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1.
Nat Commun ; 15(1): 9153, 2024 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-39443498

RESUMO

Representational drift-the gradual continuous change of neuronal representations-has been observed across many brain areas. It is unclear whether drift is caused by synaptic plasticity elicited by sensory experience, or by the intrinsic volatility of synapses. Here, using chronic two-photon calcium imaging in primary visual cortex of female mice, we find that the preferred stimulus orientation of individual neurons slowly drifts over the course of weeks. By using cylinder lens goggles to limit visual experience to a narrow range of orientations, we show that the direction of drift, but not its magnitude, is biased by the statistics of visual input. A network model suggests that drift of preferred orientation largely results from synaptic volatility, which under normal visual conditions is counteracted by experience-driven Hebbian mechanisms, stabilizing preferred orientation. Under deprivation conditions these Hebbian mechanisms enable adaptation. Thus, Hebbian synaptic plasticity steers drift to match the statistics of the environment.


Assuntos
Plasticidade Neuronal , Neurônios , Córtex Visual , Animais , Plasticidade Neuronal/fisiologia , Feminino , Camundongos , Córtex Visual/fisiologia , Neurônios/fisiologia , Camundongos Endogâmicos C57BL , Estimulação Luminosa , Córtex Visual Primário/fisiologia , Modelos Neurológicos , Cálcio/metabolismo , Percepção Visual/fisiologia , Sinapses/fisiologia , Orientação/fisiologia
2.
Neuron ; 112(19): 3226-3227, 2024 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-39389010

RESUMO

Visual perception requires aligned feedforward and feedback processing, yet the role of experience remains unclear. The study by Dias et al.1 in this issue of Neuron shows that the retinotopic organization of orientation-tuned feedback from higher to primary visual cortex is learned in mice.


Assuntos
Córtex Visual , Percepção Visual , Animais , Percepção Visual/fisiologia , Córtex Visual/fisiologia , Camundongos , Humanos , Aprendizagem/fisiologia , Vias Visuais/fisiologia , Retroalimentação Sensorial/fisiologia , Neurônios/fisiologia
3.
Cereb Cortex ; 33(7): 3715-3733, 2023 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-36017976

RESUMO

Pyramidal cells of neocortical layer 2/3 (L2/3 PyrCs) integrate signals from numerous brain areas and project throughout the neocortex. These PyrCs show pial depth-dependent functional and structural specializations, indicating participation in different functional microcircuits. However, whether these depth-dependent differences result from separable PyrC subtypes or whether their features display a continuum correlated with pial depth is unknown. Here, we assessed the stimulus selectivity, electrophysiological properties, dendritic morphology, and excitatory and inhibitory connectivity across the depth of L2/3 in the binocular visual cortex of mice. We find that the apical, but not the basal dendritic tree structure, varies with pial depth, which is accompanied by variation in subthreshold electrophysiological properties. Lower L2/3 PyrCs receive increased input from L4, while upper L2/3 PyrCs receive a larger proportion of intralaminar input. In vivo calcium imaging revealed a systematic change in visual responsiveness, with deeper PyrCs showing more robust responses than superficial PyrCs. Furthermore, deeper PyrCs are more driven by contralateral than ipsilateral eye stimulation. Importantly, the property value transitions are gradual, and L2/3 PyrCs do not display discrete subtypes based on these parameters. Therefore, L2/3 PyrCs' multiple functional and structural properties systematically correlate with their depth, forming a continuum rather than discrete subtypes.


Assuntos
Neocórtex , Córtex Visual , Camundongos , Animais , Células Piramidais/fisiologia , Fenômenos Eletrofisiológicos , Córtex Visual/fisiologia
4.
J Physiol ; 601(15): 3037-3053, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36069408

