Nerve Impulses Research Articles

ELECTRONEUROMYOGRAPHY AS ONE OF THE METHODS OF DIAGNOSTICS OF PATHOLOGIES OF DIFFERENT GENESIS (LITERATURE REVIEW)

Modern possibilities of using the auxiliary method of electroneuromyography (ENMG) research by narrow specialists are multifaceted. This is primarily due to the safety and wide range of its use in clinical practice. Thus, diagnostics of the speed and time of the nerve impulse to organs and tissues, as well as the ability of the muscular apparatus to respond to stimulation of nerve endings is increasingly used in neurological, coloproctological, urological, surgical, endocrinological, pediatric specialties, in occupational medicine. The heterogeneity of the use of electroneuromyography in clinical medicine allows to identify functional and organic pathologies of the nervous and muscular apparatus, the causes of their occurrence and further development, the extent of the spread of the pathological process, as well as to establish the stages of the detected violation and assess possible risks for the subsequent life of patients. This is achieved by determining the main parameters of individual motor units that are functional elements of each skeletal muscle: shape, amplitude, duration, latent period of evoked potentials and analysis of spontaneous activity of the muscle fiber. Interpretation of the data obtained together with clinical manifestations of neuromotor diseases and with the results of additional research methods allow clinicians to make the correct diagnosis and choose the necessary tactics for managing patients with neuromuscular pathology.

Contributions of Non-Neuronal Cholinergic Systems to the Regulation of Immune Cell Function, Highlighting the Role of α7 Nicotinic Acetylcholine Receptors.

Loewi's discovery of acetylcholine (ACh) release from the frog vagus nerve and the discovery by Dale and Dudley of ACh in ox spleen led to the demonstration of chemical transmission of nerve impulses. ACh is now well-known to function as a neurotransmitter. However, advances in the techniques for ACh detection have led to its discovery in many lifeforms lacking a nervous system, including eubacteria, archaea, fungi, and plants. Notably, mRNAs encoding choline acetyltransferase and muscarinic and nicotinic ACh receptors (nAChRs) have been found in uninnervated mammalian cells, including immune cells, keratinocytes, vascular endothelial cells, cardiac myocytes, respiratory, and digestive epithelial cells. It thus appears that non-neuronal cholinergic systems are expressed in a variety of mammalian cells, and that ACh should now be recognized not only as a neurotransmitter, but also as a local regulator of non-neuronal cholinergic systems. Here, we discuss the role of non-neuronal cholinergic systems, with a focus on immune cells. A current focus of much research on non-neuronal cholinergic systems in immune cells is α7 nAChRs, as these receptors expressed on macrophages and T cells are involved in regulating inflammatory and immune responses. This makes α7 nAChRs an attractive potential therapeutic target.

Insights into Nerve Signal Propagation: The Effect of Extracellular Space in Governing Neuronal Signal for healthy and injured Nerve Fiber using Modified Cable Model

Nerve injuries are complex medical conditions that may arise from a variety of traumatic events or diseases, altering the intricate structure of neural pathways. During neuronal injury, the potassium and sodium ion concentration that controls signaling endures significant changes such as the ion channels getting blocked or an increase in the intracellular ionic concentration. The Extracellular Space which surrounds a nerve fiber has a significant impact on the neuronal signal and variation in its size can alter neuronal signal transmission. Hence, to fully understand neuronal signal transmission, it is essential to explore the effect that the Extracellular Space exerts on the neuronal signal. The aim of this study is to develop a mathematical model which yields a simplistic yet robust mathematical expression of the nerve membrane potential, incorporating the Extracellular Space dependent parameters for having a holistic approach towards understanding neuronal signal transmission in healthy and injured nerve fiber. The conventional cable model focuses solely on the intrinsic properties of the nerve fiber, but the current work expands this model by incorporating the Extracellular Space dependent parameters into the final membrane potential expression. The results obtained from this study shows that certain combination of the Extracellular Space and fiber diameter could bring about hyperexcitation whereas in some cases it may lead to hypoexcitation to the neuronal signal as it propagates along the nerve fiber. Moreover, prolonged refractory period and delayed refractory period are also observed in certain combination of the Extracellular Space and fiber diameter. The proposed framework manages to show trends associated with certain medical conditions and may also be useful to further understand, and early diagnosis of various neurological conditions under the effect of an Extracellular Space of varied sizes.

