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Kang Y, Jamison K, Jaywant A, Dams-O’Connor K, Kim N, Karakatsanis NA, Butler T, Schiff ND, Kuceyeski A, Shah SA. Longitudinal alterations in gamma-aminobutyric acid (GABAA) receptor availability over ∼ 1 year following traumatic brain injury. Brain Commun 2022; 4:fcac159. [PMID: 35794871 PMCID: PMC9253887 DOI: 10.1093/braincomms/fcac159] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/24/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Longitudinal alterations of gamma-aminobutyric acid (GABAA) receptor availability following traumatic brain injury have remained uncharacterized and may reflect changes in neuronal structure and function linked to cognitive recovery. We measured GABAA receptor availability using the tracer [11C]flumazenil in nine adults with traumatic brain injury (3–6 months after injury, subacute scan) and in 20 non-brain-injured individuals. A subset of subjects with traumatic brain injury (n = 7) were scanned at a second chronic time-point, 7–13 months after their first scan; controls (n = 9) were scanned for a second time, 5–11 months after the first scan. After accounting for atrophy in subjects with traumatic brain injury, we find broad decreases in GABAA receptor availability predominantly within the frontal lobes, striatum, and posterior-medial thalami; focal reductions were most pronounced in the right insula and anterior cingulate cortex (p < 0.05). Greater relative increase, compared to controls, in global GABAA receptor availability appeared between subacute and chronic scans. At chronic scan (>1 year post-injury), we find increased pallidal receptor availability compared to controls. Conversely, receptor availability remained depressed across the frontal cortices. Longitudinal improvement in executive attention correlated with increases in receptor availability across bilateral fronto-parietal cortical regions and the anterior-lateral aspects of the thalami. The specific observations of persistent bi-frontal lobe reductions and bilateral pallidal elevation are consistent with the anterior forebrain mesocircuit hypothesis for recovery of consciousness following a wide range of brain injuries; our results provide novel correlative data in support of specific cellular mechanisms underlying persistent cognitive deficits. Collectively, these measurements support the use of [11C]flumazenil to track recovery of large-scale network function following brain injuries and measure response to therapeutics.
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Affiliation(s)
- Y Kang
- Department of Mathematics, Howard University , Washington, DC 20059 , USA
| | - K Jamison
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - A Jaywant
- Department of Rehabilitation Medicine, Weill Cornell Medicine , New York, NY 10065 , USA
- Department of Psychiatry, Weill Cornell Medicine , New York, NY 10065 , USA
| | - K Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
| | - N Kim
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N A Karakatsanis
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - T Butler
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
| | - A Kuceyeski
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - S A Shah
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
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Nagai M, Kobayashi Y, Kobatake H, Dote K, Kato M, Oda N, Kunita E, Kagawa E, Yamane A, Osawa A, Shiota H, Takeuchi M, Förster CY. Happy heart syndrome: a case of Takotsubo syndrome with left internal carotid artery occlusion. Clin Auton Res 2020; 30:347-350. [PMID: 32451755 DOI: 10.1007/s10286-020-00696-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/11/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan.
