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Behavioral Effects of Deep Brain Stimulation of the Anterior Nucleus of Thalamus, Entorhinal Cortex and Fornix in a Rat Model of Alzheimer＇s Disease

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Chinese Medical Journal 2015年第9期128卷 1190-1195页

作者： Chao Zhang Wen-Han Hu De-Long Wu Kai Zhang Jian-Guo Zhang Department of neurosurgery Beijing Tian Tan Hospital Capital Medical University Beijing 100050 China Beijing Key laboratory of Neurostimulation Beijing 100050 China Stereotactic and Functional Neurosurgery Laboratory Beijing Neurosurgical Institute Capital Medical University Beijing 100050 China Department of neurosurgery Xiamen Fifth Hospital Xiamen University Xiamen Fujian 361101 China

Background：Recent clinical and preclinical studies have suggested that deep brain stimulation （DBS） can be used as a tool to enhance cognitive functions.The aim of the present study was to investigate the impact of DBS at three separate targets in the Papez circuit,including the anterior nucleus of thalamus （ANT）,the entorhinal cortex （EC）,and the fornix （FX）,on cognitive behaviors in an Alzheimer＇s disease （AD） rat model.Methods：Forty-eight rats were subjected to an intrahippocampal injection ofamyloid peptides 1-42 to induce an AD model.Rats were divided into six groups：DBS and sham DBS groups of ANT,EC,and FX.Spatial learning and memory were assessed by the Morris water maze （MWM）.Recognition memory was investigated by the novel object recognition memory test （NORM）.Locomotor and anxiety-related behaviors were detected by the open field test （OF）.By using two-way analysis of variance （ANOVA）,behavior differences between the six groups were analyzed.Results：In the MWM,the ANT,EC,and FX DBS groups performed differently in terms of the time spent in the platform zone （F（2.23） =6.04,P ＜ 0.01）,the frequency of platform crossing （F（2,23） =11.53,P ＜ 0.001）,and the percent time spent within the platform quadrant （F（2,23） =6.29,P ＜ 0.01）.In the NORM,the EC and FX DBS groups spent more time with the novel object,although the ANT DBS group did not （F（2,23） =10.03,P ＜ 0.001）.In the OF,all of the groups showed a similar total distance moved （F（1.42） =1.14,P =0.29）and relative time spent in the center （F（2,42） =0.56,P =0.58）.Conclusions：Our results demonstrated that DBS of the EC and FX facilitated hippocampus-dependent spatial memory more prominently thanANT DBS.In addition,hippocampus-independent recognition memory was enhanced by EC and FX DBS.None of the targets showed side-effects of anxiety or locomotor behaviors.

关键词： Anterior Thalamic Nuclei Deep Brain Stimulation Entorhinal Cortex Fornix Memory

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Acute Fornix Deep Brain Stimulation Improves Hippocampal Glucose Metabolism in Aged Mice

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Chinese Medical Journal 2018年第5期131卷 594-599页

作者： Xiu Wang Wen-Hart HU Kai Zhang Jun-Jian Zhou De-Feng Liu Mei-Yu Zhang Jian-Guo Zhang Department of neurosurgery Beijing Tian Tan Hospital Capital Medical University Beijing 100050 China Stereotactic and Functional Neurosurgery Laboratory Beijing Neurosurgical Institute Capital Medical University Beijing 100050 China Beijing Key laboratory of Neurostimulation Beijing 100050 China Experimental Research Center China Academy of Traditional Chinese Medicine Beijing 100700 China

