Long-term levodopa administration can lead to the development of levodopa-induced dyskinesia.Gamma oscillations are a widely recognized hallmark of abnormal neural electrical activity in levodopa-induced dyskinesia.Cu...Long-term levodopa administration can lead to the development of levodopa-induced dyskinesia.Gamma oscillations are a widely recognized hallmark of abnormal neural electrical activity in levodopa-induced dyskinesia.Currently,studies have reported increased oscillation power in cases of levodopa-induced dyskinesia.However,little is known about how the other electrophysiological parameters of gamma oscillations are altered in levodopa-induced dyskinesia.Furthermore,the role of the dopamine D3 receptor,which is implicated in levodopa-induced dyskinesia,in movement disorder-related changes in neural oscillations is unclear.We found that the cortico-striatal functional connectivity of beta oscillations was enhanced in a model of Parkinson’s disease.Furthermore,levodopa application enhanced cortical gamma oscillations in cortico-striatal projections and cortical gamma aperiodic components,as well as bidirectional primary motor cortex(M1)↔dorsolateral striatum gamma flow.Administration of PD128907(a selective dopamine D3 receptor agonist)induced dyskinesia and excessive gamma oscillations with a bidirectional M1↔dorsolateral striatum flow.However,administration of PG01037(a selective dopamine D3 receptor antagonist)attenuated dyskinesia,suppressed gamma oscillations and cortical gamma aperiodic components,and decreased gamma causality in the M1→dorsolateral striatum direction.These findings suggest that the dopamine D3 receptor plays a role in dyskinesia-related oscillatory activity,and that it has potential as a therapeutic target for levodopa-induced dyskinesia.展开更多
Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have rev...Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have revealed that gut microbiota can communicate bidirectionally with the brain through the gut microbiota–brain axis.This axis indicates that gut microbiota is closely related to the development and prognosis of intracerebral hemorrhage and its associated secondary white matter injury.The NACHT,LRR,and pyrin domain-containing protein 3(NLRP3)inflammasome plays a crucial role in this context.This review summarizes the dysbiosis of gut microbiota following intracerebral hemorrhage and explores the mechanisms by which this imbalance may promote the activation of the NLRP3 inflammasome.These mechanisms include metabolic pathways(involving short-chain fatty acids,lipopolysaccharides,lactic acid,bile acids,trimethylamine-N-oxide,and tryptophan),neural pathways(such as the vagus nerve and sympathetic nerve),and immune pathways(involving microglia and T cells).We then discuss the relationship between the activated NLRP3 inflammasome and secondary white matter injury after intracerebral hemorrhage.The activation of the NLRP3 inflammasome can exacerbate secondary white matter injury by disrupting the blood–brain barrier,inducing neuroinflammation,and interfering with nerve regeneration.Finally,we outline potential treatment strategies for intracerebral hemorrhage and its secondary white matter injury.Our review highlights the critical role of the gut microbiota–brain axis and the NLRP3 inflammasome in white matter injury following intracerebral hemorrhage,paving the way for exploring potential therapeutic approaches.展开更多
Achieving high-resolution intracranial imaging in a safe and portable manner is critical for the diagnosis of intracranial diseases,preoperative planning of craniotomies and intraoperative management during craniotomy...Achieving high-resolution intracranial imaging in a safe and portable manner is critical for the diagnosis of intracranial diseases,preoperative planning of craniotomies and intraoperative management during craniotomy procedures.Adaptive waveform inversion(AWI),a variant of full waveform inversion(FWI),has shown potential in intracranial ultrasound imaging.However,the robustness of AWI is affected by the parameterization of the Gaussian penalty matrix and the challenges posed by transcranial scenarios.Conventional AWI struggles to produce accurate images in these cases,limiting its application in critical medical settings.To address these issues,we propose a stabilized adaptive waveform inversion(SAWI)method,which introduces a user-defined zero-lag position for theWiener filter.Numerical experiments demonstrate that SAWI can achieve accurate imaging under Gaussian penalty matrix parameter settings where AWI fails,perform successful transcranial imaging in configurations where AWI cannot,and maintain the same imaging accuracy as AWI.The advantage of this method is that it achieves these advancements without modifying the AWI framework or increasing computational costs,which helps to promote the application of AWI in medical fields,particularly in transcranial scenarios.展开更多
Subarachnoid hemorrhage is associated with high morbidity and mortality and lacks effective treatment.Pyroptosis is a crucial mechanism underlying early brain injury after subarachnoid hemorrhage.Previous studies have...Subarachnoid hemorrhage is associated with high morbidity and mortality and lacks effective treatment.Pyroptosis is a crucial mechanism underlying early brain injury after subarachnoid hemorrhage.Previous studies have confirmed that tumor necrosis factor-stimulated gene-6(TSG-6)can exert a neuroprotective effect by suppressing oxidative stress and apoptosis.However,no study to date has explored whether TSG-6 can alleviate pyroptosis in early brain injury after subarachnoid hemorrhage.In this study,a C57BL/6J mouse model of subarachnoid hemorrhage was established using the endovascular perforation method.Our results indicated that TSG-6 expression was predominantly detected in astrocytes,along with NLRC4 and gasdermin-D(GSDMD).The expression of NLRC4,GSDMD and its N-terminal domain(GSDMD-N),and cleaved caspase-1 was significantly enhanced after subarachnoid hemorrhage and accompanied by brain edema and neurological impairment.To explore how TSG-6 affects pyroptosis during early brain injury after subarachnoid hemorrhage,recombinant human TSG-6 or a siRNA targeting TSG-6 was injected into the cerebral ventricles.Exogenous TSG-6 administration downregulated the expression of NLRC4 and pyroptosis-associated proteins and alleviated brain edema and neurological deficits.Moreover,TSG-6 knockdown further increased the expression of NLRC4,which was accompanied by more severe astrocyte pyroptosis.In summary,our study revealed that TSG-6 provides neuroprotection against early brain injury after subarachnoid hemorrhage by suppressing NLRC4 inflammasome activation-induced astrocyte pyroptosis.展开更多
