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Motor Cortex/surgery

Daniella C Parravano, Daniel A Ciampi, Erich T Fonoff, Bernardo Monaco, Jessie Navarro, Lin T Yeng, Manoel J Teixeira, Clement Hamani
BACKGROUND: Motor cortex stimulation (MCS) is routinely used for the treatment of chronic neuropathic pain but its effect on quality of life remains uncertain. OBEJCTIVE: To systematically review the published literature on MCS and quality of life and report the effects of this therapy in a series of patients prospectively followed in our center. METHODS: The systematic literature review was conducted using the search words "motor cortex stimulation and pain and neurosurgery" and "motor cortex stimulation and pain and quality of life...
March 14, 2018: Neurosurgery
Giovanni Tringali, Beatrice Bono, Ivano Dones, Roberto Cordella, Giuseppe Didato, Flavio Villani, Francesco Prada
BACKGROUND: Type II focal cortical dysplasia is the most common malformation of cortical development associated with drug resistant epilepsy and susceptible to surgical resection. Although advanced imaging modalities are nowadays capable to detect the majority of such cortical disorders, it is still a challenge for the surgeon to visualize them intraoperatively. The lack of direct boundaries' identification between normal brain and subtle dysplastic tissue may explain poor results in terms of seizure-free patients compared to other forms of epilepsy...
March 3, 2018: World Neurosurgery
Jennica M Young, Michael R Hoane
After sustaining a traumatic brain injury (TBI), a person's ability to make daily decisions can be affected. Simple tasks such as, deciding what to wear are no longer effortless choices, but are instead difficult decisions. This study explored the use of a discrimination task with a magnesium treatment in order to examine how decision-making skills are affected after TBI and if the treatment helped to attenuate cognitive and motor impairments. Thirty-one male rats were separated into MAG/TBI, VEH/TBI, or VEH/Sham groups...
March 1, 2018: Brain Research Bulletin
Miran Skrap, Maria Caterina Vescovi, Giada Pauletto, Marta Maieron, Tomasino Barbara, Daniele Bagatto, Francesco Tuniz
BACKGROUND: Cavernous malformations (CMs) are congenital malformations and may be located anywhere in the brain. We present a series of CMs located close to or inside of the motor-sensory cortex or corticospinal tract (CST) with clinical onset due to hemorrhage or mass effect. In such cases, surgery becomes an acceptable option. OBJECTIVE: To evaluate the role of diffusion tensor imaging (DTI), functional-magnetic-resonance imaging (fMRI), intraoperative neurophysiological monitoring, neuronavigation, and brain-mapping and the clinical results of surgical treatment of CMs in this critical location...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
Lina Bunketorp Käll, Robert J Cooper, Johanna Wangdell, Jan Fridén, Malin Björnsdotter
BACKGROUND: Tendon transfer is a surgical technique for restoring upper limb motor control in patients with cervical spinal cord injuries (SCI), and offers a rare window into cortical neuroplasticity following regained arm and hand function. OBJECTIVE: Here, we aimed to examine neuroplasticity mechanisms related to re-established voluntary motor control of thumb flexion following tendon transfer. METHODS: We used functional Magnetic Resonance Imaging (fMRI) to test the hypothesis that restored limb control following tendon transfer is mediated by activation of that limb's area of the primary motor cortex...
2018: Restorative Neurology and Neuroscience
Georgios Naros, Florian Grimm, Daniel Weiss, Alireza Gharabaghi
BACKGROUND: Both the cerebello-thalamo-cortical circuit and the basal ganglia/cortical motor loop have been postulated to be generators of tremor in PD. The recent suggestion that the basal ganglia trigger tremor episodes and the cerebello-thalamo-cortical circuitry modulates tremor amplitude combines both competing hypotheses. However, the role of the STN in tremor generation and the impact of proprioceptive feedback on tremor suppression during voluntary movements have not been considered in this model yet...
February 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Mariam Alaverdashvili, Sally Caine, Xue Li, Mark J Hackett, Michael P Bradley, Helen Nichol, Phyllis G Paterson
Protein-energy malnutrition (PEM) pre-existing at stroke onset is believed to worsen functional outcome, yet the underlying mechanisms are not fully understood. Since brain inflammation is an important modulator of neurological recovery after stroke, we explored the impact of PEM on neuroinflammation in the acute period in relation to stroke-initiated sensori-motor abnormalities. Adult rats were fed a low-protein (LP) or normal protein (NP) diet for 28 days before inducing photothrombotic stroke (St) in the forelimb region of the motor cortex or sham surgery; the diets continued for 3 days after the stroke...