| | - Yusuke Kobayashi
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Hiroshi Kobatake
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Keigo Dote
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Masaya Kato
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Noboru Oda
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Eiji Kunita
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Eisuke Kagawa
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Aya Yamane
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Ayano Osawa
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Haruko Shiota
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Makoto Takeuchi
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Carola Y Förster
- Department of Anaesthesiology and Critical Care, Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany
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Baron JC. Selective neuronal loss progression in chronic carotid or middle cerebral artery obstruction is accentuated by lower follow-up systolic blood pressure. J Neurol Neurosurg Psychiatry 2019; 90:964. [PMID: 31203210 DOI: 10.1136/jnnp-2019-320943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Jean-Claude Baron
- Department of Neurology, Université de Paris, INSERM U1266, Saint Anne Hospital Centre, Paris 75014, France
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Yamauchi H, Kagawa S, Takahashi M, Kusano K, Okuyama C. Selective neuronal damage and blood pressure in atherosclerotic major cerebral artery disease. J Neurol Neurosurg Psychiatry 2019; 90:975-980. [PMID: 31127015 PMCID: PMC6820160 DOI: 10.1136/jnnp-2019-320326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In patients with atherosclerotic major cerebral artery disease, low blood pressure might impair cerebral perfusion, thereby exacerbate the risk of selective neuronal damage. The purpose of this retrospective study was to determine whether low blood pressure at follow-up is associated with increased selective neuronal damage. METHODS We retrospectively analysed data from 76 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease with no ischaemic episodes on a follow-up of 6 months or more. All patients had measurements of the distribution of central benzodiazepine receptors twice using positron emission tomography and 11C-flumazenil. Using three-dimensional stereotactic surface projections, we quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the middle cerebral artery distribution and correlated these changes in the benzodiazepine receptors index with blood pressure values at follow-up examinations. RESULTS The changes in the benzodiazepine receptor index during follow-up (mean 27±21 months) were negatively correlated with systolic blood pressure at follow-up. The relationship between changes in benzodiazepine receptor index and systolic blood pressure was different among patients with and without decreased cerebral blood flow at baseline (interaction, p<0.005). Larger increases in benzodiazepine receptor index (neuronal damage) were observed at lower systolic blood pressure levels in patients with decreased cerebral blood flow than in patients without such decreases. CONCLUSION In patients without ischaemic stroke episodes at follow-up but with decreased cerebral blood flow due to arterial disease, low systolic blood pressure at follow-up may be associated with increased selective neuronal damage.
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Affiliation(s)
- Hiroshi Yamauchi
- Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Shinya Kagawa
- Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Masaaki Takahashi
- Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Kuninori Kusano
- Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Chio Okuyama
- Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
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Oudeman E, Kappelle L, Van den Berg-Vos R, Weinstein H, van den Berg E, Klijn C. Cognitive functioning in patients with carotid artery occlusion; a systematic review. J Neurol Sci 2018; 394:132-137. [DOI: 10.1016/j.jns.2018.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/23/2018] [Accepted: 09/05/2018] [Indexed: 11/17/2022]
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Yamauchi H, Kagawa S, Kishibe Y, Takahashi M, Higashi T. Progressive Cortical Neuronal Damage and Extracranial-Intracranial Bypass Surgery in Patients with Misery Perfusion. AJNR Am J Neuroradiol 2017; 38:935-941. [PMID: 28255031 DOI: 10.3174/ajnr.a5110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/17/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Misery perfusion may cause selective neuronal damage in atherosclerotic ICA or MCA disease. Bypass surgery can improve misery perfusion and may prevent neuronal damage. On the other hand, surgery conveys a risk for neuronal damage. The purpose of this retrospective study was to determine whether progression of cortical neuronal damage in surgically treated patients with misery perfusion is larger than that in surgically treated patients without misery perfusion or medically treated patients with misery perfusion. MATERIALS AND METHODS We evaluated the distribution of benzodiazepine receptors twice by using PET and 11C-labeled flumazenil in 18 surgically treated patients with atherosclerotic ICA or MCA disease (9 with misery perfusion and 9 without) and no perioperative stroke before and after bypass surgery; in 8 medically treated patients with misery perfusion and no intervening ischemic event; and in 7 healthy controls. We quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the MCA distribution and compared changes in the benzodiazepine receptor index among the 3 groups. RESULTS The change in the benzodiazepine receptor index in surgically treated patients with misery perfusion (27.5 ± 15.6) during 7 ± 5 months was significantly larger than that in surgically treated patients without misery perfusion (-5.2 ± 9.4) during 6 ± 4 months (P < .001) and in medically treated patients with misery perfusion (3.2 ± 15.4) during 16 ± 6 months (P < .01). CONCLUSIONS Progression of cortical neuronal damage in surgically treated patients with misery perfusion and no perioperative stroke may occur and may be larger than that in medically treated patients with misery perfusion and no intervening ischemic event.
