Hasil untuk "Neurophysiology and neuropsychology"

V. Hachinski, C. Iadecola, Ron C. Petersen et al.

N. Cohen, H. Eichenbaum

E. Westhall, A. Rossetti, A. van Rootselaar et al.

Objective: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. Methods: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3–5 until 180 days. Results: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome. Conclusions: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.

Iñaki Ortego-Isasa, J. Ortega-Morán, Héctor E. Lozano et al.

Chronic constipation affects around 20% of the population and there is no efficient solution. This perspective review explores the potential of colonic electric stimulation (CES) using neural implants and methods of bioelectronic medicine as a therapeutic way to treat chronic constipation. The review covers the neurophysiology of colonic peristaltic function, the pathophysiology of chronic constipation, the technical aspects of CES, including stimulation parameters, electrode placement, and neuromodulation target selection, as well as a comprehensive analysis of various animal models highlighting their advantages and limitations in elucidating the mechanistic insights and translational relevance for CES. Finally, the main challenges and trends in CES are discussed.

Jai Gupta, Latha Ganti

Objective: The objective of this study was to compare the severity of head injury in patients on an anticoagulant or antiplatelet agent and to look at the burden of these medications in patients 55 + years vs. younger. Methods: This was an observational cohort study of 2256 adult head trauma patients who presented to a Level I Trauma Center and were stratified by anticoagulant/antiplatelet medication use and age. Logistic regression analyses were performed to ascertain whether use of these medications resulted in worse outcomes. Results: Overall, elderly (>55yrs) patients had worse outcomes after TBI. Specifically, they were more likely to have an intracranial hemorrhage, be admitted to the hospital, have an ICU stay, be re-admitted within 30 days, die in the hospital and be dead within 3 months. Conclusion: Geriatric trauma patients along with their preexisting comorbidities are often on anticoagulants that increase their risk for complications, bleeding, mortality in the setting of even minor traumas.

Ying Q, Wang M, Zhao Z et al.

Qiaohui Ying,1,2,* Mingwei Wang,3,* Zichen Zhao,1,2 Yongwei Wu,1,2 Changyun Sun,1,2 Xinyi Huang,1,2 Xin Zhang,1,2 Jie Guo1,2 1Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People&rsquo;s Republic of China; 2Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, People&rsquo;s Republic of China; 3Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, People&rsquo;s Republic of China*These authors contributed equally to this workCorrespondence: Jie Guo, Department of Orthodontics, School and Hospital of Stomatology, Shandong University, No. 44-1 Wenhua Road West, Jinan, Shandong, 250012, People&rsquo;s Republic of China, Tel +86 13583104999, Fax +86 53188382923, Email kqgj@sdu.edu.cnPurpose: Sleep apnea (SA), associated with absent neural output, is characterised by recurrent episodes of hypoxemia and repeated arousals during sleep, resulting in decreased sleep quality and various health complications. Mitochondrial DNA copy number (mtDNA-CN), an easily accessible biomarker in blood, reflects mitochondrial function. However, the causal relationship between mtDNA-CN and SA remains unclear. This study aimed to investigate the causality between mtDNA-CN and SA while identifying potential mediating brain imaging phenotypes (BIPs).Methods: Two-sample bidirectional Mendelian randomisation (MR) analysis was performed to estimate the causal relationship between mtDNA-CN and SA, with further validation using Bayesian framework-based MR analysis. A two-step approach was employed to evaluate causal relationships between BIPs, mtDNA-CN and SA, utilising the &ldquo;product of coefficients&rdquo; method to assess the mediating effects of BIPs. Multiple testing errors were corrected using the Benjamini&ndash;Hochberg method.Results: Genetically predicted mtDNA-CN had a negative causal effect on SA (OR = 0.859, 95% CI = 0.785&ndash; 0.939, P = 3.20&times; 10&minus; 4), whereas SA did not have a causal effect on mtDNA-CN (OR = 1.0056, 95% CI = 0.9954&ndash; 1.0159, P = 0.2825). Among 3935 BIPs, two features related to white matter microstructure served as partial mediators: the second eigenvalue from diffusion MRI data analysed by tract-based spatial statistics in the right posterior thalamic radiation, with a mediation proportion of 11.37% (P = 0.0450), and fractional anisotropy in the right sagittal stratum, with a mediation proportion of 12.79% (P = 0.0323).Conclusion: This study demonstrated a causal relationship between mtDNA-CN and SA, with specific brain white matter microstructure phenotypes potentially acting as mediators. These findings highlight the potential of mtDNA-CN as a biomarker for SA and underscore its relevance in guiding future therapeutic strategies targeting mitochondrial health and brain white matter microstructure.Keywords: mitochondrion, sleep disorder, brain structure, magnetic resonance imaging, causal relationship

