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1.
Nat Neurosci ; 27(3): 527-535, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38291282

RESUMEN

Neocortical activity is thought to mediate voluntary control over vocal production, but the underlying neural mechanisms remain unclear. In a highly vocal rodent, the male Alston's singing mouse, we investigate neural dynamics in the orofacial motor cortex (OMC), a structure critical for vocal behavior. We first describe neural activity that is modulated by component notes (~100 ms), probably representing sensory feedback. At longer timescales, however, OMC neurons exhibit diverse and often persistent premotor firing patterns that stretch or compress with song duration (~10 s). Using computational modeling, we demonstrate that such temporal scaling, acting through downstream motor production circuits, can enable vocal flexibility. These results provide a framework for studying hierarchical control circuits, a common design principle across many natural and artificial systems.


Asunto(s)
Corteza Motora , Masculino , Animales , Ratones , Corteza Motora/fisiología , Neuronas/fisiología , Retroalimentación Sensorial , Vocalización Animal/fisiología
2.
Curr Biol ; 33(21): 4704-4712.e3, 2023 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-37757833

RESUMEN

Bilaterally organized brain regions are often simultaneously active in both humans1,2,3 and animal models,4,5,6,7,8,9 but the extent to which the temporal progression of internally generated dynamics is coordinated across hemispheres and how this coordination changes with brain state remain poorly understood. To address these issues, we investigated the zebra finch courtship song (duration: 0.5-1.0 s), a highly stereotyped complex behavior10,11 produced by a set of bilaterally organized nuclei.12,13,14 Unilateral lesions to these structures can eliminate or degrade singing,13,15,16,17 indicating that both hemispheres are required for song production.18 Additionally, previous work demonstrated broadly coherent and symmetric bilateral premotor signals during song.9 To precisely track the temporal evolution of activity in each hemisphere, we recorded bilaterally in the song production pathway. We targeted the robust nucleus of the arcopallium (RA) in the zebra finch, where population activity reflects the moment-to-moment progression of the courtship song during awake vocalizations19,20,21,22,23,24 and sleep, where song-related network dynamics reemerge in "replay" events.24,25 We found that activity in the left and right RA is synchronized within a fraction of a millisecond throughout song. In stark contrast, the two hemispheres displayed largely independent replay activity during sleep, despite shared interhemispheric arousal levels. These findings demonstrate that the degree of bilateral coordination in the zebra finch song system is dynamically modulated by behavioral state.


Asunto(s)
Pinzones , Vocalización Animal , Animales , Humanos , Encéfalo
3.
BMC Genomics ; 24(1): 569, 2023 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-37749493

RESUMEN

BACKGROUND: Developing genomic resources for a diverse range of species is an important step towards understanding the mechanisms underlying complex traits. Specifically, organisms that exhibit unique and accessible phenotypes-of-interest allow researchers to address questions that may be ill-suited to traditional model organisms. We sequenced the genome and transcriptome of Alston's singing mouse (Scotinomys teguina), an emerging model for social cognition and vocal communication. In addition to producing advertisement songs used for mate attraction and male-male competition, these rodents are diurnal, live at high-altitudes, and are obligate insectivores, providing opportunities to explore diverse physiological, ecological, and evolutionary questions. RESULTS: Using PromethION, Illumina, and PacBio sequencing, we produced an annotated genome and transcriptome, which were validated using gene expression and functional enrichment analyses. To assess the usefulness of our assemblies, we performed single nuclei sequencing on cells of the orofacial motor cortex, a brain region implicated in song coordination, identifying 12 cell types. CONCLUSIONS: These resources will provide the opportunity to identify the molecular basis of complex traits in singing mice as well as to contribute data that can be used for large-scale comparative analyses.


Asunto(s)
Evolución Biológica , Genómica , Masculino , Animales , Ratones , Herencia Multifactorial , Fenotipo , Reproducción
4.
bioRxiv ; 2023 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-37693383

RESUMEN

Many brain areas exhibit activity correlated with language planning, but the impact of these dynamics on spoken interaction remains unclear. Here we use direct electrical stimulation to transiently perturb cortical function in neurosurgical patient-volunteers performing a question-answer task. Stimulating structures involved in speech motor function evoked diverse articulatory deficits, while perturbations of caudal inferior and middle frontal gyri - which exhibit preparatory activity during conversational turn-taking - led to response errors. Perturbation of the same planning-related frontal regions slowed inter-speaker timing, while faster responses could result from stimulation of sites located in other areas. Taken together, these findings further indicate that caudal inferior and middle frontal gyri constitute a critical planning network essential for interactive language use.

