Bulbospinal projections to the intermediolateral cell column; a neuroanatomical study

Amendt, Klaus; Czachurski, J.; Dembowsky, Klaus; Seller, H.

doi:10.1016/0165-1838(79)90009-2

Cited by 298 publications

(50 citation statements)

References 17 publications

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“…The literature affords robust anatomical/ physiological evidence that compression of the ninth and tenth cranial nerve (CN IX-X) root entry/exit zone (REZ) and adjacent ventrolateral medulla-especially on the left side, known to convey inputs from the baroreceptors of the (left-sided) cardiac atrium-could be the origin of systemic arterial hypertension. 2,3,4,6,8,9,11,15,16,18,22,23,25,[42][43][44] In the quest for patients affected with essential hypertension to be candidates for vascular decompression, as many as 14 studies have been conducted to investigate the reliability of MRI for the detection of compressive vessels with a potential role in the genesis of hypertension. 1,10,12,21,24,28,35,37,39,45,50,57,58,61 In most of these publications, images of vascular contact/compression at the ventrolateral medulla were reported at a higher rate in patients with hypertension than in those with normal blood pressure (BP).…”

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confidence: 99%

Hypertension of neurogenic origin: effect of microvascular decompression of the CN IX-X root entry/exit zone and ventrolateral medulla on blood pressure in a prospective series of 48 patients with hemifacial spasm associated with essential hypertension

Sindou

Mahmoudi

Brînzeu

2015

JNS

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aBBreViatiONS AICA = anterior inferior cerebellar artery; BA = basilar artery; BP = blood pressure; CN = cranial nerve; ENMG = electroneuromyographic; GP = general practitioner; HFS = hemifacial spasm; MVD = microvascular decompression; NVC = neurovascular compression; PICA = posterior inferior cerebellar artery; REZ = root entry/exit zone; VA = vertebral artery. SuBmitted August 1, 2014. accepted December 30, 2014. iNclude wheN citiNg Published online July 31, 2015; DOI: 10.3171/2014.12.JNS141775. diSclOSure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. OBJect In spite of solid anatomical and physiological arguments and the promising results of Jannetta in the 1970s, treating essential hypertension by microvascular decompression (MVD) of the brainstem has not gained acceptance as a mainstream technique. The main reason has been a lack of established selection criteria. Because of this, the authors' attempts have been limited to patients referred for MVD for hemifacial spasm (HFS) who also had hypertension likely to be related to neurovascular compression (NVC). methOdS Of 201 patients referred for HFS, 48 (23.8%) had associated hypertension. All had high-resolution MR images that demonstrated NVC. All underwent MVD of the root exit/entry zone (REZ) of the ninth and tenth cranial nerves (CN IX-X) and adjacent ventrolateral medulla in addition to the CN VII REZ. Effects on hypertension, graded using the WHO classification, were studied up to the latest follow-up, which was 2-16 years from the time of surgery, 7 years on average. Also, effects of MVD on blood pressure (BP) according to the side of vascular compression were evaluated. reSultS Preoperatively, hypertension was severe in all but 1 of the patients; in spite of medical treatment, 47 patients still had WHO Grade 1 or 2 hypertension, and 18 still had unstable BP. After MVD, at latest follow-up, BP had returned to normal (i.e., systolic pressure < 140 mm Hg) in 28 patients; 14 of these patients (29.10% of the whole series) were able to maintain normal BP without any antihypertensive treatment; the other 14 still required some medication to maintain their BP below 140 mm Hg (p < 0.0001). Also, at latest follow-up, BP remained unstable in only 8 of the 18 patients with instability prior to MVD (p < 0.02). Analysis according to side of compression showed that of the 30 patients with left-sided compression, 17 had their BP normalized (without medication in 11 cases), and of the 18 patients with right-sided compression, 11 had their BP normalized (without medication in 3 cases). The difference between sides was not significant. cONcluSiONS These results argue for considering MVD for the treatment of hypertension likely to be due to NVC at the CN IX-X REZ and adjacent ventrolateral medulla. Criteria for selecting patients with hypertension alone still need to be established and could include the following indications: apparently essential hypertension, likely to be neuro...

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confidence: 99%

Hypertension of neurogenic origin: effect of microvascular decompression of the CN IX-X root entry/exit zone and ventrolateral medulla on blood pressure in a prospective series of 48 patients with hemifacial spasm associated with essential hypertension

Sindou

Mahmoudi

Brînzeu

2015

JNS

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“…Those include afferents from baroreceptors and chemoreceptors as well as somatosensory fibers of spinal and trigeminal afferents. Moreover, some neurons in the ventrolateral medulla send descending bulbospinal axons to the region of the sympathetic preganglionic neurons (AMENDT et al, 1979;Ross et al, 1984) and subserve reflex sympathetic responses to these sensory inputs (TERuI et al, 1987). It is also a site of afferent projections from supramedullary structures such as the paraventricular nucleus of the hypothalamus (SUN and GUYENET, 1986).…”

Section: Discussionmentioning

confidence: 99%

Physiological characterization of the renal-sympathetic reflex in rabbits.

