This thesis assessed the suitability of unilateral, electrolytic lesions as a model of spinal cord damage and repair in the adult rat. This type of lesion resulted acutely in localized damage in the upper motor neuron at the L2-L3 level of the spinal cord. Minimal acute damage to ascending sensory pathways was indicated by preserved somatosensory evoked potentials elicited by stimulation of the tibial nerve. Immediately after lesion generation one of several substrates was injected into the lesion cavity. These substrates were saline buffer, liquid collagen solution, foetal spinal cord cells from 14 day old rat embryos, and a mixture of collagen and E 14 foetal spinal cord cells. The 4 groups were compared for functional recovery over 3 months using the inclined plane test and a Tarlov movement scale. After sacrifice, the tibialis anterior muscles were dissected and weighed to assess atrophy due to lower motor neuron injury. After removing and embedding the spinal cords in paraffin, transverse and longitudinal sections were taken for cytoarchitectural investigation. Cresyl violet was used to indicate Nissl substance, Luxol fast blue stained for myelin and anti - glial fibrillary acidic protein (GFAP) antibody revealed the expression of GFAP in the cord sections. Chronic electrolytic lesions were characterized by the highly variable degree of cavitation, demyelination and macrophage infiltration that was present. There was no significant performance deficit on the inclined plane test in any of the lesioned groups when compared to unoperated animals. The tibialis muscles from all groups were of normal weight, indicating that the lower motor neurons were not significantly damaged by the lesions used. There was, however, a marked decrease in the number of GFAP reactive astrocytes in the lesioned animals when compared to unlesioned controls (P < 0.01, Wilcoxon test). Moreover, this reduction of GFAP - like immunoreactivity was not prevented by implants of foetal neurons, collagen or foetal neurons suspended in collagen. Possible explanations for the reduced GFAP - like immunoreactivity seen in all electrolytically lesioned cords are discussed. / Medicine, Faculty of / Cellular and Physiological Sciences, Department of / Graduate

INTRODUÇÃO: Os Movimentos Periódicos dos Membros (PLM) são movimentos repetitivos, estereotipados, que ocorrem principalmente nos membros inferiores e associam-se freqüentemente à Síndrome das Pernas Inquietas (SPI), na qual os pacientes relatam necessidade de mover os membros, geralmente associada a desconforto que pode ser exacerbado com a inatividade e piora no fim da tarde ou à noite. PLM são relatados em pacientes com lesão medular, indicando um componente medular da desordem. Neste trabalho, PLM e SPI são analisados em pacientes com lesão medular. MÉTODOS: Neste estudo observacional realizado entre novembro de 2007 e novembro de 2008, comparou-se achados polissonográficos, Escala de Sonolência de Epworth, Questionário de Síndrome das Pernas Inquietas, entre 2 grupos de indivíduos com idade de 18 a 40 anos, sem outros distúrbios de sono: Grupo Controle (GC) e Grupo Lesão Medular (LM). RESULTADOS: LM contou com 9 homens e GC tinha 8 homens e 8 mulheres. Não houve diferença significativa entre as idades de cada grupo: LM com 28 ±7,382 anos e CG com 24,38 ± 4,031 anos. O grupo LM caracterizou-se por 3 lesões cervicais ASIA A, 5 lesões torácicas A e 1 lesão torácica B avaliados através da avaliação American Spinal Cord Injury Association ASIA, com tempo de lesão variando de 1 ano e 1 mês a 5 anos e 2 meses, com mediana de 4, 615 anos; as causas de lesão medular foram acidente de motocicleta (86,44%), mergulho (6,78%) e queda de bicicleta (6,78%). 