[Translated article] Latarjet procedure for shoulder instability: Implications in the innervation of the subscapularis muscle.

INTRODUCTION: Our aim was to describe whether Latarjet's technique affects subscapularis muscle innervation. MATERIALS AND METHODS: We studied 12 embalmed shoulders. Subscapularis muscle innervation pattern was registered. Dimensions of the subscapularis at the glenohumeral joint line and the nerves entry point were measured. Horizontal distances from the nerves to the glenohumeral joint line as well as vertical ones to the split were measured before and after Latarjet procedure. A safe zone for the split was designed to avoid damage to subscapularis innervation. RESULTS: Subscapularis muscle is innervated by three principal branches: upper, middle, and inferior subscapularis nerves. No statistical differences were found between innervation distances before and after Latarjet procedure. To perform subscapularis split along the muscle safe zone, two thirds' proportions throughout all the split must be maintained. CONCLUSIONS: Subscapularis muscle has a triple innervation and was not altered after Latarjet procedure. Therefore, Latarjet technique seems to respect subscapularis muscle innervation if its split is placed through the subscapularis muscle safe zone.

Latarjet procedure for shoulder instability: Implications in the innervation of the subscapularis muscle. / Técnica de Latarjet para la inestabilidad anterior de hombro: implicaciones en la inervación del músculo subescapular.

INTRODUCTION: Our aim was to describe whether Latarjet's technique affects subscapularis muscle innervation. MATERIALS AND METHODS: We studied 12 embalmed shoulders. Subscapularis muscle innervation pattern was registered. Dimensions of the subscapularis at the glenohumeral joint line and the nerves entry point were measured. Horizontal distances from the nerves to the glenohumeral joint line as well as vertical ones to the split were measured before and after Latarjet procedure. A safe zone for the split was designed to avoid damage to subscapularis innervation. RESULTS: Subscapularis muscle is innervated by three principal branches: upper, middle, and inferior subscapularis nerves. No statistical differences were found between innervation distances before and after Latarjet procedure. To perform subscapularis split along the muscle safe zone, two thirds' proportions throughout all the split must be maintained. CONCLUSIONS: Subscapularis muscle has a triple innervation and was not altered after Latarjet procedure. Therefore, Latarjet technique seems to respect subscapularis muscle innervation if its split is placed through the subscapularis muscle safe zone.

Calcium-binding proteins as markers of layer-I projecting vs. deep layer-projecting thalamocortical neurons: a double-labeling analysis in the rat.

The thalamus contains two main populations of projection neurons that selectively innervate different elements of the cortical microcircuit: the well-known "specific" or "core" (C-type) cells that innervate cortical layer IV, and, the "matrix" (M-type) cells that innervate layer I. Observations in different mammal species suggest that this may be a conserved, basic organizational principle of thalamocortical networks. Fragmentary observations in primate sensory nuclei suggest that M-type and C-type cells might be distinguished by their selective expression of calcium binding-proteins. In adult rats, we tested this proposal in a systematic manner throughout the thalamus. Applying Fast-Blue (FB) to a large swath of the pial surface in the lateral aspect of the cerebral hemisphere we labeled a large part of the M-type cell populations in the thalamus and subsequently examined FB co-localization with calbindin or parvalbumin immunoreactivity in thalamic neuron somata. FB-labeled cells were present in large numbers in the ventromedial, interanteromedial, posterior, lateral posterior and medial geniculate nuclei. Distribution of the FB-labeled neuron somata was roughly coextensive with that of the calbindin immunolabeled somata, while parvalbumin immunoreactive somata were virtually absent from dorsal thalamus. Co-localization of FB and calbindin immunolabeling ranged from >95% in the ventromedial and interanteromedial nuclei, to 30% in the dorsal lateral geniculate. Moreover, in the ventromedial and interanteromedial nuclei nearly all of the calbindin-immunoreactive neurons were also labeled with FB. In most other nuclei, however, a major population of M-type cells cannot be identified with calbindin immunolabeling. Consistent with studies in primates and carnivores, present data show that in rats M-type cells are numerous and widely distributed across the rat thalamus; however, calbindin is expressed only by a fraction, albeit a large one, of these cells.

