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Munoz-Gualan AP, Güngör A, Cezayirli PC, Rahmanov S, Gurses ME, Puelles L, Türe U. Human Adapted Prosomeric Model: A Future for Brainstem Tumor Classification. Brain Res 2024; 1837:148961. [PMID: 38679312 DOI: 10.1016/j.brainres.2024.148961] [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] [Received: 12/12/2023] [Revised: 03/30/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
This study reevaluates the conventional understanding of midbrain anatomy and neuroanatomical nomenclature in the context of recent genetic and anatomical discoveries. The authors assert that the midbrain should be viewed as an integral part of the forebrain due to shared genetic determinants and evolutionary lineage. The isthmo-mesencephalic boundary is recognized as a significant organizer for both the caudal midbrain and the isthmo-cerebellar area. The article adopts the prosomeric model, redefining the whole brain as neuromeres, offering a more precise depiction of brain development, including processes like proliferation, neurogenesis, cell migration, and differentiation. This shift in understanding challenges traditional definitions of the midbrain based on external brain morphology. The study also delves into the historical context of neuroanatomical models, including the columnar model proposed by Herrick in 1910, which has influenced our understanding of brain structure. Furthermore, the study has clinical implications, affecting neuroanatomy, neurodevelopmental studies, and the diagnosis and treatment of brain disorders. It emphasizes the need to integrate molecular research into human neuroanatomical studies and advocates for updating neuroanatomical terminology to reflect modern genetic and molecular insights. The authors propose two key revisions. First, we suggest reclassifying the isthmo-cerebellar prepontine region as part of the hindbrain, due to its role in cerebellar development and distinct location caudal to the genetically-defined midbrain. Second, we recommend redefining the anterior boundary of the genetically-defined midbrain to align with genetic markers. In conclusion, the authors highlight the importance of harmonizing neuroanatomical nomenclature with current scientific knowledge, promoting a more precise and informed understanding of brain structure, which is crucial for both research and clinical applications related to the human brain.
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Affiliation(s)
| | - Abuzer Güngör
- Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey; Department of Neurosurgery, Istinye University, Istanbul, Turkey
| | - Phillip Cem Cezayirli
- Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey; Haynes Neurosurgical Group, Birmingham, AL, United States
| | - Serdar Rahmanov
- Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Muhammet Enes Gurses
- Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey; Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Luis Puelles
- Department of Human Anatomy and Psychobiology, School of Medicine, University of Murcia, Murcia, Spain; Institute of Biomedical Research of Murcia -IMIB, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Uğur Türe
- Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey.
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2
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Sultana OF, Bandaru M, Islam MA, Reddy PH. Unraveling the complexity of human brain: Structure, function in healthy and disease states. Ageing Res Rev 2024; 100:102414. [PMID: 39002647 DOI: 10.1016/j.arr.2024.102414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/29/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
The human brain stands as an intricate organ, embodying a nexus of structure, function, development, and diversity. This review delves into the multifaceted landscape of the brain, spanning its anatomical intricacies, diverse functional capacities, dynamic developmental trajectories, and inherent variability across individuals. The dynamic process of brain development, from early embryonic stages to adulthood, highlights the nuanced changes that occur throughout the lifespan. The brain, a remarkably complex organ, is composed of various anatomical regions, each contributing uniquely to its overall functionality. Through an exploration of neuroanatomy, neurophysiology, and electrophysiology, this review elucidates how different brain structures interact to support a wide array of cognitive processes, sensory perception, motor control, and emotional regulation. Moreover, it addresses the impact of age, sex, and ethnic background on brain structure and function, and gender differences profoundly influence the onset, progression, and manifestation of brain disorders shaped by genetic, hormonal, environmental, and social factors. Delving into the complexities of the human brain, it investigates how variations in anatomical configuration correspond to diverse functional capacities across individuals. Furthermore, it examines the impact of neurodegenerative diseases on the structural and functional integrity of the brain. Specifically, our article explores the pathological processes underlying neurodegenerative diseases, such as Alzheimer's, Parkinson's, and Huntington's diseases, shedding light on the structural alterations and functional impairments that accompany these conditions. We will also explore the current research trends in neurodegenerative diseases and identify the existing gaps in the literature. Overall, this article deepens our understanding of the fundamental principles governing brain structure and function and paves the way for a deeper understanding of individual differences and tailored approaches in neuroscience and clinical practice-additionally, a comprehensive understanding of structural and functional changes that manifest in neurodegenerative diseases.
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Affiliation(s)
- Omme Fatema Sultana
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Madhuri Bandaru
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Md Ariful Islam
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA 5. Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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Piazza A, Spiriev T, Corvino S, Corrivetti F, Laleva L, Iaconetta G, de Notaris M. The Course of the Trochlear Nerve Presented via a 3-Dimensional Photorealistic Anatomic Model. World Neurosurg 2024; 186:e156-e160. [PMID: 38548050 DOI: 10.1016/j.wneu.2024.03.099] [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] [Received: 02/05/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Several factors contribute to the anatomical complexity of the trochlear nerve, including small diameter, complex and longest intracranial course, deep location, and numerous neurovascular relationships. A 3-dimensional (3D) photorealistic model of the cranial nerves provides a detailed and immersive representation of the anatomy, enabling one to improve surgical planning, advanced surgical research, and training. The purpose of this work is to present a 3D photogrammetric study for a more intuitive and interactive way to explore and describe the entire course of trochlear nerve. METHODS Two injected-fixed head human specimens (4 sides) were examined. The dissection protocol was divided into the following steps: 1) brain hemisphere exposure; 2) hemispherectomy dissecting all cranial nerves and partial removal of the free edge of the tentorium; 3) middle fossa and lateral wall of cavernous sinus exposure; and 4) orbital exposure. A detailed 3D photogrammetric model was generated for each dissection step. RESULTS Four main volumetric models were generated during a step-by-step layered dissection of the entire nerve pathway highlighting its different segments. Finally, a full and integrated model of the entire course of the nerve was created. The models are available for visualization on monoscopic display, virtual, and augmented reality environment. CONCLUSIONS The present photogrammetric model provides a more comprehensive understanding of the nerve's anatomy in its different segments, allows for customizable views thus simulating different perspectives, and can be a valuable alternative to traditional dissections. It is an advanced tool for surgical planning and surgical simulation as well as virtual reality representation of the anatomy.
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Affiliation(s)
- Amedeo Piazza
- Department of Neurosurgery, Sapienza University, Rome, Italy; Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Sergio Corvino
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy.
| | - Lili Laleva
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Giorgio Iaconetta
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy; Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy; Neuroanatomy Committee of the Italian Society of Neurosurgery, SINch, Italy
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4
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Novello M, Bosman LWJ, De Zeeuw CI. A Systematic Review of Direct Outputs from the Cerebellum to the Brainstem and Diencephalon in Mammals. CEREBELLUM (LONDON, ENGLAND) 2024; 23:210-239. [PMID: 36575348 PMCID: PMC10864519 DOI: 10.1007/s12311-022-01499-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 05/13/2023]
Abstract
The cerebellum is involved in many motor, autonomic and cognitive functions, and new tasks that have a cerebellar contribution are discovered on a regular basis. Simultaneously, our insight into the functional compartmentalization of the cerebellum has markedly improved. Additionally, studies on cerebellar output pathways have seen a renaissance due to the development of viral tracing techniques. To create an overview of the current state of our understanding of cerebellar efferents, we undertook a systematic review of all studies on monosynaptic projections from the cerebellum to the brainstem and the diencephalon in mammals. This revealed that important projections from the cerebellum, to the motor nuclei, cerebral cortex, and basal ganglia, are predominantly di- or polysynaptic, rather than monosynaptic. Strikingly, most target areas receive cerebellar input from all three cerebellar nuclei, showing a convergence of cerebellar information at the output level. Overall, there appeared to be a large level of agreement between studies on different species as well as on the use of different types of neural tracers, making the emerging picture of the cerebellar output areas a solid one. Finally, we discuss how this cerebellar output network is affected by a range of diseases and syndromes, with also non-cerebellar diseases having impact on cerebellar output areas.
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Affiliation(s)
- Manuele Novello
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Chris I De Zeeuw
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
- Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands.
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5
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Janssen R, Ariëns M, van Genugten J, Jacobi L, Koek G. Complex Dysautonomia in a Patient With Cerebral Cavernous Malformations Due to a KRIT1 Pleiotropic Gene Mutation. Cureus 2024; 16:e55202. [PMID: 38425333 PMCID: PMC10902799 DOI: 10.7759/cureus.55202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Dysautonomia is a disruption of the body's autonomic processes. Symptoms vary among patients, depending on the underlying disease pathways. Given that symptoms can affect all organ functions, dysautonomia often significantly impacts quality of life. However, due to its complex and varied presentation, early recognition of dysautonomia remains a challenge, yet it is crucial for improving patient outcomes. We report a case of a patient with a KRIT1 mutation presenting with dysautonomia causing urological, sexual, and bowel dysfunction. We hypothesize that the patient's symptoms are due to a pontine cavernous malformation (CM) caused by the KRIT1 mutation. A literature review was conducted to establish a link between pontine CM and dysautonomia.
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Affiliation(s)
- Roel Janssen
- Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, NLD
| | - Maxime Ariëns
- Department of Primary Care Medicine, Radboud University Medical Center, Nijmegen, NLD
| | | | - Linda Jacobi
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, NLD
| | - Ger Koek
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, NLD
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Nieuwland JM, Nutma E, Philippens IHCHM, Böszörményi KP, Remarque EJ, Bakker J, Meijer L, Woerdman N, Fagrouch ZC, Verstrepen BE, Langermans JAM, Verschoor EJ, Windhorst AD, Bontrop RE, de Vries HE, Stammes MA, Middeldorp J. Longitudinal positron emission tomography and postmortem analysis reveals widespread neuroinflammation in SARS-CoV-2 infected rhesus macaques. J Neuroinflammation 2023; 20:179. [PMID: 37516868 PMCID: PMC10387202 DOI: 10.1186/s12974-023-02857-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) patients initially develop respiratory symptoms, but they may also suffer from neurological symptoms. People with long-lasting effects after acute infections with severe respiratory syndrome coronavirus 2 (SARS-CoV-2), i.e., post-COVID syndrome or long COVID, may experience a variety of neurological manifestations. Although we do not fully understand how SARS-CoV-2 affects the brain, neuroinflammation likely plays a role. METHODS To investigate neuroinflammatory processes longitudinally after SARS-CoV-2 infection, four experimentally SARS-CoV-2 infected rhesus macaques were monitored for 7 weeks with 18-kDa translocator protein (TSPO) positron emission tomography (PET) using [18F]DPA714, together with computed tomography (CT). The baseline scan was compared to weekly PET-CTs obtained post-infection (pi). Brain tissue was collected following euthanasia (50 days pi) to correlate the PET signal with TSPO expression, and glial and endothelial cell markers. Expression of these markers was compared to brain tissue from uninfected animals of comparable age, allowing the examination of the contribution of these cells to the neuroinflammatory response following SARS-CoV-2 infection. RESULTS TSPO PET revealed an increased tracer uptake throughout the brain of all infected animals already from the first scan obtained post-infection (day 2), which increased to approximately twofold until day 30 pi. Postmortem immunohistochemical analysis of the hippocampus and pons showed TSPO expression in cells expressing ionized calcium-binding adaptor molecule 1 (IBA1), glial fibrillary acidic protein (GFAP), and collagen IV. In the hippocampus of SARS-CoV-2 infected animals the TSPO+ area and number of TSPO+ cells were significantly increased compared to control animals. This increase was not cell type specific, since both the number of IBA1+TSPO+ and GFAP+TSPO+ cells was increased, as well as the TSPO+ area within collagen IV+ blood vessels. CONCLUSIONS This study manifests [18F]DPA714 as a powerful radiotracer to visualize SARS-CoV-2 induced neuroinflammation. The increased uptake of [18F]DPA714 over time implies an active neuroinflammatory response following SARS-CoV-2 infection. This inflammatory signal coincides with an increased number of TSPO expressing cells, including glial and endothelial cells, suggesting neuroinflammation and vascular dysregulation. These results demonstrate the long-term neuroinflammatory response following a mild SARS-CoV-2 infection, which potentially precedes long-lasting neurological symptoms.