77,80% de LM apresenta Movimentos Periódicos dos Membros (PLM) em comparação com 31,30% de GC (p=0,04; IC95% = 1,2-51,2). Não houve diferença significativa na gravidade de PLM entre os grupos (p>0,05). Em LM, não houve diferença significativa entre PLM índex NREM e PLM índex REM (p= 0,05). Na avaliação de sonolência, não houve diferença significativa entre os grupos (p>0,05); não houve correlação entre PLM e sonolência excessiva diurna (r= 0,02). LM apresentou 100% de frequência de SPI contra 17% de GC (p < 0,0001). Não houve diferença significativa entre os grupos na gravidade da SPI (p>0,05). Em relação ao número de microdespertares, não houve diferença significativa entre os grupos (p>0,05). Não houve diferença significativa entre os grupos na comparação de eficiência de sono (p>0,05), porém o subgrupo dos tetraplégicos de LM apresentou 9,97±2,17 minutos de tempo de latência enquanto o GC apresentou 3,65±2,43 minutos (p=0,01). CONCLUSÕES: a SPI e o PLM são mais frequentes em lesados medulares que na população em idade de 18 a 40 anos sem outros distúrbios de sono associados, o que pode sugerir que PLM e SPI estejam relacionados ao Centro Gerador de Padrão Medular. / INTRODUCTION: The Periodic Leg Movements (PLM) are repetitive, stereotyped movements that occur mainly in legs and are frequently associated to Restless Legs Syndrome (RLS) in which patients refer the need to move the limbs, usually associated to discomfort that might worse with inactivity and worse in the evening or night. PLM are reported in patients with spinal cord injury thus indicating a spinal component in the disorder. In this research PLM were analyzed in spinal cord injury patients. METHODS: In this observation study performed from November 2007 to November 2008, polysomnographic findings, Epworth Sleepiness Scale Score and an adapted form of International Restless Legs Syndrome Scale Score were compared between 2 groups formed by 18 to 40 years old volunteers without any other sleep disturbances: Control Group (CG) and Spinal Cord Injury Group (SCIG). RESULTS: The SCIG was composed by 9 men and the CG was composed by 8 men and 8 women. There was no statistically significant difference in ages of each group: SCIG 28 ±7,382 years and CG 24,38 ± 4,031 years. The SCGI group was characterized by 3 A cervical spinal cord injury (SCI), 5 A thoracic SCI and 1 B thoracic SCI classified according to American Spinal Cord Injury Association (ASIA) evaluation, presenting from 1 year and 1 month to 5 years and 2 months of injury time, with median of 4,615 years. The SCI were caused by motorcycle accident (86,44%), shallow water diving (6,78%) and bicycle fall (6,78%). In SCIG 77,80% presented PLM while 31,30% presented PLM in CG (p=0,041; CI95% = 1,2-51,2). There wasn´t significant difference in PLM severity between groups (p>0,05). In SCIG there wasn´t significant difference between PLM index NREM and PLM index REM (p>0,05). There wasn´t correlation between PLM and excessive diurnal somnolence (r=0,02). SCGI presented 100% of RLS comparing to 17% in CG (p < 0,0001). There was no significant difference in RLS severity between groups (p>0,05). There was no significant difference in arousal index between groups (p>0,05).There was no significant difference in sleep efficiency (p>0,05), however the subgroup of tetraplegic patients in SCIG presented 9,97±2,17 minutes while CG presented 3,65±2,43 minutes of sleep onset time (p=0,01). CONCLUSIONS: RLS and SPI are more recurrent in SCI patients than in general population from 18 to 40 years old without any other sleep disturbances. This might suggest that PLM and RLS are related to Spinal Cord Central Pattern Generator.

