David W McNeal

Kansas City VA Medical Center, Kansas City, Missouri, United States

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Publications (18)50.59 Total impact

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    ABSTRACT: Concurrent damage to the lateral frontal and parietal cortex is common following middle cerebral artery infarction leading to upper extremity paresis, paresthesia and sensory loss. Motor recovery is often poor and the mechanisms that support, or impede this process are unclear. Since the medial wall of the cerebral hemisphere is commonly spared following stroke, we investigated the long-term (6 and 12 month) effects of lateral frontoparietal injury (F2P2 lesion) on the terminal distribution of the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2) at spinal levels C5 to T1. Isolated injury to the frontoparietal arm/hand region resulted in a significant loss of contralateral corticospinal boutons from M2 compared to controls. Specifically, reductions occurred in the medial and lateral parts of lamina VII and the dorsal quadrants of lamina IX. There were no statistical differences in the ipsilateral corticospinal projection. Contrary to isolated lateral frontal motor injury (F2 lesion) which results in substantial increases in contralateral M2 labeling in laminae VII and IX (McNeal et al., Journal of Comparative Neurology 518:586-621, 2010), the added effect of adjacent parietal cortex injury to the frontal motor lesion (F2P2 lesion) not only impedes a favorable compensatory neuroplastic response, but results in a substantial loss of M2 CSP terminals. This dramatic reversal of the CSP response suggests a critical trophic role for cortical somatosensory influence on spared ipsilesional frontal corticospinal projections, and that restoration of a favorable compensatory response will require therapeutic intervention. J. Comp. Neurol., 2014. © 2014 Wiley Periodicals, Inc.
    The Journal of Comparative Neurology 10/2014; · 3.66 Impact Factor
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    ABSTRACT: We investigated recovery of precision grasping of small objects between the index finger and thumb of the impaired hand without forced use after surgically placed lesions to the hand/arm areas of M1 and M1 + lateral premotor cortex in two monkeys. The unilateral lesions were contralateral to the monkey's preferred hand, which was established in prelesion testing as the hand used most often to acquire raisins in a foraging board (FB) task in which the monkey was free to use either hand to acquire treats. The lesions initially produced a clear paresis of the contralesional hand and use of only the ipsilesional hand to acquire raisins in the FB task. However, beginning about 3 weeks after the lesion both monkeys spontaneously began using the impaired contralesional hand in the FB task and increased use of that hand over the next few tests. Moreover, the monkeys clearly used precision grasp to acquire the raisins in a similar manner to prelesion performances, although grasp durations were longer. Although the monkeys used the contralesional hand more often than the ipsilesional hand in some postlesion testing sessions, they did not recover to use the hand as often as in prelesion testing when the preferred hand was used almost exclusively. These findings suggest that recovery of fine hand/digit motor function after localized damage to the lateral frontal motor areas in rhesus monkeys does not require forced use of the impaired hand.
    Experimental Brain Research 08/2014; · 2.22 Impact Factor
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    ABSTRACT: To further our understanding of the corticospinal projection (CSP) from the hand/arm representation of the primary motor cortex (M1), high-resolution anterograde tracing methodology and stereology were used to investigate the terminal distribution of this connection at spinal levels C5 to T1. The highest number of labeled terminal boutons occurred contralaterally (98%) with few ipsilaterally (2%). Contralaterally, labeled boutons were located within laminae I - X, with the densest distribution found in lamina VII and, to a lesser extent, laminae IX and VI. Fewer terminals were found in other contralateral laminae. Within lamina VII, terminal boutons were most prominent in the dorsomedial, dorsolateral and ventrolateral subsectors. Within lamina IX, the heaviest terminal labeling was distributed dorsally. Ipsilaterally, boutons were found in laminae V - X. The most pronounced distribution occurred in the dorsomedial and ventromedial sectors of lamina VII and fewer labeled boutons were located in other ipsilateral laminae. Segmentally, contralateral lamina VII labeling was highest at levels C5-C7. In contrast, lamina IX labeling was highest at C7-T1 and more widely dispersed amongst the quadrants at C8-T1. Our findings suggest dominant contralateral influence of the M1 hand/arm CSP, a contralateral innervation pattern in lamina VII supporting Kuypers (1982) conceptual framework of a "lateral motor system", and a projection to lamina IX indicating significant influence on motoneurons innervating flexors acting on the shoulder and elbow rostrally (C5-C7), along with flexors, extensors, abductors and adductors acting on the digits, hand and wrist caudally (C8-T1). J. Comp. Neurol., 2013. © 2013 Wiley Periodicals, Inc.
