Nerve

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Nerve

  • accessory nerve
  • adrenergic nerve
  • affected nerve
  • afferent nerve
  • alveolar nerve
  • antennal nerve
  • auditory nerve
  • auricular nerve
  • auriculotemporal nerve
  • autonomic nerve
  • cardiac nerve
  • carotid sinus nerve
  • cavernous nerve
  • cervical vagus nerve
  • cholinergic nerve
  • cochlear nerve
  • common fibular nerve
  • common peroneal nerve
  • control nerve
  • cranial nerve
  • cutaneous nerve
  • dorsal cutaneous nerve
  • enteric nerve
  • facial nerve
  • femoral nerve
  • fibular nerve
  • greater occipital nerve
  • hypoglossal nerve
  • inferior alveolar nerve
  • inferior laryngeal nerve
  • infraorbital nerve
  • injured nerve
  • intercostal nerve
  • involved nerve
  • laryngeal nerve
  • lingual nerve
  • mandibular nerve
  • median nerve
  • mental nerve
  • motor nerve
  • muscle nerve
  • myelinated nerve
  • occipital nerve
  • olfactory nerve
  • optic nerve
  • parasympathetic nerve
  • pelvic nerve
  • peripheral nerve
  • perivascular nerve
  • peroneal nerve
  • phrenic nerve
  • pudendal nerve
  • radial nerve
  • rat optic nerve
  • rat sciatic nerve
  • recurrent laryngeal nerve
  • sciatic nerve
  • segmental nerve
  • sensory nerve
  • sinus nerve
  • spinal accessory nerve
  • spinal nerve
  • splanchnic nerve
  • superior laryngeal nerve
  • sural nerve
  • sympathetic nerve
  • terminal nerve
  • tibial nerve
  • trigeminal nerve
  • ulnar nerve
  • vagal nerve
  • vagus nerve
  • vestibular nerve

  • Terms modified by Nerve

  • nerve action potential
  • nerve activity
  • nerve agent
  • nerve allograft
  • nerve anaesthesia
  • nerve atrophy
  • nerve biopsy
  • nerve block
  • nerve blood flow
  • nerve branch
  • nerve bundle
  • nerve cell
  • nerve cell body
  • nerve compression
  • nerve conduction
  • nerve conduction studies
  • nerve conduction study
  • nerve conduction velocity
  • nerve conduit
  • nerve conduits
  • nerve cord
  • nerve crush injury
  • nerve damage
  • nerve defect
  • nerve deficit
  • nerve degeneration
  • nerve density
  • nerve disease
  • nerve disorders
  • nerve distal
  • nerve distribution
  • nerve dysfunction
  • nerve electrical stimulation
  • nerve ending
  • nerve entrapment
  • nerve fascicle
  • nerve fiber
  • nerve fiber density
  • nerve fiber layer
  • nerve fiber layer thickness
  • nerve fibre
  • nerve fibre density
  • nerve fibre layer
  • nerve function
  • nerve gap
  • nerve graft
  • nerve grafting
  • nerve growth
  • nerve growth factor
  • nerve growth factor receptor
  • nerve head
  • nerve hypoplasia
  • nerve impairment
  • nerve impulse
  • nerve injury
  • nerve injury model
  • nerve innervation
  • nerve invasion
  • nerve involvement
  • nerve lesion
  • nerve ligation
  • nerve monitoring
  • nerve morphology
  • nerve myelin
  • nerve nucleus
  • nerve palsy
  • nerve paralysis
  • nerve paresis
  • nerve pathology
  • nerve pathway
  • nerve plexus
  • nerve preservation
  • nerve reconstruction
  • nerve regeneration
  • nerve repair
  • nerve resection
  • nerve response
  • nerve ring
  • nerve root
  • nerve sample
  • nerve section
  • nerve segment
  • nerve sheath
  • nerve sheath tumor
  • nerve sheath tumour
  • nerve specimen
  • nerve sprouting
  • nerve stimulation
  • nerve stimulator
  • nerve studies
  • nerve stump
  • nerve supply
  • nerve surgery
  • nerve system
  • nerve terminal
  • nerve territory
  • nerve tissue
  • nerve tract
  • nerve transection
  • nerve transfer
  • nerve trauma
  • nerve trunk
  • nerve trunks

