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1.
ACS Appl Mater Interfaces ; 16(20): 26899-26914, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38741334

RESUMEN

The extreme sensitivity of 2D-layered materials to environmental adsorbates, which is typically seen as a challenge, is harnessed in this study to fine-tune the material properties. This work investigates the impact of environmental adsorbates on electrical properties by studying metal-semiconductor-metal (MSM) devices fabricated on CVD-synthesized SnSe flakes. The freshly prepared devices exhibit positive photoconductivity (PPC), whereas they gradually develop negative photoconductivity (NPC) after being exposed to an ambient environment for ∼1 day. While the photodetectors based on positive photoconductivity exhibit a responsivity and detectivity of 6.1 A/W and 5.06 × 108 Jones, the same for the negative photoconductivity-based photodetector reaches up to 36.3 A/W and 1.49 × 109 Jones, respectively. In addition, the noise-equivalent power of the NPC photodetector decreases by 300 times as compared to the PPC device, which implies a prominent detection capability of the NPC device against weak photo signals. To substantiate the hypothesis that negative photoconductivity stems from the photodesorption of water and oxygen molecules on the dangling bonds of SnSe flakes, the flakes are etched along the most active planes (010) with a focused laser beam in an inert environment, which enhances responsivity by 43%, supporting negative photoconductivity linked to photodesorption. Furthermore, the humidity-dependent dark current variation of the NPC photodetectors is used to design a humidity sensor for human respiration monitoring with faster response and recovery times of 0.72 and 0.68 s, respectively. These findings open up the possibility of tuning the photoelectrical response of layered materials in a facile manner to develop future sensors and optoelectronic multifunctional devices.

2.
Head Neck Pathol ; 18(1): 21, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38502412

RESUMEN

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a commonly occurring malignancy with complex genetic alterations contributing to its development. The H-Ras, a proto-oncogene, becomes an oncogene when mutated and has been implicated in various cancers. This systematic review aims to research to what extent H-Ras expression and mutation contribute to the development and progression of OSCC, and how does this molecular alteration impacts the clinical characteristics and prognosis in patients with OSCC. METHODS: A thorough electronic scientific literature search was carried out in PUBMED, SCOPUS, and GOOGLE SCHOLAR databases from 2007 to 2021. The search strategy yielded 120 articles. Following aggregation and filtering all results through our inclusion and exclusion criteria total 9 articles were included in our literature review. It has also been registered with PROSPERO (CRD42023485202). RESULTS: It was found that mutations in the Ras gene commonly reported in hotspots at codons 12, 13, and 61 resulting in the activation of downstream signaling pathways causing abnormal and uncontrolled cell growth. This systematic review has shown an increased prevalence of H-Ras mutation in well-differentiated OSCC and also the prevalence of H-Ras mutation in individuals engaging in multiple risk behaviors, particularly chewing tobacco, demonstrated a significant association with a higher prevalence of H-Ras positivity. CONCLUSION: This review sheds light on the prevalence of H-Ras mutations, their association with clinical characteristics, and their potential implications for OSCC prognosis. It also enhances our comprehension of the molecular mechanisms that underlie OSCC and paves the way for further research into targeted treatments based on H-Ras alterations.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Humanos , Carcinoma de Células Escamosas/patología , Neoplasias de la Boca/patología , Mutación , Carcinoma de Células Escamosas de Cabeza y Cuello/genética
3.
Head Neck Pathol ; 18(1): 18, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38489075

RESUMEN

Only limited cases have been reported about the clear cell variant of squamous cell carcinoma occurring in the oral cavity. The present study regards the case showing the histopathological features of both the clear cell and acantholytic variants of oral squamous cell carcinoma. A review of the literature has been done to understand the pathogenesis of those changes. Also, a hypothesis has been given that the clear cell changes could be the consequences of the cascades of the acantholytic process and not a separate entity. Therefore, more research is required to confirm this hypothesis and understand the prognosis of the lesion.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Humanos , Carcinoma de Células Escamosas/patología , Neoplasias de la Boca/patología , Carcinoma de Células Escamosas de Cabeza y Cuello , Acantólisis/patología
4.
Indian J Otolaryngol Head Neck Surg ; 76(1): 1178-1182, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38440495

RESUMEN

Brown tumor represents a terminal stage of bone remodeling process due to an imbalance between osteoclastic and osteoblastic activity. It represents a reparative cellular process, rather than a neoplastic process mostly associated with primary or secondary hyperparathyroidism. Although parathyroidectomy is the first treatment of choice for brown tumors, several cases don't resolve even after normalization of parathyroid hormone levels which leads to surgical intervention. Therefore, to avoid multiple bone surgeries in the same patient, it is crucial to have a conservative approach like targeted therapy which could block certain molecules involved in bone resorption. In this string, we have recognized and quantified three molecules namely sclerostin, MCP-1 and CD73 in brown tumors and correlated their expression with bone resorption pathogenesis and potential therapeutic approach.

