Neuropeptide Y-like immunoreactivity in the lumbosacral pia mater in normal cats and after sciatic neuroma formation

Re-utilization of Schwann cells during ingrowth of ventral root afferents in perinatal kittens

Ventral roots in all mammalian species, including humans, contain significant numbers of unmyelinated axons, many of them afferents transmitting nociceptive signals from receptive fields in skin, viscera, muscles and joints. Observations in cats indicate that these afferents do not enter the spinal cord via the ventral root, but rather turn distally and enter the dorsal root. Some unmyelinated axons are postganglionic autonomic efferents that innervate blood vessels of the root and the pia mater. In the feline L7 segment, a substantial proportion of unmyelinated axons are not detectable until late in perinatal development. The mechanisms inducing this late ingrowth, and the recruitment of Schwann cells (indispensable, at this stage, for axonal survival and sustenance), are unknown. We have counted axons and Schwann cells in both ends of the L7 ventral root in young kittens and made the following observations. (1) The total number of axons detectable in the root increased throughout the range of investigated ages. (2) The number of myelinated axons was similar in the root's proximal and distal ends. The increased number of unmyelinated axons with age is thus due to increased numbers of small unmyelinated axons. (3) The number of separated large probably promyelin axons was about the same in the proximal and distal ends of the root. (4) Schwann cells appeared to undergo redistribution, from myelinated to unmyelinated axons. (5) During redistribution of Schwann cells they first appear as aberrant Schwann cells and then become endoneurial X-cells temporarily free of axonal contact. We hypothesize that unmyelinated axons invade the ventral root from its distal end, that this ingrowth is particularly intense during the first postnatal month and that disengaged Schwann cells, eliminated from myelinated motoneuron axons, provide the ingrowing axons with structural and trophic support.

Survival, regeneration and functional recovery of motoneurons after delayed reimplantation of avulsed spinal root in adult rat

We have established that extensive reinnervation and functional recovery follow immediate reimplantation of avulsed ventral roots in adult rats. In the present study, we examined the consequences of reimplantation delayed for 2 weeks after avulsion of the C6 spinal root. Twelve and 20 weeks after delayed reimplantation, 57% and 53% of the motoneurons in the injured spinal segment survived. More than 80% of surviving motoneurons regenerated axons into the reimplanted spinal root. Cholinesterase-silver staining revealed axon terminals on endplates in the denervated muscles. The biceps muscles in reimplanted animals had atrophied less than those in animals with avulsion only, as indicated by muscle wet weight and histological appearance. After electrical stimulation of the motor cortex or the C6 spinal root, typical EMG signals were recorded in biceps of reimplanted animals. The latency of the muscle potential at 20 weeks was similar to that of sham-operated controls. Behavioral recovery was demonstrated by a grooming test and ipsilateral forepaw movements were well coordinated in both voluntary and automatic activities. These results demonstrate that ventral root reimplantation can protect severed motoneurons, enable the severed motoneurons to regenerate axons, and enhance the recovery of forelimb function even when it is delayed for 2 weeks after avulsion.

Management of infant brachial plexus injuries

Management of brachial plexus injuries is geared toward normalization of limb function, primarily through optimization of nerve regeneration and mechanical increase in elbow flexion and shoulder stabilization. Changes in the skeletal muscles and the osteous structures of the upper extremity are ongoing throughout the course of treatment, mandating continual assessment and aggressive rehabilitation. In patients who present too late for microsurgical intervention, irreversible changes take place in skeletal muscles, highlighting the importance of early referral. However, secondary procedures have been shown to be beneficial in older patients and in those whose primary procedures failed. Further advances in bionics and stem cell therapy may help replace the dynamic functional deficits of obstetric brachial plexus palsy.

Does the right side know what the left is doing?

