Focal cortical seizures cause distant thalamic lesions.

Topical application of convulsants to the rat sensorimotor cortex in concentrations sufficient to cause repetitive focal motor seizures resulted in acute neuropathology (dark cell neuronal degeneration and spongiform neurophil changes) involving both the cortical seizure focus and certain thalamic nuclei within seizure pathways. Changes in the cortex were localized primarily in layer IV and those in the thalamus in nuclei having reciprocal connections with the cortical focus. The spongiform neuropil changes consisted of massively dilated presynaptic axon terminals in the cortex and postsynaptic dendrites in the thalamus. The dendritic and dark cell changes resemble the excitotoxic damage caused by glutamate and aspartate. Since these putative transmitters may be released locally from recurrent collaterals and remotely from corticothalamic axons, excessive release of glutamate or aspartate may account for the changes in both sites. The abnormal axons in sensory cortex appear to be terminals of thalamocortical neurons. Swelling of these axons may be caused by excessive anti- and orthodromic firing in the course of focal motor seizures.

The effects of ivermectin on transmission of Onchocerca volvulus.

Ivermectin, given to onchocerciasis patients as a single oral dose of 200 micrograms per kilogram of body weight, substantially reduced the uptake of Onchocerca volvulus microfilariae by Simulium yahense, an efficient black fly vector of the parasite in the tropical rain forests of West Africa. Three months after treatment, patients given ivermectin infected flies at a significantly lower rate than those who had received diethylcarbamazine or placebo, thereby reducing the number of developing larvae in the vector population. This diminished rate of infectiousness was also evident 6 months after treatment. These results strongly suggest that ivermectin could be effective in interrupting transmission of Onchocerca volvulus for epidemiologically important periods of time.

Spatial and temporal variation in biting rates and parasite transmission potentials of onchocerciasis vectors in Ecuador.

The influence of spatial and temporal factors on onchocerciasis transmission by Simulium exiguum s.l. and S. quadrivittatum in Ecuador was investigated to help develop sampling protocols for entomological surveillance of ivermectin programmes. Flies were collected in alternate months (November 1995-November 1996) at four sites each in the hyperendemic communities of San Miguel and El Tigre. A fixed-effects analysis of variance was used to explore the influence on vector abundance of locality, site, month and hour. Infectivity rates detected by dissection and PCR assays were compared. Simulium exiguum s.l. predominated at El Tigre (75%) whereas S. quadrivittatum prevailed at San Miguel (62%). Vector abundance was highest on river banks and outside houses. Biting and infection rates peaked from March to July. Hourly activity patterns were bimodal in S. exiguum but unimodal in S. quadrivittatum. Annual transmission potentials (ATP) for both species combined were 385 and 733 third stage larvae/person in San Miguel and El Tigre respectively, with S. exiguum accounting for 80% of the combined ATP at both localities. We recommend protocols that may maximize detection of parasite transmission. Infection rates thus obtained must be linked with vector density estimates to assess meaningfully host exposure as treatment progresses.

Distribution of cytochrome oxidase in rat brain: studies with diaminobenzidine histochemistry in vitro and [14C]cyanide tissue labeling in vivo.

Studies in experimental animals and post-mortem studies in humans have indicated that the level of the mitochondrial enzyme cytochrome oxidase within brain anatomical pathways is regulated by the long-term functional use of those pathways. To study this relationship, we have measured cytochrome oxidase spectrophotometrically in punch biopsies from different brain regions of rat. We compared these assays against results from the diaminobenzidine histochemical technique. We found a high degree of correlation (r = 0.90) between the density of diaminobenzidine reaction product and enzyme activity. This validates the usefulness of the diaminobenzidine technique for anatomical localization and measurement of this enzyme. To study the feasibility of using radioactive cyanide as an in vivo ligand of cytochrome oxidase, we performed quantitative autoradiographic analysis of rat brains of animals given an intravenous bolus injection of [14C]cyanide. Analysis of the arterial blood curve indicated a complex redistribution of cyanide between red blood cells, plasma, and tissues. Brain labeling reached peak levels at 1 min and then fell despite rising concentrations of free plasma cyanide. Analysis of autoradiographic images revealed good anatomical resolution. The density of labeling in individual structures over time failed to show a strong correlation with cytochrome oxidase activity or diaminobenzidine reaction product.

Metabolic anatomy of brain: a comparison of regional capillary density, glucose metabolism, and enzyme activities.

