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Analysis of human brain tissue derived from DBS surgery

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Translational Neurodegeneration 2022年第1期11卷 625-640页

作者： Salla M.Kangas Jaakko Teppo Maija J.Lahtinen Anu Suoranta Bishwa Ghimire Pirkko Mattila Johanna Uusimaa Markku Varjosalo Jani Katisko Reetta Hinttala PEDEGO Research Unit University of OuluOuluFinland Medical Research Center Oulu University HospitalUniversity of OuluOuluFinland Biocenter Oulu University of OuluOuluFinland Institute of Biotechnology HiLIFE Helsinki Institute of Life ScienceUniversity of HelsinkiHelsinkiFinland Drug Research Program Faculty of PharmacyUniversity of HelsinkiHelsinkiFin-land Neurosurgery Research Unit of Clinical NeuroscienceOulu University HospitalUniversity of OuluOuluFinland Oulu Research Group of Advanced Surgical Technologies and Physics(ORGASTP) Research Unit of Clinical NeuroscienceOulu University HospitalUniversity of OuluOuluFinland Institute for Molecular Medicine Finland(FIMM) HiLIFE Helsinki Institute of Life ScienceUniversity of HelsinkiHelsinkiFinland Clinic for Children and Adolescents Division of Pediatric NeurologyOulu University HospitalOuluFinland

Background:Transcriptomic and proteomic profiling of human brain tissue is hindered by the availability of fresh samples from living patients.Postmortem samples usually represent the advanced disease stage of the patient.Fur-thermore,the postmortem interval can affect the transcriptomic and proteomic profiles.Therefore,fresh brain tissue samples from living patients represent a valuable resource of metabolically intact tissue.Implantation of deep brain stimulation(DBS)electrodes into the human brain is a neurosurgical treatment for,e.g.,movement disorders.Here,we describe an improved approach to collecting brain tissues from surgical instruments used in implantation of DBS device for transcriptomics and proteomics analyses.Methods:Samples were extracted from guide tubes and recording electrodes used in routine DBS implantation procedure to treat patients with Parkinson’s disease,genetic dystonia and tremor.RNA sequencing was performed in tissues extracted from the recording microelectrodes and liquid chromatography-mass spectrometry(LC-MS)per-formed in tissues from guide tubes.To assess the performance of the current approach,the obtained datasets were compared with previously published datasets representing brain tissues.Results:Altogether,32,034 RNA transcripts representing the unique Ensembl gene identifiers were detected from eight samples representing both hemispheres of four patients.By using LC-MS,we identified 734 unique proteins from 31 samples collected from 14 patients.The datasets are available in the BioStudies database(accession number S-BSST667).Our results indicate that surgical instruments used in DBS installation retain brain material sufficient for protein and gene expression studies.Comparison with previously published datasets obtained with similar approach proved the robustness and reproducibility of the protocol.Conclusions:The instruments used during routine DBS surgery are a useful source for obtaining fresh brain tis-sues from living patients.This approach overcomes the issues that arise

关键词： Deep brain stimulation movement disorders Brain Proteomics Transcriptomics RNA sequencing LC-MS Personalized medicine

Hemichorea in patients with temporal lobe infarcts: Two case reports

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World Journal of Clinical Cases 2024年第4期12卷 806-813页

作者： Xu-Dong Wang Xing Li Chun-Lian Pan Department of Neurology Puren Hospital Affiliated to Wuhan University of Science and TechnologyWuhan 430081Hubei ProvinceChina School of Medicine Wuhan University of Science and TechnologyWuhan 430065Hubei ProvinceChina

