurring during sexual behavior. By receiving ascending projections from the spinal level which convoy informations from genitals, they could reinforce penile erection. Role of putative neuromediators or regulatory peptides is evoked.

Afferent Pathways↗

Magnetic stimulation of the sacral roots.

Magnetic stimulation using an external surface coil induces an electrodynamic field that penetrates various tissues and stimulates peripheral nerves in a similar fashion to conventional electrical stimulation. An 83 mm magnetic surface coil was used to stimulate 11 spinal cord injury (SCI) patients, during which time detrusor activity and evoked potentials of the striated urinary sphincter motor pathways were evaluated. All patients had urodynamic studies and conventional sacral evoked potentials prior to magnetic stimulation. The mean bladder capacity was 337 ml (range 109-590), mean leak point pressure was 50 cm H2O (range 10-80), and mean sacral reflex (afferent-efferent) latency was 37.9 ms (range 25.1-49.3). Eight patients had detrusor-sphincter dyssynergia. Magnetic stimulation over the sacral spine at different bladder volumes was performed. Detrusor and striated sphincter responses were recorded during stimulation. In all patients the technique was easy and the results were reproducible. The mean sacral motor pathway (efferent) latency was 27.9 ms (range 18.7-39.6). Using maximal stimulation, no detrusor response was recorded at bladder volumes < 200 ml. However, a detrusor response was recorded in 7 patients (> 10 cm H2O in 2, < 10 cm H2O in 5) when the bladder volume was > 200 ml. No complications were seen. Sacral evoked potential measurements assess the function and integrity of the sacral arc but it does not distinguish between afferent and efferent pathways. Magnetic stimulation is a safe and effective method to assess the integrity and function of the detrusor and striated sphincter motor (efferent) pathways. When combined with sacral evoked potential studies, the sensory (afferent) pathways can be evaluated indirectly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure.

Autonomic functions were evaluated in 25 nondialyzed patients with chronic renal failure and eight controls. Eight patients were reassessed after 6.6 +/- 1.0 weeks of hemodialysis and 12 patients were restudied 24 +/- 4.0 weeks after renal transplantation. In addition, six patients who had been on maintenance hemodialysis for a duration of 21.5 +/- 3.0 weeks were also studied. Autonomic function tests, including blood pressure and heart rate response to sudden loud noise, mental arithmetic, hand immersion in cold water, Valsalva maneuver, change in posture and respiration, were performed using brachial artery cannulation and continuous monitoring by electrocardiogram. Baroreceptor sensitivity slope was determined using bolus injections of phenylephrine. Supine and standing plasma norepinephrine levels were measured. The cold pressor test, response to sudden loud noise and mental arithmetic were normal in nondialyzed patients with chronic renal failure, suggesting an intact efferent sympathetic pathway. The plasma norepinephrine concentration varied widely but the mean value was similar to the control group (P greater than 0.05). Expiration/inspiration ratio, lying/standing ratio, Valsalva ratio and the baroreceptor sensitivity slope were significantly abnormal (P less than 0.001) in nondialyzed patients. This indicates a defective efferent parasympathetic pathway and depressed baroreceptor sensitivity. The blood pressure response to phenylephrine was lower in the uremics, suggesting a reduced end-organ responsiveness to alpha agonists. The presence of hypertension did not affect autonomic function. The heart rate response to standing and the baroreceptor sensitivity were significantly lower (P less than 0.05) in patients who developed hypotension during hemodialysis. Lower baroreflex sensitivity could contribute to hypotension during dialysis. Autonomic functions remained unaltered after short- and long-term dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cortical, thalamic, and hypothalamic responses to cooling and warming the skin in awake humans: a positron-emission tomography study.

Thermoregulatory mechanisms are remarkably efficient, ensuring minimal temperature variation within the core of the human body under physiological conditions. Diverse afferent and efferent neural pathways contribute to the monitoring of core and skin temperature, generation of heat, and control of thermal exchange with the external environment. We have investigated the cortical, thalamic, and hypothalamic responses to cooling and warming by using positron-emission tomography activation imaging of subjects clad in a water-perfused suit, which enabled rapid change of their skin-surface temperature. Human brain regions that respond to changes in skin temperature have been identified in the somatosensory cortex, insula, anterior cingulate, thalamus, and hypothalamus, with evidence that the hypothalamic response codes for the direction of temperature change. We conclude that signals from thermosensors in the skin providing crucial afferent information to the brain are integrated with signals from central thermosensors, resulting in thermoregulatory responses that maintain core temperature within a remarkably narrow range.

Adult↗

Potential mechanisms in chemical intolerance and related conditions.

