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1.
Science ; 372(6540)2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33888612

RESUMO

Cell-cell interactions control the physiology and pathology of the central nervous system (CNS). To study astrocyte cell interactions in vivo, we developed rabies barcode interaction detection followed by sequencing (RABID-seq), which combines barcoded viral tracing and single-cell RNA sequencing (scRNA-seq). Using RABID-seq, we identified axon guidance molecules as candidate mediators of microglia-astrocyte interactions that promote CNS pathology in experimental autoimmune encephalomyelitis (EAE) and, potentially, multiple sclerosis (MS). In vivo cell-specific genetic perturbation EAE studies, in vitro systems, and the analysis of MS scRNA-seq datasets and CNS tissue established that Sema4D and Ephrin-B3 expressed in microglia control astrocyte responses via PlexinB2 and EphB3, respectively. Furthermore, a CNS-penetrant EphB3 inhibitor suppressed astrocyte and microglia proinflammatory responses and ameliorated EAE. In summary, RABID-seq identified microglia-astrocyte interactions and candidate therapeutic targets.


Assuntos
Astrócitos/fisiologia , Comunicação Celular , Sistema Nervoso Central/patologia , Encefalomielite Autoimune Experimental/fisiopatologia , Microglia/fisiologia , Esclerose Múltipla/fisiopatologia , Análise de Célula Única , Animais , Antígenos CD/metabolismo , Encéfalo/patologia , Encéfalo/fisiopatologia , Sistema Nervoso Central/fisiopatologia , Encefalomielite Autoimune Experimental/patologia , Efrina-B3/metabolismo , Herpesvirus Suídeo 1/genética , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/metabolismo , Esclerose Múltipla/patologia , NF-kappa B/metabolismo , Proteínas do Tecido Nervoso/metabolismo , RNA-Seq , Espécies Reativas de Oxigênio/metabolismo , Receptor EphB3/antagonistas & inibidores , Receptor EphB3/metabolismo , Receptores de Superfície Celular/metabolismo , Semaforinas/metabolismo , Transdução de Sinais , Linfócitos T/fisiologia , Serina-Treonina Quinases TOR/metabolismo
2.
Int J Mol Sci ; 22(3)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33530477

RESUMO

In migraine pain, cannabis has a promising analgesic action, which, however, is associated with side psychotropic effects. To overcome these adverse effects of exogenous cannabinoids, we propose migraine pain relief via activation of the endogenous cannabinoid system (ECS) by inhibiting enzymes degrading endocannabinoids. To provide a functional platform for such purpose in the peripheral and central parts of the rat nociceptive system relevant to migraine, we measured by activity-based protein profiling (ABPP) the activity of the main endocannabinoid-hydrolases, monoacylglycerol lipase (MAGL) and fatty acid amide hydrolase (FAAH). We found that in trigeminal ganglia, the MAGL activity was nine-fold higher than that of FAAH. MAGL activity exceeded FAAH activity also in DRG, spinal cord and brainstem. However, activities of MAGL and FAAH were comparably high in the cerebellum and cerebral cortex implicated in migraine aura. MAGL and FAAH activities were identified and blocked by the selective and potent inhibitors JJKK-048/KML29 and JZP327A, respectively. The high MAGL activity in trigeminal ganglia implicated in the generation of nociceptive signals suggests this part of ECS as a priority target for blocking peripheral mechanisms of migraine pain. In the CNS, both MAGL and FAAH represent potential targets for attenuation of migraine-related enhanced cortical excitability and pain transmission.


Assuntos
Amidoidrolases/metabolismo , Endocanabinoides/metabolismo , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/metabolismo , Monoacilglicerol Lipases/metabolismo , Amidoidrolases/antagonistas & inibidores , Amidoidrolases/genética , Animais , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/fisiopatologia , Modelos Animais de Doenças , Ativação Enzimática , Inibidores Enzimáticos/farmacologia , Hidrólise , Masculino , Monoacilglicerol Lipases/antagonistas & inibidores , Monoacilglicerol Lipases/genética , Nervos Periféricos/metabolismo , Nervos Periféricos/fisiopatologia , Ratos
3.
Toxicol Appl Pharmacol ; 415: 115429, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33524447

