Neurological Function (neurological + function)

Distribution by Scientific Domains


Selected Abstracts


Retrospective Analysis of Spinal Arachnoid Cysts in 14 Dogs

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2002
Helena Rylander
Spinal cord dysfunction secondary to spinal arachnoid cysts (SACs) has been reported previously in dogs. This retrospective study reviews the clinical signs, radiographic findings, and outcome after surgical resection of SACs in 14 dogs. Plain vertebral column radiographs and myelography were done in all dogs. Computed tomography (CT) was done in 7 dogs and magnetic resonance (MR) imaging in 3 dogs. Affected dogs were between 1 and 12 years of age, and 8 of 14 were Rottweilers. Abnormalities detected on neurological examination depended on the location of the SAC. Five dogs had bilobed or multiple SACs. SACs were located in the cervical vertebral column in 11 dogs and in the thoracic vertebral column in 4 dogs. All dogs had dorsally or dorsolaterally located SACs. Two dogs also had additional ventrally located SACs. Spinal cord compression secondary to intervertebral disc extrusion or protrusion was demonstrated at the site of the SACs in 2 dogs. Surgical resection of the SACs was completed in all dogs. Eleven dogs were available for follow-up. Five weeks postoperatively, 7 dogs improved in neurological function, with some residual ataxia and paresis in 6 of these dogs. Neurological function had deteriorated in 4 dogs. It was concluded from this study that Rottweilers have a higher incidence of SACs than other breeds of dog. Furthermore, bilobed or multiple SACs can occur commonly, and myelography effectively localized SACs in dogs. Surgical resection of SACs resulted in improvement in neurological function in the majority of treated dogs. [source]


S -Nitrosylated Pegylated Hemoglobin Reduces the Size of Cerebral Infarction in Rats

ARTIFICIAL ORGANS, Issue 2 2009
Akira T. Kawaguchi
Abstract Cell-free hemoglobin-based oxygen carriers have well-documented safety and efficacy problems such as nitric oxide (NO) scavenging and extravasation that preclude clinical use. To counteract these effects, we developed S -nitrosylated pegylated hemoglobin (SNO-PEG-Hb, P50 = 12 mm Hg) and tested it in a brain ischemia and reperfusion model. Neurological function and extent of cerebral infarction was determined 24 h after photochemically induced thrombosis of the middle cerebral artery in the rat. Infarction extent was determined from the integrated area in the cortex and basal ganglia detected by triphenyltetrazolium chloride staining in rats receiving various doses of SNO-PEG-Hb (2, 0.4, and 0.08 mL/kg) and compared with rats receiving pegylated hemoglobin without S -nitrosylation (PEG-Hb) or saline of the same dosage. Results indicated that successive dilution revealed SNO-PEG-Hb but not PEG-Hb to be effective in reducing the size of cortical infarction but not neurological function at a dose of 0.4 mL/kg. In conclusion, SNO-PEG-Hb in a dose of 0.4 mL/kg (Hb 24 mg/kg) showed to be most effective in reducing the size of cortical infarction, however, without functional improvement. [source]


Delayed pharmacological pre-conditioning effect of mitochondrial ATP-sensitive potassium channel opener on neurologic injury in a rabbit model of spinal cord ischemia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2008
K. O. KIM
Background: Diazoxide, pharmacological openers of mitochondrial ATP-sensitive potassium channels have been shown to induce early pre-conditioning in the spinal cord. Here, the authors investigated whether diazoxide also induce delayed pre-conditioning and thereby reduce neurologic complications using a rabbit model of spinal cord ischemia. Methods: Infrarenal blood flow was interrupted for 20 min in 21 rabbits. Non-treated control animals received no pre-treatment. Diazoxide (5 mg/kg) were given 48 h before 20 min ischemia in the 48-h DZ group, whereas 15-min DZ group received diazoxide (5 mg/kg) 15 min before 20-min ischemia. Neurological functions were evaluated using Johnson scores for 3 days after reperfusion, after which, spinal cords were procured for hematoxylin and eosin staining for cell counting. Results: Johnson scores revealed a marked improvement in both the diazoxide-treated groups vs. the non-treated control group at 3, 24, 48, and 72 h after reperfusion (P<0.01). The histologic changes were proportional to the Johnson scores, with better preservation of motor neuron numbers in the animals of the 48-h DZ and 15-min DZ group relative to the non-treated controls (81±12, 90±10, 50±23 motor neurons, respectively, P<0.01). No difference was found between the 48-h DZ group and 15-min DZ group with respect to the Johnson scores or neuron numbers. Conclusions: The study demonstrates that pre-treatment with diazoxide 48 h before ischemia, induce delayed pharmacological pre-conditioning, thereby significantly improving clinical neurologic scores and histologic findings in this animal model. [source]


Human neural stem cell transplantation attenuates apoptosis and improves neurological functions after cerebral ischemia in rats

