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1.
Muscle Nerve ; 46(6): 932-6, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23018984

ABSTRACT

INTRODUCTION: In this study we investigated the effects of aging on corticospinal tract conduction by measuring the corticoconus motor conduction time (CCCT). METHODS: Motor evoked potentials were recorded from the right tibialis anterior muscle in 100 healthy volunteers. To activate the most proximal part of the cauda equina, magnetic stimulation was performed using a MATS coil over the L1 spinous process (L1-level latency). Transcranial magnetic stimulation of the motor cortex was also conducted (cortical latency). To obtain the CCCT, the L1-level latency was subtracted from the cortical latency. RESULTS: Age was significantly correlated with L1-level latency, but it was not significantly correlated with CCCT. CONCLUSIONS: CCCT is the most direct indicator of corticospinal tract conduction, whereas L1-level latency reflects whole peripheral motor conduction. Central motor conduction was found to be relatively less affected by aging compared with peripheral motor conduction.


Subject(s)
Aging , Central Nervous System/physiology , Evoked Potentials, Motor/immunology , Neural Conduction/physiology , Peripheral Nerves/physiology , Transcranial Magnetic Stimulation , Adult , Aged , Aged, 80 and over , Biophysics , Cauda Equina/physiology , Evoked Potentials, Motor/physiology , Female , Humans , Male , Middle Aged , Pyramidal Tracts/physiology , Reaction Time , Young Adult
2.
Muscle Nerve ; 46(5): 823-7, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23055320

ABSTRACT

INTRODUCTION: Paraneoplastic lower motor neuronopathies have been reported rarely with Hodgkin lymphoma. METHODS: We report a case of rapidly progressive motor neuronopathy preceding the diagnosis of Hodgkin lymphoma. RESULTS: A 31-year-old woman developed subacute rapidly progressive quadriparesis. Electrodiagnostic studies revealed a severe diffuse disorder of motor neurons and their axons. Symmetric enhancement of the cauda equina motor nerve roots was notable on magnetic resonance imaging scan. Further imaging demonstrated an enlarged supraclavicular lymph node, and biopsy revealed Hodgkin lymphoma. A final diagnosis of paraneoplastic motor neuronopathy was made after investigations for alternative causes of motor neuronopathy were unrevealing. Neurological improvement was seen with combined treatment of the underlying malignancy and intravenous immunoglobulin. CONCLUSIONS: Paraneoplastic causes should be considered in the differential diagnosis of subacute motor neuronopathy, as the neurological presentation may precede cancer detection. Combinations of lymphoma treatment and immunotherapy may result in a favorable outcome.


Subject(s)
Hodgkin Disease/complications , Hodgkin Disease/diagnosis , Motor Neurons/pathology , Paraneoplastic Polyneuropathy/complications , Paraneoplastic Polyneuropathy/diagnosis , Adult , Cauda Equina/pathology , Cauda Equina/physiology , Female , Hodgkin Disease/pathology , Humans , Motor Neurons/physiology , Neural Conduction/physiology , Paraneoplastic Polyneuropathy/pathology , Peripheral Nervous System Neoplasms/complications , Peripheral Nervous System Neoplasms/diagnosis , Peripheral Nervous System Neoplasms/pathology
3.
Muscle Nerve ; 43(2): 274-82, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21254095

ABSTRACT

In this study we aim to establish a motor nerve conduction study (NCS) for the cauda equina and examine its usefulness in multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS). NCS of the tibial nerve proximal to the knee was performed with an optimized high-voltage electrical stimulation (HV-ES) method in 21 normal subjects, 5 with MMN, and 11 with ALS. HV-ES, but not magnetic stimulation, could supramaximally stimulate the cauda equina. Cauda equina motor conduction time determined by HV-ES, but not that with F-waves, correlated well with cauda equina length on magnetic resonance imaging. HV-ES revealed proximal lesions in 4 MMN patients but in none of the ALS patients. Importantly, 1 patient with "MMN without conduction block (CB)" had a CB in the cauda equina. Cauda equina motor conduction is better evaluated by HV-ES than with F-wave study or magnetic stimulation. HV-ES can help to distinguish MMN and "MMN without CB" from ALS.


