Introduction: To discuss the thought-provoking and difficult clinical management of a case of spontaneous intracerebral haemorrhage and immune thrombocytopenic purpura (ITP). Case presentation: A 6-year-old female, known ITP, presented with a one-day history of traumatic dislodged tooth, with associated neurological symptoms. However, her neurological status was alert and oriented, with absence of focal deficits. The complete blood count showed a platelet count of 26 x 10 9 /L and was in keeping with her known baseline platelet level. Computed tomography of the brain demonstrated three sites of cerebral contusions with no associated midline shift. Hours after admission, there was progressive decline in the patient’s clinical status. Additionally, repeat blood investigations showed a downward trend in platelet counts. Aggressive medical management was implemented with the aid of neurosurgery, haematology, paediatrics, and the intensive care unit. Despite various therapeutic modalities, the patient succumbed to her underlying disorder. Conclusion: On retrospective review, this patient had a severe phenotype of ITP. This was demonstrated by repeated oral mucosa bleeds, gastrointestinal bleeds and episodes of haematuria preceding this last admission. Despite multimodal therapies and the combined efforts of a multi-disciplinary team, the clinical management remained arduous.
{"title":"Immune thrombocytopenic purpura and intracranial haemorrhage: A formidable medical challenge","authors":"C. Calderon, A. Pérez","doi":"10.15761/JBN.1000132","DOIUrl":"https://doi.org/10.15761/JBN.1000132","url":null,"abstract":"Introduction: To discuss the thought-provoking and difficult clinical management of a case of spontaneous intracerebral haemorrhage and immune thrombocytopenic purpura (ITP). Case presentation: A 6-year-old female, known ITP, presented with a one-day history of traumatic dislodged tooth, with associated neurological symptoms. However, her neurological status was alert and oriented, with absence of focal deficits. The complete blood count showed a platelet count of 26 x 10 9 /L and was in keeping with her known baseline platelet level. Computed tomography of the brain demonstrated three sites of cerebral contusions with no associated midline shift. Hours after admission, there was progressive decline in the patient’s clinical status. Additionally, repeat blood investigations showed a downward trend in platelet counts. Aggressive medical management was implemented with the aid of neurosurgery, haematology, paediatrics, and the intensive care unit. Despite various therapeutic modalities, the patient succumbed to her underlying disorder. Conclusion: On retrospective review, this patient had a severe phenotype of ITP. This was demonstrated by repeated oral mucosa bleeds, gastrointestinal bleeds and episodes of haematuria preceding this last admission. Despite multimodal therapies and the combined efforts of a multi-disciplinary team, the clinical management remained arduous.","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133894686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Morphology of the dural venous complex of skull base in human ontogenesis","authors":"M. Kornieieva","doi":"10.15761/JBN.1000122","DOIUrl":"https://doi.org/10.15761/JBN.1000122","url":null,"abstract":"","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114254797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The nature of consciousness and the meaning of life","authors":"Michael J Vandeman","doi":"10.15761/jbn.1000123","DOIUrl":"https://doi.org/10.15761/jbn.1000123","url":null,"abstract":"","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128689191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rajan Adhikari, Kevin S. Steed, BreAnna Hutchinson, Haonan Wang, M. A. Mendoza, Ryan S Staudte, Maya Atmojo, P. Cox, Ty Hancock, Kyle Barkdull, Matthew L Harris, R. K. Watt, N. Bangerter, J. Wisco
We propose that Alzheimer’s disease (AD) progression is largely caused by excess reactive oxygen species (ROS) or free radicals created by iron dysregulation. An AD brain is struggling with damage control creating harmful tau tangles and amyloid plaques to deal with the dysregulated iron. We hypothesized that transgenic APP/PS1 (Amyloid precursor protein/ Presenilin-1) and Tau mice would exhibit higher levels of deposits in the brain which can be detected through MRI as well as decreased behavioral performance in radial arm maze tasks. We bred APP/PS1 transgenic mice overexpressing chimeric mouse/human APP-695 with mutations and human PSEN1 carrying the exon-9-deleted variant (PSEN1dE9), and Tau mice overexpressing all six isoforms of hyper-phosphorylated human MAPT (Microtubule associated protein Tau), which were compared with age controlled wild type mice. Mice received a