5.
Indian J Otolaryngol Head Neck Surg ; 76(1): 1402-1409, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38440613

RESUMEN

The objective of this study was to review the clinical, radiologic, and histologic aspects of cases of dentigerous cysts metamorphosing into different entities along with comments on the molecular factors involved in the process. A series comprising 8 cases of dentigerous cysts was performed retrospectively along with a comprehensive literature review. Two cases of dentigerous cyst converting into mucous metaplasia were included, out of which one case was transformed into ameloblastoma after a year. The other two cases were reported as acanthomatous and unicystic ameloblastoma, whereas four transitioned to AOT. The complete review of cases and literature with molecular profiling concluded that the lining of dentigerous cysts has the potential for transforming into benign odontogenic tumors. Therefore, a careful clinical and histopathological examination is crucial for the correct diagnosis. Also, a thorough molecular understanding of the cystic lining is required.

6.
Small ; 20(14): e2306756, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38126960

RESUMEN

For an uninterrupted self-powered network, the requirement of miniaturized energy storage device is of utmost importance. This study explores the potential utilization of phosphorus-doped nickel oxide (P-NiO) to design highly efficient durable micro-supercapacitors. The introduction of P as a dopant serves to enhance the electrical conductivity of bare NiO, leading to 11-fold augmentation in volumetric capacitance to 841.92 Fcm-3 followed by significant enhancement of energy and power density from 6.71 to 42.096 mWhcm-3 and 0.47 to 1.046 Wcm-3, respectively. Theoretical calculations used to determine the adsorption energy of OH- ions, revealing higher in case of bare NiO (1.52 eV) as compared to phosphorus-doped NiO (0.64 eV) leading to high electrochemical energy storage performance. The as-designed micro-supercapacitor (MSC) device demonstrates a facile integration with the photovoltaic system for renewable energy storage and smooth transfer to external loads for enlightening the blue LED for ≈1 min. The choice of P-NiO/Ni not only contributes to cost reduction but also ensures minimal lattice mismatch at the interface facilitating high durability up to 15 K cycles along with capacitive retention of ≈100% and coulombic efficiency of 93%. Thus, the heterostructure unveils the possibilities of exploring miniaturized energy storage devices for portable electronics.

7.
Med Image Anal ; 92: 103047, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38157647

RESUMEN

Nuclear detection, segmentation and morphometric profiling are essential in helping us further understand the relationship between histology and patient outcome. To drive innovation in this area, we setup a community-wide challenge using the largest available dataset of its kind to assess nuclear segmentation and cellular composition. Our challenge, named CoNIC, stimulated the development of reproducible algorithms for cellular recognition with real-time result inspection on public leaderboards. We conducted an extensive post-challenge analysis based on the top-performing models using 1,658 whole-slide images of colon tissue. With around 700 million detected nuclei per model, associated features were used for dysplasia grading and survival analysis, where we demonstrated that the challenge's improvement over the previous state-of-the-art led to significant boosts in downstream performance. Our findings also suggest that eosinophils and neutrophils play an important role in the tumour microevironment. We release challenge models and WSI-level results to foster the development of further methods for biomarker discovery.


Asunto(s)
Algoritmos , Procesamiento de Imagen Asistido por Computador , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Núcleo Celular/patología , Técnicas Histológicas/métodos
8.
Indian J Otolaryngol Head Neck Surg ; 75(4): 3136-3145, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37974737