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Affiliation(s)
- H Yamauchi
- From the Division of PET Imaging (H.Y., S.K., Y.K., M.T., T.H.), Shiga Medical Center Research Institute, Moriyama, Japan
| | - S Kagawa
- From the Division of PET Imaging (H.Y., S.K., Y.K., M.T., T.H.), Shiga Medical Center Research Institute, Moriyama, Japan
| | - Y Kishibe
- From the Division of PET Imaging (H.Y., S.K., Y.K., M.T., T.H.), Shiga Medical Center Research Institute, Moriyama, Japan
| | - M Takahashi
- From the Division of PET Imaging (H.Y., S.K., Y.K., M.T., T.H.), Shiga Medical Center Research Institute, Moriyama, Japan
| | - T Higashi
- From the Division of PET Imaging (H.Y., S.K., Y.K., M.T., T.H.), Shiga Medical Center Research Institute, Moriyama, Japan.,National Institute of Radiological Sciences (T.H.), National Institutes of Quantum and Radiological Science and Technology, Chiba, Japan
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Yamauchi H, Kagawa S, Kishibe Y, Takahashi M, Higashi T. Progressive Cortical Neuronal Damage and Chronic Hemodynamic Impairment in Atherosclerotic Major Cerebral Artery Disease. Stroke 2016; 47:1534-41. [DOI: 10.1161/strokeaha.116.013093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/29/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Cross-sectional studies suggest that chronic hemodynamic impairment may cause selective cortical neuronal damage in patients with atherosclerotic internal carotid artery or middle cerebral artery occlusive disease. The purpose of this longitudinal study was to determine whether the progression of cortical neuronal damage, evaluated as a decrease in central benzodiazepine receptors (BZRs), is associated with hemodynamic impairment at baseline or hemodynamic deterioration during follow-up.
Methods—
We evaluated the distribution of BZRs twice using positron emission tomography and
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C-flumazenil over time in 80 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery occlusive disease that had no ischemic episodes during follow-up. Using 3D stereotactic surface projections, we quantified abnormal decreases in the BZRs in the cerebral cortex within the middle cerebral artery distribution and correlated changes in the BZR index with the mean hemispheric values of hemodynamic parameters obtained from
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O gas positron emission tomography.
Results—
In the hemisphere affected by arterial disease, the BZR index in 40 patients (50%) was increased during follow-up (mean 26±20 months). In multivariable logistic regression analyses, increases in the BZR index were associated with the decreased cerebral blood flow at baseline and an increased oxygen extraction fraction during follow-up. Increases in the oxygen extraction fraction during follow-up were associated with a lack of statin use.
Conclusions—
In patients with atherosclerotic internal carotid artery or middle cerebral artery disease, the progression of cortical neuronal damage was associated with hemodynamic impairment at baseline and hemodynamic deterioration during follow-up. Statin use may be beneficial against hemodynamic deterioration and therefore neuroprotective.
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Affiliation(s)
- Hiroshi Yamauchi
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Shinya Kagawa
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Yoshihiko Kishibe
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Masaaki Takahashi
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
| | - Tatsuya Higashi
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
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8
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Nishino A, Tajima Y, Takuwa H, Masamoto K, Taniguchi J, Wakizaka H, Kokuryo D, Urushihata T, Aoki I, Kanno I, Tomita Y, Suzuki N, Ikoma Y, Ito H. Long-term effects of cerebral hypoperfusion on neural density and function using misery perfusion animal model. Sci Rep 2016; 6:25072. [PMID: 27116932 PMCID: PMC4846861 DOI: 10.1038/srep25072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 03/23/2016] [Indexed: 11/09/2022] Open
Abstract
We investigated the chronic effects of cerebral hypoperfusion on neuronal density and functional hyperemia using our misery perfusion mouse model under unilateral common carotid artery occlusion (UCCAO). Neuronal density evaluated 28 days after UCCAO using [(11)C]flumazenil-PET and histology indicated no neurologic deficit in the hippocampus and neocortex. CBF response to sensory stimulation was assessed using laser-Doppler flowmetry. Percentage changes in CBF response of the ipsilateral hemisphere to UCCAO were 18.4 ± 3.0%, 6.9 ± 2.8%, 6.8 ± 2.3% and 4.9 ± 2.4% before, and 7, 14 and 28 days after UCCAO, respectively. Statistical significance was found at 7, 14 and 28 days after UCCAO (P < 0.01). Contrary to our previous finding (Tajima et al. 2014) showing recovered CBF response to hypercapnia on 28 days after UCCAO using the same model, functional hyperemia was sustained and became worse 28 days after UCCAO.