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Affiliation(s)
- Juliana M Nieuwland
- Department of Neurobiology and Aging, Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288GJ, Rijswijk, The Netherlands
| | - Erik Nutma
- Department of Neurobiology and Aging, Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288GJ, Rijswijk, The Netherlands
| | - Ingrid H C H M Philippens
- Department of Neurobiology and Aging, Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288GJ, Rijswijk, The Netherlands
| | - Kinga P Böszörményi
- Department of Virology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Jaco Bakker
- Department of Radiology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Lisette Meijer
- Department of Radiology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Noor Woerdman
- Department of Radiology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Zahra C Fagrouch
- Department of Virology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Babs E Verstrepen
- Department of Virology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Jan A M Langermans
- Department of Animal Sciences, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
- Department Population Health Sciences, Unit Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Ernst J Verschoor
- Department of Virology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Albert D Windhorst
- Department of Radiology and Nuclear Medicine, Tracer Center Amsterdam (TCA), Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ronald E Bontrop
- Department of Comparative Genetics and Refinement, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
- Department of Biology, Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, The Netherlands
| | - Helga E de Vries
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Marieke A Stammes
- Department of Radiology, Biomedical Primate Research Centre (BPRC), Rijswijk, The Netherlands
| | - Jinte Middeldorp
- Department of Neurobiology and Aging, Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288GJ, Rijswijk, The Netherlands.
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Motallebzadeh E, Aghighi F, Vakili Z, Talaei SA, Mohseni M. Neuroprotective effects of alpha-lipoic acid on radiation-induced brainstem injury in rats. Res Pharm Sci 2023; 18:202-209. [PMID: 36873276 PMCID: PMC9976052 DOI: 10.4103/1735-5362.367798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/08/2022] [Accepted: 09/11/2022] [Indexed: 01/20/2023] Open
Abstract
Background and purpose Alpha-lipoic acid (ALA) is an antioxidant with radioprotective properties. We designed the current work to assess the neuroprotective function of ALA in the presence of oxidative stress induced by radiation in the brainstem of rats. Experimental approach Whole-brain radiations (X-rays) was given at a single dose of 25 Gy with or without pretreatment with ALA (200 mg/kg BW). Eighty rats were categorized into four groups: vehicle control (VC), ALA, radiation-only (RAD), and radiation + ALA (RAL). The rats were given ALA intraperitoneally 1 h before radiation and killed following 6 h, thereafter superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), and total antioxidant capacity (TAC) in the brainstem were measured. Furthermore, a pathological examination was carried out after 24 h, 72 h, and five days to determine tissue damage. Findings/Results The findings indicated that MDA levels in the brainstem were 46.29 ± 1.64 μM in the RAD group and decreased in the VC group (31.66 ± 1.72 μM). ALA pretreatment reduced MDA levels while simultaneously increasing SOD and CAT activity and TAC levels (60.26 ± 5.47 U/mL, 71.73 ± 2.88 U/mL, and 227.31 ± 9.40 mol/L, respectively). The greatest pathological changes in the rat's brainstems were seen in RAD animals compared to the VC group after 24 h, 72 h, and 5 days. As a result, karyorrhexis, pyknosis, vacuolization, and Rosenthal fibers vanished in the RAL group in three periods. Conclusion and implications ALA exhibited substantial neuroprotectivity following radiation-induced brainstem damage.
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Affiliation(s)
- Elham Motallebzadeh
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran.,Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Fatemeh Aghighi
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Zarichehr Vakili
- Department of Pathology, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Sayyed Alireza Talaei
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Mehran Mohseni
- Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran.,Department of Medical Physics and Radiology, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, I.R. Iran
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Corrêa DG, Hygino da Cruz LC, Freddi TDAL. The Vestibulocochlear Nerve: Anatomy and Pathology. Semin Ultrasound CT MR 2023; 44:81-94. [PMID: 37055143 DOI: 10.1053/j.sult.2023.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
The vestibulocochlear nerve is the eighth cranial nerve, entering the brainstem in the medullopontine sulcus after crossing the internal auditory canal and cerebellopontine angle cistern. It is a purely sensitive nerve, originating from the Scarpa's and spiral ganglions, responsible for balance and hearing. It has 6 nuclei located in the lower pons. Magnetic resonance imaging (MRI) is useful for evaluating the vestibulocochlear nerve, although computed tomography may have a complementary role in assessing bone lesions. A heavily T2-weighted sequence, such as fast imaging employing steady-state acquisition (FIESTA) or constructive interference steady state (CISS), is crucial in imaging exams to depict the canalicular and cisternal segments of the vestibulocochlear nerve, as well as the fluid signal intensity in the membranous labyrinth. The vestibulocochlear nerve can be affected by several diseases, such as congenital malformations, trauma, inflammatory or infectious diseases, vascular disorders, and neoplasms. The purpose of this article is to review the vestibulocochlear nerve anatomy, discuss the best MRI techniques to evaluate this nerve and demonstrate the imaging aspect of the main diseases that affect it.
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Affiliation(s)
- Diogo Goulart Corrêa
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Rio de Janeiro, RJ, Brazil.; Department of Radiology, Federal Fluminense University, Niterói, RJ, Brazil..
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9
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Levinson S, Miller M, Iftekhar A, Justo M, Arriola D, Wei W, Hazany S, Avecillas-Chasin JM, Kuhn TP, Horn A, Bari AA. A structural connectivity atlas of limbic brainstem nuclei. FRONTIERS IN NEUROIMAGING 2023; 1:1009399. [PMID: 37555163 PMCID: PMC10406319 DOI: 10.3389/fnimg.2022.1009399] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/13/2022] [Indexed: 08/10/2023]
Abstract
Background Understanding the structural connectivity of key brainstem nuclei with limbic cortical regions is essential to the development of therapeutic neuromodulation for depression, chronic pain, addiction, anxiety and movement disorders. Several brainstem nuclei have been identified as the primary central nervous system (CNS) source of important monoaminergic ascending fibers including the noradrenergic locus coeruleus, serotonergic dorsal raphe nucleus, and dopaminergic ventral tegmental area. However, due to practical challenges to their study, there is limited data regarding their in vivo anatomic connectivity in humans. Objective To evaluate the structural connectivity of the following brainstem nuclei with limbic cortical areas: locus coeruleus, ventral tegmental area, periaqueductal grey, dorsal raphe nucleus, and nucleus tractus solitarius. Additionally, to develop a group average atlas of these limbic brainstem structures to facilitate future analyses. Methods Each nucleus was manually masked from 197 Human Connectome Project (HCP) structural MRI images using FSL software. Probabilistic tractography was performed using FSL's FMRIB Diffusion Toolbox. Connectivity with limbic cortical regions was calculated and compared between brainstem nuclei. Results were aggregated to produce a freely available MNI structural atlas of limbic brainstem structures. Results A general trend was observed for a high probability of connectivity to the amygdala, hippocampus and DLPFC with relatively lower connectivity to the orbitofrontal cortex, NAc, hippocampus and insula. The locus coeruleus and nucleus tractus solitarius demonstrated significantly greater connectivity to the DLPFC than amygdala while the periaqueductal grey, dorsal raphe nucleus, and ventral tegmental area did not demonstrate a significant difference between these two structures. Conclusion Monoaminergic and other modulatory nuclei in the brainstem project widely to cortical limbic regions. We describe the structural connectivity across the several key brainstem nuclei theorized to influence emotion, reward, and cognitive functions. An increased understanding of the anatomic basis of the brainstem's role in emotion and other reward-related processing will support targeted neuromodulatary therapies aimed at alleviating the symptoms of neuropsychiatric disorders.
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Affiliation(s)
- Simon Levinson
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
- Stanford Department of Neurosurgery, Stanford University, Palo Alto CA, United States
| | - Michelle Miller
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Ahmed Iftekhar
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Monica Justo
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Daniel Arriola
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Wenxin Wei
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Saman Hazany
- Department of Radiology, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | | | - Taylor P. Kuhn
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Andreas Horn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany
- Department of Neurology, Center for Brain Circuit Therapeutics, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States
- Massachusetts General Hospital Neurosurgery and Center for Neurotechnology and Neurorecovery (CNTR) at MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ausaf A. Bari
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
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10
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Sarma A, Pruthi S. Congenital Brain Malformations- Update on Newer Classification and Genetic Basis. Semin Roentgenol 2023; 58:6-27. [PMID: 36732012 DOI: 10.1053/j.ro.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Asha Sarma
- Department of Radiology, Vanderbilt University Medical Center, Monroe Carell Children's Hospital, Nashville, TN.
| | - Sumit Pruthi
- Department of Radiology, Vanderbilt University Medical Center, Monroe Carell Children's Hospital, Nashville, TN
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11
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Surgent O, Riaz A, Ausderau KK, Adluru N, Kirk GR, Guerrero-Gonzalez J, Skaletski EC, Kecskemeti SR, Dean III DC, Weismer SE, Alexander AL, Travers BG. Brainstem white matter microstructure is associated with hyporesponsiveness and overall sensory features in autistic children. Mol Autism 2022; 13:48. [PMID: 36536467 PMCID: PMC9762648 DOI: 10.1186/s13229-022-00524-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Elevated or reduced responses to sensory stimuli, known as sensory features, are common in autistic individuals and often impact quality of life. Little is known about the neurobiological basis of sensory features in autistic children. However, the brainstem may offer critical insights as it has been associated with both basic sensory processing and core features of autism. METHODS Diffusion-weighted imaging (DWI) and parent-report of sensory features were acquired from 133 children (61 autistic children with and 72 non-autistic children, 6-11 years-old). Leveraging novel DWI processing techniques, we investigated the relationship between sensory features and white matter microstructure properties (free-water-elimination-corrected fractional anisotropy [FA] and mean diffusivity [MD]) in precisely delineated brainstem white matter tracts. Follow-up analyses assessed relationships between microstructure and sensory response patterns/modalities and analyzed whole brain white matter using voxel-based analysis. RESULTS Results revealed distinct relationships between brainstem microstructure and sensory features in autistic children compared to non-autistic children. In autistic children, more prominent sensory features were generally associated with lower MD. Further, in autistic children, sensory hyporesponsiveness and tactile responsivity were strongly associated with white matter microstructure in nearly all brainstem tracts. Follow-up voxel-based analyses confirmed that these relationships were more prominent in the brainstem/cerebellum, with additional sensory-brain findings in the autistic group in the white matter of the primary motor and somatosensory cortices, the occipital lobe, the inferior parietal lobe, and the thalamic projections. LIMITATIONS All participants communicated via spoken language and acclimated to the sensory environment of an MRI session, which should be considered when assessing the generalizability of this work to the whole of the autism spectrum. CONCLUSIONS These findings suggest unique brainstem white matter contributions to sensory features in autistic children compared to non-autistic children. The brainstem correlates of sensory features underscore the potential reflex-like nature of behavioral responses to sensory stimuli in autism and have implications for how we conceptualize and address sensory features in autistic populations.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI USA
| | - Ali Riaz
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Karla K. Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
| | - Nagesh Adluru
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Radiology, University of Wisconsin-Madison, Madison, WI USA
| | - Gregory R. Kirk
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
| | - Emily C. Skaletski
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
| | - Steven R. Kecskemeti
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Douglas C Dean III
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI USA
| | - Susan Ellis Weismer
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Andrew L. Alexander
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI USA
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
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12
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Berman S, Drori E, Mezer AA. Spatial profiles provide sensitive MRI measures of the midbrain micro- and macrostructure. Neuroimage 2022; 264:119660. [PMID: 36220534 DOI: 10.1016/j.neuroimage.2022.119660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022] Open
Abstract
The midbrain is the rostral-most part of the brainstem. It contains numerous nuclei and white matter tracts, which are involved in motor, auditory and visual processing, and changes in their structure and function have been associated with aging, as well as neurodegenerative disorders. Current tools for estimating midbrain subregions and their structure with MRI require high resolution and multi-parametric quantitative MRI measures. We propose an approach that relies on morphology to calculate profiles along the midbrain and show these profiles are sensitive to the underlying macrostructure of the midbrain. First, we show that the midbrain structure can be sampled, within subject space, along three main axes of the left and right midbrain, producing profiles that are similar across subjects. We use two data sets with different field strengths, that contain R1, R2* and QSM maps and show that the profiles are highly correlated both across subjects and between datasets. Next, we compare profiles of the midbrain that sample ROIs, and show that the profiles along the first two axes sample the midbrain in a way that reliably separates the main structures, i.e., the substantia nigra, the red nucleus, and periaqueductal gray. We further show that age differences which are localized to specific nuclei, are reflected in the profiles. Finally, we generalize the same approach to calculate midbrain profiles on a third clinically relevant dataset using HCP subjects, with metrics such as the diffusion tensor and semi-quantitative data such as T1w/T2w maps. Our results suggest that midbrain profiles, both of quantitative and semi-quantitative estimates are sensitive to the underlying macrostructure of the midbrain. The midbrain profiles are calculated in native space, and rely on simple measurements. We show that it is robust and can be easily expanded to different datasets, and as such we hope that it will be of great use to the community and to the study of the midbrain in particular.
