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Richard Rammo, Karam Asmaro, Lonni Schultz, Lisa Scarpace, Salim Siddiqui, Tobias Walbert, Steven Kalkanis, Ian Lee
Cerebral radiation necrosis (CRN) is a known complication of radiation therapy. Treatment options are limited and include steroids, bevacizumab, and surgery. This study seeks to determine the safety of laser interstitial thermal therapy (LITT) for CRN and identify the pattern of post-ablation volume change over time. Patients undergoing LITT for tumor treatment at Henry Ford Hospital between November 2013 and January 2016 with biopsy-confirmed CRN were prospectively collected and retrospectively reviewed with attention to ablation volume, survival, demographic data, steroid dose, and complications...
March 13, 2018: Journal of Neuro-oncology
Vejay N Vakharia, Rachel Sparks, Kuo Li, Aidan G O'Keeffe, Anna Miserocchi, Andrew W McEvoy, Michael R Sperling, Ashwini Sharan, Sebastien Ourselin, John S Duncan, Chengyuan Wu
OBJECTIVE: Surgical resection of the mesial temporal structures brings seizure remission in 65% of individuals with drug-resistant mesial temporal lobe epilepsy (MTLE). Laser interstitial thermal therapy (LiTT) is a novel therapy that may provide a minimally invasive means of ablating the mesial temporal structures with similar outcomes, while minimizing damage to the neocortex. Systematic trajectory planning helps ensure safety and optimal seizure freedom through adequate ablation of the amygdalohippocampal complex (AHC)...
March 12, 2018: Epilepsia
Nam Ju Lee, Harold Litt
PURPOSE OF REVIEW: To compare outcomes between registries and randomized controlled trials of coronary computed tomographic angiography (CCTA)-based versus standard of care approaches to the initial evaluation of patients with acute chest pain. RECENT FINDINGS: Randomized trials have demonstrated CCTA to be a safe and efficient tool for triage of low- to intermediate-risk patients presenting to the emergency department with chest pain. Recent studies demonstrate heterogeneous result using different standard of care approaches for evaluation of hard endpoints in comparison with standard evaluation...
March 8, 2018: Current Cardiology Reports
Hank Bink, Madineh Sedigh-Sarvestani, Ivan Fernandez-Lamo, Lohith Kini, Hoameng Ung, Duygu Kuzum, Flavia Vitale, Brian Litt, Diego Contreras
New devices that use targeted electrical stimulation to treat refractory localization-related epilepsy have shown great promise, though it is not well known which targets most effectively prevent the initiation and spread of seizures. To better understand how the brain transitions from healthy to seizing on a local scale, we induced focal epileptiform activity in the visual cortex of five anesthetized cats with local application of the GABAA blocker picrotoxin while simultaneously recording local field potentials on a high-resolution electrocorticography array and laminar depth probes...
February 28, 2018: Journal of Neurophysiology
Jared W Magnani, Courtney L Schlusser, Everlyne Kimani, Bruce L Rollman, Michael K Paasche-Orlow, Timothy W Bickmore
Background: Atrial fibrillation (AF) is a highly prevalent heart rhythm condition that has significant associated morbidity and requires chronic treatment. Mobile health (mHealth) technologies have the potential to enhance multiple aspects of AF care, including education, monitoring of symptoms, and encouraging and tracking medication adherence. We have previously implemented and tested relational agents to improve outcomes in chronic disease and sought to develop a smartphone-based relational agent for improving patient-centered outcomes in AF...
July 2017: JMIR Cardio
Tracey A Garcia, Anne M Fairlie, Dana M Litt, Katja A Waldron, Melissa A Lewis
Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use...
February 15, 2018: Addictive Behaviors
Robin A Litt, Hua-Chen Wang, Jessica Sailah, Nicholas A Badcock, Anne Castles
No abstract text is available yet for this article.
January 1, 2018: Quarterly Journal of Experimental Psychology: QJEP
Derek A Nichols, Inderbir S Sondh, Steven R Litte, Paolo Zunino, Riccardo Gottardi
Bioreactors are systems that can be used to monitor the response of tissues and cells to candidate drugs. Building on the experience developed in the creation of an osteochondral bioreactor, we have designed a new 3D printed system, which allows optical access to the cells throughout testing for in line monitoring. Because of the use of 3D printing, the fluidics could be developed in the third dimension, thus maintaining the footprint of a single well of a typical 96 well plate. This new design was optimized to achieve the maximum fluid transport through the central chamber, which corresponds to optimal nutrient or drug exposure...
