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Abstract: Objective: This study examined the somatosensory function in the trigeminal region and quantitative measures of the exteroceptive suppression (ES) period in the masseteric EMG, in relation to a psychological evaluation. Methods: The ES in the surface EMG was recorded from the left masseter muscle in 12 men and 12 women. The stimulation intensity at which the ES appeared first and the lowest intensity at which the subjects reported it to be painful were defined as the electrical reflex threshold and electrical pain threshold, respectively. Three experimental sessions were scheduled. The state and trait anxiety inventory was used to evaluate the psychological status. Results: The electrical reflex threshold significantly decreased (p <0.01), and the electrical pain threshold significantly increased (p <0.01) over the sessions in line with the effect on the state anxiety inventory (p <0.05). Conclusions: The present results illustrate that reflex parameters and electrical pain thresholds are associated with state anxiety. Possibly, habituation or decreased fear from the experimental set-up may play a role. Significance: This is important when electrophysiology or quantitative sensory testing is used to assess trigeminal nociception, e.g., in orofacial pain conditions. [Copyright &y& Elsevier]

This research examined the psychophysiology of emotional arousal anticipatory to potentially aversive and highly pleasant outcomes. Human brain reactions (event-related potentials) and body reactions (heart rate, skin conductance, the probe startle reflex) were assessed along motivational gradients determined by apparent distance from sites of potential punishment or reward. A predator-prey survival context was simulated using cues that signaled possible money rewards or possible losses; the cues appeared to loom progressively closer to the viewer, until a final step when a rapid key response could ensure reward or avoid a punishing loss. The observed anticipatory response patterns of heightened vigilance and physiological mobilization are consistent with the view that the physiology of emotion is founded on action dispositions that evolved in mammals to facilitate survival by dealing with threats or capturing life-sustaining rewards. [ABSTRACT FROM AUTHOR]

We compared the diagnostic values of multifrequency tympanometry (MFT) and conventional 226-Hz tympanometry in adults with otitis media with effusion (OME) and discuss whether the resonant frequency (RF) can be used as a reliable method in adults with OME. Prospective study was designed to compare the normal hearing group and the group with OME. In the OME group ( n = 85), conductive or mixed hearing loss was found, air-bone gap was more than 10 dBHL, and acoustic reflex was not elicited. In the normal hearing group ( n = 36), pure tone threshold was less than or equal to 15 dBHL and air-bone gap was less than 10 dBHL. Levene’s test was used to compare the difference between the OME group and the normal hearing group on day1, day15, day30, day90, respectively. The relationship among multifrequency tympanometry, 226-Hz tympanometry and acoustic reflex test in ears recovering from OME was also investigated. A statistically significant decrease in RF value was found in ears with OME compared to normative data. In follow-up visits, both the RF values and the percentage of type A tympanograms increased while the percentage of type B and C tympanograms decreased. A high agreement between middle ear resonant frequency test and acoustic reflex test in ears recovering from OME was found. The resonant frequency test provides more detailed information than the 226-Hz tympanometry. Multifrequency tympanometry may be a more sensitive and objective diagnostic tool in adults with OME. [ABSTRACT FROM AUTHOR]

Abstract: We reported two cases of Pelizaeus-Merzbacher disease. Both cases visited our hospital manifesting horizontal nystagmoid movements present from birth, and delayed motor development. Magnetic resonance imaging of the brain showed diffuse dysmyelination of the cerebral white matter, and auditory brainstem response showed waves I and II but absence of all subsequent components. Conditioned orientation reflex (COR) audiometry showed poor reactions in an infantile case whose development was severely retarded, and who spoke no meaningful words. Auditory steady-state response (ASSR) was a helpful tool for identifying her auditory ability; thereafter, her communication skills improved naturally. The other case was mildly developmentally retarded, and the results of COR audiometry and ASSR were considered the same level. The discrepancy between results of these hearing tests may arise under the influence of developmental level of the case. [Copyright &y& Elsevier]

Abstract: This article addresses the relationships between motion sickness (MS) and three-dimensional (3D) ocular responses during otolith stimulation. A group of 19 healthy subjects was tested for motion sickness during a 16 min otolith stimulation induced by off-vertical axis rotation (OVAR) (constant velocity 60°/s, frequency 0.16 Hz). For each subject, the MS induced during the session was quantified, and based on this quantification, the subjects were divided into two groups of less susceptible (MS−), and more susceptible (MS+) subjects. The angular eye velocity induced by the otolith stimulation was analyzed in order to identify a possible correlation between susceptibility to MS and 3D eye velocity. The main results show that: (1) MS significantly correlates in a multiple regression with several components of the horizontal vestibular eye movements i.e. positively with the velocity modulation (P<0.01) and bias (P<0.05) of the otolith ocular reflex and negatively with the time constant of the vestibulo-ocular reflex (P<0.01) and (2) the length of the resultant 3D eye velocity vector is significantly larger in the MS+ as compared with the MS− group. Based on these results we suggest that the CNS, including the velocity storage mechanism, reconstructs an eye velocity vector modulated by head position whose length might predict MS occurrence during OVAR. [Copyright &y& Elsevier]

Conclusion. The otolithic organs of patients with vestibular drop attack (VDA) secondary to Meniere's disease were damaged but the damage was not complete. In other words, the otolithic functions of patients with VDA were unstable. Objective. To evaluate otolithic function using vestibular evoked myogenic potential (VEMP) in patients with VDA secondary to Meniere's disease. Patients and methods. Clinical records of three patients with VDA secondary to Meniere's disease were reviewed with special reference to VEMP testing. Results. The three patients were classified as stage II or III Meniere's disease. A long-term follow-up of VEMP in two patients showed reversible changes of VEMP reflexes, and VEMP testing with glycerol administration in two patients revealed the recovery of VEMP responses after taking glycerol, and the existence of saccular endolymphatic hydrops. [ABSTRACT FROM AUTHOR]

The present study assessed the influence of visual feedback on stance stability and soleus H-reflex excitability. The centre of pressure (COP) displacement was measured in upright stance on a rigid surface (stable surface) and on a spinning top (unstable surface) while subjects either received “normal” visual feedback (without laser pointer = WLP) or pointed with a laser pointer on a target on the wall (LP). In order to verify that laser pointing influenced visual feedback, two additional experiments were conducted: (1) Subjects performed a finger reaction task which was thought to increase attention and cognitive demands without alteration of the visual feedback. (2) The effect of laser pointing on the wall was compared with pointing at a board, which was attached to the subjects themselves. In this case, the laser point could not serve as a reference for sway because the board moved in synchrony with the body. On stable and unstable surface, COP displacement was reduced in the LP compared to the WLP task (−17 cm ± 6, P < 0.05; −14 cm ± 6, P < 0.05). Conversely, H-reflexes were greater in the LP condition (stable: +20 μV ± 30, not significant; unstable +115 μV ± 40, P < 0.05). Stance stability and H-reflex modulation were negatively correlated ( R 2 = −0.5; P < 0.001). The finger reaction task did neither influence COP displacement nor H-reflexes. Pointing at the body-fixed target did not alter COP displacement. These findings suggest that postural sway can be reduced by a handheld laser pointer targeting on an external reference point. It is argued that altered visual input was responsible for modulating the H-reflex. [ABSTRACT FROM AUTHOR]

