Cord In Humans Research Articles

Electrophysiology Methods for Assessing of Neurodegenerative and Post-Traumatic Processes as Applied to Translational Research.

Electrophysiological studies have long established themselves as reliable methods for assessing the functional state of the brain and spinal cord, the degree of neurodegeneration, and evaluating the effectiveness of therapy. In addition, they can be used to diagnose, predict functional outcomes, and test the effectiveness of therapeutic and rehabilitation programs not only in clinical settings, but also at the preclinical level. Considering the urgent need to develop potential stimulators of neuroregeneration, it seems relevant to obtain objective data when modeling neurological diseases in animals. Thus, in the context of the application of electrophysiological methods, not only the comparison of the basic characteristics of bioelectrical activity of the brain and spinal cord in humans and animals, but also their changes against the background of neurodegenerative and post-traumatic processes are of particular importance. In light of the above, this review will contribute to a better understanding of the results of electrophysiological assessment in neurodegenerative and post-traumatic processes as well as the possibility of translating these methods from model animals to humans.

Current strategies for regenerative therapy of spinal cord injury

Spinal cord injury (SCI) is a leading cause of death and severe disability amongst young people. The incidence of SCI is 0.6–1.0 per 10,000 individuals. Unfortunately, there are no effective methods of restoring locomotor function for individuals with severe SCI. To address this issue, exoskeleton technology controlled using BCI is actively being developed for prosthetic locomotion. Despite the lack of encouraging data for severe spinal cord injuries, regenerative technologies continue to hold promise for spinal cord repair. The limited options for regenerating the central nervous system in humans necessitate creating new sources of neural stem cells for regeneration. Reprogramming autologous somatic cells neurologically can effectively serve as such a source [1]. Nevertheless, the constitution of neuroglial progenitors, which are necessary for regenerating damaged axons of the pyramidal tract, still requires clarification [2]. Some interesting efforts are underway to directly reprogram glial cells in situ using a variety of biotechnological approaches [3]. Overcoming or preventing the formation of a harsh scar tissue at the injury site is the key obstacle to successful regeneration therapy for SCI. Various scaffolds are being developed to facilitate axon regeneration, and several gene therapy agents are being tested to either knock down scar formation factors or activate extracellular matrix remodeling and reparative regeneration. Neuromodulation shows promise for SCI treatment. Studies indicate that epidural stimulation of the L2-S1 spinal cord in humans and mammals activates SPG neurons, aiding spinal walking generator functions. A potentially successful treatment approach involves scaffolds with reprogrammed cells and neuromodulation [4].

Improving Efficiency of Direct Pro-Neural Reprogramming: Much-Needed Aid for Neuroregeneration in Spinal Cord Injury.

Spinal cord injury (SCI) is a medical condition affecting ~2.5-4 million people worldwide. The conventional therapy for SCI fails to restore the lost spinal cord functions; thus, novel therapies are needed. Recent breakthroughs in stem cell biology and cell reprogramming revolutionized the field. Of them, the use of neural progenitor cells (NPCs) directly reprogrammed from non-neuronal somatic cells without transitioning through a pluripotent state is a particularly attractive strategy. This allows to "scale up" NPCs in vitro and, via their transplantation to the lesion area, partially compensate for the limited regenerative plasticity of the adult spinal cord in humans. As recently demonstrated in non-human primates, implanted NPCs contribute to the functional improvement of the spinal cord after injury, and works in other animal models of SCI also confirm their therapeutic value. However, direct reprogramming still remains a challenge in many aspects; one of them is low efficiency, which prevents it from finding its place in clinics yet. In this review, we describe new insights that recent works brought to the field, such as novel targets (mitochondria, nucleoli, G-quadruplexes, and others), tools, and approaches (mechanotransduction and electrical stimulation) for direct pro-neural reprogramming, including potential ones yet to be tested.

Encephalic meningioangiomatosis in a dog with high-grade undefined glioma

Meningioangiomatosis (MA) is a rare proliferative meningovascular disorder that affects mainly the cerebral cortex, brainstem and spinal cord of humans and animals and can coexist with other proliferative disorders. A 7.5-year-old male Brazilian Campeiro Bulldog died after a convulsive crisis and cardiorespiratory arrest. At necropsy, a firm, white mass involving the piriform and right occipital lobes was seen. Histologically, the mass consisted of two morphologically distinct entities that collided: a congenital malformation characterized by a proliferation of meningothelial cells around blood vessels, within the perivascular spaces; and a neoplasm composed of two cell populations with astrocytic and oligodendrocytic differentiation. Meningothelial cells and neoplastic glial cells immunolabelled for vimentin. This first reported case of encephalic MA with a high-grade undefined glioma in a dog was confirmed through clinical signs, pathological and immunohistochemical findings.

