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Tran VD, Nguyen BT, Van Dong H, Lieber BA, Bista J, Van Vu H, Bui TN, Chu HT, Nguyen PX, Nguyen TA, Ono T, Trieu ST, Nhu SD. Temporal Lobe Surgery for Epilepsy in a Resource-Limited Vietnamese Cohort. World Neurosurg 2023; 178:e559-e565. [PMID: 37532017 DOI: 10.1016/j.wneu.2023.07.119] [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: 07/04/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Epilepsy surgery is traditionally difficult to pursue in resource-limited countries but is nevertheless essential in the treatment of medication-refractory, surgically amenable epilepsy. METHODS With the help of international collaboration, a successful epilepsy program was started in Vietnam. This article comprises a retrospective chart review, combined with prospective longitudinal follow-up of 35 cases of unilateral drug-resistant epilepsy in the temporal lobe who underwent temporal lobectomy, in Viet Duc University Hospital from May 2018 to September 2022. RESULTS The female/male ratio was 0.6:1, and focal seizures with impaired awareness accounted for 97.14% of patients. Of patients with focal awareness seizures, 51.41% were localized and detected by electroencephalography. Postoperatively, 80% of patients were seizure free (Engel I) at 1 year, and the remaining 20% had worthwhile seizure improvement (Engel II). Postoperative temporal lobe pathology was categorized as follows: mesial temporal sclerosis (48.57%), focal cortical dysplasia (25.71%), and low-grade neoplasms (25.71%). Of patients, 17.14% had postoperative complications (5 infections and 1 transient extremity paresis), and there were no deaths. CONCLUSIONS Even in low-resource environments, effective and safe surgical care can be provided for drug-resistant epilepsy caused by temporal lobe disease. This study serves as a model of international collaboration and support for future hospitals in low-resource environments to replicate.
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Affiliation(s)
- Van Dinh Tran
- Vietnam Military Medical University, Hanoi, Vietnam; Neurosurgery Center of Viet Duc Hospital, Hanoi, Vietnam
| | | | - He Van Dong
- Neurosurgery Center of Viet Duc Hospital, Hanoi, Vietnam
| | - Bryan A Lieber
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurosurgery, Dr. Kiran C. Patel College of Allopathic Medicine, Davie, Florida, USA.
| | - Jehan Bista
- The University of Queensland-Ochsner Clinical School, New Orleans, Louisiana, USA
| | - Hoe Van Vu
- Vietnam Military Medical University, Hanoi, Vietnam
| | - Tien Ngoc Bui
- Neurosurgery Center of Viet Duc Hospital, Hanoi, Vietnam
| | - Hung Thanh Chu
- Department of Neurological Surgery, Hanoi Medical University, Hanoi, Vietnam
| | | | | | - Tomonori Ono
- Epilepsy Center, Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | | | - Son Dinh Nhu
- Vietnam Military Medical University, Hanoi, Vietnam
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Stein A, Sody E, Bruns N, Felderhoff-Müser U. Development of an Ultrasound Scoring System to Describe Brain Maturation in Preterm Infants. AJNR Am J Neuroradiol 2023; 44:846-852. [PMID: 37321856 PMCID: PMC10337624 DOI: 10.3174/ajnr.a7909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/22/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND PURPOSE Cerebral maturation in preterm infants predominantly occurs postnatally, necessitating the development of objective bedside markers to monitor this process. This study aimed to develop a straightforward objective Ultrasound Score of Brain Development to assess cortical development in preterm infants. MATERIALS AND METHODS A total of 344 serial ultrasound examinations from 94 preterm infants born at ≤ 32 weeks of gestation were analyzed to identify brain structures suitable for a scoring system. RESULTS Among 11 candidate structures, 3 cerebral landmarks were selected due to their correlation with gestational age: the interopercular opening (P < .001), the height of the insular cortex (P < .001), and the depth of the cingulate sulcus (P < .001). These structures can be easily visualized in a single midcoronal view in the plane through the third ventricle and the foramina of Monro. A score point from 0 to 2 was assigned to each measurement, culminating in a total score ranging from 0 to 6. The Ultrasound Score of Brain Development correlated significantly with gestational age (P < .001). CONCLUSIONS The proposed Ultrasound Score of Brain Development has the potential for application as an objective indicator of brain maturation in correlation with gestational age, circumventing the need to rely on individual growth trajectories and percentiles for each specific structure.
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Affiliation(s)
- A Stein
- From the Department of Pediatrics I, Neonatology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - E Sody
- From the Department of Pediatrics I, Neonatology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - N Bruns
- From the Department of Pediatrics I, Neonatology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - U Felderhoff-Müser
- From the Department of Pediatrics I, Neonatology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
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Fenske SJ, Liu J, Chen H, Diniz MA, Stephens RL, Cornea E, Gilmore JH, Gao W. Sex differences in resting state functional connectivity across the first two years of life. Dev Cogn Neurosci 2023; 60:101235. [PMID: 36966646 PMCID: PMC10066534 DOI: 10.1016/j.dcn.2023.101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/17/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023] Open
Abstract
Sex differences in behavior have been reported from infancy through adulthood, but little is known about sex effects on functional circuitry in early infancy. Moreover, the relationship between early sex effects on the functional architecture of the brain and later behavioral performance remains to be elucidated. In this study, we used resting-state fMRI and a novel heatmap analysis to examine sex differences in functional connectivity with cross-sectional and longitudinal mixed models in a large cohort of infants (n = 319 neonates, 1-, and 2-year-olds). An adult dataset (n = 92) was also included for comparison. We investigated the relationship between sex differences in functional circuitry and later measures of language (collected in 1- and 2-year-olds) as well as indices of anxiety, executive function, and intelligence (collected in 4-year-olds). Brain areas showing the most significant sex differences were age-specific across infancy, with two temporal regions demonstrating consistent differences. Measures of functional connectivity showing sex differences in infancy were significantly associated with subsequent behavioral scores of language, executive function, and intelligence. Our findings provide insights into the effects of sex on dynamic neurodevelopmental trajectories during infancy and lay an important foundation for understanding the mechanisms underlying sex differences in health and disease.