Following peripheral-nerve lesions there are well-documented events that affect the contralateral nonlesioned structures. These contralateral effects are qualitatively similar to those occurring at the ipsilateral side, but are usually smaller in magnitude and have a briefer time course. It is unclear whether the findings are an epiphenomenon or serve a biological purpose, but in either case the existence of these effects implies the presence of unrecognized signalling mechanisms that link the two sides of the body. Strong circumstantial evidence argues against a peripheral mechanism (for example, via circulating factors) and in favour of a central mechanism, in particular signalling via the system of commissural interneurons that is present in spinal cord and brainstem. While an altered pattern of activity in this system might underlie the phenomenon, there are several reasons for proposing that the changes depend upon chemical signals, possibly growth factors. Because of its relative easy access for experimental manipulation, the spinal cord could serve as a model system to study these transmedian signalling systems.

Ganglionic axons in motor roots and pia mater

In addition to motor axons and preganglionic axons, ventral roots contain unmyelinated or thin myelinated sensory axons and postganglionic sympathetic axons. It has been said that ventral roots channel sensory axons to the CNS. However, it now seems that these axons end blindly, shift to the pia or loop and return towards the periphery and that these units reach the CNS via dorsal roots. Sensory ventral root axons project from a variety of somatic or visceral receptors; some of them are third branches of dorsal root afferents and some seem to lack a CNS projection. Many ventral root afferents contain substance P (SP) and/or calcitonin gene-related peptide (CGRP). These fibres are not affected by neonatal capsaicin treatment and they cannot induce radicular or pial extravasation. Some thin ventral root axons are sympathetic and relate to blood vessels. Afferents containing SP and/or CGRP and sympathetic axons also occur in the spinal pia mater. The sensory axons mediate pain. They might also have vasomotor, tissue-regulatory and/or mechanoreceptive functions. The motor roots of cranial nerves IV, VI and XI contain unmyelinated axons arranged like in ventral roots outside the autonomic outflow. However, the motor root of cranial nerve V channels some unmyelinated axons into the CNS. The occurrence of thin axons in ventral roots and pia mater changes during development and ageing. After peripheral nerve injury, ipsilateral ventral roots and pia are invaded by new sensory and postganglionic sympathetic axons.

Nerve fibre regeneration across the peripheral-central transitional zone

Neurons cannot negotiate an elongation across the peripheral (PNS)-central nervous system (CNS) transitional zone and grow into or out of the spinal cord in the mature mammal. The astrocytic rich CNS part of the spinal nerve root is most effective in preventing regeneration even of nerve fibres from transplanted embryonic ganglion cells. Regeneration of severed nerve fibres into the spinal cord occurs when the transition zone is absent as in the immature animal. Before the establishment of a transition zone there is also new growth of neuronal processes from dorsal horn neurons distally to the injured dorsal root. Thus the experimental strategy to reestablish spinal cord to peripheral nerve connectivity has been to delete the transitional region and implant severed ventral or dorsal roots into the spinal cord. Dorsal root implantation resulted in reestablished afferent connectivity by new neuronal processes from secondary sensory neurons in the dorsal horn of the spinal cord extending into the PNS. The ability for plasticity in these cells allowed for a concurrent retention of their original rostral projection. Ventral root implantation into the spinal cord corrected deficit motor function. In a long series of experiments performed in different species, the functional restitution was demonstrated to depend on an initial regrowth of motor neuron axons through spinal cord tissue (CNS). These findings have led to the design of a new surgical strategy in cases of traumatic spinal nerve root injuries.

Postnatal development and aging of the rat ventral root L5: electron microscopic and immunohistochemical studies

The ventral root L5 of neonatal and adult rats has been used in many experimental studies on ganglionic C-fibers. Since the normal presence of such axons in L5 roots from animals of different ages is unknown, the results of these studies cannot be appropriately interpreted. In the present study we examine L5 ventral roots from developing and aging rats in this respect. Electron microscopic examination revealed that C-fibers occur in neonatal roots. The adult proportion has been established at day 30. Immunohistochemical analysis showed that thin ganglionic fibers with substance P/calcitonin gene-related peptide- or tyrosine hydroxylase-like immunoreactivity in the L5 root and the spinal pia mater seem to increase postnatally from low levels at birth. In roots from aged rats, myelinated fibers with a variety of aberrant features occur in normal numbers. The occurrence of unmyelinated axons is elevated. The increased presence of fibers with calcitonin gene-related peptide- or tyrosine hydroxylase-like immunoreactivity in aged roots indicates that the extra unmyelinated fibers may represent motor sprouts and sympathetic fibers, respectively. We conclude that the rat ventral root L5 contains a variable number of putative sensory and sympathetic axons at all ages.