The symptom of chemical intolerance may occur in isolation, but often occurs in conjunction with other chronic symptoms such as pain, fatigue, memory disturbances, etc. This frequent clustering of symptoms in individuals has led to the definition of several chronic multisymptom syndromes, such as multiple chemical sensitivity, fibromyalgia, chronic fatigue syndrome, and Gulf War illnesses. The aggregate research into these syndromes has suggested some unifying mechanisms that contribute to symptomatology. Multiple lines of evidence suggest that there is aberrant function of numerous efferent neural pathways, such as the autonomic nervous system and hypothalamic-pituitary axes, in subsets of individuals with these conditions. There is perhaps the greatest evidence for abnormal sensory processing in these syndromes, with a low "unpleasantness threshold" for multiple types of sensory stimuli. Psychological and behavioral factors are known to play a significant role in initiating or perpetuating symptoms in some persons with these illnesses. In the field of pain research, the interrelationship between physiologic and psychologic factors in symptom expression has been well studied. Using both established and novel methodologies, studies have suggested that psychologic factors such as hypervigilance and expectancy are playing a relatively minor role in most individuals with fibromyalgia and that clear evidence exists of physiologic amplification of sensory stimuli. These studies need to be extended to more sensory tasks and to larger numbers of subjects with related conditions. It is of note, though, that existing data on this spectrum of illnesses would suggest that there may be greater psychologic contributions to symptomatology if an illness is defined in part by behavior (e.g., avoidance of chemical exposures) rather than on the basis of symptoms alone.

Afferent Pathways↗

Thermoregulation: some concepts have changed. Functional architecture of the thermoregulatory system.

While summarizing the current understanding of how body temperature (T(b)) is regulated, this review discusses the recent progress in the following areas: central and peripheral thermosensitivity and temperature-activated transient receptor potential (TRP) channels; afferent neuronal pathways from peripheral thermosensors; and efferent thermoeffector pathways. It is proposed that activation of temperature-sensitive TRP channels is a mechanism of peripheral thermosensitivity. Special attention is paid to the functional architecture of the thermoregulatory system. The notion that deep T(b) is regulated by a unified system with a single controller is rejected. It is proposed that T(b) is regulated by independent thermoeffector loops, each having its own afferent and efferent branches. The activity of each thermoeffector is triggered by a unique combination of shell and core T(b)s. Temperature-dependent phase transitions in thermosensory neurons cause sequential activation of all neurons of the corresponding thermoeffector loop and eventually a thermoeffector response. No computation of an integrated T(b) or its comparison with an obvious or hidden set point of a unified system is necessary. Coordination between thermoeffectors is achieved through their common controlled variable, T(b). The described model incorporates Kobayashi's views, but Kobayashi's proposal to eliminate the term sensor is rejected. A case against the term set point is also made. Because this term is historically associated with a unified control system, it is more misleading than informative. The term balance point is proposed to designate the regulated level of T(b) and to attract attention to the multiple feedback, feedforward, and open-loop components that contribute to thermal balance.

Afferent Pathways↗

Familial amyotrophic lateral sclerosis with a mutation in exon 4 of the Cu/Zn superoxide dismutase gene: pathological and immunocytochemical changes.

Detailed molecular pathology studies and clinicopathological phenotyping of familial amyotrophic lateral sclerosis (FALS) with characterised mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1) will yield important insights into the pathogenesis of motor neuron degeneration. An autopsy case is described with the mutation E100G (exon 4) of the SOD1 gene in which full neuropathological examination including immunocytochemistry of ubiquitin and neurofilament epitopes was performed. The case falls into the category of "amyotrophic lateral sclerosis (ALS) with posterior column involvement." Critical analysis of the findings indicates a truly multisystem disorder in which ascending sensory pathways and components of the efferent cerebellar pathways are at least as severely affected as the motor system. Abnormal neurofilament phosphorylation was not a prominent feature. Ubiquitinated neuronal inclusions were infrequent except in the hippocampal denate granule cells where they were indistinguishable from sporadic cases of ALS-dementia. The motor cortex was preserved despite severe distal axonal loss in the corticospinal tract. These findings suggest a primary failure of axonal maintainance affecting several neuronal groups with long projecting axons. The differences and similarities compared to previously reported case with I113T (exon 4) and A4T (exon 1) mutations are discussed. Findings related to inflammatory cell infiltration, ubiquitination and neurofilament phosphorylation are discussed with reference to the pathogenesis of sporadic ALS.

Adult↗

Intubation of the lacrimal pathways under endoscopic control.

Described herein is a new modification of the lacrimal pathway intubation in children with efferent lacrimal pathway obstruction. For removal of the intubation set probe without olive tips from the inferior nasal meatus, a special titanium loop is used. An endoscopic technique allows us a basically more considerate performance of this procedure and to speed it up. The risk of iatrogenic damage to the mucous membrane of the inferior meatus is, thus, reduced too. From April 1994 to June 1998, lacrimal pathway intubation was performed in 235 children 283 times. Infraction of the inferior concha was performed 27 times. Insertion of a probe submucously into the inferior nasal meatus was found 35 times and the probe was released by focused incision of the mucous membrane.

Adolescent↗