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Robert S, Granovetter MC, Patterson C, Behrmann M. Hemispheric functional organization, as revealed by naturalistic neuroimaging, in pediatric epilepsy patients with cortical resections. Proc Natl Acad Sci U S A 2024; 121:e2317458121. [PMID: 38950362 DOI: 10.1073/pnas.2317458121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/14/2024] [Indexed: 07/03/2024] Open
Abstract
Functional changes in the pediatric brain following neural injuries attest to remarkable feats of plasticity. Investigations of the neurobiological mechanisms that underlie this plasticity have largely focused on activation in the penumbra of the lesion or in contralesional, homotopic regions. Here, we adopt a whole-brain approach to evaluate the plasticity of the cortex in patients with large unilateral cortical resections due to drug-resistant childhood epilepsy. We compared the functional connectivity (FC) in patients' preserved hemisphere with the corresponding hemisphere of matched controls as they viewed and listened to a movie excerpt in a functional magnetic resonance imaging (fMRI) scanner. The preserved hemisphere was segmented into 180 and 200 parcels using two different anatomical atlases. We calculated all pairwise multivariate statistical dependencies between parcels, or parcel edges, and between 22 and 7 larger-scale functional networks, or network edges, aggregated from the smaller parcel edges. Both the left and right hemisphere-preserved patient groups had widespread reductions in FC relative to matched controls, particularly for within-network edges. A case series analysis further uncovered subclusters of patients with distinctive edgewise changes relative to controls, illustrating individual postoperative connectivity profiles. The large-scale differences in networks of the preserved hemisphere potentially reflect plasticity in the service of maintained and/or retained cognitive function.
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Affiliation(s)
- Sophia Robert
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Michael C Granovetter
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA 15213
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213
| | - Christina Patterson
- Department of Pediatrics, Division of Child Neurology, University of Pittsburgh, Pittsburgh, PA 15213
| | - Marlene Behrmann
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213
- The Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219
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2
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Ramantani G, Cserpan D, Tisdall M, Otte WM, Dorfmüller G, Cross JH, van Schooneveld M, van Eijsden P, Nees F, Reuner G, Krayenbühl N, Zentner J, Bulteau C, Braun KPJ. Determinants of Functional Outcome after Pediatric Hemispherotomy. Ann Neurol 2024; 95:377-387. [PMID: 37962290 DOI: 10.1002/ana.26830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE We aimed to evaluate determinants of functional outcome after pediatric hemispherotomy in a large and recent multicenter cohort. METHODS We retrospectively investigated the functional outcomes of 455 children who underwent hemispherotomy at 5 epilepsy centers in 2000-2016. We identified determinants of unaided walking, voluntary grasping with the hemiplegic hand, and speaking through Bayesian multivariable regression modeling using missing data imputation. RESULTS Seventy-five percent of children were seizure-free, and 44% stopped antiseizure medication at a 5.1-year mean follow-up (range = 1-17.1). Seventy-seven percent of children could walk unaided, 8% could grasp voluntarily, and 68% could speak at the last follow-up. Children were unlikely to walk when they had contralateral magnetic resonance imaging (MRI) abnormalities (40/73, p = 0.04), recurrent seizures following hemispherotomy (62/109, p = 0.04), and moderately (50/61, p = 0.03) or severely impaired (127/199, p = 0.001) postsurgical intellectual functioning, but were likely to walk when they were older at outcome determination (p = 0.01). Children were unlikely to grasp voluntarily with the hand contralateral to surgery when they had Rasmussen encephalitis (0/61, p = 0.001) or Sturge-Weber syndrome (0/32, p = 0.007). Children were unlikely to speak when they had contralateral MRI abnormalities (30/69, p = 0.002) and longer epilepsy duration (p = 0.01), but likely to speak when they had Sturge-Weber syndrome (29/35, p = 0.01), were older at surgery (p = 0.04), and were older at outcome determination (p < 0.001). INTERPRETATION Etiology and bilaterality of structural brain abnormalities were key determinants of functional outcome after hemispherotomy. Longer epilepsy duration affected language outcomes. Not surprisingly, walking and talking ability increased with older age at outcome evaluation. ANN NEUROL 2024;95:377-387.