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Affiliation(s)
- Shai Berman
- The Edmond and Lily Safra Center for Brain Science, the Hebrew University of Jerusalem, Israel; Mortimer B. Zuckerman Mind, Brain, Behavior Institute, Columbia University, New York, NY, United States.
| | - Elior Drori
- The Edmond and Lily Safra Center for Brain Science, the Hebrew University of Jerusalem, Israel
| | - Aviv A Mezer
- The Edmond and Lily Safra Center for Brain Science, the Hebrew University of Jerusalem, Israel
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13
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Guberinic A, van den Elshout R, Kozicz T, Laan MT, Henssen D. Overview of the microanatomy of the human brainstem in relation to the safe entry zones. J Neurosurg 2022; 137:1524-1534. [PMID: 35395628 DOI: 10.3171/2022.2.jns211997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The primary objective of this anatomical study was to apply innovative imaging techniques to increase understanding of the microanatomical structures of the brainstem related to safe entry zones. The authors hypothesized that such a high-detail overview would enhance neurosurgeons' abilities to approach and define anatomical safe entry zones for use with microsurgical resection techniques for intrinsic brainstem lesions. METHODS The brainstems of 13 cadavers were studied with polarized light imaging (PLI) and 11.7-T MRI. The brainstem was divided into 3 compartments-mesencephalon, pons, and medulla-for evaluation with MRI. Tissue was further sectioned to 100 μm with a microtome. MATLAB was used for further data processing. Segmentation of the internal structures of the brainstem was performed with the BigBrain database. RESULTS Thirteen entry zones were reported and assessed for their safety, including the anterior mesencephalic zone, lateral mesencephalic sulcus, interpeduncular zone, intercollicular region, supratrigeminal zone, peritrigeminal zone, lateral pontine zone, median sulcus, infracollicular zone, supracollicular zone, olivary zone, lateral medullary zone, and anterolateral sulcus. The microanatomy, safety, and approaches are discussed. CONCLUSIONS PLI and 11.7-T MRI data show that a neurosurgeon possibly does not need to consider the microanatomical structures that would not be visible on conventional MRI and tractography when entering the mentioned safe entry zones. However, the detailed anatomical images may help neurosurgeons increase their understanding of the internal architecture of the human brainstem, which in turn could lead to safer neurosurgical intervention.
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Affiliation(s)
- Alis Guberinic
- 1Department of Neurosurgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Rik van den Elshout
- 2Department of Radiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Tamas Kozicz
- 3Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota; and
- 4Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota
| | - Mark Ter Laan
- 1Department of Neurosurgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Dylan Henssen
- 2Department of Radiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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14
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Gurses ME, Gungor A, Rahmanov S, Gökalp E, Hanalioglu S, Berker M, Cohen-Gadol AA, Türe U. Three-Dimensional Modeling and Augmented Reality and Virtual Reality Simulation of Fiber Dissection of the Cerebellum and Brainstem. Oper Neurosurg (Hagerstown) 2022; 23:345-354. [DOI: 10.1227/ons.0000000000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022] Open
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15
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Rath TJ, Policeni B, Juliano AF, Agarwal M, Block AM, Burns J, Conley DB, Crowley RW, Dubey P, Friedman ER, Gule-Monroe MK, Hagiwara M, Hunt CH, Jain V, Powers WJ, Rosenow JM, Taheri MR, DuChene Thoma K, Zander D, Corey AS. ACR Appropriateness Criteria® Cranial Neuropathy: 2022 Update. J Am Coll Radiol 2022; 19:S266-S303. [PMID: 36436957 DOI: 10.1016/j.jacr.2022.09.021] [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] [Received: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 11/27/2022]
Abstract
Cranial neuropathy can result from pathology affecting the nerve fibers at any point and requires imaging of the entire course of the nerve from its nucleus to the end organ in order to identify a cause. MRI with and without intravenous contrast is often the modality of choice with CT playing a complementary role. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Tanya J Rath
- Division Chair of Neuroradiology, Mayo Clinic Arizona, Phoenix, Arizona.
| | - Bruno Policeni
- Panel Chair; Department of Radiology Vice-Chair, University of Iowa Hospitals and Clinics, Iowa City, Iowa; President Iowa Radiological Society and ACR Councilor
| | - Amy F Juliano
- Panel Vice-Chair, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; NI-RADS committee chair
| | - Mohit Agarwal
- Froedtert Memorial Lutheran Hospital Medical College of Wisconsin, Milwaukee, Wisconsin; Fellowship Program Director
| | - Alec M Block
- Stritch School of Medicine Loyola University Chicago, Maywood, Illinois
| | - Judah Burns
- Montefiore Medical Center, Bronx, New York; Vice-Chair for Education & Residency Program Director, Montefiore Medical Center; Vice-Chair, Subcommittee on Methodology
| | - David B Conley
- Practice Director, Northwestern ENT and Rhinology Fellowship Director, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and Member, American Academy of Otolaryngology-Head and Neck Surgery
| | - R Webster Crowley
- Rush University Medical Center, Chicago, Illinois; Neurosurgery expert; Chief, Cerebrovascular and Endovascular Neurosurgery; Medical Director, Department of Neurosurgery; Surgical Director, Rush Comprehensive Stroke Center; Program Director, Endovascular Neurosurgery
| | | | - Elliott R Friedman
- University of Texas Health Science Center, Houston, Texas; Diagnostic Radiology Residency Program Director
| | - Maria K Gule-Monroe
- The University of Texas MD Anderson Cancer Center, Houston, Texas; Medical Director of Diagnostic Imaging at Houston Area Location Woodlands
| | - Mari Hagiwara
- Neuroradiology Fellowship Program Director and Head and Neck Imaging Director, New York University Langone Medical Center, New York, New York
| | | | - Vikas Jain
- MetroHealth Medical Center, Cleveland, Ohio; Medical Director, Lumina Imaging
| | - William J Powers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina; American Academy of Neurology
| | - Joshua M Rosenow
- Neuroradiology Fellowship Program Director and Head and Neck Imaging Director, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - M Reza Taheri
- George Washington University Hospital, Washington, District of Columbia; Director of Neuroradiology
| | - Kate DuChene Thoma
- Director of Faculty Development Fellowship, University of Iowa Hospital, Iowa City, Iowa; Primary care physician
| | - David Zander
- Chief of Head and Neck Radiology, University of Colorado Denver, Denver, Colorado
| | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
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16
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Pérez-Navarro L, Sánchez-Miranda Román I, Martín Santana I, Malo de Molina Zamora R. Ptosis palpebral bilateral: ¿Cuándo sospechar causa vascular? Neurologia 2022. [DOI: 10.1016/j.nrl.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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17
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Smith KJ, Gwyer Findlay E. Expression of antimicrobial host defence peptides in the central nervous system during health and disease. DISCOVERY IMMUNOLOGY 2022; 1:kyac003. [PMID: 38566904 PMCID: PMC10917193 DOI: 10.1093/discim/kyac003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/13/2022] [Accepted: 07/21/2022] [Indexed: 04/04/2024]
Abstract
Antimicrobial host defence peptides (HDP) are critical for the first line of defence against bacterial, viral, and fungal pathogens. Over the past decade we have become more aware that, in addition to their antimicrobial roles, they also possess the potent immunomodulatory capacity. This includes chemoattracting immune cells, activating dendritic cells and macrophages, and altering T-cell differentiation. Most examinations of their immunomodulatory roles have focused on tissues in which they are very abundant, such as the intestine and the inflamed skin. However, HDP have now been detected in the brain and the spinal cord during a number of conditions. We propose that their presence in the central nervous system (CNS) during homeostasis, infection, and neurodegenerative disease has the potential to contribute to immunosurveillance, alter host responses and skew developing immunity. Here, we review the evidence for HDP expression and function in the CNS in health and disease. We describe how a wide range of HDP are expressed in the CNS of humans, rodents, birds, and fish, suggesting a conserved role in protecting the brain from pathogens, with evidence of production by resident CNS cells. We highlight differences in methodology used and how this may have resulted in the immunomodulatory roles of HDP being overlooked. Finally, we discuss what HDP expression may mean for CNS immune responses.
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Affiliation(s)
- Katie J Smith
- Centre for Inflammation Research, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK
| | - Emily Gwyer Findlay
- Centre for Inflammation Research, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK
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18
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Narrative as co-regulation: A review of embodied narrative in infant development. Infant Behav Dev 2022; 68:101747. [PMID: 35839557 DOI: 10.1016/j.infbeh.2022.101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/21/2022]
Abstract
We review evidence of non-verbal, embodied narratives in human infancy to better understand their form and function as generators of common experience, regulation, and learning. We examine their development prior to the onset of language, with a view to improve understanding of narrative as regular motifs or schemas of early experience in both solitary and social engagement. Embodied narratives are composed of regular patterns of interest, arousal, affect, and intention that yield a characteristic four-part structure of (i) introduction, (ii) development, (iii) climax, and (iv) resolution. Made with others these form co-created shared acts of meaning, and are parsed in time with discreet beginnings and endings that allow a regular pattern to frame and give predictive understanding for prospective regulation (especially important within social contexts) that safely returns to baseline again. This characteristic pattern, co-created between infant and adult from the beginning of life, allows the infant to contribute to, and learn, the patterns of its culture. We conclude with a view on commonalities and differences of co-created narrative in non-human primates, and discuss implications of disruption to narrative co-creation for developmental psychopathology.