The neurons that restore walking after paralysis

A spinal cord injury interrupts pathways from the brain and brainstem that project to the lumbar spinal cord, leading to paralysis. Here we show that spatiotemporal epidural electrical stimulation (EES) of the lumbar spinal cord1–3 applied during neurorehabilitation4,5 (EESREHAB) restored walking in nine individuals with chronic spinal cord injury. This recovery involved a reduction in neuronal activity in the lumbar spinal cord of humans during walking. We hypothesized that this unexpected reduction reflects activity-dependent selection of specific neuronal subpopulations that become essential for a patient to walk after spinal cord injury. To identify these putative neurons, we modelled the technological and therapeutic features underlying EESREHAB in mice. We applied single-nucleus RNA sequencing6–9 and spatial transcriptomics10,11 to the spinal cords of these mice to chart a spatially resolved molecular atlas of recovery from paralysis. We then employed cell type12,13 and spatial prioritization to identify the neurons involved in the recovery of walking. A single population of excitatory interneurons nested within intermediate laminae emerged. Although these neurons are not required for walking before spinal cord injury, we demonstrate that they are essential for the recovery of walking with EES following spinal cord injury. Augmenting the activity of these neurons phenocopied the recovery of walking enabled by EESREHAB, whereas ablating them prevented the recovery of walking that occurs spontaneously after moderate spinal cord injury. We thus identified a recovery-organizing neuronal subpopulation that is necessary and sufficient to regain walking after paralysis. Moreover, our methodology establishes a framework for using molecular cartography to identify the neurons that produce complex behaviours.

Comparison of biological characteristics of human adipose- and umbilical cord- derived mesenchymal stem cells and their effects on delaying the progression of osteoarthritis in a rat model

BackgroundThe prevalence of osteoarthritis (OA) is constantly increasing with age. Adipose-derived (AD-) and umbilical cord-derived (UC-) mesenchymal stem cells (MSCs) are attractive alternatives in OA therapy and regenerative medicine. However, whether there are differences in the efficacy of MSCs derived from different tissues in the cartilage regeneration, and the frequency of administration of MSCs needs to be further studied. ExperimentUC-MSCs and AD-MSC were isolated from the umbilical cord and subcutaneous fatty tissue of humans respectively and identified by flow cytometry. In vitro, the proliferation ability and chondrogenic potential of AD-MSCs and UC-MSCs were analyzed. In vivo, forty-three Sprague-Dawley rats were used for the OA model induced by ACLT surgery. OA rats were divided into a sham group, an ACLT model group, and two therapy groups (treated with AD-MSCs or UC-MSCs). Therapy groups were treated using a single or repeated twice injection of AD-MSCs and UC-MSCs at a concentration of 1.0 × 106 cells and were followed up for 12 weeks. Serial sections of knees were examined for histological, immunohistochemical and TUNEL analysis. ResultsWe demonstrated that the proliferation of UC-MSCs was higher than that of AD-MSCs, consistent with the bigger pellets from UC-MSCs in a chondrogenic induction medium. Degeneration of articular cartilage was observed in histological appearance of Safranine O and Toluidine blue staining, and quantitative results of modified Mankin’s Score. Importantly, both AD-MSCs and UC-MSCs transplantation significantly attenuated ACLT surgical-induced OA development. In addition, ACLT-induced reduction in cartilage extracellular matrix synthesis (aggrecan) was significantly suppressed by AD-MSCs or UC-MSCs transplantation. TUNEL assay showed that AD-MSCs and UC-MSCs treatments significantly protected chondrocytes against apoptosis compared with the ACLT group. No significant differences were observed between single injections and repeated twice injections. ConclusionsThe current study suggested that, in vitro, AD-MSCs and UC-MSCs showed a comparable chondrogenic potential, although UC-MSCs displayed a superior proliferation capacity. Furthermore, our results confirmed that the injection of AD-MSCs and UC-MSCs, either single or repeated twice, could significantly inhibit the progression of ACLT-induced osteoarthritis with a similar effect, and MSCs transplantation can decrease the apoptosis of articular chondrocytes caused by ACLT.