  • Selected Abstracts


    MYELINATION DEFICIT IN NERVE OF SUCKLING RATS DUE TO CYCLOLEUCINE -INDUCED DEFICIENCY OF METHYL DONORS

    JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2000
    R. Bianchi
    We used cycloleucine (CL) , which prevents methionine conversion to S-adenosyl-methionine (SAMe) by inhibiting ATP-L-methionine-adenosyl-transferase (MAT) , to characterize the lipid and protein changes induced by methyl donors deficit in peripheral nerve and brain myelin in rats during development. We have previously shown that CL (400 mg/kg ip) given to suckling rats at days 7, 8, 12, and 13 after birth reduced brain and sciatic nerve weight gain, brain myelin content, protein, phospholipid (PL), and galactolipid concentration in comparison to control. Among PLs, only sphingomyelin (SPH) significantly increased by 35,50%. SAMe p-toluensulphonate (SAMe-SD4) (100 mg/kg, ip) given daily from day 7, as with exogenous SAMe, partially prevented some lipid alterations induced by CL, particularly galactolipid and SPH. To test the ability of CL to affect PL metabolism we have measured de novo PL biosynthesis, ex vivo in nerve homogenates (in comparison with brain homogenates) from control and CL-treated animals killed at day 18 after birth, starting from labelled substrates ([3H]-choline, specific activity 20 mCi/mmol) in a Tris/HCl buffer, containing 5 mM MgCl2, 0.2 mM EDTA, 0.1 mM ATP, and 0.5 mM of the labelled substrates. After 60 min incubation, lipids were extracted, PL separated by TLC, and corresponding silica gel fractions scraped and counted in a liquid scintillator. Phosphatidylcholine enrichment in labelled choline resulted in slight increases in brain and sciatic nerve of CL-treated rats, suggesting an increased synthesis rate via the Kennedy pathway, possibly due to the reduced availability of methyl donors. Interestingly, choline incorporation into SPH in brain and nerve myelin resulted in significant increases of 30,40%. In agreement with the observed decrease of galactolipid content and the relative increase in SPH, these data suggest an alteration in sphingolipid metabolism after CL. Among proteins, in sciatic nerves of CL-treated pups the relative content of a number of polypeptides, namely the 116, 90, 66, 58, and 56 kDa bands, decreased, whereas others increased; the most abundant PNS protein, protein zero, remained unchanged. The analyses of myelin basic protein isoforms revealed a dramatic increase in the 14.0 and 18.5 forms, indicating early active myelination. SAMe-SD4 treatment counteracted, and in some cases normalized, these changes. In summary, methyl donor deficiency induced by MAT inhibition produces myelin lipid and protein alterations, partly counteracted by SAMe-SD4 administration. The financial support of Telethon-Italy (grant No. D 51) is gratefully acknowledged. [source]


    MACROPHAGE INFILTRATION AND INDUCTION OF P75 NTR AND IL-1B IN THE NERVE OF DIABETIC RATS

    JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2000
    G. Conti
    Recently, inflammation has been involved in the pathogenesis of diabetic neuropathy, and activated macrophages have been found in the peripheral nervous system of diabetic rats, with a possible role in chemotaxis and regeneration. In this study, we obtained sciatic nerve specimens from diabetic rats at different time points following STZ administration. Macrophages infiltration, IL-1b and p75NTR induction were analyzed by immunocytochemistry on frozen sections and on teased nerve fibers. Apoptosis was detected on teased nerve fibers by TUNEL and DAPI staining. Cell phenotype was characterized by double-staining with antibodies specific for Schwann cells and macrophages. The nerves obtained from STZ-diabetic rats showed macrophages infiltration by day 14 following STZ administration, with complete clearance by day 35. Fifteen percent of these cells were TUNEL positive. IL-1B induction was concomitant with macrophages infiltration and not detectable by day 35. p75NTR expression began by day 21, peaking by day 35, and dropping to barely detectable levels by day 105. These findings seem to indicate that the concomitance of these processes may be crucial in the regulation of nerve damage and in promoting an attempt of regeneration at the early stages of STZ diabetic neuropathy. [source]


    Anatomy and Physiology of the Right Interganglionic Nerve: Implications for the Pathophysiology of Inappropriate Sinus Tachycardia

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2008
    JING ZHOU M.D.
    Objective: To simulate inappropriate sinus tachycardia (IST) in experimental animals. Background: We recently found that epinephrine injected into the anterior right ganglionated plexi (ARGP) adjacent to the sinoatrial (SA) node induced an arrhythmia simulating IST. Methods: In 19 anesthetized dogs, via a right thoracotomy, the course of the interganglionic nerve (IGN) from the right stellate ganglion along the superior vena cava to the heart was delineated. High-frequency stimulation (HFS; 0.1 msec duration, 20 Hz, 4.5,9.3 V) was applied to IGN at the junction of innominate vein and SVC. Results: HFS of the IGN significantly increased the sinus rate (SR) (baseline: 156 ± 19 beats/minutes [bpm], 4.5 V: 191 ± 28 bpm*, 8.0 V: 207 ± 23 bpm*, 9.3 V: 216 ± 18 bpm*; *P < 0.01 compared to baseline) without significant changes in A-H interval or blood pressure. P-wave morphology, ice mapping, and noncontact mapping indicated that this tachycardia was sinus tachycardia. In 8 of 19 dogs, injecting hexamethonium (5 mg), a ganglionic blocker, into the ARGP attenuated the response elicited by IGN stimulation (baseline: 160 ± 21 bpm, 4.5 V: 172 ± 32 bpm, 8.0 V: 197 ± 32 bpm*, 9.3 V: 206 ± 26 bpm*; *P < 0.05 compared to baseline). In 19 of 19 animals, after formaldehyde injection into the ARGP, SR acceleration induced by IGN stimulation was markedly attenuated (baseline: 149 ± 17 bpm, 4.5 V: 151 ± 21 bpm, 8.0 V: 155 ± 23 bpm, 9.3 V: 167 ± 24 bpm*; *P < 0.05 compared to baseline). Conclusions: HFS of the IGN caused a selective and significant acceleration of the SR. A significant portion of IGN traverses the ARGP or synapses with the autonomic ganglia in the ARGP before en route to the SA node. Dysautonomia involving the IGN and/or ARGP may play an important role in IST. [source]


    Neuropeptide Y Cotransmission with Norepinephrine in the Sympathetic Nerve,Macrophage Interplay