RESUMO

Due to the staggering complexity of the brain and its neural circuitry, neuroscientists rely on the analysis of mathematical models to elucidate its function. From Hodgkin and Huxley's detailed description of the action potential in 1952 to today, new theories and increasing computational power have opened up novel avenues to study how neural circuits implement the computations that underlie behaviour. Computational neuroscientists have developed many models of neural circuits that differ in complexity, biological realism or emergent network properties. With recent advances in experimental techniques for detailed anatomical reconstructions or large-scale activity recordings, rich biological data have become more available. The challenge when building network models is to reflect experimental results, either through a high level of detail or by finding an appropriate level of abstraction. Meanwhile, machine learning has facilitated the development of artificial neural networks, which are trained to perform specific tasks. While they have proven successful at achieving task-oriented behaviour, they are often abstract constructs that differ in many features from the physiology of brain circuits. Thus, it is unclear whether the mechanisms underlying computation in biological circuits can be investigated by analysing artificial networks that accomplish the same function but differ in their mechanisms. Here, we argue that building biologically realistic network models is crucial to establishing causal relationships between neurons, synapses, circuits and behaviour. More specifically, we advocate for network models that consider the connectivity structure and the recorded activity dynamics while evaluating task performance.


Assuntos
Aprendizado de Máquina , Redes Neurais de Computação , Encéfalo/fisiologia , Modelos Neurológicos , Neurônios/fisiologia
5.
Curr Biol ; 32(8): 1743-1753.e7, 2022 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-35276098

RESUMO

The functional properties of neocortical pyramidal cells (PCs), such as direction and orientation selectivity in visual cortex, predominantly derive from their excitatory and inhibitory inputs. For layer 2/3 (L2/3) PCs, the detailed relationship between their functional properties and how they sample and integrate information across cortical space is not fully understood. Here, we study this relationship by combining functional in vivo two-photon calcium imaging, in vitro functional circuit mapping, and dendritic reconstruction of the same L2/3 PCs in mouse visual cortex. Our work reveals direct correlations between dendritic morphology and functional input connectivity and the orientation as well as direction tuning of L2/3 PCs. First, the apical dendritic tree is elongated along the postsynaptic preferred orientation, considering the representation of visual space in the cortex as determined by its retinotopic organization. Additionally, sharply orientation-tuned cells show a less complex apical tree compared with broadly tuned cells. Second, in direction-selective L2/3 PCs, the spatial distribution of presynaptic partners is offset from the soma opposite to the preferred direction. Importantly, although the presynaptic excitatory and inhibitory input distributions spatially overlap on average, the excitatory input distribution is spatially skewed along the preferred direction, in contrast to the inhibitory distribution. Finally, the degree of asymmetry is positively correlated with the direction selectivity of the postsynaptic L2/3 PC. These results show that the dendritic architecture and the spatial arrangement of excitatory and inhibitory presynaptic cells of L2/3 PCs play important roles in shaping their orientation and direction tuning.


Assuntos
Inibição Neural , Córtex Visual , Animais , Dendritos , Camundongos , Inibição Neural/fisiologia , Neurônios/fisiologia , Células Piramidais/fisiologia , Córtex Visual/fisiologia
6.
Proc Natl Acad Sci U S A ; 119(7)2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-35135885

RESUMO

The medial entorhinal cortex (MEC) creates a map of local space, based on the firing patterns of grid, head-direction (HD), border, and object-vector (OV) cells. How these cell types are organized anatomically is debated. In-depth analysis of this question requires collection of precise anatomical and activity data across large populations of neurons during unrestrained behavior, which neither electrophysiological nor previous imaging methods fully afford. Here, we examined the topographic arrangement of spatially modulated neurons in the superficial layers of MEC and adjacent parasubiculum using miniaturized, portable two-photon microscopes, which allow mice to roam freely in open fields. Grid cells exhibited low levels of co-occurrence with OV cells and clustered anatomically, while border, HD, and OV cells tended to intermingle. These data suggest that grid cell networks might be largely distinct from those of border, HD, and OV cells and that grid cells exhibit strong coupling among themselves but weaker links to other cell types.


Assuntos
Mapeamento Encefálico/métodos , Córtex Entorrinal/anatomia & histologia , Córtex Entorrinal/fisiologia , Microscopia/instrumentação , Animais , Masculino , Camundongos , Miniaturização , Atividade Motora , Neurônios/fisiologia
7.
Curr Biol ; 31(19): R1129-R1132, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34637715

RESUMO

The response of individual neurons to stable sensory input or behavioral output can change over time. A new study provides evidence from the mouse visual system that such drift does not follow the hierarchy of information flow across the brain.


