Polysynaptic components of the early somato-sympathetic reflex response in the lumbar white rami communicantes]

The second and third components of early somatosympathetic relfex discharge were studied in anesthetized cats. Polysynaptic components of the early somatosympathetic and propriospinal somatosomatic discharges were compared. Evidence was found that these reflexes have both common and specialized interneurons in their central polysynaptic chains. It is suggested that the components of the early somatosympathetic reflex are formed by different types of sympathetic preganglionic neurons, namely the second component by neurons of the lateral horns and the third one--by neurons detected in the lateral part of intermediate zone (axonal velocity less than 1.5 m/s). A classification of sympathetic preganglionic neurons is presented.     

Supraspinal regulation of spinal reflex discharge into cardiac sympathetic nerves

(1) In chloralose anaesthetized cats, reflex responses were recorded in inferior cardiac nerves following stimulation of intercostal nerves and hind limb afferent nerves. (2) In 80% of cats, a long latency reflex response alone was recorded, whereas, in the others, a short and long latency response was present to intercostal nerve stimulation. (3) In cats displaying only a long latency somatocardiac reflex response, damage to the ventral quadrant of the ipsilateral cervical spinal cord, through which runs a bulbospinal inhibitory pathway, resulted in the appearance of shorter latency reflexes to intercostal nerve stimulation. Lesions elsewhere in the cervical cord did not do this. (4) The characteristics of the early responses indicated that they were somatosympathetic reflexes and not dorsal root reflexes. (5) The early reflexes remained and the late reflex disappeared on subsequent complete transection of the spinal cord. The early reflexes were therefore spinal reflexes, and suppressed in the animal with cord intact. (6) Lesions at C4, which included a contralateral hemisection and a section of dorsal columns extending into the dorsal part of the lateral funiculus, abolished the inhibition of a sympathetic reflex that followed stimulation of some somatic afferent nerve fibres. These sections did not release the spinal reflex. Therefore, this reflex inhibition was not responsible for the suppression of the spinal somatosympathetic reflex. (7) The descending inhibitory influence on the segmental reflex pathway was not antagonized by strychnine, bicuculline or picrotoxin. (8) The possibility is discussed that the spinal reflex pathway into cardiac sympathetic nerves is tonically inhibited by a bulbospinal pathway originating from the classical depressor region of the ventromedial reticular formation.     

Propriospinal neurons in the C1-C2 spinal segments project to the L5-S1 segments of the rat spinal cord

Physiological studies indicate that neurons in the upper cervical spinal cord have descending projections to the lumbosacral spinal cord and mediate inhibition of dorsal horn neurons activated from afferent input. In the present study, retrograde tracing techniques were used to examine the distribution of propriospinal neurons in C1-C2 spinal segments that project to lumbosacral spinal segments. Fluorogold or horseradish peroxidase were injected unilaterally or bilaterally into the L5-S1 spinal segments. After 2–4 days, rats were perfused with fixative and C1-C2 spinal segments were processed for retrograde labeling. Numerous neurons were found in the C1-C2 segments. In unilaterally and bilaterally injected rats, retrogradely labeled neurons were located on both the ipsilateral and contralateral sides. Retrogradely labeled neurons were located in the following locations: lateral cervical and spinal nuclei, nucleus proprius, ventral horn and the central gray region (area X). These studies demonstrate a descending projection from C1-C2 segments to the lower lumbar and sacral spinal cord. We hypothesize that many of these C1-C2 propriospinal neurons are important in modulating responses of spinal neurons at lower segmental levels to various peripheral stimuli.     