The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation.This stereoelectroencephalography(SEEG)study investigated how the dorsolateral prefrontal corte...The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation.This stereoelectroencephalography(SEEG)study investigated how the dorsolateral prefrontal cortex(DLPFC)interacts with the hippocampus in the online processing of sequential information.Twenty patients with epilepsy(eight women,age 27.6±8.2 years)completed a line ordering task with SEEG recordings over the DLPFC and the hippocampus.Participants showed longer thinking times and more recall errors when asked to arrange random lines clockwise(random trials)than to maintain ordered lines(ordered trials)before recalling the orientation of a particular line.First,the ordering-related increase in thinking time and recall error was associated with a transient theta power increase in the hippocampus and a sustained theta power increase in the DLPFC(3–10 Hz).In particular,the hippocampal theta power increase correlated with the memory precision of line orientation.Second,theta phase coherences between the DLPFC and hippocampus were enhanced for ordering,especially for more precisely memorized lines.Third,the theta band DLPFC→hippocampus influence was selectively enhanced for ordering,especially for more precisely memorized lines.This study suggests that theta oscillations may support DLPFC-hippocampal interactions in the online processing of sequential information.展开更多
Introduction:Spinal cord injury is one of the main causes of severe neurological trauma and disability.Intramedullary decompression of acute spinal cord contusion in acute phase is one of the important therapeutic exp...Introduction:Spinal cord injury is one of the main causes of severe neurological trauma and disability.Intramedullary decompression of acute spinal cord contusion in acute phase is one of the important therapeutic exploration methods.Due to the lack of multicenter,randomized,double-blind,placebo-controlled clinical studies,true effect of this treatment remains controversial.Objective of the study:This design of the study is to explore the safety and neuro-restorativeeffects of intramedullary decompression for acute complete spinal cord contusion injury.Design of the study:We design the prospective,multicenter,randomized,double-blind placebo-controlled trial(MRDPT)for acute(less than 24 hours after injury)spinal cord contusion injury.Sixty patients with acute complete spinal cord contusion injury(20 in cervical 4 to thoracic 1,20 in thoracic 2 to thoracic 9,and 20 in thoracic 10 to lumbar vertebra 1)are selected according to the selected conditions.All patients receive conventional treatments such as reduction and fixation of spinal fractures and/or spinal spondylolisthesis,bone external decompression relieves spinal cord compression.At the same time,group A(n=30,10 of each segment group)undergoes intramedullary decompression surgery and group B(n=30)does not undergo intramedullary decompression.All relevant functional changes before,after,and during the follow-up period are recorded to ensure objective evaluation of the results of the treatment.Ethics and dissemination:The clinical study protocol and consent form were approved by China Branch of International Association of Neurorestoratology and the ethics committees of the hospitals which join this trial.Registration No.of this study is ChiCTR1800020458.Findings will be published in peer-reviewed journals.展开更多
Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimul...Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex- plosive injury received continuous stimulation （10 V, 5 Hz, 5 ms, 20 minutes） of the right cervical vagus nerve. Tumor necrosis factor-a, interleukin-l~ and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-a and interleukin-1β concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-a, interleukin-1 β and interleukin-10 in the serum and brain tissue.展开更多
Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analy...Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuro- nal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deficits expected after damage to the cortical motor system due to stroke. These findings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.展开更多
Tuberculous infection manifesting as an isolated intramedullary tuberculoma of the spinal cord is distinctly unusual.We report a case of a 35 year old woman presenting with an insidious onset of myelopathy,where MRI s...Tuberculous infection manifesting as an isolated intramedullary tuberculoma of the spinal cord is distinctly unusual.We report a case of a 35 year old woman presenting with an insidious onset of myelopathy,where MRI showed characteristic imaging findings suggestive of intramedullary tuberculosis.展开更多
Traumatic injuries to the central nervous system,such as traumatic brain injury,spinal cord injury and stroke,have a high prevalence,enormous financial costs and lack clinical treatments that restore neurological func...Traumatic injuries to the central nervous system,such as traumatic brain injury,spinal cord injury and stroke,have a high prevalence,enormous financial costs and lack clinical treatments that restore neurological function（Ma et al.,2014）These injuries trigger a series of secondary biochemical and cellular responses that ultimately lead to cellular death and themaintenance of an unsupportive extracellular matrix （ECM） for tissue regeneration （Silva et al., 2014）. Artificial ECM or scaf- folds represent a way to alter this unsupportive environment to improve the efficacy of stem cell therapies and enhance neural tissue regeneration （Figure 1）.展开更多