February 3, 2018: Translational Stroke Research
Omar Chehadi, Boris Suchan, Kerstin Konietzny, Odo Köster, Tobias Schmidt-Wilcke, Monika I Hasenbring
Introduction: Pain catastrophizing (PC), the increased attention to harmful aspects of pain (magnification), and the belief of low controllability (helplessness) has been shown to be important in the maintenance of pain. A growing research on structural alterations in chronic pain revealed an association between PC and brain areas that are involved in affective and cognitive pain processing. However, little is known about a differential effect of the components magnification and helplessness...
September 2017: Pain Reports (Baltimore, Md.)
Harith Akram, Viswas Dayal, Philipp Mahlknecht, Dejan Georgiev, Jonathan Hyam, Thomas Foltynie, Patricia Limousin, Enrico De Vita, Marjan Jahanshahi, John Ashburner, Tim Behrens, Marwan Hariz, Ludvic Zrinzo
The ventral intermediate nucleus (VIM) of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS) in the treatment of tremor in Parkinson's disease (PD) and essential tremor (ET). It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT). The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates...
2018: NeuroImage: Clinical
Masahiro Sawada, Takuro Nakae, Toshihiro Munemitsu, Masato Hojo
BACKGROUND: Depressed mood following neuronal damage not only impedes functional recovery, but negatively affects quality of life for many patients. Depressed patients with cervical myelopathy often show improvement in both mood and motor function following spinal decompression surgery; however, the neural mechanism underlying this psychological benefit from the surgery remains unclear. The aim of this study is clarifying the brain sites that relates to the alleviation of depression following the spinal decompression surgery...
January 24, 2018: World Neurosurgery
Anne Barz, Anika Noack, Peter Baumgarten, Volker Seifert, Marie-Therese Forster
OBJECTIVE: Evidence for cerebral reorganization after resection of low-grade glioma has mainly been obtained by serial intraoperative cerebral mapping. Non-invasively collected data on cortical plasticity in tumor patients over a surgery-free period are still scarce. The present study therefore aimed at evaluating motor cortex reorganization by navigated transcranial magnetic stimulation (nTMS) in patients after perirolandic glioma surgery. METHODS: nTMS was performed pre- and postoperatively in 20 patients, separated by 26...
January 19, 2018: World Neurosurgery
Alice Rolland, Guillaume Herbet, Hugues Duffau
OBJECTIVE: Little is known about the functional role of the white matter connections running within and around the right inferior parietal lobule (IPL). We used direct electrostimulation during awake surgery to investigate this connectivity and to avoid permanent deficit following resection for right IPL gliomas. METHODS: We reviewed patients who underwent awake mapping for a glioma involving the right IPL. Resection was achieved up to functional cortico-subcortical boundaries detected by electrostimulation...
January 16, 2018: World Neurosurgery
Kayla Ryan, Sandy Goncalves, Robert Bartha, Neil Duggal
OBJECTIVE The authors used functional MRI to assess cortical reorganization of the motor network after chronic spinal cord compression and to characterize the plasticity that occurs following surgical intervention. METHODS A 3-T MRI scanner was used to acquire functional images of the brain in 22 patients with reversible cervical spinal cord compression and 10 control subjects. Controls performed a finger-tapping task on 3 different occasions (baseline, 6-week follow-up, and 6-month follow-up), whereas patients performed the identical task before surgery and again 6 weeks and 6 months after spinal decompression surgery...
January 19, 2018: Journal of Neurosurgery. Spine
Aparna Wagle Shukla, Jill L Ostrem, David E Vaillancourt, Robert Chen, Kelly D Foote, Michael S Okun
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN DBS) surgery is clinically effective for treatment of cervical dystonia; however, the underlying physiology has not been examined. We used transcranial magnetic stimulation (TMS) to examine the effects of STN DBS on sensorimotor integration, sensorimotor plasticity and motor cortex excitability, which are identified as the key pathophysiological features underlying dystonia. METHODS: TMS paradigms of short latency afferent inhibition (SAI) and long latency afferent inhibition (LAI) were used to examine the sensorimotor integration...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Thomas Carlstedt, Nicholas James, Mårten Risling
This mini review describes the current surgical strategy for restoring function after traumatic spinal nerve root avulsion in brachial or lumbosacral plexus injury in man. As this lesion is a spinal cord or central nervous injury functional return depends on spinal cord nerve cell growth within the central nervous system. Basic science, clinical research and human application has demonstrated good and useful motor function after ventral root avulsion followed by spinal cord reimplantation. Recently, sensory return could be demonstrated following spinal cord surgery bypassing the injured primary sensory neuron...
