Acute reductions in blood flow restricted to the dorsomedial medulla induce a pressor response in rats.

OBJECTIVES: The brainstem nucleus of the solitary tract (nucleus tractus solitarii, NTS) is a pivotal region for regulating the set-point of arterial pressure, the mechanisms of which are not fully understood. Based on evidence that the NTS exhibits O2-sensing mechanisms, we examined whether a localized disturbance of blood supply, resulting in hypoxia in the NTS, would lead to an acute increase in arterial pressure. METHODS: Male Wistar rats were used. Cardiovascular parameters were measured before and after specific branches of superficial dorsal medullary veins were occluded; we assumed these were drainage vessels from the NTS and would produce stagnant hypoxia. Hypoxyprobe-1, a marker for detecting cellular hypoxia in the post-mortem tissue, was used to reveal whether vessel occlusion induced hypoxia within the NTS. RESULTS: Following vessel occlusion, blood flow in the dorsal surface of the medulla oblongata including the NTS region showed an approximately 60% decrease and was associated with hypoxia in neurons located predominantly in the caudal part of the NTS as revealed using hypoxyprobe-1. Arterial pressure increased and this response was pronounced significantly in both magnitude and duration when baroreceptor reflex afferents were sectioned. CONCLUSION: These results suggest that localized hypoxia in the NTS increases arterial pressure. We suggest this represents a protective mechanism whereby the elevated systemic pressure is a compensatory mechanism to enhance cerebral perfusion. Whether this physiological mechanism has any relevance to neurogenic hypertension is discussed.

Anatomical basis of hypoxic and hyperoxic injuries to the centres of cardiorespiratory regulation.

The aim of the present paper is to briefly review the changes occurring in the nucleus tractus solitarii and carotid body in response to hypoxic and hyperoxic injuries. Selective alterations of dendrites and Fos-immunoreactivity of neurons have been observed in the subnucleus gelatinosus of the nucleus tractus solitarii of adult subjects dying after hypoxic-ischaemic injury. The selective vulnerability of this portion of the nucleus tractus solitarii may be explained mainly with reference to the vascularization of medullary tegmentum. In the carotid body, chronic hypoxia and hyperoxia cause a series of morphological, cellular and biochemical changes which may play a major role during the first postnatal period and may have implications in the pathogenesis of Sudden Infant Death Syndrome. Intermittent hypoxia may cause hypersensitivity of the carotid body, possibly increasing the risk of unstable respiration. Conversely, hyperoxia exposure has been reported to cause hyposensitivity and reduction in volume of the carotid body, possibly leading to ineffective response.

Microvascular changes in estrogen-α sensitive brainstem structures of aging female hamsters.

Structural neuronal plasticity is present in the nucleus para-retroambiguus (NPRA) and the commissural nucleus of the solitary tract/A2 group (NTScom/A2) in female hamsters. Both brainstem nuclei play a role in estrous cycle related autonomic adaptations. We investigated how aging affects the capillary condition in these adaptive brainstem regions. Senescent female hamsters (+/-95 weeks) were tested weekly for their 4-day estrous cycle. Subsequently morphological changes of NPRA and NTScom/A2 were compared with those of young (+/-20 weeks) females in an ultrastructural study. The medial tegmental field served as control area. In 841 capillaries (n=319 capillaries, young females (N=3); n=522 capillaries, aged females (N=4)) vascular aberrations were classified into 3 categories: endothelial and tight junction, basement membrane and pericyte aberrations. In old animals, capillaries showed marked endothelial changes, disrupted tight junctions, and thickening and splitting of basement membranes. Aberrations were found in 40-60% of all capillaries. About 70% of the pericytes contained degenerative inclusions. Despite this generalized vascular degeneration, the reproductive cycle of female hamsters was unaffected by vascular senescence. Perivascular fibrosis as reported in aging rats was never observed, which suggests the existence of species differences.

Microvascular patterns in human medullary tegmentum at the level of the area postrema.

Abstract The aim of the present study was to evaluate the regional differences in microvessel density (MVD) of the human medullary tegmentum in adults and newborns/infants. Transverse serial sections of formalin-fixed, paraffin-embedded brainstems, taken from 16 adult and eight newborn/infant subjects, were stained with anti-von Willebrand factor (vWF) polyclonal antibodies. The boundaries of the area postrema (AP), dorsal motor vagal nucleus (DMVN), solitary tract nucleus (STN), solitary tract (ST) and hypoglossal nucleus (XII) were defined, all vessels were counted and the values were divided by the areas. In adult cases, statistically significant heterogeneity in MVD was found among the nuclei studied (P < 0.001). DMVN and AP showed higher MVD with respect to XII and ST (P < 0.001). The MVD of STN was lower with respect to DMVN (P < 0.001) and higher with respect to XII and ST (P < 0.05). The MVD and capillary density of the AP of newborns/infants were not significantly different with respect to adults. In sections of the medulla of adult subjects stained with anti-vWF, all vessels showed an intense reaction of endothelial cells whereas in the DMVN, XII, STN and ST of newborns/infants, only rare, isolated vessels showed anti-vWF reactivity and in the AP, 41 +/- 21% of vessels expressed vWF. Differences in MVD among the nuclei may be related to their different functions and metabolic demands. Light and heterogeneous expression of vWF in endothelial cells of newborns/infants indicates that differentiation of microvasculature in the human medullary tegmentum extends beyond fetal stages.