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009
P. ZHANG
Background: Neuroprotection is a major therapeutic approach for ischemic brain injury. We investigated the neuroprotective effects induced by transplantation of human embryonic neural stem cells (NSCs) into the cortical penumbra 24 h after focal cerebral ischemia. Methods: NSCs were prepared from human embryonic brains obtained at 8 weeks of gestation. Focal cerebral ischemia was induced in adult rats by permanent occlusion of the middle cerebral artery. Animals were randomly divided into two groups: NSCs-grafted group and medium-grafted group (control). Infarct size was assessed 28 days after transplantation by hematoxylin and eosin staining. Neurological severity scores were evaluated before ischemia and at 1, 7, 14, and 28 days after transplantation. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and immunohistochemical analysis of Bcl-2 and Bax were performed at 7, 14, and 28 days after transplantation. Results: Physiological parameters of the two groups were comparable, but not significantly different. NSC transplantation significantly improved neurological function (P<0.05) but did not reduce the infarct size significantly (P>0.05). Compared with the control, NSC transplantation significantly reduced the number of TUNEL- and Bax-positive cells in the penumbra at 7 days. Interestingly, the number of Bcl-2-positive cells in the penumbra after NSC transplantation was significantly higher than that after medium transplantation (P<0.05). Conclusions: The results indicate that NSC transplantation has anti-apoptotic activity and can improve the neurological function; these effects are mediated by the up-regulation of Bcl-2 expression in the penumbra. [source]


Outcome, timing and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009
N. NIELSEN
Background: Therapeutic hypothermia (TH) after cardiac arrest protects from neurological sequels and death and is recommended in guidelines. The Hypothermia Registry was founded to the monitor outcome, performance and complications of TH. Methods: Data on out-of-hospital cardiac arrest (OHCA) patients admitted to intensive care for TH were registered. Hospital survival and long-term outcome (6,12 months) were documented using the Cerebral Performance Category (CPC) scale, CPC 1,2 representing a good outcome and 3,5 a bad outcome. Results: From October 2004 to October 2008, 986 TH-treated OHCA patients of all causes were included in the registry. Long-term outcome was reported in 975 patients. The median time from arrest to initiation of TH was 90 min (interquartile range, 60,165 min) and time to achieving the target temperature (,34 °C) was 260 min (178,400 min). Half of the patients underwent coronary angiography and one-third underwent percutaneous coronary intervention (PCI). Higher age, longer time to return of spontaneous circulation, lower Glasgow Coma Scale at admission, unwitnessed arrest and initial rhythm asystole were all predictors of bad outcome, whereas time to initiation of TH and time to reach the goal temperature had no significant association. Bleeding requiring transfusion occurred in 4% of patients, with a significantly higher risk if angiography/PCI was performed (2.8% vs. 6.2%P=0.02). Conclusions: Half of the patients survived, with >90% having a good neurological function at long-term follow-up. Factors related to the timing of TH had no apparent association to outcome. The incidence of adverse events was acceptable but the risk of bleeding was increased if angiography/PCI was performed. [source]


Postinjury estrogen treatment of chronic spinal cord injury improves locomotor function in rats

JOURNAL OF NEUROSCIENCE RESEARCH, Issue 8 2010
Eric A. Sribnick
Abstract Spinal cord injury (SCI) causes loss of neurological function and, depending on serverity, may cause paralysis. The only recommended pharmacotherapy for the treatment of SCI is high-dose methylprednisolone, and its use is controversial. We have previously shown that estrogen treatment attenuated cell death, axonal and myelin damage, calpain and caspase activities, and inflammation in acute SCI. The aim of this study was to examine whether posttreatment of SCI with estrogen would improve locomotor function by protecting cells and axons and reducing inflammation during the chronic phase following injury. Moderately severe injury (40 g · cm force) was induced in male Sprague-Dawley rats following laminectomy at T10. Three groups of animals were used: sham (laminectomy only), vehicle (dimethyl sulfoxide; DMSO)-treated injury group, and estrogen-treated injury group. Animals were treated with 4 mg/kg estrogen at 15 min and 24 hr postnjury, followed by 2 mg/kg estrogen daily for the next 5 days. After treatment, animals were sacrificed at the end of 6 weeks following injury, and 1-cm segments of spinal cord (lesion, rostral to lesion, and caudal to lesion) were removed for biochemical analyses. Estrogen treatment reduced COX-2 activity, blocked nuclear factor-,B translocation, prevented glial reactivity, attenuated neuron death, inhibited activation and activity of calpain and caspase-3, decreased axonal damage, reduced myelin loss in the lesion and penumbra, and improved locomotor function compared with vehicle-treated animals. These findings suggest that estrogen may be useful as a promising therapeutic agent for prevention of damage and improvement of locomotor function in chronic SCI. © 2010 Wiley-Liss, Inc. [source]


Neurovascular and neuronal protection by E64d after focal cerebral ischemia in rats

JOURNAL OF NEUROSCIENCE RESEARCH, Issue 4 2006
Tamiji Tsubokawa
Abstract Calpains and cathepsins are two families of proteases that play an important role in ischemic cell death. In this study, we investigated the effect of E64d, a ,-calpain and cathepsin B inhibitor, in the prevention of neuronal and endothelial apoptotic cell death after focal cerebral ischemia in rats. Rats underwent 2 hr of transient focal ischemia from middle cerebral artery occlusion (MCAO) and were sacrificed 24 hr later. E64d (5 mg/ kg intraperitoneally) was administered 30 min before MCAO. Assessment included neurological function, infarction volume, brain water content, blood,brain barrier permeability, histology, and immunohistochemistry. The E64d-treated rats had significant brain protection against ischemic damage. We observed a reduction of infarction volume, brain edema, and improved neurological scores in E64d-treated rats compared with the nontreated control. Furthermore, there was a remarkable reduction in both proteases and caspase-3 activation and apoptotic changes in both neurons and endothelial cells in E64d-treated rats. These results suggest that E64d protects the brain against ischemic/reperfusion injury by attenuating neuronal and endothelial apoptosis. © 2006 Wiley-Liss, Inc. [source]


Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2010
Gye Song Cho
J Oral Pathol Med (2010) 39: 722,727 Background:, Zinc is known to play an important role for growth and development, the immune response, neurological function, and reproduction. Although the etiology of burning mouth syndrome (BMS) is unknown, zinc deficiency may be implicated in the pathogenesis of BMS. The aim of this study was to demonstrate a causal relationship between zinc deficiency and BMS and to assess whether zinc replacement is an effective therapy for BMS. Methods:, Serum zinc level was evaluated in 276 patients with BMS. To assess the therapeutic effect of zinc replacement, patients with zinc deficiency were administered a zinc supplement (14.1 mg/day). Pain intensity 6 months after zinc replacement was evaluated using an 11-point numerical scale. We also developed an animal model of zinc deficiency to assess the effects of zinc deficiency on the oral mucosa. Results:, Of the 276 patients with BMS, 74 (26.8%) had low serum zinc levels. Zinc replacement therapy lowered the mean numerical pain scale in these patients from 8.1 to 4.1, compared with a mean decrease from 7.7 to 6.7 in a control group (P = 0.004). In our animal model of zinc deficiency, the main pathologic findings were hyperkeratinization and increased mitosis on the dorsum of the tongue, although there were no gross oral mucosal lesions. Conclusions:, Zinc deficiency might play a role in some patients with BMS. In such patients, appropriate zinc replacement therapy is effective in relieving symptoms. [source]


Retrospective Analysis of Spinal Arachnoid Cysts in 14 Dogs

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2002
Helena Rylander
Spinal cord dysfunction secondary to spinal arachnoid cysts (SACs) has been reported previously in dogs. This retrospective study reviews the clinical signs, radiographic findings, and outcome after surgical resection of SACs in 14 dogs. Plain vertebral column radiographs and myelography were done in all dogs. Computed tomography (CT) was done in 7 dogs and magnetic resonance (MR) imaging in 3 dogs. Affected dogs were between 1 and 12 years of age, and 8 of 14 were Rottweilers. Abnormalities detected on neurological examination depended on the location of the SAC. Five dogs had bilobed or multiple SACs. SACs were located in the cervical vertebral column in 11 dogs and in the thoracic vertebral column in 4 dogs. All dogs had dorsally or dorsolaterally located SACs. Two dogs also had additional ventrally located SACs. Spinal cord compression secondary to intervertebral disc extrusion or protrusion was demonstrated at the site of the SACs in 2 dogs. Surgical resection of the SACs was completed in all dogs. Eleven dogs were available for follow-up. Five weeks postoperatively, 7 dogs improved in neurological function, with some residual ataxia and paresis in 6 of these dogs. Neurological function had deteriorated in 4 dogs. It was concluded from this study that Rottweilers have a higher incidence of SACs than other breeds of dog. Furthermore, bilobed or multiple SACs can occur commonly, and myelography effectively localized SACs in dogs. Surgical resection of SACs resulted in improvement in neurological function in the majority of treated dogs. [source]


Transcranial application of low-energy laser irradiation improves neurological deficits in rats following acute stroke

LASERS IN SURGERY AND MEDICINE, Issue 1 2006
Luis DeTaboada MSEE
Abstract Background and Objectives Low-level laser therapy (LLLT) has been shown to have beneficial effects on ischemic skeletal and heart muscles tissues. The aim of the present study was to approve the effectiveness of LLLT treatment at different locations on the brain in acute stroked rats. Study Design/Materials and Methods Stroke was induced in 169 rats that were divided into four groups: control non-laser and three laser-treated groups where laser was employed ipsilateral, contralateral, and both to the side of the induced stroke. Rats were tested for neurological function. Results In all three laser-treated groups, a marked and significant improvement in neurological deficits was evident at 14, 21, and 28 days post stroke relative to the non-treated group. Conclusions These observations suggest that LLLT applied at different locations in the skull and in a rather delayed-phase post stroke effectively improves neurological function after acute stroke in rats. Lasers Surg. Med. 38:70,73, 2006. © 2006 Wiley-Liss, Inc. [source]


Endocannabinoids and liver disease , review

LIVER INTERNATIONAL, Issue 5 2005
Ezra Gabbay
Abstract: Aims: Endocannabinoids are endogenous compounds that bind to the same receptors as tetrahydrocannabinol, the active component in marijuana and hashish. They have been found to have many physiological and patho-physiological functions, including mood alteration, control of feeding and appetite, motor and co-ordination activities, analgesia, immune modulation and gut motility. In this review we aim to elucidate current knowledge as to their role in liver physiology and disease. Methods: The major findings published to date concerning endocannabinoids and liver disease are described, and their implications with regard to understanding disease mechanisms, and the development of new treatments is considered. Results: Recently, endocannabinoids have been implicated in the hemodynamic alterations occurring in cirrhosis. These changes appear to be mediated via specific cannabinoid receptors (CB1) on splanchnic and hepatic vascular endothelium. Plasma levels of endocannabinoids also seem to be elevated in hepatitis, and are involved in apoptosis of hepatocytes by a membrane mechanism not related to a specific receptor. Other studies suggest a beneficial role for cannabinoids in reducing the inflammation of experimental hepatitis. In an animal model of acute hepatic failure, both endocannabinoids and the antagonist to the CB1 receptor have been found to have a beneficial effect on neurological and cognitive function. Conclusions: Endocannabinoids appear to be involved in several aspects of acute and chronic liver disease, including vascular changes, modulation of inflammatory process and neurological function, Further research may provide new insights into the pathophysiology of liver disease, as well as a basis for novel treatment modalities. [source]


