Estimation of premotor synaptic drives to simulated abducens motoneurons for control of eye position

The firing rate of an abducens motoneuron (AbMN) is linearly related to eye position with slope K, above recruitment threshold theta. Within the AbMN population K increases as theta increases. It is possible that these properties depend on the synaptic drives generated by the major premotor inputs to AbMNs, namely position-vestibular-pause (PVP) cells and eye and head velocity (EHV) cells in the medial vestibular nucleus, and eye-position and burst-position cells in the nucleus prepositus hypoglossi (NPH). Premotor inputs to AbMNs were therefore modelled by a two-layer net, in which the output nodes represented the AbMNs (with fixed intrinsic properties) and the input nodes the three classes of premotor units ( n=20/class). Conjugate eye-position commands were used to generate the firing rates in premotor units found experimentally. The output of the net was compared with observed AbMN firing rates, and the resultant error used to adjust the magnitude and sign of the connection weights between premotor units and AbMNs. To provide additional constraints on permitted weights, the net was also trained under simulated smooth pursuit, cancellation of the vestibular-ocular reflex, and the vestibulo-ocular reflex itself (all at 0.5 Hz). Since the projections of EHV cells have not been clearly characterized, two versions of the model were trained, corresponding to different assumptions about these projections. In both versions, position-related AbMN firing rates were derived mainly from an excitatory drive from PVP cells and an inhibitory drive from NPH cells with the opposite ON direction. Variation in AbMN threshold theta and position sensitivity K depended on the strength of the drive from the NPH: the stronger the drive, the higher both K and theta. This arrangement was observed in six variants of the basic model with different parameter values, and in a simplified form (constant PVP drive and varying NPH drive) was able to generate qualitatively the observed relationship between K and theta even in the absence of input from EHV cells. It appears to be a robust mechanism for producing the experimentally observed variation in position-related firing of AbMNs, even without a contribution from their intrinsic properties, and predicts that local blocking of the inhibitory drive from cells in the NPH should lower both the position threshold and sensitivity of an individual AbMN. The model also indicates that if EHV cells have ipsilateral inhibitory projections, as has been proposed on the basis of their similarity with cells receiving input from the flocculus, then their role in eye-position control would reinforce that of cells in the NPH.

Site-specific molecular design and its relevance to pharmacogenomics and chemical biology

The emergence of the new discipline of pharmacogenomics reflects the growing convergence of chemical and genomic space. The massive information-driven growth in both computational chemistry and structural biology is leading to unprecedented opportunities in both chemical and biological design. In this paper we relate current opinion in structural biology to recent developments in computational drug design. Sequence information now permits protein structure prediction and, together with experimental protein structure determination, a complete database of ligand-binding sites and protein-protein interactions can be assembled. When aligned with site exploration and virtual screening, this information provides a foundation for structure-based pharmacogenomics. In association with chemical genomics, structure-based design will allow major new insights into a compound's biological and pharmaceutical properties.

Developmental dyslexia: the cerebellar deficit hypothesis

Surprisingly, the problems faced by many dyslexic children are by no means confined to reading and spelling. There appears to be a general impairment in the ability to perform skills automatically, an ability thought to be dependent upon the cerebellum. Specific behavioural and neuroimaging tests reviewed here indicate that dyslexia is indeed associated with cerebellar impairment in about 80% of cases. We propose that disorders of cerebellar development can in fact cause the impairments in reading and writing characteristic of dyslexia, a view consistent with the recently appreciated role of the cerebellum in language-related skills. This proposal has implications for early remedial treatment.

Audit in general practice: how much and how complete? Frequency of audit in general practice

The aim of this study was to determine the frequency of audit and the proportion completed in a group of practices. Data obtained by interviewing a member of each practice and inspecting practice records were independently coded by researchers. Practices initiated an average of 3.5 (range 1-7) audits in 2 years, of which an average of 0.9 (range 0-3) were completed. Ten of 16 completed audits were externally funded or facilitated. Few audits are completed in general practice and practices require continuing support for audit.

