Suppression of synchronous spiking in two interacting populations of excitatory and inhibitory quadratic integrate-and-fire neurons.

Collective oscillations and their suppression by external stimulation are analyzed in a large-scale neural network consisting of two interacting populations of excitatory and inhibitory quadratic integrate-and-fire neurons. In the limit of an infinite number of neurons, the microscopic model of this network can be reduced to an exact low-dimensional system of mean-field equations. Bifurcation analysis of these equations reveals three different dynamic modes in a free network: a stable resting state, a stable limit cycle, and bistability with a coexisting resting state and a limit cycle. We show that in the limit cycle mode, high-frequency stimulation of an inhibitory population can stabilize an unstable resting state and effectively suppress collective oscillations. We also show that in the bistable mode, the dynamics of the network can be switched from a stable limit cycle to a stable resting state by applying an inhibitory pulse to the excitatory population. The results obtained from the mean-field equations are confirmed by numerical simulation of the microscopic model.

Successful management of spinal cord ischemia in a pediatric patient with fibrocartilaginous embolism: illustrative case.

BACKGROUND: Fibrocartilaginous embolism (FCE) is a rare cause of ischemic myelopathy that occurs when the material of the nucleus pulposus migrates into vessels supplying the spinal cord. The authors presented a case of pediatric FCE that was successfully managed by adapting evidence-based recommendations used for spinal cord neuroprotection in aortic surgery. OBSERVATIONS: A 7-year-old boy presented to the emergency department with acute quadriplegia and hemodynamic instability that quickly progressed to cardiac arrest. After stabilization, the patient regained consciousness but remained in a locked-in state with no spontaneous breathing. The patient presented a diagnostic challenge. Traumatic, inflammatory, infectious, and ischemic etiologies were considered. Eventually, the clinical and radiological findings led to the presumed diagnosis of FCE. Treatment with continuous cerebrospinal fluid drainage (CSFD), pulse steroids, and mean arterial pressure augmentation was applied, with subsequent considerable and consistent neurological improvement. LESSONS: The authors proposed consideration of the adaptation of spinal cord neuroprotection principles used routinely in aortic surgery for the management of traumatic spinal cord ischemia (FCE-related in particular), namely, permissive arterial hypertension and CSFD. This is hypothesized to allow for the maintenance of sufficient spinal cord perfusion until adequate physiological blood perfusion is reestablished (remodeling of the collateral arterial network and/or clearing/absorption of the emboli).

Single root multiple spinal schwannomas: Case report, treatment strategy and review of literature.

INTRODUCTION: Schwannomatosis is defined as multiple schwannomas without presence of neurofibromatosis and is a rare pathology. In vast majority of cases the schwannomas grow from different nerve roots or peripheral nerves. PRESENTATION OF CASE: A 52-year-old woman presented with multiple intradural schwannomas arranged in a chain along the spinal canal causing significant compression. The lesions were successfully removed using a left side en-bloc hemilaminectomy technique in order to preserve maximal stability of the posterior column. Back and leg pain resolved completely. Tendon reflexes returned to normal shortly. There was decreased pain sensation in the distribution of the left L3 spinal root. DISCUSSION: The traditional surgical strategy for posterior approach by laminectomy or laminotomy is sometimes complicated with instability or deformation of the vertebral column that requires surgical stabilization. We performed a one side en-bloc hemilaminectomy thus maintaining the integrity of the muscles and ligaments on the opposite side and preserving maximal stability of the vertebral column. Densely adherent tumors required careful sharp dissection and separation under neurosurgical monitoring and stimulation for recognition and preservation of spinal roots. An additional tumor was discovered by exploration of the spinal canal using an endoscope. CONCLUSION: Multiple spinal cord schwannomas that are growing along the same part of the vertebral column can be safely removed by one-sided hemilaminectomy with preservation of the integrity of the muscles and ligaments on the opposite side and thus maintain spinal stability. The 30° endoscope can be a good tool for visual exploration of the spinal canal.

Entrainment of a network of interacting neurons with minimum stimulating charge.

Periodic pulse train stimulation is generically used to study the function of the nervous system and to counteract disease-related neuronal activity, e.g., collective periodic neuronal oscillations. The efficient control of neuronal dynamics without compromising brain tissue is key to research and clinical purposes. We here adapt the minimum charge control theory, recently developed for a single neuron, to a network of interacting neurons exhibiting collective periodic oscillations. We present a general expression for the optimal waveform, which provides an entrainment of a neural network to the stimulation frequency with a minimum absolute value of the stimulating current. As in the case of a single neuron, the optimal waveform is of bang-off-bang type, but its parameters are now determined by the parameters of the effective phase response curve of the entire network, rather than of a single neuron. The theoretical results are confirmed by three specific examples: two small-scale networks of FitzHugh-Nagumo neurons with synaptic and electric couplings, as well as a large-scale network of synaptically coupled quadratic integrate-and-fire neurons.