Isoliquiritin exert protective effect on telencephalon infarction injury by regulating multi-pathways in zebrafish model of ischemic stroke.

BACKGROUND: Ischemic stroke is a multifactorial disease contributing to mortality and neurological dysfunction. Isoliquiritin (ISL) has been reported to possess a series of pharmacological activities including antioxidant, anti-inflammatory, antifungal, anti-depression, anti-neurotoxicity and pro-angiogenesis activities but whether it can be used for ischemic stroke treatment remains unknown. PURPOSE: The goal of this study is to explore its therapeutic effect on ischemic stroke and demonstrated the potential mechanism of ISL in zebrafish model. METHODS: Using the photothrombotic-induced adult zebrafish model of ischemic stroke, we visualized the telencephalon (Tel) and optic tectum (OT) infarction injury at 24 h post-light exposure for 30 min by TTC and H&E staining. The effect of ISL on neurological deficits was analyzed during open tank swimming by video tracking. The antioxidant activity against ischemia injury was quantified by SOD, GSH-Px and MDA assay. Transcriptome analysis of zebrafish Tel revealed how ISL regulating gene expression to exert protective effect, which were also been validated by real-time quantitative PCR assays. RESULTS: We found for the first time that the Tel tissue was the first damaged site of the whole brain and it showed more sensitivity to the brain ischemic damage compared to the OT. ISL reduced the rate of Tel injury, ameliorated neurological deficits as well as counteracted oxidative damages by increasing SOD, GSH-Px and decreasing MDA activity. GO enrichment demonstrated that ISL protected membrane and membrane function as well as initiate immune regulation in the stress response after ischemia. KEGG pathway analysis pointed out that immune-related pathways, apoptosis as well as necroptosis pathways were more involved in the protective mechanism of ISL. Furthermore, the log2 fold change in expression pattern of 25 genes detected by qRT-PCR was consistent with that by RNA-seq. CONCLUSIONS: Tel was highly sensitive to the brain ischemia injury in zebrafish model of ischemic stroke. ISL significantly exerted protective effect on Tel injury, neurological deficits and oxidative damages. ISL could regulate a variety of genes related to immune, apoptosis and necrosis pathways against complex cascade reaction after ischemia. These findings enriched the study of ISL, making it a novel multi-target agent for ischemic stroke treatment.

Prenatal alcohol exposure is a leading cause of interneuronopathy in humans.

Alcohol affects multiple neurotransmitter systems, notably the GABAergic system and has been recognised for a long time as particularly damaging during critical stages of brain development. Nevertheless, data from the literature are most often derived from animal or in vitro models. In order to study the production, migration and cortical density disturbances of GABAergic interneurons upon prenatal alcohol exposure, we performed immunohistochemical studies by means of the proliferation marker Ki67, GABA and calretinin antibodies in the frontal cortical plate of 17 foetal and infant brains antenatally exposed to alcohol, aged 15 weeks' gestation to 22 postnatal months and in the ganglionic eminences and the subventricular zone of the dorsal telencephalon until their regression, i.e., 34 weeks' gestation. Results were compared with those obtained in 17 control brains aged 14 weeks of gestation to 35 postnatal months. We also focused on interneuron vascular migration along the cortical microvessels by confocal microscopy with double immunolabellings using Glut1, GABA and calretinin. Semi-quantitative and quantitative analyses of GABAergic and calretininergic interneuron density allowed us to identify an insufficient and delayed production of GABAergic interneurons in the ganglionic eminences during the two first trimesters of the pregnancy and a delayed incorporation into the laminar structures of the frontal cortex. Moreover, a mispositioning of GABAergic and calretininergic interneurons persisted throughout the foetal life, these cells being located in the deep layers instead of the superficial layers II and III. Moreover, vascular migration of calretininergic interneurons within the cortical plate was impaired, as reflected by low numbers of interneurons observed close to the cortical perforating vessel walls that may in part explain their abnormal intracortical distribution. Our results are globally concordant with those previously obtained in mouse models, in which alcohol has been shown to induce an interneuronopathy by affecting interneuron density and positioning within the cortical plate, and which could account for the neurological disabilities observed in children with foetal alcohol disorder spectrum.