Assuntos
Córtex Visual , Animais , Cognição , Camundongos , Neurônios/fisiologia , Visão Ocular , Córtex Visual/fisiologia , Percepção Visual/fisiologia
8.
Neuron ; 109(15): 2457-2468.e12, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34146468

RESUMO

Segregation of retinal ganglion cell (RGC) axons by type and eye of origin is considered a hallmark of dorsal lateral geniculate nucleus (dLGN) structure. However, recent anatomical studies have shown that neurons in mouse dLGN receive input from multiple RGC types of both retinae. Whether convergent input leads to relevant functional interactions is unclear. We studied functional eye-specific retinogeniculate convergence using dual-color optogenetics in vitro. dLGN neurons were strongly dominated by input from one eye. Most neurons received detectable input from the non-dominant eye, but this input was weak, with a prominently reduced AMPAR:NMDAR ratio. Consistent with this, only a small fraction of thalamocortical neurons was binocular in vivo across visual stimuli and cortical projection layers. Anatomical overlap between RGC axons and dLGN neuron dendrites alone did not explain the strong bias toward monocularity. We conclude that functional eye-specific input selection and refinement limit convergent interactions in dLGN, favoring monocularity.


Assuntos
Lateralidade Funcional/fisiologia , Corpos Geniculados/citologia , Células Ganglionares da Retina/citologia , Visão Binocular/fisiologia , Vias Visuais/citologia , Animais , Corpos Geniculados/fisiologia , Camundongos , Células Ganglionares da Retina/fisiologia , Vias Visuais/fisiologia
9.
Nat Protoc ; 13(6): 1275-1293, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29748648

RESUMO

In vivo two-photon calcium imaging provides detailed information about the activity and response properties of individual neurons. However, in vitro methods are often required to study the underlying neuronal connectivity and physiology at the cellular and synaptic levels at high resolution. This protocol provides a fast and reliable workflow for combining the two approaches by characterizing the response properties of individual neurons in mice in vivo using genetically encoded calcium indicators (GECIs), followed by retrieval of the same neurons in brain slices for further analysis in vitro (e.g., circuit mapping). In this approach, a reference frame is provided by fluorescent-bead tracks and sparsely transduced neurons expressing a structural marker in order to re-identify the same neurons. The use of GECIs provides a substantial advancement over previous approaches by allowing for repeated in vivo imaging. This opens the possibility of directly correlating experience-dependent changes in neuronal activity and feature selectivity with changes in neuronal connectivity and physiology. This protocol requires expertise both in in vivo two-photon calcium imaging and in vitro electrophysiology. It takes 3 weeks or more to complete, depending on the time allotted for repeated in vivo imaging of neuronal activity.


Assuntos
Sinalização do Cálcio , Separação Celular/métodos , Microscopia Intravital/métodos , Neurônios/fisiologia , Imagem Óptica/métodos , Animais , Camundongos , Biologia Molecular/métodos , Coloração e Rotulagem/métodos
10.
Curr Opin Neurobiol ; 53: 22-28, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29733916

RESUMO

Experience-dependent plasticity in the visual system is traditionally thought to be exclusively cortical whereas the dorsal lateral geniculate nucleus (dLGN) is classically considered to just be a 'relay' of visual information between the retina and the cortex. However, a number of recent experiments call into question the simplistic view of visual cortex being the only site of plasticity. Thalamic neurons, at least in mouse dLGN, combine inputs from ganglion cells located in both eyes and recent evidence suggests that the feature selectivity of dLGN neurons is subject to experience-dependent plasticity. Here we discuss new insights into the nature of thalamic visual processing, focusing on the unexpected degree and plasticity of functional binocular convergence in mouse dLGN.