Influence of L-DOPA on transmission in long ascending propriospinal pathways in the cat

In high spinal cats the influence of an intravenous injection ofl-3,4,-dihydroxyphenylalanine (DOPA) has been investigated on the transmission of long ascending propriospinal pathways to certain groups of forelimb motoneurones. The early discharge evoked in pectoralis major and deep radial motoneurones on electrical stimulation of hindlimb afferents, which may be obtained in some high spinal preparations, is facilitated after DOPA. A late discharge (30–80 msec) appears after DOPA in the same forelimb motoneurones and may often last up to 600 msec or more. Facilitation by hindlimb nerves of forelimb mono- and polysynaptic reflexes is similarly prolonged. Ipsilateral hindlimb nerves are more effective than contralateral. Late discharges have also been evoked in forelimb motoneurones on stimulation of forelimb afferents after DOPA and it is concluded that a somewhat similar organization of late reflexes exists in brachial segments as previously reported by Jankowskaet al. in the lumbar cord.The influence of DOPA on long ascending propriospinal and forelimb reflexes is ascribed to excitation of the terminals of noradrenergic reticulospinal fibres. The reflex changes are considered to reflect activity in neuronal systems involved in the control of stepping in the cat.A further system modifying long ascending propriospinal transmission could be excited by stimulation of the ventral quadrant of the spinal cord at C₁. The effects on propriospinal transmission could outlast the stimulus by several tens of minutes.     

Artificial autonomic reflexes: using functional electrical stimulation to mimic bladder reflexes after injury or disease

Autonomic reflexes controlling bladder storage (continence) and emptying (micturition) involve spinal and supraspinal nerve pathways, with complex mechanisms coordinating smooth muscle activity of the lower urinary tract with voluntary muscle activity of the external urethral sphincter (EUS). These reflexes can be severely disrupted by various diseases and by neurotrauma, particularly spinal cord injury (SCI). Functional electrical stimulation (FES) refers to a group of techniques that involve application of low levels of electrical current to artificially induce or modify nerve activation or muscle contraction, in order to restore function, improve health or rectify physiological dysfunction. Various types of FES have been developed specifically for improving bladder function and while successful for many urological patients, still require substantial refinement for use after spinal cord injury. Improved knowledge of the neural circuitry and physiology of human bladder reflexes, and the mechanisms by which various types of FES alter spinal outflow, is urgently required. Following spinal cord injury, physical and chemical changes occur within peripheral, spinal and supraspinal components of bladder reflex circuitry. Better understanding of this plasticity may determine the most suitable methods of FES at particular times after injury, or may lead to new FES approaches that exploit this remodeling or perhaps even influence the plasticity. Advances in studies of the neuroanatomy, neurophysiology and plasticity of lumbosacral nerve circuits will provide many further opportunities to improve FES approaches, and will provide "artificial autonomic reflexes" that much more closely resemble the original, healthy neuronal regulatory mechanisms.     

Increased c-fos expression in spinal lumbosacral projection neurons and preganglionic neurons after irritation of the lower urinary tract in the rat.

Chemical irritation of the lower urinary tract (LUT) induces c-fos expression in neurons in the lumbosacral (L(6) and S(1)) spinal cord. This study used axonal tracing with fluorescent dyes to identify the types of spinal neurons expressing Fos immunoreactivity (IR) after LUT irritation in the rat. Fos-IR was detected in lateral and medial superficial dorsal horn, the sacral parasympathetic nucleus (SPN) and lamina X around the central canal. Fos-IR was detected in spinal neurons projecting to supraspinal sites (brainstem and hypothalamus), in preganglionic neurons (PGN) and in unlabeled segmental interneurons. A substantial percentage (20%) of dye labeled PGN exhibited Fos-IR after LUT irritation; and a larger percentage (36%) exhibited Fos-IR after electrical stimulation of the pelvic nerve which contains afferent pathways from all of the pelvic organs. The majority (average 55%) of Fos-positive neurons projecting to supraspinal sites were also located in the region of the SPN. A selective distribution of different types of neurons was detected in this region: PGN were located ventral to the spinal projection neurons which in turn were located ventral to the majority of unidentified Fos-positive neurons. The distribution of Fos-positive PGN and projection neurons was similar in spinal intact and spinal transected animals indicating that c-fos expression was mediated by monosynaptic afferent input or input from segmental interneurons and was not due to activation of supraspinal micturition reflex pathways.     