diet of either regular or methionine rich chow as an oxidative stressor. Subgroups received a rescue treatment of either zinc, metformin or clioquinol chow. MRI (Magnetic Resonance Imaging) scans were performed using a Siemens 3 Tesla scanner. Behavioral data was collected using a radial arm maze (RAM) for 2 weeks at each point. Data collection time points were: 1 (baseline), 3, 6 and 9 months. Mean T2 TSE signals from scans on these mice revealed significant signal loss in bilateral hippocampi when compared by age. We also found a significant main effect of genotype and a trend toward significance for genotype and treatment interaction in the mean time mice spent in the RAM. Pairwise comparison showed a significant difference between the time male and female mice spent in the RAM. There was, however, no effect of signal loss or behavior deficit when comparing rescue treatments with or without oxidative insults. The decrease in signal and RAM performance is due to plaque increase and accompanying iron, which offers a possibility to refine the imaging techniques in pursuit of a noninvasive diagnostic biomarker. *Correspondence to: Jonathan J Wisco, PhD, Associate Professor, Boston University School of Medicine, Department of Anatomy and Neurobiology, Laboratory for Translational Anatomy of Degenerative Diseases and Developmental Disorders (TAD4), 72 E Concord St, L-1004, Boston, MA 02118, USA, Tel: 310-746-6647/ Office: 617-358-2002; E-mail: jjwisco@bu.edu
我们认为阿尔茨海默病(AD)的进展很大程度上是由过量的活性氧(ROS)或铁调节失调产生的自由基引起的。阿尔茨海默症患者的大脑正在努力控制损伤，产生有害的tau蛋白缠结和淀粉样斑块来处理失调的铁。我们假设转基因APP/PS1(淀粉样蛋白前体蛋白/早老素-1)和Tau小鼠会在大脑中表现出更高水平的沉积，这可以通过MRI检测到，并且在桡臂迷宫任务中行为表现下降。我们培育了过表达嵌合小鼠/人APP-695突变和携带外显子9缺失变体(PSEN1dE9)的人PSEN1的APP/PS1转基因小鼠，以及过表达所有六种超磷酸化人MAPT(微管相关蛋白Tau)亚型的Tau小鼠，并将其与年龄控制的野生型小鼠进行比较。小鼠接受常规或富含蛋氨酸的食物作为氧化应激源。亚组接受锌、二甲双胍或氯喹诺周星的抢救治疗。MRI(磁共振成像)扫描使用西门子3特斯拉扫描仪。采用桡臂迷宫(RAM)在每个点收集行为数据，为期2周。数据收集时间点分别为:1个月(基线)、3个月、6个月和9个月。扫描这些小鼠的平均T2 TSE信号显示，与年龄相比，双侧海马的信号明显丢失。我们还发现了基因型的显著主效应，以及基因型和治疗相互作用在小鼠在RAM中平均时间的显著趋势。两两比较显示雄性和雌性小鼠在RAM中的时间存在显著差异。然而，当比较有或没有氧化损伤的抢救治疗时，没有信号丢失或行为缺陷的影响。信号和RAM性能的下降是由于斑块增加和伴随的铁，这为改进成像技术以追求非侵入性诊断生物标志物提供了可能性。*通讯对象:Jonathan J Wisco，博士，副教授，波士顿大学医学院，解剖与神经生物学系，变性疾病与发育障碍转化解剖实验室(TAD4)， 72 E Concord St, L-1004, Boston, MA 02118, USA, Tel: 310-746-6647/ Office: 617-358-2002;电子邮件:jjwisco@bu.edu
{"title":"Hippocampal T2 signal loss and decreased radial arm maze performance in transgenic murine model for AD","authors":"Rajan Adhikari, Kevin S. Steed, BreAnna Hutchinson, Haonan Wang, M. A. Mendoza, Ryan S Staudte, Maya Atmojo, P. Cox, Ty Hancock, Kyle Barkdull, Matthew L Harris, R. K. Watt, N. Bangerter, J. Wisco","doi":"10.15761/jbn.1000127","DOIUrl":"https://doi.org/10.15761/jbn.1000127","url":null,"abstract":"We propose that Alzheimer’s disease (AD) progression is largely caused by excess reactive oxygen species (ROS) or free radicals created by iron dysregulation. An AD brain is struggling with damage control creating harmful tau tangles and amyloid plaques to deal with the dysregulated iron. We hypothesized that transgenic APP/PS1 (Amyloid precursor protein/ Presenilin-1) and Tau mice would exhibit higher levels of deposits in the brain which can be detected through MRI as well as decreased behavioral performance in radial arm maze tasks. We bred APP/PS1 transgenic mice overexpressing chimeric mouse/human APP-695 with mutations and human PSEN1 carrying the exon-9-deleted variant (PSEN1dE9), and Tau mice overexpressing all six isoforms of hyper-phosphorylated human MAPT (Microtubule associated protein Tau), which were compared with age controlled wild type mice. Mice received a diet of either regular or methionine rich chow as an oxidative stressor. Subgroups received a rescue treatment of either zinc, metformin or clioquinol chow. MRI (Magnetic Resonance Imaging) scans were performed using a Siemens 3 Tesla scanner. Behavioral data was collected using a radial arm maze (RAM) for 2 weeks at each point. Data collection time points were: 1 (baseline), 3, 6 and 9 months. Mean T2 TSE signals from scans on these mice revealed significant signal loss in bilateral hippocampi when compared by age. We also found a significant main effect of genotype and a trend toward significance for genotype and treatment interaction in the mean time mice spent in the RAM. Pairwise comparison showed a significant difference between the time male and female mice spent in the RAM. There was, however, no effect of signal loss or behavior deficit when comparing rescue treatments with or without oxidative insults. The decrease in signal and RAM performance is due to plaque increase and accompanying iron, which offers a possibility to refine the imaging techniques in pursuit of a noninvasive diagnostic biomarker. *Correspondence to: Jonathan J Wisco, PhD, Associate Professor, Boston University School of Medicine, Department of