Synaptogenesis in the Fetal Corpus Striatum, Globus Pallidus, and Substantia Nigra: Correlations With Striosomes of Graybiel and Dyskinesias in Premature Infants

Abstract Synaptogenesis can be detected in tissue sections by immunoreactivity for synaptophysin, a synaptic vesicle glycoprotein that serves as a marker of synaptic maturation. Reactivity was prospectively studied postmortem in sections of the striatum, globus pallidus, and substantia nigra in 172 normal human fetuses and neonates of 6 to 41 weeks' gestation. Caudate nucleus and putamen show patchy reactivity beginning at 13 weeks' gestation around some intracapsular neurons; the pattern is well developed in all regions before midgestation. Near-uniform reactivity throughout the striatum is achieved by 34 weeks, but subtle patchiness is still perceived at term. The globus pallidus shows uniform reactivity without stria from 13 weeks and the substantia nigra from 9 weeks. Synaptic patchiness in the fetal corpus striatum appears to correspond to the ''striosomes of Graybiel'' that define adjacent neurotransmitter-rich and neurotransmitter-poor zones. Clinical correlation is proposed with dystonic postures and athetoid movements observed in normal preterm neonates of 26 to 32 weeks. Keywords corpus striatum, dyskinesias, globus pallidus, striosomes of Graybiel, substantia nigra, synaptogenesis, synaptophysin, caudate, putamen Received October 25, 2011. Accepted for publication January 31, 2012. The temporal and spatial sequence of synaptogenesis can be demonstrated reliably in formalin-fixed, paraffin-embedded sections of human fetal brain using synaptophysin immunocytochemistry

The ILAE consensus classification of focal cortical dysplasia: An update proposed by an ad hoc task force of the ILAE diagnostic methods commission

Ongoing challenges in diagnosing focal cortical dysplasia (FCD) mandate continuous research and consensus agreement to improve disease definition and classification. An International League Against Epilepsy (ILAE) Task Force (TF) reviewed the FCD classification of 2011 to identify existing gaps and provide a timely update. The following methodology was applied to achieve this goal: a survey of published literature indexed with ((Focal Cortical Dysplasia) AND (epilepsy)) between 01/01/2012 and 06/30/2021 (n = 1349) in PubMed identified the knowledge gained since 2012 and new developments in the field. An online survey consulted the ILAE community about the current use of the FCD classification scheme with 367 people answering. The TF performed an iterative clinico-pathological and genetic agreement study to objectively measure the diagnostic gap in blood/brain samples from 22 patients suspicious for FCD and submitted to epilepsy surgery. The literature confirmed new molecular-genetic characterizations involving the mechanistic Target Of Rapamycin (mTOR) pathway in FCD type II (FCDII), and SLC35A2 in mild malformations of cortical development (mMCDs) with oligodendroglial hyperplasia (MOGHE). The electro-clinical-imaging phenotypes and surgical outcomes were better defined and validated for FCDII. Little new information was acquired on clinical, histopathological, or genetic characteristics of FCD type I (FCDI) and FCD type III (FCDIII). The survey identified mMCDs, FCDI, and genetic characterization as fields for improvement in an updated classification. Our iterative clinico-pathological and genetic agreement study confirmed the importance of immunohistochemical staining, neuroimaging, and genetic tests to improve the diagnostic yield. The TF proposes to include mMCDs, MOGHE, and “no definite FCD on histopathology” as new categories in the updated FCD classification. The histopathological classification can be further augmented by advanced neuroimaging and genetic studies to comprehensively diagnose FCD subtypes; these different levels should then be integrated into a multi-layered diagnostic scheme. This update may help to foster multidisciplinary efforts toward a better understanding of FCD and the development of novel targeted treatment options

Eye Size at Birth in Prosimian Primates: Life History Correlates and Growth Patterns