Late prolonged discharges in the motor nerves of the hindlimbs and their relationship to locomotor rhythmicity in thalamically immobilized cats]

Effects of flexor reflex afferents stimulation were investigated on high decerebrated curarized cats. Stimulation of ipsilateral flexor reflex afferents evoked late long-lasting discharges in flexor nerves. Contralateral flexor reflex afferents stimulation evoked late discharges both in extensor and flexor nerves. Transition from late discharges to rhythmic discharges was observed. Early segmental reflexes were tonically depressed in thalamic in comparison with acute spinal cats. A similar tonic depression of segmental reflexes took place in acute spinal cats after DOPA injection. Segmental reflexes were distinctly modulated during late and rhythmic discharges. On the basis of the data available possible central mechanisms of the observed changes of segmental reflexes are discussed.     

Increased c-fos expression in spinal lumbosacral projection neurons and preganglionic neurons after irritation of the lower urinary tract in the rat

Chemical irritation of the lower urinary tract (LUT) induces c-fos expression in neurons in the lumbosacral (L₆ and S₁) spinal cord. This study used axonal tracing with fluorescent dyes to identify the types of spinal neurons expressing Fos immunoreactivity (IR) after LUT irritation in the rat. Fos-IR was detected in lateral and medial superficial dorsal horn, the sacral parasympathetic nucleus (SPN) and lamina X around the central canal. Fos-IR was detected in spinal neurons projecting to supraspinal sites (brainstem and hypothalamus), in preganglionic neurons (PGN) and in unlabeled segmental interneurons. A substantial percentage (20%) of dye labeled PGN exhibited Fos-IR after LUT irritation; and a larger percentage (36%) exhibited Fos-IR after electrical stimulation of the pelvic nerve which contains afferent pathways from all of the pelvic organs. The majority (average 55%) of Fos-positive neurons projecting to supraspinal sites were also located in the region of the SPN. A selective distribution of different types of neurons was detected in this region: PGN were located ventral to the spinal projection neurons which in turn were located ventral to the majority of unidentified Fos-positive neurons. The distribution of Fos-positive PGN and projection neurons was similar in spinal intact and spinal transected animals indicating that c-fos expression was mediated by monosynaptic afferent input or input from segmental interneurons and was not due to activation of supraspinal micturition reflex pathways.     

Diversity of sympathetic vasoconstrictor pathways and their plasticity after spinal cord injury

Sympathetic vasoconstrictor pathways pass through paravertebral ganglia carrying ongoing and reflex activity arising within the central nervous system to their vascular targets. The pattern of reflex activity is selective for particular vascular beds and appropriate for the physiological outcome (vasoconstriction or vasodilation). The preganglionic signals are distributed to most postganglionic neurones in ganglia via synapses that are always suprathreshold for action potential initiation (like skeletal neuromuscular junctions). Most postganglionic neurones receive only one of these “strong” inputs, other preganglionic connections being ineffective. Pre- and postganglionic neurones discharge normally at frequencies of 0.5–1 Hz and maximally in short bursts at <10 Hz. Animal experiments have revealed unexpected changes in these pathways following spinal cord injury. (1) After destruction of preganglionic neurones or axons, surviving terminals in ganglia sprout and rapidly re-establish strong connections, probably even to inappropriate postganglionic neurones. This could explain aberrant reflexes after spinal cord injury. (2) Cutaneous (tail) and splanchnic (mesenteric) arteries taken from below a spinal transection show dramatically enhanced responses in vitro to norepinephrine released from perivascular nerves. However the mechanisms that are modified differ between the two vessels, being mostly postjunctional in the tail artery and mostly prejunctional in the mesenteric artery. The changes are mimicked when postganglionic neurones are silenced by removal of their preganglionic input. Whether or not other arteries are also hyperresponsive to reflex activation, these observations suggest that the greatest contribution to raised peripheral resistance in autonomic dysreflexia follows the modifications of neurovascular transmission.     

