Donald B. Newman

Brainstem reticular nuclei that project to the cerebellum in rats : a retrograde tracer study

The nuclear origins of projections from the brainstem reticular formation to the cerebellum were examined using four retrograde tracer substances: horseradish peroxidase, wheat germ agglutinin-horseradish peroxidase conjugate, Fluoro-Gold, and rhodamine beads. Tracer injections were made into each of the three major longitudinal zones of the cerebellar cortex (vermis, paravermal hemisphere, and lateral hemisphere) as well as into the various deep cerebellar nuclei. Counts of retrogradely labeled cells were done on a large sample of select cases. The data generated by these cell counts indicate that the strongest reticulocerebellar projections arise from the three specialized pre-cerebellar reticular nuclei: the lateral reticular nucleus, the medullary paramedian reticular nucleus, and the reticulotegmental nucleus. The presumed noradrenergic locus coeruleus (A6 cell group) was also densely packed with retrogradely labeled neurons. However, strong reticulocerebellar projections also arose from other presumed catecholamine cell groups such as those in the ventrolateral medulla (the A1/C1 complex) and the caudal pons (A5). Substantial cerebellar projections originated from most of the various presumed serotonergic brainstem raphe cell groups (particularly raphe obscurus in the medulla), as well as from the presumed cholinergic Ch5 cell group (the pedunculopontine pars compactus nucleus). Labeled cells were also seen in several nonaminergic isodendritic reticular nuclei thought to be involved in visuomotor activity (e.g. paragigantocellularis dorsalis, raphe interpositus, and the pontine dorsomedial tegmental area), as well as in the lateral reticular zone of the medulla and lower pons (reticularis dorsalis and parvocellularis). Tracer injections into the deep nuclei produced relatively greater numbers of labeled neurons in large-celled medial reticular nuclei associated with skeletomotor activity, such as gigantocellularis, magnocellularis, and pontis caudalis. Reticular nuclei conspicuous in their lack of projections to the cerebellum included reticularis ventralis in the medulla, pontis oralis, and both subdivisions of the midbrain reticular formation (cuneiformis and subcuneiformis). As a whole, the various isodendritic reticular nuclei project most strongly to midline cerebellar structures (vermal cortex or fastigial nuclei), less strongly to the paravermal cortex or interposed nuclei, and least strongly to the lateral cortex or dentate nucleus. Within individual reticular nuclei, the morphology of labeled neurons is identical to that reported previously by this laboratory subsequent to spinal or cortical HRP injections, thus strengthening this laboratorys hypothesis that the various brainstem reticular nuclei can be distinguished on the basis of neuronal morphology.

Behavioral and neural toxicity of the artemisinin antimalarial, arteether, but not artesunate and artelinate, in rats

Three artemisinin antimalarials, arteether (AE), artesunate (AS), and artelinate (AL) were evaluated in rats using an auditory discrimination task (ADT) and neurohistology. After rats were trained on the ADT, equimolar doses of AE (25 mg/kg, in sesame oil, n=6), AS (31 mg/kg, in sodium carbonate, n=6), and AL (36 mg/kg, in saline, n=6), or vehicle (sodium carbonate, n=6) were administered (IM) for 7 consecutive days. Behavioral performance was evaluated, during daily sessions, before, during, and after administration. Histological evaluation of the brains was performed using thionine staining, and damaged cells were counted in specific brainstem nuclei of all rats. Behavioral performance was not significantly affected in any rats treated with AS, AL, or vehicle. Furthermore, histological examination of the brains of rats treated with AS, AL, and vehicle did not show damage. In stark contrast, all rats treated with AE showed a progressive and severe decline in performance on the ADT. The deficit was characterized by decreases in accuracy, increases in response time and, eventually, response suppression. When performance on the ADT was suppressed, rats also showed gross behavioral signs of toxicity that included tremor, gait disturbances, and lethargy. Subsequent histological assessment of AE-treated rats revealed marked damage in the brainstem nuclei, ruber, superior olive, trapezoideus, and inferior vestibular. The damage included chromatolysis, necrosis, and gliosis. These results demonstrate distinct differences in the ability of artemisinins to produce neurotoxicity. Further research is needed to uncover pharmacokinetic and metabolic differences in artemisinins that may predict neurotoxic potential.