    The Journal of Comparative Neurology 07/2013; · 3.66 Impact Factor
  • Randolph J Nudo, David McNeal
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    ABSTRACT: Over the past two decades, results from neurophysiological studies in animal models and neuroimaging studies in human populations have converged along a common thread. Neuroplasticity in the remaining, intact tissue accompanies functional recovery after brain injury. Now, virtually every new therapeutic approach in postinjury rehabilitation relies on the fundamental principles of neuroplasticity for theoretical validity. In this chapter, the basic tenets of plasticity are outlined, and the neural substrates in the cerebral cortex that may subserve recovered functions are reviewed.
    Handbook of Clinical Neurology 01/2013; 110:13-21.
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    ABSTRACT: The cytoarchitecture and cortical connections of the anterior cingulate, medial and dorsal premotor, and precentral region are investigated using the Nissl and NeuN staining methods and the fluorescent retrograde tract tracing technique. There is a gradual stepwise laminar change in the cytoarchitectonic organization from the proisocortical anterior cingulate region, through the lower and upper banks of the cingulate sulcus, to the dorsolateral isocortical premotor and precentral motor regions of the frontal lobe. These changes are characterized by a gradational emphasis on the lower stratum layers (V and VI) in the proisocortical cingulate region to the upper stratum layers (II and III) in the premotor and precentral motor region. This is accompanied by a progressive widening of layers III and VI, a poorly delineated border between layers III and V and a sequential increase in the size of layer V neurons culminating in the presence of giant Betz cells in the precentral motor region. The overall patterns of corticocortical connections paralleled the sequential changes in cytoarchitectonic organization. The proisocortical areas have connections with cingulate motor, supplementary motor, premotor and precentral motor areas on the one hand and have widespread connections with the frontal, parietal, temporal and multimodal association cortex and limbic regions on the other. The dorsal premotor areas have connections with the proisocortical areas including cingulate motor areas and supplementary motor area on the one hand, and premotor and precentral motor cortex on the other. Additionally, this region has significant connections with posterior parietal cortex and limited connections with prefrontal, limbic and multimodal regions. The precentral motor cortex also has connections with the proisocortical areas and premotor areas. Its other connections are limited to the somatosensory regions of the parietal lobe. Since the isocortical motor areas on the dorsal convexity mediate voluntary motor function, their close connectional relationship with the cingulate areas form a pivotal limbic-motor interface that could provide critical sources of cognitive, emotional and motivational influence on complex motor function.
    Brain research bulletin 03/2012; 87(4-5):457-97. · 2.97 Impact Factor
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    ABSTRACT: Damage to the motor cortex of one hemisphere has classically been associated with contralateral upper limb paresis, but recent patient studies have identified deficits in both upper limbs. In non-human primates, we tested the hypothesis that the severity of ipsilesional upper limb motor impairment in the early post-injury phase depends on the volume of gray and white matter damage of the motor areas of the frontal lobe. We also postulated that substantial recovery would accompany minimal task practice and that ipsilesional limb recovery would be correlated with recovery of the contralesional limb. Gross (reaching) and fine hand motor functions were assessed for 3-12 months post-injury using two motor tests. Volumes of white and gray matter lesions were assessed using quantitative histology. Early changes in post-lesion motor performance were inversely correlated with white matter lesion volume indicating that larger lesions produced greater decreases in ipsilesional hand movement control. All monkeys showed improvements in ipsilesional hand motor skill during the post-lesion period, with reaching skill improvements being positively correlated with total lesion volume indicating that larger lesions were associated with greater ipsilesional motor skill recovery. We suggest that reduced trans-callosal inhibition from the lesioned hemisphere may play a role in the observed skill improvements. Our findings show that significant ipsilesional hand motor recovery is likely to accompany injury limited to frontal motor areas. In humans, more pronounced ipsilesional motor deficits that invariably develop after stroke may, in part, be a consequence of more extensive subcortical white and gray matter damage.
