Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 779
Filtrar
Mais filtros

Intervalo de ano de publicação
1.
Cereb Cortex ; 34(7)2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-39042031

RESUMO

Interhemispheric inhibition of the homotopic motor cortex is believed to be effective for accurate unilateral motor function. However, the cellular mechanisms underlying interhemispheric inhibition during unilateral motor behavior remain unclear. Furthermore, the impact of the neuromodulator acetylcholine on interhemispheric inhibition and the associated cellular mechanisms are not well understood. To address this knowledge gap, we conducted recordings of neuronal activity from the bilateral motor cortex of mice during the paw-reaching task. Subsequently, we analyzed interhemispheric spike correlation at the cell-pair level, classifying putative cell types to explore the underlying cellular circuitry mechanisms of interhemispheric inhibition. We found a cell-type pair-specific enhancement of the interhemispheric spike correlation when the mice were engaged in the reaching task. We also found that the interhemispheric spike correlation was modulated by pharmacological acetylcholine manipulation. The local field responses to contralateral excitation differed along the cortical depths, and muscarinic receptor antagonism enhanced the inhibitory component of the field response in deep layers. The muscarinic subtype M2 receptor is predominantly expressed in deep cortical neurons, including GABAergic interneurons. These results suggest that GABAergic interneurons expressing muscarinic receptors in deep layers mediate the neuromodulation of interhemispheric inhibition in the homotopic motor cortex.


Assuntos
Acetilcolina , Córtex Motor , Inibição Neural , Animais , Córtex Motor/fisiologia , Córtex Motor/efeitos dos fármacos , Acetilcolina/metabolismo , Camundongos , Masculino , Inibição Neural/fisiologia , Inibição Neural/efeitos dos fármacos , Lateralidade Funcional/fisiologia , Camundongos Endogâmicos C57BL , Interneurônios/fisiologia , Interneurônios/efeitos dos fármacos , Antagonistas Muscarínicos/farmacologia , Receptor Muscarínico M2/antagonistas & inibidores , Receptor Muscarínico M2/metabolismo , Neurônios GABAérgicos/fisiologia , Neurônios GABAérgicos/efeitos dos fármacos , Potenciais de Ação/fisiologia , Potenciais de Ação/efeitos dos fármacos
2.
J Physiol ; 602(12): 2931-2943, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38872383

RESUMO

Theta-burst transcranial ultrasound stimulation (tbTUS) increases primary motor cortex (M1) excitability for at least 30 min. However, the remote effects of focal M1 tbTUS on the excitability of other cortical areas are unknown. Here, we examined the effects of left M1 tbTUS on right M1 excitability. An 80 s train of active or sham tbTUS was delivered to the left M1 in 20 healthy subjects. Before and after the tbTUS, we measured: (1) corticospinal excitability using motor-evoked potential (MEP) amplitudes from single-pulse transcranial magnetic stimulation (TMS) of left and right M1; (2) interhemispheric inhibition (IHI) from left to right M1 and from right to left M1 using a dual-site paired-pulse TMS paradigm; and (3) intracortical circuits of the right M1 with short-interval intracortical inhibition and intracortical facilitation (ICF) using paired-pulse TMS. Left M1 tbTUS decreased right M1 excitability as shown by decreased MEP amplitudes, increased right M1 ICF and decreased short-interval IHI from left to right hemisphere at interstimulus interval (ISI) of 10 ms but not long-interval IHI at interstimulus interval of 40 ms. The study showed that left M1 tbTUS can change the excitability of remote cortical areas with decreased right M1 excitability and interhemispheric inhibition. The remote effects of tbTUS should be considered when it is used in neuroscience research and as a potential neuromodulation treatment for brain disorders. KEY POINTS: Transcranial ultrasound stimulation (TUS) is a novel non-invasive brain stimulation technique for neuromodulation with the advantages of being able to achieve high spatial resolution and target deep brain structures. A repetitive TUS protocol, with an 80 s train of theta burst patterned TUS (tbTUS), has been shown to increase primary motor cortex (M1) excitability, as well as increase alpha and beta movement-related spectral power in distinct brain regions. In this study, we examined on the effects of the motor cortical tbTUS on the excitability of contralateral M1 measured with MEPs elicited by transcranial magnetic stimulation. We showed that left M1 tbTUS decreased right M1 excitability and left-to-right M1 interhemispheric inhibition, and increased intracortical facilitation of right M1. These results lead to better understand the effects of tbTUS and can help the development of tbTUS for the treatment of neurological and psychiatric disorders and in neuroscience research.


