Long projections from the brainstem to the lumbar cord activate locomotion. Using in vitro neonatal rats our laboratory showed that relay (propriospinal - PS) neurons also contribute to transmission of the locomotor signal. This thesis examines whether locomotor-related PS neurons exist in adult mammals, which has important clinical implications. The brainstem of adult decerebrate rats was stimulated to elicit stepping. The following manipulations were performed: 1) suppression of synaptic transmission to PS neurons, 2) lesioning of direct bulbospinal projections to lumbar segments, and 3) neurochemical excitation of PS neurons. In addition, in the absence of brainstem stimulation, the ability of neurochemically excited PS neurons to induce stepping was examined. Brainstem-evoked locomotion was suppressed by synaptic blockade, enhanced by PS neuron excitation, persists after lesioning of long-direct projections, and hindlimb stepping was elicited by PS neuron excitation alone. The findings support the existence of a locomotor-related PS system in adult mammals. / October 2016

ABSTRACT   Background Removal of mandibular third molars can be associated with postoperative complications. Coronectomy with partial removal of the crown, is described as an alternative surgical method when risks for post-operative complications are substantial.  Aim  The aim of this study was to evaluate risk factors for post-operative complications after coronectomy.   Materials and Methods Fifty-six patients (26 men/30 women, median age 51 years) were operated with coronectomy of mandibular third molars. Risk factors were identified from medical records and radiographic examinations. Post-operative complications lasting over 14 days were registered.   Results  Fifty percent of the patients had a post-operative complication with significant higher risk for complications for patients over 51 years (p = 0.016). The most common complications were pain from surgical site and local infection. Three patients were registered with affected sensory function. Root migration was registered in 16 patients. Gender, comorbidity, medication, tobacco use, cause of referral (bacterial/other causes) or angulation of the third molar did not affect the risk for complications. Conclusion  The results indicate that coronectomy is an appropriate surgical technique when the risks for postoperative complications are significant, although a high level of short-term complications has been observed.

Les effets des lésions de la moelle épinière sur la locomotion sont souvent évalués sur un tapis roulant avec une surface plane, ce qui demande peu d’implication active des structures supraspinales. L’objectif du présent travail est d’évaluer si un type d’entraînement nécessitant une plus grande part de contrôle volontaire (c.-à-d. supraspinal) pourrait améliorer la récupération de la marche chez le chat après une hémilésion unilatérale spinale au niveau thoracique (T10). Pour ce faire, pendant 6 semaines les chats ont été entrainés sur un tapis roulant conventionnel ou sur un tapis-échelle roulante, tâche requérant un placement des pattes plus précis. Les paramètres de la marche ont été évalués par cinématique et électromyographie (EMG) avant et une fois par semaine pendant 6 semaines après lésion. Nos résultats comparant la marche sur tapis conventionnel à celle sur échelle roulante montrent des différences dans les excursions angulaires et les couplages entre les membres. On observe aussi des différences dans l’amplitude des EMG notamment une augmentation de la deuxième bouffée du muscle Semitendineux (St) sur l’échelle roulante. Après l’hémilésion spinale cette bouffée disparait du côté de la lésion tandis qu’elle est maintenue du côté intact. Après l’entrainement sur échelle roulante, on observe des changements de trajectoire de la patte et une disparition du pied tombant (foot drag) qui suggèrent une amélioration du contrôle de la musculature distale. Nos résultats montrent que le patron locomoteur observé sur tapis conventionnel est influencé par le type d’entraînement procuré. De plus, certains paramètres de la locomotion suggèrent que l’entraînement sur échelle roulante, qui requiert plus de contrôle supraspinal, favorise une meilleure récupération de la marche après lésion spinale. / The effects of spinal cord lesions on locomotion in animals is often assessed on a flat surface which requires minimal supraspinal demands. Here we investigated whether locomotor training requiring more voluntary commands could improve recovery in cats after a unilateral hemisection on the left side (Thoracic 10). Cats were trained for 6 weeks on a conventional flat treadmill (FTM) or on a ‘ladder treadmill’ (LTM) requiring precise foot positioning. Locomotor parameters such as kinematics and electromyographic activity (EMG) were evaluated before and once a week for 6 weeks after spinal hemisection. There were differences in angular excursions and limb couplings when comparing walking on FTM and LTM and important changes occurred in the amplitude of EMGs such as an increased second burst in Semitendinosus (St) during LTM stepping. After the left hemisection, this burst disappeared on the left side while it was maintained on the right (non lesioned) side. With LTM training, we observed changes in limb trajectories and disappearance of foot drag of the left foot during FTM stepping suggesting a better control of distal musculature. Our results show that locomotor patterns observed during FTM stepping are influenced by different training modalities and also that training on the LTM after a spinal hemisection, demanding more supraspinal control, leads to a better stepping pattern.