Brainstem inputs to the ferret medial geniculate nucleus and the effect of early deafferentation on novel retinal projections to the auditory thalamus.

Following specific neonatal brain lesions in rodents and ferrets, retinal axons have been induced to innervate the medial geniculate nucleus (MGN). Previous studies have suggested that reduction of normal retinal targets along with deafferentation of the MGN are two concurrent factors required for the induction of novel retino-MGN projections. We have examined, in ferrets, the relative influence of these two factors on the extent of the novel retinal projection. We first characterized the inputs to the normal MGN, and the most effective combination of neonatal lesions to deafferent this nucleus, by injecting retrograde tracers into the MGN of normal and neonatally operated adult ferrets, respectively. In a second group of experiments, newborn ferrets received different combinations of lesions of normal retinal targets and MGN afferents. The resulting extent of retino-MGN projections was estimated for each case at adulthood, by using intraocular injections of anterograde tracers. We found that the extent of retino-MGN projections correlates well with the extent of MGN deafferentation, but not with extent of removal of normal retinal targets. Indeed, the presence of at least some normal retinal targets seems necessary for the formation of retino-MGN connections. The diameters of retino-MGN axons suggest that more than one type of retinal ganglion cells innervate the MGN under a lesion paradigm that spares the visual cortex and lateral geniculate nucleus. We also found that, after extensive deafferentation of MGN, other axonal systems in addition to retinal axons project ectopically to the MGN. These data are consistent with the idea that ectopic retino-MGN projections develop by sprouting of axon collaterals in response to signals arising from the deafferented nucleus, and that these axons compete with other sets of axons for terminal space in the MGN.

Insular cortex and neighboring fields in the cat: a redefinition based on cortical microarchitecture and connections with the thalamus.

The insular areas of the cerebral cortex in carnivores remain vaguely defined and fragmentarily characterized. We have examined the cortical microarchitecture and thalamic connections of the insular region in cats, as a part of a broader study aimed to clarify their subdivisions, functional affiliations, and eventual similarities with other mammals. We report that cortical areas, which resemble the insular fields of other mammals, are located in the cat's orbital gyrus and anterior rhinal sulcus. Our data suggest four such areas: (a) a "ventral agranular insular area" in the lower bank of the anterior rhinal sulcus, architectonically transitional between iso- and allocortex and sparsely connected to the thalamus, mainly with midline nuclei; (b) a "dorsal agranular insular area" in the upper bank of the anterior rhinal sulcus, linked to the mediodorsal, ventromedial, parafascicular and midline nuclei; (c) a "dysgranular insular area" in the anteroventral half of the orbital gyrus, characterized by its connections with gustatory and viscerosensory portions of the ventroposterior complex and with the ventrolateral nucleus; and (d) a "granular insular area", dorsocaudal in the orbital gyrus, which is chiefly bound to spinothalamic-recipient thalamic nuclei such as the posterior medial and the ventroposterior inferior. Three further fields are situated caudally to the insular areas. The anterior sylvian gyrus and dorsal lip of the pseudosylvian sulcus, which we designate "anterior sylvian area", is connected to the ventromedial, suprageniculate, and lateralis medialis nuclei. The fundus and ventral bank of the pseudosylvian sulcus, or "parainsular area", is associated with caudal portions of the medial geniculate complex. The rostral part of the ventral bank of the anterior ectosylvian sulcus, referred to as "ventral anterior ectosylvian area", is heavily interconnected with the lateral posterior-pulvinar complex and the ventromedial nucleus. Present results reveal that these areas interact with a wide array of sensory, motor, and limbic thalamic nuclei. In addition, these data provide a consistent basis for comparisons with cortical fields in other mammals.

Innervation from the claustrum of the frontal association and motor areas: axonal transport studies in the cat.