Regional variations in capillary density, glucose utilization rate, and activities of the glycolytic enzyme lactate dehydrogenase and the mitochondrial enzyme cytochrome oxidase were compared in the rat brain. The distributions of capillaries and enzymes were studied by means of histochemical staining techniques, and glucose metabolism was measured by means of [14C]2-deoxyglucose autoradiography. Analysis of 18 gray and five white matter regions revealed a positive correlation between capillary density and glucose utilization rate. A negative correlation was found between capillary density and lactate dehydrogenase among gray matter structures. Analysis of capillaries and enzymes was also performed within laminated histological fields: hippocampus, olfactory bulb, and olfactory cortex. In general, this revealed reciprocal patterns of staining for lactate dehydrogenase and cytochrome oxidase. Capillary density paralleled cytochrome oxidase activity. The zones of intense staining for lactate dehydrogenase and cytochrome oxidase corresponded to the synaptic terminal fields of different input pathways. These findings demonstrate distinct distributions of a glycolytic and an oxidative enzyme within the brain which are at least partly associated with pathway specificity.

Metabolic response to optic centers to visual stimuli in the albino rat: anatomical and physiological considerations.

The functional organization of the visual system was studied in the albino rat. Metabolic differences were measured using the 14-C-2-deoxyglucose (DG) autoradiographic technique during visual stimulation of one entire retina in unrestrained animals. All optic centers responded to changes in light intensity but to different degrees. The greatest change occurred in the superior colliculus, less in the lateral geniculate, and considerably less in second-order sites such as layer IV of visual cortex. These optic centers responded in particular to on/off stimuli, but showed no incremental change during pattern reversal or movement of orientation stimuli. Both the superior colliculus and lateral geniculate increased their metabolic rate as the frequency of stimulation increased, but the magnitude was twice as great in the colliculus. The histological pattern of metabolic change in the visual system was not homogenous. In the superior colliculus glucose utilization increased only in stratum griseum superficiale and was greatest in visuotopic regions representing the peripheral portions of the visual field. Similarly, in the lateral geniculate, only the dorsal nucleus showed an increased response to greater stimulus frequencies. Second-order regions of the visual system showed changes in metabolism in response to visual stimulation, but no incremental response specific for type or frequency of stimuli. To label proteins of axoplasmic transport to study the terminal fields of retinal projections 14C-amino acids were used. This was done to study how the differences in the magnitude of the metabolic response among optic centers were related to the relative quantity of retinofugal projections to these centers. Fast and slow axoplasmic transport were studied using three separate amino acids. In each case over 64% of the radioactivity projecting contralateral from the eye was found in superior colliculus. considerably less isotope was found in dorsal lateral geniculate (11-17%), ventral lateral geniculate (3, 7-6.2%), pretectal nuclei (5-12%), and the accessory optic system (3-7%). The greatest concentration of radioactivity within each optic center was found in the visuotopic aspect subserving the superior visual field; particularly the medial aspects of the superior colliculus, olivary pretectal nucleus, and posterior pretectal nucleus, and the anterior portion of the nucleus of the optic tract. The representation of central vision in the colliculus was relatively pale, as was a zone within the middle of the contralateral dorsal lateral geniculate. The anatomical and physiological results of this study suggest that differences in deoxyglucose metabolism among optic centers are primarily related to the number of retinofugal endings and the kind of visual stimulation. Changes within any one center primarily reflect the density of retinal endings subserving the visual field.

Metabolic anatomy of focal motor seizures.

Contralateral focal seizures occurred in rats following the intracortical injection of penicillin into the anterior motor cortex. The anatomic dimensions of the metabolic response in the focus as well as the spread of increased activity through the brain were studied by autoradiography following intravenous injection of carbon 14-labeled 2-deoxyglucose. Injections of 25 to 200 units of penicillin resulted in mild to severe contralateral motor jerks coincident with repetitive single spike discharges on the electroencephalogram. Concurrent autoradiography revealed a 1.3- to 2.5-fold increase in metabolic activity in discrete areas in ipsilateral cortex, basal ganglia, thalamus, and contralateral cerebellum. Intracortical injections of over 300 units resulted in the development of recurrent contralateral tonic-clonic seizures, with 20% becoming bilateral. In brains of these animals there was activation of bilateral medial frontal cortex, bilateral extrapyramidal system, thalamus, cerebellum, and limbic structures.

Anticonvulsant effects of muscimol.