1 Overview Glioma is originated in the glial cells in the brain tumor.Gliomas account for the great majority of primary tumors that arise within the brain parenchyma.The term“glioma”refers to tumors that have histol...1 Overview Glioma is originated in the glial cells in the brain tumor.Gliomas account for the great majority of primary tumors that arise within the brain parenchyma.The term“glioma”refers to tumors that have histologic features similar to normal glial cells.The World Health Organization(WHO)classification of glioma divided into the central nervous system tumor gradesⅠ-Ⅳ.The slower-growing lesions,corresponding to WHO gradesⅠandⅡ,have been commonly referred to as low-grade gliomas,while the gradesⅢandⅣtumors are referred to as high-grade gliomas.展开更多
The novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2 has created a life-threatening world pandemic.Unfortunately,this disease can be worse in older patients or individu...The novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2 has created a life-threatening world pandemic.Unfortunately,this disease can be worse in older patients or individuals with comorbidities,having dangerous consequences,including stroke.COVID-19–associated stroke widely increases the risk of death from COVID-19.In addition to the personal hygiene protocols and preventive policies,it has been proven that immune-compromised,oxidative,and pro-coagulant conditions make a person more susceptible to severe COVID-19 complications,such as stroke;one of the most effective and modifiable risk factors are poor nutritional status.Previous literature has shown that healthy dietary patterns,such as the Mediterranean diet,some food groups,and specific micronutrients,reduce the risk of ischemic and hemorrhagic stroke.In this work,for the first time,we hypothesized that a healthy diet could also be a protective/preventive factor against COVID-19–associated stroke risk.In order to prove this hypothesis,it is required to study nutritional intake and dietary patterns in patients suffering from COVID-19–associated stroke.If this hypothesis is proven,the chronic supportive role of a healthy diet in critical situations will be highlighted once again.展开更多
Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presenta...Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presentation: A 35-year-old woman with a history of mastectomy left breast cancer 5 years below radiotherapy was referred to the neurosurgery department with a parietal extra-axial mass parietal evolving for one year. CT scan with Magnetic resonance imaging revealed an extra-axial tumor with lysis bone. A craniotomy was performed to remove the mass that was located extra-axial. Histopathological examination revealed metastasis. Conclusions: Lesion skull vaults are rare but they should be considered in the differential diagnosis of intraosseous meningioma lesions. In this report, we discuss the clinical aspects of cases we observed, in which the metastasis bone was found thanks to the histological examination of a calvarial mass after surgery.展开更多
IntroductionThe severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic has taken a toll on humans,and the development of effective vaccines has been a promising tool to end the pandemic.However,for a vacc...IntroductionThe severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic has taken a toll on humans,and the development of effective vaccines has been a promising tool to end the pandemic.However,for a vaccination program to be successful,a considerable proportion of the community must be vaccinated.Hence,public acceptance of coronavirus disease 2019(COVID-19)vaccines has become the key to controlling the pandemic.Recent studies have shown vaccine hesitancy increasing over time.This systematic review aims to evaluate the COVID-19 vaccine hesitancy rate and related factors in different communities.MethodA comprehensive search was performed in MEDLINE(via PubMed),Scopus,and Web of Science from January 1,2019 to January 31,2022.All relevant descriptive and observational studies(cross-sectional and longitudinal)on vaccine hesitancy and acceptance were included in this systematic review.In the meta-analysis,odds ratio(OR)was used to assess the effects of population characteristics on vaccine hesitancy,and event rate(acceptance rate)was the effect measure for overall acceptance.Publication bias was assessed using the funnel plot,Egger's test,and trim-and-fill methods.ResultA total of 135 out of 6,417 studies were included after screening.A meta-analysis of 114 studies,including 849,911 participants,showed an overall acceptance rate of 63.1%.In addition,men,married individuals,educated people,those with a history of flu vaccination,those with higher income levels,those with comorbidities,and people living in urban areas were less hesitant.ConclusionIncreasing public awareness of the importance of COVID-19 vaccines in overcoming the pandemic is crucial.Being men,living in an urban region,being married or educated,having a history of influenza vaccination,having a higher level of income status,and having a history of comorbidities are associated with higher COVID-19 vaccine acceptance.展开更多
Transcranial magnetic stimulation(TMS)is a noninvasive neurophysiologic technique that can stimulate the human brain.Positioning of the coil was often performed based merely on external landmarks on the head,meaning t...Transcranial magnetic stimulation(TMS)is a noninvasive neurophysiologic technique that can stimulate the human brain.Positioning of the coil was often performed based merely on external landmarks on the head,meaning that the anatomical target in the cortex remains inaccurate.Navigated transcranial magnetic stimulation(nTMS)combines a frameless stereotactic navigational system and TMS coil and can provide a highly accurate delivery of TMS pulses with the guidance of imaging.Therefore,many novel utilities for TMS could be explored due to the ability of precise localization.Many studies have been published,which indicate nTMS enables presurgical functional mapping.This review aimed to provide a comprehensive literature review on nTMS,especially the principles and clinical applications of nTMS.All articles in PubMed with keywords of'motor mapping,''presurgical mapping,''navigated transcranial magnetic stimulation,'and'language mapping'published from 2000 to 2018 were included in the study.Frequently cited publications before 2000 were also included.The most valuable published original and review articles related to our objective were selected.Motor mapping of nTMS is validated to be a trustful tool to recognize functional areas belonging to both normal and lesioned primary motor cortex.It can offer reliable mapping of speech and motor regions at cortex prior to operation and has comparable accuracy as direct electrical cortical stimulation.nTMS is a powerful tool for mapping of motor and linguistic function prior to operation,has high application value in neurosurgery and the treatment of neurological and psychiatric diseases,and has gained increasing acceptance in neurosurgical centers across the world.展开更多