Abstract: Background: Evaluation of syncope remains often unstructured. The aim of the study was to assess the effectiveness of a standardized protocol designed to improve the diagnosis of syncope. Methods: Consecutive patients with syncope presenting to the emergency departments of two primary and tertiary care hospitals over a period of 18 months underwent a two-phase evaluation including: 1) noninvasive assessment (phase I); and 2) specialized tests (phase II), if syncope remained unexplained after phase I. During phase II, the evaluation strategy was alternately left to physicians in charge of patients (control), or guided by a standardized protocol relying on cardiac status and frequency of events (intervention). The primary outcomes were the diagnostic yield of each phase, and the impact of the intervention (phase II) measured by multivariable analysis. Results: Among 1725 patients with syncope, 1579 (92%) entered phase I which permitted to establish a diagnosis in 1061 (67%) of them, including mainly reflex causes and orthostatic hypotension. Five-hundred-eighteen patients (33%) were considered as having unexplained syncope and 363 (70%) entered phase II. A cause for syncope was found in 67 (38%) of 174 patients during intervention periods, compared to 18 (9%) of 189 during control (p <0.001). Compared to control periods, intervention permitted diagnosing more cardiac (8%, vs 3%, p =0.04) and reflex syncope (25% vs 6%, p <0.001), and increased the odds of identifying a cause for syncope by a factor of 4.5 (95% CI: 2.6–8.7, p <0.001). Overall, adding the diagnostic yield obtained during phase I and phase II (intervention periods) permitted establishing the cause of syncope in 76% of patients. Conclusion: Application of a standardized diagnostic protocol in patients with syncope improved the likelihood of identifying a cause for this symptom. Future trials should assess the efficacy of diagnosis-specific therapy. [Copyright &y& Elsevier]

Theories of animal defensive behavior postulate that imminent, predictable threat elicits highly focused attention toward the threat source, whereas remote, unpredictable threat elicits distributed attention to the overall environment. We used threat of shock combined with measurement of prepulse inhibition of the startle reflex to test these claims in humans. Twenty-seven participants experienced periods of threat and safety. Threat and safe periods were short or long, with the short threat periods conveying relatively predictable, imminent shocks and the long threat periods conveying unpredictable shocks. Startle reflexes were elicited with equal numbers of acoustic probes presented alone, preceded by a tactile prepulse, or preceded by an auditory prepulse. We observed enhanced tactile relative to auditory prepulse inhibition during short threat periods only. This finding supports the notion that imminent threat, but not remote threat, elicits attention focused toward the relevant modality, potentially reflecting preparatory activity to minimize the impact of the noxious stimulus. [ABSTRACT FROM AUTHOR]

In healthy humans, we recorded the H reflex induced by transcutaneous stimulation of the tibial nerve (recording from the soleus muscle). In subjects in the lying position, we studied changes in the H reflex values after preceding voluntary arm movements realized with a maximum velocity after presentation of an acoustic signal. On the 200th to 300th msec after forearm flexion, long-lasting inhibition of the H reflex developed following a period of initial facilitation and reached the maximum, on average, 700 msec from the moment of the movement. Flexion of the contralateral upper limb in the elbow joint induced deeper inhibition than analogous movement of the ipsilateral arm. Long-lasting clear inhibition of the H reflex developed after arm flexion in the elbow joint but was slightly expressed after finger clenching. After inhibition reached the maximum, its time course was satisfactorily approximated by a logarithmic function of the time interval between the beginning of the conditioning voluntary movement and presentation of the test stimulus. Durations of inhibition calculated using a regression equation were equal to 6.6 sec and 8.5 sec after ipsilateral and contralateral elbow-joint flexions, respectively. Inhibition was not eliminated under conditions of tonic excitation of motoneurons of the tested muscle upon voluntary foot flexion. Long-lasting inhibition of the H reflex was also observed after electrical stimulation-induced flexions of the upper limb. The obtained data indicate that movements of the upper limb cause reflex long-lasting presynaptic inhibition of the soleus-muscle H reflex that can play a noticeable role in redistribution of the muscle tone during motor activity. [ABSTRACT FROM AUTHOR]

Abstract: Our sense of gravitation and linear acceleration is mediated by stimulation of vestibular hair cells through displacement of otoconia in the utricle and saccule (the gravity receptor organ). We recently showed that otoconin-90 (Oc90) deletion led to formation of giant otoconia. In the present study, we determined the extent to which the giant otoconia affected balance and gravity receptor sensory input and compared the findings with other otoconia mutants. We employed a wide spectrum of balance behavioral tests, including reaching and air-righting reflexes, gait, swimming, beam-crossing, rotorod latencies, and a direct measure of gravity receptor input, vestibular evoked potentials (VsEPs). All tests on homozygous adult mutants consistently ranked the order of imbalance as (from worst to best) Nox3het

Objectives: The role of the anterolateral abdominal wall muscles (AAWM) during vesical filling and evacuation has not been sufficiently addressed in the literature. We investigated the hypothesis that the AAWM exhibit increased electromyographic (EMG) activity on vesical distension and contraction that presumably assists in vesical evacuation. Methods: The effect of vesical balloon distension on vescial (VP) and vesical neck (VNP) pressures and on AAWM EMG activity was studied in 28 healthy volunteers of age 40.7 ± 9.7 years (18 men and 10 women). This effect was tested after anesthetization on individual vesical and AAWM and after saline infiltration. Results: The VP and VNP showed gradual increase on incremental vesical balloon distension starting at a distending volume of 120 to 140 mL. At a mean volume of 364.6 ± 23.8 mL, the VP increased to a mean of 36.6 ± 3.2 cm H2O, the VNP decreased to 18.4 ± 2.4 cm H2O, and AAWM EMG registered a significant increase. This effect disappeared with anesthetization on individual vesical or AAWM, but not with saline administration. Conclusions: AAWM appear to contract simultaneously with vesical contraction; this action presumably increases the intra-abdominal pressure and assists vesical contraction. The AAWM contraction on vesical contraction seems to be mediated through a reflex that we call the “vesico-abdominal wall reflex.” Further studies are required to investigate the role of this reflex in vesical disorders. [Copyright &y& Elsevier]

Aims To establish the longitudinal relationship of foot complications to neuropathy based on a 4-year follow-up of diabetic patients stratified by sudomotor dysfunctions. Methods One hundred and nineteen Type 2 diabetic patients and 36 non-diabetic subjects were initially registered in the prospective cohort study. Plantar skin temperature and sympathetic skin response (SSR) were used to monitor sympathetic mediated thermoregulation and sudomotor function. Peripheral somatic and central autonomic functions were studied using clinical, nerve conduction and cardiovascular reflex tests. At enrolment, the diabetic patients were classified into one of three groups by the progressive stages of sudomotor dysfunction: SSR+ (SSR present; 49 patients), SSR− (SSR absent; 41 patients) and at-risk group (SSR absent but with cracked skin involving partial thickness of the dermis; 29 patients). Results The at-risk group had 13.4 times (95% confidence interval 1.4–125.7) higher plantar ulceration rates than the other two patient groups during the 4 years. Skin temperature elevation occurred in parallel with development of foot sweating problems. There were no significant differences between the three patient groups in the ratios of abnormal heart rate variation, orthostatic test and clinical neuropathy score at follow-up. After 4 years of follow-up, nerve conduction abnormalities were more frequent in the at-risk and SSR− groups than in the SSR+ group. Conclusions Early deterioration of small sympathetic fibres could not be quantified accurately by the clinical, somatic and autonomic tests. Assessing skin integrity and sudomotor function in at-risk individuals identifies early peripheral sympathetic neuropathy, even if the patients have no overt clinical symptoms. [ABSTRACT FROM AUTHOR]

The article discusses the study which aims to assess differences in amplitude, latency, and duration between the active and reference electrodes when performing sural nerve conduction studies. In this study, a focused medical history and physical examination are performed on all subjects consist of 12 males and 10 females. Furthermore, examination of strength, reflexes, sensation and muscle tone testing are executed to them. It is concluded that recorded sural nerve action potential parameters amplitudes did not differ with the use of interelectrode separation.

