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Bosco F, Ruga S, Citraro R, Leo A, Guarnieri L, Maiuolo J, Oppedisano F, Macrì R, Scarano F, Nucera S, Bava I, Palma E, Muscoli C, Hancke J, De Sarro G, Mollace V. The Effects of Andrographis paniculata (Burm.F.) Wall. Ex Nees and Andrographolide on Neuroinflammation in the Treatment of Neurodegenerative Diseases. Nutrients 2023; 15:3428. [PMID: 37571363 PMCID: PMC10421033 DOI: 10.3390/nu15153428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Neurodegenerative diseases (NDs) affect millions of people worldwide, and to date, Alzheimer's and Parkinson's diseases are the most common NDs. Of the many risk factors for neurodegeneration, the aging process has the most significant impact, to the extent that it is tempting to consider neurodegenerative disease as a manifestation of accelerated aging. However, genetic and environmental factors determine the course of neurodegenerative disease progression. It has been proposed that environmental stimuli influence neuroplasticity. Some clinical studies have shown that healthy lifestyles and the administration of nutraceuticals containing bioactive molecules possessing antioxidant and anti-inflammatory properties have a preventive impact or mitigate symptoms in previously diagnosed patients. Despite ongoing research efforts, the therapies currently used for the treatment of NDs provide only marginal therapeutic benefits; therefore, the focus is now directly on the search for natural products that could be valuable tools in combating these diseases, including the natural compound Andrographis paniculata (Ap) and its main constituent, andrographolide (Andro). Preclinical studies have shown that the aqueous extract of Ap can modulate neuroinflammatory and neurodegenerative responses, reducing inflammatory markers and oxidative stress in various NDs. Therefore, in this review, we will focus on the molecular mechanisms by which Ap and Andro can modulate the processes of neurodegeneration and neuroinflammation, which are significant causes of neuronal death and cognitive decline.
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Affiliation(s)
- Francesca Bosco
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
| | - Stefano Ruga
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Rita Citraro
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Leo
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Lorenza Guarnieri
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, IRC-FSH Center, Department of Health Sciences, School of Pharmacy and Nutraceutical, Faculty of Pharmacy, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Federica Scarano
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Saverio Nucera
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Irene Bava
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Ernesto Palma
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Carolina Muscoli
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | | | - Giovambattista De Sarro
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
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Use of a Pericranial Flap Technique for Deep Brain Stimulation Hardware Protection and Improved Cosmesis. Neuromodulation 2023; 26:466-470. [PMID: 36581532 DOI: 10.1016/j.neurom.2022.10.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) has become an established neuromodulation therapy; however, surgical site complications such as hardware skin erosion remain an important risk and can predispose to infection, requiring explantation of the system. Nuances of surgical technique can affect wound healing, cosmetic outcome, comfort, and risk of infection. In this study, we describe our experience with a layered closure technique using a vascularized pericranial flap for improving cosmesis and protection of the implanted hardware against skin erosion and infection. MATERIALS AND METHODS We retrospectively reviewed 636 individuals (746 lead implantations) who underwent DBS surgery by a single academic neurosurgeon between 2001 and 2020. A layered pericranial flap closure technique for the burr-hole and connector sites was instituted in 2015. We assessed the effects of a multimodal infection prevention approach that included the pericranial flap on hardware complication rates compared with the premultimodality cohort, and we report the nuances of the technique. RESULTS In our institutional experience, we found that implementation of a pericranial flap closure technique can enhance the subjective cosmetic result at the burr-hole cover site and increase patient comfort and satisfaction. In addition, we found a decrease in hardware infection rates in the current cohort with a multimodal infection prevention regimen that includes the pericranial-flap technique (n = 256, 2015-2020 period) to 1.2% (p = 0.006), from 6.9% in the earlier cohort (n = 490, 2001-2015 period). CONCLUSIONS The report highlights the potential of a pericranial-flap closure technique as a surgical adjunct to improve DBS surgical site healing and cosmesis and may, as part of a multimodal strategy, contribute to decreased risk of skin breakdown and hardware infection.
