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imaging AND awake

Felipe de Oliveira, José Alberto Landeiro, Igor de Castro
Background: Medulloblastoma is an embryonal neoplasm and accounts for 1% of all adult intracranial tumors. It is associated with many familiar cancer syndromes, but there is no known cause for medulloblastoma. Many studies have documented differences between childhood and adult medulloblastomas in terms of location, proliferation, and apoptotic indices. There are four histological groups - classic and the variant forms (desmoplastic/nodular, anaplasic, and large cell). There are four major subgroups according to molecular configuration: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4 with differences between them according to prognostic outcomes...
2018: Surgical Neurology International
François-Xavier Ferracci, Hugues Duffau
Radical glioma resection improves overall survival, both in low-grade and high-grade glial tumors. However, preservation of the quality of life is also crucial. Areas covered: Due to the diffuse feature of gliomas, which invade the central nervous system, and due to considerable variations of brain organization among patients, an individual cerebral mapping is mandatory to solve the classical dilemma between the oncological and functional issues. Because functional neuroimaging is not reliable enough, intraoperative electrical stimulation, especially in awake patients benefiting from a real-time cognitive monitoring, is the best way to increase the extent of resection while sparing eloquent neural networks...
March 9, 2018: Expert Review of Neurotherapeutics
Matilde Balbi, Matthieu P Vanni, Max J Vega, Gergely Silasi, Yuki Sekino, Jamie D Boyd, Jeffrey M LeDue, Timothy H Murphy
Small vessel disease is characterized by sporadic obstruction of small vessels leading to neuronal cell death. These microinfarcts often escape detection by conventional magnetic resonance imaging and are identified only upon postmortem examination. Our work explores a brain-wide microinfarct model in awake head-fixed mice, where occlusions of small penetrating arterioles are reproduced by endovascular injection of fluorescent microspheres. Mesoscopic functional connectivity was mapped longitudinally in awake GCaMP6 mice using genetically encoded calcium indicators for transcranial wide-field calcium imaging...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Ashley J Guthrie, Raymond L Chai
IMPORTANCE: Transoral robotic surgery has revolutionized the practice of head and neck surgery over the past decade, with indications now expanding to include laryngeal pathology. Although laryngeal chondrosarcoma is a rare entity, trends in otolaryngology literature suggest that it can frequently be managed with conservative approaches. We hope to inspire other head and neck surgeons to consider transoral robotic surgery for the treatment of such tumors so that outcomes data can be collected and studied...
March 1, 2018: American Journal of Otolaryngology
Fan Zhang, Benhao Li, Lingfei Lu, Mengyao Zhao, Zuhai Lei
A novel small molecule fluorophore FD-1080 with both excitation and emission in NIR-II region has been successfully synthesized for in vivo imaging. A heptamethine structure is designed to shift the absorption and emission into NIR-II region. Sulphonic group and cyclohexene group are introduced to enhance its water solubility and stability. The quantum yield of FD-1080 is 0.31 %, and can be increased to 5.94 % after combining with fetal bovine serum (FBS). Significantly, 1064 nm NIR-II excitation was demonstrated with the high tissue penetration depth and superior imaging resolution compared to previously reported NIR excitation from 650 nm to 980 nm...
March 1, 2018: Angewandte Chemie
Stavros Stivaros, Shruti Garg, Maria Tziraki, Ying Cai, Owen Thomas, Joseph Mellor, Andrew A Morris, Carly Jim, Karolina Szumanska-Ryt, Laura M Parkes, Hamied A Haroon, Daniela Montaldi, Nicholas Webb, John Keane, Francisco X Castellanos, Alcino J Silva, Sue Huson, Stephen Williams, D Gareth Evans, Richard Emsley, Jonathan Green
Background: Neurofibromatosis 1 (NF1) is a monogenic model for syndromic autism. Statins rescue the social and cognitive phenotype in animal knockout models, but translational trials with subjects > 8 years using cognition/behaviour outcomes have shown mixed results. This trial breaks new ground by studying statin effects for the first time in younger children with NF1 and co-morbid autism and by using multiparametric imaging outcomes. Methods: A single-site triple-blind RCT of simvastatin vs...
2018: Molecular Autism
Rodger J Elble, Ludy Shih, Jeffrey W Cozzens
Essential tremor is the most common form of pathologic tremor. Surgical therapies disrupt tremorogenic oscillation in the cerebellothalamocortical pathway and are capable of abolishing severe tremor that is refractory to available pharmacotherapies. Surgical methods are rapidly improving and are the subject of this review. Areas covered: A PubMed search on January 18, 2018 using the query essential tremor AND surgery produced 839 abstracts. 379 papers were selected for review of the methods, efficacy, safety and expense of stereotactic deep brain stimulation (DBS), stereotactic radiosurgery (SRS), focused ultrasound (FUS) ablation, and radiofrequency ablation of the cerebellothalamocortical pathway...
February 23, 2018: Expert Review of Neurotherapeutics
Anna Rylova, Mervyn Maze
Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery...
February 21, 2018: Journal of Neurosurgical Anesthesiology
Bhik Kotecha, Andrea De Vito
Sleep related breathing disorders cause obstruction of the upper airway which can be alleviated by continuous positive airway pressure (CPAP) therapy, oral devices or surgical intervention. Non-surgical treatment modalities are not always accepted by patients and in order to attain successful surgical outcomes, evaluation of the upper airway is necessary to carefully select the patients who would benefit from surgery. There are numerous techniques available to assess the upper airway obstruction and these include imaging, acoustic analysis, pressure transducer recording and endoscopic evaluation...
January 2018: Journal of Thoracic Disease
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.)
