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Aging and Disease    2015, Vol. 6 Issue (1) : 6-16     DOI: 10.14336/AD.2014.0310
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The Human Trochlear and Abducens Nerves at Different Ages - a Morphometric Study
Muthu Ramkumar1, Saroj Sharma1, Tony G. Jacob1, Daya N. Bhardwaj2, Tapas C. Nag1, Tara Sankar Roy1
1Department of Anatomy, All India Institute of Medical Sciences, New Delhi-110608, India
2Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi-110608, India
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Abstract  

The trochlear and abducens nerves (TN and AN) control the movement of the superior oblique and lateral rectus muscles of the eyeball, respectively. Despite their immense clinical and radiological importance no morphometric data was available from a wide spectrum of age groups for comparison with either pathological or other conditions involving these nerves. In the present study, morphometry of the TN and AN was performed on twenty post-mortem samples ranging from 12-90 years of age. The nerve samples were processed for resin embedding and toluidine blue stained thin (1μm) sections were used for estimating the total number of myelinated axons by fractionator and the cross sectional area of the nerve and the axons by point counting methods. We observed that the TN was covered by a well-defined epineurium and had ill-defined fascicles, whereas the AN had multiple fascicles with scanty epineurium. Both nerves contained myelinated and unmyelinated fibers of various sizes intermingled with each other. Out of the four age groups (12-20y, 21-40y, 41-60y and >61y) the younger groups revealed isolated bundles of small thinly myelinated axons. The total number of myelinated fibers in the TN and AN at various ages ranged from 1100-3000 and 1600-7000, respectively. There was no significant change in the cross-sectional area of the nerves or the axonal area of the myelinated nerves across the age groups. However, myelin thickness increased significantly in the AN with aging (one way ANOVA). The present study provides baseline morphometric data on the human TN and AN at various ages.

Keywords stereology      morphometry      ocular motor nerves      myelin thickness     
Corresponding Authors: Tara Sankar Roy   
Just Accepted Date: 25 November 2014   Issue Date: 02 February 2015
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Muthu Ramkumar
Saroj Sharma
Tony G. Jacob
Daya N. Bhardwaj
Tapas C. Nag
Tara Sankar Roy
Cite this article:   
Muthu Ramkumar,Saroj Sharma,Tony G. Jacob, et al. The Human Trochlear and Abducens Nerves at Different Ages - a Morphometric Study[J]. Aging and Disease, 2015, 6(1): 6-16.
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http://www.aginganddisease.org/EN/10.14336/AD.2014.0310     OR     http://www.aginganddisease.org/EN/Y2015/V6/I1/6
Figure 1.  Cross-sections of the trochlear nerve in various age groups. Panel of low magnification (left column) and high magnification (right column) photomicrographs of toluidene blue stained semithin resin sections of trochlear nerves showing the Epineurium (Epi), Perineurium (Peri) and a bundle of Small Thinly Myelinated Axons (STMA). The darkly stained profiles seen in the micrographs are the myelin sheaths surrounding the axons of the trochlear nerve. A. and B. are of a 14 year old female; C. and D. are of a 38 year old female; E. and F. are of a 51 year old male and G. and H. are of a 71 year old male. Scale bar: A = C = E = G = 300 &x003BC;m. B = D = F = H = 50 &x003BC;m.
Figure 2.  Cross-sections of the abducens nerve in various age groups. Panel of low magnification (left column) and high magnification (right column) photomicrographs of toluidene blue stained semithin resin sections of trochlear nerves showing the Epineurium (Epi) and Perineurium (Peri). The darkly stained profiles seen in the micrographs are the myelin sheaths surrounding the axons of the abducens nerve. A. and B. are of a 16 year old female; C. and D. are of a 24 year old female; E. and F. are of a 45 year old male and G. and H. are of a 61 year old man. Scale bar: A = 500 &x003BC;m. C = E = G = 300 &x003BC;m. B = D = F = H = 50 &x003BC;m.