5.
Nature ; 616(7955): 132-136, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36949189

RESUMEN

While motor cortical circuits contain information related to specific movement parameters1, long-range inputs also have a critical role in action execution2,3. Thalamic projections can shape premotor activity2-6 and have been suggested7 to mediate the selection of short, stereotyped actions comprising more complex behaviours8. However, the mechanisms by which thalamus interacts with motor cortical circuits to execute such movement sequences remain unknown. Here we find that thalamic drive engages a specific subpopulation of premotor neurons within the zebra finch song nucleus HVC (proper name) and that these inputs are critical for the progression between vocal motor elements (that is, 'syllables'). In vivo two-photon imaging of thalamic axons in HVC showed robust song-related activity, and online perturbations of thalamic function caused song to be truncated at syllable boundaries. We used thalamic stimulation to identify a sparse set of thalamically driven neurons within HVC, representing ~15% of the premotor neurons within that network. Unexpectedly, this population of putative thalamorecipient neurons is robustly active immediately preceding syllable onset, leading to the possibility that thalamic input can initiate individual song components through selectively targeting these 'starter cells'. Our findings highlight the motor thalamus as a director of cortical dynamics in the context of an ethologically relevant behavioural sequence.


Asunto(s)
Cortejo , Pinzones , Tálamo , Vocalización Animal , Animales , Pinzones/fisiología , Neuronas/fisiología , Tálamo/citología , Tálamo/fisiología , Vocalización Animal/fisiología , Corteza Motora/citología , Corteza Motora/fisiología , Vías Nerviosas/fisiología , Encéfalo/citología , Encéfalo/fisiología , Masculino
6.
bioRxiv ; 2023 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-36747850

RESUMEN

Neocortical activity is thought to mediate voluntary control over vocal production, but the underlying neural mechanisms remain unclear. In a highly vocal rodent, the Alston's singing mouse, we investigate neural dynamics in the orofacial motor cortex (OMC), a structure critical for vocal behavior. We first describe neural activity that is modulated by component notes (approx. 100 ms), likely representing sensory feedback. At longer timescales, however, OMC neurons exhibit diverse and often persistent premotor firing patterns that stretch or compress with song duration (approx. 10 s). Using computational modeling, we demonstrate that such temporal scaling, acting via downstream motor production circuits, can enable vocal flexibility. These results provide a framework for studying hierarchical control circuits, a common design principle across many natural and artificial systems.

7.
Radiat Prot Dosimetry ; 199(5): 482-489, 2023 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-36840519

RESUMEN

Establishing realistic radiation dose limits with a solid scientific basis is a key component of the 'as low as reasonably achievable' (ALARA) principle. Although existing occupational dose limits have been established for civil astronauts, with the rise in popularity and technological maturation of the 'space tourism' sector, there does not appear to be considerable discussion on the subject of non-occupational astronaut dose limits. The necessity to come to a collective decision on dose limits and radiation safety procedures for recreational spaceflight is urgent and imperative to maintain ALARA goals, as existing federal dose limits to the public cannot be adequately or universally applied to the space tourism sector. Development of an entirely new set of regulations and guidelines should also provide long-term benefits in public perception as evidence of safety commitments from decision makers and the community in protecting passengers from radiological risks balanced with other spaceflight hazards.


Asunto(s)
Vuelo Espacial , Humanos , Astronautas
8.
Case Rep Infect Dis ; 2022: 6289211, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36465568

RESUMEN

A 65 year-old gentleman had been brought to our Respiratory Emergency Department for patients with respiratory symptoms and a possible COVID-19 infection with a 3-day history of shortness of breath (SOB), fever, a productive cough of yellow sputum, and right-sided chest pain. The patient had received both vaccinations at the time and initially reported no travel history, although later it was revealed that he had recently stayed at a hotel. He tested positive for COVID-19 and had hyponatremia and a raised procalcitonin, indicating a bacterial infection as well. He had been initiated on our local treatment guidelines for COVID with antibiotics, guided by local hospital guidelines. An atypical pneumonia screen returned a positive result for Legionella urine antigen, and his antibiotic regime was changed accordingly. Our patient deteriorated significantly, and despite being escalated to our intensive care unit (ICU), he unfortunately passed away. Our case highlights the importance of early ICU involvement and escalation of antibiotics in cases of suspected concurrent Legionella and COVID-19 infections.

