Superficial architecture of the jaw-closing muscles of the cat (Felis catus): the temporo-masseteric complex.

The muscle fiber fascicles of the temporo-masseter complex of the cat were minutely dissected. Some heads were embedded in paraffin while others were put into methyl-methacrylate resin and sections were made. The results of this anatomical study demonstrate that this complex consists of the masseter muscle, the temporal muscle and two well individualized transitional fascicles: the maxillomandibularis and zygomato-comandibularis muscles. The masseter and temporal muscles are composed of individualized compartments in which the orientation and aponeuroses of the fibers of which they are composed differ with regard to the centric occlusion plane. The masseter muscle consists of a superficial fascicle made up of two layers, an intermediate fascicle, and a deep fascicle composed of two layers. The temporal muscle consists of one anterior orbital part and one posterior temporal part. This structure is in accordance with the mammalian archetype described by Gaspard and Saban. These findings should lead towards a homology-based nomenclature founded on comparative anatomy studies of mammalian species. Such a classification would permit the comparison of results obtained from physiological and histochemical studies of these complex muscle fibers when they are published by different researchers.

[Treatment of central and neuropathic facial pain by chronic stimulation of the motor cortex: value of neuronavigation guidance systems for the localization of the motor cortex]. / Traitement des douleurs centrales et neuropathiques faciales par stimulation chronique du cortex moteur. Intêret des systèmes de neuronavigation pour le repérage du cortex moteur]

Thirty two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27. 3 months. The first 24 patients were operated according to the technique described by Tsubokawa. The last 13 cases (8 new patients and 5 reinterventions) were operated by a technique including localization by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organisation of the motor cortex was established peroperatively by studying the motor responses at stimulation of the motor cortex through the dura. Ten of the 13 patients with central pain (77%) and nine of the 12 patients with neuropathic facial pain had experienced substantial pain relief (75%). One of the 3 patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zoster. None of the patients developed epileptic seizures. The position of the stimulating poles effective on pain corresponded to the somatotopic representation of the motor cortex. The neuronavigator localization and guidance technique proved to be most useful identifying the appropriate portion of the motor gyrus. It also allowed the establishment of reliable correlations between electrophysiological-clinical and anatomical data which may be used to improve the clinical results and possibly to extend the indications of this technique.

Motor cortex stimulation in the treatment of central and neuropathic pain.

BACKGROUND: Motor cortex stimulation has been proposed for the treatment of central pain. METHODS: Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated on according to the technique described by Tsubokawa. The last 13 cases (8 new patients and 5 reinterventions) were operated on by a technique including localization by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organization of the motor cortex was established preoperatively by studying the motor responses at stimulation of the motor cortex through the dura. RESULTS: Ten of the 13 patients with central pain (77%) and 10 of the 12 patients with neuropathic facial pain experienced substantial pain relief (83.3%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zoster. None of the patients developed epileptic seizures. CONCLUSIONS: Our results confirm that chronic stimulation of the motor cortex is an effective method in treating certain forms of refractory pain.

[Substance P in the primary sensory neurons innervating the dental pulp in the guinea pig]. / Substance P dans les neurones sensitifs primaires innervant la pulpe dentaire, chez le cobaye.

Primary sensory trigeminal neurons supplying the dental pulp of incisors in guinea pigs were labelled by retrograde axonal transport. Using an autometallographic intensification procedure, 48 h after injection of wheat germ agglutinin/colloidal gold in the pulp, gold particles were detected in the cytoplasm of the neurons as black granulations. A morphometric study showed a bimodal repartition of the labelled neurons of the ganglion. By submitting ganglion slices to an anti-substance P immunserum revealed by immunocytochemistry, it could be observed that, among the neurons supplying the dental pulp of incisors, the majority of the largest were substance P immunopositive while the smallest were substance P immunonegative. These observations suggest that there could be at least two different populations of nerve fibres supplying the guinea pig incisor dental pulp. Substance P negative neurons could express different neurotransmitters.

Effects of RPR 100893, a potent NK1 antagonist, on the jaw-opening reflex in the guinea pig.

