Search Results (409)

Cervical myoclonus (CM) has been associated with intervertebral disc extrusion (IVDE), with a higher prevalence in French Bulldogs. The presence of CM in other breeds and with other aetiologies has not been reported. The purpose of this study was to describe the signalment, neurological examination, neuroanatomical localisation and grade, imaging findings, diagnosis, treatment, follow-up and resolution of CM in dogs. An observational multicentred retrospective analysis identified 173 dogs with CM; of those, 113 met the inclusion criteria. French Bulldogs (n = 52/113, 46%), Beagles (n = 8/113, 7.1%), Chihuahuas and Shih-Tzus (n = 6/113 for each, 5.31%) were the most affected breeds. Apparent cervical pain was the most common finding on neurologic examination (n = 70/113, 62%). Magnetic resonance imaging (MRI) was consistent with nerve root impingement in 17% (n = 19/113) of the dogs. The most frequently diagnosed conditions were degenerative (n = 100/113, 88.5%), inflammatory (n = 8/113, 7.1%), neoplastic (n = 3/113, 2.7%), vascular (n = 1/113, 0.9%) and congenital (n = 1/113, 0.9%) in origin. Dogs with a neoplastic aetiology tended to be older than those with other causes. Follow-up was recorded in 77 dogs, and 75 of these (n = 75/77, 97.4%) had resolution of the CM. The results supported that cervical myoclonus can be caused by various underlying conditions and can affect different dog breeds. Full article

Background/Objectives: Chemotherapy-induced neuropathic pain (CINP) represents a critical challenge in oncology, emerging as a common and debilitating side effect of widely used chemotherapeutic agents, such as paclitaxel (PTX). Current therapeutic interventions and preventive strategies for CINP are largely insufficient, as they fail to address the underlying peripheral nerve damage, highlighting an urgent need for the development of new drugs. This study aimed to investigate the dual-function effects on normal cell protection and tumor suppression of BMX-001, a redox-active manganese metalloporphyrin that has demonstrated antioxidant and anti-inflammatory properties, which offers potential in protecting central nervous system tissues and treating CINP. Methods: This study assessed BMX-001’s different roles in protecting normal cells while acting as a pro-oxidant and pro-inflammatory molecule in cancer cells in vitro. We also evaluated its neuroprotective effect in preclinical PTX-induced CINP models in vivo. Results: Our results showed significant reductions in mechanical and cold allodynia, decreased pro-inflammatory cytokine levels, and restored antioxidant capacity in peripheral nerves and dorsal root ganglia (DRGs) following BMX-001 treatment. Conclusions: Overall, our study highlights the therapeutic potential of BMX-001 to mitigate CINP and enhance anticancer efficiency. Its dual-selective mechanism supports the future clinical investigation of BMX-001 as a novel adjunct to chemotherapeutic regimens. Full article

This review explores current and emerging neuromodulation techniques targeting the cardiac autonomic nervous system for the treatment and prevention of atrial and ventricular arrhythmias. Arrhythmias remain a significant cause of morbidity and mortality, with the autonomic nervous system playing a crucial role in arrhythmogenesis. Interventions span surgical, pharmacological, and bioelectronic methods. We discuss the range of neuromodulation methods targeting the stellate ganglion, the spinal region, the parasympathetic system, and other promising methods. These include stellate ganglion block, stellate ganglion ablation, cardiac sympathetic denervation, subcutaneous electrical stimulation, thoracic epidural anesthesia, spinal cord stimulation, dorsal root ganglion stimulation, vagus nerve stimulation, baroreflex activation therapy, carotid body ablation, renal denervation, ganglionated plexi ablation, acupuncture, and transcutaneous magnetic stimulation. Both preclinical and clinical studies are presented as evidence for arrhythmia management. Full article

