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13 pages, 1198 KiB  
Brief Report
Cognitive Training Combined with Multifocal tDCS over the Reading Network Improves Reading Performance: A Case of Severe Dyslexia
by Gloria Di Filippo, Marika Bonuomo, Martina Ravizza, Andrea Velardi and Rinaldo Livio Perri
J. Clin. Med. 2025, 14(16), 5671; https://doi.org/10.3390/jcm14165671 - 11 Aug 2025
Viewed by 433
Abstract
Background: Developmental dyslexia (DD) is the most common form of specific learning disorders (SLDs). From a neurocognitive point of view, dyslexic reading is associated with atypical neurofunctional patterns in the left hemisphere, mainly in the posterior areas linked to lexical access and phonological [...] Read more.
Background: Developmental dyslexia (DD) is the most common form of specific learning disorders (SLDs). From a neurocognitive point of view, dyslexic reading is associated with atypical neurofunctional patterns in the left hemisphere, mainly in the posterior areas linked to lexical access and phonological processing. Nowadays, rehabilitation treatments do not aim to fix the disorder but rather improve adaptive skills. On the other hand, the transcranial direct current stimulation (tDCS) has recently gained popularity in this field. In fact, a few studies have documented enhanced accuracy and speed after the tDCS over the parietal cortex, although the results were mainly limited to non-word reading. Methods: We conducted a single-case study employing an innovative multifocal eight-channel tDCS aimed at increasing the reading network activity in the left hemisphere and inhibiting the contralateral areas. The participant was a 9-year-old boy with a diagnosis of severe mixed-type specific learning disorder. The high-definition multifocal tDCS was administered over key areas of the frontal, temporal, parietal, and occipital lobes (four 3.14 cm2 electrodes per hemisphere) in conjunction with tachistoscope training over a span of 10 weeks, with three sessions per week for a total of thirty sessions. Standardized assessments of reading were carried out at the beginning, at the end of the treatment, and at one- and six-month follow-up. Results: The treatment led to a 77% improvement in the accuracy of passage reading and an 83% improvement in the reading of high-frequency short words, with stable results at the 1- and 6-month follow-up. By contrast, in line with the severity of the disorder, there were only slight improvements in the speed parameter. Conclusions: This is the first study to document such remarkable improvements in reading in a case of severe SLD: if confirmed, these promising findings could pave the way for an effective, non-invasive rehabilitation for SLDs using multifocal tDCS. However, future studies are needed to overcome the limitations of single-case studies, such as the lack of control conditions and quantifiable analysis. Full article
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16 pages, 2443 KiB  
Article
Contralateral Structure and Molecular Response to Severe Unilateral Brain Injury
by Xixian Liao, Xiaojian Xu, Ming Li, Runfa Tian, Yuan Zhuang and Guoyi Gao
Brain Sci. 2025, 15(8), 837; https://doi.org/10.3390/brainsci15080837 - 5 Aug 2025
Viewed by 471
Abstract
Background: Severe damage to one side of the brain often leads to adverse consequences and can also cause widespread changes throughout the brain, especially in the contralateral area. Studying molecular changes in the contralateral cerebral hemisphere, especially with regard to genetic regulation, [...] Read more.
Background: Severe damage to one side of the brain often leads to adverse consequences and can also cause widespread changes throughout the brain, especially in the contralateral area. Studying molecular changes in the contralateral cerebral hemisphere, especially with regard to genetic regulation, can help discover potential treatment strategies to promote recovery after severe brain trauma on one side. Methods: In our study, the right motor cortex was surgically removed to simulate severe unilateral brain injury, and changes in glial cells and synaptic structure in the contralateral cortex were subsequently assessed through immunohistological, morphological, and Western blot analyses. We conducted transcriptomic studies to explore changes in gene expression levels associated with the inflammatory response. Results: Seven days after corticotomy, levels of reactive astrocytes and hypertrophic microglia increased significantly in the experimental group, while synapsin-1 and PSD-95 levels in the contralateral motor cortex increased. These molecular changes are associated with structural changes, including destruction of dendritic structures and the encapsulation of astrocytes by synapses. Genome-wide transcriptome analysis showed a significant increase in gene pathways involved in inflammatory responses, synaptic activity, and nerve fiber regeneration in the contralateral cortex after corticorectomy. Key transcription factors such as NF-κB1, Rela, STAT3 and Jun were identified as potential regulators of these contralateral changes. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) confirmed that the mRNA expression levels of Cacna1c, Tgfb1 and Slc2a1 genes related to STAT3, JUN, and NF-κB regulation significantly increased in the contralateral cortex of the experimental group. Conclusions: After unilateral brain damage occurs, changes in the contralateral cerebral hemisphere are closely related to processes involving inflammation and synaptic function. Full article
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21 pages, 1842 KiB  
Article
Acute Stroke Severity Assessment: The Impact of Lesion Size and Functional Connectivity
by Karolin Weigel, Christian Gaser, Stefan Brodoehl, Franziska Wagner, Elisabeth Jochmann, Daniel Güllmar, Thomas E. Mayer and Carsten M. Klingner
Brain Sci. 2025, 15(7), 735; https://doi.org/10.3390/brainsci15070735 - 9 Jul 2025
Viewed by 591
Abstract
Background/Objectives: Early and accurate prediction of stroke severity is crucial for optimizing guided therapeutic decisions and improving outcomes. This study investigates the predictive value of lesion size and functional connectivity for neurological deficits, assessed by the National Institutes of Health Stroke Scale (NIHSS [...] Read more.