Expression of Fos in rat central nervous system elicited by afferent stimulation of the femoral nerve

To investigate the distribution of Fos-like immunoreactivity (FLI)_in the central nervous system of urethane anesthetized rats after activation of a somatosympathetic reflex pathway, the cut central end of the right femoral nerve of 17 male Wistar rats was stimulated electrically for 1 h at parameters such that increases in heart rate and arterial pressure were elicited. Sections of brain and spinal cord were incubated in anti-Fos antibody and the presence of FLI was detected using the ABC immunoperoxidase method. In the spinal cord FLI was present in the ipsilateral lumbar spinal cord (laminae 1 and 2, 4–6 and 10) and contralateral intermediolateral nucleus in the thoracic spinal cord. In the hindbrain, FLI was present in the contralateral rostral ventrolateral medulla and bilaterally in the cochlear nucleus, external cuneate nucleus, locus coeruleus and lateral parabrachial nucleus. In the midbrain, label appeared in the Edinger-Westphal nucleus and peripenduncular nucleus on both sides. In the forebrain, FLI appeared bilaterally in the central nucleus of the amygdala, para- and periventricular hypothalamus, supraoptic nucleus, paraventricular thalamus, reuniens nucleus, subfornical organ and bed nucleus of the stria terminalis. These results define the central nervous system pathways of somatosymphathetic reflexes and demonstrate that areas in the forebrain not previously known to be activated by somatosympathetic reflexes, but previously implicated in mediating the defense reaction, are activated by these reflexes.     

Neural organization of the viscero-cardiac reflexes

The reflex responses evoked in the postganglionic nerves to the heart were tested in chloralose-anaesthetized cats. Electrical stimulation of the A delta afferent fibres from the left inferior cardiac nerve evoked spinal and supraspinal reflex responses with the onset latencies of 36 ms and 77 ms respectively. The most effective stimulus was a train of 3-4 electrical pulses with the intratrain frequency of 200-300 Hz. Electrical stimulation of the high threshold afferent fibres (C-fibres) from the left inferior cardiac nerve evoked the reflex response with the onset latency of 200 ms. The C-reflex was present in intact animals and disappeared after spinalization. The most effective stimulus to evoke this reflex was a train of electrical pulses delivered at a frequency of 1-2 Hz with an intratrain frequency of 20-30 Hz. The most prominent property of the C-reflex was its marked increase after prolonged repeated electrical stimulation. We conclude that: (1) viscero-cardiac sympathetic reflexes may be organized at the spinal and supraspinal level; (2) viscero-cardiac sympathetic reflexes evoked by stimulation of the A delta and C afferent fibres from the left inferior cardiac nerve have different central organization.     

Reflex patterns in postganglionic vasoconstrictor neurons following chronic nerve lesions

Lesions of limb nerves in man may be associated with a variety of painful disorders with trophic changes described by the generic term 'reflex sympathetic dystrophy'. Our hypothesis is that pain and trophic changes are produced by an abnormal discharge pattern in postganglionic neurons supplying the limb (see refs. 3,24). In relation to this hypothesis, reflex patterns in postganglionic vasoconstrictor neurons supplying the skin (CVC) and the skeletal muscle (MVC) of the cat hindlimb were investigated at various times after a peripheral nerve lesion had been produced. These reflex patterns were compared with those in animals without nerve lesions (control preparations). The following lesions were made: cutting and ligating the superficial peroneal nerve (skin nerve) with subsequent neuroma formation, suturing the central stump of the superficial peroneal nerve to the peripheral stumps of muscle branches of the deep peroneal nerve, suturing the central stumps of muscle branches of the deep peroneal nerve to the peripheral stump of the superficial peroneal nerve, cutting and resuturing the superficial peroneal nerve, deafferentation of the whole hindlimb. The responses of vasoconstrictor neurons to stimulation of arterial chemoreceptors, arterial baroreceptors (cardiac rhythmicity of postganglionic activity) and cutaneous nociceptors were tested. In the animals with nerve lesions, the following groups of postganglionic vasoconstrictor neurons were analyzed: neurons projecting to the lesioned nerve, neurons projecting to hairy skin through an intact skin nerve (sural nerve) and neurons projecting to skeletal muscle through intact muscle nerves. In control preparations without nerve lesions, MVC neurons were excited by stimulation of arterial chemoreceptors and cutaneous nociceptors and inhibited by stimulation of arterial baroreceptors. Most CVC neurons were inhibited by stimulation of chemoreceptors and nociceptors and weakly inhibited by stimulation of baroreceptors. In animals with nerve lesions a and b, many CVC neurons in the lesioned nerves, as well as in the non-lesioned cutaneous nerve nearby, behaved in the same manner as MVC neurons. With respect to the control, this difference proved to be statistically significant. In preparations with lesions a, b and c, MVC neurons did not change their reflex patterns. After nerve lesions d and e, no major changes of reflex patterns were observed in CVC and MVC neurons. The inhibitory influence of arterial baroreceptors on CVC activity decreased in deafferented preparations (lesion e).(ABSTRACT TRUNCATED AT 400 WORDS)     

