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Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
Gözde Yeşil, Ayşe Aralaşmak, Enes Akyüz, Dilara İçağasıoğlu, Türkan Uygur Şahin, Yavuz Bayram
BACKGROUND: The KCNMA1 gene encodes the α-subunit of the large conductance, voltage and calcium-sensitive potassium channel (BK channels) which plays an important role in neuronal excitability. Heterozygous mutations in KCNMA1 were firstly described in a large family with generalized epilepsy and paroxysmal nonkinesigenic dyskinesia. Recently, homozygous KCNMA1 mutations were reported to cause a phenotype of cerebellar atrophy, developmental delay and seizures. CASE REPORT: Herein; we report a patient with a novel homozygous truncating mutation in KCNMA1 (p...
March 16, 2018: Balkan Medical Journal
Sh U Kadyrov, A N Konovalov, I N Pronin
We describe two cases of surgical treatment of well-circumscribed basal ganglia tumors. The choice of a neurosurgical approach to a deep tumor was based on the MR tractography data and depended on the course and dislocation extent of the corticospinal tract. MR tractography provides information on the course and dislocation or destruction extent of the corticospinal tract running in the internal capsule and brainstem and clarifies the exact location of a tumor within the basal ganglia. This information promotes the choice of an optimal approach for radical resection of well-circumscribed tumor, leading to improvement in neurological symptoms and patient's quality of life...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
V S Klimov, V V Kel'makov, N V Chishchina, A V Evsyukov
AIM: The study aim was to evaluate the effectiveness of intraoperative monitoring of motor evoked potentials (MEPs) for predicting changes in the neurological status of patients with cervical spinal cord tumors in the early postoperative period. MATERIAL AND METHODS: The study included 74 patients with intradural cervical spinal cord tumors who were operated on using motor evoked potential monitoring in the period from 2013 to 2016. There were 29 (39%) males and 46 (61%) females...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Joery P Molenaar, Nicol C Voermans, Lysanne A de Jong, Dick F Stegeman, Jonne Doorduin, Baziel G van Engelen
Impaired muscle relaxation is a feature of many neuromuscular disorders. However, there are few tests available to quantify muscle relaxation. Transcranial magnetic stimulation (TMS) of the motor cortex can induce muscle relaxation by abruptly inhibiting corticospinal drive. The aim of our study is to investigate if repeatability and reliability of TMS-induced relaxation is greater than voluntary relaxation. Furthermore, effects of sex, cooling and fatigue on muscle relaxation properties were studied. Muscle relaxation of deep finger flexors was assessed in twenty-five healthy subjects (14 M and 11 F, aged 39...
March 15, 2018: Journal of Applied Physiology
David T Fernandes Cabral, Georgios A Zenonos, Maximiliano Nuñez, Pinar Celtikci, Carl Snyderman, Eric Wang, Paul A Gardner, Juan C Fernandez-Miranda
BACKGROUND: The endoscopic endonasal approach (EEA) has been proposed as a potential alternative for ventral brainstem lesions. The surgical anatomy, feasibility, and limitations of the EEA for intrinsic brainstem lesions are still poorly understood. OBJECTIVE: To describe the surgical planning, anatomy, and technique of an intrinsic pontine glioma operated via EEA. METHODS: Six-human brainstems were prepared for white matter microdissection...
March 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Kimiya Fujio, Hiroki Obata, Taku Kitamura, Noritaka Kawashima, Kimitaka Nakazawa
Recent studies demonstrated that the corticospinal pathway is one of the key nodes for the feedback control of human standing and that the excitability is flexibly changed according to the current state of posture. However, it has been unclear whether this pathway is also involved in a predictive control of human standing. Here, we investigated whether the corticospinal excitability of the soleus (SOL) and tibialis anterior (TA) muscles during standing would be modulated anticipatorily when perturbation was impending...
2018: Frontiers in Human Neuroscience
Belinda J Poole, Marius Mather, Evan J Livesey, Irina M Harris, Justin A Harris
Transcranial magnetic stimulation (TMS) of the motor cortex produces motor-evoked potentials (MEPs) in contralateral muscles. The amplitude of these MEPs can be used to measure the excitability of the corticospinal tract during motor planning. In two experiments, we investigated learning-related changes in corticospinal excitability as subjects prepared to respond in a choice reaction-time task. Subjects responded with their left or right hand to a left or right arrow, and on some trials the arrow was immediately preceded by a warning cue that signaled which response would be required...
