bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Outcomes of Adult Medulloblastoma: A Retrospective Analysis at a Single Institute
Authors: Jiang Tao , Zhu Jin , Dong Jing , Wang Junmei , Du Jiang , Li Chunde , Zhang Yuqi
Published: December 2018

Objectives

Adult medulloblastoma is a rare tumor, and few retrospective studies on medulloblastoma have been published to date. A standard treatment regimen has not yet been established. Accordingly, this study was designed to determine the treatment outcomes and prognostic factors for patients with adult medulloblastoma.

Methods

We retrospectively reviewed all cases of adult medulloblastoma at the Beijing Tiantan Hospital between 2004 and 2007. There were 33 patients in total. Tumor removal followed by radiotherapy was performed in all patients. Five patients received maintenance chemotherapy after radiotherapy. Statistical analysis was performed using the log-rank test, Kaplan–Meier method, and Cox regression analysis.

Results

The median follow-up period was 73 months. The 5-year progression-free survival (PFS) and overall survival (OS) rates were 45.5% ± 8.7% and 51.5% ± 8.7%, respectively. Recurrence or progression was observed in 21 patients, and 14 patients were still alive. Tumor location at the midline with infiltration to the floor of the fourth ventricle was associated with the worst PFS and OS (P = 0.032). Hemispheric desmoplastic/nodular medulloblastomas (DNMBs) were associated with a better outcome than midline DNMB. The average-risk group tended to have a better 5-year PFS rate than the high-risk group (P = 0.065).

Conclusions

Tumor location is an important prognostic marker for adulthood MB. We propose a molecular and clinical staging system should be established for adulthood MB. Further prospective clinical trials should be performed to draw a conclusion.
Remote Multi-Wave Radioneuroengineering: An Innovative Technology for Non-Contact Radio Restoration of Damaged Nervous Tissue of the Human Brain and Spinal Cord
Authors: Bryukhovetskiy Andrey S. , Bryukhovetskiy Igor S.
Published: December 2018

Objectives

Significant advances in neurosciences will result from research focused on the non-contact treatment of the nervous tissue (NT). The objective of the article is to describe a novel non-contact method of restoration of damaged NT of the human brain and spinal cord that was termed multi-wave neuro-bioengineering.

Methods

The method includes a purposeful complex program of different therapeutic ionizing and non-ionizing electromagnetic radiation effects on the damaged NT, which is approved for clinical practice. Exposure of the human brain to a stepwise algorithmized combination of different ionizing and non-ionizing radiations and simultaneous application of various types of electromagnetic radiation at the specific site of restoration considerably reduce the adverse effects of all types of radiation on NT.

Results

The technology for non-contact restoration of the injured tissue of brain or spinal cord was appiled in 30 cases of neurological disorders using the stereotaxic system, structural resonance therapy, radiotherapy and focused ultrasound. The applied methods are approved for humans and theorem programmed combination opens new perspective for the treatment of brain and spinal cord disorders.

Conclusions

The approach provides quick restoration of the disordered function of damaged brain tissue and establishes a new paradigm of radio non-contact neurorestoration of the brain and spinal cord.
Differentiated Cells Derived from Fetal Neural Stem Cells Improve Motor Deficits in a Rat Model of Parkinson's Disease
Authors: Wang Wei , Song Hao , Shen Aifang , Chen Chao , Liu Yanming , Dong Yabing , Han Fabin
Published: December 2018

Objective

Parkinson's disease (PD), which is one of the most common neurodegenerative disorders, is characterized by the loss of dopamine (DA) neurons in the substantia nigra in the midbrain. Experimental and clinical studies have shown that fetal neural stem cells (NSCs) have therapeutic effects in neurological disorders. The aim of this study was to examine whether cells that were differentiated from NSCs had therapeutic effects in a rat model of PD.

Methods

NSCs were isolated from 14-week-old embryos and induced to differentiate into neurons, DA neurons, and glial cells, and these cells were characterized by their expression of the following markers: βIII-tubulin and microtubule-associated protein 2 (neurons), tyrosine hydroxylase (DA neurons), and glial fibrillary acidic protein (glial cells). After a 6-hydroxydopamine (6-OHDA)-lesioned rat model of PD was generated, the differentiated cells were transplanted into the striata of the 6-OHDA-lesioned PD rats.

Results

The motor behaviors of the PD rats were assessed by the number of apomorphine-induced rotation turns. The results showed that the NSCs differentiated in vitro into neurons and DA neurons with high efficiencies. After transplantation into the striata of the PD rats, the differentiated cells significantly improved the motor deficits of the transplanted PD rats compared to those of the control nontransplanted PD rats by decreasing the apomorphine-induced turn cycles as early as 4 weeks after transplantation. Immunofluorescence analyses showed that the differentiated DA neurons survived more than 16 weeks.