Fateme Al-Sadat Khormian Isfahani, Sima Andalib

Aim and Background: The experience of childhood trauma is all the unpleasant and unpleasant experiences that a person has experienced during childhood either directly in relation to his caregivers and attachment figures, or as a result of the neglect and negligence of his attachment figures in relation to a stranger, he has experienced misbehavior. The present study was conducted with the aim of investigating the effectiveness of emotion-oriented intervention on attachment styles, hyperexcitability and fearful dreams in people with complex trauma symptoms. Methods and Materials: This semi-experimental research, including pre-test-post-test, control group, was conducted on all adults with symptoms of complex trauma referring to psychological clinics in Isfahan province in spring 2002. The sampling method in the first stage was based on the available sampling method and they were randomly divided into two experimental groups (15 people) and control (15 people) and using the questionnaire of consequences of childhood traumas in adulthood by Bernstein et al, Collins and Reed attachment style questionnaire, Mitmansgruber hyperexcitability questionnaire, Mitmansgruber et al. The data were analyzed using Levine's test, Shapiro-Wilko test, analysis of covariance test. Findings: The findings indicate that for secure attachment (F=44. 628 and df=1), avoidant attachment (F=28. 168 and df=1), anxious attachment (F=42. 228 and df=1), For the variable of negative over-excitement (F=74. 508 and df=1) and positive over-excitement (F=27. 197 and df=1) as well as for the variable of scary dreams (F=46. 446 and df=1), then From the pre-test control, in the post-test phase, the effect of the group is significant (P<0. 01). Conclusions: The results of the research showed that emotion-oriented intervention has an effect on attachment styles, hyperexcitability and scary dreams in people with complex trauma symptoms

Divya Nair, Abdias Diaz-Rosado, Elisa Varella-Branco et al.

TBCK‐related encephalopathy is a rare pediatric neurodegenerative disorder caused by biallelic loss‐of‐function variants in the TBCK gene. After receiving anecdotal reports of neurologic phenotypes in both human and mouse TBCK heterozygotes, we quantified if TBCK haploinsufficiency causes a phenotype in mice and humans. Using the tbck+/− mouse model, we performed a battery of behavioral assays and mTOR pathway analysis to investigate potential alterations in neurophysiology. We conducted as well a phenome‐wide association study (PheWAS) analysis in a large adult biobank to determine the presence of potential phenotypes associated to this variant. The tbck+/− mouse model demonstrates a reduction of exploratory behavior in animals with significant sex and genotype interactions. The concurrent PheWAS analysis of 10,900 unrelated individuals showed that patients with one copy of a TBCK loss‐of‐function allele had a significantly higher rate of acquired toe and foot deformities, likely indicative of a mild peripheral neuropathy phenotype. This study presents an example of what may be the underappreciated occurrence of mild neurogenic symptoms in heterozygote individuals of recessive neurogenetic syndromes.