RESUMO

The zebrafish is extensively used as a model organism for studying several disorders of the central nervous system (CNS), including epilepsy. Some antiseizure drugs (ASDs) have been shown to produce discrepant results in larvae and adults zebrafish, therefore, their anticonvulsant efficacy in subsequent stages of the pentylenetetrazole (PTZ)-induced seizures should be more precisely characterized. The purpose of this study was to investigate behavioral effects of five classic ASDs: valproate (VPA), phenytoin (PHT), carbamazepine (CBZ), diazepam (DZP), and phenobarbital (PB) administered intraperitoneally (i.p.) in the PTZ-induced seizure test in adult zebrafish. We determined the time of maximal effect and the dose-response relationship of the studied ASDs. Furthermore, we assessed changes in the locomotor activity and the anxiety-like behavior in the color preference test. Moreover, drug concentrations in zebrafish homogenates were examined. VPA, DZP, and PB significantly increased the seizure latency at three subsequent stages of seizures (SI-SIII). PHT produced the anticonvulsant-like effect at SI and SII, while CBZ was effective at SII and SIII. Only DZP decreased zebrafish locomotor activity. A strong anxiolytic-like effect was observed after administration of PHT and PB. A weak anxiolytic-like effect occurred after treatment with VPA and DZP. The HPLC analysis showed the average concentrations of the studied ASDs in the fish body during the maximum anticonvulsant activity of each drug. Our results confirm the advantages of using zebrafish with the mature CNS over larval models and its utility to investigate some neuropharmacological properties of the tested drugs.


Assuntos
Ansiolíticos/farmacologia , Anticonvulsivantes/farmacologia , Ansiedade/prevenção & controle , Comportamento Animal/efeitos dos fármacos , Sistema Nervoso Central/efeitos dos fármacos , Convulsões/prevenção & controle , Fatores Etários , Animais , Ansiolíticos/metabolismo , Anticonvulsivantes/metabolismo , Ansiedade/fisiopatologia , Ansiedade/psicologia , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/fisiopatologia , Percepção de Cores/efeitos dos fármacos , Visão de Cores/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Locomoção/efeitos dos fármacos , Masculino , Pentilenotetrazol , Convulsões/induzido quimicamente , Convulsões/fisiopatologia , Fatores de Tempo , Peixe-Zebra/metabolismo
4.
Med Hypotheses ; 146: 110469, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33401106

RESUMO

There has been concern about possible long-term sequelae resembling myalgic encephalomyelitis/chronic fatigue syndrome in COVID-19 patients. Clarifying the mechanisms underlying such a "post-COVID-19 fatigue syndrome" is essential for the development of preventive and early treatment methods for this syndrome. In the present paper, by integrating insights pertaining to the glymphatic system and the nasal cerebrospinal fluid outflow pathway with findings in patients with chronic fatigue syndrome, idiopathic intracranial hypertension, and COVID-19, I provide a coherent conceptual framework for understanding the pathophysiology of post-COVID-19 fatigue syndrome. According to this hypothesis, this syndrome may result from damage to olfactory sensory neurons, causing reduced outflow of cerebrospinal fluid through the cribriform plate, and further leading to congestion of the glymphatic system with subsequent toxic build-up within the central nervous system. I further postulate that patients with post-COVID-19 fatigue syndrome may benefit from cerebrospinal fluid drainage by restoring glymphatic transport and waste removal from the brain. Obviously, further research is required to provide further evidence for the presence of this post-viral syndrome, and to provide additional insight regarding the relative contribution of the glymphatic-lymphatic system to it. Other mechanisms may also be involved. If confirmed, the glymphatic-lymphatic system could represent a target in combating post-COVID-19 fatigue syndrome. Moreover, further research in this area could also provide new insights into the understanding of chronic fatigue syndrome.