9.
PDA J Pharm Sci Technol ; 76(6): 485-496, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35613741

RESUMEN

Interventions performed by personnel during an aseptic process can be a key source of microbiological contamination of sterile biopharmaceutical products, irrespective of the type of manufacturing system used. Understanding the relative risk of this source of contamination provides valuable information to help make decisions for the design, qualification, validation, operation, monitoring, and evaluation of the aseptic process. These decisions can be used to improve the aseptic process and provide assurance of the sterility of the products. To achieve these goals, an assessment of the contamination risk is needed. This risk assessment should be objective, accurate, and useful. This article presents an Intervention Risk Evaluation Model (IREM) philosophy and an objective, accurate, and useful method for intervention risk determination. The IREM uses a key word approach to identify, obtain, measure, and evaluate intervention risk factors. This article presents a general discussion of the method with the help of a case study to illustrate the development of the model, whereas subsequent parts would focus on application of this model with practical examples. This not only attempts to create objectivity of the entire process, but it develops awareness of the associated risks among shop floor operators, which can lead to a reduction of the overall risk level of the process and an improvement in the sterility assurance level.


Asunto(s)
Contaminación de Medicamentos , Infertilidad , Humanos , Contaminación de Medicamentos/prevención & control , Medición de Riesgo/métodos , Factores de Riesgo
10.
J Comp Neurol ; 530(12): 2075-2099, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35385140

RESUMEN

Vocalizations are often elaborate, rhythmically structured behaviors. Vocal motor patterns require close coordination of neural circuits governing the muscles of the larynx, jaw, and respiratory system. In the elaborate vocalization of Alston's singing mouse (Scotinomys teguina) each note of its rapid, frequency-modulated trill is accompanied by equally rapid modulation of breath and gape. To elucidate the neural circuitry underlying this behavior, we introduced the polysynaptic retrograde neuronal tracer pseudorabies virus (PRV) into the cricothyroid and digastricus muscles, which control frequency modulation and jaw opening, respectively. Each virus singly labels ipsilateral motoneurons (nucleus ambiguus for cricothyroid, and motor trigeminal nucleus for digastricus). We find that the two isogenic viruses heavily and bilaterally colabel neurons in the gigantocellular reticular formation, a putative central pattern generator. The viruses also show strong colabeling in compartments of the midbrain including the ventrolateral periaqueductal gray and the parabrachial nucleus, two structures strongly implicated in vocalizations. In the forebrain, regions important to social cognition and energy balance both exhibit extensive colabeling. This includes the paraventricular and arcuate nuclei of the hypothalamus, the lateral hypothalamus, preoptic area, extended amygdala, central amygdala, and the bed nucleus of the stria terminalis. Finally, we find doubly labeled neurons in M1 motor cortex previously described as laryngeal, as well as in the prelimbic cortex, which indicate these cortical regions play a role in vocal production. The progress of both viruses is broadly consistent with vertebrate-general patterns of vocal circuitry, as well as with circuit models derived from primate literature.


Asunto(s)
Herpesvirus Suido 1 , Corteza Motora , Animales , Ratones , Neuronas Motoras , Prosencéfalo/fisiología , Vocalización Animal/fisiología
11.
Annu Rev Neurosci ; 45: 295-316, 2022 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-35316612

RESUMEN

Vocal communication is a critical feature of social interaction across species; however, the relation between such behavior in humans and nonhumans remains unclear. To enable comparative investigation of this topic, we review the literature pertinent to interactive language use and identify the superset of cognitive operations involved in generating communicative action. We posit these functions comprise three intersecting multistep pathways: (a) the Content Pathway, which selects the movements constituting a response; (b) the Timing Pathway, which temporally structures responses; and (c) the Affect Pathway, which modulates response parameters according to internal state. These processing streams form the basis of the Convergent Pathways for Interaction framework, which provides a conceptual model for investigating the cognitive and neural computations underlying vocal communication across species.