December 2017: Neural Regeneration Research
Miao Ling, Xiaorong Tao, Siyuan Ma, Xiaocui Yang, Li Liu, Xing Fan, Guijun Jia, Hui Qiao
OBJECTIVE: We sought to validate the feasibility of facial motor evoked potential (FMEP) in facial nerve (FN) monitoring during vestibular schwannoma (VS) surgery under 2 anesthesia protocols and to examine its value for postoperative prognosis. METHODS: This prospective study included 106 patients with VS who underwent microsurgical excision between May 2014 and November 2016 at the Beijing Tiantan Hospital, Capital Medical University, China. All patients were investigated for FMEP elicited by transcranial electrical stimulation in the contralateral facial motor cortex...
December 16, 2017: World Neurosurgery
Giulia Cossu, Sebastien Lebon, Margitta Seeck, Etienne Pralong, Mahmoud Messerer, Eliane Roulet-Perez, Roy Thomas Daniel
Refractory frontal lobe epilepsy has been traditionally treated through a frontal lobectomy. A disconnective technique may allow similar seizure outcomes while avoiding the complications associated with large brain resections. The aim of this study was to describe a new technique of selective disconnection of the frontal lobe that can be performed in cases of refractory epilepsy due to epileptogenic foci involving 1 frontal lobe (anterior to the motor cortex), with preservation of motor function. In addition to the description of the technique, an illustrative case is also presented...
February 2018: Journal of Neurosurgery. Pediatrics
Stephen T Magill, Seunggu J Han, Jing Li, Mitchel S Berger
OBJECTIVE Brain tumors involving the primary motor cortex are often deemed unresectable due to the potential neurological consequences that result from injury to this region. Nevertheless, we have challenged this dogma for many years and used asleep, as well as awake, intraoperative stimulation mapping to maximize extent of resection. It remains unclear whether these tumors can be resected with acceptable morbidity, whether performing the surgery with the patient awake or asleep impacts extent of resection, and how stimulation mapping influences outcomes...
December 8, 2017: Journal of Neurosurgery
Giovanni Raffa, Alfredo Conti, Antonino Scibilia, Salvatore Massimiliano Cardali, Felice Esposito, Filippo Flavio Angileri, Domenico La Torre, Carmela Sindorio, Rosaria Viola Abbritti, Antonino Germanò, Francesco Tomasello
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) enables preoperative mapping of the motor cortex (M1). The combination of nTMS with diffusion tensor imaging fiber tracking (DTI-FT) of the corticospinal tract (CST) has been described; however, its impact on surgery of motor-eloquent lesions has not been addressed. OBJECTIVE: To analyze the impact of nTMS-based mapping on surgery of motor-eloquent lesions. METHODS: In this retrospective case-control study, we reviewed the data of patients operated for suspected motor-eloquent lesions between 2012 and 2015...
November 29, 2017: Neurosurgery
Wiesław Marcol, Wojciech Ślusarczyk, Magdalena Larysz-Brysz, Krzysztof Łabuzek, Bartosz Kapustka, Rafał Staszkiewicz, Paulina Rosicka, Katarzyna Kalita, Władysław Węglarz, Joanna Lewin-Kowalik
Spinal cord injuries are still a serious problem for regenerative medicine. Previous research has demonstrated that activated microglia accumulate in spinal lesions, influencing the injured tissues in various ways. Therefore, transplantation of activated microglia may have a beneficial role in the regeneration of the nervous system. The present study examined the influence of transplanted activated microglial cells in adult rats with injured spinal cords. Rats were randomly divided into an experimental (M) and control (C) group, and were subjected to non-laminectomy focal injury of spinal cord white matter by means of a high-pressured air stream...
November 2017: Experimental and Therapeutic Medicine
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