Assuntos
Corpos Geniculados/fisiologia , Plasticidade Neuronal/fisiologia , Células Ganglionares da Retina/fisiologia , Visão Binocular/fisiologia , Vias Visuais/fisiologia , Animais , Camundongos
11.
Nat Neurosci ; 20(12): 1708-1714, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29184207

RESUMO

Experience-dependent plasticity in the mature visual system is widely considered to be cortical. Using chronic two-photon Ca2+ imaging of thalamic afferents in layer 1 of binocular visual cortex, we provide evidence against this tenet: the respective dorsal lateral geniculate nucleus (dLGN) cells showed pronounced ocular dominance (OD) shifts after monocular deprivation in adult mice. Most (86%), but not all, of dLGN cell boutons were monocular during normal visual experience. Following deprivation, initially deprived-eye-dominated boutons reduced or lost their visual responsiveness to that eye and frequently became responsive to the non-deprived eye. This cannot be explained by eye-specific cortical changes propagating to dLGN via cortico-thalamic feedback because the shift in dLGN responses was largely resistant to cortical inactivation using the GABAA receptor agonist muscimol. Our data suggest that OD shifts observed in the binocular visual cortex of adult mice may at least partially reflect plasticity of eye-specific inputs onto dLGN neurons.


Assuntos
Dominância Ocular/fisiologia , Corpos Geniculados/citologia , Corpos Geniculados/fisiologia , Plasticidade Neuronal/fisiologia , Neurônios/fisiologia , Córtex Visual/citologia , Córtex Visual/fisiologia , Animais , Cegueira/patologia , Retroalimentação Sensorial/fisiologia , Agonistas GABAérgicos/farmacologia , Corpos Geniculados/efeitos dos fármacos , Masculino , Camundongos , Muscimol/farmacologia , Plasticidade Neuronal/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios Aferentes/fisiologia , Tálamo/citologia , Tálamo/fisiologia , Visão Binocular/fisiologia , Vias Visuais/citologia , Vias Visuais/fisiologia
12.
Nature ; 547(7664): 408-410, 2017 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-28700582
13.
Artigo em Inglês | MEDLINE | ID: mdl-28093552

RESUMO

We summarize here the results presented and subsequent discussion from the meeting on Integrating Hebbian and Homeostatic Plasticity at the Royal Society in April 2016. We first outline the major themes and results presented at the meeting. We next provide a synopsis of the outstanding questions that emerged from the discussion at the end of the meeting and finally suggest potential directions of research that we believe are most promising to develop an understanding of how these two forms of plasticity interact to facilitate functional changes in the brain.This article is part of the themed issue 'Integrating Hebbian and homeostatic plasticity'.


Assuntos
Encéfalo/fisiologia , Homeostase , Plasticidade Neuronal , Animais , Humanos
14.
Artigo em Inglês | MEDLINE | ID: mdl-28093555

RESUMO

The brain extracts behaviourally relevant sensory input to produce appropriate motor output. On the one hand, our constantly changing environment requires this transformation to be plastic. On the other hand, plasticity is thought to be balanced by mechanisms ensuring constancy of neuronal representations in order to achieve stable behavioural performance. Yet, prominent changes in synaptic strength and connectivity also occur during normal sensory experience, indicating a certain degree of constitutive plasticity. This raises the question of how stable neuronal representations are on the population level and also on the single neuron level. Here, we review recent data from longitudinal electrophysiological and optical recordings of single-cell activity that assess the long-term stability of neuronal stimulus selectivities under conditions of constant sensory experience, during learning, and after reversible modification of sensory input. The emerging picture is that neuronal representations are stabilized by behavioural relevance and that the degree of long-term tuning stability and perturbation resistance directly relates to the functional role of the respective neurons, cell types and circuits. Using a 'toy' model, we show that stable baseline representations and precise recovery from perturbations in visual cortex could arise from a 'backbone' of strong recurrent connectivity between similarly tuned cells together with a small number of 'anchor' neurons exempt from plastic changes.This article is part of the themed issue 'Integrating Hebbian and homeostatic plasticity'.


Assuntos
Comportamento , Aprendizagem , Neurônios/fisiologia , Sensação , Córtex Visual/fisiologia , Animais , Fenômenos Eletrofisiológicos , Modelos Neurológicos , Plasticidade Neuronal , Fenômenos Ópticos , Análise de Célula Única
15.
Science ; 352(6291): 1319-22, 2016 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-27284193

RESUMO

Monocular deprivation evokes a prominent shift of neuronal responses in the visual cortex toward the open eye, accompanied by functional and structural synaptic rearrangements. This shift is reversible, but it is unknown whether the recovery happens at the level of individual neurons or whether it reflects a population effect. We used ratiometric Ca(2+) imaging to follow the activity of the same excitatory layer 2/3 neurons in the mouse visual cortex over months during repeated episodes of ocular dominance (OD) plasticity. We observed robust shifts toward the open eye in most neurons. Nevertheless, these cells faithfully returned to their pre-deprivation OD during binocular recovery. Moreover, the initial network correlation structure was largely recovered, suggesting that functional connectivity may be regained despite prominent experience-dependent plasticity.