Background/Objectives: Early and accurate prediction of stroke severity is crucial for optimizing guided therapeutic decisions and improving outcomes. This study investigates the predictive value of lesion size and functional connectivity for neurological deficits, assessed by the National Institutes of Health Stroke Scale (NIHSS score), in patients with acute or subacute subcortical ischemic stroke. Methods: Forty-four patients (mean age: 68.11 years, 23 male, and admission NIHSS score 4.30 points) underwent high-resolution anatomical and resting-state functional Magnetic Resonance Imaging (rs-fMRI) within seven days of stroke onset. Lesion size was volumetrically quantified, while functional connectivity within the motor, default mode, and frontoparietal networks was analyzed using seed-based correlation methods. Multiple linear regression and cross-validation were applied to develop predictive models for stroke severity. Results: Our results showed that lesion size explained 48% of the variance in NIHSS scores (R2 = 0.48, cross-validated R2 = 0.49). Functional connectivity metrics alone were less predictive but enhanced model performance when combined with lesion size (achieving an R2 = 0.71, cross-validated R2 = 0.73). Additionally, left hemisphere connectivity features were particularly informative, as models based on left-hemispheric connectivity outperformed those using right-hemispheric or bilateral predictors. This suggests that the inclusion of contralateral hemisphere data did not enhance, and in some configurations, slightly reduced, model performance—potentially due to lateralized functional organization and lesion distribution in our cohort. Conclusions: The findings highlight lesion size as a reliable early marker of stroke severity and underscore the complementary value of functional connectivity analysis. Integrating rs-fMRI into clinical stroke imaging protocols offers a potential approach for refining prognostic models. Future research efforts should prioritize establishing this approach in larger cohorts and analyzing additional biomarkers to improve predictive models, advancing personalized therapeutic strategies for stroke management. Full article
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13 pages, 6124 KiB  
Article
Neuroradiological Evaluation of Anatomo-Morphometric Arcuate Fascicle Modifications According to Different Brain Tumor Histotypes: An Italian Multicentric Study
by Roberto Altieri, Andrea Bianconi, Stefano Caneva, Giovanni Cirillo, Fabio Cofano, Sergio Corvino, Oreste de Divitiis, Giuseppe Maria Della Pepa, Ciro De Luca, Pietro Fiaschi, Gianluca Galieri, Diego Garbossa, Giuseppe La Rocca, Salvatore Marino, Edoardo Mazzucchi, Grazia Menna, Antonio Mezzogiorno, Alberto Morello, Alessandro Olivi, Michele Papa, Daniela Pacella, Rosellina Russo, Giovanni Sabatino, Giovanna Sepe, Assunta Virtuoso, Giovanni Vitale, Rocco Vitale, Gianluigi Zona and Manlio Barbarisiadd Show full author list remove Hide full author list
Brain Sci. 2025, 15(6), 625; https://doi.org/10.3390/brainsci15060625 - 10 Jun 2025
Viewed by 682
Abstract
Background: The arcuate fasciculus (AF) is a critical white matter (WM) tract that connects key cortical language-processing regions, including the so-called Broca’s and Wernicke’s areas. The aim of the present study was to quantitatively assess its radiological–anatomical–morphometric modifications according to different brain tumor [...] Read more.