    JOURNAL OF NEUROCHEMISTRY, Issue 6 2000
    Rainer H. Straub
    Abstract: The CNS modulates immune cells by direct synaptic-likecontacts in the brain and at peripheral sites, such as lymphoid organs. Tostudy the nerve-macrophage communication, a superfusion method was used toinvestigate cotransmission of neuropeptide Y (NPY) with norepinephrine (NE),with interleukin (IL)-6 secretion used as the macrophage read-out parameter.Spleen tissue slices spontaneously released NE, NPY, and IL-6 leading to asuperfusate concentration at 3-4 h of 1 nM, 10 pM, and 120pg/ml, respectively. Under these conditions, NPY dose-dependently inhibitedIL-6 secretion with a maximum effect at 10 -10M(p = 0.012) and 10 -9M (p < 0.001).Simultaneous addition of NPY at 10 -9M and the,-2-adrenergic agonist p -aminoclonidine further inhibited IL-6secretion (p < 0.05). However, simultaneous administration of NPYat 10 -9M and the ,-adrenergic agonist isoproterenolat 10 -6M or NE at 10 -6Msignificantly increased IL-6 secretion (p < 0.005). To objectifythese differential effects of NPY, electrical field stimulation of spleenslices was applied to release endogenous NPY and NE. Electrical fieldstimulation markedly reduced IL-6 secretion, which was attenuated by the NPYY1 receptor antagonist BIBP 3226 (10 -7M, p = 0.039;10 -8M, p = 0.035). This indicates that NPY increases theinhibitory effect of endogenous NE, which is mediated at low NE concentrationsvia ,-adrenoceptors. Blockade of ,-adrenoceptors attenuatedelectrically induced inhibition of IL-6 secretion (p < 0.001),which was dose-dependently abrogated by BIBP 3226. This indicates that underblockade of ,-adrenoceptors endogenous NPY supports the stimulatingeffect of endogenous NE via ,-adrenoceptors. These experimentsdemonstrate the ambiguity of NPY, which functions as a cotransmitter of NE inthe nerve-macrophage interplay. [source]


    The Role of the Vagus Nerve in Mediating the Long-Term Anorectic Effects of Leptin

    JOURNAL OF NEUROENDOCRINOLOGY, Issue 4 2007
    C. Sachot
    Leptin, the product of the obese (ob) gene, is mainly known for its regulatory role of energy balance by direct activation of hypothalamic receptors. Recently, its function in the acute control of food intake was additionally attributed to activation of the vagus nerve to regulate meal termination. Whether vagal afferent neurones are involved in longer term effects of leptin on food intake, however, remains undetermined. Using vagotomised (VGX) rats, we sought to clarify the contributions of vagal afferents in mediating the long-lasting effect of leptin on appetite suppression. Intraperitoneal (i.p.) injection of leptin (3.5 mg/kg) attenuated food intake at 4, 6, 8 and 24 h and body weight at 24 h postinjection in SHAM-operated rats; however, this response was not abrogated by vagotomy. In a separate study using immunohistochemistry, we observed leptin-induced Fos expression in the nucleus tractus solitarii, a brain structure where vagal afferent fibres terminate. This signal was not attenuated in VGX animals compared to the SHAM group. Moreover, leptin treatment led to a similar level of nuclear STAT3 translocation, a marker of leptin signalling, in the hypothalami of SHAM and VGX animals. In addition to the effects of leptin, vagotomy surgery itself resulted in a decrease of 24 h food intake. Analyses of brains from saline-treated VGX animals revealed a significant induction of Fos in the nucleus tractus solitarii and changes in agouti-related peptide and pro-opiomelanocortin mRNA expression in the hypothalamus compared to their SHAM counterparts, indicating that the vagotomy surgery itself induced a modification of brain activity in areas involved in regulating appetite. Collectively, our data suggest that vagal afferents do not constitute a major route of mediating the regulatory effect of leptin on food intake over a period of several hours. [source]


    Ultrasonographic Reference Values for Assessing the Normal Median Nerve in Adults

    JOURNAL OF NEUROIMAGING, Issue 1 2009
    Michael S. Cartwright MD
    ABSTRACT BACKGROUND AND PURPOSE Several studies have evaluated the cross-sectional area of the median nerve at the wrist, but none have examined other sites along the median nerve. Nerve enlargement has been demonstrated in entrapment, hereditary and acquired neuropathies, as well as with intraneural masses, and cross-sectional area reference values at sites along the nerve will help in the evaluation of these conditions. In addition, muscle intrusion into the carpal tunnel has been implicated in carpal tunnel syndrome, but the normal amount of muscle intrusion has not been quantified. METHODS Fifty asymptomatic volunteers (100 arms) were evaluated to determine the mean cross-sectional area of the median nerve at 6 sites and the mean amount of muscle intruding into the carpal tunnel. RESULTS The cross-sectional area of the nerve was consistent along its course (7.5 to 9.8 mm2). The amount of muscle within the carpal tunnel varied greatly, with the mean area of flexor digitorum being 15.5 mm2 and lumbricals 13.5 mm2. CONCLUSIONS These reference values are necessary for advancing the field of neuromuscular ultrasound, because they facilitate studies of the median nerve in conditions such as entrapment, hereditary neuropathy, acquired neuropathy, and intraneural masses. [source]


    Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

    JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2007
    Michel W. Coppieters
    Abstract Nerve and tendon gliding exercises are advocated in the conservative and postoperative management of carpal tunnel syndrome (CTS). However, traditionally advocated exercises elongate the nerve bedding substantially, which may induce a potentially deleterious strain in the median nerve with the risk of symptom exacerbation in some patients and reduced benefits from nerve gliding. This study aimed to evaluate various nerve gliding exercises, including novel techniques that aim to slide the nerve through the carpal tunnel while minimizing strain ("sliding techniques"). With these sliding techniques, it is assumed that an increase in nerve strain due to nerve bed elongation at one joint (e.g., wrist extension) is simultaneously counterbalanced by a decrease in nerve bed length at an adjacent joint (e.g., elbow flexion). Excursion and strain in the median nerve at the wrist were measured with a digital calliper and miniature strain gauge in six human cadavers during six mobilization techniques. The sliding technique resulted in an excursion of 12.4 mm, which was 30% larger than any other technique (p,,,0.0002). Strain also differed between techniques (p,,,0.00001), with minimal peak values for the sliding technique. Nerve gliding associated with wrist movements can be considerably increased and nerve strain substantially reduced by simultaneously moving neighboring joints. These novel nerve sliding techniques are biologically plausible exercises for CTS that deserve further clinical evaluation. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:972,980, 2007 [source]