Main lesions in the central nervous system of dogs due to Leishmania infantum infection.

BACKGROUND: Canine visceral leishmaniasis (CVL) is endemic in São Luís Maranhão/Brazil and it leads a varied clinical picture, including neurological signs. RESULTS: Histopathological evaluation showed that 14 dogs exhibited pathological alterations in at least one of the analyzed areas. Of these, mononuclear inflammatory reaction was the most frequent, although other lesions, such as hemorrhage, chromatolysis and gliosis were also observed. The presence of L. infantum amastigotes was confirmed in eight dogs, identified in four regions: telencephalon, hippocampus, thalamus and caudal colliculus, but only one presented neurological signs. Polymerase chain reaction results detected the DNA of the parasite in 11 samples from seven dogs. The positive areas were the telencephalon, thalamus, hippocampus, cerebellum, caudal and rostral colliculus. CONCLUSION: These results reveal that during canine visceral leishmaniasis, the central nervous system may display some alterations, without necessarily exhibiting clinical neurological manifestations. In addition, the L. infantum parasite has the ability to cross the blood brain barrier and penetrate the central nervous system.

The ciliogenic transcription factor Rfx3 is required for the formation of the thalamocortical tract by regulating the patterning of prethalamus and ventral telencephalon.

Primary cilia are complex subcellular structures that play key roles during embryogenesis by controlling the cellular response to several signaling pathways. Defects in the function and/or structure of primary cilia underlie a large number of human syndromes collectively referred to as ciliopathies. Often, ciliopathies are associated with mental retardation (MR) and malformation of the corpus callosum. However, the possibility of defects in other forebrain axon tracts, which could contribute to the cognitive disorders of these patients, has not been explored. Here, we investigate the formation of the corticothalamic/thalamocortical tracts in mice mutant for Rfx3, which regulates the expression of many genes involved in ciliogenesis and cilia function. Using DiI axon tracing and immunohistochemistry experiments, we show that some Rfx3(-/-) corticothalamic axons abnormally migrate toward the pial surface of the ventral telencephalon (VT). Some thalamocortical axons (TCAs) also fail to leave the diencephalon or abnormally project toward the amygdala. Moreover, the Rfx3(-/-) VT displays heterotopias containing attractive guidance cues and expressing the guidance molecules Slit1 and Netrin1. Finally, the abnormal projection of TCAs toward the amygdala is also present in mice carrying a mutation in the Inpp5e gene, which is mutated in Joubert Syndrome and which controls cilia signaling and stability. The presence of identical thalamocortical malformations in two independent ciliary mutants indicates a novel role for primary cilia in the formation of the corticothalamic/thalamocortical tracts by establishing the correct cellular environment necessary for its development.

Characterization of antioxidant protection of cultured neural progenitor cells (NPC) against methylmercury (MeHg) toxicity.

Methylmercury (MeHg) is an environmental pollutant known to cause neurobehavioral defects and is especially toxic to the developing brain. With recent studies showing that fetal exposure to low-dose MeHg causes developmental abnormalities, it is therefore important to find ways to combat its effects as well as to clarify the mechanism(s) underlying MeHg toxicity. In the present study, the effects of MeHg on cultured neural progenitor cells (NPC) derived from mouse embryonic brain were investigated. We first confirmed the vulnerability of embryonic NPC to MeHg toxicity, NPC from the telencephalon were more sensitive to MeHg compared to those from the diencephalon. Buthionine sulfoximine (BSO) which is known to inhibit glutathione synthesis accelerated MeHg toxicity. Furthermore, antioxidants such as N-acetyl cysteine and alpha-tocopherol dramatically rescued the NPC from MeHg's toxic effects. Interestingly, a 12 hr delay in the addition of either antioxidant was still able to prevent the cells from undergoing cell death. Although it is now difficult to avoid MeHg exposure from our environment and contaminated foods, taking anti-oxidants from foods or supplements may prevent or diminish the toxicological effects of MeHg.