    Experimental Neurology 06/2011; 231(1):56-71. · 4.65 Impact Factor
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    ABSTRACT: The purpose of this study was to determine if recovery of neurologically impaired hand function following isolated motor cortex injury would occur without constraint of the non-impaired limb, and without daily forced use of the impaired limb. Nine monkeys (Macaca mulatta) received neurosurgical lesions of various extents to arm representations of motor cortex in the hemisphere contralateral to the preferred hand. After the lesion, no physical constraints were placed on the ipsilesional arm/hand and motor testing was carried out weekly with a maximum of 40 attempts in two fine motor tasks that required use of the contralesional hand for successful food acquisition. These motor tests were the only "forced use" of the contralesional hand. We also tested regularly for spontaneous use of the contralesional hand in a fine motor task in which either hand could be used for successful performance. This minimal intervention was sufficient to induce recovery of the contralesional hand to such a functional level that eight of the monkeys chose to use that hand on some trials when either hand could be used. Percentage use of the contralesional hand (in the task when either hand could be used) varied considerably among monkeys and was not related to lesion volume or recovery of motor skill. These data demonstrate a remarkable capacity for recovery of spontaneous use of the impaired hand following localized frontal lobe lesions. Clinically, these observations underscore the importance of therapeutic intervention to inhibit the induction of the learned nonuse phenomenon after neurological injury.
    Experimental Brain Research 05/2010; 202(3):529-42. · 2.22 Impact Factor
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    ABSTRACT: Brain injury affecting the frontal motor cortex or its descending axons often causes contralateral upper extremity paresis. Although recovery is variable, the underlying mechanisms supporting favorable motor recovery remain unclear. Because the medial wall of the cerebral hemisphere is often spared following brain injury and recent functional neuroimaging studies in patients indicate a potential role for this brain region in the recovery process, we investigated the long-term effects of isolated lateral frontal motor cortical injury on the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2). After injury to the arm region of the primary motor (M1) and lateral premotor (LPMC) cortices, upper extremity recovery is accompanied by terminal axon plasticity in the contralateral CSP but not the ipsilateral CSP from M2. Furthermore, significant contralateral plasticity occurs only in lamina VII and dorsally within lamina IX. Thus, selective intraspinal sprouting transpires in regions containing interneurons, flexor-related motor neurons, and motor neurons supplying intrinsic hand muscles, which all play important roles in mediating reaching and digit movements. After recovery, subsequent injury of M2 leads to reemergence of hand motor deficits. Considering the importance of the CSP in humans and the common occurrence of lateral frontal cortex injury, these findings suggest that spared supplementary motor cortex may serve as an important therapeutic target that should be considered when designing acute and long-term postinjury patient intervention strategies aimed to enhance the motor recovery process following lateral cortical trauma.
    The Journal of Comparative Neurology 03/2010; 518(5):586-621. · 3.66 Impact Factor
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    Experimental Neurology - EXP NEUROL. 01/2010; 222(1):171-171.
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    ABSTRACT: Due to the heterogeneous nature of most brain injuries, the contributions of gray and white matter involvement to motor deficits and recovery potential remain obscure. We tested the hypothesis that duration of hand motor impairment and recovery of skilled arm and hand motor function depends on the volume of gray and white matter damage of the frontal lobe. Lesions of the primary motor cortex (M1), M1 + lateral premotor cortex (LPMC), M1 + LPMC + supplementary motor cortex (M2) or multifocal lesions affecting motor areas and medial prefrontal cortex were evaluated in rhesus monkeys. Fine hand motor function was quantitatively assessed pre-lesion and for 3-12 months post-lesion using two motor tests. White and gray matter lesion volumes were determined using histological and quantitative methods. Regression analyses showed that duration of fine hand motor impairment was strongly correlated (R(2)>0.8) with the volume of gray and white matter lesions, with white matter lesion volume being the primary predictor of impairment duration. Level of recovery of fine hand motor skill was also well correlated (R(2)>0.5) with gray and white matter lesion volume. In some monkeys post-lesion skill exceeded pre-lesion skill in one or both motor tasks demonstrating that continued post-injury task practice can improve motor performance after localized loss of frontal motor cortex. These findings will assist in interpreting acute motor deficits, predicting the time course and expected level of functional recovery, and designing therapeutic strategies in patients with localized frontal lobe injury or neurosurgical resection.