Assuntos
/complicações , Síndrome de Fadiga Crônica/etiologia , Encéfalo/fisiopatologia , /etiologia , Sistema Nervoso Central/fisiopatologia , Osso Etmoide/fisiopatologia , Síndrome de Fadiga Crônica/líquido cefalorraquidiano , Síndrome de Fadiga Crônica/fisiopatologia , Sistema Glinfático/fisiopatologia , Humanos , Modelos Neurológicos , Neurônios Receptores Olfatórios/fisiologia , Pandemias , Pseudotumor Cerebral/líquido cefalorraquidiano , Pseudotumor Cerebral/etiologia , Pseudotumor Cerebral/fisiopatologia , Fatores de Tempo
5.
Physiol Rev ; 101(1): 259-301, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584191

RESUMO

Neuropathic pain caused by a lesion or disease of the somatosensory nervous system is a common chronic pain condition with major impact on quality of life. Examples include trigeminal neuralgia, painful polyneuropathy, postherpetic neuralgia, and central poststroke pain. Most patients complain of an ongoing or intermittent spontaneous pain of, for example, burning, pricking, squeezing quality, which may be accompanied by evoked pain, particular to light touch and cold. Ectopic activity in, for example, nerve-end neuroma, compressed nerves or nerve roots, dorsal root ganglia, and the thalamus may in different conditions underlie the spontaneous pain. Evoked pain may spread to neighboring areas, and the underlying pathophysiology involves peripheral and central sensitization. Maladaptive structural changes and a number of cell-cell interactions and molecular signaling underlie the sensitization of nociceptive pathways. These include alteration in ion channels, activation of immune cells, glial-derived mediators, and epigenetic regulation. The major classes of therapeutics include drugs acting on α2δ subunits of calcium channels, sodium channels, and descending modulatory inhibitory pathways.


Assuntos
Sistema Nervoso Central/fisiopatologia , Neuralgia/fisiopatologia , Neuralgia/terapia , Animais , Humanos , Fibras Nervosas , Nervos Periféricos/fisiopatologia , Sistema Nervoso Periférico/fisiopatologia
6.
Nutrients ; 12(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33371247

RESUMO

Glucose is the primary energy source for the brain, and exposure to both high and low levels of glucose has been associated with numerous adverse central nervous system (CNS) outcomes. While a large body of work has highlighted the impact of hyperglycemia on peripheral and central measures of oxidative stress, cognitive deficits, and vascular complications in Type 1 and Type 2 diabetes, there is growing evidence that glycemic variability significantly drives increased oxidative stress, leading to neuroinflammation and cognitive dysfunction. In this review, the latest data on the impact of glycemic variability on brain function and neuroinflammation will be presented. Because high levels of oxidative stress have been linked to dysfunction of the blood-brain barrier (BBB), special emphasis will be placed on studies investigating the impact of glycemic variability on endothelial and vascular inflammation. The latest clinical and preclinical/in vitro data will be reviewed, and clinical/therapeutic implications will be discussed.


Assuntos
Glicemia/metabolismo , Fenômenos Fisiológicos Cardiovasculares/efeitos dos fármacos , Sistema Nervoso Central/fisiopatologia , Hiperglicemia/fisiopatologia , Estresse Oxidativo/efeitos dos fármacos , Barreira Hematoencefálica/fisiopatologia , Encéfalo/metabolismo , Humanos , Inflamação
7.
Rev Cardiovasc Med ; 21(2): 205-216, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32706209

RESUMO

Sudden cardiac death (SCD) is a rare clinical encounter in pediatrics, but its social impact is immense because of its unpredicted and catastrophic nature in previously healthy individuals. Unlike in adults where the primary cause of SCD is related to ischemic heart disease, the etiology is diverse in young SCD victims. Although certain structural heart diseases may be identified during autopsy in some SCD victims, autopsy-negative SCD is more common in pediatrics, which warrants the diagnosis of sudden arrhythmic death syndrome (SADS) based upon the assumption that the usual heart rhythm is abruptly replaced by lethal ventricular arrhythmia. Despite current advances in molecular genetics, the causes of more than half of SADS cases remain unanswered even after postmortem genetic testing. Moreover, the majority of these deaths occur at rest or during sleep even in the young. Recently, sudden unexpected death in epilepsy (SUDEP) has emerged as another etiology of SCD in children and adults, suggesting critical involvement of the central nervous system (CNS) in SCD. Primary cardiac disorders may not be solely responsible for SCD; abnormal CNS function may also contribute to the unexpected lethal event. In this review article, we provide an overview of the complex pathogenesis of SADS and its diverse clinical presentation in the young and postulate that SADS is, in part, induced by unfortunate miscommunication between the heart and CNS via the autonomic nervous system.