Smart grading of diabetic retinopathy: an intelligent recommendation-based fine-tuned EfficientNetB0 framework.

Diabetic retinopathy is a condition that affects the retina and causes vision loss due to blood vessel destruction. The retina is the layer of the eye responsible for visual processing and nerve signaling. Diabetic retinopathy causes vision loss, floaters, and sometimes blindness; however, it often shows no warning signals in the early stages. Deep learning-based techniques have emerged as viable options for automated illness classification as large-scale medical imaging datasets have become more widely available. To adapt to medical image analysis tasks, transfer learning makes use of pre-trained models to extract high-level characteristics from natural images. In this research, an intelligent recommendation-based fine-tuned EfficientNetB0 model has been proposed for quick and precise assessment for the diagnosis of diabetic retinopathy from fundus images, which will help ophthalmologists in early diagnosis and detection. The proposed EfficientNetB0 model is compared with three transfer learning-based models, namely, ResNet152, VGG16, and DenseNet169. The experimental work is carried out using publicly available datasets from Kaggle consisting of 3,200 fundus images. Out of all the transfer learning models, the EfficientNetB0 model has outperformed with an accuracy of 0.91, followed by DenseNet169 with an accuracy of 0.90. In comparison to other approaches, the proposed intelligent recommendation-based fine-tuned EfficientNetB0 approach delivers state-of-the-art performance on the accuracy, recall, precision, and F1-score criteria. The system aims to assist ophthalmologists in early detection, potentially alleviating the burden on healthcare units.

Human oligodendrocyte-like cell differentiation is promoted by TSPO-mediated endogenous steroidogenesis

Mature oligodendrocytes (OLs) arise from oligodendrocyte precursor cells that, in case of demyelination, are recruited at the lesion site to remyelinate the axons and therefore restore the transmission of nerve impulses. It has been widely documented that exogenously administered steroid molecules are potent inducers of myelination. However, little is known about how neurosteroids produced de novo by OLs can impact this process.Here, we employed a human OL precursor cell line to investigate the role of de novo neurosteroidogenesis in the regulation of OLs differentiation, paying particular attention to the 18 kDa Translocator Protein (TSPO) which controls the rate-limiting step of the neurosteroidogenic process. Our results showed that, over the time of OL maturation, the availability of cholesterol, which is the neurosteroidogenesis initial substrate, and key members of the neurosteroidogenic machinery, including TSPO, were upregulated. In addition, OLs differentiation was impaired following neurosteroidogenesis inhibition and TSPO silencing. On the contrary, TSPO pharmacological stimulation promoted neurosteroidogenic function and positively impacted differentiation.Collectively, our results suggest that de novo neurosteroidogenesis is actively involved in the autocrine and paracrine regulation of human OL differentiation. Moreover, since TSPO was able to promote OL differentiation through a positive modulation of the neurosteroid biosynthetic process, it could be exploited as a promising target to tackle demyelinating diseases.

Epidemiology, Diagnosis and Reconstruction of Anterior Cruciate Ligament Injury

Both female athletes and physically active persons are susceptible to anterior cruciate ligament (ACL) rupture, a common sports-related injury. The ACL is structurally complex and is considered to be an important proprioceptor, as well as limiting tibial translation. The standard test for ACL tears is magnetic resonance imaging (MRI); however, there is currently no suitable method to accurately determine the severity of the injury. Numerous factors, including gender, muscle strength, and exercise habits, are linked to the causes of ACL tears. ACL tears prevent athletes from playing sports in the near future. They could eventually develop psychological problems, chronic knee disease, and blocked nerve signals, all of which would lower their post-ACL repair return numbers and performance. Reconstruction and recovery are the two stages of ACL treatment, and the therapy plan should be tailored to each patient's unique needs. Athletes' leg muscles should be strengthened as the primary means of preventing ACL injuries, but venues and coaches should also be taken into account.