    Experimental Neurology 09/2009; 220(1):90-108. · 4.65 Impact Factor
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    ABSTRACT: The primate facial nucleus is a prominent brainstem structure that is composed of cell bodies giving rise to axons forming the facial nerve. It is musculotopically organized, but we know little about the morphological features of its motor neurons. Using the Lucifer Yellow intracellular filling method, we examined 11 morphological parameters of motor neurons innervating the monkey orbicularis oculi (OO) muscle, which plays an important role in eyelid closure and voluntary and emotional facial expressions. All somata were multipolar and remained confined to the intermediate subnucleus, as did the majority of its aspiny dendritic branches. We found a mean maximal cell diameter of 54 microm in the transverse dimension, cell diameter of 60 microm in the rostrocaudal dimension, somal surface area of 17,500 microm(2) and somal volume of 55,643 microm(3). Eight neurons were used in the analysis of dendritic parameters based upon complete filling of the distal segments of the dendritic tree. We found a mean number of 16 dendritic segments, an average dendritic length of 1036 microm, diameter of 7 microm, surface area of 12,757 microm(2) and total volume of 16,923 microm(3). Quantitative analysis of the dendritic branch segments demonstrated that the average number, diameter and volume gradually diminished from proximal to distal segments. A Sholl analysis revealed that the highest number of dendritic intersections occurred 60 microm distal to the somal center with a gradual reduction of intersections occurring distally. These observations advance our understanding of the morphological organization of the primate facial nucleus and provide structural features for comparative studies, interpreting afferent influence on OO function and for designing studies pinpointing structural alterations in OO motor neurons that may accompany disorders affecting facial movement.
    Neuroscience 02/2008; 151(1):12-27. · 3.12 Impact Factor
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    ABSTRACT: Impaired fine motor functions after traumatic brain injury (TBI) in humans and non-human primates often continue to improve months after injury. To initiate a series of studies in the primate model designed to investigate possible involvement of microglia/macrophage in the long-term recovery processes, changes in these cells were studied in the rhesus monkey central nervous system at 1, 6, and 12 months after a combined unilateral lesion of the arm area of the primary motor cortex and arm area of the lateral premotor cortex. Immunohistological studies showed profound CD68 immunoreactivity in the lesion area and the contralateral lateral corticospinal tract in the spinal cord at all time points, demonstrating that microglia/macrophage remain reactive at the sites of injury and axonal degeneration/survival for at least 12 months. We also observed marked increases in brain-derived neurotrophic factor (BDNF) and its receptor subtypes, TrkB[gp145] and TrkB[TK-], around the cortical lesion site after 6-month survival. Similar increases were also observed in the spinal cord, although it was less apparent for TrkB[gp145]. Double-labeling revealed that a subpopulation of CD68-immunoreacitve microglia/macrophage co-expressed BDNF in the cortex and spinal cord, and also TrkB[gp145] or TrkB[TK-] in the spinal cord. In contrast, cytokine expression of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and interleukin-6 (IL-6) at these time intervals was less prominent, suggesting that immediate inflammatory responses had subsided. These results demonstrate that microglia/macrophage undergo prolonged activation after TBI in the non-human primate brain and express BDNF and its receptors, suggesting their tropic/trophic roles in the long-term recovery processes.
