Journal of Neurorestoratology最新文献

We report a case of pediatric intracerebral hemorrhage with cerebral herniation treated with stereotaxic minimally invasive surgery. A 4-month-old premature male infant with vitamin K deficiency presented to the emergency department with focal seizures and vomiting. A computed tomography scan revealed a massive intracerebral hemorrhage in the left frontal lobe with cerebral herniation. The child successfully underwent stereotaxic minimally invasive surgery hematoma evacuation, and the neurological function improved significantly. Brain magnetic resonance imaging was performed to further characterize the lesion, but no intracranial vascular malformation was found. Overall, the neurological function was completely recovered at the 18-month follow-up, and there were no postoperative complications such as infection, rebleeding and seizures.

Approximately 10,000 cases of spinal cord injury (SCI), most caused by trauma, are reported each year. We present a unique case of injury secondary to electrical stimulation of the thoracic spinal cord for the treatment of diabetic foot. The patient developed symptoms of acute-phase spinal cord shock after surgery, and the expected therapeutic results were achieved by methylprednisolone and other treatments. Improper program control may destroy the efficacy of spinal cord stimulation for pain relief. This case should alert physicians to the potential risks of neuroregulation following epidural placement of electrodes.

Low-intensity pulsed ultrasound (LIPUS) stimulation has shown promising results in neurorehabilitation following a traumatic injury in brain and peripheral nerves. However, the effects of LIPUS stimulation in the injured neural circuit after spinal cord injury (SCI) are still unknown. We investigated the effects of LIPUS on forelimb functions in chronic cervical cord injured rats with and without a serotonergic agonist drug, Buspirone treatment. Twenty-six rats were trained for forelimb reaching and grasping followed by C4 dorsal funiculi crush injury. To deliver LIPUS, a silicon-coated ultrasound disc was implanted above the cervical cord and electromyography electrodes were implanted into forelimb muscles. In two cohorts (LIPUS and LIPUS + Buspirone combined) rats were tested pre-, with- and post-ultrasound stimulation. In LIPUS group rats, fore-limb reaching and grasping success rates first increased and then dropped after 3 weeks while for combination of drug and LIPUS stimulation the score continued to increase. Furthermore, LIPUS stimulation alone did not result in any significant improvement of grip strength compared to the control and combined groups. The findings of this study indicated the potential of LIPUS in SCI recovery and offer a future research direction of a new neuromodulation method.

Restoring neurological dysfunctions is challenging in patients with the sequels of vertebral and spinal cord lesions. Current guidelines focus on treating the early stage of vertebral and spinal cord lesions, such as tethered cord syndrome, syringomyelia, spinal degenerative diseases, spinal infection, ankylosing spondylitis, myelitis, vertebral and spinal cord vascular malformations, and others, whereas the treatments of the sequels of those lesions have received limited attention. Restoring neurological dysfunctions and damaged structures caused by these lesions could improve patient quality of life. The Chinese Association of Neurorestoratology (Preparatory) and the China Committee of International Association of Neurorestoratology therefore proposed and approved this guideline providing the restorative therapeutic rules and references for physicians to treat patients with neurological dysfunction of sequels from vertebral and spinal cord lesions.

Non-progressive conditions that develop in the growing fetus or newborn brain and result in lifelong motor impairments and activity restrictions are collectively referred to as cerebral palsy. In the present review, recent advancements in the treatment of cerebral palsy are discussed. Studies are currently being conducted on high-tech aids such as telemedicine, robotics, virtual reality, telerehabilitation, and exoskeletons. In the current review, we focus on the effectiveness of interventions including neurologic music therapy, aquatic therapy, virtual reality, robotics, electrical stimulation, constraint-induced movement therapy, hippotherapy, and hyperbaric oxygen therapy. We also discuss the drugs used for the treatment of spasticity in cerebral palsy, as well as the effects of nutritional intake. Neurologic music therapy alongside physiotherapy leads to positive rehabilitation outcomes, as does treadmill gait training combined with robotics for lower limb improvements. Furthermore, kinesio taping is helpful for positioning the wrist, thumb, and fingers, and for reducing upper limb stiffness. Neurorestorative therapies such as cell therapy, brain–computer interface technology, and transcranial magnetic stimulation may also effectively restore neural networks in a positive direction in cerebral palsy. Finally, rehabilitation along with neurofeedback and biofeedback is considered helpful in patients with this neurological disorder.

Objective

To analyze the clinical manifestations and genetic examination results of affected members of two Chinese ATP1A2 gene variants pedigrees, and to summarize their phenotypic and genotypic features.

Methods

The clinical features were recorded in detailed. The cranial magnetic resonance imaging for patients and gene sequencing of two Chinese ATP1A2 gene variant pedigrees were perform. The correlation between the types of variants and the clinical phenotypes of ATP1A2 gene were analyzed.

Results

These two pedigrees are diagnosed as familial hemiplegic migraine type 2 (FHM2) with ATP1A2 heterozygous missense variants, c.1091C > T (p.T364M) found in pedigree 1 and c.899T > C (p.L300P) in pedigree 2. Multiple phenotypes coexist in both families, and the two probands have severe cranial magnetic resonance imaging manifesting hemiplegic contralateral cortical swelling and diffusion weighted imaging hyperintense signal, which can be fully recovered. ATP1A2 gene variants were seen in FHM2, sporadic hemiplegic migraine and atypical alternating hemiplegia of childhood (AHC) families or sporadic cases, etc. The clinical features of ATP1A2 variant c.1091C > T (p.T364M) are basically similar in Chinese patients and European patients.

Conclusion

These two Chinese pedigrees had FHM2 due to ATP1A2 heterozygous missense variation. It would expand the understanding of ATP1A2.

Objective

To study the effects and potential control mechanisms of the agrin signaling pathway on the repair of distal sciatic nerve damage.

Methods

50 Sprague-Dawleyrats were randomly allocated into the control group (SCI group, n = 25) and the treatment group (Treat group, n = 25). In both groups, the sciatic nerve damage model was created. Following surgery, the SCI group and the Treat group received intragastric administrations of normal saline and Jiawei Buyang Huanwu Decoction, respectively. The dose for both groups was 2mL/(kg·d) for 12 consecutive weeks. At 4, 8, and 12 weeks post-surgery, the wet-to-weight ratio of the gastrocnemius muscle in the two groups was assessed; and hematoxylin-eosin staining and Masson staining were used to detect pathological alterations in the sciatic nerve and collagen. The expression of agrin, Dag1, Dmd, and Lamb2 proteins in the agrin pathway, as well as ERK, MEK, and their corresponding phosphorylated proteins, p-ERK and p-MEK, were all detected by Western blot in the gastrocnemius muscle.

Results

The wet weight of the gastrocnemius muscle in the Treat group increased considerably (p < 0.05) after 4, 8, and 12 weeks following the operation compared to the SCI group, and it continued to rise over time. The expression level of Dag1, Dmd, and Lamb2 protein in agrin pathway, as well as p-ERK and p-MEK protein were all significantly lower than they were in the SCI group (p < 0.05). Additionally, Jiawei Buyang Huanwu Decoction greatly reduced the amount of nerve scars at the sciatic nerve injury and significantly healed sciatic neuropathy according to the results of pathological staining.

Conclusion

Jiawei Buyang Huanwu Decoction can inhibit the expression of agrin, Dag1, Dmd, and Lamb2, as well as p-ERK and p-MEK. It can effectively promote the distal repair of sciatic nerve injury probably through argin pathway.