Topographic organization in the cerebellar nuclei and inferior olive in relation to cerebellar hemispheric lobules in the mouse: Distinction between crus I and neighboring lobules

The parallel closed-loop topographic connections between subareas of the inferior olive (IO), cerebellar cortex, and cerebellar nuclei (CN) define the fundamental modular organization of the cerebellum. The cortical modules or zones are organized into longitudinal zebrin stripes which are extended across transverse cerebellar lobules. However, how cerebellar lobules, which are related to the cerebellar functional localization, are incorporated into the olivo-cortico-nuclear topographic organization has not been fully clarified. In the present study, we analyzed the lobular topography in the CN and IO by making 57 small bidirectional tracer injections in the lateral zebrin-positive stripes equivalent with C2, D1, and D2 zones in every hemispheric lobule in zebrin stripe-visualized mice. C2, D1, and D2 zones were connected to the lateral part of the posterior interpositus nucleus (lPIN), and caudal and rostral parts of the lateral nucleus (cLN, rLN), respectively, and from the rostral part of the medial accessory olive (rMAO), and ventral and dorsal lamellas of the PO (vPO, dPO), respectively, as reported. Within these areas, crus I was specifically connected to the ventral parts of the lPIN, cLN, and rLN, and from the rostrolateral part of the rMAO and the lateral parts of the vPO and dPO. The results indicated that the cerebellar modules have lobule-related subdivisions and that crus I is topographically distinct from other lobules. We speculate that crus I and crus I-connected subdivisions in the CN and IO are involved more in nonmotor functions than other neighboring areas in the mouse.

Medial Olivocochlear Reflex Strength in Ears With Low-to-Moderate Annual Noise Exposure

PURPOSE

Studies in lower mammals demonstrate enhancement of the medial olivocochlear reflex (MOCR) following noise exposure. A similar effect may occur in humans, and there is some evidence of an individual's acoustic history affecting the MOCR. The current work evaluates the relationship between an individual's annual noise exposure history and their MOCR strength. Given the potential role of the MOCR as a biological hearing protector, it is important to identify factors associated with MOCR strength.

METHOD

Data were collected from 98 normal-hearing young adults. Annual noise exposure history was estimated using the Noise Exposure Questionnaire. MOCR strength was assayed using click-evoked otoacoustic emissions (CEOAEs) measured with and without noise presented to the contralateral ear. MOCR metrics included the MOCR-induced otoacoustic emission (OAE) magnitude shift and phase shift. A CEOAE signal-to-noise ratio (SNR) of at least 12 dB was required for estimation of the MOCR metrics. Linear regression was applied to evaluate the relationship between MOCR metrics and annual noise exposure.

RESULTS

Annual noise exposure was not a statistically significant predictor of the MOCR-induced CEOAE magnitude shift. However, annual noise exposure was a statistically significant predictor of the MOCR-induced CEOAE phase shift-the MOCR-induced phase shift decreased with increasing noise exposure. Additionally, annual noise exposure was a statistically significant predictor of OAE level.

CONCLUSIONS

Findings contrast with recent work that suggests MOCR strength increases with annual noise exposure. Compared with previous work, data for this study were collected using more stringent SNR criteria, which is expected to increase the precision of the MOCR metrics. Additionally, data were collected for a larger subject population with a wider range of noise exposures. Whether findings generalize to other exposure durations and levels is unknown and requires future study.

[A case of the palatal tremor that disappeared during swallowing, thought to be caused by microbleeds of bilateral dentate nucleus]

A 72-year-old female presented with slowly progressive dysphonia, which was a syllable-separated utterance, for three years. She had the rhythmic continues contraction of palatal and uvula muscles during speech with a frequency of about 2 Hz. The videoendoscopy showed that the rhythmic contraction, which synchronized in the nasopharynx and the larynx, did not disappear during vocalization. The swallowing videofluorography showed that the rhythmic contraction disappeared transiently during the swallowing reflex, and there was no aspiration. The MRI revealed olivary pseudohypertrophy and multiple microbleedings including the bilateral dentate nucleus. The degeneration of olivary nucleus secondary to the bilateral asymptomatic dentate nucleus microbleedings within the dentato-rubro-olivary pathway was thought to be a cause of palatal tremor. This is a first report that a dynamic relation between vocalization and swallowing in palatal tremor.