RPR 100893 appears as a new potent NK1 selective non-peptide antagonist both in vitro and in vivo, and exhibits high affinity for guinea pig and human NK1 receptor [M. Tabart, J.-F. Peyronel, Synthesis of RPR 100893, prototype of a new series of potent and selective non-peptide NK1 antagonists: the triarylperhydroisoindolols, Bioorg. Med. Chem. Lett., 4 (1994) 673-676.]. Intra-oral administration of RPR 100893 (3, 15, 10, 30 mg/kg) was performed in freely moving guinea pigs during recording of the short- (6-10 ms) and long-latency (18-26 ms) jaw-opening reflex (JOR) elicited by electrical stimulation (0.5 Hz) of the lower incisor tooth pulp. RPR 100893 induced a noticeable and dose-dependent increase of the long-latency reflex thresholds (P<0. 001) but was ineffective on the short-latency responses (P=0.14). The results suggest that, in guinea pigs, the long-latency JOR requires activation of NK1 receptors, while the earlier reflex component, elicited by activation of periodontal afferents, does not. These NK1 receptors could be located either on JOR interneurons activated by tooth pulp afferents or on digastric motoneurons, receiving the tooth pulp input through a polysynaptic pathway.

Improvement of action tremor by chronic cortical stimulation.

The authors present a patient who had long-term improvement of a severe upper limb action tremor after chronic cortical stimulation. A 40-year-old woman complained of facial pain and tremor of the left arm after removal of an acoustic neurinoma. A motor cortex stimulation was performed to treat the deafferentation facial pain in 1993. Chronic cortical stimulation induced complete relief of both pain and tremor and allowed the patient to recover functional capacity of the limb. These effects persisted throughout a 32-month follow up. Differential effects on pain and tremor were observed when parameters of stimulation were varied, suggesting different mechanisms for the relief of pain and tremor. Attention was focused on control of the tremor. This effect could be the result of the inhibition of subcortical structures which are involved in tremor. Chronic cortical stimulation appears to be an effective treatment for controlling severe action tremors.

Reciprocal connections between the red nucleus and the trigeminal nuclei: a retrograde and anterograde tracing study.

An anterograde biocytin and a retrograde WGA-colloidal gold study in the rat can provide information about reciprocal communication pathways between the red nucleus and the trigeminal sensory complex. No terminals were found within the trigeminal motor nucleus, in contrast with the facial motor nucleus. A dense terminal field was observed in the parvicellular reticular formation ventrally to the trigeminal motor nucleus. The parvicellular area may be important for the control of jaw movements by rubrotrigeminal inputs. On the other hand, the contralateral rostral parvicellular part of the red nucleus receives terminals from the same zone in the rostral part of the trigeminal sensory complex, where retrogradely labelled neurones were found after tracer injections into the red nucleus. Such relationships could be part of a control loop for somatosensory information from the orofacial area.

Potentiation of fentanyl suppression of the jaw-opening reflex by transcranial electrical stimulation.

Stinus et al. [L. Stinus, M. Auriacombe, J. Tignol, A. Limoge, M. Le Moal, Transcranial electrical stimulation with high frequency intermittent current (Limoge's) potentiates opiate-induced analgesia: blind studies, Pain, 42 (1990) 351-363.] observed that transcranial electrical stimulation (TCES) with high-frequency intermittent current potentiated opiate-induced analgesia using the tail-flick test. In unanesthetized, chronic preparations, electrical stimulation (0.5 Hz) of the lower incisor pulp of rats elicits a short-(6 ms) and a long-latency (12-18 ms) jaw-opening reflex (JOR) without any evidence of aversive behavior [J. Azerad, F. Fuentes, I. Lendais, A. Limoge, B. Pollin, Methods for selective tooth pulp stimulation in acute and chronic preparations in rats, J. Physiol., 406 (1988) 3P.]. Fentanyl increases thresholds of both reflexes and transiently suppresses the long-latency JOR. We then decided to look at the influence of TCES on both drug-induced mean of maximal threshold variation (MMTV) and duration of JOR suppression period. These parameters have been investigated in 43 Wistar rats with or without TCES administered for 3 h before the drug injection and throughout the testing period. TCES alone has no effect. In contrast, it significantly increases the duration of the reflex suppression period (149 +/- 5% vs. control, P < 0.001) while fentanyl-increased reflex thresholds remain unchanged. The fentanyl-induced JOR suppression period returns to the control values 2 days later. When a second 3-h TCES session is delivered 2 or 4 days after the first TCES session, a similar increase of this suppression period is observed. Moreover, 2 days after a second TCES session, an increase of the duration of the fentanyl-induced JOR suppression period is systematically observed. In contrast, a 6-h TCES session never induces such effects. These results confirm a potentiating effect of TCES on opioid action and demonstrate the value of repeated TCES sessions.

Treatment of deafferentation pain by chronic stimulation of the motor cortex: report of a series of 20 cases.