Assuntos
Dominância Ocular/fisiologia , Córtex Visual/fisiologia , Animais , Cálcio/análise , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Camundongos , Neuroimagem/métodos , Neurônios/fisiologia , Regiões Promotoras Genéticas , Proteínas/genética , Privação Sensorial/fisiologia , Análise de Célula Única/métodos , Córtex Visual/citologia
16.
Front Mol Neurosci ; 7: 88, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25477779

RESUMO

More than a decade ago genetically encoded calcium indicators (GECIs) entered the stage as new promising tools to image calcium dynamics and neuronal activity in living tissues and designated cell types in vivo. From a variety of initial designs two have emerged as promising prototypes for further optimization: FRET (Förster Resonance Energy Transfer)-based sensors and single fluorophore sensors of the GCaMP family. Recent efforts in structural analysis, engineering and screening have broken important performance thresholds in the latest generation for both classes. While these improvements have made GECIs a powerful means to perform physiology in living animals, a number of other aspects of sensor function deserve attention. These aspects include indicator linearity, toxicity and slow response kinetics. Furthermore creating high performance sensors with optically more favorable emission in red or infrared wavelengths as well as new stably or conditionally GECI-expressing animal lines are on the wish list. When the remaining issues are solved, imaging of GECIs will finally have crossed the last milestone, evolving from an initial promise into a fully matured technology.

17.
Nat Protoc ; 9(12): 2809-22, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25393778

RESUMO

Studies on the cellular function of the pancreas are typically performed in vitro on its isolated functional units, the endocrine islets of Langerhans and the exocrine acini. However, these approaches are hampered by preparation-induced changes of cell physiology and the lack of an intact surrounding. We present here a detailed protocol for the preparation of pancreas tissue slices. This procedure is less damaging to the tissue and faster than alternative approaches, and it enables the in situ study of pancreatic endocrine and exocrine cell physiology in a conserved environment. Pancreas tissue slices facilitate the investigation of cellular mechanisms underlying the function, pathology and interaction of the endocrine and exocrine components of the pancreas. We provide examples for several experimental applications of pancreas tissue slices to study various aspects of pancreas cell biology. Furthermore, we describe the preparation of human and porcine pancreas tissue slices for the validation and translation of research findings obtained in the mouse model. Preparation of pancreas tissue slices according to the protocol described here takes less than 45 min from tissue preparation to receipt of the first slices.


Assuntos
Células Acinares/citologia , Técnicas Citológicas/métodos , Técnicas In Vitro , Ilhotas Pancreáticas/citologia , Pâncreas/citologia , Animais , Sinalização do Cálcio , Humanos , Camundongos , Microtomia/instrumentação , Microtomia/métodos , Ratos , Sus scrofa
18.
Surg Endosc ; 27(10): 3883-90, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23708716

RESUMO

BACKGROUND: Anastomotic leakage after esophagectomy is a life-threatening complication. No comparative outcome analyses for the different treatment regimens are yet available. METHODS: In a single-center study, data from all esophagectomy patients from January 1995 to January 2012, including tumor characteristics, surgical procedure, postoperative anastomotic leakage, leakage therapy regimens, APACHE II scores, and mortality, were collected, and predictors of patient survival after anastomotic leakage were analyzed. RESULTS: Among 366 resected patients, 62 patients (16 %) developed an anastomotic leak, 16 (26 %) of whom died. Therapy regimens included surgical revision (n = 18), endoscopic endoluminal vacuum therapy (n = 17), endoscopic stent application (n = 12), and conservative management (n = 15). APACHE II score at the initiation of treatment for leakage was the strongest predictor of in-hospital mortality (p < 0.0017). Conservatively managed patients showed mild systemic illness (mean APACHE II score 5) and no mortality. In systemically ill patients matched for APACHE II scores (mean, 14.4), endoscopic endoluminal vacuum therapy patients had lower mortality (12 %) compared to surgically treated (50 %, p = 0.01) cases and patients managed by stent placement (83 %, p = 00014, log rank test). No other clinical or laboratory parameters significantly influenced patient survival. CONCLUSIONS: Endoscopic endoluminal vacuum therapy was the best treatment of anastomotic leakage in systemically ill patients after esophagectomy in this retrospective analysis. It should therefore be considered an important instrument in the management of this disorder.