Olivocochlear projections contribute to superior intensity coding in cochlear nucleus small cells

Understanding communication signals, especially in noisy environments, is crucial to social interactions. Yet, as we age, acoustic signals can be disrupted by cochlear damage and the subsequent auditory nerve fibre degeneration. The most vulnerable medium- and high-threshold-auditory nerve fibres innervate various cell types in the cochlear nucleus, among which the small cells are unique in receiving this input exclusively. Furthermore, small cells project to medial olivocochlear (MOC) neurons, which in turn send branched collaterals back into the small cell cap. Here, we use single-unit recordings to characterise small cell firing characteristics and demonstrate superior intensity coding in this cell class. We show converse effects when activating/blocking the MOC system, demonstrating that small-cell unique coding properties are facilitated by direct cholinergic input from the MOC system. Small cells also maintain tone-level coding in the presence of background noise. Finally, small cells precisely code low-frequency modulation more accurately than other ventral cochlear nucleus cell types, demonstrating accurate envelope coding that may be important for vocalisation processing. These results highlight the small cell olivocochlear circuit as a key player in signal processing in noisy environments, which may be selectively degraded in ageing or after noise insult. KEY POINTS: Cochlear nucleus small cells receive input from low/medium spontaneous rate auditory nerve fibres and medial olivocochlear neurons. Electrical stimulation of medial olivocochlear neurons in the ventral nucleus of the trapezoid body and blocking cholinergic input to small cells using atropine demonstrates an excitatory cholinergic input to small cells, which increases responses to suprathreshold sound. Unique inputs to small cells produce superior sound intensity coding. This coding of intensity is preserved in the presence of background noise, an effect exclusive to this cell type in the cochlear nucleus. These results suggest that small cells serve an essential function in the ascending auditory system, which may be relevant to disorders such as hidden hearing loss.

The effect of broadband elicitor laterality on psychoacoustic gain reduction across signal frequency

There are psychoacoustic methods thought to measure gain reduction, which may be from the medial olivocochlear reflex (MOCR), a bilateral feedback loop that adjusts cochlear gain. Although studies have used ipsilateral and contralateral elicitors and have examined strength at different signal frequencies, these factors have not been examined within a single study. Therefore, basic questions about gain reduction, such as the relative strength of ipsilateral vs contralateral elicitation and the relative strength across signal frequency, are not known. In the current study, gain reduction from ipsilateral, contralateral, and bilateral elicitors was measured at 1-, 2-, and 4-kHz signal frequencies using forward masking paradigms at a range of elicitor levels in a repeated measures design. Ipsilateral and bilateral strengths were similar and significantly larger than contralateral strength across signal frequencies. Growth of gain reduction with precursor level tended to differ with signal frequency, although not significantly. Data from previous studies are considered in light of the results of this study. Behavioral results are also considered relative to anatomical and physiological data on the MOCR. These results indicate that, in humans, cochlear gain reduction is broad across frequencies and is robust for ipsilateral and bilateral elicitation but small for contralateral elicitation.

Dopamine in Auditory Nuclei and Lemniscal Projections is Poised to Influence Acoustic Integration in the Inferior Colliculus

Dopamine (DA) modulates the activity of nuclei within the ascending and descending auditory pathway. Previous studies have identified neurons and fibers in the inferior colliculus (IC) which are positively labeled for tyrosine hydroxylase (TH), a key enzyme in the synthesis of dopamine. However, the origins of the tyrosine hydroxylase positive projections to the inferior colliculus have not been fully explored. The lateral lemniscus (LL) provides a robust inhibitory projection to the inferior colliculus and plays a role in the temporal processing of sound. In the present study, immunoreactivity for tyrosine hydroxylase was examined in animals with and without 6-hydroxydopamine (6-OHDA) lesions. Lesioning, with 6-OHDA placed in the inferior colliculus, led to a significant reduction in tyrosine hydroxylase immuno-positive labeling in the lateral lemniscus and inferior colliculus. Immunolabeling for dopamine beta-hydroxylase (DBH) and phenylethanolamine N-methyltransferase (PNMT), enzymes responsible for the synthesis of norepinephrine (NE) and epinephrine (E), respectively, were evaluated. Very little immunoreactivity for DBH and no immunoreactivity for PNMT was found within the cell bodies of the dorsal, intermediate, or ventral nucleus of the lateral lemniscus. The results indicate that catecholaminergic neurons of the lateral lemniscus are likely dopaminergic and not noradrenergic or adrenergic. Next, high-pressure liquid chromatography (HPLC) analysis was used to confirm that dopamine is present in the inferior colliculus and nuclei that send projections to the inferior colliculus, including the cochlear nucleus (CN), superior olivary complex (SOC), lateral lemniscus, and auditory cortex (AC). Finally, fluorogold, a retrograde tracer, was injected into the inferior colliculus of adult rats. Each subdivision of the lateral lemniscus contained fluorogold within the somata, with the dorsal nucleus of the lateral lemniscus showing the most robust projections to the inferior colliculus. Fluorogold-tyrosine hydroxylase colocalization within the lateral lemniscus was assessed. The dorsal and intermediate nuclei neurons exhibiting similar degrees of colocalization, while neurons of the ventral nucleus had significantly fewer colocalized fluorogold-tyrosine hydroxylase labeled neurons. These results suggest that several auditory nuclei that project to the inferior colliculus contain dopamine, dopaminergic neurons in the lateral lemniscus project to the inferior colliculus and that dopaminergic neurotransmission is poised to play a pivotal role in the function of the inferior colliculus.