Vimentin-immunopositive cells in the rat telencephalon after experimental ischemic stroke.

The aim of the present work was to perform immunocytochemical studies of cells synthesizing the intermediate filament protein vimentin in the telencephalon of intact rats and rats subjected to unilateral permanent occlusion of the middle cerebral artery, which models ischemic stroke. In the intact rat brain, vimentin-containing cells were seen in the brain barriers. At 14 days from occlusion of the middle cerebral artery, there were numerous vimentin-immunopositive cells in the perifocal damage zone, and these accounted for a significant proportion of the cells in the regenerating nervous tissue at the boundary with undamaged tissue. The subependymal proliferative zone contained a significant number of vimentin-negative small cells, located between the long processes of vimentin-immunopositive cells running towards the lesioned zone. These data provide evidence of the predominant location of vimentin-immunopositive brain cells (in both intact and lesioned animals) in the zones forming barrier structures.

Structural brain magnetic resonance imaging of limbic and thalamic volumes in pediatric bipolar disorder.

BACKGROUND: Youths with bipolar disorder are ideal for studying illness pathophysiology given their early presentation, lack of extended treatment, and high genetic loading. Adult bipolar disorder MRI studies have focused increasingly on limbic structures and the thalamus because of their role in mood and cognition. On the basis of adult studies, the authors hypothesized a priori that youths with bipolar disorder would have amygdalar, hippocampal, and thalamic volume abnormalities. METHOD: Forty-three youths 6-16 years of age with DSM-IV bipolar disorder (23 male, 20 female) and 20 healthy comparison subjects (12 male, eight female) similar in age and sex underwent structured and clinical interviews, neurological examination, and cognitive testing. Differences in limbic and thalamic brain volumes, on the logarithmic scale, were tested using a two-way (diagnosis and sex) univariate analysis of variance, with total cerebral volume and age controlled. RESULTS: The subjects with bipolar disorder had smaller hippocampal volumes. Further analysis revealed that this effect was driven predominantly by the female bipolar disorder subjects. In addition, both male and female youths with bipolar disorder had significantly smaller cerebral volumes. No significant hemispheric effects were seen. CONCLUSIONS: These findings support the hypothesis that the limbic system, in particular the hippocampus, may be involved in the pathophysiology of pediatric bipolar disorder. While this report may represent the largest MRI study of pediatric bipolar disorder to date, more work is needed to confirm these findings and to determine if they are unique to pediatric bipolar disorder.

Neurorrehabilitación en esclerosis múltiple / Neurorehabilitation in multiple sclerosis

La neurorrehabilitación es, predominantemente, un proceso educativo y dinámico basado en la adaptación del individuo y su entorno al deterioro neurológico. El objetivo último del proceso neurorrehabilitador es disminuir el impacto de la enfermedad sobre el individuo para conseguir la mejor calidad de vida dentro de las limitaciones impuestas por el déficit neurológico. Se ha llegado a sugerir por algunos autores que la neurorrehabilitación es la única herramienta de que disponemos para disminuir las limitaciones en la actividad y las restricciones en la participación social de las personas con esclerosis múltiple. El enfoque neurorrehabilitador es holístico y debería constituir una parte fundamental de la atención neurológica; no debería ser olvidado por los neurólogos, especialmente en el trato de pacientes con enfermedades como la esclerosis múltiple. Junto al modelo social de discapacidad, el concepto de neurología restauradora, un intento científico y terapéutico de minimizar los problemas neurológicos más directamente responsables de la discapacidad presentada por la persona, está recientemente ganando terreno entre neurocientíficos y clinicos. En esta revisión se presentarán los fundamentos conceptuales de la neurorrehabilitación y se revisará la literatura concerniente a los aspectos biológicos de la terapia neurorrehabilitadora (neuroplasticidad) y a los ensayos clínicos que han evaluado la efectividad de la neurorrehabilitación en personas con esclerosis múltiple. Finalmente se revisará la literatura relativa al proceso rehabilitador enfocado desde la práctica clínica