Twenty patients with deafferentation pain were treated by chronic stimulation of the motor cortex. The central fissure was localized using stereotactic MRI and the motor cortex was mapped using intra-operative somatosensory evoked potentials. Seven patients with trigeminal neuropathic pain experienced definite pain relief varying between 40 and 100%. Ten patients had central pain secondary to central nervous system lesions. A satisfactory long-lasting pain control (pain relief > 40%) was obtained in five of them (50% of cases). One patient with pain from peripheral nerve injury obtained more than 80% pain relief. Two patients had pain from spinal cord lesions. One did not respond but the other obtained an excellent long-term result. The location of the effective stimulation plots was in agreement with the somatotopic maps of the primary motor cortex. One patient developed a small extradural haematoma which resolved spontaneously. None of the patients developed seizure activity. This study confirms the potential value of motor cortex stimulation in the treatment of certain forms of intractable pain, especially in cases with trigeminal neuropathic pain.

Reciprocal interactions between intralaminar and lateral thalamic nuclei in rats.

Reciprocal interactions between intralaminar thalamic nuclei (ncl. centralis lateralis, CL, and ncl. parafascicularis, Pf), the pretectal area (Pt) and lateral thalamic nuclei (ventrobasal complex, VB, ncl. anterior ventralis, AV, and ncl. ventralis anterior, VA) have been observed in ketamine-anaesthetized rats. Extracellular single unit activity has been recorded after single electrical stimuli. Electrical stimulation of the VB evoked a short latency orthodromic response followed by a pause in spontaneous activity in neurones of medial thalamic nuclei. Lateral thalamic neurones responded to electrical stimulation of the intralaminar nuclei or the pretectal area with the same pattern of response. Striatal, sensorimotor cortical or peripheral electrical stimulation also evoked similar responses. The pauses in spontaneous activity were shown to be the result of inhibition since the responsiveness of the intralaminar nuclei or the lateral thalamic neurones to all inputs was abolished or reduced after a conditioning electrical single-shock stimulation in the VB or in the intralaminar nuclei, respectively. The two components of the response were of a different origin, since most of the short latency responses disappeared after medullary, upper cervical sections or large decortications, while the inhibitions persisted. These inhibitions were shown to be of thalamic origin since their duration was decreased after extensive decortications increased after medullary section. It is concluded that the neuroneal properties studied in this report are probably broadly represented throughout the thalamus and that thalamic neurones are under inhibitory control elicited by afferent volleys. This inhibitory control includes a relay in the nucleus reticularis thalami (nRT). The mechanisms of sensory interaction can be purely thalamic, but they can be modulated by suprathalamic and/or mesencephalic loops.

Abnormal neuroneal activities in intralaminar thalamic nuclei following chronic lesions of nucleus reticularis thalami in rats.

Extracellular single unit activity in the intralaminar thalamic nuclei (ncl. centralis lateralis, CL, n = 77 and ncl. parafascicularis, Pf, n = 163) and in the pretectal area (Pt, n = 75) was examined following chronic electrolytic lesions of the nucleus reticularis thalami (nRT) in ketamine-anaesthetized rats after single electrical stimuli to the ventrobasal complex (VB). Extensive alterations of either the ongoing ("spontaneous") activity or the pattern of VB evoked responses were observed. Four major changes were observed in the activity of these intralaminar or pretectal neurones: 1) many neurones were silent, two times more frequently than in a parallel study with control intact rats; 2) the firing pattern of all the other neurones was in the form of tonic (stationary-like) discharge, without burst discharges as previously described in intact animals. They were ranked into classes according to their spontaneous discharge: class I, silent (no resting discharge) 12%, class II (1-15 Hz), 54 % and class III (> 16 Hz), 34%. Class III neurones were never found in intact rats; 3) electrical stimulation of the VB evoked a short latency orthodromic excitatory response in these neurones but this response was not followed by any slowing or depression of the spontaneous activity in more than 40% of recorded cells. When it occurred, this pause was shorter than that always observed in intact rats by more than 35% and longer in 7% of the responsive cells. All these changes were correlated with the extent of damage to the ipsilateral nRT; 4) VB stimulation evoked prolonged excitatory responses lasting more than 150 ms in 13% of the responsive cells, and nRT stimulation led to a short latency response followed by a pause of activity. These findings suggest that the nRT is involved in sensory integration and modulation.

Improvement of severe postural cerebellar tremor in multiple sclerosis by chronic thalamic stimulation.