Subject(s)
Amyotrophic Lateral Sclerosis/therapy , Cauda Equina/physiology , Electric Stimulation , Neural Conduction/physiology , Polyneuropathies/therapy , Tibial Nerve/physiopathology , Action Potentials/physiology , Adult , Aged , Aged, 80 and over , Ankle/innervation , Cauda Equina/physiopathology , Electromyography/methods , Female , Hip/innervation , Humans , Knee/innervation , Magnetics , Male , Middle Aged , Muscle, Skeletal/physiopathology , Young Adult
4.
J Neurophysiol ; 103(3): 1580-90, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20089814

ABSTRACT

Previous studies have demonstrated that "locomotor-like" rhythmic patterns can be evoked in the isolated neonatal rat spinal cord by several means, including pharmacological neuromodulation and electrical stimulation of various pathways. Recent studies have used stimulation of afferent pathways to evoke rhythmic patterns, relying on synaptic activation of interneuronal systems rather than global imposition of neuromodulatory state by pharmacological agents. We use the in vitro neonatal rat spinal cord with attached hindlimb to examine the muscle activation patterns evoked by stimulation of these different pathways and evaluate whether stimulation of these pathways all evoke the same patterns. We find that the patterns evoked by bath application of serotonin (5-HT) and N-methyl-D-aspartic acid (NMDA) consisted of alternation between hip flexors and extensors and similar alternation was observed in the patterns evoked by electrical stimulation of the cauda equina (CE) or contralateral fifth lumbar (L(5)) dorsal nerve root. In contrast, the knee extensor/hip flexor rectus femoris (RF) and knee flexor/hip extensor semitendinosus (ST) were activated differentially across stimulation conditions. In 5-HT/NMDA patterns, RF was active in late flexion and ST in late extension. In CE patterns, these two muscles switched places with RF typically active in late extension and ST active in flexion. In L(5) patterns, ST was activated in extension and RF was silent or weakly active during flexion. There were also systematic differences in the consistency of rhythms evoked by each stimulation method: patterns evoked by electrical stimulation of CE or L(5) were less consistently modulated with the rhythm when compared with 5-HT/NMDA-evoked patterns. All differences were preserved following deafferentation, demonstrating that they reflect intrinsic properties of spinal systems. These results highlight the intrinsic flexibility of motor pattern generation by spinal motor circuitry which is present from birth and provides important information to many studies examining spinal pattern generating networks.


Subject(s)
Animals, Newborn/physiology , Instinct , Spinal Cord/physiology , Algorithms , Animals , Cauda Equina/physiology , Data Interpretation, Statistical , Denervation , Electric Stimulation , Excitatory Amino Acid Agonists/pharmacology , Hindlimb/innervation , Hindlimb/physiology , Locomotion/physiology , Muscle, Skeletal/innervation , Muscle, Skeletal/physiology , N-Methylaspartate/pharmacology , Neural Pathways/physiology , Neurons, Afferent/physiology , Rats , Serotonin/pharmacology , Spinal Cord/drug effects , Spinal Nerve Roots/physiology
5.
J Cell Biol ; 148(6): 1255-65, 2000 Mar 20.
Article in English | MEDLINE | ID: mdl-10725338

ABSTRACT

Kinesin superfamily proteins (KIFs) comprise several dozen molecular motor proteins. The KIF3 heterotrimer complex is one of the most abundantly and ubiquitously expressed KIFs in mammalian cells. To unveil the functions of KIF3, microinjection of function-blocking monovalent antibodies against KIF3 into cultured superior cervical ganglion (SCG) neurons was carried out. They significantly blocked fast axonal transport and brought about inhibition of neurite extension. A yeast two-hybrid binding assay revealed the association of fodrin with the KIF3 motor through KAP3. This was further confirmed by using vesicles collected from large bundles of axons (cauda equina), from which membranous vesicles could be prepared in pure preparations. Both immunoprecipitation and immunoelectron microscopy indicated the colocalization of fodrin and KIF3 on the same vesicles, the results reinforcing the evidence that the cargo of the KIF3 motor consists of fodrin-associating vesicles. In addition, pulse-labeling study implied partial comigration of both molecules as fast flow components. Taken together, the KIF3 motor is engaged in fast axonal transport that conveys membranous components important for neurite extension.


Subject(s)
Carrier Proteins/physiology , Kinesins/physiology , Microfilament Proteins/physiology , Neurites/physiology , Neurons/physiology , Synaptic Vesicles/physiology , Animals , Antibodies, Monoclonal/pharmacology , Axons/physiology , Cauda Equina/physiology , Cells, Cultured , Immunoglobulin Fab Fragments/pharmacology , Kinesins/antagonists & inhibitors , Kinesins/biosynthesis , Mice , Mice, Inbred C57BL , Neurites/ultrastructure , Neurons/cytology , Optic Nerve/metabolism , Rats , Superior Cervical Ganglion/cytology , Superior Cervical Ganglion/physiology , Synaptic Vesicles/ultrastructure
6.
Hepatogastroenterology ; 56(89): 120-3, 2009.
Article in English | MEDLINE | ID: mdl-19453041