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Mitochondrial Genetics Reinforces Multiple Layers of Interaction in Alzheimer’s Disease. Biomedicines 2022; 10:biomedicines10040880. [PMID: 35453630 PMCID: PMC9028063 DOI: 10.3390/biomedicines10040880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Nuclear DNA remains the main source of genome-wide loci association in neurodegenerative diseases, only partially accounting for the heritability of Alzheimer’s Disease (AD). In this context, mitochondrial DNA (mtDNA) is gaining more attention. Here, we investigated mitochondrial genes and genetic variants that may influence mild cognitive impairment and AD, through an integrative analysis including both differential gene expression and mitochondrial genome-wide epistasis analysis. Our results highlight important layers of interactions involving mitochondrial genetics and suggest specific molecular alterations as potential biomarkers for AD. Abstract Nuclear DNA has been the main source of genome-wide loci association in neurodegenerative diseases, only partially accounting for the heritability of Alzheimer’s Disease (AD). In this context, mitochondrial DNA (mtDNA) is gaining more attention. Here, we investigated mitochondrial genes and genetic variants that may influence mild cognitive impairment and AD, through an integrative analysis including differential gene expression and mitochondrial genome-wide epistasis. We assessed the expression of mitochondrial genes in different brain tissues from two public RNA-Seq databases (GEO and GTEx). Then, we analyzed mtDNA from the ADNI Cohort and investigated epistasis regarding mitochondrial variants and levels of Aβ1−42, TAU, and Phosphorylated TAU (PTAU) from cognitively healthy controls, and both mild cognitive impairment (MCI) and AD cases. We identified multiple differentially expressed mitochondrial genes in the comparisons between cognitively healthy individuals and AD patients. We also found increased protein levels in MCI and AD patients when compared to healthy controls, as well as novel candidate networks of mtDNA epistasis, which included variants in all mitochondrially-encoded oxidative phosphorylation complexes, 12S rRNA and MT-DLOOP. Our results highlight layers of potential interactions involving mitochondrial genetics and suggest specific molecular alterations as potential biomarkers for AD.
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Colloby SJ, Nathan PJ, McKeith IG, Bakker G, O'Brien JT, Taylor JP. Cholinergic muscarinic M 1/M 4 receptor networks in dementia with Lewy bodies. Brain Commun 2020; 2:fcaa098. [PMID: 32954342 PMCID: PMC7475694 DOI: 10.1093/braincomms/fcaa098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/13/2022] Open
Abstract
Cholinergic dysfunction is central in dementia with Lewy bodies, possibly contributing to the cognitive and psychiatric phenotypes of this condition. We investigated baseline muscarinic M1/M4 receptor spatial covariance patterns in dementia with Lewy bodies and their association with changes in cognition and neuropsychiatric symptoms after 12 weeks of treatment with the cholinesterase inhibitor donepezil. Thirty-eight participants (14 cholinesterase inhibitor naive patients, 24 healthy older individuals) underwent 123I-iodo-quinuclidinyl-benzilate (M1/M4 receptor assessment) and 99mTc-exametazime (perfusion) single-photon emission computed tomography scanning. We implemented voxel principal components analysis, producing a series of images representing patterns of inter-correlated voxels across individuals. Linear regression analyses derived specific M1/M4 and perfusion spatial covariance patterns associated with patients. A discreet M1/M4 pattern that distinguished patients from controls (W1,19.7 = 16.7, P = 0.001), showed relative decreased binding in right lateral temporal and insula, as well as relative preserved/increased binding in frontal, precuneus, lingual and cuneal regions, implicating nodes within attention and dorsal visual networks. We then derived from patients an M1/M4 pattern that correlated with a positive change in mini-mental state examination (r = 0.52, P = 0.05), showing relative preserved/increased uptake in prefrontal, temporal pole and anterior cingulate, elements of attention-related networks. We also generated from patients an M1/M4 pattern that correlated with a positive change in neuropsychiatric inventory score (r = 0.77, P = 0.002), revealing relative preserved/increased uptake within a bilateral temporal-precuneal-striatal system. Although in a small sample and therefore tentative, we posit that optimal response of donepezil on cognitive and neuropsychiatric signs in patients with dementia with Lewy bodies were associated with a maintenance of muscarinic M1/M4 receptor expression within attentional/executive and ventral visual network hubs, respectively.
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Affiliation(s)
- Sean J Colloby
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - Pradeep J Nathan
- Experimental Medicine, Neuroscience Therapeutic Area, Sosei Heptares, Steinmetz Building, Granta Park, Cambridge CB21 6DG, UK.,Department of Psychiatry, University of Cambridge, Cambridge CB2 0QC, UK
| | - Ian G McKeith
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - Geor Bakker
- Experimental Medicine, Neuroscience Therapeutic Area, Sosei Heptares, Steinmetz Building, Granta Park, Cambridge CB21 6DG, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0QC, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
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