Addition of low sodium does not increase sensitivity to glucose in wild-type mice, or lead to partial glucose taste detection in T1R3 knock-out mice

The sodium glucose cotransporter 1 (SGLT1) has been proposed as a non-T1R glucosensor contributing to glucose taste. Studies have shown that the addition of NaCl at very weak concentrations to a glucose stimulus can enhance signaling in the gustatory nerves of mice and significantly lower glucose detection thresholds in humans. Here, we trained mice with (wild-type; WT) and without (knockout; KO) a functioning T1R3 subunit on a two-response operant detection task to differentially respond to the presence or absence of a taste stimulus immediately after sampling. After extensive training (∼40 sessions), KO mice were unable to reliably discriminate 2 M glucose+0.01 M NaCl from 0.01 M NaCl alone, but all WT mice could. We then tested WT mice on a descending array of glucose concentrations (2.0–0.03 M) with the addition of 0.01 M NaCl vs. 0.01 M NaCl alone. The concentration series was then repeated with glucose alone vs. water. We found no psychophysical evidence of a non-T1R taste transduction pathway involved in the detection of glucose. The addition of NaCl to glucose did not lower taste detection thresholds in WT mice, nor did it render the stimulus detectable to KO mice, even at 2 M. The proposed pathway must contribute to functions other than sensory-discriminative detection, at least when tested under these conditions. Detection thresholds were also derived for fructose and found to be 1/3 log10 lower than for glucose, but highly correlated (r = 0.88) between the two sugars, suggesting that sensitivity to these stimuli in this task was based on a similar neural process.

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

The vagus nerve is the only pathway for transmitting parasympathetic signals between the brain and thoracoabdominal organs, thereby exhibiting anti-inflammatory functions through the cholinergic anti-inflammatory pathway. Despite often being resected during lymph node dissection in upper gastrointestinal cancer surgery, the impact of vagotomy on postoperative outcomes in gastric cancer patients remains unclear. Sub-diaphragmatic vagotomy was performed on C57BL/6 mice. Three weeks later, syngeneic murine gastric cancer cell line YTN16P was injected into the peritoneal cavity, and the number of peritoneal metastases (PM) on the mesentery and omentum compared with control mice. The phenotypes of immune cells in peritoneal lavage and omental milky spots one day after tumor inoculation were analyzed using flow cytometry and immunohistochemistry. Intraperitoneal transfer of 3 × 105 YTN16P significantly increased the number of metastatic nodules on the mesentery in the vagotomy group compared to the control group. The omental metastasis grade was also significantly higher in the vagotomy group. Phenotypic analysis of immune cells in peritoneal lavage did not reveal significant differences after vagotomy. However, vagotomized mice exhibited a notable increase in milky spot area, with a higher presence of cytokeratin(+) tumor cells, F4/80(+) macrophages, and CD3(+) T cells. Vagus nerve signaling appears to regulate the immune response dynamics within milky spots against disseminated tumor cells and inhibits the development of PM. Preserving the vagus nerve may offer advantages in advanced gastric cancer surgery to reduce peritoneal recurrence.

Pros and cons of alternative therapy omega-3 fatty acids during pregnancy and lactation for mental problems