Background: The arcuate fasciculus (AF) is a critical white matter (WM) tract that connects key cortical language-processing regions, including the so-called Broca’s and Wernicke’s areas. The aim of the present study was to quantitatively assess its radiological–anatomical–morphometric modifications according to different brain tumor histotypes. Methods: A retrospective multicentric Italian study was conducted. AF reconstructions were calculated for both hemispheres for each patient diagnosed with glioblastoma (GBM), low-grade glioma (LGG), brain metastasis, and meningioma using Elements Fibertracking 2.0 software (Brainlab AG, Munich, Germany). A 3D object of each fascicle was evaluated for its volume, average fractional anisotropy (FA), and length. The cerebral healthy hemisphere was compared to the pathological contralateral in different tumor histotypes. Results: In total, 1294 patients were evaluated. A total of 156 met the inclusion criteria. We found a significant difference between healthy hemisphere and the contralateral for AF mean length and volume (p = 0.01 and p < 0.001, respectively). Considering separately the different tumor histotypes, the GBM subgroup (98, 63%) confirmed the results for mean FA and volume (p-value < 0.001); LGG patients (26, 17%) showed no significant difference between healthy and pathological hemisphere for AF mean length, mean FA, and volume (p-value 0.5, p-value 0.3, p-value <0.1, respectively). In patients affected by brain metastasis (18, 12%), Student’s t-test showed a significant difference for FA (p-value 0.003). No differences were found in patients affected by meningiomas (14, 9%) (14). Conclusions: Thorough knowledge of the microscopic anatomy and function of the arcuate fasciculus, as well as the pattern of growth of the different brain tumor histotypes, along with a careful preoperative neuroradiological assessment are mandatory to plan a tailored surgical strategy and perform a safe and effective surgical technique. The AF could be displaced and infiltrated/destructed by the solid component and peritumoral edema, respectively, of GBM. LGG shows a prevalent infiltrative pattern. Metastases account for AF dislocation due to peritumoral edema. Meningiomas do not affect WM anatomy. Full article
(This article belongs to the Special Issue Current Research in Neurosurgery)
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17 pages, 855 KiB  
Article
The Influence of Transcranial Alternating Current Stimulation on the Excitability of the Unstimulated Contralateral Primary Motor Cortex
by Erik W. Wilkins, Richard J. Young, Ryder Davidson, Reese Krider, George Alhwayek, Jonathan A. Park, Armaan C. Parikh, Zachary A. Riley and Brach Poston
Brain Sci. 2025, 15(5), 512; https://doi.org/10.3390/brainsci15050512 - 17 May 2025
Viewed by 1012
Abstract
Objectives: Transcranial alternating current stimulation (tACS) can enhance primary motor cortex (M1) excitability and improve motor skill when delivered unilaterally to the dominant hemisphere. However, the impact of tACS on contralateral M1 excitability both during and after application has not been studied. The [...] Read more.
Objectives: Transcranial alternating current stimulation (tACS) can enhance primary motor cortex (M1) excitability and improve motor skill when delivered unilaterally to the dominant hemisphere. However, the impact of tACS on contralateral M1 excitability both during and after application has not been studied. The purpose of this study was to examine the effects of tACS delivered to the dominant left M1 on the excitability of the unstimulated contralateral non-dominant right M1. Methods: This study implemented a double-blind, randomized, SHAM-controlled, within-subjects, crossover experimental design. Eighteen young adults completed a tACS condition and a SHAM condition on two different days in counterbalanced order with a week washout period between days. Transcranial magnetic stimulation (TMS) was utilized to assess excitability of the contralateral right M1 while tACS was delivered to the left M1. TMS was administered in five test blocks (termed Pre, D5, D10, D15, and Post) relative to a 20 min application of tACS (70 Hz, 1 mA current strength). The Pre and Post TMS test blocks were conducted before and immediately after tACS was applied to the left M1, whereas the TMS test blocks performed during tACS were completed at time points starting at the 5, 10, and 15 min marks of the 20 min stimulation period. The primary dependent variable was the 1 mV motor evoked potential (MEP) amplitude. MEP data were analyzed with a 2 condition (tACS, SHAM) × 5 test (Pre, D5, D10, D15, Post) within-subjects ANOVA. Results: The main effect for condition (p = 0.704) and condition × test interaction (p = 0.349) were both non-statistically significant. There was a significant main effect for test (p = 0.003); however, post hoc analysis indicated that none of the pairwise comparisons were statistically significant. Conclusions: Overall, the findings indicate that tACS applied to the left M1 does not significantly modulate contralateral right M1 excitability during or immediately after stimulation, at least when utilizing the present tACS parameters. Full article
(This article belongs to the Special Issue New Insights into Movement Generation: Sensorimotor Processes)
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11 pages, 3540 KiB  
Article
Effect of Cilostazol and Aspirin During Hyperacute Stroke Phase in Rats: An Experimental Research Study
by Christiana Anastasiadou, Anastasios Papapetrou, George Galyfos, Kostas Vekrellis, Patroklos Katafygiotis, Andreas Lazaris, George Geroulakos, Angelos Megalopoulos, Christos Liapis, Nikolaos Kostomitsopoulos and John Kakisis
Neurol. Int. 2025, 17(5), 69; https://doi.org/10.3390/neurolint17050069 - 28 Apr 2025
Viewed by 501
Abstract
Objective: The contralateral hippocampus, a critical region for cognitive function, is often overlooked in everyday clinical practice and stroke research. This study aimed to evaluate the effect of specific antiplatelet agents on the hippocampus (ipsilateral and contralateral) during the hyperacute phase of stroke. [...] Read more.
