An Overview of Laryngologic Manifestations of Neurologic Diseases.

Purpose Of Review: Patients with various neurological disorders often present with or manifest during their disease process laryngologic pathology that can lead to significant morbidity. Recognizing and treating this aspect of their disease may be crucial in optimizing patient outcome.

Recent Findings: We discuss updated information and management regarding various neurological disorders that affect the larynx and how these sequelae are diagnosed and treated.

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions.

Introduction: Directional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images.

Artifacts Can Be Deceiving: The Actual Location of Deep Brain Stimulation Electrodes Differs from the Artifact Seen on Magnetic Resonance Images.

Introduction: Deep brain stimulation (DBS) is a common treatment for a variety of neurological and psychiatric disorders. Recent studies have highlighted the role of neuroimaging in localizing the position of electrode contacts relative to target brain areas in order to optimize DBS programming. Among different imaging methods, postoperative magnetic resonance imaging (MRI) has been widely used for DBS electrode localization; however, the geometrical distortion induced by the lead limits its accuracy.

True location of deep brain stimulation electrodes differs from what is seen on postoperative magnetic resonance images: An anthropomorphic phantom study.

Deep brain stimulation (DBS) is an established yet growing treatment for a range of neurological and psychiatric disorders. Over the last decade, numerous studies have underscored the effect of electrode placement on the clinical outcome of DBS. As a result, imaging is now extensively used for DBS electrode localization, even though the accuracy of different modalities in determining the true coordinates of DBS electrodes is less explored.

Analysis of the intended and actual orientations of directional deep brain stimulation leads across deep brain stimulation systems.

Deep brain stimulation (DBS) offers therapeutic benefits to patients suffering from a variety of treatment-resistant neurological and psychiatric disorders. The newest generation of DBS devices now offer directional leads, which utilize segmented electrodes to direct current asymmetrically to the neuronal tissue. Since segmented electrodes offer a larger degree of freedom for contact positioning, it is critical to assess how well the surgically intended and the actual orientation of the lead match to facilitate programming and allow appropriate interpretation of the therapeutic outcome.

Neurenteric cyst of the dorsal craniocervical junction in an adult: A case report and operative video.

Background: Neurenteric cysts (NCs) are rarely located in the dorsal craniocervical junction (CCJ).

Case Description: Here, we present a case and show the surgical video of a 24-year-old man with a history of neck pain, progressive hemiparesis, and difficulty swallowing. Radiological images revealed an intradural extramedullary lesion at the dorsal CCJ.

Patient-specific modeling of the volume of tissue activated (VTA) is associated with clinical outcome of DBS in patients with an obsessive-compulsive disorder.

Deep brain stimulation (DBS) promises to treat an increasing number of neurological and psychiatric disorders. DBS outcome is directly a factor of optimal targeting of the relevant brain structures. Computational models can help to interpret a patient's outcome by predicting the volume of tissue activated (VTA) around DBS electrode contacts.

Safety and image quality at 7T MRI for deep brain stimulation systems: Ex vivo study with lead-only and full-systems.

Ultra-high field MRI at 7 T can produce much better visualization of sub-cortical structures compared to lower field, which can greatly help target verification as well as overall treatment monitoring for patients with deep brain stimulation (DBS) implants. However, use of 7 T MRI for such patients is currently contra-indicated by guidelines from the device manufacturers due to the safety issues. The aim of this study was to provide an assessment of safety and image quality of ultra-high field magnetic resonance imaging at 7 T in patients with deep brain stimulation implants.

Classification of internal carotid artery injuries during endoscopic endonasal approaches to the skull base.

Background: Internal carotid artery (ICA) injuries are a major complication of endoscopic endonasal approaches (EEAs), which can be difficult to manage. Adding to the management difficulty is the lack of literature describing the surgical anatomical classification of these types of injuries. This article proposing a novel classification of ICA injuries during EEAs.

RF heating of deep brain stimulation implants during MRI in 1.2 T vertical scanners versus 1.5 T horizontal systems: A simulation study with realistic lead configurations.

Patients with deep brain stimulation (DBS) implants are often denied access to magnetic resonance imaging (MRI) due to safety concerns associated with RF heating of implants. Although MR-conditional DBS devices are available, complying with manufacturer guidelines has proved to be difficult as pulse sequences that optimally visualize DBS target structures tend to have much higher specific absorption rate (SAR) of radiofrequency energy than current guidelines allow. The MR-labeling of DBS devices, as well as the majority of studies on RF heating of conductive implants have been limited to horizontal close-bore MRI scanners.

Device Configuration and Patient's Body Composition Significantly Affect RF Heating of Deep Brain Stimulation Implants During MRI: An Experimental Study at 1.5T and 3T.

Patients with deep brain stimulation (DBS) devices have limited access to magnetic resonance imaging (MRI) due to safety concerns associated with RF heating generated around the implant. The problem of predicting RF heating of conductive leads is complex with a large parameter space and several interplaying factors. Recently however, off-label use of MRI in patients with DBS devices has been reported based on limited safety assessments, raising the concern that potentially dangerous scenarios may have been overlooked.

Effect of Biophysical Model Complexity on Predictions of Volume of Tissue Activated (VTA) during Deep Brain Stimulation.

Deep brain stimulation (DBS) has evolved to an important treatment for several drug-resistant neurological and psychiatric disorders, such as epilepsy, Parkinson's disease, essential tremor and dystonia. Despite general effectiveness of DBS, however, its mechanisms of action are not completely understood. Simulations are commonly used to predict the volume of tissue activated (VTA) around DBS electrodes, which in turn helps interpreting clinical outcomes and understand therapeutic mechanisms.