Conclusions

Our results showed that cells that were differentiated from NSCs had therapeutic effects in a rat PD model, which suggests that differentiated cells may be an effective treatment for patients with PD.
Progress in the Research and Development of Nerve Conduits
Authors: Wang Xiyuan , Chen Lin , Ao Qiang , Sharma Aruna , Sharma Hari Shanker
Published: December 2018

The reconstruction after peripheral nerve damage, especially for long-segment nerve defects, remains a clinical challenge. Autologous nerve graft transplantation is an efficient method for the repair of peripheral nerve defects, but the involved complications and shortcomings have greatly limited the clinical efficacy of treatments offered to patients with nerve defects. Thus, there is an urgent need to develop new therapeutic strategies and explore alternatives to autologous nerve transplantation in clinical practice, based on the knowledge of the peripheral nerve regeneration mechanism and biological histocompatibility principles. With significant advances in the research and application of nerve conduits, they have been used to repair peripheral nerve injury for several decades. In this paper, the study background of nerve conduits, their applications in clinic, status of conduit material research and construction of tissue-engineered artificial nerves were reviewed.
Why Does a Little Mean a Lot When you Have Nothing? A Brief Review of Cell Therapy Strategies for Spinal Cord Injury
Authors: Wang Dajue
Published: December 2018

Without an understanding of functional musculoskeletal system recovery, the translation of knowledge concerning neurological recovery from laboratory discoveries to bedside applications will be incomplete. Because improvements in neurological function after cell transplantation are minor and can be easily ignored, this article draws attention to the minimal improvements required to allow a spinal cord injury patient or person to live a relatively independent life. These minimal improvements include (1) the key muscle power required for trunk stability; (2) the key muscle power required to allow a paraplegic to walk; and (3) the key muscle power required for hand usefulness or functionality.

The system of muscle power grading promoted by the British Medical Research Council (MRC) is more sensitive and delicate than the ASIA Standards, as the latter only accept the full range of movement of a joint. The MRC system seems to be preferable to the ASIA Standards in clinical trials of cell transplantation, wherein minute improvements in function might result in large differences in the quality of life.

The threshold of function is a grade 3 power level. Even if all relevant muscles fail to achieve a power higher than grade 3, the patient can be minimally functional and hence relatively independent. These relevant muscles include the latissimus dorsi, hip flexors, hip abductors, shoulder abductors and flexors, elbow flexors and extensors, and wrist extensors. These muscles are innervated by the C5–7 spinal cord segments except the latissimus dorsi, for which innervation extends to C8.
Biomarkers in Alzheimer's Disease
Authors: Liscic Rajka M. , Yang Yuanhan
Published: December 2018

Alzheimer's disease (AD) so far did not have promising treatment. The accurate and early diagnosis is still the important issue. For these purpose, biomarkers related to diagnosis, clinical course, and other aims have been proposed and reported. Meanwhile, along with the ongoing researches for AD, biomarkers with their own aims are also on the way.
Looking for Positive Viewpoints for Alzheimer's Caregivers: Case Evaluation of a Positive Energy Group
Authors: Hsieh Wenchien , Chen Qinying , Sun Qingling , Chen Peixuan , Chen Yijia , Xu Wenting , Zhang Yiting , Yu Yiqian , Huang Yimei
Published: December 2018

Objective

As estimated in a report of global Alzheimer's disease published by Alzheimer's Disease International in 2015, there will be 9.9 million new patients worldwide with Alzheimer's disease in 2015, with a new Alzheimer's patient diagnosed, on average, every 3 seconds. Since Alzheimer's disease is an irreversible disease, the most that can be done for Alzheimer's patients is to merely delay the onset of disease, which to date cannot be completely cured. Therefore, even though great effort is put into caring for the patient, caregivers should not expect any substantial changes. The caring process is a dynamic process that contains negative and positive experiences. During the caring period, not only do caregivers spend a lot of effort and work very hard to help the patient, but in fact care recipients themselves also give energy to caregivers. This study attempts to take a positive energy viewpoint to explore and design a program that is suitable for Alzheimer's caregivers. The aims of the study were as follows: (a) to explore the needs and burdens of Alzheimer's caregivers in the treatment process of patients, (b) to design a program that meets the needs of the caregivers, and (c) to evaluate the effects of implementing a program.

Methods

The study is a qualitative study employing in-depth interviews. Interviews were conducted from September 2015 to December 2015; the interview results were reviewed and a positive energy group program was designed. Pre-test and post-test interviews were carried out for the program so as to evaluate the effects of the program.

Results

According to the caregiver interview results, we understand the caring needs and caring process of caregivers. From the interview results, we now know that caregivers' continuous care mainly comes from positive energy in psychological, social and relationship aspects. Positive energy seems to have been affecting caregivers' caring ability and willingness. Therefore, a two-stage group activity program was designed to provide a recollective handmade craft group and an art therapy group. Research results of the study show that when the main caregivers of Alzheimer's patients took part in group activities, positive energy in social and relationship aspects increased for the caregiver group too.

Conclusions

From these intervention programs caregivers could obtain more knowledge of patient care and these activities could effectively lighten caregivers' burdens.
A New Drainage Tube Device
Authors: He Chao , Zhao Ming , Yang Dong , Wu Tianya , Qiu Leiyu
Published: December 2018

Objective

Drainage tubes (e.g., intracranial, abdominal cavity and thoracic) are commonly used to drain blood and fluid collections after surgery. It usually fails due to the lack of fixation perpendicular to the skin and the variety of tube materials. The objective of the article is to describe a new drainage tube device.