Objective: The contralateral hippocampus, a critical region for cognitive function, is often overlooked in everyday clinical practice and stroke research. This study aimed to evaluate the effect of specific antiplatelet agents on the hippocampus (ipsilateral and contralateral) during the hyperacute phase of stroke. Materials and Methods: Twelve-week-old rats were randomly assigned to four groups, each containing six rats: a cilostazol group, an aspirin group, an aspirin plus cilostazol group, and a control group. Each substance was administered for four weeks. Permanent brain ischemia was induced over 2 h using intraluminal middle cerebral artery occlusion. A neurologic examination was conducted, followed by euthanasia and histological examination of the CA1 hippocampal region. The hematoxylin and eosin stain was used to assess the total number of intact neuronal cell bodies and pyknotic nuclei, an indicator of early irreversible neuronal injury. Results: In the ipsilateral hippocampus, monotherapy with either aspirin or cilostazol significantly reduced pyknotic nuclei compared with the control group (p = 0.0016 and p = 0.0165, respectively). However, combination therapy showed no significant difference from the controls (p = 0.2375). In the contralateral hippocampus, cilostazol monotherapy demonstrated significantly reduced pyknotic nuclei (p = 0.0098), whereas aspirin monotherapy and combination therapy did not (p = 0.1009 and p = 0.9999, respectively). A cumulative analysis of both hemispheres revealed that monotherapy with aspirin or cilostazol markedly reduced injury markers (p = 0.0002 and p = 0.0001, respectively), whereas combined therapy revealed no significant benefit (p = 0.1984). A neurological assessment indicated that the most severe deficits were in the combination therapy group. Conclusions: To the best of our knowledge, this is the first study to compare acute histopathological changes in the affected and unaffected hippocampus after a stroke in a rat model. Dual antiplatelet therapy resulted in worse outcomes (histopathological and neurological) than monotherapy. Full article
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13 pages, 2329 KiB  
Article
Surface EEG Evidence for Cerebellar Control of Distal Upper Limbs in Humans
by Anna Latorre, Kais Humaidan, Mauro Sanna, Maria Lucrezia Lavena, Sara Pittalis, Clio Raimondi, Elias Paolo Casula and Lorenzo Rocchi
Brain Sci. 2025, 15(5), 440; https://doi.org/10.3390/brainsci15050440 - 24 Apr 2025
Viewed by 612
Abstract
Background/Objectives: The cerebellum plays a crucial role in motor control, but its direct electrophysiological investigation in humans is challenging. Electrocerebellograms (ECeGs), recorded via surface electrodes below the inion, have been proposed as a non-invasive method to assess cerebellar activity. However, its interpretation [...] Read more.
Background/Objectives: The cerebellum plays a crucial role in motor control, but its direct electrophysiological investigation in humans is challenging. Electrocerebellograms (ECeGs), recorded via surface electrodes below the inion, have been proposed as a non-invasive method to assess cerebellar activity. However, its interpretation is complicated by potential interference from occipital alpha rhythms and neck muscle signals. This study aimed to investigate whether ECeG signals genuinely reflect cerebellar involvement during upper limb movement and to explore possible confounding influences. Methods: We recorded electroencephalograms (EEGs) from occipital (Oz) and cerebellar electrodes (Cb1 and Cb2), alongside EMGs from forearm muscles in healthy individuals performing sinusoidal (~1 Hz) and tremor-like (~4 Hz) wrist movements. To assess occipital contamination, recordings were obtained under both eyes-open and eyes-closed conditions. Results: Occipital alpha power was present in Cb1 and Cb2 but was less affected by eye-opening than at Oz, suggesting a partially distinct neural source. During the tremor condition, movement-frequency power increased at Cb2 and C3 (corresponding to the ipsilateral cerebellar hemisphere and contralateral motor cortex), indicating authentic cerebellar activity. No significant movement-related EEG changes were observed during sinusoidal movements, likely due to weaker neuronal synchronization. Conclusions: These findings suggest that ECeGs can detect cerebellar signals linked to movement, especially during faster and rhythmic motions, and are only moderately affected by occipital contamination. This supports the feasibility of non-invasive cerebellar electrophysiology and underscores the need for further methodological refinement to enhance signal specificity. Full article
(This article belongs to the Section Sensory and Motor Neuroscience)
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18 pages, 5527 KiB  
Article
Bilateral Cerebral Hypoperfusion in Asymptomatic Unilateral Carotid Artery Stenosis: An Arterial Spin Labeling MRI Study
by Nikola Dacic, Srdjan Stosic, Olivera Nikolic, Zoran D. Jelicic, Aleksandra Dj Ilic, Mirna N. Radovic and Jelena Ostojic
Medicina 2025, 61(5), 771; https://doi.org/10.3390/medicina61050771 - 22 Apr 2025
Viewed by 730
Abstract
Background and Objectives: Carotid artery stenosis is a significant risk factor for ischemic stroke due to impaired cerebral blood flow (CBF). Even asymptomatic unilateral stenosis can induce subclinical cerebrovascular changes, potentially affecting both hemispheres through collateral circulation. This study aimed to systematically [...] Read more.
