Neurosciences最新文献

Objectives: To determine the correlations of ADP-induced platelet-inhibition rate (ADP-PIR) and CYP2C19 genotypes with carotid plaque types in acute ischemic stroke (AIS). Unstable carotid plaques are implicated in AIS. Clopidogrel (commonly prescribed in AIS) produces adenosine diphosphate (ADP)-induced platelet inhibition, and is metabolized by CYP2C19.

Methods: We retrospectively evaluated the data of AIS patients treated at our hospital during 2019-2022, and administered maintenance clopidogrel (75 mg/d). Carotid plaques, ADP-PIR, and CYP2C19 genotypes were assessed using color Doppler ultrasonography, thromboelastography, and polymerase chain reaction assays, respectively. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted.

Results: Of 692 study patients, 378 (54.6%) and 128 (18.5%) had unstable and stable carotid plaques, respectively. Multivariate logistic regression identified PIR and CYP2C19 genotype as independent risk factors for stable carotid plaque (PIR, OR: 0.984, 95% CI: 0.974-0.995, p=0.003; intermediate metabolizer, OR: 0.158, 95% CI: 0.066-0.379, p<0.001; poor metabolizer, OR: 0.584, 95% CI: 0.155-2.206, p=0.428) and unstable carotid plaque (PIR, OR: 0.957, 95% CI: 0.949-0.966, p<0.001; intermediate metabolizer, OR: 0.151, 95% CI: 0.063-0.362, p<0.001; poor metabolizer, OR: 0.145, 95% CI: 0.051-0.416, p<0.001). Areas under the ROC curve for predicting unstable and stable carotid plaques were 0.700 (PIR) and 0.716 (CYP2C19 genotype), and 0.631 (PIR) and 0.650 (CYP2C19 genotype), respectively.

Conclusion: The PIR and CYP2C19 genotype are correlated with and may predict carotid plaque types in AIS.

Objectives: To explore the beneficial effects and mechanisms of Poloxamer 188 (P188) in mitigating cerebral ischemia-reperfusion (I/R) injury in mice.

Methods: This study was conducted from 2020 to 2022. Neurological function, brain water content, and infarct size were assessed in mice 24 h after I/R injury. Iridium-labeled Poloxamer 188 (Ir-P188) was characterized using ¹H-NMR, UV-Vis spectroscopy, and fluorescence emission analysis. Immunofluorescence was used to evaluate intracellular distribution of Ir-P188 in OGD/R-induced HT22 cells in vitro and ischemic mice in vivo. 24 h after reperfusion, the levels of ROS and inflammation in ischemic brain were measured, along with the protein levels of mitochondrial, lysosomal, and cytoplasmic fractions. Additionally, the protective effects of p188 and Ginkgolide B, both as single agents and in combination, against I/R were compared.

Results: P188 intravenous administration could significantly reduce the infarct brain areas, improved neurological deficit, and decreased brain water content in mice after I/R injury. The accumulation of Ir-P188 was observed in OGD/R-induced HT22 cells and ischemic brain in mice. P188 suppressed ROS, inflammatory factors (NF-kB, IL-6, TNF-a), and inhibiting mitochondrial cytochrome C release and lysosomal protease translocation to the cytoplasm.

Conclusion: P188 can penetrate intracellular compartments and effectively protect mice against I/R injury. The underlying mechanism may involve inhibiting ROS generation, mitigating inflammatory responses, and alleviating mitochondrial dysfunction and lysosomal damage.

A 67-year-old male presented with sudden headache and decreased consciousness, diagnosed as spontaneous subarachnoid hemorrhage (SAH). Imaging revealed an anterior communicating artery (ACoA) aneurysm and congenital absence of the left internal carotid artery (ICA), confirmed by the absence of the carotid canal. The aneurysm was surgically clipped. Postoperative angiography demonstrated that the left anterior and middle cerebral arteries were perfused via collateral flow from the posterior circulation. The patient made a full recovery. Congenital ICA absence is rare but significantly alters cerebral hemodynamics, especially within the circle of Willis, predisposing patients to aneurysm formation. This case underlines the importance of vascular imaging in patients with SAH and highlights the need for urgent diagnosis and intervention in the presence of congenital vascular anomalies.

Objectives: To investigate the factors affecting participation in rehabilitation in patients with spinal cord injury.

Methods: Our prospective clinical follow-up study included 87 patients with spinal cord injuries who were hospitalized in a tertiary Physical Therapy and Rehabilitation Hospital. General characteristics of the patients were noted. Depression, neuropathic pain, independence in activities of daily living, and participation in the rehabilitation program were assessed using the Beck Depression Scale, DN-4 score, Spinal Cord Injury Independence Measure (SCIM), and Pittsburgh Rehabilitation Participation Scale, respectively.

Results: Nearly one-third of patients (31%) showed low participation. The frequency of tetraplegics was higher, the median motor score was statistically lower, the rate of training in the locomat and mechanical balance devices was lower, and the median Beck Depression Scale score was higher in the lower participation group (p=0.043, p<0.001, p=0.007 and p<0.001, p=0.019, respectively). The determinant factors for low participation in rehabilitation were low motor score p<0.001, not receiving locomat training p=0.006, presence of neuropathic pain p=0.016, and high Beck Depression Scale scores p=0.040. Patients with high participation showed greater improvement in SCIM scores (p=0.030).

Conclusion: Our results confirm the importance of rehabilitation participation. Patients should be encouraged to participate in rehabilitation and problems such as neuropathic pain and depression should be appropriately addressed and solved. Intensive rehabilitation including locomat and mechanical balance training is recommended.

Objectives: To evaluate the use of susceptibility-enhanced sequence with conventional magnetic resonance imaging (MRI) of the brain for identification of venous angiomas in epilepsy work up.

Methods: A record-based study was performed retrospectively in Radiology department at our Hospital in Eastern region of Saudi Arabia, from Jan. 2019-2024. Adult patients for whom MRI brains were conducted for epilepsy work-up with added SWAN (susceptibility weighted angiography) sequence were considered. Imaging proven cases of space occupying lesions in the brain, post-injury, and post-interventional cases were not taken. A venous angioma (or malformation) was documented when a tuft of veins drained to a larger vein (traversing through cortex or reaching under ependymal layer), appeared low signal structure on SWAN image, and enhanced on contrast-enhanced sequence. Consensus reporting was made by 2 experienced neuroradiologists. The usefulness of the SWAN sequence in the detection of venous malformation determined if the visualized abnormality was found to be related to a focus resulting in abnormal waves on the brain electroencephalography. This observation was compared to the accidently found such malformations that were seen in epileptic patients with normal EEGs (control group). Fisher's Exact test was applied and a P-value of <0.05 was taken as statistically significant for an association.

Results: Total number of patients was 114; 65 females (57%) and 49 males (43%), with an average age of 31.4 (range, 15-50). The SWAN found venous angiomas in 34 (29.8%), and 8 were responsible for abnormal electroencephalograms while neither of the 3 accidently detected venous malformations in the control with normal EEGs (p-value=0.001).

Conclusion: An added SWAN sequence with conventional MRI brain imaging for patients with seizures can assist to visualize symptomatic venous angiomas leading to focal seizures.