Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

Astrocytes play a key role in demyelinating diseases, like multiple sclerosis (MS), although many of their functions remain unknown. The aim of this study was to investigate the impact of astrocyte depletion upon de- and remyelination, inflammation, axonal damage, and virus distribution in Theiler`s murine encephalomyelitis (TME). Groups of two to six glial fibrillary acidic protein (GFAP)-thymidine-kinase transgenic SJL mice and SJL wildtype mice were infected with TME virus (TMEV) or mock (vehicle only). Astrocyte depletion was induced by the intraperitoneal administration of ganciclovir during the early and late phase of TME. The animals were clinically investigated while using a scoring system and a rotarod performance test. Necropsies were performed at 46 and 77 days post infection. Cervical and thoracic spinal cord segments were investigated using hematoxylin and eosin (H&E), luxol fast blue-cresyl violet (LFB), immunohistochemistry targeting Amigo2, aquaporin 4, CD3, CD34, GFAP, ionized calcium-binding adapter molecule 1 (Iba1), myelin basic protein (MBP), non-phosphorylated neurofilaments (np-NF), periaxin, S100A10, TMEV, and immunoelectron microscopy. The astrocyte depleted mice showed a deterioration of clinical signs, a downregulation and disorganization of aquaporin 4 in perivascular astrocytes accompanied by vascular leakage. Furthermore, astrocyte depleted mice showed reduced inflammation and lower numbers of TMEV positive cells in the spinal cord. The present study indicates that astrocyte depletion in virus triggered CNS diseases contributes to a deterioration of clinical signs that are mediated by a dysfunction of perivascular astrocytes.

Download Full-text

Intermittent Atrioventricular Block following Fingolimod Initiation

Case Reports in Neurological Medicine ◽

10.1155/2014/191305 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

E. Gialafos ◽

S. Gerakoulis ◽

A. Grigoriou ◽

V. Haina ◽

C. Kilidireas ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Atrioventricular Block ◽

Frequency Domain Analysis ◽

Thoracic Spinal Cord ◽

Sympathetic Function ◽

Thoracic Spinal ◽

Demyelinating Lesions ◽

Cardiac Sympathetic Function ◽

Upper Thoracic

A 47-year-old female patient with multiple sclerosis (MS) developed symptomatic intermittent 2nd degree atrioventricular block (AVB) of five-hour duration, five hours after the first two doses of fingolimod, that resolved completely. Frequency domain analysis of heart rate variability (HRV) revealed increased parasympathetic activity and decreased sympathetic tone, while modified Ewing tests were suggestive of impaired cardiac sympathetic function. We hypothesize that expression of this particular arrhythmia might be related to autonomic nervous system (ANS) dysfunction due to demyelinating lesions in the upper thoracic spinal cord, possibly augmented by the parasympathetic effect of the drug.

Download Full-text

A pathway of NADPH diaphorase positivity between central canal and pial surface at anterior fissure in spinal cord: Supra fissure area with hypothesis configuring from dog, rat, monkey and pigeon

10.1101/2020.05.02.074450 ◽

2020 ◽

Author(s):

Yunge Jia ◽

Yinhua Li ◽

Wei Hou ◽

Fuhong Li ◽

Haoran Sun ◽

...

Keyword(s):

Spinal Cord ◽

Gray Matter ◽

Anterior Commissure ◽

Central Canal ◽

Nadph Diaphorase ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Enzyme Histology ◽

Aged Monkey ◽

Anterior Median

ABSTRACTThe spinal cord is a cylinder structure in the vertebra and thought a simplified with the gray matter and white matter. Rexed lamination for the gray matter and regional sub-division for whiter matter are completely termed to date. Anterior commissure locates between the central canal and the anterior median fissure. However, some experimental data may still confront with new confined anatomical interpretation. By using NADPH diaphorase [N-d] enzyme histology, we found a vertical oriented neuronal pathway between the central canal and the anterior median fissure in the sacral spinal cord of young adult and aged dog. We used a term “supra fissure area” [SFA] to illustrate the region which consisted of the gray commissure and anterior white commissure. The N-d pathway was notably observable in aged animals. The vertical neurites revealed the cerebrospinal fluid [CSF] contacting neurites between the anterior median fissure and the central canal. We further examined the monkey, rat and pigeon in the region for better understanding of the structure and potential function. The neurodegeneration of N-d dystrophy was detected in the [SFA] in the thoracic spinal cord of the aged monkey. N-d positive fibers were detected in anterior fissure of the rat spinal cord. N-d fibrous structures were also detected in the pigeon spinal cord. These results suggested a new pathway of CSF contacting neurons and the neuronal communications about the central canal.

Download Full-text

Effects of epidural hypothermic saline infusion on locomotor outcome and tissue preservation after moderate thoracic spinal cord contusion in rats

Journal of Neurosurgery Spine ◽

10.3171/spi.2005.2.3.0308 ◽

2005 ◽

Vol 2 (3) ◽

pp. 308-318 ◽

Cited By ~ 30

Author(s):

Carlos E. Casas ◽

Loren P. Herrera ◽

Chad Prusmack ◽

Gladys Ruenes ◽

Alexander Marcillo ◽

...