Background and Objectives: Carotid artery stenosis is a significant risk factor for ischemic stroke due to impaired cerebral blood flow (CBF). Even asymptomatic unilateral stenosis can induce subclinical cerebrovascular changes, potentially affecting both hemispheres through collateral circulation. This study aimed to systematically assess cerebral perfusion in asymptomatic individuals with unilateral carotid artery stenosis by comparing ipsilateral and contralateral hemispheres with healthy controls, challenging the assumption that the contralateral hemisphere remains unaffected. Materials and Methods: This cross-sectional study included 114 participants, comprising 54 asymptomatic individuals (mean age 65.5) with significant unilateral carotid stenosis and 60 age-matched controls (mean age 64.8). Cerebral perfusion was assessed using 1.5T Magnetic Resonance Imaging (MRI) with pseudo-continuous arterial spin labeling (pCASL). CBF was measured bilaterally in four predefined middle cerebral artery (MCA) regions: precentral gyrus, lentiform nucleus, insular cortex, and temporal cortex. Statistical analyses included multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), paired t-tests, and discriminant analysis (DA). Results: Significant bilateral reductions in CBF were observed in individuals with carotid stenosis compared to controls (MANOVA and ANOVA, p < 0.001). The greatest perfusion deficit was in the ipsilateral insular cortex (49.88 ± 10.83 mL/100 g/min), followed by intermediate contralateral perfusion (51.49 ± 8.86 mL/100 g/min) and higher control values (58.78 ± 10.44 mL/100 g/min). DA indicated the insular cortex as the region with the highest discriminative contribution (64.7%). Conclusions: Unilateral carotid artery stenosis in asymptomatic individuals is associated with significant bilateral cerebral hypoperfusion, suggesting widespread hemodynamic effects. Pronounced perfusion deficits in the insular cortex underline its vulnerability. The observed contralateral perfusion reductions challenge the traditional use of the contralateral hemisphere as a reference standard, underscoring the need for comprehensive perfusion assessment in carotid artery disease. Full article
(This article belongs to the Section Neurology)
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19 pages, 1153 KiB  
Article
Prefrontal Cortical Near-Infrared Spectroscopy for Acute Pain Assessment in Infants: A Feasibility Study
by Matthias Nissen and Ralf-Bodo Tröbs
J. Clin. Med. 2025, 14(7), 2525; https://doi.org/10.3390/jcm14072525 - 7 Apr 2025
Viewed by 962
Abstract
Background: Assessing pain in infants is challenging due to their inability to communicate discomfort. Accurate pain evaluation is essential, as unaddressed pain might lead to long-term neurological consequences. This study investigates the use of conventional two-site near-infrared spectroscopy (NIRS) to evaluate hemodynamic responses [...] Read more.
Background: Assessing pain in infants is challenging due to their inability to communicate discomfort. Accurate pain evaluation is essential, as unaddressed pain might lead to long-term neurological consequences. This study investigates the use of conventional two-site near-infrared spectroscopy (NIRS) to evaluate hemodynamic responses in the prefrontal cortex during nociceptive stimuli. Methods: Data were prospectively collected from ten infants undergoing elective heel lance/squeeze (HLS) after surgery. Continuous bilateral NIRS oxygenation monitoring was performed alongside cardiorespiratory and behavioral (Children’s and Infant’s Postoperative Pain Score (CHIPPS)) pain assessments before, during, and after HLS. The primary outcome was the correlation between NIRS response and CHIPPS. Results: The average gestational and postnatal ages were 39 weeks and 49 days. No significant changes in prefrontal oxygenation levels (left, right, combined, ipsilateral, contralateral) were observed during the first ten seconds of HLS compared with baseline. Although CHIPPS and heart rates increased, oxygenation levels remained unchanged throughout the entire HLS event. Significant fluctuations in oxygenation levels from baseline were recorded across all optode configurations, with changes in the lowest oxygenation levels at the contralateral and left hemispheres inversely correlated with CHIPPS and HR changes. Conclusions: While there were subtle alterations in NIRS signals suggesting potential nociceptive-evoked changes, these were inconclusive. By design, the utilized two-site conventional NIRS system may not effectively detect acute pain. Future studies on prefrontal cortical pain processing could benefit from confirmatory NIRS signals from the primary somatosensory and motor regions. Integrating data from fNIRS, fMRI, EEG, along with sympathetic indicators like skin conductance and heart rate variability, would improve the quantification of cortical pain processing in non-verbal infants. Full article
(This article belongs to the Special Issue Targeted Medicine in Postoperative Pain Management)
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17 pages, 2307 KiB  
Article
Clinicopathological Parameters and Immunohistochemical Profiles in Correlation with MRI Characteristics in Glioblastomas
by Tamás-Csaba Sipos, Kövecsi Attila, Lóránd Kocsis, Adrian Bălașa, Rareș Chinezu, Beáta Ágota Baróti and Zsuzsánna Pap
Int. J. Mol. Sci. 2024, 25(23), 13043; https://doi.org/10.3390/ijms252313043 - 4 Dec 2024
Cited by 1 | Viewed by 1192
Abstract
Glioblastoma is considered the most aggressive tumor of the central nervous system. The tumor microenvironment includes several components, such as endothelial cells, immune cells, and extracellular matrix components like matrix metalloproteinase-9 (MMP-9), which facilitates the proliferation of endothelial cells with pro-angiogenic roles. The [...] Read more.
