Wnt5a Drives an Invasive Phenotype in Human Glioblastoma Stem-like Cells.

Brain invasion by glioblastoma determines prognosis, recurrence, and lethality in patients, but no master factor coordinating the invasive properties of glioblastoma has been identified. Here we report evidence favoring such a role for the noncanonical WNT family member Wnt5a. We found the most invasive gliomas to be characterized by Wnt5a overexpression, which correlated with poor prognosis and also discriminated infiltrating mesenchymal glioblastoma from poorly motile proneural and classical glioblastoma.

Mitochondrial DNA sequence characteristics modulate the size of the genetic bottleneck.

With a combined carrier frequency of 1:200, heteroplasmic mitochondrial DNA (mtDNA) mutations cause human disease in ∼1:5000 of the population. Rapid shifts in the level of heteroplasmy seen within a single generation contribute to the wide range in the severity of clinical phenotypes seen in families transmitting mtDNA disease, consistent with a genetic bottleneck during transmission. Although preliminary evidence from human pedigrees points towards a random drift process underlying the shifting heteroplasmy, some reports describe differences in segregation pattern between different mtDNA mutations.

Hand-tool-tissue interaction forces in neurosurgery for haptic rendering.

Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user.

Unimanual and bimanual intensive training in children with hemiplegic cerebral palsy and persistence in time of hand function improvement: 6-month follow-up results of a multisite clinical trial.

This study aims to compare in hemiplegic children the effectiveness of intensive training (unimanual and bimanual) versus standard treatment in improving hand function, assessing the persistence after 6 months. A multicenter, prospective, cluster-randomized controlled clinical trial was designed comparing 2 groups of children with hemiplegic cerebral palsy, treated for 10 weeks (3 h/d 7 d/wk; first with unimanual constraint-induced movement therapy, second with intensive bimanual training) with a standard treatment group. Children were assessed before and after treatment and at 3 and 6 months postintervention using Quality of Upper Extremity Skills Test (QUEST) and Besta Scales.

Scurvy hidden behind neuropsychiatric symptoms.

Approaching an uncommon disease may result in diagnostic delay even in patients with typical clinical features. In this respect, diseases related to nutritional deficiencies may represent a diagnostic challenge. We describe a 2.

Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia.

Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH).

Chronic migraine with medication overuse pre-post withdrawal of symptomatic medication: clinical results and FMRI correlations.

Background: Chronic migraine with symptomatic medication overuse (CMwMO) is a common and often debilitating clinical condition. Withdrawal of the offending drug(s) is considered the first step in management. Functional magnetic resonance imaging (fMRI) may be a useful technique for obtaining information on particular neuronal changes in the pain network involved in this condition.

An innovative approach for migraine prevention in young age: a preliminary study.

Headache is one of the commonest conditions to affect children and adolescents in industrialized countries. Effective pharmacological treatments without side effects are still lacking. Ginkgolide B, an herbal constituent extract from ginkgo biloba tree leaves, is a natural antiplatelet activating factor (PAF).

Feasibility of simultaneous vagal nerve and deep brain stimulation in chronic cluster headache: case report and considerations.

In pathologies, such as refractory epilepsy, major depression and cluster headache, there could be indication to both vagal nerve stimulation (VNS) and deep brain stimulation (DBS). In particular, Mauskop (Cephalalgia 25:82-96, 2005) reported the efficacy and safety of VNS in chronic cluster headache. At our Institute, we perform posterior hypothalamic DBS for such clinical condition since 2000 and results appear to be encouraging.

Psychological variables in chronic migraine with medication overuse before and after inpatient withdrawal: results at 1-year follow-up.

Investigations on psychological variables and migraine have confirmed a strong association between migraine and depression or migraine and anxiety disorders. In particular patients suffering from chronic migraine with medication overuse have an elevated risk of mood and anxiety disorders, which may compromise treatment efforts. The aim of this study was to investigate a group of patients suffering from CM with medication overuse before and after inpatient withdrawal program after a long-term follow-up to examine clinical indexes and psychological variables changes in particular anxiety and depression by using Spielberger State-Trait Anxiety Inventory (STAI) 1, 2 and Zung Self-rating Depression Scale (Zung) tests, in order to verify if a specific psychological pattern in these patients is present, and if changes in psychological variables correspond with clinical improvement.

Behavioral plus pharmacological treatment versus pharmacological treatment only for chronic migraine with medication overuse after day-hospital withdrawal.