Assuntos
Potencial Evocado Motor , Córtex Motor , Estimulação Magnética Transcraniana , Humanos , Córtex Motor/fisiologia , Masculino , Feminino , Adulto , Estimulação Magnética Transcraniana/métodos , Adulto Jovem , Ritmo Teta
3.
Neurobiol Dis ; 191: 106398, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38182075

RESUMO

Parkinson's disease (PD) is characterized by the progressive and asymmetrical degeneration of the nigrostriatal dopamine neurons and the unilateral presentation of the motor symptoms at onset, contralateral to the most impaired hemisphere. We previously developed a rat PD model that mimics these typical features, based on unilateral injection of a substrate inhibitor of excitatory amino acid transporters, L-trans-pyrrolidine-2,4-dicarboxylate (PDC), in the substantia nigra (SN). Here, we used this progressive model in a multilevel study (behavioral testing, in vivo 1H-magnetic resonance spectroscopy, slice electrophysiology, immunocytochemistry and in situ hybridization) to characterize the functional changes occurring in the cortico-basal ganglia-cortical network in an evolving asymmetrical neurodegeneration context and their possible contribution to the cell death progression. We focused on the corticostriatal input and the subthalamic nucleus (STN), two glutamate components with major implications in PD pathophysiology. In the striatum, glutamate and glutamine levels increased from presymptomatic stages in the PDC-injected hemisphere only, which also showed enhanced glutamatergic transmission and loss of plasticity at corticostriatal synapses assessed at symptomatic stage. Surprisingly, the contralateral STN showed earlier and stronger reactivity than the ipsilateral side (increased intraneuronal cytochrome oxidase subunit I mRNA levels; enhanced glutamate and glutamine concentrations). Moreover, its lesion at early presymptomatic stage halted the ongoing neurodegeneration in the PDC-injected SN and prevented the expression of motor asymmetry. These findings reveal the existence of endogenous interhemispheric processes linking the primary injured SN and the contralateral STN that could sustain progressive dopamine neuron loss, opening new perspectives for disease-modifying treatment of PD.


Assuntos
Doença de Parkinson , Transtornos Parkinsonianos , Núcleo Subtalâmico , Ratos , Animais , Neurônios Dopaminérgicos/metabolismo , Dopamina/metabolismo , Glutamina/metabolismo , Transtornos Parkinsonianos/metabolismo , Doença de Parkinson/metabolismo , Substância Negra/metabolismo , Glutamatos/metabolismo , Oxidopamina/farmacologia
4.
Eur J Neurosci ; 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830753

RESUMO

Left hemisphere injury can cause right spastic arm paralysis and aphasia, and recovery of both motor and language functions shares similar compensatory mechanisms and processes. Contralateral cervical seventh cross transfer (CC7) surgery can provide motor recovery for spastic arm paralysis by triggering interhemispheric plasticity, and self-reports from patients indicate spontaneous improvement in language function but still need to be verified. To explore the improvements in motor and language function after CC7 surgery, we performed this prospective observational cohort study. The Upper Extremity part of Fugl-Meyer scale (UEFM) and Modified Ashworth Scale were used to evaluate motor function, and Aphasia Quotient calculated by Mandarin version of the Western Aphasia Battery (WAB-AQ, larger score indicates better language function) was assessed for language function. In 20 patients included, the average scores of UEFM increased by .40 and 3.70 points from baseline to 1-week and 6-month post-surgery, respectively. The spasticity of the elbow and fingers decreased significantly at 1-week post-surgery, although partially recurred at 6-month follow-up. The average scores of WAB-AQ were increased by 9.14 and 10.69 points at 1-week and 6-month post-surgery (P < .001 for both), respectively. Post-surgical fMRI scans revealed increased activity in the bilateral hemispheres related to language centrals, including the right precentral cortex and right gyrus rectus. These findings suggest that CC7 surgery not only enhances motor function but may also improve the aphasia quotient in patients with right arm paralysis and aphasia due to left hemisphere injuries.