    Hyperbaric oxygen treatment has different effects on nerve regeneration in acellular nerve and muscle grafts

    JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2001
    Yasumasa Nishiura
    Abstract Effects of hyperbaric oxygen treatment (HBO) on nerve regeneration in acellular nerve and muscle grafts were investigated in rats. Nerve and muscle grafts were made acellular by freeze-thawing and the obtained grafts were used to bridge a 10-mm gap in the sciatic nerve on the left and right sides, respectively. Rats were treated with HBO (100% oxygen for 90 minutes at 2.5 atmospheres absolute pressure ATA) twice a day for 7 days. Axonal outgrowth, Schwann cell migration and invasion of macrophages were examined 10 days after the graft procedure by staining neurofilaments, S-100 proteins and the macrophage antibodies ED1 and ED2, respectively. Axonal outgrowth and Schwann cell migration in acellular nerve grafts were superior to that found in the acellular muscle grafts. However, there was no difference between HBO-treated and non-treated rats in acellular nerve grafts. Such a difference was found in acellular muscle grafts concerning both axonal outgrowth and Schwann cell migration from the proximal nerve end. No differences in the content of macrophages or neovascularization (alkaline phosphatase staining) in either of the grafts and treatments were seen. It is concluded that there is a differential effect of HBO-treatment in acellular nerve and muscle grafts and that HBO-treatment has no effect on the regeneration process in acellular nerve grafts, in contrast to fresh cellular nerve grafts where a beneficial effect has previously been reported. [source]


    HCV-RNA In Sural Nerve From Hcv Infected Patients With Peripheral Neuropathy

    JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2001
    L De Martino
    Objective: Evaluation of hepatitis C virus (HCV) by reverse transcription-polymerase chain reaction (RT-PCR) in peripheral nerve tissues from HCV infected patients with peripheral neuropathy. METHODS: RT-PCR was performed on homogenates of nerve biopsies from 17 consecutive HCV-positive patients with peripheral neuropathy, with or without mixed cryoglobulinemia, hospitalised from 1996 to 2000. Sural nerve specimens were frozen in iso-pentane pre-cooled in liquid nitrogen and stored at ,80°C until use. RNA was extracted from ten 7-,m thick cryostatic sections or from a nerve trunk specimen of about 3 mm length, collected from each biopsy. Three different protocols of RNA extraction were tested (1,3). Complementary DNAs (cDNAs) were obtained without or with RNasin (Promega, Madison, WI) addition in the reaction mixture to inhibit residual RNase activity. Two sets of commercially available PCR primers for the outer and the nested reaction were used. PCR products were analysed by agarose gel electrophoresis and ethidium bromide staining. Serum samples and liver specimens from proven HCV positive patients served as positive controls, whereas sera from healthy subjects were negative controls. RESULTS: Sufficient amount of RNA could be obtained either by cryostatic sections or by in toto nerve specimens. Extraction by Trizol (Gibco-BRL) allowed the best concentration and purity of RNA as assessed by biophotometry. The presence of RNasin didn't improve the cDNA synthesis. The resulting amplification product of the nested PCR was 187 bp long. We have always observed this product in our positive controls and never in the negative. Six samples from patients either with or without cryoglobulinemia resulted positive; 7 were negative. Four samples gave variable results. CONCLUSIONS: While 40% of the nerves in our series were undoubtedly HCV positive, the cause(s) of negative and variable results in the remaining samples is likely more complex than variations in the detection protocols and deserve further investigations. REFERENCES: 1) Chomczynski P, Sacchi N (1987). Anal Biochem 162:156. 2) Marquardt O et al. (1996). Med Microbiol Lett 5:55. 3) Chomczynski P (1993). Bio/Techniques 15:532. [source]


    Task-specific dystonia in tabla players

    MOVEMENT DISORDERS, Issue 10 2004
    Mona Ragothaman MBBS
    Abstract Task-specific dystonia significantly impairs the performance of approximately 8% of musicians [Lederman RJ. Muscle Nerve 2003;27:549,561]. We describe hand dystonia in two professional musicians experienced while playing tabla, a percussion instrument. © 2004 Movement Disorder Society [source]


    Vascular pathology in dermatomyositis and anatomic relations to myopathology

    MUSCLE AND NERVE, Issue 1 2010
    Alan Pestronk MD
    Abstract The causes of perifascicular myofiber atrophy and capillary pathology in dermatomyositis are incompletely understood. We studied 11 dermatomyositis muscles by histochemistry, immunohistochemistry, and ultrastructure. We found that endomysial capillaries within regions of perifascicular atrophy are not entirely lost, but they have reduced size, endothelial loss, C5b9 complement deposits, and relatively preserved connective tissue molecules and pericytes. In all muscles, the perimysium varies regionally. Some areas contain intermediate-sized vessels. Others are avascular. In dermatomyositis, vascular perimysium contains abnormal vessel fragments, perivascular inflammation, and increased PECAM-1. Perifascicular myofiber atrophy and capillary pathology are concentrated near the avascular perimysium. We conclude that both perimysial intermediate-sized vessels and endomysial capillaries within regions of perifascicular myofiber atrophy are abnormal in dermatomyositis. Capillary damage and myofiber atrophy are concentrated in regions distant from intermediate-sized perimysial vessels. Chronic immune vascular damage and insufficiency in dermatomyositis may cause ischemia, myofiber atrophy, and capillary damage in "watershed" regions of muscle near the avascular perimysium. Muscle Nerve, 2010 [source]