Asunto(s)
Lenguaje , Vocalización Animal , Animales , Humanos , Vocalización Animal/fisiología
12.
Nature ; 602(7895): 117-122, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34987226

RESUMEN

During conversation, people take turns speaking by rapidly responding to their partners while simultaneously avoiding interruption1,2. Such interactions display a remarkable degree of coordination, as gaps between turns are typically about 200 milliseconds3-approximately the duration of an eyeblink4. These latencies are considerably shorter than those observed in simple word-production tasks, which indicates that speakers often plan their responses while listening to their partners2. Although a distributed network of brain regions has been implicated in speech planning5-9, the neural dynamics underlying the specific preparatory processes that enable rapid turn-taking are poorly understood. Here we use intracranial electrocorticography to precisely measure neural activity as participants perform interactive tasks, and we observe a functionally and anatomically distinct class of planning-related cortical dynamics. We localize these responses to a frontotemporal circuit centred on the language-critical caudal inferior frontal cortex10 (Broca's region) and the caudal middle frontal gyrus-a region not normally implicated in speech planning11-13. Using a series of motor tasks, we then show that this planning network is more active when preparing speech as opposed to non-linguistic actions. Finally, we delineate planning-related circuitry during natural conversation that is nearly identical to the network mapped with our interactive tasks, and we find this circuit to be most active before participant speech during unconstrained turn-taking. Therefore, we have identified a speech planning network that is central to natural language generation during social interaction.


Asunto(s)
Conducta Social , Habla/fisiología , Adulto , Anciano , Área de Broca/fisiología , Electrocorticografía , Función Ejecutiva , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas , Factores de Tiempo
13.
Int J Offender Ther Comp Criminol ; 66(4): 430-450, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33153330

RESUMEN

Drawing on prior studies, green criminologists have hypothesized that climate change will both raise the mean temperature and the level of crime. We call this the "climate change-temperature-crime hypothesis" ("CC-T-C"). This hypothesis is an extension of research performed on temperature and crime at the individual level. Other research explores this relationship by testing for the relationship between seasonality and crime within a given period of time (i.e., within years). Climate change, however, produces small changes in temperature over long periods of time, and in this view, the effect of climate change on crime should be assessed across and not within years. In addition, prior CC-T-C studies sometimes employ large geographic aggregations (e.g., the entire whole United States), which masks the CC-T-C association that appears at lower levels of aggregation. Moreover, globally, crime has declined across nations since the early 1990s, during a period of rising mean global temperatures, suggesting that the CC-T-C hypothesis does not fit the general trends in temperature and crime over time. Addressing these issues, the present study assesses the CC-T-C relationship for a sample of 15 large (N = 15) US cities over a 14-year period. Given the CC-T-C hypothesis parameters, we assessed this relationship using correlations between individual crime and temperature trends for each city. Crime trends were measured by both the number and rate of eight Uniform Crime Report (UCR) Part I crimes, so that for each city, there are 16 crime-temperature correlations. Using a liberal p value (p = .10), the temperature-crime correlations were rejected as insignificant in 220 of the 234 tests (94%). We discuss the Implications of this finding and suggest that rather than focusing on the temperature-crime relationship, green criminologists interested in the deleterious effects of climate change draw attention to its larger social, economic, environmental and ecological justice implications.


Asunto(s)
Cambio Climático , Crimen , Ciudades , Humanos , Temperatura , Estados Unidos
14.
Neuron ; 109(23): 3851-3861.e4, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34626537

RESUMEN

Neural circuits often exhibit sequences of activity, but the contribution of local networks to their generation remains unclear. In the zebra finch, song-related premotor sequences within HVC may result from some combination of local connectivity and long-range thalamic inputs from nucleus uvaeformis (Uva). Because lesions to either structure abolish song, we examine "sleep replay" using high-density recording methods to reconstruct precise song-related events. Replay activity persists after the upstream nucleus interfacialis of the nidopallium is lesioned and slows when HVC is cooled, demonstrating that HVC provides temporal structure for these events. To further gauge the importance of intra-HVC connectivity for shaping network dynamics, we lesion Uva during sleep and find that residual replay sequences could span syllable boundaries, supporting a model in which HVC can propagate sequences throughout the duration of the song. Our results highlight the power of studying offline activity to investigate behaviorally relevant circuit organization.


Asunto(s)
Pinzones , Animales , Sueño , Vocalización Animal
15.
Neuron ; 109(16): 2508-2518, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34171292

RESUMEN

Establishing a causal link between neural function and behavioral output has remained a challenging problem. Commonly used perturbation techniques enable unprecedented control over intrinsic activity patterns and can effectively identify crucial circuit elements important for specific behaviors. However, these approaches may severely disrupt activity, precluding an investigation into the behavioral relevance of moment-to-moment neural dynamics within a specified brain region. Here we discuss the application of mild focal cooling to slow down intrinsic neural circuit activity while preserving its overall structure. Using network modeling and examples from multiple species, we highlight the power and versatility of focal cooling for understanding how neural dynamics control behavior and argue for its wider adoption within the systems neuroscience community.