BACKGROUND Hemichorea and other hyperkinetic movement disorders are uncommon present-ations of stroke and are usually secondary to deep infarctions affecting the basal ganglia and thalamus.Therefore,temporal ischemic lesions causing hemichorea are rare.We report the cases of two patients with acute ischemic temporal lobe infarct strokes that presented as hemichorea.CASE SUMMARY Patient 1:An 82-year-old woman presented with a 1-mo history of involuntary movement of the left extremity,which was consistent with hemichorea.Her diffusion-weighted imaging(DWI)revealed an acute ischemic stroke that predominantly affected the right temporal cortex,and magnetic resonance angiography of the head showed significant stenosis of the right middle cerebral artery(MCA).Treatment with 2.5 mg of olanzapine per day was initiated.When she was discharged from the hospital,her symptoms appeared to have improved compared with those previously observed.Twenty-seven days after the first admission,she was readmitted due to acute ischemic stroke.Computed tomogra-phy perfusion showed marked hypoperfusion in the right MCA territory.An emergency transfemoral cerebral angiogram was performed and showed severe stenosis in the M1 segment of the right MCA.After percutaneous transluminal angioplasty was successfully performed,abnormal movements or other neuro-logic problems did not occur.Patient 2:A 76-year-old man was admitted to our hospital for a 7-d history of right-upper-sided involuntary movements.DWI showed an acute patchy ischemic stroke in the left temporal lobe without basal ganglia involvement.Subsequent diffusion tensor imaging confirmed fewer white matter fiber tracts on the left side than on the opposite side.Treatment with 2.5 mg of olanzapine per day improved his condition,and he was discharged.CONCLUSION When acute hemichorea suddenly appears,temporal cortical ischemic stroke should be considered a possible diagnosis.In addition,hemichorea may be a sign of impending cerebral infarction with MCA stenosis.

关键词： Acute ischemic stroke Temporal ischemic stroke movement disorders Cortical hemichorea Case report

Botulinum Toxin Type A Satisfaction in Different Neurological disorders

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Neuroscience & Medicine 2022年第1期13卷 1-16页

作者： Jasem Yousef Al-Hashel Doaa Youssry Soliman Ismail Ibrahim Ismail Samar Farouk Ahmed Department of Neurology Ibn Sina Hospital Kuwait City Kuwait Department of Medicine Faculty of Medicine Health Sciences Centre Kuwait University Kuwait City Kuwait Department of Neurology Cairo University Cairo Egypt Department of Neuropsychiatry Faculty of Medicine Minia University Minia Egypt

Background: The botulinum toxin type A (BoNT-A) is used in a wide range of neurological diseases. We aimed to study the overall patients/caregivers’ satisfaction with BoNT-A treatment in different neurological conditions. Methods: Prospective study included patients who had received at least two BoNT-A treatment sessions. They were asked to rate overall treatment satisfaction at the peak of treatment effect on a 1 to 10 scale (1 = not at all satisfied;10 = fully satisfied). Subjects with a rating of 1to3 were classified as not at all satisfied, those with a rating of 4 to7 as somewhat satisfied, and those with a rating of 8 to10 as very satisfied. Treatment satisfaction questionnaire for medicine (TSQM) was assessed at the end of observational period. Quality of life QOL was assessed before BoNT-A treatment and at the last visit. Results: The study was conducted from first April 2014 to August 2021. 548 patients were identified with mean age 43.66 ± 14.50. Most of participants 389 (71%) were female. At the end of observational period, the mean satisfaction was 7.28 ± 1.78. There was a highly significant difference (P P P = 0.001). Conclusion: Satisfaction with BoNT-A therapy for different neurological disorders is overall good. The highest patient satisfaction was observed with primary focal HH, and the least satisfaction was observed in writer’s cramp. BoNT-A therapy improved QOL.

关键词： Botulinum Toxin Type A Satisfaction Headache Dystonia movement disorders Hyperhidrosis

Rare coexistence of multiple manifestations secondary to thalamic hemorrhage:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4817-4822页

作者： Qi-Wei Yu Tian-Fen Ye Wen-Jun Qian Department of Rehabilitation Medicine The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou 215008Jiangsu ProvinceChina

BACKGROUND A growing body of literature indicates that the occurrence of thalamic lesions could lead to various dysfunctions,such as somatosensory disturbances,hemiparesis,language deficits,and movement disorders.However,clinical cases describing the coexistence of these types of manifestations have not been reported.Herein,we report a patient who exhibited these rare complications secondary to thalamic hemorrhage.CASE SUMMARY A 53-year-old right-handed man experienced sudden left hemiparesis,numbness of the left side of body,and language alterations due to an acute hemorrhage located in the right basal ganglia and thalamus 18 mo ago.Approximately 17 mo after the onset of stroke,he exhibited rare complications including dysphasia,kinetic tremor confined to the left calf,and mirror movement of the left arm which are unique and interesting,and a follow-up computed tomography scan revealed an old hemorrhagic lesion in the right thalamus and posterior limb of the internal capsule.CONCLUSION Hypophonia may be a recognizable clinical sign of thalamus lesions;thalamus injury could cause tremor confined to the lower extremity and mimicking extremity movements.