Neurorehabilitation is predominantly an educational, dynamic process based on the adaptation of the individual and his environment to the actual neurological impairment and focuses on decreasing the impact of disabling neurological conditions on the individual in order to achieve optimum quality of life. It has been suggested by some that neurorehabilitation is the only approach available to us which can improve the limitations in activity and restrictions in social participation of people with multiple sclerosis. The neurorehabilitation approach is a holistic one and is a fundamental part of neurological care; it should not be forgotten by neurologists, especially when dealing with people with chronic disabling conditions such as multiple sclerosis. Together with the social model of disability, the concept of restorative neurology, as a scientific and therapeutic attempt to minimize those impairments directly responsible for the disability presented by the person, is recently gaining ground among neuroscientists and clinicians. In this review the conceptual basis for neurorehabilitation will be presented together with a review of the literature concerning the biological aspects of neurorehabilitative therapy (neuroplasticity) and the clinical trials evaluating the effectiveness of neurorehabilitation in people with multiple sclerosis. Finally, we will consider the practical aspects of neurorehabilitation

Macrocefalia como forma de presentación de la aciduria glutárica tipo 1. Importancia de un diagnóstico precoz / Macrocephaly in the first manifestation of glutaric aciduria type I: the importance of early diagnosis

Introducción. La aciduria glutárica tipo I (AG-I) habitualmente se presenta con un deterioro neurológico agudo en los primeros 2 años de vida con secuelas irreversibles. La macrocefalia progresiva puede ser una manifestación precoz de la enfermedad. Presentamos un caso diagnosticado en la fase presintomática, por estudio de macrocefalia, en el cual el tratamiento instaurado precozmente evitó las crisis encefalopáticas y el deterioro neurológico. Caso clínico. Varón de 9 meses de edad remitido por macrocefalia de 51 cm (> p97). El perímetro cefálico al nacimiento era de 37,5 cm (p97) y presentó un incremento acelerado durante los primeros 4 meses de vida. En la exploración física presentaba una discreta hipotonía axial sin otros hallazgos y desarrollo psicomotor normal. Exploraciones complementarias: ácidos orgánicos (o): glutárico: 78.000 mmolfmol creatinina (normal: 2-10); 3-hidroxiglutárico: 250 mmolfmol creatinina (normal: 1-12). Resonancia magnética (RM) cerebral a los 12 meses: atrofia frontotemporal con aumento del espacio subaracnoideo de predominio bitemporal, hiperintensidad en T2 en núcleos pálidos y hematomas subdurales bilaterales. Estudio genético: mutación S 305 L/Q 352 X. Se inició tratamiento con carnitina y riboflavina y dieta restringida en lisina y triptófano. Los procesos intercurrentes infecciosos o de intolerancia oral fueron tratados con aportes intravenosos de líquidos, glucosa y carnitina. Con 3 años y 6 meses no ha presentado crisis encefalopáticas y el desarrollo es normal sin distonías. La RM muestra atrofia de predominio temporal, sin alteraciones de núcleos de la base. Conclusiones. En la AG-I la macrocefalia con frecuencia precede al resto de las manifestaciones neurológicas. El tratamiento en la fase presintomática puede prevenir las crisis encefalopáticas, mejorar el pronóstico e incluso mantener al paciente asintomático. También las alteraciones neurorradiológicas de los núcleos de la base pueden desaparecer con el tratamiento precoz. Ante una macrocefalia de diagnóstico incierto debe realizarse un estudio de ácidos orgánicos en orina