Junyi Chu, Laura E. Schulz

M. Manto, G. Argyropoulos, T. Bocci et al.

E. Rounis, F. Binkofski

Stroke is a leading cause of disability worldwide. Limb apraxia is a group of higher order motor disorders associated with greater disability and dependence after stroke. Original neuropsychology studies distinguished separate brain pathways involved in perception and action, known as the dual stream hypothesis. This framework has allowed a better understanding of the deficits identified in Limb Apraxia. In this review, we propose a hierarchical organization of this disorder, in which a distinction can be made between several visuomotor pathways that lead to purposeful actions. Based on this, executive apraxias (such as limb kinetic apraxia) cause deficits in executing fine motor hand skills, and intermediate apraxias (such as optic ataxia and tactile apraxia) cause deficits in reaching to grasp and manipulating objects in space. These disorders usually affect the contralesional limb. A further set of disorders collectively known as limb apraxias include deficits in gesture imitation, pantomime, gesture recognition, and object use. These deficits are due to deficits in integrating perceptual and semantic information to generate complex movements. Limb apraxias are usually caused by left-hemisphere lesions in right-handed stroke patients, affecting both limbs. The anterior- to posterior-axis of brain areas are disrupted depending on the increasing involvement of perceptual and semantic processes with each condition. Lower-level executive apraxias are linked to lesions in the frontal lobe and the basal ganglia, while intermediate apraxias are linked to lesions in dorso-dorsal subdivisions of the dorsal fronto-parietal networks. Limb apraxias can be caused by lesions in both dorsal and ventral subdivisions including the ventro-dorsal stream and a third visuomotor pathway, involved in body schema and social cognition. Rehabilitation of these disorders with behavioral therapies has aimed to either restore perceptuo-semantic deficits or compensate to overcome these deficits. Further studies are required to better stratify patients, using modern neurophysiology and neuroimaging techniques, to provide targeted and personalized therapies for these disorders in the future.

Danton H. O’Day, Robert J. Huber

Abstract Calcium dysregulation (“Calcium Hypothesis”) is an early and critical event in Alzheimer’s and other neurodegenerative diseases. Calcium binds to and regulates the small regulatory protein calmodulin that in turn binds to and regulates several hundred calmodulin binding proteins. Initial and continued research has shown that many calmodulin binding proteins mediate multiple events during the onset and progression of Alzheimer’s disease, thus establishing the “Calmodulin Hypothesis”. To gain insight into the general applicability of this hypothesis, the involvement of calmodulin in neuroinflammation in Alzheimer’s, amyotrophic lateral sclerosis, Huntington’s disease, Parkinson’s disease, frontotemporal dementia, and other dementias was explored. After a literature search for calmodulin binding, 11 different neuroinflammatory proteins (TREM2, CD33, PILRA, CR1, MS4A, CLU, ABCA7, EPHA1, ABCA1, CH3L1/YKL-40 and NLRP3) were scanned for calmodulin binding domains using the Calmodulin Target Database. This analysis revealed the presence of at least one binding domain within which visual scanning demonstrated the presence of valid binding motifs. Coupled with previous research that identified 13 other neuroinflammation linked proteins (BACE1, BIN1, CaMKII, PP2B, PMCA, NOS, NMDAR, AchR, Ado A2AR, Aβ, APOE, SNCA, TMEM175), this work shows that at least 24 critical proteins involved in neuroinflammation are putative or proven calmodulin binding proteins. Many of these proteins are linked to multiple neurodegenerative diseases indicating that calmodulin binding proteins lie at the heart of neuroinflammatory events associated with multiple neurodegenerative diseases. Since many calmodulin-based pharmaceuticals have been successfully used to treat Huntington’s and other neurodegenerative diseases, these findings argue for their immediate therapeutic implementation.