Methods

This new device consists of a drainage tube fixator and diverter with a rotating handle. The fixator and diverter are fixed to the skin with a pair of wings, and the base comprises acircular arc with chamfering of the edge. The removable stopper and plastic diverter have a memory function. There are 2 holes on either side of the wings, by which they can be sewn to the skin or stapled for strength and stability.

Results

The removable limiting stopper and plastic diverter with memory function work together to ensure that the drainage tube is firmly fixed. Therefore, the tube will not move either vertically or horizontally on the skin. Moreover, the device is fit for drainage tubes with different specifications and materials.

Conclusions

The limiting stopper can be moved easily, which is conducive to local skin disinfection around the drainage tube. The device deserves clinical promotion.
Effects of Aging on Working Memory Performance and Prefrontal Cortex Activity: A Time-Resolved Spectroscopy Study
Authors: Shi Jie , Zhou Wenjing , Geng Tongchao , Zuo Huancong , Tanida Masahiro , Sakatani Kaoru
Published: December 2018

Objective

This study aimed to employ time-resolved spectroscopy (TRS) to explore age-related differences in prefrontal cortex (PFC) activity while subjects performed a working memory task.

Methods

We employed TRS to measure PFC activity in ten healthy younger and ten healthy older subjects while they performed a working memory (WM) task. All subjects performed the Sternberg test (ST) in which the memory-set size varied between one and six digits. Using TRS, we recorded changes in cerebral blood oxygenation as a measure of changes in PFC activity during the task. In order to identify left/right asymmetry of PFC activity during the working memory task, we calculated the laterality score, i.e., Δoxy-Hb (right Δoxy-Hb—left Δoxy-Hb); positive values indicate greater activity in the right PFC, while negative values indicate greater activity in the left PFC.

Results

During the ST, statistical analyses showed no significant differences between the younger and older groups in accuracy for low memory-load and high memory-load. In high memory-load tasks, however, older subjects were slower than younger subjects (P < 0.05). We found that the younger group showed right lateral responses with a stronger right than left activation in the frontal pole, whereas the older group showed bilateral responses (P < 0.05).

Conclusions

The present results are consistent with the hemispheric asymmetry reduction in older adults (HAROLD) model; working memory tasks cause asymmetrical PFC activation in younger adults, while older adults tend to show reduced hemispheric lateralization.
Cell-Based Therapy in Alzheimer's Disease: Current Knowledge and Perspective
Authors: Qiao Liyan , Huang Hongyun , Chen Lin
Published: December 2018

Alzheimer's disease (AD) is the most prevalent type of dementia, and its neuropathology is characterized by the deposition of insoluble β-amyloid (Aβ) peptides, intracellular neurofibrillary tangles, amyloid angiopathy, age-related brain atrophy, synaptic pathology, white matter rarefaction, granulovacuolar degeneration, neuron loss, and neuroinflammation. Although much is known about the neurobiology of AD, very few conventional therapies are available to arrest or slow the disease. There is an urgent need for novel therapeutic approaches for AD. AD subjects have significantly fewer viable precursor cells in the hippocampus compared with age-matched healthy control subjects. However, the viable precursor cells that remain in AD and age-matched healthy control brain specimens can be induced to differentiate. To facilitate or mimic the natural compensatory effect in AD, cell therapy, including endogenous and exogenous stem cells, has been considered in AD. In this review, we focus on the history and development of cell therapy in AD, and consider the role of cell therapy as a potential treatment for AD.
Surgical Complications Secondary to Decompressive Craniectomy for Patients with Severe Head Trauma
Authors: Yang Xiaofeng , Wen Liang
Published: December 2018

Decompressive craniectomy (DC) is a surgical method for managing highly elevated intracranial increased pressure (ICP) resulted from severe head trauma. This procedure is able to reduce the ICP rapidly and effectively. However, it may lead to kinds of secondary complications, which would cause patient's severe neurological dysfunction or even death. In this paper, we reviewed the literatures about surgical complications secondary to DC, and tried to bring up suggestions on surgical techniques aiming to prevention and treatment of these complications.
Effects of Regional Cerebral Blood Flow Perfusion on Learning and Memory Function and Its Molecular Mechanism in Rats
Authors: Xu Cunli , Wu Wenhua , Kong Lingbin
Published: December 2018

Objective

To study the effects of regional cerebral blood flow (rCBF) perfusion on learning and memory function in special brain areas and its molecular mechanism in rat.

Methods

Sixty-four adult male healthy Sprague-Dawley (SD) rats were randomly divided into two groups: A false operation group and an operation group. The false operation group was randomly divided into four subgroups (A0, B0, C0, and D0) and the operation group was randomly divided into four subgroups (A, B, C, and D), with eight rats in each subgroup. The operation group underwent bilateral common carotid artery permanent ligation, while the other group only underwent a skin incision without the bilateral common carotid artery permanent ligation. Learning memory function of rats in each subgroup was measured using a Y-maze at 4 h, 8 h, 24 h, and 3 days after surgery. The rCBF in the right frontal lobe and hippocampus was detected using the Periflux PF model laser Doppler flowmetry and c-fos, c-jun, Bcl-2, and Bax protein expression in the right frontal lobe and hippocampus was measured using immunohistochemistry.

