Thalamic and Subthalamic Deep Brain Stimulation for Essential Tremor

Abstract

BACKGROUND Brain damage markers released in cerebrospinal fluid (CSF) and blood may provide valuable information about diagnosis and outcome prediction after traumatic brain injury (TBI). OBJECTIVE This study examined concentrations of a novel brain injury biomarker Ubiquitin C-terminal Hydrolase-L1 (UCH-L1) in CSF and serum of severe TBI patients and their association with clinical characteristics and outcome. METHODS This case-control study enrolled ninety-five severe TBI subjects (Glasgow Coma Score [GCS] ≤8). Using sensitive UCH-L1 sandwich ELISA, we studied the temporal profile of CSF and serum UCH-L1 levels over 7 days for severe TBI patients. RESULTS Comparison of serum and CSF levels of UCH-L1 in TBI patients versus controls show robust and significant elevation of UCH-L1 in acute phase and over the 7 day study period. Serum and CSF UCH-L1 Receiver Operation Characteristics (ROC) curves further confirm strong specificity and selectivity for diagnosing severe TBI versus controls, with area under the curve (AUC) values in serum and CSF statistically significant at all time points up to 24 h (p < .001). The first 12 hour levels of both serum and CSF UCH-L1 in patients GCS 3–5 were also significantly higher than those with GCS 6–8. Furthermore, UCH-L1 levels in CSF and serum appear to distinguish severe TBI survivors versus non-survivors within the study, with non-survivors having significantly higher and more persistent levels of serum and CSF UCH-L1. Cumulative serum UCH-L1 level >5.22 ng/ml predicted death (odds ratio 4.8). CONCLUSION Taken together, serum levels of UCH-L1 appear to have potential clinical utility in diagnosing TBI, including correlating to injury severity and survival outcome.

cPKCγ‐mediated down‐regulation of UCHL1 alleviates ischaemic neuronal injuries by decreasing autophagy viaERK‐mTOR pathway

“…The significant elevation of UCHL1 in CSF and serum is found in the traumatic brain injury (TBI) patients and rats subjected to MCAO, which may be correlated with injury severity and survival outcome of brain injuries 22, 23, 42. In this study, we observed the same change in CSF and serum of mice with 1‐hr MCAO/24‐hr R treatment.…”

Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases

“…Second, the spatial resolution of rs-fcMRI is limited. Small changes in DBS electrode position below this resolution can have profound effects on clinical response that may limit the utility of rs-fcMRI (115)(116)(117). Finally, seed-based functional-connectivity results are highly dependent on the position of the seed region.…”

“…However, effective DBS electrode contacts may lie outside the targeted neuroanatomical structure (e.g., ref. 115), and modeling the volume of tissue affected by DBS is nontrivial (116,121). Similarly, regions of interest (ROIs) representing sites of noninvasive brain stimulation often had to be approximated based on clinical descriptions and scalp landmarks and used a relatively simple model of tissue activation (44,122,123).…”

Blood biomarkers for evaluation of perinatal encephalopathy: state of the art

“…Because of its high and specific expression in brain tissue, increased levels of UCHL1 have been suggested as a marker of CNS injury such as acute cerebral ischemic disease and early stage severe traumatic brain injury (Lv et al, 2015). Serum UCHL1 is a useful biomarker of severe traumatic brain injury both in the acute phase and in the 1st week after injury (Mondello et al, 2012b). In 251 patients with suspected mild to moderate traumatic brain injury UCHL1 outperformed GFAP and S100B in reducing CT scan use without sacrificing sensitivity (Welch et al, 2016).…”