I. Marriott Haresign, E.A.M. Phillips, M. Whitehorn et al.

Current approaches to analysing EEG hyperscanning data in the developmental literature typically consider interpersonal entrainment between interacting physiological systems as a time-invariant property. This approach obscures crucial information about how entrainment between interacting systems is established and maintained over time. Here, we describe methods, and present computational algorithms, that will allow researchers to address this gap in the literature. We focus on how two different approaches to measuring entrainment, namely concurrent (e.g., power correlations, phase locking) and sequential (e.g., Granger causality) measures, can be applied to three aspects of the brain signal: amplitude, power, and phase. We guide the reader through worked examples using simulated data on how to leverage these methods to measure changes in interbrain entrainment. For each, we aim to provide a detailed explanation of the interpretation and application of these analyses when studying neural entrainment during early social interactions.

Alexander B. Silva, Ankit N. Khambhati, Benjamin A. Speidel et al.

Implanted neurostimulation devices are gaining traction as palliative treatment options for certain forms of drug-resistant epilepsy, but clinical utility of these devices is hindered by incomplete mechanistic understanding of their therapeutic effects. Approved devices for anterior thalamic nuclei deep brain stimulation (ANT DBS) are thought to work at a network level, but limited sensing capability precludes characterization of neurophysiological effects outside the thalamus. Here, we describe a patient with drug-resistant temporal lobe epilepsy who was implanted with a responsive neurostimulation device (RNS System), involving hippocampal and ipsilateral temporal neocortical leads, and subsequently received ANT DBS. Over 1.5 years, RNS System electrocorticography enabled multiscale characterization of neurophysiological effects of thalamic stimulation. In brain regions sampled by the RNS System, ANT DBS produced acute, phasic, frequency-dependent responses, including suppression of hippocampal low frequency local field potentials. ANT DBS modulated functional connectivity between hippocampus and neocortex. Finally, ANT DBS progressively suppressed hippocampal epileptiform activity in relation to the extent of hippocampal theta suppression, which informs stimulation parameter selection for ANT DBS. Taken together, this unique clinical scenario, involving hippocampal recordings of unprecedented chronicity alongside ANT DBS, sheds light on the therapeutic mechanism of thalamic stimulation and highlights capabilities needed in next-generation devices

Rozita Tanbakouchian, Firozeh Zanganeh, Mohammad Reza Bayat

Aim and Background: Research has shown that resilience and self-control are associated with marital boredom; In this regard, various therapeutic approaches have been used by researchers; therefore, this study was conducted to compare the effectiveness of emotion-focused and schema therapy approaches on ambiguity resilience, and self-control of women with marital burnout. Methods and Materials: The research method was applied in terms of purpose and quasi-experimental in terms of implementation method with pretest-posttest design of two experimental groups and a control group with follow-up test. From the community of women suffering from marital burnout in district three of tehran, 45 people were selected by the convenient sampling method and were replaced in three groups using the random method. Ambiguity resilience questionnaire (Freison et al., 1994) and self-control questionnaire (Gramisk et al., 1993) were used. Research data were analyzed by ANOVA using repeated measures and bonferroni's post hoc test. Findings: Findings showed that both emotion-focused and schema therapy approaches have a significant and lasting effect on increasing the resilience of ambiguity and self-control of women with marital burnout (p=0.001). Also, the result of comparing the two approaches showed that the effect of schema therapy approach on self-control of women with marital burnout is more than the emotion-focused approach (p=0.001). But the difference between the two approaches on the resilience of ambiguity was not significant. Conclusions: According to the obtained results, it seems that the use of both schema therapy and emotion-focused approaches to improve self-control and resilience of ambiguity in women with marital burnout is effective and it is recommended to be used as therapeutic approaches.

Sumayyah Abumurad, Naoum P. Issa, Shasha Wu et al.

Introduction: NPRL3 gene mutations cause autosomal dominant familial focal epilepsy of variable foci (FFEVF) and is characterized by focal epilepsy arising from different brain regions including temporal, frontal, parietal and occipital lobes. About 50% of patients with NPRL3 related epilepsy are resistant to medical treatment. Method: We present a case of 27 years old man with NPRL3 related focal drug-resistant epilepsy. Stereotactic EEG showed two independent seizure foci, namely, left hippocampus and left orbitofrontal cortices. He underwent laser interstitial thermal therapy for ablating both foci in the same procedure that led to seizure cessation. Conclusion: laser interstitial thermal therapy can be an effective treatment for drug resistant NPRL3 related focal epilepsy with better tolerance and less morbidity as compared to open surgical resection, particularly in those with multiple seizure foci.