ABSTRACT

BACKGROUND/AIMS: To assess the neurological function of the puborectalis muscles (PM) in patients with or without soiling after low anterior resection (LAR) for lower rectal cancer, we examined the sacral nerve terminal motor latency (SNTML) of the PM. METHODOLOGY: The latency of the response in the PM following transcutaneous magnetic stimulation of the cauda equina at the levels from S3 to S4 by SNTML was measured in 24 patients after LAR. They were divided into a group with soiling (10 cases; 8 men and 2 women, aged 55 to 70 years with a mean age of 61.6 years) and one without soiling (14 cases; 10 men and 4 women, aged 50 to 69 years with a mean age of 60.3 years), and results were compared with data obtained from 25 control subjects (16 men and 9 women, aged 48 to 71 years with a mean age of 62.1 years). Postoperative monitoring of patients was initiated after a period of more than 10 years (121-144 months; mean: 128.2 months). RESULTS: 1) Distance of anastomosis from the dentate line measured with rectoscopy: Patients with and without soiling registered respective coloproctostomy distances of 2.5 +/- 0.6 (2-3.8) and 5.1 +/- 1.2 (3.0-6.5) cm, with the former showing a tendency (p < 0.0001) toward shorter distances. 2) Values of the SNTML: Patients with soiling (6.9 +/- 2.1 ms) exhibited significant extensions compared with patients without soiling (4.2 +/- 0.6 ms), and control subjects (3.9 +/- 0.6ms) (p < 0.0001, respectively). Moreover, patients without soiling showed more extended SNTML than control subjects at all sites. The conduction delay of SNTML in the patients with soiling was longest, followed by that in those without any soiling, then that in the control subjects. CONCLUSIONS: Soiling after LAR may be caused by damage to the sacral motor nerves.


Subject(s)
Fecal Incontinence/physiopathology , Lumbosacral Plexus/physiology , Rectal Neoplasms/physiopathology , Rectal Neoplasms/surgery , Sacrum/innervation , Aged , Anastomosis, Surgical , Case-Control Studies , Cauda Equina/physiology , Electromyography , Female , Humans , Male , Middle Aged , Statistics, Nonparametric , Transcutaneous Electric Nerve Stimulation
7.
Clin Neurophysiol ; 130(1): 1-11, 2019 01.
Article in English | MEDLINE | ID: mdl-30471467

ABSTRACT

OBJECTIVE: To establish a method to measure cauda equina action fields (CEAFs) and visualize the electrical activities of the cauda equina in a broadly aged group of healthy adults. METHODS: Using a 124-channel magnetospinography (MSG) system with superconducting interference devices, the CEAFs of 43 healthy volunteers (22-64 years of age) were measured after stimulation of the peroneal nerve at the knee. Reconstructed currents were obtained from the CEAFs and superimposed on the X-ray image. Conduction velocities were also calculated from the waveform of the reconstructed currents. RESULTS: The reconstructed currents were successfully visualized. They flowed into the L5/S1 foramen about 8.25-8.95 ms after the stimulation and propagated cranially along the spinal canal. In 32 subjects (74%), the conduction velocities of the reconstructed currents in the cauda equina could be calculated from the peak latency at the L2-L5 level. CONCLUSIONS: MSG visualized the electrical activity of the cauda equina after peroneal nerve stimulation in healthy adults. In addition, the conduction velocities of the reconstructed currents in the cauda equina could be calculated, despite previously being difficult to measure. SIGNIFICANCE: MSG has the potential to be a novel and noninvasive functional examination for lumbar spinal disease.


Subject(s)
Cauda Equina/diagnostic imaging , Cauda Equina/physiology , Magnetometry/methods , Neural Conduction/physiology , Adult , Female , Healthy Volunteers , Humans , Male , Middle Aged , Young Adult
8.
Brain Res ; 1707: 208-215, 2019 03 15.
Article in English | MEDLINE | ID: mdl-30500401

