Search results for "Spinal"
showing 10 items of 906 documents
Lithium and GSK3-β promoter gene variants influence white matter microstructure in bipolar disorder
2013
Lithium is the mainstay for the treatment of bipolar disorder (BD) and inhibits glycogen synthase kinase 3-beta (GSK3-beta). The less active GSK3-beta promoter gene variants have been associated with less detrimental clinical features of BD. GSK3-beta gene variants and lithium can influence brain gray matter structure in psychiatric conditions. Diffusion tensor imaging (DTI) measures of white matter (WM) integrity showed widespred disruption of WM structure in BD. In a sample of 70 patients affected by a major depressive episode in course of BD, we investigated the effect of ongoing long-term lithium treatment and GSK3-beta promoter rs334558 polymorphism on WM microstructure, using DTI and …
Cisternostomy for Traumatic Brain Injury: Pathophysiologic Mechanisms and Surgical Technical Notes
2016
Objective Traumatic brain injury (TBI) is one of the major challenges in health care, representing the third most frequent cause of death. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies. Here we describe cisternostomy, an emerging surgical treatment for the treatment of TBI. Methods Cisternostomy is a novel technique that incorporates knowledge of skull base and microvascular surgery. By opening the brain cisterns to atmospheric pressure, the technique could decrease the intracranial pressure due to a backshift of the cerebrospinal fluid (CSF) from the swollen brain to the cisterns through the Virchow-Rob…
Radiofrequency treatment of cervicogenic headache
2010
Objectives: In the clinical management of facial pain, a possible cervical origin must be considered. A clinical exploration is therefore essential. The disorder originates in the intimate connections between the cranial portion of the spinal cord and the trigeminal system. Although solid evidence supporting the use of radiofrequency (RF) treatment is lacking, it remains one of the management options to be taken into account. The present study evalu - ates the efficacy of RF in application to cervicogenic headache. Study design: We present three cases of severe facial pain arising from different cervical structures. Results: In two cases the pain originated in cervical roots C2 and C3, whil…
Spinal ependymoma in adults: a multicenter investigation of surgical outcome and progression-free survival
2018
OBJECTIVESpinal ependymomas are rare glial neoplasms. Because their incidence is low, only a few larger studies have investigated this condition. There are no clear data concerning prognosis and therapy. The aim of the study was to describe the natural history, perioperative clinical course, and local tumor control of adult patients with spinal ependymomas who were surgically treated under modern treatment standards.METHODSThe authors performed a multicenter retrospective study. They identified 158 adult patients with spinal ependymomas who had received surgical treatment between January 2006 and June 2013. The authors analyzed the clinical and histological aspects of these cases to identif…
Abnormal BAEP and internal auditory canal MRI in intracranial hypotension
2017
Intracranial hypotension (IH) is a treatable condition due to cerebrospinal fluid leak, characterised by variable clinical and MRI findings.1 Positional headache, neck stiffness, hearing changes with subdural fluid collection, enhancement of meninges, engorgement of venous structures and brain sagging are among the most frequent clinical and MRI findings. Typical abnormalities are found in 68%–85% of patients1. Hearing alterations (ranging from misperception to severe hearing loss) are known clinical symptoms of IH.1 The mechanism involves secondary perilymph depression due to patency of the cochlear aqueduct, inducing a compensatory expansion of the endolymphatic compartment, decreasing ba…
Characterization of blink reflex interneurons by activation of diffuse noxious inhibitory controls in man.
1998
The blink reflex consists of an early, pontine R1-component and a late, medullary R2-component. R1 and R2 can be evoked by innocuous stimuli, but only the R2 also by painful heat, suggesting that the R2 is mediated by wide dynamic range neurons (WDR) of the spinal trigeminal nucleus. Remote noxious stimuli suppress the activity in WDR neurons via activation of diffuse noxious inhibitory controls (DNIC), whereas low-threshold mechanoreceptive neurons (LTM) are unaffected. In order to characterize the trigeminal interneurons of R1 and R2 we investigated the modulation of the blink reflex by remote painful heat. The blink reflex was elicited in 11 healthy subjects by innocuous electrical pulse…
Inward currents in primary nociceptive neurons of the rat and pain sensations in humans elicited by infrared diode laser pulses
2002
Radiant heat is often used to study nociception in vivo. We now used infrared radiation generated by a diode laser stimulator (wavelength 980 nm) to investigate transduction mechanisms for noxious heat stimuli in acutely dissociated dorsal root ganglion (DRG) neurons of rats in vitro. The laser stimulator offered the unique opportunity to test whether the same stimuli also elicit pain sensations in humans. A specific heat-induced current (I(heat)) was elicited in six of 13 small DRG neurons (diameteror =30 microm) tested in the whole-cell configuration of the patch-clamp mode. Current responses in the seven heat-insensitive neurons were within the range explainable by the temperature depend…
Training the Motor Cortex by Observing the Actions of Others During Immobilization
2014
International audience; Limb immobilization and nonuse are well-known causes of corticomotor depression. While physical training can drive the recovery from nonuse-dependent corticomotor effects, it remains unclear if it is possible to gain access to motor cortex in alternative ways, such as through motor imagery (MI) or action observation (AO). Transcranial magnetic stimulation was used to study the excitability of the hand left motor cortex in normal subjects immediately before and after 10 h of right arm immobilization. During immobilization, subjects were requested either to imagine to act with their constrained limb or to observe hand actions performed by other individuals. A third gro…
Determination of acetylcholine, nitrostigmine and acetylcholinesterase activity in four patients with severe nitrostigmine (E 605 forte) intoxication.
1974
Concentrations of acetylcholine and nitrostigmine as well as acetylcholinesterase activity were determined in 4 patients with severe nitrostigmine intoxication. In the acute phase of the intoxication, acetylcholine levels up to 36 and 55 ng/ml were found in blood plasma and cerebrospinal fluid, respectively. At the same time no activity of acetylcholinesterase in plasma and erythrocytes was detected. Acetylcholinesterase activity gradually recovered at the end of the second week. In the first 3 days after the ingestion plasma nitrostigmine concentrations ranged from 409 to 86 ng/ml. At the end of the third week nitrostigmine was still found in a concentration of about 1 ng/ml plasma. Redist…
Spinal Endocannabinoids and CB 1 Receptors Mediate C-Fiber–Induced Heterosynaptic Pain Sensitization
2009
Plastic Pain Perception Drugs and endocannabinoids acting on cannabinoid (CB) receptors have potential in the treatment of certain types of pain. In the spinal cord they are believed to suppress nociception, the perception of pain and noxious stimuli. Pernia-Andrade et al. (p. 760 ) now find that endocannabinoids, which are released in spinal cord by noxious stimulation, may promote rather than inhibit nociception by acting on CB1 receptors. Endocannabinoids not only depress transmission at excitatory synapses in the spinal cord, but also block the release of inhibitory neurotransmitters, thereby facilitating nociception.