Classification by morphology of multipolar neurons of the human principal olivary nucleus

The principal olivary nucleus is the largest part of the inferior olivary complex and is involved in the spatial and temporal organization of movement and motor learning. Nearly all neurons in this nucleus is multipolar along with having a highly complex dendritic tree and significant asymmetry in shape. In this study, we updated the current classification scheme, examined morphological differences between the proposed groups, and investigated age-related morphological changes. Histological preparations were digitized by a light microscope and a sample of 259 images of neurons was analyzed by 17 computationally generated parameters of morphology. These were reduced to the four variables of principal component analysis and the sample was classified by k-means method of clustering into three clusters. The differences between clusters were documented and for medium-sized neurons the relationship between four morphological parameters and age were investigated. Finally, for two of the age groups the changes in the morphology were explored. This study includes a detailed and robust classification of the PON neurons and the findings improve upon past qualitative work.

Efferent-induced shifts in synchronized-spontaneous-otoacoustic-emission magnitude and frequency

Synchronized-spontaneous otoacoustic emissions (SSOAEs) present as slow-decaying emission energy that persists after the transient-evoked otoacoustic emission (TEOAE). SSOAEs possess high amplitudes and signal-to-noise ratios, making them potentially ideal candidates to assay the medial-olivocochlear reflex (MOCR). The current work quantified MOCR-induced changes to SSOAEs over a 36-dB stimulus level range and compared MOCR effects between TEOAE- and SSOAE-based assays. Otoacoustic emissions were evoked using band limited clicks from 52 to 88 dB peak sound pressure level (pSPL) with and without contralateral-acoustic stimulation (CAS) in 25 normal-hearing, female adults. The CAS was 50-dB sound pressure level (SPL) broadband noise and served to activate the MOCR. The number of SSOAEs increased with the stimulus level through approximately 70 dB pSPL. The presentation of CAS resulted in fewer SSOAEs. SSOAEs exhibited compressive growth and approached saturation for stimulus levels of 70 dB pSPL. The primary effects of CAS were a reduction in the SSOAE magnitude and an upward shift in the SSOAE frequency. These changes were not strongly affected by the stimulus level. Time-domain analysis of the SSOAE revealed an increase in the CAS-induced magnitude shift during the decay portion of the SSOAE. Compared to CAS-induced TEOAE magnitude shifts, SSOAE magnitude shifts were typically 2-3 dB larger. Findings support SSOAEs as a means to assay the MOCR.

Medial olivocochlear reflex effects on synchronized spontaneous otoacoustic emissions

This study characterized medial olivocochlear (MOC) reflex activity on synchronized spontaneous otoacoustic emissions (SSOAEs) as compared to transient-evoked otoacoustic emissions (TEOAEs) in normal-hearing adults. Using two time windows, changes in TEOAE and SSOAE magnitude and phase due to a MOC reflex elicitor were quantified from 1 to 4 kHz. In lower frequency bands, changes in TEOAE and SSOAE magnitude were significantly correlated and were significantly larger for SSOAEs. Changes in TEOAE and SSOAE phase were not significantly different, nor were they significantly correlated. The larger effects on SSOAE magnitude may improve the sensitivity for detecting the MOC reflex.

Reconnecting neuronal networks in the auditory brainstem following unilateral deafening

When we disturbed the auditory input of the adult rat by cochleotomy or noise trauma on one side, several substantial anatomical, cellular, and molecular changes took place in the auditory brainstem. We found that: (1) cochleotomy or severe noise trauma both lead to a considerable increase of immunoreactivity of the growth-associated protein GAP-43 in the ventral cochlear nucleus (VCN) of the affected side; (2) the expression of GAP-43 in VCN is restricted to presynaptic endings and short fiber segments; (3) axon collaterals of the cholinergic medial olivocochlear (MOC) neurons are the path along which GAP-43 reaches VCN; (4) partial cochlear lesions induce the emergence of GAP-43 positive presynaptic endings only in regions tonotopically corresponding to the extent of the lesion; (5) judging from the presence of immature fibers and growth cones in VCN on the deafened side, at least part of the GAP-43 positive presynaptic endings appear to be newly formed neuronal contacts following axonal sprouting while others may be modified pre-existing contacts; and (6) GAP-43 positive synapses are formed only on specific postsynaptic profiles, i.e., glutamatergic, glycinergic and calretinin containing cell bodies, but not GABAergic cell bodies. We conclude that unilateral deafening, be it partial or total, induces complex patterns of reconnecting neurons in the adult auditory brainstem, and we evaluate the possibility that the deafness-induced chain of events is optimized to remedy the loss of a bilaterally balanced activity in the auditory brainstem.

