Left ventricular non compaction: epidemiology, clinical findings, diagnosis and therapy.

Left ventricular non compaction (LVNC) is a cardiomyopathy due to an arrest of the normal development of myocardium which determines the persistence of fetal myocardium in postnatal life in at least 2/3 of the wall (criterion known as non compacted/ compacted ratio greater than 2). Although in absence of a confirmed prevalence of LVNC, reviewing literature shows an increasing number of reports over the years, though diagnosed cases represent just the tip of a realistically far wider phenomenon. Clinical manifestations are variable, ranging from the absence of any symptom to congestive heart failure, arrhythmias and systemic thromboembolism. Echocardiography is the gold standard for the diagnosis. Tissue Doppler and three-dimensional echocardiography may give further information in the evaluation of patients affected by LVNC. Magnetic resonance could refine diagnosis particularly in those patients with not conclusive echocardiogram: it may help in differential diagnosis and give prognostic information. There is no specific therapy for patients with LVNC but the treatment is aimed at treating heart failure, or other complications such as arrhythmias and thromboembolic events.

Striatonigral suppression of focal hippocampal epilepsy.

Both caudate nucleus (CN) and substantia nigra (SN) appear to be involved in the control of epileptogenic events. Previous investigations had demonstrated that both CN and SN stimulations are able to induce hippocampal theta (theta) rhythm and an inhibition of epileptiform spikes. Since the two structures are reciprocally linked by fibre pathways, experiments were carried out to test the possibility that CN influences the hippocampus via SN or vice versa. To this end, changes in penicillin-induced hippocampal spikes by CN or SN stimulation were studied before and after destruction of SN and CN respectively. Steady interictal activity was induced in the hippocampus of encéphale isolé cats by local injection of penicillin. Stimulations of both CN and SN induced statistically significant reduction of hippocampal spike frequency, and in some cases a clear and regular theta-rhythm. These effects were unchanged by the destruction of either CN or SN. The results add further information to the role played by the basal ganglia and SN in the control of epilepsy, and underline the possibility that caudate and nigral influences on the hippocampus are mediated by different pathways.

A study of caudate inhibition on an epileptic focus in the cat hippocampus.

The mechanisms whereby the caudate nucleus modifies hippocampal spiking activity have been studied. Epileptiform activity was induced in the cat hippocampus by topical application of sodium penicillin in different concentrations. The frequency of induced spikes appeared to be directly correlated to the two doses of epileptogenic agent. The inhibitory effect of 10 Hz caudate stimulation on spike frequency was present even when stimulation lasted for 180 s. Likewise 25 Hz caudate stimulation brought about an inhibition which was maintained by stimulus trains lasting up to 90 s, while the degree of inhibition was reduced by trains of longer duration (120, 150 and 180 s); similar results were also noted in some atropine-treated cats. The time course of spikes in cats with electrolytic lesions of the caudate exhibited an increase in both frequency and duration. The results indicate that there is an optimal parameter for caudate stimulation causing inhibition of penicillin-induced hippocampal spiking activity, and suggest the possibility of tonic control of hippocampal excitability exerted by the caudate nucleus.

Pigeon oesophageal EMG activity: analysis of intramural neural control.

The effects of agonist and antagonist cholinergic and adrenergic drugs on spontaneous electrical activity of transverse muscular strips of pigeon cervical oesophagus were examined. Tetrodotoxin failed to affect EMG activity. Cholinomimetics produced excitatory effects. The response to carbachol was enhanced by hexamethonium and reversed into an inhibitory effect by atropine. Noradrenaline evoked a concentration-dependent, biphasic effect (inhibition at low and excitation at high concentrations). Isoproterenol induced inhibitory response unaffected by tetrodotoxin. Phenylephrine induced excitatory response completely antagonized by tetrodotoxin and partially opposed by atropine. It is concluded that: i) the oesophageal spontaneous EMG activity is myogenic; ii) the intramural neurons have no tonic influence on the spontaneous EMG activity; iii) in the intramural plexuses there are cholinergic excitatory-, non-cholinergic excitatory- and inhibitory neurons, with unknown neurotransmitter; iv) excitatory alpha-adrenoceptors, located on the nervous elements and inhibitory beta-adrenoceptors, located on the smooth-muscle cells, are present.

Study of spindle-spike interactions: features of basal ganglia control.

Changes in cortical spindle distribution following penicillin (PCN) injections were studied in feline generalized PCN epilepsy. PCN activation caused no substantial changes in spindle duration, frequency and intraburst frequency, while significant reductions in the amplitude of the negative waves were noted. At the same time combinations of spindle waves and epileptic complexes were recorded with one or more spikes randomly occurring at the beginning, in the middle, or at the end of a spindle envelope. Low frequency stimulation of the caudate nucleus induced a certain degree of enhancement in cortical precruciate spike frequency while high frequency activation of the entopeduncular nucleus caused significant inhibition of cortical spike frequency. The results are discussed in the light of the reciprocal interrelationship between spindles and spikes. Furthermore, the role played by the caudate and the entopeduncular nucleus in the control of the cortico-thalamo-cortical circuit is also emphasized.

Hippocampal seizures and striatal regulation: a possible functional pathway.

