Richard A. Rudick

Treatment of Pathologic Laughing and Weeping with Amitriptyline

Patients with bilateral forebrain disease may commonly manifest the syndrome of pathologic laughing and weeping. We investigated the efficacy of low-dose amitriptyline in 12 patients in whom this syndrome was a consequence of multiple sclerosis. In a double-blind crossover study comparing amitriptyline with placebo, eight patients experienced dramatic and significant improvement with amitriptyline (P = 0.02). The mean dose of amitriptyline was 57.8 mg per day and did not exceed 75 mg per day in any patient. Concurrent measurements of depression showed no change during the study. We conclude that amitriptyline is effective in the treatment of this disturbance of affective expression, and that this effect is distinct from the antidepressant effect of the medication.

Multiple sclerosis Free light chains in cerebrospinal fluid

We found free light chains in the CSF of 18 MS patients, but not in any of 14 patients with other neurologic disease. CSF from all MS patients contained kappa and lambda chain dimers, less frequently contained light chain monomers, and never contained free gamma heavy chains. Light chains were not detected in matched serum samples. CSF from MS patients did not release free light chains from whole IgG in CSF of controls. The findings suggest that these free light chains originate in plasma cells, not from degradation of whole IgG.

Integrity of blood-brain barrier to peroxidase in senescent mice

The brain distribution of systemically-administered horseradish peroxidase was studied in senescent mice and compared with the distribution in a group of young mice. The distribution of HRP was surveyed in both the experimental and control groups by light and electron microscopy by an observer unaware of the source of the material. No qualitative differences were observed in the brain distribution of systemically-administered HRP in old mice compared to young mice. The results of this study suggest that the blood-brain barrier to HRP is preserved in senescent mice.

Isolation of model soluble immune complexes in the fluid phase by monoclonal anti-IgG-ferritin antibodies

Ferritin conjugates of monoclonal IgG anti‐human gamma chain (anti‐IgG‐F) were reacted with soluble heat aggregates of IgG (A‐IgG) and with soluble DNA‐anti‐DNA complexes to increase the S rate of the model soluble immunecomplexes (ICx) and thus facilitate isolation of ICx in the fluid phase and provide an immunochemical marker for subsequent ultrastructural analysis. A‐IgG appeared as globular or curvilinear structures withindividual IgG molecules arranged in a random fashion. The technique appears promising for characterization of other soluble ICx.

The morphology of murine cerebral ventriculosubarachnoid space I. Light microscopy

Abstract A new method is described for producing plastic casts of murine Ventriculosubarachnoid space. Photographs of a representative cast demonstrate the highly detailed tridimensional anatomy obtainable with this method.