Muscimol is a potent agonist at GABA-inhibitory synapses in mammalian brain. Given systemically at 7 mumol per kilogram, it blocks topical penicillin seizures and delays the onset of generalized metrazol convulsions in rats. It has no effect against generalized seizures caused by picrotoxin or strychnine. Higher doses of muscimol cause bradykinesia, ataxia, catatonic posturing, and slowing of the electroencephalogram. When applied topically to cortex, muscimol blocks focal penicillin, bicuculline, and picrotoxin discharges in a dose-response relationship. It has no effect against topical strychnine. Muscimol offers a potential new approach to the treatment of epilepsy.

Functional anatomy of occipital lobe seizures: an experimental study in rats.

Small amounts of penicillin were used to create a seizure focus in the primary visual cortex (area 17), extrastriate cortex (area 18 and 18a), and neighboring somatosensory and temporal areas in rats. Autoradiography with 14C-deoxyglucose was used to map the focus and the local cortical and long subcortical circuits. Mild seizures from area 17 were associated with focal spiking without behavioral manifestations. There was restricted utilization of local U-fiber circuits and ipsilateral subcortical visual system nuclei. Stronger seizures filled up the visual cortex and projected into adjacent neocortex and limbic cortex, the contralateral 17-18a border, and additional subcortical nuclei. Seizures originating in the posterior visual cortex were associated with prolonged afterdischarges and stereotyped behavioral manifestations, with spread into the posterior cingulum, the subicular complex, and the bilateral hippocampus. After analyzing the electrographic discharges, behavior, and seizure pathways in each animal, we conclude that ictal symptoms associated with seizures would not be the expression of the function of a cortical focus, but rather of the dysfunction of excessive discharges through many local and long circuits.

Kainic acid-induced limbic seizures: electrophysiologic studies.

Surface and depth electroencephalograms (EEGs) were studied after intravenous injections of kainic acid (KA). High frequency oscillations and spikes appeared in the hippocampus at a dose (1 mg per kilogram) that did not affect other structures. Higher doses (greater than or equal to 4 mg per kilogram) led to electrical seizures in limbic structures, similar to those in temporal lobe epilepsy. In hippocampal slices maintained in vitro, 0.1 to 1.0 microM KA produced spontaneous epileptiform spikes, originating in CA3, and increased evoked potentials. Systemic KA is a potent means of inducing limbic seizures with a primary action in the hippocampus. We propose that this selective activation arises when KA augments excitatory glutamatergic synapses in critical epileptogenic areas, such as the CA3 region of the hippocampus.

Neurologic manifestations of intravascular coagulation in patients with cancer. A clinicopathologic analysis of 12 cases.

Among 1,459 autopsied patients with cancer, 12 had multifocal infarcts of the brain that appeared to be caused by intravascular coagulation. Most of these patients were women with leukemia or lymphoma, and all had a clinical course in which neurologic signs and symptoms were prominent. All had evidence of generalized brain disease (delirium and stupor or coma), and several also had focal brain disease (focal seizures, hemiparesis). All patients had laboratory evidence of coagulation abnormalities, although these were often not severe when neurologic symptoms began. Pathologically, there were multifocal hemorrhagic or ischemic infarcts in the distribution of several cerebral vessels, without a systemic source for cerebral emboli. Fibrin thrombi were identified in cerebral vessels and in vessels of several other organs. The clinical findings fit the pathologic picture, and in most instances the correct diagnosis might have been made earlier had it been considered.

Histochemical changes in enzymes of energy metabolism in the dentate gyrus accompany deafferentation and synaptic reorganization.

The dentate gyrus of adult rats was examined histochemically for cytochrome oxidase and lactate dehydrogenase activity after unilateral lesions of the entorhinal cortex. In normal animals, synaptic terminal fields of the perforant pathway from the entorhinal cortex show high levels of cytochrome oxidase activity (the other two-thirds dentate molecular layer), whereas terminal zones of the commissural and associational fibers show high levels of lactate dehydrogenase activity (the inner one-third dentate molecular layer). Lesions of the entorhinal cortex result in a significant reduction in staining for cytochrome oxidase in the deafferented outer molecular layer of the dentate gyrus. The changes become prominent at 16-24 h after the lesion and persist until 90 days, the longest post-lesion survival time studied. In the non-deafferented inner zones ipsilateral to the lesion, there is an increase in staining for cytochrome oxidase and lactate dehydrogenase at 24 h post-lesion that disappears by days 2-4. From 8 to 90 days post-lesion, the band of high reactivity for lactate dehydrogenase in the inner molecular layer spreads approximately 40 microns into the overlying deafferented zone. This expansion parallels the expansion of the commissural and associational terminal fields into the adjacent deafferented molecular layer. Thus, lesion-induced synaptogenesis in the dentate gyrus is accompanied by a corresponding change in enzyme activity. The results indicate that the pattern of activity of enzymes involved in energy metabolism in the dentate gyrus depends on the distribution of pathway-specific synaptic input.

