SEEG in Frontal Lobe Epilepsy

Frontal lobe epilepsy (FLE) constitutes a challenge for presurgical evaluation because of specific anatomical and physiological factors. Semiological expression of frontal lobe seizures is notably varied and complex but nevertheless certain distinct patterns can be characterized, associated with different sublobar epilepsy localizations. These electro-clinical patterns have been largely demonstrated by stereo-electroencephalographic (SEEG) studies. An electro-clinical spectrum of semiological expression has been shown, with the most anterior prefrontal regions being associated with complex motor behaviour, distal stereotypies, and an integrated or naturalistic appearance; posterior prefrontal regions associated with proximal stereotypies sometimes associated with tonic posture; and motor/premotor regions associated with elementary motor signs. This rostrocaudal gradient is in keeping with current theories of frontal lobe functional organization. This chapter discusses issues specific to SEEG exploration of FLE, reviews historical investigations of frontal semiology, and highlights different patterns of semiological expression in both focal and widespread frontal seizures, as elucidated by SEEG.

Gastrointestinal Biopsies for the Diagnosis of Alpha-Synuclein Pathology in Parkinson’s Disease

The diagnosis of Parkinson’s disease (PD) relies on clinical features whereas pathological confirmation is only possible with autopsy examination. The neuropathological hallmarks of PD are neuronal loss and the presence of inclusions termed Lewy bodies/neurites in affected regions. A major component of these inclusions is phosphorylated alpha-synuclein (α-SYN) protein. There is evidence thatα-SYN pathology is widely distributed outside the central nervous system in patients with PD. The gastrointestinal tract is importantly affected byα-SYN containing inclusions and typically there is a rostrocaudal gradient for the distribution of the pathology. The highest amounts of Lewy bodies/neurites are found at the submandibular gland together with the lower esophagus and the lowest amounts are found in the rectum. Autopsy findings prompted research aimed at achieving in vivo pathological diagnosis of PD by demonstrating the presence ofα-SYN pathology in biopsy material of these peripheral accessible tissues. So far, biopsy studies of the gut have demonstrated the presence ofα-SYN pathology in the salivary glands, stomach, duodenum, colon, and rectum. Further research is necessary in order to determine which are the most sensitive targets for in vivoα-SYN pathology detection and the safest techniques for these approaches in patients with PD.

Locomotor-activated neurons of the cat. II. Noradrenergic innervation and colocalization with NEα1a or NEα2b receptors in the thoraco-lumbar spinal cord

Norepinephrine (NE) is a strong modulator and/or activator of spinal locomotor networks. Thus noradrenergic fibers likely contact neurons involved in generating locomotion. The aim of the present study was to investigate the noradrenergic innervation of functionally related, locomotor-activated neurons within the thoraco-lumbar spinal cord. This was accomplished by immunohistochemical colocalization of noradrenergic fibers using dopamine-β-hydroxylase or NEα1A and NEα2B receptors with cells expressing the c-fos gene activity-dependent marker Fos. Experiments were performed on paralyzed, precollicular-postmamillary decerebrate cats, in which locomotion was induced by electrical stimulation of the mesencephalic locomotor region. The majority of Fos labeled neurons, especially abundant in laminae VII and VIII throughout the thoraco-lumbar (T13-L7) region of locomotor animals, showed close contacts with multiple noradrenergic boutons. A small percentage (10–40%) of Fos neurons in the T7-L7 segments showed colocalization with NEα1A receptors. In contrast, NEα2B receptor immunoreactivity was observed in 70–90% of Fos cells, with no obvious rostrocaudal gradient. In comparison with results obtained from our previous study on the same animals, a significantly smaller proportion of Fos labeled neurons were innervated by noradrenergic than serotonergic fibers, with significant differences observed for laminae VII and VIII in some segments. In lamina VII of the lumbar segments, the degree of monoaminergic receptor subtype/Fos colocalization examined statistically generally fell into the following order: NEα2B = 5-HT2A ≥ 5-HT7 = 5-HT1A > NEα1A. These results suggest that noradrenergic modulation of locomotion involves NEα1A/NEα2B receptors on noradrenergic-innervated locomotor-activated neurons within laminae VII and VIII of thoraco-lumbar segments. Further study of the functional role of these receptors in locomotion is warranted.