IntroductionFatty acids omega-3 are irreplaceable. They stabilize cell membranes, nerve impulses, homeostasis, immune reactions, the birth process, the psycho-emotional state of the fetus-mother dyad. Correlations between adequate dietary intake of omega-3 and cognitive health have been described in detail. According to the literature, docosahexaenoic acid is associated with the synthesis of serotonin, dopamine, acetylcholine, glutamate, neuroprotective and anti-apoptotic action, has antidepressant effect. Omega-3 makes up 60% of neuronal membrane phospholipids. Under clinical aspect,according to publications, fish oil reduces the risk of preterm birth by 44%.Objectives The aim is to study the risks and benefits of using omega-3 during pregnancy and lactation in patients with mental disorders.Methods Comparative analysis of evidence-based scientific publications for the use of omega-3 fatty acids in pregnancy and lactation.Results The body level of omega-3 depends on the quantitative intake from food, as well as gene polymorphism and age. For pregnant and lactating women are recommended 200-300 mg per day or about 300 g per week from food. Deficiency of omega-3 (protectins) affects the processes of myelination, neurogenesis, synaptogenesis, the metabolism of neurotransmitters, cell differentiation, neuronal migration and inflammatory responses.Conclusions There are many probably mechanisms of action of omega-3, namely: Enhances peroxisomal oxidation, reduces the synthesis of triglycerides in the liver; inhibits plasma acyltransfrerase. Omega-3 acts on phospholipids of the cell membranes of the nervous system and retina, their adequate functioning, improve psychomotor development of newborns. It was found the effect of decreasing the levels of cytokines and depressive symptoms, as well the risk of food allergies and depression. In conclusion, in adequate doses, omega-3 fatty acids seems to be useful in deficiencies and for prophylactic purposes in pregnancy and lactation.Keywordsomega- 3 fatty acids, pregnancy, lactation, mental disorders.Disclosure of InterestNone Declared

Retraction Note.

The publisher and Editor in Chief have withdrawn four articles published between 2016 and 2018. These articles were discovered to contain problems, such as image manipulation, absence of ethics approval, and inconsistencies in data presented. This retraction notice pertains to the following articles, with detailed explanations below: - "The effects of MCA-MAO on cAMP pathway in rats with cerebral hemorrhage" by Y. Jiang, X.-F. Wang, Y.-L. Niu, J.-H. Xia-Eur Rev Med Pharmacol Sci 2016; 20 (9): 1834-1838-PMID: 27212177. Readers have pointed out on PubPeer that Figures 1B and D appear to contain some overlaps. Moreover, there is no ethical approval statement for this study. The editorial team has contacted the authors but received no reply. The journal investigation revealed a figure duplication. Therefore, the Editor in Chief mistrusts the results and decided to retract the manuscript. Although the authors were notified of the retraction decision, they remained unresponsive. - "Research on the role of GLP-2 in the central nervous system EPK signal transduction pathway of mice with vascular dementia" by C.-L. Chi, S.-A. Zhang, Z. Liu, M.-X. Chang, H. Wang, Y. Huang-Eur Rev Med Pharmacol Sci 2017; 21 (1): 131-137-PMID: 28121365. Readers have pointed out on PubPeer that Figure 3 appears to contain some overlaps. Moreover, there is no ethical approval statement for this study. The editorial team has contacted the authors but received no reply. The journal investigation revealed a figure duplication. Therefore, the Editor in Chief mistrusts the results and decided to retract the manuscript. Although the authors were notified of the retraction decision, they remained unresponsive. - "Studies on the relationship between P13K/AKT signal pathway-mediated MMP-9 gene and lung cancer" by H. Zheng, J.-F. Liu-Eur Rev Med Pharmacol Sci 2017; 21 (4): 753-759-PMID: 28272723. Readers on PubPeer have expressed concerns about Western blots, as shown in Figure 2. Moreover, there is no ethical approval statement for this study. The editorial team has contacted the authors but received no reply. The journal investigation did not detect figure manipulation; however, since the lack of ethics statement and the lack of the original data, the Editor in Chief decided to retract the manuscript. Although the authors were notified of the retraction decision, they remained unresponsive. - "LncRNA LINC01116 competes with miR-145 for the regulation of ESR1 expression in breast cancer" by H.-B. Hu, Q. Chen, S.-Q. Ding-Eur Rev Med Pharmacol Sci 2018; 22 (7): 1987-1993-DOI: 10.26355/eurrev_201804_14726-PMID: 29687853. Readers on PubPeer have expressed concerns regarding inconsistencies between data presented in Tables and figures, deficiencies in the description of sample collection, and a lack of ethics approval. The editorial team has contacted the authors to request the raw data of the manuscript and a reply to those concerns but has not received any response. Throughout the journal investigation, numerous flaws and inconsistencies were discovered in the presented results. Therefore, the editors deem the conclusions of this article to be invalid and decided to retract the manuscript. The corresponding author did not respond to journal correspondence about the investigation and retraction of this article. These articles have been retracted. The Publisher apologizes for any inconvenience this may cause.