Abstract  Inflammation of visceral structures in rats has been shown to produce visceral/somatic hyperalgesia. Our objectives were to determine if trinitrobenzene sulfonic acid (TNBS) induced colitis in rats leads to visceral/somatic hypersensitivity. Male Sprague-Dawley rats (200–250 g) were treated with 20 mg of TNBS in 50% ethanol (n = 40) or an equivalent volume of ethanol (n = 40) or saline (n = 25) via the colon. Colonic distension, Von Frey, Hargreaves, and tail reflex tests were used to evaluate for visceral, mechanical, and thermal sensitivity. The rats demonstrated visceral hypersensitivity at 2–28 days following TNBS administration (P P  [ABSTRACT FROM AUTHOR]

The responses of incisal periodontal mechanoreceptors to increasing mechanical stimulation are known to follow a hyperbolic-saturating course. The implications of these properties for the reflexive control of bite-force have not been examined directly. In line with the above-mentioned receptor characteristics, we hypothesized that the periodontal-masseteric reflex will reduce as a function of increasing incisal pre-load. In 10 participants, a central incisor was repeatedly tapped (0.4 N). We measured the modulation by pre-load (0.2-2.0 N) of the reflex frequency-response at and between 3 and 20 Hz. The entrainment of the reflex increased with frequency up to 20 Hz and diminished with increasing pre-load. Importantly, the hyperbolic relationship shown here between the periodontal-masseteric reflex and tooth pre-load agreed with the load/response relationships predicted by single-receptor and tooth movement studies. This study demonstrated that periodontal mechano-receptors are able to contribute to the ongoing control of only small bite-forces. [ABSTRACT FROM AUTHOR]

Abstract Background  The Br�ckner test is usually performed at a distance of 1 m. Due to optical reasons, the test should detect ametropia more sensitively at an extended distance. We compared the sensitivity of the test to detect unilateral ametropia at a distance of 4 m versus the traditional distance of 1 m. Patients and methods  In this study, five blinded experienced observers (experts) performed the Br�ckner transillumination test on five emmetropic subjects (age 22.3 − 2.3 years) at a distance of 1 m which was then extended up to 4 m. Unilateral ametropia was simulated by both spherical and cylindrical lenses of −1, −2, −3, −4, and , , , diopters in front of one eye and a plano lens in front of the other eye in a randomised order. Controls with plano lenses in front of both eyes were interspersed. The test was considered positive in case of any difference between the red reflexes of both eyes. For spherical ametropia, the procedure was repeated with 25 medical students who examined one subject each. Results  At a distance of 1 m, unilateral myopia/hypermetropia of more than 1 diopter was detected in 78.7%/71.3% by experts and in 34.7%/53.3% by students. At 4 m, detection rates increased to 99.3%/96.0% and 98.7%/100% respectively. Rates of false positive findings for experts vs students were 3.1% vs 1.5% at 1 m and 4.0% vs 3.0% at 4 m. For unilateral astigmatism, experts’ detection rates were similar at 1 m (64.7%/70.0%) and lower at 4 m (91.7%/90.3%), depending on the astigmatism axis. Conclusions  The sensitivity of the Br�ckner reflex for anisometropia improves by extension of the examination distance, especially in the hands of less experienced observers. To detect ametropia more sensitively, a test distance of 4 m is recommended. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence implicates metabotropic glutamate receptor (mGluR) function in the neurobiological effects of ethanol. The recent development of subtype specific mGluR antagonists has made it possible to examine the roles of specific mGluRs in biochemical and behavioral responses to ethanol. The purpose of the present study was to determine if mGluRs modulate the acute sedative-hypnotic properties of ethanol in mice. Methods: C57BL/6J mice were tested for locomotor activity (sedation) and duration of loss of the righting reflex (hypnosis) following acute systemic administration of ethanol alone or in combination with the mGluR5-selective antagonist, 2-methyl-6-(phenylethynyl)pyridine (MPEP), the mGluR1-selective antagonist, 7-(hydroxyimino)cyclopropa[b]chromen-1a-carboxylate ethyl ester (CPCCOEt), or the mGluR2/3-selective antagonist (2S)-2-Amino-2-[(1S,2S)-2-carboxycycloprop-1-yl]-3-(xanth-9-yl) propanoic acid (LY341495)). Results: MPEP (10 and 30 mg/kg) significantly enhanced both the sedative and hypnotic effects of ethanol, while LY341495 (10 and 30 mg/kg) significantly reduced the sedative-hypnotic effects of ethanol. CPCCOEt had no effect at any concentration tested. Further loss of righting reflex experiments revealed that LY341495 (30 mg/kg) significantly reduced hypnosis induced by the gamma-aminobutyric acid type A (GABAA) positive modulators, pentobarbital (50 mg/kg) and midazolam (60 mg/kg), and the N-methyl-d-aspartate (NMDA) receptor antagonist, ketamine (150 mg/kg), while MPEP (30 mg/kg) only significantly enhanced the hypnotic properties of ketamine (150 mg/kg). Conclusions: These findings suggest that specific subtypes of the metabotropic glutamate receptor differentially modulate the sedative-hypnotic properties of ethanol through separate mechanisms of action, potentially involving GABAA and NMDA receptors. [ABSTRACT FROM AUTHOR]

Background: γ-Aminobutyric acid type A receptors (GABAA-Rs) have been implicated in mediating some of the behavioral effects of ethanol (EtOH), but the contribution of specific GABAA-R subunits is not yet fully understood. The GABAA-R α4 subunit often partners with β2/3 and δ subunits to form extrasynaptic GABAA-Rs that mediate tonic inhibition. Several in vitro studies have suggested that these extrasynaptic GABAA-Rs may be particularly relevant to the intoxicating effects of low doses of EtOH. In α4 subunit knockout mice, tonic inhibition was greatly reduced, as were the potentiating effects of EtOH. We therefore hypothesized that those behavioral responses to EtOH that are mediated by α4-containing GABAA-Rs would be diminished in α4 knockout mice. Methods: We investigated behavioral responses to acute administration of moderate/high dose EtOH or pentylenetetrazol in α4 subunit knockout mice. We compared behavioral responses to EtOH in α4 knockout and wild-type littermates in the elevated plus maze (0.0, 1.0 g/kg EtOH), screen test (1.5, 2.0 g/kg), hypothermia (1.5, 2.0 g/kg), fixed speed rotarod (1.5, 2.0, 2.5 g/kg), open field (0.0, 1.0, 2.0 g/kg), radiant tail flick (2.0 g/kg), loss of righting reflex (3.5 g/kg), and EtOH metabolism and clearance assays. Sensitivity to pentylenetetrazol-induced seizures was also analyzed. Results: No differences were observed between α4 knockout mice and wild-type controls in terms of the baseline behavior in the absence of EtOH treatment or in the behavioral effects of EtOH in the assays tested. In contrast, α4 knockout mice were significantly more sensitive to pentylenetetrazol-induced seizures. Conclusions: We conclude that GABAA-Rs containing the α4 subunit are not absolutely required for the acute behavioral responses to moderate/high dose EtOH that were assessed with the elevated plus maze, screen test, hypothermia, fixed speed rotarod, open field, radiant tail flick, and loss of right reflex assays. We further suggest that these findings are complicated by the demonstrated compensatory alterations in synaptic GABAA-R EtOH sensitivity and function in α4 knockout mice. [ABSTRACT FROM AUTHOR]