The functional anatomy and pathology of lithium-pilocarpine and high-dose pilocarpine seizures.

Subcutaneous treatment of rats with low doses of lithium and pilocarpine or a high dose of pilocarpine results in a severe seizure--brain damage syndrome. Rats thus treated were studied with multiple-depth electrodes, quantitative [14C]2-deoxyglucose autoradiography, and light and electron microscopy. Rats receiving lithium-pilocarpine did not differ from high-dose pilocarpine rats in behavioral, electrographic, metabolic or histopathological findings, but lithium-pilocarpine reproduced the syndrome more reliably and with a lower acute mortality rate. Organized electrographic seizure activity developed just prior to the onset of behavioral forelimb clonus and appeared to originate from ventral forebrain in the vicinity of the ventral pallidum and/or nucleus accumbens. From these sites activity spread rapidly to involve other regions. Once initiated, electrographic seizures persisted for hours. Increased glucose utilization was found in most brain regions during the period of continuous seizure activity. The greatest increases were found in the ventral pallidum, globus pallidus, hippocampus, entorhinal cortex, amygdala, lateral septum, substantia nigra, ventrobasal and mediodorsal thalamus and frontal motor cortex. Animals sustaining seizures displayed a disseminated pattern of neural degeneration not involving globus pallidus or ventral pallidum but otherwise coinciding with the above pattern of enhanced glucose utilization. No consistent correlation was observed between the pattern of brain damage and known regions of high muscarinic cholinergic receptor density. Ultrastructurally, the cytopathological changes, like those associated with various other sustained seizure syndromes, resemble the excitotoxic type of damage glutamate is known to cause. This seizure-brain damage syndrome and that induced by systemic kainic acid appear to be similar in behavioral but not in electrophysiological or metabolic manifestations. During kainic acid seizures, electrographic changes are first recorded in the hippocampus while they are first detected in the ventral forebrain region in pilocarpine seizures. Pilocarpine also induced metabolic activation of ventral forebrain sites not activated by kainic acid. The cytopathology associated with the two syndromes is identical in type but not in pattern, the cholinergic model being characterized by much greater neocortical and slightly less hippocampal damage. Further study of these cholinergic models may provide new insights into the roles of the major excitatory neurotransmitter systems (cholinergic and glutamergic) in limbic epilepsy.

Development of Onchocerca volvulus in Simulium ochraceum and Simulium metallicum.

The development of Onchocerca volvulus was compared in Simulium ochraceum and S. metallicum by maintaining infected flies under uniform conditions. Larval development in S. ochraceum was synchronous and orderly so that nearly all larvae reaching the thoracic muscles from a single blood meal matured to third-stage infective larvae within 192 hours. In contrast, development in S. metallicum was asynchronous, slower, and retarded. In this species many first-larvae were malformed and stunted after the 5th day of development; and microfilariae and first- and second-stage larvae were still present 8--10 days after a single infecting blood meal when third-stage larvae had developed. The development of O. volvulus in S. ochraceum is more compatible with the intense transmission associated with human disease.

Onchocerciasis transmission potentials of four species of Guatemalan simuliidae.

Two complete days of collections and dissections of all black fly species landing on two persons infected with Onchocerca volvulus were made at monthly intervals for 13 months within a single endemic area of Guatemala. A comparison of the infective biting densities and transmission potentials showed that Simulium ochraceum was the only significant vector.

Implant chemotherapy of experimental filariasis.

The in vitro diffusion of the organophosphate famphur from polydimethylsiloxane (PDS) capsules into plasma and their effects on Litomosoides carinii and Dipetalonema witei in jirds was studied. The in vitro rate of diffusion per 24 hours was constant and was directly proportional to the capsule lumen surface area and inversely proportional to the capsule wall thickness. One capsule implanted subcutaneously into each jird almost completely eliminated the microfilaremia of L. carinii while in situ (5 weeks) but had no effect on the levels of microfilaremia of D. witei. The adults of both species were unaffected. The capsules were well tolerated by the jirds and little tissue response to them was noted. The possibilities of using PDS-incapsulated drugs for prophylactic chemotherapy of canine and human filariasis is discussed.