Assuntos
Arritmias Cardíacas/etiologia , Sistema Nervoso Central/fisiopatologia , Morte Súbita Cardíaca/etiologia , Coração/inervação , Morte Súbita Inesperada na Epilepsia/etiologia , Potenciais de Ação , Adolescente , Adulto , Fatores Etários , Animais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/genética , Arritmias Cardíacas/fisiopatologia , Causas de Morte , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Frequência Cardíaca , Humanos , Lactente , Masculino , Medição de Risco , Fatores de Risco , Adulto Jovem
8.
Diabetes Metab Syndr ; 14(5): 1053-1060, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32640417

RESUMO

BACKROUND AND AIMS: After the emergence of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the last two decades, the world is facing its new challenge in SARS-CoV-2 pandemic with unfathomable global responses. The characteristic clinical symptoms for Coronavirus (COVID-19) affected patients are high fever, dry-cough, dyspnoea, lethal pneumonia whereas some patients also show additional neurological signs such as headache, nausea, vomiting etc. The accumulative evidences suggest that SARS-CoV-2 is not only confined within the respiratory tract but may also invade the central nervous system (CNS) and peripheral nervous system (PNS) inducing some fatal neurological diseases. Here, we analyze the phylogenetic perspective of SARS-CoV-2 with other strains of ß-Coronaviridae from a standpoint of neurological spectrum disorders. METHODOLOGY: A Pubmed/Medline, NIH Lit Covid, Cochrane library and some open data bases (BioRxiv, MedRxiv,preprint.org and others) search were carried out by using keywords relevant to our topic of discussion. The extracted literatures are scrutinized by the authors. RESULTS: 58 literatures including original articles, case reports and case series were selected by the authors to analyze the differential distribution of neurological impairments in COVID-19 positive patients along with angiotensin-converting enzyme-2 (ACE2) expression dynamics in neuronal and non-neuronal tissue in CNS and PNS with neuroinvasive potential of SARS-CoV2. CONCLUSION: We discuss the need for modulations in clinical approach from a neurological point of view, as a measure towards reducing disease transmission, morbidity and mortality in SARS-CoV2 positive patients.


Assuntos
Betacoronavirus/isolamento & purificação , Sistema Nervoso Central/virologia , Infecções por Coronavirus/epidemiologia , Cefaleia/virologia , Pneumonia Viral/epidemiologia , Sistema Nervoso Central/fisiopatologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Saúde Global , Cefaleia/fisiopatologia , Humanos , Incidência , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
9.
Am J Physiol Regul Integr Comp Physiol ; 319(1): R106-R113, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32493036

RESUMO

Electroacupuncture (EA) is widely used as an effective method to treat stress-related disorders. However, its mechanisms remain largely unknown. The aim of this study was to investigate the effects and mechanisms of EA on gastric slow wave (GSW) dysrhythmia and c-Fos expression in the nucleus of the solitary tract (NTS) induced by stress in a rodent model of functional dyspepsia (FD). Rats in the neonatal stage were treated using intragastric iodoacetamide. Eight weeks later, the rats were implanted with electrodes in the stomach for the measurement of GSW and electrodes into accupoints ST36 for EA. Autonomic functions were assessed by spectral analysis of heart rate variability. Rats were placed for 30 min in a cylindrical plastic tube for acute restraint stress. The involvement of a central afferent pathway was assessed by measuring c-Fos-immunoreactive cells in the NTS. 1) EA normalized restraint stress-induced impairment of GSW in FD rats. 2) EA significantly increased vagal activity (P = 0.002) and improved sympathovagal balance (P = 0.004) under stress in FD rats. 3) In FD rats under restraint stress, plasma norepinephrine concentration was increased substantially (P < 0.01), which was suppressed with EA. 4) The EA group showed increased c-Fos-positive cell counts in the NTS compared with the sham EA group (P < 0.05) in FD rats. Acute restraint stress induces gastric dysrhythmia in a rodent model of FD. EA at ST36 improves GSW under stress in FD rats mediated via the central and autonomic pathways, involving the NTS and vagal efferent pathway.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Sistema Nervoso Central/fisiopatologia , Dispepsia/fisiopatologia , Dispepsia/terapia , Eletroacupuntura , Gastropatias/terapia , Estresse Psicológico/complicações , Vias Aferentes/fisiopatologia , Animais , Animais Recém-Nascidos , Esvaziamento Gástrico , Iodoacetamida , Masculino , Norepinefrina/sangue , Proteínas Proto-Oncogênicas c-fos/biossíntese , Ratos , Ratos Sprague-Dawley , Restrição Física , Núcleo Solitário/metabolismo , Gastropatias/induzido quimicamente , Nervo Vago/fisiopatologia
10.
Int J STD AIDS ; 31(7): 694-698, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32538333