Introduction. The clinical manifestations of glutaric aciduria type 1 (GA-I) usually develop during the first two years of life as acute encephalopathic crisis leading to irreversible dystonic. Progressive macrocephaly can be an early clinical signo We report a 9 month old patient with macrocephaly diagnosed of GA-I in the presyntomatic stage. This early diagnosis and treatment avoided the irreversible neurologic damage associated to this disease. Case report. A 9 month old male referred to the pediatrics neurology clinic because of macrocephaly with a head circumference of 51 cm (> 97th percentle). At birth this head circumference was 37.5 cm (97th percentile) and showed rapid growth during the first 4 months of life. In the physical exam there was ínild hypotonia and no other neurologic alterations with normal psychomotor development. In the work up for macrocephaly urinary organic acids were determined showing a glutaric acid: 78,000 mmolfmol creatinine (normal values: 2-10); 3-hydroxyglutaric acid: 250 mmolfmol creatinine (normal values: 1-12). Cerebral magnetic resonance (MR) performed at 12 months of age showed frontotemporal atrophy with enlargement of subarachnoid spaces, a high signal in T2 in the pallidus nucleus and subdural hematomas. Genetic analysis showed a mutation S 305 LfQ 352 X in GCDH gene. L-camitine and riboflavin supplementation and a diet with restriction of lysine and tryptophan was started. Intercurrent illnesses were treated with intravenous fluid, glucose and L-camitine. At 3 years and 6 month of age, he had not shown any encephalopathic crisis, he had a normal psychomotor development and no dystonia. MR shows mild temporal lobe atrophy without basal ganglia alterations. Conclusions. In GA-I, macrocephaly is an early sign before other neurologic alterations. In patients with little or no neurological symptoms, early treatment may prevent the acute encephalopathic crisis and neurological deterioration, improving the prognosis and may also normalize the basal ganglia neuroradiological alterations. Urinary organic acid analysis should be performed in the work up of macrocephaly of unknown aetiology

Clinical and pathological aspects of experimental oleander (Nerium oleander) toxicosis in sheep.

Dried Nerium oleander leaves at single lethal dose of 110 mg/kg body weight were administered orally to six native male sheep. Clinical signs of toxicosis in sheep began to appear about 30 min after receiving the oleander and included decrease of the heart rate followed by cardiac pauses and tachyarrhythmias; ruminal atony, mild to moderate tympany, abdominal pain, polyuria and polakiuria. Electrocardiography revealed bradycardia, atrio-ventricular blocks, depression of S-T segments, ventricular premature beats and tachycardia, and ventricular fibrillation. Five sheep died within 4-12 h and one survived. At necropsy there were varying degrees of haemorrhages in different organs and gastroenteritis. Histopathological examination of tissue sections revealed myocardial degeneration and necrosis, degeneration and focal necrosis of hepatocytes, necrosis of tubular epithelium in kidneys, oedema in the lungs, and ischemic changes in the cerebrum.

Hypothalamic digoxin and hemispheric chemical dominance: relation to alcoholic addiction, alcoholic cirrhosis, and acquired hepatocerebral degeneration.