Reconfigurable MRI coil technology can substantially reduce RF heating of deep brain stimulation implants: First in-vitro study of RF heating reduction in bilateral DBS leads at 1.5 T.

Patients with deep brain stimulation (DBS) implants can significantly benefit from magnetic resonance imaging (MRI), however access to MRI is restricted in these patients because of safety concerns due to RF heating of the leads. Recently we introduced a patient-adjustable reconfigurable transmit coil for low-SAR imaging of DBS at 1.5T.

Bio-based synthesis of Nano-Ceria and evaluation of its bio-distribution and biological properties.

Bio-based synthesis of Nano-Ceria (NC) was performed in Linum usitatissimum L. (Lu) seeds extract as capping agent. Obtained gel was calcined at 400, 500, and 600 °C to investigate the effect of temperature on the size and morphology of the particles.

Reconfigurable MRI technology for low-SAR imaging of deep brain stimulation at 3T: Application in bilateral leads, fully-implanted systems, and surgically modified lead trajectories.

Patients with deep brain stimulation devices highly benefit from postoperative MRI exams, however MRI is not readily accessible to these patients due to safety risks associated with RF heating of the implants. Recently we introduced a patient-adjustable reconfigurable coil technology that substantially reduced local SAR at tips of single isolated DBS leads during MRI at 1.5 T in 9 realistic patient models.

Rubber hand illusion modulates the influences of somatosensory and parietal inputs to the motor cortex.

The rubber hand illusion (RHI) paradigm experimentally produces an illusion of rubber hand ownership and arm shift by simultaneously stroking a rubber hand in view and a participant's visually occluded hand. It involves visual, tactile, and proprioceptive multisensory integration and activates multisensory areas in the brain, including the posterior parietal cortex (PPC). Multisensory inputs are transformed into outputs for motor control in association areas such as PPC.

Neuromuscular transmission defects in myopathies: Rare but worth searching for.

Introduction: Decremental responses in repetitive nerve stimulation have been reported in a few hereditary myopathies. We examined the frequency of decrement in a cohort of myopathy patients.

Methods: We reviewed all patients referred for myopathy who underwent repetitive nerve stimulation between January 2007 and May 2017.

Using the Collective System Design Methodology to Improve a Medical Center Emergency Room Performance.

Emergency Room (ER) crowding is one of the more complex issues in the healthcare system worldwide. Crowding gives rise to long ER waiting times, patient dissatisfaction, and negative effects on a healthcare systems' performance. This paper focuses on the utilization of the Collective System Design (CSD) methodology to optimize the performance of an ER, which is of principal importance both from a life-threatening and an economic standpoint.

Food Footprint as a Measure of Sustainability for Grazing Dairy Farms.

Livestock productions require significant resources allocation in the form of land, water, energy, air, and capital. Meanwhile, owing to increase in the global demand for livestock products, it is wise to consider sustainable livestock practices. In the past few decades, footprints have emerged as indicators for sustainability assessment.

RF-induced heating in tissue near bilateral DBS implants during MRI at 1.5 T and 3T: The role of surgical lead management.

Access to MRI is limited for patients with deep brain stimulation (DBS) implants due to safety hazards, including radiofrequency (RF) heating of tissue surrounding the leads. Computational models provide an exquisite tool to explore the multi-variate problem of RF heating and help better understand the interaction of electromagnetic fields and biological tissues. This paper presents a computational approach to assess RF-induced heating, in terms of specific absorption rate (SAR) in the tissue, around the tip of bilateral DBS leads during MRI at 64MHz/1.

Effect of a punctal plug on ocular surface disease in patients using topical prostaglandin analogues: a randomized controlled trial.

Importance: Ocular surface disease (OSD) is common and can reduce treatment compliance and quality of life.

Background: To determine whether a punctal plug improves OSD and reduces intraocular pressure (IOP) in patients using prostaglandin analogue monotherapy.

Design: Randomized controlled trial.

Human dorsomedial parieto-motor circuit specifies grasp during the planning of goal-directed hand actions.

According to one influential view, two specialized parieto-frontal circuits control prehension: a dorsomedial stream for hand transport during reaching and a dorsolateral stream for preshaping the fingers during grasping. However, recent evidence argues that an area within the dorsomedial stream-macaque area V6A and, its putative human homolog, superior parietal occipital cortex (SPOC) - encodes both hand transport and grip formation. We tested whether planning varied hand actions modulates functional connectivity between left SPOC and ipsilateral primary motor cortex (M1) using a dual-site, paired-pulse transcranial magnetic stimulation paradigm with two coils (TMS).

Evaluating the significance of wetland restoration scenarios on phosphorus removal.

Freshwater resources are vital for human and natural systems. However, anthropogenic activities, such as agricultural practices, have led to the degradation of the quality of these limited resources through pollutant loading. Agricultural Best Management Practices (BMPs), such as wetlands, are recommended as a valuable solution for pollutant removal.

Efficacy and Safety of Pedunculopontine Nuclei (PPN) Deep Brain Stimulation in the Treatment of Gait Disorders: A Meta-Analysis of Clinical Studies.

Background: Pedunculopontine nucleus (PPN) has complex reciprocal connections with basal ganglia, especially with internal globus pallidus and substantia nigra, and it has been postulated that PPN stimulation may improve gait instability and freezing of gait. In this meta-analysis, we will assess the evidence for PPN deep brain stimulation in treatment of gait and motor abnormalities especially focusing on Parkinson disease patients.

Methods: PubMed and Scopus electronic databases were searched for related studies published before February 2014.