RESUMO

Human immunodeficiency virus (HIV) ribonucleic acid (RNA) levels generally remain undetectable in the cerebrospinal fluid of people living with HIV with peripheral viral suppression. Secondary HIV central nervous system (CNS) escape refers to the rare independent replication of HIV RNA in the central nervous system despite peripheral viral suppression that occurs in the setting of a concomitant non-HIV infection. We describe here a young man with perinatal HIV infection considered a viral controller who developed secondary HIV CNS escape in the setting of a presumed fungal CNS infection.


Assuntos
Antirretrovirais/uso terapêutico , Sistema Nervoso Central/virologia , Líquido Cefalorraquidiano/virologia , Infecções por HIV/líquido cefalorraquidiano , Infecções por HIV/tratamento farmacológico , Cefaleia/etiologia , Fotofobia/etiologia , Carga Viral/efeitos dos fármacos , Replicação Viral/genética , Adulto , Antifúngicos/uso terapêutico , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/fisiopatologia , Infecções por HIV/virologia , Humanos , Masculino , Micoses/tratamento farmacológico , RNA Viral/líquido cefalorraquidiano , RNA Viral/efeitos dos fármacos , RNA Viral/genética , Resultado do Tratamento
11.
J Neurosci ; 40(27): 5314-5326, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32527981

RESUMO

An epileptic seizure can trigger a headache during (ictal) or after (postictal) the termination of the event. Little is known about the pathophysiology of seizure-induced headaches. In the current study, we determined whether a seizure can activate nociceptive pathways that carry pain signals from the meninges to the spinal cord, and if so, to what extent and through which classes of peripheral and central neurons. To achieve these goals, we used single-unit recording techniques and an established animal model of seizure (picrotoxin) to determine the effects of epileptic seizure on the activity of trigeminovascular Aδ-, C-, wide-dynamic range, and high-threshold neurons in male and female rats. Occurrence of seizure activated 54%, 50%, 68%, and 39% of the Aδ-, C-, wide-dynamic range, and high-threshold neurons, respectively. Regardless of their class, activated neurons exhibited a twofold to fourfold increase in their firing, which started immediately (1 min) or up to 90 min after seizure initiation, and lasted as short as 10 min or as long as 120 min. Administration of lidocaine to the dura prevented activation of all neuronal classes but not the initiation or maintenance of the seizure. These findings suggest that all neuronal classes may be involved in the initiation and maintenance of seizure-induced headache, and that their activation patterns can provide a neural substrate for explaining the timing and duration of ictal and possibly postictal headaches. By using seizure, which is evident in humans, this study bypasses controversies associated with cortical spreading depression, which is less readily observed in humans.SIGNIFICANCE STATEMENT This preclinical study provides a neural substrate for ictal and postictal headache. By studying seizure effects on the activity of peripheral (C and Aδ) and central (wide dynamic range and high-threshold) trigeminovascular neurons in intact and anesthetized dura, the findings help resolve two outstanding questions about the pathophysiology of headaches of intracranial origin. The first is that abnormal brain activity (i.e., seizure) that is evident in human (unlike cortical spreading depression) gives rise to specific and selective activation of the different components of the trigeminovascular system, and the second is that the activation of all components of the trigeminovascular pathway (i.e., peripheral and central neurons) depends on activation of the meningeal nociceptors from their receptors in the dura.