5.
J Magn Reson Imaging ; 59(3): 998-1007, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37334908

RESUMO

BACKGROUND: Carotid stenosis, even in the clinically asymptomatic stage, causes cognitive impairment, silent lesions, and hemispheric changes. The corpus callosum (CC) is crucial for hemispheric cortical integration and specialization. PURPOSE: To examine if CC morphology and connectivity relate to cognitive decline and lesion burden in asymptomatic carotid stenosis (ACS). STUDY TYPE: Retrospective, cross-sectional. POPULATION: 33 patients with unilaterally severe (70%) ACS and 28 demographically and comorbidity-matched controls. A publicly available healthy adult lifespan (ages between 18 and 80; n = 483) MRI dataset was also included. FIELD STRENGTH/SEQUENCE: A 3.0 T; T1 MPRAGE and diffusion weighted gradient echo-planar imaging sequences. ASSESSMENT: Structural MRI and multidomain cognitive data were obtained. Midsagittal CC area, circularity, thickness, integrity, and probabilistic tractography were calculated and correlated with cognitive tests and white matter hyperintensity. Fractional anisotropy, mean diffusivity (MD), and radial diffusivity were determined from DTI. STATISTICAL TESTS: Independent two-sample t-tests, χ2 tests, Mann-Whitney U, locally weighted scatterplot smoothing (LOWESS) curve fit, and Pearson correlation. A P value < 0.05 was considered statistically significant. RESULTS: Patients with ACS demonstrated significant reductions in callosal area, circularity, and thickness compared to controls. The callosal atrophy was significantly correlated with white matter hyperintensity size (r = -0.629, P < 0.001). Voxel-wise analysis of diffusion measures in the volumetric CC showed that ACS patients exhibited significantly lower fractional anisotropy and higher MD and radial diffusivity in the genu and splenium of the CC than controls. Further lifespan trajectory analysis showed that although the midsagittal callosal area, circularity, and thickness exhibited age-related decreases, the values in the ACS patients were significantly lower in all age groups. DATA CONCLUSION: Midsagittal callosal atrophy and connectivity reflect the load of silent lesions and the severity of cognitive decline, respectively, suggesting that CC degeneration has potential to serve as an early marker in ACS. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.


Assuntos
Estenose das Carótidas , Adulto , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estenose das Carótidas/patologia , Estudos Transversais , Estudos Retrospectivos , Corpo Caloso , Atrofia/patologia
6.
Psychophysiology ; 61(6): e14529, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38279560

RESUMO

The visual system has long been considered equivalent across hemispheres. However, an increasing amount of data shows that functional differences may exist in this regard. We therefore tried to characterize the emergence of visual perception and the spatiotemporal dynamics resulting from the stimulation of visual cortices in order to detect possible interhemispheric asymmetries. Eighteen participants were tested. Each of them received 360 transcranial magnetic stimulation (TMS) pulses at phosphene threshold intensity over left and right early visual areas while electroencephalography was being recorded. After each single pulse, participants had to report the presence or absence of a phosphene. Local mean field power analysis of TMS-evoked potentials showed an effect of both site (left vs. right TMS) of stimulation and hemisphere (ipsilateral vs. contralateral to the TMS): while right TMS determined early stronger activations, left TMS determined later stronger activity in contralateral electrodes. The interhemispheric signal propagation index revealed differences in how TMS-evoked activity spreads: left TMS-induced activity diffused contralaterally more than right stimulation. With regard to phosphenes perception, distinct electrophysiological patterns were found to reflect similar perceptual experiences: left TMS-evoked phosphenes are associated with early occipito-parietal and frontal activity followed by late central activity; right TMS-evoked phosphenes determine only late, fronto-central, and parietal activations. Our results show that left and right occipital TMS elicits differential electrophysiological patterns in the brain, both per se and as a function of phosphene perception. These distinct activation patterns may suggest a different role of the two hemispheres in processing visual information and giving rise to perception.


Assuntos
Eletroencefalografia , Lateralidade Funcional , Estimulação Magnética Transcraniana , Percepção Visual , Humanos , Masculino , Feminino , Adulto , Lateralidade Funcional/fisiologia , Percepção Visual/fisiologia , Adulto Jovem , Córtex Visual/fisiologia , Fosfenos/fisiologia , Potenciais Evocados Visuais/fisiologia , Mapeamento Encefálico
7.
Exp Brain Res ; 242(7): 1761-1772, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38822825

RESUMO

BACKGROUND: Multiple sclerosis is a neurodegenerative disease that damages the myelin sheath within the central nervous system. Axonal demyelination, particularly in the corpus callosum, impacts communication between the brain's hemispheres in persons with multiple sclerosis (PwMS). Changes in interhemispheric communication may impair gait coordination which is modulated by communication across the corpus callosum to excite and inhibit specific muscle groups. To further evaluate the functional role of interhemispheric communication in gait and mobility, this study assessed the ipsilateral silent period (iSP), an indirect marker of interhemispheric inhibition and how it relates to gait adaptation in PwMS. METHODS: Using transcranial magnetic stimulation (TMS), we assessed interhemispheric inhibition differences between the more affected and less affected hemisphere in the primary motor cortices in 29 PwMS. In addition, these same PwMS underwent a split-belt treadmill walking paradigm, with the faster paced belt moving under their more affected limb. Step length asymmetry (SLA) was the primary outcome measure used to assess gait adaptability during split-belt treadmill walking. We hypothesized that PwMS would exhibit differences in iSP inhibitory metrics between the more affected and less affected hemispheres and that increased interhemispheric inhibition would be associated with greater gait adaptability in PwMS. RESULTS: No statistically significant differences in interhemispheric inhibition or conduction time were found between the more affected and less affected hemisphere. Furthermore, SLA aftereffect was negatively correlated with both average percent depth of silent period (dSP%AVE) (r = -0.40, p = 0.07) and max percent depth of silent period (dSP%MAX) r = -0.40, p = 0.07), indicating that reduced interhemispheric inhibition was associated with greater gait adaptability in PwMS. CONCLUSION: The lack of differences between the more affected and less affected hemisphere indicates that PwMS have similar interhemispheric inhibitory capacity irrespective of the more affected hemisphere. Additionally, we identified a moderate correlation between reduced interhemispheric inhibition and greater gait adaptability. These findings may indicate that interhemispheric inhibition may in part influence responsiveness to motor adaptation paradigms and the need for further research evaluating the neural mechanisms underlying the relationship between interhemispheric inhibition and motor adaptability.


