Stroke is a main cause of death and disability worldwide.The ability of the brain to selfrepair in the acute and chronic phases after stroke is minimal;however,promising stem cell-based interventions are emerging that...Stroke is a main cause of death and disability worldwide.The ability of the brain to selfrepair in the acute and chronic phases after stroke is minimal;however,promising stem cell-based interventions are emerging that may give substantial and possibly complete recovery of brain function after stroke.Many animal models and clinical trials have demonstrated that neural stem cells(NSCs)in the central nervous system can orchestrate neurological repair through nerve regeneration,neuron polarization,axon pruning,neurite outgrowth,repair of myelin,and remodeling of the microenvironment and brain networks.Compared with other types of stem cells,NSCs have unique advantages in cell replacement,paracrine action,inflammatory regulation and neuroprotection.Our review summarizes NSC origins,characteristics,therapeutic mechanisms and repair processes,then highlights current research findings and clinical evidence for NSC therapy.These results may be helpful to inform the direction of future stroke research and to guide clinical decision-making.展开更多
Fifty-one patients with mild （n -- 14）, moderate （n = 10） and severe traumatic brain injury （n = 27） received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score Functional le...Fifty-one patients with mild （n -- 14）, moderate （n = 10） and severe traumatic brain injury （n = 27） received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury.展开更多
Traumatic brain injury is a serious and complex neurological condition that affects millions of people worldwide.Despite significant advancements in the field of medicine,effective treatments for traumatic brain injur...Traumatic brain injury is a serious and complex neurological condition that affects millions of people worldwide.Despite significant advancements in the field of medicine,effective treatments for traumatic brain injury remain limited.Recently,extracellular vesicles released from mesenchymal stem/stromal cells have emerged as a promising novel therapy for traumatic brain injury.Extracellular vesicles are small membrane-bound vesicles that are naturally released by cells,including those in the brain,and can be engineered to contain therapeutic cargo,such as anti-inflammatory molecules,growth factors,and microRNAs.When administered intravenously,extra cellular vesicles can cross the blood-brain barrier and deliver their cargos to the site of injury,where they can be taken up by recipient cells and modulate the inflammatory response,promote neuroregeneration,and improve functional outcomes.In preclinical studies,extracellular vesicle-based therapies have shown promising results in promoting recove ry after traumatic brain injury,including reducing neuronal damage,improving cognitive function,and enhancing motor recovery.While further research is needed to establish the safety and efficacy of extra cellular vesicle-based therapies in humans,extra cellular vesicles represent a promising novel approach for the treatment of traumatic brain injury.In this review,we summarize mesenchymal ste m/stromal cell-de rived extracellular vesicles as a cell-free therapy for traumatic brain injury via neuroprotection and neurorestoration and brainderived extracellular vesicles as potential biofluid biomarkers in small and large animal models of traumatic brain injury.展开更多
Functional magnetic resonance imaging(fMRI) is em-ployed in many behavior analysis studies, with blood oxygen level dependent-(BOLD-) contrast imaging being the main method used to generate images. The use of BOLD-con...Functional magnetic resonance imaging(fMRI) is em-ployed in many behavior analysis studies, with blood oxygen level dependent-(BOLD-) contrast imaging being the main method used to generate images. The use of BOLD-contrast imaging in f MRI has been refined over the years, for example, the inclusion of a spin echo pulse and increased magnetic strength were shown to produce better recorded images. Taking careful precautions to control variables during measurement, comparisons between different specimen groups can be illustrated by f MRI imaging using both quantitative and qualitative methods. Differences have been observed in comparisons of active and resting, developing and aging, and defective and damaged brains in various studies. However, cognitive studies using f MRI still face a number of challenges in interpretation that can only be overcome by imaging large numbers of samples. Furthermore, f MRI studies of brain cancer, lesions and other brain pathologies of both humans and animals are still to be explored.展开更多
Parkinson's disease is a neurodegenerative disorder caused by loss of dopamine neurons in the substantia nigra pars compacta. Tremor, rigidity, and bradykinesia are the major symptoms of the disease. These motor i...Parkinson's disease is a neurodegenerative disorder caused by loss of dopamine neurons in the substantia nigra pars compacta. Tremor, rigidity, and bradykinesia are the major symptoms of the disease. These motor impairments are often accompanied by affective and emotional dysfunctions which have been largely studied over the last decade. The aim of this study was to investigate emotional processing organization in the brain of patients with Parkinson's disease and to explore whether there are differences between recognition of different types of emotions in Parkinson's disease. We examined 18 patients with Parkinson's disease(8 men, 10 women) with no history of neurological or psychiatric comorbidities. All these patients underwent identical brain blood oxygenation level-dependent functional magnetic resonance imaging for emotion evaluation. Blood oxygenation level-dependent functional magnetic resonance imaging results revealed that the occipito-temporal cortices, insula, orbitofrontal cortex, basal ganglia, and parietal cortex which are involved in emotion processing, were activated during the functional control. Additionally, positive emotions activate larger volumes of the same anatomical entities than neutral and negative emotions. Results also revealed that Parkinson's disease associated with emotional disorders are increasingly recognized as disabling as classic motor symptoms. These findings help clinical physicians to recognize the emotional dysfunction of patients with Parkinson's disease.展开更多
