RESUMEN
PURPOSE: Subthalamotomy using magnetic resonance-guided focused ultrasound (MRgFUS) has become a potential treatment option for the cardinal features of Parkinson's disease (PD). The purpose of this study was to evaluate the effects of MRgFUS-subthalamotomy on brain metabolism using different scale levels. METHODS: We studied resting-state glucose metabolism in eight PD patients before and after unilateral MRgFUS-subthalamotomy using hybrid [18F]FDG-PET/MR imaging. We used statistical nonparametric mapping (SnPM) to study regional metabolic changes following this treatment and also quantified whole-brain treatment-related changes in the expression of a spatial covariance-based Parkinson's disease-related metabolic brain pattern (PDRP). Modulation of regional and network activity was correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores. RESULTS: After subthalamotomy, there was a significant reduction in FDG uptake in the subthalamic region, globus pallidus internus, motor and premotor cortical regions, and cingulate gyrus in the treated hemisphere, and the contralateral cerebellum (p < 0.001). Diffuse metabolic increase was found in the posterior parietal and occipital areas. Treatment also resulted in a significant decline in PDRP expression (p < 0.05), which correlated with clinical improvement in UPDRS motor scores (rho = 0.760; p = 0.002). CONCLUSIONS: MRgFUS-subthalamotomy induced metabolic alterations in distributed nodes of the motor, associative, and limbic circuits. Clinical improvement was associated with reduction in the PDRP expression. This treatment-induced modulation of the metabolic network is likely to mediate the clinical benefit achieved following MRgFUS-subthalamotomy.
Asunto(s)
Enfermedad de Parkinson , Encéfalo/diagnóstico por imagen , Encéfalo/cirugía , Fluorodesoxiglucosa F18 , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/terapiaRESUMEN
Essential tremor is the most common movement disorder in adults. In patients who are not responsive to medical treatment, functional neurosurgery and, more recently, transcranial MR-guided focused ultrasound thalamotomy are considered effective therapeutic approaches. However, the structural brain changes following a thalamotomy that mediates the clinical improvement are still unclear. In here diffusion weighted images were acquired in a cohort of 24 essential tremor patients before and 3 months after unilateral transcranial MR-guided focused ultrasound thalamotomy targeting at the posteroventral part of the VIM. Microstructural changes along the DRTT were quantified by means of probabilistic tractography, and later related to the clinical improvement of the patients at 3-months and at 1-year after the intervention. In addition the changes along two neighboring tracts, that is, the corticospinal tract and the medial lemniscus, were assessed, as well as the relation between these changes and the presence of side effects. Thalamic lesions produced local and distant alterations along the trajectory of the DRTT, and each correlated with clinical improvement. Regarding side effects, gait imbalance after thalamotomy was associated with greater impact on the DRTT, whereas the presence of paresthesias was significantly related to a higher overlap between the lesion and the medial lemniscus. This work represents the largest series describing the microstructural changes following transcranial MR-guided focused ultrasound thalamotomy in essential tremor. These results suggest that clinical benefits are specific for the impact on the cerebello-thalamo-cortical pathway, thus reaffirming the potential of tractography to aid thalamotomy targeting.
Asunto(s)
Temblor Esencial/terapia , Vías Nerviosas/diagnóstico por imagen , Ablación por Radiofrecuencia/métodos , Cirugía Asistida por Computador/métodos , Núcleos Talámicos Ventrales/efectos de la radiación , Anciano , Mapeo Encefálico , Imagen de Difusión por Resonancia Magnética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Terapia por Ultrasonido/métodosRESUMEN
Photocatalytic CO2 reduction offers a promising strategy to produce hydrocarbons without reliance on fossil fuels. Visible light-absorbing colloidal nanomaterials composed of earth-abundant metals suspended in aqueous media are particularly attractive owing to their low-cost, ease of separation, and highly modifiable surfaces. The current study explores such a system by employing water-soluble ZnSe quantum dots and a Co-based molecular catalyst. Water solubilization of the quantum dots is achieved with either carboxylate (3-mercaptopropionic acid) or ammonium (2-aminoethanethiol) functionalized ligands to produce nanoparticles with either negatively or positively-charged surfaces. Photocatalysis experiments are performed to compare the effectiveness of these two surface functionalization strategies on CO2 reduction and ultrafast spectroscopy is used to reveal the underlying photoexcited charge dynamics. We find that the positively-charged quantum dots can support sub-picosecond electron transfer to the carboxylate-based molecular catalyst and also produce >30% selectivity for CO and >170 mmolCO gZnSe-1. However, aggregation reduces activity in approximately one day. In contrast, the negatively-charged quantum dots exhibit >10 ps electron transfer and substantially lower CO selectivity, but they are colloidally stable for days. These results highlight the importance of the quantum dot-catalyst interaction for CO2 reduction. Furthermore, multi-dentate catalyst molecules create a trade-off between photocatalytic efficiency from strong interactions and deleterious aggregation of quantum dot-catalyst assemblies.
RESUMEN
OBJECTIVE: This cross-sectional study aimed to establish normative values for masticatory side switch (MSS) frequency in young Mexican adults and to assess the relationship between various indices and MSS frequency when masticating different chewing materials. DESIGN: We enrolled 101 dentate adults and performed four masticatory assays that involved masticating different chewing materials (i.e., two-colored chewing gum, sweet cracker, salty cracker, and bread). Participants were asked to eat and swallow these foods and to chew the gum for 40 cycles and the following indices were determined: MSS index (MSSI), unilateral chewing index, chewing cycle duration, and number of cycles before terminal swallowing. The participants then rated perceived flavor intensity, salivary flow, and muscle fatigue during each trial. RESULTS: The MSSI ranged from 0.03-0.06 (10th percentile) to 0.48-0.54 (90th percentile). A repeated-measures general linear model revealed a mean MSSI value of 0.28 (95 %CI, 0.25-0.30) adjusted by several factors. Male sex, soft food, and the last chewing period were associated with lower MSS frequency. Spearman's test showed a high correlation for the MSSI among the different foods. MSSI correlated negatively with the unilateral chewing index for each chewing material and with number of cycles for the sweet cracker. However, no significant correlation was detected between MSSI and sensory perception. CONCLUSIONS: In healthy dentate individuals, the mean MSS relative frequency is 25-30 % with an 80-central percentile of 5-50 % of the maximum possible side changes. Lower MSS frequencies were detected in men, when chewing soft food, and during the final chewing period.