The reading requirements for Module 6: Reflexogenic systems of Human Kind by Professor Frederick Robert Carrick are taken from PRINCIPLES OF NEURAL SCIENCE, THIRD EDITION, KANDEL, SCHWARTZ AND JESSELL

Chapter 37: Muscle Receptors and Spinal Reflexes: The Stretch Reflex, Pgs 564-580

Chapter 38: Spinal Mechanisms of Motor Coordination: Pgs 581-594

Chapter 39: Posture: Pgs 596-605

 

The following references were used by Prof Frederick Carrick in his lecture on the Reflex system of Human Kind, module 6 of the Diplomate Program in Neurology.

 

Bibliography

 

1. Abbruzzese, M.; Rubino, V.; Schieppati, M. Task-dependent effects

evoked by foot muscle afferents on leg muscle activity in

humans. Electroencephalogr-Clin-Neurophysiol. 1996 Aug;

101(4): 339-48; ISSN: 0013-4694.

IRELAND. The effect of low intensity electrical stimulation of

the posterior tibial nerve (PTN) at the ankle on the active

triceps surae (TS) muscles was studied in normal subjects,

both in a prone position and while standing. PTN stimulation

regularly evoked the H-reflex in the flexor digitorum brevis

and, in the prone position, a short-latency facilitatory effect

in the soleus muscle. During standing, the facilitatory effect

was preceded by a clear-cut reduction in electromyograph

(EMG) activity. The inhibition-facilitation sequence was

evoked in the gastrocnemii under both conditions, on average,

though individual differences were present. An EMG modulation

similar to that observed under standing conditions was

present also in the prone position when subjects pressed the

sole of the foot against the wall. Stimulation of sural or

digital nerves did not evoke similar effects. It is concluded

that foot muscle afferents establish oligosynaptic connections

transmitting mixed effects to the TS motoneuronal pool, and

that contact with the sole of the foot plays an enabling role

for the inhibitory pathway directed to the soleus muscle.

2. Adnet, F.; Baud, F. Relation between Glasgow Coma Scale and

aspiration pneumonia [letter]. Lancet. 1996 Jul 13; 348(9020):

123-4; ISSN: 0140-6736.

ENGLAND.

3. Anand, P.; Terenghi, G.; Warner, G.; Kopelman, P.; Williams

Chestnut, R. E.; Sinicropi, D. V. The role of endogenous nerve

growth factor in human diabetic neuropathy. Nat-Med. 1996

Jun; 2(6): 703-7; ISSN: 1078-8956.

UNITED-STATES. Nerve growth factor (NGF) is trophic to

sensory and sympathetic fibers. In animal models, NGF is

depleted in diabetic nerves and NGF deprivation produces

hypoalgesia. Exogenous NGF can reverse some of the

pathological changes in diabetic nerves and NGF excess leads

to hyperalgesia. We have quantified sensory and autonomic

function in early diabetic polyneuropathy and correlated

changes with levels of NGF and neuropeptides in affected skin.

We describe an early length-dependent dysfunction of sensory

small-diameter fibers, prior to dysfunction of sympathetic

fibers, with depletion of skin NGF and the sensory

neuropeptide substance P. We describe a significant

correlation between NGF depletion and decreased skin axon-

reflex vasodilation, mediated by small sensory fibers partly

via substance P release. Immunostaining shows depletion of

NGF in keratinocytes in diabetic skin. We propose that a

decrease in endogenous skin-derived NGF influences the

presentation of diabetic polyneuropathy, although metabolic or

vascular abnormalities may be the cause of the neuropathy. As

loss of nociception and axon-reflex vasodilation contribute to

diabetic foot ulceration, early and prolonged NGF treatment at

an appropriate dose may provide rational prophylaxis for this

condition.. 0; 33507-63-0.

4. Anastasopoulos, D.; Lempert, T.; Gianna, C.; Gresty, M. A.;

Bronstein, A. M. Horizontal otolith-ocular responses to lateral

translation in benign paroxysmal positional vertigo. Acta-

Otolaryngol-Stockh. 1997 Jul; 117(4): 468-71; ISSN: 0001-

6489.

NORWAY. Benign paroxysmal positional vertigo (BPPV) is

assumed to result from utricular damage, but it is

controversial if patients have manifest utricular dysfunction.

Therefore, we investigated linear vestibulo-ocular reflexes

(LVORs) during lateral whole-body translation in 14 patients

with unilateral BPPV. Patients were subjected to linear

acceleration steps of 0.24 g along the interaural axis, which

were applied randomly to the left and right, both in the dark

and in the light with a visual target at a distance of 60 cm.

The LVOR was measured by EOG from the slow phase velocity

of the averaged and desaccaded compensatory eye movement.

In normal cases, maximum asymmetry of LVOR velocity was

13% in the dark and 10% in the light. In patients, LVOR

velocities were normal in the dark but mildly reduced in the

light (p < 0.05). Five patients had mild LVOR asymmetries in

the dark (range 18-38%) and two in the light (11 and 13%), but

there was no consistent relationship to the affected side. The

absence of gross changes of the LVOR may be explained either

by minor utricular damage that is functionally irrelevant or by

central compensation of a chronic unilateral deficit.

5. Anderson, C. J. Lid speculum for surgery without lid block [letter].

J-Cataract-Refract-Surg. 1996 Jan; 22(1): 4-5; ISSN: 0886-

3350.

UNITED-STATES.

6. Aramideh, M.; Kwa, I. H.; Brans, J. W.; Speelman, J. D.; Verbeeten, B.

Jr. Apraxia of eyelid closure accompanied by denial of eye

opening. Mov-Disord. 1997 Nov; 12(6): 1105-8; ISSN: 0885-

3185.

UNITED-STATES.

7. Ardic, F. N.; Topaloglu, I.; Oncel, S.; Ardic, F.; Uguz, M. Z. Does the

stapes reflex remain the same after Bell's palsy? Am-J-Otol.

1997 Nov; 18(6): 761-5; ISSN: 0192-9763.

UNITED-STATES. OBJECTIVE: The authors investigated the

integrity and function of nervus stapedius 1 year after facial

paralysis. STUDY DESIGN: Patients with Bell's palsy were

observed prospectively for 1 year and compared with healthy

patients. SETTING: The follow-up of patients was done in the

outpatient clinic and tests were applied in the audiology unit.

PATIENTS: The mean age of 32 patients was 41.03 years. Eight

of 32 patients were grade II (25%), 11 were grade III (35%),

and 13 were grade IV (40%) according to House-Brackman

grading system. The mean age of the control group (10 persons)

was 36.5 years. INTERVENTION: Contralateral stimulus was

used in acoustic reflex test at 500 and 1,000 Hz with 80-, 90-

, 100-, and 110-dB stimulus intensity. Tests were applied in

three ways: normal position, eye-closed position, and grin

position. Tests were done in the first 15 days of facial

paralysis and repeated at least 1 year thereafter. The

millimeter difference in amplitude of impedance recording of

middle ear between the normal ear and paralyzed ear was

accepted as criterion. MAIN OUTCOME MEASURES: There were 6-

to 9-mm amplitude differences between normal side and

healed side of grade IV patients with 100- and 110-dB stimuli.

RESULTS: In the second test (after 1 year), statistically

significant differences were present between control group

and grade IV patients on 1,000 and 500 Hz frequencies with

100- and 110-dB stimulus intensity (p < 0.05). There were no

significant differences between grade II and control group and

between grade III and control group. CONCLUSIONS: A

permanent partial denervation is present on the stapedial

nerve, especially after grade IV paralysis, and it affects the

function of stapes muscle in high decibel sounds. But it does

not affect the stapes reflex threshold. No synkinetic

innervation was found in the authors' patient group with their

test method.

8. Averill, D. B.; Matsumura, K.; Ganten, D.; Ferrario, C. M. Role of

area postrema in transgene hypertension. Hypertension. 1996

Mar; 27(3 Pt 2): 591-7; ISSN: 0194-911X.

UNITED-STATES. Transgenic [Tg(+)] rats carrying the mouse

Ren-2d gene [(mRen-2d)27] are a newly established

monogenetic form of experimental hypertension. To determine

whether the area postrema contributes to the development of

hypertension in mRen-2 Tg(+) rats, this circumventricular

organ in the fourth ventricle was removed from 5-week-old

Tg(+) rats. From weeks 4 through 9, systolic blood pressure

was measured weekly by tail-cuff plethysmography in area

postrema-lesioned and sham-lesioned Tg(+) rats. Although

systolic blood pressure rose markedly in sham-lesioned Tg(+)

rats, the increase in systolic blood pressure was significantly

attenuated in area postrema-lesioned Tg(+) rats. At 9 weeks of

age, a femoral artery was cannulated for the measurement of

arterial pressure in awake rats. Mean arterial pressure (MAP)

in area postrema-lesioned Tg(+) rats was significantly (P <

.01) lower than that in sham-lesioned rats: 171 +/- 7 and

132.+/- 5 mm Hg, respectively. Baroreceptor reflex was

evaluated by intravenous infusion of sodium nitroprusside.

There was no significant difference in baroreceptor reflex

sensitivity between the two groups. Intravenous pentolinium

(5 mg/kg), used to produce sympathetic ganglionic block,

caused significant decreases in MAP in both groups. However,

the reduction of MAP in the sham-lesioned group was

significantly (P < .05) greater than that in the area postrema-

lesioned group: -73 +/- 4 and -48 +/- 6 mm Hg, respectively.

The ratio of left ventricular weight to body weight in sham-

lesioned Tg(+) rats was significantly larger than that of area

postrema-lesioned rats. These results suggest that ablation of

the area postrema markedly attenuates the development of

hypertension in mRen-2d Tg(+) rats, and this attenuation may

be attributed to decrease in sympathetic outflow.

9. Baloh, R. W.; Lopez, I.; Beykirch, K.; Ishiyama, A.; Honrubia, V.

Clinical-pathologic correlation in a patient with selective

loss of hair cells in the vestibular endorgans. Neurology. 1997

Nov; 49(5): 1377-82; ISSN: 0028-3878.

UNITED-STATES. We found a selective loss of vestibular hair

cells in a patient followed for more than 10 years with

imbalance and oscillopsia due to idiopathic progressive loss of

vestibular function. Hearing function and cochlear hair cells

were normal. The vestibulo-ocular reflex (VOR) gain at high

frequencies was relatively maintained despite marked

shortening of the dominant VOR time constant (to less than

500 ms). Ultrastructural examination of remaining hair cells

showed mitochondrial abnormalities. The ultrashort VOR time

constant probably resulted from changes in firing patterns of

the primary afferent nerves due to loss of hair cells and

impaired energy metabolism in remaining hair cells.

10. Bapat, P.; Joshi, R. N.; Young, E.; Jago, R. H. Comparison of propofol

versus thiopentone with midazolam or lidocaine to facilitate

laryngeal mask insertion. Can-J-Anaesth. 1996 Jun; 43(6):

564-8; ISSN: 0832-610X.

CANADA. PURPOSE: To assess the ease of insertion of

laryngeal mask airway (LMA) comparing propofol with

lidocaine or midazolam followed by thiopentone and compare

the costs with each technique. METHODS: One hundred and fifty

ASA 1 or 2 patients equally divided into three groups

scheduled for elective surgery were recruited into this

prospective, single blind, randomized, parallel groups study.

Anaesthetic induction was achieved with 1 microgram.kg-1

fentanyl i.v. followed by either 2.5 mg.kg-1 propofol (group P),

or a sequence of 1.5 mg.kg-1 lidocaine and 5 mg.kg-1

thiopentone (group LT), or midazolam 0.1 mg.kg-1 and, three

minutes later, 5 mg.kg-1 thiopentone (group MT). The LMA was

inserted by the blinded anaesthetist who assessed and graded

the conditions for LMA insertion and noted any adverse

responses (i.e., inadequate jaw relaxation, gagging, coughing,

limb or head movement, hiccough and laryngospasm).

Conditions were considered "excellent" if there were no

adverse responses, and "satisfactory" if such a response was

mild and transient. RESULTS: Excellent or satisfactory

conditions were observed in 48 (96%) patients in the

midazolam-thiopentone group, 46 (92%) in the propofol group,

and 34 (68%) in the lidocaine-thiopentone group (P = 0.0001).

The incidence of gagging (P = 0.042), limb movement (P =

0.031), and laryngospasm (P = 0.0001) was higher in the

lidocaine-thiopentone group. CONCLUSIONS: With the above

doses, a fentanyl-midazolam-thiopentone combination which

is about 35% less expensive than fentanyl-propofol, provides

equally good conditions for the insertion of LMA.. 0; 0; 137-

58-6; 2078-54-8; 437-38-7; 59467-70-8; 76-75-5.

11. Barger, S. D.; Kircher, J. C.; Croyle, R. T. The effects of social

context and defensiveness on the physiological responses of

repressive copers. J-Pers-Soc-Psychol. 1997 Nov; 73(5):

1118-28; ISSN: 0022-3514.

UNITED-STATES. In previous research (T.L. Newton & R.J.

Contrada, 1992), social context was found to moderate

exaggerated physiological reactivity among individuals

identified as using a repressive coping style. In this

experiment, 119 undergraduates were classified into low-

anxious, high-anxious, repressor, and defensive high-anxious

coping categories. All participants completed a stressful

speech task under either a public or private social context

condition. The experimental social context was related to

physiological reactivity and self-reported affect but did not

moderate reactivity among repressive copers. Additionally,

reactivity among repressive copers was not attributable to

high defensiveness alone. Consistent with a theory of

emotional inhibition, nonspecific skin conductance responses,

but not heart rate, discriminated between repressors and

nonrepressors.

12. Barron, H. V.; Lesh, M. D. Autonomic nervous system and sudden

cardiac death. J-Am-Coll-Cardiol. 1996 Apr; 27(5): 1053-60;

ISSN: 0735-1097.

UNITED-STATES. In the United States, sudden cardiac death is

a major public health problem, accounting for approximately

300,000 deaths annually. Accurate identification of those

patients at highest risk for this event has been problematic.

The use of signal-averaged electrocardiography, Holter

monitoring and assessment of left ventricular function have

been shown to be predictive of future arrhythmic events in

patients after a myocardial infarction. However, the clinical

utility of these tests has been limited by their low sensitivity

and positive predictive value. It has become increasingly clear

that the autonomic nervous system is extremely important in

the pathogenesis of ventricular arrhythmias and sudden

cardiac death. The two most important techniques used to

study the autonomic nervous system--heart rate variability

and baroreflex sensitivity--are reviewed, and the clinical and

experimental data suggesting that these techniques are

powerful predictors of future arrhythmic events are discussed

in depth.

13. Beard, J. P.; Wade, W. H.; Barber, D. B. Sacral insufficiency stress

fracture as etiology of positional autonomic dysreflexia: case

report. Paraplegia. 1996 Mar; 34(3): 173-5; ISSN: 0031-1758.

ENGLAND. The medical literature is replete with case reports

of the syndrome known as autonomic dysreflexia. Although the

majority of cases are known to be induced by either bladder or

bowel distention. there does exist a small number of cases in

which the inciting stimulus is more obscure. In such cases, a

comprehensive medical evaluation is necessary to ensure

proper identification of the source of irritation and the

appropriate medical management of the patient. We present a

patient with a heretofore unreported suspected etiology of

autonomic dysreflexia, axial loading of a sacral stress

fracture.

14. Bearzoti, P. [Magnus-De Kleijn tonic neck reflex]. Consideracoes

sobre o reflexo tonico cervical de Magnus-De Kleijn. Arq-

Neuropsiquiatr. 1997 Mar; 55(1): 70-4; ISSN: 0004-282X.

BRAZIL. The Magnus-De Kleijn's tonic neck reflex is analyzed

concerning to the developmental psychologies of Gesell, Spitz

and Piaget. It is considered its phylogenetic nature, it is taken

into account its favorable disappearing about three months old

and, it is made a great account of its participation in baby

development.

15. Bellamy, Mary Louise Ed.; Frame, Kathy Ed. Neuroscience

Laboratory and Classroom Activities. 1996;

Note: 268 p.

National Association of Biology Teachers, 11250 Roger Bacon

Drive #19, Reston, VA 22090-5202, or Society for

Neuroscience, Suite 500, 11 Dupont Circle, Washington, DC

20036.. Guides - Classroom - Teacher (052). U.S.; Virginia.

This publication is part of a larger project involving

partnerships between high school biology teachers and

neuroscientists. It contains neuroscience laboratories and

classroom activities, most of which provide opportunities for

students to design and conduct their own experiments. Each lab

contains directions for both teachers and students and is

based on the Learning Cycle approach. Directions for teachers

include synopsis, level, student prior knowledge, integration

into the biology curriculum and across the curriculum,

objectives, getting ready, teacher background, safety notes,

procedure, teaching tips, suggested modifications for students

who are exceptional, references, and suggested reading.

Directions for students include introduction, materials, safety

notes, procedure, and analysis. Topics include the sense of

hearing, the vestibular system, reflex responses, neural

processing, neuronal plasticity, making sensory comparisons,

pain pathways, stress and the nervous system, olfactory

fatigue and memory, epilepsy, reaction time and neural

circuitry, and visual perception. Appendices include formats

used to develop the labs and classroom activities and

scientists' guidelines for preparing activities for high school

students. (JRH).

16. Ben Shakhar, G.; Dolev, K. Psychophysiological detection through

the guilty knowledge technique: effects of mental

countermeasures. J-Appl-Psychol. 1996 Jun; 81(3): 273-81;

ISSN: 0021-9010.

UNITED-STATES. The effects of mental countermeasures on

the efficiency of psychophysiological detection with the

Guilty Knowledge Technique were examined in a mock-crime

experiment with 4 groups of participants: innocent

participants who were not involved in the mock crime, guilty

controls who committed the mock crime but received no

countermeasure instructions, and guilty participants who

received countermeasure instructions, and guilty participants

who received countermeasure instructions and were allowed

to practice the countermeasures. The countermeasure

instructions encouraged participants to recall emotional

situations from their past and imagine themselves in these

situations during presentation of irrelevant questions. Results

revealed a significant reduction in electrodermal detection

efficiency under the 2 countermeasure conditions with no

differences between them. No countermeasures effects were

observed with the respiration line length measure.

17. Berliner, M. N. Reduced skin hyperemia during tap water

iontophoresis after intake of acetylsalicylic acid. Am-J-Phys-

Med-Rehabil. 1997 Nov; 76(6): 482-7; ISSN: 0894-9115.

UNITED-STATES. Skin microcirculation and skin temperature

of 10 healthy subjects (6 men and 4 women, 20-44 yr of age)

without any vascular diseases were registered when a

thermoindifferent tap water iontophoresis was applied. The

aim of this controlled study was to evaluate the development

of skin hyperemia after the intake of 500 mg of

acetylsalicylic acid (ASA). The measurement was conducted by

laser-Doppler flowmetry on the proximal forearm. The skin

temperature was measured before and after the treatment by

an infrared thermometer. In all persons there was an intense

erythema on the side of the cathode and only a modest one on

the side of the anode. Without ASA preliminary treatment, the

cutaneous flow showed an increase of 106% at the anodal side

and that of 834% at the cathodal side (P < 0.001). After ending

tap water iontophoresis, the skin temperature increased more

on the cathode side than on the anode side (P < 0.001). After

the intake of 500 mg ASA, the increase of the flow was 78% at

the anode and 88% at the cathode. The comparison of the skin

microcirculation did not show any differences at the anodal

side when acetylsalicylic acid was taken before, but a strong

suppression of the galvanic erythema at the cathodal side was

observed after the intake of ASA. There is a direct influence of

acetylsalicylic acid on the induction of the neurogenic

inflammation caused by a galvanic erythema. The intensity of

the induced erythema correlates with the analgesic effects of

constant current treatment. An attenuation of the

electrotherapeutic analgesia is possible.. 0; 50-78-2.

18. Bertoli, S.; Probst, R. The role of transient-evoked otoacoustic

emission testing in the evaluation of elderly persons. Ear-

Hear. 1997 Aug; 18(4): 286-93; ISSN: 0196-0202.

UNITED-STATES. OBJECTIVE: The purposes of this study were:

To determine the quantitative and qualitative changes that

occur in transient-evoked otoacoustic emissions (TEOAEs) in

older individuals without addressing the effect of aging alone

and without correction for hearing loss of the subject

selection. To investigate the clinical value of measuring

TEOAEs in the routine audiological evaluation of older people

reasoning that a finding of hearing loss in the presence of

TEOAEs could indicate a form of presbycusis with a primary

central component. DESIGN: Click-evoked otoacoustic

emissions (CEOAEs) were measured in 201 subjects without

middle ear problems aged 60 yr and older (range 60 to 97 yr)

who volunteered for the study because of complaints

concerning their hearing. Audiological procedures included a

pure-tone audiogram, modified Speech Perception in Noise test

(German version: Basler Satztest), and the Hearing Handicap

Inventory for the Elderly (German version). Results from ears

with a pure-tone average (PTA) at 0.5, 1, and 2 kHz of < or = 30

dB HL were further analyzed with respect to the presence or

absence of CEOAEs. In addition, tone burst evoked otoacoustic

emissions (TbOAEs) were tested in ears with responses to

click stimuli. The test consisted of a paradigm used previously

in our laboratory to assess superposition and suppression of

frequency within the cochlea (see Xu, Probst, Harris, & Roede,

1994). RESULTS: CEOAEs were not detectable in ears with a

PTA > 30 dB HL. The prevalence of CEOAEs in ears with a PTA <

or = 30 dB HL was 60%. Response levels decreased as hearing

thresholds became poorer, but there was no apparent influence

on TEOAE level due to age alone. The audiological measures

from ears with and without CEOAEs and with PTAs < or = 30 dB

HL were similar with the exception of small between group

differences at lower frequencies. The TbOAE results showed no

differences in linear superposition and suppression when

results were compared with those of younger subjects tested

previously. CONCLUSIONS: The lower overall amplitudes of

TEOAEs and the lower prevalence of 60% in comparison to

results from younger subjects with normal hearing imply that

cochlear changes do occur with aging. However, the

preservation or loss of TEOAEs does not separate subjects

with presbycusis into distinct audiological categories or

handicaps. Tone burst results suggest that frequency

processing within the cochlea is not affected by age alone. We

conclude that TEOAEs add no relevant information in the

routine clinical evaluation of elderly persons with hearing

problems.

19. Blumenthal, T. D.; Schicatano, E. J.; Chapman, J. G.; Norris, C. M.;

Ergenzinger, ER Jr. Prepulse effects on magnitude estimation

of startle-eliciting stimuli and startle responses. Percept-

Psychophys. 1996 Jan; 58(1): 73-80; ISSN: 0031-5117.

UNITED-STATES. The present studies investigated the

relationship between prepulse effects on the modification of

the brainstem startle reflex and magnitude estimates of

startle-eliciting stimuli. In Experiment 1, startle eyeblink

responses were elicited in 24 students, half of whom were

instructed to estimate the loudness of the startle stimulus

(actual intensities of 80, 90, and 100 dB) and half of whom

were instructed to estimate the magnitude of their eyeblink.

When weak acoustic prepulses preceded the startle-eliciting

stimulus, eyeblink amplitude was inhibited, and estimates of

response magnitude decreased, but estimates of startle

stimulus magnitude decreased only when 100-dB startle

stimuli were presented. In Experiment 2, the same startle

stimuli were preceded on some trials by a vibrotactile

prepulse to the hand. In conditions in which startle amplitude

was inhibited, startle stimulus magnitude estimates were not

affected. This suggests that the effect of acoustic prepulses

on 100-dB startle stimuli in Experiment 1 may have been due

to loudness assimilation, an effect independent of the prepulse

inhibition of startle responding.

20. Bono Arino, A.; Pinero Fernandez, A.; Rodriguez Vela, L.; Ascaso

Cornago, I.; Allepuz Losa, C.; Rioja Sanz, L. A. [The neurological

status in patients with erectile dysfunction: somatosensory

evoked potentials and the bulbocavernosus reflex]. Estudio

neurologico en pacientes con disfuncion erectil: potenciales

evocados somatosensoriales y reflejo bulbo-cavernoso. Arch-

Esp-Urol. 1997 Oct; 50(8): 897-905; ISSN: 0004-0614.

SPAIN. OBJECTIVES: The present study investigated the

somatosensory evoked potential (SSEP) from the dorsal penile

nerve and the bulbocavernosus reflex (BCR) in healthy

volunteers and patients with erectile dysfunction in order to

establish a model of normality and investigate the abnormal

neuro-urophysiological measurements in patients with

erectile dysfunction and their relationship with different

factors (age, neurological disease). METHODS: 30 healthy

volunteers and 102 patients who had consulted for erectile

dysfunction underwent neuro-urophysiological diagnostic

evaluation (dorsal penile nerve SSEP and BCR). The mean age

was 51.2 years (range 27 to 66). RESULTS: The group of healthy

volunteers showed SSEP mean latency of 46.374 ms and a BCR

mean latency of 43.721 ms. Thirty-four patients (33.33%) had

at least one abnormal neuro-urophysiological measurement,

the SSEP were abnormal in 7 (20.58%), the BCR in 5 (14.70%)

and both in 22 (64.70%). We found an increased SSEP latency

and BCR latency in the patients with erectile dysfunction and

with no urological disease. Comparison of the older with the

younger patients was only statistically significant for

increased BCR latency in patients > 60 years old. CONCLUSIONS:

The study revealed neuro-urophysiological abnormalities in 34

impotent patients (33.33%). The finding of abnormalities in

both BCR and SSEP was the most frequent.

21. Brandt, T. Bilateral vestibulopathy revisited. Eur-J-Med-Res.

1996 May 24; 1(8): 361-8; ISSN: 0949-2321.

GERMANY. Bilateral vestibular failure (BVF) is an often

undetected disorder of the peripheral labyrinths or the eighth

nerves. Key symptoms are oscillopsia during locomotion or

head movements and unsteadiness, particularly in the dark.

Diagnosis is made by a bedside test for defective vestibulo-

ocular reflex and the absence of nystagmic reaction to both

caloric and rotatory pendular testing. Most frequent etiologies

include ototoxicity, cerebellar degeneration, meningitis,

neuropathies, sequential vestibular neuritis, autoimmune

disorders, tumors, and miscellaneous otological diseases.

Idiopathic BVF is found in more than twenty percent of the

patients. Recovery is possible but mostly incomplete.

Somatosensory and visual input largely substitute the

vestibular deficit for spatial orientation, postural balance and

ocular motor control.

22. Braverman, I.; Jaber, L.; Levi, H.; Adelman, C.; Arons, K. S.; Fischel

Ghodsian, N.; Shohat, M.; Elidan, J. Audiovestibular findings in

patients with deafness caused by a mitochondrial

susceptibility mutation and precipitated by an inherited

nuclear mutation or aminoglycosides. Arch-Otolaryngol-Head-

Neck-Surg. 1996 Sep; 122(9): 1001-4; ISSN: 0886-4470.

UNITED-STATES. OBJECTIVE: To characterize the audiological

and vestibular changes associated with a mitochondrial DNA

mutation in an Arab-Israeli family and in other families with

mitochondrial predisposition to aminoglycoside-induced

hearing loss. DESIGN: Evaluation of audiological (pure tone

thresholds, speech reception thresholds, speech

discrimination, tympanometry, acoustic reflex thresholds,

tone decay, and auditory brain-stem evoked response

recording) and vestibular (complete history, physical

examination, and 2-channel electronystagmography) systems.

In 5 patients, structural evaluation of the inner ear was done

by magnetic resonance imaging. PATIENTS: Fifteen members of

an Arab-Israeli family, and 1 Chinese woman with the same

mitochondrial DNA mutation who experienced hearing loss

after short-term exposure to streptomycin. RESULTS: Most of

the patients had a profound hearing loss due to cochlear

involvement. The hearing loss usually was not accompanied by

notable peripheral vestibular dysfunction. In the patient with

severe hearing loss after exposure to aminoglycoside, the

vestibular function was completely normal. CONCLUSIONS: In

most of the Arab-Israeli patients with congenital deafness,

the vestibular system function was normal, in contrast to the

frequency of vestibular abnormality among deaf children,

which was described in the literature. This may be related to

genetic predisposition to aminoglycoside-induced deafness..

0; 0.

23. Brechue, W. F.; Koceja, D. M.; Stager, J. M. Acetazolamide reduces

peripheral afferent transmission in humans. Muscle-Nerve.

1997 Dec; 20(12): 1541-8; ISSN: 0148-639X.

UNITED-STATES. Carbonic anhydrase has been localized in

skeletal muscle and nerve, thus, inhibition with acetazolamide

(ACZ) may alter nerve and/or muscle function in healthy

humans. ACZ (3 oral doses 14, 8, and 2 h prior to testing)

reduced isometric force (37%) and peak to peak

electromyographic (EMG) amplitude (1.38 mV to 0.83 mV),

while increasing EMG latency associated with a unilateral

Achilles tendon-tap. Reflex recovery profiles, following a

contralateral conditioning tap, were similar in both placebo

and ACZ experiments. ACZ led to significant changes in

Hmax/Mmax ratio (52.19/14.42 to 45.73/15.65) and H-reflex

latency (34.18 +/- 2.54 ms to 35.24 +/- 2.74 ms). Motor nerve

conduction velocity and maximal voluntary isometric torque

(knee extensors) were unaltered by ACZ. These data suggest

that inhibition of the tendon-tap reflex and associated

isometric force, following ACZ, is related to impairment of

synaptic integrity between la fibers of the muscle spindle and

the alpha motor neuron and not impairment of the muscle

spindle or force-generating capacity.. 0; 59-66-5.

24. Brimacombe, J. Jaw thrust and laryngeal mask insertion--a

warning [letter]. Anaesthesia. 1996 Feb; 51(2): 203; ISSN:

0003-2409.

ENGLAND.

25. Brinar, V.; Brzovic, Z.; Papa, J.; Malojcic, B.; Dawidowsky, K.

Autonomic dysfunction in patients with multiple sclerosis.

Coll-Antropol. 1997 Dec; 21(2): 493-7; ISSN: 0350-6134.

CROATIA. The disturbances of autonomic cardiovascular

reflexes have already been described in patients with multiple

sclerosis (MS). It seems that this disturbances are the result

of reflex pathways impairment in the central nervous system.

We have tested 28 patients with MS and control group of 21

healthy volunteers using a set of autonomic cardiovascular

reflexes tests. In all of patients zones of demyelinization have

been discovered with magnetic resonance imaging (MRI). The

biggest number of abnormal results was found in respiratory

sinus arrhythmia (RSA) test (60.7%) and cortical activation

test (35.7%). In 11 patients we found abnormal results in 2 or

more tests. Patients with abnormal results in 4 or more tests

had clinical impairment of other autonomic functions (urinary

bladder regulation). The results of autonomic dysfunction

tests show positive correlation to the MRI findings.

26. Brunt, D.; Robichaud, J. Relationship between motoneuron pool

excitability and parameters of timing and force in an

isometric ankle-extension movement. Percept-Mot-Skills.

1996 Apr; 82(2): 448-50; ISSN: 0031-5125.

UNITED-STATES. The changes in peak facilitation and slope of

facilitation of the H-reflex were compared to the parameters

of an isometric plantarflexion task. The amplitude of the

reflex was significantly greater for reflexes elicited within

50 msec. of the onset of soleus muscle activity. Neither peak

amplitude of the reflex nor slope correlated with rate of rise

of isometric force; however, they did show a modest

relationship between premotor time and reaction time.

27. Burke, J. R.; Kamen, G. Changes in spinal reflexes preceding a

voluntary movement in young and old adults. J-Gerontol-A-

Biol-Sci-Med-Sci. 1996 Jan; 51(1): M17-22; ISSN: 1079-5006.

UNITED-STATES. BACKGROUND. Age-related differences in

spinal excitability during response preparation were assessed

by eliciting either a 50% H-reflex or an Achilles tendon reflex

preceding the onset of a right plantar flexion contraction in 20

young adults (23.1 +/- 1.64 yrs) and 20 old adults (68.5 +/-

5.53 yrs). METHODS. On each simple reaction time trial, the

test reflex was elicited at a specific test interval during

either the foreperiod or the response period. The foreperiod

test intervals were 500, 600, 700, 800, 900, and 1000 msec

after the presentation of the warning stimulus. The response

period test intervals were 50, 100, 150, 200, 250, and 300

msec after the presentation of the response stimulus. Control

reflexes were randomly elicited between the simple reaction

time trials. RESULTS. Changes in reflex excitability were not

observed during the foreperiod in either age group. During the

response period, the percentage of H-reflex facilitation as

compared to control H-reflexes was similar for the young

(68%) and the old (61%) adults, but the magnitude of Achilles

tendon reflex facilitation with respect to control reflex

responses was greater in the young adults (74%) than in the

old adults (38%). The time course of H- and tendon reflex

facilitation was delayed in the old group during the response

period. CONCLUSIONS. The results indicate that processes

underlying the preparation and generation of a motor response

are similar in young and old adults. However, these processes

occur at a slower rate in old adults.

28. Carlson, S. R.; Katsanis, J.; Iacono, W. G.; McGue, M. Emotional

modulation of the startle reflex in twins: preliminary findings.

Biol-Psychol. 1997 Oct 10; 46(3): 235-46; ISSN: 0301-0511.

NETHERLANDS. This study investigated twin similarity in

general startle reflex reactivity and emotional modulation.

Seventeen monozygotic (MZ) and 12 dizygotic (DZ) male twin

pairs received startling acoustic stimuli while viewing

emotionally positive, negative and neutral slides.

Electromyographic (EMG) responses were recorded from the

orbicularis oculi. Members of MZ twin pairs had similar

response amplitudes under all three valence conditions. In

addition, modulation scores for the positive and negative

conditions, representing the percent change in response

amplitude between the affective and the neutral conditions,

also showed significant similarity within MZ twin pairs.

Overall, members of DZ twin pairs were not found to be

significantly similar of any of the measures. These

preliminary findings suggest that emotional modulation of the

startle reflex shows familial resemblance within MZ pairs.

Given the lack of resemblance between DZ twins, it is

tentatively suggested that affective modulation may be under

partial genetic control.

29. Carlsson, M. [The man behind the syndrome: William John Adie. He

won an involuntary victory in an academic dispute]. Mannen

bakom syndromet: William John Adie. Vann ofrivillig seger i

akademisk strid. Lakartidningen. 1996 May 15; 93(20): 1966-9;

ISSN: 0023-7205.

SWEDEN.

30. Chancellor, M. B. Should we be using chili pepper extracts to treat

the overactive bladder? [editorial; comment]. J-Urol. 1997 Dec;

158(6): 2097; ISSN: 0022-5347.

Note: Comment on: J Urol 1997 Dec;158(6):2087-92. Comment

on: J Urol 1997 Dec;158(6):2093-6.

UNITED-STATES. 404-86-4.

31. Charles, P. D.; Davis, T. L. Drug therapy for Parkinson's disease.

South-Med-J. 1996 Sep; 89(9): 851-6; ISSN: 0038-4348.

UNITED-STATES. Parkinson's disease (PD) is a common

neurodegenerative disease characterized by tremor, rigidity,

bradykinesia, and loss of postural reflexes. Although the

agents available for symptomatic treatment now allow most

parkinsonian patients to live a normal life-span, these

patients become progressively unable to participate in social

functions, perform activities of daily living, and work. Therapy

for PD may be associated with many complications that

contribute to these disabilities. For this reason, education is

helpful for the patient newly diagnosed with PD. Over the past

6 years, three new medications (selegiline, pergolide, and

controlled-release levodopa) have been approved for use in

Parkinson's disease. Other agents now available for the

treatment of psychiatric illness may also be helpful in

selected cases of PD. With this in mind, we review the

commonly prescribed drugs and outline a rational plan for

treatment of parkinsonism.. 0; 0.

32. Chaudhry, V.; Moser, H. W.; Cornblath, D. R. Nerve conduction

studies in adrenomyeloneuropathy. J-Neurol-Neurosurg-

Psychiatry. 1996 Aug; 61(2): 181-5; ISSN: 0022-3050.

ENGLAND. OBJECTIVE--Adrenomyeloneuropathy (AMN) is an X

linked metabolic disorder presenting with progressive spastic

paraparesis in the third to fifth decade of life. Although

peripheral neuropathy is also present in most patients,

prominent pyramidal signs may make its clinical recognition

difficult. The objective was to characterise the peripheral

neuropathy in patients with AMN by nerve conduction studies.