Lateral cerebellum: functional localization within crus I and correspondence to cortical zones

The present study investigates the functional connections of different parts of the medial-most folium of crus I in the cat cerebellar hemisphere. Three areas were identified physiologically by recording on the cerebellar surface climbing fibre (CF) field potentials evoked by electrical stimulation of different body sites. From medial to lateral in relation to the long axis of the folium, area 1 receives convergent input from all body sites tested (optic chiasm, ipsilateral periorbital region, ipsilateral and contralateral forelimbs), area 2 receives input mainly from the ipsilateral periorbital region, while area 3 receives input mainly from the optic chiasm. These physiological differences were used to guide injections of bi-directional tracer material into individual cortical areas. The inferior olive and cerebellar nuclei were then mapped, revealing a precise topography within the olivo-cerebellar and cortico-nuclear projections for each area. On the basis of their anatomical and physiological characteristics areas 1, 2 and 3 correspond to zones C2, C3 and D1, respectively. CF inputs arise from the rostral medial accessory olive (C2), the interface between the rostral dorsal accessory olive and ventral lamella of the principal olive (vlPO, C3), and from vlPO (D1). The corresponding cortico-nuclear projections are nucleus interpositus posterior (C2), the transitional region between the dentate nucleus and nucleus interpositus anterior (C3), and the dentate nucleus (D1). Overall, the results provide a comprehensive description of the functional localization of different zones within crus I (folium 1), and suggest that a potent source of CF input to the C2 and D1 zones within this region of cortex arises from visual pathways.

Unilateral hearing losses alter loud sound-induced temporary threshold shifts and efferent effects in the normal-hearing ear

In animals with bilaterally normal hearing, olivocochlear pathways can protect the cochlea from the temporary shifts in hearing sensitivity (temporary threshold shifts; TTSs) caused by short-duration intense loud sounds. The crossed olivocochlear pathway provides protection during binaural loud sound, and uncrossed pathways protect when monaural or binaural loud sounds occur in noise backgrounds. Here I demonstrate that when there is a chronic unilateral hearing loss, effects of loud sounds, and efferent effects on loud sound, in the normal-hearing ear differ markedly from normal. Three categories of test animals with unilateral hearing loss were tested for effects at the normal-hearing ear. In all categories a monaural loud tone to the normal-hearing ear produced lower-than-normal TTSs, apparently because of a tonic re-setting of that ear's susceptibility to loud sound. Second, in the two test categories in which the hearing-loss ear was only partly damaged, binaural loud sound exacerbated TTSs in the normal-hearing ear because it caused threshold shifts that were a combination of "pure" TTSs and uncrossed efferent suppression of cochlear sensitivity. (In normal cats, this binaural tone results in crossed olivocochlear protection that reduces TTS.) Binaural loud sound did not produce such uncrossed efferent effects in the test category in which the nontest ear had suffered total hearing loss, suggesting that this uncrossed efferent effect required binaural input to the CNS. It is noteworthy that, in the absence of this uncrossed efferent suppression, the pure loud sound-alone induced TTSs after binaural exposure were low. Thus in the absence of any efferent effect, the normal-hearing cochlea had a reduced susceptibility to loud tone-induced damage. Finally, the results suggest that, with respect to cochlear actions at high sound levels, uncrossed and crossed efferent pathways may exert different effects at the one type of receptor cell.

X-linked female band heterotopia-male lissencephaly syndrome

We report a family with band heterotopia in a mother and daughter and lissencephaly in a son (X-linked inheritance pattern). Postmortem examination of the boy revealed classical lissencephaly and, among other findings, simplified and discontinuous inferior olives without inferior olivary heterotopia. The absence of inferior olivary heterotopia may distinguish X-linked lissencephaly from other conditions with classic lissencephaly such as Miller-Dieker syndrome.

Decreased expression of microtubule-associated protein 5 (MAP5) in the molecular layer of cerebellum in preterm infants with olivocerebellar lesions

The changes in microtubule-associated protein 5 (MAP5) expression in the cerebellum with olivocerebellar degeneration (OCD) were investigated by means of immunohistochemical method, compared with gestational age-matched controls. In controls of 24-33 postmenstrual weeks, the molecular layer was diffusely immunoreactive. However, in cases of olivocerebellar degeneration (25-35 postmenstrual weeks), MAP5 immunoreactivity was reduced in the inner half of the molecular layer, especially in a portion where Purkinje cells were absent. The ratio of the density in the outer half of the molecular layer to that in the inner half was also determined with an image analyzer, and increased significantly in Purkinje cell-negative areas. Because MAP5 was believed to be expressed mainly on growing axons in the early fetal period, the reduction of MAP5 immunoreactivity in OCD cases suggested that normal interaction of Purkinje cells and climbing fibers is vulnerable to ischemia and hypoxia in developing stage and that retrograde transynaptic degeneration of the inferior olivary nuclei is secondarily induced.

