Subthalamic nucleus deep brain stimulation in primary Meige syndrome: motor and non-motor outcomes.

BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) has emerged as a promising treatment for movement disorders. This prospective study aims to evaluate the effects of bilateral subthalamic nucleus DBS (STN-DBS) on motor and non-motor symptoms in patients with primary Meige syndrome. METHODS: Thirty patients who underwent bilateral STN-DBS between April 2017 and June 2020 were included. Standardized and validated scales were utilized to assess the severity of dystonia, health-related quality of life, sleep, cognitive function and mental status at baseline and at 1 year and 3 years after neurostimulation. RESULTS: The Burke-Fahn-Marsden Dystonia Rating Scale movement scores showed a mean improvement of 63.0% and 66.8% at 1 year and 3 years, respectively, after neurostimulation. Similarly, the Burke-Fahn-Marsden Dystonia Rating Scale disability scores improved by 60.8% and 63.3% at the same time points. Postoperative quality of life demonstrated a significant and sustained improvement throughout the follow-up period. However, cognitive function, mental status, sleep quality and other neuropsychological functions did not change after 3 years of neurostimulation. Eight adverse events occurred in six patients, but no deaths or permanent sequelae were reported. CONCLUSIONS: Bilateral STN-DBS is a safe and effective alternative treatment for primary Meige syndrome, leading to improvements in motor function and quality of life. Nevertheless, it did not yield significant amelioration in cognitive, mental, sleep status and other neuropsychological functions after 3 years of neurostimulation.

[Value of urinary liver fatty acid-binding protein in assessing severity of brain trauma and predicting acute kidney injury].

OBJECTIVE: To assess the value of urinary liver-type fatty acid-binding protein (L-FABP) in early assessment of the severity of traumatic brain injury and in predicting the occurrence of acute kidney injury (AKI) following the brain injury. METHODS: Sixty-five patients with traumatic brain injury patients were divided into 4 groups according to their Glasgow coma scale (GCS) scores. Blood and urine samples were collected at 2, 6, 12, 24, 48 and 72 h after the injury to detect serum creatinine (SCr) level using biochemical analyzer and urinary L-FABP using enzyme-linked immunosorbent assay (ELISA), with samples from 15 healthy adults as controls. The correlations were analyzed among SCr, urinary L-FABP, GCS score upon admission and AKI occurrence. RESULTS: The patients with moderate to severe brain injuries showed significantly higher SCr and urinary L-FABP levels than the control group (P<0.05). GCS score of the patients was inversely correlated with the levels of SCr and urinary L-FABP (P<0.05), and the changes were more prominent in urinary L-FABP than in SCr. The incidence of AKI was 21.54% in these patients. In patients with AKI, urinary L-FABP reached the peak level as soon as 6 h after the injury, as compared with 24 to 48 h when peak SCr level occurred. CONCLUSION: Urinary L-FABP can be used as a marker for early assessment of the severity of traumatic brain injury and for predicting the occurrence of AKI following the injury.

[Effect of alpha-difluoromethylornithine on the expression of ODC mRNA in the cortex and hippocampus in rats after cerebral ischemia reperfusion].

OBJECTIVE: To explore the mechanism of alpha-difluoromethylornithine (DFMO) inhibiting ODC activity in the cortex and hippocampus in rats. METHODS: Forty male rats was randomly divided into ischemal control group and DFMO pretreatment group. DFMO was given intravenously half an hour before global cerebral ischemia, and expression of ODC mRNA was measured by comparative reverse transcription-polymerase chain reaction (RT-PCR) in the cortex and hippocampus in rats after 2, 4, 6 h and 8 h of reperfusion. The variations of the expression of ODC mRNA were studied in the DFMO pretreatment group and the ischemal control group respectively. RESULTS: After 2, 4 and 6 h of reperfusion, the expression of ODC mRNA in the cortex and hippocampus in the pretreatment group was lower than that in the ischemia control group significantly (P <0.05, P <0.01), but not at 8 h reperfusion (P > 0.05). CONCLUSION: DFMO suppressed the expression of ODC mRNA after different lengths of reperfusion following 10-minute global cerebral ischemia in rats and it may be one of the ways for DFMO to inhibit ODC activity.

[Changes and significance of PAO activities and polyamine levels at different time of reperfusion after transient focal cerebral ischemia in rats].

OBJECTIVE: To assay the changes of polyamine oxidase (PAO) activities and polyamine levels in the cortex and subcortex at different time of reperfusion following 2 h focal cerebral ischemia in rats in order to explore the regularity and signifiance ofh these changes. METHODS: Rats of 2 h reversible focal cerebral ischemia were produced by ameliorated method of Longa's intraluminal suture occlusion of middle cerebral artery (MCA). PAO activities and polyamine levels in the cortex and subcortex were measured by homovanillic acid fluorometry and high-performance liquid chromatograph (HPLC) after 2, 4, 8, and 24 h reperfusion following 2 h ischemia, respectively. RESULTS: PAO activity of the experimental group increased after 8 h reperfusion (P < 0.01). The peak value of PAO activity appeared after 24 h reperfusion (P < 0.01). Putrescine level of the experimental group was elevated after 4 h reperfusion (P < 0.05), and the peak value of putrescine appeared after 24 h reperfusion (P < 0.05). Spermidine and spermine levels of 8, 24 h reperfusion in the experiment group decreased significantly c eompared with the control group (P < 0.05). CONCLUSION: PAO activities increased significantly after reperfusion following transient focal cerebral ischemia, which promoted the later peak production of putrescine. It may be contributed to the brain damage after cerebral ischemia.

[Expression of ornithine decarboxylase mRNA in the cortex and hippocampus of rat after transient cerebral ischemia].

OBJECTIVE: To detect the expression of ornithine decarboxylase (ODC) mRNA in the cortex and hippocampus of rat over different postischemic recirculation periods, and to explore the mechanism of increase in ODC activity after transient cerebral ischemia. METHODS: A 10-min transient cerebral ischemia was produced in anesthetized rat by ameliorated four-vessel occlusion, and the expression of ODC mRNA was measured using comparative reverse transcription-polymerase chain reaction (RT-PCR) in the cortex and hippocampus of rats sacrificed at 2, 4, 6 and 8 h after the ischemia. The variations were studied. RESULTS: There was no expression of ODC mRNA in the cortex and hippocampus of rats in nonischemic control groups, and there was expression of ODC mRNA in the cortex and hippocampus of rats in the ischemic experimental groups, with a significant increase between 2 h and 6 h after the ischemia (P < 0.01). CONCLUSION: Increased expression of ODC mRNA could contribute to the increase in ODC activity after transient cerebral ischemia.