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Koh EJ, Golubovsky JL, Rammo R, Momin A, Walter B, Fernandez HH, Machado A, Nagel SJ. Estimating the Risk of Deep Brain Stimulation in the Modern Era: 2008 to 2020. Oper Neurosurg (Hagerstown) 2021; 21:277-290. [PMID: 34392372 DOI: 10.1093/ons/opab261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 05/16/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) was first approved by the United States Food and Drug Administration in 1997. Although the fundamentals of DBS remain the same, hardware, software, and imaging have evolved significantly. OBJECTIVE To test our hypothesis that the aggregate complication rate in the medical literature in the past 12 years would be lower than what is often cited based on early experience with DBS surgery. METHODS PubMed, PsycINFO, and EMBASE were queried for studies from 2008 to 2020 that included patients treated with DBS from 2007 to 2019. This yielded 34 articles that evaluated all complications of DBS surgery, totaling 2249 patients. RESULTS The overall complication rate in this study was 16.7% per patient. There was found to be a systemic complication rate of 0.89%, intracranial complication rate of 2.7%, neurological complication rate of 4.6%, hardware complication rate of 2.2%, and surgical site complication rate of 3.4%. The infection and erosion rate was 3.0%. CONCLUSION This review suggests that surgical complication rates have decreased since the first decade after DBS was first FDA approved. Understanding how to minimize complications from the inception of a technique should receive more attention.
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Affiliation(s)
- Eun Jeong Koh
- Department of Neurosurgery, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Joshua L Golubovsky
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Richard Rammo
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Arbaz Momin
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Benjamin Walter
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hubert H Fernandez
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Andre Machado
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sean J Nagel
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
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Parkinsonism and subthalamic deep brain stimulation dysregulate behavioral motivation in a rodent model. Brain Res 2020; 1736:146776. [PMID: 32171706 DOI: 10.1016/j.brainres.2020.146776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Apathy and impulsivity constitute opposite poles of a behavioral motivation spectrum often disrupted by both the symptoms and therapies for Parkinson's Disease (PD). Upwards of 70% of PD patients experience symptoms of apathy, frequently unresolved or worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). Worse, more than half of patients receiving DBS for PD experience new-onset impulse control disorders of varying severity following therapy initiation. While these symptoms and side-effects have been widely reported in clinical studies, they are largely unexplored in animal models. METHODS We applied high-frequency DBS in a 6-OHDA hemiparkinsonian rat model. We trained rats on a series of go/stop and go/no-go behavioral paradigms and examined how parkinsonism and DBS modulated task responses. RESULTS STN DBS in healthy rodents drove impulsive behavior in the form of stop and no-go task failure, impulsive reward seeking, and noninstructed task attempts. While trained rats without DBS only tended to fail stop and no-go cues very shortly after the cue, DBS led to failures at significantly later time points. Hemiparkinsonism slowed response times and reduced response rates, not alleviated by effective DBS. INTERPRETATIONS PD interrupts neural signaling responsible for healthy action selection, not restored by DBS. PD may be associated with a dearth of action commands, manifesting as apathy. Conversely, effective DBS may bias the system toward the impulsive end of the behavioral motivation spectrum without restoring behaviorally reasonable actions, mis-weighting reward-based action selection and manifesting as impulsivity, aided by DBS interfering with stop signaling.
