This study examined the effect of spinal nerve ligation on different populations of immunohistochemically identified neurons in the dorsal root ganglia (DRG) of the rat. The optical fractionator method was used to count neurons in the ipsilateral L4 and L5 DRG 1-20 weeks after ligation of the L5 and L6 spinal nerves, sham surgery, or no surgery. One week after ligation, neurons in the L5 DRG that were labeled by IB4, a marker of unmyelinated primary afferent neurons, were largely absent. The numbers of IB4-labeled neurons then progressively increased to reach control values by 20 weeks. A smaller, sustained decrease occurred in the number of small-, medium- and large-sized neurons immunoreactive for calcitonin gene-related peptide (CGRP), a marker for peptidergic primary afferents, in the L5 DRG. There was a proportionately greater decrease in the numbers of medium- to large-sized CGRP-like immunoreactive neurons. The number of myelinated afferents in the L5 DRG, identified by their staining for neurofilament protein (N52), did not change after ligation. However, closer examination revealed a significant decrease in the numbers of large-sized neurons, coupled with an increase in the numbers of small- to medium-sized neurons, and the appearance of a novel population of very small-sized neurons labeled by N52. The numbers and cell size distributions of IB4-labeled, CGRP-like immunoreactive, and N52-labeled neurons were unchanged in the adjacent L4 DRG. Unlike the L5 DRG, injury-induced changes in the expression of various receptors, neurotransmitters and neurotrophic factors in the L4 DRG are not confounded by a change in the immunohistochemical phenotype of primary afferent neurons.
Background and purposeFunctional magnetic resonance imaging (fMRI) is a non-invasive pre-surgical tool used to assess localization and lateralization of language function in brain tumor and vascular lesion patients in order to guide neurosurgeons as they devise a surgical approach to treat these lesions. We investigated the effect of varying the statistical thresholds as well as the type of language tasks on functional activation patterns and language lateralization. We hypothesized that language lateralization indices (LIs) would be threshold- and task-dependent.Materials and methodsImaging data were collected from brain tumor patients (n = 67, average age 48 years) and vascular lesion patients (n = 25, average age 43 years) who received pre-operative fMRI scanning. Both patient groups performed expressive (antonym and/or letter-word generation) and receptive (tumor patients performed text-reading; vascular lesion patients performed text-listening) language tasks. A control group (n = 25, average age 45 years) performed the letter-word generation task.ResultsBrain tumor patients showed left-lateralization during the antonym-word generation and text-reading tasks at high threshold values and bilateral activation during the letter-word generation task, irrespective of the threshold values. Vascular lesion patients showed left-lateralization during the antonym and letter-word generation, and text-listening tasks at high threshold values.ConclusionOur results suggest that the type of task and the applied statistical threshold influence LI and that the threshold effects on LI may be task-specific. Thus identifying critical functional regions and computing LIs should be conducted on an individual subject basis, using a continuum of threshold values with different tasks to provide the most accurate information for surgical planning to minimize post-operative language deficits.
Background: Functional Magnetic Resonance Imaging (fMRI) is a presurgical planning technique used to localize functional cortex so as to maximize resection of diseased tissue and avoid viable tissue. In this retrospective study, we examined differences in morbidity and mortality of brain tumor patients who received preoperative fMRI in comparison to those who did not. Methods: Brain tumor patients (n=206) were selected from a retrospective review of neurosurgical case logs from 2001–2009 at the University of Wisconsin-Madison. Results: Univariate analysis showed improved mortality in the fMRI group and the fMRI+Electrical Cortical Stimulation Mapping (ECM) group compared to the No-fMRI group. Multivariate analyses showed improved mortality of the fMRI group and the fMRI+ECM group compared to the No-fMRI group, with age and tumor grade being the most significant influencers. Overall, the fMRI group showed survival benefits at 3 years; twice that of the No-fMRI group. Furthermore, patients with high-grade tumors showed significant survival benefits in the fMRI group, while patients with low-grade tumors did not (controlling for age and ECM). There was also a significant difference in the two groups with respect to morbidity, with patients receiving fMRI showing improved outcomes in the motor and language domains. Conclusions: This study analyzing a large retrospective series of brain tumor patients with and without the use of fMRI in the preoperative planning has resulted in improved mortality and morbidity outcomes with the use of fMRI. These results point to the importance of incorporating fMRI in presurgical planning in the clinical management of patients with brain tumors.
