In spinal cord stimulation (SCS) large diameter cutaneous (Abeta) fibres in the dorsal columns (DCs) are activated and have an inhibiting effect on the transmission of pain signals by Adelta and C fibres from the corresponding dermatome(s). The largest Abeta fibres can be activated up to a maximum depth of about 0.25 mm in the DCs. No data are available on the distribution of the large fibres in this superficial human DC layer at the common SCS levels Th(10-11). Such data are indispensable to improve the predictive capability of a computer model of SCS. The whole myelinated fibre population in the superficial 300 microm of the dorsal column (DC(0-300)) at Th(10-11 )of two human subjects was morphometrically analysed. Some data was obtained from a third subject. The superficial dorsolateral column (DLC(0-300)) was included in this analysis because it was hypothesized that large dorsal spinocerebellar tract fibres could also be activated by SCS. Only very few fibres larger than 10.7 microm were found: a mean of 68 (0.5%) in DC(0-300) and 114 (2%) in DLC(0-300). Considering that the effect of SCS is primarily attributed to activation of these largest fibres, it is concluded that a surprisingly small average amount of 2.4 fibres per running 0.1 mm width and 6 fibres per segmental division of the DC is involved. Distinct mediolateral heterogeneity in fibre composition was found in both DC(0-300) and DLC(0-300). In the DC(0-300), the mean diameter of fibres > or =7.1 microm increases significantly by 5% from medial to lateral. Density (i.e. number of fibres per 1000 microm(2)) and frequency (i.e. percentage of a fibre size group compared to its parent population) of the large fibres increase significantly from medial to lateral in the DC(0-300). For fibres > or =10.7 microm, these parameters increase by 200 and 269%, respectively. It is concluded that the difference in stimulation threshold of large Abeta fibres in the median and lateral DC can be mainly attributed to the absence and presence, respectively, of collaterals at the stimulation site. Marked differences were found between DC(0-300) and DLC(0-300). The largest DLC(0-300) fibres (> or =10.7 microm) have a 320% higher frequency and a 473% higher density. Their mean diameter is, however, only 2% larger. The largest DLC(0-300) fibres are not likely to be recruited by SCS, since they are not larger than their DC(0-300) counterparts, they lack collaterals (which would reduce the threshold stimulus substantially) and they are more remote from the stimulation electrode.

The chick is a well-understood developmental model of cerebellar pattern formation,but we know much less about the patterning of the adult chicken cerebellum. Therefore an expression study of two Purkinje cell stripe antigens-zebrin II/aldolase C and phospholipase Cbeta4 (PLCbeta4)-has been carried out in the adult chicken (Gallus domesticus). The mammalian cerebellar cortex is built around transverse expression domains ("transverse zones"), each of which is further subdivided into parasagittally oriented stripes. The results from the adult chicken reveal a similar pattern. Five distinct transverse domains were identified. In the anterior lobe a uniformly zebrin II-immunopositive/PLCbeta4-immunonegative lingular zone (LZ; lobule I) and a striped anterior zone (AZ; lobules II-VIa) were distinguished. A central zone (CZ; approximately lobules VIa-VIIIa,b) and a posterior zone (PZ; approximately lobules VIIIa,b-IXc,d) were distinguished in the posterior lobe. Finally, the nodular zone (NZ; lobule X) is uniformly zebrin II-immunoreactive and is innervated by vestibular mossy fibers. Lobule IXc,d is considered as a transitional region between the PZ and the NZ, because the vestibular mossy fiber projection extends into these lobules and because they receive optokinetic mossy and climbing fiber input. It is proposed that the zebrin II-immunonegative P3- stripe corresponds to the lateral vermal B zone of the mammalian cerebellum and that the border between the avian homologs of the mammalian vermis and hemispheres is located immediately lateral to P3-. Thus, there seem to be transverse zones in chicken that are plausible homologs of those identified in mammals, together with an LZ that is characteristic of birds.

Current opinion holds that pores in synthetic nerve guides facilitate nerve regeneration. Solid factual support for this opinion, however, is absent; most of the relevant studies assessed only morphological parameters and results have been contradictory. To evaluate the effect of pores, the rat sciatic nerve was either autografted or grafted with nonporous, macroporous (10-230 mum), and microporous (1-10 microm) biodegradable epsilon-caprolactone grafts. Twelve weeks later, the grafted nerves were resected, and the electrophysiological properties were determined in vitro. Subsequently midgraft-level sections were inspected, and peroneal nerve sections were evaluated morphometrically. Finally, the gastrocnemic and tibial muscle morphometrical properties were quantified. The microporous nerve graft performed much better than the nonporous and macroporous grafts with respect to most parameters: it was bridged by a free floating bundle that contained myelinated nerve fibers, there were more nerve fibers present distal to the graft, the electrophysiological response rate was higher, and the decrease in muscle cross-sectional area was markedly smaller. Hence, the present study demonstrates the beneficial effect of synthetic nerve guide pores on nerve regeneration, although with the caveat that not pores per se, but only small (1-10 microm) pores were effective.

Both histopathological and morphometric examination showed a reduction of the quantity of myelin in C-5 or C-6 stumps used as donor sites for grafts. The amount of myelin is significantly correlated with biceps muscle function after nerve grafting. Because it is possible to assess the quantity of myelin by intraoperative examination of frozen sections, this correlation is potentially useful in the decision-making process of whether to use stumps for grafting or to use nerve transfer procedures to restore biceps muscle function.

Chronic motor cortex stimulation (MCS) is currently being investigated as a treatment method for Parkinson's disease (PD). Unfortunately, the underlying mechanisms of this treatment are unclear and there are many uncertainties regarding the most effective stimulation parameters and electrode configuration. In this paper, we present a MCS model with a 3D representation of several axonal populations. The model predicts that the activation of either the basket cell or pyramidal tract (PT) type axons is involved in the clinical effect of MCS. We propose stimulation protocols selectively targeting one of these two axon types. To selectively target the basket cell axons, our simulations suggest using either cathodal or bipolar stimulation with the electrode strip placed perpendicular rather than parallel to the gyrus. Furthermore, selectivity can be increased by using multiple cathodes. PT type axons can be selectively targeted with anodal stimulation using electrodes with large contact sizes. Placing the electrode epidurally is advisable over subdural placement. These selective protocols, when practically implemented, can be used to further test which axon type should be activated for clinically effective MCS and can subsequently be applied to optimize treatment. In conclusion, this paper increases insight into the neuronal population involved in the clinical effect of MCS on PD and proposes strategies to improve this therapy.

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