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19
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Reeves KC, Shah N, Muñoz B, Atwood BK. Opioid Receptor-Mediated Regulation of Neurotransmission in the Brain. Front Mol Neurosci 2022; 15:919773. [PMID: 35782382 PMCID: PMC9242007 DOI: 10.3389/fnmol.2022.919773] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/26/2022] [Indexed: 12/15/2022] Open
Abstract
Opioids mediate their effects via opioid receptors: mu, delta, and kappa. At the neuronal level, opioid receptors are generally inhibitory, presynaptically reducing neurotransmitter release and postsynaptically hyperpolarizing neurons. However, opioid receptor-mediated regulation of neuronal function and synaptic transmission is not uniform in expression pattern and mechanism across the brain. The localization of receptors within specific cell types and neurocircuits determine the effects that endogenous and exogenous opioids have on brain function. In this review we will explore the similarities and differences in opioid receptor-mediated regulation of neurotransmission across different brain regions. We discuss how future studies can consider potential cell-type, regional, and neural pathway-specific effects of opioid receptors in order to better understand how opioid receptors modulate brain function.
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Affiliation(s)
- Kaitlin C. Reeves
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC, United States
| | - Nikhil Shah
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States
- Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Braulio Muñoz
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Brady K. Atwood
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
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20
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Memmedova F, Arı Sevingil S, Jafarova U, Cifter G, Aykac O, Ozdemir AO. Progression rates of medulla oblongata infarcts in clinical follow-up: A retrospective study. Clin Neurol Neurosurg 2022; 219:107329. [PMID: 35717765 DOI: 10.1016/j.clineuro.2022.107329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/28/2022] [Accepted: 06/03/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine clinical progression rates in patients with medulla oblongata infarction (MOI). MATERIALS AND METHODS The data of patients diagnosed with MOI were analysed retrospectively. Dermographic characteristics of the patients; Age, gender, history and stroke etiology were evaluated. Radiological imagings were reviewed retrospectively. Intensive care unit (ICU) requirement, number of intubation days, failed extubation and death rates, good clinical outcome at discharge and 3 months [modified Rankin Scale (mRS 0-2)] and poor clinical outcome (mRS 3-6) rates were evaluated. In addition, the clinical results of patients with medial medullary infarction (MMI) and lateral medullary infarction (LMI) were compared. RESULTS 33 patients were included in the study, 22 (66.7 %) were male. The mean age of the patients was 72.0 (43.0-85.0). The characteristics of the patients (dermographic features, comorbidities, clinical symptoms, infarct localization, etc.) were evaluated. The results of MMI and LMI patients were compared. The intubation rate was 4 (44.4 %) in the MME group, while it was 8 (33.3 %) in the LME group. There was no statistically significant difference between the two groups in terms of failed extubation, tracheostomy, hospitalization and mortality rates. However, while discharge mRS was statistically significant between the two groups, the mRS at 3 months was not statistically significant. Twelve (36.4 %) of all patients were intubated due to severe clinical progression. In the clinical follow-up, 6 (50.0 %) of the intubated patients died, 3rd month mRS of 6 (50.0 %) patients who survived was 5. In all patients 3-month good clinical outcome rate was % 48,5. CONCLUSION It should not be forgotten that life-threatening clinical progressions may develop at a considerable rate during the early treatment process of patients diagnosed with MOI.
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Affiliation(s)
- Fergane Memmedova
- Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
| | - Semra Arı Sevingil
- Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
| | - Ulviyyat Jafarova
- Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
| | - Gizem Cifter
- Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
| | - Ozlem Aykac
- Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
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21
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Nogo D, Nazal H, Song Y, Teopiz KM, Ho R, McIntyre RS, Lui LMW, Rosenblat JD. A review of potential neuropathological changes associated with ketamine. Expert Opin Drug Saf 2022; 21:813-831. [PMID: 35502632 DOI: 10.1080/14740338.2022.2071867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Ketamine is an established intervention for treatment resistant depression (TRD). However, long-term adverse effects with repeated doses remain insufficiently characterized. Although several animal models have shown N-methyl-D-aspartate glutamate receptor antagonists to produce various neuropathological reactions, attention surrounding the risk of brain lesions has been minimal. AREAS COVERED : The current review focuses on potential neuropathological changes associated with ketamine. Search terms included variations of ketamine, Olney lesions, tau hyperphosphorylation, and parvalbumin interneurons. EXPERT OPINION : Daily high-dose ketamine use in substance use disorder (SUD) populations was associated with clear neurotoxic effects, while no studies specifically evaluated effects of ketamine protocols used for TRD. It is difficult to discern effects directly attributable to ketamine due to methodological factors, such as comorbidities and dramatic differences in dose in SUD populations versus infrequent sub-anesthetic doses typically prescribed for TRD. Taken together, animal models and human ketamine SUD populations suggest potential neuropathology with chronic high-dose ketamine exposure exceeding those recommended for adults with TRD. It is unknown whether repeat sub-anesthetic dosing of ketamine in adults with TRD is associated with Olney lesions or other neuropathologies. In the interim, practitioners should be vigilant for this possibility recognizing that the condition itself is associated with neurodegenerative processes.
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Affiliation(s)
- Danica Nogo
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Hana Nazal
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,McMaster University, Hamilton, Canada
| | - Yuetong Song
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,University of Toronto, Toronto, Canada.,Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,University of Toronto, Toronto, Canada.,Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,University of Toronto, Toronto, Canada.,Brain and Cognition Discovery Foundation, Toronto, Canada
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22
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Pérez-Navarro L, Sánchez-Miranda Román I, Martín Santana I, Malo de Molina Zamora R. Bilateral ptosis: when to consider a vascular cause? NEUROLOGÍA (ENGLISH EDITION) 2022; 37:704-705. [DOI: 10.1016/j.nrleng.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022] Open
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23
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Lucio LL, Freddi TDAL, Ottaiano AC. The Abducens Nerve: Anatomy and Pathology. Semin Ultrasound CT MR 2022; 43:414-419. [DOI: 10.1053/j.sult.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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van Cappellen van Walsum A, Henssen DJ. E-Learning Three-Dimensional Anatomy of the Brainstem: Impact of Different Microscopy Techniques and Spatial Ability. ANATOMICAL SCIENCES EDUCATION 2022; 15:317-329. [PMID: 33507593 PMCID: PMC9292761 DOI: 10.1002/ase.2056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/08/2021] [Accepted: 01/23/2021] [Indexed: 05/05/2023]
Abstract
Polarized light imaging (PLI) is a new method which quantifies and visualizes nerve fiber direction. In this study, the educational value of PLI sections of the human brainstem were compared to histological sections stained with Luxol fast blue (LFB) using e-learning modules. Mental Rotations Test (MRT) was used to assess the spatial ability. Pre-intervention, post-intervention, and long-term (1 week) anatomical tests were provided to assess the baseline knowledge and retention. One-on-one electronic interviews after the last test were carried out to understand the students' perceptions of the intervention. Thirty-eight medical students, (19 female and 19 males, mean age 21.5 ± SD 2.4; median age: 21.0 years) participated with a mean MRT score of 13.2 ± 5.2 points and a mean pre-intervention knowledge test score of 49.9 ± 11.8%. A significant improvement in both, post-intervention and long-term test scores occurred after learning with either PLI or LFB e-learning module on brainstem anatomy (both P < 0.001). No difference was observed between groups in post-intervention test scores and long-term test scores (P = 0.913 and P = 0.403, respectively). A higher MRT-score was significantly correlated with a higher post-intervention test score (rk = 0.321; P < 0.05, respectively), but there was not a significant association between the MRT- and the long-term scores (rk = -0.078; P = 0.509). Interviews (n = 10) revealed three major topics: Learning (brainstem) anatomy by use of e-learning modules; The "need" of technological background information when studying brainstem sections; and Mnemonics when studying brainstem anatomy. Future studies should assess the cognitive burden of cross-sectional learning methods with PLI and/or LFB sections and their effects on knowledge retention.
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Affiliation(s)
- Anne‐Marie van Cappellen van Walsum
- Department of Medical ImagingRadboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
| | - Dylan J.H.A. Henssen
- Department of Medical ImagingRadboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
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Guardia T, Geerligs L, Tsvetanov KA, Ye R, Campbell KL. The role of the arousal system in age-related differences in cortical functional network architecture. Hum Brain Mapp 2022; 43:985-997. [PMID: 34713955 PMCID: PMC8764482 DOI: 10.1002/hbm.25701] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/04/2021] [Accepted: 10/17/2021] [Indexed: 01/10/2023] Open
Abstract
A common finding in the aging literature is that of the brain's decreased within- and increased between-network functional connectivity. However, it remains unclear what is causing this shift in network organization with age. Given the essential role of the ascending arousal system (ARAS) in cortical activation and previous findings of disrupted ARAS functioning with age, it is possible that age differences in ARAS functioning contribute to disrupted cortical connectivity. We test this possibility here using resting state fMRI data from over 500 individuals across the lifespan from the Cambridge Center for Aging and Neuroscience (Cam-CAN) population-based cohort. Our results show that ARAS-cortical connectivity declines with age and, consistent with our expectations, significantly mediates some age-related differences in connectivity within and between association networks (specifically, within the default mode and between the default mode and salience networks). Additionally, connectivity between the ARAS and association networks predicted cognitive performance across several tasks over and above the effects of age and connectivity within the cortical networks themselves. These findings suggest that age differences in cortical connectivity may be driven, at least in part, by altered arousal signals from the brainstem and that ARAS-cortical connectivity relates to cognitive performance with age.
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Affiliation(s)
- Tiago Guardia
- Department of PsychologyBrock UniversitySt. CatharinesOntarioCanada
| | - Linda Geerligs
- Donders Institute for Brain, Cognition, and BehaviourRadboud UniversityNijmegenThe Netherlands
| | | | - Rong Ye
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
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Nelson T, Zhang LX, Guo H, Nacul L, Song X. Brainstem Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Scoping Review and Evaluation of Magnetic Resonance Imaging Findings. Front Neurol 2021; 12:769511. [PMID: 34975729 PMCID: PMC8718708 DOI: 10.3389/fneur.2021.769511] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multisystem medical condition with heterogeneous symptom expression. Currently, there is no effective cure or treatment for the standard care of patients. A variety of ME/CFS symptoms can be linked to the vital life functions of the brainstem, the lower extension of the brain best known as the hub relaying information back and forth between the cerebral cortex and various parts of the body. Objective/Methods: Over the past decade, Magnetic Resonance Imaging (MRI) studies have emerged to understand ME/CFS with interesting findings, but there has lacked a synthesized evaluation of what has been found thus far regarding the involvement of the brainstem. We conducted this study to review and evaluate the recent MRI findings via a literature search of the MEDLINE database, from which 11 studies met the eligibility criteria. Findings: Data showed that MRI studies frequently reported structural changes in the white and gray matter. Abnormalities of the functional connectivity within the brainstem and with other brain regions have also been found. The studies have suggested possible mechanisms including astrocyte dysfunction, cerebral perfusion impairment, impaired nerve conduction, and neuroinflammation involving the brainstem, which may at least partially explain a substantial portion of the ME/CFS symptoms and their heterogeneous presentations in individual patients. Conclusions: This review draws research attention to the role of the brainstem in ME/CFS, helping enlighten future work to uncover the pathologies and mechanisms of this complex medical condition, for improved management and patient care.