METHODS--Nerve conduction studies were performed in 99 men

known to have AMN and in 38 heterozygous women, all of whom

had neurological disabilities. RESULTS--Of the 13 variables

obtained, at least one was abnormal in 82% of patients. The

abnormalities were more common in men than in women (87% v

67%); in legs than in arms (77% v 38%); in motor than in

sensory conduction (80% v 39%); and in latency (distal and F

wave) and velocity compared with amplitude (80% v 29%).

Twenty six patients had at least one nerve variable value in

the demyelinating range. Four variables (sural velocity,

peroneal amplitude, peroneal velocity, and peroneal F wave)

were correlated with the expanded disability status scale;

five variables (peroneal velocity, tibial H reflex, median distal

latency, median conduction velocity, and median F wave

latency) were correlated with serum very long chain fatty

acids (VLCFAs); and two variables (sural amplitude and

peroneal distal latency) were more likely to be abnormal in

patients with normal adrenal function than in patients with

Addison's disease. CONCLUSIONS--Nerve conduction studies in

patients with AMN are often abnormal and suggest a mixture of

axonal loss and multifocal demyelination. Their correlation

with disability status and serum VLCFAs suggests that

measures from nerve conduction studies may be useful in

evaluating future treatments.

33. Christensen, J. Mechanisms of secondary esophageal peristalsis.

Am-J-Med. 1997 Nov 24; 103(5A): 44S-46S; ISSN: 0002-9343.

UNITED-STATES.

34. Chun, M. M. Temporal binding errors are redistributed by the

attentional blink. Percept-Psychophys. 1997 Nov; 59(8): 1191-

9; ISSN: 0031-5117.

UNITED-STATES. When one searches for a target among

nontargets appearing in rapid serial visual presentation

(RSVP), one's errors in performance typically involve the

misreporting of neighboring nontargets. Such illusory

conjunctions or intrusion errors are distributed differently

around the target, depending on task or stimulus variables. It

is shown here that shifts in intrusion error patterns can be

produced by the manipulation of attention alone. In a dual-task

paradigm, the magnitude and distribution of intrusion errors

changed systematically as a function of available attentional

resources. Intrusion errors in RSVP tasks reflect internal

capacity limitations for binding independent features. The

present results support a two-stage model of RSVP target

processing.

35. Clark, A. L.; McDonagh, T. The origin of symptoms in chronic heart

failure [editorial]. Heart. 1997 Nov; 78(5): 429-30; ISSN: 1355-

6037.

ENGLAND.

36. Cohen, M.; Luxon, L.; Rudge, P. Auditory deficits and hearing loss

associated with focal brainstem haemorrhage. Scand-Audiol.

1996; 25(2): 133-41; ISSN: 0105-0397.

DENMARK. Four cases of central pontine haemorrhage are

described in which auditory dysfunction was documented. Two

cases had a hearing loss, in one of which there was recovery of

the low frequencies. This case provides support for the

tonotopic organization of the auditory pathways in the caudal

pontine area, with the lowest frequencies being encoded

medially. In all cases, there were abnormalities of the

auditory brainstem responses, wave V being consistently

involved, while wave III was abnormal in only one patient. In

three cases, the masking level differences and crossed

acoustic reflex thresholds were abnormal. The ipsilateral

reflex thresholds were normal at least on one side in all cases.

In the patient with the most significant hearing loss, loudness

recruitment, assessed both psychophysically and with the

acoustic reflex thresholds, was evident. These data are

interpreted in terms of there being damage to the medial

superior olivary nuclei and trapezoid body involving both

afferent and efferent fibres.

37. Colvin, L. A.; Mark, M. A.; Duggan, A. W. The effect of a peripheral

mononeuropathy on immunoreactive (ir)-galanin release in the

spinal cord of the rat. Brain-Res. 1997 Aug 22; 766(1-2): 259-

61; ISSN: 0006-8993.

NETHERLANDS. The pattern of ir-galanin release in the spinal

cord of rats with a peripheral mononeuropathy was studied. On

the side of the cord ipsilateral to the nerve injury enhanced

ir-galanin release was found in the superficial dorsal horn. It

is probable that, after nerve injury, some primary afferent

neurons spontaneously release galanin from their central

terminals.. 88813-36-9.

38. Conroy, T.; Etienne, P. L.; Adenis, A.; Wagener, D. J.; Paillot, B.;

Francois, E.; Bedenne, L.; Jacob, J. H.; Seitz, J. F.; Bleiberg, H.;

Van Pottelsberghe, C.; Van Glabbeke, M.; Delgado, F. M.; Merle,

S.; Wils, J. Phase II trial of vinorelbine in metastatic

squamous cell esophageal carcinoma. European Organization

for Research and Treatment of Cancer Gastrointestinal Treat

Cancer Cooperative Group. J-Clin-Oncol. 1996 Jan; 14(1): 164-

70; ISSN: 0732-183X.

UNITED-STATES. PURPOSE: To evaluate the response rate and

toxic effects of vinorelbine (VNB) administered as a single

agent in metastatic squamous cell esophageal carcinoma.

PATIENTS AND METHODS: Forty-six eligible patients with

measurable lesions were included and were stratified

according to previous chemotherapy. Thirty patients without

prior chemotherapy and 16 pretreated with cisplatin-based

chemotherapy were assessable for toxicity and response. VNB

was administered weekly as a 25-mg/m2 short intravenous

(i.v.) infusion. RESULTS: Six of 30 patients (20%) without prior

chemotherapy achieved a partial response (PR) (95%

confidence interval [CI], 8% to 39%). The median duration of

response was 21 weeks (range, 17 to 28). One of 16 patients

(6%) with prior chemotherapy had a complete response (CR) of

31 weeks' duration (95% CI, 0% to 30%). The overall response

rate (World Health Organization [WHO] criteria) was 15% (CR,

2%; PR 13%; 95% CI, 6% to 29%). The median dose-intensity

(DI) was 20 mg/m2/wk. VNB was well tolerated and zero

instances of WHO grade 4 nonhematologic toxicity occurred. At

least one episode of grade 3 or 4 granulocytopenia was seen in

59% of patients. A grade 2 or 3 infection occurred in 16% of

patients, but no toxic deaths occurred. Other side effects were

rare, and peripheral neurotoxicity has been minor (26% grade

1). CONCLUSION: These data indicate that VNB is an active

agent in metastatic esophageal squamous cell carcinoma.

Given its excellent tolerance profile and low toxicity, further

evaluation of VNB in combination therapy is warranted.. 0;

71486-22-1; 865-21-4.

39. Cornelius, C. P.; Altenmuller, E.; Ehrenfeld, M. The use of flash

visual evoked potentials in the early diagnosis of suspected

optic nerve lesions due to craniofacial trauma. J-

Craniomaxillofac-Surg. 1996 Feb; 24(1): 1-11; ISSN: 1010-

5182.

SCOTLAND. Craniofacial trauma encroaching on the orbital

apex and optic canal can result in direct or indirect optic

nerve lesions, leading to visual impairment or blindness. Early

diagnosis of a visual loss and immediate therapy are generally

considered crucial for a successful restoration of vision in

indirect trauma. However, in comatose or sedated patients the

assessment of optic nerve function by testing pupillary

reactivity may be severely compromised or impossible because

of tensely swollen eyelids, conjunctival oedema, concussion of

the ciliary muscle or pharmacological effects. In the event

that clinical ophthalmic examination, computer tomography or

nuclear magnetic resonance scanning fail to clarify the state

of the optic nerve, visual evoked potentials (VEPs) to flash

stimulation appear to provide reliable information on function

within the visual pathway. On this basis, treatment with

corticosteroids and/or surgical decompression can be rapidly

initiated. Our results in a preliminary patient series confirm

the value of acutely monitored VEPs as an objective test of

optic nerve function in cases of suspected optic nerve injury

immediately after admission to the emergency care unit. The

imaging techniques usually applied may be complemented by

VEPs to show the functional significance of structural

abnormalities found in the vicinity of the optic nerve.

40. Czarkowska Bauch, J. Variety of muscle responses to tactile

stimuli. Acta-Neurobiol-Exp-Warsz. 1996; 56(1): 435-9; ISSN:

0065-1400.

POLAND. Influences exerted by tactile stimuli on the muscle

activity were investigated with two methods: (1) analysis of

kinematics and electromyographic (EMG) activity of eight

forelimb muscles during contact placing (CP) reactions

elicited by tactile stimuli applied to the dorsal, medial or

lateral sides of the paw in cats, and (2) the Hoffmann (H)-

reflex technique to quantify the effects of the tactile stimuli

on the excitability of the alpha motoneurones of the soleus

muscle in awake rats. The first group of the data showed that

the tactile stimuli applied to dorsal, medial or lateral aspects

of the paw led to different strategies of the forelimb

movements during CP reactions. These differences arose from

various patterns of activation of the elbow flexor and extensor

muscles at the beginning of CP reactions and a various

involvement of the medio-lateral components of movements,

depending on the site of the tactile stimulus application. With

the H-reflex technique it was found that the tactile stimulus

diminished the excitability of alpha motoneurones of the

soleus muscle when applied to the skin overlying the lateral

side of the ankle joint. This effect was in line with the

observation that the tactile stimulus applied to the lateral

side of the paw activated the elbow flexor muscles but not

their antagonists to initiate CP reaction.

41. da Camara, Carlos C.; And, Others. Survey of Physical Assessment

Course Offerings in American Colleges of Pharmacy. 1996;

Reports - Research (143). Journal Articles (080). A survey of

55 pharmacy schools found that of those offering a pharmacy

doctoral program, three-fourths had a separate course devoted

to physical assessment of patients, most offered in the third

professional year. Most require students to demonstrate use of

stethoscope, sphygmomanometer, ophthalmo-otoscope, tuning

fork, reflex hammer. Reasons for offering the course and

course content were also identified. (Author/MSE).

42. Davis, M.; Walker, D. L.; Lee, Y. Amygdala and bed nucleus of the

stria terminalis: differential roles in fear and anxiety

measured with the acoustic startle reflex. Philos-Trans-R-

Soc-Lond-B-Biol-Sci. 1997 Nov 29; 352(1362): 1675-87; ISSN:

0962-8436.

ENGLAND. Neural stimuli associated with traumatic events

can readily become conditioned so as to reinstate the memory

of the original trauma. These conditioned fear responses can

last a lifetime and may be especially resistant to extinction. A

large amount of data from many different laboratories

indicate that the amygdala plays a crucial role in conditioned

fear. The amygdala receives information from all sensory

modalities and projects to a variety of hypothalamic and

brainstem target areas known to be critically involved in

specific signs that are used to define fear and anxiety.

Electrical stimulation of the amygdala elicits a pattern of

behaviours that mimic natural or conditioned states of fear.

Lesions of the amygdala block innate or conditioned fear and

local infusion of drugs into the amygdala have anxiolytic

effects in several behavioural tests. Excitatory amino acid

receptors in the amygdala are critical for the acquisition,

expression and extinction of conditioned fear.

43. De Ridder, D.; Chandiramani, V.; Dasgupta, P.; Van Poppel, H.;

Baert, L.; Fowler, C. J. Intravesical capsaicin as a treatment

for refractory detrusor hyperreflexia: a dual center study with

long-term followup [see comments]. J-Urol. 1997 Dec; 158(6):

2087-92; ISSN: 0022-5347.

Note: Comment in: J Urol 1997 Dec;158(6):2097.

UNITED-STATES. PURPOSE: We described the long-term

outcome of intravesical capsaicin instillations in patients

with urinary incontinence and compared its efficacy in 2

similar populations of patients with multiple sclerosis in a

dual center study. MATERIALS AND METHODS: During 5 years 79

patients with intractable urinary incontinence have been

treated with intravesical capsaicin. The majority of patients

had spinal cord disease due to multiple sclerosis but 4 were

neurologically normal. Cystometry was performed before and 4

to 6 weeks after intravesical instillation of 1 to 2 mmol./l. of

capsaicin in 30% ethanol in saline. Instillations of vehicle

(30% ethanol in saline) alone were carried out in 5 patients.

RESULTS: In patients with phasic detrusor hyperreflexia

complete continence was achieved in 44%, satisfactory

improvement occurred in 36% and treatment failed in 20%.

Clinical benefit from a single instillation lasted 3 to 6 months

and was repeated in some patients with similar improvement.

Capsaicin was ineffective in patients with poor bladder

compliance and in neurologically normal patients with sensory

urgency and detrusor instability. There was no clinical or

urodynamic improvement in patients treated with vehicle

alone. There have been no long-term complications.

CONCLUSIONS: Our study shows that repeated instillations of

intravesical capsaicin are effective in treatment of patients

with detrusor hyperreflexia due to spinal cord disease and that

effectiveness of the treatment persists at least 3 to 5 years..

404-86-4.

44. Deo, S. D.; Knottenbelt, J. D. Involuntary defaecation in acutely

injured patients: a useful clinical sign. Injury. 1996 Mar; 27(2):

93-5; ISSN: 0020-1383.

ENGLAND. The phenomenon of involuntary defaecation

following acute, severe injuries has never been documented

before, but has been noted by those who work in major trauma

units. The exact cause of the phenomenon is unknown. We

prospectively noted 14 patients who involuntarily defaecated

in a 3-month period and analysed their clinical findings

retrospectively. Involuntary defaecation occurred only in

patients with severe penetrating or blunt injuries. In those

with precordial stabs, involuntary defaecation was

particularly predictive of cardiac injury, and in all injuries

was associated with higher surgical intervention and

mortality rates. The occurrence of involuntary defaecation in

injured patients is a useful sign that nearly always indicates

the need for urgent intervention.

45. Di Lazzaro, V.; Restuccia, D.; Nardone, R.; Tartaglione, T.;

Quartarone, A.; Tonali, P.; Rothwell, J. C. Preliminary clinical

observations on a new trigeminal reflex: the trigemino-

cervical reflex. Neurology. 1996 Feb; 46(2): 479-85; ISSN:

0028-3878.

UNITED-STATES. Short latency trigemino-cervical reflexes

can be recorded from sternocleidomastoid muscle after

stimulation of the infraorbital branch of the trigeminal nerve.

We studied the trigemino-cervical reflexes and the

conventional blink reflex in three patients with an isolated

lesion in the medulla oblongata, eight patients with multiple

sclerosis, and two patients with supratentorial ischemic

lesion. The trigemino-cervical response was abnormal in the

patients with an isolated lesion in the medulla oblongata and

in all multiple sclerosis patients, whereas both components of

the blink reflex were preserved in the patients with a lesion in

the medulla oblongata and in half of the patients with multiple

sclerosis. The trigemino-cervical reflex was preserved in

patients with supratentorial lesions, whereas the late

component of the blink reflex was abnormal. These findings

suggest that central pathways generating the trigemino-

cervical reflex are confined to the medulla oblongata and that

they are independent from those generating the long latency

(R2) component of the blink reflex. The trigemino-cervical

reflex may help in disclosing and localizing brainstem lesions.

46. DiBona, G. F.; Sawin, L. L.; Jones, S. Y. Differentiated sympathetic

neural control of the kidney. Am-J-Physiol. 1996 Jul; 271(1 Pt

2): R84-90; ISSN: 0002-9513.

UNITED-STATES. Anatomic and neurophysiological methods

were used to identify functionally specific subgroups of renal

sympathetic nerve fibers. The distribution of diameters of the

predominating unmyelinated fibers showed a major mode at

1.1 microns and a minor mode at 1.6 microns. The conduction

velocity was 2.10 +/- 0.10 m/s, consistent with unmyelinated

C fibers. Analysis of strength-duration relationships during

renal nerve stimulation showed that both rheobase and

chronaxie values for renal blood flow were greater than those

for urinary flow rate and were independent of stimulation

frequency. This difference suggests a higher stimulation

threshold (smaller diameter) for those renal nerve fibers

involved in the renal blood flow response (renal

vasoconstriction) compared with those for the urinary flow

rate response (antidiuresis) to renal nerve stimulation. Single

renal units that responded to preganglionic splanchnic nerve

stimulation were studied. Those with spontaneous activity

(88%) responded to stimulation of arterial baroreceptors,

arterial and central chemoreceptors, and peripheral

thermoreceptors, whereas those that lacked spontaneous

activity (12%) responded only to stimulation of peripheral

thermoreceptors (known to produce renal vasoconstriction). A

minority population of single renal units has been identified

that, although renal vasoconstrictor, does not exhibit other

characteristic features of vasoconstrictor neurons (i.e.,

responsiveness to stimulation of arterial baroreceptors and

arterial and central chemoreceptors). These findings suggest

the existence of functionally specific subgroups of renal nerve

fibers.

47. Drummond, H. A.; Seagard, J. L. Acute baroreflex resetting.

Differential control of pressure and nerve activity.

Hypertension. 1996 Mar; 27(3 Pt 1): 442-8; ISSN: 0194-911X.

UNITED-STATES. This study evaluated acute resetting of

carotid baroreflex control of arterial blood pressure and renal

or thoracic sympathetic nerve activity in thiopental-

anesthetized mongrel dogs with the use of a vascularly

isolated carotid sinus preparation, the experimental model

used previously to characterize acute resetting in carotid

baroreceptor afferent fibers. Carotid baroreceptors were

conditioned with a pulsatile pressure for 20 minutes at three

pressure ranges: low (50 to 75 mm Hg), mid (100 to 125), or

high (150 to 175). Blood pressure and nerve activity were

recorded in response to slow ramp increases in sinus pressure;

nonlinear regression and best-fit analyses were used for

determination of curve fit parameters of the blood pressure

and nerve activity versus sinus pressure response curves.

Carotid sinus pressure thresholds for blood pressure and renal

nerve activity responses at all conditioning pressures were

significantly different; however, only the pressure threshold

for thoracic nerve activity at the low conditioning pressure

was significantly different from the responses at other

conditioning pressures. Average renal activity resetting (0.506

+/- 0.072) was significantly greater than blood pressure

resetting (0.335 +/- 0.046) in the same dogs, and thoracic

activity (0.200 +/- 0.057) was not different from blood

pressure resetting (0.194 +/- 0.031) in the same dogs. In a

previous investigation, our laboratory had demonstrated that

type 1 carotid baroreceptors acutely reset at a value of about

0.15. These results indicate that (1) renal and thoracic nerve

activities and blood pressure acutely reset to a greater degree

than type 1 carotid baroreceptors and that (2) renal activity

acutely resets to a greater degree than blood pressure and

thoracic nerve activity.

48. Drummond, P. D. The site of sympathetic deficit in cluster

headache. Headache. 1996 Jan; 36(1): 3-9; ISSN: 0017-8748.

UNITED-STATES. The pattern of autonomic deficit in the face

of cluster headache patients resembles the deficit in patients

with a postganglionic sympathetic lesion from some other

cause; however, the presence of abnormal cardiac rhythms and

bilateral pupillary reflex deficit in some patients with cluster

headache suggests that the lesion might compromise central

sympathetic drive. To investigate this possibility, the

vasomotor and sudomotor startle reflex was investigated in

the hands of six cluster headache patients with ocular and

thermoregulatory signs of postganglionic sympathetic deficit

in the face; for comparison, responses were also investigated

in 15 patients with a lesion in the cervical sympathetic

pathway from some other cause. The startle reflex was intact

in the hands of the six cluster headache patients, but was

diminished ipsilaterally in patients with a central or

preganglionic sympathetic lesion and also, surprisingly, in

patients with a postganglionic lesion caused by an aneurysm of

the internal carotid artery. Ocular sympathetic deficit was

greater in patients with an aneurysm of the internal carotid

artery than in cluster headache patients or in patients with a

postganglionic sympathetic lesion from some other cause; the

aneurysm may have compromised neurons with projections to

the face and hand, or could have induced transsynaptic

degeneration of preganglionic fibers supplying both regions.

The findings indicate that central sympathetic drive is not

impaired in cluster headache patients; thus, a peripheral

lesion probably induces sympathetic deficit on the

symptomatic side of the face.

49. Dukat, M.; Abdel Rahman, A. A.; Ismaiel, A. M.; Ingher, S.; Teitler,

M.; Gyermek, L.; Glennon, R. A. Structure-activity relationships

for the binding of arylpiperazines and arylbiguanides at 5-HT3

serotonin receptors. J-Med-Chem. 1996 Sep 27; 39(20): 4017-

26; ISSN: 0022-2623.

UNITED-STATES. Arylpiperazines are nonselective agents that

bind at 5-HT3 serotonin receptors with moderate to high

affinity, whereas 1-phenylbiguanide is a low-affinity but

more selective 5-HT3 agonist. In an attempt to enhance the

affinity of the latter agent, and working with the assumption

that similarities might exist between the binding of the two

types of agents, we formulated structure-activity

relationships for the binding of the arylpiperazines and then

incorporated those substituents, leading to high affinity for

the arylpiperazines, into 1-phenylbiguanide. A subsequent

investigation examined the structure-activity relationships of

the arylbiguanides and identified arylguanidines as a novel

class of 5-HT3 ligands. Although curious similarities exist

between the structure-activity relationships of the

arylpiperazines, arylbiguanides, and arylguanidines, it cannot

be concluded that all three series of compounds are binding in

the same manner. Furthermore, upon investigating pairs of

compounds in the three series, the arylpiperazines behaved as

5-HT3 antagonists (von Bezold-Jarisch assay) whereas the

arylbiguanides and arylguanidines acted as 5-HT3 agonists.. 0;

0; 0; 0; 0.

50. Eekhof, J. L.; Aramideh, M.; Bour, L. J.; Hilgevoord, A. A.; Speelman,

H. D.; Ongerboer, de Visser BW. Blink reflex recovery curves in

blepharospasm, torticollis spasmodica, and hemifacial spasm.

Muscle-Nerve. 1996 Jan; 19(1): 10-5; ISSN: 0148-639X.

UNITED-STATES. R1 and R2 blink reflex responses to single

and paired stimuli were investigated in 23 control subjects,

21 patients with blepharospasm (BSP), 20 patients with

torticollis spasmodica (TS), and 23 with hemifacial spasm

(HFS). For paired stimuli, we compared measurements of area

and peak responses at two and three times R2 threshold. R1

and R2 indices were calculated as the average of the recovery

values at 0.5-, 0.3-, and 0.21-s interstimulus intervals to test

individual patients. Peak amplitude measurements at three

times R2 threshold were optimal. The R2 index was abnormal

in 67% of BSP patients, 37% of TS patients, and 50% of HFS

patients on the affected side and 20% on the unaffected side. A

normal R2 index in one third of patients with BSP may indicate

that different pathophysiological mechanisms are involved in

this type of focal dystonia.

51. Epelboim, J.; Steinman, R. M.; Kowler, E.; Pizlo, Z.; Erkelens, C. J.;

Collewijn, H. Gaze-shift dynamics in two kinds of sequential

looking tasks. Vision-Res. 1997 Sep; 37(18): 2597-607; ISSN:

0042-6989.

ENGLAND. Gaze-shift dynamics of unrestrained seated

subjects were examined. The subjects participated in two

tasks. In the first task, they tapped sequences of 3-D targets

located on a table in front of them. In the second task, they

only looked at similar sequences of targets. The purpose of the

task (tapping vs only looking) affected the dynamics of gaze-

shifts. Gaze and eye-in-head peak velocities were higher and

gaze-shift durations were shorter during tapping than during

looking-only. We conclude that task variables affect gaze-

shift dynamics, altering characteristics of the so-called

saccadic "main sequence".

52. Ertas, M.; Uludag, B.; Ertekin, C. Slow motor conduction mainly

limited to motor root in amyotrophic lateral sclerosis.

Muscle-Nerve. 1996 Aug; 19(8): 1003-8; ISSN: 0148-639X.

UNITED-STATES. Motor conduction velocity is expected to be

normal or nearly normal in amyotrophic lateral sclerosis

(ALS). Some studies have suggested that pathology may be

present in the proximal axons. Indeed, some investigators have

shown a decrease in the proximal conduction velocity in ALS

by using motor conduction velocity measurements and H-reflex

and F-response recordings, but they could not delineate the

precise region of the conduction pathology. In this study,

unlike the ones carried out previously, the most proximal

segment has been studied in 11 patients with ALS, 13 normal

controls, and 5 patients with sequel of poliomyelitis (SPM) by

recording sensory and motor spinal root potentials. While no

conduction pathology, H-reflex, or F-response abnormalities

were found in ALS patients compared to normal subjects, it

was shown that conduction velocity decreased in the proximal

segment of the lower motor neuron of the ventral root. Despite

motor neuron pathology in SPM, there was no proximal motor

conduction slowing compared with that in normal subjects.

53. Faist, M.; Dietz, V.; Pierrot Deseilligny, E. Modulation, probably

presynaptic in origin, of monosynaptic Ia excitation during

human gait. Exp-Brain-Res. 1996 Jun; 109(3): 441-9; ISSN:

0014-4819.

GERMANY. Modulation of presynaptic inhibition of Ia afferents

projecting monosynaptically to soleus motoneurones was

investigated during human gait. Changes in presynaptic

inhibition of Ia afferents were deduced from alterations in the

amount of heteronymous soleus H-reflex facilitation evoked by

a constant femoral nerve stimulation. It has been shown that

this facilitation is mediated through a monosynaptic Ia

pathway and that during its first 0.5 ms it is still

uncontaminated by any polysynaptic effect and can be used to

assess ongoing presynaptic inhibition of Ia terminals to soleus

motoneurones. During gait, heteronymous facilitation was

reduced with respect to its control value (rest during sitting)

and modulated during the step cycle: it reached its maximum

at mid-stance and decreased to near zero by the end of stance.

At the same time the H-reflex amplitude was to some extent

similarly modulated. It is argued that this decrease in

heteronymous Ia facilitation and in H-reflex amplitude

reflects an increased, ongoing presynaptic inhibition of Ia

terminals projecting onto soleus motoneurones, which could be

from central and/or peripheral origin. D1 inhibition, i.e. the

late and long-lasting inhibition of the soleus H-reflex evoked

by a train of stimuli to the common peroneal nerve, was used

as another method to assess presynaptic inhibition. This D1

inhibition was decreased during gait, and it is argued that this

decrease might reflect an occlusion in presynaptic pathways

or increased presynaptic inhibition of pathways mediating the

conditioning volley.

54. Feng Chen, K. C.; Wolpaw, J. R. Operant conditioning of H-reflex

changes synaptic terminals on primate motoneurons. Proc-

Natl-Acad-Sci-U-S-A. 1996 Aug 20; 93(17): 9206-11; ISSN:

0027-8424.

UNITED-STATES. Operant conditioning of the primate triceps

surae H-reflex, the electrical analog of the spinal stretch

reflex, creates a memory trace that includes changes in the

spinal cord. To define the morphological correlates of this

plasticity, we analyzed the synaptic terminal coverage of

triceps surae motoneurons from animals in which the triceps

surae H-reflex in one leg had been increased (HRup mode) or

decreased (HRdown mode) by conditioning and compared them

to each other and to motoneurons from unconditioned animals.

Motoneurons were labeled by intramuscular injection of

cholera toxin-horseradish peroxidase. A total of 5055

terminals on the cell bodies and proximal dendrites of 114

motoneurons from 14 animals were studied by electron

microscopy. Significant differences were found between HRup

and HRdown animals and between HRup and naive (i.e.,

unconditioned) animals. F terminals (i.e., putative inhibitory

terminals) were smaller and their active zone coverage on the

cell body was lower on motoneurons from the conditioned side

of HRup animals than on motoneurons from the conditioned

side of HRdown animals. C terminals (i.e., terminals associated

with postsynaptic cisterns and rough endoplasmic reticulum)

were smaller and the number of C terminals in each C complex

(i.e., a group of contiguous C terminals) was larger on

motoneurons from the conditioned side of HRup animals than

on motoneurons either from the conditioned side of HRdown

animals or from naive animals. Because the treatment of HRup

and HRdown animals differed only in the reward contingency,

the results imply that the two contingencies had different

effects on motoneuron synaptic terminals. In combination with

other recent data, they show that H-reflex conditioning

produces a complex pattern of spinal cord plasticity that

includes changes in motoneuron physiological properties as

well as in synaptic terminals. Further delineation of this

pattern should reveal the contribution of the structural

changes described here to the learned change in behavior.

55. Fleminger, S.; Murphy, L.; Lishman, W. A. Malignant distress on eye

contact after severe head injury [letter]. J-Neurol-Neurosurg-

Psychiatry. 1996 Jul; 61(1): 114-5; ISSN: 0022-3050.

ENGLAND.

56. Floeter, M. K.; Kohn, A. F. H-reflexes of different sizes exhibit

differential sensitivity to low frequency depression.

Electroencephalogr-Clin-Neurophysiol. 1997 Dec; 105(6): 470-

5; ISSN: 0013-4694.

IRELAND. The amplitude of the H-reflex declines when

activated repetitively. The magnitude of decline is greater

when the amplitude of the H-reflex is small. To explore

whether pre- or postsynaptic factors contribute to the

differences observed in H-reflexes of different sizes, changes

in the amplitude of H-reflexes of different sizes were

measured during a train of stimulation in 10 normal subjects.

Amplitudes of different sizes were obtained using differing

stimulus intensities or during superimposed contraction, two

manipulations which differently affect the number of active

afferents and the excitation of the motoneuron pool. Small

amplitude H-reflexes depressed to a lower plateau than larger

H-reflexes and superimposed contraction did not alleviate the

depression during each train. Nearly all the decline in larger

amplitude H-reflexes occurred in a component that was in

common with smaller amplitude H-reflexes. This suggests that

the depressibility of the earliest activated units is greater

than later activated units in H-reflexes and that the magnitude

of decline is affected by prior activity as well as size.

57. Flowers, WM Jr; Patel, B. R. Radionuclide angiography as a

confirmatory test for brain death: a review of 229 studies in

219 patients. South-Med-J. 1997 Nov; 90(11): 1091-6; ISSN:

0038-4348.

UNITED-STATES. BACKGROUND: Radionuclide angiography (RA)

has been used for many years to confirm the clinical diagnosis

of brain death, but quantitative data regarding the technique

are unavailable. METHODS: We conducted a retrospective

review of 229 RA procedures done in 219 patients. RESULTS: Of

206 patients who had interpretable studies and met clinical

criteria for brain death (profound coma, absent brain stem

reflexes, and apnea), including 10 patients who had repeated

studies, 203 (98.5% sensitivity) had positive studies, and 6

(2.9%) had negative studies. Of nine patients who had

interpretable studies and did not meet the clinical criteria for

brain death, five (56% specificity) had positive studies and

four (44%) had negative studies. CONCLUSIONS: Radionuclide

angiography is a sensitive confirmatory test of brain death.

The study does not evaluate the posterior fossa circulation,

and an occasional patient may have residual brain stem

function. The examination is most reliable when the patient is

in a deep coma, has no brain stem reflexes, and has failed a

formal apnea test.. 0; 23288-60-0.

58. Frohman, E. M.; Tusa, R.; Mark, A. S.; Cornblath, D. R. Vestibular

dysfunction in chronic inflammatory demyelinating

polyneuropathy. Ann-Neurol. 1996 Apr; 39(4): 529-35; ISSN:

0364-5134.

UNITED-STATES. Chronic inflammatory demyelinating

polyneuropathy (CIDP) has occasionally been associated with

clinical or laboratory evidence (magnetic resonance

imaging,[MRI], visual evoked response, and brainstem auditory

evoked response [BAER] of cranial neuropathy. In most cases,

the relationship of cranial nerve involvement to CIDP remains

unclear. A 45-year-old woman noted foot numbness, limb

weakness, gait and postural instability, and oscillopsia. An IgG

kappa monoclonal gammopathy of undetermined significance

was found. Bilateral vestibulopathy was documented by

clinical examination, bithermal calorics, rotary chair testing,

BAERs, and dynamic posturography. MRI with gadolinium

demonstrated enhancement of cranial nerve VIII bilaterally.

Over the next 6 years, the patients's relapsing and remitting

course of CIDP and vestibulopathy was assessed by

quantitative muscle and vestibular function testing (clinically

and neurophysiologically), and dynamic visual acuity. There

was a striking synchronization between her CIDP and

vestibulopathy with respect to clinical course including

relapses and responses to immune therapy. The response to

therapy, and evidence derived from clinical and laboratory

investigations, suggest that the vestibular dysfunction was

immune mediated.

59. Froklaer, J.; Djurhuus, J. C. [Renorenal reflexes]. Renorenale

reflekser. Ugeskr-Laeger. 1996 Jun 3; 158(23): 3329-30; ISSN:

0041-5782.

DENMARK. 0.

60. Fukuda, M.; Fullard, R. J.; Willcox, M. D.; Baleriola Lucas, C.;

Bestawros, F.; Sweeney, D.; Holden, B. A. Fibronectin in the tear

film. Invest-Ophthalmol-Vis-Sci. 1996 Feb; 37(2): 459-67;

ISSN: 0146-0404.

UNITED-STATES. PURPOSE. Fibronectin plays an important role

in corneal healing and has been detected previously in the tear

film. To investigate the levels of fibronectin in normal human

tears, the authors measured and compared fibronectin

concentration in open-eye, closed-eye, and reflex tear fluid.

The origin of fibronectin in the tear film was investigated by

comparing fibronectin concentration in sequentially collected

reflex tear samples with the concentrations of total protein

and albumin in the same samples. METHODS. Open-eye and

closed-eye tears were collected from 11 noncontact lens

wearers. From 7 subjects, 20 uninterrupted reflex tear

samples (10 microliters each) subsequently were collected,

using the sneeze reflex method of stimulation, followed by an

additional 10 nonstimulated tear samples (3 microliters each)

immediately after cessation of stimulus. Enzyme-linked

immunosorbent assays were used to determine fibronectin and

albumin concentrations, and bicinchoninic acid protein assays

were used to determine total protein concentration in each

sample. RESULTS. Fibronectin concentration in open-eye tears

(19 +/- 24 eta g/ml, range 3 to 78 eta g/ml) was significantly

different (P = 0.004) from that in closed-eyes tears (4127 +/-

3222 eta g/ml, range 1177 to 11384 eta g/ml). In the first 50

microliters of reflex tears, fibronectin concentrations were

low (10 +/- 23 eta g/ml), but they increased significantly (P =

0.028) after 100 microliters of reflex tears had been collected

(220 +/- 126 eta g/ml). There was a further marked transient

increase (767 +/- 946 eta g/ml) after cessation of stimulus.

Total protein concentration in the same samples decreased

significantly during reflex tear collection compared to open-

eye tears, and it increased gradually after cessation of

stimulus. Albumin concentration in the same samples,

analyzed for two subjects only, showed a pattern similar to

that for fibronectin. Dilation of conjunctival blood vessels

was noted in all subjects after reflex tear collection.

Administration of a topical vasoconstrictor in two subjects

eliminated the increase in fibronectin concentration during

reflex tearing but did not affect total protein concentration.

Under reducing conditions, the molecular mass of fibronectin

in open-eye and reflex tears was 240 kDa, identical to

commercially available purified plasma fibronectin, whereas

fibronectin in closed-eye tears was degraded into small

molecular mass fragments. CONCLUSIONS. These findings

suggest that fibronectin in tear fluid is derived from plasma

and that the increase in concentration in closed-eye and reflex

tear fluid is caused by leakage from dilated conjunctival blood

vessels.. 0; 0; 0; 0.

61. Fuller, R.; Hansson, L.; Karlsson, J. A. Neurophysiology of the cough

reflex [letter]. Eur-Respir-J. 1996 Mar; 9(3): 622-4; ISSN:

0903-1936.

DENMARK.

62. Funase, K.; Imanaka, K.; Nishihira, Y. Inhibition of the soleus H-

reflex during dorsiflexion is dependent on individual

differences in maximal soleus H-reflex as a test reflex.

Percept-Mot-Skills. 1996 Apr; 82(2): 403-10; ISSN: 0031-

5125.

UNITED-STATES. The quantitative differences among

individuals in the natural reciprocal inhibition of the soleus H-

reflex during dorsiflexion were examined, in conjunction with

the maximal H-reflex as the test reflex size in each individual.

Maximal H-reflex was expressed relative to the maximal M-

response (H(max)) when compared among individuals. Analysis

showed that with increases in H(max) at rest in each

individual, the inhibitory effect was first enhanced, then

reached a peak, and was finally alleviated. This pattern was

similar to the intraindividual pattern of the inhibitory effect

induced by specific conditioning stimulus as a function of the

test reflex size.