Repetitive traumatic brain injury impacts adult neurogenesis in the hippocampal dentate gyrus,leading to long-term cognitive impairment.However,the mechanism underlying this neurogenesis impairment remains unknown.In ...Repetitive traumatic brain injury impacts adult neurogenesis in the hippocampal dentate gyrus,leading to long-term cognitive impairment.However,the mechanism underlying this neurogenesis impairment remains unknown.In this study,we established a male mouse model of repetitive traumatic brain injury and performed long-term evaluation of neurogenesis of the hippocampal dentate gyrus after repetitive traumatic brain injury.Our results showed that repetitive traumatic brain injury inhibited neural stem cell proliferation and development,delayed neuronal maturation,and reduced the complexity of neuronal dendrites and spines.Mice with repetitive traumatic brain injuryalso showed deficits in spatial memory retrieval.Moreover,following repetitive traumatic brain injury,neuroinflammation was enhanced in the neurogenesis microenvironment where C1q levels were increased,C1q binding protein levels were decreased,and canonical Wnt/β-catenin signaling was downregulated.An inhibitor of C1 reversed the long-term impairment of neurogenesis induced by repetitive traumatic brain injury and improved neurological function.These findings suggest that repetitive traumatic brain injury–induced C1-related inflammation impairs long-term neurogenesis in the dentate gyrus and contributes to spatial memory retrieval dysfunction.展开更多
Traumatic brain injury （TBI） is the leading cause of death and disability of persons under 45 years old in the United States, affecting over 1.5 million individtials each year. It had been th ought that recovery fro...Traumatic brain injury （TBI） is the leading cause of death and disability of persons under 45 years old in the United States, affecting over 1.5 million individtials each year. It had been th ought that recovery from such injuries is severely limited due to the inability of the adult bra in to replace damaged neurons. However, recent studies indicate that the mature mammalian central nervous system （CNS） has the potential to replenish damaged neurons by proliferation and neuronal differentiation of adult neural stem/progenitor cells residing in the neurogenic regions in the brain. Furthermore, increasing evidence indicates that these endogenous stem/ progenitor cells may play regenerative and reparative roles in response to CNS injuries or diseases. In support of this notion, heightened levels of cell proliferation and neurogenesis have been ob- served in response to brain trauma or insults suggesting that the brain has the inherent potential to restore populations of damaged or destroyed neurons. This review will discuss the potential functions of adult neurogenesis and recent development of strategies aiming at harnessing this neurogenic capacity in order to repopulate and repair the injured brain.展开更多
To investigate the supplement of lost nerve cells in rats with traumatic brain injury by intravenous administration of allogenic bone marrow mesenchymal stem cells, this study established a Wistar rat model of traumat...To investigate the supplement of lost nerve cells in rats with traumatic brain injury by intravenous administration of allogenic bone marrow mesenchymal stem cells, this study established a Wistar rat model of traumatic brain injury by weight drop impact acceleration method and administered 3 × 106 rat bone marrow mesenchymal stem cells via the lateral tail vein. At 14 days after cell transplantation, bone marrow mesenchymal stem cells differentiated into neurons and astrocytes in injured rat cerebral cortex and rat neurological function was improved significantly. These findings suggest that intravenously administered bone marrow mesenchymal stem cells can promote nerve cell regeneration in injured cerebral cortex, which supplement the lost nerve cells.展开更多
Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjuncti...Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid（2.5–3.0 atm impact force）. The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions.展开更多
BACKGROUND： Stereotactic injection （striatum or lateral ventricle） and vascular injection （ tail vein or carotid artery） are now often used in cellular therapy for cerebral infarction. Stereotactic injection can ...BACKGROUND： Stereotactic injection （striatum or lateral ventricle） and vascular injection （ tail vein or carotid artery） are now often used in cellular therapy for cerebral infarction. Stereotactic injection can accurately deliver cells to the infarct area, but requires a stereotactic device and causes secondary trauma; vascular injection is easy and better for host neurological deficit recovery, but can cause thrombosis. OBJECTIVE： To compare the therapeutic potential of adult bone marrow-derived mesenchymal stem cells （BMSCs） transplantation by intraperitoneal versus intravenous administration to cerebral ischemic rats. DESIGN, TIME AND SE＇B＇ING： A randomized controlled animal experiment was performed at the Cell Room and Pathology Laboratory, Brain Hospital Affiliated to Nanjing Medical University from November 2007 to September 2008. MATERIALS： BMSCs were derived from 20 healthy Sprague-Dawley rats aged 4-6 weeks. METHODS： Forty-five adult middle cerebral artery occlusion （MCAO） rats were randomly divided into control, intravenous and intraperitoneal injection groups, with 15 rats in each group. At 21 days after modeling, rats in the control group received 1 mL of 0.01 mol/L phosphate buffered saline via tail vein injection and each experimental rat received 4 x 106 BMSCs labeled by bromodeoxyuridine （BrdU） via intravenous or intraperitoneal injection. MAIN OUTCOME MEASURES： Angiogenin expression and survival of transplanted cells were measured by immunohistochemical staining of brain tissue in infarction hemisphere at 7, 14 or 21 days after BMSC transplantation. Co-expression of BrdU/microtubule-associated protein 2 or BrdU/glial fibrillary acidic protein was observed by double-labeled immunofluorescence of cerebral cortex. Evaluation of nerve function adhesion-removal test was performed on the 14 or 21 days after BMSCs treatment. using the neurological injury severity score and the 1st and 21st day before and after MCAO, and at 3, 7 RESULTS： Angiogenin-positive new vessels were distributed in the bilateral striatum, hippocampus and cerebral cortex of each group of rats at each time point, most markedly in the intravenous injection group. There were significantly more BrdU-positive cells in the intravenous injection group than in the intraperitoneal injection group （P 〈 0.01）. Co-expression of BrdU/ microtubule-associated protein 2 or BrdU/glial fibrillary acidic protein were almost only seen in the intravenous group by fluorescence microscopy. After transplantation, BMSCs significantly restored nerve function in rats, particularly in the intravenous injection group. CONCLUSION： BMSCs were able to enter brain tissue via the tail vein or peritoneal injection and improve neurological function by promoting the regeneration of nerves and blood vessels in vivo, more effectively after intravenous than intraperitoneal injection.展开更多