Midbrain tremor and hypertrophic olivary degeneration after pontine hemorrhage

A severe rest tremor arose in a patient's right arm 9 months after a pontine tegmental hemorrhage. Magnetic resonance studies at 4 and 10 months showed residual hemosiderin in the pons and increasing hypertrophic olivary degeneration (HOD) affecting primarily the left olive. The tremor was refractory to pharmacotherapy (clonazepam, propranolol, and levodopa), but was reduced after implantation of a thalamic stimulator device. Although pontine hemorrhage is among several common causes of HOD, it has not previously been appreciated as a cause of midbrain ("rubral") tremor. A disynaptic dentatorubroolivary tract associated with tremor and monosynaptic dentatoolivary tract associated with HOD may both be components of the rubroolivocerebellorubral loop implicated in midbrain tremor. Their proximity makes the combination of tremor and HOD after pontine tegmental damage plausible and even likely.

CLICK-EVOKED POTENTIAL MAP FROM THE SUPERIOR OLIVARY NUCLEUS

Potential distributions in the superior olivary nucleus were mapped in response to ipsilateral and contralateral click stimulation. From the medial segment of the superior olivary nucleus a dipole field was recorded which reversed polarity and slightly shifted the zero isopotential on contralateral stimulation. On the basis of the anatomic arrangement the potentials of the lateral segment of the superior olivary nucleus are discussed in terms of a closed field.

NUCLEUS OF THE TRAPEZOID BODY: DUAL AFFERENT INNERVATION

Lesions of the anterior ventral cochlear nucleus caused degeneration of synaptic endings in the anterior half of the nucleus of the trapezoid body. Lesions of the posterior ventral cochlear nucleus caused similar degeneration in the posterior half of the nucleus of the trapezoid body. Thus, the cochlea projects twice upon the nucleus of the trapezoid body.

Colchicine administered into the area of the nucleus basalis decreases cortical nicotinic cholinergic receptors labelled by [3H]-acetylcholine

Lesions in the nucleus basalis in the rat are known to decrease presynaptic markers for acetylcholine, including levels of cholineacetyltransferase (CHAT), high affinity uptake of choline and levels of acetylcholinesterase. Effects of lesions of the nucleus basalis on populations of nicotinic and muscarinic receptors are less well understood. After bilateral injection of the neurotoxic agent, colchicine into the nucleus basalis in the rat, levels of CHAT in the cerebral cortex were reduced 44%. Muscarinic cholinergic [( 3H]QNB) and dopaminergic [( 3H]spiroperidol) binding was not changed in the cortex, hippocampus or striatum. However, significant decreases in nicotinic binding sites, labelled by [( 3H]acetylcholine), were observed in the frontal cortex of nucleus basalis treated animals; scatchard plot analysis indicated a significant decrease in the number, but not affinity, of nicotinic binding sites. Colchicine injected into the nucleus basalis had no effect on the binding of [3H]acetylcholine in the hippocampus, but decreased binding of [3H]acetylcholine in the striatum. Subsequent experiments, in which colchicine was administered into the striatum at a site above the nucleus basalis had no significant effect on nicotinic binding in the striatum or frontal cortex. These results support the hypothesis that degeneration of the nucleus-basalis-cortical cholinergic pathway results in a loss of presynaptic nicotinic binding sites in the cortex as well as in the striatum (through transsynaptic degeneration of the cortico-striatal pathway).

A transcervical surgical approach to the ventral medulla of the cat

For the purpose of injection of anatomical tracers, it is desirable to have a surgical approach which provides the most direct approach to the target structure. This minimizes the amount of neural tissue that must be transgressed, and hence the leakage of tracer along the tract and the potential undesirable labelling that may result from this. In addition, visual guidance is preferable to stereotaxic guidance of injections where possible, particularly in situations where the target structure is far removed from the ear bar zero coordinate. Some of our work has necessitated small, discrete injections in the inferior olive sparing the adjacent reticular formation. The ventral transcervical approach to the medulla which was developed for this purpose is described below. It may conceivably be of use to physiologists wishing to record from ventral medullary structures. We feel it is a useful technique, but one which those with little surgical experience might not attempt. It is hoped that our description may guide others who could benefit by this approach.

