Spinal Reflexes in Ankle Flexor and Extensor Muscles After Chronic Central Nervous System Lesions and Functional Electrical Stimulation

2008 ◽  
Vol 23 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Aiko K. Thompson ◽  
Kristen L. Estabrooks ◽  
SuLing Chong ◽  
Richard B. Stein
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Nerve Stimulation ◽  
Reciprocal Inhibition ◽  
Spinal Reflexes ◽  
Foot Drop ◽  
Emg Activity ◽  
Muscle Nerve ◽  
Voluntary Contractions ◽  
Cns Lesions

Objective. Spinal reciprocal inhibitory and excitatory reflexes of ankle extensor and flexor muscles were investigated in ambulatory participants with chronic central nervous system (CNS) lesions causing foot drop as a function of time after lesion and stimulator use. Methods. Thirty-nine participants with progressive (eg, secondary progressive MS) and 36 with generally nonprogressive (eg, stroke) conditions were studied. The tibialis anterior (TA) and soleus maximum H-reflex/M-wave (Hmax/Mmax) ratios and maximum voluntary contractions (MVC) were measured and compared with those in age-matched control participants. Reciprocal inhibition was measured as a depression of the ongoing electromyographic (EMG) activity produced by antagonist muscle—nerve stimulation. Results. Participants with CNS lesions had significantly higher soleus Hmax/Mmax ratios than control participants, and reduced voluntary modulation of the reflexes occurred in both muscles. Reciprocal inhibition of soleus from common peroneal (CP) nerve stimulation was not significantly different from controls in either group. Inhibition of the TA by tibial nerve stimulation decreased and was eventually replaced by excitation in participants with nonprogressive disorders. No significant change occurred in progressive disorders. Use of a foot drop stimulator increased the TA, but not the soleus MVC overall. H-reflexes only showed small changes. Reciprocal inhibition of the TA increased considerably, while that of the soleus muscle decreased toward control values. Conclusions. Disorders that produce foot drop also produce reflex changes, some of which only develop over a period of years or even decades. Regular use of a foot drop stimulator strengthens voluntary pathways and changes some reflexes toward control values. Thus, stimulators may provide multiple benefits to people with foot drop.

scholarly journals Foot Drop due to Central cause – A Case Report on Bilateral Parasagittal Meningioma

2014 ◽  
Vol 4 (1) ◽  
pp. 52-55
Author(s):  
R Habib ◽  
SB Mizan ◽  
A Rahman ◽  
NB Bhowmik ◽  
A Haque
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Pyramidal Tract ◽  
Foot Drop ◽  
Nerve Lesion ◽  
Drop Foot ◽  
Peripheral Nerve Lesion ◽  
The Central Nervous System ◽  
Parasagittal Meningioma

Most clinicians consider a peripheral nerve lesion in patients with drop foot. However, causes stemming from the central nervous system represent rare, important, and underappreciated differential etiologies. Central causative lesions usually occur at locations where pyramidal tract connections are condensed and specific and the function is somatotopically organized. Here we report case presenting as central foot drop or spastic foot-drop and other myriad clinical features which after investigations was found due to bilateral parasagittal meningiomas. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18559 Birdem Med J 2014; 4(1): 52-55

Is there a central nervous system component to acute baroreflex resetting in rats?

1992 ◽  
Vol 262 (2) ◽  
pp. H503-H510 ◽  
Author(s):  
C. M. Heesch ◽  
K. W. Barron
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Nerve Stimulation ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
System Component ◽  
Nerve Activity ◽  
Linear Portion ◽  
Aortic Nerve ◽  
Maximum Inhibition

This study was designed to evaluate a possible central nervous system (CNS) component to acute baroreflex resetting. In nine arterial baroreceptor-denervated, chloralose-urethan-anesthetized rats, a control (C) aortic nerve stimulation curve (3-5 V, 1 ms, 0-64 Hz) was obtained. Next, a constant "baroreceptor" input was delivered to the CNS (left aortic nerve stimulation, 10 min, 10.2 +/- 1.5 Hz). Within the first 13 s of aortic nerve stimulation, maximum inhibition of lumbar sympathetic nerve activity (LSNA) was 60 +/- 7.8% of baseline and at 1 min it increased to 68 +/- 5.6% of baseline. At the end of the 10-min aortic nerve stimulation, LSNA was not different from the response at 1 min (68 +/- 5.6% = 74 +/- 4.1%). Immediately after the constant stimulation (within 30 s), a test or reset (RS) curve was obtained (0-64 Hz). A recovery (RC) curve was obtained 10-20 min later. The slope of the linear portion of the curve and the stimulation frequency that produced 50% maximum inhibition (ES50) were compared among the three baroreflex curves (C, RS, RC,) and no significant differences were found. Thus, although a CNS component to baroreflex adaptation was evident during the first minute of aortic nerve stimulation, a longer term acute resetting of the baroreflex curve did not occur.