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Affiliation(s)
- Todd Nelson
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Lan-Xin Zhang
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Department of Human Biology, Physiology, University of Toronto, Toronto, ON, Canada
| | - Hui Guo
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Department of Diagnostic Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Luis Nacul
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, BC, Canada
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Xiaowei Song
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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Alpay V, Davutoglu EA, Kaymak D, Madazli R. Establishment of nomograms for fetal vermis and brainstem structures in the midsagittal cranial plane by ultrasonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:947-955. [PMID: 34363244 DOI: 10.1002/jcu.23053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To construct nomograms for the fetal cerebellar vermis and brainstem structures obtainable from the midsagittal plane of the brain by two-dimensional sonography. METHODS This was a prospective cross-sectional study of 434 healthy fetuses in low-risk singleton pregnancies between 18 and 35 gestational weeks. The following parameters were evaluated in the midsagittal cranial plane; cerebellar vermis anteroposterior diameter (APD), craniocaudal diameter (CCD), pons, midbrain and medulla oblongata APD and tectum length. The measurements were presented as growth charts according to gestational age. RESULTS The mean ± SD, and 5%, 50%, 95% centile charts according to gestational age for vermis APD and CCD, pons, midbrain and medulla oblongata APD and tectum length were constructed. Pearson's correlation coefficients for vermis CCD and APD, pons, midbrain, medulla oblongata APD and tectum length by gestational week were 0.961, 0.929, 0.918, 0.761, 0.731 and 0.854, respectively (p < 0.0001). CONCLUSION The reference data provided in the present study would be helpful in the prenatal diagnosis of challenging fetal conditions with involvement of the brainstem and cerebellum.
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Affiliation(s)
- Verda Alpay
- Department of Obstetrics and Gynecology, Division of Perinatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ebru Alıcı Davutoglu
- Department of Obstetrics and Gynecology, Division of Perinatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Didem Kaymak
- Department of Obstetrics and Gynecology, Division of Perinatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Riza Madazli
- Department of Obstetrics and Gynecology, Division of Perinatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Elias GJB, Loh A, Gwun D, Pancholi A, Boutet A, Neudorfer C, Germann J, Namasivayam A, Gramer R, Paff M, Lozano AM. Deep brain stimulation of the brainstem. Brain 2021; 144:712-723. [PMID: 33313788 DOI: 10.1093/brain/awaa374] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 01/02/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus, pallidum, and thalamus is an established therapy for various movement disorders. Limbic targets have also been increasingly explored for their application to neuropsychiatric and cognitive disorders. The brainstem constitutes another DBS substrate, although the existing literature on the indications for and the effects of brainstem stimulation remains comparatively sparse. The objective of this review was to provide a comprehensive overview of the pertinent anatomy, indications, and reported stimulation-induced acute and long-term effects of existing white and grey matter brainstem DBS targets. We systematically searched the published literature, reviewing clinical trial articles pertaining to DBS brainstem targets. Overall, 164 studies describing brainstem DBS were identified. These studies encompassed 10 discrete structures: periaqueductal/periventricular grey (n = 63), pedunculopontine nucleus (n = 48), ventral tegmental area (n = 22), substantia nigra (n = 9), mesencephalic reticular formation (n = 7), medial forebrain bundle (n = 8), superior cerebellar peduncles (n = 3), red nucleus (n = 3), parabrachial complex (n = 2), and locus coeruleus (n = 1). Indications for brainstem DBS varied widely and included central neuropathic pain, axial symptoms of movement disorders, headache, depression, and vegetative state. The most promising results for brainstem DBS have come from targeting the pedunculopontine nucleus for relief of axial motor deficits, periaqueductal/periventricular grey for the management of central neuropathic pain, and ventral tegmental area for treatment of cluster headaches. Brainstem DBS has also acutely elicited numerous motor, limbic, and autonomic effects. Further work involving larger, controlled trials is necessary to better establish the therapeutic potential of DBS in this complex area.
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Affiliation(s)
- Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Aaron Loh
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Dave Gwun
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Aditya Pancholi
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada.,Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Clemens Neudorfer
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Andrew Namasivayam
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Robert Gramer
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Michelle Paff
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
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Tao LS, Lin JJ, Zou M, Chen SF, Weng YY, Chen KY, Hu BL. A comparative analysis of 375 patients with lateral and medial medullary infarction. Brain Behav 2021; 11:e2224. [PMID: 34124854 PMCID: PMC8413826 DOI: 10.1002/brb3.2224] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have compared the etiology and clinical features between pure lateral medullary infarction (LMI) and pure medial medullary infarction (MMI). METHODS All patients included were hospitalized at The First Affiliated Hospital and The Second Affiliated Hospital of Wenzhou Medical University from January 2015 to July 2020. Their risk factors, clinical manifestation, stroke mechanisms and short-term prognosis were analyzed retrospectively. RESULTS Among the 387 patients enrolled, 266 (68.7%) had LMI, 109 (28.2%) had MMI, and 12 (3.1%) (nine men and three women) had LMI plus MMI. We analyzed the 375 patients of LMI and MMI. The average ages of LMI and MMI were 59.4 years and 62.69 years, respectively. Univariate analysis and multivariable logistic regression was used to investigate the existing risk factors of MMI relative to LMI. Prior infarction, poor glycemic control, and atherosclerosis were more frequently associated with MMI than with LMI. The clinical manifestation was significantly different between LMI and MMI. We used modified Rankin Scale (mRS) score as the short-term prognostic evaluation criteria, and MMI appeared worse than LMI. CONCLUSIONS This study reveals that: (1) patients with MMI are older than those with LMI; (2) prior infarction, poor glycemic control, and atherosclerosis are independent risk factors of MMI than that of LMI; (3) the clinical manifestations of LMI and MMI are heterogeneous; (4) short-term prognosis of MMI is worse than LMI.
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Affiliation(s)
- Lin-Shuang Tao
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing-Jing Lin
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ming Zou
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Song-Fang Chen
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-Yun Weng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke-Yang Chen
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bei-Lei Hu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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30
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Dudoit T, Balossier A, Reyes-Botero G, Laigle-Donadey F, Emery E, Blond S, Carluer L, Lechapt-Zalcman E, Delattre JY, Guillamo JS. Adult brainstem glioma presenting with isolated persistent hemifacial spasm or facial nerve palsy. Rev Neurol (Paris) 2021; 177:1276-1282. [PMID: 34272066 DOI: 10.1016/j.neurol.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
OBJECT Adult brainstem gliomas are a rare group of heterogeneous brain tumors. Classical clinical presentation includes progressive impairment of cranial nerves associated with long tract signs. The prognosis and response to treatment are poor; nevertheless, some patients do have a long survival. The objective of this study was to describe a series of patients with an isolated persistent hemifacial spasm and/or facial nerve palsy as the presenting symptom of a brainstem glioma. METHODS Fourteen patients from 3 French hospitals (Paris, Caen, Lille) were included. Clinical and radiological features and overall survival were retrospectively analyzed. A review of the literature of similar cases was performed. RESULTS Mean age at diagnosis was 35 years (range 19-57 years). Mean duration of facial nerve involvement before diagnosis was 17 months (range 1-48 months). Tumors were characterized on MRI by a lateralized location in the pons, a T1-weighted hyposignal, a T2-weighted hypersignal and no contrast enhancement after Gadolinium injection except for 2 cases. Biopsies were performed in 10 cases and showed 8 low-grade and 2 high-grade gliomas. All the patients were initially treated with radiotherapy and 6 patients with chemotherapy after progression. Eleven patients died from tumor progression. Median survival time was 90 months. CONCLUSIONS Adult brainstem gliomas revealed by a progressive isolated involvement of the facial nerve seem to have particular clinico-radiological features of slow progressive tumors and may be associated with long patient survival.
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Affiliation(s)
- T Dudoit
- Service de neurochirurgie, CHU de Caen, 14000 Caen, France
| | - A Balossier
- Service de neurochirurgie, CHU de Caen, 14000 Caen, France; Université de Caen Basse-Normandie, UFR de Médecine, 14000 Caen, France
| | - G Reyes-Botero
- Service de neurologie Mazarin, groupe hospitalier Pitié-Salpêtrière, université Pierre et Marie Curie-Paris 6, AP-HP, Paris, France
| | - F Laigle-Donadey
- Service de neurologie Mazarin, groupe hospitalier Pitié-Salpêtrière, université Pierre et Marie Curie-Paris 6, AP-HP, Paris, France
| | - E Emery
- Service de neurochirurgie, CHU de Caen, 14000 Caen, France; Université de Caen Basse-Normandie, UFR de Médecine, 14000 Caen, France
| | - S Blond
- Service de neurochirurgie, CHRU de Lille, 59037 Lille, France
| | - L Carluer
- Service de neurologie, CHU de Caen, 14000 Caen, France
| | | | - J-Y Delattre
- Service de neurologie Mazarin, groupe hospitalier Pitié-Salpêtrière, université Pierre et Marie Curie-Paris 6, AP-HP, Paris, France
| | - J-S Guillamo
- Université de Caen Basse-Normandie, UFR de Médecine, 14000 Caen, France; Service de neurologie, CHU de Caen, 14000 Caen, France; Service de neurologie, CHU de Nîmes, 30029 Nîmes, France.
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Bouhrara M, Cortina LE, Khattar N, Rejimon AC, Ajamu S, Cezayirli DS, Spencer RG. Maturation and degeneration of the human brainstem across the adult lifespan. Aging (Albany NY) 2021; 13:14862-14891. [PMID: 34115614 PMCID: PMC8221341 DOI: 10.18632/aging.203183] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/20/2021] [Indexed: 04/12/2023]
Abstract
Brainstem tissue microstructural properties change across the adult lifespan. However, studies elucidating the biological processes that govern brainstem maturation and degeneration in-vivo are lacking. In the present work, conducted on a large cohort of 140 cognitively unimpaired subjects spanning a wide age range of 21 to 94 years, we implemented a multi-parameter approach to characterize the sex- and age differences. In addition, we examined regional correlations between myelin water fraction (MWF), a direct measure of myelin content, and diffusion tensor imaging indices, and transverse and longitudinal relaxation rates to evaluate whether these metrics provide information complementary to MWF. We observed region-dependent differences in myelin content and axonal density with age and found that both exhibit an inverted U-shape association with age in several brainstem substructures. We emphasize that the microstructural differences captured by our distinct MRI metrics, along with their weak associations with MWF, strongly indicate the potential of using these outcome measures in a multi-parametric approach. Furthermore, our results support the gain-predicts-loss hypothesis of tissue maturation and degeneration in the brainstem. Indeed, our results indicate that myelination follows a temporally symmetric time course across the adult life span, while axons appear to degenerate significantly more rapidly than they mature.
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Affiliation(s)
- Mustapha Bouhrara
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Luis E. Cortina
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Nikkita Khattar
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Abinand C. Rejimon
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Samuel Ajamu
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Defne S. Cezayirli
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Richard G. Spencer
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
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Cullins MJ, Russell JA, Booth ZE, Connor NP. Central activation deficits contribute to post stroke lingual weakness in a rat model. J Appl Physiol (1985) 2021; 130:964-975. [PMID: 33600285 DOI: 10.1152/japplphysiol.00533.2020] [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] [Indexed: 01/17/2023] Open
Abstract
Lingual weakness frequently occurs after stroke and is associated with deficits in speaking and swallowing. Chronic weakness after stroke has been attributed to both impaired central activation of target muscles and reduced force-generating capacity within muscles. How these factors contribute to lingual weakness is not known. We hypothesized that lingual weakness due to middle cerebral artery occlusion (MCAO) would manifest as reduced muscle force capacity and reduced muscle activation. Rats were randomized into MCAO or sham surgery groups. Maximum volitional tongue forces were quantified 8 wk after surgery. Hypoglossal nerve stimulation was used to assess maximum stimulated force, muscle twitch properties, and force-frequency response. The central activation ratio was determined by maximum volitional/maximum stimulated force. Genioglossus muscle fiber type properties and neuromuscular junction innervation were assessed. Maximum volitional force and the central activation ratio were significantly reduced with MCAO. Maximum stimulated force was not significantly different. No significant differences were found for muscle twitch properties, unilateral contractile properties, muscle fiber type percentages, or fiber size. However, the twitch/tetanus ratio was significantly increased in the MCAO group relative to sham. A small but significant increase in denervated neuromuscular junctions (NMJs) and fiber-type grouping occurred in the contralesional genioglossus. Results suggest that the primary cause of chronic lingual weakness after stroke is impaired muscle activation rather than a deficit of force-generating capacity in lingual muscles. Increased fiber type grouping and denervated NMJs in the contralesional genioglossus suggest that partial reinnervation of muscle fibers may have preserved force-generating capacity, but not optimal activation patterns.NEW & NOTEWORTHY Despite significant reductions in maximum volitional forces, the intrinsic force-generating capacity of the protrusive lingual muscles was not reduced with unilateral cerebral ischemia. Small yet significant increases in denervated NMJs and fiber-type grouping of the contralesional genioglossus suggest that the muscle underwent denervation and reinnervation. Together these results suggest that spontaneous neuromuscular plasticity was sufficient to prevent atrophy, yet central activation deficits remain and contribute to chronic lingual weakness after stroke.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - John A Russell
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - Zoe E Booth
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
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Magnetic resonance imaging of the brainstem in children, part 1: imaging techniques, embryology, anatomy and review of congenital conditions. Pediatr Radiol 2021; 51:172-188. [PMID: 33496830 DOI: 10.1007/s00247-020-04953-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/10/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
Part 1 of this series of two articles describes conventional and advanced MRI techniques that are useful for evaluating brainstem pathologies. In addition, it provides a review of the embryology, normal progression of myelination, and clinically and radiologically salient imaging anatomy of the normal brainstem. Finally, it discusses congenital diseases of the brainstem with a focus on distinctive imaging features that allow for differentiating pathologies. Part 2 of this series of two articles includes discussion of neoplasms; infections; and vascular, demyelinating, toxic and metabolic, and miscellaneous disease processes affecting the brainstem. The ultimate goal of this pair of articles is to empower the radiologist to add clinical value in the care of pediatric patients with brainstem pathologies.