Locomotor-Activated Neurons of the Cat. I. Serotonergic Innervation and Co-Localization of 5-HT7, 5-HT2A, and 5-HT1A Receptors in the Thoraco-Lumbar Spinal Cord

Monoamines are strong modulators and/or activators of spinal locomotor networks. Thus monoaminergic fibers likely contact neurons involved in generating locomotion. The aim of the present study was to investigate the serotonergic innervation of locomotor-activated neurons within the thoraco-lumbar spinal cord following induction of hindlimb locomotion. This was determined by immunohistochemical co-localization of serotonin (5-HT) fibers or 5-HT7/5-HT2A/5-HT1A receptors with cells expressing the activity-dependent marker c-fos. Experiments were performed on paralyzed, decerebrate cats in which locomotion was induced by electrical stimulation of the mesencephalic locomotor region. Abundant c-fos immunoreactive cells were observed in laminae VII and VIII throughout the thoraco-lumbar segments of locomotor animals. Control sections from the same segments showed significantly fewer labeled neurons, mostly within the dorsal horn. Multiple serotonergic boutons were found in close apposition to the majority (80–100%) of locomotor cells, which were most abundant in lumbar segments L3–7. 5-HT7 receptor immunoreactivity was observed on cells across the thoraco-lumbar segments (T7–L7), in a dorsoventral gradient. Most locomotor-activated cells co-localized with 5-HT7, 5-HT2A, and 5-HT1A receptors, with largest numbers in laminae VII and VIII. Co-localization of c-fos and 5-HT7 receptor was highest in the L5–L7 segments (>90%) and decreased rostrally (to ∼50%) due to the absence of receptors on cells within the intermediolateral nucleus. In contrast, 60–80 and 35–80% of c-fos immunoreactive cells stained positive for 5-HT2A and 5-HT1A receptors, respectively, with no rostrocaudal gradient. These results indicate that serotonergic modulation of locomotion likely involves 5-HT7/5-HT2A/5-HT1A receptors located on the soma and proximal dendrites of serotonergic-innervated locomotor-activated neurons within laminae VII and VIII of thoraco-lumbar segments.

Ultrasonographic observations of the maturation of basic movements in guinea pig fetuses

Ultrasonography has not previously been used for studying fetal movements in precocial rodents. The objective of this study was to ultrasonographically determine the sequence of the appearance of basic movements in a guinea pig fetus. The research included eight guinea pig females carrying one fetus each. Fetal movements were observed for 10 minutes each day, from the 25th to 38th day of gestation. The time and sequence of the appearance of movements was observed as follows: whole body flexion (mean 27.6 SD ± 1.68), whole body extension (mean 28.1 SD ± 1.12), head flexion (mean 28.1 SD ± 1.80), head extension (mean 30.5 SD ± 2.67) forelimbs flexion (mean 30.5 SD ± 2.32), forelimbs extension (mean 30.7 SD ± 1.84), trunk rotation (mean 31.9 SD ± 2.23), forelimbs alternating flexion and extension (mean 32.1 SD ± 2.1), hind limbs extension (mean 32.2 SD ± 3.2), hind limbs flexion (mean 32.4 SD ± 3.16), and hind limbs alternating flexion and extension (mean 33.5 SD ± 2.39). The identical sequences of basic movement appearances in guinea pigs, sheep, and rats suggest that the rostrocaudal gradient of basic movement appearance could be a general developmental pattern in mammalian species.

Heterogeneity of metabolic activity in the canine parasternal intercostals during breathing

In the dog, the inspiratory mechanical advantage of the parasternal intercostals shows a marked spatial heterogeneity, whereas the expiratory mechanical advantage of the triangularis sterni is relatively uniform. The contribution of a particular respiratory muscle to lung volume expansion during breathing, however, depends both on the mechanical advantage of the muscle and on its neural input. To evaluate the distribution of neural input across the canine parasternal intercostals and triangularis sterni, we have examined the distribution of metabolic activity among these muscles in seven spontaneously breathing animals by measuring the uptake of the glucose tracer analog [18F]fluorodeoxyglucose (FDG). FDG uptake in any given parasternal intercostal was greatest in the medial bundles and decreased rapidly toward the costochondral junctions. In addition, FDG uptake in the medial parasternal bundles increased from the first to the second interspace, plateaued in the second through fifth interspaces, and then decreased progressively toward the eighth interspace. In contrast, uptake in the triangularis sterni showed no significant rostrocaudal gradient. These results overall strengthen the idea that the spatial distribution of neural input within a particular set of respiratory muscles is closely matched with the spatial distribution of mechanical advantage.