Glioblastoma is considered the most aggressive tumor of the central nervous system. The tumor microenvironment includes several components, such as endothelial cells, immune cells, and extracellular matrix components like matrix metalloproteinase-9 (MMP-9), which facilitates the proliferation of endothelial cells with pro-angiogenic roles. The MRI characteristics of glioblastomas can contribute to determining the prognosis. The aim of this study was to analyze the relationship between tumor angiogenesis in glioblastomas in association with MMP-9 immunoexpression. The results were correlated with the Ki-67 proliferation index, p53 immunoexpression, and the mutational status of IDH1 and ATRX, as well as MRI imaging data. This retrospective study included forty-four patients diagnosed with glioblastoma at the Department of Pathology, Târgu Mureș County Emergency Clinical Hospital. MMP-9 immunoexpression was observed in approximately half of the cases, more frequently in patients over 65 years old. Comparing the imaging data with the immunohistochemical results, we observed that the median tumor volume was higher in glioblastomas with IDH1 and p53 mutations, ATRX wild-type status, negative MMP-9 expression, and high Ki-67 proliferation indexes. The median values of MVD-CD34 and MVD-CD105 were higher in cases with extensive peritumoral edema in the contralateral hemisphere. Additionally, ATRX mutations were frequently associated with a more pronounced deviation of the median structures. To statistically validate the associations between MRI and the histopathological features of glioblastomas, further studies with larger cohorts are required. Full article
(This article belongs to the Special Issue Glioblastoma: From Molecular Mechanisms to Therapies)
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16 pages, 5515 KiB  
Article
Asymmetry of the Frontal Aslant Tract and Development of Supplementary Motor Area Syndrome
by Jahard M. Aliaga-Arias, Josephine Jung, Jose Pedro Lavrador, Kapil Rajwani, Ana Mirallave-Pescador, Amy Jones, Hilary Wren, Richard Gullan, Ranj Bhangoo, Keyoumars Ashkan, Flavio Dell’Acqua and Francesco Vergani
Cancers 2024, 16(22), 3739; https://doi.org/10.3390/cancers16223739 - 5 Nov 2024
Cited by 3 | Viewed by 1363
Abstract
Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA [...] Read more.
Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA between 2018 and 2022. Inclusion criteria were availability of preoperative and postoperative Magnetic Resonance Imaging, no previous surgery, and no neurological deficits at presentation. Diffusion-weighted data were processed by spherical deconvolution (SD) and diffusion tensor imaging tractography algorithms, and TrackVis was used to dissect the FAT of both hemispheres. The FAT data were analyzed for correlation with postoperative SMA syndrome onset. Results: N = 25 cases were included in the study, among which n = 23 had preoperative bilaterally identifiable FAT by SD. N = 12 developed an SMA syndrome, 6 demonstrated a motor-only syndrome, 4 had a verbal-only syndrome, and 2 had mixed verbal and motor features. The SMA syndrome incidence was significantly more frequent in lower-grade gliomas (p = 0.005). On the tumor side, the FAT identified by SD was smaller than the contralateral (mean volume 6.53 cm3 and 13.33 cm3, respectively, p < 0.001). In the 6 cases that developed a verbal SMA syndrome, a normalized FAT volume asymmetry (FAT-VA) demonstrated an asymmetry shifted towards the non-dominant side (mean FAT-VA = −0.68), while the cases with no postoperative verbal impairment had opposite asymmetry towards the dominant side (mean FAT-VA = 0.42, p = 0.010). Conclusions: Preoperative interhemispheric FAT volume asymmetry estimated according to functional dominance can predict postoperative onset of verbal SMA syndrome, with proportionally smaller FAT on the affected dominant hemisphere. Full article
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8 pages, 1528 KiB  
Case Report
Transient Ipsilateral Hemineglect Following Brain Laser Ablation in Patient with Focal Cortical Dysplasia
by Georgios Ntolkeras, Fatemeh Mohammadpour Touserkani, Michelle Y. Chiu, Sanjay P. Prabhu, Scellig Stone and Alexander Rotenberg
Neurol. Int. 2024, 16(5), 958-965; https://doi.org/10.3390/neurolint16050072 - 3 Sep 2024
Viewed by 1342
Abstract
Sensory integration is the province of the parietal lobe. The non-dominant hemisphere is responsible for both body sides, while the dominant hemisphere is responsible for the contralateral hemi-body. Furthermore, the posterior cingulate cortex (PCC) participates in a network involved in spatial orientation, attention, [...] Read more.