Keyword(s):

Spinal Cord ◽

Gray Matter ◽

Thoracic Spinal Cord ◽

Content Type ◽

Treatment Groups ◽

Thoracic Spinal ◽

Cord Injury ◽

Spinal Cord Contusion ◽

Tissue Sparing ◽

Fine Print

Object. Regionally delivered hypothermia has advantages over systemic hypothermia for clinical application following spinal cord injury (SCI). The effects of local hypothermia on tissue sparing, neuronal preservation, and locomotor outcome were studied in a moderate thoracic spinal cord contusion model. Methods. Rats were randomized to four treatment groups and data were collected and analyzed in a blinded fashion. Chilled saline was perfused into the epidural space 30 minutes postcontusion to achieve the following epidural temperatures: 24 ± 2.3°C (16 rats), 30 ± 2.4°C (13 rats), and 35 ± 0.9°C (13 rats). Hypothermia was continued for 3 hours when a 45-minute period of rewarming was instituted. In a fourth group a moderate contusion only was induced in 14 animals. Rectal (core) and T9–10 (epidural) temperatures were measured continuously. Locomotor testing, using the Basso-Beattie-Bresnahan (Ba-Be-Br) scale, was performed for 6 weeks, and rats were videotaped for subsequent analysis. The lesion/preserved tissue ratio was calculated throughout the entire lesion cavity and the total lesion, spinal cord, and spared tissue volumes were determined. The rostral and caudal extent of gray matter loss was also measured. At 6 weeks locomotor recovery was similar in all groups (mean Ba-Be-Br Scale scores 14.88 ± 3.71, 14.83 ± 2.81, 14.50 ± 2.24, and 14.07 ± 2.39 [p = 0.77] for all four groups, respectively). No significant differences in spared tissue volumes were found when control and treatment groups were compared, but gray matter preservation was reduced in the infusion-treated groups. Conclusions. Regional cooling applied 30 minutes after a moderate contusive SCI was not beneficial in terms of tissue sparing, neuronal preservation, or locomotor outcome. This method of cooling may reduce blood flow in the injured spinal cord and exacerbate secondary injury.

Download Full-text

Effect of Electrical Stimulation of the Thoracic Spinal Cord on the Function of the Bladder in Multiple Sclerosis

The Journal of Urology ◽

10.1016/s0022-5347(17)58436-0 ◽

1977 ◽

Vol 117 (3) ◽

pp. 285-288 ◽

Cited By ~ 24

Author(s):

Anthony D. Abbate ◽

Albert W. Cook ◽

Marwan Atallah

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Electrical Stimulation ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Stimulation Of

Download Full-text

Acute Polyradiculomyelitis With Spinal Cord Gray Matter Lesions: A Report of Two Cases

Frontiers in Neurology ◽

10.3389/fneur.2021.721669 ◽

2021 ◽

Vol 12 ◽

Author(s):

Charidimos Tsagkas ◽

Maria Janina Wendebourg ◽

Matthias Mehling ◽

Johannes Lorscheider ◽

Philippe Lyrer ◽

...

Keyword(s):

Spinal Cord ◽

Gray Matter ◽

Case Reports ◽

Motor Impairment ◽

Bowel Dysfunction ◽

Motor Deficits ◽

Spinal Cord Lesions ◽

Rare Presentation ◽

Thoracic Spinal Cord ◽

Thoracic Spinal

Objective: Inflammatory polyradiculomyelitis belongs to a rare group of immune-mediated diseases affecting both the central and peripheral nervous system. We aimed to describe an unusual presentation of acute polyradiculomyelitis with marked spinal cord lesions restricted to the gray matter.Methods: Thorough examination of two case reports including clinical, MRI, serologic, electrophysiologic and CSF examinations as well as short-term follow-up.Results: We present two adult patients with acute polyradiculomyelitis and unusual spinal cord lesions restricted to the gray matter on MRI. The clinical presentation, serologic, electrophysiologic and CSF features of the two patients varied, whereas both patients demonstrated severe, asymmetrical, predominantly distal, motor deficits of the lower extremities as well as bladder and bowel dysfunction. Both patients only partially responded to anti-inflammatory treatment. Severe motor impairment and bladder dysfunction persisted even months after symptom onset.Conclusions: To our best of knowledge, these are the first reports of acute polyradiculomyelitis with distinct involvement of the lower thoracic spinal cord gray matter. Currently, it remains unclear whether gray matter lesions reflect a separate pathophysiologic mechanism or an exceedingly rare presentation of spinal cord involvement in acute polyradiculomyelitis.

Download Full-text

Syringomyelia in demyelinating disease of the central nervous system: Report of two cases

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1110657s ◽

2011 ◽

Vol 139 (9-10) ◽

pp. 657-660 ◽

Cited By ~ 1

Author(s):

Dejan Savic ◽

Slobodan Vojinovic ◽

Mirjana Spasic ◽

Zoran Peric ◽

Stevo Lukic

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Magnetic Resonance ◽

Demyelinating Disease ◽

Clinical Signs ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

The Central Nervous System

Introduction. Syringomyelia is a cavitary extension inside the spinal cord which can be either symptomatic or congenitally-idiopathic. Syringomyelia during the course of the disease in patients presenting with clinically definite multiple sclerosis was described earlier. Syringomyelia in patients presenting with a clinically isolated syndrome suggestive of multiple sclerosis is unusual. Case Outline. We present two patients presenting with demy-elinating disease of the central nervous system with syringomyelia in the cervical and thoracic spinal cord. We did not find classical clinical signs of syringomyelia in our patients, but we disclosed syringomyelia incidentally during magnetic resonance exploration. Magnetic resonance exploration using the gadolinium contrast revealed the signs of active demyelinating lesions in the spinal cord in one patient but not in the other. Conclusion. Syringomyelia in demyelinating disease of the central nervous system opens the question whether it is a coincidental finding or a part of clinical features of the disease. Differentiation of the significance of syringomyelia finding in these patients plays a role in the choice of treatment concept in such patients.

Download Full-text