Accuracy of Intraoperative Examination in Central Nervous System Lesions: A Study of 133 Cases

2019 ◽  
Vol 63 (3) ◽  
pp. 224-232
Author(s):  
Ludmila Barbosa de Souza Balsimelli ◽  
Jamille Costa de Oliveira ◽  
Flora Ávila Adorno ◽  
Clarissa Almeida Brites ◽  
Giuliano Stefanello Bublitz ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Frozen Section ◽  
Final Diagnosis ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Predictive Values ◽  
Health Organization ◽  
Cns Lesions

Objective: Intraoperative examination is a highly valuable tool for the evaluation of central nervous system (CNS) lesions, helping the neurosurgeon to determine the best surgical management. This study aimed to evaluate the accuracy and to analyze the diagnostic disagreements and pitfalls of the intraoperative examinations through correlation with the final histopathological diagnosis in CNS lesions. Study Design: Retrospective analysis of intraoperative examination of CNS lesions and their final diagnosis obtained during 16 consecutive years. All diagnoses were reviewed and classified according to World Health Organization (WHO) grading for CNS tumors. Squash was performed in 119 cases, while frozen section and both methods were done in 7 cases each. Results: Among the 133 intraoperative examinations considered, 114 (85.7%) presented concordance and 19 (14.3%) diagnostic disagreement when compared with subsequent histopathological examinations. The sensitivity and specificity for the detection of neoplasia in intraoperative examination was 98 and 94%, respectively. The positive and negative predictive values were 99 and 88%, respectively. The accuracy for neoplastic and nonneoplastic disease was 85.7%. Disagreements were more frequent among low-grade (WHO grades I and II) neoplasms and nonmalignant cases. Conclusions: Our results showed good accuracy of the intraoperative assessments for diagnosis of CNS lesions, particularly in high-grade (grades III and IV) lesions and metastatic neoplasms.

scholarly journals Is Crush Cytology of Central Nervous System Lesions Relevant in Surgical Practice Today?

2019 ◽  
Vol 10 (01) ◽  
pp. 34-38 ◽  
Author(s):  
Krishan Kumar Yadav ◽  
Rashmi Bhatti ◽  
Nikhil Moorchung ◽  
Deepti Mutreja ◽  
Ajay S. Carvalho
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Imaging Techniques ◽  
Diagnostic Technique ◽  
High Grade ◽  
Surgical Practice ◽  
The Central Nervous System ◽  
Cns Lesions ◽  
Neurosurgical Intervention

ABSTRACT Background: Intraoperative crush cytology is a useful tool for diagnosing the lesions of the central nervous system (CNS). However, because of the development of newer and better imaging techniques, it is important to evaluate if crush cytology is still relevant in neurosurgical practice. Aims: We evaluated the crush cytology smears in a series of cases where neurosurgical intervention was performed. We studied the role of crush cytology in the intraoperative diagnosis. We report a series of cases where intraoperative crush cytology helped the surgeon revise the surgery during the operation. Materials and Methods: A small portion of all CNS lesions was taken intraoperatively and the tissue was crushed between two slides. The slide was stained using the toluidine blue, Leishman stain, Pap stain and a routine H & E stain. The slides were the evaluated. Results: We evaluated the 50 cases of CNS lesions. We found that intraoperative crush cytology is particularly important in differentiating between neoplastic and nonneoplastic CNS lesions. It may also help in differentiating lymphomas from high-grade gliomas. Finally, crush cytology may help the surgeon in delineating the lesions during surgery. Conclusion: We conclude that crush cytology remains relevant in neurosurgical practice today and it should be adopted in all neurosurgical centers as a routine diagnostic technique.

Glial response in the central nervous system of cats with feline infectious peritonitis

2016 ◽  
Vol 18 (12) ◽  
pp. 1023-1030 ◽  
Author(s):  
Leonardo P Mesquita ◽  
Aline S Hora ◽  
Adriana de Siqueira ◽  
Fernanda A Salvagni ◽  
Paulo E Brandão ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Ricinus Communis ◽  
Molecular Layer ◽  
Lectin Histochemistry ◽  
Vimentin Expression ◽  
Feline Infectious Peritonitis ◽  
The Central Nervous System ◽  
Microglial Response ◽  
Cns Lesions

Objectives The aim of the study was to evaluate central nervous system (CNS) lesions in non-effusive and effusive cases of feline infectious peritonitis (FIP) regarding aspects related to astrocytic and microglial reactions. Methods Five necropsied cats that were naturally infected with FIP virus, confirmed by reverse transcriptase polymerase chain reaction and immunohistochemistry, with different intensities of CNS lesions, were studied. Brain and cerebellum were evaluated by light microscopy and immunohistochemistry for glial fibrillary acidic protein (GFAP) and vimentin to assess astrocytic morphology, and lectin histochemistry for Ricinus communis agglutinin-I (RCA-I) to detect microglia was performed to evaluate the glial response in the CNS of cats with FIP. Results An important astrocytic response in many areas of the CNS of all cats, including the periventricular areas of lateral ventricles and fourth ventricle, the molecular layer of the cerebellum and cerebral cortex, was visualized. This astrocytic reactivity was associated with areas of granulomatous or pyogranulomatous vasculitis/perivasculitis in most cases, and it was characterized by multifocal to coalescing astrocytosis and astrogliosis with an increase in the expression of intermediate filaments, such as GFAP. However, astrocytes exhibited strong vimentin expression in neuroparenchyma with severe inflammatory and necrotic changes, but GFAP expression was mild or absent in these cases. A microglial response was present only in severe lesions, and RCA-I expression was detected primarily in gitter cells and resting microglia. Conclusions and relevance The present study indicates a strong astrocytic response, including the presence of many less differentiated vimentin-positive astrocytes and gitter cells positive for RCA-1 in severe lesions in the CNS of cats with FIP.