Results

The rCBF in the right frontal lobule division and right hippocampus division was significantly lower in the operation group than in the false operation group (P < 0.05). The error number (EN), time to reach the target, and total reaction time (TRT) for the learning index using the Y-type labyrinth test in the operation group were significantly higher than that in the false operation group (P < 0.05); however, the active avoid rate in the operation group was significantly lower than that of the false operation group. Expression of c-fos and c-jun as well as the average absorbency in the right frontal lobule division and right hippocampus division in the operation group were significantly higher than those in the false operation group (P < 0. 05). The number of Bax and Bcl-2-positive cells was significantly higher in the operation group, and the expression ratio of Bax/Bcl-2 in the operation group was significantly higher than that in the false operation group (P < 0.01).

Conclusions

rCBF decrease can impair learning and memory function in rats, which may be related to the increased expression of c-fos, c-jun, Bcl-2, and Bax proteins in the frontal cortex and hippocampus.
An Association between the Location of White Matter Changes and the Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease Patients
Authors: Lin Tzuchou , Lin Yihui , Kao Linli , Kao Yihui , Yang Yuanhan , Chou Pingsong , Wu Mengni
Published: December 2018

Objective

The frontal lobe may be involved in circuits associated with depression, apathy, aggression, and other psychiatric symptoms. Although white matter changes (WMC) are related to the severity of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD), it is unclear which part of the WMC may play the most important role in BPSD. This study was designed to investigate the relationship between the location of WMC and the severity of BPSD in AD patients.

Methods

Among patients diagnosed with Alzheimer's disease between 2009 and 2014, 387 patients were retrospectively reviewed after those with pre-existing organic brain syndrome, psychiatric diseases, or toxic-metabolic encephalopathy were excluded. Patients' demographic and laboratory data, WMC measured with brain computed tomography and scored using the age-related white matter changes (ARWMC) scale, and neuropsychological tests, including the cognitive abilities screening instrument (CASI), the Mini-Mental State Examination (MMSE), the clinical dementia rating scale with sum-box (CDR-SB), and the neuropsychiatric inventory (NPI) were analyzed.

Results

There was no significant difference in the NPI between patients with and without a history of stroke, hypertension, and diabetes. No significant difference in the NPI was identified between different sexes or different Apolipoprotein E (APOE) alleles. The NPI score was significantly correlated with the duration of education (r = −0.4515, P = 0.0172), CASI (r = −0.2915, P < 0.0001), MMSE (r = −0.8476, P < 0.0001), and CDR-SB (r = 2.2839, P < 0.0001). WMC in the right frontal lobe showed a significant difference in NPI in comparison to those without WMC (P = 0.0255). After adjusting for age, duration of education, and CASI, WMC in the right frontal lobe remained significantly associated with the NPI score (β = 3.8934, P = 0.042).

Conclusions

WMC involving the right frontal lobe may play an important role in the BPSD in AD patients during their dementia diagnosis. Further studies are necessary to confirm whether controlling the risk factors of WMC can slow the progression of BPSD.
Dementia in Taiwan Area
Authors: Yang Yuanhan
Published: December 2018

Objective

Taiwan has an increasing aging population like other developed areas. The aging population will lead to an increased prevalence of dementia.

Methods

This article will reflect the status of dementia in Taiwan, including updated epidemiology, diagnosis, subtypes, and optimal treatment of dementia.

Results

The article also describes and interprets the Taiwan Dementia Policy to establish a clear, large view of the current state of management of dementia in Taiwan and future policy implementation.

Conclusion

A comprehensive policy to dementia, from the basic researches to clinical care and treatment, is necessary to the increased aged population in Taiwan.
A Study of the Effects of 3,5-Diiodo-L-Thyronine in the Tail Suspension and Forced Swim Models of Depression
Authors: Markova Nataliia , Chernopiatko Anton , Kubatiev Asian , Bachurin Sergey , Steinbusch Harry M. W. , Strekalova Tatyana
Published: December 2018

Objectives

Recent findings have further highlighted the role of the thyroid system in the pathophysiology of depression and revealed new physiologically relevant elements of the thyroid system. Our previous study showed an antidepressant-like effect of 3,5-diiodo-L-thyronine (T2), which was previously considered to be a physiologically inactive molecule, in mice. Here, we aimed to investigate the antidepressant-like effects of T2 further.

Methods

We studied the effects of bolus injections of T2 to C57Bl6J mice at doses of 0.25 or 0.75 mg/kg with the tail suspension and forced swim models. The effects of the higher dose were investigated in CD1 mice in the forced swim test. Potential behavioral effects of these treatments were also studied using the novel cage and dark-light box tests.

Results

A reduction of depressive-like behavior was found in mice treated with 0.75 mg/kg of T2 in the tail suspension test, but not in the forced swim test. Locomotion and anxiety variables were unaltered following treatment with T2. There were no significant changes after bolus administration of 0.25 mg/kg T2 in either test for depressive-like behavior. Thus, bolus injection of T2 at the dose 0.75 mg/kg can induce antidepressant-like effects without affecting other behaviors.