    Direct immunofluoresence in vasculitic neuropathy: Specificity of vascular immune deposits

    MUSCLE AND NERVE, Issue 1 2010
    Michael P. Collins MD
    Abstract In suspected vasculitic neuropathy, vasculitis is demonstrated in only 30% of superficial peroneal nerve (SPN)/peroneus brevis muscle (PBM) specimens. Pathologic predictors of vasculitis are thus needed for non-diagnostic cases. Immune deposits in epineurial vessels have an established sensitivity but unknown specificity. In this study we assessed specificity using direct immunofluorescence (DIF) in SPN/PBM biopsies for suspected vasculitic neuropathy. Biopsies from 13 patients with vasculitis, 13 without vasculitis, and 6 with diabetic radiculoplexus neuropathy (DRPN) were stained for immunoglobulin G (IgG), IgM, and complement 3 (C3), and analyzed in a blinded manner. Vascular immunoglobulin or C3 deposits occurred in 12 of 13 nerve or muscle biopsies (11 of 13 nerves, 5 of 13 muscles) in vasculitis vs. 1 of 13 (1 of 13 nerves, 0 of 13 muscles) in controls (P = 0.00003). Specificity was 92%. For DRPN, vascular immune deposits occurred in 5 of 6 nerves or muscles (4 of 6 nerves, 1 of 5 muscles), similar to vasculitis but significantly different from controls. Epineurial/perimysial vascular deposits of immunoglobulin/C3 by DIF are a specific marker of vasculitic neuropathy. Muscle Nerve 000:000,000, 2009 [source]


    Disseminated intravascular large-cell lymphoma with initial presentation mimicking Guillain,Barré syndrome

    MUSCLE AND NERVE, Issue 1 2010
    Qin Li Jiang MD
    Abstract We report a patient with intravascular large B-cell lymphoma who initially presented with acute ascending weakness and sensory changes. Electrodiagnostic testing and cerebral spinal fluid (CSF) studies were initially suggestive of a demyelinating polyneuropathy. Further clinical evaluation and testing were consistent with mononeuropathy multiplex. Autopsy revealed disseminated intravascular large-cell lymphoma. Intravascular large-cell lymphoma should be considered in the differential diagnosis of a rapidly evolving neuropathy associated with other organ involvement. Muscle Nerve, 2010 [source]


    Sonographic evaluation of the sciatic nerve in patients with lower-limb amputations

    MUSCLE AND NERVE, Issue 6 2010
    A. Salim Göktepe MD
    Abstract Hypertrophy of the sciatic nerve after lower-limb amputation in patients with sarcomas has been previously reported by magnetic resonance imaging; however, sonographic evaluation of the sciatic nerve after lower-limb amputation due to nonmalignant causes has not been done before. Therefore, the aim of this study was to perform imaging of the sciatic nerve in lower-limb amputees and to find out whether sonographic findings were related to clinical characteristics. Twenty-three males with lower-limb amputations due to traumatic injuries were enrolled. Sonographic evaluations were performed using a linear array probe (Aloka UST-5524-7.5 MHZ). Sciatic nerve diameters were measured bilaterally at the same level, and the values of the normal limbs were taken as controls. Sciatic nerve width and thickness values were found to be greater on the amputated sides than the normal sides (P = 0.001). The thickness values were greater in above-knee amputees than below-knee amputees (P = 0.05). Subjects with a neuroma also had thicker sciatic nerves (P = 0.04). The diameters were found not to change between subjects with different liners (P > 0.05), but they were correlated with time after amputation (r = 0.6, P = 0.006; r = 0.4, P = 0.05, respectively). Our results clearly show that the sciatic nerves were wider and thicker on the amputated sides. Amputation level, duration, and the presence of a neuroma seem to affect the eventual diameters of the nerves. Muscle Nerve, 2010 [source]


    The inhibitory effect of a chewing task on a human jaw reflex

    MUSCLE AND NERVE, Issue 6 2010
    Pauline Maillou BDS
    Abstract This study was undertaken to investigate whether an inhibitory jaw reflex could be modulated by experimentally controlled conditions that mimicked symptoms of temporomandibular disorders. Reflecting on previous work, we anticipated that these conditions might suppress the reflex. Electromyographic recordings were made from a masseter muscle in 18 subjects, while electrical stimuli were applied to the upper lip. An inhibitory reflex wave (mean latency 47 ms) was identified and quantified. Immediately following an accelerated chewing task, which in most cases produced muscle fatigue and/or pain, the size of the reflex wave decreased significantly by about 30%. The suppression of inhibitory jaw reflexes by fatigue and pain may result in positive feedback, which may contribute to the symptoms of temporomandibular disorders. Future studies of temporomandibular disorder sufferers will help to determine whether such reflex changes reflect the underlying etiology and/or are a result of the temporomandibular disorder itself. Muscle Nerve, 2010 [source]


    Dorsal caudal tail and sciatic motor nerve conduction studies in adult mice: Technical aspects and normative data