The isoprenoid pathway produces three key metabolites--endogenous digoxin (modulate tryptophan/tyrosine transport), dolichol (important in N -glycosylation of proteins), and ubiquinone (free radical scavenger). It was considered pertinent to assess the pathway in alcoholic addiction, alcoholic cirrhosis, and acquired hepatocerebral degeneration. Since endogenous digoxin can regulate neurotransmitter transport, the pathway was also assessed in individuals with differing hemispheric dominance to find out the role of hemispheric dominance in its pathogenesis. In the patient group there was elevated digoxin synthesis, increased dolichol and glycoconjugate levels, and low ubiquinone and elevated free radical levels. There was also an increase in tryptophan catabolites and a reduction in tyrosine catabolites as reduced endogenous morphine synthesis from tyrosine. There was an increase in cholesterol:phospholipid ratio and a reduction in glycoconjugate level of RBC membrane in these groups of patients. The same patterns were obtained in individuals with right hemispheric chemical dominance. Alcoholic cirrhosis, alcoholic addiction, and acquired hepatocerebral degeneration are associated with an upregulated isoprenoid pathway and elevated digoxin secretion from the hypothalamus. This can contribute to NMDA excitotoxicity and altered connective tissue/lipid metabolism important in its pathogenesis. Endogenous morphine deficiency plays a role in alcoholic addiction. Alcoholic cirrhosis, addiction, and acquired hepato -cerebral degeneration occur in right hemispheric chemically dominant individuals. Ninety percent of the patients with alcoholic addiction, alcoholic cirrhosis, and acquired hepatocerebral degeneration were right-handed and left hemispheric dominant by the dichotic listening test. However, their biochemical patterns were similar to those obtained in right hemispheric chemical dominance. Hemispheric chemical dominance is a different entity and has no correlation with handedness or the dichotic listening test.

Neuroprotection of creatine supplementation in neonatal rats with transient cerebral hypoxia-ischemia.

We hypothesized that creatine (Cr) supplementation would preserve energy metabolism and thus ameliorate the energy failure and the extent of brain edema seen after severe but transient cerebral hypoxia-ischemia (HI) in the neonatal rat model. Six-day-old (P6) rats received subcutaneous Cr monohydrate injections for 3 consecutive days (3 g/kg body weight/day), followed by 31P-magnetic resonance spectroscopy (MRS) at P9. In a second group, P4 rats received the same Cr dose as above for 3 days prior to unilateral common carotid artery ligation followed 1 h later by 100 min of hypoxia (8% O2) at P7. Rats were maintained at 37 degrees C rectal temperature until magnetic resonance imaging was performed 24 h after HI. Cr supplementation for 3 days significantly increased the energy potential, i.e. the ratio of phosphocreatine to beta-nucleotide triphosphate (PCr/betaNTP) and PCr/inorganic phosphate (PCr/Pi) as measured by 31P-MRS. Rats with hemispheric cerebral hypoxic-ischemic insult that had received Cr showed a significant reduction (25%) of the volume of edemic brain tissue compared with controls as calculated from diffusion-weighted images (DWI). Thus, prophylactic Cr supplementation demonstrated a significant neuroprotective effect 24 h after transient cerebral HI. We hypothesize that neuroprotection is probably due to the availability of a larger metabolic substrate pool leading to a reduction of the secondary energy failure because DWI has been reported to correlate with the PCr/Pi ratio in the acute phase of injury. Additional protection by Cr may be related to prevention of calcium overload, prevention of mitochondrial permeability transition pore opening and direct antioxidant effects.

Neurons lacking huntingtin differentially colonize brain and survive in chimeric mice.

To determine whether neurons lacking huntingtin can participate in development and survive in postnatal brain, we used two approaches in an effort to create mice consisting of wild-type cells and cells without huntingtin. In one approach, chimeras were created by aggregating the 4-8 cell embryos from matings of Hdh (+/-) mice with wild-type 4-8 cell embryos. No chimeric offspring that possessed homozygous Hdh (-/-) cells were obtained thereby, although statistical considerations suggest that such chimeras should have been created. By contrast, Hdh (-/-) ES cells injected into blastocysts yielded offspring that were born and in adulthood were found to have Hdh (-/-) neurons throughout brain. The Hdh (-/-) cells were, however, 5-10 times more common in hypothalamus, midbrain, and hindbrain than in telencephalon and thalamus. Chimeric animals tended to be smaller than wild-type littermates, and chimeric mice rich in Hdh (-/-) cells tended to show motor abnormalities. Nonetheless, no brain malformations or pathologies were evident. The apparent failure of aggregation chimeras possessing Hdh (-/-) cells to survive to birth is likely attributable to the previously demonstrated critical role of huntingtin in extraembryonic membranes. That Hdh (-/-) cells in chimeric mice created by blastocyst injection are under-represented in adult telencephalon and thalamus implies a role for huntingtin in the development of these regions, whereas the neurological dysfunction in brains enriched in Hdh (-/-) cells suggests a role for huntingtin in adult brain. Nonetheless, the lengthy survival of Hdh (-/-) cells in adult chimeric mice indicates that individual neurons in many brain regions do not require huntingtin to participate in normal brain development and to survive.