Inflammatory and Hemodynamic Changes in the Cerebral Microcirculation of Aged Rats after Global Cerebral Ischemia and Reperfusion

MICROCIRCULATION, Issue 4 2008
Leslie Ritter
ABSTRACT Effects of aging on inflammation and blood flow in the brain are unclear. Young (three to six months) and aged (19,22 months) male Brown Norway Fisher rats were used to compare (i) leukocyte function in nonischemic conditions and (ii) leukocyte function and hemodynamic changes after ischemia-reperfusion (I-R). In nonischemic studies, polymorphonuclear (PMN) CD11b expression and reactive oxygen species (ROS) production were measured with flow cytometry and PMN chemotaxis was measured with a Boyden chamber (+/-fMLP). In I-R studies, ischemia was induced by bilateral carotid artery occlusion and hypotension (20 minutes). During early reperfusion (30 minutes), leukocyte adhesion and rolling and blood-shear rates were measured using fluorescence microscopy. During late reperfusion (48 hours), mortality, neurological function, and leukocyte infiltration were measured. Stimulated PMN chemotaxis was increased in nonischemic aged rats (p < 0.05). In early reperfusion, there was a significant increase in leukocyte rolling and adhesion in the cerebral microcirculation and a significant decrease in shear rate in aged rats, compared to the young (p < 0.05). During late reperfusion, neurologic function was worse in aged vs. young rats (p < 0.05). These findings suggest that increased intravascular PMN adhesion and vascular dysfunction may contribute to poor neurologic outcome after cerebral I-R in the aged brain. [source]


Performance measures in Friedreich ataxia: Potential utility as clinical outcome tools

MOVEMENT DISORDERS, Issue 7 2005
David R. Lynch MD
Abstract Although several neuroprotective agents have been proposed as potential therapies in Friedreich ataxia (FA), clinical trials of their efficacy are limited by a lack of sensitive outcome measures. We assessed whether performance measures (nine-hole peg test, the timed 25-foot walk, and low-contrast letter acuity) provide valid measures of disease status in FA. Scores for each measure correlated significantly with neurologic disability and disease duration. Rank correlations between scores for performance measures were moderate in magnitude, suggesting that the each test captures separate yet related dimensions of neurological function in FA. Linear regression models demonstrated that scores from the nine-hole peg test and the timed 25-foot walk (after reciprocal transformation) were predicted by age and triplet repeat length in patients with FA. In addition, comparison of the temporal courses of change for each performance measure demonstrated that scores from the timed 25-foot walk change early in the course of FA, nine-hole peg test scores change slowly over the full course of the disorder, and low-contrast letter acuity scores change in the later stages of the disease. Thus, a composite scale derived from these performance measures may provide the best overall measure for assessing disease progression throughout the illness. © 2005 Movement Disorder Society [source]


Peripheral somatosensory fMRI in mouse at 11.7 T

NMR IN BIOMEDICINE, Issue 5 2001
Eric T. Ahrens
Abstract The feasibility of performing extremely-high resolution somatosensory fMRI in anesthetized mice using BOLD contrast at 11.7,T was investigated. A somatosensory stimulus was applied to the hindlimb of an ,-chlorolose anesthetized mouse resulting in robust (p,<,4,×,10,3) BOLD changes in somatosensory cortex and large veins. Percentage modulation of the MR signal in cortex exceeded 7%. Experiments that artificially modulated the inspired oxygen tension were also conducted; the results revealed large, heterogeneous, BOLD contrast changes in the mouse brain. In addition, T1, T2, and T2* values in gray matter at 11.7,T were evaluated. Discussion of the sensitivity limitations of BOLD fMRI in the tiny mouse central nervous system is presented. These methods show promise for the assessment of neurological function in mouse models of CNS injury and disease. Copyright © 2001 John Wiley & Sons, Ltd. [source]


Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-up

ORTHOPAEDIC SURGERY, Issue 2 2010
Qing-shui Yin MD
Objective:, To evaluate the mid-term outcomes of transoral atlantoaxial reduction plate (TARP) internal fixation for the treatment of irreducible atlantoaxial dislocation. Methods:, From April 2003 to April 2005, 31 patients with irreducible atlantoaxial dislocation were treated with TARP internal fixation. The average age was 37.9 years (range, 15,69 years). The subjective symptoms, objective signs, and neurological function of the patients were assessed. Radiography and magnetic resonance imaging (MRI) were performed and the results analyzed according to the Symon and Lavender clinical standard, Japanese Orthopaedic Association (JOA) score for spinal cord function and imaging standard for spinal cord decompression. Results:, Complete or almost complete anatomical reduction was obtained in all 31 patients. No screw-loosening or atlantoaxial redislocation was found in 29 cases. According to the Symon and Lavender clinical standard, 14 cases had recovered completely, 7 to mild, 6 to moderate, and 4 to severe type by final follow-up, compared to the preoperative classifications of 4 as moderate, 15 as severe, and 12 as extra severe type. The outcome for 26 patients was evaluated as excellent and in 5 as adequate. The average postoperative improvement in spinal cord function was 73.3% and of decompression of the cervical cord 92.6%. The only complication was loosening of screws in two cases with senile osteoporosis. One case underwent TARP revision surgery and the other posterior occipitocervical internal fixation. Both of them were eventually cured. Conclusion:, The TARP operation is a good choice for patients with irreducible atlantoaxial dislocation and has valuable clinical application. [source]