Assuntos
Cefaleia/etiologia , Cefaleia/fisiopatologia , Neurônios , Convulsões/complicações , Convulsões/fisiopatologia , Nervo Trigêmeo/fisiopatologia , Anestésicos Locais/farmacologia , Animais , Sistema Nervoso Central/fisiopatologia , Eletroencefalografia , Feminino , Lidocaína/farmacologia , Masculino , Meninges/fisiopatologia , Fibras Nervosas Mielinizadas , Fibras Nervosas Amielínicas , Vias Neurais/fisiopatologia , Nociceptores , Sistema Nervoso Periférico/fisiopatologia , Ratos , Ratos Sprague-Dawley , Medula Espinal/fisiopatologia
12.
PLoS One ; 15(6): e0233915, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484819

RESUMO

Cognitive control and incentive sensitivity are related to overeating and obesity. Optimal white matter integrity is relevant for an efficient interaction among reward-related brain regions. However, its relationship with sensitivity to incentives remains controversial. The aim of this study was to assess the incentive sensitivity and its relationship to white matter integrity in normal-weight and overweight groups. Seventy-six young adults participated in this study: 31 were normal-weight (body mass index [BMI] 18.5 to < 25.0 kg/m2, 14 females) and 45 were overweight (BMI ≥ 25.0 kg/m2, 22 females). Incentive sensitivity was assessed using an antisaccade task that evaluates the effect of incentives (neutral, reward, and loss avoidance) on cognitive control performance. Diffusion tensor imaging studies were performed to assess white matter integrity. The relationship between white matter microstructure and incentive sensitivity was investigated through tract-based spatial statistics. Behavioral antisaccade results showed that normal-weight participants presented higher accuracy (78.0 vs. 66.7%, p = 0.01) for loss avoidance incentive compared to overweight participants. Diffusion tensor imaging analysis revealed a positive relationship between fractional anisotropy and loss avoidance accuracy in the normal-weight group (p < 0.05). No relationship reached significance in the overweight group. These results support the hypothesis that white matter integrity is relevant for performance in an incentivized antisaccade task.


Assuntos
Encéfalo/diagnóstico por imagem , Sistema Nervoso Central/fisiopatologia , Cognição/fisiologia , Obesidade/fisiopatologia , Adulto , Anisotropia , Índice de Massa Corporal , Encéfalo/fisiologia , Mapeamento Encefálico , Sistema Nervoso Central/diagnóstico por imagem , Chile/epidemiologia , Imagem de Tensor de Difusão , Movimentos Oculares/fisiologia , Feminino , Humanos , Masculino , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Perda de Peso/fisiologia , Substância Branca/diagnóstico por imagem , Substância Branca/fisiologia , Adulto Jovem
13.
Medicine (Baltimore) ; 99(22): e20492, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481462

RESUMO

To investigate the characteristics of diffusion tensor imaging (DTI) of the central nervous system in children with Tourette syndrome (TS).Fifteen children with TS (TS group) and 15 normal children (control group) were studied, and all of them underwent DTI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) parameters were calculated using the DTIStudio software. The region of interest was delineated manually. The ADC and FA values of the bilateral caudate nucleus, bilateral globus pallidus, bilateral putamen, bilateral thalamus, and bilateral frontal lobe white matter were measured using the region of interest editor software. The differences of FA values and ADC values between the same brain areas were compared. The associations between ADC, FA values and Yale Global Tic Severity Scale (YGTSS) scores were evaluated by Pearson correlation analyses.The FA values of left globus pallidus and left thalamus were significantly lower in the TS group than in the control group (P < .05), while the ADC values of the right caudate nucleus and bilateral thalamus were significantly higher in the TS group than in the control group (P < .05). The decrease in FA in the left thalamus significantly correlated with the YGTSS score (r = 0.692; P < .05). No correlation was found between FA and ADC values in other brain regions and the YGTSS score (P > .05).After the DTI analyses, abnormalities were found in the left globus pallidus, right caudate nucleus, and bilateral thalamus in children with TS. Especially the changes in the left thalamus structure was crucial in the pathophysiological clock of TS.


Assuntos
Sistema Nervoso Central/diagnóstico por imagem , Sistema Nervoso Central/fisiopatologia , Imagem de Tensor de Difusão/métodos , Síndrome de Tourette/diagnóstico por imagem , Síndrome de Tourette/fisiopatologia , Anisotropia , Criança , Pré-Escolar , Feminino , Humanos , Masculino
14.
Stroke Vasc Neurol ; 5(2): 146-151, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32385132

RESUMO

Coronavirus disease 2019 (COVID-19) has become a pandemic disease globally. Although COVID-19 directly invades lungs, it also involves the nervous system. Therefore, patients with nervous system involvement as the presenting symptoms in the early stage of infection may easily be misdiagnosed and their treatment delayed. They become silent contagious sources or 'virus spreaders'. In order to help neurologists to better understand the occurrence, development and prognosis, we have developed this consensus of prevention and management of COVID-19. It can also assist other healthcare providers to be familiar with and recognise COVID-19 in their evaluation of patients in the clinic and hospital environment.