Reflex mechanisms of interlimb interrelationships displayed in lumbar flexor centers of the cat spinal cord]

Interaction of segmental, propriospinal and spino-bulbo-spinal components of the lumbar flexor reflexes evoked by activation of the hind-and forelimb afferents with paired stimuli was studied in anesthetized cats. Coincidence in time of a reflex discharge evoked by stimulation of the forelimb afferent nerves with monosynaptic hindlimb flexor reflex causes considerable facilitation of the latter. The monosynaptic reflex increases for 40-50 ms. tthe polysynaptic flexor reflexes of segmental, propriospinal and spino-bulbo-spinal origin act upon each other in both a facilitatory and an inhibitory manner. Facilitation takes place only during the period of coincidence of the responses, inhibition when the responses are separated in time. Three types of inhibition with duration of 7-15, 40-150, 300-500 ms were observed. Possible neuronal mechanisms of interaction of the above-mentioned responses and their role in the inter limb interrelations are discussed     

Commissural neurons in the cat upper cervical spinal cord.

We have begun a study of the intrinsic circuitry of the cat's upper cervical cord, in part to elucidate the role of spinal interneurons in vestibulocollic reflexes. Using retrograde labelling with Fluoro-Gold and intraspinal microstimulation, we have identified commissural neurons projecting to the contralateral ventral horn. Neurons tended to be in the medial half of lamina VIII. Approximately half of the neurons were propriospinal neurons that could be activated antidromically from the rostral border of the cervical enlargement. Most of the tested, spontaneously active neurons were driven by stimulation of the ipsi- and/or contralateral vestibular nerve, in some cases disynaptically.     

Functional organization of long ascending propriospinal pathways linking lumbo-sacral and cervical segments in the cat