63. Furman, J. M.; Mendoza, J. C. Visual-vestibular interaction during

off-vertical axis rotation. J-Vestib-Res. 1996 Mar; 6(2): 93-

103; ISSN: 0957-4271.

UNITED-STATES. The aim of this study was to further define

the eye movement response to combined visual and vestibular

stimulation, especially during linear acceleration. Subjects

included 15 asymptomatic healthy individuals (8 females and 7

males) between the ages of 20 and 31 years. Vestibular

stimulation consisted of earth-vertical axis rotation and off-

vertical axis rotation (OVAR). Visual stimuli consisted of

projected vertical stripes that were rotated for optokinetic

trials and stationary for visual augmentation trials. A small

laser target (0.5 mW, 0.5 degree arc) that rotated with the

subject was used for fixation trials. Eye movements were

measured with electro-oculography. Results showed that

visual-vestibular interaction during sinusoidal rotation was

not affected by a 15 degree off-vertical tilt. Constant velocity

OVAR induced a continuous nystagmus whose slow component

velocity contained a nonzero baseline, that is, a bias, and a

periodic fluctuation at the rotation frequency, that is, a

modulation component. The modulation component during

visual fixation was reduced as compared with that seen during

rotation in the dark, but was not absent. Constant velocity

OVAR in the presence of earth-fixed stripes induced a

consistent sinusoidal modulation. Our results suggest that

visual-vestibular interaction for otolith stimulation differs

from visual-vestibular interaction for semicircular canal

stimulation. The modulation component of the response to

OVAR appears to be modified by visual stimulation to a lesser

extent than other vestibular-induced eye movements and thus

may reflect a more "direct" vestibulo-ocular response. The

bias component of the response to OVAR can be substantially

influenced by vision and thus may depend upon more "indirect"

pathways.

64. Garber, N. The use of photoscreening to identify visual problems

in the preschool population. J-Ophthalmic-Nurs-Technol. 1997

Sep; 16(5): 235-43; ISSN: 0744-7132.

UNITED-STATES.

65. Gasecki, A. [Josef Babinski: co-founder of contemporary neurology

and neurosurgery]. Jozef Babinski wspoltworca wspolczesnej

neurologii i neurochirurgii. Neurol-Neurochir-Pol. 1997 May;

31(3): 641-56; ISSN: 0028-3843.

POLAND.

66. Gasecki, A. P.; Hachinski, V. On the names of Babinski. Can-J-

Neurol-Sci. 1996 Feb; 23(1): 76-9; ISSN: 0317-1671.

CANADA. The 100th anniversary of the discovery of the

extensor plantar response will be celebrated in 1996. It was

Joseph Francois Felix Babinski who became known worldwide

for the sign that bears his name. In order to help Joseph in

establishing his career, brother Henri gave up his aspirations

and abandoned engineering. Clovis Vincent, "father' of French

neurosurgery and pupil of Joseph, stated: "Joseph Babinski

lived for science, and Henri lived for his brother; without

Henri Babinski, Joseph would not have accomplished that

much". However, Henri's name became famous in all Paris for a

cookbook Gastronomie Pratique written under the pseudonym

of "Ali-Bab.' Throughout Joseph's career his surname remained

distorted despite his own efforts to spell and pronounce it

correctly. Several people can claim the name Babinski, but in

neurology and neurosurgery there is only one, Joseph.

67. Gecelovska, V.; Javorka, K. [Cardiovascular and hemodynamic

changes after artificial pulmonary ventilation].

Kardiovaskularne a hemodynamicke zmeny pocas umelej

ventilacie pluc. Bratisl-Lek-Listy. 1996 May; 97(5): 260-6;

ISSN: 0006-9248.

SLOVAKIA. The cardio-respiratory interactions include

mechanical, reflex and humoral mechanisms. However, in the

organism they mutually overlap, thus mating their separate

investigation is problematic. Mechanical effects of

conventional artificial ventilation (AV) and high frequency

ventilation (HFV) are elicited by increased intrapulmonary

pressure during lung inflation, as well as during application of

positive end expiratory pressure (PEEP). The increase in

intrapulmonary pressure compresses the pulmonary vessels

and increases the pulmonary vascular resistance. These

changes deteriorate the right ventricular function. Mechanical

factors are responsible for the fall of the left ventricular (LV)

filling, stroke volume and alteration of the LV preload and

afterload. LV filling is decreased during artificial ventilation

(AV) owing to the shifting of blood from the central to the

peripheral circulation, and to the rise in pulmonary vascular

resistance. Application of positive intrathoracic pressure

during ventricular ejection phase can diminish LV afterload

and increase the cardiac output. This effect is striking in LV

failure. The reflex effects of artificial ventilation are due to

the activation of baroreflexes and pulmo-vagally cardiac and

vasoactive reflexes. Activation of these reflexes depends on

the level and characteristic of the pressure in the airways,

lungs, heart and vessels. Humoral effects of AV on the

cardiovascular system and hemodynamics are triggered by lung

expansion, circulatory changes, and they result in a release of

vasoactive substances from lung parenchyma. (Fig. 5, Ref. 45.).

68. Goddard, Sally. A Teacher's Window into the Child's Mind and

Papers from the Institute for Neuro-Physiological Psychology.

A Non-Invasive Approach to Solving Learning and Behavior

Problems. 1996;

Note: 128 p.

Fern Ridge Press, 1927 McLean Boulevard, Eugene, OR 97405

($19.95; video available).. Books (010). Guides - Non-

classroom (055). U.S.; Oregon. This book describes a neuro-

developmental approach to learning difficulty assessment and

remediation through assessment of a student's reception of

information through the sensory channels, processing of

sensory information in the brain, and repertoire of responses

for expression. Chapter 1, "Reflexes: Their Impact on Success

or Failure in Education," describes the Moro, Palmar,

Asymmetrical Tonic Neck , Rooting, Spinal Galant, Tonic

Labyrinthine, and Symmetrical Tonic Neck reflexes. Chapter 2,

"From Primitive Reflex to Postural Control" discusses postural

reflexes and in particular the Landau, Amphibian, and

Segmental Rolling Reflexes as well as equilibrium reflexes.

Chapter 3, "Brain Development," looks at development in the

first year of life. Chapter 4, "The Senses," covers balance and

the vestibular system, touch, hearing, seeing, taste, and smell

as well as proprioception or kinesthesis. Chapter 5, "Reflex

Testing," gives test procedures and scoring ranges for 15

reflexes and is illustrated with drawings. Chapter 6,

"Remedial Steps Available to the Teacher," discusses various

sensory difficulties and corrective activities, and provides

tables outlining the development and transformation of the

reflex system, historical indicators of neuro-developmental

delays, and suggested remediation for retained reflexes. An

appendix contains useful addresses, a glossary and index, and

three selected papers: "Elective Mutism: The Unchosen

Silence"; "Developmental Milestones: A Blueprint for Survival";

and "Why Do Our Children Roll and Tumble?" (Contains 84

references.) (JB).

69. Gould, T. J.; Steinmetz, J. E. Changes in rabbit cerebellar cortical

and interpositus nucleus activity during acquisition,

extinction, and backward classical eyelid conditioning.

Neurobiol-Learn-Mem. 1996 Jan; 65(1): 17-34; ISSN: 1074-

7427.

UNITED-STATES. Multiple- and single-unit neuronal activities

were recorded from cerebellar cortex (Larsell's lobule HVI and

adjacent ansiform cortex) and the cerebellar interpositus

nucleus during forward (CS-US), backward (US-CS), and

explicitly unpaired classical eyeblink conditioning in several

rabbits. Whereas learning-related activity was observed in the

interpositus nucleus only during forward pairing of the

conditioning stimuli, a variety of patterns of learning-related

neuronal firings were observed in cerebellar cortex during

forward, backward, and even unpaired presentations of the

conditioning stimuli. These data suggest that the cerebellar

cortex and the deep cerebellar nuclei play different roles

during classical eyeblink conditioning.

70. Gratadour, P.; Viale, J. P.; Parlow, J.; Sagnard, P.; Counioux, H.;

Bagou, G.; Annat, G.; Hughson, R.; Quintin, L. Sympathovagal

effects of spinal anesthesia assessed by the spontaneous

cardiac baroreflex. Anesthesiology. 1997 Dec; 87(6): 1359-67;

ISSN: 0003-3022.

UNITED-STATES. BACKGROUND: The changes in sympathovagal

balance induced by spinal anesthesia remain controversial. The

spontaneous baroreflex method allows the continuous

assessment of the spontaneous engagement of the cardiac

baroreflex, giving an index of sympathovagal balance. The

purpose of this study was to follow the effects of spinal

anesthesia on spontaneous baroreflex sensitivity. METHODS:

Continuous electrocardiogram and noninvasive blood pressure

were recorded in 24 patients scheduled for elective inguinal

hernia repair and randomly assigned to three groups: (1) no

volume loading, (2) volume loading of 15 ml/kg lactated

Ringer's solution, and (3) continuous infusion of etilefrine (an

ephedrine-like drug). Each patient was studied before, during,

and after bupivacaine-induced spinal anesthesia (mean sensory

block: T4). Spontaneous baroreflex sensitivity and parameters

of time-domain analysis of heart rate variability were

calculated from 30 min of recording of each period. RESULTS:

No significant change in spontaneous baroreflex slope or

parameters of time-domain analysis were observed after

regional anesthesia in any group. However, three patients

experienced episodes of bradycardia and hypotension in the

absence of a high block; these three patients showed an

increase in spontaneous baroreflex sensitivity and time-

domain parameters. CONCLUSIONS: Using a noninvasive,

continuous technique to estimate cardiac sympathovagal

balance, no significant variation in autonomic balance induced

by spinal anesthesia was observed. However, untoward

episodes of bradycardia and hypotension occurred in three

patients, who could not be prospectively identified by the

parameters studied.. 0; 0; 0; 0; 2180-92-9; 59467-70-8; 709-

55-7; 8022-63-7.

71. Grunwald, Bernice Bronia; McAbee, Harold V. Guiding the Family:

Practical Counseling Techniques. 1985;

Note: 355 p.

Accelerated Development Inc., Publishers, 3400 Kilgore Ave.,

Muncie, IN 47304-4896 ($22.95).. Books (010). U.S.; Indiana.

This book, intended as a text for therapists and counselors in

family counseling, is based on principles of Adlerian

psychology. The first chapter examines Adlerian theory and

family counseling. Basic principles of individual psychology

are applied to family counseling, and the goals of children

with disturbing behavior are discussed. Reasons why parents

pamper children are examined. The second chapter provides a

framework within which the counselor can find an

individualistic approach. Basic considerations are outlined

which are safe and consistent with Adlerian psychology. The

third chapter contains seven basic steps considered essential

to family counseling. The fourth chapter outlines and

discusses confrontation techniques for psychological

disclosure, goals of distributing behavior, and the recognition

reflex. The fifth chapter examines diagnostic techniques and

discusses how to gather significant information. The sixth

chapter examines the use of corrective measures. Use of

recommendations, encouragement, training children with

logical consequences, paradoxical intentions, the family

council, and giving directions are all examined. The seventh

chapter contains vignettes with concrete suggestions for

improving relationships between parents and their children in

a variety of problem situations. The eighth chapter focuses on

counseling adolescents. Special sections are included for

counseling the defiant adolescent and juvenile delinquents. The

ninth chapter is concerned with special family circumstances

such as single parent families, blended families, and extended

families. The tenth chapter contains case studies which

illustrate principles and techniques delineated throughout the

book. (LLL).

72. Guyot, J. P.; Psillas, G. Test-retest reliability of vestibular

autorotation testing in healthy subjects. Otolaryngol-Head-

Neck-Surg. 1997 Dec; 117(6): 704-7; ISSN: 0194-5998.

UNITED-STATES. Vestibulo-ocular reflex rotational chair

testing in the high-frequency range is seldom performed

because it requires specialized and powerful systems. But

today a new method of sweep-frequency vestibulo-ocular

reflex testing, the Vestibular Autorotation Test system

(Western Systems Research, Inc., Pasadena, Calif.), based on

active head movements increasing from 2 to 6 Hz, is available

on the market. The goal of this study was to evaluate the test-

retest variability of this test in healthy subjects. Twelve

young adults (22 to 42 years old) without any history of

auditory or vestibular dysfunction were included in the study.

Subjects underwent five tests under standardized conditions

with a 1-week interval. Each test consisted of three

measurements of the gain and phase of the vestibulo-ocular

reflex in the horizontal and vertical planes. Statistical

analysis shows that the test-retest reliability of the

Vestibular Autorotation Test is poor. Therefore this method

cannot be used routinely to evaluate precise vestibulo-ocular

reflex anomalies.

73. Haapaniemi, J. J. Immittance findings in school-aged children.

Ear-Hear. 1996 Feb; 17(1): 19-27; ISSN: 0196-0202.

UNITED-STATES. OBJECTIVE: The purpose of the present study

was to obtain the median values and distributions of

tympanometric variables and the distributions of acoustic

reflex thresholds for three age groups of unselected school-

aged children. Furthermore, the investigation was undertaken

to provide normative immittance data for selected,

otologically normal 7-, 10-, and 14-yr-old children. DESIGN: A

total of 687 children, aged 6 to 15 yr, were thoroughly

examined clinically, audiometrically, and tympanometrically.

The same examinations were made in 471 otologically normal

children, selected from the total population on the basis of the

findings that both tympanic membranes were

otomicroscopically healthy, and the hearing thresholds were

better than or equal to 25 dB HL at all frequencies. RESULTS:

The results showed that the median equivalent ear canal

volume (Vec) increased from 0.65 ml to 1.00 ml with

increasing age both in the unselected and selected populations.

The median peak admittance values (Ytm) were between 0.55

and 0.5 mmho in the respective study groups, somewhat higher

in older than in younger children. The same tendency was also

seen in gradient and tympanometric peak pressure (TPP)

results. Depending on the age, the median tympanometric peak

pressures were 5 to 10 daPa higher in otologically normal

children than in the unselected population. The median TPP

was -10 daPa in a group of unselected children, and -5 daPa in

a group of otologically normal children. The distribution of

ipsi- and contralateral acoustic reflex thresholds is

presented. Thresholds were higher in younger than in older

children. CONCLUSIONS: The obtained results give new

information on immittance findings in an unselected sample of

school-aged children who were representative of children in

the general population. Furthermore, the results are useful as

normative immittance values in 7-, 10-, and 14-yr-old

children when the limitations relating to the equipment are

taken into account.

74. Hallett, M.; Daroff, R. B. Blepharospasm: report of a workshop.

Neurology. 1996 May; 46(5): 1213-8; ISSN: 0028-3878.

UNITED-STATES.

75. Hannam, S.; Ingram, D. M.; Milner, A. D. A possible role for the

Hering-Breuer deflation reflex in apnea of prematurity. J-

Pediatr. 1998 Jan; 132(1): 35-9; ISSN: 0022-3476.

UNITED-STATES. BACKGROUND: The vagally mediated Hering-

Breuer deflation reflex terminates expiration and initiates

inspiration when lung volume is reduced to less than

functional residual capacity. The effects of prematurity on

this reflex are not known. STUDY DESIGN: Fifteen term and 20

preterm nonventilated infants were studied. Lung deflation

was achieved by chest compression using an inflatable jacket.

Relative changes in expiratory time and inspiratory time on

chest compression were calculated from airflow recordings.

Esophageal pressure changes in the term infants and chest

wall movements in the preterm infants were also measured.

RESULTS: The term infants had a mean prolongation of

inspiratory time on squeezing of 15% versus a 24% shortening

in the preterm infants (p < 0.001). The term infants had a mean

shortening of expiratory time on squeezing of 35% versus 18%

in the preterm infants (p < 0.001). Fifteen of the 20 preterm

infants demonstrated a tendency to have short apneas (2 to 5

seconds) on squeezing, 88% of which were central in origin. In

these infants shortening of inspiratory time was greater than

that seen in the preterm infants not having apneas (p < 0.05).

CONCLUSIONS: Preterm infants responded to a rapid reduction

in lung volume with a shortened inspiratory effort and a

tendency to have central apneas. This may be due to an

immaturity in part of the reflex arc responsible for

transmitting the Hering-Breuer deflation reflex.

76. Herrero, J. F.; Cervero, F. Supraspinal influences on the

facilitation of rat nociceptive reflexes induced by carrageenan

monoarthritis. Neurosci-Lett. 1996 May 3; 209(1): 21-4; ISSN:

0304-3940.

IRELAND. During hyperalgesia there is an enhancement of

wind-up and the appearance of a novel wind-up of the A-fibre-

mediated responses. We have examined if these phenomena are

influenced by supraspinal mechanisms by analysing single

motor unit activity in control and arthritic rats, either intact

or acutely spinalised. Enhancement of the C-fibre wind-up and

the novel A-fibre wind-up were only observed in the intact

arthritic animals. We conclude that C-fibre wind-up is a spinal

phenomenon, whereas the enhancement of the C-fibre wind-up

and the novel A-fibre wind-up during arthritis depend also on

supraspinal influences.. 9000-07-1.

77. Herzog, W. On sounds and reflexes. J-Manipulative-Physiol-Ther.

1996 Mar; 19(3): 216-8; ISSN: 0161-4754.

UNITED-STATES.

78. Hesse, S.; Krajnik, J.; Luecke, D.; Jahnke, M. T.; Gregoric, M.;

Mauritz, K. H. Ankle muscle activity before and after botulinum

toxin therapy for lower limb extensor spasticity in chronic

hemiparetic patients. Stroke. 1996 Mar; 27(3): 455-60; ISSN:

0039-2499.

UNITED-STATES. BACKGROUND AND PURPOSE: Recent studies

have been made of the novel treatment of lower limb

spasticity after stroke with botulinum toxin A, and the results

were based mostly on the clinical assessment made before and

after treatment. This study investigated the effects of toxin

on ankle muscle activity during gait in patients with severe

extensor spasticity. The questions posed were whether the

toxin particularly diminishes the so-called premature muscle

activity as a major cause of equinovarus deformity and

whether different types of altered motor control allow a

prediction of the outcome of the treatment. METHODS: In 12

chronic hemiparetic outpatients with pronounced lower limb

spasticity, we injected 400 U botulinum toxin A into the

soleus and tibialis posterior muscles and both heads of the

gastrocnemius muscles. Ankle spasticity and complex gait

analysis including kinematic electromyography (EMG) of the

soleus and tibialis muscles were assessed before treatment

and 4 weeks after the injection. RESULTS: Nine patients

profited with a reduction of spasticity, improved gait ability,

and a more normal temporal pattern of muscle activity with a

prominent reduction of the premature activity of the plantar

flexors. Eight patients exhibited a qualitative pattern (type I)

corresponding to an increased stretch-reflex excitability.

Three patients did not profit; their muscle tone, gait ability,

and muscle activation remained stable or even deteriorated.

CONCLUSIONS: This study further supports the beneficial

effects of botulinum toxin in the treatment of lower limb

extensor spasticity. A correlation was observed between the

clinical reduction of muscle tone, functional gait parameters,

and a more normal EMG pattern with a predominant reduction

of the premature activity of the plantar flexors. The

qualitative type of EMG pattern corresponding to an increased

stretch-reflex excitability (type I) was a positive predictor

for the outcome.. 0; 0.

79. Hirschl, M.; Kundi, M.; Blazek, G. Five-year follow-up of patients

after thromboendarterectomy of the internal carotid artery:

Relevance of baroreceptor sensitivity. Stroke. 1996 Jul; 27(7):

1167-72; ISSN: 0039-2499.

UNITED-STATES. BACKGROUND AND PURPOSE: In patients after

myocardial infarction, baroreceptor sensitivity has been

identified as a factor of prognostic relevance. This study was

designed to assess the effects of an increased baroreceptor

sensitivity in patients after surgery in the area of the internal

carotid artery with respect to blood pressure variability,

therapeutic interventions, and vascular events during a 5-year

follow-up. METHODS: Receptor sensitivity before and

immediately after carotid surgery was measured in 84

patients. Blood pressure variability, carotid artery status, and

echocardiographic findings were assessed before and after

surgery and at the end of follow-up. Vascular events as well

as changes in blood pressure therapy during the follow-up

period were evaluated. RESULTS: Significant negative

correlations between an increase of baroreceptor sensitivity

after surgery and the range of systolic (r=-.47; P<.001) and

diastolic (r=-.33; P<.01) blood pressure were found for the

immediate postoperative period. For the range of systolic

blood pressure, this relation persisted (4.3 to 7 years after

surgery) at the end of the observation period (r=-.38; P<.001).

An inverse relation to the increase in baroreceptor function

was also found for the average annual number of therapeutic

interventions during follow-up (r=-.38; P<.001). Furthermore,

the subgroup of patients without a postoperative increase of

receptor sensitivity was characterized by a significantly

higher risk of major vascular events (log-rank test, P<.018).

CONCLUSIONS: Because an improvement of receptor sensitivity

after carotid surgery is related to a long-lasting reduction of

blood pressure levels and variability, baroreceptor function

may be considered an indirect indicator for the later

postoperative course.

80. Hockman, C. H.; Weerasuriya, A.; Bieger, D. GABA receptor-

mediated inhibition of reflex deglutition in the cat. Dysphagia.

1996 Jun; 11(3): 209-15; ISSN: 0179-051X.

UNITED-STATES. In anesthetized cats, swallowing elicited by

electrical stimulation of the superior laryngeal nerves (SLNs)

was inhibited by the GABA-mimetic muscimol and by

diazepam, an action that was reversed by picrotoxin and

bicuculline. This inhibition supports the involvement of GABA

receptors, specifically those of the GABAA subtype which both

antagonists have been shown to block in various areas of the

central nervous system. The inhibition of reflex swallowing

and its reversal were unaltered by a transection of the

brainstem at a midcollicular level. Stimulation of the SLNs

also caused a bradycardia that was inhibited by both muscimol

and diazepam and was restored by both GABA antagonists. Data

from these experiments provide suggestive evidence for a role

of GABA-ergic transmission in the central control of the

deglutitory reflex.. 0; 0; 2763-96-4; 439-14-5.

81. Hohenfellner, M.; Fahle, H.; Dahms, S.; Linn, J. F.; Hutschenreiter,

G.; Thuroff, J. W. Continent reconstruction of detrusor

hyperreflexia by sacral bladder denervation combined with

continent vesicostomy. Urology. 1996 Jun; 47(6): 930-1; ISSN:

0090-4295.

UNITED-STATES. We describe a two-stage surgical procedure

for complex hyperreflexic detrusor dysfunction refractory to

conservative therapy. First, ventral and dorsal sacral

rhizotomies (S2 to S4/5) are performed to restore vesical

storage function and abolish autonomic dysreflexia. Then,

after an interval of several weeks to allow for detrusor

relaxation, continent vesicostomy is performed for suprapubic

clean intermittent catheterization. The procedure is effective

both objectively and subjectively, is only moderately invasive,

and requires neither sophisticated nor expensive medical

equipment.

82. Holcomb, L.; Gordon, M. N.; McGowan, E.; Yu, X.; Benkovic, S.;

Jantzen, P.; Wright, K.; Saad, I.; Mueller, R.; Morgan, D.; Sanders,

S.; Zehr, C.; O'Campo, K.; Hardy, J.; Prada, C. M.; Eckman, C.;

Younkin, S.; Hsiao, K.; Duff, K. Accelerated Alzheimer-type

phenotype in transgenic mice carrying both mutant amyloid

precursor protein and presenilin 1 transgenes. Nat-Med. 1998

Jan; 4(1): 97-100; ISSN: 1078-8956.

UNITED-STATES. Genetic causes of Alzheimer's disease (AD)

include mutations in the amyloid precursor protein (APP),

presenilin 1 (PS1), and presenilin 2 (PS2) genes. The mutant

APP(K670N,M671L) transgenic line, Tg2576, shows markedly

elevated amyloid beta-protein (A beta) levels at an early age

and, by 9-12 months, develops extracellular AD-type A beta

deposits in the cortex and hippocampus. Mutant PS1 transgenic

mice do not show abnormal pathology, but do display subtly

elevated levels of the highly amyloidogenic 42- or 43-amino

acid peptide A beta42(43). Here we demonstrate that the

doubly transgenic progeny from a cross between line Tg2576

and a mutant PS1M146L transgenic line develop large numbers

of fibrillar A beta deposits in cerebral cortex and hippocampus

far earlier than their singly transgenic Tg2576 littermates. In

the period preceding overt A beta deposition, the doubly

transgenic mice show a selective 41% increase in A

beta42(43) in their brains. Thus, the development of AD-like

pathology is substantially enhanced when a PS1 mutation,

which causes a modest increase in A beta42(43), is introduced

into Tg2576-derived mice. Remarkably, both doubly and singly

transgenic mice showed reduced spontaneous alternation

performance in a "Y" maze before substantial A beta deposition

was apparent. This suggests that some aspects of the

behavioral phenotype in these mice may be related to an event

that precedes plaque formation.. 0; 0; 0; 0.

83. Hughes, T. A.; Wiles, C. M. Palatal and pharyngeal reflexes in

health and in motor neuron disease. J-Neurol-Neurosurg-

Psychiatry. 1996 Jul; 61(1): 96-8; ISSN: 0022-3050.

ENGLAND. Palatal and pharyngeal sensation and motor

responses, and volitional palatal movement, were tested in

171 healthy adults and 43 patients with motor neuron disease.

In healthy adults palatal and pharyngeal sensation and

volitional palatal elevation were present in all; the palatal and

pharyngeal motor responses could not be elicited on first

testing in two (1.1%) and seven (4.1%) subjects respectively.

Pharyngeal motor responses were more easily elicited in older

subjects and palatal responses were more easily elicited in

women. Eye watering and retching were the most common

accompanying features. In 57 normal subjects tested on five

occasions there was considerable variation in the stimulus

required to elicit the motor responses within subjects: in none

of four subjects (7%) who initially had absent responses were

they always absent. Pharyngeal motor responses were more

easily elicited in patients with motor neuron disease than in

matched normal subjects; within the motor neuron disease

group pharyngeal motor responses elicited by tongue

depression were associated with the symptom of food or drink

"going down the wrong way" > 1/month and a reduction in

average volume per swallow (ml) and swallowing capacity

(ml/s). Volitional palatal elevation was absent in five patients

(11.6%). In six of eight patients with motor neuron disease

studied repeatedly (on between two and seven occasions) the

palatal and pharyngeal responses were elicited with the same

stimulus on each occasion. In healthy adults palatal and

pharyngeal sensation and motor responses should be present

although considerable variation occurs in the stimulus

required. In patients with motor neuron disease features of

impaired swallowing are associated with a brisk rather than a

depressed pharyngeal response.

84. Hultborn, H.; Illert, M.; Nielsen, J.; Paul, A.; Ballegaard, M.; Wiese,

H. On the mechanism of the post-activation depression of the

H-reflex in human subjects. Exp-Brain-Res. 1996 Mar; 108(3):

450-62; ISSN: 0014-4819.

GERMANY. It was demonstrated that the soleus H-reflex was

depressed for more than 10 s following a preceding passive

dorsiflexion of the ankle joint. This depression was caused by

activation of large-diameter afferents with receptors located

in the leg muscles, as an ischaemic block of large-diameter

fibres just below the knee joint abolished the depression,

whereas a similar block just proximal to the ankle joint was

ineffective. The depression of the H-reflex was not caused by

changes in motoneuronal excitability, as motor-evoked

potentials by magnetic brain stimulation were not depressed

by the same passive dorsiflexion. Therefore it was concluded

that the long-lasting depression is due to mechanisms acting

at presynaptic level. The transmission of the monosynaptic Ia

excitation from the femoral nerve to soleus motoneurones was

not depressed by the ankle dorsiflexion. The depression thus

seems to be confined to those afferents that were activated by

the conditioning dorsiflexion. In parallel experiments on

decerebrate cats, more invasive methods have complemented

the indirect techniques used in the experiments on human

subjects. A similar long-lasting depression of triceps surae

monosynaptic reflexes was evoked by a preceding conditioning

stimulation of the triceps surae Ia afferents. This depression

was accompanied by a reduction of the monosynaptic Ia

excitatory postsynaptic potential recorded intracellularly in

triceps surae motoneurones, but not by changes in the input

resistance or membrane potential in the motoneurones.

Stimulation of separate branches within the triceps surae

nerve demonstrated that the depression is confined to those

afferents that were activated by the conditioning stimulus.

This long-lasting depression was not accompanied by a dorsal

root potential. It is concluded that the long-lasting depression

is probably caused by a presynaptic effect, but different from

the "classical" GABAergic presynaptic inhibition which is

widely distributed among afferent fibres and accompanied by

dorsal root potentials. It is more probably related to the

phenomenon of a reduced transmitter release from previously

activated fibres, i.e. a homosynaptic post-activation

depression. The consequences of this post-activation

depression for the interpretation of results on spinal

mechanisms during voluntary movements in man are discussed.

85. Igarashi, K. [Neurophysiological mechanism of jaw-tongue reflex

in man]. Kokubyo-Gakkai-Zasshi. 1996 Mar; 63(1): 108-21;

ISSN: 0300-9149.

JAPAN. The present study was carried out to examine if the

jaw-tongue reflex (JTR) could be elicited in man and if

afferent fibers from the jaw-closing muscles were involved in

this reflex. Electromyographic (EMG) activities were

simultaneously recorded from the genioglossus (GG), the

tongue retruding (TR) muscles, and the anterior temporal (TA),

the posterior temporal (TP), the masseteric (Mass) and the

digastric (Dig) muscles under various conditions. The results

were as follows: 1. EMG activities of the GG and the TR

muscles were increased during clenching, voluntary and

passive jaw-opening, and chin-tapping. 2. Electrical

stimulation of the deep temporal and masseteric nerves

evoked H-reflex in the TA and the Mass muscles. EMG activities

in the GG and the TR muscles were detected as the intensity of

the electrical stimulation were increased. 3. The tonic

vibration reflex (TVR) was induced in the jaw-closing muscles

by applying vibratory stimulation to the bellies of the TA and

the Mass muscles. EMG activities of the GG and the TR muscles

were increased as the TA muscle activity was increased. It is

concluded that the JTR is elicited in man and suggested that

low threshold afferent fibers from the jaw-closing muscles,

mainly the temporal muscle, were involved in eliciting the JTR

in man.

86. Ismailov, D. B.; Kanatbaeva, A. B.; Aiubaev, A. S.; Dosumova, S. M.;

Ushurova, A. I. [Neurosomatic parallels in children with

neurogenic bladder dysfunction]. Neirosomaticheskie paralleli

u detei s neirogennoi disfunktsiei mochevogo puzyria. Urol-

Nefrol-Mosk. 1997 Sep; (5): 43-5; ISSN: 0042-1154.

RUSSIA. Clinical, urodynamic and neurological examinations of

30 children with hyperreflex dysfunction of the bladder gave

evidence for clinical symptoms of natal trauma sequelae in 23

of them. Diagnosis of polyvisceral functional changes and

chronic urinary diseases was made significantly more

frequently in children with neurological symptoms. High

occurrence of neurological symptoms of natal subclinical

cervical traumas in children with hyperreflex dysfunction of

the bladder suggests their pathogenetic relations.

Hemodynamic changes of the cerebral vessels with affection

of the venous outflow may cause hypoxia of the hypothalamo-

hypophyseal structures with emergence of symptom complex

of vegetovascular dystonia and marked neurogenic dysfunction

of the bladder. The authors conclude on validity of

pathogenetic neurological therapy to coordinate the activity of

spinal and supraspinal centers regulating function of the

bladder.

87. Jaaskelainen, S. K.; Peltola, J. K.; Lehtinen, R. The mental nerve

blink reflex in the diagnosis of lesions of the inferior alveolar

nerve following orthognathic surgery of the mandible. Br-J-

Oral-Maxillofac-Surg. 1996 Feb; 34(1): 87-95; ISSN: 0266-

4356.

SCOTLAND. The purpose of this study was to evaluate the

diagnostic value of a new modification of the blink reflex test

with stimulation of the distribution of the mental nerve in

iatrogenic lesions of the inferior alveolar nerve. The test was

performed on 23 patients undergoing orthognathic surgery of

the mandible, most of them (20) with bilateral sagittal split

osteotomies. The function of the inferior alveolar nerve was

studied preoperatively, and 2 weeks, 2 months, 6 months and 1

year postoperatively with both mental nerve blink reflex test

and clinical neurosensory testing. The objective

electrophysiological test proved to be useful in the diagnosis

and follow-up of sensory impairment of the inferior alveolar

nerve. The results of the mental nerve blink reflex test and

clinical neurosensory testing were closely related. The results

of the two tests did not differ statistically significantly in

the two first postoperative examinations. The positive

predictive value of the mental nerve blink reflex test was

better than that of clinical neurosensory testing: an initially

abnormal reflex response predicted persistent subjective

sensory symptoms after one year more reliably than did

altered sensation at the first two examinations. Irrespective

of the possible coexistent sensory symptoms and signs, a

normal mental nerve blink reflex within 2 months after

operation also predicted a reasonably good sensory recovery at

1 year.

88. Jenner, J. A. [Startle disease: growing rigid with fear (letter)

(see comments)]. 'Startle disease': van schrik verstijven. Ned-

Tijdschr-Geneeskd. 1996 Mar 2; 140(9): 511; ISSN: 0028-2162.

Note: Comment in: Ned Tijdschr Geneeskd 1995 Sep

23;139(38):1940-3.

NETHERLANDS.

89. Johansson, B. B. Functional outcome in rats transferred to an

enriched environment 15 days after focal brain ischemia.

Stroke. 1996 Feb; 27(2): 324-6; ISSN: 0039-2499.

UNITED-STATES. BACKGROUND AND PURPOSE: The aim was to

determine whether a delayed transfer to an enriched

environment improves outcome after focal brain ischemia.

METHODS: Performance on a rotating pole, prehensile traction,

limb placement, and postural reflexes were tested in 15

spontaneously hypertensive rats housed in standard laboratory

cages for 2 weeks after middle cerebral artery ligation. Seven

of the 15 rats were then transferred to an enriched

environment, and the two groups were tested 1, 3, and 5 weeks

later. RESULTS: The enriched environment significantly

improved pole performance, prehensile traction, and limb

placement. CONCLUSIONS: Delayed postoperative environmental

enrichment improves outcome in experimental stroke.

90. Josefsson, T.; Nordh, E.; Eriksson, P. O. A flexible high-precision

video system for digital recording of motor acts through

lightweight reflex markers. Comput-Methods-Programs-

Biomed. 1996 Mar; 49(2): 119-29; ISSN: 0169-2607.

IRELAND. This paper describes and evaluates the digital

MacReflex system for wireless recording of movements in

three dimensions. Up to seven high resolution infra-red

sensitive CCD video cameras with electronic shutters register

the positions of maximally 40 stroboscopically illuminated

retro-reflective tape markers. The system is equipped with

real-time video processors for computation of position co-

ordinates for the markers and for optimised data transmission

and storage. Data are output to any type of computer through a

standard serial interface, which also provides possibilities

for simultaneous A/D-sampling. Dynamic manipulation of the

recorded signals in three-dimensional plots is provided by

standard software and transformation and evaluation of

recorded data are performed in standard software. The

described equipment is found to offer a flexible and easily

operated solution for recording of movements with high

resolution.

91. Kahrilas, P. J.; Shi, G. Why do we hiccup? [comment]. Gut. 1997

Nov; 41(5): 712-3; ISSN: 0017-5749.

Note: Comment on: Gut 1997 Nov;41(5):590-3.

ENGLAND. 0; 0; 0; 123618-00-8.

92. Kallikazaros, I.; Stratos, C.; Tsioufis, C.; Stefanadis, C.; Sideris,

A.; Sideris, S.; Toutouzas, P. Carotid sinus hypersensitivity in

patients undergoing coronary arteriography: relation with the

severity of carotid atherosclerosis and the extent of coronary

artery disease. J-Cardiovasc-Electrophysiol. 1997 Nov; 8(11):

1218-28; ISSN: 1045-3873.