Introduction:We developed the method of cervical spinal cord decompression through durotomy followed by duroplasty and analyzed its efficacy.Purpose:To develop a tactic of decompression durotomy and duroplasty for the...Introduction:We developed the method of cervical spinal cord decompression through durotomy followed by duroplasty and analyzed its efficacy.Purpose:To develop a tactic of decompression durotomy and duroplasty for the treatment of severe spinal cord injury(SCI)with extensive edema of the spinal cord and without intramedullary hematoma,and to demonstrate the effectiveness of this method.Methods:From October 2016 to January 2018,17 decompression operations were performed in the cervical spine in patients with SCI.Decompression laminectomy was done without durotomy in the first group of patients.In the second group,duroplasty of the spinal cord was performed after decompression durotomy.A total of 17 patients,16 males(94%)and 1 female(6%),were operated on(ages from 32 to 66 years).The patients were divided into two groups:a control group and an experimental group.We used the ASIA scale for assessing the patients.The mean follow up time is 12 months(8−24 months).Results:The first group,i.e.,the control group consisted of 10 patients who underwent decompression laminectomy without durotomy.The second group,i.e.,the experimental group consisted of 7 patients who underwent durotomy followed by duroplasty.In this group,the positive dynamics were observed in 6 patients.Out of 2 patients with ASIA grade“A”,one showed improvement to ASIA grade“C”,and one improved to ASIA“D”.Two patients with ASIA grade“B”showed recovery to ASIA“D”.Two patients with ASIA grade“C”improved to grade“D”while one patient showed no change from ASIA“C”.Durotomy and duroplasty was effective in the experimental group.Conclusion:The performance of durotomy and duroplasty is an efficient method for the full-scale decompression of the spinal cord and the prevention of edema.This method aims at decreasing intraspinal pressure,as well as preventing ischemia and apoptosis,which is possible for the prevention and treatment of the spinal cord com-partment syndrome or spinal cord intramedullary hypertension.展开更多
Background Cerebral palsy(CP)is the most prevalent motor disability among children,for which effective treatment options remain limited.This research sought to evaluate the safety and initial effectiveness of multiple...Background Cerebral palsy(CP)is the most prevalent motor disability among children,for which effective treatment options remain limited.This research sought to evaluate the safety and initial effectiveness of multiple intrathecal administrations of autologous bone marrow-derived mesenchymal stem cells(MSCs)in children with spastic CP.Methods A phase I,prospective,single-arm,open-label clinical trial was conducted on 16 children aged 2–12 years with spastic CP.Patients received four intrathecal injections of MSCs at monthly intervals.Safety was evaluated based on the occurrence of adverse events,while efficacy was assessed using various clinical scales,including the Gross Motor Function Classification System(GMFCS),Gross Motor Function Measure(GMFM),Berg Balance Scale(BBS),and the Modified Ashworth Scale(MAS).Assessments were conducted at baseline before treatment,and at a 12-month post-treatment follow-up.Results Safety assessment revealed no severe adverse events.Mild adverse events included nausea(18.75%),fatigue(12.5%),and headache(12.5%).Statistically significant improvements were observed in motor function,balance,and spasticity.GMFCS levels improved,with the proportion of patients in Level V decreasing from 62.5%to 43.75%(p=0.0047).Total GMFM scores increased significantly from 47.01±21.45 to 54.69±22.62(p<0.001),with domain-specific improvements in lying(p=0.002),sitting(p=0.001),crawling(p=0.002),standing(p=0.004),and walking(p=0.043).BBS scores improved from 6.75±10.88 to 9.88±13.60(p=0.001),while MAS reduced from 2.25±1.18 to 1.62±0.96(p=0.004).Functional independence improved significantly,with FIM motor scores increasing from 38.63±24.35 to 47.44±25.27(p=0.001)and cognitive scores from 57.06±29.15 to 70.88±26.96(p=0.001).Conclusion Repeated intrathecal injections of autologous MSCs are safe and significantly improve motor function,balance,and spasticity in children with spastic CP.These findings suggest that MSC therapy enhances functional outcomes and quality of life,though larger randomized controlled trials are needed.展开更多
Globally,the discipline of neurosurgery has evolved remarkably fast.Despite being one of the latest medical specialties,which appeared only around hundred years ago,it has witnessed innovations in the aspects of diagn...Globally,the discipline of neurosurgery has evolved remarkably fast.Despite being one of the latest medical specialties,which appeared only around hundred years ago,it has witnessed innovations in the aspects of diagnostics methods,macro and micro surgical techniques,and treatment modalities.Unfortunately,this development is not evenly distributed between developed and developing countries.The same is the case with neurosurgical education and training,which developed from only traditional apprentice programs in the past to more structured,competencebased programs with various teaching methods being utilized,in recent times.A similar gap can be observed between developed and developing counties when it comes to neurosurgical education.Fortunately,most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice.In context to this understanding,a symposium was organized during the World Federation of Neurological Surgeons(WFNS)Special World Congress Beijing 2019.This symposium was the brain child of Prof.Yoko Kato-one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons.Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries.This paper summarizes the outcome of these presentations,with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.展开更多
基金supported by the National Natural Science Foundation of China,No.82071254(to WZ).
