Case Studies in Physiology: Sympathetic neural discharge patterns in a healthy young male during end-expiratory breath hold-induced sinus pause

We characterize the occurrence of a square-wave discharge pattern of efferent muscle sympathetic nerve activity during a sinus pause in a young healthy male. This discharge pattern comprised large recruited action potential clusters undetected at baseline that continuously discharged during the sinus pause. Notably, this discharge pattern was still contained within a single cardiac cycle.

Primary Nongestational Ovarian Choriocarcinoma Mistaken for Ectopic Pregnancy: A Case Report

Trigeminal neuralgia (TN) or tic douloureux is one of the commonest cause of fascial pain after 50 years of age. It is characterized by recurrent, episodic, lancinating pain over the distribution of trigeminal nerve. There is a lack of certainty regarding the aetiology and pathophysiology of TN. Evidence suggests that the likely etiology is vascular compression of the trigeminal nerve leading to focal demyelination and aberrant neural discharge. Secondary causes such as multiple sclerosis or brain tumors can also produce symptomatic TN. The treatment of TN can be very challenging despite the numerous options patients and physicians can choose from. This multitude of treatment options poses the question as to which treatment fits which patient best. For patients refractory to medical therapy, Gasserian ganglion percutaneous techniques, gamma knife surgery and microvascular decompression are the most promising invasive treatment options. Among them three common interventions commonly carried out by interventional pain physician to provide pain relief are balloon compression, Glycerol rhizolysis and RF rhizotomy. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 73-77

Trigeminal Neuralgia: Role of Interventional Pain Physician

Trigeminal neuralgia (TN) or tic douloureux is one of the commonest cause of fascial pain after 50 years of age. It is characterized by recurrent, episodic, lancinating pain over the distribution of trigeminal nerve. There is a lack of certainty regarding the aetiology and pathophysiology of TN. Evidence suggests that the likely etiology is vascular compression of the trigeminal nerve leading to focal demyelination and aberrant neural discharge. Secondary causes such as multiple sclerosis or brain tumors can also produce symptomatic TN. The treatment of TN can be very challenging despite the numerous options patients and physicians can choose from. This multitude of treatment options poses the question as to which treatment fits which patient best. For patients refractory to medical therapy, Gasserian ganglion percutaneous techniques, gamma knife surgery and microvascular decompression are the most promising invasive treatment options. Among them three common interventions commonly carried out by interventional pain physician to provide pain relief are balloon compression, Glycerol rhizolysis and RF rhizotomy. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 73-77

A Mechanism of Real-Time Noise Modulation in Neurons

Uncertainties pose an ongoing challenge for information processing in the nervous system. It is not entirely clear how neurons maintain dynamic stability of information, encoded in the temporal features of spike trains, notwithstanding stochastic influences. Here we examined the contribution of subclasses of membrane sodium currents in real-time noise modulation in sensory neurons. Fast sodium (Na+) currents are essential for spike generation, and a persistent Na+ current can entrain preferred input frequencies via membrane resonance. Using mathematical modeling, theory and experiments, we show that a resurgent Na+ current can stabilize the temporal features of burst discharge and confer noise tolerance. These novel insights reckon the role of biophysical properties of Na+ currents beyond mere spike generation. Instead, these mechanisms might be how neurons perform real-time signal processing to maintain order and entropy in neural discharge. Our model analysis further predicts a negative feedback loop in the molecular machinery of an underlying Nav1.6-type Na+ channel gating considered in this study.

Central control of autonomic function

In this review, current understanding of the control of autonomic function is outlined and its development over the last 50 years highlighted. Using the control of the cardiovascular system as the primary tool, the importance of the patterning of autonomic outflows is shown to be crucial in both homeostasis and behaviour. Technical advances have made it possible to obtain a clearer idea of how the central nervous system evolves patterns of autonomic discharge that optimise autonomic changes to support motor and behavioural responses. The specific roles of sympathetic and parasympathetic preganglionic neurones and premotor neurones are surveyed and the importance of their roles in integrating afferent inputs that result from peripheral sensory inputs and drive from multiple levels of the neuraxis is outlined. The autonomic control of the viscera, including the urinogenital organs and other organs is discussed briefly. The current ability to use animal models to monitor and modulate autonomic neural discharge and simultaneously co-relate this with end-organ activity is shown to have translational potential. There is every prospect that these studies will lead to the identification of new therapies for pathophysiological conditions.

Calibrated variability of muscle sympathetic nerve activity during graded head-up tilt in humans and its link with noradrenaline data and cardiovascular rhythms

Muscle sympathetic nerve activity (MSNA) variability is traditionally computed through a low-pass filtering procedure that requires normalization. We proposed a new beat-to-beat MSNA variability computation that preserves dimensionality typical of an integrated neural discharge (i.e., bursts per unit of time). The calibrated MSNA (cMSNA) variability technique is contrasted with the traditional uncalibrated MSNA (ucMSNA) version. The powers of cMSNA and ucMSNA variabilities in the low-frequency (LF, from 0.04 to 0.15 Hz) band were computed with those of the heart period (HP) of systolic and diastolic arterial pressure (SAP and DAP, respectively) in seven healthy subjects (age, 20–28 years; median, 22 years; 5 women) during a graded head-up tilt. Subjects were sequentially tilted at 0°, 20°, 30°, 40°, and 60° table inclinations. The LF powers of ucMSNA and HP variabilities were expressed in normalized units (LFnu), whereas all remaining spectral markers were expressed in absolute units. We found that 1) the LF power of cMSNA variability was positively correlated with tilt angle, whereas the LFnu power of the ucMSNA series was uncorrelated; 2) the LF power of cMSNA variability was correlated with LF powers of SAP and DAP, LFnu power of HP and noradrenaline concentration, whereas the relationship of the LFnu power of ucMSNA variability to LF powers of SAP and DAP was weaker and that to LFnu power of HP was absent; and 3) the stronger relationship of cMSNA variability to SAP and DAP spectral markers compared with the ucMSNA series was confirmed individually. The cMSNA variability appears to be more suitable in describing sympathetic control in humans than traditional ucMSNA variability.

Mushroom body extrinsic neurons in the honeybee (Apis mellifera) brain integrate context and cue values upon attentional stimulus selection

Multimodal GABA-immunoreactive feedback neurons in the honeybee brain connecting the output region of the mushroom body with its input are expected to tune the input to the mushroom body in an experience-dependent way. These neurons are known to change their rate responses to learned olfactory stimuli. In this work we ask whether these neurons also transmit learned attentional effects during multisensory integration. We find that a visual context and an olfactory cue change the rate responses of these neurons after learning according to the associated values of both context and cue. The learned visual context promotes attentional response selection by enhancing olfactory stimulus valuation at both the behavioral and the neural level. During a rewarded visual context, bees reacted faster and more reliably to a rewarded odor. We interpreted this as the result of the observed enhanced neural discharge toward the odor. An unrewarded context reduced already low rate responses to the unrewarded odor. In addition to stimulus valuation, these feedback neurons generate a neural error signal after an incorrect behavioral response. This might act as a learning signal in feedback neurons. All of these effects were exclusively found in trials in which the animal prepares for a motor response that happens during attentional stimulus selection. We discuss possible implications of the results for the feedback connections of the mushroom body.