Apoptosis in the central nervous system of cerebral adrenoleukodystrophy patients.

The childhood cerebral form of adrenoleukodystrophy (ALD) is a fatal demyelinating disease, yet mice deficient in the ALD gene do not show such clinicopathological phenotype. We have therefore investigated in human autopsy tissues whether the ALD gene mutation results in apoptosis of CNS cells. Specimens from telencephalic and brainstem regions of four patients, and three controls were examined for internucleosomal DNA fragmentation, in situ detection of DNA breaks by the TUNEL method, and caspase-3 immunostaining. None of the controls showed significant apoptosis in white matter, while apoptotic nuclei with chromatin alterations were detected in areas of active demyelination in three ALD patients. A large proportion of apoptotic cells were oligodendrocytes and some express activated caspase-3. TUNEL-positive nuclei and/or caspase-3 staining were also detected in perivascular infiltrates and, occasionally, in neurons. We conclude that apoptosis of oligodendrocytes may account, at least in part, for the demyelinating process in the ALD brain.

Calcificaciones cerebrales en la enfermedad celíaca. Diagnóstico diferencial con el síndrome de Sturge-Weber atípico / Intracranial calcifications in celiac disease: inclusion of atypical Sturge-Weber syndrome in the differential diagnosis

En la última década se ha descrito la asociación entre enfermedad celíaca, epilepsia y calcificaciones cerebrales. La morfología y localización de estas calcificaciones son similares a las observadas en el síndrome de Sturge-Weber, por lo que muchos pacientes epilépticos con enfermedad celíaca silente han sido diagnosticados de síndrome de Sturge-Weber atípico. Presentamos un caso de enfermedad celíaca en un varón de 35 años de edad que mostró calcificaciones cerebrales, haciendo hincapié en los signos radiológicos que ayudan al diagnóstico diferencial con el síndrome de Sturge-Weber atípico. La instauración temprana del tratamiento adecuado (dieta sin gluten), mejora en muchos casos el cuadro clínico epiléptico, lo que da mayor relevancia al diagnóstico (AU)

Grupo de cuidador primario de daño cerebral: una perspectiva de análisis / Group of primary nursing of brain harm: a prospect of analysis

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Transfusión en la cirugía intracraneal / Transfusion in intracraneal surgery

Fundamentos: Analizar la transfusión en los pacientes de cirugía intracraneal a partir de los datos del Conjunto Mínimo Básico de Datos del paciente. Métodos: Informes de alta de los pacientes intervenidos durante 1996, codificados según la Clasificación Internacional de Enfermedades (CIE-9-MC), evaluando: edad, sexo, los códigos de diagnósticos, de procedimientos, incluidas las transfusiones, y los códigos de las intervenciones quirúrgicas. Resultados: Fueron operados 203 pacientes, de los que se transfundieron 19 (9.4 por ciento). El mayor riesgo de transfusión ocurre en los pacientes con fractura de cráneo (18.5 por ciento), hemorragias intracraneales (12.1 por ciento) y tumoraciones benignas (10.3 por ciento). Mediante análisis univariante, se detecta una asociación estadísticamente significativa de la transfusión con el diagnóstico (p: 0.049), número de diagnósticos codificados (p: 0.049) y de técnicas quirúrgicas codificadas (p: 0.018), posibles indicadores indirectos de la severidad clínica y quirúrgica. Sin embargo mediante el análisis multivariante de regresión logística no se detectó ninguna asociación ajustada de las variables estudiadas con el riesgo de transfusión. Conclusiones: 1º Aunque no hemos podido encontrar un modelo predictor del riesgo de transfusión, este es mayor en los pacientes con fractura de cráneo, hemorragias intracraneales y tumores benignos. 2º Es coste-efectivo el poder monitorizar las transfusiones a partir de los datos administrativos del hospital, dada su fácil disponibilidad y los beneficios del análisis de los mismos. 3º Son necesarios ulteriores estudios para intentar definir con exactitud el subgrupo de los pacientes con mayor riesgo a priori de ser transfundido en la cirugía intracraneal (AU)

