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Graham N, Zimmerman K, Heslegrave AJ, Keshavan A, Moro F, Abed-Maillard S, Bernini A, Dunet V, Garbero E, Nattino G, Chieregato A, Fainardi E, Baciu C, Gradisek P, Magnoni S, Oddo M, Bertolini G, Schott JM, Zetterberg H, Sharp D. Alzheimer's disease marker phospho-tau181 is not elevated in the first year after moderate-to-severe TBI. J Neurol Neurosurg Psychiatry 2024; 95:356-359. [PMID: 37833041 PMCID: PMC10958285 DOI: 10.1136/jnnp-2023-331854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is associated with the tauopathies Alzheimer's disease and chronic traumatic encephalopathy. Advanced immunoassays show significant elevations in plasma total tau (t-tau) early post-TBI, but concentrations subsequently normalise rapidly. Tau phosphorylated at serine-181 (p-tau181) is a well-validated Alzheimer's disease marker that could potentially seed progressive neurodegeneration. We tested whether post-traumatic p-tau181 concentrations are elevated and relate to progressive brain atrophy. METHODS Plasma p-tau181 and other post-traumatic biomarkers, including total-tau (t-tau), neurofilament light (NfL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP), were assessed after moderate-to-severe TBI in the BIO-AX-TBI cohort (first sample mean 2.7 days, second sample within 10 days, then 6 weeks, 6 months and 12 months, n=42). Brain atrophy rates were assessed in aligned serial MRI (n=40). Concentrations were compared patients with and without Alzheimer's disease, with healthy controls. RESULTS Plasma p-tau181 concentrations were significantly raised in patients with Alzheimer's disease but not after TBI, where concentrations were non-elevated, and remained stable over one year. P-tau181 after TBI was not predictive of brain atrophy rates in either grey or white matter. In contrast, substantial trauma-associated elevations in t-tau, NfL, GFAP and UCH-L1 were seen, with concentrations of NfL and t-tau predictive of brain atrophy rates. CONCLUSIONS Plasma p-tau181 is not significantly elevated during the first year after moderate-to-severe TBI and levels do not relate to neuroimaging measures of neurodegeneration.
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Affiliation(s)
- Neil Graham
- Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
| | - Karl Zimmerman
- Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
| | | | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Federico Moro
- Laboratory of Acute Brain Injury and Neuroprotection, Department of Acute Brain and Cardiovascular Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Dipartimento di Anestesia e Rianimazione, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Samia Abed-Maillard
- Neuroscience Critical Care Research Group, Department of Intensive Care Medicine, CHUV Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Adriano Bernini
- Department of Clinical Neurosciences, CHUV Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Medical Radiology, CHUV Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elena Garbero
- Laboratory of Clinical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Giovanni Nattino
- Laboratory of Clinical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Arturo Chieregato
- Terapia Intensiva ad indirizzo Neurologico & Neurochirurgico, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Enrico Fainardi
- Department of Experimental and Clinical Sciences, Careggi University Hospital and University of Firenze, Florence, Italy
| | - Camelia Baciu
- Terapia Intensiva ad indirizzo Neurologico & Neurochirurgico, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Primoz Gradisek
- Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Center, Ljubljana, Slovenia
| | - Sandra Magnoni
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, Trento, Italy
| | - Mauro Oddo
- Neuroscience Critical Care Research Group, Department of Intensive Care Medicine, CHUV Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Directorate for Innovation and Clinical Research, CHUV Lausanne University Hospital, Lausanne, Switzerland
| | - Guido Bertolini
- Laboratory of Clinical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Jonathan M Schott
- UK Dementia Research Institute, University College London, London, UK
- Dementia Research Centre and Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Henrik Zetterberg
- UK Dementia Research Institute, University College London, London, UK
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - David Sharp
- Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
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Graham NSN, Blissitt G, Zimmerman K, Friedland D, Dumas ME, Coady E, Heslegrave A, Zetterberg H, Escott-Price V, Schofield S, Fear NT, Boos C, Bull AMJ, Cullinan P, Bennett A, Sharp DJ. ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 - a longitudinal cohort study. BMJ Open 2023; 13:e069243. [PMID: 36944467 PMCID: PMC10032415 DOI: 10.1136/bmjopen-2022-069243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytrauma including TBI characterising the UK campaign in Afghanistan. The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE)-TBI substudy will describe the patterns, associations and long-term outcomes of TBI in the established ADVANCE cohort. METHODS AND ANALYSIS The ADVANCE cohort comprises 579 military personnel exposed to major battlefield trauma requiring medical evacuation, and 566 matched military personnel without major trauma. TBI exposure has been captured at baseline using a standardised interview and registry data, and will be refined at first follow-up visit with the Ohio State Method TBI interview (a National Institute of Neurological Disorders and Stroke TBI common data element). Participants will undergo blood sampling, MRI and detailed neuropsychological assessment longitudinally as part of their follow-up visits every 3-5 years over a 20-year period. Biomarkers of injury, neuroinflammation and degeneration will be quantified in blood, and polygenic risk scores calculated for neurodegeneration. Age-matched healthy volunteers will be recruited as controls for MRI analyses. We will describe TBI exposure across the cohort, and consider any relationship with advanced biomarkers of injury and clinical outcomes including cognitive performance, neuropsychiatric symptom burden and function. The influence of genotype will be assessed. This research will explore the relationship between military head injury exposure and long-term outcomes, providing insights into underlying disease mechanisms and informing prevention interventions. ETHICS AND DISSEMINATION The ADVANCE-TBI substudy has received a favourable opinion from the Ministry of Defence Research Ethics Committee (ref: 2126/MODREC/22). Findings will be disseminated via publications in peer-reviewed journals and presentations at conferences.
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Affiliation(s)
- Neil S N Graham
- Department of Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
| | - Grace Blissitt
- National Heart and Lung Institute, Imperial College London, London, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK
| | - Karl Zimmerman
- Department of Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
| | - Daniel Friedland
- Department of Brain Sciences, Imperial College London, London, UK
| | - Marc-Emmanuel Dumas
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Emma Coady
- National Heart and Lung Institute, Imperial College London, London, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK
| | - Amanda Heslegrave
- Institute of Neurology, UCL Queen Square, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Henrik Zetterberg
- Institute of Neurology, UCL Queen Square, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Valentina Escott-Price
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Susie Schofield
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, King's College London, London, UK
- Academic Department for Military Mental Health, King's College London, London, UK
| | - Christopher Boos
- National Heart and Lung Institute, Imperial College London, London, UK
- Academic Department for Military Mental Health, King's College London, London, UK
| | - Anthony M J Bull
- Centre for Injury Studies, Imperial College London, London, UK
- Department of Bioengineering, Imperial College London, London, UK
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Alexander Bennett
- National Heart and Lung Institute, Imperial College London, London, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK
| | - David J Sharp
- Department of Brain Sciences, Imperial College London, London, UK
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK
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Graham NSN, Zimmerman K, Parker TD, Friedland D, Sylvester R, Sharp DJ. 165 The advanced BRAIN health clinic and study of long-term neurological outcomes in retired elite athletes. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The long-term effects of elite contact sports participation on brain health are poorly understood. This clinic aims to provide expert clinical review of retired players with neurocognitive and neuropsychiatric symptoms and, in an integrated research programme, better understand their neurological outcomes.Former professional rugby players aged 30-55 are eligible, expanding to include footballers and control participants shortly. Assessment includes questionnaires documenting head injury exposure (Ohio State Method), substance use, affective, sleep, post-traumatic and post-concussive symptoms, quality of life and behavioural difficulties, including caregiver collateral. 3T MRI is acquired incorporating volumetric T1w, FLAIR, DTI, SWI and resting state-fMRI. Blood markers of neuronal damage and neurodegeneration are taken including neurofilament light and ptau181. Plasma/serum are stored for further research analyses. Neuropsychological performance is assessed including working memory, processing speed, executive functioning and performance validity testing. Participants undergo neurological review, receiving indi- vidual level multidisciplinary assessment and support. Assessment is repeated longitudinally after two and four years.We will test the relationship of head injury exposure, genotype, biomarkers of injury and neurodegenera- tion, cognitive, neuropsychiatric and functional status. Sub-studies incorporating 7T MRI and tau PET are planned to further clarify disease mechanisms. The work is funded by but performed independently of the Rugby Football Union.
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Parker T, Zimmerman K, Laverse E, Bourke N, Graham N, Hesle-Grave A, Zetterberg H, Kemp S, Morris H, Sharp D. Active elite rugby participation predicts alterations in cortical thickness. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRugby is a collision sport with high rates of head injury. The effect of rugby participation at the elite level on cerebral grey matter structure is unclear.MethodsData from 44 active professional rugby players, including 21 acquired within one week of mild traumatic brain injury, and 47 healthy controls were analysed. Whole-cortex and region of interest analyses investigating the effects of rugby participation, sub-acute mild traumatic brain injury, and biomarkers of traumatic brain injury (fractional anisotropy, plasma neurofilament light and glial fibrillary acidic protein) on cortical thickness were performed. Plasma neurofilament light and glial fibrillary acidic protein concen- trations were measured using Single molecule array technology.ResultsWhole-cortex analysis revealed evidence of lower right hemisphere precentral cortical thickness in non-injured rugby players compared to controls. In region of interest analyses, there was evidence rugby participation predicted lower cortical thickness in the inferior part of the precentral sulcus (right hemisphere). In the same region, there was evidence sub-acute mild traumatic brain injury predicted higher cortical thickness compared to non-injured players, and that plasma glial fibrillary acidic protein was positively associated with cortical thickness in players with sub-acute mild traumatic brain injury. No associations with neurofilament light concentration were found.ConclusionWe present evidence that elite rugby participation predicts alterations in cortical thickness. Larger scale study with prolonged follow-up to understand the clinical implications of these findings is warranted.