    MUSCLE AND NERVE, Issue 6 2010
    Robin H. Xia MD
    Abstract Mice provide an important tool to investigate human neuromuscular disorders. The variability of electrophysiological techniques limits direct comparison between studies. The purpose of this study was to establish normative motor nerve conduction data in adult mice. The dorsal caudal tail nerve and sciatic nerve motor conduction studies were performed bilaterally on restrained anesthetized adult mice. The means and standard deviations for each electrophysiological parameter were determined in normal mice. Data were compared with inflammatory demyelinating polyneuropathy mice to determine whether these parameters discriminate between normal and abnormal peripheral nerves. Normal adult mice had a distal latency of 0.89 (±0.17) ms and 0.75 (±0.09) ms, distal compound motor unit action potential amplitude of 13.2 (±5.9) mV and 28.1 (±8.3) mV, and conduction velocity of 74.6 (±9.0) m/s and 76.5 (±8.3) m/s, respectively. These data were validated by the finding of statistically significant differences in several electrophysiological parameters that compared normal and polyneuropathy-affected mice. A standardized method for motor nerve conduction studies and associated normative data in mice should facilitate comparisons of disease severity and response to treatment between studies that use similar models. This would assist in the process of translational therapeutic drug design in neuromuscular disorders. Muscle Nerve, 2010 [source]


    Immunopathogenesis of juvenile dermatomyositis

    MUSCLE AND NERVE, Issue 5 2010
    Sahil Khanna MBBS
    Abstract There is increasing evidence for involvement of the mechanisms of the innate immune system in the pathogenesis of idiopathic inflammatory myopathies (IIMs), especially in the adult and juvenile forms of dermatomyositis. Juvenile dermatomyositis (JDM) is the most common form of childhood IIM, and this review focuses on recent advances in understanding the actions of the innate immune system in this condition. Over the last few years, great strides have been made in understanding immune dysregulation in IIM, including JDM. Novel autoantibodies have been identified, and new genetic contributions have been described. Among the most striking findings is type I interferon activity in JDM tissue and peripheral blood. This is in conjunction with the description of dysregulation of the major histocompatibility complex (MHC) class I gene and identification of plasmacytoid dendritic infiltrates as the possible cellular source of type I interferons. These findings also point toward the potential prognostic value of muscle biopsies and have helped expand our understanding of the etiopathogenesis of IIM. Muscle Nerve 41: 581,592, 2010 [source]


    Ultrasonography in patients with ulnar neuropathy at the elbow: Comparison of cross-sectional area and swelling ratio with electrophysiological severity

    MUSCLE AND NERVE, Issue 5 2010
    Ayse Oytun Bayrak MD
    Abstract The aim of this study was to determine the diagnostic value of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE) and to assess the relationship between the measurements and the electrophysiological severity. The largest anteroposterior diameter (LAPD) and cross-sectional area (CSA) measurements of the ulnar nerve were noted at multiple levels along the arm, and the distal-to-proximal ratios were calculated. Almost all of the measurements and swelling ratios between patients and controls showed statistically significant differences. The largest CSA, distal/largest CSA ratio, CSA at the epicondyle, and proximal LAPD had larger areas under the curve than other measurements. The sensitivity and specificity in diagnosing UNE were 95% and 71% for the largest CSA, 83% and 85% for the distal/largest CSA ratio, 83% and 81% for the CSA at the epicondyle, and 93% and 43% for the proximal LAPD, respectively. There was a statistically significant correlation between the electrophysiological severity scale score (ESSS) and the largest CSA, the CSA at the epicondyle and 2 cm proximal to the epicondyle, and the LAPD at the level of the epicondyle (P < 0.05). None of the swelling ratios showed a significant correlation with the ESSS. The largest CSA measurement is the most valuable ultrasonographic measurement both for diagnosis and determining the severity of UNE. Muscle Nerve, 2010 [source]


    Effects of stimulation frequency and pulse duration on fatigue and metabolic cost during a single bout of neuromuscular electrical stimulation

    MUSCLE AND NERVE, Issue 5 2010
    Julien Gondin PhD
    Abstract We have investigated the effects of stimulation frequency and pulse duration on fatigue and energy metabolism in rat gastrocnemius muscle during a single bout of neuromuscular electrical stimulation (NMES). Electrical pulses were delivered at 100 Hz (1-ms pulse duration) and 20 Hz (5-ms pulse duration) for the high (HF) and low (LF) frequency protocols, respectively. As a standardization procedure, the averaged stimulation intensity, the averaged total charge, the initial peak torque, the duty cycle, the contraction duration and the torque-time integral were similar in both protocols. Fatigue was assessed using two testing trains delivered at a frequency of 100 Hz and 20 Hz before and after each protocol. Metabolic changes were investigated in vivo using 31P-magnetic resonance spectroscopy (31P-MRS) and in vitro in freeze-clamped muscles. Both LF and HF NMES protocols induced the same decrease in testing trains and metabolic changes. We conclude that, under carefully controlled and comparable conditions, the use of low stimulation frequency and long pulse duration do not minimize the occurrence of muscle fatigue or affect the corresponding stimulation-induced metabolic changes so that this combination of stimulation parameters would not be adequate in the context of rehabilitation. Muscle Nerve, 2010 [source]


    Chronic inflammatory demyelinating polyneuropathy associated with tumor necrosis factor-, antagonists

