Medullary motoneurons drive vocalization in many vertebrate lineages including fish, amphibians, birds, and mammals. The developmental history of vocal motoneuron populations in each of these lineages remains largely unknown. The highly conserved transcription factor Paired-like Homeobox 2b (Phox2b) is presumed to be expressed in all vertebrate hindbrain branchial motoneurons, including laryngeal motoneurons essential for vocalization in humans. We used immunohistochemistry and in situ hybridization to examine Phox2b protein and mRNA expression in caudal hindbrain and rostral spinal cord motoneuron populations in seven species across five chordate classes. Phox2b was present in motoneurons dedicated to sound production in mice and frogs (bullfrog, African clawed frog), but not those in bird (zebra finch) or bony fish (midshipman, channel catfish). Overall, the pattern of caudal medullary motoneuron Phox2b expression was conserved across vertebrates and similar to expression in sea lamprey. These observations suggest that motoneurons dedicated to sound production in vertebrates are not derived from a single developmentally or evolutionarily conserved progenitor pool.

No abstract

No abstract

INTRODUCTION AND OBJECTIVE: To assess decisional regret (DR) amongst patients with spina bifida (SB) regarding the decisions caregivers made to manage their neurogenic bladder (NB) as children.METHODS: Consecutive adult patients with SB were surveyed at clinic appointments (6/18-1/20). Higher DR Scale scores indicated greater DR (range 0-100). We analyzed whether presence of a ventriculoperitoneal shunt (VPS), mobility, gender, age, history of a bladder augment, history of a catheterizable channel, history of a bladder neck procedure, history of a bladder stone, history of a catheterizable channel revision, urinary incontinence, bothersome urinary incontinence, or recurrent urinary tract infection (!3/year) had any impact on DR. Non-parametric statistical tests were used.RESULTS: Ninety-six patients with a median age of 26.3 (79.2% shunted, 56.3% female) had childhood surgery for NB. Median DR score was 0 (mean 11.9). Overall, 60.4% reported no regret and of those who reported regret, 89.5% reported only mild-moderate regret. In total, 4.2% of patients reported strong or very strong regret. Having any regret was associated with having a bladder neck procedure (OR 3.45, p[0.007) or bothersome urinary incontinence (OR 5.59, p[0.001). Regret was not associated with other factors.CONCLUSIONS: Patients with SB and resultant NB reported low levels of DR after surgery to manage their NB in childhood. When present, DR is usually mild. DR is more likely in those with a bladder neck procedure or bothersome urinary incontinence.