Due to the absence of studies supporting the role of intraoperative neurophysiological monitoring (IONM) in intradural spinal tumors, this study evaluates the clinical outcome after these surgeries in relation to the use of the advanced intraoperative neurophysiological techniques. This is an observational, descriptive and retrospective study of two cohort groups in relation to the presence or absence of IONM during the intervention and the subsequent evaluation of the clinical and functional results in the short and medium terms. Ninety-six patients with extra- or intramedullary intradural spinal tumors operated on by the neurosurgery team of our center completed the current study.
View Article and Find Full Text PDFPurpose: Intraoperative neurophysiologic monitoring in thoracoabdominal aneurysms (TAAA) is essential to avoid intraoperative spinal cord injury). Motor and somatosensory evoked potentials may be considered intraoperative tools for detecting spinal cord injury. H-reflex is a well-known neurophysiologic technique to evaluate L5-S1 root.
View Article and Find Full Text PDFBackground: Advanced stages of idiopathic Parkinson's disease are often characterised by gait alterations and postural instability. Despite improvements in patients' motor symptoms after deep brain stimulation of the subthalamic nucleus, its effects on gait and balance remain a matter of debate. This study investigated the effects of deep brain stimulation on balance and kinematic parameters of gait.
View Article and Find Full Text PDFDeep brain stimulation of the subthalamic nucleus is efficient for the treatment of motor symptoms (i.e., tremors) in patients with Parkinson's disease.
View Article and Find Full Text PDFObjective: To assess the PTS method in neuromonitoring of thoracic pedicle screws in a young cohort of AIS patients. The accuracy of both PTS (Pulse-train stimulation) and SPS (Single-pulse stimulation) techniques in the detection of misplaced thoracic screws was compared with special reference to the screws placed at the concavity and the convexity of the curve.
Patients And Methods: A single-center prospective clinical cohort study.
Cerebral ischemia induces an inhibition of protein synthesis and causes cell death and neuronal deficits. These deleterious effects do not occur in resilient areas of the brain, where protein synthesis is restored. In cellular stress conditions, as brain ischemia, translational repressors named eukaryotic initiation factor (eIF) 4E-binding proteins (4E-BPs) specifically bind to eIF4E and are critical in the translational control.
View Article and Find Full Text PDFObjective: Coronavirus disease 2019 (COVID-19) has a high incidence of intensive care admittance due to the severe acute respiratory syndrome (SARS). Intensive care unit (ICU)-acquired weakness (ICUAW) is a common complication of ICU patients consisting of symmetric and generalised weakness. The aim of this study was to determine the presence of myopathy, neuropathy or both in ICU patients affected by COVID-19 and whether ICUAW associated with COVID-19 differs from other aetiologies.
View Article and Find Full Text PDFObjective: Intraoperative neurophysiological monitoring (INM) allows obtaining real-time information on the functional integrity of nervous system structures. The objective of this article is to present the role of clinical neurophysiology in Urology in the identification and preservation, on the one hand, of the prostate neurovascular bundles in radical prostatectomy (RP), and of the pudendal nerve in the release of this in Pudendal Nerve Entrapment Syndrome (PNS).
Methods: A bipolar laparoscopic probe was used for intraoperative stimulation for both the identification in PNS and neurovascular bundles in RP, obtaining response at the external anal sphincter in the first one; and intracavernous pressure in the second through needle electrodes.
Background: Levodopa-carbidopa intestinal gel (LCIG) is effective in the treatment of advanced Parkinson's disease (PD). However, the patients' profile that might benefit from treatment with LCIG has not been characterized.
Objective: This retrospective study explored the influence of disease duration (DD) on the effectiveness of LCIG and identified factors associated with treatment discontinuation in a cohort of advanced PD patients.
Objectives: To compare the characteristics of patients undergoing treatment with continuous intestinal infusion of levodopa-carbidopa (CIILC) for advanced Parkinson's disease and the data on the effectiveness and safety of CIILC in the different autonomous communities (AC) of Spain.
Methods: A retrospective, longitudinal, observational study was carried out into 177 patients from 11 CAs who underwent CIILC between January 2006 and December 2011. We analysed data on patients' clinical and demographic characteristics, variables related to effectiveness (changes in off time/on time with or without disabling dyskinesia; changes in Hoehn and Yahr scale and Unified Parkinson's Disease Rating Scale scores; non-motor symptoms; and Clinical Global Impression scale scores) and safety (adverse events), and the rate of CIILC discontinuation.
Background: We report the accumulated experience with ventral intermediate nucleus deep brain stimulation for medically refractory orthostatic tremor.
Methods: Data from 17 patients were reviewed, comparing presurgical, short-term (0-48 months), and long-term (≥48 months) follow-up. The primary end point was the composite activities of daily living/instrumental activities of daily living score.