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Bordia T, Zahr NM. The Inferior Colliculus in Alcoholism and Beyond. Front Syst Neurosci 2020; 14:606345. [PMID: 33362482 PMCID: PMC7759542 DOI: 10.3389/fnsys.2020.606345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/02/2020] [Indexed: 12/28/2022] Open
Abstract
Post-mortem neuropathological and in vivo neuroimaging methods have demonstrated the vulnerability of the inferior colliculus to the sequelae of thiamine deficiency as occurs in Wernicke-Korsakoff Syndrome (WKS). A rich literature in animal models ranging from mice to monkeys-including our neuroimaging studies in rats-has shown involvement of the inferior colliculi in the neural response to thiamine depletion, frequently accomplished with pyrithiamine, an inhibitor of thiamine metabolism. In uncomplicated alcoholism (i.e., absent diagnosable neurological concomitants), the literature citing involvement of the inferior colliculus is scarce, has nearly all been accomplished in preclinical models, and is predominately discussed in the context of ethanol withdrawal. Our recent work using novel, voxel-based analysis of structural Magnetic Resonance Imaging (MRI) has demonstrated significant, persistent shrinkage of the inferior colliculus using acute and chronic ethanol exposure paradigms in two strains of rats. We speculate that these consistent findings should be considered from the perspective of the inferior colliculi having a relatively high CNS metabolic rate. As such, they are especially vulnerable to hypoxic injury and may be provide a common anatomical link among a variety of disparate insults. An argument will be made that the inferior colliculi have functions, possibly related to auditory gating, necessary for awareness of the external environment. Multimodal imaging including diffusion methods to provide more accurate in vivo visualization and quantification of the inferior colliculi may clarify the roles of brain stem nuclei such as the inferior colliculi in alcoholism and other neuropathologies marked by altered metabolism.
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Affiliation(s)
- Tanuja Bordia
- Neuroscience Program, SRI International, Menlo Park, CA, United States
| | - Natalie M. Zahr
- Neuroscience Program, SRI International, Menlo Park, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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Kang J, Shen J. Cell-autonomous role of Presenilin in age-dependent survival of cortical interneurons. Mol Neurodegener 2020; 15:72. [PMID: 33302995 PMCID: PMC7731773 DOI: 10.1186/s13024-020-00419-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/01/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Mutations in the PSEN1 and PSEN2 genes are the major cause of familial Alzheimer's disease. Previous studies demonstrated that Presenilin (PS), the catalytic subunit of γ-secretase, is required for survival of excitatory neurons in the cerebral cortex during aging. However, the role of PS in inhibitory interneurons had not been explored. METHODS To determine PS function in GABAergic neurons, we generated inhibitory neuron-specific PS conditional double knockout (IN-PS cDKO) mice, in which PS is selectively inactivated by Cre recombinase expressed under the control of the endogenous GAD2 promoter. We then performed behavioral, biochemical, and histological analyses to evaluate the consequences of selective PS inactivation in inhibitory neurons. RESULTS IN-PS cDKO mice exhibit earlier mortality and lower body weight despite normal food intake and basal activity. Western analysis of protein lysates from various brain sub-regions of IN-PS cDKO mice showed significant reduction of PS1 levels and dramatic accumulation of γ-secretase substrates. Interestingly, IN-PS cDKO mice develop age-dependent loss of GABAergic neurons, as shown by normal number of GAD67-immunoreactive interneurons in the cerebral cortex at 2-3 months of age but reduced number of cortical interneurons at 9 months. Moreover, age-dependent reduction of Parvalbumin- and Somatostatin-immunoreactive interneurons is more pronounced in the neocortex and hippocampus of IN-PS cDKO mice. Consistent with these findings, the number of apoptotic cells is elevated in the cerebral cortex of IN-PS cDKO mice, and the enhanced apoptosis is due to dramatic increases of apoptotic interneurons, whereas the number of apoptotic excitatory neurons is unaffected. Furthermore, progressive loss of interneurons in the cerebral cortex of IN-PS cDKO mice is accompanied with astrogliosis and microgliosis. CONCLUSION Our results together support a cell-autonomous role of PS in the survival of cortical interneurons during aging. Together with earlier studies, these findings demonstrate a universal, essential requirement of PS in the survival of both excitatory and inhibitory neurons during aging.
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Affiliation(s)
- Jongkyun Kang
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA 02115 USA
| | - Jie Shen
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA 02115 USA
- Program in Neuroscience, Harvard Medical School, Boston, MA 02115 USA
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Arienti C, Farinola F, Ratti S, Daccò S, Fasulo L. Variations of HRV and skin conductance reveal the influence of CV4 and Rib Raising techniques on autonomic balance: A randomized controlled clinical trial. J Bodyw Mov Ther 2020; 24:395-401. [PMID: 33218540 DOI: 10.1016/j.jbmt.2020.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 06/28/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of the present study was to evaluate whether Fourth Ventricle Compression Technique (CV4) and Rib Raising (RR) osteopathic techniques influence Autonomic Nervous System (ANS) activity, as measured by Heart Rate Variability (HRV) and Skin Conductance (SC). METHOD A randomized-controlled clinical trial has been performed from June 2010 to January 2011. 32 healthy adults (33.9 ± 14 years, and 72% female) were selected. Subjects were randomized in three groups: CV4 group, RR group and Placebo group. Each subject of each group underwent respective technique only once. HRV and SC were continuously recorded during the session. All data analysis was performed using SPSS statistical software (version 21.0) and the significance level was considered at p ≤ 0.05. RESULTS RR technique intra-group subject analysis showed a significant decrease in LF/HF ratio (F = 25.18; p < 0.001), a statistically significant decrease of LF (F = 27.09; p < 0.001), and increase of HF, both at the end of treatment (F = 27.09; p < 0.001). CV4 technique intra-group subject analysis showed a significant reduction of the LF/HF ratio (F = 81.15; p < 0.001), a significant decrease in LF (F = 38.29; p < 0.001) and a significant increase of HF, at the end of treatment (F = 38.28; p < 0.001). Between-group analysis showed only a significant difference in LF/HF ratio between CV4 and PL groups (F = 3.44; p = 0.042). DISCUSSION Our results suggest that the application of CV4 and RR techniques favors a shift in the autonomic balance towards a parasympathetic predominant state. Thus, their use within OMT protocol, as holistic approach, might improve the outcome of the treatment of clinical neuro-vegetative conditions.
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Affiliation(s)
| | - Federica Farinola
- Division of Research, Istituto Superiore di Osteopatia, Milan, Italy
| | - Silvia Ratti
- Division of Research, Istituto Superiore di Osteopatia, Milan, Italy
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Luigi Fasulo
- Osteopathic Clinic, ASP nr 9 of Mazara del Vallo, Trapani, Italy
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Peng L, Leung EHW, So J, Mak PHS, Lee CL, Tan H, Lee KF, Chan SY. TSPYL1 regulates steroidogenic gene expression and male factor fertility in mice. F&S SCIENCE 2020; 1:115-123. [PMID: 35559922 DOI: 10.1016/j.xfss.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/31/2020] [Accepted: 08/20/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the importance of testis-specific, Y-encoded-like 1 (TSPYL1) in survival and male factor fertility in mice. DESIGN Experimental prospective study. SETTING Research laboratories in a university medical faculty. ANIMALS We generated Tspyl1 knockout (KO) mouse lines by CRISPR/Cas9. The lines were maintained by pairing heterozygous mice to provide wild-type control and KO males for comparison. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Mendelian ratio, body and testis weight, histology, sperm motility, mating tests, pregnancy outcome, transcript levels of genes for testosterone production, and serum testosterone level. RESULT(S) A variable percentage of Tspyl1 KO mice survived beyond weaning depending on the genetic background. Growth around weaning was retarded in KO mice, but the testes-to-body weight ratio remained normal and complete spermatogenesis was revealed in testis histology. Sperm was collected from the cauda epididymis, and a significantly smaller percentage of sperm was progressively motile (22.3% ± 18.3%, n = 14 samples) compared with wild type (58.9% ± 11.5%, 11 samples). All 11 KO mice tested had defective mounting behavior. From 11 KO males paired with a total of 88 females, only one litter was born, compared with 53 litters sired by 11 age-matched wild-type males. Expression of Star, Cyp11a1, Cyp17a1, Hsd3b6, and Hsd17b3 in the KO testis was significantly reduced, while serum testosterone level was within the normal range. CONCLUSION(S) TSPYL1 is critical for survival and reproductive success in mice. TSPYL1 enhances the expression of key steroidogenic genes in the mouse testis.
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Affiliation(s)
- Lei Peng
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Eva Hin Wa Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Joan So
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Priscilla Hoi Shan Mak
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cheuk-Lun Lee
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Huiqi Tan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Kai-Fai Lee
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Siu Yuen Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
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Engmann AK, Bizzozzero F, Schneider MP, Pfyffer D, Imobersteg S, Schneider R, Hofer AS, Wieckhorst M, Schwab ME. The Gigantocellular Reticular Nucleus Plays a Significant Role in Locomotor Recovery after Incomplete Spinal Cord Injury. J Neurosci 2020; 40:8292-8305. [PMID: 32978289 PMCID: PMC7577599 DOI: 10.1523/jneurosci.0474-20.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
Abstract
Traditionally, the brainstem has been seen as hardwired and poorly capable of plastic adaptations following spinal cord injury (SCI). Data acquired over the past decades, however, suggest differently: following SCI in various animal models (lamprey, chick, rodents, nonhuman primates), different forms of spontaneous anatomic plasticity of reticulospinal projections, many of them originating from the gigantocellular reticular nucleus (NRG), have been observed. In line with these anatomic observations, animals and humans with incomplete SCI often show various degrees of spontaneous motor recovery of hindlimb/leg function. Here, we investigated the functional relevance of two different modes of reticulospinal fiber growth after cervical hemisection, local rewiring of axotomized projections at the lesion site versus compensatory outgrowth of spared axons, using projection-specific, adeno-associated virus-mediated chemogenetic neuronal silencing. Detailed assessment of joint movements and limb kinetics during overground locomotion in female adult rats showed that locally rewired as well as compensatory NRG fibers were responsible for different aspects of recovered forelimb and hindlimb functions (i.e., stability, strength, coordination, speed, or timing). During walking and swimming, both locally rewired as well as compensatory NRG plasticity were crucial for recovered function, while the contribution of locally rewired NRG plasticity to wading performance was limited. Our data demonstrate comprehensively that locally rewired as well as compensatory plasticity of reticulospinal axons functionally contribute to the observed spontaneous improvement of stepping performance after incomplete SCI and are at least partially causative to the observed recovery of function, which can also be observed in human patients with spinal hemisection lesions.SIGNIFICANCE STATEMENT Following unilateral hemisection of the spinal cord, reticulospinal projections are destroyed on the injured side, resulting in impaired locomotion. Over time, a high degree of recovery can be observed in lesioned animals, like in human hemicord patients. In the rat, recovery is accompanied by pronounced spontaneous plasticity of axotomized and spared reticulospinal axons. We demonstrate the causative relevance of locally rewired as well as compensatory reticulospinal plasticity for the recovery of locomotor functions following spinal hemisection, using chemogenetic tools to selectively silence newly formed connections in behaviorally recovered animals. Moving from a correlative to a causative understanding of the role of neuroanatomical plasticity for functional recovery is fundamental for successful translation of treatment approaches from experimental studies to the clinics.