Age Groups (Years)No. of samplesMean cross sectional area of nerve (mm2)(SD)Mean estimated myelinated fibers (SD)Mean axonal area of myelinated fibers (&x003BC;m2) (SD)Axonal Diameter (&x003BC;m)Mean myelin thickness (&x003BC;m)(SD)Percentage distribution of fibers (&x00025;)
SmallMediumLarge
A (0-20)50.26 (0.05)2280 (683.37)22.69 (7.24)5.371.84 (0.88)25.6130.4943.9
B (21-40)50.27 (0.08)1920 (294.96)23.27 (7.36)5.442.42 (0.71)#13.6827.3758.95
C (41-60)50.28 (0.08)2400 (758.29)24.13 (3.38)5.542.46 (0.53)#12.1926.8360.98
D (&x0003E;60)50.23 (0.06)2140 (541.29)19.45 (2.64)4.982.48 (0.39)#17.9535.946.15
Table 1:  Morphometric parameters of human trochlear nerve
Age Groups (Years)No. of samplesMean cross sectional area of nerve (mm2) (SD)Mean estimated myelinated fibersMean axonal area of myelinated fibers (&x003BC;m2) (SD)Axonal Diameter (&x003BC;m)Mean myelin thickness (&x003BC;m) (SD)Percentage distribution of fibers(&x00025;)
SmallMediumLarge
A (0-20)50.86 (0.15)5380 (861.39)24.57 (5.91)5.592.78(0.51)8.4531.6959.86
B (21-40)50.95 (0.36)5120 (1145.43)26.93 (5.53)5.852.79 (0.44)5.8433.5860.58
C (41-60)50.67 (0.33)4600 (1662.83)24.22 (4.39)5.552.68 (0.52)*9.2728.8761.86
D(&x0003E;60)50.78 (0.32)4580 (1845.81)23.72 (6.01)5.492.90 (0.51)*8.8330.3960.78
Table 2:  Morphometric parameters of human abducens nerve
Supplementary Figure 1.  Print screen of Optical fractionator and Nucleators in StereoInvestigator Software. This figure illustrates the optical fractionator and the nucleator methods. The unbiased counting frame is used with the fractionator probe. Axonal profiles contained either within the frame or touching the green lines were counted; whereas those that touched the &x02018;forbidden&x02019; red lines were excluded. For the nucleator, a uniform random point within the profile of the axon is used to generate isotropic rays (in yellow) and the distances from the sampled point to the boundaries of the axon profile are marked (as depicted diagramtically in the left inset).
Supplementary Figure 2.  Print Screen showing the morphometric program workflow in StereoInvestigator Software. This figure illustrates the nerve sectional profile contour (N) showing the unbiased counting frame (F) and the sampling grid (G). The contour was traced at a magnification of 100X using a BX61 motorized Olympus microscope. The ideal sampling grid size for this study was determined to be 250&x000B5;m &x000D7; 250&x000B5;m and the unbiased counting frame was 25&x000B5;m &x000D7; 25&x000B5;m. The axon profiles within the unbiased counting frame or touching its green lines were counted, whereas those that touched the &x02018;forbidden&x02019; red lines were excluded.
[1] Glimcher PW(2003). Eye movements. Squire LR, Bloom FE, McConnel SK, Roberts JL, Spitzer NC, Zigmond MJ Fundamental Neuroscience2nd EdnNew YorkAcademic Press873-892
http://118.145.16.217/magsci/article/article?id=14633419
[2] Calisaneller T, Ozdemir O, Altinors N(2006). Posttraumatic acute bilateral abducens nerve palsy in a child. Childs Nerv Syst, 22:726-728
http://118.145.16.217/magsci/article/article?id=16835217
[3] Dwarakanath S, Gopal S, Venkataramana NK(2006). Post-traumatic bilateral abducens nerve palsy. Neurol India, 54:221-222
[4] Kurbanyan K, Lessell S(2008). Intracranial hypotension and abducens palsy following upper spinal manipulation. Br J Ophthalmol, 92:153-155
[5] Hanu-Cernat LM, Hall T(2009). Late onset of abducens palsy after Le Fort I maxillary osteotomy. Br J Oral Maxillofac Surg, 47:414-416
http://118.145.16.217/magsci/article/article?id=14931511
[6] Brazis PW(1993). Palsies of the trochlear nerve: diagnosis and localization- recent concepts. Mayo Clin Proc, 68:501-509
http://dx.doi.org/10.1016/S0025-6196(12)60201-8
