关键词： Brain tumor survivors   Adaptive skills   Frontal systems   Neurological sequelae   Long-term outcomes   Apathy   Cognition  

摘要： Objectives: Survivors of childhood brain tumors experience neurological sequelae that disrupt everyday adaptive functioning (AF) skills. The Neurological Predictor Scale (NPS), a cumulative measure of tumor treatments and sequelae, predicts cognitive outcomes, but findings on its relation to informant-reported executive dysfunction (ED) and AF are mixed. Given known effects of frontal-subcortical system disruptions on AF, this study assessed the NPS' relationship with AF as mediated by frontal systems dysfunction, measured by the Frontal Systems Behavior Scale (FrSBe). Methods: 75 participants (M-age = 23.5, SDage = 4.5) were young adult survivors of childhood brain tumors at least 5 years past diagnosis. FrSBe and Scales of Independent Behavior-Revised (SIB-R), a measure of AF, were administered to informants. Parallel multiple mediator models included Apathy and ED as mediators, and age at diagnosis and time between diagnosis and assessment as covariates. Results: More complex treatment and sequelae were correlated with poorer functioning. Mediation models were significant for all subscales: Motor Skills (MS), p = .0001;Social Communication (SC), p = .002;Personal Living (PL), p = .004;Community Living (CL), p = .007. The indirect effect of ED on SC and CL was significant;the indirect effect of Apathy was not significant for any subscales. Conclusions: More complex tumor treatment and sequelae were associated with poorer long-term AF via increased ED. Cognitive rehabilitation programs may focus on the role of executive function and initiation that contribute to AF, particularly SC and CL skills, to help survivors achieve comparable levels of independence in everyday function as their peers.

关键词： angiopoietin‐   1   neuroprotection   neurorestoration   stroke   type 1 diabetes mellitus   vasculotide  

摘要： Aim Vasculotide (VT), an angiopoietin-1 mimetic peptide, exerts neuroprotective effects in type one diabetic (T1DM) rats subjected to ischemic stroke. In this study, we investigated whether delayed VT treatment improves long-term neurological outcome after stroke in T1DM rats. Methods Male Wistar rats were induced with T1DM, subjected to middle cerebral artery occlusion (MCAo) model of stroke, and treated with PBS (control), 2 mu g/kg VT, 3 mu g/kg VT, or 5.5 mu g/kg VT. VT treatment was initiated at 24 h after stroke and administered daily (i.p) for 14 days. We evaluated neurological function, lesion volume, vascular and white matter remodeling, and inflammation in the ischemic brain. In vitro, we evaluated the effects of VT on endothelial cell capillary tube formation and inflammatory responses of primary cortical neurons (PCN) and macrophages. Results Treatment of T1DM-stroke with 3 mu g/kg VT but not 2 mu g/kg or 5.5 mu g/kg significantly improves neurological function and decreases infarct volume and cell death compared to control T1DM-stroke rats. Thus, 3 mu g/kg VT dose was employed in all subsequent in vivo analysis. VT treatment significantly increases axon and myelin density, decreases demyelination, decreases white matter injury, increases number of oligodendrocytes, and increases vascular density in the ischemic border zone of T1DM stroke rats. VT treatment significantly decreases MMP9 expression and decreases the number of M1 macrophages in the ischemic brain of T1DM-stroke rats. In vitro, VT treatment significantly decreases endothelial cell death and decreases MCP-1, endothelin-1, and VEGF expression under high glucose (HG) and ischemic conditions and significantly increases capillary tube formation under HG conditions when compared to non-treated control group. VT treatment significantly decreases inflammatory factor expression such as MMP9 and MCP-1 in macrophages subjected to LPS activation and significantly decreases IL-1 beta and MMP9 expression

关键词： LRRK2   Parkinson   microbiome   gut–   brain axis   gut immunity  

关键词： Adult-onset Still's disease   Aseptic meningitis   Hearing loss   Sudden confounding syndrome  

摘要： Adult-onset Still's disease (AOSD) is a rare inflammatory disorder in which pathophysiology is yet to be fully understood. We report the case of a 66-year-old male that presents with fever, arthralgia, and laboratory abnormalities suggestive of a systemic inflammatory disease. During a diagnostic workout, the patient developed neurological symptoms, namely a sudden confounding syndrome and hearing loss that improved with corticosteroid therapy. After exclusion of malignancy, infection-namely nervous system infection-and other rheumatic diseases, AOSD diagnosis was made using the Yamaguchi criteria. In some rare cases, neurological symptoms are present and the diagnosis may become even more challenging if the clinicians are not aware of these rare manifestations of AOSD. Therefore, the authors present the case of a patient with neurological manifestations of AOSD.

关键词： flexible optoelectronic fibers   multichannel electrophysiological recording   optical fiber   optogenetics  

摘要： Optical fibers made of polymeric materials possess high flexibility that can potentially integrate with flexible electronic devices to realize complex functions in biology and neurology. Here, a multichannel flexible device based on four individually addressable optical fibers transfer-printed with flexible electronic components and controlled by a wireless circuit is developed. The resulting device offers excellent mechanics that is compatible with soft and curvilinear tissues, and excellent diversity through switching different light sources. The combined configuration of optical fibers and flexible electronics allows optical stimulation in selective wavelengths guided by the optical fibers, while conducting distributed, high-throughput biopotential sensing using the flexible microelectrode arrays. The device has been demonstrated in vivo with rats through optical stimulation and simultaneously monitoring of spontaneous/evoked spike signals and local field potentials using 32 microelectrodes in four brain regions. Biocompatibility of the device has been characterized by behavior and immunohistochemistry studies, demonstrating potential applications of the device in long-term animal studies. The techniques to integrate flexible electronics with optical fibers may inspire the development of more flexible optoelectronic devices for sophisticated applications in biomedicine and biology.