Intrathecal Catheter Granuloma Associated with Continuous Sufentanil Infusion

PAIN MEDICINE, Issue 6 2010
Anita Gupta DO, PharmD
Abstract Intrathecal sufentanil is a minimally utilized opioid for patients with intractable pain refractory to traditional intrathecal medications. We present an 86-year-old female with a history of multiple spine surgeries who eventually progressed to having chronic, intractable, and diffuse low back pain. After failing medical management, she underwent a successful intrathecal trial of opioid therapy and was subsequently treated with an implantable drug delivery system (IDDS) or intrathecal pump. We describe the first reported case of formation of a catheter tip granuloma associated with intrathecal infusion of sufentanil. Due to increasing opioid requirements and gradually escalating pain, a computed tomography myelogram was performed to explore neuraxial etiologies of her symptoms. This investigation revealed the presence of a catheter tip-associated inflammatory mass (granuloma). All patients receiving intrathecal medications, including sufentanil, must be considered for the possibility of catheter-associated granuloma, particularly with symptoms of altered neurological function and/or increasing medication requirements associated with worsening pain. [source]


Medical and developmental impact of transition from subcutaneous insulin to oral glyburide in a 15-yr-old boy with neonatal diabetes mellitus and intermediate DEND syndrome: extending the age of KCNJ11 mutation testing in neonatal DM

PEDIATRIC DIABETES, Issue 3 2010
Ali Mohamadi
Mohamadi A, Clark LM, Lipkin PH, Mahone EM, Wodka EL, Plotnick LP. Medical and developmental impact of transition from subcutaneous insulin to oral glyburide in a 15-yr-old boy with neonatal diabetes mellitus and intermediate DEND syndrome: extending the age of KCNJ11 mutation testing in neonatal DM. Mutations in the KCNJ11 gene, which encodes the Kir6.2 subunit of the ATP-sensitive potassium channel, often result in neonatal diabetes. Patients with this mutation have been successfully transitioned from insulin to sulfonylurea (SU) therapy without compromise in their glycemic control. Among patients with neonatal diabetes due to KCNJ11 mutations, approximately 25% have neurological findings including developmental delay, motor dysfunction, and epilepsy, known as DEND syndrome. There have been rare cases of juvenile patients with intermediate DEND syndrome (iDEND) reporting variable improvement in neurological function following transition from insulin to SU treatment. We describe the response to glyburide in a 15-yr-old boy with severe global developmental delays resulting from the KCNJ11 mutation V59M. The patient was discovered to have diabetes mellitus at 11.5 months of age, making this the oldest age at diagnosis of a KCNJ11 mutation-related case of neonatal diabetes. Because consensus has been to screen patients for this mutation only if younger than 6 months at the time of diagnosis, we suggest that all patients under the age of 12 months at diagnosis should receive genetic testing for monogenic causes of diabetes. [source]


ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Genital Sensation and Sexual Function in Women Bicyclists and Runners: Are Your Feet Safer than Your Seat?

THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2006
Marsha K. Guess MD
ABSTRACT Introduction., Bicycling is associated with neurological impairment and impotence in men. Similar deficits have not been confirmed in women. Aim., To evaluate the effects of bicycling on genital sensation and sexual function in women. Methods., Healthy, premenopausal, competitive women bicyclists and runners (controls) were compared. Main Outcome Measures., (1) Genital vibratory thresholds (VTs) were determined using the Medoc Vibratory Sensation Analyzer 3000. (2) Sexual function and sexually related distress were assessed by the Dennerstein Personal Experience Questionnaire (SPEQ) and the Female Sexual Distress Scale (FSDS). Results., Forty-eight bicyclists and 22 controls were enrolled. The median age was 33 years. The bicyclists were older, had higher body mass indices (BMIs), were more diverse in their sexual orientation, and were more likely to have a current partner. Bicyclists rode an average of 28.3 ± 19.7 miles/day (range 4,100), 3.8 ± 1.5 days/week, for an average of 2.1 ± 1.8 hours/ride. The mean number of years riding was 7.9 ± 7.1 years (range 0.5,30). Controls ran an average of 4.65 ± 2.1 miles/day (range 1.5,8) and 5.0 ± 1.2 days/week. On bivariate analysis, bicyclists had significantly higher VTs than runners, indicating worse neurological function at all sites (P < 0.05). Multivariate analysis found significant correlations between higher VTs and bicycling at the left and right perineum, posterior vagina, left and right labia. Increasing VTs at the clitoris, anterior vagina, and urethra were associated with age. In bicyclists, there were no correlations between VTs and miles biked per week, duration of riding, or BMI. Composite SPEQ scores indicated normal sexual function in all sexually active subjects. Neither group suffered from sexually related distress. Conclusion., There is an association between bicycling and decreased genital sensation in competitive women bicyclists. Negative effects on sexual function and quality of life were not apparent in our young, healthy premenopausal cohort. Guess MK, Connell K, Schrader S, Reutman S, Wang A, LaCombe J, Toennis C, Lowe B, Melman A, and Mikhail MK. Genital sensation and sexual function in women bicyclists and runners: Are your feet safer than your seat? J Sex Med 2006;3:1018,1027. [source]