Modern aspects of vagus-induced gastroprotection and ulcerogenesis in gastric and duodenal ulcers

The vagus nerve is an essential connection between the body and the brain that controls vital aspects of autonomic physiology such as respiration, heart rate, blood pressure and intestinal motility, reflexes such as coughing and swallowing, and survival behaviors such as eating, drinking and response to nausea. The stomach has a complex nervous apparatus. The innervation of the stomach is provided by both the somatic and the autonomic nervous system. The stomach receives innervation from the vagus nerve and derivatives of the celiac plexus (superior mesenteric, gastric, splenic, hepatic). The vagus nerve has the greatest influence on the work of the stomach and intestines. The vagus nerve is the longest splanchnic nerve, literally wandering throughout the body. The vagus nerves play a dominant role in stimulating gastric secretion. The basal or continuous secretion of gastric juice in normal humans is entirely due to tonic impulses in the vagus nerves. The purpose of our review was to identify the pathogenetic role of the vagus nerve in gastric and duodenal ulcers.

Regulators of Oligodendrocyte Differentiation.

Myelination has evolved as a mechanism to ensure fast and efficient propagation of nerve impulses along axons. Within the central nervous system (CNS), myelination is carried out by highly specialized glial cells, oligodendrocytes. The formation of myelin is a prolonged aspect of CNS development that occurs well into adulthood in humans, continuing throughout life in response to injury or as a component of neuroplasticity. The timing of myelination is tightly tied to the generation of oligodendrocytes through the differentiation of their committed progenitors, oligodendrocyte precursor cells (OPCs), which reside throughout the developing and adult CNS. In this article, we summarize our current understanding of some of the signals and pathways that regulate the differentiation of OPCs, and thus the myelination of CNS axons.

Structure of singularities in the nonlinear nerve conduction problem

We give a characterization of the singular points of the free boundary \partial \{u>0\} for viscosity solutions of the nonlinear equation F(D^{2} u)=-\chi_{\{u>0\}}, where F is a fully nonlinear elliptic operator and \chi is the characteristic function. This equation models the propagation of a nerve impulse along an axon. We analyze the structure of the free boundary \partial\{u>0\} near the singular points where u and \nabla u vanish simultaneously. Our method uses the stratification approach developed in Dipierro and the author’s 2018 paper. In particular, when n=2 we show that near a flat singular free boundary point, \partial\{u>0\} is a union of four C^{1} arcs tangential to a pair of crossing lines.

Methylome-wide and meQTL analysis helps to distinguish treatment response from non-response and pathogenesis markers in schizophrenia.

Schizophrenia is a complex condition with entwined genetic and epigenetic risk factors, posing a challenge to disentangle the intermixed pathological and therapeutic epigenetic signatures. To resolve this, we performed 850K methylome-wide and 700K genome-wide studies on the same set of schizophrenia patients by stratifying them into responders, non-responders, and drug-naïve patients. The key genes that signified the response were followed up using real-time gene expression studies to understand the effect of antipsychotics at the gene transcription level. The study primarily implicates hypermethylation in therapeutic response and hypomethylation in the drug-non-responsive state. Several differentially methylated sites and regions colocalized with the schizophrenia genome-wide association study (GWAS) risk genes and variants, supporting the convoluted gene-environment association. Gene ontology and protein-protein interaction (PPI) network analyses revealed distinct patterns that differentiated the treatment response from drug resistance. The study highlights the strong involvement of several processes related to nervous system development, cell adhesion, and signaling in the antipsychotic response. The ability of antipsychotic medications to alter the pathology by modulating gene expression or methylation patterns is evident from the general increase in the gene expression of response markers and histone modifiers and the decrease in class II human leukocyte antigen (HLA) genes following treatment with varying concentrations of medications like clozapine, olanzapine, risperidone, and haloperidol. The study indicates a directional overlap of methylation markers between pathogenesis and therapeutic response, thereby suggesting a careful distinction of methylation markers of pathogenesis from treatment response. In addition, there is a need to understand the trade-off between genetic and epigenetic observations. It is suggested that methylomic changes brought about by drugs need careful evaluation for their positive effects on pathogenesis, course of disease progression, symptom severity, side effects, and refractoriness.