Chronic migraine with medication overuse is a difficult problem to manage. Different withdrawal approaches have been tried, with different results. Withdrawal in a day-hospital setting is a recent modality.

Costs of hypothalamic stimulation in chronic drug-resistant cluster headache: preliminary data.

In about 20% of chronic cluster headache (CH) cases, drugs may become ineffective. Under these circumstances, steroids and triptans are frequently employed leading to fearful side effects in one and high costs in the other. The direct costs of drug-resistant chronic CH are mainly due to frequent medical consultations and frequent use of expensive drugs.

Caliber fluctuations of cervical internal carotid artery and migraine with aura: a possible vasospasm detected by ultrasonographic examinations.

Caliber fluctuations of extra- and intracranial arteries, mostly related to vasospasm, are often recognized in various neurological conditions. We report a case of a 33-year-old woman affected by migraine with and without aura who exhibited a possible cervical internal carotid artery vasospasm, detected by ultrasound, before a typical migraine aura.

Reduction in the impact of chronic migraine with medication overuse after day-hospital withdrawal therapy.

The 6-item Headache Impact Test questionnaire (HIT-6) is a simple and reliable tool to measure the impact headaches have on patients' lives. Patients with chronic migraine (CM) and medication overuse are markedly impaired in their functional activity. The aim of this study was to investigate the responsiveness of the HIT-6 tool to clinical changes induced by treatment in patients with CM and medication overuse.

In-patient vs. day-hospital withdrawal treatment for chronic migraine with medication overuse and disability assessment: results at one-year follow-up.

Chronic headaches have increasingly become a focus within the field of head pain. Most patients with frequent headache eventually overuse their medications. The diagnosis of medication-overuse headache is clinically important, because patients rarely respond to preventive medications whilst overusing acute medications.

Safety and efficacy of ultrasound assistance during internal jugular vein cannulation in neurosurgical infants.

Objective: Ultrasound guidance (USG) for internal jugular cannulation is the best solution in difficult settings where paediatric patients are involved. This is an outcome study on efficacy and complications of the USG for the internal jugular vein (IJV) cannulation in neurosurgical infants as well as an ultrasound study of anatomical findings of the IJVs in infants.

Design And Settings: A prospective study conducted in two Academic Neurosurgical hospitals.

Cognitive profiles and visuoperceptual abilities in preterm and term spastic diplegic children with periventricular leukomalacia.

Although relations between the extent of periventricular leukomalacia and neuropsychological performance in preterm children with spastic diplegia have been extensively investigated, studies on term children with spastic diplegia are rare. The authors examined 15 preterm children and 9 term children with spastic diplegia, all of whom had periventricular leukomalacia as a main magnetic resonance imaging (MRI) finding (excluding full-term spastic diplegic children with other MRI findings). Cognitive abilities (Griffith scale) and visuoperceptual abilities (Developmental Test of Visual Perception) were compared in the 2 groups and related to periventricular leukomalacia severity.

Magnesium as a preventive treatment for paediatric episodic tension-type headache: results at 1-year follow-up.

The objective was to confirm the long-term utility of magnesium salts treatment on a group of young patients suffering from episodic tension-type headache (ETTH). The study was carried out at the Outpatient Headache Center at the National Neurological Institute "C. Besta," Milan, Italy, with 45 children/adolescents with ETTH reporting consecutively for treatment.

Chronic headaches: pharmacological and non-pharmacological treatment.

Chronic headaches have increasingly become a focus within the field of head pain. Most patients with frequent headache eventually overuse their medications, and when it happens, the diagnosis of medication-overuse headache is clinically important, because patients rarely respond to preventive medications whilst overusing acute medications. Properly treating medication overuse and preventing relapse require recognition of the different factors that contribute to its development and perpetuation, including some behaviours and psychological elements that are important in sustaining the overuse of medication.

In vitro study of low molecular weight heparin effect on cell growth and cell invasion in primary cell cultures of high-grade gliomas.

Heparins represent the first choice for prevention and treatment of venous thromboembolism. In particular, low molecular weight heparins (LMWHs) provide pharmacokinetic advantages compared to unfractionated heparin (UFH): longer half-life, better bioavailability, and lower binding to plasma proteins. In the last years results of preclinical and clinical studies have suggested that LMWH may be able to inhibit cell growth, cell invasion, and angiogenesis, which are key mechanisms involved in tumor progression, possibly influencing favorable clinical outcome in at least a proportion of cancer patients.