Brainstem enkephalinergic projections to spinal autonomic nuclei

Romagnano, MA; Harshbarger, RJ; Hamill, RW

doi:10.1523/jneurosci.11-11-03539.1991

Cited by 29 publications

(23 citation statements)

References 75 publications

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“…The finding that pressor sites within the RVMM region innervate a number of cardiovascular control areas within the brainstem and spinal cord is consistent with several studies using both anterograde and retrograde tracttracing techniques to identify the efferent projections of RVMM neurons (Allen and Cechetto, 1994;Bowker et al, 1981a,b;Dobbins and Feldman, 1994;Ellenberger and Feldman, 1990;Ellenberger et al, 1992;Hadziefendic and Haxhiu, 1999;Holtman et al, 1990;Holtman and Speck, 1994;Jones et al, 1991;Kausz, 1991;Loewy, 1981;Romagnano et al, 1991;Sasek and Helke, 1989;Sasek et al, 1990;Smith et al, 1989;Stornetta and Guyenet, 1999;Zagon, 1995;Zemlan et al, 1984). Of considerable interest in this study was the finding of a dense innervation in the brainstem of both the dorsal vagal complex and the Amb/ VLM region.…”

Section: Discussionsupporting

confidence: 86%

“…Direct bilateral projections to the intermediolateral nucleus, nucleus intercalatus, and the central autonomic area (lamina X) surrounding the central canal have been demonstrated from pressor sites in the RVMM region. This finding is supported by a number of retrograde tract-tracing studies showing that spinal cord injections that included these autonomic areas resulted in the labeling of neurons scattered within the RVMM region (Allen and Cechetto, 1994;Holtman and Speck, 1994;Jones et al, 1991;Kausz, 1991;Loewy, 1981;Romagnano et al, 1991;Sasek and Helke, 1989;Sasek et al, 1990;Smith et al, 1989;Stornetta and Guyenet, 1999).…”

mentioning

confidence: 56%

“…Data from retrograde tract-tracing studies have shown that neurons in the region of RVMM project to the thoracic spinal cord (Allen and Cechetto, 1994;Jones et al, 1991;Kausz, 1991;Loewy, 1981;Romagnano et al, 1991;Sasek and Helke, 1989;Sasek et al, 1990;Stornetta and Guyenet, 1999;Zemlan et al, 1984), although the precise sites of termination within the spinal cord are not known. However, there are data to suggest that some of these neurons in the RVMM region may innervate the thoracolumbar intermediolateral nucleus, as injections of the anterograde tract-tracer Fluoro-Ruby into the medial medullary reticular formation around the caudal levels of the RVMM region resulted in labeling within the region of the intermediolateral nucleus (Hermann et al, 2003).…”

mentioning

confidence: 99%

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Medullary and spinal cord projections from cardiovascular responsive sites in the rostral ventromedial medulla

Babic

Ciriello

2004

J of Comparative Neurology

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The rostral ventromedial medulla (RVMM) is a sympathoexcitatory area. However, little is known about its efferent projections. In this study, biotinylated dextran amine (BDA) or Phaseolus vulgaris leucoagglutinin (PHA-L) were used to investigate the medullary and spinal cord projections from pressor sites in RVMM. Initially, RVMM was systematically explored in urethane-anesthetized rats using microinjection of L-glutamate for sites that elicited increases in arterial pressure. A pressor area was identified that included the rostral magnocellular reticular and rostral lateral paragigantocellular reticular nuclei. In the second series of experiments, BDA or PHA-L was iontophoretically injected into RVMM pressor sites. Anterograde labeling was observed throughout the brainstem and spinal cord, bilaterally, but with an ipsilateral predominance. Dense labeling was observed within the nucleus of the solitary tract (NTS); the greatest density of labeling was observed in the caudal dorsolateral, medial, and ventrolateral subnuclei. Additionally, light to moderately dense labeling was found within the nucleus substantia gelatinosus and commissural nucleus. In the nucleus ambiguus/ventrolateral medullary (Amb/VLM) region, the density of labeling was greatest in caudal regions. Within Amb, most of the labeling was localized to its external formation. Anterograde labeling was also found throughout the spinal cord. In the thoracolumbar segments, dense axonal labeling was observed within the dorsolateral funiculus. These labeled axons innervated the intermediolateral nucleus and the central autonomic area. Taken together, these data suggest that RVMM neurons elicit increases in sympathetic activity by likely providing a direct excitatory input to spinal sympathetic preganglionic neurons, and by a direct inhibitory input to medullary cardioinhibitory and depressor areas.