Chihiro Namatame, Tomohiro Sonoo, Kazutaka Fukushima, Hiromu Naraba, Hideki Hashimoto, Kensuke Nakamura
RATIONALE: Various neurological manifestations are observed in thyroid storm patients but protracted disturbance of consciousness is rare. PATIENT CONCERNS: A 58-year-old male was admitted to our hospital after a traffic accident. DIAGNOSES: Although awake on arrival, he fell into coma after admission. Based on the clinical symptoms and hyperthyroidism, the patient was diagnosed with thyroid storm (TS). INTERVENTIONS: Even after improvement of hyperthyroidism, disturbance of consciousness was protracted...
February 2018: Medicine (Baltimore)
Jun Muto, Edouard Dezamis, Odile Rigaux-Viode, Sophie Peeters, Alexandre Roux, Marc Zanello, Charles Mellerio, Xavier Sauvageon, Pascale Varlet, Catherine Oppenheim, Johan Pallud
OBJECTIVE: We assessed the impact of surgery on postoperative cognitive function and ability to work in adult patients harboring a diffuse low-grade glioma involving eloquent brain regions and having a functional-based maximal surgical resection using intraoperative corticosubcortical mapping under awake conditions. METHODS: We prospectively included 39 consecutive diffuse IDH-mutant low-grade glioma patients without preoperative and adjuvant oncological treatment and assessed preoperative (mean 24...
February 9, 2018: World Neurosurgery
M Granell Gil, P Solís Albamonte, C Córdova Hernández, I Cobo, R Guijarro, J A de Andrés Ibañez
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction...
February 8, 2018: Revista Española de Anestesiología y Reanimación
Cristina Rodríguez, Na Ji
With the ability to correct for the aberrations introduced by biological specimens, adaptive optics-a method originally developed for astronomical telescopes-has been applied to optical microscopy to recover diffraction-limited imaging performance deep within living tissue. In particular, this technology has been used to improve image quality and provide a more accurate characterization of both structure and function of neurons in a variety of living organisms. Among its many highlights, adaptive optical microscopy has made it possible to image large volumes with diffraction-limited resolution in zebrafish larval brains, to resolve dendritic spines over 600μm deep in the mouse brain, and to more accurately characterize the orientation tuning properties of thalamic boutons in the primary visual cortex of awake mice...
February 6, 2018: Current Opinion in Neurobiology
Jaakko Paasonen, Petteri Stenroos, Raimo A Salo, Vesa Kiviniemi, Olli Gröhn
Resting-state functional magnetic resonance imaging (rsfMRI) is a translational imaging method with great potential in several neurobiologic applications. Most preclinical rsfMRI studies are performed in anesthetized animals, but the confounding effects of anesthesia on the measured functional connectivity (FC) are poorly understood. Therefore, we measured FC under six commonly used anesthesia protocols and compared the findings with data obtained from awake rats. The results demonstrated that each anesthesia protocol uniquely modulated FC...
January 27, 2018: NeuroImage
Martin Mamach, Florian Wilke, Martin Durisin, Frank A Beger, Mareike Finke, Andreas Büchner, Barbara Schultz, Arthur Schultz, Lilli Geworski, Frank M Bengel, Thomas Lenarz, Anke Lesinski-Schiedat, Georg Berding
BACKGROUND: 15O-Water positron emission tomography (PET) enables functional imaging of the auditory system during stimulation via a promontory electrode or cochlear implant, which is not possible using functional magnetic resonance imaging (fMRI). Although PET has been introduced in this context decades ago, its feasibility when performed during general anesthesia has not yet been explored. However, due to a shift to earlier (and bilateral) auditory implantation, the need to study children during general anesthesia appeared, since they are not able to cooperate during scanning...
February 5, 2018: EJNMMI Research
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
Susanne Skora, Fanny Mende, Manuel Zimmer
Neural information processing entails a high energetic cost, but its maintenance is crucial for animal survival. However, the brain's energy conservation strategies are incompletely understood. Employing functional brain-wide imaging and quantitative behavioral assays, we describe a neuronal strategy in Caenorhabditis elegans that balances energy availability and expenditure. Upon acute food deprivation, animals exhibit a transiently elevated state of arousal, indicated by foraging behaviors and increased responsiveness to food-related cues...
January 23, 2018: Cell Reports
Haiying Tang, Daniel Kukral, Yu-Wen Li, Matthew Fronheiser, Harold Malone, Adrienne Pena, Rick Pieschl, Kurex Sidik, Gabriel Tobon, Patrick L Chow, Linda J Bristow, Wendy Hayes, Feng Luo
Major depressive disorder is a leading cause of disability globally. Improvements in the efficacy of antidepressant therapy are needed as a high proportion (>40%) of individuals with major depressive disorder fail to respond adequately to current treatments. The non-selective N-methyl-D-aspartate receptor channel blocker, (±)-ketamine, has been reported to produce a rapid and long-lasting antidepressant response in treatment-resistant major depressive disorder patients, which provides a unique opportunity for investigation of mechanisms that mediate its therapeutic effect...
January 1, 2018: Journal of Psychopharmacology
Caio M Matias, Leonardo A Frizon, Sean J Nagel, Darlene A Lobel, André G Machado
OBJECTIVE The authors' aim in this study was to evaluate placement accuracy and clinical outcomes in patients who underwent implantation of deep brain stimulation devices with the aid of frame-based stereotaxy and intraoperative MRI after induction of general anesthesia. METHODS Thirty-three patients with movement disorders (27 with Parkinson's disease) underwent implantation of unilateral or bilateral deep brain stimulation systems (64 leads total). All patients underwent the implantation procedure with standard frame-based techniques under general anesthesia and without microelectrode recording...
January 26, 2018: Journal of Neurosurgery
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