New techniques in female pudendal somatosensory evoked potential testing

Objective—The primary nerves innervating the female genitalia are the dorsal nerve of the clitoris (DNC) and the perineal nerve, which innervate the clitoris and the external genitalia/distal vagina, respectively. We describe two novel electrodiagnostic techniques for evaluating the integrity of these female genital somatosensory pathways.

Subjects and methods—Seventy-seven healthy women (mean age 29.3 years) were enrolled for this study. We performed DNC somatosensory evoked potentials (SEPs), stimulating through self-adhesive disk electrodes on either side of the clitoris. Perineal nerve SEPs were evoked through a vaginal probe. Cortical responses were measured through cup electrodes affixed to the scalp at Cpz and Fpz. Stimulus parameters were duration 0.1?ms, frequency 4.1?Hz, filters 5–5,000?Hz, at three times sensory threshold.

Results—DNC and perineal nerve SEPs from both the right and left sides were reproducible and easily discerned. The mean P1 latencies were: right DNC 39.4?ms (SD 2.8?ms), left DNC 39.3?ms (SD 3.3?ms), right perineal nerve 37.8?ms (SD 3.4?ms), left perineal nerve 37.6?ms (SD 3.1?ms). We recorded SEP responses from 90 to 92% of subjects for the DNC, and 69% for the perineal nerve.

Conclusions—We are able to evoke somatosensory potentials from the four primary somatic nerves that mediate female genital cutaneous sensation. In healthy subjects, the DNC responses are robust and maintain laterality. The perineal nerve responses are less consistently obtained, but when recorded, are easily discerned. These preliminary data provide a foundation from which to study female genital innervation, particularly as it applies to sexual function.     

Schwannomas of the peroneal nerves: Clinical and functional results of surgical treatment

Objectives:Peroneal nerves Schwannomas are rare benign tumors. Literature is still poor of studies about clinical and functional outcomes after surgical treatment. We evaluated the pre-operative presentation of the disease and assessed clinical and functional outcomes after surgery.Methods:We collected all the cases of peroneal nerves’ neurinoma treated surgically between June 2016 and June 2020. We analyzed each patients’ personal data and carried out accurate clinical examinations before and after surgery. MRI was performed both pre-operatively and post-operatively.Results:We reported 9 cases of peroneal nerves schwannomas: five arising from the common peroneal nerve and four arising from the deep or superficial branches alone. Their mean size was 22.6 mm. Each patient showed sensation deficits before surgery; pre-operative MRC score was 4.2. Pre-Operative MSTS and LEFS scores were 23.6 and 64.4. Surgery was successful in each case. No local recurrence nor major complication occurred. Tumor size was significantly associated with both diagnostic delay and development of pre-operative deficits. Surgery was proven to be globally successful: post-operative evaluations highlighted a marked reduction of neurological signs and overall functional limitations.Conclusions:Surgical treatment at early stages of the disease represents a reliable and relatively safe therapeutic option.     

Substance P binding sites in the nucleus tractus solitarius of the cat

Substance P binding sites in the nucleus tractus solitarius were visualized with receptor autoradiography using Bolton-Hunter [¹²⁵I]substance P. Substance P binding sites were found to have distinct patterns within the cat nucleus tractus solitarius. The majority of substance P binding sites were present in the medial, intermediate and the peripheral rim of the parvocellular subdivisions. Lower amounts of substance P binding sites were present in the commissural, ventrolateral, interstitial and dorsolateral subdivisions. No substance P binding sites were present in the central region of the parvocellular subdivision or the solitary tract. The localization of substance P binding sites in the nucleus tractus solitarius is very similar to the patterns of substance P immunoreactive fibers previously described for this region. Results of this study add further support for a functional role of substance P in synaptic circuits of the nucleus tractus solitarius.     

The thoracic muscular system and its innervation in third instar Calliphora vicina Larvae. II. Projection patterns of the nerves associated with the pro‐ and mesothorax and the pharyngeal complex