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Affiliation(s)
- Georgia Ramantani
- Department of Neuropediatrics, University Children's Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dorottya Cserpan
- Department of Neuropediatrics, University Children's Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Martin Tisdall
- Department of Neurosurgery, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Willem M Otte
- Department of Child Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Member of European Reference Network EpiCARE, Utrecht, the Netherlands
| | - Georg Dorfmüller
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital, Member of European Reference Network EpiCARE, Paris, France
| | - J Helen Cross
- Department of Neurology, Great Ormond Street Hospital for Children National Health Service Foundation Trust, Great Ormond Street and University College London National Institute for Health and Care Research Biomedical Research Centre Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Monique van Schooneveld
- Department of Child Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Member of European Reference Network EpiCARE, Utrecht, the Netherlands
| | - Pieter van Eijsden
- Department of Child Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Member of European Reference Network EpiCARE, Utrecht, the Netherlands
| | - Frauke Nees
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Gitta Reuner
- Institute of Education Studies, Faculty of Behavioral and Cultural Studies, University of Heidelberg, Heidelberg, Germany
| | - Niklaus Krayenbühl
- Department of Neurosurgery, University Children's Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Josef Zentner
- Department of Neurosurgery, Medical Center, University of Freiburg, Freiburg, Germany
| | - Christine Bulteau
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital, Member of European Reference Network EpiCARE, Paris, France
- University of Paris, MC2Lab, Institute of Psychology, Boulogne-Billancourt, France
| | - Kees P J Braun
- Department of Child Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Member of European Reference Network EpiCARE, Utrecht, the Netherlands
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3
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Pur DR, Sivakumar GK, Bursztyn LLCD, Iordanous Y, de Ribaupierre S. Strabismus outcomes in pediatric patients undergoing disconnective hemispheric surgery for intractable epilepsy: a systematic review. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023:S0008-4182(23)00244-2. [PMID: 37640228 DOI: 10.1016/j.jcjo.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/09/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Children undergoing hemispheric surgery for intractable seizures are susceptible to visual complications including strabismus. This systematic review aims to investigate the rates and characteristics of strabismus development after hemispheric surgery and evaluate clinical implications for ophthalmologic care. METHODS A systematic search of MEDLINE, EMBASE, Cochrane, PsychINFO, and Web of Science databases was performed from database inception to May 2022. Included articles referred to strabismus outcomes in pediatric populations after hemispherectomy or hemispherotomy. Reviews and non-English-language publications were excluded. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Demographic data and characteristics of strabismus were extracted and tabulated. RESULTS Of 41 articles identified, 10 studies consisting of 384 pediatric participants (48% females) and age at surgery between 6 months and 16 years were included. Preoperative strabismus rates ranged between 3% and 56%, whereas postoperative rates ranged between 38% and 100%. With respect to the site of hemispheric surgery, contralateral exodeviation was the most common (16%-67%; n = 7) and then ipsilateral exodeviation (16%-56%; n = 2), whereas ipsilateral esodeviation was infrequent (4%-9%; n = 3). CONCLUSIONS Contralateral exotropia and ipsilateral esotropia may occur after hemispheric surgery and may have the potential to be field expanding. Concerns regarding negative social reactions should be balanced with the risk of visual field reduction and (or) diplopia by strabismus surgery. Higher-quality articles with large, homogeneous, and well-described populations (i.e., complete pre- and postoperative ophthalmologic assessments) are required to establish the risks and rates of strabismus development after hemispheric surgery.
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Affiliation(s)
- Daiana R Pur
- Schulich School of Medicine and Dentistry, Western University, London, ON.
