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Methionine-enkephalin facilitates the cardiovascular response to epinephrine in the conscious dog.

Methionine-enkephalin (ME) is present in high concentrations in the adrenal medulla; it is co-stored with catecholamines in chromaffin vesicles, and released together with catecholamines during adrenal stimulation. We have examined the interactions of intravenously administered bolus doses of ME and epinephrine (EPI) in the conscious dog. EPI, 1.0 microgram/kg, increased mean arterial pressure (MAP) from 104 +/- 6 to 130 +/- 11 mm Hg, while reflexly reducing heart rate(HR) from 103 +/- 13 to 83 +/- 13 beats/min (bpm). ME, 5.0 micrograms/kg, increased MAP from 106 +/- 7 to 122 +/- 7 mm Hg and increased HR from 111 +/- 12 to 139 +/- 14 bpm. EPI and ME administered together increased MAP in apparently additive fashion from 106 +/- 6 to 153 +/- 12 mm Hg, and also increased HR from 102 +/- 10 to 114 +/- 17 bpm. ME, 1.0 microgram/kg, exerted a similar effect. Thus, in these concentrations, ME exerts a co-operative influence upon the EPI cardiovascular response in the conscious, neurologically intact dog, probably by inhibiting baroreceptor reflexes. These findings suggest a possible role for ENK as an excitatory stress hormone.

Animals↗

Influence of CCK and bombesin on ACTH and cortisol secretion in the conscious dog.

Bombesin and cholecystokinin (CCK) have a variety of similar actions. Previous investigations have demonstrated that IP injections of bombesin and CCK-33 increased corticosterone secretion in conscious, freely-moving, fed rats. In this study bombesin or CCk-8 was administered by continuous, intravenous infusion to conscious, awake, fasted, mongrel dogs. Following a 30-40 minute control infusion, a progressively-increasing, stepwise infusion of either bombesin (0.1, 1.0 and 2.0 micrograms/kg-hr) or CCK-8 (62.5, 125, and 250 ng/kg-hr) was administered. Each drug dose was infused for 40-45 minutes and blood samples were drawn at 20-22.5 minutes intervals. Bombesin caused significant, dose-dependent increases in plasma cortisol (286 +/- 39% of control) and plasma ACTH (176 +/- 33% of control). CCK-8 had no consistent effect on either cortisol or ACTH secretion. Whether the lack of effect of CCK-8 in dogs, as compared to rats, is due to species variations or to the differing experimental designs is unknown.

Adrenocorticotropic Hormone↗

Blood pressure responses of conscious rats to intravenous administration of enkephalin derivatives (D-ala2 methionine and leucine enkephalinamide, and methionine and leucine enkephalinamide.

The present study was designed to determine the blood pressure (BP) responses of conscious rats given intravenous (IV) injections of enkephalin derivatives (D-ala2-methionine enkephalinamide, DAMEA; D-ala2-leucine enkephalinamide, DALEA; methionine enkephalinamide, MEA; leucine enkephalinamide, LEA) and the receptor mechanisms mediating the resultant change in BP. IV injection of 1.6-16.0 nmoles of DAMEA or DALEA caused a transient but potent decrease in mean arterial pressure (MAP) and mean heart rate (MHR). LEA and MEA (16.0 nmoles) given IV produced slight pressor responses, which were not associated with concomitant tachycardia whereas 48 nmoles of MEA elicited a hypotensive effect accompanied by a fall in MHR. Pretreatment studies whereby various receptor antagonists (naloxone, diprenorphine, phentolamine, D-L-propranolol or atropine) were given IV 5 min before subsequent IV administration of DAMEA, DALEA, MEA or LEA (16 nmoles) showed that naloxone, diprenorphine and atropine blocked the depressor and bradycardic effects of DALEA and DAMEA. Naloxone and phentolamine suppressed the pressor response of both MEA and LEA (16.0 nmoles) while diprenorphine blocked the rise in MAP to only MEA. The results show that DAMEA and DALEA mediate their depressor actions in conscious rats via a negative chronotropic effect through an interaction of muscarinic cholinergic receptors on the myocardium. It suggested that the pressor response of MEA and LEA may be produced via an alpha-receptor mediated effect on the peripheral vasculature to cause vasoconstriction.