Invasion of the rat ventral root L5 by putative sympathetic C-fibers after neonatal sciatic nerve crush

The present study examines the occurrence of C-fibers in lumbar ventral roots after sciatic nerve crush in neonatal and adult rats. Electron microscopic analysis showed that the number of C-fibers in the ventral root L5 increased significantly on the lesion side after neonatal but not adult sciatic nerve crush and that the number of C-fibers was higher in the ventral root L5 on the unoperated side compared to this root in normal control rats. In order to determine whether the new C-fibers in the L5 root on the lesion side are sensory or sympathetic we made immunohistochemical studies on roots from neonatally crushed rats. We found that there was no obvious lesion side/contralateral side or operated rat/control rat difference with respect to the occurrence and general configuration of axons with substance P-, calcitonin gene-related peptide- or vasoactive intestinal polypeptide-like immunoreactivity. However, the occurrence of axons with tyrosine hydroxylase-like immunoreactivity appeared clearly higher in the ventral root L5 on the lesion side compared to the unoperated side in neonatally crushed rats. Moreover, these axons seemed to be more numerous also in the ventral root L5 on the unoperated side compared to normal control rats. No lesion side/contralateral side or operated rat/control rat differences were seen in the ventral root L4. We propose that the ventral root L5 is invaded by putative sympathetic C-fibers after sciatic nerve crush lesions in newborn rats.

Aberrant regeneration of motor axons into the pia mater after ventral root neuroma formation

The spinal pia mater receives a rich innervation of small sensory and autonomic axons via the ventral roots. In the present study this pathway was interrupted by the transection of the L7 ventral root in young kittens. The animals were killed 12-18 months postoperatively. It was observed that the pia mater adjacent to the divided ventral root contained large numbers of myelinated axons. We suggest that these axons represent sprouts which had reached the pia mater by retrograde growth from the neuroma on the ventral root. Some of these aberrant pial axons ended blindly in the pia mater. Abnormal terminal-like swellings were observed along pial blood vessels. Fibers with diameters exceeding 11 microns were observed. Many fibers had an internodal spacing below 100 microns and the maximum value was only about 300 microns. Thus, motor axons which are forced to grow into a foreign territory show a maldevelopment which is more obvious with regard to nodal spacing than to fiber diameter.

Fibre composition of the ventral roots L7 and S1 in the owl monkey (Aotus trivirgatus)

The ventral roots L7 and S1 of the owl monkey Aotus trivirgatus, were examined by electron microscopy. On average, these roots contain 2950 and 1837 myelinated axons respectively. In both roots the myelinated axons have bimodal size distributions, but the S1 root contains more small myelinated axons. Both roots contain a substantial proportion of unmyelinated axon profiles (UAP). In the L7 root the proportion of UAP decreases as the spinal cord is approached, from 19% distally to 5% in the juxtamedullary rootlets. Unmyelinated and very small myelinated CNS-type axons have not been observed in the L7 transitional region. The average S1 root contains some 40% unmyelinated axons at all examined proximo-distal levels. Unmyelinated/very small myelinated axons are easily found on the CNS side of the S1 transitional region, in direct relation to motoraxon bundles. Bundles of unmyelinated and small myelinated axons occur in the ventral pia mater of both segments. The unmyelinated axons in the L7 root of the owl monkey appear to be arranged like those in the feline L7 ventral root, possibly representing afferents. It is likely that most unmyelinated and small myelinated axons in the ventral root S1 are autonomic efferents.