文摘Long-term levodopa administration can lead to the development of levodopa-induced dyskinesia.Gamma oscillations are a widely recognized hallmark of abnormal neural electrical activity in levodopa-induced dyskinesia.Currently,studies have reported increased oscillation power in cases of levodopa-induced dyskinesia.However,little is known about how the other electrophysiological parameters of gamma oscillations are altered in levodopa-induced dyskinesia.Furthermore,the role of the dopamine D3 receptor,which is implicated in levodopa-induced dyskinesia,in movement disorder-related changes in neural oscillations is unclear.We found that the cortico-striatal functional connectivity of beta oscillations was enhanced in a model of Parkinson’s disease.Furthermore,levodopa application enhanced cortical gamma oscillations in cortico-striatal projections and cortical gamma aperiodic components,as well as bidirectional primary motor cortex(M1)↔dorsolateral striatum gamma flow.Administration of PD128907(a selective dopamine D3 receptor agonist)induced dyskinesia and excessive gamma oscillations with a bidirectional M1↔dorsolateral striatum flow.However,administration of PG01037(a selective dopamine D3 receptor antagonist)attenuated dyskinesia,suppressed gamma oscillations and cortical gamma aperiodic components,and decreased gamma causality in the M1→dorsolateral striatum direction.These findings suggest that the dopamine D3 receptor plays a role in dyskinesia-related oscillatory activity,and that it has potential as a therapeutic target for levodopa-induced dyskinesia.
基金supported by the Guangdong Basic and Applied Basic Research Foundation,No.2023A1515030045(to HS)Presidential Foundation of Zhujiang Hospital of Southern Medical University,No.yzjj2022ms4(to HS)。
文摘Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have revealed that gut microbiota can communicate bidirectionally with the brain through the gut microbiota–brain axis.This axis indicates that gut microbiota is closely related to the development and prognosis of intracerebral hemorrhage and its associated secondary white matter injury.The NACHT,LRR,and pyrin domain-containing protein 3(NLRP3)inflammasome plays a crucial role in this context.This review summarizes the dysbiosis of gut microbiota following intracerebral hemorrhage and explores the mechanisms by which this imbalance may promote the activation of the NLRP3 inflammasome.These mechanisms include metabolic pathways(involving short-chain fatty acids,lipopolysaccharides,lactic acid,bile acids,trimethylamine-N-oxide,and tryptophan),neural pathways(such as the vagus nerve and sympathetic nerve),and immune pathways(involving microglia and T cells).We then discuss the relationship between the activated NLRP3 inflammasome and secondary white matter injury after intracerebral hemorrhage.The activation of the NLRP3 inflammasome can exacerbate secondary white matter injury by disrupting the blood–brain barrier,inducing neuroinflammation,and interfering with nerve regeneration.Finally,we outline potential treatment strategies for intracerebral hemorrhage and its secondary white matter injury.Our review highlights the critical role of the gut microbiota–brain axis and the NLRP3 inflammasome in white matter injury following intracerebral hemorrhage,paving the way for exploring potential therapeutic approaches.
基金supported by the National Natural Science Foundation of China(Grant No.82151302)the National High Level Hospital Clinical Research Funding(Grant No.2022-PUMCH-B-113)+1 种基金the National High Level Hospital Clinical Research Funding(Grant No.2022-PUMCH-A-019)the CAMS Innovation Fund for Medical Sciences(Grant No.2021-12M-1-014).
文摘Achieving high-resolution intracranial imaging in a safe and portable manner is critical for the diagnosis of intracranial diseases,preoperative planning of craniotomies and intraoperative management during craniotomy procedures.Adaptive waveform inversion(AWI),a variant of full waveform inversion(FWI),has shown potential in intracranial ultrasound imaging.However,the robustness of AWI is affected by the parameterization of the Gaussian penalty matrix and the challenges posed by transcranial scenarios.Conventional AWI struggles to produce accurate images in these cases,limiting its application in critical medical settings.To address these issues,we propose a stabilized adaptive waveform inversion(SAWI)method,which introduces a user-defined zero-lag position for theWiener filter.Numerical experiments demonstrate that SAWI can achieve accurate imaging under Gaussian penalty matrix parameter settings where AWI fails,perform successful transcranial imaging in configurations where AWI cannot,and maintain the same imaging accuracy as AWI.The advantage of this method is that it achieves these advancements without modifying the AWI framework or increasing computational costs,which helps to promote the application of AWI in medical fields,particularly in transcranial scenarios.
基金supported the National Natural Science Foundation of China,No.81974178(to CD).