High-velocity rotational stimuli have the potential to improve the diagnostic capabilities of clinical rotation testing by revealing nonlinear vestibulo-ocular reflex (VOR) responses that are indicative of asymmetric vestibular function. However, eye movements evoked by high-velocity rotations often are inconsistent over time and therefore do not yield reliable diagnostic measures. This study investigated whether use of a novel "visual guide" could improve the consistency and quality of VORs obtained during testing with pulse-step-sine (PSS) stimuli providing periodic high-velocity, horizontal-plane rotations with peak velocities up to 290 deg/s. The visual guide (narrow phosphorescent line spanning 180° field of view) was mounted horizontally on the rotation chair at the subject's eye level. Eight healthy human subjects were tested either in complete darkness while performing an alerting task, or while viewing the visual guide in an otherwise dark room. We found that the visual guide improved the quality of VOR responses as shown by an increased proportion of slow-phase velocity data segments retained for analysis, by a decreased variance of the processed eye velocity data, and by a reduction of outlying VOR response measures. We also found that the visual guide did not induce visual suppression because VOR gain measures were not diminished. [ABSTRACT FROM AUTHOR]

This study proposes a method to quantitatively evaluate decreases in the mental capacity allocated to driving. Evaluation was conducted using a tracking task as a primary task, accompanied by visual searches as a secondary task. The influence of decreases in the driver's mental capacity on the vestibulo-ocular reflex were then investigated by varying the degree of difficulty of the tasks. Moreover, a method based on a dynamical model of the vestibulo-ocular reflex is proposed for evaluating the influence of mental workload. The results show that the method can quantitatively evaluate decreases in the mental capacity allocated to driving. [ABSTRACT FROM AUTHOR]

Aims: To assess the responsive fetal extremity movement to vibro-acoustic stimulaton test (VAST). Methods: The moving velocity of fetal femur was assessed after VAST by pulsed Doppler device. The ultrasonic beam was insonated at a right angle to the fetal femur. The following parameters were determined: limb retreat velocity in accelerative slope (Pk1); limb replenishment velocity in decelerative slope (Pk2); mean flexion to extension velocity; and the response time to VAST. Among 80 normal singleton pregnancies in 33–41 weeks, 68 were weekly evaluated and the others were assessed for two or more times during the study period, for a total of 680 studies of fetal kinetics. Results: The Pk1 declined from 9.6 to 6.26 cm/s; Pk2 decreased from 2.6 to 1.3 cm/s; mean velocity was reduced from 6.0 to 4.25 cm/s; whereas the response time increased from 0.1 to 0.3 s throughout the study period, i.e., fetal response reduces and the response time increases as maturation progresses. Conclusion: The pulsed Doppler may assess fetal activity in any body structure. Reflex responses become slow and complex on both the velocity and response time as maturation increases with gestational age. Our observations have resulted in a novel and easy method for the quantitative assessment of fetal reflex reactivity to external stimuli. [ABSTRACT FROM AUTHOR]

To evaluate the relevance of muscle weight as a functional parameter of motor regeneration, the nerve-dependent muscle weights were measured and compared with the toe-spreading reflex and the muscle action potential in different designs of nerve conditioning of the peroneal nerve in New Zealand White rabbits. From 100 peroneal nerves in 50 rabbits, 60 nerves received a conditioning crush lesion and 4 weeks later a test lesion-a transection with suturing at different sites. An additional 10 peroneal nerves were solely transected and sutured, 10 peroneal nerves were sham-operated, and 20 peroneal nerves remained unoperated for control. Eleven weeks after the final lesion, when the toe-spreading reflex had returned, the peroneal muscle weight showed a non-significant relation with the toe-spreading reflex (area 0.650, P = 0.149), whereas the relation of the amplitude (area 0.964, P < 0.001) and the conduction velocity (area 0.721, P = 0.033, left side) with the toe-spreading reflex were significant. Despite the lower sensitivity and specificity of the muscle weight, the possibility to measure the weight of all three peroneal nerve-dependent muscles separately represents a more detailed method of evaluation than both the toe-spreading reflex testing and the muscle action potential recording and justifies its use as a functional parameter in the early phase of peroneal motor regeneration in the rabbit. [ABSTRACT FROM AUTHOR]

Objective: To investigate the reflex response time (RRT) of the vastus medialis obliquus (VMO), vastus lateralis obliquus (VLO) and vastus lateralis longus (VLL) muscles in clinically healthy individuals and subjects with patellofemoral pain syndrome (PPS). Methods: Twelve clinically health women and twelve women with PPS were evaluated. Electromyography (EMG) records were obtained using active electrodes connected to an electromyograph that was activated by an external sensor attached to the medial portion of the patella ligament, by means of percussion. The RRT was analyzed by measuring the time, in seconds, between zero and peak electrical response of the VMO, VLO and VLL muscles, for both groups. The statistical analysis consisted of analysis of variance (ANOVA, p< 0.05) and the Tukey post-hoc test (p< 0.05) to compare the response between muscles, and Student's t test (p< 0.05) to compare the response between groups. Results: Both groups presented lower RRT for the VMO muscle than for the VLO and VLL muscles. However, no significant difference was seen between the VLO and VLL muscles. There was no significant difference in RRT between the groups. Conclusions: According to these results, it can be suggested that the RRTs in the different portions of the quadriceps muscle do not distinguish between subjects with PPS and clinically healthy individuals. The RRT for the VMO muscle was lower than the RRT for the VLO and VLL muscles, for both groups. [ABSTRACT FROM AUTHOR]

Neurophysiological testing has become a valuable tool for investigating brain excitability and nociceptive systems in headache disorders. Previous reviews have suggested that most neurophysiological tests have limited value for headache diagnosis, but a vast potential for exploring the pathophysiology of headaches, the central effects of certain pharmacological treatments and phenotype-genotype correlations. Many protocols, however, lack standardization. This meta-analytical review of neurophysiological methods in migraine was initiated by a task force within the EUROHEAD project (EU Strep LSHM-CT-2004–5044837-Workpackage 9). Most of the neurophysiological approaches that have been used in headache patients are reviewed, i.e. evoked potentials, nociception-specific blink reflex, single-fibre electromyography, neuroimaging methods (functional MRI, PET, and voxel-based morphometry) and the nitroglycerin attack-provoking test. For each of them, we summarize the results, analyse the methodological limitations and propose recommendations for improved methodology and standardization of research protocols. The first part is devoted to electrophysiological methods, the second to neuroimaging techniques and the NTG test. [ABSTRACT FROM AUTHOR]