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Affiliation(s)
- Anne K Engmann
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Flavio Bizzozzero
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Marc P Schneider
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Dario Pfyffer
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Stefan Imobersteg
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Regula Schneider
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Anna-Sophie Hofer
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Martin Wieckhorst
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
| | - Martin E Schwab
- Department of Health Sciences and Technology, ETH Zurich, Brain Research Institute, University of Zurich, 8057 Zurich, Switzerland
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Saganuwan SA. Chemistry and Effects of Brainstem Acting Drugs. Cent Nerv Syst Agents Med Chem 2020; 19:180-186. [PMID: 31223094 DOI: 10.2174/1871524919666190620164355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Brain is the most sensitive organ, whereas brainstem is the most important part of Central Nervous System (CNS). It connects the brain and the spinal cord. However, a myriad of drugs and chemicals affects CNS with severe resultant effects on the brainstem. METHODS In view of this, a number of literature were assessed for information on the most sensitive part of brain, drugs and chemicals that act on the brainstem and clinical benefit and risk assessment of such drugs and chemicals. RESULTS Findings have shown that brainstem regulates heartbeat, respiration and because it connects the brain and spinal cord, all the drugs that act on the spinal cord may overall affect the systems controlled by the spinal cord and brain. The message is sent and received by temporal lobe, occipital lobe, frontal lobe, parietal lobe and cerebellum. CONCLUSION Hence, the chemical functional groups of the brainstem and drugs acting on brainstem are complementary, and may produce either stimulation or depression of CNS.
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Affiliation(s)
- Saganuwan Alhaji Saganuwan
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Federal University of Agriculture, P.M.B. 2373, Makurdi, Benue State, Nigeria
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40
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Duque-Parra JE, Barco-Ríos J, Barco-Cano JA. El verdadero origen aparente de los nervios glosofaríngeo, vago y accesorio. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.15446/revfacmed.v67n2.68096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Existe un vacío conceptual asociado con los sitios precisos por donde emergen las raíces de los nervios glosofaríngeo, vago y accesorio, un conocimiento que es de suma importancia para los neurocirujanos.Objetivo. Determinar el sitio preciso por donde las raíces de los nervios glosofaríngeo, vago y accesorio emergen como origen aparente en la médula oblongada.Materiales y métodos. Se valoraron 67 troncos encefálicos humanos que con anterioridad habían sido fijados en solución de formalina al 10%. Mediante inspección directa, luego de retirar las meninges, se examinó y registró el sitio preciso por donde emergen las raíces de tales nervios y se comparó con lo registrado en la literatura.Resultados. En el 100% de los troncos encefálicos estudiados se encontró que las raíces nerviosas emergen entre 2mm a 3mm por detrás del surco retro-olivar, distinto a lo reportado en la literatura consultada.Conclusión. Hay disparidad de criterios en cuanto al origen aparente de los nervios glosofaríngeo, vago y accesorio, lo que amerita un estudio más amplio que permita llegar a un consenso generalizado sobre el sitio preciso por donde las raíces de tales nervios hacen su aparición.
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Wildman JK, Rimawi BH. Cerebral pontine infarctions during pregnancy - A case report and review of the literature. Case Rep Womens Health 2019; 21:e00097. [PMID: 30733924 PMCID: PMC6358547 DOI: 10.1016/j.crwh.2019.e00097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/13/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022] Open
Abstract
Cerebrovascular disease is not uncommon during pregnancy as a result of either venous or arterial occlusion, or a hemorrhagic event, resulting in ischemia. Pregnancy may alter the prognosis of these neurologic disorders, with increased risks of morbidity and mortality for the mother and the developing fetus. Etiologies of stroke during pregnancy and the postpartum period include preeclampsia, eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), amniotic fluid embolism, postpartum angiopathy, postpartum cardiomyopathy, thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), cerebral venous thrombosis, CNS infections, and maternal thrombophilia. Essentially any of the vessels in the brain can be involved in cerebral infarction; however, pontine infarctions are rare and are generally secondary to occlusive insults or after dissection of an aneurysm. Though not common, these conditions can result in devastating sequelae and significant disability. Scant literature is available regarding pontine infarctions during pregnancy. Here we present a rare case of a pregnant patient who presented with new-onset seizures and was found to have a cerebral pontine infarction on imaging. The purpose of this article is to summarize existing data regarding the incidence, risk factors, and potential etiologies, as well as treatment strategies for pontine infarctions during pregnancy. Pontine infarctions are rare during pregnancy and do not differ compared to non-pregnant women. A CT scan, MRI and lumbar puncture can safely be performed during pregnancy for diagnosis purposes. Treatment options available during pregnancy is similar to those used in non-pregnant women. Immediate delivery of a pregnant woman with a vascular cerebral injury is not always indicated. The risk of recurrence is likely to be low, and thus should not impact on mode of delivery.
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Affiliation(s)
- Jenna Kaye Wildman
- University of South Alabama, Children's and Women's Hospital, Department of Obstetrics and Gynecology, 251 Cox Street, Mobile, AL 36604, United States
| | - Bassam H Rimawi
- University of South Alabama, Children's and Women's Hospital, Department of Obstetrics and Gynecology, 251 Cox Street, Mobile, AL 36604, United States.,Division of Maternal Fetal Medicine, United States
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Intersection of Brain Development and Paediatric Diffuse Midline Gliomas: Potential Role of Microenvironment in Tumour Growth. Brain Sci 2018; 8:brainsci8110200. [PMID: 30453529 PMCID: PMC6266894 DOI: 10.3390/brainsci8110200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/03/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023] Open
Abstract
Diffuse intrinsic pontine glioma (DIPG) is a devastating and incurable paediatric brain tumour with a median overall survival of 9 months. Until recently, DIPGs were treated similarly to adult gliomas, but due to the advancement in molecular and imaging technologies, our understanding of these tumours has increased dramatically. While extensive research is being undertaken to determine the function of the molecular aberrations in DIPG, there are significant gaps in understanding the biology and the influence of the tumour microenvironment on DIPG growth, specifically in regards to the developing pons. The precise orchestration and co-ordination of the development of the brain, the most complex organ in the body, is still not fully understood. Herein, we present a brief overview of brainstem development, discuss the developing microenvironment in terms of DIPG growth, and provide a basis for the need for studies focused on bridging pontine development and DIPG microenvironment. Conducting investigations in the context of a developing brain will lead to a better understanding of the role of the tumour microenvironment and will help lead to identification of drivers of tumour growth and therapeutic resistance.
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Grzegorczyk M, Krasucki C, Ciszek B. Vertical bundles of the white matter fibers in the pons revisited: preliminary study utilizing the Klingler technique. Anat Sci Int 2018; 94:180-183. [PMID: 30370477 DOI: 10.1007/s12565-018-0465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 10/16/2018] [Indexed: 10/28/2022]
Abstract
The inner structure of the pons contains several layers of transverse and vertical fibers and many nuclei. The vertical bundles are described as fibers of the corticospinal tract, corticonuclear tract, frontopontine tract and parieto-temporopontine tract organized in three layers. The aim of this study was to investigate the structure of the vertical bundles in the ventral pons using the modified Klingler method. Ten brain stem specimens were investigated. Specimens were fixed in 10% formalin, frozen for 24 h to separate nerve fibers by ice crystals, and then unfrozen again in 10% formalin solution. Afterwards, the specimens were dissected using a sharpened spatula. Results point to the existence of three main layers of vertical bundles and a small, constant, and superficial fourth fascicle that is yet to be described in the literature. We propose the name fasciculus longitudinalis superficialis (superficial longitudinal fascicle) for this group of vertical fibers of the pons.
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Affiliation(s)
- Michał Grzegorczyk
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.,, Warsaw, Poland
| | - Cristobal Krasucki
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland
| | - Bogdan Ciszek
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.,Department of Neurosurgery, Boganowicz Children Hospital, Warsaw, Poland
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Dadalko OI, Travers BG. Evidence for Brainstem Contributions to Autism Spectrum Disorders. Front Integr Neurosci 2018; 12:47. [PMID: 30337860 PMCID: PMC6180283 DOI: 10.3389/fnint.2018.00047] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/18/2018] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects one in 59 children in the United States. Although there is a mounting body of knowledge of cortical and cerebellar contributions to ASD, our knowledge about the early developing brainstem in ASD is only beginning to accumulate. Understanding how brainstem neurotransmission is implicated in ASD is important because many of this condition’s sensory and motor symptoms are consistent with brainstem pathology. Therefore, the purpose of this review was to integrate epidemiological, behavioral, histological, neuroimaging, and animal evidence of brainstem contributions to ASD. Because ASD is a neurodevelopmental condition, we examined the available data through a lens of hierarchical brain development. The review of the literature suggests that developmental alterations of the brainstem could have potential cascading effects on cortical and cerebellar formation, ultimately leading to ASD symptoms. This view is supported by human epidemiology findings and data from animal models of ASD, showing that perturbed development of the brainstem substructures, particularly during the peak formation of the brainstem’s monoaminergic centers, may relate to ASD or ASD-like behaviors. Furthermore, we review evidence from human histology, psychophysiology, and neuroimaging suggesting that brainstem development and maturation may be atypical in ASD and may be related to key ASD symptoms, such as atypical sensorimotor features and social responsiveness. From this review there emerges the need of future research to validate early detection of the brainstem-based somatosensory and psychophysiological behaviors that emerge in infancy, and to examine the brainstem across the life span, while accounting for age. In all, there is preliminary evidence for brainstem involvement in ASD, but a better understanding of the brainstem’s role would likely pave the way for earlier diagnosis and treatment of ASD.