Tremor can be particularly disabling in patients with multiple sclerosis (MS) and is mildly improved by drug treatment. The efficiency of stereotactic thalamotomy has been reported in a small number of patients but was counterbalanced by severe postoperative complications. Stimulation of the thalamic ventral intermediate nucleus, which is a less aggressive surgical method, is efficient in essential and in parkinsonian tremors. We report here the results of thalamic stimulation in 13 patients with MS with tremor. All patients were subjected to clinical examination, videorecording, and quantification of the functional disability before surgery and 3 months postoperatively. The surgical intervention was well tolerated in all cases. A clear improvement of the tremor was observed in 69.2% of the patients. Functional improvement was more varied and depended on the severity of tremor and coexistence of other neurological symptoms. Of the eight most severely affected patients, seven recovered the possibility to easily catch an object and use it. The results indicate that thalamic stimulation may be useful in the treatment of severe postural cerebellar tremor in MS.

Microinfusions of excitatory amino acid antagonists into the trigeminal sensory complex antagonize the jaw opening reflex in freely moving rats.

Microinfusions of EAA antagonists (APV 0.1 microliter 25 mM, gamma-DGG 0.1 microliter 50 mM, CNQX 0.1 microliter 50 mM, ketamine 0.1 microliter 0.2 M) were performed in freely moving rats while recording the long latency jaw opening reflex (JOR) elicited by electrical stimulation of the dental pulp. NMDA and non-NMDA antagonists were applied in the trigeminal sensory complex at the termination of dental pulp afferents. The selective NMDA antagonist APV strongly reduced the amplitude of the polysynaptic JOR. gamma-DGG and ketamine, which are broader spectrum NMDA antagonists, showed similar effects with some variations in their kinetics. CNQX, an antagonist for non-NMDA receptor subtypes, failed to affect the JOR. The results suggest that long latency JOR requires activation of NMDA receptors, while the early component elicited by periodontal afferents does not. These NMDA-receptors could belong either to JOR interneurons activated by tooth pulp afferents or to digastric motoneurons, receiving the inputs through a polysynaptic pathway. Recent anatomical results favour the first hypothesis while not excluding the second.

[Treatment of tremor by stereotactic surgery]. / Traitement du tremblement par chirurgie stéréotaxique.

Thalamotomy in the ventrolateral thalamic nucleus is a common treatment of severe parkinsonian or essential tremor. Although results are often satisfactory, complications may occur and alter the success of the operation. High frequency stimulation of the target before thalamotomy leads to transitory abolition of the tremor. Therefore, a chronic stimulation device was developed and its use produced results similar to those of thalamotomy for parkinsonian tremor. Unwanted side-effect can be reduced by changing the parameters of the stimulation. Improvements in multiple sclerosis and post-traumatic tremors may be expected. We present a review of the indications and results of both technics.

[Demonstration of glutamate in primary sensory trigeminal neurons innervating dental pulp in rats]. / Mise en évidence de glutamate dans des neurones sensitifs primaires trigéminaux innervant la pulpe dentaire, chez le rat.

Primary sensory trigeminal neurons supplying the dental pulp of incisors in rats were labelled by retrograde axonal transport. Using an auto-metallographic intensification procedure, 48 hrs. after injection of wheat-germ colloidal gold in the pulp, gold particles were detected in the cytoplasm of the neurons as black granulations. Glutamate was found in 45-60% of the neurons by submitting ganglion slices to an anti-glutamate immuno-serum revealed by immunocytochemistry. Among the neurons supplying the dental pulp of incisors by their peripheral process, 70% are Glu+, 30% Glu-. These observations suggest that the population of neurons supplying the dental pulp is not functionally homogeneous and that Glu- neurons use a different neurotransmitter. The coexistence of Glu+ and Glu- neurons could also indicate that glutamate expression is modulated during the life of these neurons.

Proportion of fatigue-resistant motor units in hindlimb muscles of cat and their relation to axonal conduction velocity.

1. A study of motor units to hindlimb muscles of cat has been made, with as complete a sample as possible of the motor axons to an individual muscle. In single experiments as much as 95% of the motor supply to a muscle has been examined. 2. The following muscles have been studied: peroneus brevis, peroneus tertius, peroneus longus, plantaris, gastrocnemius medialis, soleus, tenuissimus and lumbricalis superficialis. 3. Units were identified as slow resistant (S), fast resistant (FR), fast fatigable (FF) and fast intermediate (FI). The proportion of various motor unit types differs from one muscle to another. There is also some variation in the proportions to a given muscle from one animal to another. With the exceptions of soleus, which is entirely slow resistant, and gastrocnemius, which has relatively fewer resistant units, most muscles contain 60% or more of resistant (S and FR) units. 4. The conduction velocity ranges of FF, FR and FI units overlapped. There was little overlap between the conduction velocity ranges of these F units and of S units. 5. In individual experiments there was a strong and significant positive correlation between the logarithm of maximal tetanic tension and axonal conduction velocity in S and in S+FR units. In terms of contractile response the total fatigue-resistant population appeared to be a continuum. The correlation coefficient between maximal tetanic tension and conduction velocity was also high in the totality of units of all types, although within the FF group there appeared to be little or no correlation. In pooled data there was much more scatter and these relations were less clear. This resulted largely from differences in the ranges of axonal conduction velocity for a given motor unit type from one animal to another. 6. There was a highly significant negative correlation between isometric twitch contraction time and axonal conduction velocity in individual experiments. This relationship could also be seen, but less clearly, in pooled data. 7. The possible bases for these relationships are discussed.