Assuntos
Adaptação Fisiológica , Córtex Motor , Esclerose Múltipla , Estimulação Magnética Transcraniana , Humanos , Feminino , Masculino , Adulto , Adaptação Fisiológica/fisiologia , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Córtex Motor/fisiopatologia , Inibição Neural/fisiologia , Marcha/fisiologia , Corpo Caloso/fisiopatologia , Corpo Caloso/fisiologia , Lateralidade Funcional/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/etiologia , Potencial Evocado Motor/fisiologia
8.
Eur Arch Psychiatry Clin Neurosci ; 274(3): 497-506, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37253876

RESUMO

This study aimed to detect alterations in interhemispheric interactions in patients with panic disorder (PD), determine whether such alterations could serve as biomarkers for the diagnosis and prediction of therapeutic outcomes, and map dynamic changes in interhemispheric interactions in patients with PD after treatment. Fifty-four patients with PD and 54 healthy controls (HCs) were enrolled in this study. All participants underwent clinical assessment and a resting-state functional magnetic resonance imaging scan at (i) baseline and (ii) after paroxetine treatment for 4 weeks. A voxel-mirrored homotopic connectivity (VMHC) indicator, support vector machine (SVM), and support vector regression (SVR) were used in this study. Patients with PD showed reduced VMHC in the fusiform, middle temporal/occipital, and postcentral/precentral gyri, relative to those of HCs. After treatment, the patients exhibited enhanced VMHC in the lingual gyrus, relative to the baseline data. The VMHC of the fusiform and postcentral/precentral gyri contributed most to the classification (accuracy = 87.04%). The predicted changes were accessed from the SVR using the aberrant VMHC as features. Positive correlations (p < 0.001) were indicated between the actual and predicted changes in the severity of anxiety. These findings suggest that impaired interhemispheric coordination in the cognitive-sensory network characterized PD and that VMHC can serve as biomarkers and predictors of the efficiency of PD treatment. Enhanced VMHC in the lingual gyrus of patients with PD after treatment implied that pharmacotherapy recruited the visual network in the early stages.


Assuntos
Transtorno de Pânico , Paroxetina , Humanos , Paroxetina/farmacologia , Paroxetina/uso terapêutico , Transtorno de Pânico/diagnóstico por imagem , Transtorno de Pânico/tratamento farmacológico , Imageamento por Ressonância Magnética/métodos , Lobo Occipital , Biomarcadores
9.
Cereb Cortex ; 33(12): 7335-7346, 2023 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-36882526

RESUMO

The "interlimb transfer" phenomenon consists of improved performance of the trained and untrained contralateral limbs after unilateral motor practice. We here assessed whether a visuomotor learning task can be transferred from one hemisphere to the other, whether this occurs symmetrically, and the cortical neurophysiological correlates of this phenomenon, focusing on interhemispheric connectivity measures. We enrolled 33 healthy subjects (age range: 24-73 years). Participants underwent two randomized sessions, which investigated the transfer from the dominant to the nondominant hand and vice versa. Measures of cortical and intracortical excitability and interhemispheric inhibition were assessed through transcranial magnetic stimulation before and after a visuomotor task. The execution of the visuomotor task led to an improvement in motor performance with the dominant and nondominant hands and induced a decrease in intracortical inhibition in the trained hemisphere. Participants were also able to transfer the visuomotor learned skill. The interlimb transfer, however, only occurred from the dominant to the nondominant hand and positively correlated with individual learning-related changes in interhemispheric inhibition. We here demonstrated that the "interlimb transfer" of a visuomotor task occurs asymmetrically and relates to the modulation of specific inhibitory interhemispheric connections. The study results have pathophysiological, clinical, and neuro-rehabilitative implications.