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Graham N, Zimmerman K, Moro F, Gradisek P, Magnoni S, Oddo M, Zetterberg H, Bertolini G, Sharp D. Advanced blood and neuroimaging biomarkers of axonal injury after TBI in the prospective multi-centre BIO-AX-TBI study. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundOutcomes after traumatic brain injury (TBI) are variable and frequently poor. Axonal injury is considered a significant determinant of outcome, which may be quantified using novel fluid biomark- ers and advanced MRI.MethodsBIO-AX-TBI is a multi-centre cohort study of acute moderate-severe TBI. Patients underwent clinical and blood biomarker/MRI assessment over one year. Blood levels of neurofilament light (NfL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), glial fibrillary acidic protein (GFAP), total tau and S100B were quantified, with cerebral microdialysis facilitating measures in brain extracellular fluid.Results197 patients were assessed post-TBI. Compared with controls, TBI patients had significant acute elevations in GFAP, S100B, tau and UCH-L1, with NfL peaking subacutely and remaining elevated. NfL in plasma and brain interstitial fluid were highly correlated in the microdialysis subgroup. Diffusion tensor imaging (DTI) showed reduced fractional anisotropy, remaining chronically abnormal post-injury. Early cortical atrophy was predicted by acute plasma tau and chronic white matter atrophy was predicted by NfL. Clinical outcomes were accurately predicted by acute blood biomarker levels and DTI MRI.ConclusionsNeuronal/glial markers in blood provided a reliable readout of TBI severity and predicted clinical outcomes. NfL and DTI MRI were highly sensitive to white matter injury and predicted chronic atrophy.neil.graham@imperial.ac.uk
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Kurtin DL, Violante IR, Zimmerman K, Leech R, Hampshire A, Patel MC, Carmichael DW, Sharp DJ, Li LM. Investigating the interaction between white matter and brain state on tDCS-induced changes in brain network activity. Brain Stimul 2021; 14:1261-1270. [PMID: 34438046 PMCID: PMC8460997 DOI: 10.1016/j.brs.2021.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation whose potential as a cognitive therapy is hindered by our limited understanding of how participant and experimental factors influence its effects. Using functional MRI to study brain networks, we have previously shown in healthy controls that the physiological effects of tDCS are strongly influenced by brain state. We have additionally shown, in both healthy and traumatic brain injury (TBI) populations, that the behavioral effects of tDCS are positively correlated with white matter (WM) structure. Objectives In this study we investigate how these two factors, WM structure and brain state, interact to shape the effect of tDCS on brain network activity. Methods We applied anodal, cathodal and sham tDCS to the right inferior frontal gyrus (rIFG) of healthy (n = 22) and TBI participants (n = 34). We used the Choice Reaction Task (CRT) performance to manipulate brain state during tDCS. We acquired simultaneous fMRI to assess activity of cognitive brain networks and used Fractional Anisotropy (FA) as a measure of WM structure. Results We find that the effects of tDCS on brain network activity in TBI participants are highly dependent on brain state, replicating findings from our previous healthy control study in a separate, patient cohort. We then show that WM structure further modulates the brain-state dependent effects of tDCS on brain network activity. These effects are not unidirectional - in the absence of task with anodal and cathodal tDCS, FA is positively correlated with brain activity in several regions of the default mode network. Conversely, with cathodal tDCS during CRT performance, FA is negatively correlated with brain activity in a salience network region. Conclusions Our results show that experimental and participant factors interact to have unexpected effects on brain network activity, and that these effects are not fully predictable by studying the factors in isolation. We replicated the brain state and polarity dependent effects of tDCS. White matter structure influences tDCS's state-dependent changes in neural activity The parameters of tDCS may operate under a hierarchy of influence.
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Affiliation(s)
- Danielle L Kurtin
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom; Neuromodulation Laboratory, School of Psychology, University of Surrey, Guildford, United Kingdom.
| | - Ines R Violante
- Neuromodulation Laboratory, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Karl Zimmerman
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom
| | - Robert Leech
- Centre for Neuroimaging Science, King's College London, Denmark Hill, London, United Kingdom
| | - Adam Hampshire
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom; Department of Biomedical Imaging, King's College London, 3rd Floor Lambeth Wing, St Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Maneesh C Patel
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom
| | - David W Carmichael
- Department of Biomedical Imaging, King's College London, 3rd Floor Lambeth Wing, St Thomas' Hospital, London SE1 7EH, United Kingdom
| | - David J Sharp
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom; Imperial UK Dementia Research Institute at Imperial Care Research and Technology Centre, United Kingdom
| | - Lucia M Li
- Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom; Imperial UK Dementia Research Institute at Imperial Care Research and Technology Centre, United Kingdom.
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Sinclair NW, Turneaure SJ, Wang Y, Zimmerman K, Gupta YM. The fast multi-frame X-ray diffraction detector at the Dynamic Compression Sector. J Synchrotron Radiat 2021; 28:1216-1228. [PMID: 34212887 DOI: 10.1107/s1600577521003775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 04/07/2021] [Indexed: 06/13/2023]
Abstract
A multi-frame, X-ray diffraction (XRD) detector system has been developed for use in time-resolved XRD measurements during single-event experiments at the Dynamic Compression Sector (DCS) at the Advanced Photon Source (APS). The system is capable of collecting four sequential XRD patterns separated by 153 ns, the period of the APS storage ring in the 24-bunch mode. This capability allows an examination of the temporal evolution of material dynamics in single-event experiments, such as plate impact experiments, explosive detonations, and split-Hopkinson pressure bar experiments. This system is available for all user experiments at the DCS. Here, the system description and measured performance parameters (detective quantum efficiency, spatial and temporal resolution, and dynamic range) are presented along with procedures for synchronization and image post-processing.
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Affiliation(s)
- N W Sinclair
- Dynamic Compression Sector (DCS), Institute for Shock Physics, Washington State University, Argonne, IL 60439, USA
| | - S J Turneaure
- Institute for Shock Physics and Department of Physics, Washington State University, Pullman, Washington, USA
| | - Y Wang
- Dynamic Compression Sector (DCS), Institute for Shock Physics, Washington State University, Argonne, IL 60439, USA
| | - K Zimmerman
- Institute for Shock Physics and Department of Physics, Washington State University, Pullman, Washington, USA
| | - Y M Gupta
- Institute for Shock Physics and Department of Physics, Washington State University, Pullman, Washington, USA
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Jolly AE, Bălăeţ M, Azor A, Friedland D, Sandrone S, Graham NSN, Zimmerman K, Sharp DJ. Detecting axonal injury in individual patients after traumatic brain injury. Brain 2021; 144:92-113. [PMID: 33257929 PMCID: PMC7880666 DOI: 10.1093/brain/awaa372] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 12/04/2022] Open
Abstract
Poor outcomes after traumatic brain injury (TBI) are common yet remain difficult to predict. Diffuse axonal injury is important for outcomes, but its assessment remains limited in the clinical setting. Currently, axonal injury is diagnosed based on clinical presentation, visible damage to the white matter or via surrogate markers of axonal injury such as microbleeds. These do not accurately quantify axonal injury leading to misdiagnosis in a proportion of patients. Diffusion tensor imaging provides a quantitative measure of axonal injury in vivo, with fractional anisotropy often used as a proxy for white matter damage. Diffusion imaging has been widely used in TBI but is not routinely applied clinically. This is in part because robust analysis methods to diagnose axonal injury at the individual level have not yet been developed. Here, we present a pipeline for diffusion imaging analysis designed to accurately assess the presence of axonal injury in large white matter tracts in individuals. Average fractional anisotropy is calculated from tracts selected on the basis of high test-retest reliability, good anatomical coverage and their association to cognitive and clinical impairments after TBI. We test our pipeline for common methodological issues such as the impact of varying control sample sizes, focal lesions and age-related changes to demonstrate high specificity, sensitivity and test-retest reliability. We assess 92 patients with moderate-severe TBI in the chronic phase (≥6 months post-injury), 25 patients in the subacute phase (10 days to 6 weeks post-injury) with 6-month follow-up and a large control cohort (n = 103). Evidence of axonal injury is identified in 52% of chronic and 28% of subacute patients. Those classified with axonal injury had significantly poorer cognitive and functional outcomes than those without, a difference not seen for focal lesions or microbleeds. Almost a third of patients with unremarkable standard MRIs had evidence of axonal injury, whilst 40% of patients with visible microbleeds had no diffusion evidence of axonal injury. More diffusion abnormality was seen with greater time since injury, across individuals at various chronic injury times and within individuals between subacute and 6-month scans. We provide evidence that this pipeline can be used to diagnose axonal injury in individual patients at subacute and chronic time points, and that diffusion MRI provides a sensitive and complementary measure when compared to susceptibility weighted imaging, which measures diffuse vascular injury. Guidelines for the implementation of this pipeline in a clinical setting are discussed.
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Affiliation(s)
- Amy E Jolly
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
| | - Maria Bălăeţ
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Adriana Azor
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Daniel Friedland
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Stefano Sandrone
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Neil S N Graham
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Karl Zimmerman
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - David J Sharp
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
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Graham NSN, Jolly A, Zimmerman K, Bourke NJ, Scott G, Cole JH, Schott JM, Sharp DJ. Diffuse axonal injury predicts neurodegeneration after moderate-severe traumatic brain injury. Brain 2021; 143:3685-3698. [PMID: 33099608 DOI: 10.1093/brain/awaa316] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/16/2020] [Accepted: 08/03/2020] [Indexed: 11/14/2022] Open
Abstract
Traumatic brain injury is associated with elevated rates of neurodegenerative diseases such as Alzheimer's disease and chronic traumatic encephalopathy. In experimental models, diffuse axonal injury triggers post-traumatic neurodegeneration, with axonal damage leading to Wallerian degeneration and toxic proteinopathies of amyloid and hyperphosphorylated tau. However, in humans the link between diffuse axonal injury and subsequent neurodegeneration has yet to be established. Here we test the hypothesis that the severity and location of diffuse axonal injury predicts the degree of progressive post-traumatic neurodegeneration. We investigated longitudinal changes in 55 patients in the chronic phase after moderate-severe traumatic brain injury and 19 healthy control subjects. Fractional anisotropy was calculated from diffusion tensor imaging as a measure of diffuse axonal injury. Jacobian determinant atrophy rates were calculated from serial volumetric T1 scans as a measure of measure post-traumatic neurodegeneration. We explored a range of potential predictors of longitudinal post-traumatic neurodegeneration and compared the variance in brain atrophy that they explained. Patients showed widespread evidence of diffuse axonal injury, with reductions of fractional anisotropy at baseline and follow-up in large parts of the white matter. No significant changes in fractional anisotropy over time were observed. In contrast, abnormally high rates of brain atrophy were seen in both the grey and white matter. The location and extent of diffuse axonal injury predicted the degree of brain atrophy: fractional anisotropy predicted progressive atrophy in both whole-brain and voxelwise analyses. The strongest relationships were seen in central white matter tracts, including the body of the corpus callosum, which are most commonly affected by diffuse axonal injury. Diffuse axonal injury predicted substantially more variability in white matter atrophy than other putative clinical or imaging measures, including baseline brain volume, age, clinical measures of injury severity and microbleeds (>50% for fractional anisotropy versus <5% for other measures). Grey matter atrophy was not predicted by diffuse axonal injury at baseline. In summary, diffusion MRI measures of diffuse axonal injury are a strong predictor of post-traumatic neurodegeneration. This supports a causal link between axonal injury and the progressive neurodegeneration that is commonly seen after moderate/severe traumatic brain injury but has been of uncertain aetiology. The assessment of diffuse axonal injury with diffusion MRI is likely to improve prognostic accuracy and help identify those at greatest neurodegenerative risk for inclusion in clinical treatment trials.