ABSTRACT

The filum terminale (FT) is a potential source of ependymal cells for transplantation. The present study was performed to clarify the characteristics of ependymal cells of the central canal (CC) of the FT in rats. The FT was a thin strand continuous with the conus medullaris (CM), a caudal end of the main spinal cord, situated at the L3-4 level in adult rats. The border between the CM and FT was not visible, but could be defined as the site where the strand was as thin as its more caudal segment. While the CM contained an appreciable amount of white and grey matter associated with the CC at its center, the FT had no or only a negligible amount of such spinal cord parenchymal tissue. The FT was tracked ca. 4 cm from the site defined above to the level of S4-5 in adult rats. The rostral part of the FT (FTI) included within the cauda equina is exposed to cerebrospinal fluid, whereas the more caudal part (FTE) was surrounded by a dense layer of connective tissue. Almost all ependymal cells were immunostained for Sox2, Sox9, FoxJ1, and CD133, generally recognized immunochemical markers for ependymal cells of the CC in the spinal cord. Ependymal cells of the CC of FT exhibited almost the same structural and immunohistochemical characteristics as those of the CC of the main spinal cord. Ependymal cells of FTI covered by a thin layer of connective tissue are considered appropriate for transplantation.


Subject(s)
Cauda Equina/metabolism , Cauda Equina/pathology , Ependyma/pathology , Animals , Cauda Equina/physiology , Cerebral Ventricles/pathology , Ependyma/metabolism , Female , Neuroglia/pathology , Rats , Rats, Sprague-Dawley , Spinal Cord/pathology
9.
Turk Neurosurg ; 29(6): 909-914, 2019.
Article in English | MEDLINE | ID: mdl-31573062

ABSTRACT

AIM: To demonstrate the value of special intraoperative neuromonitoring techniques for cauda equina and conus medullaris tumors (CECMT) by describing standard methods used at our center. MATERIAL AND METHODS: Neurophysiological records were retrospectively reviewed for 16 patients (eight females and eight males; age range: 27â€"60 years) who underwent surgery for CECMT at our department between 2016 and 2018. RESULTS: Motor and/or sensorial deficits were preoperatively identified in 10 patients; no patients had bladder or sexual dysfunction. Motor evoked potential (MEP) loss occurred in seven patients with full or partial recovery. No changes were seen in pudendal somatosensory evoked potential (SEP) or bulbocavernosus reflex (BCR), and morphological deterioration and amplitude loss of tibial SEPs were present in four patients. Postoperatively, no new neurological deficits and/or bladder and sexual dysfunction were present. CONCLUSION: Pudendal SEP and BCR are useful tests for monitoring CECMT surgeries. BCR is an easily obtainable modality for preserving sacral functions and recommended as a primary monitoring modality in conjunction with traditional neurophysiological techniques during CECMT surgery.


Subject(s)
Cauda Equina/physiology , Cauda Equina/surgery , Intraoperative Neurophysiological Monitoring/methods , Spinal Cord Neoplasms/surgery , Spinal Cord/physiology , Spinal Cord/surgery , Adult , Cauda Equina/diagnostic imaging , Evoked Potentials, Motor/physiology , Evoked Potentials, Somatosensory/physiology , Female , Humans , Male , Middle Aged , Retrospective Studies , Spinal Cord/diagnostic imaging , Spinal Cord Neoplasms/diagnostic imaging
10.
J Neurotrauma ; 25(3): 196-204, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18352833

ABSTRACT

Studies of regeneration of transected adult central nervous system (CNS) axons are difficult due to lack of appropriate in vivo models. In adult rats, we described filum terminale (FT), a caudal slender extension of the sacral spinal cord and an integral part of the central nervous system (CNS), to use it as a model of spinal cord injury. FT is more than 3 cm long, encompasses a central canal lined with ependymal cells surrounded by a narrow band of axons interspersed with oligodendrocytes and astrocytes but not neurons. Two weeks after the crush of FT, histological, ultrastructural, and axonal tracing studies revealed long distance descending axonal regeneration uniquely in close proximity of the ependymal cells of the central canal. Ependymal cells extended basal processes to form channels encompassing axons apparently regenerating at a rate of more than 2 mm a day. Remarkable increase of axonal sprouting was observed in the sacral spinal cord of Long Evans Shaker (LES) rats with crushed FT. FT offers an excellent model to study mechanisms of axonal regeneration regulated by ependymal cells in the adult CNS.