Dose-dependent brainstem neuropathology following repeated arteether administration in rats

Histopathological effects of the artemisinin antimalarial, beta-arteether, were evaluated in rats. Arteether (3.125-12.5 mg/kg/day, IM, in sesame oil) was administered for 7 consecutive days. Seven days following the last injection, histological evaluation of the brainstem was performed. Rats treated with 12.5 mg/kg showed significant neuropathology, including chromatolysis, in the nucleus trapezoideus and nucleus superior olive. To a lesser extent, neuropathology was present in the nucleus ruber. Mild neuropathology was also detected in other brainstem regions examined. Although no statistically significant neuropathology was found for the groups treated with 6.25 mg/kg/day and 3.125 mg/kg/day, substantial neuropathology was observed in a single rat in each of these treatment conditions. These results confirm and extend previous studies demonstrating brainstem neurotoxicity from artemisinin antimalarials. Furthermore, these results suggest that, in rats, brainstem auditory pathways may be particularly vulnerable. Early detection of arteether neuropathology may, therefore, require examination of auditory functions.

Behavioral and Neural Toxicity of Arteether in Rats

Repeated administration of the artemisinin antimalarial compound, 3-arteether (AE) (25 mg/kg, i.m.) was evaluated in rats using a two-choice, discrete trial, auditory discrimination task and subsequent neurohistology. Rats were trained to choose one of two response levers following presentation of white noise or a tone + white noise. Increasing and decreasing the intensity of the tone increased and decreased discriminability, respectively, and differential reinforcement density produced systematic changes in response bias. AE (n = 5) or vehicle (n = 5) was injected daily (9-12 days). Initial injections of AE did not affect behavioral performance. Continuing daily injections produced significant decreases in choice accuracy and significant increases in choice reaction time. When overt signs of severe toxicity were observed, rats were sacrificed and significant neural pathology was observed in the nucleus trapezoideus of AE-treated rats. In a subsequent experiment, AE was injected for 3 (n = 5), 5 (n = 5), or 7 (n = 5), consecutive days and performance was examined for an additional 7 days. Behavioral disruption was only observed in rats receiving AE for 7 days and the greatest degree of disruption occurred after AE injections were completed. Histopathological examination showed significant neural pathology in the nuclei trapezoideus, superior olive, and ruber of rats receiving 7- and 5-day AE regimens, and in the nucleus trapezoideus of rats receiving the 3-day regimen. Thus, behavioral disruption reflected, but did not predict, neuropathology. These results confirm and extend earlier results demonstrating neurotoxicity of AE in rats. Further, these results demonstrate that the auditory discrimination task provides an objective behavioral measure of AE neurotoxicity, and thus, can serve as a valuable tool for the safety development of AE and other artemisinin antimalarial compounds.

Understanding artemisinin-induced brainstem neurotoxicity

Artemisinins are fast-acting and highly efficacious antimalarials. There has been a rapid increase in their use in response to increasing drug resistance and further increases in their use are anticipated as they continue to replace existing therapies. In laboratory studies, artemisinins can produce relatively specific brainstem neurotoxicity. Select nuclei in the medulla, pons and mesencephalon are usually found to be most vulnerable. Species-specific differences in the vulnerability of nuclei may also exist. While not yet completely understood, occurrence of the lesion seems to be dependent upon a sustained, rather than peak, level of circulating drug or metabolite. With daily administrations, the onset of signs of brainstem neurotoxicity frequently develops abruptly and sometimes is observable only at the end of, or after, a regimen of administration. Behavioral correlates of brainstem neurotoxicity in laboratory animals include ataxic symptoms such as tremor, gait impairment and balance disturbance. Symptoms may also include auditory impairment. Screening and diagnostic procedures to guard against artemisinin-induced brainstem neurotoxicity in humans need to be based on the available, albeit limited, data from laboratory studies. Substantial and fundamental gaps in our understanding of artemisinin brainstem neurotoxicity exist including the mode of action of neurotoxicity and the specific conditions under which it occurs. Further, the possibility of increased vulnerability from age-related factors, drug interactions and cumulative administration regimens has not yet been investigated. Substantial progress addressing these issues is needed to maintain appropriate pharmacovigilance as the use of these powerful and life-saving antimalarials increases.