INTRODUÇÃO: Os Movimentos Periódicos dos Membros (PLM) são movimentos repetitivos, estereotipados, que ocorrem principalmente nos membros inferiores e associam-se freqüentemente à Síndrome das Pernas Inquietas (SPI), na qual os pacientes relatam necessidade de mover os membros, geralmente associada a desconforto que pode ser exacerbado com a inatividade e piora no fim da tarde ou à noite. PLM são relatados em pacientes com lesão medular, indicando um componente medular da desordem. Neste trabalho, PLM e SPI são analisados em pacientes com lesão medular. MÉTODOS: Neste estudo observacional realizado entre novembro de 2007 e novembro de 2008, comparou-se achados polissonográficos, Escala de Sonolência de Epworth, Questionário de Síndrome das Pernas Inquietas, entre 2 grupos de indivíduos com idade de 18 a 40 anos, sem outros distúrbios de sono: Grupo Controle (GC) e Grupo Lesão Medular (LM). RESULTADOS: LM contou com 9 homens e GC tinha 8 homens e 8 mulheres. Não houve diferença significativa entre as idades de cada grupo: LM com 28 ±7,382 anos e CG com 24,38 ± 4,031 anos. O grupo LM caracterizou-se por 3 lesões cervicais ASIA A, 5 lesões torácicas A e 1 lesão torácica B avaliados através da avaliação American Spinal Cord Injury Association ASIA, com tempo de lesão variando de 1 ano e 1 mês a 5 anos e 2 meses, com mediana de 4, 615 anos; as causas de lesão medular foram acidente de motocicleta (86,44%), mergulho (6,78%) e queda de bicicleta (6,78%). 77,80% de LM apresenta Movimentos Periódicos dos Membros (PLM) em comparação com 31,30% de GC (p=0,04; IC95% = 1,2-51,2). Não houve diferença significativa na gravidade de PLM entre os grupos (p>0,05). Em LM, não houve diferença significativa entre PLM índex NREM e PLM índex REM (p= 0,05). Na avaliação de sonolência, não houve diferença significativa entre os grupos (p>0,05); não houve correlação entre PLM e sonolência excessiva diurna (r= 0,02). LM apresentou 100% de frequência de SPI contra 17% de GC (p < 0,0001). Não houve diferença significativa entre os grupos na gravidade da SPI (p>0,05). Em relação ao número de microdespertares, não houve diferença significativa entre os grupos (p>0,05). Não houve diferença significativa entre os grupos na comparação de eficiência de sono (p>0,05), porém o subgrupo dos tetraplégicos de LM apresentou 9,97±2,17 minutos de tempo de latência enquanto o GC apresentou 3,65±2,43 minutos (p=0,01). CONCLUSÕES: a SPI e o PLM são mais frequentes em lesados medulares que na população em idade de 18 a 40 anos sem outros distúrbios de sono associados, o que pode sugerir que PLM e SPI estejam relacionados ao Centro Gerador de Padrão Medular. / INTRODUCTION: The Periodic Leg Movements (PLM) are repetitive, stereotyped movements that occur mainly in legs and are frequently associated to Restless Legs Syndrome (RLS) in which patients refer the need to move the limbs, usually associated to discomfort that might worse with inactivity and worse in the evening or night. PLM are reported in patients with spinal cord injury thus indicating a spinal component in the disorder. In this research PLM were analyzed in spinal cord injury patients. METHODS: In this observation study performed from November 2007 to November 2008, polysomnographic findings, Epworth Sleepiness Scale Score and an adapted form of International Restless Legs Syndrome Scale Score were compared between 2 groups formed by 18 to 40 years old volunteers without any other sleep disturbances: Control Group (CG) and Spinal Cord Injury Group (SCIG). RESULTS: The SCIG was composed by 9 men and the CG was composed by 8 men and 8 women. There was no statistically significant difference in ages of each group: SCIG 28 ±7,382 years and CG 24,38 ± 4,031 years. The SCGI group was characterized by 3 A cervical spinal cord injury (SCI), 5 A thoracic SCI and 1 B thoracic SCI classified according to American Spinal Cord Injury Association (ASIA) evaluation, presenting from 1 year and 1 month to 5 years and 2 months of injury time, with median of 4,615 years. The SCI were caused by motorcycle accident (86,44%), shallow water diving (6,78%) and bicycle fall (6,78%). In SCIG 77,80% presented PLM while 31,30% presented PLM in CG (p=0,041; CI95% = 1,2-51,2). There wasn´t significant difference in PLM severity between groups (p>0,05). In SCIG there wasn´t significant difference between PLM index NREM and PLM index REM (p>0,05). There wasn´t correlation between PLM and excessive diurnal somnolence (r=0,02). SCGI presented 100% of RLS comparing to 17% in CG (p < 0,0001). There was no significant difference in RLS severity between groups (p>0,05). There was no significant difference in arousal index between groups (p>0,05).There was no significant difference in sleep efficiency (p>0,05), however the subgroup of tetraplegic patients in SCIG presented 9,97±2,17 minutes while CG presented 3,65±2,43 minutes of sleep onset time (p=0,01). CONCLUSIONS: RLS and SPI are more recurrent in SCI patients than in general population from 18 to 40 years old without any other sleep disturbances. This might suggest that PLM and RLS are related to Spinal Cord Central Pattern Generator.