UNITED-STATES. INTRODUCTION: The purpose of the present

investigation was to study the precise relationship between

carotid sinus hypersensitivity (CSH) and both the severity of

carotid atherosclerosis and the extent of coronary artery

disease in patients who were referred for evaluation for

suspected ischemic heart disease. METHODS AND RESULTS:

Duplex echocardiography and coronary angiography were used

to assess carotid and coronary artery atherosclerosis in 130

consecutive patients. Carotid sinus stimulation was performed

before coronary arteriography with simultaneous recordings of

the ECG and aortic pressure. Coronary artery disease was

present in 103 patients (79%). Thirty patients (23.08%) had

one-vessel disease (1-VD), 31 (23.85%) had 2-VD, 29 (22.31%)

had 3-VD, and 13 patients (10%) had left main coronary artery

disease. Carotid artery atherosclerosis was present in 100

patients (76.92%) and carotid disease (diameter stenosis >

50%) was present in 24 patients (18.46%). CSH was found in 33

patients (25%). The incidence of CSH was 9% in patients with

carotid stenosis 1%-15%, 17% in patients with stenosis 16%-

49%, 85% in patients with stenosis 50%-79%, and 100% in

patients with stenosis > or = 80%. The incidence of CSH was

11%, 17%, 23%, 34%, and 62% in patients with no VD, 1-VD, 2-

VD, 3-VD, and left main coronary artery disease, respectively.

Stepwise multiple logistic regression analysis revealed that

carotid disease and left main coronary artery disease were the

most significant determinants of CSH (P < 0.001 and P = 0.013,

respectively). CONCLUSION: The incidence of CSH increased in

proportion to the severity of carotid and coronary

atherosclerosis. These data provide evidence that CSH is

closely related to severe carotid atherosclerosis or left main

coronary artery disease in patients being evaluated for

suspected ischemic heart disease.

93. Kautzner, J.; Hartikainen, J. E.; Camm, A. J.; Malik, M. Arterial

baroreflex sensitivity assessed from phase IV of the Valsalva

maneuver. Am-J-Cardiol. 1996 Sep 1; 78(5): 575-9; ISSN:

0002-9149.

UNITED-STATES. To assess the feasibility of 2 noninvasive

methods for arterial baroreflex sensitivity testing based on

phase IV of the Valsalva maneuver, the performance of a

simple arterial baroreflex sensitivity index compared with a

slope method and reproducibility of repeated measurements of

either parameter were evaluated in 36 subjects without

structural heart disease. The study showed feasibility and

reproducibility of both these methods for arterial baroreflex

sensitivity assessment and demonstrated the importance of an

appropriate rest period between repeated Valsalva maneuvers,

giving a basis for prospective testing of noninvasive

determination of arterial baroreflex sensitivity together with

phenylephrine method in survivors of myocardial infarction.

94. Khodos, K. h. G. [The gifts of the clinical power of observation].

Dary klinicheskoi nabliudatel'nosti. Zh-Nevropatol-Psikhiatr-

Im-S-S-Korsakova. 1996; 96(1): 85-7; ISSN: 0044-4588.

RUSSIA.

95. Killian, J. M.; Tiwari, P. S.; Jacobson, S.; Jackson, R. D.; Lupski, J.

R. Longitudinal studies of the duplication form of Charcot-

Marie-Tooth polyneuropathy. Muscle-Nerve. 1996 Jan; 19(1):

74-8; ISSN: 0148-639X.

UNITED-STATES. This study presents a longitudinal

comparison of motor nerve conduction velocities (MCVs) in

patients with Charcot-Marie-Tooth type 1A with proven

duplication of a segment of chromosome 17p11.2p12. Results

were compared for 8 CMT1A duplication patients from one

family whose MCV measurements were taken 22 years apart

(1967 and 1989). Measurements from a total of seven median

motor and five peroneal motor MCVs were compared. Median

MCVs showed a slight reduction that averaged 2.2 m/s, and

peroneal MCVs showed an average decrease of 3.0 m/s. In

addition, mild objective increase in limb weakness was seen

in only 1 of 8 patients and subjective symptoms of gradual

worsening of leg strength were noted in half the patients over

the same period. In this study of a small group of CMT1A

patients with proven segmental duplication of chromosome

17p11.2p12, the motor conduction velocities and clinical

motor exam did not change significantly over 22 years.

96. Kim, J. J.; Krupa, D. J.; Thompson, R. F. Inhibitory cerebello-olivary

projections and blocking effect in classical conditioning.

Science. 1998 Jan 23; 279(5350): 570-3; ISSN: 0036-8075.

UNITED-STATES. The behavioral phenomenon of blocking

indicates that the informational relationship between the

conditioned stimulus and the unconditioned stimulus is

essential in classical conditioning. The eyeblink conditioning

paradigm is used to describe a neural mechanism that

mediates blocking. Disrupting inhibition of the inferior olive, a

structure that conveys unconditioned stimulus information

(airpuff) to the cerebellum prevented blocking in rabbits.

Recordings of cerebellar neuronal activity show that the

inferior olive input to the cerebellum becomes suppressed as

learning occurs. These results suggest that the inferior olive

becomes functionally inhibited by the cerebellum during

conditioning, and that this negative feedback process might be

the neural mechanism mediating blocking.. 124-87-8; 56-12-

2.

97. Kimura, E.; Young, R. S. A chromatic-cancellation property of

human pupillary responses. Vision-Res. 1996 Jun; 36(11):

1543-50; ISSN: 0042-6989.

ENGLAND. The pupil exhibits a response property somewhat

analogous to perceptual red-green cancellation. Across a

limited range of flash intensities near threshold, pupillary

constrictions evoked by red flashes can be reduced, if not

nulled, by the simultaneous addition of a green flash. The

percentage of trials on which a stimulus-evoked response can

be correctly discriminated from noise also falls to chance

level as a green flash is added to the red flash. In terms of the

quanta absorbed by L and M cones, the cancellation can be

modelled as a function of magnitude of 0.65*L-M.

98. King, T. E.; Joynes, R. L.; Meagher, M. W.; Grau, J. W. Impact of

shock on pain reactivity: II. Evidence for enhanced pain. J-Exp-

Psychol-Anim-Behav-Process. 1996 Jul; 22(3): 265-78; ISSN:

0097-7403.

UNITED-STATES. Shocked rats (Rattus norvegicus) often

exhibit longer tail withdrawal latencies to radiant heat, which

suggests that exposure to shock reduces pain. But at the same

time, rats appear hyperreactive to shock, suggesting than pain

is enhanced. Experiment 1 replicated these findings and

showed that when tail movement was monitored, shocked rats

were less responsive to heat and hyperreactive to shock even

when the same behavioral criteria were used. When latency to

vocalize was measured, shocked rats appeared hyperreactive

to both test stimuli (Experiments 2 and 3). Prior exposure to

shock also enhanced the acquisition of conditioned fear in a

different context (Experiment 4) and the speed with which

rats learned a response to avoid a thermal stimulus

(Experiment 5). The results suggest that exposure to shock

enhances pain.

99. Kodsi, M. H.; Swerdlow, N. R. Reduced prepulse inhibition after

electrolytic lesions of nucleus accumbens subregions in the

rat. Brain-Res. 1997 Oct 31; 773(1-2): 45-52; ISSN: 0006-

8993.

NETHERLANDS. A variety of neurochemical and anatomical

studies have shown that the ventral striatal nucleus

accumbens (NAcc) can be divided into a predominantly medial

'shell' and a predominantly lateral 'core'. These accumbens

subdivisions are innervated by different cortical regions and

project to different anatomical targets. Additionally, recent

behavioral observations suggest functional differences

between the accumbens shell and core. In order to further

examine core and shell function, we measured prepulse

inhibition (PPI) of the acoustic startle reflex after

electrolytic lesions aimed at the central NAcc, the NAcc shell,

the NAcc core, and the adjacent anteroventrolateral striatum.

Acoustic startle is the contraction of whole-body musculature

in response to a sudden, loud auditory stimulus, and PPI is the

inhibition of acoustic startle by a weak auditory 'prepulse'

administered 30-500 ms prior to the startling stimulus.

Previous work has shown that PPI is regulated by the NAcc,

and recent observations suggest that PPI is regulated by

different neurochemical interactions in the core and shell. PPI

was significantly reduced by electrolytic lesions of the

central NAcc, as well as by lesions that predominantly

damaged either the NAcc shell or the core. Lesions of the

anteroventrolateral striatum and lateral edge of the NAcc core

did not significantly alter PPI. These findings suggest that,

despite neurochemical differences between the two

subregions, PPI is regulated by both the NAcc shell and core.

100. Kohn, A. F.; Floeter, M. K.; Hallett, M. Presynaptic inhibition

compared with homosynaptic depression as an explanation for

soleus H-reflex depression in humans. Exp-Brain-Res. 1997

Sep; 116(2): 375-80; ISSN: 0014-4819.

GERMANY. The H-reflex is depressed for seconds if elicited

following a single H-reflex or train of H-reflexes. Presynaptic

inhibition from flexor afferents (tibialis anterior) onto soleus

Ia afferents elicited by either single or trains of stimuli had

no effect on the soleus H-reflex on a time scale of seconds.

Postsynaptic inhibition was also excluded by magnetic

stimulation tests that showed that the excitability of the

motoneuron pool was not changed at latencies within a range

of seconds. Homosynaptic depression localized at the

presynaptic terminal seems to be the mechanism behind the H-

reflex depression in humans.. 0.

101. Komiyama, T.; Kasai, T. Changes in the H-reflexes of ankle

extensor and flexor muscles at the initiation of a stepping

movement in humans. Brain-Res. 1997 Aug 22; 766(1-2): 227-

35; ISSN: 0006-8993.

NETHERLANDS. The underlying neural mechanisms of the

silencing of electromyographic (EMG) activity observed

between antagonistic muscles of the human ankle joint

preceding a fast stepping movement were examined. Twelve

subjects were asked to perform a unilateral stepping

movement under a reaction time condition while standing

upright. A silent phase (SP) which was composed of the time

difference between the offset of tonic soleus (Sol) activity

and the onset of phasic tibialis anterior (TA) activity was

observed consistently in all subjects. At the time interval

corresponding to the SP, inhibition of the Sol Hoffmann reflex

(H-reflex) and facilitation of the TA H-reflex took place. In

nine of the 12 subjects, disynaptic reciprocal Ia inhibition (Ia

inhibition) from TA Ia fibers to the Sol motoneuron (MN) pool

increased before the TA EMG onset. We also observed a clear

distinction between the changes in the time course of the Ia

inhibition and that of long latency reciprocal (D1) inhibition in

six of the 12 subjects. However, when the subjects performed

the same motor task with their backs supported against a wall

wherein the tonic Sol activation disappeared, no changes in the

H-reflex occurred. These results suggest that these changes,

occurring at the segmental level, might be controlled by the

supraspinal motor center in a feed-forward manner during

anticipatory postural adjustment. The functional significance

would be to counterbalance the disturbance from an

intentional forthcoming movement in order to maintain an

adequate posture.

102. Kring, A. M.; Neale, J. M. Do schizophrenic patients show a

disjunctive relationship among expressive, experiential, and

psychophysiological components of emotion? J-Abnorm-

Psychol. 1996 May; 105(2): 249-57; ISSN: 0021-843X.

UNITED-STATES. Recent research has found a discrepancy

between schizophrenic patients' outward expression of

emotion and their reported emotional experience. In this study,

which attempts to replicate and extend the findings of

previous studies, participants with and without schizophrenia

viewed emotional film clips while their facial expressions

were videotaped and skin conductance was recorded.

Participants also reported their subjective experience of

emotion following each film. Those with schizophrenia were

less facially expressive than controls during the emotional

films and reported experiencing as much positive and negative

emotion, replicating previous findings. Additionally,

schizophrenic patients exhibited greater skin conductance

reactivity to all films than controls. These findings suggest a

disjunction among emotional response domains for

schizophrenic patients; alternative explanations for the

findings are considered as well as suggestions for future

research.. 0.

103. Krop, J.; Lewith, G. T.; Gziut, W.; Radulescu, C. A double blind,

randomized, controlled investigation of electrodermal testing

in the diagnosis of allergies. J-Altern-Complement-Med. 1997

Sep; 3(3): 241-8; ISSN: 1075-5535.

UNITED-STATES. This investigation evaluates electrodermal

(ED) testing in 41 polysymptomatic allergic patients.

Electrodermal testing discriminated correctly 82% of the time

between house dust mite and histamine (allergens) and saline

or water (nonallergens) in our first study group involving 17

patients (p = 0.007). The second study involved 24 patients and

used the same double-blind methodology discriminating 96% of

the time between allergic and nonallergic substances (p =

0.000002). We conclude that ED testing is a reliable method of

differentiating between allergic and nonallergic substances in

the context of our study.. 51-45-6.

104. Kubo, T.; Imaizumi, T.; Harasawa, Y.; Ando, S.; Tagawa, T.; Endo, T.;

Shiramoto, M.; Takeshita, A. Transfer function analysis of

central arc of aortic baroreceptor reflex in rabbits. Am-J-

Physiol. 1996 Mar; 270(3 Pt 2): H1054-62; ISSN: 0002-9513.

UNITED-STATES. While electrically stimulating the aortic

depressor nerve (ADN) pseudorandomly, we recorded renal

sympathetic nerve activity (RSNA) and systemic arterial

pressure (SAP) in 19 alpha-chloralose-anesthetized rabbits

with sinoaortic denervation. From the recorded signals, we

determined the transfer functions from ADN stimulation by a

pseudorandom binary sequence to RSNA [HCMD.RSNA(f)] and to

SAP [HCMD.SAP(f)]. The modulus of HCMD.RSNA(f) was flat over

0.0122-0.8 Hz, whereas the phase lag increased linearly with

frequency. Thus the central transduction appeared not to

modify the relative amplitude of the signals from the

baroreflex afferents but to provide a fixed time delay

(approximately 400 ms). In contrast, the modulus of

HCMD.SAP(f) decreased precipitously toward high frequencies,

and the degree of the phase lag was larger than that of

HCMD.RSNA(f). We conclude that 1) the transfer property of the

central are does not significantly modify the relative

amplitude of the frequency components of the baroreflex

afferents but provides a fixed time delay and 2) the frequency

independence of the modulus of the transfer property is not

preserved when the analysis is extended to SAP.

105. Kumano, H.; Horie, H.; Kuboki, T.; Suematsu, H.; Sato, H.; Yasushi,

M.; Kamei, T.; Masumura, S. EEG-driven photic stimulation

effect on plasma cortisol and beta-endorphin. Appl-

Psychophysiol-Biofeedback. 1997 Sep; 22(3): 193-208; ISSN:

1090-0586.

UNITED-STATES. The effect of EEG-driven photic stimulation

on stress-related endocrine function was studied. Subjects

were 16 healthy males divided into a photic stimulation group

(n = 8) and a control group (n = 8). Electrodermal and emotional

lability measures were assessed by nonspecific skin

conductance response and the Maudsley Personality Inventory,

respectively. Plasma cortisol and beta-endorphin

concentrations were measured both before and after EEG-

driven photic stimulation as well as the resting condition.

Subjects with electrodermal, emotional, or both lability

showed comparable decreases of plasma beta-endorphin on

photic stimulation as did the stable subjects. Under resting

control conditions, however, they showed significant

increases of beta-endorphin compared to both stable subjects

as well as the photic stimulation condition. In addition, labile

subjects showed significant alpha enhancement on photic

stimulation compared to stable subjects and to the resting

control condition. The data suggest that increases of plasma

beta-endorphin in labile control subjects may denote a stress

response to the conditions of these experiments, and that any

decrease by EEG-driven photic stimulation may indicate a

reduction of responsiveness to an acute stress.. 50-23-7;

60617-12-1.

106. La Rovere, M. T.; Schwartz, P. J. Baroreflex sensitivity as a

cardiac and arrhythmia mortality risk stratifier. Pacing-Clin-

Electrophysiol. 1997 Oct; 20(10 Pt 2): 2602-13; ISSN: 0147-

8389.

UNITED-STATES. The last two decades have provided clear

evidence for the tight and casual relation existing between

arrhythmic mortality and the autonomic nervous system,

particularly with imbalances characterized by decreases in

vagal and/or increases in sympathetic activity. A series of

compelling experimental results has represented the driving

force for the clinical evaluation of the potential prognostic

value of baroreflex sensitivity (BRS), a measure that can

provide information on the capability to augment vagal

activity. This article reviews the methodology more commonly

used to quantify the clinical evaluation of this parameter, and

then focuses on the key clinical studies highlighting those

performed in postmyocardial infarction patients. Among them

the most informative is ATRAMI, a multicenter prospective

study involving almost 1300 patients. The main conclusion is

that both heart rate variability and BRS are strong and

independent risk factors for post-infarction mortality, thus

demonstrating the clinical usefulness of autonomic markers.

107. Lagopoulos, J.; Gordon, E.; Lim, C. L.; Bahramali, H.; Morris, J. G.;

Clouston, P.; Li, W. M.; Lesley, J. Automatic processing

dysfunction in Parkinson's disease. Neurol-Res. 1997 Dec;

19(6): 609-12; ISSN: 0161-6412.

ENGLAND. Simultaneous measures of Event Related Potentials

(ERP) and electrodermal activity (EDA) allow the delineation

of ERPs that did, and did not, evoke an electrodermal 'Orienting

Reflex' (OR). The OR is an automatic reflex invoked by novel or

significant stimuli. Our group have developed a model to

quantify electrodermal OR activity acquired in conventional

late component ERP paradigms with short interstimulus

intervals. Target late component (N100, P200, N200, P300)

ERPs (acquired in an auditory oddball paradigm) and EDA was

examined in 15 Parkinson's disease (PD) subjects and 50

normal controls. Single-trial target ERPs were averaged

according to whether or not they elicited an electrodermal OR.

Compared with controls, the PD group showed significantly

decreased N100 and N200 amplitudes in the OR related ERPs

('Orienting ERPs'). These preliminary findings suggest that

conventional late component ERPs can be delineated according

to whether or not they evoked an OR. The 'orienting ERPs' in PD

showed more significant disturbances compared with controls,

than ERPs that did not evoke an OR.

108. Lang, I. M.; Shaker, R. Anatomy and physiology of the upper

esophageal sphincter. Am-J-Med. 1997 Nov 24; 103(5A): 50S-

55S; ISSN: 0002-9343.

UNITED-STATES. The upper esophageal sphincter (UES) is

composed of the cricopharyngeus (CP), thyropharyngeus (TP;

inferior pharyngeal constrictor [IPC] in humans), and cranial

cervical esophagus. All 3 muscles may at times function to

maintain tone in the UES, but only the CP contracts and relaxes

in all physiologic states consistent with the UES. The CP is a

striated muscle composed of variable-sized small (25-35

microm) muscle fibers that are primarily type I (slow twitch),

highly oxidative, and contain abundant (40%) endomysial

elastic connective tissue. The fibers may attach to the

connective tissue framework, forming a muscular net. In

humans and rats, but not other animals, the CP has no median

raphe. The optimum length of the CP for development of active

tension is about 1.7 times resting length; therefore, in some

respects the CP acts more like cardiac than striated muscle. A

passive tone in the CP is present and increases through all

degrees of stretch. The high compliance of the CP allows it to

be opened by distraction of other muscles (e.g., geniohyoideus)

or increased intraluminal pressure. The CP is innervated by

branches of the vagus nerves: pharyngoesophageal (PE),

superior laryngeal (SLN), and recurrent laryngeal (RLN);

glossopharyngeal (GPN); and cervical sympathetics. Only the PE

and SLN provide motor fibers to the CP. The GLN may be

sensory; the sympathetics may innervate the mucosa, blood

vessels, and glands; but no functional innervation by the RLN

has been identified. Parasympathetic ganglia and various

peptides (galanin, cGRP, VIP, neuropeptide Y, substance P,

tyrosine hydroxylase) have been found in the CP, but their role

in control of the CP is unknown. The motoneurons of the CP are

found in the nucleus ambiguus, and the innervation is

ipsilateral for animal species in which the CP has a median

raphe. These motoneurons are topographically organized with

other pharyngeal and laryngeal muscles and the striated

muscle esophagus. Pharyngeal motoneurons often have a

respiratory rhythm, but not a spontaneous background

discharge. Therefore, the CP motoneurons may not generate CP

tone. Various reflexes control the tone of the CP. Distension of

the esophagus causes contraction of the CP and UES, which is

mediated by a vago-vagal reflex. Pressure on the pharyngeal

mucosa contracts the CP and UES and is mediated by a

glossopharyngo-vagal reflex. Inflation of the lungs causes

contraction of the CP and UES, which is mediated by a vago-

vagal reflex. The pharyngo-UES and pulmonary-UES reflexes

may generate the respiratory rhythm often observed on UES

pressure or electromyographic activity. The UES or CP also

contracts with arousal or with changes in posture. All of these

reflexes and responses and the passive elastic properties of

the CP may contribute to the generation of tone in the CP and

UES.

109. Lang, Peter J.; And, Others. Emotion, Attention, and the Startle

Reflex. 1990;

UMI. Reports - Evaluative (142). Evidence that the vigor of the

startle reflex varies systematically with the organism's

emotional state is reviewed. A theory elucidating this

relationship suggests how amplitude of eyeblink response to a

probe may be modulated by affective content of perception and

thought. Implications for research on emotion are outlined.

(SLD).

110. Layne, JR Jr; Costanzo, J. P.; Lee, RE Jr. Freeze duration

influences postfreeze survival in the frog Rana sylvatica. J-

Exp-Zool. 1998 Feb 1; 280(2): 197-201; ISSN: 0022-104X.

UNITED-STATES. Survival, cryoprotection, and the time course

for recovery of vital functions were studied in autumn-

collected juvenile wood frogs (Rana sylvatica) following

freezing at -1.5 degrees C for various periods. Frogs readily

tolerated freezing for 3 or 9 d, but only 50% survived a 28-d

freezing trial. Generally, the postfreeze return of vital

functions (vascular circulation, pulmonary breathing, righting

reflex, jumping reflex) occurred later in frogs frozen for

longer periods. Augmenting endogenous levels of the

cryoprotectant glucose (via injections) prior to freezing

substantially increased freeze endurance, as these frogs had

excellent survival after remaining frozen for as long as 49 d.

The improved freeze endurance of glucose-loaded frogs

apparently was not associated with a reduction in ice content

but rather may reflect the greater availability of energy

substrate needed to support metabolism of frozen ischemic

tissues.. 0.

111. Lehto, S.; Ronnemaa, T.; Pyorala, K.; Laakso, M. Risk factors

predicting lower extremity amputations in patients with

NIDDM. Diabetes-Care. 1996 Jun; 19(6): 607-12; ISSN: 0149-

5992.

UNITED-STATES. OBJECTIVE: To examine the predictors of

lower extremity amputation in patients with NIDDM. RESEARCH

DESIGN AND METHODS: At baseline, risk factors for amputation

were determined in 1,044 NIDDM patients (571 men, 473

women) aged 45 to 64 years. These patients were followed up

to 7 years with respect to amputation. RESULTS: The incidence

of amputation was 5.6% in men and 5.3% in women. High

fasting plasma glucose at baseline examination and the

duration of diabetes were associated with a twofold risk for

amputation. Similarly, glycemic control measured at baseline

by HbA1 was an important predictor of amputation. There was

a dose-response relationship between plasma glucose or HbA1

and the risk for amputation. The effect of hyperglycemia on

the risk of amputation was seen clearly even after the

adjustment for other cardiovascular risk factors. Signs of

peripheral neuropathy and bilateral absence of Achilles tendon

reflexes and vibration sense were important predictors for

amputation. Furthermore, absent peripheral artery pulses and

femoral artery bruit on auscultation predicted amputation.

CONCLUSIONS: Our 7-year follow-up study gives strong

evidence that poor glycemic control is an important predictor

of amputation in patients with NIDDM in addition to clinically

detectable peripheral arterial disease and peripheral

neuropathy.. 0; 0; 0; 0; 57-88-5.

112. Leis, A. A.; Kronenberg, M. F.; Stetkarova, I.; Paske, W. C.; Stokic, D.

S. Spinal motoneuron excitability after acute spinal cord

injury in humans. Neurology. 1996 Jul; 47(1): 231-7; ISSN:

0028-3878.

UNITED-STATES. BACKGROUND: Few studies in humans have

assessed the ability of Ia afferent and antidromic motor

volleys to activate motoneurons during spinal shock. Hence,

little is known about the excitability state of the spinal

motoneuron pool after acute spinal cord injury (SCI) in humans.

METHODS: In 14 patients with acute SCI involving anatomic

levels T10 and above, we performed clinical and

electrophysiologic studies early after injury (within 24 hours

in seven subjects) and on day 10, 20, and 30 postinjury.

Maximal H:M ratios, F-wave persistence, and tendon tap T-

reflexes were recorded. Sixteen normal subjects and eight

chronic SCI patients served as control subjects. RESULTS: Ten

of 14 patients had spinal shock (complete paralysis, loss of

sensation, absent reflexes, and muscle hypotonia below the

injury) at the time of initial evaluation. F-waves were absent

in patients with spinal shock, reduced in persistence in

patients with acute SCI without spinal shock, and normal in

persistence in patients with chronic SCI. H-reflexes were

absent or markedly suppressed in patients with spinal shock

within 24 hours of injury but recovered to normal amplitudes

within several days postinjury. This recovery occurred despite

absence of F-waves that persisted for several weeks

postinjury. Deep tendon reflexes were proportionally more

depressed in spinal shock than were H-reflexes. All patients

had elicitable H-reflexes for days or weeks before the

development of clinical reflexes. CONCLUSIONS: Rostral cord

injury causes postsynaptic changes (hyperpolarization) in

caudal motoneurons. This hyperpolarization is a major

physiologic derangement in spinal shock. The rise in H-reflex

amplitude despite evidence of persistent hyperpolarization is

due to enhanced transmission at Ia fiber-motoneuron

connections below the SCI. Finally, the observation that the

stretch reflex is proportionally more depressed than the H-

reflex is consistent with fusimotor drive also being depressed

after SCI.

113. Leon, S. FE; Arimura, K.; Osame, M. Multiple sclerosis and HTLV-I

associated myelopathy/tropical spastic paraparesis are two

distinct clinical entities. Mult-Scler. 1996 Sep; 2(2): 88-90;

ISSN: 1352-4585.

ENGLAND. Multiple sclerosis (MS) and HTLV-I associated

myelopathy/tropical spastic paraparesis (HAM/TSP) can

overlap in their clinical features and thereby cause

difficulties for clinicians in relation to diagnosis and therapy.

However, epidemiological biochemical, immunological,

virological and radiological studies point to a number of

significant differences. Recent comparative

neurophysiological data, including blink reflex studies,

obtained in these disorders, is briefly reviewed here and

provides additional evidence of difference. The abnormal blink

reflex in patients with MS consist of prolonged latencies and

absences of R1 and R2 responses and are mainly due to

demyelinating lesions around the pans. In contrast, in HAM/TSP

the blink reflex abnormalities frequently include an unusual

early response, R1k, which is probably a consequence of

interneuronal hyperexcitability around the brainstem. Thus

these findings provide further support for our contention that

HAM/TSP and multiple sclerosis are distinctly different both

as clinical entities and in their underlying pathomechanisms.

114. Liberman, M. C.; Puria, S.; Guinan, JJ Jr. The ipsilaterally evoked

olivocochlear reflex causes rapid adaptation of the 2f1-f2

distortion product otoacoustic emission. J-Acoust-Soc-Am.

1996 Jun; 99(6): 3572-84; ISSN: 0001-4966.

UNITED-STATES. The onset behavior of the distortion product

otoacoustic emission (DPOAE) at 2f1-f2 in anesthetized cats

was measured with temporal resolution finer than 70 ms. The

amplitude of the DPOAE adapts after onset of the primary

tones by as much as 6 dB for monaural stimulation and 10 dB

when the primaries are presented binaurally. DPOAE adaptation

consists of a large, rapid component, with a time constant of

roughly 100 ms, and a small, slower component with a time

constant of roughly 1000 ms. The rapid component disappears

when only the crossed olivocochlear bundle (OCB) is cut,

whereas the slow adaptation persists after complete OCB

section. The loss of rapid adaptation upon OC section is

accompanied by a concomitant increase in the steady-state

amplitude of the DPOAE. Thus an intact OC reflex can

significantly alter DPOAEs obtained during routine

measurement. Rapid adaptation of the monaurally evoked 2f1-

f2 DPOAE is probably mediated by reflex activity in

ipsilaterally responsive OC neurons innervating outer hair

cells. The effects of this ipsilateral reflex on DPOAE

amplitudes are typically twice as large as those of the

contralateral reflex, presumably because there are twice as

many ipsilaterally responsive OC neurons. Tests for the

ipsilateral OC reflex based on the phenomenon of rapid

adaptation should be both feasible and useful in human

subjects.

115. Lock, G.; Zeuner, M.; Lang, B.; Hein, R.; Scholmerich, J.; Holstege, A.

Anorectal function in systemic sclerosis: correlation with

esophageal dysfunction? Dis-Colon-Rectum. 1997 Nov; 40(11):

1328-35; ISSN: 0012-3706.

UNITED-STATES. PURPOSE: This study was designed to

compare esophageal and anorectal function parameters in

patients with systemic sclerosis and to define the role of

anorectal manometry in the diagnosis of gastrointestinal

involvement of systemic sclerosis. PATIENTS AND METHODS:

Twenty-six consecutive patients (22 females) with systemic

sclerosis originally referred for assessment of esophageal

function were evaluated by esophageal and anorectal

manometry. Anorectal function parameters were compared

between patients with normal and those with disturbed

esophageal function. RESULTS: A total of 17 of 26 patients (65

percent) had severe esophageal dysfunction with aperistalsis

of the lower two-thirds of the esophagus, whereas 9 patients

(35 percent) had normal esophageal manometry. Only three

patients (11.5 percent) suffered from occasional fecal

incontinence. Anorectal function parameters (resting pressure,

maximum squeeze pressure, perception threshold) were not

significantly different between patients with normal and

those with disturbed esophageal motility. Rectoanal inhibitory

reflex was excitable in nearly 90 percent of patients.

CONCLUSION: In an unselected group of patients with systemic

sclerosis, fecal incontinence and abnormal anorectal function

are rather rare findings. Anorectal manometry cannot

differentiate between patients with and without

gastrointestinal involvement of systemic sclerosis.

116. Logigian, E. L.; Shefner, J. M.; Goumnerova, L.; Scott, R. M.; Soriano,

S. G.; Madsen, J. The critical importance of stimulus intensity

in intraoperative monitoring for partial dorsal rhizotomy.

Muscle-Nerve. 1996 Apr; 19(4): 415-22; ISSN: 0148-639X.

UNITED-STATES. During partial lumbosacral dorsal rhizotomy

(PDR), intraoperative dorsal rootlet stimulation (drs) evokes

motor responses, presumed to be reflexes, which are used to

select rootlets for section. However, dr stimuli may also

costimulate ventral root (vr) and evoke an M rather than a

reflex response, the two being distinguishable only by

comparison of response latencies after drs at two separate

sites. In 15 consecutive spastic cerebral palsy patients

undergoing PDR, we asked whether reflex and M responses

were distinguishable on the basis of stimulus intensity (SI).

For soleus H reflexes evoked by percutaneous tibial nerve

stimulation, the SI for reflex afferents was usually

subthreshold for exciting motor fibers. Similarly, for nerve

roots, reflexes were evoked by drs at SIs generally less than

that for M responses evoked by vr stimulation (vrs). In

contrast, M responses evoked by drs required SIs that were on

average 20 times greater. Finally, costimulation of

contralateral vr after ipsilateral vrs occurred at SIs shown to

evoke M responses after drs. We conclude that: (1) reflex and M

responses evoked by drs are distinguishable on the basis of the

required SI; and (2) drs employing SIs greater than required for

vrs evokes M rather than reflex responses due to costimulation

of ipsilateral and contralateral vr.

117. Loscher, W. N.; Cresswell, A. G.; Thorstensson, A. Recurrent

inhibition of soleus alpha-motoneurons during a sustained

submaximal plantar flexion. Electroencephalogr-Clin-

Neurophysiol. 1996 Aug; 101(4): 334-8; ISSN: 0013-4694.

IRELAND. During 10 min of sustained isometric plantar flexion

at 20% of maximal voluntary contraction, recurrent inhibition

of soleus alpha-motoneurons was studied in 9 healthy subjects

(age 22-37 years). Recurrent inhibition was brought about by a

conditioning H-reflex and assessed by a test H-reflex

delivered 10 ms later. The amplitude of the test H-reflex

during the tenth minute of the contraction (16.9 +/- 13.2% of

the maximal compound motor action potential) was

significantly increased as compared to that during the first

minute (9.8 +/- 7.6%), while the conditioning H-reflex

remained unchanged. Concomitantly, muscle fatigue was

evidenced by a significant increase in amplitude of the soleus

electromyogram. The increase of the test-H-reflex amplitude

implies that a decrease in recurrent inhibition occurred during

the sustained submaximal contraction, which contrasts

results from studies on maximal voluntary contractions. These

results indicate a modulation of soleus Renshaw interneurons,

which is likely to serve the purpose of optimising motor unit

recruitment and firing rates of this muscle during a sustained

submaximal contraction.

118. Macor, F.; Fagard, R.; Amery, A. Power spectral analysis of RR

interval and blood pressure short-term variability at rest and

during dynamic exercise: comparison between cyclists and

controls. Int-J-Sports-Med. 1996 Apr; 17(3): 175-81; ISSN:

0172-4622.

GERMANY. To determine the adaptations of the autonomic

nervous system in the control of heart rate and blood pressure

induced by endurance training, 10 competitive cyclists aged 27

+/- 7 years and 10 age-, weight- and height-matched

sedentary controls were subjected to Power Spectral Analysis

of the RR interval and of blood pressure at supine rest and

during submaximal cycloergometric exercise test in the supine

position at 20% and 40% of maximal workload. At rest, the

high-frequency (HF) power of the RR interval was higher in

cyclists (p < 0.05) compared to controls, whereas the power

spectrum of both systolic and diastolic blood pressure did not

differ between cyclists and controls. During exercise the

variance, the low-frequency (LF) and the HF power of the RR

interval decreased significantly (p < 0.005) and similarly in

cyclists and controls. The LF/HF ratio of the RR interval

increased (p < 0.001) and the alfa index of baroreflex

sensitivity decreased (p < 0.05) without differences between

cyclists and controls. The variance of both systolic and

diastolic blood pressure increased (p < 0.001 and p < 0.005,

respectively) as well as the HF power of systolic blood

pressure (p < 0.001) similarly in cyclists and in controls. In

conclusion, the data of the present study suggest that

competitive cycling causes an enhanced vagal drive to the

sinus node, whereas the neural control of blood pressure is not

affected. During exercise a vagal withdrawal and a

sympathetic activation in the neural control of heart rate,

together with a reduction of baroreflex sensitivity are

operative. These changes are similar in cyclists and controls.

119. Maeoka, Y.; Eda, I. [The blink reflex in severely handicapped

patients with dysphagia]. No-To-Hattatsu. 1996 Jul; 28(4):

283-90; ISSN: 0029-0831.

JAPAN. We investigated the blink reflex in 27 severely

handicapped patients. 15 males and 12 females, from 5 to 60

years old. They were divided into three groups; the tube-

feeding group (9 patients), the oral-feeding group (9 patients),

and the mixed-feeding group (9 patients). Seven normal

subjects also were included in this study. There was a

significant difference in the late ipsilateral component (R2)

between the tube-feeding and oral-feeding groups. The average

R 2 time were 43.0 msec. in the tube-feeding group and 36.7

msec. in the oral feeding group. The auditory brainstem

response (ABR) showed no significant difference between the

two groups. These results suggested that the swallowing

function in the patients needed for tube feeding was affected

by not only the cortical lesions but also the brainstem ones.

Furthermore, it is speculated that the degree of brainstem

dysfunction in the tube-feeding group was more severe than in

the non-tube-feeding group. The blink reflex is one of the

useful electrophysiological parameters for evaluating the

brainstem function in severely handicapped patients with

dysphagia.

120. Maki, W. S.; Couture, T.; Frigen, K.; Lien, D. Sources of the

attentional blink during rapid serial visual presentation:

perceptual interference and retrieval competition. J-Exp-

Psychol-Hum-Percept-Perform. 1997 Oct; 23(5): 1393-411;

ISSN: 0096-1523.