Nuclear Terminations of Corticoreticular Fiber Systems in Rats; pp. 253–264

Corticoreticular fiber systems were examined in adult albino and hooded rats using anterograde transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) and anterograde degeneration. WGA-HRP injections were made stereotactically into the medial prefrontal cortex, the medial agranular cortex, the anterior cingulate cortex, the face motor cortex, the forelimb motor cortex, the trunk-hindlimb motor cortex, the face somatosensory cortex, the primary auditory cortex, the secondary visual cortex and the primary visual cortex. With exception of the cingulate cortex (which is relatively inaccessible to lesioning methods) and the primary visual cortex, electrocautery lesions were made into these same cortical areas. The precise locations of cortical injection/lesion sites were corroborated on the basis of cortical cytoarchitectonic criteria, patterns of retrograde and anterograde thalamic labeling, and patterns of anterograde labeling in non-reticular brainstem nuclei such as the red nucleus, trigeminal nuclei and dorsal column nuclei. The heaviest corticoreticular projections arise from the medial agranular cortex. The medial prefrontal cortex also gives rise to consistently strong corticoreticular projections. The anterior cingulate cortex sends robust corticoreticular projections to the upper brainstem but relatively weak projections to the lower brainstem. With respect to the primary motor cortex, the face area gives rise to the densest corticoreticular projections, rivaling those emanating from the medial agranular cortex. The trunk-hindlimb area gives rise to substantial corticoreticular projections, but those originating from the forelimb area are modest and directed chiefly to midbrain and medullary levels. The face area of the somatosensory cortex gives rise to rather weak corticoreticular projections, while those arising from the primary auditory cortex are fewer still. Descending projections from the secondary visual cortex are sparse, with labeled terminals occurring in a few pontine and medullary reticular nuclei. Only one brainstem reticular nucleus (nucleus cuneiformis) was found to receive projections from the primary visual cortex, and this input was extremely sparse. Corticoreticular projections to the upper brainstem terminate predominantly ipsilateral to the cortical injection site, whereas medullary corticoreticular projections distribute bilaterally. Corticoreticular fibers from the medial agranular, face motor and trunk-hindlimb motor cortex terminate heavily in somatomotor brainstem reticular nuclei such as the pontis oralis, the pontis caudalis and the gigantocellularis.(ABSTRACT TRUNCATED AT 400 WORDS)

Reticulo- and trigemino-hypoglossal connections: a quantitative comparison of ultrastructural substrates

Axon terminals were identified and characterized by electron microscopy after injections of horseradish peroxidase (HRP) into the spinal V nucleus (SPVN) or the medullary reticular formation adjacent to the XIIth nucleus. The synaptic organization and topology of these two different populations of hypoglossal afferents (T-XII and R-XII respectively) were determined by quantitative comparisons. Significant differences were obtained in the ratios of morphological types of terminals, sizes of axonal endings and their location on postsynaptic structures. Axon terminals containing spherical vesicles (S-terminals) and those with flattened/pleomorphic vesicles (F-terminals) were anterogradely labeled with HRP from both injection sites. However, the S/F ratio for R-XII terminals was 1.2:1 compared to 2.6:1 for T-XII afferents. Asymmetrical membrane densities (Gray Type I) were the predominant form of junctional specialization for S-terminal synapses. Asymmetrical densities with subjunctional dense bodies/bars (S-Taxi) were associated with a higher proportion of T-XII synapses than R-XII synapses. Almost all of the F-terminals from both sources had symmetrical densities (Gray Type II). The average diameter of R-XII terminals was greater than that of T-XII terminals. R-XII-F terminals were the largest terminals. The majority of axon terminals from both sources formed axodendritic synapses. However, R-XII terminals had a higher incidence (10% vs. 3%) of axosomatic contacts. The proportion of R-XII-F-terminals decreased from the central toward the distal dendrites, whereas the opposite was found for T-XII-F and T-XII-S-terminals. In contrast to these findings, R-XII-S-terminals were more uniformly distributed on dendrites of all sizes.(ABSTRACT TRUNCATED AT 250 WORDS)