Assuntos
Lateralidade Funcional , Aprendizagem , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Lateralidade Funcional/fisiologia , Aprendizagem/fisiologia , Inibição Psicológica , Mãos/fisiologia , Desempenho Psicomotor/fisiologia , Destreza Motora/fisiologia
10.
Cereb Cortex ; 33(7): 3387-3400, 2023 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-35851912

RESUMO

Functional homotopy, the high degree of spontaneous activity synchrony and functional coactivation between geometrically corresponding interhemispheric regions, is a fundamental characteristic of the intrinsic functional architecture of the brain. However, little is known about the genetic mechanisms underlying functional homotopy. Resting-state functional magnetic resonance imaging data from a discovery dataset (656 healthy subjects) and 2 independent cross-race, cross-scanner validation datasets (103 and 329 healthy subjects) were used to calculate voxel-mirrored homotopic connectivity (VMHC) indexing brain functional homotopy. In combination with the Allen Human Brain Atlas, transcriptome-neuroimaging spatial correlation analysis was conducted to identify genes linked to VMHC. We found 1,001 genes whose expression measures were spatially associated with VMHC. Functional enrichment analyses demonstrated that these VMHC-related genes were enriched for biological functions including protein kinase activity, ion channel regulation, and synaptic function as well as many neuropsychiatric disorders. Concurrently, specific expression analyses showed that these genes were specifically expressed in the brain tissue, in neurons and immune cells, and during nearly all developmental periods. In addition, the VMHC-associated genes were linked to multiple behavioral domains, including vision, execution, and attention. Our findings suggest that interhemispheric communication and coordination involve a complex interaction of polygenes with a rich range of functional features.


Assuntos
Imageamento por Ressonância Magnética , Transcriptoma , Humanos , Encéfalo , Mapeamento Encefálico/métodos , Neuroimagem
11.
Childs Nerv Syst ; 40(4): 1169-1176, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38051311

RESUMO

OBJECTIVE: In children, interhemispheric arachnoid cysts (IHACs) are rare lesions often associated with corpus callosum dysgenesis. It is still controversial about surgical treatments for IHACs. We aim to report our experience with pediatric IHAC patients and evaluate surgical courses and neurological developments. METHODS: Pediatric IHACs treated between 2001 and 2021 were reviewed retrospectively. IHAC was observed until they represented rapid cyst enlargement or neurological symptoms. Cyst fenestration was done by microscope or endoscope, depending on the IHAC's location. Cyst size and corpus callosum dysgenesis were evaluated with neuroimaging. Neurological development was assessed from medical records at the last follow-up. RESULTS: Fifteen children received cyst fenestration surgery (mean age 11.4 months). Eleven patients (73.3%) under observation showed rapid cyst enlargement in a short period (median 5 months). Cysto-ventriculostomy (CVS) and cysto-cisternostomy (CCS) regressed the cyst size significantly (p = 0.003). The median follow-up duration was 51 months (range 14-178 months). Corpus callosum dysgenesis was observed in eleven patients (73.3%, complete = 5, partial = 6). Among eight patients (53.3%) having developmental delay, five patients (33.3%) showed speech delay, including one patient with intractable seizures. CONCLUSION: Pediatric IHACs frequently present within 1 year after birth, with rapid cyst enlargement. CVS and CCS were effective in regressing the cyst size. Corpus callosum dysgenesis accompanied by IHAC might have a risk of language achievement; however, development delay could rely on multifactorial features, such as epilepsy or other brain anomalies.


Assuntos
Cistos Aracnóideos , Malformações do Sistema Nervoso , Criança , Humanos , Lactente , Cistos Aracnóideos/cirurgia , Estudos Retrospectivos , Agenesia do Corpo Caloso , Ventriculostomia/métodos , Malformações do Sistema Nervoso/complicações , Imageamento por Ressonância Magnética
12.
Childs Nerv Syst ; 40(8): 2637-2640, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38762563

RESUMO

BACKGROUND: Intracranial arachnoid cysts are benign collections of cerebrospinal fluid that are often asymptomatic and discovered incidentally. An interhemispheric location of these lesions is rare, with only a few such cases reported in the literature. Though spontaneous regression of arachnoid cysts has been described in other locations, to date this phenomenon has not been reported in interhemispheric fissure cysts. OBSERVATIONS: In this report, we describe a patient with a large, multiloculated interhemispheric arachnoid cyst diagnosed on prenatal ultrasound. She did not exhibit neurologic deficits or signs of increased intracranial pressure and was observed with serial imaging. After several years of observation, imaging revealed spontaneous and progressive decrease in the cyst size. LESSONS: We illustrate a case of regression of an interhemispheric arachnoid cyst in a pediatric patient. To our knowledge, this is the first reported case of spontaneous shrinkage of an arachnoid cyst in this location. Although the current presentation is rare, this reporting adds to the current understanding of natural history of arachnoid cysts and provides an example of radiographical improvement without intervention of a cyst located within the interhemispheric fissure.