RESUMEN

Hypoxia-inducible factor-1α is a transcriptional protein that has been extensively researched in human cancers whose overexpression is found to be associated with unfavorable prognosis. Contemporary studies have proved its vital role in ameloblastoma by correlating its expression with the aggressiveness of the tumor. Therefore, an attempt was made to explore its significance in the malignant transformation and prognosis of ameloblastoma. The present systematic review aimed to understand the impact of HIF-1α in AMB which might lead to favorable outcomes in the treatment. An electronic search was carried out using PubMed, Scopus, Google scholar, Cochrane library, and EMBASE databases. Original articles from all languages involving HIF-1α in AMB were scrutinized by two independent authors. Data were compiled and tabulated in Microsoft Excel and the Risk of bias was analyzed using the JBI tool. Twelve eligible articles were included for the quantitative analysis comprising 305 cases of AMB in which HIF-1α expression was studied for various characteristics like pattern, intensity, and site of immunoexpression which were found to be increased with an increase in the aggressiveness of AMB. It was concluded that HIF-1α is proven to have a crucial role in the progression and aggressiveness of AMB. Extended research regarding the crucial role of HIF-1α in the initiation of tumors and therapies aiming at HIF-1α in AMB cases might show promising outcomes in the future.

9.
J Exp Clin Cancer Res ; 42(1): 231, 2023 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-37670323

RESUMEN

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common pediatric hematological malignancy, with ETV6::RUNX1 being the most prevalent translocation whose exact pathogenesis remains unclear. IGF2BP1 (Insulin-like Growth Factor 2 Binding Protein 1) is an oncofetal RNA binding protein seen to be specifically overexpressed in ETV6::RUNX1 positive B-ALL. In this study, we have studied the mechanistic role of IGF2BP1 in leukemogenesis and its synergism with the ETV6::RUNX1 fusion protein. METHODS: Gene expression was analyzed from patient bone marrow RNA using Real Time RT-qPCR. Knockout cell lines were created using CRISPR-Cas9 based lentiviral vectors. RNA-Seq and RNA Immunoprecipitation sequencing (RIP-Seq) after IGF2BP1 pulldown were performed using the Illumina platform. Mouse experiments were done by retroviral overexpression of donor HSCs followed by lethal irradiation of recipients using a bone marrow transplant model. RESULTS: We observed specific overexpression of IGF2BP1 in ETV6::RUNX1 positive patients in an Indian cohort of pediatric ALL (n=167) with a positive correlation with prednisolone resistance. IGF2BP1 expression was essential for tumor cell survival in multiple ETV6::RUNX1 positive B-ALL cell lines. Integrated analysis of transcriptome sequencing after IGF2BP1 knockout and RIP-Seq after IGF2BP1 pulldown in Reh cell line revealed that IGF2BP1 targets encompass multiple pro-oncogenic signalling pathways including TNFα/NFκB and PI3K-Akt pathways. These pathways were also dysregulated in primary ETV6::RUNX1 positive B-ALL patient samples from our center as well as in public B-ALL patient datasets. IGF2BP1 showed binding and stabilization of the ETV6::RUNX1 fusion transcript itself. This positive feedback loop led to constitutive dysregulation of several oncogenic pathways. Enforced co-expression of ETV6::RUNX1 and IGF2BP1 in mouse bone marrow resulted in marrow hypercellularity which was characterized by multi-lineage progenitor expansion and strong Ki67 positivity. This pre-leukemic phenotype confirmed their synergism in-vivo. Clonal expansion of cells overexpressing both ETV6::RUNX1 and IGF2BP1 was clearly observed. These mice also developed splenomegaly indicating extramedullary hematopoiesis. CONCLUSION: Our data suggest a combined impact of the ETV6::RUNX1 fusion protein and RNA binding protein, IGF2BP1 in activating multiple oncogenic pathways in B-ALL which makes IGF2BP1 and these pathways as attractive therapeutic targets and biomarkers.


Asunto(s)
Leucemia-Linfoma Linfoblástico de Células Precursoras B , Leucemia-Linfoma Linfoblástico de Células Precursoras , Animales , Ratones , Subunidad alfa 2 del Factor de Unión al Sitio Principal , Ratones Noqueados , Fosfatidilinositol 3-Quinasas , Proteína ETS de Variante de Translocación 6
10.
J Phys Condens Matter ; 35(41)2023 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-37402382

RESUMEN

Two-dimensional materials are emerging as promising dielectric materials and have enormous possibilities in wearable micro and nanoelectronics, sensor, and detectors. The theoretical calculation is performed to investigate the pyroelectric coefficient and pyroelectric figure of merit (FOM) of Janus CrSeBr monolayer. Quasi-harmonic approximation (QHA) is used to calculate primary (p1) and secondary (p2) pyroelectric coefficients. Spontaneous polarization is calculated for different temperatures using QHA. Pyroelectric coefficient (1.21 µC m-2 K at 300 K) is obtained for CrSeBr monolayer, which is∼5times higher compared to MoSSe monolayer. A high FOM is found for CrSeBr monolayer(Fv=0.035 m2 C-1),(Fi=1.97 pm V-1). High FOM for voltage responsivity of CrSeBr monolayer could be beneficial for several commercial applications.