BACKGROUND: Primates have large eyes relative to head size, which profoundly influence the ontogenetic emergence of facial form. However, growth of the primate eye is only understood in a narrow taxonomic perspective, with information biased toward anthropoids.\ud \ud METHODOLOGY/PRINCIPAL FINDINGS: We measured eye and bony orbit size in perinatal prosimian primates (17 strepsirrhine taxa and Tarsius syrichta) to infer the extent of prenatal as compared to postnatal eye growth. In addition, multiple linear regression was used to detect relationships of relative eye and orbit diameter to life history variables. ANOVA was used to determine if eye size differed according to activity pattern. In most of the species, eye diameter at birth measures more than half of that for adults. Two exceptions include Nycticebus and Tarsius, in which more than half of eye diameter growth occurs postnatally. Ratios of neonate/adult eye and orbit diameters indicate prenatal growth of the eye is actually more rapid than that of the orbit. For example, mean neonatal transverse eye diameter is 57.5% of the adult value (excluding Nycticebus and Tarsius), compared to 50.8% for orbital diameter. If Nycticebus is excluded, relative gestation age has a significant positive correlation with relative eye diameter in strepsirrhines, explaining 59% of the variance in relative transverse eye diameter. No significant differences were found among species with different activity patterns.\ud \ud CONCLUSIONS/SIGNIFICANCE: The primate developmental strategy of relatively long gestations is probably tied to an extended period of neural development, and this principle appears to apply to eye growth as well. Our findings indicate that growth rates of the eye and bony orbit are disassociated, with eyes growing faster prenatally, and the growth rate of the bony orbit exceeding that of the eyes after birth. Some well-documented patterns of orbital morphology in adult primates, such as the enlarged orbits of nocturnal species, mainly emerge during postnatal development.\ud \u

Compensating control participants when the intervention is of significant value: experience in Guatemala, India, Peru and Rwanda

The Household Air Pollution Intervention Network (HAPIN) trial is a randomised controlled trial in Guatemala, India, Peru and Rwanda to assess the health impact of a clean cooking intervention in households using solid biomass for cooking. The HAPIN intervention—a liquefied petroleum gas (LPG) stove and 18-month supply of LPG—has significant value in these communities, irrespective of potential health benefits. For control households, it was necessary to develop a compensation strategy that would be comparable across four settings and would address concerns about differential loss to follow-up, fairness and potential effects on household economics. Each site developed slightly different, contextually appropriate compensation packages by combining a set of uniform principles with local community input. In Guatemala, control compensation consists of coupons equivalent to the LPG stove’s value that can be redeemed for the participant’s choice of household items, which could include an LPG stove. In Peru, control households receive several small items during the trial, plus the intervention stove and 1 month of fuel at the trial’s conclusion. Rwandan participants are given small items during the trial and a choice of a solar kit, LPG stove and four fuel refills, or cash equivalent at the end. India is the only setting in which control participants receive the intervention (LPG stove and 18 months of fuel) at the trial’s end while also being compensated for their time during the trial, in accordance with local ethics committee requirements. The approaches presented here could inform compensation strategy development in future multi-country trials

Functions of the corticospinal and corticobulbar tracts in the human newborn

The corticospinal and corticobulbar tracts (CST, CBT) are immature at birth, in neuroanatomical terms of myelination and terminal axonal sprouting for multiple synaptic contact; these developmental features are not mature until 2 years of age. Physiologically, the CST is mainly inhibitory. Nevertheless, these pathways have an important role to play in normal neurological function at this age, though different from their functions in the older child and adult. They are important in the neonate by 1) inhibition of the monosynaptic stretch reflexes at spinal cord levels, beginning at 25 weeks gestation or earlier; 2) influence upon muscle tone, hence posture, by mediating proximal flexion in axial and limb girdle muscles and distal extension of the fingers and toes and abduction of the thumbs; 3) antagonism of the proximal extension and distal flexion and adduction from the medial subcorticospinal pathways of Lawrence and Kuypers; 4) reinforcement of tactile reflexes, the most important of which are suck and swallow; 5)early individualization of finger movements; 6) transmission of epileptic activity from the cerebral cortex. Understanding the unique roles of the CST at birth provide rational, physiological explanations of such neonatal phenomena as clonus, opisthotonus, strong distal flexion and adduction ("cortical thumb") and fisting), and poor suck and swallow in affected neonates, regardless of the cause of cerebral cortical impairment or its reversibility or irreversibility. In summary, the CST and CBT are indeed important functional pathways in the neonate, but many of their functions are very different than in the adult. (J Pediatr Neurol 2003; 1(1): 3-8)