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Affiliation(s)
- Neil S N Graham
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK
| | - Amy Jolly
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK
| | - Karl Zimmerman
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK
| | - Niall J Bourke
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK
| | - Gregory Scott
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK
| | - James H Cole
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.,Centre for Medical Image Computing, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - David J Sharp
- Department of Brain Sciences, Division of Medicine, Imperial College London, London, UK.,UK Dementia Research Institute, Centre for Care, Research and Technology, London, UK.,Centre for Blast Injury Studies, Imperial College London, London, UK
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Abayazid F, Ding K, Zimmerman K, Stigson H, Ghajari M. A New Assessment of Bicycle Helmets: The Brain Injury Mitigation Effects of New Technologies in Oblique Impacts. Ann Biomed Eng 2021; 49:2716-2733. [PMID: 33973128 PMCID: PMC8109224 DOI: 10.1007/s10439-021-02785-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/24/2021] [Indexed: 01/04/2023]
Abstract
New helmet technologies have been developed to improve the mitigation of traumatic brain injury (TBI) in bicycle accidents. However, their effectiveness under oblique impacts, which produce more strains in the brain in comparison with vertical impacts adopted by helmet standards, is still unclear. Here we used a new method to assess the brain injury prevention effects of 27 bicycle helmets in oblique impacts, including helmets fitted with a friction-reducing layer (MIPS), a shearing pad (SPIN), a wavy cellular liner (WaveCel), an airbag helmet (Hövding) and a number of conventional helmets. We tested whether helmets fitted with the new technologies can provide better brain protection than conventional helmets. Each helmeted headform was dropped onto a 45° inclined anvil at 6.3 m/s at three locations, with each impact location producing a dominant head rotation about one anatomical axes of the head. A detailed computational model of TBI was used to determine strain distribution across the brain and in key anatomical regions, the corpus callosum and sulci. Our results show that, in comparison with conventional helmets, the majority of helmets incorporating new technologies significantly reduced peak rotational acceleration and velocity and maximal strain in corpus callosum and sulci. Only one helmet with MIPS significantly increased strain in the corpus collosum. The helmets fitted with MIPS and WaveCel were more effective in reducing strain in impacts producing sagittal rotations and a helmet fitted with SPIN in coronal rotations. The airbag helmet was effective in reducing brain strain in all impacts, however, peak rotational velocity and brain strain heavily depended on the analysis time. These results suggest that incorporating different impact locations in future oblique impact test methods and designing helmet technologies for the mitigation of head rotation in different planes are key to reducing brain injuries in bicycle accidents.
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Affiliation(s)
- Fady Abayazid
- Dyson School of Design Engineering, Imperial College, London, UK.
| | - Ke Ding
- Dyson School of Design Engineering, Imperial College, London, UK
| | - Karl Zimmerman
- Dyson School of Design Engineering, Imperial College, London, UK
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, UK
| | - Helena Stigson
- Folksam Insurance Group, Stockholm, Sweden
- Vehicle Safety Division, Department of Applied Mechanics, Chalmers University of Technology, Gothenburg, Sweden
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Mazdak Ghajari
- Dyson School of Design Engineering, Imperial College, London, UK
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11
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Laverse E, Guo T, Zimmerman K, Foiani MS, Velani B, Morrow P, Adejuwon A, Bamford R, Underwood N, George J, Brooke D, O'Brien K, Cross MJ, Kemp SPT, Heslegrave AJ, Hardy J, Sharp DJ, Zetterberg H, Morris HR. Plasma glial fibrillary acidic protein and neurofilament light chain, but not tau, are biomarkers of sports-related mild traumatic brain injury. Brain Commun 2020; 2:fcaa137. [PMID: 33543129 PMCID: PMC7846133 DOI: 10.1093/braincomms/fcaa137] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 12/17/2022] Open
Abstract
Mild traumatic brain injury is a relatively common event in contact sports and there is increasing interest in the long-term neurocognitive effects. The diagnosis largely relies on symptom reporting and there is a need for objective tools to aid diagnosis and prognosis. There are recent reports that blood biomarkers could potentially help triage patients with suspected injury and normal CT findings. We have measured plasma concentrations of glial and neuronal proteins and explored their potential in the assessment of mild traumatic brain injury in contact sport. We recruited a prospective cohort of active male rugby players, who had pre-season baseline plasma sampling. From this prospective cohort, we recruited 25 players diagnosed with mild traumatic brain injury. We sampled post-match rugby players without head injuries as post-match controls. We measured plasma neurofilament light chain, tau and glial fibrillary acidic protein levels using ultrasensitive single molecule array technology. The data were analysed at the group and individual player level. Plasma glial fibrillary acidic protein concentration was significantly increased 1-h post-injury in mild traumatic brain injury cases compared to the non-injured group (P = 0.017). Pairwise comparison also showed that glial fibrillary acidic protein levels were higher in players after a head injury in comparison to their pre-season levels at both 1-h and 3- to 10-day post-injury time points (P = 0.039 and 0.040, respectively). There was also an increase in neurofilament light chain concentration in brain injury cases compared to the pre-season levels within the same individual at both time points (P = 0.023 and 0.002, respectively). Tau was elevated in both the non-injured control group and the 1-h post-injury group compared to pre-season levels (P = 0.007 and 0.015, respectively). Furthermore, receiver operating characteristic analysis showed that glial fibrillary acidic protein and neurofilament light chain can separate head injury cases from control players. The highest diagnostic power was detected when biomarkers were combined in differentiating 1-h post-match control players from 1-h post-head injury players (area under curve 0.90, 95% confidence interval 0.79–1.00, P < 0.0002). The brain astrocytic marker glial fibrillary acidic protein is elevated in blood 1 h after mild traumatic brain injury and in combination with neurofilament light chain displayed the potential as a reliable biomarker for brain injury evaluation. Plasma total tau is elevated following competitive rugby with and without a head injury, perhaps related to peripheral nerve trauma and therefore total tau does not appear to be suitable as a blood biomarker.
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Affiliation(s)
- Etienne Laverse
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, UK
| | - Tong Guo
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, UK
| | - Karl Zimmerman
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Martha S Foiani
- Department of Neurodegenerative Disease, UK Dementia Research Institute at UCL, UCL Institute of Neurology, University College London, London, UK
| | - Bharat Velani
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, UK
| | | | | | | | | | | | | | | | | | | | - Amanda J Heslegrave
- Department of Neurodegenerative Disease, UK Dementia Research Institute at UCL, UCL Institute of Neurology, University College London, London, UK
| | - John Hardy
- Department of Neurodegenerative Disease, UK Dementia Research Institute at UCL, UCL Institute of Neurology, University College London, London, UK
| | - David J Sharp
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UK Dementia Research Institute at UCL, UCL Institute of Neurology, University College London, London, UK
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, UK
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12
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Chu EY, Vo TD, Chavez MB, Nagasaki A, Mertz EL, Nociti FH, Aitken SF, Kavanagh D, Zimmerman K, Li X, Stabach PR, Braddock DT, Millán JL, Foster BL, Somerman MJ. Genetic and pharmacologic modulation of cementogenesis via pyrophosphate regulators. Bone 2020; 136:115329. [PMID: 32224162 PMCID: PMC7482720 DOI: 10.1016/j.bone.2020.115329] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 11/27/2022]
Abstract
Pyrophosphate (PPi) serves as a potent and physiologically important regulator of mineralization, with systemic and local concentrations determined by several key regulators, including: tissue-nonspecific alkaline phosphatase (ALPL gene; TNAP protein), the progressive ankylosis protein (ANKH; ANK), and ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1; ENPP1). Results to date have indicated important roles for PPi in cementum formation, and we addressed several gaps in knowledge by employing genetically edited mouse models where PPi metabolism was disrupted and pharmacologically modulating PPi in a PPi-deficient mouse model. We demonstrate that acellular cementum growth is inversely proportional to PPi levels, with reduced cementum in Alpl KO (increased PPi levels) mice and excess cementum in Ank KO mice (decreased PPi levels). Moreover, simultaneous ablation of Alpl and Ank results in reestablishment of functional cementum in dKO mice. Additional reduction of PPi by dual deletion of Ank and Enpp1 does not further increase cementogenesis, and PDL space is maintained in part through bone modeling/remodeling by osteoclasts. Our results provide insights into cementum formation and expand our knowledge of how PPi regulates cementum. We also demonstrate for the first time that pharmacologic manipulation of PPi through an ENPP1-Fc fusion protein can regulate cementum growth, supporting therapeutic interventions targeting PPi metabolism.
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Affiliation(s)
- E Y Chu
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA.
| | - T D Vo
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
| | - M B Chavez
- Biosciences Division, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - A Nagasaki
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
| | - E L Mertz
- National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - F H Nociti
- Department of Prosthodontics & Periodontics, State University of Campinas, Piracicaba Dental School, Piracicaba, São Paulo, Brazil
| | - S F Aitken
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
| | - D Kavanagh
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - K Zimmerman
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - X Li
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - P R Stabach
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - D T Braddock
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - J L Millán
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - B L Foster
- Biosciences Division, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - M J Somerman
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
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13
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Murtada SI, Kawamura Y, Caulk AW, Ahmadzadeh H, Mikush N, Zimmerman K, Kavanagh D, Weiss D, Latorre M, Zhuang ZW, Shadel GS, Braddock DT, Humphrey JD. Paradoxical aortic stiffening and subsequent cardiac dysfunction in Hutchinson-Gilford progeria syndrome. J R Soc Interface 2020; 17:20200066. [PMID: 32453981 DOI: 10.1098/rsif.2020.0066] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Hutchinson-Gilford progeria syndrome (HGPS) is an ultra-rare disorder with devastating sequelae resulting in early death, presently thought to stem primarily from cardiovascular events. We analyse novel longitudinal cardiovascular data from a mouse model of HGPS (LmnaG609G/G609G) using allometric scaling, biomechanical phenotyping, and advanced computational modelling and show that late-stage diastolic dysfunction, with preserved systolic function, emerges with an increase in the pulse wave velocity and an associated loss of aortic function, independent of sex. Specifically, there is a dramatic late-stage loss of smooth muscle function and cells and an excessive accumulation of proteoglycans along the aorta, which result in a loss of biomechanical function (contractility and elastic energy storage) and a marked structural stiffening despite a distinctly low intrinsic material stiffness that is consistent with the lack of functional lamin A. Importantly, the vascular function appears to arise normally from the low-stress environment of development, only to succumb progressively to pressure-related effects of the lamin A mutation and become extreme in the peri-morbid period. Because the dramatic life-threatening aortic phenotype manifests during the last third of life there may be a therapeutic window in maturity that could alleviate concerns with therapies administered during early periods of arterial development.
