Evaluation of the effects of the Zika Virus-Immunoglobulin G+ complex on murine microglial cells.

After the Zika virus (ZIKV) epidemic in Brazil, ZIKV infections were linked to damage to the central nervous system (CNS) and congenital anomalies. Due to the virus's ability to cross the placenta and reach brain tissue, its effects become severe, leading to Congenital Zika Syndrome (CZS) and resulting in neuroinflammation, microglial activation, and secretion of neurotoxic factors. The presence of ZIKV triggers an inadequate fetal immune response, as the fetus only has the protection of maternal antibodies of the Immunoglobulin G (IgG) class, which are the only antibodies capable of crossing the placenta. Because of limited understanding regarding the long term consequences of ZIKV infection and the involvement of maternal antibodies, this study sought to assess the impact of the ZIKV + IgG⁺complex on murine microglial cells. The cells were exposed to ZIKV, IgG antibodies, and the ZIKV + IgG⁺complex for 24 and 72 h. Treatment-induced cytotoxic effects were evaluated using the cell viability assay, oxidative stress, and mitochondrial membrane potential. The findings indicated that IgG antibodies exhibit cytotoxic effects on microglia, whether alone or in the presence of ZIKV, leading to compromised cell viability, disrupted mitochondrial membrane potential, and heightened oxidative damage. Our conclusion is that IgG antibodies exert detrimental effects on microglia, triggering their activation and potentially disrupting the creation of a neurotoxic environment. Moreover, the presence of antibodies may correlate with an elevated risk of ZIKV-induced neuroinflammation, contributing to long-term CNS damage.

Epileptogenesis and drug-resistant in focal cortical dysplasias: Update on clinical, cellular, and molecular markers.

Focal cortical dysplasia (FCD) is a cortical malformation in brain development and is considered as one of the major causes of drug-resistant epilepsiesin children and adults. The pathogenesis of FCD is yet to be fully understood. Imaging markers such as MRI are currently the surgeons major obstacle due to the difficulty in delimiting the precise dysplasic area and a mosaic brain where there is epileptogenic tissue invisible to MRI. Also increased gene expression and activity may be responsible for the alterations in cell proliferation, migration, growth, and survival. Altered expressions were found, particularly in the PI3K/AKT/mTOR pathway. Surgery is still considered the most effective treatment option, due to drug-resistance, and up to 60 % of patients experience complete seizure control, varying according to the type and location of FCD. Both genetic and epigenetic factors may be involved in the pathogenesis of FCD, and there is no conclusive evidence whether these alterations are inherited or have an environmental origin.

Anatomical Organization of the Amygdala: A Brief Visual Review.

The amygdala consists of a collection of nuclei that are deep within the medial temporal lobe. Despite its small size, the amygdala is one of the most densely connected structures in the brain, and it plays a role in many superior neural functions, including neurovegetative control, motor control, memory processing, and neuromodulation. Advances in neuroimaging technology for examining brain activity have opened up new ways of understanding the functional contribution of this structure to emotions, learning, and related memories. Many studies have shown that the amygdala plays a key role in the pathophysiology of neuropsychiatric disorders, such as anxiety disorders, depression, aggression, and temporal epilepsy. This article reviews the anatomical structure of the amygdaloid complex and the connectivity among its subdivisions and with other brain structures, which will serve as a basis for understanding the clinical correlations.

Endoscopic Transsphenoidal Surgery of Pituitary Adenomas: Preliminary Results of the Neurosurgery Service of Hospital Cristo Redentor / Cirurgia endoscópica transesfenoidal de adenomas pituitários: resultados preliminares do Serviço de Neurocirurgia do Hospital Cristo Redentor