文摘Subarachnoid hemorrhage is associated with high morbidity and mortality and lacks effective treatment.Pyroptosis is a crucial mechanism underlying early brain injury after subarachnoid hemorrhage.Previous studies have confirmed that tumor necrosis factor-stimulated gene-6(TSG-6)can exert a neuroprotective effect by suppressing oxidative stress and apoptosis.However,no study to date has explored whether TSG-6 can alleviate pyroptosis in early brain injury after subarachnoid hemorrhage.In this study,a C57BL/6J mouse model of subarachnoid hemorrhage was established using the endovascular perforation method.Our results indicated that TSG-6 expression was predominantly detected in astrocytes,along with NLRC4 and gasdermin-D(GSDMD).The expression of NLRC4,GSDMD and its N-terminal domain(GSDMD-N),and cleaved caspase-1 was significantly enhanced after subarachnoid hemorrhage and accompanied by brain edema and neurological impairment.To explore how TSG-6 affects pyroptosis during early brain injury after subarachnoid hemorrhage,recombinant human TSG-6 or a siRNA targeting TSG-6 was injected into the cerebral ventricles.Exogenous TSG-6 administration downregulated the expression of NLRC4 and pyroptosis-associated proteins and alleviated brain edema and neurological deficits.Moreover,TSG-6 knockdown further increased the expression of NLRC4,which was accompanied by more severe astrocyte pyroptosis.In summary,our study revealed that TSG-6 provides neuroprotection against early brain injury after subarachnoid hemorrhage by suppressing NLRC4 inflammasome activation-induced astrocyte pyroptosis.
基金supported by the STI2030-Major Project(2021ZD0203600)with additional support from the Shanghai Municipal Science and Technology Commission(2018SHZDZX05 and 2018ZR1406500)+3 种基金the Shanghai Pujiang Program(19PJ1407500)the Shanghai Jiao Tong University Medical and Engineering Cross Research Fund(YG2019QNA31)the Shanghai Municipal Health Commission Clinical Study Special Fund(20194Y0067)the Ruijin Hospital Guangci Excellence Youth Training Program(GCQN-2019-B10).
文摘The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation.This stereoelectroencephalography(SEEG)study investigated how the dorsolateral prefrontal cortex(DLPFC)interacts with the hippocampus in the online processing of sequential information.Twenty patients with epilepsy(eight women,age 27.6±8.2 years)completed a line ordering task with SEEG recordings over the DLPFC and the hippocampus.Participants showed longer thinking times and more recall errors when asked to arrange random lines clockwise(random trials)than to maintain ordered lines(ordered trials)before recalling the orientation of a particular line.First,the ordering-related increase in thinking time and recall error was associated with a transient theta power increase in the hippocampus and a sustained theta power increase in the DLPFC(3–10 Hz).In particular,the hippocampal theta power increase correlated with the memory precision of line orientation.Second,theta phase coherences between the DLPFC and hippocampus were enhanced for ordering,especially for more precisely memorized lines.Third,the theta band DLPFC→hippocampus influence was selectively enhanced for ordering,especially for more precisely memorized lines.This study suggests that theta oscillations may support DLPFC-hippocampal interactions in the online processing of sequential information.
文摘Introduction:Spinal cord injury is one of the main causes of severe neurological trauma and disability.Intramedullary decompression of acute spinal cord contusion in acute phase is one of the important therapeutic exploration methods.Due to the lack of multicenter,randomized,double-blind,placebo-controlled clinical studies,true effect of this treatment remains controversial.Objective of the study:This design of the study is to explore the safety and neuro-restorativeeffects of intramedullary decompression for acute complete spinal cord contusion injury.Design of the study:We design the prospective,multicenter,randomized,double-blind placebo-controlled trial(MRDPT)for acute(less than 24 hours after injury)spinal cord contusion injury.Sixty patients with acute complete spinal cord contusion injury(20 in cervical 4 to thoracic 1,20 in thoracic 2 to thoracic 9,and 20 in thoracic 10 to lumbar vertebra 1)are selected according to the selected conditions.All patients receive conventional treatments such as reduction and fixation of spinal fractures and/or spinal spondylolisthesis,bone external decompression relieves spinal cord compression.At the same time,group A(n=30,10 of each segment group)undergoes intramedullary decompression surgery and group B(n=30)does not undergo intramedullary decompression.All relevant functional changes before,after,and during the follow-up period are recorded to ensure objective evaluation of the results of the treatment.Ethics and dissemination:The clinical study protocol and consent form were approved by China Branch of International Association of Neurorestoratology and the ethics committees of the hospitals which join this trial.Registration No.of this study is ChiCTR1800020458.Findings will be published in peer-reviewed journals.
文摘Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex- plosive injury received continuous stimulation （10 V, 5 Hz, 5 ms, 20 minutes） of the right cervical vagus nerve. Tumor necrosis factor-a, interleukin-l~ and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-a and interleukin-1β concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-a, interleukin-1 β and interleukin-10 in the serum and brain tissue.
基金supported by intramural funding from the University of South Carolina McCausland Center for Brain Imaging
文摘Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuro- nal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deficits expected after damage to the cortical motor system due to stroke. These findings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.
文摘Tuberculous infection manifesting as an isolated intramedullary tuberculoma of the spinal cord is distinctly unusual.We report a case of a 35 year old woman presenting with an insidious onset of myelopathy,where MRI showed characteristic imaging findings suggestive of intramedullary tuberculosis.