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Affiliation(s)
- S-I Murtada
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Y Kawamura
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - A W Caulk
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - H Ahmadzadeh
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - N Mikush
- Translational Research Imaging Center, Yale School of Medicine, New Haven, CT, USA
| | - K Zimmerman
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - D Kavanagh
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - D Weiss
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - M Latorre
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Z W Zhuang
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - G S Shadel
- Molecular and Cellular Biology, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - D T Braddock
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - J D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.,Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, CT, USA
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14
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Li LM, Violante IR, Zimmerman K, Leech R, Hampshire A, Patel M, Opitz A, McArthur D, Jolly A, Carmichael DW, Sharp DJ. Traumatic axonal injury influences the cognitive effect of non-invasive brain stimulation. Brain 2019; 142:3280-3293. [PMID: 31504237 PMCID: PMC6794939 DOI: 10.1093/brain/awz252] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/06/2019] [Accepted: 06/25/2019] [Indexed: 01/05/2023] Open
Abstract
Non-invasive brain stimulation has been widely investigated as a potential treatment for a range of neurological and psychiatric conditions, including brain injury. However, the behavioural effects of brain stimulation are variable, for reasons that are poorly understood. This is a particular challenge for traumatic brain injury, where patterns of damage and their clinical effects are heterogeneous. Here we test the hypothesis that the response to transcranial direct current stimulation following traumatic brain injury is dependent on white matter damage within the stimulated network. We used a novel simultaneous stimulation-MRI protocol applying anodal, cathodal and sham stimulation to 24 healthy control subjects and 35 patients with moderate/severe traumatic brain injury. Stimulation was applied to the right inferior frontal gyrus/anterior insula node of the salience network, which was targeted because our previous work had shown its importance to executive function. Stimulation was applied during performance of the Stop Signal Task, which assesses response inhibition, a key component of executive function. Structural MRI was used to assess the extent of brain injury, including diffusion MRI assessment of post-traumatic axonal injury. Functional MRI, which was simultaneously acquired to delivery of stimulation, assessed the effects of stimulation on cognitive network function. Anodal stimulation improved response inhibition in control participants, an effect that was not observed in the patient group. The extent of traumatic axonal injury within the salience network strongly influenced the behavioural response to stimulation. Increasing damage to the tract connecting the stimulated right inferior frontal gyrus/anterior insula to the rest of the salience network was associated with reduced beneficial effects of stimulation. In addition, anodal stimulation normalized default mode network activation in patients with poor response inhibition, suggesting that stimulation modulates communication between the networks involved in supporting cognitive control. These results demonstrate an important principle: that white matter structure of the connections within a stimulated brain network influences the behavioural response to stimulation. This suggests that a personalized approach to non-invasive brain stimulation is likely to be necessary, with structural integrity of the targeted brain networks an important criterion for patient selection and an individualized approach to the selection of stimulation parameters.
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Affiliation(s)
- Lucia M Li
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
- UK DRI Centre for Care Research and Technology, Imperial College London, UK
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, UK
| | - Karl Zimmerman
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
| | - Rob Leech
- Centre of Neuroimaging Science, Kings College London, UK
| | - Adam Hampshire
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
- UK DRI Centre for Care Research and Technology, Imperial College London, UK
| | - Maneesh Patel
- Department of Imaging, Charing Cross Hospital, London, UK
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - David McArthur
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Amy Jolly
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
| | | | - David J Sharp
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
- UK DRI Centre for Care Research and Technology, Imperial College London, UK
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15
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, 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Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Li L, Violante I, Zimmerman K, Ross E, Leech R, Hampshire A, Carmichae D, Sharp D. Po267 Exploring the targeted application of TDCS after TBI. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Blériot A, Martin E, Lebranchu P, Zimmerman K, Libeau L, Weber M, Vabres B, Orignac I. Comparison of 12-month anatomic and functional results between Z6 femtosecond laser-assisted and manual trephination in deep anterior lamellar keratoplasty for advanced keratoconus. J Fr Ophtalmol 2017; 40:e193-e200. [PMID: 28601345 DOI: 10.1016/j.jfo.2017.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 04/23/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022]
Abstract
The management of severe keratoconus requires corneal transplantation, for which the gold standard is deep anterior lamellar keratoplasty (DALK), preserving the healthy Descemet's membrane and endothelium. The safety and reproducibility of corneal cuts have been improved by the evolution of femtosecond lasers in refractive surgery, and femtosecond laser in DALK would seem to provide the same advantages over the manual method. In our retrospective study, we compare functional and anatomical results of femtosecond-assisted DALK versus manual trephination DALK in patients with keratoconus in stage 4 of the Krumeich classification. It is a retrospective study including all patients with stage 4 keratoconus who underwent femtosecond laser-assisted DALK between November 2012 and November 2015 in Nantes university medical center. We compared those patients to a group of patients who underwent manual DALK in the same period, paired by age and maximal keratometry. We assessed visual acuity, pachymetry, endothelial cell density (specular microscopy), and keratometry before surgery and at 4, 8 and 12 months of follow-up. Laser settings and intraoperative complications were recorded. Nineteen patients underwent surgery by femtosecond-assisted DALK, 6 women and 12 men with average age 30.2±10.8 years at transplantation. They were paired with a group of 17 patients who underwent manual DALK in order to compare results. Before surgery, mean visual acuity in the femtosecond group was 0.90 logMAR versus 0.89 logMAR in the manual group, showing no statistically significant difference (P=0.96). Both groups were similar in terms of preoperative age, mean keratometry, pachymetry and endothelial cell density. Average visual acuity post-surgery was 0.27; 0.26; and 0.14 logMAR for femtosecond DALK versus 0.27; 0.17 et 0.25 for manual DALK at 4, 8 and 12 months follow-up respectively, showing no statistically significant difference. After surgery, at 4, 8 and 12 months, mean pachymetry was similar in both groups, and average endothelial cell density was 2390 cells/mm2 for femto DALK versus 2531 cells/mm2 for manual DALK at 12 months of follow-up, showing no statistically significant difference (P=0.5726). The rate of Descemet's membrane microperforations during the procedure was low and similar for both groups. Our study allows for a 12-month follow-up, with assessment of visual recovery, anatomic result and endothelial safety in a series of 19 femtosecond laser-assisted DALK with no statistical significant difference versus the manual trephination group. Femtosecond laser allows for increased reproducibility of the DALK procedure without reducing adverse effects during surgery. Femtosecond laser seems to improve the technique of the DALK procedure, and future developments could improve the reproducibility of DALK even further. A medical economics study would be necessary to determine the cost-effectiveness of femtosecond laser-assisted DALK.
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Affiliation(s)
- A Blériot
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - E Martin
- Ophthalmology service, Saint-Nazaire medical center, cité sanitaire Georges-Charpak, 11, boulevard Georges-Charpak, BP 414, 44606 Saint-Nazaire, France
| | - P Lebranchu
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - K Zimmerman
- MEDICARE-HTM, 3, rue Alain-Bombard, 44800 Saint-Herblain, France
| | - L Libeau
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - M Weber
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - B Vabres
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - I Orignac
- Ophthalmology service, Nantes university medical center, 1, place Alexis-Ricordeau, 44000 Nantes, France
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Datta G, Violante IR, Scott G, Zimmerman K, Santos-Ribeiro A, Rabiner EA, Gunn RN, Malik O, Ciccarelli O, Nicholas R, Matthews PM. Translocator positron-emission tomography and magnetic resonance spectroscopic imaging of brain glial cell activation in multiple sclerosis. Mult Scler 2016; 23:1469-1478. [PMID: 27903933 DOI: 10.1177/1352458516681504] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterised by a diffuse inflammatory response mediated by microglia and astrocytes. Brain translocator protein (TSPO) positron-emission tomography (PET) and [myo-inositol] magnetic resonance spectroscopy (MRS) were used together to assess this. OBJECTIVE To explore the in vivo relationships between MRS and PET [11C]PBR28 in MS over a range of brain inflammatory burden. METHODS A total of 23 patients were studied. TSPO PET imaging with [11C]PBR28, single voxel MRS and conventional magnetic resonance imaging (MRI) sequences were undertaken. Disability was assessed by Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC). RESULTS [11C]PBR28 uptake and [ myo-inositol] were not associated. When the whole cohort was stratified by higher [11C]PBR28 inflammatory burden, [ myo-inositol] was positively correlated to [11C]PBR28 uptake (Spearman's ρ = 0.685, p = 0.014). Moderate correlations were found between [11C]PBR28 uptake and both MRS creatine normalised N-acetyl aspartate (NAA) concentration and grey matter volume. MSFC was correlated with grey matter volume (ρ = 0.535, p = 0.009). There were no associations between other imaging or clinical measures. CONCLUSION MRS [ myo-inositol] and PET [11C]PBR28 measure independent inflammatory processes which may be more commonly found together with more severe inflammatory disease. Microglial activation measured by [11C]PBR28 uptake was associated with loss of neuronal integrity and grey matter atrophy.
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Affiliation(s)
- Gourab Datta
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Ines R Violante
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Gregory Scott
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Karl Zimmerman
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Andre Santos-Ribeiro
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Eugenii A Rabiner
- Imanova Ltd, Imperial College London, London, UK/Centre for Neuroimaging Sciences, King's College London, London, UK
| | - Roger N Gunn
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK/manova Ltd, Imperial College London, London, UK
| | - Omar Malik
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Olga Ciccarelli
- Queen Square Multiple Sclerosis Centre, Institute of Neurology, University College London, London, UK
| | - Richard Nicholas
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Paul M Matthews
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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Rinne P, Mace M, Nakornchai T, Zimmerman K, Fayer S, Sharma P, Liardon JL, Burdet E, Bentley P. Democratizing Neurorehabilitation: How Accessible are Low-Cost Mobile-Gaming Technologies for Self-Rehabilitation of Arm Disability in Stroke? PLoS One 2016; 11:e0163413. [PMID: 27706248 PMCID: PMC5051962 DOI: 10.1371/journal.pone.0163413] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/08/2016] [Indexed: 11/19/2022] Open
Abstract
Motor-training software on tablets or smartphones (Apps) offer a low-cost, widely-available solution to supplement arm physiotherapy after stroke. We assessed the proportions of hemiplegic stroke patients who, with their plegic hand, could meaningfully engage with mobile-gaming devices using a range of standard control-methods, as well as by using a novel wireless grip-controller, adapted for neurodisability. We screened all newly-diagnosed hemiplegic stroke patients presenting to a stroke centre over 6 months. Subjects were compared on their ability to control a tablet or smartphone cursor using: finger-swipe, tap, joystick, screen-tilt, and an adapted handgrip. Cursor control was graded as: no movement (0); less than full-range movement (1); full-range movement (2); directed movement (3). In total, we screened 345 patients, of which 87 satisfied recruitment criteria and completed testing. The commonest reason for exclusion was cognitive impairment. Using conventional controls, the proportion of patients able to direct cursor movement was 38–48%; and to move it full-range was 55–67% (controller comparison: p>0.1). By comparison, handgrip enabled directed control in 75%, and full-range movement in 93% (controller comparison: p<0.001). This difference between controllers was most apparent amongst severely-disabled subjects, with 0% achieving directed or full-range control with conventional controls, compared to 58% and 83% achieving these two levels of movement, respectively, with handgrip. In conclusion, hand, or arm, training Apps played on conventional mobile devices are likely to be accessible only to mildly-disabled stroke patients. Technological adaptations such as grip-control can enable more severely affected subjects to engage with self-training software.
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Affiliation(s)
- Paul Rinne
- Division of Brain Sciences, Imperial College, London, United Kingdom
- Dept. of Bioengineering, Human Robotics Group, Imperial College, London, United Kingdom
| | - Michael Mace
- Dept. of Bioengineering, Human Robotics Group, Imperial College, London, United Kingdom
| | - Tagore Nakornchai
- Division of Brain Sciences, Imperial College, London, United Kingdom
| | - Karl Zimmerman
- Division of Brain Sciences, Imperial College, London, United Kingdom
| | - Susannah Fayer
- Division of Brain Sciences, Imperial College, London, United Kingdom
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University, London, United Kingdom
| | - Jean-Luc Liardon
- Division of Brain Sciences, Imperial College, London, United Kingdom
| | - Etienne Burdet
- Dept. of Bioengineering, Human Robotics Group, Imperial College, London, United Kingdom
| | - Paul Bentley
- Division of Brain Sciences, Imperial College, London, United Kingdom
- * E-mail:
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Zimmerman K, Levitis D, Addicott E, Pringle A. Selection of pairings reaching evenly across the data (SPREAD): A simple algorithm to design maximally informative fully crossed mating experiments. Heredity (Edinb) 2015; 116:182-9. [PMID: 26419337 DOI: 10.1038/hdy.2015.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 08/11/2015] [Accepted: 08/13/2015] [Indexed: 11/09/2022] Open
Abstract
We present a novel algorithm for the design of crossing experiments. The algorithm identifies a set of individuals (a 'crossing-set') from a larger pool of potential crossing-sets by maximizing the diversity of traits of interest, for example, maximizing the range of genetic and geographic distances between individuals included in the crossing-set. To calculate diversity, we use the mean nearest neighbor distance of crosses plotted in trait space. We implement our algorithm on a real dataset of Neurospora crassa strains, using the genetic and geographic distances between potential crosses as a two-dimensional trait space. In simulated mating experiments, crossing-sets selected by our algorithm provide better estimates of underlying parameter values than randomly chosen crossing-sets.