Distribution of neuropeptide Y in the spinal cords of cat, dog, rat, man and pig

Regional distribution of neuropeptide Y (NPY) in spinal cord, dorsal root ganglia (DRG) and peripheral nerves was quantitated in rat, cat, dog, pig, and man. Spinal cords were harvested post mortem and dissected into regions or individual segments. A further dissection into dorsal and ventral horns was carried out, and DRG were harvested in all species except rat. Tissues were extracted into boiling 0.1 M HCl, and NPY was measured by radioimmunoassay using a specific antibody and I125-labeled NPY. Highest concentrations of NPY were consistently found in the dorsal horn of the lumbo-sacral cord (200-800 ng/g). DRG concentrations, in contrast, were routinely low or undetectable. Sciatic nerve concentrations in rat and pig were considerable. High performance liquid chromatography (HPLC) confirmed that the NPY immunoreactivity measured in dorsal horns of each species coeluted with authentic NPY (1-36) as a single peak.

A quantitative study of the central projection patterns of unmyelinated ventral root afferents in the cat

1. The ventral roots of the spinal cord contain a large number of unmyelinated primary afferent neurones. There is some controversy, however, about the function of these fibres and the route of their central projection. Here we have used electrophysiological techniques to quantify the central projection patterns of these neurones in the segment S2 of adult chloralose-anaesthesized cats. 2. A total of 1185 single unmyelinated units were recorded in small filaments isolated from intact and de-efferented ventral roots or intact dorsal roots of the segment S2 in nineteen cats. The projection patterns of these neurones were tested using supramaximal electrical stimulation of the pelvic and pudendal nerve (the main tributaries of the spinal nerve of this segment) and of the segmental companion root (dorsal or ventral as appropriate). 3. The principal finding of this study is that 85% of unmyelinated afferent axons in the ventral root are direct and exclusive projections. They constitute a separate class of afferents which is only capable of transmitting information from the periphery via the ventral roots. However, the proportion of these fibres that enter the central nervous system is unknown and it seems likely that some of them peter out as they approach the spinal cord and end blindly. The functional role of such afferents remains obscure. 4. For the remaining 15% of unmyelinated ventral root afferents, a projection into the segmental dorsal root was found. The majority of those fibres (about two-thirds) are primary afferent neurones innervating the pia mater. Some of these units had a small spot-like receptive field and responded to mechanical stimuli such as pressure and stretch of the root. They did not have axon projections in a peripheral nerve. 5. A few (5%) unmyelinated ventral root fibres are collateral branches of normal primary afferents projecting through the dorsal root. These trifurcating neurones are a small population which make up only some 0.5% of all dorsal root ganglion cells. The functional significance of this population too is unknown. 6. For none of the fibres that projected into both dorsal and ventral root was there positive evidence for the existence of looping axons that merely make a detour into one of the roots. Although the existence of loops cannot completely be excluded, our evidence suggests that they can constitute at most 5% of the unmyelinated ventral root afferents.

Calcitonin gene-related peptide and chromogranin A: presence and intra-axonal transport in lumbar motor neurons in the rat, a comparison with synaptic vesicle antigens in immunohistochemical studies

The presence and intra-axonal transport of calcitonin gene-related peptide and chromogranin A were investigated in motor neurons belonging to the rat sciatic nerve. Their co-localization with markers of cholinergic organelles (SV2, p38, and synapsin I) was also investigated, using immunofluorescence techniques, including double labelling experiments. It was found that motor perikarya in the lumbar spinal cord contained calcitonin gene-related peptide-like immunoreactivity and chromogranin A-like immunoreactivity, and probably also caligulin-like immunoreactivity, located in the Nissl substance of the cytoplasm. Also, some SV2 (detected by the monoclonal antibody 10H) was present in some motor neuron perikarya, but most often these were devoid of SV2 and p38, as well as of synapsin I-like immunoreactivity. These three antigens were, on the other hand, concentrated in nerve terminals in the entire gray substance of the spinal cord. In the ventral root, after crushing, calcitonin gene-related peptide, chromogranin A, synapsin I, SV2, p38 and caligulin-like immunoreactivity accumulated in thick and medium-sized axons proximal to the crush, while only antisera against SV2 and p38 labelled accumulated material distal to the crush. In the sciatic nerve, the same essential picture was observed as in the ventral root, but here two other nervous components were also present in the normal sciatic nerve, i.e. peripheral branches of the sensory system and axons of the sympathetic system. By various denervation procedures, it was demonstrated that most calcitonin gene-related peptide-like immunoreactivity and almost all chromogranin A-like immunoreactivity, accumulating in thick axons proximally, emanated from the ventral root. Thin and medium-sized axons originated from the sensory and sympathetic systems and contributed to accumulations both proximally and distally to the crush. Synapsin I-like immunoreactive material accumulated only proximal to the crush, while SV2 and p38-like material accumulated bidirectionally in axons of all sizes. In motor endplates of the rat diaphragm and gastrocnemic muscle, no calcitonin gene-related peptide-like material was observed. However, some chromogranin A-like immunoreactivity was present, in addition to large amounts of synapsin I-like, p38-like and SV2-like material, which had a finely granular appearance and was concentrated near the presynaptic membrane of the nerve terminal endfeet, where synaptic vesicles are known to be located.