A critical reappraisal of corticospinal tract somatotopy and its role in traumatic cervical spinal cord syndromes.

The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.

A preliminary safety assessment of vertebral augmentation with 32P brachytherapy bone cement

Comprehensive treatment for vertebral metastatic lesions commonly involves vertebral augmentation (vertebroplasty or kyphoplasty) to relieve pain and stabilize the spine followed by multiple sessions of radiotherapy. We propose to combine vertebral augmentation and radiotherapy into a single treatment by adding 32P, a β-emitting radionuclide, to bone cement, thereby enabling spinal brachytherapy to be performed without irradiating the spinal cord. The goal of this study was to address key dosimetry and safety questions prior to performing extensive animal studies. The 32P was in the form of hydroxyapatite powder activated by neutron bombardment in a nuclear reactor. We performed ex vivo dosimetry experiments to establish criteria for safe placement of the cement within the sheep vertebral body. In an in vivo study, we treated three control ewes and three experimental ewes with brachytherapy cement containing 2.23–3.03 mCi 32P ml−1 to identify the preferred surgical approach, to determine if 32P leaches from the cement and into the blood, urine, or feces, and to identify unexpected adverse effects. Our ex vivo experiments showed that cement with 4 mCi 32P ml−1 could be safely implanted in the vertebral body if the cement surface is at least 4 mm from the spinal cord in sheep and 5 mm from the spinal cord in humans. In vivo, a lateral retroperitoneal surgical approach, ventral to the transverse processes, was identified as easy to perform while allowing a safe distance to the spinal cord. The blood, urine, and feces of the sheep did not contain detectable levels of 32P, and the sheep did not experience any neurologic or other adverse effects from the brachytherapy cement. These results demonstrate, on a preliminary level, the relative safety of this brachytherapy cement and support additional development and testing.

Motavkin Scientific School

Remembrance of the outstanding scientist Professor P.A. Motavkin is largely connected with the creation of the famous neuromorphological school in Vladivostok. During a relatively short historical period, scientific discoveries were made under the leadership of P.A. Motavkin. New ideas about the mechanisms of vascular regulation of the brain and spinal cord of humans and animals were presented on the basis of these discoveries. Extensive factual material accumulated over the years of research has allowed not only to identify the basic laws of the functioning of this regulatory system in normal conditions of life, but also to solve a number of problems related to the correction of its disorders in case of vascular diseases.

Translational PET Imaging of Spinal Cord Injury with the Serotonin Transporter Tracer [11C]AFM.

The descending raphespinal serotonin (5-HT) system contributes to neural activities required for locomotion. The presynaptic serotonin transporter (SERT) is a marker of 5-HT innervation. In this study, we explored the use of PET imaging with the SERT radioligand [11C]AFM as a biomarker of 5-HT axon damage after spinal cord injury (SCI) in a rodent model and its translation to imaging SCI in humans. PET imaging with [11C]AFM was performed in healthy rats under baseline and citalopram blocking conditions and a mid-thoracic transection rat model of SCI. The lumbar-to-cervical activity (L/C) ratio was calculated for the healthy and SCI animals to assess SERT binding decrease after SCI. Finally, translation of [11C]AFM PET was attempted to explore its potential to image SCI in humans. Intense uptake in the brain and intact spinal cord was observed at 30-60min post-injection of [11C]AFM in healthy rats. About 65% of [11C]AFM uptake in the spinal cord was blocked by citalopram. In the SCI rat model, the cervical uptake of [11C]AFM was similar to that in healthy rats, but the lumbar uptake was dramatically reduced, resulting in about half the L/C ratio in SCI rats compared to healthy rats. In contrast, [11C]AFM uptake in the human spinal cord showed no obvious decrease after treatment with citalopram. In the human subjects with SCI, decreases in [11C]AFM uptake were also not obvious in the section of spinal cord caudal to the injury point. [11C]AFM PET imaging of SERT provides a useful preclinical method to non-invasively visualize the rodent spinal cord and detect SERT changes in SCI rodent models. However, there appears to be little detectable specific binding signal for [11C]AFM in the human spinal cord. An SERT tracer with higher affinity and lower non-specific binding signal is needed to image the spinal cord in humans and to assess the axonal status in SCI patients.