Background： A beneficial memory effect of acute formix deep brain stimulation （DBS） has been reported in clinical studies. The aim of this study was to investigate the acute changes in glucose metabolism induced by fornix DBS. Methods： First, the Morris water maze test and novel object recognition memory test were used to confirm declined memory in aged mice （C57BL/6, 20-22 months old）. Then, four groups of mice were used as follows： aged mice with stimulation （n = 12）, aged mice with sham-stimulation （n = 8）, adult mice （3-4 months old） with stimulation （n = 12）, and adult mice with sham-stimulation （n = 8）. lpsilateral hippocampal glucose metabolism and glutamate levels were measured in vivo by microdialysis before, during, and after fornix DBS treatment. Histological staining was used to verify the localization of electrodes and mice with inaccurate placement were excluded from subsequent analyses. The effects of fornix DBS on extracellular glucose, lactate, pyruvate, and glutamate levels over time were analyzed by repeated-measures analysis of variance followed by Fisher＇s least significant difference post hoc test. Results： The aged mice had a higher basal lactate/pyruvate ratio （LPR） and lactate/glucose ratio （LGR） than the adult mice （LPR： 0.34 ± 0.04 vs. 0.13 ± 0.02, t = 4.626, P 〈 0.0001 ; LGR： 6.06± 0.59 vs. 4.14 ± 0.36, t = 2.823, P 〈 0.01 ）. Fomix DBS decreased the ipsilateral hippocampal pyruvate and lactate levels （P 〈 0.05）, but the glucose levels were not obviously changed in aged mice. Similarly, the LGR and LPR also decreased in aged mice after fornix DBS treatment （P 〈 0.05）. Glucose metabolism in adult mice was not significantly influenced by tbrnix DBS. In addition, fornix DBS significantly decreased the ipsilateral hippocampal extracellular levels of glutamate in aged mice （P 〈 0.05）, while significant alterations were not found in the adult mice. Conclusions： The present study provides experimental evidence that fornix DBS could significantly improve bippocampal glucose metabolism in aged m

关键词： Deep Brain Stimulation Fornix Glucose Metabolism Memory Decline

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Is intracranial electroencephalography mandatory for MRI-negative neocortical epilepsy surgery?

Is intracranial electroencephalography mandatory for MRI-neg...

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第十六届中国医师协会神经外科医师年会

作者： Zhihao Guo Chao Zhang Xiu Wang Chang Liu Baotian Zhao Jiajie Mo Zhong Zheng Xiaoqiu Shao Jianguo Zhang Kai Zhang Wenhan Hu Department of neurosurgery Beijing Tiantan HospitalCapital Medical University Department of neurosurgery Beijing Fengtai Hospital Department of Neurology Beijing Tiantan HospitalCapital Medical University Stereotactic and Functional Neurosurgery Laboratory Beijing Neurosurgical InstituteCapital Medical University Beijing Key laboratory of Neurostimulation

Objective:MRI-negative focal epilepsy is one of the most challenging cases in epilepsy surgical treatment.Many epilepsy centers recommend intracranial electroencephalography for MRI-negative cases,especially neocortical epilepsy.This retrospective study aimed to explore whether intracranial monitoring is mandatory in MRI-negative neocortical epilepsy surgery and the factors that significantly influence the decision to perform intracranial recording or not.Methods:In this study,consecutive surgical patients with focal MRI-negative neocortical epilepsy were recruited.All patients underwent routine preoperative evaluation according to the dedicated protocol of our epilepsy center to determine the treatment plan.Patients were divided into two groups according to the surgical strategy:a direct group and a stereo-encephalography(SEEG)-guided group.History of epilepsy,seizure frequency,interictal and ictal EEG data,PET data,PET/MRI co-registration data,neuropathological findings,and surgical outcomes were compared between the two groups.Multivariate analysis was performed to identify factors influencing the decision to implement SEEG monitoring.Results:Sixty-four patients were included in this study,of whom 19 and 45 underwent direct and SEEG-guided cortical resection,respectively.At an average follow-up of 3.9 years postoperatively,56 patients(87.5%) had Engel class I results without permanent neurological deficits.Surgical outcomes were not significantly different between the direct and SEEG-guided groups(94.7% vs.84.4%).There were significant differences between the two groups in the degree of hypometabolism(focal vs.non-focal,p<0.01) and pathological subtype(FCD II vs.others,p=0.03).Multivariate analysis revealed that the degree of hypometabolism(OR 0.01,95% CI 0.00-0.15,p=0.001) was the only independent factor affecting surgical strategy.Conclusions:Careful selection of patients with MRI-negative neocortical epilepsy may yield favorable outcomes with direct cortical resection without intracranial monitoring;PET/MRI