基金funded in part by Mission Connecta program of TIRR foundationthe University of Texas Health Science Center at Houston Bentsen Stroke Center and Department of Neurosurgery William Stamps Farish Fund
文摘Traumatic injuries to the central nervous system,such as traumatic brain injury,spinal cord injury and stroke,have a high prevalence,enormous financial costs and lack clinical treatments that restore neurological function（Ma et al.,2014）These injuries trigger a series of secondary biochemical and cellular responses that ultimately lead to cellular death and themaintenance of an unsupportive extracellular matrix （ECM） for tissue regeneration （Silva et al., 2014）. Artificial ECM or scaf- folds represent a way to alter this unsupportive environment to improve the efficacy of stem cell therapies and enhance neural tissue regeneration （Figure 1）.
文摘1 Overview Glioma is originated in the glial cells in the brain tumor.Gliomas account for the great majority of primary tumors that arise within the brain parenchyma.The term“glioma”refers to tumors that have histologic features similar to normal glial cells.The World Health Organization(WHO)classification of glioma divided into the central nervous system tumor gradesⅠ-Ⅳ.The slower-growing lesions,corresponding to WHO gradesⅠandⅡ,have been commonly referred to as low-grade gliomas,while the gradesⅢandⅣtumors are referred to as high-grade gliomas.
文摘The novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2 has created a life-threatening world pandemic.Unfortunately,this disease can be worse in older patients or individuals with comorbidities,having dangerous consequences,including stroke.COVID-19–associated stroke widely increases the risk of death from COVID-19.In addition to the personal hygiene protocols and preventive policies,it has been proven that immune-compromised,oxidative,and pro-coagulant conditions make a person more susceptible to severe COVID-19 complications,such as stroke;one of the most effective and modifiable risk factors are poor nutritional status.Previous literature has shown that healthy dietary patterns,such as the Mediterranean diet,some food groups,and specific micronutrients,reduce the risk of ischemic and hemorrhagic stroke.In this work,for the first time,we hypothesized that a healthy diet could also be a protective/preventive factor against COVID-19–associated stroke risk.In order to prove this hypothesis,it is required to study nutritional intake and dietary patterns in patients suffering from COVID-19–associated stroke.If this hypothesis is proven,the chronic supportive role of a healthy diet in critical situations will be highlighted once again.
文摘Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presentation: A 35-year-old woman with a history of mastectomy left breast cancer 5 years below radiotherapy was referred to the neurosurgery department with a parietal extra-axial mass parietal evolving for one year. CT scan with Magnetic resonance imaging revealed an extra-axial tumor with lysis bone. A craniotomy was performed to remove the mass that was located extra-axial. Histopathological examination revealed metastasis. Conclusions: Lesion skull vaults are rare but they should be considered in the differential diagnosis of intraosseous meningioma lesions. In this report, we discuss the clinical aspects of cases we observed, in which the metastasis bone was found thanks to the histological examination of a calvarial mass after surgery.
文摘IntroductionThe severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic has taken a toll on humans,and the development of effective vaccines has been a promising tool to end the pandemic.However,for a vaccination program to be successful,a considerable proportion of the community must be vaccinated.Hence,public acceptance of coronavirus disease 2019(COVID-19)vaccines has become the key to controlling the pandemic.Recent studies have shown vaccine hesitancy increasing over time.This systematic review aims to evaluate the COVID-19 vaccine hesitancy rate and related factors in different communities.MethodA comprehensive search was performed in MEDLINE(via PubMed),Scopus,and Web of Science from January 1,2019 to January 31,2022.All relevant descriptive and observational studies(cross-sectional and longitudinal)on vaccine hesitancy and acceptance were included in this systematic review.In the meta-analysis,odds ratio(OR)was used to assess the effects of population characteristics on vaccine hesitancy,and event rate(acceptance rate)was the effect measure for overall acceptance.Publication bias was assessed using the funnel plot,Egger's test,and trim-and-fill methods.ResultA total of 135 out of 6,417 studies were included after screening.A meta-analysis of 114 studies,including 849,911 participants,showed an overall acceptance rate of 63.1%.In addition,men,married individuals,educated people,those with a history of flu vaccination,those with higher income levels,those with comorbidities,and people living in urban areas were less hesitant.ConclusionIncreasing public awareness of the importance of COVID-19 vaccines in overcoming the pandemic is crucial.Being men,living in an urban region,being married or educated,having a history of influenza vaccination,having a higher level of income status,and having a history of comorbidities are associated with higher COVID-19 vaccine acceptance.
文摘Transcranial magnetic stimulation(TMS)is a noninvasive neurophysiologic technique that can stimulate the human brain.Positioning of the coil was often performed based merely on external landmarks on the head,meaning that the anatomical target in the cortex remains inaccurate.Navigated transcranial magnetic stimulation(nTMS)combines a frameless stereotactic navigational system and TMS coil and can provide a highly accurate delivery of TMS pulses with the guidance of imaging.Therefore,many novel utilities for TMS could be explored due to the ability of precise localization.Many studies have been published,which indicate nTMS enables presurgical functional mapping.This review aimed to provide a comprehensive literature review on nTMS,especially the principles and clinical applications of nTMS.All articles in PubMed with keywords of'motor mapping,''presurgical mapping,''navigated transcranial magnetic stimulation,'and'language mapping'published from 2000 to 2018 were included in the study.Frequently cited publications before 2000 were also included.The most valuable published original and review articles related to our objective were selected.Motor mapping of nTMS is validated to be a trustful tool to recognize functional areas belonging to both normal and lesioned primary motor cortex.It can offer reliable mapping of speech and motor regions at cortex prior to operation and has comparable accuracy as direct electrical cortical stimulation.nTMS is a powerful tool for mapping of motor and linguistic function prior to operation,has high application value in neurosurgery and the treatment of neurological and psychiatric diseases,and has gained increasing acceptance in neurosurgical centers across the world.