LOW-INTENSITY SHOCKWAVE TREATMENT FOR NEUROGENIC BLADDER WITH CHRONIC URINE RETENTION - CASE REPORT

We present a case of neurogenic bladder accompanied by chronic urine retention in a patient diagnosed with multiple sclerosis (MS). This condition was effectively managed by low-intensity shockwave therapy (Li-ESWT). Low-intensity focused shockwave therapy (Li-ESWT) is becoming increasingly important in the treatment of urological problems. This case study investigates the feasibility and efficacy of using Li-ESWT to reduce post-void residual volume in persons with neurogenic bladder, representing the first examination of its sort. Bladder dysfunction (BD) frequently occurs in patients who have been diagnosed with multiple sclerosis (MS). Bladder dysfunction (BD) can occur due to the impairment of nerve impulses in the central nervous system regions involved for regulating bladder function and managing the contractions of the urinary sphincters, which is caused by the lesions associated with multiple sclerosis (MS). Urinary retention can cause various symptoms, including insufficient bladder emptying, urinary incontinence, frequent urinary tract infections, urosepsis resulting in the development of kidney abscesses due to localised kidney infection, and reduced kidney function. Optimal bladder function is essential for individuals with MS, as it plays a critical role in preserving kidney health, preventing urinary tract infections and incontinence, reducing the frequency of MS episodes, and improving their overall well-being. A 31-year-old woman was referred to our urology office with a chronic urinary tract infection caused by a neurogenic bladder with a significant volume of residual urine. A kidney abscess formation was identified as a complication. Li-ESWT, which stands for low-intensity extracorporeal shockwave therapy, was used as a part of a multimodal strategy to treat the urinary bladder. This treatment was delivered off-label. The therapy was given on a weekly basis for a period of 6 weeks. The procedure included administering 2500 shocks at a rate of four pulses per second, with an energy flux density (EFD) of 0.25 millijoules per square millimetre. The EFD (Energy Flux Density) used in our study exceeded 0.32 mJmm2,4, the fR (frequency rate) was set at 8 Hz (pulses per second), the treatment sessions consisted of 12 cycles of Li-ESWT (Low-Intensity Extracorporeal Shockwave Therapy), and a total of 3000 shocks were administered. At the intervals of one week, three months, six months, nine months, and twelve months following the administration of Li-ESWT and tadalafil 2.5 mg, the post-void residual (PVR) volume was consistently below 50 ml. The Li-ESWT treatment effectively reduced the post-void residual urine volume.Low-intensity extracorporeal shockwave therapy (Li-ESWT) can safely and efficiently decrease the amount of urine left in the bladder after voiding in individuals with neurogenic bladder caused by multiple sclerosis (MS). We have effectively demonstrated that Li-ESWT is a feasible and safe treatment for chronic urine retention, resulting in a decrease of post-void residual (PVR) volume from 200 ml to 50 ml. In the future, Li-ESWT has the potential to be advanced as a more efficacious alternative therapy for individuals experiencing chronic urinary retention. Further investigation is necessary to confirm the effectiveness of ESWT in addressing the neurogenic bladder.

THE Point prevalence of acetylcholinesterase inhibition, neuropathy and safety awareness among flower farm workers in naivasha, nakuru county, kenya.