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King NO, Anderson CJ, Dorval AD. Deep brain stimulation exacerbates hypokinetic dysarthria in a rat model of Parkinson's disease. J Neurosci Res 2016; 94:128-38. [PMID: 26498277 PMCID: PMC4681650 DOI: 10.1002/jnr.23679] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/28/2015] [Accepted: 09/24/2015] [Indexed: 12/15/2022]
Abstract
Motor symptoms of Parkinson's disease (PD) follow the degeneration of dopaminergic neurons in the substantia nigra pars compacta. Deep brain stimulation (DBS) treats some parkinsonian symptoms, such as tremor, rigidity, and bradykinesia, but may worsen certain medial motor symptoms, including hypokinetic dysarthria. The mechanisms by which DBS exacerbates dysarthria while improving other symptoms are unclear and difficult to study in human patients. This study proposes an animal model of DBS-exacerbated dysarthria. We use the unilateral, 6-hydroxydopamine (6-OHDA) rat model of PD to test the hypothesis that DBS exacerbates quantifiable aspects of vocalization. Mating calls were recorded from sexually experienced male rats under healthy and parkinsonian conditions and during DBS of the subthalamic nucleus. Relative to healthy rats, parkinsonian animals made fewer calls with shorter and less complex vocalizations. In the parkinsonian rats, putatively therapeutic DBS further reduced call frequency, duration, and complexity. The individual utterances of parkinsonian rats spanned a greater bandwidth than those of healthy rats, potentially reducing the effectiveness of the vocal signal. This utterance bandwidth was further increased by DBS. We propose that the parkinsonism-associated changes in call frequency, duration, complexity, and dynamic range combine to constitute a rat analog of parkinsonian dysarthria. Because DBS exacerbates the parkinsonism-associated changes in each of these metrics, the subthalamic stimulated 6-OHDA rat is a good model of DBS-induced hypokinetic dysarthria in PD. This model will help researchers examine how DBS alleviates many motor symptoms of PD while exacerbating parkinsonian speech deficits that can greatly diminish patient quality of life.
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Affiliation(s)
- Nathaniel O King
- Department of Bioengineering, University of Utah, Salt Lake City, Utah
- Department of Biomedical Engineering, Washington University, St. Louis, Missouri
| | - Collin J Anderson
- Department of Bioengineering, University of Utah, Salt Lake City, Utah
| | - Alan D Dorval
- Department of Bioengineering, University of Utah, Salt Lake City, Utah
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Polak P, Shefi O. Nanometric agents in the service of neuroscience: Manipulation of neuronal growth and activity using nanoparticles. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 11:1467-79. [DOI: 10.1016/j.nano.2015.03.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/05/2015] [Accepted: 03/15/2015] [Indexed: 11/29/2022]
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Anderson CJ, Sheppard DT, Huynh R, Anderson DN, Polar CA, Dorval AD. Subthalamic deep brain stimulation reduces pathological information transmission to the thalamus in a rat model of parkinsonism. Front Neural Circuits 2015. [PMID: 26217192 PMCID: PMC4491629 DOI: 10.3389/fncir.2015.00031] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The degeneration of dopaminergic neurons in the substantia nigra pars compacta leads to parkinsonian motor symptoms via changes in electrophysiological activity throughout the basal ganglia. High-frequency deep brain stimulation (DBS) partially treats these symptoms, but the mechanisms are unclear. We hypothesize that motor symptoms of Parkinson’s disease (PD) are associated with increased information transmission from basal ganglia output neurons to motor thalamus input neurons and that therapeutic DBS of the subthalamic nucleus (STN) treats these symptoms by reducing this extraneous information transmission. We tested these hypotheses in a unilateral, 6-hydroxydopamine-lesioned rodent model of hemiparkinsonism. Information transfer between basal ganglia output neurons and motor thalamus input neurons increased in both the orthodromic and antidromic directions with hemiparkinsonian (hPD) onset, and these changes were reversed by behaviorally therapeutic STN-DBS. Omnidirectional information increases in the parkinsonian state underscore the detrimental nature of that pathological information and suggest a loss of information channel independence. Therapeutic STN-DBS reduced that pathological information, suggesting an effective increase in the number of independent information channels. We interpret these data with a model in which pathological information and fewer information channels diminishes the scope of possible motor activities, driving parkinsonian symptoms. In this model, STN-DBS restores information-channel independence by eliminating or masking the parkinsonism-associated information, and thus enlarges the scope of possible motor activities, alleviating parkinsonian symptoms.