Conclusions

A discrepant result in the forced swim test may be due to its different sensitivity to T2 compared with the tail suspension paradigm. Furthermore, the development of procedural modifications of this model can be useful in its application in preclinical studies.
A Newly Developed Open-End Intracranial Hematoma Drainage Tube
Authors: He Chao , Wanussakul Nongnaphat , Yang Dong , Wu Tianya , Zhao Ming
Published: December 2018

Objective

To design a new open-end intracranial hematoma drainage tube for clinical application.

Methods

The newly developed device consists of two parts: the plunger and barrel. On one side, the barrel is bullet shaped with an opening tip. The plunger is located in the middle cavity of the tube barrel and extended out at the open-end. It was designed for strengthening the tube barrel and for convenience in performing the drainage procedure. It can be used by inserting the drainage tube into the lesion and pulling out the plunger, whereby blood will forcefully rise up inside the barrel, providing a satisfactory outcome. It is made for effusion drainage purposes. During the procedure, the drainage tip is placed at the deepest part of the intracranial hematoma to completely drain the blood. Moreover, the plunger fits tightly in the tube, preventing leakage during the operation. With the use of the device, brain can be separated. In addition, the device can help reduce the risk of cerebral damage because of the small operating area. The barrel sidewall has matching opening holes bilaterally and equally for exchanging substances between the inner and outer parts. The overlapping ratio in each horizontal pair is around 1/3–1/2. Each pair on the opposite side will form a different pressure. Thus, the opening holes will not easily get blocked with blood clot.

Results

Blood and accumulated liquid from the deepest part of the intracranial hematoma can be directly drawn through the drainage tube without damaging a large area. The tube does not get blocked easily and allows for complete removal of the hematoma.

Conclusions

The device is asuitable instrument for clinical application.
Transplantation of Neural Progenitor Cells Differentiated from Adipose Tissue-Derived Stem Cells for Treatment of Sciatic Nerve Injury
Authors: Dong Shasha , Liu Na , Hu Yang , Zhang Ping , Pan Chao , Zhang Youping , Tang Yingxin , Tang Zhouping
Published: December 2018

Objectives

Currently, the clinical repair of sciatic nerve injury remains difficult. Previous studies have confirmed that transplantation of adipose tissue-derived stem cells promotes nerve regeneration and restoration at peripheral nerve injury sites.

Methods

In this study, adipose tissue-derived stem cells were induced to differentiate into neural progenitor cells, transfected with a green fluorescent protein-containing lentivirus, and then transplanted into the lesions of rats with sciatic nerve compression injury.

Results

Fluorescence microscopy revealed that the transplanted cells survived, migrated, and differentiated in rats. At two weeks post-operation, a large number of transplanted cells had migrated to the injured lesions; at six weeks post-operation, transplanted cells were visible around the injured nerve and several cells were observed to express a Schwann cell marker. Sciatic function index and electrophysiological outcomes of the transplantation group were better than those of the control group. Cell transplantation promoted the recovery of motor nerve conduction velocity and compound muscle action potential amplitude, and reduced gastrocnemius muscle atrophy.

Conclusions

Our experimental findings indicate that neural progenitor cells, differentiated from adipose tissue-derived stem cells, are potential seed stem cells that can be transplanted into lesions to treat sciatic nerve injury. This provides a theoretical basis for their use in clinical applications.
Antiparkinsonian Treatment for Depression in Parkinson's Disease: Are Selective Serotonin Reuptake Inhibitors Recommended?
Authors: De Deurwaerdère Philippe , Ding Yuqiang
Published: December 2018

Depression is a frequent comorbid syndrome in Parkinson's disease. It is a difficult symptom to manage, as patients continuously receive antiparkinsonian medication and may also have to be treated for the amelioration of the side-effects of antiparkinsonian therapy. The first-line treatment for depression in Parkinson's disease is the use of selective serotonin reuptake inhibitors (SSRIs). The clinical efficacy of these medications in patients with Parkinson's disease is questionable. In fact, based on their mechanism of action, which requires at least a functional serotonergic system, it is predicted that SSRIs will have lower efficacy in patients with Parkinson's disease. Here, we consider the mechanism of action of SSRIs in the context of Parkinson's disease by investigating the fall in the levels of serotonergic markers and the inhibitory outcomes of antiparkinsonian treatment on serotonergic nerve activity. Because certain classes of antidepressant drugs are widely available, it is necessary to perform translational research to address different strategies used to manage depression in Parkinson's disease.
Are Life Sciences all about Life?
Authors: Wang Dajue
Published: December 2018

Brain function is an extremely active dynamic process. Studing a living organism is essential for explaination of the sophistication of the brain. Although there are progresses in studying living tissues of acute or cultured slice for prolonged period in vitro, clinicians prefer seeing the lesion directly on an imaging screen or material. Functional MRI (fMRI) is commonly used method to study brain pathology in dynamics.
Comparison of Different Microsurgery Methods for Trigeminal Neuralgia
Authors: Xie Zihang , Chen Lin , Wang Yan , Cui Zhiqiang , Wang Shijie , Ao Qiang , Zhang Yuqi , Zuo Huancong
Published: December 2018

Objective

To study the influence of different microsurgical methods on surgical outcomes and complications, and to improve the surgical outcomes for trigeminal neuralgia.