Analgesics↗

Cardiovascular effects of leukotriene C4 and D4 in the anesthetized and conscious domestic hen.

In anesthetized and conscious domestic hens i.v. injections of LTC4 (1 and 3 micrograms/hen) and LTD4 (0.1-10 micrograms/hen) induced a pronounced hypotension, initially interrupted by a small, upward pressure deflection. No significant changes in HR, ECG-characteristics, or hematocrit were observed. It is concluded that neither plasma leakage nor myocardial ischemia are likely to contribute significantly to the hypotension. Only experiments with LTD4 in conscious hens suggest a mediator function of cyclooxygenase products since the LTD4-induced hypotension was attenuated by IND. The failure of developing reflex tachycardia rather points to an impairment with manifestation of reflex mechanisms.

Anesthesia↗

Noninvasive measurement of blood pressure in conscious cynomolgus monkeys.

Systolic (SP), diastolic (DP), and mean arterial blood pressures (MAP) and pulse rate (PR) were recorded on treated and untreated conscious cynomolgus monkeys by the oscillometric method (Dinamap 1846SX/P). Each monkey was placed in a restraining tube with the cuff placed on the base on the shaved tail. Measurements were taken on untreated animals once or twice a day for 4 weeks. The mean and standard deviations for SP, DP, MAP, and PR were approximately 121 +/- 17, 60 +/- 14, and 84 +/- 17 mm Hg and 193 +/- 18 pulses/min, respectively. One male and one female cynomolgus monkey were treated with isoproterenol, norepinephrine, and nitroprusside. Blood pressure was measured indirectly with the cuff on the tail and directly with an indwelling catheter in the descending thoracic aorta. Although the oscillometric method was not as sensitive as the catheter, the oscillometric method detected a change in the same direction of SP, DP, MAP, and PR compared with the direct method for all drugs administered. The monitor was reliable and sufficiently accurate to conclude that it may be useful in toxicology studies for evaluation of blood pressure parameters in conscious cynomolgus monkeys.

Animals↗

Consciousness, privacy, and information.

The challenges for a scientific study of conscious experience are discussed, as well as the importance of such research for the foundations of information science. A three pronged approach to the investigation of consciousness and its functions is suggested.

Consciousness↗

Effects of dorsal raphe nucleus stimulation on cerebral blood flow and flow-metabolism coupling in the conscious rat.

In the present study, we have investigated the effects of an activation of the ascending serotonergic pathway on the cerebral blood supply to a number (63) of well-defined neuroanatomical structures. To this end, we have measured the local cerebral blood flow during electrical stimulation of the dorsal raphe nucleus. Measurement of regional blood flow was performed in the conscious rat through the use of the [14C]iodoantipyrine autoradiographic technique. Stimulation of the dorsal raphe nucleus induced increases (> 15% compared to control) in cerebral blood flow in 17 structures of which statistical significance (P < 0.05) was achieved in nine; raphe stimulation significantly decreased flow in three regions. The greatest increases (+71 and +46%) were found in the frontal sensorimotor and posterior parietal cortices. Other increases were noted in relay stations of the extrapyramidal and limbic systems. Stimulation induced a decrease in two regions of the primary auditory system and in the lateral habenular nucleus. These results show that activation of the serotonergic pathway in the conscious rat effects regional cerebral blood flow heterogeneously, differing from the widespread increase in glucose utilization that we previously observed using the same experimental paradigm. Statistical analyses indicated that activation of the dorsal raphe nucleus resulted in a global modification of the flow-metabolism ratio. Moreover, in 19 out of 31 regions analysed, this ratio is significantly altered as compared to control. The dichotomy between raphe-induced changes in flow and glucose-metabolism could be explained by one or both of two hypotheses; firstly there could be a direct serotonergic innervation of cerebral resistance vessels; secondly, during raphe stimulation it could be that glucose use is not the primary determinant of tissue perfusion.

Animals↗

Clonidine and rilmenidine suppress hypotension-induced Fos expression in the lower brainstem of the conscious rabbit.

Our current knowledge of the sites of action of the centrally-acting antihypertensive drug clonidine is based almost entirely on experiments in anesthetized animals. The aim of this study was to determine, in conscious rabbits, the sites of action in the brainstem of systemically administered clonidine, as well as its oxazoline analog rilmenidine. Three groups of experiments were carried out. In the first group, hypotension was produced by continuous intravenous infusion of sodium nitroprusside, at a rate sufficient to decrease arterial pressure by 20-30 mmHg, maintained for a period of 60 min. In the second and third groups of experiments, sustained hypotension was also produced by nitroprusside infusion as in the first group, but this was preceded by intravenous injection of clonidine (7-30 micrograms/kg i.v.) or rilmenidine (150-300 micrograms/kg i.v.), respectively. In confirmation of our previous study [Li Y.-W. and Dampney R. A. L. (1994) Neuroscience 61, 613-634], hypotension produced by nitroprusside alone induced a large increase (compared to sham control experiments) in the neuronal expression of Fos (a marker of neuronal activation) in the nucleus of the solitary tract, area postrema, the rostral, intermediate and caudal parts of the ventrolateral medulla, A5 area, locus coeruleus and subcoeruleus, and parabrachial nucleus. In comparison with this group, in rabbits pretreated with clonidine the numbers of Fos-positive cells were greatly reduced (by 76-94%) in the rostral, intermediate and caudal parts of the ventrolateral medulla, area postrema, A5 area, locus coeruleus and subcoeruleus. Clonidine pretreatment also caused a more moderate reduction (by 45%) in the number of Fos-positive cells in the nucleus of the solitary tract, but had no effect on Fos expression in the parabrachial nucleus. Double-labeling for tyrosine hydroxylase and Fos immunoreactivity showed that clonidine pretreatment greatly reduced the numbers of both catecholamine and non-catecholamine Fos-positive neurons. Rilmenidine pretreatment also greatly reduced Fos expression in the lower brainstem, with a very similar pattern to that observed after clonidine pretreatment. The results indicate that in conscious animals both clonidine and rilmenidine cause a widespread but selective inhibition of neurons in the pons and medulla that are normally activated by a hypotensive stimulus. In contrast to previous observations in anesthetized animals, the results suggest that (i) systemic administration of both drugs inhibits non-catecholamine as well as catecholamine neurons in the ventrolateral medulla, and (ii) the regional pattern of neuronal inhibition following administration of equipotent hypotensive doses of both drugs is very similar.

Animals↗

Cyclic flow variations in a conscious dog model of coronary artery stenosis and endothelial injury correlate with acute ischemic heart disease syndromes in humans.

OBJECTIVES: The purpose of this study was to test the hypothesis that episodes of cyclic flow variations (CFVs) in conscious dogs with coronary stenoses and endothelial injury correlate with acute ischemic heart disease syndromes in humans. BACKGROUND: Although the canine model with CFVs has proved to be a useful model of coronary thrombosis, whether CFVs progress to these syndromes has not been clearly described. METHODS: Cyclic flow variations were produced by an external constrictor placed at the site of the left anterior descending coronary artery with injured endothelium. Blood flow in this artery and 24-h Holter electrocardiogram (ECG) were recorded during the 1st 5 postoperative days. RESULTS: Of 41 dogs that underwent the initial operative procedure successfully, 29 developed an episode of CFVs. In five dogs in which CFVs persisted throughout the monitoring period, the left anterior descending coronary artery flow decreased until day 3 and thereafter increased through day 5. Transient coronary occlusion during CFVs induced ST segment changes that returned to baseline after reflow. In 12 dogs, CFVs progressed to persistent coronary occlusion, and histologic examination revealed thrombus formation at the stenotic site and evidence of myocardial infarction. Four of these 12 dogs died suddenly of ventricular arrhythmias during persistent coronary occlusion; another 5 dogs died of reperfusion arrhythmias during CFVs with no evidence of myocardial infarction. CONCLUSIONS: Conscious dogs with CFVs closely correlated with clinical acute ischemic heart disease syndromes, suggesting them to be a useful model for investigating the complex mechanisms of cellular interactions in the pathogenesis of these syndromes.

Animals↗

Alcohol and conscious level.

Many patients presenting to the Emergency Medical Services have recently consumed alcohol. This may profoundly affect their behaviour, conscious level and response to illness and treatment. The blood alcohol level (BAL) is of little use in the evaluation of these responses. Abnormal conscious level should never be ascribed to alcohol intoxication alone. It is only a diagnosis of exclusion. The most commonly associated conditions are head injury, cerebro-vascular incidents, hypoglycaemia and other drug intoxications.

Alcoholic Beverages↗

Clinical significance of periodic lateralized epileptiform discharges in children with relation to level of consciousness.

Six children with acute cerebral insult, ranging in age from 3 days to 8 years, revealed periodic lateralized epileptiform discharges in their electroencephalographic recordings. Their etiologic factors were cerebral infarction, intracranial bleeding, purulent meningitis, acute infantile hemiplegia, and encephalitis. Each patient exhibited a different type of convulsive seizure. Computer tomography or magnetic resonance imaging revealed diffuse lesions covering the cerebral cortex and subcortical white matter in 2 patients, a lesion of the subcortical white matter in 1 patient, a linear lesion in the cortex and along the borderline between the cortex and the subcortical white matter in 1 patient, and localized lesions in the cortex and basal ganglia in 1 patient. There were findings indicating the disconnection of the cerebral cortex with deeper structures in 3 patients. The appearance rate of periodic lateralized epileptiform discharges increased at levels of consciousness from 5 to 7 on a pediatric modification of the Glasgow Coma Scale. At levels of consciousness from 8 to 14 and below 4, the rate was very low.

Brain↗

Modified method for the performance of glucose insulin clamp studies in conscious rats.

A modified method for performance of insulin-glucose clamp studies in rats was developed via catheterization of the tail vessels, after preconditioning of animals to limited restraint. The procedure is performed in conscious animals under local anesthesia and employs a specially designed foam rubber jacket which allows the animal mobility of the limbs and forward vision. In addition, a table utilizing a belt system allows easy positioning of the animal in the left and right lateral and supine positions during surgery. After initial development of the procedure, its use in 123 animals is reported. Line placement was successfully achieved in all cases with insignificant blood loss or morbidity and zero mortality. We note that 11% of animals did not complete the subsequent insulin-glucose clamp study due to either one of the vascular cannulae leaving the vessel (one animal), venous rupture (12 animals), or cannula blockage unrelated to surgical technique (one animal). Studies on Wistar Kyoto, Spontaneously Hypertensive, and Sprague-Dawley rats showed a fall in catecholamines after animals were replaced in cages, with stabilization within 30 min. In comparison to traditional techniques, this method is, therefore, proposed as a less traumatic and rapid way of performing infusion studies in conscious rats with a high success rate and minimization of loss of animal life due to procedural problems.

Anesthesia↗

Altered consciousness and lethargy from compromised intestinal blood flow in children.

Altered state of consciousness and lethargy could be early and cardinal complaints in diseases that actually originate within the abdomen. Thirteen children were seen at our departments in whom impairment of the individual's mental state preceded the appearance of common gastrointestinal symptoms. Whereas in infants with intussusception of childhood neurological signs and symptoms have been rarely mentioned, references to an altered state of consciousness and lethargy in volvulus, strangulation or bowel incarceration have not been previously reported. Recognition of this possibility, however, should be taken into account in the diagnostic work-up of children presenting with inexplicable alterations of their mental state.

Consciousness Disorders↗

Interrater reliability of 3 simplified neurologic scales applied to adults presenting to the emergency department with altered levels of consciousness.

STUDY OBJECTIVE: The Simplified Motor Score was recently found to exhibit equal test performance to the Glasgow Coma Scale (GCS) when predicting 4 clinically important trauma outcomes. The present study tests the interrater reliability of the Simplified Motor Scale, the GCS and its components, and 2 other simplified neurologic scales when applied to patients presenting to the emergency department with altered levels of consciousness from any cause. METHODS: In this prospective observational study, emergency physicians independently assigned the GCS, Simplified Motor Scale, and 2 4-point scales--AVPU (Alert, responds to Verbal stimuli, responds to Painful stimuli, Unresponsive) and ACDU (Alert, Confused, Drowsy, Unresponsive)--to qualifying adult subjects. Two physicians filled out prospective data forms within 5 minutes of each other while remaining blinded to each other's assessments. Data were pooled and analyzed for interrater reliability of all scales using simple agreement, unweighted kappa, Spearman's rho, and Kendall's tau-b. RESULTS: One hundred twenty-six subjects were enrolled, with 6 later excluded. Percentage agreements were 83% for the Simplified Motor Scale, 58% for the ACDU scale, 57% for the AVPU scale, and 42% for the Total GCS. The kappa values were 0.70 for the Simplified Motor Scale, 0.43 for ACDU, 0.41 for AVPU, and 0.32 for the Total GCS. The Simplified Motor Scale also had the highest Spearman's rho (.85) and second highest Kendall's tau-b (0.81). CONCLUSION: The Simplified Motor Scale has the best interrater reliability for the assessment of altered level of consciousness of traumatic and nontraumatic cause among the scales tested.

Adolescent↗

Differential influence of iNOS and nNOS inhibitors on rostral ventrolateral medullary mediated cardiovascular control in conscious rats.

We evaluated the cardiovascular effects of nitric oxide (NO) inhibitors microinjected into the rostral ventrolateral medulla (RVLM) of conscious rats. Application of L-NAME or aminoguanidine (AG) induced an increase in arterial blood pressure (MAP) and an increase in heart rate, whereas 7-nitroindazole (7-NI) decreased MAP and HR. Microinjection of glutamate produced an increase in MAP which was followed by either a tachycardia or a bradycardia. Such responses were blocked totally by prior administration of L-NAME and attenuated (approximately 50%) by 7-NI. In contrast, glutamate responses were enhanced by following AG. We conclude that in conscious rats, NO has tonic effects in the RVLM and may participate in the modulation of the actions of glutamate through iNOS and nNOS pathways.

Animals↗

Central effect of mu-opioid agonists on antral motility in conscious rats.