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Affiliation(s)
- Collin J Anderson
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | - Daylan T Sheppard
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | - Rachel Huynh
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | | | - Christian A Polar
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | - Alan D Dorval
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
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Antibiotic impregnated catheter coverage of deep brain stimulation leads facilitates lead preservation after hardware infection. J Clin Neurosci 2012; 19:1369-75. [DOI: 10.1016/j.jocn.2012.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/26/2012] [Indexed: 10/28/2022]
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Ciofani G, Danti S, Ricotti L, D’Alessandro D, Moscato S, Mattoli V. Applications of Piezoelectricity in Nanomedicine. NANOMEDICINE AND NANOTOXICOLOGY 2012. [DOI: 10.1007/978-3-642-28044-3_8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Espay AJ, Giuffrida JP, Chen R, Payne M, Mazzella F, Dunn E, Vaughan JE, Duker AP, Sahay A, Kim SJ, Revilla FJ, Heldman DA. Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease. Mov Disord 2011; 26:2504-8. [PMID: 21953789 DOI: 10.1002/mds.23893] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 06/02/2011] [Accepted: 07/05/2011] [Indexed: 11/06/2022] Open
Abstract
Although movement impairment in Parkinson's disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0-4 severity scale using the Unified Parkinson's Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson's disease. Eighty five Parkinson's disease patients performed finger-tapping (item 23), hand-grasping (item 24), and pronation-supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (P < .001); however, in the ON state, speed scores improved exclusively by clinical (P < 10(-6) ) and predominantly by quantitative (P < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (P < .01) and both bradykinetic and hypokinetic (P < 10(-6) ), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson's disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies. © 2011 Movement Disorder Society.
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Affiliation(s)
- Alberto J Espay
- UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio 45267-0525, USA.
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Bhatia R, Dalton A, Richards M, Hopkins C, Aziz T, Nandi D. The incidence of deep brain stimulator hardware infection: the effect of change in antibiotic prophylaxis regimen and review of the literature. Br J Neurosurg 2011; 25:625-31. [DOI: 10.3109/02688697.2011.566384] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Prakash KM. An Overview of Surgical Therapy for Movement Disorders. PROCEEDINGS OF SINGAPORE HEALTHCARE 2010. [DOI: 10.1177/201010581001900405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Surgical treatments are an important consideration in the management of many movement disorders, particularly for patients refractory to medications. Increasing number of published reports have demonstrated an overall improvement in motor function, activities of daily living and quality of life particularly with deep brain stimulation. In addition the procedure is also relatively safe. In this article, we review the various types of movement disorders that may benefit from surgical intervention.
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Affiliation(s)
- Kumar M Prakash
- Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), Singapore
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Ciofani G, Danti S, D'Alessandro D, Ricotti L, Moscato S, Bertoni G, Falqui A, Berrettini S, Petrini M, Mattoli V, Menciassi A. Enhancement of neurite outgrowth in neuronal-like cells following boron nitride nanotube-mediated stimulation. ACS NANO 2010; 4:6267-77. [PMID: 20925390 DOI: 10.1021/nn101985a] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
In this paper, we propose an absolutely innovative technique for the electrical stimulation of cells, based on piezoelectric nanoparticles. Ultrasounds are used to impart mechanical stress to boron nitride nanotubes incubated with neuronal-like PC12 cells. By virtue of their piezoelectric properties, these nanotubes can polarize and convey electrical stimuli to the cells. PC12 stimulated with the present method exhibit neurite sprout 30% greater than the control cultures after 9 days of treatment.
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Affiliation(s)
- Gianni Ciofani
- Italian Institute of Technology c/o Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34 Pontedera (Pisa), 56025, Italy.
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Stancanello J, Romanelli P, Pantelis E, Sebastiano F, Modugno N. Atlas-based functional radiosurgery: Early results. Med Phys 2009; 36:457-63. [DOI: 10.1118/1.3056460] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Rezai AR, Machado AG, Deogaonkar M, Azmi H, Kubu C, Boulis NM. Surgery for movement disorders. Neurosurgery 2008; 62 Suppl 2:809-38; discussion 838-9. [PMID: 18596424 DOI: 10.1227/01.neu.0000316285.52865.53] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Movement disorders, such as Parkinson's disease, tremor, and dystonia, are among the most common neurological conditions and affect millions of patients. Although medications are the mainstay of therapy for movement disorders, neurosurgery has played an important role in their management for the past 50 years. Surgery is now a viable and safe option for patients with medically intractable Parkinson's disease, essential tremor, and dystonia. In this article, we provide a review of the history, neurocircuitry, indication, technical aspects, outcomes, complications, and emerging neurosurgical approaches for the treatment of movement disorders.