High levels of NPY in rabbit cerebrospinal fluid and immunohistochemical analysis of possible sources

We have analyzed rabbit cerebrospinal fluid for neuropeptide Y (NPY)-like immunoreactivity, using high performance liquid chromatography (HPLC) and radioimmunoassay (RIA) and examined the anatomical relationship of NPY-containing fibers to the cerebral vasculature and the third cerebral ventricle. Cerebrospinal fluid (CSF) obtained from the cisterna magna of rabbits was injected into a C18 column and subjected to HPLC. The fractions were collected, dried and reconstituted in buffer for NPY radioimmunoassay. A single peak of NPY immunoreactivity was obtained which corresponded in retention time to synthetic porcine NPY. Analysis of CSF samples produced displacement curves parallel to the standard curve. Immunohistochemistry revealed numerous NPY-labeled fibers which penetrated the ependymal lining of the third cerebral ventricle and directly bordered the ventricular lumen. Other fibers were observed in the pia which lines the ventral aspect of the hypothalamus. The basilar artery, its branches and other cerebral vessels were surrounded by NPY-labeled fibers. The results show that: (1) approximately 1 ng/ml of NPY immunoreactivity which corresponds chromatographically to synthetic porcine NPY is present in rabbit CSF; (2) NPY-containing fibers surround the basilar artery and other cerebral vessels; (3) NPY may be released into the CSF from axons in the pia and from axons which penetrate the ependymal lining of the third ventricle. These observations form the basis for our analysis of the vasoconstrictor effects of NPY and its role in cerebrovasospasm after experimental subarachnoid hemorrhage.

Many ventral root afferent fibers in the cat are third branches of dorsal root ganglion cells

The arrangement of the ventral root afferent fibers was investigated in anesthetized and paralyzed cats. Single unit activity was recorded from a fascicle of the distal stump of the cut S1 dorsal root. Activity was elicited by stimulating the distal stump of the cut S1 ventral root. Attempts were then made to collide this activity with that elicited by stimulation of the S1 spinal nerve. Single unit activity elicited by ventral root stimulation was recorded from a total of 33 axons. In 17 of these, the activity collided with that elicited by peripheral stimulation. These results indicate that more than half the sampled population of ventral root afferent fibers are branches of dorsal root ganglion cells that have at least 3 processes: one in the dorsal root, one in the ventral root and one in a peripheral nerve. In 10 of these units, the conduction velocity of each of 3 processes was determined using the collision technique. The conduction velocities differed in the processes of a given ganglion cell, with conduction in the ventral root process generally being the slowest. The change in conduction velocity along the length of the ventral root was examined by comparing latency differences for the unit activity elicited by ventral root stimulation at different sites in the same root separated by known distances. The conduction velocity was found not to be uniform along the course of the ventral root. In many cases, the conduction velocity slowed down as the fiber approached the spinal cord. We conclude from the present study that many ventral root afferent fibers are the third branches of dorsal root ganglion cells that also have processes in the dorsal root and in a peripheral nerve. The sizes of each of these 3 processes of the dorsal root ganglion cell may differ; the ventral root process tends to be the smallest and is usually unmyelinated. Furthermore, many of the ventral root afferent fibers may taper as they approach the spinal cord.