    Journal of Neurotrauma 12/2007; 24(11):1719-42. · 4.30 Impact Factor
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    ABSTRACT: This study investigated the relationship between hand preference and motor learning in rhesus monkeys executing fine manipulation tasks. We hypothesized that the differences in skill level of the two hands before and after task practice will strongly correlate with the magnitude of the handedness index. Subjects were male and female adult rhesus monkeys (Macaca mulatta). Preferred hand and degree of hand preference were assessed using a handedness index computed based on the percentage of initial reaches and successful acquisitions for each hand using a dexterity (Klüver) board task in which the monkeys could reach for food pellets with either hand. After assessing hand preference, monkeys were trained in two tasks using each hand without the need for restraint. These tasks were: (1) a modified movement assessment panel in which the monkey grasped and lifted carrot chips (with a central punched hole) from a flat surface and over straight and curved rods and (2) a modified dexterity board (mDB) in which the monkey grasped small food pellets from different diameter wells with 3D video recordings of hand/finger movements. Training sessions occurred on approximately a weekly basis. Performance scores on each trial for each task were computed based on acquisition success in addition to duration and size of applied 3D forces for the mMAP task and number of manipulation attempts, transport and manipulation duration, grip aperture and accuracy of hand transport in the mDB task. Learning was assessed by fitting Boltzmann equation sigmoidal curves to performance scores from the initial through final training sessions. Results in 7 monkeys showed that there were no preferred vs. non-preferred hand differences in learning the mDB task, perhaps because of previous experience with this task during determination of handedness. Surprisingly, the non-preferred hand exhibited somewhat greater learning on the mMAP task. These results support previous work suggesting that there is less evidence of hand/cerebral dominance in rhesus monkeys than in humans. Support Contributed By: NIH R01 NS 04636, NIH R24 HD 39627, S. Dakota SCI-TBI grant
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    ABSTRACT: Motor deficit severity and the potential for recovery in patients with brain injury depend on the integrity of descending corticofugal projections. Clinical assessment of these conditions following subtotal brain trauma requires a comprehensive understanding of the anatomical structures involved in the lesion as well as those structures that are spared. To assist in this endeavor, we investigated motor fiber organization in the crus cerebri of the cerebral peduncle (ccCP) in the rhesus monkey. Fibers originating from the arm representations of the primary (M1), supplementary (M2), rostral cingulate (M3), caudal cingulate (M4), dorsolateral pre- (LPMCd) and ventrolateral pre- (LPMCv) motor cortices were studied. The projections from the frontal and cingulate motor cortices formed descending longitudinal bundles that occupied the medial three-fifths of the ccCP at superior and middle levels. Although considerable overlap characterized these corticofugal projections, a general topography was discernable. Fibers from M1 and M4 occupied the central subsector of the ccCP, and fibers from M3 resided medially. The main distribution of LPMCd, LPMCv, and M2 fibers occupied the centromedial region and overlapped extensively. Progressing inferiorly, all fiber bundles in the central and centromedial sectors gradually extended medially, and overlap increased. A common location of fiber passage occurred at the midbrain-pontine isthmus where all of the fiber bundles overlapped. Our findings indicate that the widespread distribution of corticofugal motor projections may account for the favorable levels of motor recovery that accompany subtotal midbrain injury. At superior and mid-levels of the ccCP anteromedial lesions may disrupt projections from M3, whereas anterolateral lesions may disrupt projections from M1 and M4. Fibers from M2, LPMCv, and LPMCd may be compromised to some degree in both situations. The compact and commixed nature of motor fiber organization at inferior levels and the midbrain-pontine isthmus suggests a vulnerable region of passage for comprehensive disruption of frontal and cingulate corticofugal projection fibers.
    The Journal of Comparative Neurology 10/2007; 504(2):149-67. · 3.66 Impact Factor
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    ABSTRACT: A modified "Klüver" or dexterity board was developed to assess fine control of hand and digit movements by nonhuman primates during the acquisition of small food pellets from wells of different diameter. The primary advantages of the new device over those used previously include standardized positioning of target food pellets and controlled testing of each hand without the need for restraints, thereby allowing the monkey to move freely about the cage. Three-dimensional video analysis of hand motion was used to provide measures of reaching accuracy and grip aperture, as well as temporal measures of reach duration and food-pellet manipulation. We also present a validated performance score based on these measures, which serves as an indicator of successful food-pellet retrieval. Tests in three monkeys show that the performance score is an effective measure with which to study fine motor control associated with learning and handedness. We also show that the device and performance scores are effective for differentiating the effects of localized injury to motor areas of the cerebral cortex.