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Affiliation(s)
- Ali R Rezai
- Center for Neurological Restoration, and Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio 44122, USA.
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Lee TO, Hwang HS, De Salles A, Mattozo C, Pedroso AG, Behnke E. Inter-racial, gender and aging influences in the length of anterior commissure-posterior commissure line. J Korean Neurosurg Soc 2008; 43:79-84. [PMID: 19096609 DOI: 10.3340/jkns.2008.43.2.79] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 01/16/2008] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The length of anterior-posterior commissure (AC-PC) in racial groups, age, gender of patients with deep brain stimulation (DBS) and pallidotomy were investigated. METHODS From January 1996 to December 2003, 211 patients were treated with DBS and pallidotomy. There were 160 (76%) Caucasians, 35 (17%) Hispanics, 12 (5%) Asians and 4 Blacks (2%). There were 88 males and 52 females in DBS-surgery group and 44 males, 27 females in pallidotomy group. Mean age was 58 year-old. There were 19 males and 19 females and mean age was 54.7 years in the control group. Measurements were made on MRI and @Target software. RESULTS The average AC-PC distance was 24.89 mm (range 32 to 19), which increased with aging until 75 years old in Caucasian and also increased with aging in Hispanic, but the AC-PC distance peaked at 45 years old in Hispanic. The order of AC-PC distance were 25.2+/-2 mm in Caucasian, 24.6+/-2.24 mm in Asian, 24.53 mm in Black, 23.6+/-1.98 mm in Hispanic. The average AC-PC distance in all groups was 24.22 mm in female who was mean age of 56.35, 25.28 mm in male who was mean age of 60.19 and 24.5+/-2 mm in control group that was excluded because of the difference of thickness of slice. According to multiple regression analysis, the AC-PC distance was significantly correlated with age, race, and gender. CONCLUSION The AC-PC distance is significantly correlated with age, gender, and race. The atlas of functional stereotaxis would be depended on the variation of indivisual brain that can influenced by aging, gender, and race.
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Affiliation(s)
- Tae-One Lee
- Department of Neurosurgery , College of Medicine, Hallym University, Seoul, Korea
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Deogaonkar M, Walter BL, Boulis N, Starr P. CLINICAL PROBLEM SOLVING. Neurosurgery 2007; 61:815-24; discussion 824-5. [DOI: 10.1227/01.neu.0000298911.78882.ca] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Milind Deogaonkar
- Center for Neurological Restoration, The Cleveland Clinic Foundation, Cleveland, Ohio
| | - Benjamin L. Walter
- Center for Neurological Restoration, The Cleveland Clinic Foundation, Cleveland, Ohio
| | - Nicholas Boulis
- Center for Neurological Restoration, The Cleveland Clinic Foundation, Cleveland, Ohio
| | - Philip Starr
- Department of Neurosurgery, University of California, San Francisco, San Francisco, California
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Chien SL, Lin SZ, Liang CC, Soong YS, Lin SH, Hsin YL, Lee CW, Chen SY. The efficacy of quantitative gait analysis by the GAITRite system in evaluation of parkinsonian bradykinesia. Parkinsonism Relat Disord 2006; 12:438-42. [PMID: 16798053 DOI: 10.1016/j.parkreldis.2006.04.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 03/31/2006] [Accepted: 04/04/2006] [Indexed: 11/15/2022]
Abstract
The aim of this study was to assess whether the GAITRite gait analysis system an effective tool in evaluating parkinsonian bradykinesia. In their best ON and worst OFF states, 13 parkinsonian patients were asked to perform walking trail at their fastest velocity, and to submit to traditional timed tests. Significant correlations existed between OFF-ON improvement in gait parameters and in UPDRS III score (r(2)=0.59-0.78) except cadence. Among the gait parameters, stride length is the most effective indicator of timed test and UPDRS III score improvements. The GAITRite system is an efficient, yet effective device in evaluating parkinsonian bradykinesia and can be used as a substitute for the traditional timed test.