S. Beniczky, H. Aurlien, J. Brøgger et al.

Felipe Borges Almeida, Maurício Schüler Nin, Helena Maria Tannhauser Barros

Allopregnanolone (3α,5α-tetrahydroprogesterone; pharmaceutical formulation: brexanolone) is a neurosteroid that has recently been approved for the treatment of postpartum depression, promising to fill part of a long-lasting gap in the effectiveness of pharmacotherapies for depressive disorders. In this review, we explore the experimental research that characterized the antidepressant-like effects of allopregnanolone, with a particular focus on the neurotrophic adaptations induced by this neurosteroid in preclinical studies. We demonstrate that there is a consistent decrease in allopregnanolone levels in limbic brain areas in rodents submitted to stress-induced models of depression, such as social isolation and chronic unpredictable stress. Further, both the drug-induced upregulation of allopregnanolone or its direct administration reduce depressive-like behaviors in models such as the forced swim test. The main drugs of interest that upregulate allopregnanolone levels are selective serotonin reuptake inhibitors (SSRIs), which present the neurosteroidogenic property even in lower, non-SSRI doses. Finally, we explore how these antidepressant-like behaviors are related to neurogenesis, particularly in the hippocampus. The protagonist in this mechanism is likely the brain-derived neurotrophic factor (BFNF), which is decreased in animal models of depression and may be restored by the normalization of allopregnanolone levels. The role of an interaction between GABA and the neurotrophic mechanisms needs to be further investigated.

Emmanuel Cheng Seng Leong, Udaya Seneviratne

Mesial temporal lobe epilepsy, a well-characterized epilepsy syndrome, is most commonly accompanied by the pathological feature of hippocampal sclerosis. Patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) typically present in childhood to early adolescence. We describe a cohort of patients who presented with their first epileptic seizure in late adulthood with atypical features. We characterized five patients with late-onset MTLE-HS by describing their demographics, electroclinical features, imaging, autoantibody status, and response to antiseizure medication (ASM) therapy. All five patients had their first seizure after the age of 50 with no history of initial precipitating incidents. None of our patients had positive serum or CSF autoantibodies and they have all remained seizure-free for a minimum of two years on ASMs alone. Two patients had motor vehicle crashes associated with seizures whilst three patients experienced seizures in sleep. A milder form of MTLE, previously described as benign TLE, does exist in routine clinical practice. These patients respond well to ASM therapy, but potentially harmful consequences such as motor vehicle crashes can occur in the untreated.

Yasunobu Nosaki, Ken Ohyama, Maki Watanabe et al.

Mowat-Wilson syndrome (MWS) is a rare genetic disorder characterized by intellectual disability, distinctive facial features, epilepsy, and multiple anomalies caused by heterozygous loss-of-function mutations in the zinc finger E-box-binding homeobox-2 gene (ZEB2). Treatment choice is very important as patients with MWS because patients sometimes develop drug-resistant epilepsy. Here, we report the case of a 45-year-old male patient with MWS who developed drug-resistant status epilepticus after a 26-years seizure-free period while taking multiple anti-seizure medications. He showed a characteristic magnetic resonance imaging finding with a focal lesion in his left thalamic pulvinar nucleus, a finding not previously reported in status epilepticus with MWS. We succeeded in controlling seizures in the patient after trying multiple new antiseizure drug combinations. These findings indicate that patients with MWS may develop drug-resistant status epilepticus with age, even after a long-term seizure-free period, which can be managed with anti-seizure medication. Therefore, careful monitoring of seizures is important for the treatment of people with MWS, even in patients who have not experienced seizures for a long time.