There are various clinical treatments for traumatic brain injury,including surgery,drug therapy,and rehabilitation therapy;howeve r,the therapeutic effects are limited.Scaffolds combined with exosomes represent a prom...There are various clinical treatments for traumatic brain injury,including surgery,drug therapy,and rehabilitation therapy;howeve r,the therapeutic effects are limited.Scaffolds combined with exosomes represent a promising but challenging method for improving the repair of traumatic brain injury.In this study,we determined the ability of a novel 3D-printed collagen/chitosan scaffold loaded with exosomes derived from neural stem cells pretreated with insulin-like growth factor-1(3D-CC-INEXOS) to improve traumatic brain injury repair and functional recove ry after traumatic brain injury in rats.Composite scaffolds comprising collagen,chitosan,and exosomes derived from neural stem cells pretreated with insulin-like growth fa ctor-1(INEXOS) continuously released exosomes for 2weeks.Transplantation of 3D-CC-INExos scaffolds significantly improved motor and cognitive functions in a rat traumatic brain injury model,as assessed by the Morris water maze test and modified neurological seve rity scores.In addition,immunofluorescence staining and transmission electron microscopy showed that3D-CC-INExos implantation significantly improved the recove ry of damaged nerve tissue in the injured area.In conclusion,this study suggests that transplanted3D-CC-INExos scaffolds might provide a potential strategy for the treatment of traumatic brain injury and lay a solid foundation for clinical translation.展开更多
Traumatic brain injury is a major health problem worldwide. Currently, there is no effective treatment to improve neural structural repair and functional recovery of patients in the clinic. Cell transplantation is a p...Traumatic brain injury is a major health problem worldwide. Currently, there is no effective treatment to improve neural structural repair and functional recovery of patients in the clinic. Cell transplantation is a potential strategy to repair and regenerate the injured brain. This review article summarized recent development in cell transplantation studies for post-traumatic brain injury brain repair with varying types of cell sources. It also discussed the potential of neural transplantation to repair/promote recovery of the injured brain following traumatic brain injury.展开更多
Traumatic brain injury(TBI)is the main cause of disability,mental health disorder,and even death,with its incidence and social costs rising steadily.Although different treatment strategies have been developed and test...Traumatic brain injury(TBI)is the main cause of disability,mental health disorder,and even death,with its incidence and social costs rising steadily.Although different treatment strategies have been developed and tested to mitigate neurological decline,a definitive cure for these conditions remains elusive.Studies have revealed that vari-ous neurotrophins represented by the brain-derived neurotrophic factor are the key regulators of neuroinflammation,apoptosis,blood-brain barrier permeability,neurite regeneration,and memory function.These factors are instrumental in alleviating neu-roinflammation and promoting neuroregeneration.In addition,neural stem cells(NSC)contribute to nerve repair through inherent neuroprotective and immunomodulatory properties,the release of neurotrophins,the activation of endogenous NSCs,and in-tercellular signaling.Notably,innovative research proposals are emerging to combine BDNF and NSCs,enabling them to synergistically complement and promote each other in facilitating injury repair and improving neuron differentiation after TBI.In this review,we summarize the mechanism of neurotrophins in promoting neurogen-esis and restoring neural function after TBI,comprehensively explore the potential therapeutic effects of various neurotrophins in basic research on TBI,and investigate their interaction with NSCs.This endeavor aims to provide a valuable insight into the clinical treatment and transformation of neurotrophins in TBI,thereby promoting the progress of TBI therapeutics.展开更多
We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the si...We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.展开更多
Brain lesions can cause neural stem cells to activate,proliferate,diffe rentiate,and migrate to the injured area.However,after traumatic brain injury,brain tissue defects and microenvironment changes greatly affect th...Brain lesions can cause neural stem cells to activate,proliferate,diffe rentiate,and migrate to the injured area.However,after traumatic brain injury,brain tissue defects and microenvironment changes greatly affect the survival and growth of neural stem cells;the resulting reduction in the number of neural stem cells impedes effective repair of the injured area.Melatonin can promote the survival,proliferation,and differentiation of neural stem cells under adverse conditions such as oxidative stress or hypoxia that can occur after traumatic brain injury.Therefore,we investigated the therapeutic effects of melatonin combined with neural stem cells on traumatic brain injury in rats.First,in vitro studies confirmed that melatonin promoted the survival of neural stem cells deprived of oxygen and glucose.Then,we established a three-dimensional Matrigel-based transplantation system containing melatonin and neural stem cells and then used it to treat traumatic brain injury in rats.We found that treatment with the Matrigel system containing melatonin and neural stem cells decreased brain lesion volume,increased the number of surviving neuro ns,and improved recove ry of neurological function compared with treatment with Matrigel alone,neural stem cells alone,Matrigel and neural stem cells combined,and Matrigel and melatonin combined.Our findings suggest that the three-dimensional Matrigelbased transplantation system containing melatonin and neural stem cells is a potential treatment for traumatic brain injury.展开更多