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Affiliation(s)
- Asuka Nishino
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Yosuke Tajima
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan.,Department of Neurosurgery, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu, Chiba 292-8535, Japan
| | - Hiroyuki Takuwa
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Kazuto Masamoto
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan.,Brain Science Inspired Life Support Research Center, University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan
| | - Junko Taniguchi
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Hidekatsu Wakizaka
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Daisuke Kokuryo
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Takuya Urushihata
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Ichio Aoki
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Iwao Kanno
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Yutaka Tomita
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Norihiro Suzuki
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoko Ikoma
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Hiroshi Ito
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan.,Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
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9
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Han EY, Chun MH, Kim BR, Kim HJ. Functional Improvement After 4-Week Rehabilitation Therapy and Effects of Attention Deficit in Brain Tumor Patients: Comparison With Subacute Stroke Patients. Ann Rehabil Med 2015; 39:560-9. [PMID: 26361592 PMCID: PMC4564703 DOI: 10.5535/arm.2015.39.4.560] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/30/2015] [Indexed: 12/02/2022] Open
Abstract
Objective To confirm functional improvement in brain tumor patients after 4-week conventional rehabilitation therapy, to compare the cognitive impairment of brain tumor patients with subacute stroke patients using computerized neuropsychological testing, and to determine the effects on functional outcomes of daily activity. Methods From April 2008 to December 2012, 55 patients (29 brain tumor patients and 26 subacute stroke patients) were enrolled. All patients were assessed with a computerized neuropsychological test at baseline. Motricity Index, Korean version of Mini Mental Status Examination, and Korean version of Modified Barthel Index scores were assessed at the beginning and end of 4-week rehabilitation. Conventional rehabilitation therapy was applied to both groups for 4 weeks. Results Functional outcomes of all patients in both groups significantly improved after 4-week rehabilitation therapy. In brain tumor patients, the initial Motricity Index, cognitive dysfunction, and visual continuous performance test correction numbers were strong predictors of initial daily activity function (R2=0.778, p<0.01). The final Motricity Index and word-black test were strong predictors of final daily activity function (R2=0.630, p<0.01). In patients with subacute stroke, the initial Motricity index was an independent predictor of initial daily activity function (R2=0.245, p=0.007). The initial daily activity function and color of color word test were strong predictors of final daily activity function (R2=0.745, p<0.01). Conclusion Conventional rehabilitation therapy induced functional improvement in brain tumor patients. Objective evaluation of cognitive function and comprehensive rehabilitation including focused cognitive training should be performed in brain tumor patients for improving their daily activity function.
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Affiliation(s)
- Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bo Ryun Kim
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Ha Jeong Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Terada T, Kakimoto A, Yoshikawa E, Kono S, Bunai T, Hosoi Y, Sakao-Suzuki M, Konishi T, Miyajima H, Ouchi Y. The Possible Link between GABAergic Dysfunction and Cognitive Decline in a Patient with Idiopathic Hypoparathyroidism. Intern Med 2015; 54:2245-50. [PMID: 26328655 DOI: 10.2169/internalmedicine.54.4295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Idiopathic hypoparathyroidism (IHP) is accompanied by cognitive impairment. We report the case of a 70-year-old IHP patient with cognitive disturbance. Brain computed tomography showed bilateral calcification in basal ganglia, thalamus, and cerebellum. Neuropsychological assessment revealed low scores for intelligence, memory, and perseverative errors. Brain positron emission tomography showed a significant reduction in [(18)F]-Fludeoxyglucose (FDG) uptake in bilateral frontal, left temporal and parietal cortices, along with a marked reduction in [(11)C]-flumazenil binding in left frontal, temporal, parietal, and bilateral cerebellum. These findings suggest cognitive impairment in IHP may be ascribed to GABAergic dysfunction, thus leading to, or coexisting with, cerebral hypometabolism.