11.
Ann Hepatol ; 28(3): 101088, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36933885

RESUMEN

INTRODUCTION AND OBJECTIVES: Psychosocial stressors related to the coronavirus-19 (COVID-19) pandemic increased alcohol consumption. The effect on patients with alcohol-related liver diseases remains unclear. MATERIALS AND METHODS: Hospitalizations at a tertiary care center due to alcohol-related liver disease from March 1 through August 31 in 2019 (pre-pandemic cohort) and 2020 (pandemic cohort) were reviewed retrospectively. Differences in patient demographics, disease features, and outcomes were estimated in patients with alcoholic hepatitis utilizing T-tests, Mann-Whitney tests, Chi-square and Fisher Exact Tests and Anova models and logistic regression models in patients with alcoholic cirrhosis. RESULTS: 146 patients with alcoholic hepatitis and 305 patients with alcoholic cirrhosis were admitted during the pandemic compared to 75 and 396 in the pre-pandemic cohort. Despite similar median Maddrey Scores (41.20 vs. 37.45, p=0.57), patients were 25% less likely to receive steroids during the pandemic. Patients with alcoholic hepatitis admitted during the pandemic were more likely to have hepatic encephalopathy (0.13; 95% CI:0.01, 0.25), variceal hemorrhage (0.14; 95% CI:0.04, 0.25), require oxygen (0.11; 95% CI:0.01, 0.21), vasopressors (OR:3.49; 95% CI:1.27, 12.01) and hemodialysis (OR:3.70; 95% CI:1.22, 15.13). On average, patients with alcoholic cirrhosis had MELD-Na scores 3.77 points higher (95% CI:1.05, 13.46) as compared to the pre-pandemic and had higher odds of experiencing hepatic encephalopathy (OR:1.34; 95% CI:1.04, 1.73), spontaneous bacterial peritonitis (OR:1.88; 95% CI:1.03, 3.43), ascites (OR:1.40, 95% CI:1.10, 1.79), vasopressors (OR:1.68, 95% CI:1.14, 2.46) or inpatient mortality (OR:2.00, 95% CI:1.33, 2.99) than the pre-pandemic. CONCLUSIONS: Patients with alcohol-related liver disease experienced worse outcomes during the pandemic.


Asunto(s)
COVID-19 , Várices Esofágicas y Gástricas , Encefalopatía Hepática , Hepatitis Alcohólica , Humanos , Cirrosis Hepática Alcohólica/epidemiología , Cirrosis Hepática Alcohólica/terapia , Encefalopatía Hepática/epidemiología , Pandemias , Hepatitis Alcohólica/diagnóstico , Hepatitis Alcohólica/epidemiología , Estudios Retrospectivos , Hemorragia Gastrointestinal , Pronóstico , COVID-19/epidemiología , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/epidemiología
12.
Langmuir ; 39(1): 320-333, 2023 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-36525568

RESUMEN

Mechanical and solar to electrical energy conversion using piezo- and ferroelectric and photovoltaic effects may be a practical answer to the rising energy demand. In this quest, piezoelectric polymer poly(vinylidene fluoride-hexafluoroproylene) (P(VDF-HFP)) has gained interest due to its superior piezo- and ferroelectricity. In photovoltaic applications, inorganic halide perovskite (IHP) of CsPbI3 is considered a prime model compound. However, its application is limited because of the photoactive perovskite phase instability at ambient conditions. Here, we report the in situ synthesis of the stable perovskite γ-CsPbI3 through an electrospinning process at room temperature, encapsulated within a ferroelectric copolymer poly(vinylidene fluoride-hexafluoroproylene) (P(VDF-HFP)) as a composite nanofiber. Computational calculation using density functional theory (DFT) reveals that tensile strain plays a critical role in the dynamical stabilization of γ-CsPbI3. This tensile strain is triggered by the electrospinning process, which aids in the formation and growth of γ-CsPbI3. In the CsPbI3-P(VDF-HFP) composite nanofiber, γ-CsPbI3 nucleates the polar ß-crystalline phase in P(VDF-HFP), which results in the intrinsic piezo- and ferroelectric characteristics. The γ-CsPbI3 aids in preferable molecular dipole orientation, resulting in improved nanoscale piezo- and ferroelectric properties. The composite nanofiber features a higher piezoelectric d33 magnitude (∼30 pm/V) and lower decay constant for polarized domains (τcomposite ≈ 17). The composite was utilized as a piezoelectric nanogenerator to demonstrate human physiological motion monitoring in self-power mode. The relevant pressure sensitivities of 81 and 40 mV/kPa for the low-pressure (<0.6 kPa) and high-pressure (>0.6 to 12 kPa) ranges, respectively, promise its suitability in the health care sector.