Methods

The clinical data of 109 patients with trigeminal neuralgia, who were treated with microsurgery, were analyzed retrospectively. All patients were divided into 3 groups according to surgical modality: the trigeminal neuralgia decompression group (TND group, 19 patients), the TND and rhizotomy group (rhizotomy group, 55 patients), and the TND and selective lesioning group (lesioning group, 35 patients). The mid-term and short-term effects of microsurgery, and the occurrences of complications, were compared between the 3 groups.

Results

There were no statistical differences in the frequency of complications between the 3 groups (P > 0.05). Eighty-four patients were followed up for 6 to 33 months. The rate of pain disappearance was found to be 94.4% in the TND group, and 100% in both the rhizotomy and lesioning groups; thus, no significant differences were found between these 3 groups (P > 0.05). Additionally, 50% of the patients in the rhizotomy group and 3.6% of the patients in the lesioning group had facial numbness while no patients were affected with facial numbness in the TND group, and the differences between these 3 groups were significant (P < 0.05).

Conclusions

Microsurgery is effective and safe for trigeminal neuralgia. The use of TND, in combination with selective lesioning, ensures therapeutic efficacy and improves the quality of life in postoperative patients.
Gangliocytoma Combined with a Pituitary Adenoma: Reports of Three Cases and Literature Review
Authors: Wang Zhenmin , Li Peng , Zhou Qiangyi , Yang Zhijun , Liu Pinan
Published: December 2018

Objectives

Sellar gangliocytomas are extremely rare. Since they present clinically and radiologically as pituitary adenomas, the preoperative diagnosis of these mixed tumors is very difficult. Here, we report three cases of gangliocytoma combined with pituitary adenoma and describe our findings.

Methods

The clinical data of the three cases of gangliocytoma combined with pituitary adenoma have been retrospectively analyzed, and the published literature has also been reviewed.

Results

All three patients underwent pure endonasal endoscopic surgery, and no recurrence was observed over a follow-up of at least 30 months. Growth hormone (GH)-hypersecreting adenoma and tumor calcification were detected in these mixed tumors.

Conclusions

Pure endoscopic transnasal transsphenoidal surgery may be an effective way for the treatment of this kind of tumor. Gross total resection of the tumor is recommended. In addition, calcification with GH-hypersecretion may serve as a preoperative diagnostic clue for gangliocytoma in the sella turcica.
A “Logarithmic Spiral” in the Brain: Images of an Intracranial Dermoid Cyst
Authors: Lou Meiqing , Zhao Yaodong
Published: December 2018

A logarithmic spiral is a self-similar spiral curve, which often appears in nature, e.g., mollusk shells. In the normal tissues of the human body, the cochlea is also an approximate logarithmic spiral. However, approximate logarithmic spirals are rarely, if ever, reported in tumors. Recently, we treated a 26-year-old woman with a one-year history of headache. Preoperative magnetic resonance imaging showed a possible brain tumor with radiological characteristics similar to a typical logarithmic spiral, which has seldom been observed before. Because of the obvious clinical symptoms and discomfort, as well as the possible presence of an intracranial tumor, we performed a craniotomy and tumor resection. Perioperatively, we found an intact tumor capsule, with contents that appeared like egg-drop soup mixed with hairs. A postoperative pathological diagnosis of a dermoid cyst was made. However, more interestingly, the logarithmic spiral could be described mathematically with a high goodness of fit. In this paper, we present this case with various clinical images.
Management of Poststroke Neuropsychiatric Disorders
Authors: Khan Ahsan Ali , Chen Lukui , Zhang Guilong , Guo Xiaoyuan , Wu Guojian , Wang Hong , You Yang , Gu Yuchun , Yuan Yonggui
Published: December 2018

Post-stroke neuropsychiatric (NP) disorders are common and have complex etiologies. Multiple factors such as lesion location, personality characteristics, socioeconomic status, pre-stroke psychiatric history, and family support are the determining factors in most cases. Although depression and anxiety are more common, emotional incontinence and catastrophic reactions are also frequently observed. Post-stroke depression (PSD) has been associated with an increased risk of stroke recurrence. Despite its serious consequences and high prevalence, PSD remains undetected and untreated. Treatment options of NP disorders depend on severity, presentation at the time of diagnosis, and patient cooperation, and include antidepressants, mood stabilizers, exercise therapy, psychotherapy, and even revascularization. The efficient management of NP disorders improves outcomes, quality of life, and survival rates in poststroke patients. However, very few studies have identified definitive treatment for these patients; therefore, further research is required.
Prolactinoma Coexisting with Cerebrospinal Fluid Rhinorrhea and Cavernous Internal Carotid Aneurysm: Case Report and Literature Review
Authors: Yang Zhijun , Wang Zhenmin , Li Peng , Zhou Qiangyi , Liu Pinan
Published: December 2018