基金supported by the National Natural Science Foundation of China(grant Nos.81672158 and 81371939)International Science&Technology Cooperation Program of China(No.2013DFG32690)National Key R&D Program of China(No.2016YFC1100100).
文摘Introduction:We developed the method of cervical spinal cord decompression through durotomy followed by duroplasty and analyzed its efficacy.Purpose:To develop a tactic of decompression durotomy and duroplasty for the treatment of severe spinal cord injury(SCI)with extensive edema of the spinal cord and without intramedullary hematoma,and to demonstrate the effectiveness of this method.Methods:From October 2016 to January 2018,17 decompression operations were performed in the cervical spine in patients with SCI.Decompression laminectomy was done without durotomy in the first group of patients.In the second group,duroplasty of the spinal cord was performed after decompression durotomy.A total of 17 patients,16 males(94%)and 1 female(6%),were operated on(ages from 32 to 66 years).The patients were divided into two groups:a control group and an experimental group.We used the ASIA scale for assessing the patients.The mean follow up time is 12 months(8−24 months).Results:The first group,i.e.,the control group consisted of 10 patients who underwent decompression laminectomy without durotomy.The second group,i.e.,the experimental group consisted of 7 patients who underwent durotomy followed by duroplasty.In this group,the positive dynamics were observed in 6 patients.Out of 2 patients with ASIA grade“A”,one showed improvement to ASIA grade“C”,and one improved to ASIA“D”.Two patients with ASIA grade“B”showed recovery to ASIA“D”.Two patients with ASIA grade“C”improved to grade“D”while one patient showed no change from ASIA“C”.Durotomy and duroplasty was effective in the experimental group.Conclusion:The performance of durotomy and duroplasty is an efficient method for the full-scale decompression of the spinal cord and the prevention of edema.This method aims at decreasing intraspinal pressure,as well as preventing ischemia and apoptosis,which is possible for the prevention and treatment of the spinal cord com-partment syndrome or spinal cord intramedullary hypertension.
基金the ethics committee of Shahid Beheshti University of Medical Sciences(IR.SBMU.REC.1399.037)registered in the Iranian Registry of Clinical Trials(IRCT20200502047277N5).
文摘Background Cerebral palsy(CP)is the most prevalent motor disability among children,for which effective treatment options remain limited.This research sought to evaluate the safety and initial effectiveness of multiple intrathecal administrations of autologous bone marrow-derived mesenchymal stem cells(MSCs)in children with spastic CP.Methods A phase I,prospective,single-arm,open-label clinical trial was conducted on 16 children aged 2–12 years with spastic CP.Patients received four intrathecal injections of MSCs at monthly intervals.Safety was evaluated based on the occurrence of adverse events,while efficacy was assessed using various clinical scales,including the Gross Motor Function Classification System(GMFCS),Gross Motor Function Measure(GMFM),Berg Balance Scale(BBS),and the Modified Ashworth Scale(MAS).Assessments were conducted at baseline before treatment,and at a 12-month post-treatment follow-up.Results Safety assessment revealed no severe adverse events.Mild adverse events included nausea(18.75%),fatigue(12.5%),and headache(12.5%).Statistically significant improvements were observed in motor function,balance,and spasticity.GMFCS levels improved,with the proportion of patients in Level V decreasing from 62.5%to 43.75%(p=0.0047).Total GMFM scores increased significantly from 47.01±21.45 to 54.69±22.62(p<0.001),with domain-specific improvements in lying(p=0.002),sitting(p=0.001),crawling(p=0.002),standing(p=0.004),and walking(p=0.043).BBS scores improved from 6.75±10.88 to 9.88±13.60(p=0.001),while MAS reduced from 2.25±1.18 to 1.62±0.96(p=0.004).Functional independence improved significantly,with FIM motor scores increasing from 38.63±24.35 to 47.44±25.27(p=0.001)and cognitive scores from 57.06±29.15 to 70.88±26.96(p=0.001).Conclusion Repeated intrathecal injections of autologous MSCs are safe and significantly improve motor function,balance,and spasticity in children with spastic CP.These findings suggest that MSC therapy enhances functional outcomes and quality of life,though larger randomized controlled trials are needed.
文摘Globally,the discipline of neurosurgery has evolved remarkably fast.Despite being one of the latest medical specialties,which appeared only around hundred years ago,it has witnessed innovations in the aspects of diagnostics methods,macro and micro surgical techniques,and treatment modalities.Unfortunately,this development is not evenly distributed between developed and developing countries.The same is the case with neurosurgical education and training,which developed from only traditional apprentice programs in the past to more structured,competencebased programs with various teaching methods being utilized,in recent times.A similar gap can be observed between developed and developing counties when it comes to neurosurgical education.Fortunately,most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice.In context to this understanding,a symposium was organized during the World Federation of Neurological Surgeons(WFNS)Special World Congress Beijing 2019.This symposium was the brain child of Prof.Yoko Kato-one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons.Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries.This paper summarizes the outcome of these presentations,with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.