In high spinal cats propriospinal pathways ascending from lumbo-sacral levels of the spinal cord can mediate strong excitatory and inhibitory changes in reflexes to different groups of motoneurones supplying muscles of the forelimb. Discharges evoked by electrical stimulation of hindlimb nerves could be evoked in 41% of experiments in the motoneurones of pectoralis major and minor. The latency of the discharge (8–18 msec) could be shortened by increasing the repetition frequency of the stimulus, the greatest reduction occurring in the range 1–4 Hz. Contralateral hindlimb nerves were less effective and the discharge generally occurred at a latency 1–2 msec longer than for ipsilateral nerves.Monosynaptic reflexes to pectoralis major and deep radial motoneurones supplying the physiological flexor muscles were strongly facilitated by hindlimb nerve stimulation, ipsilateral nerves being more effective than contralateral. Monosynaptic reflexes to latissimus dorsi showed a reciprocal pattern of conditioning, being depressed by ipsilateral and facilitated by contralateral hindlimb extensor nerves, the flexor nerves giving the reverse pattern. Monosynaptic reflexes to median and ulnar nerves supplying physiological extensor muscles were not significantly affected by hindlimb nerve conditioning.Polysynaptic reflexes to pectoralis major and deep radial motoneurones received initial strong facilitation followed by prolonged depression, ipsilateral hindlimb nerves being more effective than contralateral. In latissimus dorsi a reciprocal pattern similar to that for monosynaptic reflex testing was found. Polysynaptic reflexes to median and ulnar motoneurones received only prolonged depression.The hindlimb afferent nerves responsible for the discharge in forelimb motoneurones and for the facilitation and depression of forelimb reflexes include groups II and II muscle afferents and group II skin afferents, especially from quadriceps and sartorius muscles, and sural and superficial peroneal nerves, respectively.The ascending long propriospinal pathways are influenced bilaterally from hindlimb nerves and are located in the lower thoracic segments in the ventrolateral funiculus. The pathways mediate effects on ipsilateral and contralateral forelimb reflex systems, the ipsilateral projections being dominant. Part of the long ascending projection terminates monosynaptically on the motoneurones of pectoralis major. It is likely that group II afferents from ipsilateral quadriceps muscle activate the ascending tract monosynaptically and those from contralateral quadriceps disynaptically.The hypothesis is suggested that long propriospinal paths primarily represent intrinsic links between hindlimb and forelimb ‘motor centres’. The pattern of long ascending influences to groups of forelimb motoneurones corresponds closely to the sequences of hindlimb and forelimb stepping observed in normal cats. A functional role in stepping is therefore proposed for long ascending propriospinal pathways.     

Discharge patterns of motility-regulating neurons projecting in the lumbar splanchnic nerves to visceral stimuli in spinal cats

Reflexes in visceral preganglionic motility-regulating (MR) neurons which project in the lumbar splanchnic nerves were investigated in acutely spinalized cats. Some neurons were analyzed before and after spinalization. The stimuli used were mechanical stimulation of mucosal skin of the anus and of perianal (perigenital) hairy skin, and distension and contraction of urinary bladder and colon. Most MR neurons exhibited a reflex pattern which consists of the following components: excitation upon bladder distension, inhibition or no effect upon colon distension and excitation (or, rarely, no effect) upon anal stimulation. This is the reflex pattern of MR1 neurons. Some neurons were excited by anal stimulation but not affected from the colon and urinary bladder. Some were inhibited by anal and perianal stimulation but otherwise exhibited the reflex patterns of the MR1 neurons. Analysis of the reflexes before and after spinalization showed that, in particular, inhibition elicited by anal, perianal and bladder stimulation was abolished; inhibition elicited from the colon was enhanced after spinalization. It is concluded that the reflexes elicited in preganglionic lumbar visceral neurons by the natural stimuli probably use spinal pathways, with the afferent input occurring at the sacral spinal cord. These spinal reflex pathways are probably controlled by descending inhibitory and excitatory spinal systems from the supraspinal neuraxis.     

Activity in sympathetic neurons supplying skin and skeletal muscle in spinal cats

In anesthetized cats with intact neuraxis, vasoconstrictor neurons supplying skeletal muscle (MVC) and hairy and hairless skin (CVC), and sudomotor neurons innervating sweat glands (SM), exhibit distinct reflex patterns. MVC and SM are largely under excitatory, CVC under inhibitory control of various afferent input systems from the body surface and from the viscera. In chronic spinal animals all 3 types of sympathetic neurons exhibit some resting activity without cardiac and respiratory modulation. Sixty to 150 days after isolation of the neural circuits within the sympathetic systems within the spinal cord from their descending control systems by spinalization, these reflex patterns are very similar to those in animals with intact neuraxis. Important changes which do occur after spinalization are the following: CVC neurons are excited by stimulation of visceral afferents in spinal animals but inhibited in animals with intact neuraxis; noxious stimulation of skin leads to long-lasting after-effects in CVC and SM neurons in spinal animals. Comparison of reflexes among spinal animals and animals with intact neuraxis indicates that spinal circuits are probably important for the functioning of the sympathetic systems. It is possible that these circuits determine the typical reaction patterns seen in the sympathetic systems by integrating multisensory information from primary afferents and information from spinal descending fiber tracts.     