UNITED-STATES. Observers watched for 1 or 2 colored words

as targets presented in lists of distractor strings (10

items/s). Identification of 1 target (T1) temporarily reduced

the accuracy of reporting a 2nd target (T2). This attentional

blink (AB) effect was most pronounced when T1 and T2

occurred close together in time. Use of recognition tests

(instead of recall) improved performance but did not eliminate

the AB effect. The AB effect was found with both word and

nonword distractors, a smaller AB effect was found with

consonant string distractors, and the AB effect was

substantially attenuated with strings of unfamiliar characters

(a false font). Analyses of errors indicated that the 2nd target

is frequently replaced or corrupted by the following distractor

during the blink. The AB effect appears to result from both

attentional and mnemonic processes.

121. Manford, M. R.; Fish, D. R.; Shorvon, S. D. Startle provoked epileptic

seizures:features in 19 patients. J-Neurol-Neurosurg-

Psychiatry. 1996 Aug; 61(2): 151-6; ISSN: 0022-3050.

ENGLAND. OBJECTIVES--To define the clinical characteristics

of a group of patients with startle provoked epileptic seizures

(SPES). METHODS--Nineteen patients were identified during

the course of a larger study of clinical seizure patterns. A

witnessed seizure account was obtained in all patients;

interictal EEG in 18, video-EEG-telemetry in eight, CT in 18,

and high resolution MRI in eight. RESULTS--The onset of SPES

was in childhood or adolescence in 14 of 19 patients. It was

preceded by exclusively spontaneous seizures in nine patients

and SPES had been replaced by exclusively spontaneous

seizures in two patients. Sudden noise was the main triggering

stimulus and somatosensory and visual stimuli were also

effective in some patients. The clinical seizure pattern

involved asymmetric tonic posturing in 16 of 19 patients.

Focal neurological signs were present in nine patients, mental

retardation in six, and 10 were clinically normal. Ictal scalp

EEG showed a clear seizure discharge in only one patient with

a tonic seizure pattern; over the lateral frontal electrodes

contralateral to the posturing limbs. Brain CT showed a

porencephalic cyst in three patients, focal frontal atrophy in

one, and generalised atrophy in one. Brain MRI was undertaken

in five normal subjects and three neurologically impaired

patients, six with normal CT. It showed a porencephalic cyst in

one patient. In six patients, there were dysplastic lesions.

They affected the lateral premotor cortex in three patients

and the perisylvian cortex in three patients, one with bilateral

perisylvian abnormality. CONCLUSIONS--SPES are more

frequent than is generally appreciated. They may be transient

and occur relatively commonly without fixed deficit, by

contrast with previous reports. The imaging abnormalities

identified in those without diffuse cerebral damage suggest

that SPES are often due to occult congenital lesions and that

the lateral premotor and perisylvian cortices are important in

this phenomenon.

122. Mao, H. Z.; Li, Z.; Chapleau, M. W. Platelet activation in carotid

sinuses triggers reflex sympathoinhibition and hypotension.

Hypertension. 1996 Mar; 27(3 Pt 2): 584-90; ISSN: 0194-911X.

UNITED-STATES. The carotid sinuses, one of the major sites

of baroreceptor innervation, are also a common site of

atherosclerotic lesions and platelet aggregation. The goal of

the present study was to determine whether platelet

activation in carotid sinuses causes reflex-mediated changes

in renal sympathetic nerve activity and arterial pressure.

Rabbit platelets were isolated, resuspended in Krebs' buffer,

and activated by thrombin. Injection of activated platelets (3 x

10(8) platelets/mL) into the vascularly isolated carotid

sinuses of anesthetized rabbits essentially eliminated

sympathetic nerve activity and acutely decreased mean

arterial pressure from 126 +/- 5 to 53 +/- 4 mm Hg (n=16; P <

.05). Sympathetic activity and arterial pressure returned to

control levels over a period of minutes despite sustained

exposure to activated platelets. Injection of U-46619, a

thromboxane analogue and vasoconstrictor, into carotid

sinuses did not alter sympathetic activity or arterial pressure.

However, serotonin (5-hydroxytryptamine [5-HT]), which is

known to be released from activated platelets, and the 5-HT3

receptor agonist phenylbiguanide mimicked the effect of

platelets. Furthermore, the platelet-induced reflex inhibition

of sympathetic activity and hypotension were not altered by

the cyclooxygenase inhibitor indomethacin but were

attenuated significantly by 5-HT receptor antagonists.

Platelet activation inhibited sympathetic activity to 5 +/- 2%

of control in the absence of antagonists but to only 35 +/- 11

and 76 +/- 4% of control after selective blockade of 5-HT2 and

5-HT3 receptors with ketanserin and MDL-72222, respectively.

The results indicate that (1) platelet activation in carotid

sinuses triggers reflex inhibition of sympathetic nerve

activity and hypotension; (2) the reflex is not caused by

carotid vasoconstriction and is not mediated by prostanoids;

and (3) the reflex is mediated by 5-HT acting primarily on 5-

HT3 and to a lesser extent on 5-HT2 receptors. We speculate

that this reflex may contribute to arterial pressure lability

and susceptibility to stroke in patients with carotid

atherosclerotic disease.

123. Maria, B. L.; Hoang, K. B.; Tusa, R. J.; Mancuso, A. A.; Hamed, L. M.;

Quisling, R. G.; Hove, M. T.; Fennell, E. B.; Booth Jones, M.;

Ringdahl, D. M.; Yachnis, A. T.; Creel, G.; Frerking, B. "Joubert

syndrome" revisited: key ocular motor signs with magnetic

resonance imaging correlation. J-Child-Neurol. 1997 Oct;

12(7): 423-30; ISSN: 0883-0738.

UNITED-STATES. Joubert syndrome is characterized by

episodic hyperpnea and apnea, developmental delay, hypotonia,

truncal ataxia, ophthalmologic abnormalities, and vermian

dysgenesis. We studied 15 patients with the diagnosis of

Joubert syndrome to (1) more fully define the syndrome's

clinical features, and (2) correlate the clinical features with

magnetic resonance imaging (MRI) findings. Eight of 15

patients had a history of episodic hyperpnea and apnea. All

patients had developmental delay and hypotonia. Of the 13

patients receiving detailed neuro-ophthalmologic evaluations,

three had optic nerve dysplasia, pendular nystagmus, and gaze-

holding nystagmus. All 13 patients had a normal vestibulo-

ocular reflex based on head thrust, but had absent to poor

ability to cancel the vestibulo-ocular reflex horizontally and

vertically. Twelve of 13 patients had impaired smooth pursuit.

Twelve of 13 patients had defects in initiation of saccades

and quick phases. Two of the most consistent radiologic

features were absent or hypoplastic posterior cerebellar

vermis, and deformed midbrain and pontomesencephalic

junction, which based on ocular motor physiology correlate

with the vestibulo-ocular reflex cancellation/ pursuit defect

and saccade initiation defect, respectively. As a result of

midbrain, vermian, and superior cerebellar peduncle

abnormalities, axial neuroimaging showed a unique "molar

tooth" appearance of these structures. These results indicate

that Joubert syndrome results from maldevelopment of the

midbrain and cerebellar vermis, producing a pathognomonic

sign on MRI.

124. Maruyama, H.; Kawakami, H.; Kohriyama, T.; Sakai, T.; Doyu, M.;

Sobue, G.; Seto, M.; Tsujihata, M.; Oh, i. T.; Nishio, T.; Sunohara,

N.; Takahashi, R.; Ohtake, T.; Hayashi, M.; Nishimura, M.; Saida,

T.; Abe, K.; Itoyama, Y.; Matsumoto, H.; Nakamura, S. CAG repeat

length and disease duration in Machado-Joseph disease: a new

clinical classification. J-Neurol-Sci. 1997 Nov 25; 152(2):

166-71; ISSN: 0022-510X.

NETHERLANDS. To evaluate the clinical characteristics of

Machado-Joseph disease (MJD) with reference to CAG repeat

length and disease duration, we analyzed neurologic findings in

108 patients from 84 families. The majority of MJD patients

presented with an ataxic gait as the initial symptom.

Dysarthria and nystagmus were observed from an early stage.

Bulging eyes, muscle atrophy and bradykinesia developed later.

Patients with a shorter CAG repeat length or later onset had

more frequent involvement of proprioceptive sensory deficit.

Incidence of abnormal reflexes, tones, and proprioceptive

sensation was not associated with disease duration, but with

CAG repeat length. Based on these results, we propose a new

clinical classification: type A (juvenile type), with

hyperreflexia and dystonia, but without a proprioceptive

sensory deficit; type C (adult type), with hyporeflexia and a

proprioceptive sensory deficit, but without dystonia; and type

B (intermediate type), the remaining patients with a mixed

presentation.

125. Matthews, J. M.; Wheeler, G. D.; Burnham, R. S.; Malone, L. A.;

Steadward, R. D. The effects of surface anaesthesia on the

autonomic dysreflexia response during functional electrical

stimulation. Spinal-Cord. 1997 Oct; 35(10): 647-51; ISSN:

1362-4393.

ENGLAND. Recently, increases in blood pressure (BP) and

concomitant bradycardia, suggestive of autonomic dysreflexia

(AD), have been documented during functional electrical

stimulation (FES) in individuals with a high spinal cord injury

(SCI). If uncontrolled, this response could preclude the safe

use of FES among such individuals. FES induced pain is partly

related to stimulation of skin nociceptors. Therefore,

measures to reduce skin sensitivity may reduce the risk of AD

during FES. The purpose of this study was to determine if

topical anaesthetic applied over the site of electrical

stimulation could minimize the AD cardiovascular and

hormonal responses to FES in individuals with SCI above the

T6 level. Seven subjects with a SCI above T6 received FES to

the quadriceps muscle of each leg under two conditions on two

different testing days. The two treatment conditions, topical

anaesthetic and placebo creams, were double blinded and

randomized. The cream was administered to an area the size of

the electrode (10 x 10 cm) 1 h prior to stimulation.

Stimulation began at 0 mAmps and increased by 16 mAmps

every 2 min until an intensity of 160 mAmps was achieved. HR

and BP were measured at each stimulation intensity level.

Catecholamines were analyzed three times during the

stimulation protocol (pre, mid and post stimulation

intensities). At the end of the stimulation protocol, FES

induced isometric quadriceps contraction force at 160 mAmps

intensity was measured using a hand held dynamometer. As FES

stimulation intensity increased, significant rises in systolic

and diastolic BP were seen, with a concomitant progressive

drop in HR. The AD response to stimulation was not

significantly different between the topical anaesthetic and

placebo conditions. Serum catecholamine (epinephrine and

norepinephrine) levels tended to rise with increasing FES

intensity levels but did not reach statistical significance. The

two treatment conditions did not significantly affect serum

catecholamine levels or FES-induced quadriceps contraction

force. In summary, FES application to the quadriceps muscle in

high level SCI subjects resulted in significant increases in BP,

decreases in HR (AD-like response), a trend towards elevations

in catecholamine levels, and no difference in quadriceps

muscular strength. However, these responses were unaffected

by the use of topical anaesthetic cream on the skin at the

stimulation site. This suggests that other mechanisms than

skin nociception are operative in FES-induced AD.. 0; 0.

126. McMahon, N. C.; Drinkhill, M. J.; Hainsworth, R. Reflex vascular

responses from aortic arch, carotid sinus and coronary

baroreceptors in the anaesthetized dog. Exp-Physiol. 1996 May;

81(3): 397-408; ISSN: 0958-0670.

ENGLAND. In chloralose-anaesthetized dogs, pressure applied

to coronary, carotid and aortic baroreceptors were changed

independently and the resulting reflex vascular responses

were determined. Increases in pressure to each group of

baroreceptors resulted in reflex vasodilatation; the maximal

responses to distension of carotid and coronary baroreceptors

were significantly larger than those to aortic receptors, but

not different from each other. Increases in pressure in all

three regions induced maximal responses at similar times

from the onset of the pressure stimulus. However, the time for

recovery of vascular resistance following a decrease in

baroreceptor pressure differed. Vasoconstriction following a

period of coronary hypertension occurred slowly, requiring 70

s for 90% of the response to develop. This was significantly

longer than the corresponding times for carotid and aortic

receptors (about 28 s). The rate of vasoconstriction in

response to coronary baroreceptor unloading was influenced by

the period for which the pressure stimulus was applied and

vasoconstriction was even slower when the pressure stimulus

had been maintained for 8 min. The mechanism responsible for

delaying the vasoconstriction following a period of coronary

hypertension is not known, but this effect may have important

implications for the control of arterial blood pressure.

127. McWhae, J. A.; Piemontesi, R. L.; Crichton, A. C. Blinking and iris

configuration in PDS [letter; comment]. Ophthalmology. 1996

Feb; 103(2): 197-9; ISSN: 0161-6420.

Note: Comment on: Ophthalmology 1995 Mar;102(3):446-55.

UNITED-STATES.

128. Meinders, M.; Price, R.; Lehmann, J. F.; Questad, K. A. The stretch

reflex response in the normal and spastic ankle: effect of

ankle position. Arch-Phys-Med-Rehabil. 1996 May; 77(5): 487-

92; ISSN: 0003-9993.

UNITED-STATES. OBJECTIVE: The influence of stretch of the

gastrocnemiussoleus muscle on the stretch reflex activity

was studied, by varying the ankle angle in steps from 10

degrees of plantarflexion (PF) to 5 degrees of dorsiflexion

(DF). DESIGN: Nonrandomized control trial. SETTING:

Department of Rehabilitation Medicine of a university medical

center. PATIENTS: Sixteen subjects with and 16 subjects

without spasticity. MAIN OUTCOME MEASURES: The passive

elastic stiffness and active reflex response, expressed by the

total and elastic path lengths, were determined at each ankle

angle as a sinusoidal displacement of 5 degrees was applied to

the joint at frequencies from 3 to 12 Hz. RESULTS: The elastic

stiffness showed no difference between the spastic and

normal subjects for all ankle angles (p > .05). The elastic

stiffness increased linearly similarly in both groups when the

ankle was dorsiflexed. The reflex response was significantly

greater in the spastic group for all positions (p < or = .01). The

total and elastic path lengths showed a linear increase in both

groups when the ankle angle was varied from PF to DF. The

spastic group, however, had a significantly faster increase (p <

or = .005). Between-group comparison showed a significant

quadratic trend in the elastic path length for the spastic group

(p < or = .05), with a maximum at 2.5 degrees of DF.

CONCLUSIONS: This study showed that the stretch reflex

activity varies with the ankle position. This must be

considered when performing spasticity tests subsequent to an

intervention that has changed the available range of motion

and when comparing subjects measured at different ankle

positions.

129. Mendoza Guevara, L.; Cervantes, A.; Aguilar Kitsu, A.; Rendon, E.;

Morales, A.; Rodriguez, F.; Castro, F.; Flores, M.; Jaramillo, R.

M.; Garcia Lopez, E. "H" reflex as a measure of subclinical

uremic polyneuropathy in children with chronic renal failure.

Adv-Perit-Dial. 1997; 13: 285-90; ISSN: 1197-8554.

CANADA. Uremic polyneuropathy (UPNP) is a serious

complication of chronic renal failure (CRF) in adults; however,

its prevalence is unknown in the pediatric population. An easy-

to-perform maneuver for its detection in children is the

evaluation of "H" reflex. The objective of this study was to

validate the usefulness of the "H" reflex maneuver for the

diagnosis of UPNP in pediatric dialysis patients for CRF.

Thirty-seven CRF patients were paired with healthy controls

by age and sex. The patients were being treated with dialysis

or one of its variants. Information was obtained regarding

diagnosis, duration, and control of dialysis. Neurological

examination was performed, conduction velocities in sensory

and motor nerves were measured, and "H" reflex elicited

bilaterally. Peripheral polyneuropathy was determined by the

presence of at least two nerves with alterations in latency

and/or conduction velocities. It was found that 59.4% (22/37)

of the children with CRF treated with dialysis developed UPNP,

17 with ambulatory peritoneal dialysis, and 5 with

hemodialysis. There was no difference in diagnosis, duration

of dialysis, or control of the same in these patients from other

CRF patients who did not have UPNP. All patients were

clinically asymptomatic. "H" reflex showed a sensibility of

44%, a specificity of 87%, a predictive value positive of 66%,

and a predictive value negative of 76%, when measured to 28

msec. With a 30 msec duration specificity rises to 95%. UPNP

presents asymptomatically in pediatric patients. "H" reflex is

an adequate screening test for the selection of pediatric

patients to be tested further.

130. Mittelstadt, S. W.; Bell, L. B.; O'Hagan, K. P.; Sulentic, J. E.;

Clifford, P. S. Muscle chemoreflex causes renal vascular

constriction. Am-J-Physiol. 1996 Mar; 270(3 Pt 2): H951-6;

ISSN: 0002-9513.

UNITED-STATES. The purpose of this study was to investigate

the effects of the muscle chemoreflex on vascular conductance

in innervated and denervated kidneys. During each experiment,

six dogs ran at 10 km/h for 8-16 min, and the muscle

chemoreflex was stimulated by reducing hindlimb blood flow

(HLBF) (0%-74%) at 4-min intervals. Small reductions in HLBF

did not cause changes in arterial blood pressure or renal

vascular conductance. However, further reductions of HLBF

caused increases in arterial blood pressure and decreases in

renal vascular conductance. Decreases in renal vascular

conductance occurred in the denervated kidneys when the HLBF

was reduced below 1,500 +/- 215 ml/min and occurred in the

innervated kidneys when HLBF was reduced below 1,402 +/-

161 ml/min. There was not a significant difference between

the reductions in HLBF required to cause a decrease in vascular

conductance in the innervated and denervated kidneys. These

results demonstrate that reductions in HLBF cause decreases

in renal vascular conductance, which are not dependent on

renal sympathetic nerve activity.

131. Morata, T. C.; Engel, T.; Durao, A.; Costa, T. R.; Krieg, E. F.; Dunn, D.

E.; Lozano, M. A. Hearing loss from combined exposures among

petroleum refinery workers. Scand-Audiol. 1997; 26(3): 141-9;

ISSN: 0105-0397.

DENMARK. Workers from a refinery (n = 438) were

interviewed, had their hearing tested and had their exposures

to noise and solvents assessed. Measurements suggested that

most exposures to noise and solvents were within exposure

limits recommended by international agencies; however, the

prevalence for hearing loss within the exposed groups ranged

from 42 to 50%, significantly exceeding the 15-30%

prevalence observed for unexposed groups. The adjusted odds

ratio estimates for hearing loss were 2.4 times greater for

groups from aromatics and paraffins (95% CI 1.0-5.7), 3 times

greater for the maintenance group (95% CI 1.3-6.9) and 1.8

times greater for the group from shipping (95% CI 0.6-4.9),

when compared to unexposed workers from the warehouse and

health clinic. The results of acoustic reflex decay tests

suggest a retrocochlear or central auditory pathway

involvement in the losses observed in certain job categories.

These findings indicate that factors in addition to noise ought

to be considered when investigating and preventing

occupational hearing loss.. 0.

132. Morgan, CA 3rd; Grillon, C.; Southwick, S. M.; Davis, M.; Charney, D.

S. Exaggerated acoustic startle reflex in Gulf War veterans

with posttraumatic stress disorder. Am-J-Psychiatry. 1996

Jan; 153(1): 64-8; ISSN: 0002-953X.

UNITED-STATES. OBJECTIVE: Exaggerated startle reflex is

reputed to be one of the cardinal symptoms of posttraumatic

stress disorder (PTSD). The goal of this study was to assess

the magnitude of the acoustic startle reflex in Gulf War

veterans with PTSD. METHOD: The eye-blink component of the

startle reflex was measured in response to six blocks of

pseudorandomized 40-msec white noise bursts of varying

intensities (90, 96, 102, 108, and 114 dB) in 10 Gulf War

veterans with PTSD, seven Gulf War veterans without PTSD,

and 15 civilian subjects without PTSD. RESULTS: The

magnitude of the first startle response, as well as the

magnitude of startle response averaged across blocks of

testing, was significantly greater in Gulf War veterans with

PTSD than in veteran and civilian comparison groups.

CONCLUSIONS: Consistent with some clinical studies

investigating the startle response in Vietnam veterans with

PTSD, this investigation provides evidence for exaggerated

startle response in this disorder. Preclinical studies of shock

sensitization of the startle response suggest that the higher

levels of startle response seen in the PTSD subjects may

reflect a sensitization of the fear/alarm response created by

the stress of combat trauma.

133. Mori, A.; Oguchi, Y.; Okusawa, Y.; Ono, M.; Fujishima, H.; Tsubota, K.

Use of high-speed, high-resolution thermography to evaluate

the tear film layer. Am-J-Ophthalmol. 1997 Dec; 124(6): 729-

35; ISSN: 0002-9394.

UNITED-STATES. PURPOSE: To evaluate the tear film layer in

patients with dry eye and in normal subjects by measuring the

corneal temperature with infrared radiation thermography.

METHODS: One eye of each of 13 patients with dry eye and one

eye of each of seven normal subjects were evaluated randomly.

The corneal temperature was measured continuously with a

recently improved infrared radiation thermography technique.

We calculated the k value, which reflected the steepness of

the corneal temperature change. The bigger the k value was,

the more rapid was the decrease in corneal temperature, and

this was directly related to increased evaporation. RESULTS:

With normal blinking, the mean k value for patients with dry

eye (5.6 +/- 2.9 per second) was significantly less than that in

the control subjects (9.3 +/- 5.0 per second; P < .05). Keeping

the eyes open after closing the eyes significantly decreased

the k values compared with normal blinking in both groups (P <

.05). CONCLUSIONS: Our findings demonstrate the usefulness of

this method of measuring corneal temperature to evaluate the

tear film layer. High-speed, high-resolution thermography

detected subtle changes in corneal temperature with enhanced

sensitivity and spatial and temporal resolution. We found that

the mean k value, and therefore the rate of decline in corneal

temperature in patients with dry eye, was significantly less

than that in normal subjects. The k value may therefore reflect

tear film layer stability. The measurement of the changes in

the corneal temperature can thus give us valuable information

on the tear film layer.

134. Morillo, C. A.; Eckberg, D. L.; Ellenbogen, K. A.; Beightol, L. A.; Hoag,

J. B.; Tahvanainen, K. U.; Kuusela, T. A.; Diedrich, A. M. Vagal and

sympathetic mechanisms in patients with orthostatic

vasovagal syncope. Circulation. 1997 Oct 21; 96(8): 2509-13;

ISSN: 0009-7322.

UNITED-STATES. BACKGROUND: Autonomic and particularly

sympathetic mechanisms play a central role in the

pathophysiology of vasovagal syncope. We report direct

measurements of muscle sympathetic nerve activity in

patients with orthostatic vasovagal syncope. METHODS AND

RESULTS: We studied 53 otherwise healthy patients with

orthostatic syncope. We measured RR intervals and finger

arterial pressures and in 15 patients, peroneal nerve muscle

sympathetic activity before and during passive 60 degree

head-up tilt, with low-dose intravenous isoproterenol if

presyncope did not develop by 15 minutes. We measured

baroreflex gain before tilt with regression of RR intervals or

sympathetic bursts on systolic or diastolic pressures after

sequential injections of nitroprusside and phenylephrine.

Orthostatic vasovagal reactions occurred in 21 patients,

including 7 microneurography patients. Presyncopal and

nonsyncopal patients had similar baseline RR intervals,

arterial pressure, and muscle sympathetic nerve activity.

Vagal baroreflex responses were significantly impaired at

arterial pressures below (but not above) baseline levels in

presyncopal patients. Initial responses to tilt were

comparable; however, during the final 200 seconds of tilt,

presyncopal patients had lower RR intervals and diastolic

pressures than nonsyncopal patients and gradual reduction of

arterial pressure and sympathetic activity. Frank presyncope

began abruptly with precipitous reduction of arterial pressure,

disappearance of muscle sympathetic nerve activity, and RR

interval lengthening. CONCLUSIONS: Patients with orthostatic

vasovagal reactions have impaired vagal baroreflex responses

to arterial pressure changes below resting levels but normal

initial responses to upright tilt. Subtle vasovagal physiology

begins before overt presyncope. The final trigger of human

orthostatic vasovagal reactions appears to be the abrupt

disappearance of muscle sympathetic nerve activity.

135. Morris, G. N. The Bezold-Jarisch reflex [letter; comment]. Anesth-

Analg. 1996 Jul; 83(1): 201-2; ISSN: 0003-2999.

Note: Comment on: Anesth Analg 1995 Jun;80(6):1158-62.

UNITED-STATES.

136. Mortara, A.; La Rovere, M. T.; Pinna, G. D.; Parziale, P.; Maestri, R.;

Capomolla, S.; Opasich, C.; Cobelli, F.; Tavazzi, L. Depressed

arterial baroreflex sensitivity and not reduced heart rate

variability identifies patients with chronic heart failure and

nonsustained ventricular tachycardia: the effect of high

ventricular filling pressure. Am-Heart-J. 1997 Nov; 134(5 Pt

1): 879-88; ISSN: 0002-8703.

UNITED-STATES. In chronic heart failure (CHF) the

contributing role of increased sympathetic activity and

hemodynamic dysfunction in the genesis of ventricular

arrhythmias has not been well established. To assess the

relation between severe ventricular arrhythmias,

hemodynamic impairment, and autonomic nervous system

derangement, 142 patients with CHF in sinus rhythm

underwent 24-hour electrocardiographic recording, right-sided

heart catheterization, and evaluation of sympathovagal

balance by heart rate variability (HRV) and baroreflex

sensitivity (BRS). Patients were grouped according to the

absence (without nonsustained ventricular tachycardia [NSVT];

n = 87) or presence (with NSVT; n = 55) of NSVT. Patients with

NSVT had higher pulmonary artery and capillary pressures and

more pronounced signs of sympathetic activation and

parasympathetic withdrawal compared with those without

NSVT. However, logistic regression analysis revealed that

depressed BRS but not reduced HRV was significantly

associated with the presence of NSVT, at both univariate

analysis and after adjustment for clinical and hemodynamic

variables. Moreover, it was found that when depressed BRS

was associated with high pulmonary capillary pressure, the

odds ratio for having NSVT rose markedly from 3.8 to 6.5. In

conclusion, this study indicates that in stable CHF the

assessment of arterial baroreflex function, but not HRV

analysis, allows identification of patients at high risk of

NSVT. It is suggested that the effect of depressed BRS is

strengthened by the simultaneous presence of increased

myocardial wall stress. These data support the hypothesis of a

contributory role of autonomic nervous system dysfunction as

expressed by the inability to activate effective vagal reflexes

and an indirect index of ventricular stretch in the genesis of

life-threatening arrhythmias.

137. Mortara, A.; Specchia, G.; La Rovere, M. T.; Bigger, JT Jr; Marcus, F.

I.; Camm, J. A.; Hohnloser, S. H.; Nohara, R.; Schwartz, P. J.

Patency of infarct-related artery. Effect of restoration of

anterograde flow on vagal reflexes. ATRAMI (Automatic Tone

and Reflexes After Myocardial Infarction) Investigators.

Circulation. 1996 Mar 15; 93(6): 1114-22; ISSN: 0009-7322.

UNITED-STATES. BACKGROUND: In post-myocardial infarction

(MI) patients, the restoration of anterograde flow in the

infarct-related artery (IRA) significantly improves survival.

Limitation of infarct size and increased electrical stability of

the myocardium are likely operating mechanisms for this

beneficial effect. We tested the hypothesis that patency of the

IRA may enhance vagal reflexes, a factor known to affect

electrical stability of the infarcted myocardium. METHODS AND

RESULTS: Analysis of angiographic data was performed in 359

of 1284 post-MI patients enrolled in a multicenter prospective

study within 8 weeks after the index MI. All the patients

underwent baroreflex sensitivity (BRS) assessment by the

phenylephrine method. The BRS of the entire population

averaged 8.2+/-5.5 ms/mm Hg and was significantly related to

age but not to ejection fraction (EF). One-, two-, and three-

vessel disease was present in 138, 96, and 99 patients,

respectively, while no coronary stenosis was observed in 26.

IRA patency was documented in 234 patients (65%), while in

the remaining 125 (35%), the artery remained occluded.

Patients with occluded IRAs had more extensive coronary

disease (2 to 3 vessels, 71% versus 46%, P<.01) and more

depressed left ventricular (LV) function (LVEF, 48+/-13%

versus 53+/-12%, P<.001). Patency of the IRA was associated

with higher BRS values (BRS, 8.9+/-5.8 versus 7.1+/-4.7

ms/mm Hg, P<.005) and with a lower incidence (9% versus 18%

P<.02) of markedly depressed BRS (<3 ms/mm Hg), a condition

suggested by preliminary studies to be associated with an

increased risk of post-MI mortality. The association between

IRA patency and BRS was more evident in anterior than in

inferior MI. Multivariate regression analysis showed that age

of the patient and patency of the IRA were the major

independent determinants of BRS, while LVEF was weakly

related to BRS and only when analyzed as a categorized

variable. CONCLUSIONS: The presence of an open IRA is

associated with higher baroreflex sensitivity, and this effect

is largely independent of limitation of infarct size by IRA

patency. These data offer new insights into the mechanisms by

which coronary artery patency may affect cardiac electrical

stability and survival.

138. Munoz Farjas, E. [Neurophysiological studies of headaches].

Estudios neurofisiologicos en cefaleas. Rev-Neurol. 1997 Oct;

25(146): 1611-6; ISSN: 0210-0010.

SPAIN. INTRODUCTION AND OBJECTIVE: The diagnosis of

headache is based on the clinical criteria suggested by the IHS

in 1988. The neurophysiological examinations often used in the

study of headache may support the clinical diagnosis and give

information as to the prognosis. The objective of this paper is

to review the neurophysiological examinations most often

used in the clinical and pathological investigation of headache.

DEVELOPMENT: As shown by recent studies, the EEG is of little

value in the routine evaluation of a patient with headache.

However, it may be useful as an exploratory test for

underlying pathology in atypical headache or when intra-

cranial pathology is suspected. Evoked potentials, when used

to study migraine, show absence of Habituation (or

Potentiation) in migraine patients. This finding may represent

abnormality in the processing of information at a cortical

level in these patients. There is a tendency to unify the theory

of neurone hypoxia and the absence of Habituation in Migraine

as a single hypothesis of pathogenesis. Negative Contingent

Variation has proved to be clinically useful to optimize

treatment in Migraine. The electromyogram and Muscle

Reflexes have been used in the study of Tension Type

Headaches, ES2 changes, showing brainstem antinociceptive

reflexes support the participation of a central factor in the

origin of chronic Tension Headache. CONCLUSION:

Neurophysiological tests may be useful in investigation of the

pathology of headache since they permit a functional study of

many neurone paths and the action of drugs on the central

nervous system.

139. Myklebust, Barbara M.; Gottlieb, Gerald L. Development of the

Stretch Reflex in the Newborn: Reciprocal Excitation and

Reflex Irradiation. 1993;

Note: This article is 1 of 9 empirical articles in a 14-article

special section, Developmental Biodynamics: Brain, Body,

Behavior Connections.

UMI. Reports - Research (143). When tendon jerk reflexes

were tested in seven newborns from one- to three-days old,

stretch reflex responses in all major muscle groups of the

lower limb were elicited. This "irradiation of reflexes" is a

normal phenomenon in newborns, with the pathway becoming

suppressed during normal maturation. In individuals with

cerebral palsy, however, the pathway endures and is

reinforced. (MDM).

140. Nakamura, M.; Sugi, T.; Ikeda, A.; Kakigi, R.; Shibasaki, H. Clinical

application of automatic integrative interpretation of awake

background EEG: quantitative interpretation, report making,

and detection of artifacts and reduced vigilance level.

Electroencephalogr-Clin-Neurophysiol. 1996 Feb; 98(2): 103-

12; ISSN: 0013-4694.

IRELAND. Methods for the automatic detection of artifacts and

vigilance level of the EEG record were developed for a

preprocessing procedure for the automatic integrative

interpretation of awake background EEG. All equations for the

detection were derived such that they would conform to the

procedure that an EEGer adopts for visual EEG inspection. The

automatic EEG interpretation system was improved by adding

the proposed preprocessing procedure and gave satisfactory

interpretation results for the EEG data even contaminated with

artifacts or in the drowsy state. The automatic EEG

interpretation method proposed here is suggested for clinical

use as an assistant tool for EEGers and physicians.

141. Narayanan, V.; Diven, W.; Ahdab Barmada, M. Congenital fumarase

deficiency presenting with hypotonia and areflexia. J-Child-

Neurol. 1996 May; 11(3): 252-5; ISSN: 0883-0738.

UNITED-STATES. EC 4.2.1.2.

142. Neumann, D. L.; Lipp, O. V.; Siddle, D. A. Conditioned inhibition of

autonomic Pavlovian conditioning in humans. Biol-Psychol.

1997 Oct 10; 46(3): 223-33; ISSN: 0301-0511.

NETHERLANDS. The present study aimed to demonstrate

conditioned inhibition of Pavlovian conditioning of autonomic

responses in humans. Subjects (N = 21) were presented

initially with four geometric shapes (A, B, C and D). An

electric shock served as the unconditioned stimulus (US)

during acquisition. Conditional stimuli lasted for 8 s and US

onset coincided with CS offset. Subjects were trained with A-

US, C-US, and AC-US pairings and AB alone and B alone

presentations. The subsequent summation test consisted of C-

US pairings and CB alone and CD alone presentations.

Conditioning was evident in self-reported US expectancy and

first and second interval electrodermal responses. Evidence

for conditioned inhibition during the summation test was

found in US expectancy and second interval electrodermal

responses.

143. Nicolaides, P.; Appleton, R. E.; Fryer, A. Cerebellar ataxia,

areflexia, pes cavus, optic atrophy, and sensorineural hearing

loss (CAPOS): a new syndrome. J-Med-Genet. 1996 May; 33(5):

419-21; ISSN: 0022-2593.

ENGLAND. There are a large number of well recognised

syndromes comprising cerebellar ataxia in association with

other neurological features. We report three family members

who presented with a relapsing, early onset cerebellar ataxia,

associated with progressive optic atrophy and sensorineural

deafness. All three patients have areflexia (in the absence of a

peripheral neuropathy), a pes cavus deformity, and show

varying degrees of severity. Extensive neurological

investigations have been normal, and the aetiology and

pathophysiology of this disorder remain unclear. This may

represent a separate syndrome of early onset cerebellar ataxia

with associated features ("cerebellar ataxia plus"), which is

likely to either have an autosomal dominant or maternal

mitochondrial pattern of inheritance. The recognition of this

association under the acronym of CAPOS (cerebellar ataxia,

areflexia, pes cavus, optic atrophy, and sensorineural

deafness) may help in the delineation of a new syndrome.

144. Nielsen, P. H.; Brushoj, J.; Fernandes, A. [Autonomous

hyperreflexia and labor]. Autonom hyperrefleksi og fodsel.

Ugeskr-Laeger. 1996 May 13; 158(20): 2859-60; ISSN: 0041-

5782.

DENMARK. Autonomic hyperreflexia is a serious complication

for tetraplegic patients, especially during labour and delivery.

The symptoms are piloerection, facial flushing, anxiety,

headache, serious blood pressure crises and cerebrovascular

accidents. A 30 year-old woman who was tetraplegic

following a high cervical spinal cord lesion, showed signs of

autonomic hyperreflexia. In early labour epidural analgesia

was established and the vaginal delivery was successful

without associated fluctuation of the blood pressure or other

signs of autonomic hyperreflexia.

145. Ohira, H. Eyeblink activity in a word-naming task as a function of

semantic priming and cognitive load. Percept-Mot-Skills. 1996

Jun; 82(3 Pt 1): 835-42; ISSN: 0031-5125.

UNITED-STATES. Eyeblink activity was examined based on a

discrete-trial paradigm in which 17 subjects engaged in a

semantic priming task. They were presented a series of pairs

of words (prime and target) associatively related or

associatively unrelated and were required to name them as

quickly as possible. Cognitive load or difficulty of naming of

the target word was also manipulated. The latency data for

naming of the target word showed a typical priming effect,

namely, facilitation of naming speed by the associatively

relate prime word. The eyeblink rate changed synchronically to

onset of stimuli as a function of prime-target relationship and

cognitive load during the task. Specifically, the eyeblink rate

was suppressed during presentation of the target word and

peaked just after that. This study showed that suppression of

eyeblinks was longer on trials with high cognitive loads than

on those with low cognitive loads and the peak of eyeblink rate

was higher on trials for which the prime and target were

unrelated than on those for which they were related. These

results suggested that the eyeblink activity is influenced by

inner cognitive processes of word recognition.

