Quality of life after brain injury-overall scale, Japanese version: assessment of reliability and validity.

This study analyzed the linguistic and psychometric validation of the Japanese version of the Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS) consisting of six items which cover several TBI-relevant domains. We hypothesized that the Japanese version has good reliability, convergent validity, and divergent validity, compared with its long version, the 37-item QOLIBRI. The QOLIBRI-OS Japanese version was forward and back-translated from the English version. In total, 129 individuals participated in this study after experiencing a traumatic brain injury and attending clinics, rehabilitation centers, and support centers in Japan. The structure of the QOLIBRI-OS was investigated by confirmatory factor analyses and compared with the QOLIBRI. Only one factor was extracted, and a model with one underlying factor had a good fit. The QOLIBRI-OS showed good-to-excellent internal consistency and test-retest reliability. The QOLIBRI-OS was positively correlated with the QOLIBRI, Short Form Health Survey-36 version 2, and Glasgow Outcome Scale Extended, and negatively correlated with the Hospital Anxiety and Depression Scale. The results suggest that the QOLIBRI-OS Japanese version is a reliable and valid tool for assessing disease-specific health-related QOL in individuals after traumatic brain injury in Japan.

Regeneration of Denervated Skeletal Muscles - Brunelli's CNS-PNS Paradigm.

The restoration of voluntary muscle activity in posttraumatic paraplegia in both animal experiments and other clinical applications requires reproducibility of a technically-demanding microsurgical procedure, limited by physicians' understanding of Brunelli's spinal cord grafting paradigm. The insufficient clinical investigation of the long-term benefits of the CNS-PNS graft application warrants additional inquiry. The objective of this study is to explore the potential benefits of the first replicated, graft-induced neuroregeneration of denervated skeletal muscle regarding long-term clinical outcomes and to investigate the effect of Cerebrolysin on neuromodulation. A randomized study evaluating 30 rats, approved by the National Animal Ethics Advisory Committee was performed. The medication was administered postoperatively. For 14 days, 12 rats received Cerebrolysin (serum), 11 received NaCl 0.9% (shams), and 7 were controls. For microsurgery, the lateral corticospinal tract T10 was grafted to the denervated internal obliquus abdominal muscle. On day 90, intraoperative proof of reinnervation was observed. On day 100, 15 rats were euthanized for fixation, organ removal, and extensive histology-morphology examination, and the Wei-Lachin statistical procedure was employed. After an open revision of 16 rats, 8 were CMAP positive. After intravenous Vecuronium application, two (Cerebrolysin, NaCl) out of two rats showed an incomplete compound muscle action potential (CMAP) loss due to glutamatergic and cholinergic co-transmission, while two others showed a complete loss of amplitude. Cerebrolysin medication initiated larger restored muscle fiber diameters and less scarring. FB+ neurons were not observed in the brain but were observed in the Rexed laminae. Brunelli's concept was successfully replicated, demonstrating the first graft induced existence of cholinergic and glutamatergic neurotransmission in denervated grafted muscles. Statistics of the histometric count of muscle fibers revealed larger fiber diameters after Cerebrolysin. Brunelli's CNS-PNS experimental concept is suitable to analyze graft-neuroplasticity focused on the voluntary restoration of denervated skeletal muscles in spinal cord injury. Neuroprotection by Cerebrolysin is demonstrated.

Music and Mind: In Memoriam Professor Carlo Alberto Pagni, MD, PhD: February 13, 1931 -March 1, 2009.

Carlo Alberto Pagni, born in La Spezia, Italy, on February 13, 1931, was an eminent and respected professor of neurosurgery and chairman of the neurosurgical clinic of the University of Turin from 1980 to 2003. He died on March 1, 2009. As a professor of neurology and neurological surgery he was renowned as an expert on vascular, tumor, and functional neurosurgery. Beyond the Italian Neurosurgical Society, he was the doyen of functional neurosurgery, specializing in motor cortex stimulation for the treatment of focal dystonia, Parkinson's disease, and postictal spasticity and pain. His home was his castle, and his family was fundamental to his life. He shared with his wife, Sandra, his passion for piano playing and for their remarkable library, and together with friends, he and his wife enjoyed dinners with fine food and Barolo wines. Listening to this Grand Seigneur talking about and explaining the music of, above all, Ludwig van Beethoven, and Richard Wagner, one felt he was emotionally just "music and mind". You can imagine this from his books on music, chess, and neuroscience. Indeed, he adored playing correspondence chess worldwide. A sportsman too, he loved hiking, mountaineering, skiing, swimming, and fishing. Nature was his source for slowing down, for regenerating, and for collecting his strength for new projects and new challenges. Friends will remember Dr. Pagni as a Grand Seigneur.

Neuro-rehabilitation--a challenge for neurosurgeons in the century 21st concepts and visions of the WFNS-Committee on neurosurgical rehabilitation.

OBJECTIVES: Patients with severe brain, spinal cord and peripheral nerve lesions today survive surgery. This, however, is quite often achieved at the burden of disabilities. Neuro-rehabilitation could improve significantly patient's quality of life (QoL). METHODS: Formed in 1997, the WFNS Committee supports all efforts regarding personal and regional activities, teaching, research, recommendations, guidelines, and practical application to improve neurosurgeon's quality management within the spectrum of rehabilitation around the world. RESULTS: Neuro-rehabilitation became part of the scientific programmes at the 11th EANS, 10th AANS, ICRAN 1999, and now 12th WFNS congresses. The first international conference on Neurosurgical Rehabilitation took place in D--Münster, 2000. CONCLUSIONS: The WFNS Committee can influence neurosurgeons to take over the challenge of neuro-rehabilitation to improve patient's outcome in respect to ICIDH-2 WHO classification. Delegates of all neurosurgical societies are kindly invited to join us.