Human immunodeficiency virus-associated neurocognitive disorders: Mind the gap

ANNALS OF NEUROLOGY, Issue 6 2010
Justin C. McArthur MBBS
Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HANDs) remain among the most common disorders in people infected with HIV, even in an era when potent antiretroviral therapy is widely deployed. This review discusses the clinical features of HANDs and the implications for more effective treatment. With the improved survival of individuals treated with antiretrovirals, comorbid conditions are increasingly salient, including particularly coinfection with hepatitis C and the effects of aging. This review attempts to answer why there appears to be a therapeutic gap between the salutary effects of antiretroviral regimens and normalization of neurological function. A second gap is found in the understanding of the pathophysiology of HANDs. This review addresses this and discusses the animal models that have helped to elucidate these mechanisms. Although triggered by productive HIV infection of brain macrophages, aberrant and sustained immune activation appears to play a major role in inducing HANDs, and may explain the often incomplete neurological response to highly active antiretroviral therapy. Novel therapies aimed at persistent central nervous system inflammation will be needed to close this gap. ANN NEUROL 2010;67:699,714 [source]


Reperfusion normalizes motor activation patterns in large-vessel disease,

ANNALS OF NEUROLOGY, Issue 2 2009
Mohamad Chmayssani MD
Objective Hemodynamic impairment in one hemisphere has been shown to trigger ipsilateral motor activation in the opposite hemisphere on functional imaging. We hypothesized that reversing the hypoperfusion would normalize the motor activation pattern. Methods We studied four patients with high-grade stenosis and impaired vasomotor reactivity (VMR) but no stroke. Functional magnetic resonance imaging motor activation pattern before and after VMR normalization was compared with seven healthy control subjects scanned at an interval of 3 months using voxel-wise statistical parametric maps and region of interest analysis. Subjects performed a repetitive hand closure task in synchrony with 1Hz metronome tone. We used repeated-measures analysis of variance to compute the interaction between group (patients/control subjects) and time by obtaining the average blood oxygen level dependent signal of three motor regions of interest in each hemisphere. Results Two patients normalized their VMR after spontaneous resolution of dissection, and two after revascularization procedures. Both voxel-wise statistical maps and region of interest analysis showed that VMR normalization was associated in each case with a reduction in the atypical activation in the hemisphere opposite to the previously hypoperfused hemisphere (p < 0.001). Interpretation In the presence of a physiological stressor such as hypoperfusion, the brain is capable of dynamic functional reorganization to the opposite hemisphere that is reversible when normal blood flow is restored. These findings are important to our understanding of the clinical consequences of hemodynamic failure and the role of the ipsilateral hemisphere in maintaining normal neurological function. Ann Neurol 2009;65:203,208 [source]


S -Nitrosylated Pegylated Hemoglobin Reduces the Size of Cerebral Infarction in Rats

ARTIFICIAL ORGANS, Issue 2 2009
Akira T. Kawaguchi
Abstract Cell-free hemoglobin-based oxygen carriers have well-documented safety and efficacy problems such as nitric oxide (NO) scavenging and extravasation that preclude clinical use. To counteract these effects, we developed S -nitrosylated pegylated hemoglobin (SNO-PEG-Hb, P50 = 12 mm Hg) and tested it in a brain ischemia and reperfusion model. Neurological function and extent of cerebral infarction was determined 24 h after photochemically induced thrombosis of the middle cerebral artery in the rat. Infarction extent was determined from the integrated area in the cortex and basal ganglia detected by triphenyltetrazolium chloride staining in rats receiving various doses of SNO-PEG-Hb (2, 0.4, and 0.08 mL/kg) and compared with rats receiving pegylated hemoglobin without S -nitrosylation (PEG-Hb) or saline of the same dosage. Results indicated that successive dilution revealed SNO-PEG-Hb but not PEG-Hb to be effective in reducing the size of cortical infarction but not neurological function at a dose of 0.4 mL/kg. In conclusion, SNO-PEG-Hb in a dose of 0.4 mL/kg (Hb 24 mg/kg) showed to be most effective in reducing the size of cortical infarction, however, without functional improvement. [source]


Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2010
R. Helseth
Helseth R, Helseth E, Johannesen TB, Langberg CW, Lote K, Rønning P, Scheie D, Vik A, Meling TR. Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme. Acta Neurol Scand: 122: 159,167. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objectives,,, To study overall survival (OS), prognostic factors, and repeated surgery in glioblastoma multiforme (GBM). Material and methods, Retrospective study of 516 consecutive adult patients who underwent primary surgery for a GBM in year 2003,2008. Results,,, Median age at primary surgery was 63.7 years (range 18.0,88.0). Median OS was 9.9 months. Age >60 years, poor preoperative ECOG score, bilateral tumor, biopsy rather than resection, and no temozolomide chemoradiotherapy were negative risk factors. Repeat surgery was performed in 65 patients (13%). Median time between first and second surgery was 7 months. Indications for second surgery were increasing neurological deficits (35.4%), raised ICP (33.8%), asymptomatic but reoperated because of tumor progression verified on MRI (20.0%), and epileptic seizures (11%). Patients who underwent repeated surgery had longer OS; 18.4 months vs 8.6 months (P < 0.001). Conclusions,,, OS for adult GBM patients was 9.9 months. Negative prognostic factors were increasing age, poor neurological function, bilateral tumor involvement, biopsy instead of resection, and RT alone compared to temozolomide chemoradiotherapy. Our rate of repeated surgery for GBM was 13% and the main indications for second surgery were raised ICP and increasing neurological deficits. In a carefully selected group of patients, repeat surgery significantly prolongs OS. [source]


Is intensive care for very immature babies justified?