Abstract: Startle reflex eliciting stimuli presented at the onset of the go signal in a simple forewarned reaction time (RT) task (at a SOA of 0ms) elicit larger blink reflexes than do stimuli presented later (e.g., at a SOA of 150ms) or during inter trial intervals. The present study investigated whether this facilitation is affected by attention to the go signal or motor preparation. Participants performed a forewarned reaction time task that crossed the requirements for a speeded response (Hold versus Move) and for a discrimination task performed with the go signal (Report versus No report). Relative to control reflexes, blinks elicited at a SOA of 0ms were facilitated and blinks elicited at a SOA of 150ms were inhibited. RTs were slower on trials that required attention to the go signal and in both attention conditions and at both SOAs shortened in the presence of a blink-eliciting stimulus. However, neither attention to the go signal nor motor preparation affected blink facilitation at the 0ms SOA. This finding suggests that the blink reflex facilitation observed at a SOA of 0ms with the onset of a go signal reflects on the summation of sub- and supra-threshold activations of the startle pathway. [Copyright &y& Elsevier]

This study examined peroneus longus (PL) Hoffmann reflex (H-reflex) during sudden inversion perturbation of the ankle/foot complex under an ankle brace and non-brace condition. Ten healthy subjects volunteered. H-reflexes were tested on the up-sloping portion of the recruitment curve, utilizing a control trial M-wave above motor threshold to maintain consistency between subjects and conditions. The PL H/maximum M-wave (Mmax) ratio was established using the PL H-reflex and PL Mmax peak-to-peak measures. The mean ratio across five trials for each subject under each ankle brace (brace, no brace) and surface (flat, inversion) conditions was utilized for analysis. The 1 × 4 repeated measures ANOVA revealed a significant main effect for treatment condition ( P<0.0001). The PL H/Mmax ratio significantly increased during sudden inversion-no ankle brace condition compared with the flat surface no-ankle brace condition ( P=0.04). Application of an ankle brace had no effect on PL H/Mmax ratio during inversion ( P=0.78). During this study PL H/Mmax ratios increased during an inversion perturbation in healthy ankles. This is believed to occur due to heightened sensorimotor demand placed on the nervous system during this motion. Moreover, application of an ankle brace during inversion does not appear to affect PL H/Mmax ratio. [ABSTRACT FROM AUTHOR]

Background: The guaiac faecal occult blood test (gFOBT) has been proved as a screening investigation for colorectal cancer, but has disadvantages. Newer faecal immunochemical tests (FITs) have many advantages, but yield higher positivity rates qnd are expensive. A two-tier reflex follow-up of gFOBT-positive individuals with a FIT before colonoscopy has been advocated as an efficient and effective approach. Methods: A new simple and stable card collection FIT was evaluated. Results: 1124 individuals who were 9FOBT positive were asked to provide samples. 558 individuals participated, 320 refused and 246 did not return samples. No evidence of sampling bias was found. 302 individuals tested FIT negative and 256 tested positive. In the 302 FIT-negative individuals, 2 (0.7%) had cancer and 12 (4.0%) had large or multiple (high-risk) adenomatous polyps. In contrast, of 254 positive individuals, 47 (18.5%) had cancer and 54 (21.3%) had high-risk polyps. 93 (30.8%) of the FIT-negative individuals had a normal colonoscopy, but only 34 (13.4%) of the FIT-positive individuals had no pathology. Sensitivity, specificity, and positive and negative likelihood ratios (and 95% CIs) for cancer were 95.9% (84.8 to 99.3), 59.2% (54.7 to 63.5), 2.35 (2.08 to 2.65) and 0.07 (0.02 to 0.27), and for cancer and high-risk polyps were 87.8% (80.1 to 92.9), 65.3% (60.6 to 69.7), 2.53 (2.19 to 2.93) and 0.19 (0.11 to 0.31), respectively. Conclusions: A two-tier reflex screening algorithm, in which gFOBT-positive participants are tested with a FIT, is effective in identifying individuals at high risk of significant colorectal neoplasia. This strategy is transferable across different FIT formats. This approach has been adopted for the Scottish Bowel Screening Programme. [ABSTRACT FROM AUTHOR]

The human soleus H-reflex is commonly tested as an indicator of the reflex excitability of the calf muscles with infrequent stimuli to a subject seated and at rest. However, the reflex varies widely with the level of voluntary contraction and with the time history of stimulation. We studied two aspects of this variation. Antagonist (tibialis anterior) activation decreases the response, while increasing agonist (soleus) activation increases the H-reflex to a peak after which it declines. In subjects with large H-reflexes at rest, the reflex peaked at low levels of contraction. In contrast, in subjects with small H-reflexes at rest, the reflex peaked at higher levels of contraction for reasons that were elucidated using a realistic computer model. A parabolic curve fitted the maximum amplitude of the H-reflex in the model and over the entire range of contractile levels studied. The second aspect studied was post-activation depression or homosynaptic depression (HD), which has been described previously as a reduction of a second H-reflex elicited shortly after an initial reflex. We confirmed the presence of HD in resting, seated subjects for intervals up to 4 s. However, by voluntarily activating the soleus muscle, HD was drastically reduced when seated and abolished when standing. This suggests that HD may be absent in normal, functional movements and perhaps in clinical conditions that alter H-reflexes. Meaningful, quantitative measurements of reflex excitability can only be made under voluntary activity that mimics the condition of interest. [ABSTRACT FROM AUTHOR]

In the anti-saccade paradigm, subjects are instructed not to make a reflexive saccade to an appearing lateral target but to make an intentional saccade to the opposite side instead. The inhibition of reflexive saccade triggering is under the control of the dorsolateral prefrontal cortex (DLPFC). The critical time interval at which this inhibition takes place during the paradigm, however, is not exactly known. In the present study, we used single-pulse transcranial magnetic stimulation (TMS) to interfere with DLPFC function in 15 healthy subjects. TMS was applied over the right DLPFC either 100 ms before the onset of the visual target (i.e. −100 ms), at target onset (i.e. 0 ms) or 100 ms after target onset (i.e. +100 ms). Stimulation 100 ms before target onset significantly increased the percentage of anti-saccade errors to both sides, while stimulation at, or after, target onset had no significant effect. All three stimulation conditions had no significant influence on saccade latency of correct or erroneous anti-saccades. These findings show that the critical time interval at which the DLPFC controls the suppression of a reflexive saccade in the anti-saccade paradigm is before target onset. In addition, the results suggest the view that the triggering of correct anti-saccades is not under direct control of the DLPFC. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate spinal reflex (SR) modulation during the performance and learning of a precision locomotor task. Healthy subjects had to minimize foot clearance when repeatedly stepping on a treadmill over a randomly approaching obstacle. The subjects walked with reduced vision and were informed about the approaching obstacle and task performance by acoustic warning and feedback signals, respectively. SRs were randomly evoked by tibial nerve stimulation (with non-nociceptive and nociceptive stimulus intensity) during the mid-stance phase in both normal and pre-obstacle stepping. Foot clearance and electromyographic activity of the tibialis anterior and biceps femoris muscles of the right leg were analysed. Only if a delay was introduced between warning signal and nerve stimulation, was the SR amplitude in both muscles enhanced prior to obstacle steps compared with normal steps for both stimulus intensities. Thus, the reflex enhancement depended on the subject's awareness of the approaching obstacle. Improved performance was reflected in a decreased foot clearance, but did not correlate with the course of SR amplitude. It is concluded that obstacle stepping is associated with a facilitation of SR pathways, probably by supraspinal drive. This facilitation might provide assistance in safe obstacle stepping, e.g. to compensate quickly if resistance is encountered. [ABSTRACT FROM AUTHOR]