关键词： Intracerebral hemorrhage   ICH volume   Pupillometry   Neurological pupil index   Midline shift  

摘要： Objectives: There is growing interest in the ability of automated infrared pupillometry to assess severity of neurological illness. We studied the correlation between computed tomography (CT) indicators of intracerebral hemorrhage (ICH) severity with objective measures of the pupillary light reflex (PLR), and hypothesized that hemorrhage volume would predict the Neurological Pupil index (TM) (NPi (TM)), an indicator of pupillary reactivity. Methods: This study examined data from patients with supratentorial ICH who underwent serial pupillometer evaluations. CT images were examined to determine the location and laterality of the hemorrhage, along with hematoma volume (using the simplified ABC/2 method), midline shift, hydrocephalus score, and modified Graeb score (indicating interventricular hemorrhage). Demographics were examined with standard measures of central tendency, hypotheses with logistic regression, categorical data with Fisher's Exact X2, and multivariate modeling with constructed MAX-R models. Results: Data were gathered from 44 subjects. ICH volume exhibited the strongest correlation with NPi (ipsilateral [r(2) = 0.48, p < 0.0001, contralateral [(r(2) = 0.39, p < 0.0001]). Horizontal midline shift of the septum pellucidum also correlated with NPi (ipsilateral [r(2) = 0.25, p = 0.0006], contralateral [r(2) = 0.15, p = 0.0106]), as did shift of the pineal gland (ipsilateral [r(2) = 0.21, p = 0.0017], contralateral[r(2) = 0.11, p = 0.0328]). ICH volume was the most predictive of abnormal NPi (AUC = 0.85 for ipsilateral and 0.88 for contralateral NPi), and multivariate modeling identified additional independent predictors of NPi. Conclusion: ICH volume and shift of midline structures correlate with NPi, and abnormalities in NPi can be predicted by hematoma volume and other CT indicators of ICH severity. Future studies should explore the role of NPi in detecting early hematoma expansion and worsening midline shift.

关键词： endovascular recanalization   revascularization   stroke   thrombectomy  

摘要： Background and purpose Mechanical thrombectomy (MT) is the standard of care for patients with anterior circulation large vessel occlusion. Early neurological improvement (ENI), defined as a reduction of >= 8 on the National Institutes of Health Stroke Scale (NIHSS) compared with baseline score, or an NIHSS score of 0 or 1 at 24 h after MT, is a strong predictor of 3-month favorable outcome in such patients. The impact of ENI after MT in stroke patients with basilar artery occlusion (BAO) on 3-month outcome is not clear. We aimed to study the effects of ENI in patients with BAO. Methods We performed a retrospective analysis of a multicenter prospective cohort of all consecutive stroke patients with BAO who underwent MT. We compared clinical outcomes between BAO patient groups according to ENI status. Multivariate analyses were performed to determine the impact of ENI on favorable 90-day outcome (modified Rankin scale score 0-3) and to report factors contributing to ENI. Results A total of 237 patients were included. ENI was observed in 70 patients (30%). Outcomes were significantly better in ENI-positive patients, with 84% achieving favorable outcome (mRS score 0-3) at 3 months versus 30% for ENI-negative patients (P < 0.0001). In multivariate analysis, ENI was an independent predictive factor associated with higher rates of favorable outcome {odds ratio (OR) 18.12 [95% confidence interval (CI) 3.95-83.10];P = 0.0001}. Higher number of passes [OR 0.62 (95% CI 0.43-0.89);P = 0.010] and need for stenting [OR 0.27 (95% CI 0.07-0.95);P = 0.041] were negatively associated with ENI. Conclusion Early neurological improvement on day 1 following MT for BAO is a strong independent predictor of a favorable 3-month clinical outcome.

关键词： genomics   preferences   personal utility   neurodevelopmental disorders   children  

摘要： Purpose To estimate the value of genomic sequencing for complex pediatric neurological disorders of suspected genetic origin. Methods A discrete choice experiment (DCE) was undertaken to elicit societal preferences and values. A Bayesian D-efficient and explicit partial profile design was used. The design included 72 choice tasks, split across six blocks, with eight attributes (three overlapping per choice task) and three alternatives. Choice data were analyzed using a panel error component mixed logit model and a latent class model. Preference heterogeneity according to personal socioeconomic, demographic, and attitudinal characteristics was explored using linear and fractional logistic regressions. Results In total, 820 members of the Australian public were recruited. Statistically significant preferences were identified across all eight DCE attributes. We estimated that society on average would be willing to pay AU$5650 more (95% confidence interval [CI]: AU$5500 to $5800) (US$3955 [95% CI: US$3850 to $4060]) for genomic sequencing relative to standard care. Preference heterogeneity was identified for some personal characteristics. Conclusion On average, society highly values all diagnostic, process, clinical, and nonclinical components of personal utility. To ensure fair prioritization of genomics, decision makers need to consider the wide range of risks and benefits associated with genomic information.

关键词： Community   District   Development   Neurology   Sialorrhoea