Asunto(s)
Conducta/fisiología , Encéfalo/fisiología , Red Nerviosa/fisiología , Neuronas/fisiología , Animales , Humanos , Neurociencias , Temperatura
16.
Front Public Health ; 9: 646916, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33981666

RESUMEN

This paper draws upon the concept of recreancy to examine the mental well-being of university students during the Covid-19 pandemic. Briefly, recreancy is loss of societal trust that results when institutional actors can no longer be counted on to perform their responsibilities. Our study of mental well-being and recreancy focuses on the role of universities and government regulators within the education sector. We surveyed 600 UK students attending 161 different public higher education providers in October 2020 during a time when many UK students were isolated in their residences and engaged in online learning. We assessed student well-being using the Short Warwick-Edinburgh Mental Well-being Scale (scored 7-35) and found the mean score to be 19.9 [95% confidence interval (CI) 19.6, 20.2]. This level of well-being indicates that a significant proportion of UK students face low levels of mental well-being. Structural equation modeling (SEM) analysis indicates that high recreancy-measured as a low trust in universities and the government-is associated with low levels of mental well-being across the student sample. While these findings are suggestive, they are also important and we suggest that government and university leaders should not only work to increase food and housing security during the Covid-19 pandemic, but also consider how to combat various sector trends that might intensify recreancy.


Asunto(s)
COVID-19 , Universidades , Gobierno , Humanos , Pandemias , SARS-CoV-2 , Estudiantes , Confianza , Reino Unido
17.
Pediatr Crit Care Med ; 22(9): 813-821, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33710074

RESUMEN

OBJECTIVES: To evaluate the performance of the Pediatric Index of Mortality 3 as mortality risk assessment model. DESIGN: This prospective study included all admissions 30 days to 18 years old for 12 months during 2016 and 2017. Data gathered included the following: age and gender, diagnosis and reason for PICU admission, data specific for the Pediatric Index of Mortality 3 calculation, PICU outcomes (death or survival), and length of PICU stay. SETTING: Nine units that care for children within tertiary or quaternary academic hospitals in South Africa. PATIENTS: All admissions 30 days to 18 years old, excluding premature infants, children who died within 2 hours of admission, or children transferred to other PICUs, and those older than 18 years old. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: There were 3,681 admissions of which 2,253 (61.3%) were male. The median age was 18 months (interquartile range, 6-59.5 mo). There were 354 deaths (9.6%). The Pediatric Index of Mortality 3 predicted 277.47 deaths (7.5%). The overall standardized mortality ratio was 1.28. The area under the receiver operating characteristic curve was 0.81 (95% CI 0.79-0.83). The Hosmer-Lemeshow goodness-of-fit test statistic was 174.4 (p < 0.001). Standardized mortality ratio for all age groups was greater than 1. Standardized mortality ratio for diagnostic subgroups was mostly greater than 1 except for those whose reason for PICU admission was classified as accident, toxin and envenomation, and metabolic which had an standardized mortality ratio less than 1. There were similar proportions of respiratory patients, but significantly greater proportions of neurologic and cardiac (including postoperative) patients in the Pediatric Index of Mortality 3 derivation cohort than the South African cohort. In contrast, the South African cohort contained a significantly greater proportion of miscellaneous (including injury/accident victims) and postoperative noncardiac patients. CONCLUSIONS: The Pediatric Index of Mortality 3 discrimination between death and survival among South African units was good. Case-mix differences between these units and the Pediatric Index of Mortality 3 derivation cohort may partly explain the poor calibration. We need to recalibrate Pediatric Index of Mortality 3 to the local setting.