146. Okuda, Y.; Kitajima, T.; Asai, T. Cremasteric reflex for

identification of successful spinal anesthesia [letter]. Anesth-

Analg. 1997 Dec; 85(6): 1410; ISSN: 0003-2999.

UNITED-STATES.

147. Ono, T.; Ishiwata, Y.; Kuroda, T.; Nakamura, Y. Swallowing-related

perihypoglossal neurons projecting to hypoglossal

motoneurons in the cat. J-Dent-Res. 1998 Feb; 77(2): 351-60;

ISSN: 0022-0345.

UNITED-STATES. Although previous studies have examined the

functional role of the neurons in the area ventrolateral to the

hypoglossal nucleus (perihypoglossal neurons) in the

trigemino-hypoglossal reflex, no convincing evidence for the

direct connection from the perihypoglossal neurons to the

hypoglossal motoneurons has yet been provided. In addition,

the role of the perihypoglossal neurons in swallowing has not

been studied. The purpose of this study was to investigate (1)

the input-output relationship of the perihypoglossal neurons

and (2) whether the afferent feedback was essential for their

swallowing-related activity in chloralose-anesthetized cats.

Before and after the cats were paralyzed, single-unit

activities were recorded extracellularly from 30

perihypoglossal neurons during swallowing elicited by

electrical stimulation of the superior laryngeal nerve. These

perihypoglossal neurons responded with spike potentials after

short latencies to stimulation of the inferior alveolar and

hypoglossal nerves. The neurons also responded with spike

potentials to single shocks applied to the superior laryngeal

nerve, but were activated transiently at the initial phase of

repetitive stimulation of the nerve and kept silent until the

occurrence of swallowing before and after the animal was

paralyzed. They showed burst activities in coincidence with

swallowing. Averaging of intracellular potentials of a

hypoglossal motoneuron by simultaneously recorded

extracellular spikes of a perihypoglossal neuron revealed

monosynaptic inhibitory post-synaptic potentials. We conclude

that, in the region ventrolateral to the hypoglossal nucleus,

there are neurons which relay trigeminal, hypoglossal, and

vagal afferents. Furthermore, some of these perihypoglossal

neurons are inhibitory hypoglossal premotor neurons that are

involved in the central programming of swallowing.

148. Ornitz, E. M.; Gabikian, P.; Russell, A. T.; Guthrie, D.; Hirano, C.;

Gehricke, J. G. Affective valence and arousal in ADHD and

normal boys during a startle habituation experiment. J-Am-

Acad-Child-Adolesc-Psychiatry. 1997 Dec; 36(12): 1698-705;

ISSN: 0890-8567.

UNITED-STATES. OBJECTIVE: To measure two dimensions of

emotion (affective valence and arousal) in 29 boys with

attention-deficit hyper-activity disorder (ADHD) and 32

normal boys. METHOD: After a startle habituation experiment

during which these subjects heard 40 startling sounds while

watching a silent interesting movie, they were asked 12

questions (categorized a priori into questions relating to

affective valence and to arousal) about their emotional

reactions to these putatively unpleasant and pleasurable

stimuli. Responses were recorded for the two dimensions of

emotion, using two cartoon strips in each of which five

expressions of a cartoon character varied linearly from happy

to unhappy (affective valence dimension) and calm to excited

(arousal dimension). RESULTS: Factor analyses of the 12

responses revealed four factors in which the highest loadings

were for affective valence to the startle responses, affective

valence to the silent movie, arousal, and scary feelings.

Relative to the normal group, the responses of the ADHD group

were significantly biased toward pleasurable valence to the

startling stimuli and to the silent movie, with a trend toward

hypoarousal. Startle magnitude and habituation were similar in

both groups. The normal tonic heart rate acceleration

throughout the experimental session was not sustained in the

ADHD group. CONCLUSIONS: The self-reports of affective

valence biased in the direction of pleasure and away from

displeasure and the trend toward hypoarousal suggest an

emotional dysfunction in ADHD.

149. O'Suilleabhain, P.; Low, P. A.; Lennon, V. A. Autonomic dysfunction

in the Lambert-Eaton myasthenic syndrome: serologic and

clinical correlates. Neurology. 1998 Jan; 50(1): 88-93; ISSN:

0028-3878.

UNITED-STATES. Autonomic dysfunction is a recognized

feature of the Lambert-Eaton myasthenic syndrome (LES).

However, the characteristic pattern of dysautonomia has not

been clearly documented and its pathophysiologic basis is not

known. We therefore abstracted autonomic symptomatology

and results of quantitative tests for salivation, and

vasomotor, cardiovagal, and sudomotor reflexes from records

of 30 LES patients. Dry mouth (77%) and impotence (45% of

men) were the most common symptoms. Composite Autonomic

Scoring Scale results were abnormal in 93% of patients, and

autonomic failure was severe in 20%. The frequency of

specific test abnormalities were the following: sudomotor

function, 83%; cardiovagal reflexes, 75%; salivation, 44%; and

adrenergic function, 37%. Although voltage-gated N-type

calcium (Ca2+) channels are implicated in autonomic

transmission, the low frequency of serum antibodies to N-type

Ca2+ channels found in the patients of this study (31%

positive) argues against a pathogenic role in mediating LES-

related dysautonomia. In contrast, 93% of the patients were

seropositive for P/Q-type Ca2+ channel antibodies. A subset of

these antibodies is thought to impair neuromuscular

transmission. Autoantibodies of thyrogastric or glutamic acid

decarboxylase specificity (markers of predisposition to type 1

diabetes mellitus) were found in 45% of patients, and type 1

antineuronal nuclear antibody (or anti-Hu, a marker of

autoimmune neuropathy associated with small-cell lung

carcinoma) was found in 3%. No autoantibody correlated with

autonomic dysfunction severity. Sensorimotor neuropathy was

documented in five patients, and was not significantly

associated with autonomic neuropathy. Autonomic failure was

most severe in older subjects with cancer (p = 0.02, age by

cancer interaction).. 0.

150. Ovchinnikov, I. u. M.; Morozova, S. V. [Objective assessment of the

olfactory analyzer function based on recording of olfacto-

vegetative and olfacto-vestibular reactions]. Ob"ektivnaia

otsenka funktsii oboniatel'nogo analizatora na osnove

registratsii ol'fakto-vegetativnykh i ol'fakto-vestibuliarnykh

reaktsii. Vestn-Otorinolaringol. 1996 May; (3): 19-20; ISSN:

0042-4668.

RUSSIA. To register objectively olfactory defects and to

assess them qualitatively and quantitatively, the authors

propose to use olfactometric techniques reflecting

olfactovegetative and olfactovestibular manifestations.

Automatic pupillographic complex APK-OI provides speed, time

and amplitude parameters of the pupillary and nyctating

reflexes. 600 pupillograms and records of the nictation reflex

proved high diagnostic significance of these methods. 104

stabilographic examinations (ST-02 unit) illustrated the

changes in 12 vestibular parameters prior to and after

olfactory impact. The results give grounds for application of

olfactovestibular reactions registration as an objective

olfactometric test.

151. Page, R. L.; Wharton, J. M.; Prystowsky, E. N. Effect of continuous

vagal enhancement on concealed conduction and refractoriness

within the atrioventricular node. Am-J-Cardiol. 1996 Feb 1;

77(4): 260-5; ISSN: 0002-9149.

UNITED-STATES. This study examined the complex interaction

between vagal enhancement and how a concealed atrial

impulse alters atrioventricular (AV) nodal function. In theory,

vagal augmentation could increase or decrease the effect that

a premature atrial beat has on the subsequent beat. In 10

patients we established the AV nodal effective refractory

period (ERP) without and with a conditioning atrial stimulus

(Sc); the stimulation protocol was then repeated after

enhancing reflex vagal tone with a continuous phenylephrine

infusion. During phenylephrine infusion, the sinus cycle length

prolonged from 827 +/- 99 to 1,029 +/- 223 ms (p < 0.001) and

AV nodal ERP increased from 331 +/- 51 to 425 +/- 64 ms (p <

0.005). At control, AV nodal ERP in the presence of Sc

prolonged to 536 +/- 69 ms (p < 0.001), and during

phenylephrine infusion increased to 579 +/- 57 ms (p < 0.01), a

change significantly less than during control (58 +/- 14% vs

31 +/- 14%, respectively, p < 0.01). Further experiments

suggest that the effect of Sc was reduced because it occurred

earlier relative to the vagally prolonged AV nodal ERP. In

conclusion, this study demonstrates a complex relation

between the timing of a premature atrial beat causing

concealed conduction and the degree of vagal tone. The

concealed beat, as related to the AV node ERP, has a

substantial effect on subsequent AV nodal conduction. These

data give insights into clinical AV nodal function.. 0; 59-42-7.

152. Papka, M.; Woodruff, Pak DS. Number of trials needed to assess

human eyeblink classical conditioning. Psychol-Aging. 1996

Jun; 11(2): 373-6; ISSN: 0882-7974.

UNITED-STATES. Eyeblink classical conditioning (EBCC) is a

useful paradigm for studying the neurobiology of learning and

memory. EBCC shows large age effects and has been shown to

be sensitive to Alzheimer-like neuropathology. The EBCC data

of 241 participants, including young, middle-aged, and elderly

normal adults, adults with Down's syndrome, and patients with

probable Alzheimer's disease, were analyzed to identify a

minimum number of trials for reliable assessment. Results

indicate that EBCC performance can be as reliably assessed in

63 trials as in 90 trials. Using fewer conditioning trials

reduces administration time, making EBCC more practical for

both research and potential diagnostic purposes.

153. Park, J. M.; Bloom, D. A.; McGuire, E. J. The guarding reflex

revisited. Br-J-Urol. 1997 Dec; 80(6): 940-5; ISSN: 0007-

1331.

ENGLAND.

154. Pearce, J. M. Babinski or Remak? [letter]. J-R-Coll-Physicians-

Lond. 1996 Mar; 30(2): 190; ISSN: 0035-8819.

ENGLAND.

155. Pilon, M.; Sullivan, S. J. Motor profile of patients in minimally

responsive and persistent vegetative states. Brain-Inj. 1996

Jun; 10(6): 421-37; ISSN: 0269-9052.

ENGLAND. The purpose of this descriptive clinical study is to

document the motor characteristics of patients in minimally

responsive and persistent vegetative states. Twelve subjects,

presenting a prolonged altered state of consciousness (x = 7.82

years, range 2-27), aged 27-78 years (x = 50, SD = 15.26) were

evaluated, using standardized protocols, on the following

variables: passive range of motion, observed movements,

reflexes, tonus, postural status and reactions. The subjects'

level of awareness and responsivity were measured with the

Coma/Near Coma (CNC) scale at each of the three data

collection sessions. While group CNC scores were stable over

the three sessions, fluctuations in the level of awareness of

individual subjects was recorded, confirming the

heterogeneity of this clientele. Abnormal primitive reflexes

were present in all subjects, with the flexor withdrawal

(75%), the tonic labyrinthine (36%) and the body-on-body

righting reaction (25%) being the most frequently observed. All

subjects presented altered tonus, considerable posturing and

varied degrees of reduced range of joint motion. A range of

abnormal (e.g. chewing, clonus) and normal patterned (e.g.

bridging, scratching) movement behaviours was recorded, but

these did not translate into functional use, such as rolling.

Collectively, the findings stress the complexity of the motor

profile of patients in minimally responsive and vegetative

states, and suggest the need for physiotherapists to become

more actively involved in the evaluation and treatment of this

clientele.

156. Pilz, P. K. D.; Schnitzler, H. U. Habituation and sensitization of the

acoustic startle response in rats: amplitude, threshold, and

latency measures. Neurobiol-Learn-Mem. 1996 Jul; 66(1): 67-

79; ISSN: 1074-7427.

UNITED-STATES. The amplitude of the acoustic startle

response habituates to repetitive stimulation. The input and

output of the startle system were measured to determine if

the decrease in startle amplitude during repetitive

stimulation is due to an increase in the startle threshold. Two

experimental approaches were used in 35 Sprague-Dawley rats

to probe the relationship between the input (the sound

pressure level of the stimulus) and the behavioral output

(startle amplitude). The results show that the minimum

threshold for a response does not change during habituation;

rather, the slope of the dependence of startle amplitude on

stimulus level decreases. Because habituation does not

influence startle threshold we propose that the site for

habituation is located in the neural circuitry downstream from

the site for startle threshold. Besides amplitude and

threshold, as an additional parameter we measured startle

latency. In general, the latency of the acoustic startle

response is negatively correlated with the response amplitude.

This correlation has been repeatedly shown, therefore one

would expect a latency increase during the amplitude decrease

caused by habituation. However, the latency of the startle

reaction also decreased during the course of repetitive

stimulation. According to the dual process theory of

habituation, a stimulus has both a response-decreasing, i. e.,

habituating, as well as a response-increasing, i.e., sensitizing,

influence on a behavior (Groves & Thompson, 1970). Our

explanation of the present results is that startle amplitude is

reduced following repetitive stimulation because it is mainly

influenced by habituation; latency, however, is shortened

because it is mainly influenced by sensitization.

157. Polagaeva, E. B.; Egorov, A. I. u.; Pirogov, A. A. [Asymmetry of skin

resistance response under activation of the right and left

cerebral hemisphere]. Asimmetriia reaktsii soprotivleniia

kozhi pri aktivatsii pravogo i levogo polusharii mozga. Fiziol-

Cheloveka. 1997 Sep; 23(5): 21-6; ISSN: 0131-1646.

RUSSIA.

158. Ponikowski, P.; Chua, T. P.; Piepoli, M.; Ondusova, D.; Webb Peploe,

K.; Harrington, D.; Anker, S. D.; Volterrani, M.; Colombo, R.;

Mazzuero, G.; Giordano, A.; Coats, A. J. Augmented peripheral

chemosensitivity as a potential input to baroreflex

impairment and autonomic imbalance in chronic heart failure.

Circulation. 1997 Oct 21; 96(8): 2586-94; ISSN: 0009-7322.

UNITED-STATES. BACKGROUND: The precise mechanisms

responsible for the sympathetic overactivity and blunted

baroreflex control in chronic heart failure (CHF) remain

obscure. Augmented peripheral chemosensitivity has recently

been demonstrated in CHF. We evaluated the relation between

peripheral chemoreflex sensitivity and autonomic activity in

patients with CHF. METHODS AND RESULTS: We studied in 26

stable patients with CHF the peripheral chemosensitivity

(ventilatory response to hypoxia using transient inhalations of

pure nitrogen), autonomic balance (spectral analysis of heart

rate variability [HRV]), and baroreflex sensitivity (bolus

phenylephrine method and alpha index). To determine whether

transient inactivation of peripheral chemoreceptors might

influence autonomic balance, 12 patients underwent a second

study during which they breathed 100% O2. Peripheral

chemosensitivity correlated inversely with HRV power within

the low-frequency band (0.04 to 0.15 Hz) (r=-.52, P=.006) and

inversely with baroreflex sensitivity (r=-.60, P=.005). When

the patients were divided into two groups according to the

chemosensitivity of age-matched normal controls (above and

below mean+2 SDs of chemosensitivity of control subjects),

those above the normal range revealed more impaired

autonomic balance, ie, lower baroreflex sensitivity (1.4 +/-

1.3 versus 5.0 +/- 1.5 ms/mm Hg, P<.0001) and depressed

values of low-frequency power (2.5 +/- 1.8 versus 4.1 +/- 0.8

ln ms2, P<.005) compared with those with normal

chemosensitivity. Transient hyperoxia did not alter heart rate

or systolic pressure but resulted in an increase in HRV and an

improvement in baroreflex sensitivity. CONCLUSIONS: A link

between increased peripheral chemosensitivity and impaired

autonomic control, including baroreflex inhibition, is

demonstrated. The clinical importance of this phenomenon

warrants further investigation.

159. Pozzessere, G.; Valle, E.; Rossi, P.; Petrucci, B.; Ambrosini, A.;

D'Alessio, M.; Pierelli, F.; Giacomini, P. Pupillometric

evaluation and analysis of light reflex in healthy subjects as a

tool to study autonomic nervous system changes with aging.

Aging-Milano. 1996 Feb; 8(1): 55-60; ISSN: 0394-9532.

ITALY. To assess the relationships between aging and

autonomic control of pupillary functions, TV-pupillometry and

light reflex evaluation were performed in 52 healthy

volunteers in the age range 15-75 years, grouped into four age

classes (group 1: 15-29 years, Group 2: 30-44 years, Group 3:

45-59 years, Group 4: 60-75 years). Baseline light pupil

diameter was found to be age-dependent, together with light

reflex contraction velocity, which presented a linear

correlation with age. Light reflex amplitude and half-

redilatation velocity were reduced in older subjects, but

presented only a weak linear correlation with age, while

latency, contraction time and half-redilatation time percent

of secondary dilatation and redilatation at 5 seconds did not

show significant changes with age. These results confirm that

there are important age-dependent changes in the mechanisms

involved in pupillary autonomic functions, regarding both

sympathetic and parasympathetic components. These changes

appear to be easily detectable by making use of a sensitive and

non-invasive technique such as TV-pupillometry.

160. Prakash, U.; Bhatia, B. D. H-reflex latency: a maturity criterion for

newborn babies. Electromyogr-Clin-Neurophysiol. 1997 Oct;

37(7): 435-7; ISSN: 0301-150X.

BELGIUM. One hundred newborn babies were investigated for

H-reflex latency (H-RL) in between 33 to 40 weeks (wk) of

post-conceptional age (PCA). Weekly data of both preterms (33

to 36 wk PCA) and fullterms (37 to 40 wk PCA) were

compared. A significant reduction in H-RL was noticed at 37

wk PCA when newborns attain their term. The babies could be

classified into preterms and fullterms by using their H-RL

values.

161. Prim Espada, M. P.; de Diego, Sastre JI; de Sarria, Lucas MJ. [EOG

findings in patients with multiple sclerosis]. Hallazgos EOG en

pacientes con esclerosis multiple. Acta-Otorrinolaringol-Esp.

1996 Jan; 47(1): 29-31; ISSN: 0001-6519.

SPAIN. Electroculography (EOG) is useful in the diagnosis of

multiple sclerosis (MS), a common disorder. We reviewed the

EOG recordings of 192 patients with MS (98 definite, 29

probable, 65 possible diagnoses) to evaluate spontaneous

nystagmus, rotation tests, positional tests, vestibulo-ocular

reflex visual suppression (VOR), optokinetic nystagmus,

saccades and pursuit tracking. The most frequent findings

were abnormalities in the pursuit tracking, saccade dysmetria

and vestibulo-ocular reflex suppression disorders. Results are

discussed and the literature is reviewed.

162. Procopio, J. Fast and slow voltage modulation of apical Cl-

permeability in toad skin at high [K+]. Braz-J-Med-Biol-Res.

1997 Aug; 30(8): 1033-44; ISSN: 0100-879X.

BRAZIL. The influence of voltage on the conductance of toad

skin was studied to identify the time course of the

activation/deactivation dynamics of voltage-dependent Cl-

channels located in the apical membrane of mitochondrion-rich

cells in this tissue. Positive apical voltage induced an

important conductance inhibition which took a few seconds to

fully develop and was instantaneously released by pulse

inversion to negative voltage, indicating a short-duration

memory of the inhibiting factors. Sinusoidal stimulation at

23.4 mM [Cl-] showed hysteresis in the current versus voltage

curves, even at very low frequency, suggesting that the rate of

voltage application was also relevant for the

inhibition/releasing effect to develop. We conclude that the

voltage modulation of apical Cl- permeability is essentially a

fast process and the apparent slow components of

activation/deactivation obtained in the whole skin are a

consequence of a gradual voltage build-up across the apical

membrane due to voltage sharing between apical and

basolateral membranes.. 0; 7440-09-7.

163. Puria, S.; Guinan, JJ Jr; Liberman, M. C. Olivocochlear reflex

assays: effects of contralateral sound on compound action

potentials versus ear-canal distortion products. J-Acoust-

Soc-Am. 1996 Jan; 99(1): 500-7; ISSN: 0001-4966.

UNITED-STATES. The strength of the olivocochlear reflex has

been assayed by comparing ipsilateral cochlear responses with

and without contralateral sound. In humans, ipsilateral

cochlear responses have usually been inferred by measuring

otoacoustic emissions (OAEs), whereas, in animal work, they

have been assessed by measuring compound action potentials

(CAPs). Thus reports that the reflex strength is smaller in

humans than in animals cannot be interpreted until the

differences between the two tests are better understood. The

present study directly compares reflex assays using

distortion-product (DP) OAE and CAP measures in the same

animals. For ipsilateral frequencies of 2-8 kHz and levels from

25 to 80 dB SPL, efferent reflex strength was computed from

the CAP or DPOAE amplitude-versus-level curves measured

with and without contralateral noise. The "effective

attenuation" produced by efferent activation was, with few

exceptions, greater when measured with the CAP than with the

DPOAE assay. Differences between the two measures increased

as frequency increased, with differences as large as 10 dB

observed. These results, coupled with previous measurements

on humans and animals, suggest that the efferent reflex is at

least as strong in humans as has been shown in animal

experiments.

164. Pynoos, R. S.; Ritzmann, R. F.; Steinberg, A. M.; Goenjian, A.;

Prisecaru, I. A behavioral animal model of posttraumatic

stress disorder featuring repeated exposure to situational

reminders. Biol-Psychiatry. 1996 Jan 15; 39(2): 129-34; ISSN:

0006-3223.

UNITED-STATES. The purpose of this study was to evaluate an

animal model of posttraumatic stress disorder (PTSD) in mice.

The model featured repeated exposures to situational

reminders of a traumatic stress, which consisted of a brief

electric shock, and included assessment of two behavioral

parameters and the startle reflex. The findings indicated an

initial, but unsustained, increase in locomotor activity in a

neutral environment due to traumatic stress. Exposure to

situational reminders was associated with a persistent

bidirectional abnormal behavioral pattern in a fear-provoking

environment and a progressive increase over time in the

magnitude of the startle reflex. Exposure to situational

reminders also produced an increase in aggressive behavior.

This animal model appears to produce behavioral changes

analogous to those seen in patients with PTSD.

165. Reiber, G. E. The epidemiology of diabetic foot problems. Diabet-

Med. 1996; 13 Suppl 1: S6-11; ISSN: 0742-3071.

ENGLAND.

166. Resta, O.; Guido, P.; Rana, L.; Procacci, V.; Scarpelli, F.; Picca, V.

Depressed baroreceptor reflex in patients with obstructive

sleep apnea (OSA). Boll-Soc-Ital-Biol-Sper. 1996 Sep; 72(9-

10): 247-54; ISSN: 0037-8771.

ITALY. In this study we evaluated the cardiovascular

autonomic function in twenty-five OSA patients and in

twenty-five control healthy subjects, by computerized

spectral analysis of R-R interval variation at rest and during

orthostatism by head-up tilt maneuver to up-right position (80

degrees) as a sympathetic provocation. The results of our

study show that most patients affected by OSA have a

sympathetic overactivity and a decreased baroreflex response

in comparison with normal subjects. The method here

described is simple, objective and very sensitive and may be

utilized to discover early signs of an autonomic dysfunction

consequent to OSA leading to cardiovascular complications of

the late stage of the disease.

167. Ribbers, G.; And, Others. The Reflex Sympathetic Dystrophy

Syndrome: A Review with Special Reference to Chronic Pain

and Motor Impairments. 1995;

Journal Articles (080). Information Analyses - General (070).

Opinion Papers (120). This article reviews reflex sympathetic

dystrophy (RSD), a symptom complex caused by a minor injury

and characterized by pain, vasomotor and trophic

disregulation, and motor impairments. Both an acute stage and

a chronic stage are described. Implications for diagnosis,

prevention of disabilities, and development of rehabilitation

strategies are drawn. (DB).

168. Riccio, M. M.; Proud, D. Evidence that enhanced nasal reactivity to

bradykinin in patients with symptomatic allergy is mediated

by neural reflexes. J-Allergy-Clin-Immunol. 1996 Jun; 97(6):

1252-63; ISSN: 0091-6749.

UNITED-STATES. OBJECTIVE: The aim of this study was to

determine whether allergic inflammation induces nasal

hyperreactivity to bradykinin by enhancing neuronal

responsiveness. METHODS: We compared the response to

localized, unilateral nasal challenge with bradykinin in

patients with perennial allergic rhinitis and nonallergic

subjects, and in patients with seasonal allergic rhinitis

challenged in and out of season. Weights of secretions from

each nostril were recorded, and levels of albumin and

lactoferrin in secretions recovered from each nostril were

assayed. Contralateral administration of atropine (0.32 mg)

was used to evaluate the role of cholinergic reflexes in nasal

hyperresponsiveness to bradykinin. RESULTS: In patients with

symptomatic allergy, bradykinin induced greater symptom

scores than in asymptomatic atopic or nonallergic control

subjects. Moreover, bradykinin caused sneezing in a majority

of patients with symptomatic allergy but in none of the

asymptomatic atopic or nonallergic control subjects. Only

patients with symptomatic allergy showed dose-dependent

bilateral increases in secretion weights and levels of the

serous glandular marker, lactoferrin. In contrast, bradykinin

induced similar increases in ipsilateral, but not contralateral,

levels of albumin in all patient populations. Atropine inhibited

contralateral secretion and lactoferrin production (p < 0.05) in

patients with symptomatic allergy. CONCLUSION: The induction

of sneezing and of atropine-inhibitable contralateral glandular

secretion demonstrates that allergic inflammation causes

nasal hyperreactivity to bradykinin, at least in part, by

enhancing neuronal responsiveness.. 0; 0; 0; 0; 37341-29-0;

51-55-8; 58-82-2.

169. Riezzo, G.; Porcelli, P.; Guerra, V.; Giorgio, I. Effects of different

psychophysiological stressors on the cutaneous

electrogastrogram in healthy subjects. Arch-Physiol-Biochem.

1996; 104(3): 282-6; ISSN: 1381-3455.

NETHERLANDS. To evaluate the effect of psychophysiological

stress on the gastric electrical activity, the cutaneous

electrogastrography (EGG), a non-invasive technique, was

performed in ten healthy subjects. Three different stressful

(cold pressor test, arithmetic task, and Stroop color-word

test) tests and a non-stressful (reading a booklet) task were

administered, and EGG parameters (dominant frequency,

coefficient of variation of dominant frequency, and gastric

power) were recorded during baseline, task and rest periods.

Neutral task did not affect EGG parameters. During stressful

stimulations, a slight decrease in the dominant frequency and

an increase in the coefficient of variation of the dominant

frequency were found. During arithmetic task, the gastric

power significantly increased (baseline vs stimulus P = 0.008;

stimulus vs rest P = 0.015; baseline vs rest P = 0.011), and a

statistically significant difference between gastric power

during arithmetic and neutral task was observed (P = 0.007).

During Stroop test, the gastric power showed only a trend

toward significance (baseline vs stimulus P = 0.018; stimulus

vs rest P = 0.018). A wide interindividual variability was

recorded during the stress period. Therefore, the individual

susceptibility to psychological stress may influence the EGG

response and gastric electrical activity. In conclusion,

cutaneous electrogastrography may be used as a non-invasive

technique to study the effects of acute stressors on the

gastric electrical activity.

170. Robichaud, J. A.; Agostinucci, J. Air-splint pressure effect on

soleus muscle alpha motoneuron reflex excitability in subjects

with spinal cord injury. Arch-Phys-Med-Rehabil. 1996 Aug;

77(8): 778-82; ISSN: 0003-9993.

UNITED-STATES. OBJECTIVE: This study investigated

circumferential pressure effect on soleus motoneuron reflex

excitability in subjects with spinal cord injury (SCI). SETTING:

A university neuromuscular research laboratory. SUBJECTS: Six

men with SCI, clinical level above L1. OUTCOME MEASURES AND

INTERVENTION: Soleus motoneuron reflex excitability was

assessed by measuring the average change in the peak-to-peak

amplitude of 10 H-reflexes before (baseline), during (1, 3, and

5min) and after (1, 3, and 5min) pressure application. Pressure

was applied to the lower leg by manually inflating an air-

splint to a maintained range of 36.7 to 40.8mmHg for 5

minutes, after which it was deflated. DESIGN: Repeated

measures, planned comparison. Dependent variables compared

with baseline values only in post hoc tests. RESULTS: A one-

way analysis of variance for repeated measures demonstrated

significant difference (F6,30 = 4.03; p = .004) in the H-reflex

amplitude across test conditions. Post hoc t tests (with

Bonferroni's correction for multiple comparisons, p < or =

.008) revealed a significant H-reflex amplitude reduction at 1,

3, and 5 minutes of pressure application when measurements

were compared with the baseline value. Postpressure

measurements returned to baseline; however, the third minute

measurement was significantly greater than baseline values.

CONCLUSIONS: Circumferential pressure applied to the lower

leg decreased soleus muscle alpha motoneuron reflex

excitability in subjects with SCI. This inhibition lasted only

as long as the pressure was applied. Circumferential pressure

application may be useful when a temporary decrease in

muscle activity is a therapeutic goal in patients with SCI.

171. Robinette, M. S.; Bauch, C. D.; Olsen, W. O.; Harner, S. G.; Beatty, C.

W. Nonsurgical factors predictive of postoperative hearing for

patients with vestibular schwannoma. Am-J-Otol. 1997 Nov;

18(6): 738-45; ISSN: 0192-9763.

UNITED-STATES. OBJECTIVE: The purposes of the study were

to determine whether preoperative cochlear reserve as

measured by evoked otoacoustic emissions (EOAE) as well as

other hearing variables often associated with hearing

preservation are correlated with hearing preservation after

tumor removal and to determine whether any hearing variables

are independent of tumor size as a predictor of hearing

preservation. STUDY DESIGN: Preoperative audiologic data for

104 patients having vestibular nerve schwannomas removed

via a retrosigmoid surgical approach were reviewed and

subjected to factor analysis. SETTING: All patients were seen

at the Mayo Clinic, Rochester, Minnesota. PATIENTS: The

patient sample was divided into two groups based on hearing

thresholds after surgery. Group I consisted of 73 ears without

hearing preservation. The remaining 31 ears, group II, had

preserved hearing (defined as average postoperative pure-tone

thresholds < or = 85-dB HL for 0.5, 1, 2, and 3 kHz). MAIN

OUTCOME MEASURES: Variables not predictive of hearing

preservation were age, gender, tumor laterality, and cochlear

reserve (EOAE). Variables predictive of hearing preservation

were small tumor size, pure-tone hearing sensitivity, speech

reception thresholds, word recognition scores, integrity of

cochlear nerve (acoustic reflex thresholds, and auditory brain

stem response [ABR] waveforms). RESULTS: A multivariate

logistic regression analysis showed that only word recognition

scores at 40-dB sensation level were independent of tumor

size as a predictor of hearing preservation.

172. Rogers, D. F. Reflexly runny noses: neurogenic inflammation in the

nasal mucosa [editorial]. Clin-Exp-Allergy. 1996 Apr; 26(4):

365-7; ISSN: 0954-7894.

ENGLAND. 0.

173. Rottach, K. G.; Riley, D. E.; DiScenna, A. O.; Zivotofsky, A. Z.; Leigh,

R. J. Dynamic properties of horizontal and vertical eye

movements in parkinsonian syndromes. Ann-Neurol. 1996 Mar;

39(3): 368-77; ISSN: 0364-5134.

UNITED-STATES. We studied dynamic properties of horizontal,

vertical, and oblique eye movements in 23 patients with the

following parkinsonian syndromes: idiopathic parkinsonism

(PD), multiple system atrophy (MSA), pure akinesia (PA),

progressive supranuclear palsy (PSP), and cortical-basal

ganglionic degeneration (CBGD). Compared with age-matched

controls, only PSP patients showed slowing of saccades.

Patients in all groups showed saccadic hypometria that was

most marked vertically. The trajectories of saccades made to

diagonal target jumps were deviated toward the horizontal

plane, due to the vertical hypometria; this was most marked in

PA and PSP groups. Saccade latency was only increased in the

CBGD group. Sinusoidal smooth pursuit did not differentiate

between controls and patients; however, with step-ramp

stimuli, pursuit eye acceleration was impaired in all patient

groups compared with controls. The vestibulo-ocular reflex,

with or without visual enhancement, was similar in patients

and controls. These findings indicate that (1) in parkinsonian

syndromes apart from PSP, the saccade-generating brainstem

burst neurons are probably spared, but the signals that they

receive, specifying the size and direction of saccades, are

flawed; and (2) measurements of the gain and trajectory of

oblique saccades, and initiation of smooth pursuit, may aid in

diagnosing these different types of parkinsonism.

174. Rousseaux, M.; Hurtevent, J. F.; Benaim, C.; Cassim, F. Late

contralateral hyperhidrosis in lateral medullary infarcts.

Stroke. 1996 May; 27(5): 991-5; ISSN: 0039-2499.

UNITED-STATES. BACKGROUND AND PURPOSE: This study

describes unilateral increases of sweating reactions observed

in the months after contralateral medullary infarct; evaluation

of sympathetic cutaneous response may help to explain

sweating disorders. SUMMARY OF REPORT: After the discovery

of the clinical phenomenon in one case, patients admitted

between 1990 and 1993 were systematically evaluated

clinically and electrophysiologically. In a group of five

patients presenting with lateral or dorsal medullary lesions,

two exhibited an increase of contralateral sweating reactions

that appeared 6 to 8 months after stroke, were elicited by

effort and exposure to heat and stress, and were more severe

over the forehead, face, and upper trunk. In one case, this was

clinically associated with an absence of sweating on the side

of the lesion. During the late phase after stroke, in three

patients presenting with lateral medullary lesions,

electrophysiological evaluation revealed significant

asymmetry of the sympathetic skin response, which was

higher on the side contralateral to the lesion than on the

ipsilateral side. In one patient, no response could be elicited

by stimulations applied on the side of the lesion.

CONCLUSIONS: Contralateral hyperhidrosis can be observed in

the late phase after lateral medullary infarct and is likely due

to lesion of the sympathetic pathway passing through the

lateral medulla, which inhibits sudomotor neurons. Evaluation

of sympathetic skin response may help to explain such clinical

disorders.

175. Sahadevan, M. G. A hundred years of the Babinski reflex. J-R-Coll-

Physicians-Lond. 1996 Jan; 30(1): 83; ISSN: 0035-8819.

ENGLAND.

176. Sakaguchi, M.; Nishimura, R.; Sasaki, N.; Ishiguro, T.; Tamura, H.;

Takeuchi, A. Anesthesia induced in pigs by use of a

combination of medetomidine, butorphanol, and ketamine and

its reversal by administration of atipamezole. Am-J-Vet-Res.

1996 Apr; 57(4): 529-34; ISSN: 0002-9645.

UNITED-STATES. OBJECTIVE--To develop an IM administrable

anesthetic combination for pigs. DESIGN--Use of a combination

of atropine, medetomidine, butorphanol, and ketamine (MB-K)

was evaluated as an anesthetic regimen and compared with

that of a combination of atropine, xylazine, butorphanol, and

ketamine (XB-K). Cardiorespiratory effects of MB-K

combination and use of atipamezole as a means of reversing

anesthesia induced by MB-K were examined. ANIMALS--18

castrated, mixed-breed, specific-pathogenfree pigs, aged 8 to

15 (mean, 12.1) weeks and weighing 14.5 to 26.0 (mean, 19.6)

kg. were studied. PROCEDURE--Dosages of drugs used in this

study were atropine, 25 micrograms/kg of body weight;

medetomidine, 80 micrograms/kg; xylazine, 2 mg/kg;

butorphanol, 200 micrograms/kg; ketamine, 10 mg/kg; and

atipamezole, 240 micrograms/kg. RESULTS--MB-K combination

proved to be more effective than XB-K combination as an

anesthetic combination. After quick and smooth induction by

IM administration, MB-K-induced anesthesia was sustained for

98.8 +/- 22.5 minutes (mean +/- SD, 47.4 +/- 16.5 minutes by

XB-K) with accompanying muscular relaxation (91 +/- 18

minutes) and loss of pedal (82 +/- 24 minutes) and laryngeal

(75 +/- 19 minutes) reflexes. Loss of these reflexes was of

significantly longer duration than the loss induced by XB-K,

enabled tracheal intubation, and, thus, supported major

surgery for at least 30 minutes after induction. Recovery from

MB-K-induced anesthesia was smooth. MB-K combination had a

slight stimulative effect on cardiovascular status, and a

significant depressant effect on blood gas and acid-base

status, but these effects were within biologically acceptable

limits. Oxygen consumption of pigs under MB-K-induced

anesthesia decreased significantly. MB-K-induced anesthesia

could be effectively and quickly reversed by IM or IV

administration of atipamezole. CONCLUSIONS--The

combination of medetomidine, butorphanol, and ketamine

induces excellent surgical anesthesia in pigs, and results in

moderate cardiorespiratory effects. A great advantage of the

anesthetic regimen is that it can be effectively and quickly

reversed by atipamezole. CLINICAL RELEVANCE--Medetomidine,

butorphanol, and ketamine-induced anesthesia is available for

short-term major surgery in pigs.. 0; 0; 0; 0; 0; 104054-27-5;

42408-82-2; 6740-88-1; 7782-44-7; 86347-14-0.