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Affiliation(s)
- Shih-Lin Chien
- Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
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Amirnovin R, Williams ZM, Cosgrove GR, Eskandar EN. Experience with microelectrode guided subthalamic nucleus deep brain stimulation. Neurosurgery 2006; 58:ONS96-102; discussion ONS96-102. [PMID: 16543878 DOI: 10.1227/01.neu.0000192690.45680.c2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Subthalamic deep brain stimulation (DBS) has rapidly become the standard surgical therapy for medically refractory Parkinson disease. However, in spite of its wide acceptance, there is considerable variability in the technical approach. This study details our technique and experience in performing microelectrode recording (MER) guided subthalamic nucleus (STN) DBS in the treatment of Parkinson disease. METHODS Forty patients underwent surgery for the implantation of 70 STN DBS electrodes. Stereotactic localization was performed using a combination of magnetic resonance and computed tomographic imaging. We used an array of three microelectrodes, separated by 2 mm, for physiological localization of the STN. The final location was selected based on MER and macrostimulation through the DBS electrode. RESULTS The trajectory selected for the DBS electrode had an average pass through the STN of 5.6 +/- 0.4 mm on the left and 5.7 +/- 0.4 mm on the right. The predicted location was used in 42% of the cases but was modified by MER in the remaining 58%. Patients were typically discharged on the second postoperative day. Eighty-five percent of patients were sent home, 13% required short-term rehabilitation, and one patient required long-term nursing services. Seven complications occurred over 4 years. Four patients suffered small hemorrhages, one patient experienced a lead migration, one developed an infection of the pulse generator, and one patient suffered from a superficial cranial infection. CONCLUSION Simultaneous bilateral MER-guided subthalamic DBS is a relatively safe and well-tolerated procedure. MER plays an important role in optimal localization of the DBS electrodes.
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Affiliation(s)
- Ramin Amirnovin
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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McCreery D, Lossinsky A, Pikov V, Liu X. Microelectrode array for chronic deep-brain microstimulation and recording. IEEE Trans Biomed Eng 2006; 53:726-37. [PMID: 16602580 DOI: 10.1109/tbme.2006.870215] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have developed an array of microelectrodes that is suitable for long-term implantation into the subthalamic nucleus (STN) or the globus pallidus and is able to record from single neurons, as well as deliver localized microstimulation. This device can be used to investigate the mechanisms by which deep brain stimulation can ameliorate the symptoms of Parkinson's disease and other movement disorders, and also may be the basis for a new clinical tool for the treatment of Parkinson's disease, by capitalizing on the high spatial specificity of intranuclear microstimulation. The array includes 16 activated iridium microelectrodes, 5-6 mm in length, within a cluster approximately 1.8 mm in diameter. We have fabricated the array using materials carrying the USP Category VI classification, and we have developed an apparatus and a procedure for implanting the microelectrode arrays into the deep brain. Ten arrays have been implanted into the STN of domestic cats, and one into the internal segment of the globus pallidus, for 140-415 days. During that time, we were able to record action potentials from individual neurons, on 4 to 8 of the 16 channels. The microelectrode' active surface areas ranged from 500 to 2000 microm2. Controlled-current pulses, 26.5 microA in amplitude and 150 micros/phase in duration (4 nC/phase) were used to excite neurons in the cat's STN. In addition to direct activation, the stimulus modulated the neuronal activity over a distance of at least 1.2 mm from the site of stimulation. These parameters did not induce histologically detectable changes around the tip sites after 35 hours of stimulation at 100 Hz (7 hours of stimulation per day, on 5 successive days), if the electrode' active surface area was 1000 microm2 or greater.
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Affiliation(s)
- Douglas McCreery
- Huntington Medical Research Institutes, Neural Engineering Program, 734 Fairmount Ave., Pasadena, CA 91105, USA.
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