Objective: to analyze the clinical effect of effective nursing measures in patients with hypertension and severe brain stem hemorrhage treated by lateral ventricle puncture and external drainage. Methods: 80 patients ...Objective: to analyze the clinical effect of effective nursing measures in patients with hypertension and severe brain stem hemorrhage treated by lateral ventricle puncture and external drainage. Methods: 80 patients with cerebral hemorrhage who received corresponding treatment were selected from our hospital, and they were randomly and evenly divided into the control group using conventional nursing and the observation group using comprehensive nursing. The neurological function, treatment compliance, patients mood, quality of life and nursing satisfaction of the two groups were compared. Results: after nursing, the score of the observation group was lower than that of the control group;the treatment compliance rate of the observation group was higher than that of the control group;nursing in the latter two groups decreased and the observation group was lower than the control group;the quality of life score of the nursing observation group was higher than that of the control group. Nursing satisfaction of the observation group was higher than that of the control group;the above differences were statistically significant (P < 0.05). Conclusion: good nursing intervention for patients with hypertension and severe brainstem hemorrhage treated by lateral ventricle puncture and external drainage can control the patients mood, improve the treatment compliance, quality of life, neurological function and other aspects, which has a great positive effect on patients.展开更多
Human brain organoids are 3-dimensional brain-like tissues derived from human pluripotent stem cells and hold promising potential for modeling neurological,psychiatric,and developmental disorders.While the molecular a...Human brain organoids are 3-dimensional brain-like tissues derived from human pluripotent stem cells and hold promising potential for modeling neurological,psychiatric,and developmental disorders.While the molecular and cellular aspects of human brain organoids have been intensively studied,their functional properties such as organoid neural networks(ONNs)are largely understudied.Here,we summarize recent research advances in understanding,characterization,and application of functional ONNs in human brain organoids.We first discuss the formation of ONNs and follow up with characterization strategies including microelectrode array(MEA)technology and calcium imaging.Moreover,we highlight recent studies utilizing ONNs to investigate neurological diseases such as Rett syndrome and Alzheimer’s disease.Finally,we provide our perspectives on the future challenges and opportunities for using ONNs in basic research and translational applications.展开更多
Exosomes derived from human bone marrow mesenchymal stem cells(MSC-Exo)are characterized by easy expansion and storage,low risk of tumor formation,low immunogenicity,and anti-inflammatory effects.The therapeutic effec...Exosomes derived from human bone marrow mesenchymal stem cells(MSC-Exo)are characterized by easy expansion and storage,low risk of tumor formation,low immunogenicity,and anti-inflammatory effects.The therapeutic effects of MSC-Exo on ischemic stroke have been widely explored.However,the underlying mechanism remains unclear.In this study,we established a mouse model of ischemic brain injury induced by occlusion of the middle cerebral artery using the thread bolt method and injected MSC-Exo into the tail vein.We found that administration of MSC-Exo reduced the volume of cerebral infarction in the ischemic brain injury mouse model,increased the levels of interleukin-33(IL-33)and suppression of tumorigenicity 2 receptor(ST2)in the penumbra of cerebral infarction,and improved neurological function.In vitro results showed that astrocyte-conditioned medium of cells deprived of both oxygen and glucose,to simulate ischemia conditions,combined with MSC-Exo increased the survival rate of primary cortical neurons.However,after transfection by IL-33 siRNA or ST2 siRNA,the survival rate of primary cortical neurons was markedly decreased.These results indicated that MSC-Exo inhibited neuronal death induced by oxygen and glucose deprivation through the IL-33/ST2 signaling pathway in astrocytes.These findings suggest that MSC-Exo may reduce ischemia-induced brain injury through regulating the IL-33/ST2 signaling pathway.Therefore,MSC-Exo may be a potential therapeutic method for ischemic stroke.展开更多
BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 ...BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.展开更多
White matter(WM)comprises approximately half of the human brain volume and is primarily composed of bundles of axons and glia.The axons conduct nerve impulses between gray matter(GM)to support information transmission...White matter(WM)comprises approximately half of the human brain volume and is primarily composed of bundles of axons and glia.The axons conduct nerve impulses between gray matter(GM)to support information transmission and coordination within brain networks or circuits.Despite the overwhelming emphasis of human brain imaging on GM,few would deny the importance of the functional contributions of WM to human cognition and behavior.For in vivo brain studies,diffusion magnetic resonance imaging(MRI)has been widely used to delineate WM fibers and measure their microstructural properties,but diffusion MRI reveals little about functional activity.For a long time,we have lacked an in vivo way to quantify functional metrics of wM.In contrast to the widespread application of functional MRI(fMRI)based on blood oxygenation-level-dependent(BOLD)signals to assess GM functions[1],BOLD effects in WM have been regarded as noise or nuisance variables in most neuroimaging studies.展开更多
基金This work was supported by the National Natural Science Foundation of China,No.81471308(to JL)Program of China National Health Commission and National Medical Products Administration(NMPA),No.CMR-20161129-1003(to JL)+1 种基金Liaoning Province Excellent Talent Program Project,No.XLYC1902031(to JL)Dalian Innovation Fund,No.2018J11CY025(to JL).