| | - Gayathri K Sivakumar
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, ON
| | - Lulu L C D Bursztyn
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Clinical Neurological Sciences, Western University, London, ON
| | - Yiannis Iordanous
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, ON
| | - Sandrine de Ribaupierre
- Department of Clinical Neurological Sciences, Western University, London, ON; Brain and Mind Institute, Western University, London, ON; Children's Health Research Institute, Western University, London, ON
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4
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Iwamoto Y, Tanaka R, Imura T, Mitsutake T, Jung H, Suzukawa T, Taki S, Imada N, Inagawa T, Araki H, Araki O. Does frequent use of an exoskeletal upper limb robot improve motor function in stroke patients? Disabil Rehabil 2023; 45:1185-1191. [PMID: 35332828 DOI: 10.1080/09638288.2022.2055163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine how differences in frequency of the single-joint hybrid assistive limb (HAL-SJ) use affect the improvement of upper limb motor function and activities of daily living (ADL) in stroke patients. MATERIALS AND METHODS Subacute stroke patients were divided into the high or low frequency of HAL-SJ use groups. The two groups were matched by propensity score, and the degree of changes 30 days after initiating HAL-SJ use was compared. A logistic regression analysis was performed to examine whether frequent use would increase the number of subjects experiencing the efficacy of more than the minimal clinically important difference (MCID) of Fugl-Meyer assessment (FMA). RESULTS Twenty-five stroke patients were matched by propensity score, and nine pairs were matched. The high-frequency group showed a significantly superior increase to total FMA shoulder, elbow, forearm, and Barthel index compared with the low-frequency group. Logistic regression analysis revealed no significant associations between frequent use and MCID. CONCLUSIONS The frequency of HAL-SJ use may affect the improvement of motor function and ADL ability of the upper limb with exception of the fingers and wrist. However, the frequency of intervention was not effective enough to further increase the number of subjects with clinically meaningful changes in upper limb motor function.IMPLICATIONS FOR REHABILITATIONThe current study aimed to clarify how differences in the frequency of single-joint hybrid assistive limb (HAL-SJ) use can affect the improvement of upper-limb motor functions and ADL in subacute stroke patients.Our results implied that the frequency of HAL-SJ use may influence the recovery of upper limb function.However, even if HAL-SJ is used frequently, it does not mean that more patients will achieve clinically meaningful recovery.
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Affiliation(s)
- Yuji Iwamoto
- Department of Rehabilitation, Araki Neurosurgical Hospital, Hiroshima, Japan
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryo Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Imura
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Tsubasa Mitsutake
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- Department of Physical Therapy, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Hungu Jung
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Takahiro Suzukawa
- Department of Rehabilitation, Araki Neurosurgical Hospital, Hiroshima, Japan
| | - Shingo Taki
- Department of Rehabilitation, Araki Neurosurgical Hospital, Hiroshima, Japan
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Imada
- Department of Rehabilitation, Araki Neurosurgical Hospital, Hiroshima, Japan
| | - Tetsuji Inagawa
- Department of Neurosurgery, Araki Neurosurgical Hospital, Hiroshima, Japan
| | - Hayato Araki
- Department of Neurosurgery, Araki Neurosurgical Hospital, Hiroshima, Japan
| | - Osamu Araki
- Department of Neurosurgery, Araki Neurosurgical Hospital, Hiroshima, Japan
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5
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Restoring After Central Nervous System Injuries: Neural Mechanisms and Translational Applications of Motor Recovery. Neurosci Bull 2022; 38:1569-1587. [DOI: 10.1007/s12264-022-00959-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/29/2022] [Indexed: 11/06/2022] Open
Abstract
AbstractCentral nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain–computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.
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6
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Liu C, Liu Q, Yu H, Sun Y, Wang Y, Wang S, Ji T, Yu G, Wang W, Liu X, Jiang Y, Cai L. Subtotal hemispherotomy for intractable lesional hemispheric epilepsy without hemiparesis in children. Epilepsy Res 2022; 185:106973. [DOI: 10.1016/j.eplepsyres.2022.106973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/19/2022] [Accepted: 06/27/2022] [Indexed: 11/03/2022]
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7
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Batschelett M, Gibbs S, Holder CM, Holcombe B, Wheless JW, Narayana S. Plasticity in the developing brain: neurophysiological basis for lesion-induced motor reorganization. Brain Commun 2021; 4:fcab300. [PMID: 35174326 PMCID: PMC8842689 DOI: 10.1093/braincomms/fcab300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/10/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
The plasticity of the developing brain can be observed following injury to the
motor cortex and/or corticospinal tracts, the most commonly injured brain area
in the pre- or peri-natal period. Factors such as the timing of injury, lesion
size and lesion location may affect a single hemisphere’s ability to
acquire bilateral motor representation. Bilateral motor representation of single
hemisphere origin is most likely to occur if brain injury occurs before the age
of 2 years; however, the link between injury aetiology, reorganization type and
functional outcome is largely understudied. We performed a retrospective review
to examine reorganized cortical motor maps identified through transcranial
magnetic stimulation in a cohort of 52 patients. Subsequent clinical,
anthropometric and demographic information was recorded for each patient. Each
patient’s primary hand motor cortex centre of gravity, along with the
Euclidian distance between reorganized and normally located motor cortices, was
also calculated. The patients were classified into broad groups including
reorganization type (inter- and intrahemispheric motor reorganization), age at
the time of injury (before 2 years and after 2 years) and injury aetiology
(developmental disorders and acquired injuries). All measures were analysed to
find commonalities between motor reorganization type and injury aetiology,
function and centre of gravity distance. There was a significant effect of
injury aetiology on type of motor reorganization
(P < 0.01), with 60.7% of patients
with acquired injuries and 15.8% of patients with developmental disorders
demonstrating interhemispheric motor reorganization. Within the interhemispheric
motor reorganization group, ipsilaterally and contralaterally projecting hand
motor cortex centres of gravity overlapped, indicating shared cortical motor
representation. Furthermore, the data suggest significantly higher prevalence of
bilateral motor representation from a single hemisphere in cases of acquired
injuries compared to those of developmental origin. Functional outcome was found
to be negatively affected by acquired injuries and interhemispheric motor
reorganization relative to their respective counterparts with developmental
lesions and intrahemispheric motor reorganization. These results provide novel
information regarding motor reorganization in the developing brain via an
unprecedented cohort sample size and transcranial magnetic stimulation.