    MUSCLE AND NERVE, Issue 5 2010
    Amer Alshekhlee MD
    Abstract Biologic therapy with tumor necrosis factor (TNF)-, antagonists for rheumatoid arthritis has been well established. We describe two patients with rheumatoid arthritis who developed chronic inflammatory demyelinating polyneuropathy (CIDP) during their course of therapy with TNF-, antagonists. A 45-year-old woman and a 49-year-old man, both with a history of rheumatoid arthritis, were treated with etanercept and infliximab, respectively. Clinical signs of peripheral neuropathy developed 2 weeks and 12 months after the initiation of TNF-, antagonists. Electrodiagnostic studies at variable points during the disease course showed signs of acquired demyelination consistent with CIDP. Cerebrospinal fluid examination showed albuminocytologic dissociation (total protein concentration 118 mg/dl and 152 mg/dl, respectively). Both patients failed to improve after discontinuation of the offending agent, and they responded poorly to corticosteroids. However, there was clinical and electrophysiologic recovery after initiation of intravenous immunoglobulin (IVIg) therapy. CIDP may occur early or late during the treatment course with TNF-, antagonists. IVIg may reverse and stabilize the inflammatory process. Muscle Nerve 41: 742,747, 2010 [source]


    Use of evans blue dye to compare limb muscles in exercised young and old mdx mice

    MUSCLE AND NERVE, Issue 4 2010
    Christine I. Wooddell PhD
    Abstract Evans blue dye (EBD) is used to mark damaged and permeable muscle fibers in mouse models of muscular dystrophy and as an endpoint in therapeutic trials. We counted EBD-positive muscle fibers and extracted EBD from muscles sampled throughout the hindlimbs in young adult and old mdx mice to determine if the natural variability in morphology would allow measurement of a functional improvement in one limb compared to the contralateral limb. Following one bout of rotarod or treadmill exercise that greatly increased serum creatine kinase levels, the number of EBD+ muscle fibers in 12,19-month-old mdx mice increased 3-fold, EBD in the muscles increased, and, importantly, contralateral pairs of muscles contained similar amounts of EBD. In contrast, the intra- and interlimb amounts of EBD in 2,7-month-old mdx mice were much too variable. A therapeutic effect can more readily be measured in old mdx mice. These results will be useful in the design of therapy protocols using the mdx mouse. Muscle Nerve, 2010 [source]


    The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy

    MUSCLE AND NERVE, Issue 4 2010
    Craig M. McDonald MD
    Abstract Walking abnormalities are prominent in Duchenne muscular dystrophy (DMD). We modified the 6-minute walk test (6MWT) for use as an outcome measure in patients with DMD and evaluated its performance in 21 ambulatory boys with DMD and 34 healthy boys, ages 4 to 12 years. Boys with DMD were tested twice, ,1 week apart; controls were tested once. The groups had similar age, height, and weight. All tests were completed. Boys who fell recovered rapidly from falls without injury. Mean ± SD [range] 6-minute walk distance (6MWD) was lower in boys with DMD than in controls (366 ± 83 [125,481] m vs. 621 ± 68 [479,754] m; P < 0.0001; unpaired t -test). Test-retest correlation for boys with DMD was high (r = 0.91). Stride length (R2 = 0.89; P < 0.0001) was the major determinant of 6MWD for both boys with DMD and controls. A modified 6MWT is feasible and safe, documents disease-related limitations on ambulation, is reproducible, and offers a new outcome measure for DMD natural history and therapeutic trials. Muscle Nerve, 2010 [source]


    A Patient with neurofibromatosis type 1 and Charcot,Marie,Tooth disease type 1B

    MUSCLE AND NERVE, Issue 4 2010
    Eric Lancaster MD
    Abstract We describe a patient with both neurofibromatosis type 1 and Charcot,Marie,Tooth disease type 1B. Although one might expect an overwhelming tumor burden due to the combination of these two disorders, the two mutations did not appear to interact. Muscle Nerve 41: 555,558, 2010 [source]


    Familial, demyelinating sensory and motor polyneuropathy with conduction block

    MUSCLE AND NERVE, Issue 4 2010
    Stephen N. Scelsa MD
    Abstract Both multifocal, demyelinating features and prednisone responsiveness are rare in Charcot,Marie,Tooth (CMT) disease. We report a mother and son with a prednisone-responsive, multifocal, demyelinating, predominantly sensory polyneuropathy that was associated with an isoleucine92valine polymorphism of lipopolysaccharide-induced TNF-alpha factor (LITAF). The mother had a multifocal, acquired, demyelinating sensory and motor polyneuropathy (MADSAM)-like presentation. The son developed left peroneal neuropathy during acute Lyme disease with a subsequent relapsing, MADSAM-like illness, despite antibiotic treatment. Both shared prednisone responsiveness and multifocal, demyelinating features electrophysiologically. MADSAM may be familial (FaDSAM) and respond to prednisone. Muscle Nerve 41: 558,562, 2010 [source]


    Linearity and reliability of the mechanomyographic amplitude versus dynamic torque relationships for the superficial quadriceps femoris muscles

    MUSCLE AND NERVE, Issue 3 2010
    Matthew S. Stock MS
    Abstract The purpose of this investigation was to examine the linearity and reliability of the mechanomyographic (MMG) amplitude versus dynamic torque relationships for the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles. Nine healthy men and 11 healthy women performed submaximal to maximal, concentric, isokinetic muscle actions of the leg extensors at 30° s,1 on two occasions. Surface MMG signals were detected from the VL, RF, and VM of the dominant thigh during both trials. The ranges of the coefficients of determination for the MMG amplitude versus dynamic torque relationships were 0.01,0.94 for the VL, 0.01,0.84 for the RF, and 0.19,0.96 for the VM. The intraclass correlation coefficients for the linear MMG amplitude versus torque slope coefficients were 0.823 (VL), 0.792 (RF), and 0.927 (VM). These results indicate that, when analyzed for individual subjects, the MMG amplitude versus dynamic torque relationships demonstrated inconsistent linearity. When using MMG in the clinical setting, dynamic muscle actions of the superficial quadriceps femoris muscles do not appear to be appropriate for assessing changes in muscle function during strength training. Muscle Nerve, 2009 [source]