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Affiliation(s)
- K Zimmerman
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - D Levitis
- Bates College, Department of Biology, Lewiston, ME, USA
| | - E Addicott
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - A Pringle
- Department of Botany, University of Wisconsin, Madison, WI, USA.,Department of Bacteriology, University of Wisconsin, Madison, WI, USA
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Gugerty L, McIntyre SE, Link D, Zimmerman K, Tolani D, Huang P, Pokorny RA. Effects of intelligent advanced warnings on drivers negotiating the dilemma zone. Hum Factors 2014; 56:1021-1035. [PMID: 25277014 DOI: 10.1177/0018720814525438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE We investigated whether intelligent advanced warnings of the end of green traffic signals help drivers negotiate the dilemma zone (DZ) at signalized intersections and sought to identify behavioral mechanisms for any warning-related benefits. BACKGROUND Prior research suggested that warnings of end of green can increase slowing and stopping frequency given the DZ, but drivers may sometimes respond to warnings by speeding up. METHOD In two simulator studies, we compared six types of roadway or in-vehicle warnings with a no-warning control condition. Using multilevel modeling, we tested mediation models of the behavioral mechanisms underlying the effects of warnings. RESULTS In both studies, warnings led to more stopping at DZ intersections and milder decelerations when stopping compared with no warning. Drivers' predominant response to warnings was anticipatory slowing on approaching the intersection, not speeding up. The increased stopping with warning was mediated by increased slowing. In Study I, anticipatory slowing given warnings generalized to green-light intersections where no warning was given. In Study 2, we found that lane-specific warnings (e.g., LED lights embedded in each lane) sometimes led to fewer unsafe emergency stops than did non-lane-specific roadside warnings. CONCLUSION End-of-green warnings led to safer behavior in the DZ and on the early approach to intersections. The main mechanism for the benefits of warnings was drivers' increased anticipatory slowing on approaching an intersection. Lane-specific warnings may have some benefits over roadside warnings. APPLICATION Applications include performance models of how drivers use end-of-green warnings, control algorithms and warning displays for intelligent intersections, and statistical methodology in human factors research.
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Pancotto T, Rossmeisl J, Zimmerman K, Robertson J, Werre S. Intramedullary Spinal Cord Neoplasia in 53 Dogs (1990-2010): Distribution, Clinicopathologic Characteristics, and Clinical Behavior. J Vet Intern Med 2013; 27:1500-8. [DOI: 10.1111/jvim.12182] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/03/2013] [Accepted: 07/31/2013] [Indexed: 12/01/2022] Open
Affiliation(s)
- T.E. Pancotto
- Department of Small Animal Clinical Sciences; Virginia-Maryland Regional College of Veterinary Medicine; Blacksburg VA
| | - J.H. Rossmeisl
- Department of Small Animal Clinical Sciences; Virginia-Maryland Regional College of Veterinary Medicine; Blacksburg VA
| | - K. Zimmerman
- Department of Biomedical Sciences and Pathobiology ; Virginia-Maryland Regional College of Veterinary Medicine; Blacksburg VA
| | - J.L. Robertson
- Department of Biomedical Sciences and Pathobiology ; Virginia-Maryland Regional College of Veterinary Medicine; Blacksburg VA
| | - S.R. Werre
- Department of Biomedical Sciences and Pathobiology ; Virginia-Maryland Regional College of Veterinary Medicine; Blacksburg VA
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Van de Heyning P, Adunka O, Arauz SL, Atlas M, Baumgartner WD, Brill S, Bruce I, Buchman C, Caversaccio M, Dillon M, Eikelboom R, Eskilsson G, Gavilan J, Godey B, Green K, Gstoettner W, Hagen R, Han D, Iwasaki S, Kameswaran M, Karltorp E, Kleine Punte A, Kompis M, Kuthubutheen J, Kuzovkov V, Lassaletta L, Li Y, Lorens A, Manikoth M, Martin J, Mlynski R, Mueller J, O'Driscoll M, Parnes L, Pillsbury H, Prentiss S, Pulibalathingal S, Raine CH, Rajan G, Rajeswaran R, Riechelmann H, Rivas A, Rivas JA, Senn P, Skarzynski PH, Sprinzl G, Staecker H, Stephan K, Sugarova S, Usami SI, Wolf-Magele A, Yanov Y, Zernotti ME, Zimmerman K, Zorowka P, Skarzynski H. Standards of practice in the field of hearing implants. Cochlear Implants Int 2013; 14 Suppl 2:S1-5. [DOI: 10.1179/1467010013z.00000000093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Gupta YM, Turneaure SJ, Perkins K, Zimmerman K, Arganbright N, Shen G, Chow P. Real-time, high-resolution x-ray diffraction measurements on shocked crystals at a synchrotron facility. Rev Sci Instrum 2012; 83:123905. [PMID: 23278003 DOI: 10.1063/1.4772577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The Advanced Photon Source (APS) at Argonne National Laboratory was used to obtain real-time, high-resolution x-ray diffraction measurements to determine the microscopic response of shock-compressed single crystals. Disk shaped samples were subjected to plane shock wave compression by impacting them with half-inch diameter, flat-faced projectiles. The projectiles were accelerated to velocities ranging between 300 and 1200 m/s using a compact powder gun designed specifically for use at a synchrotron facility. The experiments were designed to keep the sample probed volume under uniaxial strain and constant stress for a duration longer than the 153.4 ns spacing between x-ray bunches. X-rays from a single pulse (<100 ps duration) out of the periodic x-ray pulses emitted by the synchrotron were used for the diffraction measurements. A synchronization and x-ray detection technique was developed to ensure that the measured signal was obtained unambiguously from the desired x-ray pulse incident on the sample while the sample was in a constant uniaxial strain state. The synchronization and x-ray detection techniques described can be used for a variety of x-ray measurements on shock compressed solids and liquids at the APS. Detailed procedures for applying the Bragg-Brentano parafocusing approach to single crystals at the APS are presented. Analytic developments to determine the effects of crystal substructure and non-ideal geometry on the diffraction pattern position and shape are presented. Representative real-time x-ray diffraction data, indicating shock-induced microstructural changes, are presented for a shock-compressed Al(111) sample. The experimental developments presented here provided, in part, the impetus for the Dynamic Compression Sector (DCS) currently under development at the APS. Both the synchronization∕x-ray detection methods and the analysis equations for high-resolution single crystal x-ray diffraction can be used at the DCS.
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Affiliation(s)
- Y M Gupta
- Institute for Shock Physics and the Department of Physics, Washington State University, Pullman, Washington 99164-2816, USA
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Nasir AA, Niyonkuru F, Nottidge TE, Adeleye AO, Ali S, Ameh EA, Bekele A, Bonet I, Derbew M, Ekenze SO, Oluwadare E, Jani PG, Labib M, Mezue WC, Mijumbi C, Zimmerman K, Baird R, Carsen S, Dreyer JS, Fairfull Smith RJ, Ferri-de-Barros F, Friedman J, Gill R, Gray A, Howe K, Bhoj I, Poenaru D, Rosen B, Yusuf AS, Abdur-Rahman LO, Ahmed BA, Panikar D, Abraham MK, Petroze RT, Groen RS, Ntaganda E, Kushner AL, Calland JF, Kyamanywa P, Ekrikpo U, Ifesanya AO, Nnabuko RE, Mazhar SB, Kotisso B, Shiferaw S, Ngonzi J, Dorman K, Byrne N, Satterthwaite L, Pittini R, Tajirian T, Kneebone R, Bello F, Desalegn D, Henok F, Dubrowsk A, Ugwumba FO, Obi UM, Ikem IC, Oginni LM, Howard A, Onyiah E, Iloabachie IC, Ohaegbulam SC, Kaggwa S, Tindimwebwa J, Mabweijano J, Lipnick M, Dubowitz G, Goetz L, Jayaraman S, Kwizera A, Ozgediz D, Matagane J, Bishop T, Guerrero A, Ganey M, Poenaru D, Park S, Simon D, Zirkle LG, Feibel RJ, Hannay JAF, Lane RHS, Cameron BH, Rambaran M, Gibson J, Howard A, Costas A, Meara JG, St-Albin M, Dyer G, Devi PR, Henshaw C, Wright J, Leah J, Spitzer RF, Caloia D, Omenge E, Chemwolo B, Zhou G, July J, Totimeh T, Mahmud R, Bernstein M, Ostrow B, Lowe J, Lawton C, Kozody LL, Coutts P, Nesbeth H, Revoredo A, Kirton R, Sibbald G, Dodge J, Giede C, Jimenez W, Cibulska P, Sinesat S, Bernardini M, McAlpine J, Finlayson S, Miller D, Elkanah O, Itsura P, Elit L. Bethune Round Table 2012: 12th Annual Conference: Filling the GapImpact of international collaboration on surgical services in a Nigerian tertiary centreSurgeons OverSeas Assessment of Surgical Needs (SOSAS) Rwanda: a useful rural health experience for medical studentsPreinternship Nigerian medical graduates lack basic musculoskeletal competencyDecompressive craniectomy: a low-cost surgical technique from a developing countryEfficacy of surgical management with manual vacuum aspiration versus medical management with misoprostol for evacuation of Lrst trimester miscarriages: a randomized trial in PakistanGaps in workforce for surgical care of children in Nigeria: increasing capacity through international partnershipsAnalyses of the gap between surgical resident and faculty surgeons concerning operating theatre teaching: report from Addis Ababa University, EthiopiaIntroduction of structured operative obstetric course at Mbarara Regional Referral Hospital with resultant reduction in maternal mortalityA training cascade for Ethiopian surgical and obstetrical care: an interprofessional, educational, leadership and skills training programUndergraduate surgery clerkship and the choice of surgery as a career: perspective from a developing countryIntramedullary nail versus external Lxation in management of open tibia fractures: experience in a developing countryThe College of Surgeons of East, Central and Southern Africa (COSECSA) Llling the gap; increasing the number of surgeonsClinical officer surgical training in Africa: COST-AfricaSecondary neuronal injuries following cervical spine trauma: audit of 68 consecutive patients admitted to neurosurgical services in Enugu, NigeriaCapacity building and workforce expansion in surgery, anesthesia and perioperative care: the GPAS model in UgandaKnowledge retention surveys: identifying the effectiveness of a road safety education program in Dar es Salaam, TanzaniaA tale of 2 fellowships: a comparative analysis of Canadian and East-African pediatric surgical trainingOutcomes of closed diaphyseal femur fractures treated with the SIGN nailManaging surgical emergencies: delivering a new course for the College of Surgeons of East Central and Southern AfricaAn evaluation of the exam for the University of Guyana Diploma in SurgeryPriority setting for health resource allocation in Brazil: a scoping literature