关键词： Neocortical epilepsy MRI-negative FDG-PET Intracranial electroencephalography Stereo-electroencephalography

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Early cisternal fibrinolysis is more effective than rescue spasmolysis for the prevention of delayed infarction after subarachnoid haemorrhage

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Stroke & Vascular Neurology 2022年第2期7卷 108-113页

作者： Roland Roelz Christian Scheiwe Jürgen Grauvogel Istvan Csok Volker Arnd Coenen Jürgen Beck Peter C Reinacher Department of neurosurgery Medical Center-University of FreiburgFreiburgGermany Department of stereotactic and functional neurosurgery Medical Center-University of FreiburgFaculty of MedicineFreiburgGermany Fraunhofer Institute for Laser Technology(ILT) AachenGermany

Background To compare the efficacy of two different concepts of cisternal therapy—PREVENTIVE fibrinolysis plus on-demand spasmolysis versus RESCUE spasmolysis—for the prevention of cerebral vasospasm(CVS)and delayed cerebral infarction(DCI)in patients with aneurysmal subarachnoid haemorrhage(aSAH).Methods Retrospective analysis of 84 aSAH patients selected for cisternal therapy for DCI prevention.66 high-risk patients received PREVENTIVE cisternal therapy to enhance blood clearance.Either stereotactic catheter ventriculocisternostomy(STX-VCS)or intraoperative placement of a cisterno-ventriculostomy catheter(CVC),followed by fibrinolytic cisternal lavage using urokinase was performed.In case of vasospasm,nimodipine was applied intrathecally.22 low-risk patients who developed CVS against expectations were selected for STX-VCS as RESCUE intervention for cisternal spasmolysis with nimodipine.Rates of DCI and mean flow velocities of daily transcranial Doppler(TCD)ultrasonographies were evaluated.Results Despite a higher prespecified DCI risk,patients selected for PREVENTIVE intervention primarily aiming at blood clearance had a lower DCI rate compared with patients selected for intrathecal spasmolysis as a RESCUE therapy(11.3%vs 18.2%).After intrathecal treatment onset,CVS(TCD>160 cm/s)occurred in 45%of patients with PREVENTIVE and 77%of patients with RESCUE therapy(p=0.013).A stronger response of CVS to intrathecal nimodipine was observed in patients with PREVENTIVE intervention as the mean CVS duration after start of intrathecal nimodipine was 3.2 days compared with 5.8 days in patients with RESCUE therapy(p=0.026).Conclusions PREVENTIVE cisternal therapy directed at blood clearance is more effective for the prevention of CVS and delayed infarction compared with cisternal RESCUE spasmolysis.

关键词： prevention spasmolysis infarction

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Cholinergic input from the pedunculopontine nucleus to the cerebellum: implications for deep brain stimulation in Parkinson's disease

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Neural Regeneration Research 2016年第5期11卷 729-730页

作者： Eugenio Scarnati Flora Vitale Annamaria Capozzo Paolo Mazzone Department of Biotechnological and Applied Medical Sciences (DISCAB) University of L’Aquila-L’Aquila Operative Unit for stereotactic and functional neurosurgery RegionalCenter for Functional Neurosurgery and DBS

Deep brain stimulation（DBS）is a well established electrophysiological treatment initially applied to treat medication-refractory motor symptoms in Parkinson＇s disease（PD）,and is now being explored for several neurological and psychiatric disorders.The specific physiological mechanisms underlying the effectiveness of DBS are not fully understood.