The anatomical organization of the projections from the claustrum to the motor and prefrontal cortical areas of the cat's brain was investigated. Both retrograde (single horseradish peroxidase or double fluorochrome deposits in the cortex) and anterograde (peroxidase-labeled wheat germ agglutinin deposits in the claustrum) tracing techniques were used. Within the claustrum, the neurons projecting to each sector of the frontal cortex were found to be distributed according to specific patterns of segregation and overlap. Spatial segregation was particularly marked between the cell populations projecting to the various sectors of area 4. The cells projecting to the subareas of area 6 and prefrontal cortex displayed a less marked but definite segregation. The neuronal populations projecting to some sectors of areas 4, 5, and the primary somatosensory cortex known to contain homotopical representations of the body map were found intermingled in the same small claustral portions. The few double-labeled neurons found after closely adjacent fluorochrome injections indicates that, in spite of their profuse intracortical branching, claustral axons spread little within the boundaries of a single architectonic area. Anterograde transport experiments showed that claustral fibers end primarily in layers IIIb/IV, VI, and I, whereas layer V is spared. This pattern is homogeneous throughout the frontal cortex. The possible role of the claustrum as a subcortical site for organized interactions amongst wide arrays of functionally related zones of the cerebral cortex is thereby suggested.

Anterograde axonal tracing with the subunit B of cholera toxin: a highly sensitive immunohistochemical protocol for revealing fine axonal morphology in adult and neonatal brains.

We report an improved immunohistochemical protocol for revealing anterograde axonal transport of the subunit B of cholera toxin (CTB) which stains axons and terminals in great detail, so that single axons can be followed over long distances and their arbors reconstructed in their entirety. Our modifications enhance the quality of staining mainly by increasing the penetration of the primary antibody in the tissue. The protocol can be modified to allow combination in alternate sections with tetramethylbenzidine (TMB) histochemical staining of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). Using the protocol, we tested the performance of CTB as an anterograde tracer under two experimental paradigms which render other anterograde tracers less sensitive or unreliable: (1) labeling the entire retinofugal projection to the brain after injections into the vitreal chamber of the eye, and (2) labeling developing projections in the cortex and thalamus of early postnatal mammals. Qualitative comparisons were made with other tracers (Phaseolus vulgaris leucoagglutinin, dextran rhodamine, biotinylated dextran, free WGA, or WGA-HRP) that were used to label these same projections. From these observations it is clear that CTB, visualized with our protocol, provides more sensitive anterograde labeling of retinofugal projections as well as of axonal connections in the neonatal forebrain.

Hypothalamic connections of the insular cortex in the cat.

We have investigated the anatomical organization of the connections between the hypothalamus and the insular cortex of the cat by using retrograde and anterograde transport of horseradish peroxidase-wheat germ agglutinin. The rostroventral sectors of the insular cortex are strongly interconnected with the supramammillary and caudal lateral hypothalamic areas. The possible relationship of these connections with the well-known participation of the insular cortex in visceral and autonomic integration is discussed.

Layer-specific programs of development in neocortical projection neurons.

How are long-range axonal projections from the cerebral cortex orchestrated during development? By using both passively and actively transported axonal tracers in fetal and postnatal ferrets, we have analyzed the development of projections from the cortex to a number of thalamic nuclei. We report that the projections of a cortical area to its corresponding thalamic nuclei follow highly cell-specific programs of development. Axons from cells in the deepest layers of the cerebral cortex (layer 6 and superficial subplate neurons) appear to grow very slowly and be delayed for several weeks in the cerebral white matter, reaching the thalamus over a protracted period. Neurons of layer 5, on the other hand, develop their projections much faster; despite being born after the neurons of deeper layers, layer 5 neurons are the first to extend their axons out of the cortical hemisphere and innervate the thalamus. Layer 5 projections are massive in the first postnatal weeks but may become partly eliminated later in development, being overtaken in number by layer 6 cells that constitute the major corticothalamic projection by adulthood. Layer 5 projections are area-specific from the outset and arise as collateral branches of axons directed to the brainstem and spinal cord. Our findings show that the early development of corticofugal connections is determined not by the sequence of cortical neurogenesis but by developmental programs specific for each type of projection neuron. In addition, they demonstrate that in most thalamic nuclei, layer 5 neurons (and not subplate or layer 6 neurons) establish the first descending projections from the cerebral cortex.