The effect of nivolumab treatment for central nervous system metastases in non-small cell lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20601-e20601 ◽  
Author(s):  
Hiromi Watanabe ◽  
Toshio Kubo ◽  
Takashi Ninomiya ◽  
Kadoaki Ohashi ◽  
Eiki Ichihara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Group A ◽  
Group B ◽  
Nsclc Patients ◽  
Cns Lesions

e20601 Background: Central nervous system (CNS) metastases (mets) occur in 30% of patients with advanced non-small cell lung cancer (NSCLC) and are associated with poor overall survival (OS). Although nivolumab, a programmed death-1 immune checkpoint inhibitor antibody, has demonstrated a longer survival benefit compared with docetaxel in previously treated NSCLC patients (CheckMate 017 and 057; N Engl J Med, 2015), patients with symptomatic or untreated CNS mets were excluded in these trials. In CheckMate 012 Arm M, 2 of 12 patients (16.7%) with untreated CNS mets showed intracranial responses, but the effect of nivolumab treatment for CNS mets was not fully investigated. Methods: To investigate the effect and safety of nivolumab for CNS mets in NSCLC patients, we retrospectively analyzed 48 patients with NSCLC who were treated with nivolumab from February 2016 to December 2016 at Okayama University Hospital. Results: Twenty-nine patients (60%) had no CNS lesions (group A) and 19 patients (40%) had brain mets (BM) (group B). In group B, 15 patients (79%) received radiotherapy (RT) for BM, including 5 patients who received RT just before nivolumab treatment. The responses of extra-CNS lesions to nivolumab are shown in the table. The PFS was longer in group A than in group B (p=0.14). In group B, the PFS of patients who received prior RT tended to be longer than in those without RT (p=0.42); OS was not reached in either group. In group B, the effects of nivolumab treatment for CNS mets were evaluated in 12 patients: SD occurred in 3 patients (25%), PD in 4 patients (33%), and NE in 5 patients (42%). All 4 patients with PD in the CNS lesion also showed PD in the extra-CNS lesion. In group A, no patients showed progression only in the CNS lesion. Conclusions: In this retrospective study, there were no patients treated only with nivolumab who showed a response to CNS mets. RT prior to nivolumab might be more effective, so future investigations should involve additional cases and prospective studies. [Table: see text]

Spinal reciprocal inhibition in human locomotion

2004 ◽  
Vol 96 (5) ◽  
pp. 1969-1977 ◽  
Author(s):  
Aiko Kido ◽  
Naofumi Tanaka ◽  
Richard B. Stein
Keyword(s):  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Human Subjects ◽  
Tibialis Anterior Muscle ◽  
Reciprocal Inhibition ◽  
Emg Activity ◽  
Healthy Human ◽  
Fast Walking ◽  
Tibial Nerve Stimulation ◽  
The Difference

The purpose of this paper was to study spinal inhibition during several different motor tasks in healthy human subjects. The short-latency, reciprocal inhibitory pathways from the common peroneal (CP) nerve to the soleus muscle and from the tibial nerve to the tibialis anterior muscle were studied as a depression of ongoing voluntary electromyograph (EMG) activity. First, the effect of stimulus intensity on the amount of inhibition was examined to decide an appropriate stimulation to study the task-dependent modulation of inhibition. Then, the inhibition at one level of stimulation (1.5 × motor threshold) was investigated during standing, walking, and running. The change in slope of inhibition vs. EMG level, which approximates the fraction of ongoing activity that is inhibited, decreased with CP stimulation from 0.52 during standing to 0.30 during fast walking (6 km/h) to 0.17 during running at 9 km/h. Similarly, the slope decreased with tibial nerve stimulation from 0.68 (standing) to 0.42 (fast walking) to 0.35 (running at 9 km/h). All differences, except the last one, were highly significant ( P < 0.01, Student's t-test). However, the difference between walking (0.42) and running (0.36) at the same speed (6 km/h) was not significant with tibial nerve stimulation and only significant at P < 0.05 with CP nerve stimulation (0.30, 0.20). Also, the difference between standing (0.52) and slow walking (3 km/h; 0.41) with CP stimulation was not significant, but it was significant ( P < 0.01) with tibial nerve stimulation (0.68, 0.49). In conclusion, our findings indicate that spinal reciprocal inhibition decreases substantially with increasing speed and only changes to a lesser extent with task.

Sign in / Sign up

Export Citation Format

Share Document