Assuntos
Betacoronavirus/patogenicidade , Infecções do Sistema Nervoso Central/terapia , Sistema Nervoso Central/virologia , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/terapia , Neurologistas/normas , Pneumonia Viral/terapia , Sistema Nervoso Central/fisiopatologia , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/fisiopatologia , Infecções do Sistema Nervoso Central/virologia , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Diagnóstico Precoce , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Prognóstico
15.
Rev Med Suisse ; 16(692): 904-906, 2020 May 06.
Artigo em Francês | MEDLINE | ID: mdl-32374534

RESUMO

Spasticity is a common sign of central nervous system lesions and its management is difficult because it is usually associated with other symptoms of upper motoneuron syndrome (paresis, spastic dystonia, contractures, …). We propose an interprofessional evaluation, which demonstrates that a standardized evaluation, a common approach and a gait analysis improve the therapeutic decision.


Assuntos
Sistema Nervoso Central/lesões , Sistema Nervoso Central/fisiopatologia , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/terapia , Análise da Marcha , Humanos , Espasticidade Muscular/fisiopatologia
16.
Stroke Vasc Neurol ; 5(2): 177-179, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32366614

RESUMO

Coronavirus disease-2019 (COVID-19) has become a global pandemic. COVID-19 runs its course in two phases, the initial incubation phase and later clinical symptomatic phase. Patients in the initial incubation phase often have insidious clinical symptoms, but they are still highly contagious. At the later clinical symptomatic phase, the immune system is fully activated and the disease may enter the severe infection stage in this phase. Although many patients are known for their respiratory symptoms, they had neurological symptoms in their first 1-2 days of clinical symptomatic phase, and ischaemic stroke occurred 2 weeks after the onset of the clinical symptomatic phase. The key is to prevent a patient from progressing to this severe infection from mild infection. We are sharing our experience on prevention and management of COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções do Sistema Nervoso Central/terapia , Sistema Nervoso Central/virologia , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Sistema Nervoso Central/fisiopatologia , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/fisiopatologia , Infecções do Sistema Nervoso Central/virologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Progressão da Doença , Diagnóstico Precoce , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Prognóstico , Fatores de Tempo
18.
ACS Chem Neurosci ; 11(7): 995-998, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32167747

RESUMO

The recent outbreak of coronavirus infectious disease 2019 (COVID-19) has gripped the world with apprehension and has evoked a scare of epic proportion regarding its potential to spread and infect humans worldwide. As we are in the midst of an ongoing pandemic of COVID-19, scientists are struggling to understand how it resembles and differs from the severe acute respiratory syndrome coronavirus (SARS-CoV) at the genomic and transcriptomic level. In a short time following the outbreak, it has been shown that, similar to SARS-CoV, COVID-19 virus exploits the angiotensin-converting enzyme 2 (ACE2) receptor to gain entry inside the cells. This finding raises the curiosity of investigating the expression of ACE2 in neurological tissue and determining the possible contribution of neurological tissue damage to the morbidity and mortality caused by COIVD-19. Here, we investigate the density of the expression levels of ACE2 in the CNS, the host-virus interaction and relate it to the pathogenesis and complications seen in the recent cases resulting from the COVID-19 outbreak. Also, we debate the need for a model for staging COVID-19 based on neurological tissue involvement.


