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Reorganization of spinal neural circuitry and functional recovery after spinal cord injury

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Neural Regeneration Research 2015年第2期10卷 201-202页

作者： raffaele nardone Eugen Trinka Department of Neurology Christian Doppler Klinik Paracelsus Medical University Spinal Cord Injury and Tissue Regeneration Center Paracelsus Medical University Department of Neurology Franz Tappeiner Hospital

The ability of the adult central nervous system to reorganize its circuits over time is the key to understand the functional improvement in subjects with spinal cord injury （SCI）. Adaptive changes within spared neuronal circuits may occur at cortical, brainstem, or spinal cord level, both above and below a spinal lesion （Bareyre et al., 2004）. At each level the reorganization is a very dynamic process, and its degree is highly variable, depending on several factors, including the age of the subject when SCI has occurred and the rehabilitative therapy. The use of electrophysiological techniques to assess these functional changes in neural networks is of great interest, because invasive methodologies as employed in preclinical models can obviously not be used in clinical studies.

关键词： SCI Reorganization of spinal neural circuitry and functional recovery after spinal cord injury TSR

How the brain can rewire itself after an injury: the lesson from hemispherectomy

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Neural Regeneration Research 2017年第9期12卷 1426-1427页

作者： Luca Sebastianelli Leopold Saltuari raffaele nardone Department of Neurorehabilitation Hospital of Sterzing Research Unit for Neurorehabilitation of South Tyrol Department of Neurology Hochzirl Hospital Department of Neurology Franz Tappeiner Hospital Department of Neurology Christian Doppler Klinik Paracelsus Medical University

Does a post-lesional rewiring exist in the central nervous system （CNS）？ Whereas neuroimaging and neuromodulation techniques illustrate the extensive cortical reshaping after a brain injury, the remodeling of ascending and descending neuronal pathway is more difficult to be investigated. Here, we discuss how the studies dealing with hemispherectomy （HS） can provide interesting information about the functional and anatomical reorganization which take place after an extensive unilateral lesion. Indeed, studies in humans and animal models of HS clearly illustrate that the brain is capable of a widespread rewiring between the contralesional cortices and the subcortical structures as well as the medullary segments linked to the affected side of the body.

关键词： How the brain can rewire itself after an injury the lesson from hemispherectomy

Ipsilateral motor evoked potentials in a patient with unihemispheric cortical atrophy due to Rasmussen encephalitis

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Neural Regeneration Research 2019年第6期14卷 1025-1028页

作者： raffaele nardone Patrick B.Langthaler Andrea Orioli Viviana Versace Giuditta Ilaria Scarano Francesco Brigo Leopold Saltuari Luca Carnicelli Eugen Trinka Luca Sebastianelli Department of Neurology Franz Tappeiner HospitalMeranoItaly Department of Neurology Hochzirl HospitalZirlAustria Centre for Cognitive Neurosciences Salzburg SalzburgAustria University for Medical Informatics and Health Technology UMITHall in TirolAustria Department of Neurology Christian Doppler KlinikParacelsus Medical UniversitySalzburgAustria Spinal Cord Injury and Tissue Regeneration Center SalzburgAustria Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie SalzburgAustria Department of Mathematics Paris Lodron University of SalzburgAustria Department of Neurorehabilitation Hospital of VipitenoVipitenoItaly Research Unit for Neurorehabilitation South Tyrol BolzanoItaly Department of Psychology Franz Tappeiner HospitalMeranoItaly Department of Neuroscience Biomedicine and Movement ScienceUniversity of VeronaVeronaItaly

The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male patient with acquired unilateral hemispheric atrophy due to Rasmussen encephalitis. In particular,the ipsilateral corticospinal pathways were explored using focal transcranial magnetic stimulation. In the first dorsal interosseous and wrist extensors muscles, the median amplitudes of the ipsilateral motor evoked potentials induced by transcranial magnetic stimulation in the patient were higher than those of 10 age-matched healthy control subjects. In the biceps brachii muscle, the median amplitudes of the ipsilateral motor evoked potentials were the second largest in the patient compared to the controls. This study demonstrated a reinforcement of ipsilateral motor projections from the unaffected motor cortex to the hemiparetic hand in a subject with acquired unihemispheric cortical damage.

关键词： transcranial magnetic stimulation motor cortex ipsilateral motor evoked potentials ipsilateral motor pathways Rasmussen encephalitis cortical atrophy hemispheric damage

Spinal cord involvement in patients with cirrhosis

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World Journal of Gastroenterology 2014年第10期20卷 2578-2585页

作者： raffaele nardone Yvonne Hller Monica Storti Piergiorgio Lochner Frediano Tezzon Stefan Golaszewski Francesco Brigo Eugen Trinka Department of Neurology Christian Doppler Klinik Paracelsus Medical University 5020 Salzburg Austria Department of Neurology Franz Tappeiner Hospital 39012 Merano Italy Spinal Cord Injury and Tissue Regeneration Center Paracelsus Medical University 5020 Salzburg Austria Department of Medicine Franz Tappeiner Hospital 39012 Merano Italy Department of Neurological Neuropsychological Morphological and Movement Sciences Section of Clinical Neurology University of Verona 37100 Verona Italy

A severe spinal cord involvement may rarely occur in patients with cirrhosis and other chronic liver diseases;this complication is usually associated with overt liver failure and surgical or spontaneous porto-systemic *** myelopathy(HM)is characterized by progressive weakness and spasticity of the lower extremities,while sensory and sphincter disturbances have rarely been described and are usually less *** diagnosis is assigned in the appropriate clinical setting on clinical grounds after the exclusion of other clinical entities leading to spastic *** resonance imaging is often unremarkable;however,also intracerebral corticospinal tract abnor-malities have been reported *** study of motor evoked potentials may disclose central conduction abnormalities even before HM is clinically *** responds poorly to blood ammonia-lowering and other conservative medical *** transplantation represents a potentially definitive treatment for HM in patients with decompensated cirrhosis of Child-Pugh B and C *** surgical treatment options in HM include surgical ligation,shunt reduction,or occlusion by interventional procedures.

关键词： Hepatic myelopathy Spastic paraparesis Cirrhosis C