February 21, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Menuka Pallebage-Gamarallage, Sean Foxley, Ricarda A L Menke, Istvan N Huszar, Mark Jenkinson, Benjamin C Tendler, Chaoyue Wang, Saad Jbabdi, Martin R Turner, Karla L Miller, Olaf Ansorge
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a clinically and histopathologically heterogeneous neurodegenerative disorder, in which therapy is hindered by the rapid progression of disease and lack of biomarkers. Magnetic resonance imaging (MRI) has demonstrated its potential for detecting the pathological signature and tracking disease progression in ALS. However, the microstructural and molecular pathological substrate is poorly understood and generally defined histologically...
March 13, 2018: BMC Neuroscience
Hua Zhou, Yan Tang, Zhi Yuan
White matter (WM) asymmetries of the human brain have been well documented using diffusion tensor imaging (DTI). The purpose of this study was to investigate white matter asymmetry across the whole brain in cerebral small vessel disease (SVD) patients and evaluate the relation between the factors which often represent disease's existence and white matter asymmetry. A total of 105 nondemented elderly with cerebral SVD patients aged between 60 and 85 years were included in this study. All participants underwent T1 MPRAGE, fluid-attenuated inversion recovery and DTI scanning...
2018: Journal of Integrative Neuroscience
Antonino Raco, Alessandro Pesce, Flavia Fraschetti, Giancarlo D'Andrea, Filippo Maria Polli, Michele Acqui, Alessandro Frati
BACKGROUND AND STUDY OBJECTIVE:  In surgery for gliomas and brain metastases, preservation of neurologic functions is essential to ensure a good quality of life and the eligibility for adjuvant therapies. This article assesses which factors could influence the functional outcome in patients with lesions located in the motor pathways. MATERIALS AND METHODS:  A total of 92 patients with gliomas and metastases involving the motor pathways were studied for concerns regarding quality of life (Karnofsky performance status [KPS] and modified Rankin scale [mRS]) before and after surgical treatment supported by intraoperative neuromonitoring...
March 9, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Devran Ugurlu, Zeynep Firat, Uğur Türe, Gozde Unal
Accurate digital representation of major white matter bundles in the brain is an important goal in neuroscience image computing since the representations can be used for surgical planning, intra-patient longitudinal analysis and inter-subject population connectivity studies. Reconstructing desired fiber bundles generally involves manual selection of regions of interest by an expert, which is subject to user bias and fatigue, hence an automation is desirable. To that end, we first present a novel anatomical representation based on Neighborhood Resolved Fiber Orientation Distributions (NRFOD) along the fibers...
February 27, 2018: Medical Image Analysis
S J Feldman, L A Boyd, J L Neva, S Peters, K S Hayward
BACKGROUND: Information about the structural integrity of the corticospinal tract (CST) from diffusion-weighted imaging can improve our ability to understand motor outcomes in people with upper limb impairment after stroke, especially those with severe impairment. Yet, there is no consensus on which method of CST generation most accurately represents function and impairment in individuals with chronic stroke. NEW METHOD: The aim of the study was to compare different methods of CST reconstruction and resulting microstructural properties, as well as the relationship between these properties and motor function and impairment...
March 6, 2018: Journal of Neuroscience Methods
Ning Chen, Michael Chopp, Ye Xiong, Jian-Yong Qian, Mei Lu, Dong Zhou, Li He, Zhongwu Liu
In addition to thrombolysis, tissue plasminogen activator (tPA) can evoke neurorestorative processes. We therefore investigated the therapeutic effect of subacute intranasal administration of tPA post stroke on neurological recovery and on corticospinal innervation in mice. A transgenic mouse line, in which the pyramidal neurons and corticospinal tract (CST) axons are specifically labeled by yellow fluorescent protein (YFP) was employed. Adult CST-YFP mice were subjected to right unilateral middle cerebral artery occlusion (MCAo), and were randomly divided into groups treated with saline or tPA intranasally in the subacute phase...