Direct projections from the cardiovascular nucleus tractus solitarii to pontine preganglionic parasympathetic neurons: a link to cerebrovascular regulation.

Peripheral or central interruption of the baroreflex or the parasympathetic innervation of cerebral vessels leads to similar changes in regulation of cerebral blood flow. Therefore, we sought to test the hypothesis that the cardiovascular nucleus tractus solitarii, the site of termination of arterial baroreceptor nerves, projects to pontine preganglionic neurons whose stimulation elicits cerebral vasodilatation. The current study utilized both light and electron microscopic techniques to analyze anterograde tracing from the cardiovascular nucleus tractus solitarii to preganglionic parasympathetic neurons in the pons. We further used retrograde tracing from that same pontine region to the cardiovascular nucleus tractus solitarii and evaluated the confluence of tracing from the cardiovascular nucleus tractus solitarii to pontine preganglionic neurons labeled retrogradely from the pterygopalatine ganglia. The cardiovascular nucleus tractus solitarii projected to pontine preganglionic parasympathetic neurons, but more rostral and caudal regions of nucleus tractus solitarii did not. In contrast, all three regions of nucleus tractus solitarii projected to the nucleus ambiguus and dorsal motor nucleus of the vagus. Although not projecting to pontine preganglionic parasympathetic neurons, regions lateral, rostral, and caudal to cardiovascular nucleus tractus solitarii sent projections through the pons medial to the preganglionics. The study establishes the presence of a direct monosynaptic pathway from neurons in the cardiovascular nucleus tractus solitarii to pontine preganglionic parasympathetic neurons that project to the pterygopalatine ganglia, the source of nitroxidergic vasodilatory innervation of cerebral blood vessels. It provides evidence that activation of those preganglionic neurons can cause cerebral vasodilatation and increased cerebral blood flow. Finally, it demonstrates differential innervation of medullary and pontine preganglionic parasympathetic neurons by different regions of the nucleus tractus solitarii.

Volume expansion fails to normally activate neural pathways in the brain of conscious rabbits with heart failure.

Immunohistochemical detection of the protein, Fos, was used to identify neurons in the brain activated following a volume load in conscious rabbits with doxorubicin-induced congestive cardiomyopathy. The plasma expander, Haemaccel, was infused intravenously into rabbits for 60 min and significantly increased right atrial pressure, blood pressure and heart rate. The rabbits were perfusion fixed 90 min after the start of the infusion and the distribution of Fos-positive cell nuclei was examined. Compared to control rabbits with heart failure, there was a small significant increase in the number of Fos-positive cell nuclei in the organum vasculosum of the lamina terminalis following volume expansion. In other regions of the brain that were studied in detail, there were no significant increases in Fos production. These included the parvocellular paraventricular nucleus (PVN) of the hypothalamus, the midbrain periaqueductal gray, the nucleus tractus solitarius (NTS), area postrema and the ventrolateral medulla (VLM). In the supraoptic nucleus and the magnocellular PVN, no Fos-positive cell nuclei were present as expected. The median preoptic nucleus, the bed nucleus of the striae terminalis and the diagonal band of Broca contained some Fos but there was no marked difference between volume expanded and control animals. In the anterior cortical and medial subnuclei of the amygdala there was a high concentration of Fos but there was no consistent difference between the two groups. The present findings in heart failure rabbits suggest that most brain regions are not activated sufficiently by the stimulus to elicit Fos expression. The results are in accord with findings showing that sympathetic reflexes initiated by volume expansion are attenuated in heart failure.

Cerebrocortical and medullary blood flow changes after general opiate receptor blockade during hemorrhagic shock in cats.

The effect of centrally induced opiate receptor blockade on regional cerebral blood flow (rCBF) was studied in anesthetized, ventilated cats during the course of hemorrhagic shock. The blood flow of the medulla and the parietal cortex was measured with the H2-gas clearance technique. Hemorrhagic shock was produced by lowering the systemic mean arterial pressure to 60 mmHg for 120 min by blood withdrawal. Central opiate receptor blockade was induced by 10 micrograms/kg intracerebroventricularly (i.c.v.) injected naloxone at the 60th min of the bleeding period. Cortical blood flow showed no improvement after i.c.v. naloxone administration. Medullary blood flow, however, increased significantly and approached the pre-bleeding control flow values following central opiate receptor blockade. The results indicate involvement of endogenous opioid mechanisms in the regulation of rCBF during hemorrhage and may provide an explanation for the previously described beneficial effects of naloxone in hemorrhagic shock.

Vagal nuclei in the medulla oblongata: structure and activity are maintained in aged rats.