Assuntos
Fístula Anastomótica/terapia , Esofagectomia , Esofagoscopia/métodos , Tratamento de Ferimentos com Pressão Negativa , APACHE , Adenocarcinoma/cirurgia , Adenocarcinoma/terapia , Idoso , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia , Terapia Combinada , Cuidados Críticos/estatística & dados numéricos , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/terapia , Feminino , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estudos Retrospectivos , Stents , Tampões de Gaze Cirúrgicos
19.
Neuron ; 77(6): 1109-21, 2013 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-23522046

RESUMO

At synapses formed between dissociated neurons, about half of all synaptic vesicles are refractory to evoked release, forming the so-called "resting pool." Here, we use optical measurements of vesicular pH to study developmental changes in pool partitioning and vesicle cycling in cultured hippocampal slices. Two-photon imaging of a genetically encoded two-color release sensor (ratio-sypHy) allowed us to perform calibrated measurements at individual Schaffer collateral boutons. Mature boutons released a large fraction of their vesicles during simulated place field activity, and vesicle retrieval rates were 7-fold higher compared to immature boutons. Saturating stimulation mobilized essentially all vesicles at mature synapses. Resting pool formation and a concomitant reduction in evoked release was induced by chronic depolarization but not by acute inhibition of the protein phosphatase calcineurin. We conclude that synapses in CA1 undergo a prominent refinement of vesicle use during early postnatal development that is not recapitulated in dissociated neuronal culture.


Assuntos
Região CA1 Hipocampal/crescimento & desenvolvimento , Região CA1 Hipocampal/fisiologia , Endocitose/fisiologia , Sinapses/fisiologia , Vesículas Sinápticas/fisiologia , Animais , Animais Recém-Nascidos , Técnicas de Cultura de Órgãos , Ratos , Ratos Wistar
20.
J Palliat Med ; 15(1): 37-42, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22248257

RESUMO

OBJECTIVES: Thoracoscopic pleurodesis is a safe and effective method of palliative care for patients suffering from malignant pleural effusion. Health-related quality of life (QOL) is an important factor in palliative therapy; however, we are not aware of any studies that have examined the QOL of patients following thoracoscopic pleurodesis. METHODS: A total of 123 patients underwent thoracoscopic pleurodesis between January 2006 and February 2009. A total of 45 patients agreed to take part at the QOL assessment and were enrolled in our prospective study. In addition to clinical outcome, the patients' QOL data were assessed prior to thoracoscopic pleurodesis and for 12 months after surgery using the European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. We compared the patients' QOL scores at each time point with their preoperative scores and analyzed these data relative to the scores of a healthy age-matched population. RESULTS: Due to the advanced clinical status of the patients in our study, the overall median survival time was 7.5 months versus 10.2 months for patients' QOL data. Following discharge from the hospital, most functional scales (with exception of emotional function, p=0.035) did not significantly differ from preoperative scores. Throughout the study period, patients experienced statistically and clinically significant improvements in functional scales. Global health values increased after surgery throughout the entire study period. There was a clear decline in dyspnea upon discharge, followed by a continuous remote increase throughout the subsequent months. QOL of the study population remained lower than that of the healthy cohort. CONCLUSIONS: Our data are consistent with clinical findings that pleurodesis decreases respiratory symptoms, but does not alleviate impairments in the patient's general condition.


Assuntos
Avaliação de Resultados em Cuidados de Saúde , Pleurodese , Qualidade de Vida , Talco/uso terapêutico , Toracoscopia , Idoso , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural Maligno/terapia , Estudos Prospectivos , Inquéritos e Questionários
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