Transcranial magnetic stimulation is uniquely suited for use in understanding
the principles of motor reorganization, thereby aiding in the development of
more efficacious therapeutic techniques to improve functional recovery following
motor cortex injury.
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Affiliation(s)
- Mitchell Batschelett
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Rhodes College, Memphis, TN, USA
| | - Savannah Gibbs
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
| | - Christen M. Holder
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Billy Holcombe
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - James W. Wheless
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Shalini Narayana
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Anatomy and Neurobiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Ngo TB, Spearman BS, Hlavac N, Schmidt CE. Three-Dimensional Bioprinted Hyaluronic Acid Hydrogel Test Beds for Assessing Neural Cell Responses to Competitive Growth Stimuli. ACS Biomater Sci Eng 2020; 6:6819-6830. [DOI: 10.1021/acsbiomaterials.0c00940] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Tran B. Ngo
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - Benjamin S. Spearman
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - Nora Hlavac
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - Christine E. Schmidt
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611, United States
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9
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Höller Y, Versace V, Trinka E, Nardone R. Functional connectivity after hemispherectomy. Quant Imaging Med Surg 2020; 10:1174-1178. [PMID: 32489942 DOI: 10.21037/qims.2020.03.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Eugen Trinka
- Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria.,Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria.,University for Medical Informatics and Health Technology, UMIT, Hall in Tirol, Austria
| | - Raffaele Nardone
- Franz Tappeiner Hospital, Merano, Italy.,Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Austria.,Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
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10
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Asaridou SS, Demir-Lira ÖE, Goldin-Meadow S, Levine SC, Small SL. Language development and brain reorganization in a child born without the left hemisphere. Cortex 2020; 127:290-312. [PMID: 32259667 DOI: 10.1016/j.cortex.2020.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 11/08/2019] [Accepted: 02/19/2020] [Indexed: 11/18/2022]
Abstract
We present a case of a 14-year-old girl born without the left hemisphere due to prenatal left internal carotid occlusion. We combined longitudinal language and cognitive assessments with functional and structural neuroimaging data to situate the case within age-matched, typically developing children. Despite having had a delay in getting language off the ground during the preschool years, our case performed within the normal range on a variety of standardized language tests, and exceptionally well on phonology and word reading, during the elementary and middle school years. Moreover, her spatial, number, and reasoning skills also fell in the average to above-average range based on assessments during these time periods. Functional MRI data revealed activation in right fronto-temporal areas when listening to short stories, resembling the bilateral activation patterns in age-matched typically developing children. Diffusion MRI data showed significantly larger dorsal white matter association tracts (the direct and anterior segments of the arcuate fasciculus) connecting areas active during language processing in her remaining right hemisphere, compared to either hemisphere in control children. We hypothesize that these changes in functional and structural brain organization are the result of compensatory brain plasticity, manifesting in unusually large right dorsal tracts, and exceptional performance in phonology, speech repetition, and decoding. More specifically, we posit that our case's large white matter connections might have played a compensatory role by providing fast and reliable transfer of information between cortical areas for language in the right hemisphere.