Objective The transsphenoidal surgery is a safe and effective technique to manage different skull base pathologies, such as pituitary adenomas. The purpose of the present study is to describe the initial experience with endoscopic transsphenoidal surgery in the treatment of pituitary adenoma patients at a tertiary hospital that is a reference in neurosurgery in Southern Brazil. Materials and Methods We retrospectively analyzed data from 60 patients with pituitary adenoma who underwent endoscopic transsphenoidal surgery between 2012 and 2019. Demographic characteristics, type of tumor, baseline hormonal changes, and clinical presentation were reported, as well as postoperative outcomes, tumor resection rate, and complications. Results The male/female ratio was of 0.53:1, and the mean age of the sample was of 54 (range: 26 to 79) years. In total, 34 patients (57%) presented the non-functioning adenoma subtype, and 26 (43%), the functioning adenoma subtype. In the non-functioning and functioning subtype groups, the average tumor diameter was of 32 mm and 18 mm, and the mean follow-up was of 27 months and 32 months respectively. Regarding visual symptoms, 79% of the patients showed improvement after surgery. Hormonal remission was achieved in 71% of the patients with prolactinoma, 85% of those with cushing, and 57% of patients with acromegaly. Overall, gross total resection (GTR) was achieved in 50% of patients but with a significantly lower rate among patients with tumors with parasellar growth (high grade on the Knosp classification). The most prevalent surgical complications observed were postoperative cerebrospinal fluid (CSF) leak and meningitis in 11% and 6% of the cases respectively. Conclusion We have shown that transsphenoidal endoscopic surgery can produce good results in the management of pituitary adenomas, with acceptable peri- and postoperative morbidity and mortality. Regardless of the technique used, the presence of large and giant pituitary adenomas with a high Knosp grade represents an enormous challenge for contemporary neurosurgery.

Objetivo A cirurgia transesfenoidal é uma técnica segura e eficaz para o tratamento de patologias da base do crânio, como os adenomas hipofisários. O objetivo deste estudo é demonstrar a experiência inicial com a cirurgia endoscópica transesfenoidal no tratamento de pacientes com adenoma hipofisário em hospital terciário, referência em neurocirurgia no Sul do Brasil. Materiais e Métodos Analisamos retrospectivamente os dados de 60 pacientes com adenoma hipofisário submetidos à cirurgia endoscópica transesfenoidal entre 2012 e 2019. Características demográficas, tipo de tumor, alterações hormonais basais e apresentação clínica foram relatadas, bem como evolução pós-operatória, grau de ressecção tumoral e complicações. Resultados A proporção homem/mulher foi de 0.53:1, e a idade média da amostra foi de 54 (variação: 26 a 79) anos. Ao todo, 34 pacientes (57%) tinham o subtipo funcional de adenoma, e 26 (43%), o subtipo não funcional de adenoma. Nos grupos não funcional e funcional, o diâmetro médio do tumor foi de 32 mm e 18 mm, e o tempo médio de acompanhamento foi de 27 meses e 32 meses, respectivamente. Em relação aos sintomas visuais, 79% dos pacientes apresentaram melhora após a cirurgia. A remissão hormonal foi alcançada em 71% dos pacientes com adenomas secretores de prolactina, em 85% daqueles com adenomas secretores de hormônio adrenocorticotrófico e em 57% dos pacientes com adenomas secretores de hormônio do crescimento. A ressecção total foi obtida em 50% dos pacientes, mas com taxa significativamente menor em pacientes com tumores com crescimento parasselar (grau elevado na classificação de Knosp). As complicações cirúrgicas mais prevalentes observadas foram fístula liquórica pós-operatória e meningite, em 11% e 6% dos casos, respectivamente. Conclusão Demostramos que a cirurgia endoscópica transesfenoidal pode produzir bons resultados no manejo de adenomas hipofisários, com aceitável morbimortalidade peri e pós-operatória. Independentemente da técnica utilizada, a presença de adenomas hipofisários grandes e gigantes com grau de Knosp elevado representa um enorme desafio para a neurocirurgia contemporânea.

Case Report: Placental Maternal Vascular Malperfusion Affecting Late Fetal Development and Multiorgan Infection Caused by SARS-CoV-2 in Patient With PAI-1 4G/5G Polymorphism.

Background: Pregnant women are susceptible to the novel coronavirus (SARS-CoV-2), and the consequences for the fetus are still uncertain. Here, we present a case of a pregnant woman with subclinical hypothyroidism and a plasminogen activator inhibitor type 1 (PAI-1) 4G/5G polymorphism who was infected with SARS-CoV-2 at the end of the third trimester of pregnancy, with unexpected evolution of death of the newborn 4 days postpartum. Methods: Nested PCR was performed to detect the virus, followed by ssDNA sequencing. Results: Transplacental transmission of SARS-CoV-2 can cause placental inflammation, ischemia, and neonatal viremia, with complications such as preterm labor and damage to the placental barrier in patients with PAI-1 4G/5G polymorphism. Conclusion: We showed a newborn with several damages potentially caused due to the PAI-1 polymorphisms carried by the mother infected with SARS-CoV-2 during pregnancy.