    Journal of Neurophysiology 09/2007; 98(2):1015-29. · 3.30 Impact Factor
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    ABSTRACT: Amygdala interconnections with the cingulate motor cortices were investigated in the rhesus monkey. Using multiple tracing approaches, we found a robust projection from the lateral basal nucleus of the amygdala to Layers II, IIIa, and V of the rostral cingulate motor cortex (M3). A smaller source of amygdala input arose from the accessory basal, cortical, and lateral nuclei, which targeted only the rostral region of M3. We also found a light projection from the lateral basal nucleus to the same layers of the caudal cingulate motor cortex (M4). Experiments examining this projection to cingulate somatotopy using combined neural tracing strategies and stereology to estimate the total number of terminal-like immunoreactive particles demonstrated that the amygdala projection terminates heavily in the face representation of M3 and moderately in its arm representation. Fewer terminal profiles were found in the leg representation of M3 and the face, arm, and leg representations of M4. Anterograde tracers placed directly into M3 and M4 revealed the amygdala connection to be reciprocal and documented corticofugal projections to the facial nucleus, surrounding pontine reticular formation, and spinal cord. Clinically, such pathways would be in a position to contribute to mediating movements in the face, neck, and upper extremity accompanying medial temporal lobe seizures that have historically characterized this syndrome. Alterations within or disruption of the amygdalo-cingulate projection to the rostral part of M3 may also have an adverse effect on facial expression in patients presenting with neurological or neuropsychiatric abnormalities of medial temporal lobe involvement. Finally, the prominent amygdala projection to the face region of M3 may significantly influence the outcome of higher-order facial expressions associated with social communication and emotional constructs such as fear, anger, happiness, and sadness.
    The Journal of Comparative Neurology 02/2007; 500(1):134-65. · 3.66 Impact Factor
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    ABSTRACT: We present a modification of the automated movement assessment panel [Gash DM, Zhang Z, Umberger G, Mahood K, Smith M, Smith C, et al. An automated movement assessment panel for upper limb motor functions in rhesus monkeys and humans. J Neurosci Methods 1999;89:111-7] that incorporates a three-dimensional load cell to record forces applied by monkeys while manipulating food targets. The absolute force-time integral (total absolute impulse) is used to characterize the total of the applied forces over time as the food (carrot chip with a hole punched through the center) is manipulated and lifted from a flat surface (easiest task) and threaded over a straight rod (medium difficulty) or curved rod (highest difficulty). The total impulse can be measured even on unsuccessful attempts to acquire the food. Thus, it can be used to evaluate changes in performance even before successful acquisition occurs as in learning or recovery following a nervous system insult. We show from tests in three rhesus monkeys that the total absolute impulse measure is sensitive to task complexity, learning and lesion of frontal lobe motor areas (in one case) and that there is good reliability in day-to-day performance (even with long periods between performances) after the monkey has learned the task. Importantly, the task requires minimal training as the monkeys can be successful on even the most difficult of these tasks with one or two training sessions, yet performance improvements continue to occur over several testing sessions. Furthermore, the three levels of task difficulty permit analysis of a progression of ability.
    Journal of Neuroscience Methods 07/2006; 154(1-2):38-44. · 2.11 Impact Factor
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    ABSTRACT: Age-dependent poliomyelitis (ADPM) or murine amyotrophic lateral sclerosis (ALS) is a murine paralytic disease triggered in immunosuppressed genetically-susceptible mice by infection with the arterivirus lactate dehydrogenase-elevating virus (LDV). This disease provides an animal model for ALS, affecting anterior horn neurons and resulting in neuroparalysis 2-3 weeks after LDV infection. We have tested the hypothesis that spinal cord apoptosis is a feature of the LDV-induced murine ALS, since apoptosis is postulated to be a causal factor in human ALS. Gene microarray analyses of spinal cords from paralyzed animals revealed upregulation of several genes associated with apoptosis. Spinal cord apoptosis was investigated further by TUNEL and activated caspase-3 assays, and was observed to emerge concurrent with paralytic symptoms in both neuronal and non-neuronal cells. Caspase-3-dependent apoptosis was also triggered in cultured macrophages by neurovirulent LDV infection. Thus, virus-induced spinal cord apoptosis is a pre-mortem feature of ADPM, which affects both neuronal and support cells, and may contribute to the pathogenesis of this ALS-like disease.
    Virus Research 12/2004; 106(1):35-42. · 2.75 Impact Factor

Publication Stats

224 Citations
50.59 Total Impact Points

Institutions

  • 2013
    • Kansas City VA Medical Center
      Kansas City, Missouri, United States
  • 2006–2011
    • University of Iowa
      • Department of Anatomy and Cell Biology
      Iowa City, IA, United States
    • University of South Dakota
      • Division of Basic Biomedical Sciences
      Vermillion, South Dakota, United States