Measuring tumor proximity to major white matter tracts using DTI can inform clinicians of the likelihood of postoperative functional deficits. A distance of 1 cm or less from eloquent white matter structures most significantly predicts the occurrence of new deficits with current surgical and imaging techniques.
Seizure localization includes neuroimaging like electroencephalogram (EEG), and magnetic resonance imaging (MRI) with limited ability to characterize the epileptogenic network. Temporal clustering analysis (TCA) characterizes epileptogenic network congruent with interictal epileptiform discharges (IED) by clustering together voxels with transient function MRI signals. We generated epileptogenic areas for 12 of 13 epilepsy patients with TCA, congruent with different areas of seizure onset. Resting fMRI scans are non-invasive, and can be acquired quickly (5 min), in patients with different levels of severity and function. Analyzing resting fMRI data using TCA is quick and can be utilized to complement clinical methods to characterize the epileptogenic network.
Background: Vascular lesion patients may have atypical language networks (Vikingstad et al. 2000). When evaluating language function in vascular lesion patients, the threshold of significance at which functional activations are analyzed may lead to differences in the lateralization index (LI) calculated. We examine the effect of various thresholds on language LIs in vascular lesion patients and control subjects. We further aim to compare language LIs in these two groups and to analyze patient LIs for correlations with lesion activation distance (LAD). Methods: Structural and functional images were collected from 29 vascular lesion patients and 14 normal controls while they performed language tasks in the scanner such as word generation and text comprehension. Left Hemisphere, frontal lobe (Broca’s), and temporal lobe (Wernicke’s) masks as well as masks of their homologous counterparts were created based on the language network identified in a meta-analysis of language studies by Vigneau et al. 2006. LI was calculated for each subject for each task on which data was acquired using each of the six masks at four different thresholds of statistical significance. Patient LIs were further analyzed for correlations with LAD to Broca’s and Wernicke’s areas. Results: Vascular lesion patients tend to display bilateral or left-lateralized language functions. At the group level, increasing threshold value tended to shift LIs toward left-lateralization. Relative to controls, patients with vascular lesions appear to lateralize language functions necessary for word generation to a lesser degree, which was trending toward significance. Pooled data from visual receptive language tasks shows association between computed LI values for the frontal lobe and Wernicke's LAD, which was significant at lower thresholds. Conclusions: Variable thresholding may cause reclassification of some patients based on LI, and higher thresholds tend to shift LI towards left-lateralization. The association observed between frontal lobe LI values and LAD to Wernicke’s area suggest that for these patients LAD to Wernicke’s may be a significant factor in lateralization at lower thresholds. These factors may be important if using LI in presurgical planning. Differences in the degree of lateralization between vascular lesion patients and controls may be due to long-term brain reorganization.
Purpose Evaluate concordance of provider practices with clinical guidelines for thrombectomy screening in an emergency department (ED) via computed tomography perfusion and angiogram (CT-P/A). Methods A retrospective observational study was conducted for patients 18 years or older who received a CT-P/A of the head and neck in a US Midwestern ED between September 2019 through June 2021. Healthcare system records reviewed for patient information, CT-P/A findings, and treatment decisions. Results During study period, 68,403 patients presented to the ED with 718 (1.1%) receiving a CT-P/A. Of these patients, 105 (14.6%) were transferred to a regional facility for potential thrombectomy, with 74 (70.5%) receiving procedure, 28 (26.7%) not receiving procedure, and 3 (2.9%) with insufficient follow-up information. Of patients receiving CT-P/A, 23 met DAWN criteria for thrombectomy, with 21 (91.3%) transferred for potential thrombectomy and 20 (95.2%) receiving the procedure; in comparison, 81 patients (11.7%) did not meet all DAWN criteria and were transferred for potential thrombectomy, with 52 (64.2%) receiving procedure. Lastly, 55 patients met DEFUSE-3 criteria for thrombectomy with 49 (89.1%) being transferred for potential thrombectomy and 45 (91.8%) receiving procedure. In comparison, 53 patients who did not meet all DEFUSE-3 criteria were transferred for potential thrombectomy, with 27 (50.9%) receiving procedure. Conclusions This study helps to understand CT-P/A usage, especially in patients that fall outside of treatment criteria in the current thrombectomy literature. Results may have value to institutions interested in using CT-P/A as a diagnostic tool as well as institutions already incorporating it in stroke assessments. Supplementary Information The online version contains supplementary material available at 10.1007/s10140-023-02116-x.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.