ACTA PAEDIATRICA, Issue 2 2004
M Levene
Neonatal intensive care is generally considered justified in the majority of very premature infants, but there is some concern about the effectiveness of the techniques used at the margins of viability (22,24 wk of gestation). The controversy that exists in this area is largely due to a lack of agreed endpoints for geographically based populations where all live births are considered. Evaluation of outcome must also take the quality of neurological function in surviving infants into consideration, and in reviewing these data the reader is struck by the few reports providing information on a high proportion of survivors. To inform this debate, the "best data" for analysis are reviewed based on a number of criteria of quality for survival and outcome studies. Based on these data sets, >25% of babies born alive at 24 wk and below survive without major disability. Conclusion: An objective review of "best data" will provide the basis of an informed debate on whether providing intensive care for all very immature babies is appropriate in developed countries. [source]


One-year longitudinal evaluation of sensorimotor functions in APP751SL transgenic mice

GENES, BRAIN AND BEHAVIOR, Issue 2008
C. Le Cudennec
Intracerebral amyloid-beta (A,) peptide deposition is considered to play a key role in Alzheimer's disease and is designated as a principal therapeutic target. The relationship between brain A, levels and clinical deficits remains, however, unclear, both in human patients and in animal models of the disease. The purpose of the present study was to investigate, in a transgenic mouse model of brain amyloidosis, the consequences of A, deposition on basic neurological functions using a longitudinal approach. Animals were phenotyped at different ages corresponding to graded neuropathological stages (from no extracellular A, deposition to high amyloid loads). Sensory functions were evaluated by assessing visual and olfactory abilities and did not show any effects of the amyloid precursor protein (APP) transgene. Motor functions were assessed using multiple experimental paradigms. Results showed that motor strength was considerably reduced in APP transgenic mice compared with control animals. No deficit was noted in a motor coordination test although APP transgenic mice displayed decreased locomotion on a stationary beam. Hypolocomotion was also observed in the standard open-field test. Measures of anxiety obtained in the elevated plus-maze show some evidence of hyperanxiety in 15-month-old transgenic mice. Some of the neurological impairments showed by APP mice had an early onset and worsened with progressive aging, in parallel to gradual accumulation of A, in brain parenchyma. Relationships between neuropathologically assessed amyloid loads and behavioral deficits were further explored, and it was observed that motor strength deficits were correlated with cortical amyloid burden. [source]


Human neural stem cell transplantation attenuates apoptosis and improves neurological functions after cerebral ischemia in rats

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009
P. ZHANG
Background: Neuroprotection is a major therapeutic approach for ischemic brain injury. We investigated the neuroprotective effects induced by transplantation of human embryonic neural stem cells (NSCs) into the cortical penumbra 24 h after focal cerebral ischemia. Methods: NSCs were prepared from human embryonic brains obtained at 8 weeks of gestation. Focal cerebral ischemia was induced in adult rats by permanent occlusion of the middle cerebral artery. Animals were randomly divided into two groups: NSCs-grafted group and medium-grafted group (control). Infarct size was assessed 28 days after transplantation by hematoxylin and eosin staining. Neurological severity scores were evaluated before ischemia and at 1, 7, 14, and 28 days after transplantation. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and immunohistochemical analysis of Bcl-2 and Bax were performed at 7, 14, and 28 days after transplantation. Results: Physiological parameters of the two groups were comparable, but not significantly different. NSC transplantation significantly improved neurological function (P<0.05) but did not reduce the infarct size significantly (P>0.05). Compared with the control, NSC transplantation significantly reduced the number of TUNEL- and Bax-positive cells in the penumbra at 7 days. Interestingly, the number of Bcl-2-positive cells in the penumbra after NSC transplantation was significantly higher than that after medium transplantation (P<0.05). Conclusions: The results indicate that NSC transplantation has anti-apoptotic activity and can improve the neurological function; these effects are mediated by the up-regulation of Bcl-2 expression in the penumbra. [source]


Checkpoints and pitfalls in the experimental neuropathology of circulatory disturbance