Objectives: This study assesses the effect of levodopa/carbidopa intestinal infusion gel (LCIIG) as an additional treatment in patients with advanced idiopathic Parkinson disease (PD) previously treated with deep brain stimulation (DBS).
Methods: Prospective study of advanced PD patients, satisfactorily treated with bilateral DBS of the subthalamic nucleus, who had developed refractory symptoms and LCIIG was added. Controls were advanced PD patients treated with LCIIG.
Stress granules (SGs) are cytoplasmic ribonucleoprotein aggregates that are directly connected with the translation initiation arrest response to cellular stresses. Translation inhibition (TI) is observed in transient brain ischemia, a condition that induces persistent TI even after reperfusion, i.e.
View Article and Find Full Text PDFAim: To assess long-term effectiveness and tolerability of levodopa-carbidopa intestinal gel (LCIG) in Spanish patients with advanced Parkinson's disease.
Patients & Methods: This was an observational, multicenter, cross-sectional, retrospective study.
Results: Data of 177 patients were analyzed.
Aim: To describe the gait disorders and postural instability in a group of patients with advanced Parkinson's disease (PD).
Patients And Methods: Gait was analysed in patients in advanced stages of PD on medication. Using a computerised analysis system, we studied the kinematic variables: cadence, number of correct gait cycles (HFPS cycles), total number of cycles, duration of the phases of the cycle, electromyography and a goniometric study of the knee and the ankle.
Eukaryotic initiation factor (eIF) 4E-binding proteins (4E-BPs) are translational repressors that bind specifically to eIF4E and are critical in the control of protein translation. 4E-BP2 is the predominant 4E-BP expressed in the brain, but their role is not well known. Here, we characterized four forms of 4E-BP2 detected by two-dimensional gel electrophoresis (2-DGE) in brain.
View Article and Find Full Text PDFStudy Design: A cross-sectional study of nonconsecutive cases (level III evidence).
Objective: In a series of young patients with thoracic scoliosis who were treated with pedicle screw constructs, data obtained from triggered electromyography (t-EMG) screw stimulation and postoperative computed tomographic scans were matched to find different threshold limits for the safe placement of pedicle screws at the concavity (CC) and convexity (CV) of the scoliotic curves. The influence of the distance from the medial pedicle cortex to the spinal cord on t-EMG threshold intensity was also investigated at the apex segment.
Background Context: Present studies concerning the safety and reliability of neurophysiological monitoring during thoracic pedicle screw placement remain inconclusive, and therefore, universally validated threshold levels that confirm osseous breakage of the instrumented pedicles have not been properly established.
Purpose: The objective of this work was to analyze whether electromyographic (EMG) thresholds, after stimulation of the thoracic pedicle screw, depend on the distance between the neural structures and the screws. The modifier effect of different interposed tissues between a breached pedicle and neural structures was also investigated.
This study was aimed at evaluating the sensitivity and safety of a new technique to record triggered EMG thresholds from axillary chest wall electrodes when inserting pedicle screws in the upper thoracic spine (T2-T6). A total of 248 (36.6%) of a total of 677 thoracic screws were placed at the T2-T6 levels in 92 patients with adolescent idiopathic scoliosis.
View Article and Find Full Text PDFIntroduction: Deep brain stimulation (DBS) is a widely accepted clinical technique. The main motor symptoms are significantly reduced. The success of the technique depends on the experience of the neurosurgeon, neurologist and neurophysiologist who carry it out.
View Article and Find Full Text PDFJ Neurol Neurosurg Psychiatry
January 2010
Background: Dystonia is a complex clinical syndrome originated by a wide range of aetiologies. The diagnosis of dystonia is made after the evaluation of aetiological, phenomenological and genetic factors. Medications, except in patients with dopa-responsive dystonia, are of limited efficacy.
View Article and Find Full Text PDFStudy Design: A new stimulus-triggered electromyography (EMG) test for detecting stimulus diffusion to contralateral intercostal muscles during thoracic pedicle screw placement was assessed in a porcine model.
Objective: To determine if electromyographic thresholds in the intercostal muscles of both sides of the thorax could discriminate thoracic pedicle screw malpositions with and without neural contact at different aspects of the spinal cord and nerve roots.
Summary Of Background Data: There is controversy about the value of triggered EMG stimulation for aiding precise insertion of thoracic pedicle screws.
In addition to the activity of heat shock protein 90 (Hsp90/HSPC) as a chaperone, some recent studies have reported expression of Hsp90 at the cell surface in certain types of cancer and nervous system cells. We study the expression of Hsp90 at the cell surface in human neuroblastoma (NB69) cells. Immunofluorescence experiments labeling with anti-Hsp90 antibodies on both nonpermeabilized cells and live cells detected Hsp90 at the cell surface.
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