Sensory integration is the province of the parietal lobe. The non-dominant hemisphere is responsible for both body sides, while the dominant hemisphere is responsible for the contralateral hemi-body. Furthermore, the posterior cingulate cortex (PCC) participates in a network involved in spatial orientation, attention, and spatial and episodic memory. Laser interstitial thermotherapy (LiTT) is a minimally invasive surgery for focal drug-resistant epilepsy (DRE) that can target deeper brain regions, and thus, region-specific symptoms can emerge. Here, we present an 18-year-old right-handed male with focal DRE who experienced seizures characterized by sensations of déjà vu, staring spells, and language disruption. A comprehensive evaluation localized the seizure focus and revealed a probable focal cortical dysplasia (FCD) in the left posterior cingulate gyrus. The patient underwent uneventful LiTT of the identified lesion. Post-operatively, he developed transient ipsilateral spatial neglect and contralateral sensory loss, as well as acalculia. His sensory symptoms gradually improved after the surgery, and he remained seizure-free after the intervention for at least 10 months (until the time of this writing). This rare case of ipsilateral spatial and visual hemineglect post-LiTT in epilepsy underscores the importance of recognizing atypical neurosurgical outcomes and considering individual variations in brain anatomy and function. Understanding the dynamics of cortical connectivity and handedness, particularly in pediatric epilepsy, may be crucial in anticipating and managing neurocognitive effects following epilepsy surgery. Full article
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11 pages, 937 KiB  
Article
The Impact of Stimulation Parameters on Cardiovascular Outcomes in Chronic Stroke Patients Following Transcranial Direct Current Stimulation—A Pilot Controlled, Randomized, Double-Blind Crossover Trial
by Fernanda Ishida Corrêa, Laura Uehara, Michele Lacerda de Andrade, Gustavo Oliveira da Silva, Katia De Angelis, Ariane Viana, Catarina Novaes Souza Bertani, João Carlos Ferrari Corrêa and Felipe Fregni
Biomedicines 2024, 12(9), 1998; https://doi.org/10.3390/biomedicines12091998 - 2 Sep 2024
Cited by 1 | Viewed by 963
Abstract
Background: Stroke survivors often experience autonomic nervous system (ANS) dysfunction. While Transcranial Direct Current Stimulation (tDCS) has been shown to modulate the ANS when applied to the left hemisphere, its effects on the right hemisphere remain unexplored. Objective: We aimed to compare the [...] Read more.
Background: Stroke survivors often experience autonomic nervous system (ANS) dysfunction. While Transcranial Direct Current Stimulation (tDCS) has been shown to modulate the ANS when applied to the left hemisphere, its effects on the right hemisphere remain unexplored. Objective: We aimed to compare the effects of tDCS applied to both the injured and the contralateral hemispheres on heart rate variability (HRV) and functional capacity in individuals post-stroke. Methods: Twenty individuals with cerebral hemisphere lesions (ten with right-hemisphere lesions and ten with left-hemisphere lesions) were randomized into four groups: anodal and sham tDCS on the left temporal cortex (T3) and anodal and sham tDCS on the right temporal cortex (T4). HRV was assessed before the intervention, after the six-minute walk test (6MWT), and following tDCS. HRV data were categorized into frequency ranges: low frequency (LF), high frequency (HF), and sympathovagal balance. The 6MWT (meters) was conducted both pre- and post-tDCS. Results: In individuals with right-hemisphere lesions, a higher global LF value was observed (right side: 71.4 ± 16.8 nu vs. left side: 65.7 ± 17.3 nu; p = 0.008), as well as lower values of the HF component (right side: 29.5 ± 18.9 nu vs. left side: 34.0 ± 17.4 nu; p = 0.047), consequently exhibiting higher global values of the low/high-frequency ratio (right side: 3.9 ± 2.8 vs. left side: 2.9 ± 2.4). Regarding the stimulation site, tDCS over T3 led to a lower overall value of the low/high-frequency ratio (left hemisphere: 3.0 ± 2.2 vs. right hemisphere: 3.7 ± 2.9; p = 0.040) regardless of the lesion location. A significant increase in the distance covered in the 6MWT was observed for individuals with lesions in both hemispheres after tDCS at T3. Conclusions: Participants with right-hemisphere lesions exhibited superior global sympathetic autonomic nervous system activity. When the tDCS was applied on the left hemisphere, it maintained lower sympathovagal balance values and improved functional capacity regardless of the hemisphere affected by the stroke. Full article
(This article belongs to the Section Neurobiology and Clinical Neuroscience)
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17 pages, 830 KiB  
Article
Non-Dominant Hemisphere Excitability Is Unaffected during and after Transcranial Direct Current Stimulation of the Dominant Hemisphere
by Erik W. Wilkins, Richard J. Young, Daniel Houston, Eric Kawana, Edgar Lopez Mora, Meghana S. Sunkara, Zachary A. Riley and Brach Poston
Brain Sci. 2024, 14(7), 694; https://doi.org/10.3390/brainsci14070694 - 12 Jul 2024
Cited by 1 | Viewed by 1366
Abstract
Transcranial direct current stimulation (tDCS) increases primary motor cortex (M1) excitability and improves motor performance when applied unilaterally to the dominant hemisphere. However, the influence of tDCS on contralateral M1 excitability both during and after application has not been quantified. The purpose was [...] Read more.