13.
J Midlife Health ; 13(2): 127-132, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36276631

RESUMEN

Background: Menopause being an unavoidable time in every woman's life brings up various challenges. Inevitable changes in body systems affect the life of a woman permanently. The symptoms constitute the postmenopausal syndrome which further affects the quality of life (QOL). Women spend most of the time working during the menopausal transition period and also during postmenopause. The discussion of symptoms is still considered a taboo. Exercise intervention to reduce the symptoms related to menopause which can show a positive impact on health status and work needs to be incorporated. Methodology: Tai Chi exercise intervention was given for 8 weeks to the women who achieved natural menopause and were included in the study (n = 76). They were assessed for sleep, QOL, and physical performance before and after the intervention. Results: A significant difference was observed in all the outcomes after 8 weeks of intervention (Sleep Quality Scale (SQS)-t = 7.57, P = 0.0001; WHOQOL-BREF-t = 7.56, P = 0.0001; and Physical Performance Test PPT-t = 19.93, P = 0.0001). The results were consistent due to the active participation and high adherence rate of the individuals to the protocol. Conclusion: Our study revealed that besides being low velocity and low impact exercise, Tai Chi was a safe and effective mode of treatment in postmenopausal working women. In this group approach sessions were interactive and improved socialization skills because it was conducted in a community setting minimum equipment's and greater feasibility. Hence, this could also be incorporated in different age group population.

14.
Cureus ; 14(9): e29471, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36312678

RESUMEN

INTRODUCTION: Increase in blood pressure is the leading cause of comorbidity, especially cardiovascular and cerebrovascular disease, but its variability represents an independent risk factor for the same in menopausal women. Dramatic decrease of estrogen production in menopause interferes with many metabolic pathways leading to insulin resistance, increased body mass index (BMI) and dyslipidemia hence cardiovascular morbidity and mortality. In this study an assessment of the variability of blood pressure in postmenopausal women and its association with BMI have been highlighted. METHOD: In this cross-sectional study, a total of 175 postmenopausal females more than 50 years of age who were admitted to or visited medicine wards with no known major medical condition were enrolled between June and July 2019. Recording of both diastolic and systolic blood pressure of postmenopausal women was done at 6 am, 12 pm and 7 pm manually by mercury sphygmomanometer. In addition, BMI, neck circumference, and lipid profile values were also recorded. RESULTS: Variation of both systolic and diastolic blood pressure at 6 am, 12 pm and 7 pm in association with various parameters like BMI (more than 25 kg/m2 ) were 128.57 ± 12.68/78.93 ± 9.56; 124.64 ± 12.32/77.14 ± 5.35 and 124.29 ± 12.60/75.36 ± 6.37 mmHg respectively. Neck circumference (>32 cm) was similar at 128.89 ± 13.49/79.86 ± 8.47; 124.58 ± 12.99/77.08 ± 7.59 and 125.56 ± 12.21/76.94 ± 7.62 mmHg respectively. CONCLUSION: BMI and neck circumference as well as triglyceride and cholesterol increase may all independently contribute to the blood pressure variability in menopausal women.

15.
Avicenna J Med ; 12(3): 154-156, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36092381

RESUMEN

We reported a rare case of acute liver injury in a patient with chronic hepatitis C virus infection without cirrhosis 4 weeks after initiation of glecaprevir/pibrentasvir. After prompt cessation of antiviral therapy, liver enzymes rapidly improved toward baseline. This case reflects the need to remain vigilant for the development of acute liver injury after initiation of glecaprevir/pibrentasvir even without a diagnosis of cirrhosis.