Subject(s)
Axons/physiology , Cauda Equina/physiology , Ependyma/physiology , Nerve Regeneration/physiology , Spinal Cord Injuries , Animals , Axons/ultrastructure , Cauda Equina/ultrastructure , Cell Surface Extensions/physiology , Cell Surface Extensions/ultrastructure , Disease Models, Animal , Ependyma/ultrastructure , Fluorescent Dyes , Growth Cones/physiology , Growth Cones/ultrastructure , Microscopy, Electron, Transmission , Neural Pathways/injuries , Neural Pathways/pathology , Neural Pathways/physiology , Neural Pathways/physiopathology , Rats , Rats, Long-Evans , Spinal Cord Compression/pathology , Spinal Cord Compression/physiopathology , Spinal Cord Injuries/pathology , Spinal Cord Injuries/physiopathology , Wallerian Degeneration/etiology , Wallerian Degeneration/pathology , Wallerian Degeneration/physiopathology
11.
Neurosci Lett ; 431(1): 77-80, 2008 Jan 24.
Article in English | MEDLINE | ID: mdl-18162313

ABSTRACT

To explore the brain response to sacral surface therapeutic electrical stimulation (SSTES) for the treatment of refractory urinary incontinence and frequent micturition, evoked magnetic fields were measured in six healthy males. Electrical stimuli were applied between bilateral surface electrodes over the second through fourth posterior sacral foramens with intensity just below the pain threshold. Somatosensory evoked magnetic fields (SEFs) for the bilateral median (MN) and posterior tibial nerves (PTN) were also measured for the comparison. Sources of the early SEF peaks were superimposed on individual magnetic resonance images. The first peak latency for sacral stimuli, M30, occurred at 30.2+/-0.8 ms (mean+/-standard deviation, N=6), with shorter latency than those for PTN stimulus (39.3+/-1.4 ms, N=12) and longer latency than those for MN stimulus (21.0+/-0.9 ms, N=12). The second peak latency for sacral stimuli, M50, occurred at 47.2+/-2.9 ms (N=6). Both M30 and M50 peaks showed a single dipole pattern over the vertex in the isofield maps. The equivalent current dipoles of M30 and M50 were both estimated near the medial end of the central sulcus with approximately posterior current direction. These results suggest that the sacral M30 and M50 are responses from the primary somatosensory cortex. The relatively long time lag between the onset and peak of M30 suggests that SSTES directly affects both the cauda equina and cutaneous nerve of the sacral surface.


Subject(s)
Afferent Pathways/physiology , Electric Stimulation Therapy/methods , Evoked Potentials, Somatosensory/physiology , Lumbosacral Plexus/physiology , Somatosensory Cortex/physiology , Urinary Incontinence/therapy , Adult , Back/innervation , Brain Mapping , Cauda Equina/physiology , Humans , Lumbosacral Plexus/anatomy & histology , Magnetoencephalography , Male , Monitoring, Physiologic/methods , Neural Conduction/physiology , Predictive Value of Tests , Reaction Time/physiology , Somatosensory Cortex/anatomy & histology , Time Factors , Urinary Bladder/innervation , Urinary Bladder/physiopathology , Urinary Incontinence/physiopathology
12.
Brain Dev ; 30(8): 493-8, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18606513

ABSTRACT

We report our normative data of somatosensory evoked potentials (SEP) after posterior tibial nerve (PTN) stimulation from a group of 89 children and 18 adults, 0.4-29.2 years of age. We recorded near-field potentials from the peripheral nerve, the cauda equina, the lumbar spinal cord and the somatosensory cortex. Far-field potentials were recorded from the scalp electrodes with a reference at the ipsilateral ear. N8 (peripheral nerve) and P40 (cortex) were present in all children but one. N20 (cauda equina) and N22 (lumbar spinal cord) were recorded in 94 and 106 subjects, respectively. P30 and N33 (both waveforms probably generated in the brainstem) were recorded in 103 and 101 subjects, respectively. Latencies increased with age, while central conduction times including the cortical component, decreased with age (up to about age 10 years). The amplitudes of all components were very variable in each age group. We report our normative data of the interpeak latencies N8-N22 (peripheral conduction time), N22-P30 (spinal conduction time), N22-P40 (central conduction time) and P30-P40 (intracranial conduction time). These interpeak latencies should be useful to assess particular parts of the pathway. The subcortical PTN-SEPs might be of particular interest in young or retarded children and during intraoperative monitoring, when the cortical peaks are influenced by sedation and sleep, or by anesthesia.


Subject(s)
Evoked Potentials, Somatosensory/physiology , Neural Conduction/physiology , Tibial Nerve/physiology , Adolescent , Adult , Brain Stem/physiology , Cauda Equina/physiology , Child , Child, Preschool , Electric Stimulation , Humans , Infant , Lumbar Vertebrae , Somatosensory Cortex/physiology , Spinal Cord/physiology
13.
Eur J Neurol ; 14(1): 48-53, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17222113