In human beings, inhibitory jaw reflexes can be depressed by painful stimulation of remote parts of the body. Since similar effects can be produced by the stress of anticipating pain, we wished to investigate whether the effects of remote painful stimuli are dependent on stress. EMG recordings were made from a masseter muscle while subjects maintained activity in the muscle at ∼12.5% of maximum using visual feedback. The protocols involved three sequences: (1) “standard controls” in which reflexes were evoked by electrical test stimuli applied to the upper lip; (2) “standard conditioning” in which painful electrical conditioning stimuli were applied over the sural nerve 100 ms before the test stimuli; (3) “random sequences” in which test-only and conditioning-test combinations were employed in a double-blind, random, order. Data are presented as means ± SEMs. In the standard controls, the stimuli evoked clear inhibitory reflexes (latency 37 ± 1.3 ms, duration 62 ± 5.6 ms; n = 10) in all the subjects. During standard conditioning, the reflex magnitude was reduced significantly (by 50.0 ± 8.5%, P = 0.0002, one-sample t-test). When the test-only and conditioning-test responses were extracted from the random sequences, there was also a significant reduction in the reflex magnitude following conditioning (by 34.6 ± 5.5%, P = 0.0002, one-sample t-test) albeit less so than between the standard sequences ( P = 0.03, paired t-test). A second series of experiments suggested that these lesser effects during the random sequences were not substantially due to any loss of temporal summation of the conditioning mechanisms. The evidence for this was that application of pairs of conditioning stimuli did not produce a significantly greater effect than single conditioning stimuli within a random sequence (39.9 ± 9.6% as opposed to 32.7 ± 9.1% reductions in the reflex, P = 0.117, paired t-test). Therefore since any stress in the random sequences would not have been “tied” to the conditioned responses alone, the effects of remote painful stimuli on this inhibitory jaw reflex cannot be entirely secondary to stress. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to determine whether the soleus H-reflex is modulated with changes in the level of postural threat during walking. H-reflexes were tested at four points in the step cycle when subjects walked in 5 conditions representing different levels of postural threat. H-reflexes were significantly increased in amplitude at heelstrike in conditions of increased postural threat compared to normal treadmill walking with only minimal changes in H-reflex amplitude at other step cycle points. Conversely when subjects walked while holding stable handles, to decrease postural threat, the amplitude of the H-reflex was significantly smaller at heelstrike and midstance compared to normal walking. The changes in the amplitude of the H-reflex between walking conditions were not accompanied by changes in ongoing electromyographic activity or movements. Our findings suggest that the amplitude of the reflex is adjusted in a phase-specific manner, related to the postural uncertainty of the task. These adaptations in reflex amplitude may be related to changes in the amplitude of corrective responses following perturbations during walking. The adaptations in the amplitude of the H-reflex specific to heelstrike may be important in the control of foot placement at ground contact. [ABSTRACT FROM AUTHOR]

Abstract: The current study was performed to assess the vanadium(V)-induced developmental toxicity in sucklings of Wistar rats. Dams of treated litters were intraperitoneally injected with 3 mg NaVO3/kg body weight/day during 12 days starting on postnatal day (PND) 10. Surface righting reflex, negative geotaxy and hindlimb support tests were performed on pups every 48 h, from 8th to 18th PND. Open field test was performed on the 21st PND. On 22nd PND, some animals were transcardially perfusion-fixed and their brains were removed and cut with a cryostat. Brain sections were processed for myelin histochemistry and for anti-myelin basic protein immunohistochemistry. Delay in eye opening and decreased muscular strength and locomotion were observed in V-exposed pups of both sexes. A decreased myelin staining in corpus callosum and cerebellum in these pups was also observed. Results suggest that vanadium exposure through lactation would induce neurotoxicity in rat developing CNS. [Copyright &y& Elsevier]

Different aspects of driver personality may affect traffic safety. Extended driver reaction time causes deceleration of the reflexes, which is a major cause of traffic accidents. Cornell index was used in 30 drivers responsible for traffic accidents, with the aim to measure their level of neurotic disorder and compare them with results of controls (drivers not responsible for traffic accidents). Reaction time was measured and compared among subjects with normal results of Cornell test and those with pathological findings. Drivers causing traffic accidents showed significantly higher Cornell index scores than drivers not responsible for traffic accidents. Drivers with pathological results of Cornell index showed a significantly longer reaction time. [ABSTRACT FROM AUTHOR]

Rupture of the anterior cruciate ligament (ACL) is one of the most serious sports-related injuries and requires long recovery time. The quadriceps and hamstring muscles are functionally important to control stability of the knee joint complex. Fatigue, however, is an important factor that may influence stabilizing control and thus cause ACL injuries. The objective of this study was therefore to assess how submaximal fatigue exercises of the hamstring muscles affect anterior tibial translation as a direct measure of knee joint stability. While 15 test participants were standing upright with the knees in 30° of flexion, anterior tibial translation was induced by a force of 315 N. Two linear potentiometers placed on the tibial tuberosity and the patella recorded tibial motion relative to the femur. Reflex latencies and neuromuscular hamstring activity were determined using surface electromyography (EMG). Muscle fatigue produced a significant longer latency for the monosynaptic reflex latencies, whereas no differences in the latencies of the medium latency component were found. Fatigue significantly reduced EMG amplitudes of the short and medium latency components. These alterations were in line with significantly increased anterior tibial translation. Our results suggest that hamstring fatigue is effectively associated with mechanical loss of knee stability. This decrease in joint stability may at least in part explain higher risk of ACL injury, especially in fatigued muscles. Furthermore, we discuss why the present findings indicate that reduced motor activity rather than the extended latency of the first hamstring response is the reason for possible failure. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether the gating of interlimb cutaneous reflexes is altered by holding an earth-referenced handrail during locomotion. In the first experiment, subjects performed locomotor tasks of varying difficulty (level walking, incline walking, and stair climbing) while lightly holding an earth-referenced rail. In the second experiment, the extent of rail contact and nature of the rail stability (e.g., fixed vs. mobile rail) were varied while subjects performed incline walking. Cutaneous reflexes were evoked by delivering trains of electrical stimulation to the sural nerve at the ankle. EMG data were collected continuously from muscles in the upper and lower limbs and trunk. Results showed that modulation of reflexes across the body changed when the rail was held. Most interestingly, a facilitatory reflex in the shoulder extensor posterior deltoid emerged during swing phase only when subjects held a rail. This facilitatory reflex was largest during the more challenging tasks of incline walking and stair climbing, A similar reflex facilitation was observed in the elbow extensor triceps brachii. The observed facilitation of reflexes in triceps brachii and posterior deltoid was specifically expressed only when subjects held an earth-referenced rail. This suggests that interlimb reflexes in arm extensors may be enhanced to make use of a supportive handrail for stability during gait. Therefore, holding a rail may cause global changes in reflex thresholds across the body that may have widespread functional relevance for assisting in the maintenance of postural stability during locomotion. [ABSTRACT FROM AUTHOR]

Abstract: The quantitative sudomotor axon reflex test (QSART) measures sympathetic C fibre function when iontophoresed acetylcholine (Ach) evokes a measurable reliable sweat response. This study tests a novel, simplified method of sweat stimulation which accompanies hand dynamometry. In 34 healthy subjects we compared the standard sudomotor axon reflex test with a simplified method using static handgrip as sweat stimulus and recorded from the distal forearm, thumb and little finger tips. The standard method failed on technical grounds beyond the forearm. At the distal forearm, sweat rates were 313±140nl/min, representing a four-fold increase from baseline. Static handgrip induced sweat rates of 339±156 (thumb) and 296±139 (little finger)nl/min, representing a 1.7 and 1.6 fold increase from baseline. Static handgrip did not significantly alter distal forearm sweat secretion, and in females handgrip induced significantly less sweating over the thumb than in males. After dynamometry or Ach stimulation, over the three sites (thumb, little finger and forearm), the stimulated sweat secretion volumes were measured at 0.0278±0.021μl/cm2/min (thumb), 0.0204±0.020μl/cm2/min (little finger), and 0.0503±0.0283μl/cm2/min (forearm) after correction. Our study suggests the static handgrip method can be used to stimulate distal sweat production and may be of particular significance in investigating length-dependant neuropathies and assessing distal C fiber function. [Copyright &y& Elsevier]