Assuntos
Sistema Nervoso Central/virologia , Infecções por Coronavirus/fisiopatologia , Interações Hospedeiro-Patógeno , Pneumonia Viral/fisiopatologia , Betacoronavirus/fisiologia , Sistema Nervoso Central/fisiopatologia , Infecções por Coronavirus/imunologia , Humanos , Pandemias , Peptidil Dipeptidase A , Pneumonia Viral/imunologia , Receptores Virais/metabolismo , Distribuição Tecidual
19.
Phys Ther ; 100(6): 946-962, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32201890

RESUMO

BACKGROUND: Pain is one of the main symptoms associated with spinal cord injury (SCI) and can be associated with changes to the central nervous system (CNS). PURPOSE: This article provides an overview of the evidence relating to CNS changes (structural and functional) associated with pain in SCIs. DATA SOURCES: A systematic review was performed, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, on PubMed, Embase, and Web of Science in March 2018. STUDY SELECTION: Studies were selected if they concerned changes in the CNS of patients with SCI, regardless of the type of imagery. DATA EXTRACTION: Data were extracted by 2 blinded reviewers. DATA SYNTHESIS: There is moderate evidence for impaired electroencephalographic function and metabolic abnormalities in the anterior cingulate in patients experiencing pain. There is preliminary evidence that patients with pain have morphological and functional changes to the somatosensory cortex and alterations to thalamic metabolism. There are conflicting data regarding the relationships between lesion characteristics and pain. In contrast, patients without pain can display protective neuroplasticity. LIMITATIONS AND CONCLUSION: Further studies are required to elucidate fully the relationships between pain and neuroplasticity in patients with SCIs. However, current evidence might support the use of physical therapist treatments targeting CNS plasticity in patients with SCI pain.


Assuntos
Sistema Nervoso Central/patologia , Sistema Nervoso Central/fisiopatologia , Dor Crônica/etiologia , Neuralgia/etiologia , Traumatismos da Medula Espinal/complicações , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Encéfalo/patologia , Encéfalo/fisiopatologia , Sistema Nervoso Central/diagnóstico por imagem , Sistema Nervoso Central/metabolismo , Dor Crônica/fisiopatologia , Eletroencefalografia/métodos , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Humanos , Imagem por Ressonância Magnética/métodos , Neuralgia/fisiopatologia , Neuroimagem/métodos , Plasticidade Neuronal/fisiologia , Viés de Seleção , Córtex Somatossensorial/diagnóstico por imagem , Córtex Somatossensorial/patologia , Córtex Somatossensorial/fisiopatologia , Medula Espinal/diagnóstico por imagem , Medula Espinal/metabolismo , Medula Espinal/patologia , Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/fisiopatologia , Tálamo/diagnóstico por imagem , Tálamo/metabolismo
20.
J Med Virol ; 92(6): 552-555, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32104915

RESUMO

Following the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), another highly pathogenic coronavirus named SARS-CoV-2 (previously known as 2019-nCoV) emerged in December 2019 in Wuhan, China, and rapidly spreads around the world. This virus shares highly homological sequence with SARS-CoV, and causes acute, highly lethal pneumonia coronavirus disease 2019 (COVID-19) with clinical symptoms similar to those reported for SARS-CoV and MERS-CoV. The most characteristic symptom of patients with COVID-19 is respiratory distress, and most of the patients admitted to the intensive care could not breathe spontaneously. Additionally, some patients with COVID-19 also showed neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system inducing neurological diseases. The infection of SARS-CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. Furthermore, some coronaviruses have been demonstrated able to spread via a synapse-connected route to the medullary cardiorespiratory center from the mechanoreceptors and chemoreceptors in the lung and lower respiratory airways. Considering the high similarity between SARS-CoV and SARS-CoV2, it remains to make clear whether the potential invasion of SARS-CoV2 is partially responsible for the acute respiratory failure of patients with COVID-19. Awareness of this may have a guiding significance for the prevention and treatment of the SARS-CoV-2-induced respiratory failure.


Assuntos
Betacoronavirus/patogenicidade , Sistema Nervoso Central/virologia , Infecções por Coronavirus/epidemiologia , Cefaleia/virologia , Pandemias , Pneumonia Viral/epidemiologia , Vírus da SARS/patogenicidade , Betacoronavirus/fisiologia , Sistema Nervoso Central/fisiopatologia , China/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Humanos , Pulmão/fisiopatologia , Pulmão/virologia , Mecanotransdução Celular , Náusea/diagnóstico , Náusea/fisiopatologia , Náusea/virologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/virologia , Vírus da SARS/fisiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/fisiopatologia , Síndrome Respiratória Aguda Grave/transmissão , Síndrome Respiratória Aguda Grave/virologia , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
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