Acetyl cholinesterase catalyses the hydrolysis of acetylcholine in the nerve synapses, thereby terminating nerve impulse, however, it is inhibited by organophosphates and carbamates. This study aimed to assess the level of acetyl cholinesterase inhibition and the resultant neuropathy in flower farm workers as well as the farmers’ awareness of safety measures and predisposing factors while handling pesticides. A cross-sectional study was conducted involving 217 participants from different flower farms. Structured questionnaire was used to collect data to assess level of safety and predisposing awareness and to assess for neuropathy. Blood samples were collected to determine the cholinesterase levels using spectrophotometry technique at 405 nm. The mean serum cholinesterase level in flower farm workers in Naivasha was 5873.26 U/L. There was a positive correlation (R= 0.07) between the numbers of years worked in the industry and serum cholinesterase levels as shown by Karl Pearson`s coefficient. The point prevalence of cholinesterase inhibition in Naivasha was 14% indicating a significant risk of adverse health effects. The level of safety awareness and predisposing factors among workers on pesticide exposure was 65%, suggesting that while the majority of workers had some level of safety awareness, there is still room for improvement. The point prevalence of neuropathy was 38% of the participants presenting with varying symptoms of adverse effects of pesticide exposure. Musculoskeletal impairment was leading at 19.81%, followed by skin irritation at 13.36%.These findings highlighted the need for better safety measures and awareness campaigns in the flower farm industry to reduce the risk of acetyl cholinesterase inhibition.

Advances in using ultrasound to regulate the nervous system.

Ultrasound is a mechanical vibration with a frequency greater than 20kHz. Due to its high spatial resolution, good directionality, and convenient operation in neural regulation, it has recently received increasing attention from scientists. However, the mechanism by which ultrasound regulates the nervous system is still unclear. This article mainly explores the possible mechanisms of ultrasound's mechanical effects, cavitation effects, thermal effects, and the rise of sonogenetics. In addition, the essence of action potential and its relationship with ultrasound were also discussed. Traditional theory treats nerve impulses as pure electrical signals, similar to cable theory. However, this theory cannot explain the phenomenon of inductance and cell membrane bulging out during the propagation of action potential. Therefore, the flexoelectric effect of cell membrane and soliton model reveal that action potential may also be a mechanical wave. Finally, we also elaborated the therapeutic effect of ultrasound on nervous system disease such as epilepsy, Parkinson's disease, and Alzheimer's disease.

Helmholtz and the Conservation of Energy: Contexts of Creation and Reception

Helmholtz and the Conservation of Energy: Contexts of Creation and Reception

Helmholtz and the Conservation of Energy: Contexts of Creation and Reception

Helmholtz and the Conservation of Energy: Contexts of Creation and Reception

The discrepancy in triggered electromyography responses between fatty filum and normal filum terminale

BackgroundFunctional role of filum terminale (FT) was not well studied though it contains structure basis for nerve impulse conduction. We aimed to explore the possible functions of the FT from the perspective of triggered electromyography (EMG) during surgery.MethodsWe retrospectively reviewed intraoperative neurophysiological monitoring data from pediatric patients who underwent intradural surgeries at the lumbar level in Shanghai Children’s. Hospital from January 2018 to March 2023. Altogether 168 cases with complete intraoperative neurophysiological recordings of the FT were selected for further analysis. Triggered EMG recordings of the filum originated from two main types of surgeries: selective dorsal rhizotomy (SDR) and fatty filum transection.Results96 cases underwent SDR and 72 cases underwent fatty filum transection. Electrical stimulation of the FT with fatty infiltration did not elicit electromyographic activity in the monitored muscles with the maximum stimulus intensity of 4.0 mA, while the average threshold for FT with normal appearance was 0.68 mA, and 89 out of 91 FT could elicit electromyographic responses in monitored channels. The threshold ratio of filum to motor nerve roots at the same surgical segment was significantly higher in patients with fatty filum, and a cut-off point of 21.03 yielded an area under curve of 0.943, with 100% sensitivity and 85.71% specificity.ConclusionFilum with normal appearance can elicit electromyographic activity in the lower limbs/anal sphincter similar to the performance of the cauda equina nerve roots. The threshold of fatty filum is different from that of normal appearing FT. Triggered EMG plays an important role in untethering surgeries.