We describe the anatomy of the nerves that project from the central nervous system (CNS) to the pro‐ and mesothoracic segments and the cephalopharyngeal skeleton (CPS) for third instar Calliphora larvae. Due to the complex branching pattern we introduce a nomenclature that labels side branches of first and second order. Two fine nerves that were not yet described are briefly introduced. One paired nerve projects to the ventral arms (VAs) of the CPS. The second, an unpaired nerve, projects to the ventral surface of the cibarial part of the esophagus (ES). Both nerves were tentatively labeled after the structures they innervate. The antennal nerve (AN) innervates the olfactory dorsal organ (DO). It contains motor pathways that project through the frontal connectives (FC) to the frontal nerve (FN) and innervate the cibarial dilator muscles (CDM) which mediate food ingestion. The maxillary nerve (MN) innervates the sensory terminal organ (TO), ventral organ (VO), and labial organ (LO) and comprises the motor pathways to the mouth hook (MH) elevator, MH depressor, and the labial retractor (LR) which opens the mouth cavity. An anastomosis of unknown function exists between the AN and MN. The prothoracic accessory nerve (PaN) innervates a dorsal protractor muscle of the CPS and sends side branches to the aorta and the bolwig organ (BO) (stemmata). In its further course, this nerve merges with the prothoracic nerve (PN). The architecture of the PN is extremely complex. It innervates a set of accessory pharyngeal muscles attached to the CPS and the body wall musculature of the prothorax. Several anastomoses exist between side branches of this nerve which were shown to contain motor pathways. The mesothoracic nerve (MeN) innervates a MH accessor and the longitudinal and transversal body wall muscles of the second segment. J. Morphol. 271:969–979, 2010. © 2010 Wiley‐Liss, Inc.     

下丘脑腹内侧核损毁对大鼠nesfatin-1/NUCB2表达的影响

目的:观察下丘脑腹内侧核(VMH)损毁对大鼠脂肪组织nesfatin-1/NUCB2表达的影响及其机制。方法:电损毁VMH,观察大鼠体重和脂肪组织变化,采用Western blot检测脂肪组织中nesfatin-1/NUCB2表达改变。腹腔注射6-羟多巴胺(50 mg/kg)以阻断交感神经;持续外周注射卡巴胆碱(180μg/kg)用以模拟VMH损毁,观察其对大鼠皮下脂肪nesfatin-1/NUCB2表达的影响。结果:与对照组和假手术组比较,VMH损毁后大鼠体重明显增加(P0.05),皮下脂肪(P0.05)和肠系膜脂肪(P0.05)也显著增多;Western blot分析结果显示,nesfatin-1/NUCB2在胰腺和肝脏中表达较多,但皮下、肠系膜脂肪和肩胛间棕色脂肪组织(i BAT)中表达较少,骨骼肌(腓肠肌)中鲜有表达;与对照组和假手术组比较,VMH损毁组大鼠nesfatin-1/NUCB2在肝脏、胰腺、骨骼肌和i BAT中表达无显著差异(P0.05),皮下脂肪(P0.05)和肠系膜脂肪(P0.05)nesfatin-1/NUCB2表达显著增多与对照组相比,6-羟多巴胺组nesfatin-1/NUCB2表达显著升高(t=3.43,P0.05),而卡巴胆碱组nesfatin-1/NUCB2表达无显著差异(t=0.37,P=0.72)。结论:VMH损毁后大鼠脂肪组织nesfatin-1/NUCB2表达改变可能通过抑制交感神经活动介导。     

Baroreflex dysfunction in rats submitted to protein restriction

Earlier studies from the authors' laboratory showed that malnourishment induces alterations in the cardiovascular homeostasis increasing the basal mean arterial pressure and heart rate. In this study, the authors evaluated whether the sympathetic and parasympathetic efferent activities contribute to changes in the cardiovascular homeostasis through altered modulation of the arterial baroreflex of malnourished rats. After weaning, male Fischer rats were given 15% (Normal Protein--NP) or 6% (Low Protein--LP) protein diet for 35 d. The baroreflex gain and latency were evaluated before and after selective autonomic blockades in control and malnourished rats. It was observed that malnourishment affected the baroreflex gain in response to activation and deactivation of the arterial baroreflex. Moreover, malnourished rats showed increased baroreflex latency as compared to that of control rats. Regarding the autonomic efferent activity directed to the heart, the data showed increased sympathetic and decreased parasympathetic efferent activities in malnourished rats, and such alterations could be related to the observed changes in the arterial baroreflex gain as well as in the basal mean arterial pressure and heart rate.     