reviewForeign aid effects on orthopedic capacity at the Hospital Saint Nicholas, HaitiReTHINK aid: international maternal health collaborationsEffect of electronic medical record implementation on patient and staff satisfaction, and chart completeness in a resource-limited antenatal clinic in KenyaImplementation of awake craniotomy in the developing world: data from China, Indonesia and AfricaRegionalization of diabetes care In Guyana, South AmericaQuantifying the burden of pediatric surgical disease due to delayed access to careImplementation of oncology surgery in Western Kenya. Can J Surg 2012. [DOI: 10.1503/cjs.016812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kang KP, Lee JE, Lee AS, Jung YJ, Lee S, Park SK, Kim W, Pokrywczynska M, Jundzill A, Krzyzanowska S, Flisinski M, Brymora A, Bodnar M, Deptula A, Marszalek A, Manitius J, Drewa T, Kloskowski T, Grosjean F, Esposito V, Torreggiani M, Esposito C, Zheng F, Vlassara H, Striker G, Michael S, Viswanathan P, Ganesh R, Kimachi M, Nishio S, Nakazawa D, Ishikawa Y, Toyoyama T, Satou A, Nakagaki T, Shibasaki S, Atumi T, Gattone V, Peterson R, Zimmerman K, Mega C, Reis F, Teixeira de Lemos E, Vala H, Fernandes R, Oliveira J, Teixeira F, Reis F, Niculae A, Niculae A, Checherita IA, Ciocalteu A, Hamano Y, Udagawa Y, Ueda Y, Yokosuka O, Ogawa M, Satoh M, Kidokoro K, Nagasu H, Nishi Y, Ihoriya C, Kadoya H, Yada T, Channon KM, Sasaki T, Kashihara N, Nyengaard JR, Razga Z, Hartono S, Knudsen B, Grande J, Watanabe M, Watanabe M, Ito K, Abe Y, Ogahara S, Nakashima H, Sato T, Saito T, Shin YT, Choi DE, Na KR, Chang YK, Kim SS, Lee KW, Mace C, Chugh S, Clement L, Tomochika M, Seiji H, Toshio M, Tetsuya K, Takao K, Jaen JC, Sullivan TJ, Miao Z, Zhao N, Berahovich R, Krasinski A, Powers JP, Ertl L, Schall TJ, Han SY, Sun HK, Han KH, Kim HS, Ahn SH, Kokeny G, Gasparics A, Fang L, Rosivall L, Sebe A, Banki NF, Fekete A, Wagner L, Ver A, Degrell P, Prokai A, George R, Szabo A, Baylis C, Vannay A, Tulassay T, Chollet C, Hus-Citharel A, Caron N, Bouby N, Silva K, Rampaso R, Luiz R, De Angelis K, Mostarda CT, Abreu N, Irigoyen MC, Schor N, Rampaso R, Luiz R, Silva K, Montemor J, Higa EMS, Schor N, Nagasu H, Satoh M, Kidokoro K, Kashihara N, Nakayama Y, Fukami K, Obara N, Ando R, Kaida Y, Ueda S, Yamagishi SI, Okuda S, Qin Q, Wang Z, Niu J, Xu W, Qiao Z, Qi W, Gu Y, Zitman-Gal T, Golan E, Green J, Pasmanik-Chor M, Oron-Karni V, Bernheim J, Benchetrit S, Tang RN, Tang RN, Wu M, Gao M, Liu H, Zhang XL, Liu BC. Diabetes - Experimental. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chan E, Fucini R, Zimmerman K, Bui M, Hogan J, Jackson M, Taverna P, Howlett A, Flanagan M. 502 POSTER SNS-314, a selective Aurora kinase inhibitor with potent, pre-clinical antitumour activity, shows broad therapeutic potential in combination with standard chemotherapeutics and synergy with microtubule targeted agents. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70441-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Barber DS, Hancock SK, McNally AM, Hinckley J, Binder E, Zimmerman K, Ehrich MF, Jortner BS. Neurological effects of acute uranium exposure with and without stress. Neurotoxicology 2007; 28:1110-9. [PMID: 17669499 DOI: 10.1016/j.neuro.2007.05.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Revised: 05/22/2007] [Accepted: 05/24/2007] [Indexed: 10/23/2022]
Abstract
Circulating uranium rapidly enters the brain and may cause adverse effects on the nervous system that are potentially modulated by stress. In this study, the neurological effects of a single intramuscular injection of 0, 0.1, 0.3, or 1 mg uranium/kg (as uranyl acetate, UA) in rats were examined in the presence and absence of stress. Treatment with UA produced time and dose-dependent increases in serum and regional brain uranium levels. While serum levels returned to control levels by day 30, brain levels remained elevated. Application of stress did not affect the distribution or retention of uranium. Exposure to 1 mg U/kg significantly decreased ambulatory activity, weight gain, forelimb grip strength and transiently impaired working memory. Effects on grip strength and memory were prevented by application of stress prior to uranium exposure. Striatal dopamine content was reduced by 30% 3 days after treatment with 1mg/kg (59+/-6 nmol/mg tissue versus 41+/-5 nmol/mg tissue), but levels returned to control 7 days after uranium exposure. The effect on dopamine was ameliorated by prior application of stress. Exposure to UA did not alter 3,4 dihydroxyphenylacetic acid (DOPAC) levels or numbers of D2 receptors in the striatum. No effect of uranium or stress was observed on levels of GABA, serotonin, norepinephrine, or glutathione (GSH) in the striatum, hippocampus, cerebellum, or cortex. These results indicate that single intramuscular exposures to uranium produce sustained elevation of brain uranium levels and at doses above 0.3 mg/kg can have adverse neurological effects. Application of stress prior to uranium administration modulates neurological effects, but the mechanism is not due to effects on uranium distribution. Uranium exposure also produced renal toxicity which must be considered to accurately assess the effects of uranium on neurological function.
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Affiliation(s)
- D S Barber
- Center for Environmental and Human Toxicology, University of Florida, Gainesville, FL 32611, USA.
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Affiliation(s)
- R H H Tan
- Department of Large Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Duckpond Drive, Phase II, Blacksburg, VA, 24061, USA.
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Johnsen G, Zimmerman K, Lindstedt BA, Vardund T, Herikstad H, Kapperud G. Intestinal carriage of Campylobacter jejuni and Campylobacter coli among cattle from south-western Norway and comparative genotyping of bovine and human isolates by amplified-fragment length polymorphism. Acta Vet Scand 2006; 48:4. [PMID: 16987400 PMCID: PMC1553460 DOI: 10.1186/1751-0147-48-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Accepted: 06/06/2006] [Indexed: 11/30/2022] Open
Abstract
In a survey conducted in 1999-2001, the carriage of thermotolerant Campylobacters in cattle was investigated, and the genetic diversity of C. jejuni within one herd was examined and compared with human isolates. C. jejuni, C. coli and other thermotolerant Campylobacter spp. were isolated from intestinal contents from 26%, 3% and 2% of 804 cattle, respectively. The carriage rate was higher in calves (46%) than in adults (29%). Twenty-nine C. jejuni isolates from one herd and 31 human isolates from the study area were genotyped with amplified-fragment length polymorphism (AFLP). Eighty-three % of the bovine isolates fell into three distinct clusters with 95-100% similarity, persistent in the herd for 5-10 months. Among human isolates, 58% showed >90% similarity with bovine isolates. The results show that cattle are a significant and stable reservoir for C. jejuni in the study area. Transmission between individuals within the herd may be sufficient to maintain a steady C. jejuni population independent of environmental influx. The results of this study have provided new information on C. jejuni and C. coli transmission, and also on the carriage in cattle, genotypes stability and similarity between bovine and human isolates.
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Affiliation(s)
- G Johnsen
- National Veterinary Institute, Oslo, Norway
- The Norwegian Food Control Authority, Sandnes, Norway
| | - K Zimmerman
- The Norwegian Food Control Authority, Sandnes, Norway
| | | | - T Vardund
- Norwegian Institute of Public Health, Oslo, Norway
| | - H Herikstad
- The Norwegian Food Control Authority, Sandnes, Norway
| | - G Kapperud
- Norwegian Institute of Public Health, Oslo, Norway
- The Norwegian School of Veterinary Science, Oslo, Norway
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Mentel R, Ilgert U, Wegner U, Zimmerman K, Bruns R, Gürtler L. Molecular and clinical characteristics of respiratory syncytial virus infections in hospitalized children. Med Microbiol Immunol 2004; 194:67-71. [PMID: 14722763 DOI: 10.1007/s00430-003-0215-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this study was to determine the importance of respiratory syncytial virus (RSV) for hospitalization in the north east of Germany and to obtain molecular epidemiological data of the circulating strains. Using a rapid and sensitive reverse transcriptase-PCR, it was found that a quarter of pediatric respiratory disease admissions were due to RSV. Infections caused by RSV in hospitalized patients were determined over the whole year. Both RSV groups A and B were identified with a predominance of RSV A (86%) over the entire period. The analysis of the deduced amino acid sequences by direct sequencing showed that very similar RSV strains are circulating in the community.
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Affiliation(s)
- R Mentel
- Friedrich Loeffler Institute of Medical Microbiology, Greifswald, Germany.
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McKelvey D. R., Kraig RP, Zimmerman K, Ault A, Perfetti R. Solvent participation in the restriction of rotation about single bonds. II. J Org Chem 2002. [DOI: 10.1021/jo00960a037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Francis J, Weiss RM, Wei SG, Johnson AK, Beltz TG, Zimmerman K, Felder RB. Central mineralocorticoid receptor blockade improves volume regulation and reduces sympathetic drive in heart failure. Am J Physiol Heart Circ Physiol 2001; 281:H2241-51. [PMID: 11668089 DOI: 10.1152/ajpheart.2001.281.5.h2241] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The mineralocorticoid (MC) receptor antagonist spironolactone (SL) improves morbidity and mortality in patients with congestive heart failure (CHF). We tested the hypothesis that the central nervous system actions of SL contribute to its beneficial effects. SL (100 ng/h for 28 days) or ethanol vehicle (VEH) was administered intracerebroventricularly or intraperitoneally to rats with CHF induced by coronary artery ligation (CL) and to SHAM-operated controls. The intracerebroventricular SL treatment prevented the increase in sodium appetite and the decreases in sodium and water excretion observed within a week of CL in VEH-treated CHF rats. Intraperitoneal SL also improved volume regulation in the CHF rats, but only after 3 wk of treatment. Four weeks of SL treatment, either intracerebroventricularly or intraperitoneally, ameliorated both the increase in sympathetic drive and the impaired baroreflex function observed in VEH-treated CHF rats. These findings suggest that activation of MC receptors in the central nervous system plays a critical role in the altered volume regulation and augmented sympathetic drive that characterize clinical heart failure.