文摘Stroke is a main cause of death and disability worldwide.The ability of the brain to selfrepair in the acute and chronic phases after stroke is minimal;however,promising stem cell-based interventions are emerging that may give substantial and possibly complete recovery of brain function after stroke.Many animal models and clinical trials have demonstrated that neural stem cells(NSCs)in the central nervous system can orchestrate neurological repair through nerve regeneration,neuron polarization,axon pruning,neurite outgrowth,repair of myelin,and remodeling of the microenvironment and brain networks.Compared with other types of stem cells,NSCs have unique advantages in cell replacement,paracrine action,inflammatory regulation and neuroprotection.Our review summarizes NSC origins,characteristics,therapeutic mechanisms and repair processes,then highlights current research findings and clinical evidence for NSC therapy.These results may be helpful to inform the direction of future stroke research and to guide clinical decision-making.
文摘Fifty-one patients with mild （n -- 14）, moderate （n = 10） and severe traumatic brain injury （n = 27） received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury.
基金supported by Notional Institutes of Health Grant,No.1R01NS100710-01A1(to YX)。
文摘Traumatic brain injury is a serious and complex neurological condition that affects millions of people worldwide.Despite significant advancements in the field of medicine,effective treatments for traumatic brain injury remain limited.Recently,extracellular vesicles released from mesenchymal stem/stromal cells have emerged as a promising novel therapy for traumatic brain injury.Extracellular vesicles are small membrane-bound vesicles that are naturally released by cells,including those in the brain,and can be engineered to contain therapeutic cargo,such as anti-inflammatory molecules,growth factors,and microRNAs.When administered intravenously,extra cellular vesicles can cross the blood-brain barrier and deliver their cargos to the site of injury,where they can be taken up by recipient cells and modulate the inflammatory response,promote neuroregeneration,and improve functional outcomes.In preclinical studies,extracellular vesicle-based therapies have shown promising results in promoting recove ry after traumatic brain injury,including reducing neuronal damage,improving cognitive function,and enhancing motor recovery.While further research is needed to establish the safety and efficacy of extra cellular vesicle-based therapies in humans,extra cellular vesicles represent a promising novel approach for the treatment of traumatic brain injury.In this review,we summarize mesenchymal ste m/stromal cell-de rived extracellular vesicles as a cell-free therapy for traumatic brain injury via neuroprotection and neurorestoration and brainderived extracellular vesicles as potential biofluid biomarkers in small and large animal models of traumatic brain injury.
文摘Functional magnetic resonance imaging(fMRI) is em-ployed in many behavior analysis studies, with blood oxygen level dependent-(BOLD-) contrast imaging being the main method used to generate images. The use of BOLD-contrast imaging in f MRI has been refined over the years, for example, the inclusion of a spin echo pulse and increased magnetic strength were shown to produce better recorded images. Taking careful precautions to control variables during measurement, comparisons between different specimen groups can be illustrated by f MRI imaging using both quantitative and qualitative methods. Differences have been observed in comparisons of active and resting, developing and aging, and defective and damaged brains in various studies. However, cognitive studies using f MRI still face a number of challenges in interpretation that can only be overcome by imaging large numbers of samples. Furthermore, f MRI studies of brain cancer, lesions and other brain pathologies of both humans and animals are still to be explored.
文摘Parkinson's disease is a neurodegenerative disorder caused by loss of dopamine neurons in the substantia nigra pars compacta. Tremor, rigidity, and bradykinesia are the major symptoms of the disease. These motor impairments are often accompanied by affective and emotional dysfunctions which have been largely studied over the last decade. The aim of this study was to investigate emotional processing organization in the brain of patients with Parkinson's disease and to explore whether there are differences between recognition of different types of emotions in Parkinson's disease. We examined 18 patients with Parkinson's disease(8 men, 10 women) with no history of neurological or psychiatric comorbidities. All these patients underwent identical brain blood oxygenation level-dependent functional magnetic resonance imaging for emotion evaluation. Blood oxygenation level-dependent functional magnetic resonance imaging results revealed that the occipito-temporal cortices, insula, orbitofrontal cortex, basal ganglia, and parietal cortex which are involved in emotion processing, were activated during the functional control. Additionally, positive emotions activate larger volumes of the same anatomical entities than neutral and negative emotions. Results also revealed that Parkinson's disease associated with emotional disorders are increasingly recognized as disabling as classic motor symptoms. These findings help clinical physicians to recognize the emotional dysfunction of patients with Parkinson's disease.