16.
Ann Neurosci ; 29(1): 7-15, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35875423

RESUMEN

Background: Sleep deprivation (SD) is a biological stress condition for the brain, and the pathogenesis of SD is closely related to elevated oxidative stress, mitochondrial dysfunction, a major cause of neurodegeneration. This oxidative stress-mediated cell death is attributed to rise in calcium ion influx which further excites or alters the neurotransmitters level by activating neuronal nitric oxide (NO) synthase (nNOS) release of NO in mouse SD model. This study indicates that the nitrergic neurons are possible therapeutic targets for the amelioration of SD-induced cognitive dysfunction and behavioral alterations. Purpose: SD is considered as a risk factor for various neurodegenerative diseases. SD leads to biochemical, behavioral, and neurochemical alterations in animals. This study was designed to explore the possible involvement of a nitrergic neuron system in six days SD-induced morphological and neurodegenerative changes in mice. Methods: Using nNOS immunohistochemistry, we have investigated the effects of SD on nNOS positive neurons. Immunohistochemical study for the distribution of nNOS positive neuronal cell bodies was carried out in the hippocampus, prefrontal cortex (PFC), and amygdaloid nuclei of mice brain. Results: Sleep-deprived animals showed a significantly increased number of nNOS positive neurons and altered neuronal cytomorphology as compared with the control group. Conclusion: These results indicate that total SD may induce morphological changes in nNOS positive neurons in the brain, thus increasing NO synthesis, which is implicated in SD-induced neuronal cell death.

19.
Neuroradiol J ; : 19714009211067404, 2022 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-34989268

RESUMEN

While abnormalities of the hippocampus have been well characterized in temporal lobe epilepsy, various additional temporal lobe abnormalities have also been described. One poorly understood entity, the so-called temporal pole blurring (TPB), is one of the more frequently described neocortical abnormalities in TLE and is thought to represent dysmyelination and axonal loss due to chronic electrical perturbations in early age-onset temporal lobe epilepsy. In this study, we describe the first reported cases of TPB diagnosed by a recently described MRI sequence known as 3D Edge-Enhancing Gradient Echo (3D-EDGE), which has an effective "myelin weighting" making it exquisitely sensitive to this temporal pole dysmyelination. The value of detection of TPB lies in lateralizing seizure onset, as well as predicting a lower baseline neuropsychological performance compared to temporal lobe epilepsy without TPB. Additionally, it is critical to not mistake TPB for alternative diagnoses, such as focal cortical dysplasia or neoplasm.

20.
Neuroradiol J ; 35(2): 203-212, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34340623

RESUMEN

OBJECTIVE: Observational studies utilising diffusion tractography have suggested a common mechanism for tremor alleviation in deep brain stimulation for essential tremor: the decussating portion of the dentato-rubro-thalamic tract. We hypothesised that directional stimulation of the dentato-rubro-thalamic tract would result in greater tremor improvement compared to sham programming, as well as comparable improvement as more tedious standard-of-care programming. METHODS: A prospective, blinded crossover trial was performed to assess the feasibility, safety and outcomes of programming based solely on dentato-rubro-thalamic tract anatomy. Using magnetic resonance imaging diffusion-tractography, the dentato-rubro-thalamic tract was identified and a connectivity-based treatment setting was derived by modelling a volume of tissue activated using directional current steering oriented towards the dentato-rubro-thalamic tract centre. A sham setting was created at approximately 180° opposite the connectivity-based treatment. Standard-of-care programming at 3 months was compared to connectivity-based treatment and sham settings that were blinded to the programmer. The primary outcome measure was percentage improvement in the Fahn-Tolosa-Marín tremor rating score compared to the preoperative baseline. RESULTS: Among the six patients, tremor rating scores differed significantly among the three experimental conditions (P=0.030). The mean tremor rating score improvement was greater with the connectivity-based treatment settings (64.6% ± 14.3%) than with sham (44.8% ± 18.6%; P=0.031) and standard-of-care programming (50.7% ± 19.2%; P=0.062). The distance between the centre of the dentato-rubro-thalamic tract and the volume of tissue activated inversely correlated with the percentage improvement in the tremor rating score (R2=0.24; P=0.04). No significant adverse events were encountered. CONCLUSIONS: Using a blinded, crossover trial design, we have shown the technical feasibility, safety and potential efficacy of connectivity-based stimulation settings in deep brain stimulation for treatment of essential tremor.


Asunto(s)
Estimulación Encefálica Profunda , Temblor Esencial , Estimulación Encefálica Profunda/métodos , Temblor Esencial/cirugía , Temblor Esencial/terapia , Humanos , Estudios Prospectivos , Tálamo/diagnóstico por imagen , Resultado del Tratamiento , Temblor/cirugía
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