NEUROPATHOLOGY, Issue 1 2003
Toshihiko Kuroiwa
In neural tissue injury many pathological processes are common to different neurological disorders, including cerebral ischemia. Because ischemia has a fundamentally simple impact on neural tissue, good laboratory modeling can help improve the general understanding of the neuropathological processes involved. Summarized here are some basic principles that should be followed to ensure that cerebral ischemia studies are reproducible and informative: (i) selection of an appropriate model of cerebral ischemia in an appropriate species (although rodents are widely used for genomic studies, the use of larger animals, with brain structures macroscopically similar to those of humans, is appropriate for many studies, e.g. of white matter lesions or the pathophysiology of cerebral edema); (ii) correct maintenance of physiological parameters, including body temperature, systemic blood pressure, and blood gas tensions, under appropriate general anesthesia; (iii) selection of an appropriate method of cerebral blood flow (CBF) monitoring (decisions include whether or not the experiment requires real-time monitoring, in vivo measurement, and CBF mapping); (iv) appropriate timing of drug application in therapeutic studies (many drugs that are effective when given immediately after a short period of ischemi are ineffective in clinical trials, probably because of longer periods of ischemia and delayed drug delivery in clinical settings); and (v) multiparametric evaluation of therapeutic effect (with the recent increase in diagnosis of cases of mild stroke, measurement of mortality and infarct size have proven to be insufficient for the evaluation of therapeutic effect). Use of mild ischemia models and batteries of neurological tests for individual neurological functions, such as motor, somatosensory, and visual function, are becoming important in experimental ischemia research. In histological evaluation, assessment of the extent of both selective neuronal loss and the infarct will become mandatory. Regional analysis of each brain structure and coordination of the results with the apparent neurological dysfunction is a promising approach. [source]


Compartmentalization of the precheliceral neuroectoderm in the spider Cupiennius salei: Development of the arcuate body, optic ganglia, and mushroom body

THE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 13 2010
Carola Doeffinger
Abstract Similarly to vertebrates, arthropod brains are compartmentalized into centers with specific neurological functions such as cognition, behavior, and memory. The centers can be further subdivided into smaller functional units. This raises the question of how these compartments are formed during development and how they are integrated into brain centers. We show here for the first time how the precheliceral neuroectoderm of the spider Cupiennius salei is compartmentalized to form the distinct brain centers of the visual system: the optic ganglia, the mushroom bodies, and the arcuate body. The areas of the visual brain centers are defined by the formation of grooves and vesicles and express the proneural gene CsASH1, followed by expression of the neural differentiation marker Prospero. Furthermore, the transcription factor dachshund, which is strongly enriched in the mushroom bodies and the outer optic ganglion of Drosophila, is expressed in the optic anlagen and the mushroom bodies of the spider. The developing brain centers are further subdivided into single neural precursor groups, which become incorporated into the grooves and vesicles but remain distinguishable throughout development, suggesting that they encode spatial information for neural subtype identity. Several molecular and morphological aspects of the development of the optic ganglia and the mushroom bodies are similar in the spider and in insects. Furthermore, we show that the primary engrailed head spot contributes neurons to the optic ganglia of the median eyes, whereas the secondary head spot, which has been associated with the optic ganglia in insects and crustaceans, is absent. J. Comp. Neurol. 518:2612,2632, 2010. © 2010 Wiley-Liss, Inc. [source]


Inhibition of defective adenylosuccinate lyase by HNE: A neurological disease that may be affected by oxidative stress

BIOFACTORS, Issue 1-4 2005
C. Crifò
Abstract Adenylosuccinate lyase is an enzyme of fumarase superfamily that participates in the purine biosynthetic pathway, catalysing the nonhydrolytic cleavage of succinyl groups from SAICA ribotide and adenylosuccinate. Enzyme defects are associated with a human inherited disease, which arises from single point mutations to the gene and results in mild to severe psychomotor retardation, epilepsy, muscle wasting, and autistic features. Adenylosuccinate lyase activity is lost to a different extent in the patients. Diminished levels of enzyme have been attributed to loss of catalytic activity, protein instability, or environmental factors. P100A/D422Y mutation represents a feasible model for studying the effect of cell milieu on the activity of the impaired enzyme. The defective enzyme is inhibited by micromolar concentrations of trans-4-hydroxy-2-nonenal (HNE), a major product of membrane peroxidation that has been found to accumulate in brain tissues of patients with neurodegenerative disorders. It is suggested that inactivation of defective adenylosuccinate lyase by HNE and other membrane peroxidation products may account, at least in part, for the impairment of neurological functions and recurrent worsening of the symptoms. [source]


Lumbar disc herniation in young children

ACTA PAEDIATRICA, Issue 1 2010
R Haidar
Abstract Aim:, This article explores lumbar disc herniation in young children through focusing on matters relevant to patient presentation, physical examination, differential diagnosis, imaging and treatment. Methods:, Major databases were searched for studies that addressed lumbar disc herniation in young children. Results:, Diagnosis of lumbar disc herniation in young children is usually delayed because of the rarity and lack of experience with this entity and the difficulty in extracting a reliable medical history. Nevertheless, lumbar disc herniation should be considered in the differential diagnosis of any young child presenting with a chief complaint of back pain and/or radiculopathy, especially in the setting of recent trauma. This should be coupled with a directed physical examination to elicit signs and narrow the differential diagnosis. Imaging studies, mainly magnetic resonance imaging, will help establish a diagnosis; yet radiographs are still required to exclude other spinal lesions. The initial management of lumbar disc herniation in children is the same as that in adults and consists of conservative treatment unless lumbar disc herniation affects the patient's motor and neurological functions in which case, early surgical treatment must be undertaken. Although the latter remains more difficult, current experience suggests a favourable outcome. Conclusion:, Awareness of lumbar disc herniation will help the paediatrician extract a relevant medical history, perform a directed physical examination, and order appropriate imaging studies. This will aid in initiating early intervention, be it conservative or operative, and achieving a favourable outcome. [source]