Objectives – We aimed to evaluate the interictal cardiovascular autonomic functions in pediatric patients with idiopathic epilepsy, both partial and generalized. Materials and methods – The study included 25 patients with idiopathic epilepsy and 50 control subjects. Patients underwent five standardized clinical cardiovascular reflex autonomic tests [resting heart rate (HR), HR response to deep breathing and to Valsalva maneuver, the 30:15 ratio of HR response to standing, and blood pressure response to standing], as well as a 12 lead surface electrocardiogram. Heart rate variability (HRV) was tested via 24-h Holter monitoring and the time domain parameters (SDNN, PNN50, rMSDD) were assessed. Excretion of vanillyl mandelic acid and metanephrine was measured in 24-h urine collection. Results – Clinical reflex autonomic tests showed mild dysfunction in 8%, moderate dysfunction in 44% and severe dysfunction in 4% of patients. The HRV parameter, SDNN, was reduced in all age groups, while rMSDD and PNN50 were reduced only in the older age group. Metanephrine levels were significantly reduced in the patients group. Patients with uncontrolled epilepsy had a significantly higher frequency of autonomic dysfunction as assessed by clinical scoring. Conclusion – Cardiac autonomic dysfunction is not uncommon in pediatric patients with epilepsy. Altered cardiovascular regulation seems to be related to the epilepsy itself rather than to the characteristics of the disorder. [ABSTRACT FROM AUTHOR]

Abstract: An unloading reaction has been characterized as a modified flexor reflex (FR), in which the standing subjects decrease the load on the stimulated foot and increase the load on the contralateral side, but, without withdrawal of the stimulated foot. Different behavioral circumstances have been shown to modulate this reflex. It is not known whether unloading reactions can be modulated with a loaded supinated ankle position, which, in excess, may result in an ankle sprain injury. Since ankle sprain depends on the load applied to a supinated foot, our premise is that unloading reactions may protect the ankle from a sprain injury. Therefore, this study investigated how the unloading reactions were modulated during a loaded supinated ankle condition. We delivered non-nociceptive and nociceptive electrical stimulations on the lateral aspect of the ankle in standing subjects with the foot in neutral and in a supinated position. The magnitude and latencies of reflex responses were registered using kinetic and kinematic analyses and subsequently compared among the conditions. The analysis demonstrated greater reactions for the supinated ankle condition. The individuals also moved their whole body downwards and shifted the body weight to the non-stimulated foot. Therefore, this study suggested that a modified type of the classic flexion reflex, i.e., unloading reaction, may be used as a strategy to unload a supinated ankle and potentially minimize the risk of ankle sprain injuries. [Copyright &y& Elsevier]

The article focuses on the study which examines the effect of epidural administration of Osteorgenic Protein-1 (OP-1) in ectopic bone formation and pain-related behavior. The study used 40 rats where motor function and reflex responses to mechanical noxious stimuli were measured three weeks after surgery. Results indicated that OP-1 application in the epidural space is safe based on behavioral measures and macroscopic observation on ectopic bone formation.

Abstract: In a case of long-term sensory loss in the tongue following third molar extraction, a novel, efficient and effective psychophysical test was used. This initial test, which includes the presentation of pairs of a real and fake stimulus, and a forced-choice response, was applied to determine whether relatively thick or thin afferent fibres of the lingual nerve were affected. The results suggested that thick fibres on the right tongue side were mainly affected. Sensory loss was confirmed and its extent assessed by a standard test determining thresholds of light touch. Furthermore, sensory function was determined by an objective test based on inhibitory reflexes in masseteric electromyographic activity following electrical stimulation of oral tissue. Reflex features that are important for within-patient diagnosis are a difference between the injured and control sides in latency of the first reflex, and also in depth-contrast in signal amplitude between both sides at the post-stimulus time of the trough of an inhibition on the uninjured side. In agreement with the findings from the psychophysical tests, the finding of the absence of an early component of both inhibitions suggested sensory loss related to dysfunction of fast-conducting, relatively thick afferent fibres of the lingual nerve. Apart from being used for medicolegal reasons, the objective reflex test may have conclusive prognostic value or may influence surgical therapeutic decisions. [Copyright &y& Elsevier]

Abstract: A large number of genetic disease model mice have been produced by genetic engineering. However, phenotypic analysis is not sufficient, particularly for brain dysfunction in neurogenetic diseases. We tried to develop a new assessment system mainly for motor and reflex functions in GM1-gangliosidosis model mice. Two genetically engineered model mouse strains were used for this study: the β-galactosidase-deficient knockout mouse representing infantile GM1-gangliosidosis (severe form), and transgenic mouse representing juvenile GM1-gangliosidosis (mild form). We modified human child neurology techniques, and selected eleven tests for motor assessment and reflex testing. The test results were scored in four grades: 0 (normal), 1 (slightly abnormal), 2 (moderately abnormal), and 3 (severely abnormal). Both disease model mouse strains showed high scores even at the apparently pre-symptomatic stage of the disease, particularly with abnormal tail and hind limb postures. Individual and total test scores were well correlated with the progression of the disease. This method is simple, quick, and reproducible. The testing is sensitive enough to detect early neurological abnormalities, and will be useful for monitoring the natural clinical course and effect of therapeutic experiments in various neurogenetic disease model mice, such as chemical chaperone therapy for GM1-gangliosidosis model mice. [Copyright &y& Elsevier]

Abstract: Gamma-aminobutyric acid-A (GABAA) receptors are ligand-gated ion channels comprised of subunits from several classes (alpha, beta, gamma, delta). Recent studies have clearly demonstrated that the functional properties of GABAA receptors are altered following chronic ethanol administration that could provide the molecular basis for the previously proposed role of these receptors in ethanol tolerance and dependence. Because the subunit composition of GABAA receptors determines receptor pharmacology, the present study was devoted to assess if the behavioral sensitivity after acute and chronic ethanol exposure depends on β3–containing GABAA receptors. In the present study, we used knock-in mice harboring a point mutation (N265M) in the second transmembrane region of the β3 subunit of the GABAA receptor in order to study acute and chronic behavioral effects of ethanol. More specifically, we tested tolerance to loss of righting reflex (LORR) and the development of withdrawal signs after chronic ethanol exposure using ethanol vapor chambers. Our results show that the β3(N265M) mutation does not play a major modulatory role of acute ethanol-induced LORR. However, following repeated LORR testing, enhanced tolerance to the intoxicating effects of ethanol was observed–a finding which was unrelated to the pharmacokinetics of ethanol as both genotypes had the same blood alcohol concentrations following repeated LORR testing. In addition, following chronic alcohol vapor exposure, mouse mutants displayed increased handling-induced convulsions during withdrawal. The results of the present study suggest that the alcohol effects abolished by the β3(N265M) mutation do not play a dominant role in acute alcohol intoxication but influence ethanol tolerance and withdrawal. [Copyright &y& Elsevier]