Asunto(s)
Unidades de Cuidado Intensivo Pediátrico , Adolescente , Niño , Mortalidad Hospitalaria , Humanos , Lactante , Masculino , Estudios Prospectivos , Curva ROC , Sudáfrica/epidemiología
18.
Soc Sci Med ; 270: 113640, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33434716

RESUMEN

RATIONALE: There is a small but growing body of literature on litigation- and compensation-related stress after disasters. Results of these studies are consistent and unsurprising: compensation processes are a source of stress to plaintiffs and their families. "Litigation Response Syndrome"-anxiety, stress, and depression-is common among those exposed to the pressures of litigation (Lees-Haley 1988). However, little is known about how compensation processes-claims, litigation, and settlements-affect communities at large. OBJECTIVE: Building on prior research, we examine adverse impacts of compensation processes in Roane County, Tennessee five years following the Tennessee Valley Authority coal ash spill. We investigate whether compensation-related stress occurs at a community level, as well as avoidance behaviors as measured by the Impact of Event Scale. METHOD: Based on data from a 2014 household mail survey of a random sample of 716 residents of Roane County, we examine the relationship between compensation processes and event-related avoidance behaviors. RESULTS: We found that compensation-related stress is not limited to those directly involved with compensation processes. Respondents view these processes as adversely impacting the community at large. The strongest contributors to event-related avoidance behaviors are beliefs about adverse compensation impacts and the effectiveness of cleanup and restoration activities, socioeconomic status, and economic resource loss. Therefore, it appears that Litigation Response Syndrome can extend to some members of the community who were not directly involved in litigation and compensation processes.


Asunto(s)
Reacción de Prevención , Desastres , Trastornos de Ansiedad , Ceniza del Carbón , Humanos , Tennessee
19.
Public Health Pract (Oxf) ; 2: 100122, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36101602

RESUMEN

Objectives: This paper reports results of an evaluation of 17 holiday clubs located throughout North East England that ran during the summer of 2017, designed to reduced summertime food insecurity. Study design: Questionnaire administed to parents/caregivers of children who attended a holiday club. Methods: Ordinary Least Squares regression models were used to predict Warwick-Edinburg Mental Wellbeing scale scores measuring parental mental wellbeing. Results: We find that after a summer of attending a holiday club, the most important factor associated with higher parental wellbeing scores is the reduction in social isolation and increased relationships that the parent and their children build while children attend holiday clubs. Conclusions: Our results suggest that reducing social isolation for parents and families during summertime is a likely a latent function of holiday clubs. These are important findings in that the benefits of holiday club appear to extend beyond access to food and reductions in household food insecurity.

20.
World Neurosurg ; 147: e118-e129, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33307258

RESUMEN

OBJECTIVE: Electric cortical stimulation (ECS) has been the gold standard for intraoperative functional mapping in neurosurgery, yet it carries the risk of induced seizures. We assess the safety of focal cortical cooling (CC) as a potential alternative to ECS. METHODS: We reviewed 40 patients (13 with tumor and 27 with mesial temporal lobe epilepsy) who underwent intraoperative CC at the University of Iowa Hospital and Clinics (CC group), of whom 38 underwent ECS preceding CC. Intraoperative and postoperative seizure incidence, postoperative neurologic deficits, and new postoperative radiographic findings were collected to assess CC safety. Fifty-five patients who underwent ECS mapping without CC (ECS-alone group) were reviewed as a control cohort. Another 25 patients who underwent anterior temporal lobectomy (ATL) without CC or ECS (no ECS/no CC-ATL group) were also reviewed to evaluate long-term effects of CC. RESULTS: Seventy-nine brain sites in the CC group were cooled, comprising inferior frontal gyrus (44%), precentral gyrus (39%), postcentral gyrus (6%), subcentral gyrus (4%), and superior temporal gyrus (6%). The incidence of intraoperative seizure(s) was 0% (CC group) and 3.6% (ECS-alone group). The incidence of seizure(s) within the first postoperative week did not significantly differ among CC (7.9%), ECS-alone (9.0%), and no ECS/no CC-ATL groups (12%). There was no significant difference in the incidence of postoperative radiographic change between CC (7.5%) and ECS-alone groups (5.5%). Long-term seizure outcome (Engel I+II) for mesial temporal epilepsy did not differ among CC (80%), ECS-alone (83.3%), and no ECS/no CC-ATL groups (83.3%). CONCLUSIONS: CC when used as an intraoperative mapping technique is safe and may complement ECS.


Asunto(s)
Mapeo Encefálico/métodos , Corteza Cerebral/cirugía , Epilepsia del Lóbulo Temporal/cirugía , Hipotermia Inducida/métodos , Monitorización Neurofisiológica Intraoperatoria/métodos , Adulto , Anciano , Lobectomía Temporal Anterior/métodos , Corteza Cerebral/diagnóstico por imagen , Craneotomía/métodos , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia del Lóbulo Temporal/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
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