177. Sakakibara, R.; Hattori, T.; Kuwabara, S.; Yamanishi, T.; Yasuda, K.

Micturitional disturbance in patients with Guillain-Barre

syndrome. J-Neurol-Neurosurg-Psychiatry. 1997 Nov; 63(5):

649-53; ISSN: 0022-3050.

ENGLAND. OBJECTIVES: To examine the frequency and

pathophysiology of micturitional disturbance in patients with

Guillain-Barre syndrome. METHODS: Micturitional symptoms

were noted and neurological examinations made repeatedly

during admission to hospital of patients with clinical and

neurophysiologically definite Guillain-Barre syndrome.

Urodynamic studies consisted of uroflowmetry, measurement

of residual urine, urethral pressure profilometry, medium fill

water cystometry, and external sphincter EMG. RESULTS: Seven

of 28 (25%) patients with Guillain-Barre syndrome showed

micturitional disturbance. The symptoms included voiding

difficulty in six, urinary retention in three, nocturnal urinary

frequency in three, and urge incontinence in two. These

micturitional symptoms appeared after weakness occurred,

and improved gradually along with the neurological signs. All

three patients who showed retention became able to urinate.

Urodynamic studies were made on four symptomatic patients

two of whom underwent repeated study. Disturbed bladder

sensation was noted in one patient, bladder areflexia in one,

and absence of the bulbocavernosus reflex in one. Cystometry

showed decreased bladder volume in two and bladder

overactivity in two, one of whom had urge urinary incontinence

and the other urinary retention. CONCLUSIONS: A quarter of the

patients with Guillain-Barre syndrome tend to have

micturitional disturbance. The patients studied had evacuation

and storage disorders, as well as bladder areflexia and

disturbed bladder sensation indicative of peripheral types of

parasympathetic and somatic nerve dysfunction. Decreased

bladder volume with bladder overactivity but no evidence of

CNS involvement was also found, evidence that bladder

overactivity also occurs in peripheral nerve lesions with

probable pelvic nerve irritation.

178. Sangwan, Y. P.; Coller, J. A.; Schoetz, D. J.; Roberts, P. L.; Murray,

J. J. Spectrum of abnormal rectoanal reflex patterns in

patients with fecal incontinence. Dis-Colon-Rectum. 1996 Jan;

39(1): 59-65; ISSN: 0012-3706.

UNITED-STATES. PURPOSE: Abnormalities of rectoanal

inhibitory or excitatory reflex in patients with fecal

incontinence are well described. A spectrum of abnormal

responses, other than those already described in the

literature, has been observed in some patients with fecal

incontinence and forms the subject of this report. METHOD:

Forty-three patients with idiopathic or traumatic fecal

incontinence were studied to evaluate their reflex responses

to balloon distention of the rectum, and results were compared

with reflex responses of 29 control subjects with no anorectal

complaints. RESULTS: Control subjects revealed normal reflex

responses consisting of initial excitation followed by

inhibition in the proximal anal canal and an excitatory

response in the distal anal canal. Patients who were

incontinent revealed five different types of reflex patterns.

Eleven patients (25.5 percent) with segmental sphincter

defects from obstetric injuries exhibited no distal excitation

but had normal response in the proximal anal canal (Group 1).

Eleven patients (25.5 percent) with idiopathic incontinence

exhibited normal proximal response but an inhibitory as

opposed to excitatory response in the distal anal canal (Group

2). Three patients (7 percent) with iatrogenic trauma failed to

register an excitatory response in the proximal or distal anal

canal but revealed a normal inhibitory reflex (Group 3). Nine

patients (21 percent) with idiopathic incontinence revealed

excitatory response in the entire anal canal but no inhibition

(Group 4). Nine patients (21 percent) with idiopathic

incontinence had a normal reflex pattern (Group 5).

CONCLUSION: Excitatory and inhibitory components of

rectoanal reflexes may selectively be abolished in neurogenic

or traumatic insults to visceral and somatic anal sphincters,

resulting in altered rectoanal reflex patterns.

179. Sarinoglu, C.; Dell, J.; Mercer, B. M.; Sibai, B. M. Fetal startle

response observed under ultrasonography: a good predictor of a

reassuring biophysical profile. Obstet-Gynecol. 1996 Oct; 88(4

Pt 1): 599-602; ISSN: 0029-7844.

UNITED-STATES. OBJECTIVE: To correlate the vibroacoustic

stimulus-evoked fetal startle response observed under

ultrasonography with the subsequent biophysical profile (BPP)

score. METHODS: Vibroacoustic stimulation was applied under

ultrasound observation to gravidas who had a nonreactive fetal

heart rate in the first 10 minutes of monitoring. Fetal startle

response was defined as a sudden movement of fetal

extremities in the 2 seconds following stimulus. Subsequently,

nonstress testing was completed and a BPP performed on all

women who required vibroacoustic stimulation. The presence

or absence of a fetal startle response was compared with the

observed BPP score. RESULTS: Two hundred tests were

performed at 35.3 +/- 3.7 weeks. After the vibroacoustic

stimulation, 70% of the nonreactive tracings became reactive.

Mothers perceived the fetal startle response after

vibroacoustic stimulus in 93% of cases. All cases with a fetal

startle response after a vibroacoustic stimulation had a

subsequent BPP score of 8 or more (negative predictive value

of 100%). In addition, all patients with a nonreassuring BPP

score were in the group of patients with absent fetal startle

response. However, the positive predictive value of an absent

fetal startle response for a subsequent BPP score of 6 or less

was only 10%. CONCLUSION: This preliminary study suggests

that the fetal startle response predicts a BPP score equal to

or greater than 8. After the availability of larger studies

supporting these findings, this test could be used as a rapid

antepartum test to predict fetal well-being.

180. Segraves, T.; Abdel Dayem, M. Critique of DSM-IV: associated

features of neuroleptic-induced parkinsonism [letter]. Am-J-

Psychiatry. 1996 Jun; 153(6): 844; ISSN: 0002-953X.

UNITED-STATES. 0.

181. Shafik, A. Study of the effect of external urethral sphincter

contraction on the mechanical activity of the ureterovesical

junction and urinary bladder: recognition of the sphinctero-

ureterovesical reflex. Urology. 1997 Dec; 50(6): 949-52; ISSN:

0090-4295.

UNITED-STATES. OBJECTIVES: To study the effect of external

urethral sphincter (EUS) contraction on the urinary bladder and

ureterovesical junction (UVJ). METHODS: The study was

comprised of 9 healthy volunteers (7 men, 2 women; mean age

40.8 +/- 6.6 years). A manometric catheter was introduced

into each of the two UVJs and urinary bladder. The EUS was

made to contract by voluntary squeezing and by

electromyographic stimulation with a needle electrode

inserted into the sphincter. The response of the bladder and

the UVJs to EUS contraction was determined before and after

anesthetization of the EUS, bladder, and the two UVJs, each at

a different time. RESULTS: On voluntary squeezing or

electromyographic needle stimulation of the EUS, the pressure

in both the UVJs and the urinary bladder showed a significant

drop (P < 0.05 in both instances). There was no pressure

response in the UVJs or in the urinary bladder 10 minutes

after separate anesthetization of either the EUS or the UVJs

and the bladder; however, 2 hours later, the pressure response

was similar to that before anesthesia (P > 0.05). CONCLUSIONS:

Bladder and UVJ relaxation on EUS contraction postulate a

reflex relationship that was reproducible and absent on

anesthetization of either of the suggested two arms of the

reflex: the EUS on one end and the bladder and UVJs on the

other end. We call this reflex the "sphinctero-ureterovesical

reflex." Further studies are needed to evaluate the possible

role of this reflex in the micturition mechanism and disorders.

182. Shalev, A. Y.; Bonne, O. B.; Peri, T. Auditory startle response

during exposure to war stress. Compr-Psychiatry. 1996 Mar;

37(2): 134-8; ISSN: 0010-440X.

UNITED-STATES. This report describes the immediate effect

of war stress on physiological measures of the auditory

startle responses (ASRs). Ten healthy Israeli subjects were

examined 4 months before the Gulf war, during a missile alert

on the first day of the war, and 8 months after the war. The

magnitude and rate of habituation of orbicularis oculi

electromyogram (EMG), heart rate (HR), and skin conductance

(SC) responses to 15 consecutive presentations of 95-dB, 0-

rise time, 1,000-Hz pure tones were recorded on each

occasion, along with self-reports of anxiety. The group's

anxiety scores were significantly higher during the war. ASRs,

in contrast, remained stable across exposure conditions.

However, a decrease in SC habituation was observed in few

individuals during the war, and may illustrate a distinctive

vulnerability to stress. The results are discussed in light of

recent findings of abnormal startle response in posttraumatic

stress disorder (PTSD).

183. Shearer, D.; Mikulka, P. Effect of facial familiarity and task

requirement on electrodermal activity. Am-J-Psychol. 1996

Mar; 109(1): 131-7; ISSN: 0002-9556.

UNITED-STATES. We examined the effect of facial familiarity

and task requirement on electrodermal activity (EDA).

Proposed models of facial recognition suggest a sequential

process wherein a recognition of familiarity precedes any

identity-specific search. Prior research has indicated that an

automatic increase in EDA occurs to familiar faces. We

reexamined this effect while manipulating the task

requirement. One group of subjects was required to identify

(name) faces, and a control group was required to rate facial

attractiveness. The results indicated that an increase in EDA

to familiar faces occurred only when coupled with the

identification task. No increase in EDA occurred when subjects

were rating facial attractiveness and presented with a

familiar face.

184. Sheriff, M. K.; Shah, P. J.; Fowler, C.; Mundy, A. R.; Craggs, M. D.

Neuromodulation of detrusor hyper-reflexia by functional

magnetic stimulation of the sacral roots. Br-J-Urol. 1996 Jul;

78(1): 39-46; ISSN: 0007-1331.

ENGLAND. OBJECTIVE: To investigate the acute effects of

functional magnetic stimulation (FMS) on detrusor hyper-

reflexia using a multi-pulse magnetic stimulator. PATIENTS

AND METHODS: Seven male patients with established and

intractable detrusor hyper-reflexia following spinal cord

injury were studied. No patient was on medication and none

had had previous surgery for detrusor hyper-reflexia. After

optimization of magnetic stimulation of S2-S4 sacral anterior

roots by recording toe flexor electromyograms, unstable

detrusor activity was provoked during cystometry by rapid

infusion of fluid into the bladder. The provocation test

produced consistent and predictable detrusor hyper-reflexia.

On some provocations, supramaximal FMS at 20 pulses/s for 5

s was applied at detrusor pressures which were > 15 cmH2O.

RESULTS: Following FMS there was an obvious acute

suppression of detrusor hyper-reflexia. There was a profound

reduction in detrusor contraction, as assessed by the area

under the curves of detrusor pressure with time. CONCLUSIONS:

Functional magnetic stimulation applied over the sacrum can

profoundly suppress detrusor hyper-reflexia in man. It may

provide a non-invasive method of assessing patients for

implantable electrical neuromodulation devices and as a

therapeutic option in its own right.

185. Sheth, R. D.; Bodensteiner, J. B.; Riggs, J. E. The unmodulated

oculocephalic reflex: clinical feature of the persistent

vegetative state in the neonate. J-Child-Neurol. 1996 May;

11(3): 255-6; ISSN: 0883-0738.

UNITED-STATES.

186. Siche, J. P.; Laude, D. [Short-term variability of blood pressure].

Variabilite a court terme de la pression arterielle. Arch-Mal-

Coeur-Vaiss. 1997 Aug; 90(8): 1079-86; ISSN: 0003-9683.

FRANCE. The regulation of blood pressure (BP) is traditionally

described in terms of homeostasis, and indicates that BP

although being continuously perturbed by external stimulations

always displays the tendency to come back toward a reference

set point. Experimental and clinical studies indicate that these

fluctuations occurring around the average present a source of

complementary information on the mechanism of

cardiovascular control. Recently a wide variety of algorithm

and models have been proposed to study the cardiovascular

system through new technics of continuous non invasive BP or

heart rate (HR) measurements. They give new insites for the

evaluation of hypertensive patients and relevance to the

understanding of the role of the disorder of the tonic

regulation of BP, rather than its short-term variability or

reactivity. However, if available data unequivocally indicate

that the analysis of variability is a useful tool, the

interpretation of those data in clinical trials is not always

optimal because there is lot of interaction between BP, HR and

other biological signals, and furthermore the use of laboratory

data introduces problems to predict what happens on daily life

ambulatory conditions.

187. Silva, M. T.; Howard, R. S.; Kartsounis, L. D.; Ross Russell, R. W. The

alien grasp reflex. Eur-Neurol. 1996; 36(1): 55-6; ISSN: 0014-

3022.

SWITZERLAND.

188. Sinkjaer, T. Muscle, reflex and central components in the control

of the ankle joint in healthy and spastic man. Acta-Neurol-

Scand-Suppl. 1997; 170: 1-28; ISSN: 0065-1427.

DENMARK. In understanding the control of the ankle joint

during different motor tasks, we have to investigate at least

three components, namely the influence of i) the passive and

intrinsic properties of the intact and active muscle system

around the joint (termed the non-reflex component), ii) the

mechanical importance of the stretch reflex in the stretched

and unloaded muscles, and iii) the supraspinal control of the

stretch reflex. This thesis is dealing with the importance of

the three components in healthy and spastic persons during

sitting, standing, and walking. The results are based on stretch

reflex and H-reflex measurements from the ankle extensor

muscles. During stretch reflex experiments the foot was

mounted to a platform (portable during walking) from which

the ankle joint torque and the position were measured. To

elicit a stretch reflex, the ankle joint was rotated by a strong

motor connected to the platform. The mechanical importance

of the stretch reflex was investigated by measuring the

changes in joint torque. Electrically, the stretch reflex was

recorded as the compound muscle action potential through

bipolar surface EMG electrodes placed over the soleus muscle.

During H-reflex experiments, the tibial nerve was stimulated

at the popliteal fossa and the H-reflex recorded over the

soleus muscle as during stretch reflex experiments. To

investigate how the contractile properties of a muscle in

humans depend on the history of activation, we investigated

the intrinsic stiffness of the ankle extensors in healthy

subjects. At matched background contraction in sitting

subjects, a prolonged contraction increased the intrinsic

muscle stiffness by 49%. Muscle yielding has been considered

especially important for understanding the reflex

compensation. We found a general lack of muscle yield and a

mechanically important non-reflex stiffness of the ankle

extensors showing that non-reflex stiffness is a prominent

factor in normal movements of the ankle joint. In both healthy

and spastic persons, we found a mechanically strong stretch

reflex in the isometric, contracted muscles during sitting.

This posed the question; how is the reflex regulated during

more functional motor tasks. This was dealt with by studying

the H-reflex during isometric ramp contractions and during

walking in healthy and spastic persons. In the healthy subjects

the H-reflex was modulated in consistency with a task

dependent control. In the spastic patients the H-reflex lacked

a task dependent modulation. In consistency with earlier

findings it was suggested that the decreased modulation could

have been caused by decreased control of the pre-synaptic

inhibition of the Ia terminals or a change in recruitment gain.

To test if the stretch reflex behaved as the H-reflex, the short

latency stretch reflex was investigated during walking. Here

we found that the stretch reflex was strongly modulated

during a step in healthy subjects as seen for the H-reflex, but

when comparing the stretch reflex at matched excitation

levels (same background EMGs) during standing and walking, no

task-specific reflex modulation was found except the one

relating to the excitation level. Therefore, the results

emphasise that at least during walking and standing it is not

always possible to draw conclusions about the stretch reflex

based on observations of the H-reflex. When investigating the

modulation of the short latency stretch reflex during walking

in spastic patients, we found that the stretch reflex

modulation was impaired in spastic patients at least to the

extent demonstrated earlier for the H-reflex. The passive

stiffness of the ankle joint was at the same time increased in

the patients. At matched ankle extensor contraction levels,

stretch responses were compared before and after reversible

block of the common peroneal nerve and during an attempted,

voluntary, fictive dorsiflexion after common peroneal nerve

block. (ABSTRACT TRUNCATED).

189. Sirlin, Mindy W.; Levitt, Harry. Simulating Reflex Induced Changes

in the Acoustic Impedance of the Ear. 1991;

Journal Articles (080). A simple procedure for measuring

changes in the acoustic impedance of the ear is described. The

technique has several applications, including simulation using

a standard coupler of changes in real ear impedance produced

by the acoustic reflex, and calibration of response time of an

otoadmittance meter. (Author/DB).

190. Smithard, D. G. Percutaneous endoscopic gastrostomy feeding

after acute dysphagic stroke. Gag reflex has no role in ability

to swallow [letter; comment]. BMJ. 1996 Apr 13; 312(7036):

972; discussion 973-4; ISSN: 0959-8138.

Note: Comment on: BMJ 1996 Jan 6;312(7022):13-6.

ENGLAND.

191. Snoek, G. J. [Autonomic dysreflexia: a life-threatening

complication in patients with a high-level spinal cord injury].

Autonome dysreflexie: een levensbedreigende complicatie bij

patienten met een hoge dwarslaesie. Ned-Tijdschr-Geneeskd.

1996 Aug 24; 140(34): 1729-32; ISSN: 0028-2162.

NETHERLANDS. A 37-year-old patient with a traumatic spinal

cord injury at the level CVI is described, suffering from a

urinary tract infection which was complicated by autonomic

dysreflexia. Autonomic dysreflexia occurs only in patients

with a spinal cord injury at TVI or above. A variety of afferent

stimuli (mostly emerging from bladder or bowel) can induce an

uncontrolled sympathetic reaction of the spinal cord below the

laesion level that is isolated from the vasomotor centre. This

reaction induces vasoconstriction below the laesion.

Compensating mechanisms are insufficient to compensate for

the vasoconstriction below the laesion. As a result there is a

fast rise in blood pressure up to extreme values with a serious

risk of cardiac and cerebral complications. Knowledge of these

phenomena as well as of the preventive and therapeutic

measures is essential since the prevalence of spinal cord

injury patients in the population is increasing.

192. Souren, L. E.; Franssen, E. H.; Reisberg, B. Neuromotor changes in

Alzheimer's disease: implications for patient care. J-Geriatr-

Psychiatry-Neurol. 1997 Jul; 10(3): 93-8; ISSN: 0891-9887.

UNITED-STATES. As a result of the neuropathologic process of

Alzheimer's disease (AD), significant changes occur in

neuromotor function (e.g., paratonia and compulsive grasping).

These changes become manifest in the moderately severe

stage of AD, when patients begin to require ongoing assistance

with activities of daily life (ADL), and they are prominent in

the severe stage of AD, when patients are continuously

dependent on a caregiver. Patients in these stages often

display behavioral disturbances during care activities. These

disturbing behaviors result not only from cognitive

impairment, but also from a patient's physical inability to

cooperate with the caregiver. When care management

strategies take into account the characteristic physical

restrictions resulting from the neuromotor changes that

accompany advanced AD, the caregiving process may be

significantly facilitated.

193. Soussignan, Robert; Schall, Benoist. Children's Facial

Responsiveness to Odors: Influences of Hedonic Valence of

Odor, Gender, Age, and Social Presence. 1996;

UMI. Reports - Research (143). Journal Articles (080). Facial

responsiveness to pleasant and unpleasant odors was examined

in 5- to 12-year-old children. Children failed to display

reflex-like patterns, but exhibited facial configurations that

varied according to odor and social condition. Results suggest

that facial responsiveness to odors is flexible and able to

reorganize and supports emotional and communicative

functions of human facial behavior. (Author/DR).

194. Spindel, J. H. The vestibular & balance center: tools for diagnosing

the dizzy patient. Compr-Ther. 1997 Nov; 23(11): 750-7; ISSN:

0098-8243.

UNITED-STATES. Without access to adequate diagnostic

facilities, management of vestibular and balance disorders can

be a frustrating process for both clinicians and patients.

Expert clinical staff and state-of-the-art tools for the

evaluation of balance disorders and dizziness are available

within the vestibular and balance center. These centers can

provide referring physicians and their patients with access to

diagnostic expertise and facilities not practical within a

general practice environment. Providing detailed evaluative

reports, balance centers can help the referring physician

define directions for surgical and medical treatment and

assist in the management and rehabilitative treatment of

acute and chronic dizziness and balance dysfunction.

195. Stanwick, M. Aura photography: mundane physics or diagnostic

tool? Nurs-Times. 1996 Jun 19; 92(25): 39-41; ISSN: 0029-

6589.

ENGLAND. Kirlian photography is often associated with the

paranormal. Many people believe it records the auras of living

objects and that it can be used as a diagnostic tool. This paper

argues against these beliefs and maintains that there is a

simple, scientific explanation of the Kirlian effect.

196. Starikov, A. S. Functional state of segmental motoneurons in

Wilson-Konovalov hepatocerebral dystrophy. Neurosci-Behav-

Physiol. 1997 Nov; 27(6): 648-52; ISSN: 0097-0549.

UNITED-STATES. Stimulatory electromyography was used to

investigate 12 patients, and chronaximetric investigations

were performed in 18. Peak H-potential amplitudes indicated

reductions in reflex excitability in the motoneuron pool. The

stimulus size required for inducing threshold H-reflexes

demonstrated a high level of reflex excitability among those

alpha-motoneurons probably involved in generating

hyperkinesia. Motor response parameters showed the direct

electrical excitability of motor units to be elevated. Changes

in H-reflex and M-response parameters demonstrated

functional rearrangement of the movement analyzer after

stereotaxic surgery. The functional states of the alpha- and

gamma-systems are discussed.

197. Steptoe, A.; Noll, A. The perception of bodily sensations, with

special reference to hypochondriasis. Behav-Res-Ther. 1997

Oct; 35(10): 901-10; ISSN: 0005-7967.

ENGLAND. Bodily sensations are relevant to problems such as

hypochondriasis, but the issue of whether people are accurate

in their perception remains unclear. The accuracy of

perception of bodily sensations was analysed in 20 male and

20 female volunteers using two methods: a heart beat tracking

procedure and the within-S correlational approach described

by Steptoe and Vogele (1992, Behaviour Research and Therapy,

30, 597-607). The correlational approach involved monitoring

of heart rate, skin conductance level and total respiratory

resistance during relaxation and task periods, and computing

correlations between appropriate physiological parameters

and ratings of heart rate, sweaty hands and difficulty with

breathing. In general, subjective ratings of bodily sensations

were tied more closely with feelings of distress than with

objective physiological state. Error scores on the heart beat

tracking procedure showed no association with

hypochondriacal concerns or with vigilant and avoidant coping

styles measured with the Mainz Coping Inventory. Individuals

varied considerably in accuracy as assessed with the

correlational approach. However, there was a significant

negative association between hypochondriacal concerns and

accuracy of perception of sweat gland activity. The results are

discussed in relation to measures of somatic perception and

the experience of bodily sensations.

198. Stocker, H.; Berger Pusterla, J.; Lutz, H.; Ossent, P. [A new

hereditary disease in Braunvieh cattle in Switzerland: spinal

demyelinization (SDM) in calves that remain in lateral

recumbency]. Eine neue Erbkrankheit beim Braunvieh in der

Schweiz: Spinale Dysmyelinisierung (SDM) bei festliegenden

Kalbern. Schweiz-Arch-Tierheilkd. 1996; 138(6): 295-300;

ISSN: 0036-7281.

SWITZERLAND. Clinical, laboratory and histopathological

findings are described in ten Braunvieh calves with Spinal

Dysmyelination (SDM). Characteristically, immediately after

birth the animals were normally alert but remained in lateral

recumbency with opisthotonus, spastic hind limbs, partially

increased spinal reflexes and were unable to stand or support

themselves. Histological examination of the spinal cord

revealed a bilateral symmetrical reduction of myelin. Means of

differentiating between SDM and other conditions, in

particular spinal muscular atrophy (SMA) are discussed.

199. Tanaka, T. [Depression of reciprocal Ia inhibition of crural

motoneurons during rhythmical jaw movement in rabbit].

Kokubyo-Gakkai-Zasshi. 1996 Mar; 63(1): 153-63; ISSN: 0300-

9149.

JAPAN. The purpose of this study was to investigate how the

reciprocal inhibition of the ankle-flexor motoneuron by the

ankle-extensor spindle afferents is altered during cortically-

induced rhythmical jaw movement (RJM) in urethane-

anesthetized rabbit. The monosynaptic reflex (MSR) was

induced by test shock of the common peroneal nerve (CPN) and

recorded from a distal point of the nerve. The conditioning

shock applied to the tibial nerve (TN) at the intensity below

1.2 times the threshold caused a significant inhibition of the

MSR in the CPN. The inhibition tended to slightly decrease with

an increase in amplitude of the test MSR with either

application of stronger test shock or during RJM. The decrease

of the reciprocal inhibition significantly exceeded the degree

that can be ascribed to the increase of the amplitude of the

MSR during RJM. The reciprocal inhibition was significantly

reduced during fictive as well as actual RJM. It was concluded

that (1) the reciprocal Ia inhibition of the crural motoneurons

in the rabbit is reduced with RJM and (2) the intraoral sensory

input is not essential for this reduction. This study indicated

that the oral motor activity generally exerts a strong

influence on the bodily motor function.

200. Tanaka, Y. [The alien hand sign]. No-To-Shinkei. 1996 Mar; 48(3):

229-38; ISSN: 0006-8969.

JAPAN.

201. Tatar, M.; Pecova, R. [The effect of experimental gastroesophageal

reflux on the cough reflex in anesthetized cats]. Vplyu

experimentalneho gastroezofagealneho refluxu na kasel' u

anestezovanych maciek. Bratisl-Lek-Listy. 1996 May; 97(5):

284-8; ISSN: 0006-9248.

SLOVAKIA. BACKGROUND: Gastroesophageal reflux (GER) is a

common cause of chronic cough. It has been suggested that GER

most often causes chronic cough by stimulating the distal

oesophagus. Possible mechanisms of this interactive process

are: a) an oesophageal-tracheobronchial reflex, b) acid reflux

seems to be only a cofactor of cough; it decreases cough

threshold. AIM: To evaluate the effects of experimental GER on

the cardiorespiratory parameters and on the cough induced by

mechanical stimulation of airways mucosa in anaesthetised

cats. METHODS: In 10 adults cats of either sex, mean body

weight 2.4 +/- 0.2 kg, anaesthetised with pentobarbitone

sodium (30 mg/kg b.w., i.p.), oesophageal pressure, blood

pressure, and volume tidal were recorded. 2 ml 0.1 N HCl was

instilled into the isolated thoracic oesophagus with preserved

innervation over a period of 5 minutes. The cough was induced

by the insertion of nylon fibre into the airways and its

intensity was evaluated from the changes in oesophageal

pressure. Cough challenge was also repeated during

intraesophageal instillation of 2 ml capsaicin (350 mumol/l).

The parameters of cough intensity elicited during

experimental GER were compared with the control cough

parameters obtained during intraesophageal instillation of 2

ml physiological saline. RESULTS: Intraesophageal instillation

of either HCl or capsaicin was accompanied by the

contractions of oesophageal wall and by the fluctuations in

volume tidal. These changes were more pronounced after

capsaicin challenge. There was no induction of either cough or

other respiratory reflexes with forced expiration during the

experimental GER. In other part of this study there were not

obtained any significant differences of the intensity of

mechanically-induced cough during intraesophageal

instillation of physiological saline, HCl, and capsaicin.

CONCLUSION: The oesophageal-tracheobronchial reflex

mechanism for either induction or modulation of cough is not

present in healthy anaesthetised cats. We agree with previous

data that GER alone is not trigger agent of cough. (Fig. 5, Ref.

17.). 404-86-4; 7647-01-0; 7647-14-5.

202. Tavartkiladze, G. A.; Frolenkov, G. I.; Artamasov, S. V. Ipsilateral

suppression of transient evoked otoacoustic emission: role of

the medial olivocochlear system. Acta-Otolaryngol-Stockh.

1996 Mar; 116(2): 213-8; ISSN: 0001-6489.

NORWAY. Contralateral sound stimulation produces

suppression of transient evoked otoacoustic emission (TEOAE),

which is attributed to a reflex activation of the medial

olivocochlear system. More pronounced suppression of TEOAE

produced by ipsilateral masking could involve efferent-

mediated effects along with effects of cochlear origin.

However, this has not been investigated so far. Therefore,

changes of click-evoked OAE under ipsi- and contralateral

forward masking by clicks and noise-bursts were investigated

in an extremely long-lasting experiment in one normal-hearing

volunteer. The reduction of TEOAE under ipsilateral click-to-

click forward masking was maximal during the first

milliseconds after masker delivery implying that predominant

role of the cochlear processes in TEOAE ipsilateral

suppression. Ipsilateral forward masking by noise burst

revealed additional TEOAE suppression with longer latency. Its

time course was similar to that of the contralateral masking

effect. The latter data suggest the involvement of the medial

olivocochlear system in TEOAE ipsilateral suppression.

203. Tea, S. H.; Mansourati, J.; L'Heveder, G.; Mabin, D.; Blanc, J. J. New

insights into the pathophysiology of carotid sinus syndrome.

Circulation. 1996 Apr 1; 93(7): 1411-6; ISSN: 0009-7322.

UNITED-STATES. BACKGROUND: The pathophysiology of carotid

sinus syndrome remains poorly understood. Currently, two

main hypotheses are provided: a lesion at the level of carotid

sinus receptors or a central defect at the level of the nuclei of

the autonomic nervous system. The objective of our study was

to present arguments in favor of one of these two hypotheses.

METHODS AND RESULTS: Test selection was guided by the

following hypothesis: a degenerative central or local lesion

could be associated with dysfunctions in the structures

surrounding or comprising the baroreflex centers or their

pathways. To test this hypothesis, brain stem auditory-evoked

potentials; somatosensory-evoked potentials; blink reflexes;

sympathetic skin responses; and styloglossus,

sternocleidomastoid, and superior trapezius muscle

electromyography were systematically performed from the

right and left sides in 17 patients with carotid sinus syndrome

and in 17 sex- and age-matched control subjects. Similar

responses were found in the two groups for the "central" tests.

Contrasting with this result, the electromyographic analysis

of the sternocleidomastoid muscle differed significantly

between the groups: 13 (76%) had pathological responses in the

carotid sinus syndrome group compared with only 4 (23.5%) in

the control group (P < .01). Furthermore, the abnormality was

found on the right and left sides in 9 patients (53%) in the

study group and in none of the control group (P < .005).

CONCLUSIONS: This study strongly suggests that the

neuromuscular structures surrounding the carotid

mechanoreceptors are involved in the carotid sinus syndrome;

however, the exact mechanism remains speculative.

204. Tijssen, M. A.; Padberg, G. W.; van Dijk, J. G. The startle pattern in

the minor form of hyperekplexia. Arch-Neurol. 1996 Jul; 53(7):

608-13; ISSN: 0003-9942.

UNITED-STATES. BACKGROUND: The major and minor forms of

hereditary hyperekplexia (HE) are characterized by excessive

startle responses, which are accompanied by transient

stiffness only in major HE; patients with major HE also have

continuous stiffness during infancy. A point mutation has been

identified for major HE in the gene encoding the alpha 1

subunit of the glycine receptor but not for minor HE.

OBJECTIVE: To measure startle reflexes and autonomic

responses in the major and minor forms of HE in the original

Dutch HE pedigree. DESIGN: Startle reflexes and autonomic

responses were studied with 3 series of 20 auditory stimuli

with intervals of 10 seconds (at 90 and 113 dB) and 60

seconds (at 113 dB). SETTING: A university hospital neurologic

department. PATIENTS: Four patients with minor and 9 patients

with major HE (patient groups) (a part of the Dutch HE family

pedigree) and 20 healthy controls (control group). MAIN

OUTCOME MEASURES: Startle movements were quantified with

latencies and areas of electromyographic bursts of the

following 4 muscles: the orbicular muscle of the eye, the

sternocleidomastoid muscle, the biceps muscle of the arm, and

thenar muscles. Autonomic reactions were measured with

psychogalvanic responses. RESULTS. The 4 muscles contracted

in similar order in the groups. The onset latencies of the

orbicular muscle of the eye, the sternocleidomastoid muscle,

and the biceps muscle of the arm were significantly prolonged

in patients with minor HE (P < .006). The frequencies of

occurrence of the electromyographic bursts were not different

in the minor HE and major HE groups, but they were

significantly higher in both patient groups compared with

those in the control group (P < .001). The magnitude of the

startle responses did not differ between the 2 patient groups

(P = .4), but it was larger in both patient groups than in the

control group (P < .001). Startle habituation in the minor HE

group was much weaker than in the major HE group (P < .001)

or in the control group (P < .001). The size of psychogalvanic

responses (P = .1) and the degree of habituation (P = .24) in the

minor HE group did not differ from those in the major HE group.

Compared with that in the control group, the size of

psychogalvanic responses in the minor HE group was larger (P <

.001) and they habituated stronger (P < .001). CONCLUSIONS:

The differences in the startle pattern between major HE and

minor HE agree with the clinical and genetic findings: only

major HE constitutes part of the HE phenotype. The cause of

the minor HE is, as yet, unknown.

205. Tochihara, M. Reflex control of cardiac sympathetic nerve

activity in anesthetized rats. Hokkaido-Igaku-Zasshi. 1996

Mar; 71(2): 247-58; ISSN: 0367-6102.

JAPAN. Reflex control of sympathetic outflow to the heart

was evaluated by recording the efferent discharges of the

interior cardiac sympathetic nerves in anesthetized rats. The

reflex responses of inferior cardiac sympathetic nerve

activity (ICNA) to arterial baroreceptor loading by

phenylephrine and to arterial/atrial baroreceptor unloading by

hemorrhagic hypotension were compared with those of renal

sympathetic nerve activity (RNA) and adrenal sympathetic

nerve activity (ANA). The reflex decrease in ICNA to the

phenylephrine-induced graded increase in arterial blood

pressure was smaller than that of RNA or ANA. Thus ICNA is

less sensitive to arterial baroreceptor stimulation.

Hemorrhage produced a volume-dependent decrease in ICNA.

The response was significantly smaller than that in RNA and

was directionally opposite to that in ANA. Cervical vagotomy

but not sinoaortic denervation abolished the hemorrhage-

induced ICNA response, suggesting an important role of vagal

pathways. These findings demonstrate that the reflex

responses of sympathetic outflow to the heart were

quantitively and qualitatively different from those to the

kidney and the adrenal gland, indicating the regional control of

sympathetic nerve activity in the regulation of cardiovascular

functions.

206. Tojo, M. [What change was caused under short-time treatment by

the Ueda method for severely disabled infants with cerebral

palsy? Report of two cases]. No-To-Hattatsu. 1998 Jan; 30(1):

75-9; ISSN: 0029-0831.

JAPAN. A new physical therapy, Ueda method (UM), were

performed on two patients with severe motor and intellectual

disabilities syndrome and spastic cerebral palsy (CP). The

period of the UM therapy was 5 days in one case with spastic

CP and 10 days in another case with rigo-spastic CP. They

showed the remarkable reduction of abnormal muscle tone and

interesting phenomena such as postural changes of extremities

and changes of some primitive reflexes. First, peculiar

postures of treated extremities appeared on the first day of

the UM therapy, associated with the reducing muscle tone of

extremities only in the treated side. One case showed

immediate change of the posture of treated upper extremity

from internal to external rotation of the shoulder joint.

Another case disclosed immediate appearance of internal

rotation of the hip joint of the treated lower extremity and

scissoring posture of legs. These phenomena were transient

and disappeared under the UM treatment. Secondly, interesting

phenomena in some primitive reflexes were observed after the

beginning of the UM therapy. Moro reflex was elicited only in

the treated upper extremity, which could not be obtained by

stimuli before the UM therapy. After the UM therapy on

bilateral arms. Moro reflex appeared bilaterally in two cases.