关键词： Thalamic stroke Dysphasia movement disorders Case report

Neurological diseases associated with autoantibodies targeting the voltage-gated potassium channel complex:immunobiology and clinical characteristics

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Neuroimmunology and Neuroinflammation 2016年第1期3卷 69-78页

作者： Domenico Plantone Rosaria Renna Tatiana Koudriavtseva Multiple Sclerosis Center Unit of NeurologyRegina Elena National Cancer Institute00144 RomeItaly

Voltage-gated potassium channels(VGKCs)represent a group of tetrameric signaling proteins with several functions,including modulation of neuronal excitability and neurotransmitter release.Moreover,VGKCs give a key contribution to the generation of the action potential.VGKCs are complexed with other neuronal proteins,and it is now widely known that serum autoantibodies directed against VGKCs are actually directed against the potassium channel subunits only in a minority of patients.By contrast,these autoantibodies more commonly target three proteins that are complexed with alpha-dendrotoxin-labeled potassium channels in brain extracts.These three proteins are contactin-associated protein-2(Caspr-2),leucine-rich,glioma inactivated 1(LGI-1)protein and the protein Tag-1/contactin-2.Neoplasms are detected only in a minority of seropositive patients for VGKC complex-IgG and do not significantly associate with Caspr-2 or LGI-1.Among all the cancers described in association with VGKC complex-IgG,lung carcinoma,thymoma,and hematologic malignancies are the most commonly detected.We will review all the major neurological conditions associated with VGKC complex-IgG.These include Isaacs’syndrome,Morvan syndrome,limbic encephalitis,facio-brachial dystonic seizures,chorea and other movement disorders,epilepsy,psychosis,gastrointestinal neuromuscular diseases,a subacute encephalopathy that mimics Creutzfeldt-Jakob prion disease both clinically and radiologically and autoimmune chronic pain.The vast majority of these conditions are reversible by immunotherapy,and it is becoming increasingly recognized that early diagnosis and detection of VGKC complex-IgG is critical in order to rapidly start the treatment.As a result,VGKC complex-IgG are now part of the investigation of patients with unexplained subacute onset of epilepsy,memory or cognitive problems,or peripheral nerve hyperexcitability syndromes.

关键词： Chronic pain,epilepsy facio-brachial dystonic seizures leucine-rich glioma inactivated 1 protein limbic encephalitis movement disorders neuromyotonia voltage-gated potassium channels

Neuronal firing in the globus pallidus internus and the ventrolateral thalamus related to parkinsonian motor symptoms

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Chinese Medical Journal 2009年第19期122卷 2308-2314页

作者： CHEN Hai ZHUANG Ping ZHANG Yu-qing LI Jian-yu LI Yong-jie Beijing Institute of Functional Neurosurgery Department of Neurology Xuanwu Hospital Capital Medical University Beijing 100053 China

Background It has been proposed that parkinsonian motor signs result from hyperactivity in the output nucleus of the basal ganglia, which suppress the motor thalamus and cortical areas. This study aimed to explore the neuronal activity in the globus pallidus internus （GPi） and the ventrolateral thalamic nuclear group （ventral oral posterior/ventral intermediate, Vop/Vim） in patients with Parkinson＇s disease （PD）. Methods Twenty patients with PD who underwent neurosurgery were studied. Microelectrode recording was performed in the GPi （n=10） and the Vop/Vim （n=10） intraoperatively. Electromyography （EMG） contralateral to the surgery was simultaneously performed. Single unit analysis was carried out. The interspike intervals （ISI） and coefficient of variation （CV） of ISI were calculated. Histograms of ISI were constructed. A unified Parkinson＇s disease rating scale （UPDRS） was used to assess the clinical outcome of surgery. Results Three hundred and sixty-three neurons were obtained from 20 trajectories. Of 175 GPi neurons, there were 15.4% with tremor frequency, 69.2% with tonic firing, and 15.4% with irregular discharge. Of 188 thalamic neurons, there were 46.8% with tremor frequency, 22.9% with tonic firing, and 30.3% with irregular discharge. The numbers of three patterns of neuron in GPi and Vop/Vim were significantly different （P 〈0.001）. ISI analysis revealed that mean firing rate of the three patterns of GPi neurons was （80.9±63.9） Hz （n=78）, which was higher than similar neurons with 62.9 Hz in a normal primate. For the Vop/Vim group, ISI revealed that mean firing rate of the three patterns of neurons （n=95） was （23.2±17.1） Hz which was lower than similar neurons with 30 Hz in the motor thalamus of normal primates. UPDRS indicated that the clinical outcome of pallidotomy was （64.3±29.5）%, （83.4±19.1）% and （63.4±36.3）%, and clinical outcome of thalamotomy was （92.2±12.9）%, （68.0±25.2）% and （44.3±7.2）% for tremor, rigidity and bradykinesia, respectively. A significant difference of tremor and rigidity was fo