March 5, 2018: Experimental Neurology
Sung Ho Jang, Younghyeon Kwon
RATIONALE: A 45-year-old right-handed female patient suffered head trauma after being hit by a truck that ran into a house. PATIENT CONCERNS: The patient lost consciousness for 1 hour and experienced posttraumatic amnesia for 1 month after the accident. DIAGNOSES: She underwent conservative management for a subdural hematoma in the left frontotemporal lobes and intracerebral hematoma in the left frontal lobe. INTERVENTIONS: The patient's Glasgow Coma Scale score was 11...
March 2018: Medicine (Baltimore)
Gabriel Ziegler, Patrick Grabher, Alan Thompson, Daniel Altmann, Markus Hupp, John Ashburner, Karl Friston, Nikolaus Weiskopf, Armin Curt, Patrick Freund
OBJECTIVE: To quantify atrophy, demyelination, and iron accumulation over 2 years following acute spinal cord injury and to identify MRI predictors of clinical outcomes and determine their suitability as surrogate markers of therapeutic intervention. METHODS: We assessed 156 quantitative MRI datasets from 15 patients with spinal cord injury and 18 controls at baseline and 2, 6, 12, and 24 months after injury. Clinical recovery (including neuropathic pain) was assessed at each time point...
March 7, 2018: Neurology
Michael Leung, Timo Rantalainen, Wei-Peng Teo, Dawson Kidgell
This study aimed to identify the ipsilateral corticospinal responses of the contralateral limb following different types of unilateral motor-training. Three groups performing unilateral slow-paced strength training (SPST), non-paced strength training (NPST) or visuomotor skill training (VT) were compared to a control group. It was hypothesised that 4 weeks of unilateral SPST and VT, but not NPST, would increase ipsilateral corticospinal excitability (CSE) and reduce short-interval cortical inhibition (SICI), resulting in greater performance gains of the untrained limb...
March 6, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Giuseppe Lanza, Mariagiovanna Cantone, Debora Aricò, Bartolo Lanuzza, Filomena Irene Ilaria Cosentino, Domenico Paci, Maurizio Papotto, Manuela Pennisi, Rita Bella, Giovanni Pennisi, Walter Paulus, Raffaele Ferri
Background: Based on the hyperexcitability and disinhibition observed in patients with restless legs syndrome (RLS) following transcranial magnetic stimulation (TMS), we conducted a study with low-frequency repetitive TMS (rTMS) over the primary motor (M1) and somatosensory cortical areas (S1) in patients with RLS. Methods: A total of 13 right-handed patients and 10 age-matched controls were studied using clinical scales and TMS. Measurements included resting motor threshold (rMT), motor-evoked potentials (MEPs), cortical silent period (CSP), and central motor conduction time (CMCT)...
2018: Therapeutic Advances in Neurological Disorders
David Oliveira Dias, Hoseok Kim, Daniel Holl, Beata Werne Solnestam, Joakim Lundeberg, Marie Carlén, Christian Göritz, Jonas Frisén
CNS injury often severs axons. Scar tissue that forms locally at the lesion site is thought to block axonal regeneration, resulting in permanent functional deficits. We report that inhibiting the generation of progeny by a subclass of pericytes led to decreased fibrosis and extracellular matrix deposition after spinal cord injury in mice. Regeneration of raphespinal and corticospinal tract axons was enhanced and sensorimotor function recovery improved following spinal cord injury in animals with attenuated pericyte-derived scarring...
February 21, 2018: Cell
Michele Dileone, Laura Mordillo-Mateos, Antonio Oliviero, Guglielmo Foffani
BACKGROUND: Transcranial static magnetic field stimulation (tSMS) was recently added to the family of inhibitory non-invasive brain stimulation techniques. However, the application of tSMS for 10-20 min over the motor cortex (M1) induces only short-lasting effects that revert within few minutes. OBJECTIVE: We examined whether increasing the duration of tSMS to 30 min leads to long-lasting changes in cortical excitability, which is critical for translating tSMS toward clinical applications...
February 7, 2018: Brain Stimulation
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