Evolutionary origin of autonomic regulation of physiological activities in vertebrate phyla

Proper regulation of physiological activities is crucial for homeostasis in animals. Autonomic regulation of these activities is most developed in mammals, in which a part of peripheral nervous system, termed the autonomic nervous system plays the dominant role. Circulatory activity and digestive activity in vertebrates change in opposite phases to each other. The stage where circulatory activity is high and digestive activity is low is termed the "fight or flight stage" while the stage where circulatory activity is low and digestive activity is high is termed the "rest and digest stage". It has been thought that the autonomic nervous system originated in early vertebrate phyla and developed to its greatest extent in mammals. In this study, we compared the pattern of change of circulatory and digestive activities in several invertebrates and found that the two stages seen in mammals are also present in a wide variety of animals, including evolutionarily early-diverging invertebrate taxa. From this and other arguments we propose a novel possibility that the basic properties of the autonomic nervous system were established very early in metazoan evolution.     

急性力竭运动对大鼠胃肠传输速率及回肠肌间神经丛氮能神经的影响

目的：研究力竭运动对大鼠胃肠动力的影响及其肠神经机制。方法：24只大鼠随机分成对照组和急性力竭运动组,建立力竭运动大鼠模型,测定胃肠传输速率,用酶组织化学方法和计算机图像分析技术对两组大鼠回肠肌间神经丛内氮能神经元的数目和一氧化氮合酶（NOS）的表达进行测定。结果：急性力竭运动组大鼠胃肠传输速率明显延迟,回肠肌间神经丛内氮能神经元的数目明显增多和NOS的表达显著增强（P〈0．05和P〈0．01）。结论：大鼠力竭运动后小肠肌问神经丛内氮能神经元的数目增多和NOS的表达增强可能是导致胃肠传输速率延迟的重要原因之一。     

Review of spino-occipital and spinal nerves in Tetraodontiformes,with special reference to pectoral and pelvic fin muscle innervation

The spino-occipital nerve (SO) and ventral rami of the spinal nerves (SV) in 10 tetraodontiform families and 5 outgroup taxa were examined, with special reference to pectoral and pelvic fin muscle innervation. Compared with the outgroup taxa, tetraodontiforms were characteristic in having SO3 + SV1 (SO3 in tetraodontids) that gave off several lateral subbranches to the pectoral fin base and SO participation in infracarinalis anterior innervation. SO and SV1 were connected with one another (6 patterns) before entering the pectoral fin muscles in most species, including the outgroup taxa, resulting in the participation of SV1 in the innervation of almost all of the pectoral fin muscles. SO3 + SV1 was present in all tetraodontiforms (except in 2 tetraodontids having only SO3) and the outgroup taxa, an upper dorsal branch uniformly extending dorsally into the pectoral fin base. The pectoral fin base also received a branch ventrally, but its identity differed (participation or nonparticipation of SV2). SV1 alone constituting the branch was a derived condition occurring in Aracanidae, Ostraciidae, Tetraodontidae, Diodontidae, and Molidae. No strong characters supporting a tetraodontiform sister group were recognized among the spino-occipital nerve and ventral rami of spinal nerves.     

Heart rate variability as a marker of cardiovascular dysautonomia in post-COVID-19 syndrome using artificial intelligence

IntroductionCardiovascular dysautonomia comprising postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (OH) is one of the presentations in COVID-19 recovered subjects. We aim to determine the prevalence of cardiovascular dysautonomia in post COVID-19 patients and to evaluate an Artificial Intelligence (AI) model to identify time domain heart rate variability (HRV) measures most suitable for short term ECG in these subjects.MethodsThis observational study enrolled 92 recently COVID-19 recovered subjects who underwent measurement of heart rate and blood pressure response to standing up from supine position and a 12-lead ECG recording for 60 s period during supine paced breathing. Using feature extraction, ECG features including those of HRV (RMSSD and SDNN) were obtained. An AI model was constructed with ShAP AI interpretability to determine time domain HRV features representing post COVID-19 recovered state. In addition, 120 healthy volunteers were enrolled as controls.ResultsCardiovascular dysautonomia was present in 15.21% (OH:13.04%; POTS:2.17%). Patients with OH had significantly lower HRV and higher inflammatory markers. HRV (RMSSD) was significantly lower in post COVID-19 patients compared to healthy controls (13.9 ± 11.8 ms vs 19.9 ± 19.5 ms; P = 0.01) with inverse correlation between HRV and inflammatory markers. Multiple perceptron was best performing AI model with HRV(RMSSD) being the top time domain HRV feature distinguishing between COVID-19 recovered patients and healthy controls.ConclusionPresent study showed that cardiovascular dysautonomia is common in COVID-19 recovered subjects with a significantly lower HRV compared to healthy controls. The AI model was able to distinguish between COVID-19 recovered patients and healthy controls.