Transcranial direct current stimulation (tDCS) increases primary motor cortex (M1) excitability and improves motor performance when applied unilaterally to the dominant hemisphere. However, the influence of tDCS on contralateral M1 excitability both during and after application has not been quantified. The purpose was to determine the influence of tDCS applied to the dominant M1 on the excitability of the contralateral non-dominant M1. This study employed a double-blind, randomized, SHAM-controlled, within-subject crossover experimental design. Eighteen young adults performed two experimental sessions (tDCS, SHAM) in counterbalanced order separated by a one-week washout. Transcranial magnetic stimulation (TMS) was used to quantify the excitability of the contralateral M1 to which anodal tDCS was applied for 20 min with a current strength of 1 mA. Motor evoked potential (MEP) amplitudes were assessed in 5 TMS test blocks (Pre, D5, D10, D15, and Post). The Pre and Post TMS test blocks were performed immediately before and after tDCS application, whereas the TMS test blocks performed during tDCS were completed at the 5, 10, and 15 min stimulation timepoints. MEPs were analyzed with a 2 condition (tDCS, SHAM) × 5 test (Pre, D5, D10, D15, Post) within-subject ANOVA. The main effect for condition (p = 0.213), the main effect for test (p = 0.502), and the condition × test interaction (p = 0.860) were all not statistically significant. These results indicate that tDCS does not modulate contralateral M1 excitability during or immediately after application, at least under the current set of common tDCS parameters of stimulation. Full article
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15 pages, 3502 KiB  
Article
The Effect of Targeted Hyperoxemia on Brain Immunohistochemistry after Long-Term, Resuscitated Porcine Acute Subdural Hematoma and Hemorrhagic Shock
by Franziska Münz, Thomas Datzmann, Andrea Hoffmann, Michael Gröger, René Mathieu, Simon Mayer, Fabian Zink, Holger Gässler, Eva-Maria Wolfschmitt, Melanie Hogg, Enrico Calzia, Pierre Asfar, Peter Radermacher, Thomas Kapapa and Tamara Merz
Int. J. Mol. Sci. 2024, 25(12), 6574; https://doi.org/10.3390/ijms25126574 - 14 Jun 2024
Cited by 2 | Viewed by 1311
Abstract
Epidemiological data suggest that moderate hyperoxemia may be associated with an improved outcome after traumatic brain injury. In a prospective, randomized investigation of long-term, resuscitated acute subdural hematoma plus hemorrhagic shock (ASDH + HS) in 14 adult, human-sized pigs, targeted hyperoxemia (200 < [...] Read more.
Epidemiological data suggest that moderate hyperoxemia may be associated with an improved outcome after traumatic brain injury. In a prospective, randomized investigation of long-term, resuscitated acute subdural hematoma plus hemorrhagic shock (ASDH + HS) in 14 adult, human-sized pigs, targeted hyperoxemia (200 < PaO2 < 250 mmHg vs. normoxemia 80 < PaO2 < 120 mmHg) coincided with improved neurological function. Since brain perfusion, oxygenation and metabolism did not differ, this post hoc study analyzed the available material for the effects of targeted hyperoxemia on cerebral tissue markers of oxidative/nitrosative stress (nitrotyrosine expression), blood–brain barrier integrity (extravascular albumin accumulation) and fluid homeostasis (oxytocin, its receptor and the H2S-producing enzymes cystathionine-β-synthase and cystathionine-γ-lyase). After 2 h of ASDH + HS (0.1 mL/kgBW autologous blood injected into the subdural space and passive removal of 30% of the blood volume), animals were resuscitated for up to 53 h by re-transfusion of shed blood, noradrenaline infusion to maintain cerebral perfusion pressure at baseline levels and hyper-/normoxemia during the first 24 h. Immediate postmortem, bi-hemispheric (i.e., blood-injected and contra-lateral) prefrontal cortex specimens from the base of the sulci underwent immunohistochemistry (% positive tissue staining) analysis of oxidative/nitrosative stress, blood–brain barrier integrity and fluid homeostasis. None of these tissue markers explained any differences in hyperoxemia-related neurological function. Likewise, hyperoxemia exerted no deleterious effects. Full article
(This article belongs to the Special Issue Oxygen Variations, 2nd Edition)
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