Hydrocephalus associated to cervical hydromyelia /syringomyelia in domestic carnivores secondary to brain inflammatory conditions: New insights on MR imaging comparing to humans and critical review of the literature

Background: Communication or anatomic continuity of the fourth ventricle outlet (FVO) with the central cervical ependymal canal (CCEC) of the spinal cord in both humans and mammals is controversial. Aim: We hypothesize that in chronic inflammatory brain conditions (CIBC) and in early stages of age this communication can be reopened. For this purpose we have conducted a study to check the potential continuity of FVO with the CCEC of the spinal cord in small domestic carnivores presenting with obstructive hydrocephalus (OH) secondary to CIBC. Methods: Retrospective neuroradiological evaluation of a case series involving 23 domestic carnivores with CIBC presenting with both OH and cervical hydromyelia/syringomyelia. MR images checked specifically the continuity between the FVO and the CCEC. Results: There were 18 adult and five young domestic carnivores. Anatomical continuity between the FVO and a dilated CCEC (hydromyelia) could be demonstrated on MR imaging in all young cases but in only 16 % of adult cases. Conclusions: This study provides additional insights into understanding the relationship between the development of hydrocephalus and hydro/syringomyelia. MRI findings support that domestic carnivores have a virtual CCEC that is connected with the FVO at birth and might disappears over the years in normal, healthy animals, thus explaining hydromyelia in early stages of age rather than syringomyelia, in hydrocephalic conditions. When this anatomical continuity is present, the hydrodynamic theory have a pivotal role in the pathogenesis of hydromyelia. If not (most adult cases) other mechanisms may be activated and lead to spinal cord syringomyelia. Key words: CNS, inflammatory diseases; CNS, animal diseases; Hydromyelia; Syringomyelia; MR imaging, hydromyelia; MR imaging, syringomyelia; MR imaging, obstructive hydrocephalus;

Interactions between nesfatin-1 and the autonomic nervous system—An overview

Nesfatin-1, an 82-amino acid polypeptide derived from the precursor protein nucleobindin-2 (NUCB2), was first discovered in 2006 in the rat hypothalamus. The effects and distribution of nesfatin-1 immunopositive neurons in the brain and spinal cord point towards a role of NUCB2/nesfatin-1 in autonomic regulation. Therefore, studies which have been conducted to investigate the interplay between nesfatin-1 and the autonomic nervous system were examined, and the outcomes of this research were summarized. NUCB2/nesfatin-1 immunoreactivity is widely distributed in autonomic centers of the brain and spinal cord in both rodents and humans. In several regions of the hypothalamus, midbrain and brainstem, nesfatin-1 modulates autonomic functions. On the other hand, the autonomic nervous system also influences the activity of nesfatin-1 neurons. Here, the vagus nerve seems to be a crucial factor in the regulation of nesfatin-1. In summary, although data here is still sparse, there is a clear interplay between nesfatin-1 and the autonomic nervous system, the precise clarification of which still requires further research to gain more insight into these complex relationships.

What Is the Trigger for Sexual Climax?

A model is proposed to consider sexual climax in men, women, and animals as a unitary phenomenon. Sexual climax is a stereotyped rhythmic pattern of spinally generated neural activity in the autonomic and somatic nerves innervating pelvic organs. A column of neurons in the spinal cord of the male rat is strongly activated by ejaculation (sexual climax in the male). These neurons project to the thalamus and are therefore called lumbar spinothalamic cells (LSt cells). Comprehensive studies have demonstrated that the LSt cells constitute a central pattern generator of ejaculation. These findings have been extended to female animals. Further studies identified LSt cells in the lumbar spinal cord of men and women. Strong evidence indicates that the LSt cells mediate ejaculation in men. The climax model generalizes and extends these studies. It postulates that LSt cells in the lumbar spinal cord of humans and animals of both sexes generate climax. The LSt cells generate the neural activity driving the pelvic contractions and other responses of climax. The activity is transmitted to supraspinal sites to activate orgasm. The LSt cells receive excitatory and inhibitory projections from supraspinal sites. The descending projections reflect subjective arousal and inhibitions. Spinal sensory neurons from the genitals provide excitatory and inhibitory innervation to the LSt cells. These represent pleasurable and noxious sensations. The supraspinal and spinal excitatory and inhibitory inputs are integrated by the LSt. When the sum of the excitatory inputs, minus the sum of the inhibitory inputs reaches a threshold, the LSt cells generate sexual climax.