Experimental findings have suggested the possibility of a functional relationship between the basal ganglia and the hippocampus. Previous research has revealed a predominantly inhibitory action of the caudate nucleus (CN) and an excitatory effect of the globus pallidus (GP) on electrically induced hippocampal afterdischarges (HAD). The effects of electrolytic destruction of the CN on the threshold and duration of HAD has been studied in the 'encéphale isolé' cat. The threshold and duration of HAD was also studied following conditioning stimulation of the CN in animals in which the inner segment of the globus pallidus (GPi) and medial septal nucleus (MSN) had been destroyed. Following CN lesions, the hippocampal excitability threshold underwent a significant reduction, while the duration of HAD appeared to be increased. Following destruction of the GPi and MSN, the threshold and duration of HAD exhibited no change following conditioning stimulation of the CN. The results reveal a tonic inhibitory effect of the CN on the hippocampus and suggest that a strio-pallido-septal pathway is the anatomical substrate for the effect.

Relations between basal ganglia and hippocampus: action of substantia nigra and pallidum.

Several interrelationships exist between basal ganglia and hippocampus. The ventral striatum appears to be involved in the control of the dopaminergic nigro-striatal pathway. The caudate, in turn, seems to influence the hippocampal theta rhythm and to inhibit hippocampal spikes. In the present work the role played by globus pallidus pars interna and substantia nigra pars compacta on hippocampal bioelectrical activity is studied. Injection of sodium penicillin i.v. produces steady interictal spikes in the hippocampus. Substantia nigra stimulation induces regular theta rhythm and inhibits the spikes. Pallidal stimulation, on the contrary, appears to strongly enhance epileptiform activity, proceeding to generalised seizure activity. The results are discussed in the light of a putative feedback loop from basal ganglia to hippocampus, probably underlying co-participation of the two subcortical structures in the control of motor behaviour.

Modulation of paroxysmal activity in the hippocampus by caudate stimulation in the chronic cat.

Afterdischarges in the dorsal hippocampus (HADs) were studied in freely-moving cats with implanted electrodes following threshold stimulation of the mirror-image point on the contralateral side. Marked inhibition, similar so that seen in acute animals, was observed when the test stimulation was immediately preceded by a conditioning stimulus applied to the caudate nucleus. The inhibitory effect appeared to be larger in these chronic animals than in the acute preparations previously studied, probably because of the total absence of anaesthesia during the recording session. When the HAD is preceded by caudate stimulation, its duration can be graduated by the intensity of the hippocampal test stimulation. The results are discussed in terms of a possible modulation induced directly or indirectly by the caudate nucleus in the hippocampus, which reacts in a gradual manner to the excitatory volley.

Effects of caudate nucleus on paroxysmal activity in hippocampus of cat.

Electrically induced afterdischarges (ADs) were evoked in cat's dorsal hippocampus. The effect of the conditioning prestimulation of the caudate head on AD duration was tested. A strong inhibitory action was observed when conditioning caudate stimulation immediately preceded hippocampal test stimulation. An increase in threshold values following caudate stimulation was also noted. The time course of the inhibitory phenomenon showed a decrease of the caudate conditioning effect when the interval between the two stimuli increased: complete disappearance of such effect was found to occur at about 600 msec. When caudate head stimulation followed the onset of hippocampal AD, this was inhibited only during caudate stimulation while presenting facilitation after caudate stimulation terminated. The results are discussed in terms of a possible explanation of the contrasting action of the pallidum, while previous findings attesting the facilitatory role of these structures are considered, as are the effects of caudate stimulation on hippocampal AD.

[Effect of the globus pallidus on hippocampal epilepsy in the cat]. / L'azione del globo pallido sull'epilessia ippocampale nel gatto.

The action of the pallidum on electrically induced afterdischarge of the hippocampus (HAD) was studied. Significant facilitatory influences on HAD duration were observed when pallidal conditional stimulation immediately preceded hippocampal test stimulation. The phenomenon appeared to be into correlation with the interval between conditioning and test stimulation. Experimental data are discussed as strongly presumptive of a functional interrelationship between the inhibitory role played by the caudate on both pallidum and hippocampus; facilitatory influence of the pallidum on HAD duration is discussed too.

[Contrasting effects of stimulation of the caudate nucleus and globus pallidus on paroxysmal hippocampal activity in the cat]. / Effetti contrastanti della stimolazione del nucleo caudato e del globo pallido sull'attivita' parossistica ippocampale nel gatto.

The different actions exerted by pallidum and caudate nucleus on electrically induced epileptic activity of hippocampus were analyzed. Caudate appeared to inhibit hippocampal after discharges duration (HAD) while the globus pallidus exerted a facilitatory effect on HAD duration. Both effects were maximal when conditioning stimulation immediately preceded hippocampal test stimulation. The results are discussed considering reciprocal functional connections of the two striatal structures.

Role of glossopharyngeal nerve on the control of pigeon cervical esophagus motility.

The effects of i) glossopharyngeal section on the occurrence of the primary peristalsis and ii) electrical efferent stimulation of glossopharyngeal nerve on the EMG activity were studied in the pigeon cervical esophagus. The results pointed out that glossopharyngeal nerve is an indispensable requirement for the primary peristalsis occurrence and that motor sequence is centrally programmed.

Interrelations between globus pallidus and hippocampal epilepsy in the cat.

Electrically induced afterdischarge (ADs) were evoked in the cats' dorsal hippocampus. The action of the conditioning prestimulation of the pallidus nucleus on AD duration was studied. A significant facilitatory influence was observed when pallidal conditioning stimulation immediately preceded hippocampal test stimulation. The time course of the phenomenon showed a decrease of the conditioning action when the interval between the two stimulations increased : complete disappearance of the effect occurred after about 800 ms. Results are discussed as far as functional relationships between basal ganglia and rhinencephalic system are concerned.