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Lights for epilepsy:can photobiomodulation reduce seizures and offer neuroprotection?

Neural Regeneration Research 2023年第7期18卷 1423-1426页

作者： napoleon torres-Martinez Stephan Chabardes John Mitrofanis University of Grenoble Alpes FDD and CEA-LETIClinatecGrenobleFrance

Epilepsy is synonymous with individuals suffering repeated“fits”or *** seizures are triggered by bursts of abnormal neuronal activity,across either the cerebral cortex and/or the *** addition,the seizure sites are characterized by considerable neuronal *** the factors that generate this abnormal activity and death are not entirely clear,recent evidence indicates that mitochondrial dysfunction plays a central *** treatment options include drug therapy,which aims to suppress the abnormal neuronal activity,or surgical intervention,which involves the removal of the brain region generating the seizure ***,~30%of patients are unresponsive to the drugs,while the surgery option is invasive and has a morbidity ***,there is a need for the development of an effective non-pharmacological and non-invasive treatment for this disorder,one that has few side *** this review,we consider the effectiveness of a potential new treatment for epilepsy,known as photobiomodulation,the use of red to near-infrared light on body *** studies in animal models have shown that photobiomodulation reduces seizure-like activity and improves neuronal ***,it has an excellent safety record,with little or no evidence of side effects,and it is *** all together,this treatment appears to be an ideal treatment option for patients suffering from epilepsy,which is certainly worthy of further consideration.

关键词： cell death gliosis inflammation infrared mitochondria non-pharmacological red seizure

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Effects of Microselective Neurotomy on Focal Spasticity and Description of the Surgical Technique

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Open Journal of Modern Neurosurgery 2021年第3期11卷 144-156页

作者： Sergio A. Sacchettoni Joyce Bolaños napoleon torres Juan P. Abud Penelope Mantilla Luis Salazar Maria-Fernanda Vargas Julio Rodriguez-Wulff Randy Balladares Ricardo Gomez Service of Neurosurgery Hospital Vargas de Caracas Caracas Venezuela Service of Neurosurgery Centro Medico Docente La Trinidad Caracas Venezuela Neurological Unit “NeuroQX” Centro Médico Integra Caracas Venezuela Université Grenoble Alpes Grenoble France

We studied the microselective neurotomy (MSN) and its advantages to alleviate disabling spasticity. The best indication for MSN is focal spasticity. We performed 298 MSN, 87 nerves on the upper limb, 211 nerves on the lower limb) in 68 patients. The initial causes were: stroke, cranial trauma, postoperative complications and multiple sclerosis. MSN procedures were performed on the median nerve (n = 40) for wrist and finger flexion;musculo-cutaneus nerve (n = 38) for elbow flexion;ulnaris nerve (n = 9) for cubital deviation of the hand;gastrocnemius nerve (n = 98) and soleus nerve (n = 49) for equinus foot, tibial posterior nerve (n = 45) for varus foot, and fascicles (or bundles) of the flexor digitorum for “claw” toes (n = 19). The main preoperative test to identify the responsible nerve was a neuromuscular block with local anesthesia (lidocaine or bupivacaine) injected into the site of the nerve connecting the spastic muscle. During surgery, the identified nerve was exposed and its epineurium opened. Nerve bundles were teased apart into individual rootlets and a number of rootlets cut were previously planned, according to the spasticity. Follow-up was performed for up to 10 years, with a mean period of 29 months. Results demonstrated a reduction of limb spasticity of 2 to 3 points: modified Ashworth scale (MAS). Pain and clonus were also diminished in the affected limb. In some cases, voluntary movement was once again possible. MSN is a useful alternative in those cases of focal spasticity where physiotherapy and nerve block with botulinum toxin or phenol no longer produce satisfactory results.

关键词： Focal Spasticity Microselective Neurotomy Neurosurgery of Spasticity

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Dynamic Cerebral Microdialysis during Pallidotomy and Thalamotomy in Parkinson’s Disease: A Preliminary Neurochemical Study

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Open Journal of Modern Neurosurgery 2020年第2期10卷 284-296页

作者： Sergio A. Sacchettoni Juan P. Abud napoleon torres Yngo García Daniel A. Onay Juan Luis Rodulfo Juan Félix Del Corral Pedro Rada Rafael Galera Luis Hernández Service of Neurosurgery Hospital and School of Medicine JJ Vargas Universidad Central de Venezuela Caracas Venezuela Unit of Surgical Research Hospital and School of Medicine JJ Vargas Universidad Central de Venezuela Caracas Venezuela Univ. Grenoble Alpes CEA LETI Clinatec France Laboratory of Behavioral Physiology Faculty of Medicine Universidad de Los Andes Mérida Venezuela

In Parkinson’s disease (PD), dopaminergic neurons reduce the regulation of glutamatergic (glutamate-Glu) input from the cortex to neostriatum (caudate and putamen nuclei) consequently leading to a hyperactivity of globus pallidus internae (GPi) neurons that release gamma-amino-butyric acid (GABA) into the thalamic ventrolateral (VL) nucleus. The objective of the present experiment was to measure changes in GABA and Glu in the caudate and the thalamus of 2 patients during the application of electrical stimuli following either a pallidotomy or a thalamotomy. Proper insertion of the electrode was tested by applying high frequency electrical pulses (HFEP). During these procedures, we obtained neurochemical information placing cerebral (CMD) microdialysis probes in caudate nucleus and VL nucleus of ipsi- and contra-lateral thalamus. In VL thalamus, extracellular GABA decreased during HFEP, tending to reach previous levels once HFEP was finalized. Following the pallido- or thalamotomy GABA decreased again. Similarly, in the contralateral VL thalamus, extracellular GABA levels showed a similar but less pronounced profile but did not show any decrement after the lesion. Caudate Glu decreases when HFEP is applied to the GPi and recovers to previous levels after HFEP, but did not decrease again after lesion (GPi-tomy), instead it continued to rise. These results suggest that HFEP exerts a similar but reversible biochemical effect as thermopallido- or thermothalamotomy on GABA extracellular concentration in the ipsilateral VL thalamus. We also observe a distant effect of HFEP, but not of thermolesion, on contralateral thalamic GABA and ipsilateral caudate Glu.

关键词： Cerebral Microdialysis Parkinson’s Disease Pallidotomy Thalamotomy Basal Ganglia Circuit Cerebral Electromodulation DBS

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