Assuntos
Cistos Aracnóideos , Remissão Espontânea , Humanos , Cistos Aracnóideos/diagnóstico por imagem , Feminino , Imageamento por Ressonância Magnética
13.
Childs Nerv Syst ; 40(8): 2257-2259, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38935301

RESUMO

PURPOSE: Access to the pineal region has always represented a fascinating challenge to the neurosurgeons. Almost equally thrilling is the historical evolution from the hard beginnings with extremely high mortality rates to the current surgical outcomes, with excellent resection rates without long-term morbidity for most of the patients. The purpose of this paper is to provide an overview of the historical evolution of the occipital interhemispheric transtentorial (OITT) approach and its role in the development of access to the pineal region. METHODS: Review of the literature highlights the occipital transtentorial approach from the historical context prior its description and the beginning to the current modifications and new recent insights. RESULTS: The occipital transtentorial approach described initially by Poppen in 1966 has played a key role in the progress and success accessing the pineal area. CONCLUSION: This historical review aims to highlight the extraordinary effort of those neurosurgeons who guided and led the development of one of the most important approaches to the pineal region.


Assuntos
Procedimentos Neurocirúrgicos , Glândula Pineal , Humanos , História do Século XX , Procedimentos Neurocirúrgicos/história , Procedimentos Neurocirúrgicos/métodos , Glândula Pineal/cirurgia , História do Século XXI , História do Século XIX , Lobo Occipital/cirurgia
14.
Childs Nerv Syst ; 40(8): 2483-2489, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38687362

RESUMO

PURPOSE: Coherence analysis in electroencephalography (EEG) allows measurement of the degree of consistency of amplitude between pairs of electrodes. Theoretically, disconnective epilepsy surgery should decrease coherence between corresponding areas. The study aimed to evaluate postoperative changes in interhemispheric coherence values after corpus callosotomy (CC). METHODS: Non-lesional, drug-resistant, generalized epilepsy patients who underwent total CC were retrospectively collected. To evaluate coherence, we divided the scalp interictal EEG into "baseline" and "discharge" states after excluding periods with artifacts. Interhemispheric coherence values were obtained between eight pairs of symmetrically opposite scalp electrodes in six different frequency bands. We analyzed both pre- and postoperative EEG sessions and calculated the percentage of difference (POD) in coherence values. RESULTS: We collected 13 patients and analyzed 2496 interhemispheric coherence values. Preoperative coherence values differed significantly between baseline and discharge states (p = 0.0003), but postoperative values did not (p = 0.11). For baseline state, coherence values were decreased after CC and median POD was - 22.3% (p < 0.0001). Delta frequency showed the most decreased POD (-44.3%, p = 0.0009). Median POD was lowest in the Fp1-Fp2 pair of electrodes. For discharge state, coherence values were decreased after CC and median POD was - 24.7% (p < 0.0001). Delta frequency again showed the most decreased POD (-55.9%, p = 0.0016). Median POD was lowest in the F7-F8 pair. CONCLUSION: After total CC, interhemispheric coherence decreased significantly in both baseline and discharge states. The most decreased frequency band was the delta band, which may be used as a representative frequency band in future studies.


Assuntos
Corpo Caloso , Eletroencefalografia , Epilepsia Generalizada , Couro Cabeludo , Humanos , Feminino , Eletroencefalografia/métodos , Masculino , Corpo Caloso/cirurgia , Corpo Caloso/fisiopatologia , Criança , Adolescente , Estudos Retrospectivos , Pré-Escolar , Epilepsia Generalizada/cirurgia , Epilepsia Generalizada/fisiopatologia , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia Resistente a Medicamentos/fisiopatologia
15.
Childs Nerv Syst ; 40(8): 2367-2372, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38856743

RESUMO

INTRODUCTION: Outcomes for pineal region and superior cerebellar tumors in young children often hinge on extent of microsurgical resection, and thus choosing an approach that provides adequate visualization of pathology is essential. The occipital interhemispheric transtentorial (OITT) approach provides excellent exposure while minimizing cerebellar retraction. However, this approach has not been widely accepted as a viable option for very young children due to concerns for potential blood loss when incising the tentorium. The aim of this paper is to characterize our recent institutional experience with the occipital interhemispheric transtentorial approach (OITT) for tumor resection in infants and toddlers. METHODS: A retrospective study was performed between 2016 and 2023 of pediatric patients less than 36 months of age who underwent OITT for tumor resection at a high-volume referral center. Patients with at least 3 months of postoperative follow-up and postoperative MRI were included. Primary outcomes included extent of resection, intraoperative and postoperative complications, and neurologic outcome. Secondary outcomes included length of stay and estimated blood loss. RESULTS: Eight patients, five male, were included. The median age at the time of surgery was 10 months (range 5-36 months). Presenting symptoms included macrocephaly, nausea/vomiting, strabismus, gait instability, or milestone regression. Hydrocephalus was present preoperatively in all patients. Average tumor volume was 38.6 cm3, ranging from 1.3 to 71.9 cm3. All patients underwent an OITT approach for tumor resection with stereotactic guidance. No intraoperative complications occurred, and no permanent neurologic deficits developed postoperatively. Gross total resection was achieved in all cases per postoperative MRI report, and no instances of new cerebellar, brainstem, or occipital lobe ischemia were noted. CONCLUSIONS: OITT approach for tumor resection in very young children (≤ 36 months) is an effective strategy with an acceptable safety profile. In our series, no significant intraoperative or postoperative complications occurred. To our knowledge, this is the first report describing this technique specifically in patients less than 36 months of age.