A simple control law generates Listing's positions in a detailed model of the extraocular muscle system

The neural commands for maintaining static Listing's positions were identified using a detailed model of extraocular muscle based on Miller and Shamaeva (Orbit 1.5 gaze mechanics simulation 1995). The commands were approximately separable, suggesting a simple control law whereby independent horizontal and vertical commands are combined to generate tertiary positions. Tests showed that this control law (i) generated Listing' s positions to reasonable accuracy over+/-30 deg, provided pulleys were represented in the model; (ii) if driven by retinal coordinates, produced errors close to the theoretical minimum for a commutative system. The proposed commands appear consistent with electrophysiological evidence.

Building relationships between academia and the pharmaceutical industry

'The climate is perfect for a proactive search for partners between industry and academia.'

Acid phosphatases in the haemolymph of the desert locust, Schistocerca gregaria, infected with the entomopathogenic fungus Metarhizium anisopliae

A comparison has been made between the effects of wounding, chemical stimulation of the immune system and fungal infection on acid phosphatase (AcP) activity in the haemolymph of the desert locust, Schistocerca gregaria. Untreated control locusts had constitutive levels of AcP. As a lysosomal enzyme, AcP may have a role in autophagy and cell turn over as well as defence. Injection of saline and beta-1,3-glucan caused significant increases in haemocyte and plasma AcP. AcP activity also increased in the haemolymph on the 3rd day after inoculation with the entomopathogenic fungus M. anisopliae var acridum. This coincided with a decline in the total haemocyte count and a marked reduction in the proportion of plasmatocytes and coagulocytes that stained positive for AcP. Therefore a priori it seemed unlikely that the extra AcP in infected insects came from the host. A fungal origin for the enzyme was suggested by the identification of AcP isoforms from haemolymph of different treatments. Control inoculated (oil only) insects had an AcP at a pI of 4.3 that was stimulated further by the injection of laminarin. Additional isoforms appeared at around 7.3-7.5 in the laminarin treatment. However, the 4.3 isoform appeared to be suppressed in the insects infected with M. anisopliae var acridum. The band intensity was more like that of the control than the laminarin-injected insects. Two new isoforms appeared later on in infection. These enzymes had pIs that corresponded to some of the AcPs produced in vitro by the fungus. The results are discussed in the light of the possible benefits of secreted fungal acid phosphatases to the pathogen.

Epilepsy surgery in children with tuberous sclerosis complex: presurgical evaluation and outcome

PURPOSE

Children with tuberous sclerosis complex (TSC) benefit from excisional surgery if seizures can be localized to a single tuber. We evaluated the role of noninvasive studies to localize the epileptogenic tuber/region (ET/R) and the outcome of focal resection.

METHODS

We identified 21 children with TSC, ages 3 months to 15 years (mean 4.8 years). All had video-(electroencephalogram) EEG and magnetic resonance imaging (MRI) scans, and 18 also had ictal single photon emission-computed tomography (SPECT) studies. An ET/R was localized in 17 patients. Thirteen patients underwent resection guided by intraoperative electrocorticography (n = 7) or subdural monitoring (n = 6).

RESULTS

Interictal EEG revealed a principal spike focus (PSF) that corresponded to the ET/R in 14 children. In seven, PSFs occurred in rhythmic runs. PSFs were not observed remote from the ET/R. Focal polymorphic slowing and attenuation occurred in the region of the PSF in 11 patients. Sixteen patients demonstrated an ictal focus corresponding to the ET/R. Ictal SPECT revealed focal hyperperfusion correlating with the ET/R in 10 patients. Although the MRIs in all children revealed multiple tubers, the ET/R corresponded to a large discrete tuber in 8 patients and a calcified tuber in 13 patients. Patchy calcified tubers were also seen elsewhere in six patients. At a mean follow-up of 26 months, 9 of the 13 children who underwent surgery were seizure-free, one had greater than 75% reduction in seizures, two were unchanged, and one was lost to follow-up. New seizures developed in one child from a contralateral tuber.