On the other hand, the degree of asymmetrical tonic neck

reflex (ATNR) in one case with spastic CP reduced on 5th days

under the UM therapy. In another case with rigo-spastic CP

automatic walking disappeared on 3rd days after the UM

therapy and ATNR appeared. The first phenomena could be due

to imbalances of the reduced muscle tones by the UM therapy.

Second phenomena could result from the interaction between

the nervous systems of Moro reflex, ATNR and automatic

walking and the nervous system owing to the abnormal muscle

hypertone. Moro reflex might be suppressed by abnormal

muscle hypertone. The disappearance of some primitive

reflexes might not depend on the maturation of the central

nervous system.

207. Turecki, G.; Grand'Maison, F.; Lemieux, B.; Rouleau, G.

Hyperekplexia and the alpha1 subunit glycine receptor gene

(GLRA1) [letter]. Arch-Neurol. 1996 Sep; 53(9): 836-7; ISSN:

0003-9942.

UNITED-STATES. 0; 0.

208. Ugawa, Y. Subcortical reflex myoclonus? [letter]. Arch-Neurol.

1997 Nov; 54(11): 1323-4; ISSN: 0003-9942.

UNITED-STATES.

209. Vacca, G.; Mary, D. A.; Battaglia, A.; Grossini, E.; Molinari, C. The

effect of distension of the stomach on peripheral blood flow in

anaesthetized pigs. Exp-Physiol. 1996 May; 81(3): 385-96;

ISSN: 0958-0670.

ENGLAND. The present study was undertaken in anaesthetized

pigs to determine the primary reflex effects of gastric

distension on the peripheral circulation. Changes in blood flow

in the splenic, superior mesenteric, left renal and left

external iliac arteries were assessed using electromagnetic

flowmeters during distension of a balloon in the stomach,

performed at constant aortic blood pressure and heart rate,

with 0.6 l of Ringer solution (mean gastric transmural

pressure of about 12 mmHg). In fourteen pigs, a decrease in

splenic, renal and iliac flows and variable changes in

mesenteric flow were obtained. A decrease in mesenteric flow

and more marked decreases in the other flows occurred in

response to the distension after the administration of

propranolol or butoxamine. In five pigs, the vasoconstrictive

responses were graded by step increments in gastric

distending volume from 0.4 to 0.8 l. The above responses were

abolished by the administration of phentolamine (eight pigs)

and by bilateral cervical vagotomy (six pigs). The results

showed that innocuous distension of the stomach in

anaesthetized pigs reflexly caused vasoconstriction in the

splenic, renal and iliac vascular beds; vasoconstriction also

occurred in the mesenteric vascular bed but only after beta-

blockade. These reflex responses were mediated by

sympathetic mechanisms which involved both alpha and beta

vascular adrenoceptors and their afferent limb was in the

vagal nerves.. 2922-20-5; 50-60-2; 525-66-6.

210. van Gijn, J. Remak and the plantar response [letter; comment].

Lancet. 1996 Aug 3; 348(9023): 338-9; ISSN: 0140-6736.

Note: Comment on: Lancet 1996 Jun 15;347(9016):1669-70.

ENGLAND.

211. Veelken, R.; Glabasnia, A.; Stetter, A.; Hilgers, K. F.; Mann, J. F.;

Schmieder, R. E. Epicardial bradykinin B2 receptors elicit a

sympathoexcitatory reflex in rats. Hypertension. 1996 Oct;

28(4): 615-21; ISSN: 0194-911X.

UNITED-STATES. Bradykinin may be generated in the heart

during ischemia and is involved in nociception. We tested the

hypothesis that bradykinin elicits a sympathoexcitatory reflex

in rats by stimulating cardiac afferent nerve fibers. Rats were

implanted with femoral catheters for measurement of blood

pressure and heart rate, a bipolar electrode for measurement

of renal sympathetic nerve activity, and a pericardial catheter

for intrapericardial injection of substances. Rats were

slightly anesthetized with hexobarbital so pain reactions were

prevented. Graded doses of bradykinin (2.5, 12, 25 micrograms)

were injected intravenously or intrapericardially into control

rats, intrapericardially after vagotomy, intrapericardially

after intrapericardial pretreatment with the bradykinin B2

receptor antagonist Hoe 140, and intrapericardially after

cardiac autonomic blockade (intrapericardial pretreatment

with 10% procaine). For comparison, the serotonin 5-HT3

agonist phenylbiguanide, a substance known to elicit

sympathoinhibitory reflexes by cardiac vagal afferents, and

adenosine, putatively inducing sympathoexcitatory responses

via the heart, were applied intrapericardially. Bradykinin

increased blood pressure when administered intrapericardially

but decreased blood pressure when injected intravenously;

both intrapericardial and intravenous bradykinin increased

renal sympathetic nerve activity. Intrapericardial adenosine

had no effect on circulatory control. Intrapericardial

pretreatment with the B2 receptor antagonist Hoe 140

completely inhibited the increases of blood pressure and renal

sympathetic nerve activity in response to intrapericardial

bradykinin but did not affect the responses to intrapericardial

phenylbiguanide. Bilateral cervical vagotomy abolished the

decreases of blood pressure, heart rate, and renal sympathetic

nerve activity after intrapericardial phenylbiguanide but did

not influence the responses to intrapericardial bradykinin.

Cardiac autonomic blockade with intrapericardial procaine

abolished all responses to bradykinin and phenylbiguanide. We

conclude that cardiac bradykinin elicits a sympathoexcitatory

reflex by epicardial B2 receptors in rats. The afferent portion

of the reflex is most likely contained within sympathetic

cardiac afferent fibers. Bradykinin may contribute to

increased sympathetic nerve activity in pathophysiological

situations of coronary artery disease and cardiac ischemia.. 0;

58-61-7.

212. Velay, J. L.; Allin, F.; Bouquerel, A. Motor and perceptual responses

to horizontal and vertical eye vibration in humans. Vision-Res.

1997 Sep; 37(18): 2631-8; ISSN: 0042-6989.

ENGLAND. Previous studies have shown that low

amplitude/high frequency mechanical vibration applied to the

human eye muscles results in the illusory movement of a

luminous spot fixated in total darkness. The aim of the present

study was to investigate whether a vibration-induced motor

response also occurs in eye muscles, and to check whether the

visual illusions actually result from the proprioceptors being

activated by the vibration, or whether they are simply due to

the retinal slip induced by the reflex eye movement. The

effects of the vibratory stimuli on the inferior rectus (IR) and

lateral rectus (LR) muscles were evaluated by recording

subjects' eye position changes. When applied to the IR muscle,

vibration effectively elicited an upward visual illusion

accompanied by a small downward ocular rotation, whereas

when applied to the LR muscle, it also induced horizontal

visual illusion, which was less frequent and weaker than the

vertical one, but no ocular rotation. We concluded that visual

illusions of this kind cannot be attributable to the retinal

motion of the image of the fixated point. The difference

between the vertical and horizontal vibratory motor responses

is discussed as regards the particular role that oculo-

muscular proprioception may play in the vertical muscles.

213. Vetrugno, R.; Liguori, R.; Cevoli, S.; Salvi, F.; Montagna, P. Adie's

tonic pupil as a manifestation of Sjogren's syndrome. Ital-J-

Neurol-Sci. 1997 Oct; 18(5): 293-5; ISSN: 0392-0461.

ITALY. We here report two cases of Adie's tonic pupil,

associated with clinical sensory polyneuropathy and Sjogren's

syndrome, in one of whom it actually heralded the onset of the

syndrome. Electrophysiology studies indicated absent H

reflexes but normal peripheral nerve conductions, thus

suggesting an involvement of the dorsal roots or spinal

ganglion that would be in line with previously published

reports of dorsal ganglionitis as the primary neuropathological

lesion in Sjogren's syndrome. We suggest that all cases of

tonic pupils should be screened for polyneuropathy and

Sjogren's syndrome.. 0.

214. Vissing, S. F. Differential activation of sympathetic discharge to

skin and skeletal muscle in humans. Acta-Physiol-Scand-

Suppl. 1997; 639: 1-32; ISSN: 0302-2994.

ENGLAND. The present work provides insight into the relative

contribution of different mechanisms in regulating

sympathetic discharge to skin and skeletal muscle in humans.

Activation of sympathetic nerve activity during common

behaviours such as orthostasis and exercise was shown to be

highly selective, depending on the specific sympathetic

outflow under study. Regarding orthostasis, data from

experiments in this thesis revoked the concept that

cardiopulmonary afferents only regulate muscle vascular

resistance in the forearm, not in the leg. Also the concept that

the cutaneous circulation is under baroreceptor control has

been challenged. Unloading cardiopulmonary afferents with

lower body negative pressure elicited intensity dependent

increases in peroneal sympathetic discharge to skeletal

muscle, and increases in forearm and calf vascular

resistances. Therefore, it was concluded that cardiopulmonary

afferents regulate vascular resistance in skeletal muscle of

both forearm and calf, suggesting an important role for these

afferents in the reflex adjustments to upright posture. In

contrast to muscle sympathetic nerve activity, baroreceptor

deactivation with lower body negative pressure had no effect

on skin sympathetic nerve activity or skin vascular resistance.

However, assumption of upright posture increased skin

vascular resistance, this increase was abolished when

increased vascular transmural pressure was avoided by

elevating the arm. Local cutaneous nerve blockade, but not

blockade of efferent sympathetic nerve traffic, abolished the

vasoconstrictor response to upright posture. Based on these

experiments, it was concluded that baroreceptor afferents do

not regulate sympathetic vasoconstrictor outflow to the

cutaneous circulation. During upright posture at normothermia

cutaneous vasoconstriction is mainly driven by a local reflex.

To explain activation of sympathetic outflow during exercise

two theories have been proposed. One is that a "central motor

command" signal emanates from the rostral brain. The other is

that a contraction induced reflex arises in chemically and

mechanically sensitive muscle afferents. Although animal

studies have provided experimental support for both theories,

studies in humans with direct recordings of muscle

sympathetic nerve activity have only provided convincing

evidence for the muscle afferent theory. The present

experiments are the first in humans to provide direct evidence

in support of the "central motor command" theory. In addition,

these experiments demonstrated a highly dissociated pattern

of sympathetic activation to skin and skeletal muscle. Thus,

during static handgrip exercise sympathetic outflow to skin of

the resting limb showed an initial burst of activity preceding

the onset of tension development. This was followed by an

increase in sympathetic activity that continued throughout the

exercise period. Sympathetic outflow to resting muscle

showed a slow pattern of response with a latent period

between the onset of exercise and the onset of sympathetic

activation. Stimulation of central command during

neuromuscular blockade evoked large increases in skin

sympathetic discharge with only minor increases in muscle

sympathetic discharge. During stimulation of metaboreceptor

afferents with post-handgrip muscle ischaemia, muscle

sympathetic nerve activity was maintained while skin

sympathetic nerve activity showed an immediate return to

pre-exercise levels. These data provide evidence that during

moderate levels of static exercise sympathetic activation of

skin is predominantly influenced by central motor command. In

contrast, sympathetic activation of muscle is to a large extent

driven by feedback from metaboreceptor afferents in the

working muscle.

215. Vodusek, D. B. Evoked potential testing. Urol-Clin-North-Am. 1996

Aug; 23(3): 427-46; ISSN: 0094-0143.

UNITED-STATES. Electrophysiologic tests of the sacral

neuromuscular system and its suprasegmental control may be

divided into EMG and methods involving stimulation (i.e.,

evoked potential and sacral reflex testing). The latter group of

methods tests the function of defined parts of the motor or

sensory nervous system, or reflex arcs. There already is ample

experience with testing the somatic sensory pathways

(pudendal SEP) and the (somatic) sacral reflex arc, whereas

other methods (testing the motor system and tests involving

visceral afferents and sympathetic efferents) need further

study to establish their proper place in everyday clinical

diagnostics. The application of these methods in research has

led to important advances in our understanding of nervous

system involvement in different pathologic conditions leading

to neurogenic sacral dysfunctions. If applied in individual

patients, these methods should however, be used and

interpreted with restraint; they should be considered in

patients with probable or proved nervous system lesions,

those in whom additional clarification regarding proof of,

localization of, and the nature (i.e., axonal versus

demyelinative) of the lesion is relevant for diagnosis and

prognosis. If applied in patients with central nervous system

involvement, evoked potential studies may be used on their

own; but, in the author's opinion, in patients with putative

peripheral nervous system involvement these tests should be

considered, as a rule, only as an extension of a needle EMG

exploration. It is expected that further experience will clarify

the sensitivity and specificity of the available methods. The

already available methods certainly will gain a place in the

operating room helping the surgeon in selected procedures

involving the pelvis and particularly conus and cauda equina

better to identify neuromuscular structures and to monitor

their function throughout the operation in order to prevent

subsequent development of lesions.

216. Vorhees, C. V. Methods for detecting long-term CNS dysfunction

after prenatal exposure to neurotoxins. Drug-Chem-Toxicol.

1997 Nov; 20(4): 387-99; ISSN: 0148-0545.

UNITED-STATES. Current U.S. Environmental Protection Agency

regulatory guidelines for developmental neurotoxicity

emphasize functional categories such as motor activity,

auditory startle, and learning and memory. A single test of

some simple form of learning and memory is accepted to meet

the latter category. The rationale for this emphasis has been

that sensitive and reliable methods for assessing complex

learning and memory are either not available or are too

burdensome, and that insufficient data exist to endorse one

approach over another. There has been little discussion of the

fact that learning and memory is not a single identifiable

functional category and no single test can assess all types of

learning and memory. Three methods for assessing complex

learning and memory are presented that assess two different

types of learning and memory, are relatively efficient to

conduct, and are sensitive to several known neurobehavioral

teratogens. The tests are a 9-unit multiple-T swimming maze,

and the Morris and Barnes mazes. The first of these assesses

sequential learning, while the latter two assess spatial

learning. A description of each test is provided, along with

procedures for their use, and data exemplifying effects

obtained using developmental exposure to phenytoin,

methamphetamine, and MDMA. It is argued that multiple tests

of learning and memory are required to ascertain cognitive

deficits; something no single method can accomplish. Methods

for acoustic startle are also presented.. 0; 0.

217. Waespe, W.; Zahner, S. [Acute vestibular syndrome in cerebellar

infarct of the posterior inferior cerebellar artery (PICA

infarct)]. Akutes vestibulares Syndrom beim Kleinhirninfarkt

der Arteria cerebellaris posterior inferior (PICA-Infarkt).

Schweiz-Med-Wochenschr. 1996 Feb 10; 126(6): 214-9; ISSN:

0036-7672.

SWITZERLAND. The differential diagnosis of an acute

peripheral vestibulopathy ("vestibular neuritis") and of an

ischemic lesion in the cerebellar territory of the posterior-

inferior cerebellar artery (PICA) is important. Both present

with acute vertigo, vomiting, spontaneous nystagmus and

difficulties in walking. We analyze the clinical, oculographic

and NMR findings as well as the outcome in 10 patients with

an ischemic stroke in the cerebellar territory of the PICA. On

clinical grounds alone, it is not always possible to attribute

the acute vestibular syndrome to a peripheral vestibular lesion

or to a PICA insult. In our experience an important feature of a

PICA insult is a discrepancy between the amount of vertigo,

the severity of the walking difficulties, and the often weak

and rapidly resolving spontaneous nystagmus. In contrast to a

peripheral vestibulopathy, the vestibuloocular reflex is only

minimally or not decreased in PICA insults, and gain

asymmetries are accounted for by the presence of spontaneous

nystagmus. However, only neuroimaging can finally

differentiate between the two entities.

218. Watanabe, M.; Izumi, S.; Nishimura, R.; Mano, K.; Watanabe, H. [A

familial case of postural reflex disorder presenting high

intensity area mainly in the globus pallidus on T1-weighted

cerebral MRI without clear liver damage]. Rinsho-Shinkeigaku.

1997 Jul; 37(7): 636-40; ISSN: 0009-918X.

JAPAN. A 56-year-old woman was admitted because of

chronic postural reflex disorder. A cerebral MRI revealed

symmetrical high intensity area mainly in the globus pallidus

on T1-weighted image. The symptom became manifested as

gait disturbance from the age of 2 and gradually progressed.

Her condition has, however, remained stable since the age of

26. The only sign of parkinsonism was akinesia. There was

clear retropulsion but cerebellar ataxia was minimal, and

dystonia was negligible. She had no dementia. Her parents were

cousins and similar symptoms and high intensity area were

found in one of her sisters. Routine liver function tests were

normal, with only ICG elevated. Serum copper and

ceruloplasmin were normal. A hereditary factor was

suspected. There are no similar cases reported in the

literature, thus we thought it worth reporting.

219. Watkins, L. L.; Grossman, P.; Sherwood, A. Noninvasive assessment

of baroreflex control in borderline hypertension. Comparison

with the phenylephrine method. Hypertension. 1996 Aug; 28(2):

238-43; ISSN: 0194-911X.

UNITED-STATES. In this study, we examined the sensitivity of

two recently developed noninvasive baroreflex measurement

techniques to assess baroreflex control in hypertension. We

assessed baroreflex sensitivity noninvasively from

covariations of systolic pressure and RR interval using

spectral analysis and sequence detection. The noninvasive

estimates of baroreflex control were compared with

estimates derived from phenylephrine-induced increases in

systolic pressure and RR interval in normotensive subjects (n

= 27) and borderline hypertensive subjects (n = 15). Baroreflex

sensitivity was significantly reduced in the borderline

hypertensive group relative to the normotensive group when

assessed with the use of either the noninvasive or invasive

methods to index baroreflex control. In addition, estimates

obtained from the noninvasive methods were significantly

correlated with baroreflex sensitivity assessed with the

phenylephrine method (spectral: r = .48, P < .001; sequence: r =

.50, P < .001). These findings suggest that spectral analysis

and the sequence method provide viable alternatives to the

pharmacological approach for estimation of baroreflex

sensitivity in hypertension.. 59-42-7.

220. Wiezer, M. J.; Franssen, H.; Rinkel, G. J.; Wokke, J. H. Meralgia

Paraesthetica: differential diagnosis and follow-up. Muscle-

Nerve. 1996 Apr; 19(4): 522-4; ISSN: 0148-639X.

UNITED-STATES.

221. Willingale, H. L.; Gardiner, N. J.; McLymont, N.; Giblett, S.; Grubb, B.

D. Prostanoids synthesized by cyclo-oxygenase isoforms in rat

spinal cord and their contribution to the development of

neuronal hyperexcitability. Br-J-Pharmacol. 1997 Dec; 122(8):

1593-604; ISSN: 0007-1188.

ENGLAND. 1. The responses of wide dynamic range spinal

dorsal horn neurones to noxious mechanical stimulation of the

ankle or knee joint were tested before and after spinal

administration of the non-selective cyclooxygenase (COX)

inhibitors, indomethacin and meclofenamic acid. Neither of

these drugs altered the responses of these neurones to noxious

mechanical stimulation. 2. Wind-up of a spinal nociceptive

reflex evoked by electrical stimulation of the sural nerve at

C-fibre strength was dose-dependently inhibited by

intravenous administration of indomethacin, a non-selective

COX inhibitor, and SC58125, a selective COX-2 inhibitor.

Intrathecal administration of indomethacin also reduced the

wind-up of this nociceptive reflex. 3. Western blot analysis of

proteins extracted from normal rat spinal cord revealed the

presence of both cyclo-oxygenase (COX)-1 and COX-2 proteins.

4. Immunocytochemistry of sections of normal rat spinal cord

with specific COX-1 antiserum revealed little specific COX-1-

like immunoreactivity in the grey matter. With the same

antiserum, intense COX-1-like immunoreactivity was observed

in the cytoplasm, nuclear membrane and axonal processes of

small to medium sized (< 1000 microns2) dorsal root ganglion

(DRG) cell bodies. 5. Immunocytochemistry of sections of

normal rat spinal cord incubated with specific COX-2

antiserum showed intense COX-2-like immunoreactivity (COX-

2-li) in the superficial dorsal horn of the spinal cord (laminae

I and II) and around the central canal (lamina X). COX-2-li was

also observed in some neurones in deep dorsal horn and in

individual motor neurones in ventral horn. COX-2-li was not

observed in the cell bodies of DRG. 6. Superfusion of the

lumbar spinal cord of normal rats with artificial CSF and

subsequent radioimmunoassay revealed the presence of

prostaglandin D2 (PGD2) < PGE2, but not PGI2 (determined by

measurement of the stable metabolite, 6-keto-PGF1 alpha) or

PGF2 alpha. 7. These data suggest that eicosanoids synthesized

by an active COX pathway in the spinal cord of normal animals

may contribute to nociceptive processing, but only when the

spinal cord neurones are rendered hyperexcitable following C-

fibre stimulation. Selective inhibition of one or both of the

COX isoforms in normal animals may represent a novel target

for spinal analgesia.. EC 1.14.99.1; 0; 0; 0; 0; 0; 0.

222. Wilson, K. C. The reflex action: a contribution of physiology to

neurology. Pharos. 1996 Mar; 59(2): 34-6; ISSN: 0031-7179.

UNITED-STATES.

223. Windholz, G. Pavlov's conceptualization of the dynamic stereotype

in the theory of higher nervous activity. Am-J-Psychol. 1996

Jun; 109(2): 287-95; ISSN: 0002-9556.

UNITED-STATES. David Joravsky (1989) alleges that Ivan

Petrovich Pavlov's theory of higher nervous activity fails to

explain "most forms of complex behavior" because

establishment of second-order and third-order chains of

conditional reflexes was not feasible. Yet, Pavlov (1951a),

relying on experimental evidence, some of which is presented,

held that the interaction of higher organisms with the external

environment was based on the dynamic stereotype, that is, on

the integration in the cortical hemispheres of neural traces

coming from the external and internal environments. In its

formulation in the 1930s, Pavlov's theory was dynamic, not

associative. It postulated the synthesis of conditioned

reflexes, not associative chains of conditioned reflexes.

224. Wohlert, A. B. Reflex responses of lip muscles in young and older

women. J-Speech-Hear-Res. 1996 Jun; 39(3): 578-89; ISSN:

0022-4685.

UNITED-STATES. The perioral reflex in response to innocuous

mechanical stimulation of the lip vermilion was studied in 20

young and 20 older women. Responses to stimuli at the right

and left sides of both the upper and lower lips were recorded.

Results show significant specificity of response, especially

for upper lip sites. Reflex response at the site of stimulation

was greatest in amplitude and shortest in latency, followed by

response at sites ipsilateral to the site of stimulation.

Younger subjects showed greater localizing tendency than

older subjects. Stimulation was significantly less likely to

produce a reflex response in the older group. When reflex

responses did occur, they were significantly lower in

amplitude and longer in latency than the responses of the

younger group. Nonetheless, reflex responses were common in

both groups, with responses at the site of stimulation

occurring 78% of the time in older women and 90% of the time

in younger women. Every participant showed at least one

reflex response to lip stimulation. Results suggest decreasing

complexity of synaptic drive to the perioral system in old age

but also show that reflexive response does not deteriorate

completely, remaining an available element for motor control

in normal older women.

225. Wolpaw, J. R. The complex structure of a simple memory. Trends-

Neurosci. 1997 Dec; 20(12): 588-94; ISSN: 0166-2236.

ENGLAND. Operant conditioning of the vertebrate H-reflex,

which appears to be closely related to learning that occurs in

real life, is accompanied by plasticity at multiple sites.

Change occurs in the firing threshold and conduction velocity

of the motoneuron, in several different synaptic terminal

populations on the motoneuron, and probably in interneurons as

well. Change also occurs contralaterally. The corticospinal

tract probably has an essential role in producing this

plasticity. While certain of these changes, such as that in the

firing threshold, are likely to contribute to the rewarded

behavior (primary plasticity), others might preserve

previously learned behaviors (compensatory plasticity), or are

simply activity-driven products of change elsewhere (reactive

plasticity). As these data and those from other simple

vertebrate and invertebrate models indicate, a complex

pattern of plasticity appears to be the necessary and

inevitable outcome of even the simplest learning.

226. Woodruff, Pak DS; Romano, S.; Papka, M. Training to criterion in

eyeblink classical conditioning in Alzheimer's disease, Down's

syndrome with Alzheimer's disease, and healthy elderly.

Behav-Neurosci. 1996 Feb; 110(1): 22-9; ISSN: 0735-7044.

UNITED-STATES. The cholinergic antagonist scopolamine

delays acquisition of eyeblink classical conditioning (EBCC) in

rabbits and humans, but scopolamine-treated organisms

eventually acquire conditioned responses (CRs). Patients with

probable Alzheimer's disease (AD) and older adults with

Down's syndrome (DS/AD) have disrupted cholinergic systems

and perform EBCC very poorly. It was hypothesized that

patients with probable AD and DS/AD, like scopolamine-

injected organisms, would acquire CRs if given sufficient

training. Twelve probable AD patients, 12 DS/AD patients, and

6 healthy elderly control individuals participated in 5 daily

90-trial sessions of EBCC. Fifty-eight percent of the probable

AD, 92% of the DS/AD, and 100% of the control participants

achieved learning criterion. Probable AD, DS/AD, and control

participants had statistically significant increases in the

percentage of CRs produced over 5 EBCC sessions. The neural

substrate for EBCC was not eliminated in probable AD or

DS/AD patients, although the learning mechanism was

disrupted.

227. Woodward, S. Neurological observations--2. Pupil response. Nurs-

Times. 1997 Nov 12; 93(46): suppl 1-2; ISSN: 0954-7762.

ENGLAND.

228. Yagi, T.; Ohyama, Y. Three-dimensional analysis of nystagmus

induced by neck vibration. Acta-Otolaryngol-Stockh. 1996 Mar;

116(2): 167-9; ISSN: 0001-6489.

NORWAY. The role of dorsal neck proprioceptive inputs to

vestibular compensation was investigated in 11 patients with

unilateral vestibular dysfunction. Subjects had neither

spontaneous nystagmus nor disequilibrium, indicating that

they were well compensated. Vibratory stimulation to the

dorsal neck produced marked nystagmus. All subjects showed

horizontal component directed towards the contralateral side

of the lesion. Vertical and torsional components of the

nystagmus were exhibited by 10 and 7 subjects, respectively.

These results indicate that the neck vibration caused a

discompensation in vestibularly well compensated subjects

after unilateral dysfunction. In addition, the influence of neck

afferent on the vestibulo-ocular reflex pathways, not only of

the horizontal, but also the vertical systems, is discussed.

229. Yamashita, A.; Hirayama, M.; Koike, Y.; Nukata, M.; Hashizume, M.;

Takahashi, A. Orthostatic hypotension caused by a localised

dorsal medullary tumour [letter]. J-Neurol-Neurosurg-

Psychiatry. 1996 Jul; 61(1): 118-9; ISSN: 0022-3050.

ENGLAND.

230. Yang, K.; Perez Polo, J. R.; Mu, X. S.; Yan, H. Q.; Xue, J. J.; Iwamoto,

Y.; Liu, S. J.; Dixon, C. E.; Hayes, R. L. Increased expression of

brain-derived neurotrophic factor but not neurotrophin-3

mRNA in rat brain after cortical impact injury. J-Neurosci-

Res. 1996 Apr 15; 44(2): 157-64; ISSN: 0360-4012.

UNITED-STATES. Levels of brain-derived neurotrophic factor

(BDNF) and neurotrophin-3 (NT3) mRNA expression were

measured in a rodent model of traumatic brain injury (TBI)

following unilateral injury to the cerebral cortex. To obtain

reliable data on the co-expression of neurotrophin genes,

adjacent coronal sections from the same rat brains were

hybridized in situ with BDNF and NT3 cRNA probes. BDNF mRNA

increased at 1,3, and 5 hr after unilateral cortical injury in

the cortex ipsilateral to the injury site and bilaterally in the

dorsal hippocampus. NT3 mRNA did not change significantly

following injury. Our results suggest that TBI produces rapid

increases in BDNF mRNA expression in rat brain without

changes in NT3 mRNA expression, a finding which differs from

studies of ischemia and seizures. It is possible that increased

levels of BDNF mRNA rather than NT3 are important

components of pathophysiological responses to TBI.. 0; 0; 0; 0;

0.

231. Yang, T. F.; Chan, R. C.; Liao, S. F.; Chuang, T. Y.; Liu, T. J.

Electrophysiologic evaluation of autonomic function in

cerebral palsy. Am-J-Phys-Med-Rehabil. 1997 Nov; 76(6): 458-

61; ISSN: 0894-9115.

UNITED-STATES. The presence of clinical autonomic

dysfunction in patients with neurologic diseases, such as

multiple sclerosis, Parkinson's disease, and cerebrovascular

accident, has become increasingly recognized in the past

decade. Very few autonomic tests have been done on pediatric

patients thus far. The purpose of this study was to investigate

the autonomic function in patients with cerebral palsy using

two noninvasive tests: sympathetic skin response (SSR) and R-

R interval variation (RRIV). Twenty-four patients with

cerebral palsy and 24 control subjects between the ages of 4

and 12 yr were enrolled in this study. There was no significant

difference of mean latency, amplitude, or amplitude ratio of

SSR between the two groups under electric stimulus, startling

stimulus, and deep breathing conditions. No significant

difference in frequency of absent response and asymmetric

response was also noted. Mean heart rate under relaxed sitting

condition was significantly higher in the study group.

Significant negative correlation between heart rate and age

was noted in the control group but was not present in the

study group. Also, there was no statistical difference of mean

RRIV between the two groups. No objective evidence of

autonomic disturbance in patients with cerebral palsy was

found in this study.

232. Yokota, T.; Yamaguchi, O. Changes in cholinergic and purinergic

neurotransmission in pathologic bladder of chronic spinal

rabbit. J-Urol. 1996 Nov; 156(5): 1862-6; ISSN: 0022-5347.

UNITED-STATES. PURPOSE: We evaluated the changes in

cholinergic and purinergic neurotransmission in pathologic

bladder of chronic spinal rabbits. MATERIAL AND METHODS:

Detrusor muscle strips were obtained from normal rabbits and

chronic spinal rabbits with detrusor hyperreflexia and

detrusor sphincter dyssynergia (DSD). Muscle strips were

mounted in an organ bath, and transmural nerve electrical field

stimulation (EFS: supamaximal voltage, 0.5 msec. duration, 10

second trains) was performed. The responses to EFS and

agonists were determined by recording the isometric tension

of muscle strips. RESULTS: Both normal and pathologic

detrusor strips contracted in a frequency dependent fashion in

response to transmural electrical nerve stimulation. At each

frequency, atropine reduced the nerve-mediated contraction in

a dose-dependent fashion and left an atropine-resistant

response at a concentration of 1 microM. The atropine-

resistant contraction was abolished by desensitization of

P2X-purinoceptors with repeated exposure to alpha, beta-

methylene ATP (10 microM). The atropine sensitive

(cholinergic) and resistant (purinergic) contractions increased

with an increase in frequency and reached maximum at 20 Hz.

The relative contribution of cholinergic and purinergic

transmission to the nerve-mediated contraction was

determined at this frequency. In normal detrusor, the

cholinergic and purinergic components were approximately

40% and 60%. In pathologic detrusor, the cholinergic

component increased to 75% whereas the purinergic component

decreased to 25%. Exogenously administered acetylcholine and

ATP produced dose-dependent contractions of detrusor strips.

The concentration-response curves for each agonist did not

show significant differences between normal and pathologic

detrusor. CONCLUSION: These results suggest that

neurotransmission is shifted to a cholinergic dominance in

pathologic rabbit bladder affected by detrusor hyperreflexia

and DSD.. 0; 0; 0; 51-55-8; 51-84-3; 56-65-5.

233. York, M. W.; Rabinowitz, J. A.; Burdick, K.; Coffey, S.; Tongul, E.

Predicting perceptual defense. Percept-Mot-Skills. 1996 Feb;

82(1): 185-6; ISSN: 0031-5125.

UNITED-STATES. Perceptual defense as a phenomenon was

proposed by McGinnies in 1949. His findings were, in main,

replicated by York, et al. in 1984 and extended by Perroncel, et

al. in 1990. The present purpose was to assess whether four

independent variables, one related to emotional arousal (GSR)

and three, related to connotative word meaning (Evaluative,

Potency, and Activity scores from Semantic Differential

words used in the Perroncel, et al. study), could predict the

perceptual defense phenomenon. The multiple correlation

coefficient (R) was .19; however, the percent variance

accounted for by the four independent variables was 3%.

Clearly, further research is necessary to specify what factors

predict the perceptual defense effect.

234. Yoshikawa, K.; Iwamoto, K.; Sugimoto, E.; Takanashi, Y.; Nakajima,

K. [A case of porencephaly with mirror movements:

pathophysiological investigation by using long-latency long-

loop reflex and dipole tracing method]. Rinsho-Shinkeigaku.

1997 Jun; 37(6): 500-5; ISSN: 0009-918X.

JAPAN. We report a 42-year-old left-handed woman with

congenital right hemiparesis and bilateral mirror movements

in the hands. She had a porencephaly of the left hemisphere and

the brain MRI demonstrated cortical and subcortical defect of

the left hemisphere from Brodmann's area 6 to 40 including

the left motor cortex. By electrical stimulation of the left

median nerve at the wrist, N20 of the somatosensory evoked

potential was recorded in the right postcentral gyrus by using

the dipole tracing method. Long-loop reflexes from the

bilateral thenar muscles were recorded and their latencies

were almost the same. The stimulation of the right median

nerve did not evoke N20, nor long-loop reflex. These

electrophysiological findings suggest that the reorganization

of the motor system made the right motor cortex to innervate

bilateral hands, and caused bilateral mirror movements. In

other words, the mirror movements managed to relieve the

paralysis of the right hand though the damage of the left motor

cortex was present. In the previous literature we are able to

find hypotheses regarding the mechanism of mirror movements

in congenital hemiparesis. Here we discussed about the

reorganization of the motor system in the damaged brain.

235. Yoshino, T. [Effects of lateral mandibular deviation on masseter

muscle activity]. Kokubyo-Gakkai-Zasshi. 1996 Mar; 63(1): 70-

87; ISSN: 0300-9149.

JAPAN. The investigation of the physiological response of

masticatory muscle which is associated with the perception

of the mandibular lateral deviation is clinically important.

Therefore, the effects of various lateral mandibular deviation

on the masseter muscle function were investigated on five

healthy subjects. The mandibular position was deviated 0.5,

1.0, 1.5, 2.0 and 3.0 mm to the right and left from a reference

position corresponding to the rest position. The mandible was

passively retained in each test position by means of a bite

block. Electromyographic activity (background activity) was

recorded with bipolar surface electrodes applied to the right

and left masseter muscles. Jaw-jerk reflex was evoked by a

reflex hammer, and motoneuron activity was indirectly

examined. The background activity as well as the amplitude of

the jaw-jerk reflex on the mediotrusive side mainly increased

in proportion to the mandibular deviation. However, most

subjects showed no significant change about 3 mm from the

reference position in the background activity and about 2 mm

in the range of muscle activity evoked by the jaw-jerk reflex.

These results suggested that the masseter jaw-jerk reflex

may assist clinical examination of small mandibular

deviations.

236. Zaman, M. L.; Doughty, M. J. Some methodological issues in the

assessment of the spontaneous eyeblink frequency in man.

Ophthalmic-Physiol-Opt. 1997 Sep; 17(5): 421-32; ISSN: 0275-

5408.

ENGLAND. Previous assessments of spontaneous eyeblink

frequency (SEBF) or interblink intervals (IBI) have been made

over period of 0.5 to 15 min and average values calculated; the

reliability of the methods has not been validated. Video

recordings were made of 14 healthy volunteers, aged 20 to 38

years, while silently fixating on a 2 m distant, 35 mm high

target under 350 lux illumination and the traces assessed with

an event marker. Significant fluctuations in SEBF or IBI were

generally observed, but which did not conform to a minute-by-

minute periodicity. Time-dependent trends were uncommon,

although uncritical pooling or averaging of data can

effectively conceal such fluctuations or trends. Correlation's

between SEBF and IBI indicate that eyeblink monitoring over at

least 3 min is required. Simple averaging calculations are not

appropriate because of a high chance of non-Gaussian

distribution of data. Modal IBI values correlated well with an

adjusted modal calculated SEBF which is thus recommended

for further use.