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Intracerebral Microdialysis in Neurosurgery for Obsessive-Compulsive Disorder: Report of 2 Preliminary Cases

Open Journal of Modern Neurosurgery 2020年第3期10卷 371-381页

作者： Sergio A. Sacchettoni rafael galera Juan F. Del Corral Juan P. Abud Aníbal Pinero Luis Teneud Napoleón Torres rafael Rojas Pedro Rada Félix Guerrero Edgar González Mónica Bifano Dely Yazawa Luis Hernández Hospital and School of Medicine JM Vargas Universidad Central de Venezuela Caracas Venezuela Centro Medico-Docente La Trinidad Caracas Venezuela Neurology Mobile System Associates Miami FL USA Laboratory of Physiology of Behavior Universidad de Los Andes Mérida Venezuela University of Grenoble-Alpes CEA LETI Clinatec France

Neurosurgery for psychiatric disorders, notably for obsessive-compulsive disorder (OCD), was initiated in Venezuela in the decade of 1970, and consisted since that time in the classic stereotactic anterior cingulotomy. In order to know further about the physiopathology of this disorder, we performed intracerebral microdialysis in 2 patients who were operated on. The aim was to measure changes in extracellular neurotransmitters within the basal ganglia. The microdialysis probes were stereotactically placed in the right caudate nucleus and in the dorsomedial nucleus of the right thalamus. The microdialysis was done before the left cingulotomy, during the pause and after the right cingulotomy. Glutamate and gamma-aminobutyric acid (GABA) changes were similar in the caudate nucleus of both patients, whereas in the dorsomedial nucleus the changes were opposite among the 2 patients. Although this study does not bring enough data to explain such differences yet, the existence of dynamic changes in the neurochemistry of the basal ganglia during cingulotomy shows that intracerebral microdialysis can help in the understanding of the pathophysiology of OCD and eventually in the design of new surgeries with better results.

关键词： Psychiatric Neurosurgery Psychosurgery Obsessive-Compulsive Disorder Intracerebral Microdialysis

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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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HLA B27 as Predisposition Factor to Suffer Age Related Macular Degeneration

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Cellular & Molecular Immunology 2009年第4期6卷 303-307页

作者： Enrique Villegas Becerril rafael Gonzalez Fernandez Luis Perula Torres Manuel Santos Lacomba Jose Maria Gallardo galera Hospital Universitario Reina Sofia Cordoba Spain Faculty of Medicine University of Cordoba Spain Hospital Universitario Reina Sofia C/Conchita Cintron n 4 Atico 2 CP 14011

To research whether specific alleles HLA class Ⅰ （HLA-A and HLA-B） and class Ⅱ （HLA-DR） are risk factors for the development of exudative type of Age Related Macular Degeneration（ARMD）, HLA antigens are expressed both in normal and affected eyes with ARMD. We designed a prospective case-controlled study. We recruited 75 patients with choroidal neovascuiarization predominantly classic or occult, secondary to ARMD, and treated with photodynamic therapy. Two hundred and fifty patients over 55 years old, without ophthalmologic pathology who went to hospital for an analytical routine check were used as control. The analysis of the data shows a significant difference between two groups. Allele HLA-B27 correlated positively with ARMD （p 〈 0.0113）. However, we didn＇t find alleles negatively associated. Thus HLA-B27 is an allele predisposed to suffer ARMD.

关键词： HLA alleles ARMD HLA B27 patient with ARMD

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Enhanced depth OCT imaging of the lamina cribrosa for 24 hours

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International Journal of Ophthalmology(English edition) 2017年第2期10卷 306-309页

作者： Pedro Naranjo Bonilla rafael Giménez Gómez David Ríos Jiménez María Luísa Varas Fabra María del Carmen Munoz Villanueva Rocío García Catalán Pilar Font Ugalde María Soledad Poblador Fernández JoséLuís Lancho Alonso JoséMaría Gallardo galera Department of Ophthalmology Reina Sofia University HospitalCordoba 14004Spain Methodological Support to Research Maimonides Institute for Biomedical ResearchReina Sofia University HospitalCordoba 14004Spain Department of Medicine UCO Maimonides Institute for Biomedical ResearchReina Sofia University HospitalCordoba 14004Spain Department of Morphological Sciences Faculty of MedicineCordoba 14004Spain

The lamina cribrosa thickness（LCT） could be affected by dynamic changes in its *** spectral-domainoptical coherence tomography（SD-OCT）,we have studied the behaviour of the laminar region in 14 young subjects over 24 *** changes in LCT were observed,depending on the time at which the measurement was taken,with the maximum thickness being observed at 7.30 p.m.,and the minimum at 7.30 *** finding could suggests a circadian pattern in the LCT thickness in healthy subjects,which could have implications for the classification,diagnosis and prognosis of both normal and glaucomatous subjects.

关键词： lamina cribrosa laminar region glaucoma optical coherence tomography twenty-four-hours

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