Anatomy and Neurobiology, Laboratory for Translational Anatomy of Degenerative Diseases and Developmental Disorders (TAD4), 72 E Concord St, L-1004, Boston, MA 02118, USA, Tel: 310-746-6647/ Office: 617-358-2002; E-mail: jjwisco@bu.edu","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130012427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study reviews current understanding of relationship of paraoxonase1 polymorphisms and activity of paraoxonase1 in Parkinson’s Disease (PD). Paraoxonase 1 (PON1) is involved in the detoxification of insecticides and pesticides and metabolisms of these toxins. Two polymorphisms within the gene affect the activity of paraoxonase. In One of them a methionine replaces with leucine at position 54 (M54L) and the other a glutamine change to arginine variant at position 192 (Q192R). There are some evidences show the genetic polymorphisms of PON1 can protect against organophosphates such as paraoxon and diazinon. Results of studies that investigate these associations are controversial. There was no significant association between PON1-1 92Q/R alleles and risk of developing PD and also there is no evidence for an association between PON 1-192 polymorphism and development of PD, however, a study found that the 192R alleles were risk factor for developing PD. These polymorphisms explain only some of the variations in serum PON1 activity; thus, the other critical test of the hypothesis is likely to be whether low serum PON1 activity is associated with Parkinson disease or not. In this review we summarize current knowledge from PON1 association studies regarding the interaction between gene polymorphisms and activity of PON1 with the risk of PD. *Correspondence to: Mohammad Valilo, Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, Tel: +989380540895; E-mail: valilo.biomed@gmail.com
{"title":"Paraoxonase1 and its relationship with Parkinson's disease","authors":"A. Mota, A. Taheraghdam, Mohammad Valilo","doi":"10.15761/jbn.1000120","DOIUrl":"https://doi.org/10.15761/jbn.1000120","url":null,"abstract":"This study reviews current understanding of relationship of paraoxonase1 polymorphisms and activity of paraoxonase1 in Parkinson’s Disease (PD). Paraoxonase 1 (PON1) is involved in the detoxification of insecticides and pesticides and metabolisms of these toxins. Two polymorphisms within the gene affect the activity of paraoxonase. In One of them a methionine replaces with leucine at position 54 (M54L) and the other a glutamine change to arginine variant at position 192 (Q192R). There are some evidences show the genetic polymorphisms of PON1 can protect against organophosphates such as paraoxon and diazinon. Results of studies that investigate these associations are controversial. There was no significant association between PON1-1 92Q/R alleles and risk of developing PD and also there is no evidence for an association between PON 1-192 polymorphism and development of PD, however, a study found that the 192R alleles were risk factor for developing PD. These polymorphisms explain only some of the variations in serum PON1 activity; thus, the other critical test of the hypothesis is likely to be whether low serum PON1 activity is associated with Parkinson disease or not. In this review we summarize current knowledge from PON1 association studies regarding the interaction between gene polymorphisms and activity of PON1 with the risk of PD. *Correspondence to: Mohammad Valilo, Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, Tel: +989380540895; E-mail: valilo.biomed@gmail.com","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116505272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vince Macri, James D. Merrill, P. Zilber, Vanessa Lane, W. Quinn
We describe Pre-Action Games & Exercises (PAGEs) a prototype for supplemental tele-rehabilitation. PAGEs are therapist-guided exercises for chronically impaired stroke survivors: basically a computer-based platform of brain exercises based on control of virtual limbs. Survivors control virtual limbs, simultaneously actuating wearable, motorized orthoses which physically manipulate impaired limbs. Physical manipulations mirror survivor controlled virtual limb movements. PAGEs are designed to assist physical and occupational therapists to treat increased numbers of stroke survivors (estimated, in the US, Canada, Mexico and Europe to be 18 million individuals). Key elements of PAGEs tele-rehabilitation are outlined. Tele-rehabilitation is suggested as a modality for therapist-supervised, survivor-selfadministered and repetitive brain-to-body exercises either in clinics and/or at home or anywhere at any time.Thus, the genetically determined pace of reduction of the primary venous plexuses determines the final shape of the dural venous system and its compensatory abilities. *Correspondence