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Affiliation(s)
- J Francis
- Research Service, Department of Veterans Affairs Medical Center, University of Iowa, Iowa City, Iowa 52242, USA
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Blake KE, Dalbow MH, Concannon JP, Hodgson SE, Brodmerkel GJ, Panahandeh AH, Zimmerman K, Headings JJ. Clinical significance of the preoperative plasma carcinoembryonic antigen (CEA) level in patients with carcinoma of the large bowel. Dis Colon Rectum 2001; 25:24-32. [PMID: 7056138 DOI: 10.1007/bf02553544] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Preoperative levels of perchloric acid extractable plasma CEA were measured in 911 patients with complaints of the digestive system. A final diagnosis of benign disease was made for 579 patients; 332 patients were found to have cancer. Data for the preoperative CEA values were examined for clinical significance as an aide to diagnosis, preoperative disease staging, and prognosis. The results of our analysis support the conclusions of many investigators that the CEA assay is not a clinically useful diagnostic test, but it shows limited value in preoperative staging and a somewhat stronger correlation with prognosis.
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McKeon E, Roit SM, Zimmerman K. Election aftermath. How will the 2000 vote affect health care? Am J Nurs 2001; 101:24. [PMID: 11211684 DOI: 10.1097/00000446-200101000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The development of the vertebrate nervous system depends upon striking a balance between differentiating neurons and neural progenitors in the early embryo. Our findings suggest that the homeodomain-containing gene Xdbx regulates this balance by maintaining neural progenitor populations within specific regions of the neuroectoderm. In posterior regions of the Xenopus embryo, Xdbx is expressed in a bilaterally symmetric stripe that lies at the middle of the mediolateral axis of the neural plate. This stripe of Xdbx expression overlaps the expression domain of the proneural basic/helix-loop-helix-containing gene, Xash3, and is juxtaposed to the expression domains of Xenopus Neurogenin related 1 and N-tubulin, markers of early neurogenesis in the embryo. Xdbx overexpression inhibits neuronal differentiation in the embryo and when co-injected with Xash3, Xdbx inhibits the ability of Xash3 to induce ectopic neurogenesis. One role of Xdbx during normal development may therefore be to restrict spatially neuronal differentiation within the neural plate, possibly by altering the neuronal differentiation function of Xash3.
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Affiliation(s)
- A A Gershon
- Department of Developmental Neurobiology, The Rockefeller University, New York, NY 10021, USA
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Hill JA, Karimi M, Kutschke W, Davisson RL, Zimmerman K, Wang Z, Kerber RE, Weiss RM. Cardiac hypertrophy is not a required compensatory response to short-term pressure overload. Circulation 2000; 101:2863-9. [PMID: 10859294 DOI: 10.1161/01.cir.101.24.2863] [Citation(s) in RCA: 221] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Cardiac hypertrophy is considered a necessary compensatory response to sustained elevations of left ventricular (LV) wall stress. METHODS AND RESULTS To test this, we inhibited calcineurin with cyclosporine (CsA) in the setting of surgically induced pressure overload in mice and examined in vivo parameters of ventricular volume and function using echocardiography. Normalized heart mass increased 45% by 5 weeks after thoracic aortic banding (TAB; heart weight/body weight, 8.3+/-0.9 mg/g [mean+/-SEM] versus 5. 7+/-0.1 mg/g unbanded, P<0.05). Similar increases were documented in the cell-surface area of isolated LV myocytes. In mice subjected to TAB+CsA treatment, we observed complete inhibition of hypertrophy (heart weight/body weight, 5.2+/-0.3 mg/g at 5 weeks) and myocyte surface area (endocardial and epicardial fractions). The mice tolerated abolition of hypertrophy with no signs of cardiovascular compromise, and 5-week mortality was not different from that of banded mice injected with vehicle (TAB+Veh). Despite abolition of hypertrophy by CsA (LV mass by echo, 83+/-5 mg versus 83+/-2 mg unbanded), chamber size (end-diastolic volume, 33+/-6 microL versus 37+/-1 microL unbanded), and systolic ejection performance (ejection fraction, 97+/-2% versus 97+/-1% unbanded) were normal. LV mass differed significantly in TAB+Veh animals (103+/-5 mg, P<0.05), but chamber volume (end-diastolic volume, 44+/-6 microL), ejection fraction (92+/-2%), and transstenotic pressure gradients (70+/-14 mm Hg in TAB+Veh versus 77+/-11 mm Hg in TAB+CsA) were not different. CONCLUSIONS In this experimental setting, calcineurin blockade with CsA prevented LV hypertrophy due to pressure overload. TAB mice treated with CsA maintain normal LV size and systolic function.
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Affiliation(s)
- J A Hill
- Division of Cardiovascular Diseases, Department of Internal Medicine, Department of Veterans Affairs, University of Iowa College of Medicine, Iowa City 52242-1081, USA.
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Pozza MF, Zimmerman K, Bischoff S, Lingenhöhl K. Electrophysiological characterization of CGP68730A a N-methyl-D-aspartate antagonist acting at the strychnine-insensitive glycine site. Prog Neuropsychopharmacol Biol Psychiatry 2000; 24:647-70. [PMID: 10958157 DOI: 10.1016/s0278-5846(00)00099-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
1. Electrophysiological experiments were performed in vitro and in vivo. Voltage clamp recordings were done in Xenopus oocytes. Extracellular recordings were done in vitro in the neocortical slice and in the CA1 region of the hippocampal slice and in vivo in the CA1 region of the hippocampus of the anaesthetized rat. 2. In oocytes expressing either the human NMDAR1A/2A or 1A/2B subunit combinations, CGP68730A [sodium (-)-9-bromo-2,3,6,7-tetrahydro-5,6-dioxo-5H-pyrazino[1,2,3-de]-1,4-benzo thiazine-3-acetic acid] antagonized L-glutamate / glycine induced currents with calculated IC50s of 20.5 and 81.6 nM, respectively. 3. In vitro, CGP68730A was tested on NMDA induced depolarizations in the neocortical slice preparation and on epileptiform activity in hippocampal slices bathed in Mg2+-free-medium, which is known to be NMDA mediated. In both in vitro models CGP68730A exhibited antagonistic effects on the NMDA receptor mediated responses. 4. In vivo CGP68730A was tested on NMDA induced excitations in the CA1 region. CGP68730A abolished NMDA induced excitations when applied microiontophoretically. However, only weak effects on NMDA induced excitation were observed after systemic administration at 100 mg/kg i.v.. These results indicate that CGP68730A has poor central nervous system bioavailability. 5. In oocytes, an increase in the glycine concentration from the EC80 to the EC95.99 shifted the inhibition curves for CGP68730A to the right. Furthermore, in neocortical slices and in anaesthetized rats CGP68730A inhibited NMDA mediated depolarizations, and this effect could be reversed by the addition of the glycine mimetic D-serine. This indicates that these effects of CGP68730A are mediated by an action on the strychnine-insensitive glycine site. 6. Selectivity tests in oocytes and in the neocortical slice preparation, using NMDA, kainate and AMPA showed that CGP68730A was selective in antagonizing NMDA receptor mediated responses. In oocytes, the compound was about 1000 times less potent on the rat GluR3 and the human GluR6 receptors than on the human NMDAR1A/2A subunit combination. In the neocortical slice preparationCGP68730A had no effects on AMPA or kainate induced depolarizations at concentrations of 3 and 10 microM. At 30 microM CGP68730A reduced the effects of each of the three agonists tested. 7. Thus, CGP68730A seems to be a selective antagonist at the strychnine-insensitive glycine coagonist site of the NMDA receptor. However, the compound showed no obvious central NMDA antagonistic effects following intravenous application.
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Affiliation(s)
- M F Pozza
- Novartis Pharma AG, NS Research, Neuromodulation, Basel, Switzerland.
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Abstract
PURPOSE The purpose of this study was to evaluate the effect of aging on motion detection and perception. METHODS Forty-six subjects, ages 19-92 years, were asked to view a motion stimulus. Infrared oculography was used to objectively evaluate motion detection by documenting the presence of optokinetic nystagmus as the subjects viewed the stimulus. Subjective responses to motion perception were recorded using a computer joystick. RESULTS Optokinetic nystagmus was clearly detectable in all 46 subjects. Motion detection and perception thresholds showed age-related deterioration. No relationship was found to gender or age-gender interaction. CONCLUSION The results indicate motion detection and perception thresholds deteriorate with age. This may reflect a susceptibility to age-related degeneration in specific cortical areas responsible for motion perception as well as neurodegeneration in the retinogeniculate pathway.
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Affiliation(s)
- D B Tran
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
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Baschung B, Samirant M, Zimmerman K, Steinbach C, Mura D, Louati A. Behaviour of a Working Fluid in an Electrothermal Launcher Chamber. Propellants, Explosives, Pyrotechnics 1998. [DOI: 10.1002/(sici)1521-4087(199802)23:1<17::aid-prep17>3.0.co;2-h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kim P, Helms AW, Johnson JE, Zimmerman K. XATH-1, a vertebrate homolog of Drosophila atonal, induces a neuronal differentiation within ectodermal progenitors. Dev Biol 1997; 187:1-12. [PMID: 9224669 DOI: 10.1006/dbio.1997.8572] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
XATH-1, a basic/helix-loop-helix transcription factor and a homolog of Drosophila atonal and mammalian MATH-1, is expressed specifically in the dorsal hindbrain during Xenopus neural development. In order to investigate the role of XATH-1 in the neuronal differentiation process, we have examined the effects of XATH-1 overexpression during Xenopus development. XATH-1 induces the expression of neuronal differentiation markers, such as N-tubulin, within the neural plate as well as within nonneural ectodermal progenitor populations, resulting in the appearance of process-bearing neurons within the epidermis. The related basic/helix-loop-helix genes neurogenin-related-1 and neuroD are not induced in response to XATH-1 overexpression within the embryo, suggesting that XATH-1 may activate an alternate pathway of neuronal differentiation. In further contrast to neurogenin-related-1 and neuroD, high-level expression of general neural markers expressed earlier in development, such as N-CAM, is not induced by XATH-1 overexpression. Competent ectodermal progenitors therefore respond to ectopic XATH-1 expression by initiating a distinct program of neuronal differentiation.