Stimulation of the hypothamus initiates the urethrogenital reflex in male rats

The urethrogenital (UG) reflex is a spinal sexual reflex which is tonically inhibited in the intact male rat by neurons in the nucleus paragigantocellularis (nPGi). The medial preoptic area of the hypothalamus (MPOA) is involved in the actication of male sexual behavior. The present study examines the effect of hypothalamic stimulation on the UG reflex in the intact male rat. Areas of the hypothalamus were stimulated bilaterally with either electrical stimulation or D,L-homocysteic acid (DLH) and the presence of the UG reflex examined. Stimulation of discrete areas of the hypothalamus evoked the UG reflex. The UG reflex could be initiated in the absence of genital stimulation. Microinjections of DLH into the MPOA also initiate the UG reflex. These data suggest that stimulation of neurons in the MPOA overcome the inhibition by the nPGi and facilitate spinal genital reflexes leading to ejaculation.     

Autonomic pathways regulating pancreatic exocrine secretion

The parasympathetic (PNS) and sympathetic (SNS) and nervous systems densely innervate the exocrine pancreas. Efferent PNS pathways, consisting of central dorsal motor nucleus of the vagus (DMV) and peripheral pancreatic neurons, stimulate exocrine secretion. The DMV integrates cortical (olfactory, gustatory) and gastric, and intestinal vagal afferent input to determine central PNS outflow during cephalic, gastric and intestinal phases of exocrine secretion. Pancreatic neurons integrate DMV input with peripheral enteric, sympathetic, and, possibly, afferent axon reflexes to determine final PNS input to all exocrine effectors. Gut and islet hormones appear to modulate both central and peripheral PNS pathways. Preganglionic sympathetic neurons in the intermediolateral (IML) column of the spinal cord receive inputs from brain centers, some shared with the PNS, and innervate postganglionic neurons, mainly in prevertebral ganglia. Sympathetic innervation of the exocrine pancreas is primarily indirect, and inhibits secretion by decreasing blood flow and inhibiting transmission in pancreatic ganglia. Interactions between SNS and PNS pathways appear to occur in brain, spinal cord, pancreatic and prevertebral ganglia, and at neuroeffector synapses. Thus, the PNS and SNS pathways regulating the exocrine pancreas are directly or indirectly antagonistic at multiple sites: the state of exocrine secretion reflects the balance of these influences. Despite over a century of study, much remains to be understood about the connections of specific neurons forming pancreatic pathways, their processes of neurotransmission, and how disruption of these pathways contributes to pancreatic disease.     

The Role of Vasoactive Intestinal Polypeptide and Pituitary Adenylate Cyclase-Activating Polypeptide in the Neural Pathways Controlling the Lower Urinary Tract

Vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP) are expressed in the neural pathways regulating the lower urinary tract. VIP-immunoreactivity (IR) is present in afferent and autonomic efferent neurons innervating the bladder and urethra, whereas PACAP-IR is present primarily in afferent neurons. Exogenously applied VIP relaxes bladder and urethral smooth muscle and excites parasympathetic neurons in bladder ganglia. PACAP relaxes bladder and urethral smooth muscle in some species (pig) but excites the smooth muscle in other species (mouse). Intrathecal administration of VIP in cats with an intact spinal cord suppresses reflex bladder activity, but intrathecal administration of VIP or PACAP in rats enhances bladder activity and suppresses urethral sphincter activity. PACAP has presynaptic facilitatory effects and direct excitatory effects on lumbosacral parasympathetic preganglionic neurons. Chronic spinal cord transection produces an expansion of VIP-IR (cats) and PACAP-IR (rats) in primary afferent axons in the lumbosacral spinal cord and unmasks spinal excitatory effects of VIP on bladder reflexes in cats. Intrathecal administration of PACAP6-38, a PAC1 receptor antagonist, reduces bladder hyperactivity in chronic spinal-cord-injured rats. These observations raise the possibility that VIP or PACAP have a role in the control of normal or abnormal voiding.