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Affiliation(s)
- Salomi S Asaridou
- University of California, Irvine, Department of Neurology, Biological Sciences III, Irvine, CA, USA.
| | - Ö Ece Demir-Lira
- The University of Iowa, Department of Psychological and Brain Sciences, DeLTA Center, Iowa Neuroscience Institute, Iowa City, IA, USA
| | - Susan Goldin-Meadow
- Department of Psychology, Center for Gesture, Sign and Language, University of Chicago, Chicago, IL, USA
| | - Susan C Levine
- University of Chicago, Department of Psychology, Chicago, IL, USA
| | - Steven L Small
- University of California, Irvine, Department of Neurology, Biological Sciences III, Irvine, CA, USA
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11
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Mobini S, Song YH, McCrary MW, Schmidt CE. Advances in ex vivo models and lab-on-a-chip devices for neural tissue engineering. Biomaterials 2019; 198:146-166. [PMID: 29880219 PMCID: PMC6957334 DOI: 10.1016/j.biomaterials.2018.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/25/2018] [Accepted: 05/07/2018] [Indexed: 02/08/2023]
Abstract
The technologies related to ex vivo models and lab-on-a-chip devices for studying the regeneration of brain, spinal cord, and peripheral nerve tissues are essential tools for neural tissue engineering and regenerative medicine research. The need for ex vivo systems, lab-on-a-chip technologies and disease models for neural tissue engineering applications are emerging to overcome the shortages and drawbacks of traditional in vitro systems and animal models. Ex vivo models have evolved from traditional 2D cell culture models to 3D tissue-engineered scaffold systems, bioreactors, and recently organoid test beds. In addition to ex vivo model systems, we discuss lab-on-a-chip devices and technologies specifically for neural tissue engineering applications. Finally, we review current commercial products that mimic diseased and normal neural tissues, and discuss the future directions in this field.
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Affiliation(s)
- Sahba Mobini
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Young Hye Song
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Michaela W McCrary
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Christine E Schmidt
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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12
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Challenges in managing epilepsy associated with focal cortical dysplasia in children. Epilepsy Res 2018; 145:1-17. [DOI: 10.1016/j.eplepsyres.2018.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 04/30/2018] [Accepted: 05/12/2018] [Indexed: 12/15/2022]
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13
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Sebastianelli L, Saltuari L, Nardone R. How the brain can rewire itself after an injury: the lesson from hemispherectomy. Neural Regen Res 2017; 12:1426-1427. [PMID: 29089981 PMCID: PMC5649456 DOI: 10.4103/1673-5374.215247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Sterzing, Sterzing, Italy; Research Unit for Neurorehabilitation of South Tyrol, Bozen, Italy
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Sterzing, Sterzing, Italy; Research Unit for Neurorehabilitation of South Tyrol, Bozen, Italy.,Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Meran, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
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14
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Preclinical and Clinical Evidence on Ipsilateral Corticospinal Projections: Implication for Motor Recovery. Transl Stroke Res 2017; 8:529-540. [PMID: 28691140 DOI: 10.1007/s12975-017-0551-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/31/2017] [Accepted: 06/28/2017] [Indexed: 12/19/2022]
Abstract
Motor impairment is the most common complication after stroke, and recovery of motor function has been shown to be dependent on the extent of lesion in the ipsilesional corticospinal tract (iCST) and activity within ipsilesional primary and secondary motor cortices. However, work from neuroimaging research has suggested a role of the contralesional hemisphere in promoting recovery after stroke potentially through the ipsilateral uncrossed CST fibers descending to ipsilateral spinal segments. These ipsilateral fibers, sometimes referred to as "latent" projections, are thought to contribute to motor recovery independent of the crossed CST. The aim of this paper is to evaluate using cumulative evidence from animal models and human patients on whether an uncrossed CST component is present in mammals and conserved through primates and humans, and whether iCST fibers have a functional role in hemiparetic/hemiplegic human conditions. This review highlights that an ipsilateral uncrossed CST exists in human during development, but the evidence on a functionally relevant iCST component in adult humans is still elusive. In addition, this review argues that whereas activity within the ipsilesional cortex is essential for enhancing motor recovery after stroke, the role of iCST projections specifically is still controversial. Finally, conclusions from current literature emphasize the importance of activity in the ipsilesional cortex and the integrity of crossed CST fibers as major determinants of motor recovery after brain injury.
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