Neural bases of song preferences in female zebra finches (Taeniopygia guttata).

We examined the neural bases of song preferences in female zebra finches (Taeniopygia guttata). Females performed more courtship displays in response to conspecific songs than to heterospecific songs. Following electrolytic lesion to the HVc (sometimes referred to as high vocal center), females maintained normal song preferences. However, following lesion to cHV (caudal hyperstriatum ventrale, an auditory area) females performed courtship displays at high rates in response to both conspecific and heterospecific song. Thus cHV, but not HVc, must be intact for female zebra finches to exhibit normal song preferences. Differences between this study and those showing HVc lesions disrupting song preferences in female canaries (Serinus canaria) indicate interspecific variation in the function of HVc in female songbirds.

Seizures can be triggered by stimulating non-cortical structures in the quaking mutant mouse.

Mutant Quaking mice (C57BL/6J) display convulsive tonic-clonic seizures that can be either spontaneous or triggered by manipulation of the animal or by auditory stimulation. Several abnormalities have been found (especially in the noradrenergic system) in the brainstem of this mutant strain. We first verified by electrophysiological recording that the cerebral cortex was not involved in the generation or in the development of these fits. Then we showed that tonic-clonic seizures similar to those obtained in the freely moving animal were triggered by low-threshold (LT, 5-50 microA) or high-threshold (HT, 55-150 microA) stimuli performed during head restraint. LT stimuli were mostly efficient in a number of ponto-bulbar and mesencephalic structures, including several reticular nuclei, the locus coeruleus, the nucleus subcoeruleus and the red nucleus, whereas HT stimuli were generally necessary to trigger fits by stimulating the nuclei pontis, the substantia nigra, the central gray area and the cerebellar nuclei. Seizures were also provoked at the diencephalic level with LT stimulation delivered in the medial thalamic area, the nucleus reticularis thalami and some subthalamic regions (zona incerta, H field of Forel). In contrast, no fits were obtained by stimulating the cerebellar cortex and the inferior colliculus, the ventral and lateral groups of thalamic nuclei or the telencephalic regions (hippocampus, amygdala, caudate nucleus, putamen and cerebral cortex), with the exception of the globus pallidus.

Dementia lacking distinctive histologic features: a common non-Alzheimer degenerative dementia.

From a series of 460 dementia patients referred to a regional brain bank, 14 (3%) patients had a pathologic diagnosis of primary degeneration of the brain involving multiple sites (frontoparietal cortex, striatum, medial thalamus, substantia nigra, and hypoglossal nucleus), with cell loss and astrocytosis. There were no neuronal inclusions and essentially no senile plaques. This entity, which we have termed "dementia lacking distinctive histology" (DLDH), presented with memory loss and personality changes, and led to death, usually within 2 to 7 years. Dysarthria and dysphagia were prominent in the later phases of the illness in most patients. The psychometric findings of some of the patients were consistent with a "frontal" lobe dementia. A few patients had prominent caudate atrophy on CT as well as neuropathologically. Eight of our patients had positive family histories for neurologic disease, mainly dementia. DLDH, in addition to Pick's disease, is a major member of the frontal-lobe dementia group. In patients under age 70 years, the frontal lobe dementias represent an important diagnostic consideration.