Gastric myoelectrical and neurohormonal changes associated with nausea during tilt-induced syncope.

BACKGROUND: Nausea is a common prodromal symptom of neurally mediated syncope, but the biological factors linking nausea with syncope have not been studied. We aimed to characterize nausea during tilt-induced syncope by exploring related changes in gastric myoelectrical activity and plasma epinephrine, norepinephrine, and vasopressin concentrations across study phases of recumbency, tilt, syncope, and recovery. METHODS: Electrogastrographic and plasma hormone changes were compared between patients with tilt-induced syncope and nausea (n = 18) and control subjects (n = 6) without symptoms or hemodynamic changes during tilt-table testing. KEY RESULTS: Over a 4-minute period preceding syncope, sequential electrogastrography epochs demonstrated an increase over time in bradygastria (P = .003) and tachygastria (P = .014) power ratios, while the dominant frequency (P < .001) and the percent normogastria (P = .004) decreased. Syncope led to significant differences between cases and controls in electrogastrographic power ratios in each frequency range: bradygastria (P = .001), tachygastria (P = .005), and normogastria (P = .03). Nausea always followed electrogastrographic changes, and nausea resolution always preceded electrogastrographic normalization. Plasma vasopressin (676.5 ± 122.8 vs 91.2 ± 15.3 pg/mL, P = .012) and epinephrine (434 ± 91.3 vs 48.7 ± 2.5 pg/mL, P = .03), but not norepinephrine (P > .05), also differed with syncope between cases and controls. CONCLUSIONS AND INFERENCES: The nausea related to tilt-induced syncope is temporally associated with changes in gastric myoelectrical activity and increases in plasma vasopressin and epinephrine. The biological mechanisms that induce syncope are physiologically distinct from other experimental models of nausea such as illusory self-motion, yet nausea with syncope appears to have similarly associated electrogastrographic and hormone changes. Thus, tilt-induced syncope could serve as an informative experimental model for nausea research.

Magnetic orientation of spiny lobsters in the ocean: experiments with undersea coil systems

The western Atlantic spiny lobster Panulirus argus undergoes an annual migration and is also capable of homing to specific dens in its coral reef environment. Relatively little is known, however, about the orientation cues that lobsters use to guide their movements. To determine whether lobsters can orient to the earth's magnetic field, divers monitored the orientation of lobsters tethered inside magnetic coil systems submerged offshore in the Florida Keys, USA. Each coil could be used to reverse either the horizontal or vertical component of the earth's field. Tethered lobsters walking inside the coils often established and maintained consistent courses towards specific directions. After a lobster had established a course, it was exposed to one of three conditions: (1) a reversal of the horizontal component of the earth's field; (2) a reversal of the vertical component of the earth's field; or (3) no change in the ambient field (controls). Lobsters subjected to the horizontal field reversal deviated significantly from their initial courses. In contrast, control lobsters and those subjected to the reversed vertical field did not. These results demonstrate that spiny lobsters possess a magnetic compass sense. Because inverting the vertical component of the earth's field had no effect on orientation, the results suggest that the lobster compass is based on field polarity and thus differs from the inclination compasses of birds and sea turtles. The magnetic compass of lobsters may function in homing behavior, in guiding the autumn migration or in both.

Suppression of multiple sclerosis in the rat during infection with Trichinella pseudospiralis.

Injection of the rat with guinea pig myelin basic protein (MBP) induces an inflammatory demyelination that leads to development of a condition mimicking human multiple sclerosis (MS), including severe depressions in mobility, coordination, and strength in the affected animal. This model was used to observe and compare the antiinflammatory effects of the intestinal and late migratory phases of infection with Trichinella pseudospiralis on development of MBP-induced, MS-like debilitation in rats. Animal performance was measured in an activity monitor and in a series of physical tests designed to assess animal coordination and strength. Uninfected animals injected with MBP showed declines in mobility, coordination, and strength typical for this model. These changes were similar in rats infected so that the intestinal phase of infection coincided with the peak of MBP-induced debilitation. Rats infected so that the late migratory phase of infection occurred during the period of peak MBP-induced debilitation showed significantly higher performance scores in mobility, coordination and strength compared to the latter 2 groups. These finding demonstrate the potency of the anti-inflammatory effects of elevations in host corticosteroids seen during the migratory phase of infection with T. pseudospiralis.

Conversational discourse analysis as a method for evaluating progress in aphasia: a case report.

The gains made by a woman with Broca's aphasia as documented by traditional measures were paralleled by changes in conversation, including increased verbal output and efficiency, and changes in conversation repair patterns. Her conversational partner decreased her verbal output, as predicted. The progress documented with conversational discourse analysis was not observable from other test measures. Clinical and theoretical implications are discussed.

Spastic dysphonia: a patient profile of 200 cases.

A comprehensive case history profile of spastic dysphonia patients was established, using 200 patients matched to 200 controls. The case histories and epidemiologic profiles for male and female patients revealed few dissimilarities. Likewise, intergroup (patients-controls) health history profiles differed in only a few specific instances. The data suggest non-psychogenic, non-behavioral causation of spastic dysphonia; however, neither a definitive cluster or clusters of events at onset nor any unequivocal epidemiologic factor was accountable for spastic dysphonia. Short of qualified improvement with voice therapy in some patients, no form of treatment other than recurrent laryngeal nerve section was shown to be of any significant help for the patient population sampled.

Low frequency of alpha-synuclein mutations in familial Parkinson's disease.

A mutation in exon 4 of the alpha-synuclein (NACP) gene has been reported to explain the chromosome 4 linkage to autosomal dominant Parkinson's disease. We developed primers and methods for exonic sequencing of this gene and sequenced the entire coding region of the gene in 6 families with autosomal dominant disease and in 2 cases of lytico and bodig from Guam. In addition, we have sequenced exon 4 of this gene in 5 cases of familial disease and have screened for the specific mutation (A53T) in a 40 cases of idiopathic Parkinson's disease, 3 cases of multisystem atrophy, and 15 cases of Lewy body dementia. We have found no genetic variation in the gene. We discuss these findings with respect to both the epidemiology of Parkinson's disease and the possibility that NACP is not the chromosome 4 locus for disease.