关键词： Cholinergic input from the pedunculopontine nucleus to the cerebellum implications for deep brain stimulation in Parkinson’s disease deep

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Diagnosis and Treatment of Clear Cell Hidradenocarcinoma of the Scalp

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2012年第6期32卷 931-936页

作者：舒凯肖群根 Fabian Büchele 张所军蒋伟雷霆 Department of neurosurgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Lab of Molecular neurosurgery Stereotactic and Functional Neurosurgery of Albert-Ludwigs University

Clear cell hidradenocarcinoma (CCH) is an exceedingly rare and highly malignant tumor of the eccrine sweat glands. Its treatment is extremely difficult due to the characteristically aggressive clinical course including repeated local recurrence and uncontrollable distal metastasis coming along with a very poor prognosis. Most published case studies recommend a wide surgical excision followed by adjuvant conservative therapy, which is generally considered to be the standard treatment. Two cases of nodular CCH of the scalp either presenting as a singular primary lesion or at an already metastatic stage were analyzed retrospectively. Wide local excision of the tumor couldn’t prevent the primary carcinoma from recurring and metastasizing. Both cases received various therapies but the results were unsatisfactory. Although most authors have recommended that early wide surgical excision of the tumor is a feasible therapeutic measurement, our results raise doubts on the efficacy of this treatment strategy. As alternative approaches (i.e. chemotherapy, radiotherapy) are similarly controversial, further studies and a wide exchange of clinical experiences are crucial.

关键词： hidradenocarcinoma scalp diagnosis treatment

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Error Analysis and Some Suggestions on Animal stereotactic Experiment from Inaccuracy of Rhesus Macaques Atlas

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Chinese Medical Journal 2016年第13期129卷 1621-1624页

作者： Guan-Yu Zhu Ying-Chuan Chen Lin Shi An-Chao Yang Yin Jiang Xin Zhang Jian-Guo Zhang Department of neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing 100050 China Department of functional Neurosurgeiy Beijing Tianan Hospital Capital Medical University Beijing 100050 China Department of functional neurosurgery Beijing Neurosurgical Institute Capital Medical UniversityBeijing 100050 China Beijing Key laboratory of Neurostimulation Beijing 100050 China

The application ofstereotactic technique is rapidly growing. For instance, deep brain stimulation （DBS）, an important neurostimulation technique in the treatment of Parkinson＇s disease, dystonia, essential tremor, ... 详细信息

关键词： Animal Experiment Atlas Rhesus Monkey stereotactic Technique

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Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease

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Neural Regeneration Research 2023年第4期18卷 901-907页

作者： Tian-Shuo Yuan Ying-Chuan Chen De-Feng Liu Ruo-Yu Ma Xin Zhang Ting-Ting Du Guan-Yu Zhu Jian-Guo Zhang Department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of functional neurosurgery Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina Beijing Key laboratory of Neurostimulation BeijingChina

There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease,the effects of sex on treatment outcome are still unclear.The aim of this retrospective observational study,was to examine sex differences in motor symptoms,nonmotor symptoms,and quality of life after subthalamic nucleus deep brain stimulation.Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00±8.01 years(55 men and 35 women).Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test,and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex.We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation.Restless legs syndrome was alleviated to a greater extent in men than in women.Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation.Furthermore,Hoehn-Yahr stage was positively correlated with the treatment response in men,while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women.In conclusion,women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms,non-motor symptoms,and quality of life.We found sex-specific factors,i.e.,Hoehn-Yahr stage and levodopa equivalent dose,that were related to motor improvements.These findings may help to guide subthalamic nucleus deep brain stimulation patient selection,prognosis,and stimulation programming for optimal the

关键词： chronic effect deep brain stimulation generalized linear model initial effect motor symptoms non-motor symptoms Parkinson’s disease quality of life sex subthalamic nucleus

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Deep brain stimulation of the nucleus basalis of Meynert modulates hippocampal-frontoparietal networks in patients with advanced Alzheimer’s disease

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Translational Neurodegeneration 2022年第1期11卷 148-160页

作者： Yin Jiang Tian-Shuo Yuan Ying-Chuan Chen Peng Guo Teng-Hong Lian Yu-Ye Liu Wei Liu Yu-Tong Bai Quan Zhang Wei Zhang Jian-Guo Zhang Department of functional neurosurgery Beijing Neurosurgical InstituteCapital Medical UniversityBeijing 100070China Department of functional neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Center for Cognitive Neurology Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Beijing Key laboratory of Neurostimulation Beijing 100070China.