ABSTRACT

Although saddle sensory deficit seems the most useful clinical sign in the diagnosis of a cauda equina or conus medullaris lesion, findings of previous studies were controversial. The aim of the present study was to try to resolve this issue. The data from the author's series of patients with clinical, electrodiagnostic and radiological findings compatible with a cauda equina lesion were reviewed. Of the 117 patients in the series, 11 (10 men) did not have a saddle sensory deficit. These 11 patients had less severe sacral dysfunction than the others, and none of them needed urgent surgical intervention. They all had electromyographic (EMG) signs of a significant motor fibre lesion, and in seven men the sacral (penilo-cavernosus) reflex was clinically abnormal. The study revealed normal saddle sensation in approximately 10% of patients with cauda equina or conus medullaris lesions. Dissociation between preserved touch sensation and abnormal EMG findings, as well as dissociation between preserved touch sensation and a non-elicitable penilo-cavernosus reflex might be explained by preservation of the thinner sensory nerve fibres, which are more resistant to compression. Although, saddle sensory loss seems to identify patients who might benefit from urgent spinal imaging and surgery, further diagnostic evaluation is also indicated in patients with normal saddle sensation, particularly due to the increased frequency of spinal tumours found in this subgroup.


Subject(s)
Cauda Equina/pathology , Cauda Equina/physiology , Spinal Cord Injuries/physiopathology , Touch/physiology , Adult , Aged , Aged, 80 and over , Defecation/physiology , Electromyography , Female , Humans , Male , Middle Aged , Prospective Studies , Sexual Behavior/physiology , Urination/physiology
14.
Neurosci Lett ; 651: 109-115, 2017 06 09.
Article in English | MEDLINE | ID: mdl-28476410

ABSTRACT

Adult filum terminale (FT) is an atypical region from where multipotent neural progenitor cells (NPCs) have been isolated. However, poor neuronal differentiation rate of FT-NPCs currently limits their clinical applications. Using custom-designed electric fields (EFs), this study sets up a method to significantly improve neuronal differentiation rate of rat FT-NPCs in vitro. We investigated the influence of EF strength on rat FT-NPCs differentiation. By adding reasonable strength of EF to FT-NPCs, our data shows a significant increase in neuronal differentiation rate. The present innovation provides a novel method of directional differentiation and efficient production of neurons from FT-NPCs in vitro. This improved approach for inducing neuronal differentiation can be applied to future research on autoplastic transplantation.


Subject(s)
Cauda Equina/physiology , Cell Differentiation , Electric Stimulation , Neural Stem Cells/physiology , Neurons/physiology , Animals , Cells, Cultured , Male , Neurites/physiology , Rats, Sprague-Dawley
15.
Prog Neurobiol ; 64(6): 613-37, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11311464

ABSTRACT

Single or double-level compression of the lumbosacral nerve roots located in the dural sac results in a polyradicular symptomatology clinically diagnosed as cauda equina syndrome. The cauda equina nerve roots provide the sensory and motor innervation of most of the lower extremities, the pelvic floor and the sphincters. Therefore, in a fully developed cauda equina syndrome, multiple signs of sensory disorders may appear. These disorders include low-back pain, saddle anesthesia, bilateral sciatica, then motor weakness of the lower extremities or chronic paraplegia and, bladder dysfunction. Multiple etiologies can cause the cauda equina syndrome. Among them, non-neoplastic compressive etiologies such as herniated lumbosacral discs and spinal stenosis and spinal neoplasms play a significant role in the development of the cauda equina syndrome. Non-compressive etiologies of the cauda equina syndrome include ischemic insults, inflammatory conditions, spinal arachnoiditis and other infectious etiologies. The use of canine, porcine and rat models mimicking the cauda equina syndrome enabled discovery of the effects of the compression on nerve root neural and vascular anatomy, the impairment of impulse propagation and the changes of the neurotransmitters in the spinal cord after compression of cauda equina. The involvement of intrinsic spinal cord neurons in the compression-induced cauda equina syndrome includes anterograde, retrograde and transneuronal degeneration in the lumbosacral segments. Prominent changes of NADPH diaphorase exhibiting, Fos-like immunoreactive and heat shock protein HSP72 were detected in the lumbosacral segments in a short-and long-lasting compression of the cauda equina in the dog. Developments in the diagnosis and treatment of patients with back pain, sciatica and with a herniated lumbar disc are mentioned, including many treatment options available.