Centrally applied opioids delay gastric emptying and inhibit intestinal transit. However, the mechanism of inhibitory effects of central opioids on gastric motility still remains unclear. It also remains unclear which opioid receptor (mu, delta, and kappa) stimulation affects gastric motility. We studied the central effect of opioids on antral motility in conscious rats. A strain gauge transducer was implanted on the gastric antrum to record the circular muscle contractions. The area under the curve of the antral motility, calculated as a motility index, was evaluated before and after the intracerebroventricular (icv) injection of various opioid agonists in each rat. [D-Ala2, N-Me-Phe4, Gly5-ol] enkephalin (DAMGO, 0.1-10 nmol), a mu-opioid selective agonist, significantly inhibited antral motility in a dose-dependent manner (n=4). The motility index was significantly decreased to 47.3+/-10.8% (n=4) of controls at 20 min after icv injection of DAMGO (1.0 nmol). In contrast, [D-pen2, L-Pen5] enkephalin (DADLE, 1.0 nmol), a delta-opioid selective agonist, and U50,488 (1.0 nmol), a kappa-opioid selective agonist, had no significant effects on antral motility. Pretreatment with subcutaneous guanethidine (5 mg/kg) and propranolol (1 mg/kg), but not phentolamine (1 mg/kg), significantly antagonized the inhibitory effect of DAMGO (1.0 nmol). Reduced motility index induced by DAMGO (1.0 nmol) was restored from 48.7+/-3.5% to 88.6+/-10.9% (n=5) and 80.4+/-2.2% (n=5) by guanethidine and propranolol, respectively. Our findings suggest that central mu-opioid receptor has major inhibitory effects on antral motility in conscious rats. The inhibitory effects of mu-opioid receptors are mediated via sympathetic pathways and beta-adrenoceptors.

Analgesics, Opioid↗

Spontaneous blinking behaviour in persistent vegetative and minimally conscious states: relationships with evolution and outcome.

There is evidence that spontaneous blinking correlates with cognitive functions. This arises from the observation that blinking rate (BR) is modulated by arousal levels, basic cognitive processes (e.g., attention, information processing, memory, etc.) and more complex cognitive functions (e.g., reading, speaking, etc.). The aim of this work was to test the role of BR evaluation in the assessment of cognitive network functioning in awake patients with consciousness deficits. Thirteen patients were recruited for the study, and were assessed by the Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) on admittance and discharge, respectively. A level of cognitive functioning scale (LCFS) score was assigned at every change in awareness or at least every 2 weeks. At the same time as the clinical tests, the BR was observed for a 5-min period. Ten healthy subjects, observed throughout three non-consecutive days, formed the control group. The BR underwent a different temporal behaviour in the two diagnostic categories. In the persistent vegetative state (PVS) group it remained stable throughout time and linked with the clinical conditions of the patients; whereas in the non-persistent vegetative state (NPVS) group it decreased over time as the cognitive conditions improved. Moreover, a strong inverse correlation was found between overall BR values and LCFS scores. We have concluded that the blinking behaviour changes manifested in PVS and NPVS patients reflect different evolution phases of a cholinergic-dopaminergic imbalance, and that a reduced BR characterizes the early stages of consciousness recovery.

Adult↗

The neurocognitive bases of human multimodal food perception: consciousness.

This review explores how we become aware of the (integrated) flavor of food. In recent years, progress has been made understanding the neural correlates of consciousness. Experimental and computational data have been largely based on the visual system. Contemporary neurobiological frameworks of consciousness are reviewed, concluding that neural reverberation among forward- and back-projecting neural ensembles across brain areas is a common theme. In an attempt to extrapolate these concepts to the oral-sensory and olfactory systems involved with multimodal flavor perception, the integration of the sensory information of which into a flavor gestalt has been reviewed elsewhere (Verhagen, J.V., Engelen, L., 2006. The neurocognitive bases of human multimodal food perception: Sensory integration. Neurosci. Biobehav. Rev. 30(5): 613_650), I reconceptualize the flavor-sensory system by integrating it into a larger neural system termed the Homeostatic Interoceptive System (HIS). This system consists of an oral (taste, oral touch, etc.) and non-oral part (non oral-thermosensation, pain, etc.) which are anatomically and functionally highly similar. Consistent with this new concept and with a large volume of experimental data, I propose that awareness of intraoral food is related to the concomitant reverberant self-sustained activation of a coalition of neuronal subsets in agranular insula and orbitofrontal cortex (affect, hedonics) and agranular insula and perirhinal cortex (food identity), as well as the amygdala (affect and identity) in humans. I further discuss the functional anatomy in relation essential nodes. These formulations are by necessity to some extent speculative.

Brain↗