[7] Sharma S, Ray B, Bhardwaj D, Dwivedi AK, Roy TS(2009). Age changes in the human oculomotor nerve. A stereological study. Ann Anat, 191:260-266
http://dx.doi.org/10.1016/j.aanat.2009.02.008
[8] Jacobson DM, Moster ML, Eggenberger ER, Galetta SL, Liu GT(1999). Isolated trochlear nerve palsy in patients with multiple sclerosis. Neurology, 53:877-879
http://dx.doi.org/10.1212/WNL.53.4.877
[9] Barr D, Kupersmith MJ, Turbin R, Bose S, Roth R(2000). Isolated sixth nerve palsy: an uncommon presenting sign of multiple sclerosis. J Neurol, 247:701-704
http://118.145.16.217/magsci/article/article?id=16305816
[10] Peters GB3rd, Bakri SJ, Krohel GB(2002). Cause and Prognosis of nontraumatic sixth nerve palsies in young adults. Ophthalmology, 109:1925-1928
http://dx.doi.org/10.1016/S0161-6420(02)01226-5
[11] Keane JR(1993). Fourth nerve palsy: historical review and study of 215 inpatients. Neurology, 43:2439-2443
http://dx.doi.org/10.1212/WNL.43.12.2439
[12] Anwar S, Nalla S, Fernando DJ(2008). Abducens nerve palsy as a complication of lumbar puncture. Eur J Intern Med, 19:636-637
http://118.145.16.217/magsci/article/article?id=14203798
[13] Adams ME, Linn J, Yousry I(2008). Pathology of the Ocular Motor Nerves III, IV, and VI. Neuroimag Clin N Am, 18:261-282
http://118.145.16.217/magsci/article/article?id=14350031
[14] Jefferson G(1947). Isolated oculomotor palsy caused by intracranial aneurysm. Proc R Soc Med, 40:419-432
[15] Rucker CW(1966). The causes of paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol, 61:1293-1298
http://dx.doi.org/10.1016/0002-9394(66)90258-3
[16] Burger LJ, Kalvin NH, Smith JL(1970). Acquired lesions of the fourth cranial nerve. Brain, 93:567-574
http://dx.doi.org/10.1093/brain/93.3.567
[17] Ferreira T, Verbist B, van Buchem M, van Osch T, Webb A(2010). Imaging the ocular motor nerves. Euro J Radiol, 74:314-322
http://118.145.16.217/magsci/article/article?id=17482585
[18] Sterio DC(1984). The unbiased estimation of number and sizes of arbitrary particles using the disector. J Microsc, 134:127-136
http://dx.doi.org/10.1111/j.1365-2818.1984.tb02501.x
[19] Larsen JO(1998). Stereology of nerve cross sections. J Neurosci Meth, 85:107-118
http://dx.doi.org/10.1016/S0165-0270(98)00129-0
[20] Howard CV, Reed MG(1998). Random sampling and random geometry. Unbiased stereology- three dimensional measurement microscopySpringer-VerlagNew York, NY19-33
[21] Mayhew TM, Sharma AK(1984). Sampling schemes for estimating nerve fiber size. I. Methods for nerve trunks of mixed fascicularity. J Anat, 139:45-58
[22] Mayhew TM, Sharma AK(1984). Sampling schemes for estimating nerve fiber size. II. Methods for unifascicular nerve trunks. J Anat, 139:59-66
[23] Gundersen HJG(1977). Notes on estimation of numerical density of arbitrary profiles: the edge effect. J Microsc, 111:219-223
http://dx.doi.org/10.1111/j.1365-2818.1977.tb00062.x
[24] Gundersen HJG(1988). The nucleator. J Microsc, 15:3-21
[25] Gundersen HJG(1986). Stereology of arbitrary particles. A review of unbiased number and size estimators and the presentation of some new ones, in memory of William R Thompson. J Microsc, 143:3-45
http://dx.doi.org/10.1111/j.1365-2818.1986.tb02764.x
[26] Mayhew TM(1988). An efficient sampling scheme for estimating fiber number from nerve cross sections: The fractionators. J Anat, 157:127-134
[27] Ray B, Roy TS, Wadhwa S, Roy KK(2005). Development of the human fetal cochlear nerve: a morphometric study. Hear Res, 202:74-86
http://dx.doi.org/10.1016/j.heares.2004.09.013
[28] Schmitz C, Hof PR(2005). Design-based stereology in neuroscience. Neuroscience, 130:813-831
http://dx.doi.org/10.1016/j.neuroscience.2004.08.050
Miller NR (2005). Walsh and Hoyts Clinical Neuro-Ophthalmology Vol 1. Williams & Wilkins: Baltimore, MD. pp. 969–1040.