Pituitary adenoma coexisting with cerebrospinal fluid (CSF) rhinorrhea and carotid aneurysm is extremely rare. CSF rhinorrhea may cause pneumocephalus and intracranial infection. Rupture of the aneurysm may cause fatal consequence. The authors report such a rare case to draw more attentions. A 55-year-old man presented with sexual dysfunction for 2 years. The serum prolactin was tested as 1,600 ng/ml (normal range, 1.39–24.2). Enhanced cranial MR showed an evident lesion at the sellar area, invading the right cavernous sinus. Prolactinoma was diagnosed. He took bromocriptine for one year and received gamma knife therapy thereafter. Four months after the treatment of gamma knife, he got CSF rhinorrhea and nasal bleeding. The endoscopic transnasal-sphenoidal approach was performed to resect the tumor and repair the dura defect. The CSF rhinorrhea stopped after the surgery, however his nasal bleeding continued. The digital subtraction angiography (DSA) showed an aneurysm at the right cavernous internal carotid. The endovascular coil embolization was performed to treat the aneurysm. The patient recovered well. The coexistence of CSF rhinorrhea and pituitary adenoma is a high risk factor for the rupture of cavernous internal carotid aneurysm. When treating patients with pituitary adenoma and CSF rhinorrhea, doctors should exclude the aneurysm. When nasal bleeding occurs, the hemorrhage of internal carotid should be considered, and appropriate measures should be taken immediately.
Factors Influencing the Effects of Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease
Authors: Ye Na , Feng Tao
Published: December 2018

Barker first used transcranial magnetic stimulation in 1985 in human brain function research. Since then, it has gradually been developed into a secure and non-invasive treatment method for neurological diseases. In 1994, Pascual Leone first used it for the treatment of Parkinson's disease (PD) and observed an improvement in the motor symptoms of most of the patients. Recent studies have confirmed that both motor and non-motor symptoms of patients with PD could be improved through biochemical, electrophysiological, and functional magnetic resonance imaging analysis. Different therapeutic applications can be achieved by adjusting the stimulation parameters. Physical factors affecting the therapeutic effect include the shape and size of the coil, array orientation, materials and intensity, frequency of stimulus, etc.; the biological factors include stimulating targets, baseline, circadian rhythms, cerebral cortex thickness, and so on. This paper will review these factors and provide a reference for future research.
Application of Multimodal Image Fusion Technology in Brain Tumor Surgical Procedure
Authors: Li Jiefei , Zhang Yuqi , He Le , Zuo Huancong
Published: December 2018

Objective

To construct brain tumors and their surrounding anatomical structures through the method of registration, fusion and, three-dimensional (3D) reconstruction based on multimodal image data and to provide the visual information of tumor, skull, brain, and vessels for preoperative evaluation, surgical planning, and function protection.

Methods

The image data of computed tomography (CT) and magnetic resonance imaging (MRI) were collected from fifteen patients with confirmed brain tumors. We reconstructed brain tumors and their surrounding anatomical structures using NeuroTech software.

Results

The whole 3D structures including tumor, brain surface, skull, and vessels were successfully reconstructed based on the CT and MRI images. Reconstruction image clearly shows the tumor size, location, shape, and the anatomical relationship of tumor and surrounding structures. We can hide any reconstructed images such as skull, brain tissue, blood vessles, or tumors. We also can adjust the color of reconstructed images and rotate images to observe the structures from any direction. Reconstruction of brain and skull can be semi transparent to display the deep structure; reconstruction of the structures can be axial, coronal, and sagittal cutting to show relationship among tumor and surrounding structures. The reconstructed 3D structures clearly depicted the tumor features, such as size, location, and shape, and provided visual information of the spatial relationship among its surrounding structures.

Conclusions

The method of registration, fusion, and 3D reconstruction based on multimodal images to provide the visual information is feasible and practical. The reconstructed 3D structures are useful for preoperative assessment, incision design, the choice of surgical approach, tumor resection, and functional protection.
Global Action against Dementia Call for Innovations
Authors: Wang Dajue
Published: December 2018