基金supported by the Fundamental Research Program of Shanxi Province of China,No.20210302124277the Science Foundation of Shanxi Bethune Hospital,No.2021YJ13(both to JW)。
文摘Repetitive traumatic brain injury impacts adult neurogenesis in the hippocampal dentate gyrus,leading to long-term cognitive impairment.However,the mechanism underlying this neurogenesis impairment remains unknown.In this study,we established a male mouse model of repetitive traumatic brain injury and performed long-term evaluation of neurogenesis of the hippocampal dentate gyrus after repetitive traumatic brain injury.Our results showed that repetitive traumatic brain injury inhibited neural stem cell proliferation and development,delayed neuronal maturation,and reduced the complexity of neuronal dendrites and spines.Mice with repetitive traumatic brain injuryalso showed deficits in spatial memory retrieval.Moreover,following repetitive traumatic brain injury,neuroinflammation was enhanced in the neurogenesis microenvironment where C1q levels were increased,C1q binding protein levels were decreased,and canonical Wnt/β-catenin signaling was downregulated.An inhibitor of C1 reversed the long-term impairment of neurogenesis induced by repetitive traumatic brain injury and improved neurological function.These findings suggest that repetitive traumatic brain injury–induced C1-related inflammation impairs long-term neurogenesis in the dentate gyrus and contributes to spatial memory retrieval dysfunction.
文摘Traumatic brain injury （TBI） is the leading cause of death and disability of persons under 45 years old in the United States, affecting over 1.5 million individtials each year. It had been th ought that recovery from such injuries is severely limited due to the inability of the adult bra in to replace damaged neurons. However, recent studies indicate that the mature mammalian central nervous system （CNS） has the potential to replenish damaged neurons by proliferation and neuronal differentiation of adult neural stem/progenitor cells residing in the neurogenic regions in the brain. Furthermore, increasing evidence indicates that these endogenous stem/ progenitor cells may play regenerative and reparative roles in response to CNS injuries or diseases. In support of this notion, heightened levels of cell proliferation and neurogenesis have been ob- served in response to brain trauma or insults suggesting that the brain has the inherent potential to restore populations of damaged or destroyed neurons. This review will discuss the potential functions of adult neurogenesis and recent development of strategies aiming at harnessing this neurogenic capacity in order to repopulate and repair the injured brain.
基金supported by research center from Shahid Sadoughi University of Medical Sciences,Yazd,Iran
文摘To investigate the supplement of lost nerve cells in rats with traumatic brain injury by intravenous administration of allogenic bone marrow mesenchymal stem cells, this study established a Wistar rat model of traumatic brain injury by weight drop impact acceleration method and administered 3 × 106 rat bone marrow mesenchymal stem cells via the lateral tail vein. At 14 days after cell transplantation, bone marrow mesenchymal stem cells differentiated into neurons and astrocytes in injured rat cerebral cortex and rat neurological function was improved significantly. These findings suggest that intravenously administered bone marrow mesenchymal stem cells can promote nerve cell regeneration in injured cerebral cortex, which supplement the lost nerve cells.
文摘Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid（2.5–3.0 atm impact force）. The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions.
基金the"135 Project"Medical Key Talent Foundation of Jiangsu Province
文摘BACKGROUND： Stereotactic injection （striatum or lateral ventricle） and vascular injection （ tail vein or carotid artery） are now often used in cellular therapy for cerebral infarction. Stereotactic injection can accurately deliver cells to the infarct area, but requires a stereotactic device and causes secondary trauma; vascular injection is easy and better for host neurological deficit recovery, but can cause thrombosis. OBJECTIVE： To compare the therapeutic potential of adult bone marrow-derived mesenchymal stem cells （BMSCs） transplantation by intraperitoneal versus intravenous administration to cerebral ischemic rats. DESIGN, TIME AND SE＇B＇ING： A randomized controlled animal experiment was performed at the Cell Room and Pathology Laboratory, Brain Hospital Affiliated to Nanjing Medical University from November 2007 to September 2008. MATERIALS： BMSCs were derived from 20 healthy Sprague-Dawley rats aged 4-6 weeks. METHODS： Forty-five adult middle cerebral artery occlusion （MCAO） rats were randomly divided into control, intravenous and intraperitoneal injection groups, with 15 rats in each group. At 21 days after modeling, rats in the control group received 1 mL of 0.01 mol/L phosphate buffered saline via tail vein injection and each experimental rat received 4 x 106 BMSCs labeled by bromodeoxyuridine （BrdU） via intravenous or intraperitoneal injection. MAIN OUTCOME MEASURES： Angiogenin expression and survival of transplanted cells were measured by immunohistochemical staining of brain tissue in infarction hemisphere at 7, 14 or 21 days after BMSC transplantation. Co-expression of BrdU/microtubule-associated protein 2 or BrdU/glial fibrillary acidic protein was observed by double-labeled immunofluorescence of cerebral cortex. Evaluation of nerve function adhesion-removal test was performed on the 14 or 21 days after BMSCs treatment. using the neurological injury severity score and the 1st and 21st day before and after MCAO, and at 3, 7 RESULTS： Angiogenin-positive new vessels were distributed in the bilateral striatum, hippocampus and cerebral cortex of each group of rats at each time point, most markedly in the intravenous injection group. There were significantly more BrdU-positive cells in the intravenous injection group than in the intraperitoneal injection group （P 〈 0.01）. Co-expression of BrdU/ microtubule-associated protein 2 or BrdU/glial fibrillary acidic protein were almost only seen in the intravenous group by fluorescence microscopy. After transplantation, BMSCs significantly restored nerve function in rats, particularly in the intravenous injection group. CONCLUSION： BMSCs were able to enter brain tissue via the tail vein or peritoneal injection and improve neurological function by promoting the regeneration of nerves and blood vessels in vivo, more effectively after intravenous than intraperitoneal injection.