Afferent fibres in cat ventral roots: electrophysiological and histological evidence.

Electrophysiological experiments using averaging techniques, as well as anatomical experiments using horseradish peroxidase staining, have provided further evidence of afferent axons in lumbosacral ventral roots of cats. Recording from dorsal root filaments in L7, S1 or S2, following stimulation of the companion ventral root close to the dura, often shows action potentials of slow conduction velocity belonging to the A delta or C group. Stimulation applied to the proximal part of the ventral root failed to evoke such responses. Recording from multiple sites along a centrally cut ventral root filament shows responses of two types: action potentials of long latency to peripheral nerve stimulation which are seen at all recording locations and which are not seen following dorsal root stimulation. These appear to be afferent fibres which enter the cord via the ventral root; action potentials which follow dorsal root stimulation and which are usually seen only at the most distal ventral root recording site. Some of these were also activated by stimulation of some skin or muscle nerves. At appropriate intervals collision of impulses from dorsal root or peripheral nerve can be demonstrated. Such axons appear to have a recurrent course in the ventral root. Section of the spinal nerve at points progressively closer to the dorsal root ganglion abolishes the dorsal to ventral root continuity of most recurrent type axons at 2 mm distal to the ganglion. Following application of horseradish peroxidase to crushed ends of distal stumps of cut dorsal roots, thin fibres marked by the enzyme are observed in the distal part of companion ventral roots. U-turns of axons have been observed in the distal part of ventral roots and in the spinal nerve near the pole of the ganglion.

[Organization of the median and intralaminar nuclei of the thalamus: hypotheses on their role in the onset of certain central pain]. / Organisation des noyaux médians et intralaminaires du thalamus: hypothèses sur leur rôle dans la survenue de certaines douleurs centrales.

Afferent neurons from thalamic median and intralaminar (IL) nuclei arise in the spinal cord, brain stem synapses, substantia nigra, internal pallidum and cerebral cortex, directly and through the intermediary of the reticular nucleus of the thalamus (RT). Efferent neurons terminate in the anterior thalamic nuclei, RT, striatum and cerebral cortex. Tracking methods in the rat have demonstrated that some RT neurons which project towards the IL are surrounded by endings from the posterior ventral nucleus (VP). Electrical stimulation of multiple prosencephalic structures (mainly VP) and of sensory pathways induce responses in IL of brief latency followed by inhibition. Whereas the responses appear to be related to activation of excitatory projections (under the tonic facilitating control of cerebral cortex) the inhibition phases could be related to activation of RT, since they disappear after lesion of the RT. This nucleus could act as a common final pathway of inhibitions exerted on IL in the rat. Studies in this species have demonstrated that a lateral lesion of the thalamus that includes the RT provokes the appearance in IL of abnormal neuronal hyperactivity of a tonic nature and yet still exaggerated by stimuli normally capable of inducing responses of brief duration followed by inhibition. Human studies using a tomoscintigraphic method to determine regional blood flow have shown "hyperactivity" of the thalamic region in patients with pain of central origin during a natural stimulus provoking hyperpathia. This was not observed during painful states without hyperpathia. The working hypothesis proposed is that of a central lesion inducing a hyperpathia provoking pathologic hyperactivity in certain thalamic nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)

Impaired transport of iron-dextran complex in myelinated central fibers.

The labeling of retinal ganglion cells by axonal transport of an iron-dextran complex (injected into the superior colliculus and the lateral geniculate nucleus) was compared to the previously described labeling of the dopaminergic neurons of the substantia nigra (after striatal injection), to test the validity of the method in myelinated and unmyelinated CNS pathways. It was shown that the retrograde labeling in the visual pathway was impaired, consecutive to the penetration of iron-dextran into the myelin sheaths and a subsequent myelin alteration along the optic nerve.