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Section: Discussionsupporting

confidence: 86%

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confidence: 56%

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confidence: 99%

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Medullary and spinal cord projections from cardiovascular responsive sites in the rostral ventromedial medulla

Babic

Ciriello

2004

J of Comparative Neurology

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“…7) suggests that stimulation of ventrolateral PAG sites may also produce a depressor effect by activating A5 neurons that innervate the intermediolateral cell column. This suggestion is supported by several anatomical studies that have demonstrated that noradrenergic neurons in the A5 cell group innervate the intermediolateral cell column in thoracic spinal cord segments (Loewy et al, 1979b;Byrum and Guyenet, 1987;Romagnano et al, 1991;Clark and Proudfit, 1993). In addition, stimulation of sites near A5 neurons produces both pressor and depressor effects (Loewy et al, 1979a(Loewy et al, , 1986Staneck et al, 1984;Drye et al, 1990;Burnett and Gebhart, 1991).…”

Section: Function Of Neurons In the Ventrolateral Pag That Project Tomentioning

confidence: 61%

“…In addition to innervating the intermediolateral cell column in thoracic spinal cord segments (Loewy et al, 1979b;Byrum and Guyenet, 1987;Romagnano et al, 1991;Clark and Proudfit, 1993), neurons located in the A5 cell group in Sasco Sprague-Dawley rats innervate spinal cord laminae IV-VII (Clark and Proudfit, 1993), where numerous nociceptive neurons are located (Light, 1992). These observations provide anatomical support for the suggestion that these A5 neurons modulate nociception.…”

Section: Function Of Neurons In the Ventrolateral Pag That Project Tomentioning

confidence: 99%

Projections of neurons in the periaqueductal gray to pontine and medullary catecholamine cell groups involved in the modulation of nociception

1999

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Predicting mortality in patients with rheumatoid arthritis

Wolfe¹,

Michaud²,

Gefeller³

et al. 2003

Arthritis & Rheumatism

247

115

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Objective. A number of different variables have been proposed as risk factors for mortality in patients with rheumatoid arthritis (RA), but limited prospective information on the magnitude of their effects is available. This study was undertaken to evaluate the relative predictive strength and usefulness of a wide range of variables on the risk of mortality in a large, long-term, prospectively studied cohort of patients with RA.Methods. Over a 20-year period of followup beginning in 1981, 1,387 consecutive RA patients were seen in a single clinic. A wide range of clinical and demographic assessments were recorded and entered into a computer database at the time of each clinical assessment. Assessment of predictive strength included determination of standardized and fourth-versus-firstquartile odds ratios (ORs), goodness-of-fit measures, and contributing fraction.Results. The Health Assessment Questionnaire (HAQ) disability index was the strongest clinical predictor of mortality. A 1-SD change in the HAQ resulted in a much larger increase in the odds ratio for mortality compared with a 1-SD change in global disease severity, the next most powerful predictor of mortality (OR 2.31 versus 1.83). Considering the contributing fraction, mortality would be reduced by 50% for the HAQ and by 33% for global disease severity if patients in the fourth quartile for these variables could be switched to the first quartile. Global disease severity, pain, depression, anxiety, and laboratory and radiographic features were significantly weaker predictors. Disease duration, nodules, and tender joint count were clinical variables that provided very little predictive information. In multivariable analyses, HAQ and other patient self-report measures were significantly better predictors than were radiographic and laboratory variables. A single baseline observation provided the least information, with substantially increasing predictive ability associated with 1-year, 2-year, and all-time point followup observations (time-varying covariates).Conclusion. In this large 20-year study from routine clinical practice, the HAQ was the most powerful predictor of mortality, followed by other patient self-report variables. Laboratory, radiographic, and physical examination data were substantially weaker in predicting mortality. We recommend that clinicians collect patient self-report data, since they produce more useful clinical outcome information than other available clinical measures.

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Brainstem enkephalinergic projections to spinal autonomic nuclei

Cited by 29 publications

References 75 publications

Medullary and spinal cord projections from cardiovascular responsive sites in the rostral ventromedial medulla

Medullary and spinal cord projections from cardiovascular responsive sites in the rostral ventromedial medulla

Projections of neurons in the periaqueductal gray to pontine and medullary catecholamine cell groups involved in the modulation of nociception

Predicting mortality in patients with rheumatoid arthritis

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