Assuntos
Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias , Humanos , Lactente , Masculino , Feminino , Estudos Retrospectivos , Pré-Escolar , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Neoplasias Cerebelares/cirurgia , Neoplasias Encefálicas/cirurgia , Pinealoma/cirurgia
16.
Neurosurg Rev ; 47(1): 366, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39069603

RESUMO

The surgical management of anterior communicating artery aneurysms (AcomA) is challenging due to their deep midline position and proximity to complex skull base anatomy. This study compares the pterional craniotomy with the interhemispheric approach based on the specific aneurysm angulation. A total of 129 AcomA cases were analyzed, with 50 undergoing microsurgical clipping via either the pterional or interhemispheric approach. All selected cases had computed tomography-angiography with sagittal imaging slices and 2D-angiography. Using an interactive tool, 14 cases treated via the interhemispheric approach were matched with 14 cases approached pterionally based on clinical and morphological parameters, emphasizing intracranial aneurysm (IA) dome angulation relative to the frontal skull base. Outcomes included IA occlusion, temporary clipping incidence, intraoperative rupture, postoperative strokes, hemorrhages, hydrocephalus, vasospasm, and patient functionality. Matched cohorts had consistent demographics. Both approaches resulted in similar IA occlusion rates, but the interhemispheric approach led to improved clinical outcomes, measured by the modified Rankin Scale. It also had a lower incidence of hydrocephalus and reduced need for permanent ventriculoperitoneal shunt placement. Vasospasms and postoperative infarction rates were comparable between the groups. Our findings suggest potential advantages of the interhemispheric approach in managing AcomA, depending on aneurysm angulation. Despite a small sample size, the results highlight the importance of customized surgical decision-making based on the unique traits of each aneurysm and the surgeon's expertise.


Assuntos
Aneurisma Intracraniano , Microcirurgia , Procedimentos Neurocirúrgicos , Humanos , Aneurisma Intracraniano/cirurgia , Masculino , Feminino , Pessoa de Meia-Idade , Microcirurgia/métodos , Idoso , Procedimentos Neurocirúrgicos/métodos , Adulto , Craniotomia/métodos , Resultado do Tratamento , Angiografia Cerebral , Angiografia por Tomografia Computadorizada
17.
Acta Neurochir (Wien) ; 166(1): 220, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38761276

RESUMO

PURPOSE: To improve postoperative outcome in middle third falcine meningiomas by cortical venous preservation. BACKGROUND: Falcine meningiomas arise from the falx and do not involve the superior sagittal sinus (SSS). Their complete resection is often associated with the risk of venous infarction in the eloquent cortex due to overlying superficial cortical veins on the tumors. METHOD: We report one case of middle third falcine meningioma, where we used the posterior interhemispheric corridor for tumor approach. CONCLUSION: Use of the posterior interhemispheric approach, carefully raised bone flap, along with sharp dissection and vein reinforcement using fibrin glue can help to preserve the cortical veins while resecting the falcine meningiomas.


Assuntos
Neoplasias Meníngeas , Meningioma , Humanos , Córtex Cerebral/cirurgia , Córtex Cerebral/irrigação sanguínea , Veias Cerebrais/cirurgia , Veias Cerebrais/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/cirurgia , Meningioma/diagnóstico por imagem , Procedimentos Neurocirúrgicos/métodos , Resultado do Tratamento
18.
J Neurosci ; 42(37): 7060-7076, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-35953294