基金supported by the National Major Scientific and Technological Special Project for Significant New Drugs Development,No.2019ZX09301-147 (to LXZ)。
文摘There are various clinical treatments for traumatic brain injury,including surgery,drug therapy,and rehabilitation therapy;howeve r,the therapeutic effects are limited.Scaffolds combined with exosomes represent a promising but challenging method for improving the repair of traumatic brain injury.In this study,we determined the ability of a novel 3D-printed collagen/chitosan scaffold loaded with exosomes derived from neural stem cells pretreated with insulin-like growth factor-1(3D-CC-INEXOS) to improve traumatic brain injury repair and functional recove ry after traumatic brain injury in rats.Composite scaffolds comprising collagen,chitosan,and exosomes derived from neural stem cells pretreated with insulin-like growth fa ctor-1(INEXOS) continuously released exosomes for 2weeks.Transplantation of 3D-CC-INExos scaffolds significantly improved motor and cognitive functions in a rat traumatic brain injury model,as assessed by the Morris water maze test and modified neurological seve rity scores.In addition,immunofluorescence staining and transmission electron microscopy showed that3D-CC-INExos implantation significantly improved the recove ry of damaged nerve tissue in the injured area.In conclusion,this study suggests that transplanted3D-CC-INExos scaffolds might provide a potential strategy for the treatment of traumatic brain injury and lay a solid foundation for clinical translation.
基金funded by the National Institutes of Health Grant No.NS078710
文摘Traumatic brain injury is a major health problem worldwide. Currently, there is no effective treatment to improve neural structural repair and functional recovery of patients in the clinic. Cell transplantation is a potential strategy to repair and regenerate the injured brain. This review article summarized recent development in cell transplantation studies for post-traumatic brain injury brain repair with varying types of cell sources. It also discussed the potential of neural transplantation to repair/promote recovery of the injured brain following traumatic brain injury.
基金Laboratory Animal Foundation Program of Military,Grant/Award Number:SYDW[2018]01Promotion Plan of the Air Force Medical University,Grant/Award Number:2020SWAQ11Shaanxi Province Innovation Capability Support Plan,Grant/Award Number:2021PT-037。
文摘Traumatic brain injury(TBI)is the main cause of disability,mental health disorder,and even death,with its incidence and social costs rising steadily.Although different treatment strategies have been developed and tested to mitigate neurological decline,a definitive cure for these conditions remains elusive.Studies have revealed that vari-ous neurotrophins represented by the brain-derived neurotrophic factor are the key regulators of neuroinflammation,apoptosis,blood-brain barrier permeability,neurite regeneration,and memory function.These factors are instrumental in alleviating neu-roinflammation and promoting neuroregeneration.In addition,neural stem cells(NSC)contribute to nerve repair through inherent neuroprotective and immunomodulatory properties,the release of neurotrophins,the activation of endogenous NSCs,and in-tercellular signaling.Notably,innovative research proposals are emerging to combine BDNF and NSCs,enabling them to synergistically complement and promote each other in facilitating injury repair and improving neuron differentiation after TBI.In this review,we summarize the mechanism of neurotrophins in promoting neurogen-esis and restoring neural function after TBI,comprehensively explore the potential therapeutic effects of various neurotrophins in basic research on TBI,and investigate their interaction with NSCs.This endeavor aims to provide a valuable insight into the clinical treatment and transformation of neurotrophins in TBI,thereby promoting the progress of TBI therapeutics.
文摘We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.
基金financially the Project,No.16QNP101the Natural Science Foundation for Outstanding Youth of Chongqing,China No.cstc2019jcyjjqX0030(both to RH)。
文摘Brain lesions can cause neural stem cells to activate,proliferate,diffe rentiate,and migrate to the injured area.However,after traumatic brain injury,brain tissue defects and microenvironment changes greatly affect the survival and growth of neural stem cells;the resulting reduction in the number of neural stem cells impedes effective repair of the injured area.Melatonin can promote the survival,proliferation,and differentiation of neural stem cells under adverse conditions such as oxidative stress or hypoxia that can occur after traumatic brain injury.Therefore,we investigated the therapeutic effects of melatonin combined with neural stem cells on traumatic brain injury in rats.First,in vitro studies confirmed that melatonin promoted the survival of neural stem cells deprived of oxygen and glucose.Then,we established a three-dimensional Matrigel-based transplantation system containing melatonin and neural stem cells and then used it to treat traumatic brain injury in rats.We found that treatment with the Matrigel system containing melatonin and neural stem cells decreased brain lesion volume,increased the number of surviving neuro ns,and improved recove ry of neurological function compared with treatment with Matrigel alone,neural stem cells alone,Matrigel and neural stem cells combined,and Matrigel and melatonin combined.Our findings suggest that the three-dimensional Matrigelbased transplantation system containing melatonin and neural stem cells is a potential treatment for traumatic brain injury.
