Glymphatics Visualization after Focused Ultrasound-Induced Blood-Brain Barrier Opening in Humans.

It is currently unclear whether the glymphatic system, a brain-wide interstitial fluid-cerebrospinal fluid exchange described in rodents, exists in humans. Focal blood-brain barrier disruption using magnetic resonance-guided focused ultrasound allows parenchymal penetration of gadobutrol contrast, creating an opportunity to study glymphatics in vivo noninvasively. We describe patterns of contrast distribution in the perivascular space, subarachnoid space, and space surrounding large veins draining toward the dural sinuses on fluid-attenuated inversion recovery in subjects with Alzheimer disease and amyotrophic lateral sclerosis.

Blood-brain barrier opening in Alzheimer's disease using MR-guided focused ultrasound.

Magnetic resonance-guided focused ultrasound in combination with intravenously injected microbubbles has been shown to transiently open the blood-brain barrier, and reduce beta-amyloid and tau pathology in animal models of Alzheimer's disease. Here, we used focused ultrasound to open the blood-brain barrier in five patients with early to moderate Alzheimer's disease in a phase I safety trial. In all patients, the blood-brain barrier within the target volume was safely, reversibly, and repeatedly opened.

Patterns of use of somatosensory-evoked potentials for comatose patients in Canada.

Purpose: To measure how frequently somatosensory-evoked potentials (SEPs) are used in comatose patients after traumatic brain injury (TBI) and hypoxic ischemic encephalopathy (HIE), how SEPs contribute to outcome prediction and clinical decision making, and how available they are to clinicians.

Methods: A novel factual and scenario-based survey instrument to measure patterns of SEPs use in comatose patients due to HIE or TBI was distributed to critical care, neurology, and neurosurgical physicians across Canada. The analysis was based on 86 completed surveys from specialists in neurology (36), neurosurgery (24), and critical care (22).

Early somatosensory evoked potential grades in comatose traumatic brain injury patients predict cognitive and functional outcome.

Objectives: To relate early somatosensory evoked potential grades from comatose traumatic brain injury patients to neuropsychological and functional outcome 1 yr later; to determine the day (within the first week after traumatic brain injury) that somatosensory evoked potential grade best correlates with outcome; to determine whether somatosensory evoked potential grade improvement in the first week after traumatic brain injury is associated with improved outcome.

Design: Prospective cohort study.

Setting: Critical care unit at a university hospital.

Generalized peripheral nerve failure during thoracic spine surgery: a case report.

Objective: Intra-operative systemic changes impairing peripheral nerve function are not commonly detected with electrophysiology. This case presentation illustrates how somatosensory evoked potential (SSEP) monitoring can detect global changes in peripheral nerve excitability during spine surgery.

Methods: A posterior thoracic spine fixation was performed on a young male with multiple traumatic injuries.

Role of the unperturbed limb and arms in the reactive recovery response to an unexpected slip during locomotion.

Understanding reactive recovery responses to slipping is fundamental in falls research and prevention. The primary purpose of this study was to investigate the role of the unperturbed limb and arms in the reactive recovery response to an unexpected slip. Ten healthy, young adults participated in this experiment in which an unexpected slip was induced by a set of steel free-wheeling rollers.