CONCLUSIONS

Surgical resection of an ET/R alleviates seizures in most children with TSC and intractable epilepsy. The scalp EEG and MRI help define the ET/R and improve case selection when ictal SPECT is nonlocalizing.

Predictors of outcome in pediatric epilepsy surgery

OBJECTIVE

To determine the correlation between pre- and perioperative variables on the outcome of children undergoing focal resections for medically intractable partial epilepsy.

METHODS

Retrospective analysis of pre- and perioperative variables in a cohort of 75 patients younger than 12 years of age who underwent excisional surgery and had at least 1 year of follow-up. Outcome, measured by postoperative seizure frequency, was analyzed as a function of age at seizure onset, duration of epilepsy, presence of cognitive impairment, lobe of seizure origin, presence of a lesion, histopathology, and completeness of resection. Completeness of resection was defined on the basis of excising both the entire structural lesion if present and the region revealing prominent interictal and ictal abnormalities on intracranial EEG.

RESULTS

Seventy-seven percent of patients had good outcomes (class 1 or 2), and 59% were seizure-free. Lesional status, site of resection, and pathologic diagnoses were not significant predictors of outcome except for in multilobar resection, for which overall outcome was relatively poor (44% class 3 or 4; 22% seizure-free). Completeness of resection was the only significant predictor of good outcome (p < 0.001), with 92% of patients who underwent complete resection of the epileptogenic zone achieving good outcome compared with 50% of patients who had incomplete resections.

CONCLUSION

In this series of pediatric patients, complete resection of the lesion and the electrographically abnormal region was the main determinant of outcome after focal resections. Except for multilobar resections, other factors examined in this study did not significantly influence postoperative seizure prognosis and should not influence candidate selection for the surgical process.

[Epilepsy treatment by vagal stimulation]

INTRODUCTION

Vagal nerve stimulation is the latest therapeutic modality for the treatment of epilepsy. It consists of a lead implanted in the left vagal nerve which is connected to a subcutaneous stimulator implanted in the left axillary or pectorial region.

DEVELOPMENT

The stimulator is programmed to intermittently stimulate the vagal nerve throughout the day and a magnet also allows the patient to control the stimulation from the outside. This treatment has been used in patients with intractable partial seizures who are not candidates for epilepsy surgery. The results reported have varied but in general the procedure appears promising with at least 50% of the implanted having over 50% improvement in their seizure frequency and many having complete control without significant side effects.

CONCLUSION

Further review of the results are still needed to fully determine the true value of this treatment and to identify the subgroups of patients which will benefit the most.

Association of abnormal cerebellar activation with motor learning difficulties in dyslexic adults

BACKGROUND

In addition to their impairments in literacy-related skills, dyslexic children show characteristic difficulties in phonological skill, motor skill, and balance. There is behavioural and biochemical evidence that these difficulties may be attributable to mild cerebellar dysfunction. We wanted to find out whether there was abnormal brain activation when dyslexic adults undertook tasks known normally to involve cerebellar activation.

METHODS

Brain activation was monitored by positron emission tomography in matched groups of six dyslexic adults and six control adults as they carried out either a prelearned sequence or learned a novel sequence of finger movements.

FINDINGS

Brain activation was significantly lower (p<0.01) for the dyslexic adults than for the controls in the right cerebellar cortex and the left cingulate gyrus when executing the prelearned sequence, and in the right cerebellar cortex when learning the new sequence.

INTERPRETATION

The results provided direct evidence that, for this group of dyslexic adults, the behavioural signs of cerebellar abnormality reflect underlying abnormalities in cerebellar activation.

Bellini duct (collecting duct) carcinoma of the kidney

Carcinoma of the collecting ducts, or Bellini carcinoma, is a rare renal tumour and, unlike most renal cell carcinomas, it derives from distal tubules. It displays highly aggressive behaviour and has a poor prognosis. In this study, the authors present three cases which they observed over the past three years.