Effects of aging and cholinergic deafferentation on putative muscarinic cholinergic receptor subtypes in rat cerebral cortex

Despite a 34% decrease in the activity of choline acetyltransferase (ChAT) in the rat cerebral cortex following lesions of the nucleus basalis, there were no changes in the Bmax of the antagonist ligands [3H]quinuclidinyl benzilate ((-)-[3H]QNB) or (-)-[3H]N-methylscopolamine ((-)-[3H]NMS). Furthermore, this treatment produced no significant change in the proportions or affinities of muscarinic receptors having high and low affinity for pirenzepine or (-)-NMS. These data indicate that putative M2 muscarinic receptors are not restricted to ChAT-containing neurons in rat cerebral cortex. In senescent compared to mature rats there was no significant loss of ChAT activity although a significant reduction in the Bmax of both (-)-[3H]QNB and (-)-[3H]NMS binding was observed. However, no changes in the competition of pirenzepine or (-)-NMS for the remaining (-)-[3H]QNB binding sites were observed. Therefore, there is no evidence for any differential regulation of either putative muscarinic receptor subtype in response to cholinergic deafferentation or as a function of the natural aging process.

Glutamate dehydrogenase and its isozyme activity in olivopontocerebellar atrophy

Evaluation of glutamate dehydrogenase (GDH) in 12 patients with olivopontocerebellar atrophy showed deficiency of the enzyme in the group as well as in each patient. The activity of total GDH was 77.7% of that in controls. We also demonstrated two components of this enzyme differentiated by their thermostabilities. The activity of the heat-labile component was remarkably reduced in patients although that of the heat-stable component showed the same magnitude as in controls. These data suggest that GDH deficiency is mainly caused by its heat-labile component deficiency, which might be related to the pathogenesis of this disease.

Idiopathic Parkinson's disease and the Lewy body disorders

A common clinical manifestation of idiopathic Lewy body disease is levodopa responsive idiopathic Parkinson's disease. Infrequently features such as dementia or autonomic failure predominate. The Lewy body is also reported; as an incidental finding in 7-10% of normal individuals mostly over the age of 60 as an incidental sporadic finding in Parkinson's syndrome from other causes, mostly over the age of sixty; in an additional group of degenerative disorders at a younger age, some with familial inheritance. The incidental finding of Lewy bodies can precede clinical Parkinson's disease. It is though they do not occur as an age-related feature, although this cannot be stated with certainty. Current evidence suggests that about 10% of the population may possess the pathological substratum for idiopathic Parkinson's disease.

Abnormal platelet glutamate dehydrogenase activity and activation in dominant and nondominant olivopontocerebellar atrophy

Glutamate dehydrogenase (GDH) activity and its allosteric modulation by purine nucleotides were studied in platelet preparations from 4 patients with a nondominant form of adult-onset olivopontocerebellar atrophy (OPCA) and in affected and nonaffected members of two families with a dominant form of OPCA. A partial deficiency of GDH activity (40 to 50% of control values) was present in 3 patients with nondominant OPCA and in 2 patients, father and son, with a dominant form of OPCA. Platelet GDH from these patients and controls was regularly inactivated by 2 mM guanosine-5'-triphosphate (GTP) and simulated one- to twofold by 2 mM adenosine-5'-diphosphate (ADP). In the presence of 0.2% Triton X-100, the activating effect of ADP was enhanced four- to sixfold. The partial deficiency in maximum catalytic activity observed in these patients persisted under all conditions used for enzyme assay. In affected members, but not in one unaffected member of another family with a dominant type of OPCA, GDH activity was in the control range but was not activated by ADP in either the presence or absence of Triton. These results suggest that there may be at least two possible alterations of GDH in patients with OPCA: one which decreases the maximum catalytic activity and one which impairs the regulatory properties of the enzyme. Furthermore, this study suggests that platelet GDH determination in patients with OPCA may provide a simple and useful tool to classify these disorders and to understand the basic pathophysiological mechanisms involved.

Myoadenylate deaminase deficiency in twins with recessive olivopontocerebellar atrophy

Two adult non-identical twins with autosomal recessive olivopontocerebellar degeneration (OPCA) had markedly deficient adenylate deaminase in skeletal muscle homogenates. Ischemic exercise failed to increase the blood ammonia, while lactate increased normally. Glutamate dehydrogenase and NADP-dependent malic enzyme activities in muscle mitochondria of both patients were normal. The significance of adenylate deaminase deficiency in these twins with OPCA is discussed.

Enzymatic analysis of individual posterior root ganglion cells in olivopontocerebellar atrophy, amyotrophic lateral sclerosis and Duchenne muscular dystrophy

Four enzyme activities related to glucose metabolism, i.e. those of glucose-6-phosphate dehydrogenase (G6PDH; EC 1.1.1.49), lactic dehydrogenase (LDH; EC 1.1.1.27), pyruvate dehydrogenase complex (PDC) and citrate synthase (CS; EC 4.1.3.7) were estimated in posterior root ganglion cells (PRGCs) of the spinal cord in patients suffering from olivopontocerebellar atrophy (OPCA), amyotrophic lateral sclerosis (ALS), and Duchenne muscular dystrophy (DMD) by means of the NAD, NADP and CoA cycling methods. In ALS and DMD, the enzyme activities examined were within normal ranges. In OPCA, PDC activity was significantly reduced and LDH activity tended to be lower than that in controls.