Transmission of Onchocerca volvulus by secondary vectors in Guatemala.

A comprehensive study of the transmission of Onchocerca volvulus at 4 locations in Guatemala with different prevalence rates of onchocerciasis included observations on potential secondary vectors, the most prevalent of which were Simulium metallicum, S. callidum, and S. gonzalezi. Filariae encountered in S. metallicum were primarily of a Dipetalonema-like species, but third-stage larvae indistinguishable from O. volvulus were found in 4 flies of this species. Our findings suggest that O. volvulus may occasionally be transmitted by S. metallicum, but such transmission is likely limited to areas having both a high parasite prevalence maintained by S. ochraceum and a relatively high host-seeking density of S. metallicum. Two third-stage larvae that could not be differentiated from O. volvulus were found once in S. gonzalezi; however, transmission by this species appears to be inconsequential.

Biting activity of black flies in Guatemala: parity rates and differences between localities and habitats.

Host-seeking activity of anthropophilic black flies at 4 localities in Guatemala with different prevalence rates of onchocerciasis was assessed using human attractants and semimonthly catches over one year. Density of host-seeking Simulium ochraceum was greatest at the locality with the highest incidence of onchocerciasis and very reduced at the 2 localities with low levels of human infection. The overall percentage of parous host-seeking S. ochraceum at the 4 localities ranged from 41%-49%. Host-seeking activity appeared to be concentrated near streams containing immature stages, and few females dispersed as far as 3 km away. S. metallicum was the second most frequently captured species; however, at the locality with the highest prevalence of onchocerciasis, its host-seeking density was much less than that of S. ochraceum. For S. metallicum, the overall percentage of parous females ranged from 28%-34% at the 4 localities. S. metallicum were consistently taken in much greater numbers in coffee cultivation areas than in housing areas. Host-seeking S. callidum and S. gonzalezi also were captured.

Seasonality of adult black flies and Onchocerca volvulus transmission in Guatemala.

Transmission of Onchocerca volvulus, principally by Simulium ochraceum, was studied over a 14-month period in the Atitlán region of Guatemala. Semimonthly catches of black flies were made on human volunteers at 4 localities with different prevalences of human onchocerciasis. Host-seeking activity of S. ochraceum reached its greatest magnitude in the early dry season (October-January) but then declined rapidly and was lowest during the late dry season (February-May). The frequency of O. volvulus larvae in parous host-seeking S. ochraceum also varied seasonally, and this variation was most pronounced for third stage larvae. At a hyperendemic locality, the highest frequency of this larval stage occurred during the February-March period (0.0142 in 1979 and 0.0095 in 1980). From June-January, the frequency of third stage larvae in S. ochraceum was less than 0.003. The frequency of early first stage larvae exhibited the least seasonal variation, ranging from 0.0354 in August-September to 0.0628 in April-May. The transmission rate of O. volvulus by S. ochraceum also varied seasonally. At the same hyperendemic locality, infective biting density of S. ochraceum attained its greatest magnitude in February-March. The survival rate of female S. ochraceum from one gonotrophic cycle to the next was estimated from the ratio of flies with early first stage larvae to those with infective stage larvae. These rates varied seasonally and ranged from 0.2132 to 0.3974, with the highest rates occurring in the late dry season.

Descriptive statistics for the larval stages of Onchocerca volvulus in host-seeking Simulium ochraceum.

In four localities of Guatemala with dissimilar intensities of onchocerciasis, filarial larvae were recovered by dissection from host-seeking Simulium ochraceum. Measurements made on over 600 Onchocerca volvulus larvae were used to characterize the early first, late first, second, and third developmental stages. The numerical attributes used to characterize the third larval stage and the associated means were body length (657.3 microns); anterior body width (18.9 microns); posterior body width (20.2 microns); distance from anterior end to nerve ring (87.9 microns), to junction of muscular and glandular esophagus (137.6 microns), and to junction of esophagus and intestine (419.6 microns); and distance from anus to tip of tail (36.8 microns). Ratios to total body length were as follows: distance from anterior end to nerve ring, mean = 0.133, to junction of esophagus and intestine, mean = 0.634, and to anus, mean = 0.945. Differences between these phenotypic features and those reported for African O. volvulus appeared to be insufficient to distinguish the two forms. With very few exceptions, the filarial larvae found in host-seeking S. ochraceum were considered to be O. volvulus.