February 14, 2018: Biomedical Microdevices
Dimitri Laurent, Seth F Oliveria, Michael Shang, Frank Bova, Rachel Freedman, Maryam Rahman
BACKGROUND: Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia. OBJECTIVE: To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Sanjeet S Grewal, Krzysztof R Gorny, Christopher P Favazza, Robert E Watson, Timothy J Kaufmann, Jamie J Van Gompel
BACKGROUND AND IMPORTANCE: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
Thomas L Beaumont, Alireza M Mohammadi, Albert H Kim, Gene H Barnett, Eric C Leuthardt
BACKGROUND: Glioblastoma of the corpus callosum is particularly difficult to treat, as the morbidity of surgical resection generally outweighs the potential survival benefit. Laser interstitial thermal therapy (LITT) is a safe and effective treatment option for difficult to access malignant gliomas of the thalamus and insula. OBJECTIVE: To assess the safety and efficacy of LITT for the treatment of glioblastoma of the corpus callosum. METHODS: We performed a multicenter retrospective analysis of prospectively collected data...
February 8, 2018: Neurosurgery
Silvina L Ferradal, Borjan Gagoski, Camilo Jaimes, Francesca Yi, Clarisa Carruthers, Catherine Vu, Jonathan S Litt, Ryan Larsen, Brad Sutton, P Ellen Grant, Lilla Zöllei
The normal development of thalamocortical connections plays a critical role in shaping brain connectivity in the prenatal and postnatal periods. Recent studies using advanced magnetic resonance imaging (MRI) techniques in neonates and infants have shown that abnormal thalamocortical connectivity is associated with adverse neurodevelopmental outcomes. However, all these studies have focused on a single neuroimaging modality, overlooking the dynamic relationship between structure and function at this early stage...
February 7, 2018: Cerebral Cortex
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
Sanjeet S Grewal, Vivek Gupta, Prasanna Vibhute, Jerry J Shih, William O Tatum, Robert E Wharen
OBJECTIVE: The mammillary bodies have long been known as the primary relay center for the hippocampus. The fornix is the primary efferent pathway of the hippocampus, with its postcommissural fibers terminating in the mammillary bodies. In this study, we describe change in mammillary body volume after laser interstitial thermal therapy (LiTT) for mesial temporal lobe epilepsy and correlate it with seizure outcome. METHODS: Pre- and post-LiTT ablation magnetic resonance imaging was reviewed in axial and coronal planes to determine mammillary body volume as calculated by the ellipsoid method...
January 31, 2018: Epilepsy Research
Omar Ashraf, Nitesh V Patel, Simon Hanft, Shabbar F Danish
Laser therapy has become an appealing treatment modality in neurosurgery. With the advent of real-time monitoring and damage estimation, laser induced thermal therapy (LITT) has gained ground in the management of intracranial tumors. In the past decade multiple studies have demonstrated the use, outcomes, and complications associated with LITT in neurosurgery. These same studies have consistently reported an overall benefit of LITT in cases where traditional surgical approaches may be limited by the patient's clinical status, tumor location, or overall prognosis...
February 1, 2018: World Neurosurgery
Vivek Tandon, Poodipedi Sarat Chandra, Ramesh Sharanappa Doddamani, Heri Subianto, Jitin Bajaj, Ajay Garg, Manjari Tripathi
INTRODUCTION: Treatment options for hypothalamic hamartoma (HH) include microvascular surgery, stereotactic radiofrequency thermocoagulation (SRT), laser interstitial thermal therapy (LITT) or Gamma knife surgery (GKS). During SRT, thermographic monitoring cannot be performed and therefore highly accurate placement of electrode and confirmation of its position are required. We have utilized robotic guidance (ROSA) and co-registered it with O-Arm, for performing ablation of hamartoma. METHODS: Five patients of HH with gelastic seizures (GS) underwent SRT...
February 3, 2018: World Neurosurgery
Paloma Largo Flores, Felix Haglund, Pervinder Bhogal, Leonard Yeo Leong Litt, Michael Södermann
We describe two contrasting patients with multiple cerebral aneurysms and a previous history of resected cardiac myxomas with no cardiac recurrence on follow-up echocardiography. Both patients presented with stroke- like symptoms; one with a left visual defect and the other with right hemiplegia. Magnetic resonance imaging of the brain of both patients showed the presence of multiple cerebral aneurysms that was later confirmed on conventional angiography. Both patients' aneurysms were managed conservatively...
January 1, 2018: Interventional Neuroradiology
David S Xu, Tsinsue Chen, Randall J Hlubek, Ruth E Bristol, Kris A Smith, Francisco A Ponce, John F Kerrigan, Peter Nakaji
BACKGROUND: Hypothalamic hamartomas (HH) are rare lesions associated with treatment-resistant epilepsy. Open surgery results in modest seizure control (about 50%) but has a significant associated morbidity. Radiosurgery is limited to a subset of patients due to latent therapeutic effects. Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) offers a novel minimally invasive option. OBJECTIVE: To evaluate a single center's outcomes for the LITT treatment of HH...
January 13, 2018: Neurosurgery
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