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Affiliation(s)
- Tatsuhiro Terada
- Department of Biofunctional Imaging, Medical Photonics Research Center, Hamamatsu University School of Medicine, Japan
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Shi CG, Yang YS, Li H, Zhang Y, Wang N, Wang SM, Wang JD, Zhang SC. Tanshinol protects hippocampus and attenuates vascular dementia development. JOURNAL OF ASIAN NATURAL PRODUCTS RESEARCH 2014; 16:667-676. [PMID: 24957473 DOI: 10.1080/10286020.2014.930131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/28/2014] [Indexed: 06/03/2023]
Abstract
Tanshinol (3-(3',4'-dihydroxyphenyl)-(2R)-lactic acid, TSL) is widely used in traditional Chinese medicine for the treatment of cardiovascular and cerebrovascular diseases. Here, we assessed whether TSL protected hippocampus and attenuated vascular dementia (VD) development in rats. The behavioral analysis showed that TSL could decrease the distance and latency time, and increase the swim speed in water maze in rats subjected to VD. TSL remarkably increased acetylcholine level and decreased acetylcholinesterase activity in rats subjected to VD. Likewise, TSL remarkably decreased malondialdehyde and increased superoxide dismutase levels in rats subjected to VD. Furthermore, treatment with TSL reduced the level of dead neurons in dentate gyrus. In addition, TSL upregulated growth-associated protein 43 (GAP43) and vascular endothelial growth factor (VEGF) expression and downregulated phosphorylated Akt (p-AKt) and phosphorylated glycogen synthase kinase (p-GSK3β) expression in hippocampus in rats subjected to VD. These results suggest that TSL may be a potential compound in VD model.
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Affiliation(s)
- Cui-Ge Shi
- a Department of Cell Biology , National Research Institute of Family Planning , Beijing 100081 , China
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Selective neuronal loss in ischemic stroke and cerebrovascular disease. J Cereb Blood Flow Metab 2014; 34:2-18. [PMID: 24192635 PMCID: PMC3887360 DOI: 10.1038/jcbfm.2013.188] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 01/23/2023]
Abstract
As a sequel of brain ischemia, selective neuronal loss (SNL)-as opposed to pannecrosis (i.e. infarction)-is attracting growing interest, particularly because it is now detectable in vivo. In acute stroke, SNL may affect the salvaged penumbra and hamper functional recovery following reperfusion. Rodent occlusion models can generate SNL predominantly in the striatum or cortex, showing that it can affect behavior for weeks despite normal magnetic resonance imaging. In humans, SNL in the salvaged penumbra has been documented in vivo mainly using positron emission tomography and (11)C-flumazenil, a neuronal tracer validated against immunohistochemistry in rodent stroke models. Cortical SNL has also been documented using this approach in chronic carotid disease in association with misery perfusion and behavioral deficits, suggesting that it can result from chronic or unstable hemodynamic compromise. Given these consequences, SNL may constitute a novel therapeutic target. Selective neuronal loss may also develop at sites remote from infarcts, representing secondary 'exofocal' phenomena akin to degeneration, potentially related to poststroke behavioral or mood impairments again amenable to therapy. Further work should aim to better characterize the time course, behavioral consequences-including the impact on neurological recovery and contribution to vascular cognitive impairment-association with possible causal processes such as microglial activation, and preventability of SNL.
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Terada T, Kono S, Konishi T, Miyajima H, Ouchi Y. Altered GABAergic system in the living brain of a patient with spinocerebellar ataxia type 8. J Neurol 2013; 260:3164-6. [PMID: 24162040 DOI: 10.1007/s00415-013-7167-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Tatsuhiro Terada
- Department of Biofunctional Imaging, Medical Photonics Research Centre, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan,
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