Enzymes of acetylcholine metabolism in the rat cochlea

The distributions within the rat cochlea of choline acetyltransferase and acetylcholinesterase activities were measured to evaluate the prominence of cholinergic mechanisms in cochlear function. Samples obtained by microdissection of freeze-dried bony labyrinths were assayed radiometrically. Activities of both enzymes were highest in regions containing olivocochlear fibers and terminals, especially the organ of Corti and spiral ganglion. Within the organ of Corti, activities of both enzymes were consistently higher in the vicinity of the inner hair cells than in that of the outer hair cells and were much lower in the apical turn than in middle or basal turns. Surgical cuts in the brain stem transecting the olivocochlear pathway on one side led within seven days to total loss of choline acetyltransferase activity in the ipsilateral organ of Corti. It is concluded that all cholinergic structures in the rat organ of Corti derive from the brain stem and that synapses on or near both inner and outer hair cells are cholinergic.

Treatment of parkinsonism with L-threo-3,4-dihydroxyphenylserine: a pharmacokinetic study

We have examined the kinetics of oral L-threo-3,4-dihydroxyphenylserine (DOPS) alone and combined with peripheral decarboxylase inhibitors in patients with Parkinson's disease and other degenerative diseases of the brain. Combined administration of L-threo-DOPS and carbidopa or benserazide produced higher plasma concentrations of L-threo-DOPS and suppressed the increase in plasma norepinephrine. This finding indicates some advantages of combined therapy with L-threo-DOPS and decarboxylase inhibitors. Measurable quantities of DL-threo-DOPS were found in the CSF during repeated administration, but there was no consistent change in norepinephrine concentration.

Regression of cerebellar syndrome with long-term administration of 5-HTP or the combination 5-HTP-benserazide

A quantitative evaluation of cerebellar ataxia, with an ataxia score (total, static, kinetic) and the measurement of objective values relating to the major symptoms, was used in 21 patients with hereditary ataxias treated for 12 months with high doses (16 mg/kg/day) of d-l-5-HTP, l-5-HTP or the combination d-l-5-HTP (16 mg/kg/day)--benserazide (6 mg/kg/day). The data obtained from regular examination were processed by computer. The ataxia showed a significant regression at the 12th month, mainly in the static forms and speed of speech. l-5-HTP appeared to be more effective than d-l-5-HTP. Regression of the cerebellar ataxia was also observed in non-degenerative conditions such as multiple sclerosis and surgical lesion of the anterior lobe vermis, showing that 5-HTP was active on the cerebellar syndrome in general. The regression of the cerebellar ataxia was very slow in inherited diseases and continued for 2 or 4 months after the treatment stopped. A serotoninergic cerebellar control of movement is discussed.

Obstructive sleep apnea in association with posterior fossa neurologic disease

Sleep apnea in association with neurologic disease is uncommon, and its documentation with nocturnal polysomnography (PSG) is rare. Two patients with posterior fossa neurologic disease had obstructive and central sleep apnea on PSG. The first was a 40-year-old woman who experienced a respiratory arrest ten days after neurosurgical decompression of a cervical syrinx associated with syringobulbia. Nocturnal PSG demonstrated obstructive sleep apnea. Tracheostomy was performed and a second nocturnal PSG showed no sleep apnea. The second patient was a 76-year-old woman with daytime hypersomnolence, nocturnal choking spells, progressive spastic paraparesis, and left-sided cerebellar tremor. Neurologic evaluation led to the diagnosis of olivopontocerebellar degeneration. Nocturnal PSG showed multiple episodes of central and obstructive apnea. These cases support the hypothesis that central and obstructive sleep apnea can originate from a central mechanism.

Hereditary striatonigral and cerebello-olivary degeneration of the Kerry Blue Terrier. II. Ultrastructural lesions in the caudate nucleus and cerebellar cortex

The character and progression of ultrastructural lesions in the caudate nucleus and cerebellar cortex were studied in four Kerry Blue Terriers afflicted with a hereditary neurodegenerative disease. In the caudate nucleus, the initial lesion was mitochondrial hypertrophy in dendrites of intrinsic neurons. Degeneration of these neurons became widespread while axons of passage and terminal boutons were spared. During the final stages, there was severe disruption of the neuropil with loss of both neurons and glia. A narrow zone bordering the lateral ventricles, however, remained unaffected. In the cerebellar cortex, the lesions involved principally Purkinje cells and progressed through a pattern of degeneration comparable to that involving intrinsic neurons of the caudate nucleus. In the later stages, there was astroglial scarring of the molecular layer. In contrast to the caudate nucleus, there was no disruption of the neuropil with loss of structure in the cerebellum. The fact that progression of lesions during the early stages of the disease in both the caudate nucleus and cerebellar cortex was similar suggested a common mechanism for the neurodegeneration .

Electromyography and nerve conduction study in autosomal dominant olivopontocerebellar atrophy

Electromyographic examination and studies of motor and sensory conduction velocities were performed in 11 patients with a presumptive diagnosis of olivopontocerebellar atrophy with autosomal dominant transmission. Peripheral nervous system involvement was shown in eight. In two patients with early onset of disease, electrophysiological alterations clearly pointed to severe axonal degeneration, whereas in six they were compatible with slight demyelination.

[Atrophic macular degeneration in a patient with olivopontocerebellar atrophy]

Description of a man with heredoataxia, presenting with an isolated primary atrophic maculopathy in which the participation of the posterior pole was disclosed by photopic and scotopic ERG irrespective of the localized appearance of this condition. Ophthalmoscopically, the patient's sister showed only fine pigment migrations at the macula, whereas local ERG revealed a macular lesion.

Central mediation of the conditioned taste aversion induced in rats by harmaline

The assumption that drugs used as unconditioned stimuli in conditioned taste aversion (CTA) studies act centrally was tested by comparing the effects of systemic and intracerebral injections of harmaline hydrochloride (H) in 340 rats. Intraperitoneal injection of 5-20 mg/kg but not of 2.5 mg/kg H administered 5 min after 15-min saccharin (0.1%) drinking decreased saccharin-water preference in a two-choice retention test, performed 48 h later, from 55% to 20%. Since CTA was not diminished when H (10 mg/kg) was injected into rats anesthetised immediately after saccharin drinking by pentobarbital (40 mg/kg), H (1.7-50 micrograms) was administered intracerebrally to anesthetised rats fixed in the stereotaxic apparatus. Injection of 3-6 micrograms H into the inferior olive elicited CTA comparable to that of systemic injection of 10 mg/kg H. Injections of 6 and 50 micrograms H into cerebellum and bulbar reticular formation elicited weaker CTA while neocortical, hypothalamic and mesencephalic applications were ineffective. CTA could also be elicited when 50 micrograms but not 6 micrograms H was injected into the inferior olive 1 or 2 h after saccharin drinking. This delay-dependent effect and failure of non-contingent H administration to change saccharin preference indicates that the H-induced CTA is not contaminated by a non-specific increase in neophobia. It is concluded that H probably elicits CTA by activation of caudal bulbar structures, including the nucleus of the solitary tract, area postrema and lateral reticular formation.

Controlled trial of thyrotropin releasing hormone tartrate in ataxia of spinocerebellar degenerations

The clinical efficacy, dose-response relationship, and safety of TRH-T (thyrotropin releasing hormone tartrate) were assessed in 290 patients with spinocerebellar degeneration (SCD) in a 2-week, double-blind study using placebo as control. 254 patients satisfied the criteria for inclusion in evaluation of the drug efficacy. The patients were treated with TRH-T in an intramuscular dose of 2 mg, 0.5 mg or 0 mg (placebo) as TRH once a day for 2 weeks. Clinical responses to these treatments were evaluated 3 times: at the end of weeks 1 and 2 of treatment and a week after the end of treatment. The results of "global improvement rating" as well as those of "ataxia improvement rating" showed that both 2 mg and 0.5 mg TRH-T treatments were significantly superior to placebo treatment in patients with predominantly cerebellar form of SCD. The effect was well maintained a week after the end of the 2-week treatment in the patients who were given TRH-T in daily dose of 2 mg and showed improvement at the end of treatment. The results of "improvement rating of each symptom" revealed that 2 mg treatment was significantly more effective than placebo for disorders of standing, gait, speech and writing. In the patients who had no pyramidal involvement or disorder of deep sensation, the drug efficacy and dose-response relationship were evident. Adverse reactions to the drug such as headache, feeling febrile and nausea were observed in 50% of the patients on 2 mg treatment, in 38% of those on 0.5 mg treatment and in 21% of those on placebo patient, however, discontinued treatment because of adverse reactions.

Increased GABA receptor binding in dominantly-inherited cerebellar ataxias

We measured gamma-aminobutyric acid (GABA) receptor binding in the cerebellar cortex of 14 patients with dominantly-inherited cerebellar ataxias. Most of these patients had moderate to marked Purkinje cell loss as judged from the subnormal dentate nucleus GABA levels. Mean GABA receptor binding (at 25 nM GABA concentration) was elevated significantly by 37% in the total group of 14 patients studied and by 60% in the largest subgroup (n=6) analyzed. Possible explanations for the enhanced binding include glial proliferation, exposure of normally unexposed receptor sites consequent to neuronal degeneration, and/or denervation supersensitivity.