With the fast-growing aging population, dementia has become a health priority. However, in the past, medicine was largely dealing with physical disorders, and not enough knowledge and experience have been accumulated for mental health. The main and first symptom of this disorder is the loss of memory; hence, understanding the hippocampal formation is the key to tackling dementia. In 2007, a milestone book titled “Hippocampus Book” was published. One of the authors/editors is the 2014 Nobel Laureate in Physiology and Medicine, Professor John O'Keefe. It is a MUST-READ encyclopedia about the hippocampal formation, for those who wish to commit themselves to helping the patients with dementia. The formation consists of the hippocampus, entorhinal cortex, subiculum, presubiculum, parasubiculum, and dentate gyrus. The hippocampus is further divided into CA1, CA2, and CA3. The entorhinal cortex is the gateway of receiving all sensory information from the neocortex, while the subiculum is the exit for the efferent projections to the neocortex. Memory is divided into short-term and long-term memory. The former does not require protein synthesis while the latter does. The electrophysiological activities of creating these memories are short-term potentiation and long-term potentiation respectively. In most cases, the entorhinal cortex is the first structure to be damaged, and even short-term memory cannot be created. However, all except spatial memory are stored in the neocortex. Damage to the hippocampal formation would not affect the storage and retrieval of memories. Hence, past memories may remain intact in the early phases of the disorder. This devastating progressive disease has no cure. However, the highly plastic hippocampal formation may offer us some hope. It is the responsibility of the pharmaceutical industries to develop new drugs. Clinicians should add their efforts to the endeavor. The author would suggest that they explore insulin-like growth factors, brain stimulation, cell transplantation, and animal-assisted therapy to find some innovative solutions to help patients with dementia. As the current status of neuroscience stands, the animal-assisted therapy seems to stand out among all methods. It alleviates symptoms and stabilizes the ailment.
Neurocutaneous Melanosis with Intraspinal Malignant Melanoma in Adults — An Extremely Rare Clinical Entity: A Case Report with Review of Literature
Authors: Liu Dongkang , Wei Yujun , Wang James , Wang Guihuai
Published: December 2018

Objectives

Neurocutaneous melanosis (NCM) in adult patients was rare, and few cases had been reported. In this report, we summarized the features of NCM in adult patients for providing useful information about this rare clinical entity.

Methods

In this report, we present a case of a 41-year-old woman, who was eventually diagnosed with NCM with intraspinal malignant melanoma. The clinical features, treatments, and prognosis of cases of NCM in adults were thoroughly reviewed and discussed.

Results

A 41-year-old woman was eventually diagnosed with NCM with intraspinal malignant melanoma. The postoperative course was uneventful and her symptoms significantly improved (VAS: 3 points). However, she developed symptoms of intracranial hypertension and deteriorated rapidly after 11 months of operation, and died 1 month later. To date, only 15 cases of NCM in adults have been reported in the English literature. Analyses showed that the average age was 33.8 years (range 19–65 years), and 11 patients (68.8%) were between 20 and 40 years. A slight male predominance (M:F/11:5) was found. For the 12 cases which detailed follow-up information was available, 9 patients (75%) died, with a survival time ranging from 1 day to 29 months post-operation. Death occurred within the first month of operation in 6 cases (46. 2%). The median survival time was 3 months.

Conclusions

We presented a rare case of NCM with intraspinal malignant melanoma in an adult patient. Although rare, this clinical entity causes significant mortality and has poor prognosis.
The Ideal Microvascular Decompression Technique Should be Easy and Safe
Authors: Zhong Jun , Li Shiting
Published: December 2018

Microvascular decompression (MVD) surgery has been popularized as an etiological treatment around the world for more than half a century. However, as a functional operation in the cerebellopontine angle, this process should be refined to enhance cure and minimize complication. After accomplishing more than 10,000 MVDs, we have learned the following concerning the operative technique: (1) the principle of MVD is to separate the neurovascular confliction, rather than isolate with prostheses; (2) identification of the conflict relies on good exposure; (3) a satisfactory working space can be created by the appropriate positioning, i.e., either a close-to-the-sigmoid craniectomy or caudorostral approach; (4) a sharp dissection of arachnoids leads to a maximal visualization of the entire intracranial course of the nerve root; (5) all vessels contacting the trigeminal nerve root should be cleared off; (6) intraoperative electrophysiological monitoring may predict the prognosis of hemifacial spasm and guide the operation; and (7) the dura must be closed with watertight stitches at the end.
Long-Term Results of a Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Refractory Neuropathic Pain
Authors: Son Byung-chul , Choi Jin-gyu , Ha Sang-woo , Kim Deog-ryeong
Published: December 2018

Objective

Although deep brain stimulation (DBS) and motor cortex stimulation (MCS) are effective in patients with refractory neuropathic pain, their application is still empirical; there is no consensus on which technique is better.

Methods

To enhance the success rate of trial stimulation of invasive neuromodulation techniques and identify approapriate stimulation targets in individual patients, we performed a simultaneous trial of thalamic ventralis caudalis (Vc) DBS and MCS in 11 patients with chronic neuropathic pain and assessed the results of the trial stimulation and long-term analgesia.

Results

Of the 11 patients implanted with both DBS and MCS electrodes, nine (81.8%) had successful trials. Seven of these nine patients (77.8%) responded to MCS, and two (18.2%) responded to Vc DBS. With long-term follow-up (56 ± 27.5 months), the mean numerical rating scale decreased significantly (P < 0.05). The degree of percentage pain relief in the chronic MCS (n = 7) and chronic DBS (n = 2) groups were 34.1% ± 18.2% and 37.5%, respectively, and there was no significant difference (P = 0.807). Five out of the seven MCS patients (71%) and both DBS patients had long-term success with the treatments, defined as >30% pain relief compared with baseline.

Conclusions

With simultaneous trial of DBS and MCS, we could enhance the success rate of invasive trials. Considering the initial success rate and the less invasive nature of epidural MCS over DBS, we suggest that MCS may be a better, initial means of treatment in chronic intractable neuropathic pain. Further investigations including other subcortical target-associated medial pain pathways are warranted.