to: James Merrill, NeuroJungle, LLC 434 Lacy Woods Tallahassee, FL 32312, USA, Tel: 978-764-4295; E-mail: james@neurojungle.com Received: October 28, 2019; Accepted: November 13, 2019; Published: November 18, 2019 Introduction PAGES are designed to be a supplemental tool for therapists. Advances in pre-hospital, specialized mobile unit medical diagnosis and treatment, i.e. onboard first responder interventions, result in more stroke cases treated sooner and with positive results. For example, in cases of ischemic stroke, onboard administration of tPA (Tissue-Type Plasminogen Activator) is, in some cases, practiced as pre-hospital thrombolytic therapy.1 It is saving lives and improving outcomes. A new, May 2018, US Food and Drug Administration approved technology enables onboard diagnosis of severe strokes. It may be used by mobile unit paramedics.2 The technology combines transcranial ultrasound with an artificial intelligence (AI) component. AI algorithms compare on-board patient findings with thousands of stored images of severe stroke survivors to help diagnose the current survivor’s condition: therefore a pre-hospital early alert to neurosurgeons. In addition, inhospital endovascular surgical advances3 to ‘coil-out’ blood clots and other medical and surgical advances have increased survival rates and work-loads carried by physical and occupational therapists.
{"title":"Pre-action games & exercises via tele-rehabilitation: A prototype for supplemental stroke therapy","authors":"Vince Macri, James D. Merrill, P. Zilber, Vanessa Lane, W. Quinn","doi":"10.15761/jbn.1000124","DOIUrl":"https://doi.org/10.15761/jbn.1000124","url":null,"abstract":"We describe Pre-Action Games & Exercises (PAGEs) a prototype for supplemental tele-rehabilitation. PAGEs are therapist-guided exercises for chronically impaired stroke survivors: basically a computer-based platform of brain exercises based on control of virtual limbs. Survivors control virtual limbs, simultaneously actuating wearable, motorized orthoses which physically manipulate impaired limbs. Physical manipulations mirror survivor controlled virtual limb movements. PAGEs are designed to assist physical and occupational therapists to treat increased numbers of stroke survivors (estimated, in the US, Canada, Mexico and Europe to be 18 million individuals). Key elements of PAGEs tele-rehabilitation are outlined. Tele-rehabilitation is suggested as a modality for therapist-supervised, survivor-selfadministered and repetitive brain-to-body exercises either in clinics and/or at home or anywhere at any time.Thus, the genetically determined pace of reduction of the primary venous plexuses determines the final shape of the dural venous system and its compensatory abilities. *Correspondence to: James Merrill, NeuroJungle, LLC 434 Lacy Woods Tallahassee, FL 32312, USA, Tel: 978-764-4295; E-mail: james@neurojungle.com Received: October 28, 2019; Accepted: November 13, 2019; Published: November 18, 2019 Introduction PAGES are designed to be a supplemental tool for therapists. Advances in pre-hospital, specialized mobile unit medical diagnosis and treatment, i.e. onboard first responder interventions, result in more stroke cases treated sooner and with positive results. For example, in cases of ischemic stroke, onboard administration of tPA (Tissue-Type Plasminogen Activator) is, in some cases, practiced as pre-hospital thrombolytic therapy.1 It is saving lives and improving outcomes. A new, May 2018, US Food and Drug Administration approved technology enables onboard diagnosis of severe strokes. It may be used by mobile unit paramedics.2 The technology combines transcranial ultrasound with an artificial intelligence (AI) component. AI algorithms compare on-board patient findings with thousands of stored images of severe stroke survivors to help diagnose the current survivor’s condition: therefore a pre-hospital early alert to neurosurgeons. In addition, inhospital endovascular surgical advances3 to ‘coil-out’ blood clots and other medical and surgical advances have increased survival rates and work-loads carried by physical and occupational therapists.","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133813476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Banchenko D Y, Burilova T V, Saveliev L V, Shishkin L K
{"title":"Research on methods of inducing lucid dreaming in the framework of \"Ban-chenko Algorithm\"","authors":"Banchenko D Y, Burilova T V, Saveliev L V, Shishkin L K","doi":"10.15761/jbn.1000134","DOIUrl":"https://doi.org/10.15761/jbn.1000134","url":null,"abstract":"","PeriodicalId":332249,"journal":{"name":"Brain and Nerves","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129737925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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