Background: Cough reflex sensitivity, subjective estimates of cough frequency and cough-related quality of life have been used to assess cough and monitor treatment responses. The relationships between these measures and objective cough monitoring remain unclear and the usefulness of subjective assessments remains questionable. Subjects: 62 patients with chronic cough (39 women) were studied. Mean age of patients was 54.9 (SD 12.2) years, with a median duration of cough of 5.5 (range 1–30) years. Methods: Cough reflex sensitivity testing (C5; citric acid) was performed in all patients before fully ambulatory day-time and night-time cough recordings. Patients scored the frequency and severity of their cough (Visual Analogue Scales (VAS) and 0–5 score) for each recording period and completed a cough-related quality-of-life questionnaire, Leicester Cough Questionnaire (LCQ). Ambulatory cough recordings were manually counted and reported in terms of cough seconds per hour (cs/h). Cough rates were log10 transformed for analysis. Results: The median time spent coughing was 11.36 (range 1.06–46) cs/h with median day rates of 15.59 (range 2–74.8) cs/h and median night rates of 2.94 (range 0–26.67) cs/h. An inverse relationship was seen between day cough rates and log10 C5 (r= -0.452, p ⩽ 0.001). Subjective cough scores and visual analogue scales were only moderately associated with objective time spent coughing, with night-time being scores more strongly associated than day-time scores. The strongest correlation with objective cough frequency was cough-related quality of life (LCQ), (r= -0.622, p ⩽ 0.001), mediated through the psychological domain. Conclusions: Subjective measures of cough and cough reflex sensitivity are only moderately related to objective time spent coughing, and hence cannot be used as surrogate markers for objective cough-frequency measurements. Cough-related quality of life (LCQ) is most strongly related to objectively counted cough, and may be a useful adjunct to objective measures in the assessment of cough. [ABSTRACT FROM AUTHOR]

Abstract: Postmortem brain loss of reelin is noted in schizophrenia patients. Accordingly, heterozygous reeler mutant mice have been proposed as a putative model of this disorder. Little is known, however, about the involvement of the two receptors for reelin, Very-Low-Density Lipoprotein Receptor (VLDLR) and Apolipoprotein E Receptor 2 (ApoER2), on pre-cognitive processes of relevance to deficits seen in schizophrenia. Thus, we evaluated sensorimotor gating in mutant mice heterozygous or homozygous for the two reelin receptors. Mutant mice lacking one of these reelin receptors were tested for prepulse inhibition (PPI) of the acoustic startle reflex prior to and following puberty, and on a crossmodal PPI task, involving the presentation of acoustic and tactile stimuli. Furthermore, because schizophrenia patients show increased sensitivity to N-methyl-d-aspartate (NMDA) receptor blockade, we assessed the sensitivity of these mice to the PPI-disruptive effects of the NMDA receptor antagonist phencyclidine. The results demonstrated that acoustic PPI did not differ between mutant and wildtype mice. However, VLDLR homozygous mice displayed significant deficits in crossmodal PPI, while ApoER2 heterozygous and homozygous mice displayed significantly increased crossmodal PPI. Both ApoER2 and VLDLR heterozygous and homozygous mice exhibited greater sensitivity to the PPI-disruptive effects of phencyclidine than wildtype mice. These results indicate that partial or complete loss of either one of the reelin receptors results in a complex pattern of alterations in PPI function that includes alterations in crossmodal, but not acoustic, PPI and increased sensitivity to NMDA receptor blockade. Thus, reelin receptor function appears to be critically involved in crossmodal PPI and the modulation of the PPI response by NMDA receptors. These findings have relevance to a range of neuropsychiatric disorders that involve sensorimotor gating deficits, including schizophrenia. [Copyright &y& Elsevier]

The article discusses processes on how the nursing staff able to determine a brain death in adults and to identify potential organ donors. In order to protect tissue and organ viability, frequent neurologic assessments to evaluate for signs of decompensation should be made before a diagnosis of brain death. Neurologic assessment includes evaluating the level of coma or responsiveness, testing brain stem reflexes and assessing for apnea.

Caloric testing in prone/supine position and constant velocity off-vertical axis rotation (OVAR) in yaw axis (rotate-then-tilt paradigm) can evaluate labyrinth function and vestibular-ocular reflex (VOR) behaviour before and after endolymphatic shunt surgery (ESS). Preoperative and postoperative otolith dysfunction can be documented by constant velocity OVAR, before the VOR is modulated by the vestibular compensation. Vestibulo-ocular responses in prone/supine position and linear VOR (lVOR) OVAR responses were observed in 10 patients before and after ESS. Ipsilateral caloric reaction in prone/supine position was reduced after ESS. Otolith-ocular function and canal-otolith-interaction were improved postoperatively. Meniere's patients with bias component opposite to normal when rotating towards the lesioned ear showed relief of symptoms postoperatively. The bias component returning to normal can help to identify the relief of Meniere's attacks after ESS. The canal-otolith interaction can be observed pre- and postoperatively by means of caloric reaction in prone/supine position as part of the clinical routine. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: A cross-sectional comparative study between healthy controls and patients with chronic low back pain (LBP). OBJECTIVE.: To assess the effect of chronic LBP on biceps brachii muscle activation during sudden upper-limb loading. SUMMARY OF BACKGROUND DATA.: Chronic LBP is related to altered trunk muscle function. However, it is not known if these changes are also found in upper-limb function, indicating a general effect. METHODS.: Surface electromyographic recordings were made from the biceps brachii bilaterally from 22 control subjects without chronic LBP and 29 patients with chronic LBP. Electromyography was recorded during expected and unexpected limb loading, with the activation pattern recorded for analysis at 150 milliseconds before loading, and 3 consecutive 50 milliseconds periods following loading. RESULTS.: Chronic LBP patients had decreased biceps brachii activation before expected perturbation (P = 0.035) and during the third 50-millisecond period (from 100 to 150 milliseconds) after unexpected perturbation (P = 0.010). During the first 2, 50-millisecond periods (from 0 to 100 milliseconds) after the perturbation, the activation was similar. CONCLUSIONS.: Chronic LBP did not affect reflex activation of biceps brachii muscles but decreased preparatory and triggered reactions. The finding indicates that back pain may disturb higher level information processing in motor control. [ABSTRACT FROM AUTHOR]

This article reviews methods that have been developed as part of a clinical initiative on improving outcome measures for motor function assessment in subjects with spinal cord injury (SCI). Physiological motor outcome measures originally developed for limbs--transcranial magnetic stimulation (TMS) of the motor cortex to elicit motor-evoked potentials (MEPs) and mechanical stimulation to elicit spinal reflexes--have been extended to muscles of the trunk. The impetus for this development is the lack of a motor component in the American Spinal Injury Association clinical assessment for the thoracic myotomes. The application of TMS to the assessment of limb muscles is reviewed, followed by consideration of its application to the assessment of paravertebral and intercostal muscles. Spinal reflex testing of paravertebral muscles is also described. The principal markers for the thoracic SCI motor level that have emerged from this clinical initiative are (1) the threshold of MEPs in paravertebral muscles in response to TMS of the motor cortex, (2) the facilitation pattern and latency of MEPs in intercostal muscles during voluntary expiratory effort, and (3) the absence of long-latency reflex responses and the exaggeration of short-latency reflex responses in paravertebral muscles. [ABSTRACT FROM AUTHOR]