Subject(s)
Cauda Equina/physiology , Disease Models, Animal , Nerve Compression Syndromes/physiopathology , Polyradiculopathy/physiopathology , Animals , Cauda Equina/blood supply , Humans , Nerve Compression Syndromes/diagnosis , Nerve Compression Syndromes/therapy , Polyradiculopathy/diagnosis , Polyradiculopathy/therapy
16.
World Neurosurg ; 90: 565-573.e1, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26805693

ABSTRACT

BACKGROUND: The filum terminale is a fibrous band, consisting of the filum terminale internum (FTI), connecting the conus medullaris (CM) with the dural sac (DS), and the filum terminale externum (FTE), connecting the DS with the coccyx. Despite its importance in tethered cord syndrome, published anatomic and physiologic data on the filum terminale remain scarce. We describe 1) the dimensions and position of the FTI and FTE; 2) the histology of the FTI-DS-FTE transition zone; and 3) the extensibility and elastic properties of the FTI and the CM. METHODS: Anatomic measurements were performed on 10 fresh and 10 embalmed human cadavers. Four other fresh cadavers were used for strain and elasticity measurements. RESULTS: The mean FTI and FTE lengths were 158.75 and 69.33 mm, respectively. From cranially to caudally, the FTI diameter decreased from 1.93 to 0.69 mm. The most frequent vertebral level of the CM-FTI and the FTI-DS-FTE junction were L1 and S2, respectively. FTE length correlates with body length (r = 0.54; P = 0.014) and with FTI-DS-FTE junction vertebral level (ρ =-0.76; P < 0.001). Histologically, the FTI fuses with DS fibers and continues as FTE. The FTI and the CM show an exponential loaded weight-strain relationship, with the FTI showing higher strain than the CM and almost perfect elastic properties. The CM strain is increased when the dentate ligaments are cut. CONCLUSIONS: The FTI is an overturned oblate cone-shaped structure, showing bigger strain under weight loading compared with the CM, thereby protecting the CM from traction, together with the dentate ligaments.


Subject(s)
Cauda Equina/cytology , Cauda Equina/physiology , Elastic Modulus/physiology , Aged , Aged, 80 and over , Cadaver , Compressive Strength/physiology , Female , Humans , Male , Stress, Mechanical , Tensile Strength/physiology
17.
J Clin Neurophysiol ; 32(6): 501-4, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26633151

ABSTRACT

PURPOSE: To record responses in the abductor hallucis muscle after lumbosacral stimulation with a figure-of-eight magnetic coil. To compare magnetic stimulation (MS), electrical stimulation (ES), and the peripheral motor conduction time. METHODS: M and F waves and compound muscle action potentials were recorded after L1 MS, S1 MS, and L1 ES. RESULTS: The compound muscle action potential latency on L1 MS was 26.9 ± 2.6 milliseconds and on L1 ES was 25.6 ± 2.2 milliseconds, and the peripheral motor conduction time was 27.0 ± 2.5 milliseconds (analysis of variance P = 0.0008). The compound muscle action potential amplitude was 12 ± 11% of M-wave on L1 MS, 32 ± 18% on S1 MS, and 31 ± 17% on L1 ES. CONCLUSIONS: Dorsal MS reliably elicits responses in the abductor hallucis muscle. The latency of compound muscle action potentials on L1 MS is comparable to peripheral motor conduction time. A potential drawback of MS may be too weak stimulation at the proximal end of the cauda equina.


Subject(s)
Cauda Equina/physiology , Electric Stimulation/methods , Evoked Potentials, Motor/physiology , Magnetics , Peripheral Nervous System Diseases/physiopathology , Adult , Aged , Electromyography , Female , Humans , Male , Middle Aged , Muscle, Skeletal/innervation , Neural Conduction , Peripheral Nervous System Diseases/diagnosis , Reaction Time , Young Adult
18.
Int J Radiat Oncol Biol Phys ; 91(5): 995-1002, 2015 Apr 01.
Article in English | MEDLINE | ID: mdl-25832691

ABSTRACT

PURPOSE: To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. METHODS AND MATERIALS: We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P<.05. RESULTS: In the AP, LR, and SI directions, significant oscillatory motion was observed in 39.2%, 35.1%, and 10.8% of spinal segments, respectively, and significant bulk motions in all cases. The median oscillatory CNT motions in the AP, LR, and SI directions were 0.16 mm, 0.17 mm, and 0.44 mm, respectively, and the maximal statistically significant oscillatory motions were 0.39 mm, 0.41 mm, and 0.77 mm, respectively. The median bulk displacements in the AP, LR, and SI directions were 0.51 mm, 0.59 mm, and 0.66 mm, and the maximal statistically significant displacements were 2.21 mm, 2.87 mm, and 3.90 mm, respectively. In the AP, LR, and SI directions, bulk displacements were greater than 1.5 mm in 5.4%, 9.0%, and 14.9% of spinal segments, respectively. No significant differences in axial motion were observed according to cord level or cauda equina. CONCLUSIONS: Oscillatory CNT motion was observed to be relatively minor. Our results support the importance of controlling bulk patient motion and the practice of applying a planning organ-at-risk margin.