文摘Objective: to analyze the clinical effect of effective nursing measures in patients with hypertension and severe brain stem hemorrhage treated by lateral ventricle puncture and external drainage. Methods: 80 patients with cerebral hemorrhage who received corresponding treatment were selected from our hospital, and they were randomly and evenly divided into the control group using conventional nursing and the observation group using comprehensive nursing. The neurological function, treatment compliance, patients mood, quality of life and nursing satisfaction of the two groups were compared. Results: after nursing, the score of the observation group was lower than that of the control group;the treatment compliance rate of the observation group was higher than that of the control group;nursing in the latter two groups decreased and the observation group was lower than the control group;the quality of life score of the nursing observation group was higher than that of the control group. Nursing satisfaction of the observation group was higher than that of the control group;the above differences were statistically significant (P < 0.05). Conclusion: good nursing intervention for patients with hypertension and severe brainstem hemorrhage treated by lateral ventricle puncture and external drainage can control the patients mood, improve the treatment compliance, quality of life, neurological function and other aspects, which has a great positive effect on patients.
基金supported by the National Institutes of Health(awards DP2AI160242 and U01DA056242).
文摘Human brain organoids are 3-dimensional brain-like tissues derived from human pluripotent stem cells and hold promising potential for modeling neurological,psychiatric,and developmental disorders.While the molecular and cellular aspects of human brain organoids have been intensively studied,their functional properties such as organoid neural networks(ONNs)are largely understudied.Here,we summarize recent research advances in understanding,characterization,and application of functional ONNs in human brain organoids.We first discuss the formation of ONNs and follow up with characterization strategies including microelectrode array(MEA)technology and calcium imaging.Moreover,we highlight recent studies utilizing ONNs to investigate neurological diseases such as Rett syndrome and Alzheimer’s disease.Finally,we provide our perspectives on the future challenges and opportunities for using ONNs in basic research and translational applications.
基金supported by the National Natural Science Foundation of China,No.81971231(to JL)the Natural Science Foundation of Liaoning Province,No.2022-MS-391(to PW)the Scientific Research Project from the Education Department of Liaoning Province,Nos.JYTQN2020011(to PW),LJKQZ2021147(to JL)。
文摘Exosomes derived from human bone marrow mesenchymal stem cells(MSC-Exo)are characterized by easy expansion and storage,low risk of tumor formation,low immunogenicity,and anti-inflammatory effects.The therapeutic effects of MSC-Exo on ischemic stroke have been widely explored.However,the underlying mechanism remains unclear.In this study,we established a mouse model of ischemic brain injury induced by occlusion of the middle cerebral artery using the thread bolt method and injected MSC-Exo into the tail vein.We found that administration of MSC-Exo reduced the volume of cerebral infarction in the ischemic brain injury mouse model,increased the levels of interleukin-33(IL-33)and suppression of tumorigenicity 2 receptor(ST2)in the penumbra of cerebral infarction,and improved neurological function.In vitro results showed that astrocyte-conditioned medium of cells deprived of both oxygen and glucose,to simulate ischemia conditions,combined with MSC-Exo increased the survival rate of primary cortical neurons.However,after transfection by IL-33 siRNA or ST2 siRNA,the survival rate of primary cortical neurons was markedly decreased.These results indicated that MSC-Exo inhibited neuronal death induced by oxygen and glucose deprivation through the IL-33/ST2 signaling pathway in astrocytes.These findings suggest that MSC-Exo may reduce ischemia-induced brain injury through regulating the IL-33/ST2 signaling pathway.Therefore,MSC-Exo may be a potential therapeutic method for ischemic stroke.
文摘BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.
基金supported by the National Natural Science Foundation of China(82371507 and 82090034)Outstanding Youth Fund for Universities in Anhui Province(2024AH020004)+5 种基金the collaborative innovation project between universities and Hefei Comprehensive National Science Center(GXXT-2022-028)the Hefei Comprehensive National Science Center Hefei Brain Project,the 2021 Anhui Province Key R&D Project:Population Health Special Project(202104j07020033)major project of Research Fund of Anhui Institute of Translational Medicine in 2020(2020zhyx A04)the Anhui Province Clinical Medical Research Transformation Special Project(202204295107020006 and 202204295107020028)National Institutes of Health grant(R01 NS113832 and R01 NS129855)National Research and Engineering Council Canada,Discovery Grant。
文摘White matter(WM)comprises approximately half of the human brain volume and is primarily composed of bundles of axons and glia.The axons conduct nerve impulses between gray matter(GM)to support information transmission and coordination within brain networks or circuits.Despite the overwhelming emphasis of human brain imaging on GM,few would deny the importance of the functional contributions of WM to human cognition and behavior.For in vivo brain studies,diffusion magnetic resonance imaging(MRI)has been widely used to delineate WM fibers and measure their microstructural properties,but diffusion MRI reveals little about functional activity.For a long time,we have lacked an in vivo way to quantify functional metrics of wM.In contrast to the widespread application of functional MRI(fMRI)based on blood oxygenation-level-dependent(BOLD)signals to assess GM functions[1],BOLD effects in WM have been regarded as noise or nuisance variables in most neuroimaging studies.