[30] Caramel JP, Bonnel F, Rabischong P(1983). The oculomotor nerves: biometry and endoneural fascicular systematization. Anat Clin, 5:159-168
http://dx.doi.org/10.1007/BF01799001
[31] Thomas PK(1963). The connective tissue of peripheral nerve: an electron microscope study. J Anat, 97:35-44
[32] Allt G, Lawrenson JG(2000). The blood-nerve barrier: enzymes, transporters and receptors--a comparison with the blood-brain barrier. Brain Res Bull, 52:1-12
http://dx.doi.org/10.1016/S0361-9230(00)00230-6
[33] Sunderland S, Hughs ESR(1946). The pupilloconstrictor pathway and the nerves to the ocular muscles in man. Brain, 69:301-309
http://dx.doi.org/10.1093/brain/69.4.301
[34] Kerr FWL, Hollowell OW(1964). Location of pupillomotor and accommodation fibers in the oculomotor nerves: experimental observations of paralytic mydriasis. J Neurol Neurosurg Psychiatry, 27:473-481
http://dx.doi.org/10.1136/jnnp.27.5.473
[35] Mustafa GY, Gamble HJ(1979). Changes in axonal numbers in developing human trochlear nerve. J Anat, 128:323-330
[36] Schuz A, Palm G(1989). Density of neurons and synapses in the cerebral cortex of the mouse. J Comp Neurol, 286:442-445
http://dx.doi.org/10.1002/cne.902860404
[37] Miettinen RA, Kalesnykas G, Koivisto EH(2002). Estimation of the total number of cholinergic neurons containing estrogen receptor- in the rat basal forebrain. J Histochem Cytochem, 50:891-902
http://dx.doi.org/10.1177/002215540205000703
[38] Edwards K, Griffiths D, Morgan J, Pitman R, von Ruhland C(2009). Can the choice of intermediate solvent or resin affect glomerular basement membrane thickness?. Nephrol Dial Transplant, 24:400-403
[39] Sawabe Y, Matsumoto K, Goto N, Otsuka N, Kobayashi N(1998). Morphometric nerve fiber analysis and aging process of the human abducent nerve. Okajimas Folia Anat Jpn, 74:337-343
http://dx.doi.org/10.2535/ofaj1936.74.6_337
[40] Geuna S(2000). Appreciating the difference between design-based and model-based sampling strategies in quantitative morphology of the nervous system. J Comp Neurol, 427:333-339
http://dx.doi.org/10.1002/1096-9861(20001120)427:3<333::AID-CNE1>3.0.CO;2-T
[41] Kaplan S, Geuna S, Ronchi G, Ulkay MB, von Bartheld CS(2010). Calibration of the stereological estimation of the number of myelinated axons in the rat sciatic nerve: A multicenter study. J Neurosci Methods, 187:90-99
http://dx.doi.org/10.1016/j.jneumeth.2010.01.001
[42] Schroder JM, Bohl J, Von Bardeleben U(1988). Changes of the ratio between myelin thickness and axon diameter in human developing sural, femoral, ulnar, facial and trochlear nerves. Acta Neuropathol, 76:471-483
http://dx.doi.org/10.1007/BF00686386
[43] Peters A(2002). The effects of normal aging on myelin and nerve fibers: a review. J Neurocytol, 31:581-593
http://118.145.16.217/magsci/article/article?id=15979882
[44] Sturrock RR(1989). Stability of neuron and glial number in the abducens nerve nucleus of the ageing mouse brain. J Anat, 166:97-101
[45] Huaman AG, Sharpe JA(1993). Vertical saccades in senescence. Invest Ophthalmol Vis Sci, 34:2588-2595
[46] Moschner C, Baloh RW(1994). Age-related changes in visual tracking. J Gerontol, 49:M235-238
http://dx.doi.org/10.1093/geronj/49.5.M235
[47] Oguro H, Okada K, Suyama N, Yamashita K, Yamaguch S, Kobayashi S(2004). Decline of vertical gaze and convergence with aging. Gerontology, 50:177-178
http://dx.doi.org/10.1159/000076777
[48] Qing Y, Kapoula Z(2004). Saccade-vergence dynamics and interaction in children and adults. Exp Brain Res, 156:212-223
http://118.145.16.217/magsci/article/article?id=15781862
[49] Rambold H, Neuman G, Sander T, Helmchen C(2005). Age-related changes of vergence under natural viewing conditions. Neurobiol Aging, 27:163-172
[50] Yang Q, Kapoula Z(2008). Aging does not affect the accuracy of vertical saccades nor the quality of their binocular coordination: a study of a special elderly group. Neurobiol Aging, 29:622-638
http://118.145.16.217/magsci/article/article?id=14347472
[1] Hiroshi Matsuda. Voxel-based Morphometry of Brain MRI in Normal Aging and Alzheimer’s Disease[J]. Aging and Disease, 2013, 4(1): 29-37.
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