Subject(s)
Cauda Equina/physiology , Magnetic Resonance Imaging/methods , Movement/physiology , Organs at Risk/physiology , Radiosurgery/methods , Spinal Cord/physiology , Spinal Neoplasms/secondary , Spinal Neoplasms/surgery , Algorithms , Cerebrospinal Fluid/physiology , Humans , Patient Positioning , Respiration , Supine Position/physiology
19.
Neurology ; 25(1): 31-6, 1975 Jan.
Article in English | MEDLINE | ID: mdl-1167407

ABSTRACT

Summated responses to peroneal nerve stimulation were recorded from surface electrodes placed over the spine of 60 infants and children. These potentials generally were greater in amplitude in infants than in older children. Over the cauda equina and rostral cord, initially positive triphasic potentials were recorded. Over the caudal cord, complex potentials were recorded in children less than three years of age. The conduction velocity of the response from midlumbar to lower cervical recording sites was less in infants than in older children and progressively increased with age, reaching adult values after the fourth year.


Subject(s)
Child Development , Evoked Potentials , Infant, Premature , Peripheral Nerves/physiology , Spinal Cord/physiology , Adolescent , Age Factors , Cauda Equina/physiology , Child , Child, Preschool , Electric Stimulation , Gestational Age , Humans , Infant , Infant, Newborn , Neural Conduction , Peroneal Nerve/physiology , Reaction Time , Time Factors
20.
Neurosci Res ; 40(1): 23-35, 2001 May.
Article in English | MEDLINE | ID: mdl-11311402

ABSTRACT

Using the patch-clamp technique in the whole-cell configuration combined with intracellular dialysis of the fluorescent dye Lucifer yellow (LY), the membrane properties of cells in slices of the lumbar portion of the frog spinal cord (n=64) and the filum terminale (FT, n=48) have been characterized and correlated with their morphology. Four types of cells were found in lumbar spinal cord and FT with membrane and morphological properties similar to those of cells that were previously identified in the rat spinal cord (Chvátal, A., Pastor, A., Mauch, M., Syková, E., Kettenmann, H., 1995. Distinct populations of identified glial cells in the developing rat spinal cord: Ion channel properties and cell morphology. Eur. J. Neurosci. 7, 129-142). Neurons, in response to a series of symmetrical voltage steps, displayed large repetitive voltage-dependent Na(+) inward currents and K(+) delayed rectifying outward currents. Three distinct types of non-neuronal cells were found. First, cells that exhibited passive symmetrical non-decaying currents were identified as astrocytes. These cells immunostained for GFAP and typically had at least one thick process and a number of fine processes. Second, cells with the characteristic properties of rat spinal cord oligodendrocytes, with passive symmetrical decaying currents and large tail currents after the end of the voltage step. These cells exhibited either long parallel or short hairy processes. Third, cells that expressed small brief inward currents in response to depolarizing steps, delayed rectifier outward currents and small sustained inward currents identical to rat glial precursor cells. Morphologically, they were characterized by round cell bodies with a number of finely branched processes. LY dye-coupling in the frog spinal cord gray matter and FT was observed in neurons and in all glial populations. All four cell types were found in both the spinal cord gray matter and FT. The glia/neuron ratio in the spinal cord was 0.78, while in FT it was 2.0. Moreover, the overall cell density was less in the FT than in the spinal cord. The present study shows that the membrane and morphological properties of glial cells in the frog and rat spinal cords are similar. Such striking phylogenetic similarity suggests a significant contribution from distinct glial cell populations to various spinal cord functions, particularly ionic and volume homeostasis in both mammals and amphibians.


Subject(s)
Cauda Equina/physiology , Membrane Potentials/physiology , Neuroglia/physiology , Neurons/physiology , Rana pipiens/physiology , Spinal Cord/physiology , Animals , Astrocytes/cytology , Astrocytes/physiology , Cauda Equina/cytology , Cell Size/physiology , Electric Stimulation , Fluorescent Dyes/pharmacokinetics , Glial Fibrillary Acidic Protein/metabolism , Immunohistochemistry , Isoquinolines/pharmacokinetics , Neuroglia/cytology , Neurons/cytology , Oligodendroglia/cytology , Oligodendroglia/physiology , Patch-Clamp Techniques , Rana pipiens/anatomy & histology , Spinal Cord/cytology , Stem Cells/cytology , Stem Cells/physiology
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