关键词： Parkinson＇s disease movement disorders globus pallidus thalamus microelectrodes

Fast tool to evaluate 3D movements of the foot-ankle complex using multi-view depth sensors

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Medicine in Novel Technology and Devices 2023年第1期17卷 107-115页

作者： Donggang Jiang Jie-Wen Li Xiang Geng Xin Ma Wen-Ming Chen Academy for Engineering and Technology Fudan UniversityShanghai200433China Department of Orthopaedics Huashan Hospital Affiliated to Fudan UniversityShanghai200040China

movement disorders of the human foot-ankle complex are a common occurrence,owing to the altered joint mechanics during foot-ground interactions.Diagnostics of such movement disorders will require quantitative tools to evaluate in-vivo foot motions,in particular to the multi-segment/joint foot kinematics(MSFK),during gait.Unfortunately,current MSFK analysis largely rely on conventional technologies,such as skin-marker based motion capturing,video fluoroscopy and dynamic 3D scanning,being extremely time-consuming and costly.In this work,a novel movement tracking method,named the point-cloud foot analysis(PFA),was implemented with multi-view depth sensors,to allow fast evaluations of 3D motions of the foot-ankle complex during gait.Quantitative analysis obtained by the PFA methods and their accuracy relative to the conventional MSFK analysis methods were evaluated.The 3D surface reconstructions of the foot-ankle complex were achieved with a RMSE less than 2 mm.It was proven to be feasible to track multi-segment foot motions in both healthy and diseased subjects during walking conditions,with the processing time decreased from more than 4-6 h to less than 6 min for the entire flow of the contact phase analysis.The PFA method can be useful for fast evaluations of the movement disorders of the foot-ankle complex in diagnostics and design of therapeutic interventions and rehabilitation programs for clinical applications.

关键词： Biomechanics Foot model Joint mechanics movement disorders Depth sensor

movement Disorder Emergencies: Diagnosis and Treatment 2

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Update on deep brain stimulation in Parkinson’s disease

丛书名： Current Clinical Neurology

2013年

作者： Steven J. Frucht M.D. (auth.), Steven J. Frucht (eds.)

来源：畅想之星图书光盘版（南... 评论

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Translational Neurodegeneration 2015年第1期4卷 84-91页

作者： Daniel Martinez-Ramirez Wei Hu Alberto R.Bona Michael S.Okun Aparna Wagle Shukla Department of Neurology University of FloridaCollege of MedicineCenter for Movement Disorders and Neurorestoration3450 Hull RoadGainesvilleFL 32607USA Department of Neurosurgery Psychiatryand HistoryUniversity of FloridaCollege of MedicineCenter for Movement Disorders and NeurorestorationGainesvilleFL 32610USA

Deep brain stimulation(DBS)is considered a safe and well tolerated surgical procedure to alleviate Parkinson’s disease(PD)and other movement disorders symptoms along with some psychiatric conditions.Over the last few decades DBS has been shown to provide remarkable therapeutic effect on carefully selected patients.Although its precise mechanism of action is still unknown,DBS improves motor functions and therefore quality of life.To date,two main targets have emerged in PD patients:the globus pallidus pars interna and the subthalamic nucleus.Two other targets,the ventralis intermedius and zona incerta have also been selectively used,especially in tremor-dominant PD patients.The main indications for PD DBS have traditionally been motor fluctuations,debilitating medication induced dyskinesias,unpredictable“off time”state,and medication refractory tremor.Medication refractory tremor and intolerable dyskinesia are potential palliative indications.Besides aforementioned targets,the brainstem pedunculopontine nucleus(PPN)is under investigation for the treatment of ON-state freezing of gait and postural instability.In this article,we will review the most recent literature on DBS therapy for PD,including cutting-edge advances and data supporting the role of DBS in advanced neural-network modulation.

关键词： movement disorders Subthalamic nucleus Globus pallidus Neural network Brain modulation Closed-loop