1988

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In urethane-anesthetized and vagotomized rabbits, electrical stimulation of the afferent renal nerve (RN) elicited reflex changes in renal nerve activity (RNA) and arterial pressure (AP). The responses were attributable mostly to excitation of nonmyelinated afferent fibers, although, in about 30% of the animals, they were contributed slightly by myelinated afferents. In about 70% of rabbits, the peristimulus time histogram (PTH) of RNA following stimulation of the RN consisted of a long-lasting inhibitory (I) component occasionally accompanied, during its recovery phase, by a transient excitatory (E) component. In these animals, tetanic stimulation of the RN resulted in a depressor response, either alone or, if an E component was present in the PTH, followed by a slight pressor response. In the remaining rabbits, the PTH was composed exclusively of an E component and tetanic stimulation caused a pressor response. Stimulation of the RN evoked reflex changes in cardiac sympathetic discharges comparable to that of RNA, whereas the change in cervical sympathetic discharges was much smaller. The sympathetic response remained intact after a total transection of the rostral medulla near the ponto-medullary junction; the I component was even augmented. However, it usually disappeared following a transection at the high cervical cord. Bilateral lesions of the nucl. tractus solitarius (NTS) near the obex failed to appreciably affect the response. Among chemical and mechanical stimuli examined, nociceptive stimulation of the kidney elicited a sympathetic response comparable to that following nerve stimulation. In conclusion, the renal-sympathetic reflex in rabbits (1) originates predominantly from nonmyelinated afferent renal fibers activated effectively by nociceptive stimulation applied to the kidney; (2) depends critically on medullary structures other than the NTS; and (3) evokes changes of the same temporal pattern but of nonuniform magnitude in sympathetic discharges to different organs.

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“…It has been reported that fibers originating in the ventral medulla oblongata innervate the intermediolateral cell column of the spinal cord (25)(26)(27), and electrical lesions of the ventral medulla oblongata including the nucleus interfascicularis hypoglossi produces a decrease in the substance P-like im munoreactivity in the intermediolateral cell column (16). Furthermore, Takano et al (28) reported that the stimulation of the ventral medulla oblongata by the excitotoxic agent , kainic acid, elicited a release of immunoreac tive substance P in the spinal cord superfusion samples.…”

Section: Discussionmentioning

confidence: 99%

Effect of the substance P antagonist spantide on adrenal sympathetic nerve activity in rats.

et al. 1987

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Abstract-Inorder to elucidate the role of substance P in adrenal nerve activity, the effects of substance P antagonists on 1) tonic activity of the adrenal sympa thetic nerve, 2) the response to exogenous substance P and 3) cutaneo-adrenal nerve reflex were investigated in anesthetized rats. Substance P or its antagonist [(Arg', D-Trp7'9, Leu" )-substance P: spantide] was injected into the subara chnoid space via polyethylene tubing.Intrathecal administration of spantide (0.1 10 iig) produced a slight and transient increase in tonic activity of the adrenal nerve. Thereafter, a marked and prolonged decrease in adrenal nerve activity was observed, along with a decrease in arterial blood pressure.Intrathecally adminis tered substance P (0.1-10 ieg) produced a marked increase in tonic activity of the adrenal nerve in a dose-related manner. This substance P-induced increase in adrenal nerve activity was significantly antagonized by pretreatment with spantide. It was also found that spantide depressed the reflex response in adrenal nerve activity evoked by noxious mechanical pinching of the skin. These findings suggest the possibility that on the spinal level, substance P has an important role in the maintenance of tonic activity of the adrenal nerve and the transmission of nocicep tive information to the adrenal nerve in rats.

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Bulbospinal projections to the intermediolateral cell column; a neuroanatomical study

Cited by 298 publications

References 17 publications

Hypertension of neurogenic origin: effect of microvascular decompression of the CN IX-X root entry/exit zone and ventrolateral medulla on blood pressure in a prospective series of 48 patients with hemifacial spasm associated with essential hypertension

Hypertension of neurogenic origin: effect of microvascular decompression of the CN IX-X root entry/exit zone and ventrolateral medulla on blood pressure in a prospective series of 48 patients with hemifacial spasm associated with essential hypertension

Physiological characterization of the renal-sympathetic reflex in rabbits.

Effect of the substance P antagonist spantide on adrenal sympathetic nerve activity in rats.

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