Background:Deep brain stimulation(DBS)of the nucleus basalis of Meynert(NBM)has shown potential for the treatment of mild-to-moderate Alzheimer’s disease(AD).However,there is little evidence of whether NBM-DBS can improve cognitive functioning in patients with advanced AD.In addition,the mechanisms underlying the modulation of brain networks remain unclear.This study was aimed to assess the cognitive function and the resting-state connectivity following NBM-DBS in patients with advanced AD.Methods:Eight patients with advanced AD underwent bilateral NBM-DBS and were followed up for 12 months.Clinical outcomes were assessed by neuropsychological examinations using the Mini-Mental State Examination(MMSE)and Alzheimer’s Disease Assessment Scale.Resting-state functional magnetic resonance imaging and positron emis-sion tomography data were also collected.Results:The cognitive functioning of AD patients did not change from baseline to the 12-month follow-up.Interestingly,the MMSE score indicated clinical efficacy at 1 month of follow-up.At this time point,the connectivity between the hippocampal network and frontoparietal network tended to increase in the DBS-on state compared to the DBS-off state.Additionally,the increased functional connectivity between the parahippocampal gyrus(PHG)and the parietal cortex was associated with cognitive improvement.Further dynamic functional network analysis showed that NBM-DBS increased the proportion of the PHG-related connections,which was related to improved cognitive performance.Conclusion:The results indicated that NBM-DBS improves short-term cognitive performance in patients with advanced AD,which may be related to the modulation of multi-network connectivity patterns,and the hippocampus plays an important role within these networks.

关键词： Alzheimer’s disease Deep brain stimulation Nucleus basalis of Meynert Hippocampal Frontoparietal functional connectivity

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Excitatory Crossmodal Input to a Widespread Population of Primary Sensory Cortical Neurons

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Neuroscience Bulletin 2022年第10期38卷 1139-1152页

作者： Yuan-Jie Xiao Lidan Wang Yu-Zhang Liu Jiayu Chen Haoyu Zhang Yan Gao Hua He Zheng Zhao Zhiru Wang Institute and Key laboratory of Brain functional Genomics of the Chinese Ministry of Education Shanghai Key Laboratory of Brain Functional GenomicsSchool of Life SciencesEast China Normal UniversityShanghai200062China Department of neurosurgery Third Affiliated Hospital of the Navy Military Medical UniversityShanghai200438China Department of Neuroscience University of PittsburghPittsburgh15260USA

Crossmodal information processing in sensory cortices has been reported in sparsely distributed neurons under normal conditions and can undergo experience-or activity-induced plasticity.Given the potential role in brain function as indicated by previous reports,crossmodal connectivity in the sensory cortex needs to be further explored.Using perforated whole-cell recording in anesthetized adult rats,we found that almost all neurons recorded in the primary somatosensory,auditory,and visual cortices exhibited significant membrane-potential responses to crossmodal stimulation,as recorded when brain activity states were pharmacologically down-regulated in light anesthesia.These crossmodal cortical responses were excitatory and subthreshold,and further seemed to be relayed primarily by the sensory thalamus,but not the sensory cortex,of the stimulated modality.Our experiments indicate a sensory cortical presence of widespread excitatory crossmodal inputs,which might play roles in brain functions involving crossmodal information processing or plasticity.

关键词： Crossmodal input Crossmodal response Crossmodal plasticity Sensory cortex Crossmodal task Sensory loss GABAergic transmission

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