    Sonographic measurements of longitudinal median nerve sliding in patients following nerve repair

    MUSCLE AND NERVE, Issue 3 2010
    Ertan Erel FRCS
    Abstract Nerve sliding may be restricted following nerve repair. This could result in increased tension across the repair site and lead to poor functional recovery of the nerve. Ultrasound was used to examine longitudinal median nerve sliding in 10 patients who had previously undergone nerve repair surgery following complete division of the median nerve. The median longitudinal movement in the forearm in response to metacarpophalangeal (MCP) joint movements was 2.15 mm on the injured side, compared with 2.54 mm on the uninjured side, a difference that was significant. There was a significant reduction in nerve sliding following repair (median = 8%, range ,8% to 54%; P = 0.02), which correlated with time from injury to surgery (rho = 0.87; P = 0.001). These results indicate that ultrasound can be used as an adjunct assessment tool to monitor both morphology and sliding of the nerve through the repair site. It may have future application in the investigation of patients with persisting functional impairment following primary nerve repair. Muscle Nerve, 2009 [source]


    Effects of coil characteristics for femoral nerve magnetic stimulation

    MUSCLE AND NERVE, Issue 3 2010
    Katja Tomazin PhD
    Abstract The aim of this study was to compare the efficiency of two coils used for femoral nerve magnetic stimulation and to compare them with electrical stimulation in inducing maximal response of the quadriceps. The mechanical and electromyographic (EMG) responses were dependent on the coil used. The 45-mm double coil showed greater efficiency to elicit a maximal quadriceps response, which was similar to electrical stimulation. Muscle Nerve, 2010 [source]


    Clinical and electrophysiological parameters distinguishing acute-onset chronic inflammatory demyelinating polyneuropathy from acute inflammatory demyelinating polyneuropathy

    MUSCLE AND NERVE, Issue 2 2010
    Annie Dionne MD
    Abstract Up to 16% of chronic inflammatory demyelinating polyneuropathy (CIDP) patients may present acutely. We performed a retrospective chart review on 30 acute inflammatory demyelinating polyneuropathy (AIDP) and 15 acute-onset CIDP (A-CIDP) patients looking for any clinical or electrophysiological parameters that might differentiate AIDP from acutely presenting CIDP. A-CIDP patients were significantly more likely to have prominent sensory signs. They were significantly less likely to have autonomic nervous system involvement, facial weakness, a preceding infectious illness, or need for mechanical ventilation. With regard to electrophysiological features, neither sural-sparing pattern, sensory ratio >1, nor the presence of A-waves was different between the two groups. This study suggests that patients presenting acutely with a demyelinating polyneuropathy and the aforementioned clinical features should be closely monitored as they may be more likely to have CIDP at follow-up. Muscle Nerve, 2010 [source]


    Sensitivity of electrophysiological tests for upper and lower motor neuron dysfunction in ALS: A six-month longitudinal study

    MUSCLE AND NERVE, Issue 2 2010
    Mamede de Carvalho MD
    Abstract By following a group of amyotrophic lateral sclerosis (ALS) patients longitudinally using lower motor neuron (LMN) and upper motor neuron (UMN) markers of dysfunction it may be possible to better understand the functional relationships between these motor systems in this disease. We used neurophysiological techniques to follow UMN and LMN dysfunction in a group of 28 patients with ALS, in comparison with the ALS functional rating scale (ALS-FRS) score and the forced vital capacity (FVC). We used motor unit number estimation (MUNE), compound muscle action potential (CMAP) amplitude, and the Neurophysiological Index (NI) to quantify the LMN disorder, and transcranial motor stimulation to study cortical motor threshold, motor-evoked response amplitude, central motor conduction time, and cortical silent period (CSP). The patients were studied shortly after diagnosis and then 6 months later, using both abductor digiti minimi muscles (ADM); ADM strength was initially >MRC 3 (Medical Research Council, UK). The NI and MUNE changed more than any other variable. CSP increased by about 30%, a change more marked than the slight increase observed in the cortical motor threshold (9%). The normal increase of CSP after acute muscle fatigue was preserved during disease progression. The CSP increase correlated with the MUNE rate of decay but not to the NI reduction, perhaps because NI includes F-wave frequency in itscalculation. There was no definite correlation between UMN and LMNdysfunction or progression, but there was a link between CSP and LMN changes in ALS. The CSP may be a useful variable in following UMN dysfunction in clinical practice and in clinical trials. Muscle Nerve, 2010 [source]


    Sensory ataxic neuropathy dysarthria and ophthalmoparesis (SANDO) in a sibling pair with a homozygous p.A467T POLG mutation

    MUSCLE AND NERVE, Issue 2 2010
    John C. McHugh MRCPI
    Abstract Two siblings who developed fifth-decade-onset, concurrent progressive sensory ataxia, dysarthria, and ophthalmoparesis were found to be homozygous for the p.A467T mutation of the polymerase gamma (POLG) gene. The clinical course in both subjects was progression to severe disability. The enlarging spectrum of sensory ataxic neuropathies associated with mitochondrial DNA (mtDNA) instability and POLG mutations should be recognized and considered in the differential diagnosis of this unusual presentation. Muscle Nerve, 2010 [source]