Randomised clinical trial: Effect of administering platelet-rich fibrin to autologous fat tissue in injection laryngoplasty for vocal cord paralysis

The vocal cord in humans is essential in producing voice used in communication and interaction between us. Vocal cord paralysis causes dysphonia, which interferes with communication, causing disruptions towards social activity and daily activities. One of the managements for vocal cord paralysis is medialization and augmentation of the vocal cord through injection laryngoplasty. Autologous fat is one of the best fillers used in this procedure, but it is highly absorbable and can be reabsorbed very quickly when injected into body tissues. Platelet Rich Fibrin (PRF) is a biomaterial consisting of growth factors that are thought to improve fat tissue viability by increasing adipogenesis and angiogenesis. Improvement in fat viability will improve clinical outcomes after the laryngoplasty procedure, potentially reducing the number of repeated injections needed to achieve a satisfactory resolution to vocal cord paralysis. The study evaluates a combination of PRF and autologous microlobular fat compared with autologous microlobular fat alone on laryngoplasty. This single-blinded randomised control trial recruit a total of 18 patients, which are then randomised into the treatment and control groups. The evaluation was done via computerized acoustic analysis/Multidimensional Voice Program (MDVP) parameters and maximum phonation time. The MDVP results and maximum phonation time in both groups showed clinical improvement after the operation with no statistically significant differences.

DISTRIBUTION OF RABIES THAT INFECT HUMAN IN INDONESIA DURING ONE LAST DECADE

Rabies is a zoonosis that attacks the central nervous system with the ultimate goal of the central nervous system, brain, and spinal cord of warm-blooded animals and humans. The rabies virus is secreted with the saliva of infected animals and is transmitted through bites or licks on the skin injured by Animal Transmission Rabies (HPR), especially dogs, cats, and monkeys. This article is a literature review of the threat of distribution of rabies that infects humans in Indonesia in one last decade. Data collection is carried out through library research from reports of rabies cases during one last decade. Around the world, every year an estimated 24,000 people are bitten by dogs and other animals suffering from rabies. The first rabies case in Indonesia occurred in 1884. Reports of rabies cases in the last decade are still fluctuating. The average number of bite cases of rabies-carrying animals (GHPR) every year in humans in the past decade has been reported as many as 66,939 cases, and 50,065 cases (74.79%) of which get Anti-Rabies Vaccine (VAR). In the last report in 2019, the number of HPR bite cases was 100,826 cases and 67,625 cases (67%) received VAR. Until 2019, rabies is spread in 26 provinces in Indonesia. Mass vaccination as a method for controlling rabies has been known since 1920. Rabies vaccination is the most effective approach in controlling rabies in both animals and humans.

Magnetic resonance imaging in dogs with neuroangiostrongyliasis (rat lungworm disease).

The magnetic resonance imaging (MRI) appearance of the brain and spinal cord in humans with neuroangiostrongyliasis (NA) due to Angiostrongylus cantonensis infection has been well reported. Equivalent studies in animals are lacking. This case series describes clinical and MRI findings in 11 dogs with presumptively or definitively diagnosed NA. MRI of the brain and/or spinal cord was performed using high-field (1.5 T) or low-field (0.25 T) scanners using various combinations of transverse, sagittal, dorsal and three-dimensional (3D) T1-weighted (T1W), transverse, sagittal and dorsal T2-weighted (T2W), T2W fluid-attenuated inversion recovery (FLAIR) and T2*-weighted (T2*W) gradient echo (GRE), dorsal T2W short tau inversion recovery (STIR) and post-gadolinium transverse, sagittal, dorsal and 3D T1W and transverse T2W FLAIR sequences. In 4/6 cases where the brain was imaged, changes consistent with diffuse meningoencephalitis were observed. Evidence of meningeal involvement was evident even when not clinically apparent. The spinal cord was imaged in 9 dogs, with evidence of meningitis and myelitis detected in regions consistent with the observed neuroanatomical localization. Pathognomonic changes of neural larva migrans, as described in some human patients with NA, were not detected. NA should be considered in the differential diagnosis of dogs with MRI evidence of focal or diffuse meningitis, myelitis and/or encephalitis, especially in areas where A. cantonensis is endemic. If not precluded by imaging findings suggestive of brain herniation, cerebrospinal fluid (CSF) collection for cytology, fluid analysis, real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) testing should be considered mandatory in such cases after the MRI studies.