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Affiliation(s)
- Olga I Dadalko
- Motor and Brain Development Lab, Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Brittany G Travers
- Motor and Brain Development Lab, Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
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Bosco P, Giuliano A, Delafield-Butt J, Muratori F, Calderoni S, Retico A. Brainstem enlargement in preschool children with autism: Results from an intermethod agreement study of segmentation algorithms. Hum Brain Mapp 2018; 40:7-19. [PMID: 30184295 DOI: 10.1002/hbm.24351] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/25/2022] Open
Abstract
The intermethod agreement between automated algorithms for brainstem segmentation is investigated, focusing on the potential involvement of this structure in Autism Spectrum Disorders (ASD). Inconsistencies highlighted in previous studies on brainstem in the population with ASD may in part be a result of poor agreement in the extraction of structural features between different methods. A sample of 76 children with ASD and 76 age-, gender-, and intelligence-matched controls was considered. Volumetric analyses were performed using common tools for brain structures segmentation, namely FSL-FIRST, FreeSurfer (FS), and Advanced Normalization Tools (ANTs). For shape analysis SPHARM-MAT was employed. Intermethod agreement was quantified in terms of Pearson correlations between pairs of volumes obtained by the different methods. The degree of overlap between segmented masks was quantified in terms of the Dice index. Both Pearson correlations and Dice indices, showed poor agreement between FSL-FIRST and the other methods (ANTs and FS), which by contrast, yielded Pearson correlations greater than 0.93 and average Dice indices greater than 0.76 when compared with each other. As with volume, shape analyses exhibited discrepancies between segmentation methods, with particular differences noted between FSL-FIRST and the others (ANT and FS), with under- and over-segmentation in specific brainstem regions. These data suggest that research on brain structure alterations should cross-validate findings across multiple methods. We consistently detected an enlargement of brainstem volume in the whole sample and in the male cohort across multiple segmentation methods, a feature particularly driven by the subgroup of children with idiopathic intellectual disability associated with ASD.
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Affiliation(s)
- Paolo Bosco
- Pisa Division, INFN - National Institute for Nuclear Physics, Pisa, Italy
| | - Alessia Giuliano
- Pisa Division, INFN - National Institute for Nuclear Physics, Pisa, Italy
| | - Jonathan Delafield-Butt
- Faculty of Humanities and Social Science, University of Strathclyde, Glasgow, United Kingdom
| | - Filippo Muratori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Sara Calderoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Alessandra Retico
- Pisa Division, INFN - National Institute for Nuclear Physics, Pisa, Italy
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Beddok A, Faivre JC, Coutte A, Guévelou JL, Welmant J, Clavier JB, Guihard S, Janoray G, Calugaru V, Pointreau Y, Lacout A, Salleron J, Lefranc M, Hasboun D, Duvernoy HM, Thariat J. Practical contouring guidelines with an MR-based atlas of brainstem structures involved in radiation-induced nausea and vomiting. Radiother Oncol 2018; 130:113-120. [PMID: 30172454 DOI: 10.1016/j.radonc.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this project was to define consensus guidelines for delineating brainstem substructures (dorsal vagal complex, including the area postrema) involved in radiation-induced nausea and vomiting (RINV). The three parts of the brainstem are rarely delineated, so this study was also an opportunity to find a consensus on this subject. MATERIALS AND METHODS The dorsal vagal complex (DVC) was identified on autopsy sections and endoscopic descriptions. Anatomic landmarks and boundaries were used to establish radio-anatomic correlations on CT and Magnetic Resonance Imaging (MRI). Additionally, delineation of RINV structures was performed on MRI images and reported on CT scans. Next, guidelines were provided to eight radiation oncologists for delineation guidance of these RINV-related structures on DICOM-RT images of two patients being treated for a nasopharyngeal carcinoma. Interobserver variability was computed. RESULTS The DVC and the three parts of the brainstem were defined with a concise description of their main anatomic boundaries. The interobserver analysis showed that the DVC, the midbrain, the pons, and the medulla oblongata delineations were reproducible with KI = 0.72, 0.84, 0.94 and 0.89, respectively. The Supplemental Material section provides an atlas of the consensus guidelines projected on 1-mm MR axial slices. CONCLUSIONS This RINV-atlas was feasible and reproducible for the delineation of RINV structures on planning CT using fused MRI. It may be used to prospectively assess dose-volume relationship for RINV structures and occurrence of nausea vomiting during intracranial or head and neck irradiation.
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Affiliation(s)
- Arnaud Beddok
- Department of Radiation Oncology, University Hospital of Amiens, France; Department of Radiation Oncology, Curie Institute, Paris, France.
| | - Jean-Christophe Faivre
- Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, Vandœuvre-lès-Nancy, France
| | - Alexandre Coutte
- Department of Radiation Oncology, University Hospital of Amiens, France
| | | | - Julien Welmant
- Department of Radiation Oncology, Montpellier Institute of Cancer, France
| | - Jean-Baptiste Clavier
- Department of Radiation Oncology, Strasbourg Insitute of Cancerology - Paul Strauss Cancer Center, Strasbourg Cedex, France
| | - Sébastien Guihard
- Department of Radiation Oncology, Strasbourg Insitute of Cancerology - Paul Strauss Cancer Center, Strasbourg Cedex, France
| | - Guillaume Janoray
- Department of Radiation Oncology, Tours Regional University Center, France
| | | | - Yoann Pointreau
- Jean Bernard Radiation Oncology Center, Le Mans, France; CORad Department, Henry S Kaplan - Bretonneau Regional University Hospital Center, Tours, France; CNRS, UMR 7292 "Génétique, Immunothérapie, Chimie et Cancer", Tours, France
| | - Alexis Lacout
- Department of Radiology, Centre médico - chirurgical - ELSAN, Aurillac, France
| | - Julia Salleron
- Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, Vandœuvre-lès-Nancy, France
| | - Michel Lefranc
- Department of Neurosurgery, University Hospital of Amiens, France
| | - Dominique Hasboun
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Department of Neuroanatomy, Pitié-Salpêtrière University Hospital, Paris, France
| | - Henri M Duvernoy
- Besançon Regional University Hospital Center, laboratoire de pathology, Centre Hospitalier Régional Universitaire de Besançon (Besançon), France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France; Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534 - Unicaen - Normandie Université Boulevard du Marechal Juin 14050 Caen, France
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García Santos JM, Sánchez Jiménez S, Tovar Pérez M, Moreno Cascales M, Lailhacar Marty J, Fernández-Villacañas Marín MA. Tracking the glossopharyngeal nerve pathway through anatomical references in cross-sectional imaging techniques: a pictorial review. Insights Imaging 2018; 9:559-569. [PMID: 29949035 PMCID: PMC6108977 DOI: 10.1007/s13244-018-0630-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 12/13/2022] Open
Abstract
Abstract The glossopharyngeal nerve (GPN) is a rarely considered cranial nerve in imaging interpretation, mainly because clinical signs may remain unnoticed, but also due to its complex anatomy and inconspicuousness in conventional cross-sectional imaging. In this pictorial review, we aim to conduct a comprehensive review of the GPN anatomy from its origin in the central nervous system to peripheral target organs. Because the nerve cannot be visualised with conventional imaging examinations for most of its course, we will focus on the most relevant anatomical references along the entire GPN pathway, which will be divided into the brain stem, cisternal, cranial base (to which we will add the parasympathetic pathway leaving the main trunk of the GPN at the cranial base) and cervical segments. For that purpose, we will take advantage of cadaveric slices and dissections, our own developed drawings and schemes, and computed tomography (CT) and magnetic resonance imaging (MRI) cross-sectional images from our hospital’s radiological information system and picture and archiving communication system. Teaching Points • The glossopharyngeal nerve is one of the most hidden cranial nerves. • It conveys sensory, visceral, taste, parasympathetic and motor information. • Radiologists’ knowledge must go beyond the limitations of conventional imaging techniques. • The nerve’s pathway involves the brain stem, cisternal, skull base and cervical segments. • Systematising anatomical references will help with nerve pathway tracking.
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Affiliation(s)
- José María García Santos
- Radiology Department, University General Hospital JM Morales Meseguer, University of Murcia, Murcia, Spain. .,Radiology Department, University General Hospital JM Universitario Morales Meseguer, C/ Marqués de los Velez s/n, 30008, Murcia, Spain.
| | - Sandra Sánchez Jiménez
- Radiology Department, University General Hospital JM Morales Meseguer, University of Murcia, Murcia, Spain.,Radiology Department, University Hospital Santa Lucía, University of Murcia, Cartagena (Murcia), Spain
| | - Marta Tovar Pérez
- Radiology Department, University General Hospital JM Morales Meseguer, University of Murcia, Murcia, Spain.,Radiology Department, University Hospital Santa Lucía, University of Murcia, Cartagena (Murcia), Spain
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Hornix BE, Havekes R, Kas MJH. Multisensory cortical processing and dysfunction across the neuropsychiatric spectrum. Neurosci Biobehav Rev 2018; 97:138-151. [PMID: 29496479 DOI: 10.1016/j.neubiorev.2018.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 11/25/2022]
Abstract
Sensory processing is affected in multiple neuropsychiatric disorders like schizophrenia and autism spectrum disorders. Genetic and environmental factors guide the formation and fine-tuning of brain circuitry necessary to receive, organize, and respond to sensory input in order to behave in a meaningful and consistent manner. During certain developmental stages the brain is sensitive to intrinsic and external factors. For example, disturbed expression levels of certain risk genes during critical neurodevelopmental periods may lead to exaggerated brain plasticity processes within the sensory circuits, and sensory stimulation immediately after birth contributes to fine-tuning of these circuits. Here, the neurodevelopmental trajectory of sensory circuit development will be described and related to some example risk gene mutations that are found in neuropsychiatric disorders. Subsequently, the flow of sensory information through these circuits and the relationship to synaptic plasticity will be described. Research focusing on the combined analyses of neural circuit development and functioning are necessary to expand our understanding of sensory processing and behavioral deficits that are relevant across the neuropsychiatric spectrum.
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Affiliation(s)
- Betty E Hornix
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG, Groningen, The Netherlands
| | - Robbert Havekes
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG, Groningen, The Netherlands
| | - Martien J H Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG, Groningen, The Netherlands.
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Iwanaga J, Granger A, Vahedi P, Loukas M, Oskouian RJ, Fries FN, Lotfinia I, Mortazavi MM, Oakes WJ, Tubbs RS. Mapping the Internal Anatomy of the Lateral Brainstem: Anatomical Study with Application to Far Lateral Approaches to Intrinsic Brainstem Tumors. Cureus 2017; 9:e1010. [PMID: 28357160 PMCID: PMC5355003 DOI: 10.7759/cureus.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Intramedullary brainstem tumors present a special challenge to the neurosurgeon. Unfortunately, there is no ideal part of the brainstem to incise for approaches to such pathology. Therefore, the present study was performed to identify what incisions on the lateral brainstem would result in the least amount of damage to eloquent tracts and nuclei. Case illustrations are also discussed. MATERIALS AND METHODS Eight human brainstems were evaluated. Based on dissections and the use of standard atlases of brainstem anatomy, the most important deeper brainstem structures were mapped to the surface of the lateral brainstem. RESULTS With these data, we defined superior acute and inferior obtuse corridors for surgical entrance into the lateral brainstem that would minimize injury to deeper tracts and nuclei, the damage to which would result in significant morbidity. CONCLUSIONS To our knowledge, a superficial map of the lateral brainstem for identifying deeper lying and clinically significant nuclei and tracts has not previously been available. Such data might decrease patient morbidity following biopsy or tumor removal or aspiration of brainstem hemorrhage. Additionally, this information can be coupled with the previous literature on approaches into the fourth ventricular floor for more complex, multidimensional lesions.
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Affiliation(s)
| | - Andre Granger
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | | | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | - Rod J Oskouian
- Neurosurgery, Complex Spine, Swedish Neuroscience Institute
| | - Fabian N Fries
- Saarland University Faculty of Medicine, Saarland University Medical Center
| | | | - Martin M Mortazavi
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, WA
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Wenz H, Al-Zghloul M, Hart E, Kurth S, Groden C, Förster A. Track-Density Imaging of the Human Brainstem for Anatomic Localization of Fiber Tracts and Nerve Nuclei in Vivo: Initial Experience with 3-T Magnetic Resonance Imaging. World Neurosurg 2016; 93:286-92. [DOI: 10.1016/j.wneu.2016.05.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/25/2016] [Accepted: 05/26/2016] [Indexed: 11/15/2022]
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