RESUMO

In nonhuman primates, major input to the striatum originates from ipsilateral cortex and thalamus. The striatum is a target also of crossed corticostriatal (CSt) projections from the contralateral hemisphere, which have been so far somewhat neglected. In the present study, based on neural tracer injections in different parts of the striatum in macaques of either sex, we analyzed and compared qualitatively and quantitatively the distribution of labeled CSt cells in the two hemispheres. The results showed that crossed CSt projections to the caudate and the putamen can be relatively robust (up to 30% of total labeled cells). The origin of the direct and the crossed CSt projections was not symmetrical as the crossed ones originated almost exclusively from motor, prefrontal, and cingulate areas and not from parietal and temporal areas. Furthermore, there were several cases in which the contribution of contralateral areas tended to equal that of the ipsilateral ones. The present study is the first detailed description of this anatomic pathway of the macaque brain and provides the substrate for bilateral distribution of motor, motivational, and cognitive signals for reinforcement learning and selection of actions or action sequences, and for learning compensatory motor strategies after cortical stroke.SIGNIFICANCE STATEMENT In nonhuman primates the striatum is a target of projections originating from the contralateral hemisphere (crossed CSt projections), which have been so far poorly investigated. The present study analyzed qualitatively and quantitatively in the macaque brain the origin of the crossed CSt projections compared with those originating from the ipsilateral hemisphere. The results showed that crossed CSt projections originate mostly from frontal and rostral cingulate areas and in some cases their contribution tended to equal that from ipsilateral areas. These projections could provide the substrate for bilateral distribution of motor, motivational, and cognitive signals for reinforcement learning and action selection, and for learning compensatory motor strategies after cortical stroke.


Assuntos
Macaca , Acidente Vascular Cerebral , Animais , Mapeamento Encefálico , Corpo Estriado , Vias Neurais , Putamen
19.
J Proteome Res ; 22(4): 1043-1055, 2023 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-36317652

RESUMO

Post-translational modifications (PTMs) are one of the compulsive and predominant biological processes that regulate the diverse molecular mechanism, modulate the onset of disease, and are the reason behind the functional diversity of proteins. Despite the widespread research findings in neuroproteomics, one of the key drawbacks has been the lack of proteome-level knowledge of hemispheric lateralization. We have investigated the proteome level expression in different neuroanatomical regions under the Human Brain Proteome Project (HBPP) and developed the global interhemispheric brain proteome map (Brainprot) earlier. Furthermore, this study has extended to decipher the phosphoproteome map of human brain interhemispheric regions through high-resolution mass spectrometry. The phosphoproteomics examination of 12 unique interhemispheric neurological brain regions using Orbitrap fusion liquid chromatography with tandem mass spectrometry provided comprehensive coverage of 996 phosphoproteins, 2010 phosphopeptides, and 3567 phosphosites. Moreover, interhemispheric phosphoproteome profiling has been categorized according to synaptic ontologies and interhemispheric expression to understand the functionality. Finally, we have integrated the phosphosites data under the PhosphoMap section in the Inter-Hemispheric Brain Proteome Map Portal (https://www.brainprot.org/) for the advancement and support of the ongoing neuroproteomics research worldwide. Data is available via ProteomeXchange with the identifier PXD031188.


Assuntos
Proteoma , Espectrometria de Massas em Tandem , Humanos , Proteoma/genética , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida/métodos , Processamento de Proteína Pós-Traducional , Encéfalo/metabolismo , Fosfoproteínas/metabolismo , Fosfopeptídeos/análise
20.
J Neurophysiol ; 130(6): 1444-1456, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37964746

RESUMO

Human visuomotor control requires coordinated interhemispheric interactions to exploit the brain's functional lateralization. In right-handed individuals, the left hemisphere (right arm) is better for dynamic control and the right hemisphere (left arm) is better for impedance control. Table tennis is a game that requires precise movements of the paddle, whole body coordination, and cognitive engagement, providing an ecologically valid way to study visuomotor integration. The sport has many different types of strokes (e.g., serve, return, and rally shots), which should provide unique cortical dynamics given differences in the sensorimotor demands. The goal of this study was to determine the hemispheric specialization of table tennis serving - a sequential, self-paced, bimanual maneuver. We used time-frequency analysis, event-related potentials, and functional connectivity measures of source-localized electrocortical clusters and compared serves with other types of shots, which varied in the types of movement required, attentional focus, and other task demands. We found greater alpha (8-12 Hz) and beta (13-30 Hz) power in the right sensorimotor cortex than in the left sensorimotor cortex, and we found a greater magnitude of spectral power fluctuations in the right sensorimotor cortex for serve hits than return or rally hits, in all right-handed participants. Surprisingly, we did not find a difference in interhemispheric functional connectivity between a table tennis serve and return or rally hits, even though a serve could arguably be a more complex maneuver. Studying real-world brain dynamics of table tennis provides insight into bilateral sensorimotor integration.NEW & NOTEWORTHY We found different spectral power fluctuations in the left and right sensorimotor cortices during table tennis serves, returns, and rallies. Our findings contribute to the basic science understanding of hemispheric specialization in a real-world context.


Assuntos
Córtex Sensório-Motor , Tênis , Humanos , Mãos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA