Thesis (M.S.)--West Virginia University, 1999. / Title from document title page. Document formatted into pages; contains viii, 138 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 105-134).

Objetivo: Avaliar e comparar os achados dos Potenciais Evocados Auditivos de Tronco Encefálico em indivíduos com holoprosencefalia (HPE) e holoprosencefalia-like (HPE-like). Modelo: Análise prospectiva comparando os achados dos PEATE entre três grupos: indivíduos com HPE clássica (GH), indivíduos com HPE-like (GHL) e grupo controle (GC), a um nível de significância de 5%. Local de Execução: Setor de Genética, HRAC-USP. Participantes: 57 pacientes, com idades entre 1 ano e 6 meses e 22 anos, sendo 13 com HPE clássica, 22 com HPE-like, e um grupo controle de 22 indivíduos normais. Variáveis: Latências absolutas das ondas I, III e V; latências interpicos I-V, III-V e I-III e diferença interaural da onda V do PEATE, em milissegundos, para cada orelha. Resultados: Os valores médios em milissegundos das latências absolutas e interpicos nas orelhas direita e esquerda respectivamente foram os seguintes. ara a onda I: 2,21 e 2,19 (GH); 1,99 e 2,01 (GHL); 1,92 e 1,91 (GC). Para a onda III: 4,35 e 4,52 (GH); 4,04 e 4,04 (GHL); 3,97 e 3,94 (GC). Para a onda V: 6,47 e 6,51 (GH); 5,95 e 5,94 (GHL); 5,90 e 5,90 (GC). Para o interpicos I-V: 4,20 e 4,24 (GH); 3,94 e 3,92 (GHL); 3,97 e 3,97 (GC). Para o interpicos III-V: 2,27 e 2,07 (GH); 1,91 e 1,90 (GHL); 1,92 e 1,95 (GC). Para o interpicos I-III: 2,14 e 2,33 (GH); 1,03 e 2,01 (GHL); 2,04 e 2,01 (GC). Os valores de diferença interaural da onda V foram: 0,13 (GH); 0,06 (GHL) e 0,03 (GC). Conclusões: Os dados sugerem que grande parte dos indivíduos com HPE clássica apresentam alterações de PEATE compatíveis com o grau de comprometimento neurológico, enquanto aqueles com HPE-like apresentam poucas alterações, sendo estas justificadas pelas patologias de orelha média decorrentes da fissura de palato. / Objective: To evaluate and compare Auditory Brainstem Response (ABR) findings in patients with holoprosencephaly (HPE) and the “HPE-like" phenotype. Model: A prospective analysis comparing ABR results among three different groups: patients with classic HPE (GH), patients with HPE-like (GHL) and control group (GC), at a 5% significance level. Setting: Genetics Department, HRAC-USP. Participants: 57 patients, aged from 18 months to 22 years. Thirteen of them had classic HPE, 22 had HPE-like, and 22 were audiologically normal individuals, who joined the GC. Variables: Waves I, III and V absolute latencies; interpeak intervals I-V, III-V and I-III and wave V interear difference of ABR, in milisseconds, considering both right and left ears. Results: Mean values, in milisseconds, of absolute latencies and interpeaks recorded from right and left ears, respectivelly, were: Wave I: 2,21 and 2,19 (GH); 1,99 and 2,01 (GHL); 1,92 and 1,91 (GC). Wave III: 4,35 and 4,52 (GH); 4,04 and 4,04 (GHL); 3,97 and 3,94 (GC). Wave V: 6,47 and 6,51 (GH); 5,95 and 5,94 (GHL); 5,90 and 5,90 (GC). Interpeak I-V: 4,20 and 4,24 (GH); 3,94 and 3,92 (GHL); 3,97 and 3,97 (GC). Interpeak III-V: 2,27 and 2,07 (GH); 1,91 and 1,90 (GHL); 1,92 and 1,95 (GC). Interpeak I-III: 2,14 and 2,33 (GH); 1,03 and 2,01 (GHL); 2,04 and 2,01 (GC). Wave V interear difference were: 0,13 (GH); 0,06 (GHL) and 0,03 (GC). Conclusions: Results suggest that most patients with classic HPE have abnormalities detected by ABR testing, which are related to the severity of neurologic impairment. Otherwise, those with the HPE-like phenotype have few alterations, most likely resulting from middle ear pathologies that occur in presence of cleft palate.

Recent studies have shown that the Sudden Infant Death Syndrome (SIDS) is related to abnormal control of respiration (Ischemic degeneration of the brainstem may play an important role in altered respiratory control leading to death). In our studies we have examined brainstem ganglioside compositions in samples derived from SIDS victims and appropriate controls. Gangliosides are acidic glycosphingolipids that contain sialic acid. The high concentration of gangliosides in the central nervous system (CNS) implies that these lipids play an important role in CNS function. Some studies have indicated that gangliosides may function as receptor site determinants or modifiers, and in neural transmission. In our studies we used the Tettamanti, et al methodology to extract gangliosides, and High Performance Thin Layer Chromatography (HPTLC) and laser densitometry techniques for ganglioside analysis. The results of these analyses are being employed to establish lipid profile patterns to determine if there are significant variations in these lipid patterns between SIDS and control groups.

Activation of the immune system by e.g. bacteria induces the acute-phase-response and sickness behaviour. The latter encompasses among other things fever, lethargy, anorexia and hyperalgesia. An often used model to study sickness behaviour is the intravenous injection of the gram negative bacterial endotoxin lipopolysaccharide (LPS). LPS induces the production of inflammatory mediators, such as cytokines and prostaglandins, which in turn can interact with the central nervous system (CNS) to affect behaviour. The CNS also memorises substances that have made us sick in the past to avoid future harm, a phenomenon called conditioned taste aversion (CTA). An often used model to study CTA is the intraperitoneal injection of LiCl. The pontine parabrachial nucleus (PB) is an autonomic relay nucleus situated in the rostral brain stem that integrates afferent somatosensory and interoceptive information and forwards this information to the hypothalamus and limbic structures. PB is crucial for the acquisition of CTA and PB neurons are activated by many anorexigenic substances. Further, PB neurons express neuropeptides, among those calcitonin gene related peptide (CGRP) and enkephalin, both of which have been implicated in immune signalling, nociception, food intake, and aversion. By using a dual-labelling immunohistochemical/in situ hybridization technique we investigated if enkephalinergic neurons in PB are activated by systemic immune challenge. While there were many neurons in the external lateral parabrachial subnucleus (PBel) that expressed the immediate early gene fos after intravenous injection of LPS and while a large proportion of the PBel neurons expressed preproenkephalin, there were very few double-labelled cells. The fos-expressing cells were predominantly located to the outer part of the PBel (PBelo), whereas the preproenkephalin-expressing PBel neurons were located closest to the peduncle. Thus we conclude that although enkephalin has been implicated in autonomic and immune signalling, enkephalinergic neurons in PB do not seem to be activated by immune stimulation (paper I). To further characterise the PBelo neurons activated by immune challenge we investigated if these neurons expressed CGRP. Dual-labelling in situ hybridisation showed that PBelo neurons that expressed fos after intravenous injection of LPS to a large extent co-expressed CGRP mRNA, indicating that CGRP may be involved in the regulation of the sickness response in immune challenge (paper II). Using dual-labelling immunohistochemistry we examined if PBel neurons activated by an immune stimulus projected to the amygdala, a limbic structure implicated in the affective response to homeostatic challenge. Animals were injected with the retrograde tracer substance cholera toxin b (CTb) into the amygdala and subsequently subjected to immune challenge. We found that approximately a third of the neurons that expressed fos after the intravenous injection of LPS also were labelled with CTb. Thus PBel neurons activated by immune challenge project to the amygdala. The PBel-amygdala pathway has earlier been suggested to be important in nociceptive signalling. To investigate if amygdala-projecting PBel neurons are activated by nociceptive stimuli we again injected animals with CTb into the amygdala. After recovery the animals were injected with formalin into a hindpaw. Dual-labelling immunohistochemistry against fos and CTb showed that very few noxiously activated PB neurons projected to the amygdala. Thus, the PBel-amygdala projection seems to be important in immune challenge but not in nociceptive signalling (paper III). Many PBel neurons express fos after intraperitoneal injection of LiCl. Melanocortins are neuropeptides that recently have been implicated in metabolism, food intake and aversive mechanisms. The PB is known to express melanocortin receptor-4 (MC4-R) mRNA. Using dual-labelling in situ hybridization we investigated if PB neurons activated by intravenous injection of LPS or intraperitoneal injection of LiCl expressed MC4-R mRNA. We found that many PBelo neurons were activated by either LPS or LiCl and that a large proportion of such activated neurons expressed MC4-R mRNA. Further, using dual-labelling in situ hybridization against MC4-R mRNA and CGRP mRNA, we found that a large proportion of the CGRP positive PBelo neurons also expressed MC4-R mRNA. In summary, this thesis shows that CGRP-expressing neurons in the PBel are activated by peripheral immune challenge, that lipopolysaccharide-activated PBel neurons project to the amygdala, that the amygdala-projecting neurons in the PBel are CGRP-positive, and that PBel neurons activated by immune or aversive challenge express MC4-R. Taken together, these data suggest the presence of a melanocortin-regulated CGRP-positive pathway from the PBel to the amygdala that relays information of importance to certain aspects of sickness behaviour. / On the day of the defence date the title of article II was: Feeding-related immune responsive brain stem neurons: association with CGRP. Article II: Erratum for in Neuroreport 2001;12(16):inside back cover. Neuroreport 2001;12(13):inside back cover. Article III: Erratum in: J Comp Neurol. 2005; 483:489-90.

Brain stem cardiovascular regulatory dysfunction during brain stem death is underpinned by an upregulation of nitric oxide synthase II (NOS II) in rostral ventrolateral medulla (RVLM), the origin of a life-and-death signal detected from blood pressure of comatose patients that disappears before brain stem death ensues. At the same time, the ubiquitin-proteasome system (UPS) is involved in the synthesis and degradation of NOS II. We assessed the hypothesis that the UPS participates in brain stem cardiovascular regulation during brain stem death by engaging in both synthesis and degradation of NOS II in RVLM. In a clinically relevant experimental model of brain stem death using Sprague-Dawley rats, pretreatment by microinjection into the bilateral RVLM of proteasome inhibitors (lactacystin or proteasome inhibitor II) antagonized the hypotension and reduction in the life-and-death signal elicited by intravenous administration of Escherichia coli lipopolysaccharide (LPS). On the other hand, pretreatment with an inhibitor of ubiquitin-recycling or UCH-L1 potentiated the elicited hypotension and blunted the prevalence of the life-and-death signal. Real-time polymerase chain reaction, Western blot, electrophoresis mobility shift assay, chromatin immunoprecipitation and co-immunoprecipitation experiments further showed that the proteasome inhibitors antagonized the augmented nuclear presence of NF-£eB or binding between NF-£eB and nos II promoter and blunted the reduced cytosolic presence of phosphorylated I£eB. The already impeded NOS II protein expression by proteasome inhibitor II was further reduced after gene-knockdown of NF-£eB in RVLM. In animals pretreated with UCH-L1 inhibitor and died before significant increase in nos II mRNA occurred, NOS II protein expression in RVLM was considerably elevated. We conclude that UPS participates in the defunct and maintained brain stem cardiovascular regulation during experimental brain stem death by engaging in both synthesis and degradation of NOS II at RVLM. Our results provide information on new therapeutic initiatives against this fatal eventuality.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 3 uppsatser.

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 118-136).

Migraine, a neurovascular disorder, is associated with disturbances in brain stem activity during attacks. Interictal persistence of these disturbances might increase vulnerability to recurrent attacks of migraine. To explore this possibility, effects of motion sickness and pain on migrainous symptoms and extracranial vascular reponses were investigated in 27 migraine sufferers in the headache-free interval, and 23 healthy age/sex matched controls. Symptoms of migraine and motion sickness are remarkably similar. As both maladies involve reflexes that relay in the brain stem, they most probably share the same neural circuitry. Furthermore, migraineurs are usually susceptible to motion sickness and, conversely, motion sickness-prone individuals commonly experience migraine. Participants in the present study were exposed to optokinetic stimulation (OKS), a well-established way of inducing symptoms of motion sickness in susceptible individuals. Sensitivity to painful stimulation of the head and hand was also explored. Head pain is a hallmark of a migraine attack and cutaneous allodynia has been observed elsewhere in the body during attacks. The trigeminal nerve is associated with head pain in migraine, and trigeminal activity evokes reflexes that relay in the brain stem. To stimulate the trigeminal nerve, ice was applied to the temple. To stimulate nociceptors elsewhere in the body the participant immersed their fingers and palm in ice-water. Procedures used in this study were physically stressful and probably psychologically stressful. The impact of stress in relation to the development of symptomatic and vascular responses, particularly anticipatory stress-responses, was explored. This research involved one central experiment that consisted of six experimental conditions. On separate occasions participants were exposed to optokinetic stimulation and painful stimulation of the head or limb, individually and in combination. In migraine sufferers, symptomatic responses were enhanced during all procedures involving OKS and during temple pain after OKS, in the presence of residual motion sickness. During trigeminal stimulation independent of OKS, headache initially developed followed by nausea as the procedure progressed. In contrast, symptoms barely developed in controls during any of the six procedures except for slight dizziness, self-motion and visual-illusion during conditions involving OKS, and slight nausea when the temple was painfully stimulated during OKS and during OKS alone. Trigeminal stimulation during OKS intensified nausea and headache in migraine sufferers compared to during OKS alone or limb pain during OKS. However, the remaining symptomatic ratings were not affected by temple pain during OKS, suggesting a specific association between nausea and head pain. It may be that these cardinal symptoms compound one another during a migraine attack. Enhanced symptomatic responses in migraine sufferers during the headache interval may indicate activation of hypersensitive neural pathways that mediate symptoms of motion sickness or migraine. Migraineurs found procedures generally more unpleasant, and ice-induced pain ratings more intense and unpleasant, than controls, which may further indicate hyperexcitable nociception in this group, or a difference in their criterion of discomfort. Vascular responses, particularly during OKS alone, and during painful stimulation independent of OKS, were greater in migraine sufferers than in controls. The added stress of painful stimulation during OKS appeared to boost facial blood flow in controls to approach levels obtained in migraine sufferers. Enhanced vasodilatation was observed in migraineurs prior to painful stimulation, presumably due to anticipatory anxiety. For both groups ipsilateral vascular responses were greater than contralateral responses when the hand was painfully stimulated. During limb pain before OKS asymmetry was minimal in migraine sufferers but more apparent in controls. An enhanced stress response in migraineurs may have drawn ipsilateral and contralateral responses closer together. The development of symptoms during the procedures of this study provides an insight into how symptoms might develop sequentially in a migraine attack. Once the headache is in motion, nausea and headache may mutually exacerbate one another. In turn, trigemino-vascular responses and stress appear to be associated with the migraine crisis. Given the interactive nature of symptomatic, vascular, and stress responses, it may be more effective to target multiple, rather than individual, symptoms, in prophylactic or acute chemical and psychological interventions.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 6 uppsatser.

Thesis (Ph. D.)--University of Sydney, 2007. / Title from title screen (viewed 1 November 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Discipline of Physiology, Faculty of Medicine. Degree awarded 2007 ; thesis submitted 2006. Bibliography: leaves 239-284. Also issued in print.