[Amygdaloid innervation of the frontal cortex in cats]. / Inervación amigdalina de la corteza frontal en el gato.

The amygdaloid complex has been reported to innervate the frontal cortex (prefrontal, premotor and motor cortex) in a variety of mammal species. We have investigated the topographic and laminar distribution of such projections in the cat by using anterograde and retrograde axonal transport of HRP and WGA-HRP. Premotor and medial prefrontal cortices, receive abundant projections from the basal magnocellular amygdaloid nucleus, while rostrolateral prefrontal or caudodorsal motor cortices are almost spared by amygdaloid projections. Striking differences are observed in the laminar patterns of distribution of amygdaloid axons in the various frontal areas. This selective areal and laminar distribution may entail noticeable functional dissimilarities. Possible roles of these neural networks and the concept of "limbic cortex" are discussed in view of these findings.

Cortical connections of the insular and adjacent parieto-temporal fields in the cat.

We present a comprehensive analysis of the cortical connections of the insular and adjacent cortical areas in the domestic cat by using microinjections of wheat-germ agglutinin conjugated to horseradish peroxidase. We examined the identity and extent of the cortical fields connected to each area, the relative anatomical weights of the various connections, their laminar origin, and their paths across the cerebral commissures. Our main finding is that despite their relatively small size and close apposition, the connections of the insular and adjacent areas are far more widespread and more specific to each area than previously realized, suggesting that each area is involved in disparate aspects of cortical integration. The granular insular area is linked to a constellation of somatosensory, motor, premotor and prefrontal districts. The dysgranular insular area is chiefly associated with lateral prefrontal and premotor, lateral somatosensory and perirhinal cortices. The dorsal agranular insular area is connected with limbic neocortical fields, while the ventral agranular insular area is associated with an array of olfactory allocortical fields. The anterior sylvian area is associated with visual, auditory and multimodal areas, with the dorsolateral prefrontal cortex, and with perirhinal area 36. The parainsular area is linked to non-tonotopic auditory and ventromedial frontal areas. Trajectories followed by the callosal axons of each of the investigated areas are extremely divergent. As a whole, the picture of the insular region that emerges from this and a parallel study (Clascá et al., J Comp Neurol 384:456-482, 1997) is that of an extreme heterogeneity, both in terms of histological architecture and neural connections. Comparison with earlier published reports on primates suggests that most, but not all, of the areas we investigated in cats may have an direct counterpart within the insula of Old World monkeys.

Experimentally induced retinal projections to the ferret auditory thalamus: development of clustered eye-specific patterns in a novel target.

We have examined the relative role of afferents and targets in pattern formation using a novel preparation, in which retinal projections in ferrets are induced to innervate the medial geniculate nucleus (MGN). We find that retinal projections to the MGN are arranged in scattered clusters. Clusters arising from the ipsilateral eye are frequently adjacent to, but spatially segregated from, clusters arising from the contralateral eye. Both clustering and eye-specific segregation in the MGN arise as a refinement of initially diffuse and overlapped projections. The shape, size, and orientation of retinal terminal clusters in the MGN closely match those of relay cell dendrites arrayed within fibrodendritic laminae in the MGN. We conclude that specific aspects of a projection system are regulated by afferents and others by targets. Clustering of retinal projections within the MGN and eye-specific segregation involve progressive remodeling of retinal axon arbors, over a time period that closely parallels pattern formation by retinal afferents within their normal target, the lateral geniculate nucleus (LGN). Thus, afferent-driven mechanisms are implicated in these events. However, the termination zones are aligned within the normal cellular organization of the MGN, which does not differentiate into eye-specific cell layers similar to the LGN. Thus, target-driven mechanisms are implicated in lamina formation and cellular differentiation.