The neurones and microvessels of the dorsal motor nucleus of the vagus (DMN), the nucleus ambiguus (NA) and the nucleus tractus solitarius (NTS) of 4, 24 and 30 month male Wistar rats have been examined morphometrically and by quantitative enzyme histochemical methods (4 and 24 months only) to assess the affects of old age on the structure and activity of their neurones. DMN and NTS neuronal soma area increased whilst NA neuronal area was reduced in the aged groups; the changes in neuronal size were reflected in the density of neurones per unit area. The mean diameter and percentage area occupied by microvessels was unchanged with increased age in all three nuclei. Quantitative assessment of cytochrome oxidase and NADH-tetrazolium reductase activities in the nuclei revealed no changes in old age, indicating that old age does not affect neuronal or metabolic activity of central vagal neurones. These results compliment previous age-related studies on the vagus nerve and nodose ganglion in which little change has been reported, suggesting that the vagal system is well preserved in aged rats.

Ascending pathways from the nucleus of the solitary tract to the subfornical organ in the rat.

Electrical stimulation of the nucleus of the solitary tract (NTS) produced orthodromic excitation (n = 28, 15%) and inhibition (n = 6, 4%) of the activity of neurons in the subfornical organ (SFO) in male rats under urethane anesthesia. Almost all (n = 26) of the excitatory responses (n = 28) were blocked by microiontophoretically applied phentolamine, an alpha-adrenergic antagonist, but not by timolol, a beta-adrenergic antagonist. In contrast, the inhibitory response of all the neurons (n = 6) tested was not affected by either phentolamine or timolol. Approximately two-third (n = 19) of SFO neurons that demonstrated the excitatory response to NTS stimulation exhibited an increase in neuronal activity in response to hemorrhage (10 ml/kg b.w.t.). Hemorrhage did not cause any change in the activity of all the neurons that demonstrated the inhibitory response to NTS stimulation. These results suggest that the excitatory pathways from the NTS to the SFO may transmit the peripheral baroreceptor information through alpha-adrenoreceptor mechanisms.

Cerebral blood flow decreases following microinjection of sodium nitroprusside into the nucleus tractus solitarii of anesthetized rats.

The present study was undertaken to examine the effects of microinjection of sodium nitroprusside (SNP), which releases nitric oxide (NO) spontaneously, into the nucleus tractus solitarii (NTS) on cerebral circulation. Cerebral blood flow (CBF) was measured in urethane-anesthetized (1.5 g middle dotkg-1, i.p.), paralysed and artificially ventilated rats using labeled microspheres or laser Doppler flowmetry. The CBF was significantly decreased by microinjection of SNP (5 nmol, n=10, microsphere technique; 0.5 nmol, n=6, laser Doppler flowmetry) into the unilateral NTS. Microinjection of NG-monomethyl-L-arginine (L-NMMA), an inhibitor of the formation of NO, prevented cerebral vasoconstrictor responses induced by microinjection of L-glutamate into the NTS (n=10). Microinjection of NG-monomethyl-D-arginine (D-NMMA) had no effect on the cerebral vasoconstrictor responses induced by L-glutamate (n=11). Unilateral microinjections of L-NMMA into the NTS (n=9), of SNP into the area adjacent to the NTS (n=9), of vehicle solution into the NTS (n=10), and of light-inactivated SNP into the NTS (n=6) had no effect on cerebral circulation. Cerebral autoregulation was well maintained in our protocols (n=9). These results indicate that microinjection of SNP, an NO donor, into the NTS decreases CBF.

Baroreflex failure in a patient with central nervous system lesions involving the nucleus tractus solitarii.

Animal studies have shown the importance of the nucleus tractus solitarii, a collection of neurons in the brain stem, in the acute regulation of blood pressure. Impulses arising from the carotid and aortic baroreceptors converge in this center, where the first synapse of the baroreflex is located. Stimulation of the nucleus tractus solitarii provides an inhibitory signal to other brain stem structures, particularly the rostral ventrolateral medulla, resulting in a reduction in sympathetic outflow and a decrease in blood pressure. Conversely, experimental lesions of the nucleus tractus solitarii lead to loss of baroreflex control of blood pressure, sympathetic activation, and severe hypertension in animals. In humans, baroreflex failure due to deafferentation of baroreceptors has been previously reported and is characterized by episodes of severe hypertension and tachycardia. We present a patient with an undetermined process of the central nervous system characterized pathologically by ubiquitous infarctions that were particularly prominent in the nucleus tractus solitarii bilaterally but spared the rostral ventrolateral medulla. Absence of a functioning baroreflex was evidenced by the lack of reflex tachycardia to the hypotensive effects of sodium nitroprusside, exaggerated pressor responses to handgrip and cold pressor test, and exaggerated depressor responses to meals and centrally acting alpha 2-agonists. This clinicopathological correlate suggests that the patient's baroreflex failure can be explained by the unique combination of the destruction of sympathetic inhibitory centers (ie, the nucleus tractus solitarii) and preservation of centers that exert a positive modulation on sympathetic tone (ie, the rostral ventrolateral medulla).