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Affiliation(s)
- P Kim
- Department of Developmental Neurobiology, The Rockefeller University, New York, New York 10021, USA
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Yokoyama K, Zimmerman K, Scholten J, Gelb MH. Differential prenyl pyrophosphate binding to mammalian protein geranylgeranyltransferase-I and protein farnesyltransferase and its consequence on the specificity of protein prenylation. J Biol Chem 1997; 272:3944-52. [PMID: 9020098 DOI: 10.1074/jbc.272.7.3944] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Protein geranylgeranyltransferase-I (PGGT-I) and protein farnesyltransferase (PFT) attach geranylgeranyl and farnesyl groups, respectively, to the C termini of eukaryotic cell proteins. In vitro, PGGT-I and PFT can transfer both geranylgeranyl and farnesyl groups from geranylgeranyl pyrophosphate (GGPP) and farnesyl pyrophosphate (FPP) to their protein or peptide prenyl acceptor substrates. In the present study it is shown that PGGT-I binds GGPP 330-fold tighter than FPP and that PFT binds FPP 15-fold tighter than GGPP. Therefore, in vivo, where both GGPP and FPP compete for the binding to prenyltransferases, PGGT-I and PFT will likely be bound predominantly to GGPP and FPP, respectively. Previous studies have shown that K-Ras4B and the Ras-related GTPase TC21 are substrates for both PGGT-I and PFT in vitro. It is shown that TC21 can compete with the C-terminal peptide of the gamma subunit of heterotrimeric G proteins and with the C-terminal peptide of lamin B for geranylgeranylation by PGGT-I and for farnesylation by PFT, respectively. K-Ras4B competes in both cases but is almost exclusively farnesylated by PFT in the presence of the lamin B peptide competitor. Rapid and single turnover kinetic studies indicate that the rate constant for the PGGT-I-catalyzed geranylgeranyl transfer step of the reaction cycle is 14-fold larger than the steady-state turnover number, which indicates that the rate of the overall reaction is limited by a step subsequent to prenyl transfer such as release of products from the enzyme. PGGT-I-catalyzed farnesylation is 37-fold slower than geranylgeranylation and is limited by the farnesyl transfer step. These results together with earlier studies provide a paradigm for the substrate specificity of PGGT-I and PFT and provide information that is critical for the design of prenyltransferase inhibitors as anti-cancer agents.
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Affiliation(s)
- K Yokoyama
- Departments of Chemistry and Biochemistry, University of Washington, Seattle, Washington 98195-1700, USA
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Abstract
The conservation of transcriptional regulatory mechanisms across species, combined with the restricted expression of these molecules in time and space within the embryo, has offered new insights into CNS cell specification. Studies examining transcriptional control in the generation of specific cell classes within the cerebellar cortex have been particularly elucidative.
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Affiliation(s)
- M E Hatten
- Laboratory of Developmental Neurobiology, The Rockefeller University, 1230 York Avenue, New York, New York 10021-6399, USA.
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WuDunn D, Zimmerman K, Sadun AA, Feldon SE. Comparison of visual function in fellow eyes after bilateral nonarteritic anterior ischemic optic neuropathy. Ophthalmology 1997; 104:104-11. [PMID: 9022112 DOI: 10.1016/s0161-6420(97)30354-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Although previous studies have examined the risk of bilaterality of nonarteritic ischemic optic neuropathy (NAION), none have compared extensively the extent of visual loss between fellow eyes. The authors examined cases of bilateral NAION to determine the extent of vision loss in the second eye compared with that in the first eye. METHODS Thirty-one cases of bilateral NAION were reviewed. Variables included age, gender, and the presence of comorbid disease. Visual function was assessed by Snellen visual acuity, color vision, and pattern and mean deviation of the visual fields. RESULTS No correlation was detected between the extent or pattern of visual loss in fellow eyes. No significant difference in visual function existed between first and second eyes for the patients overall. Patients who retained better visual function in the second eye were significantly older than those who retained better visual function in the first eye (visual acuity, P = 0.0005; color vision, P = 0.07; mean deviation, P = 0.02). In patients older than 50 years of age (25 of 31 cases), the second eye had significantly better visual acuity (P = 0.04) and less Humphrey visual field mean deviation (P = 0.04) than the first eye. CONCLUSION Visual function in the second eye correlated poorly with that of the first eye. Older patients with bilateral NAION retained better visual function in the second eye than in the first eye. For younger patients, the extent of visual loss in the second eye could not be predicted based on the visual loss in the first eye.
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Affiliation(s)
- D WuDunn
- Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA
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Ouyang A, Zimmerman K, Wong KL, Sharp D, Reynolds JC. Effect of celiac ganglionectomy on tachykinin innervation, receptor distribution and intestinal responses in the rat. J Auton Nerv Syst 1996; 61:292-300. [PMID: 8988488 DOI: 10.1016/s0165-1838(96)00099-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Substance P (SP) is an important neurotransmitter in the control of intestinal motility and is found in both the enteric and sympathetic nervous systems. This study examined the effect of celiac ganglionectomy on (1) mechanical properties of the circular muscles of the duodenum, ileum and proximal colon, (2) circular muscle responses to SP and neurokinin A. (3) distribution of substance P-like immunoreactive nerves, and (4) the distribution of neurokinin 1 and neurokinin 2 receptors. Celiac ganglionectomy resulted in an effective sympathectomy as evidenced by a marked decrease in norepinephrine content and tyrosine hydroxylase staining in the duodenum, ileum and proximal colon. The in vitro length/tension characteristics of the circular muscle of the duodenum, ileum and colon were unchanged after ganglionectomy. In all regions of the gut studied, substance P and neurokinin A caused dose-dependent contractions that were unaltered by celiac ganglionectomy. Immunohistochemistry revealed moderate substance P-like immunoreactive fibers in the myenteric plexus, submucosal plexus and circular muscle of the ileum, while in the colon, substance P-like immunoreactivity was intense in the myenteric plexus, and moderate in the circular muscle. In vitro autoradiography showed minimal binding of SP (NK1 receptor) or neurokinin A (NK2 receptor) in the ileum and significantly greater binding in the circular muscle layer of the colon. Celiac ganglionectomy did not affect substance P-like immunoreactivity, or NK1 or NK2 receptor binding. A greater contractile response to neurokinins was seen in the colon than in the duodenum or ileum, which paralleled the receptor density. The studies demonstrate that surgical celiac ganglionectomy, unlike chemical sympathectomy, does not affect the substance P innervation, receptor density or physiological responses of the intestine. The greater contractile response of the colon than the ileum parallels the greater receptor density rather than the peptide content as determined by immunhistochemistry.
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Affiliation(s)
- A Ouyang
- Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA
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Foutch PG, Zimmerman K. Diverticular bleeding and the pigmented protuberance (sentinel clot): clinical implications, histopathological correlation, and results of endoscopic intervention. Am J Gastroenterol 1996; 91:2589-93. [PMID: 8946992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED Over a 3-yr period, we performed colonoscopy on five patients (mean age 71 yr) in whom a specific diverticulum that contained a pigmented protuberance (PiP) was unequivocally identified as the cause for hemorrhage. Four of these individuals had endoscopic bipolar cauterization of the PiP, and two patients had surgery. AIM To (1) determine the clinical significance of an intradiverticular PiP, (2) correlate endoscopic features of a PiP with histopathological findings and, (3) assess results of endoscopic treatment for affected patients with lower GI bleeding. METHODS Medical charts were reviewed to garner data and assess outcome for patients. The bleeding diverticulum in one surgical case was detected in the resected specimen, and histological examination was performed. RESULTS The mean number of transfusions, bleeding days, and lowest hemoglobin concentration before definitive treatment was 4.8, 3.4, and 8.4 gm%, respectively. All patients rebled before treatment. In all instances, the PiP projected through the neck of the diverticulum, which was actively bleeding in two patients. Endoscopic bipolar cautery directed at the PiP achieved permanent hemostasis in three of four subjects (75%) (morbidity 0%). Endoscopic therapy failed in one subject, and a hemicolectomy was performed. Histological evaluation of the resected specimen showed erosion of a medium sized artery into the diverticulum. The PiP represented a sentinel clot (not a visible vessel) adherent to a breach in the vessel wall. A patient who had surgery instead of endoscopic therapy had a prolonged, complicated postoperative course. CONCLUSIONS (1) The presence of an intradiverticular PiP may identify a subset of patients at risk for severe recurrent diverticular bleeding. (2) Histopathological analysis showed the PiP to be a sentinel clot rather than a visible vessel. (3) In patients with severe recurrent diverticular bleeding, endoscopic treatment of the vessel beneath this lesion may be a viable alternative to surgery.
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Affiliation(s)
- P G Foutch
- Department of Pathology, Desert Samaritan Hospital, Mesa, Arizona, USA
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Marder SR, Wirshing WC, Mintz J, McKenzie J, Johnston K, Eckman TA, Lebell M, Zimmerman K, Liberman RP. Two-year outcome of social skills training and group psychotherapy for outpatients with schizophrenia. Am J Psychiatry 1996; 153:1585-92. [PMID: 8942455 DOI: 10.1176/ajp.153.12.1585] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The authors evaluated the effectiveness of behaviorally oriented social skills training and supportive group therapy for improving the social adjustment of schizophrenic patients living in the community and for protecting them against psychotic relapse. METHOD Eighty male outpatients with schizophrenia were stabilized with a low dose of fluphenazine decanoate (5 to 10 mg every 14 days), which was supplemented with oral fluphenazine (5 mg twice daily) or a placebo when they first met criteria for a prodromal period. (Half of the patients did so at some time during the study.) Patients were randomly assigned to receive either social skills training or supportive group therapy twice weekly for 6 months and then weekly for the next 18 months. Rates of psychotic exacerbation were monitored, as were scores on the Social Adjustment Scale II. RESULTS There were significant main effects favoring social skills training over supportive group therapy on two of the six Social Adjustment Scale II cluster totals examined (personal well-being and total) and significant interactions between psychosocial treatment and drug treatment for three items (external family, social and leisure activities, and total). In each case, these interactions indicated that the advantage of social skills training over supportive group therapy was greatest when it was combined with active drug supplementation. Social skills training did not significantly decrease the risk of psychotic exacerbation in the full group, but an advantage was observed (post hoc) among patients who received placebo supplementation. CONCLUSIONS These findings suggest that social skills training resulted in greater improvement in certain measures of social adjustment than supportive group therapy. The greatest improvement in social outcomes occurred when social skills training was combined with a pharmacological strategy of active drug supplementation at the time prodromal worsening of psychotic symptoms was first observed. However, these improvements were modest in absolute terms and confined to certain subgroups of patients.
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Affiliation(s)
- S R Marder
- West Los Angeles VA Medical Center, CA 90073, USA.
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Pellicena P, Scholten JD, Zimmerman K, Creswell M, Huang CC, Miller WT. Involvement of the alpha subunit of farnesyl-protein transferase in substrate recognition. Biochemistry 1996; 35:13494-500. [PMID: 8873619 DOI: 10.1021/bi961336h] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Using photoaffinity labeling, we have identified a region in mammalian farnesyl-protein transferase (FPTase) involved in substrate recognition. The photolabel used (Compound 1) is a peptide containing the photoactive amino acid p-benzoylphenylalanine (Bpa). Upon exposure to UV light. Compound 1 inhibits FPTase activity in a time- and concentration-dependent manner. Photoinhibition of FPTase activity by Compound 1 is prevented by adding H-Ras to the reaction mixture, indicating that labeling is targeted to the enzyme active site. We used peptide mapping by HPLC, Edman sequencing, and matrix-assisted time-of-flight (MALDI-TOF) mass spectrometry to identify the site of interaction with radiolabeled Compound 1. These experiments indicate that a specific region of the alpha subunit of the enzyme, Asp110-Arg112, is involved in substrate binding and suggest that Glu111 is likely to be the residue covalently modified by the photoaffinity label. Sequence alignments between yeast and mammalian FPTases reveal that Glu111 is conserved. The implications of this finding are discussed in light of previous mutagenesis studies on FPTase.
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Affiliation(s)
- P Pellicena
- Department of Physiology and Biophysics, School of Medicine, State University of New York at Stony Brook 11794, USA
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