Diagnosis of conduction block in cervical myelopathy patients by non-invasive magnetospinography

We had previously reported that magnetospinography (MSG) enables visualization of electrophysiological activity in the cervical spinal cord in healthy humans. In this study, we measured MSG after the peripheral nerve stimulation in patients with cervical myelopathy and evaluated feasibility of MSG. Eight patients with cervical myelopathy diagnosed by neurological findings and imaging findings were recruited. MSG was measured on the surface of the dorsal neck in response to the median nerve or ulnar nerve stimulation. Neural currents were calculated from recorded magnetic fields and were superimposed on X-ray images. We could record cervical MSG in all patients. In six of the eight cases, ascending neural currents were blocked at the caudal end of spinal cord compressions (including single compressive lesion) on MRI. In one case of C4/5 compression with widespread T2 high area in spinal cords on MRI, a conduction block site was at the caudal end of the T2 high area. In one case with multiple compressions in C3-6, neural currents flowed into the intervertebral foramen but did not ascend the spinal canal. In the present study, electrophysiological information from MSG were consistent with the neurological findings and the imaging studies. MSG is completely non-invasive and enable detailed diagnosis of the conduction block site of the spinal cord. MSG is expected to be an innovative neurophysiology test.

Mechanisms of blood flow regulation of in the skin during stimulation of the spinal cord in humans

Changes of the blood flow in the shin skin in the case of 12 healthy subjects by laser doppler flowmetry were observed under transcutaneous electrical spinal cord stimulation (TSCS) by subthreshold bipolar pulses with a frequency of 30 Hz were detected. It was found that the TSCS in the area of the vertebrae T11 and L1 leads to a significant increase in skin blood flow. With a stimulus intensity of 90% of the motor threshold, the microcirculation rate increased by more than 85% relative to baseline.The results of the study show that the stimulation of blood flow in the skin by TSCS is realized mainly due to the antidromic stimulation of sensory nerve fibers. An important mediator that contributes to vasodilation and increase of cutaneous blood flow in PSCS is nitric oxide (NO), which is predominantly endothelial in origin.

Mechanisms of Blood Flow Regulation in the Skin during Stimulation of the Spinal Cord in Humans

Changes in the blood flow in the shin skin were observed by laser Doppler flowmetry after transcutaneous electrical spinal cord stimulation (TSCS) by subthreshold bipolar pulses with a frequency of 30 Hz in 12 healthy subjects. It was found that TSCS in the area of the T11 and L1 vertebrae led to a significant increase in skin blood flow. The microcirculation rate increased by more than 85% relative to the baseline at a stimulus intensity of 90% of the motor threshold. Cutaneous blood flow activization by TSCS is implemented mainly through the antidromic stimulation of sensory nerve fibers. Nitric oxide (NO) is an important mediator that contributes to vasodilation and increase in cutaneous blood flow upon TSCS. NO is predominantly of endothelial origin.

WT1-Expressing Interneurons Regulate Left-Right Alternation during Mammalian Locomotor Activity.

The basic pattern of activity underlying stepping in mammals is generated by a neural network located in the caudal spinal cord. Within this network, the specific circuitry coordinating left-right alternation has been shown to involve several groups of molecularly defined interneurons. Here we characterize a population of spinal neurons that express the Wilms' tumor 1 (WT1) gene and investigate their role during locomotor activity in mice of both sexes. We demonstrate that WT1-expressing cells are located in the ventromedial region of the spinal cord of mice and are also present in the human spinal cord. In the mouse, these cells are inhibitory, project axons to the contralateral spinal cord, terminate in close proximity to other commissural interneuron subtypes, and are essential for appropriate left-right alternation during locomotion. In addition to identifying WT1-expressing interneurons as a key component of the locomotor circuitry, this study provides insight into the manner in which several populations of molecularly defined interneurons are interconnected to generate coordinated motor activity on either side of the body during stepping.SIGNIFICANCE STATEMENT In this study, we characterize WT1-expressing spinal interneurons in mice and demonstrate that they are commissurally projecting and inhibitory. Silencing of this neuronal population during a locomotor task results in a complete breakdown of left-right alternation, whereas flexor-extensor alternation was not significantly affected. Axons of WT1 neurons are shown to terminate nearby commissural interneurons, which coordinate motoneuron activity during locomotion, and presumably regulate their activity. Finally, the WT1 gene is shown to be present in the spinal cord of humans, raising the possibility of functional homology between these species. This study not only identifies a key component of the locomotor circuitry but also begins to unravel the connectivity among the growing number of molecularly defined interneurons that comprise this neural network.