Neuropathic pain (NP) is a prevalent clinical condition resulting from diseases or injuries affecting the somatosensory system. Conventional analgesics often exhibit limited efficacy, leading to suboptimal therapeutic outcomes. The pathogenesis of NP is complex and involves multiple mechanisms. The existing evidence suggests that maladaptive neuronal plasticity plays a central role in NP development. Additionally, emerging research highlights the contribution of neuroinflammatory responses mediated by glial cells in the onset of NP and associated sensory hypersensitivity. Among non-invasive neuromodulation techniques, transcranial direct current stimulation (tDCS) has gained prominence as a potential treatment for NP. Numerous studies have demonstrated its analgesic effects; however, the precise regulatory mechanisms remain unclear. The current evidence indicates that tDCS may alleviate NP by enhancing glial–neuronal interactions, which suppress nociceptive signaling pathways and reduce pain sensitivity. The reciprocal modulation between tDCS-mediated anti-inflammatory actions, as evidenced by decreased levels of pro-inflammatory cytokines and increased levels of anti-inflammatory mediators, and its facilitation of adaptive neural plasticity represents a particularly compelling therapeutic axis. This review elucidates inflammatory regulation by tDCS as a fundamental mechanism for NP alleviation, while delineating important unresolved questions regarding these complex interactions. Full article

(1) Background: The sophisticated function of the aortic root relies on the coordinated movement of its constituent components. This study examines the extracellular components of the interleaflet triangles (ILTs) and characterises the cells that are present within this region of the aortic root. (2) Methods: A total of 10 human aortic valves and 6 porcine aortic valves were processed for immunohistochemical staining, scanning, and transmission electron microscopy. (3) Results: The three ILTs differed in size and macroscopic appearance. Each triangle comprised up to five distinct layers of tissue: an innermost endothelial layer, an inner elastin-rich layer, a thicker outer layer comprising densely packed layers of collagen and glycosaminoglycans, and an outer layer of intermingled myocardial and adipose tissue. A band of cells near the luminal surfaces of all ILTs expressed smooth muscle cell α-actin with variable expression of smooth muscle myosin heavy chain. In all the ILTs, there was evidence of neurofilament staining, indicating the presence of nerve fibres. (4) Conclusions: Each ILT is unique in its structure and organisation, with differing amounts of elastin and collagen, as well as myocardial, adipose, and fibrous content. The ILTs contain multiple cell types in varying abundance. Functional studies are required to determine the role of the different cells and their organisation in contributing to the sophisticated, dynamic behaviour of the aortic root. Full article

Background/Objectives: The co-existence of multiple compression sites on the same nerve can pose a clinical and diagnostic challenge, warranting a different treatment strategy. This so-called double crush syndrome (DCS) has mainly been investigated in the upper limb. Only a few studies have investigated DCS for the lower limb. In this article, a single-center illustrative clinical case series is presented, and current literature on L5 nerve root (NR) and concomitant common peroneal nerve (CPN) is reviewed. Methods: All patients presenting between 2019 and 2022 with L5 nerve root (NR) compression and, along their clinical courses, concomitant compression of the common peroneal nerve (CPN) at the fibular head were included. Information on clinical features, diagnostics and surgeries was obtained. The outcome was assessed at the last outpatient follow-up appointment. In addition, an extensive literature review has been conducted. Results: Fourteen patients were included with a mean follow-up of 6.8 months. The majority had pain (71%) or motor deficits (71%). Seven patients were referred for clinical and radiological L5 NR compression but were also found to have CPN compression; the other seven patients had persisting or recurrent symptoms after surgically or conservatively treated L5 NR compression, suggestive of additional peroneal neuropathy. All patients had CPN decompression at the fibular head, with successful results obtained in 93% of the patients. Pain of the lower leg improved in all patients, and dorsiflexion function improved in 78%. Conclusions: Concomitant L5 NR and CPN appear to occur more frequently than expected. Peroneal neuropathy can present simultaneously with L5 nerve radiculopathy or after surgically or conservatively treated L5 NR compression. Overlapping symptoms and variation in clinical presentations make it difficult to diagnose and, therefore, underrecognized. More awareness among treating physicians of this specific double crush syndrome is important to prevent any delay in treatment, in this case, a less invasive common peroneal nerve release at the fibular head, and to avoid unnecessary (additional) spinal surgery. Full article

Postamputation pain (PAP), including residual limb pain (RLP) and phantom limb pain (PLP), remains a significant and debilitating complication after limb loss. Despite advances in pharmacological management, many patients experience inadequate pain relief, underscoring the need for alternative therapeutic strategies. Objective: This narrative review critically synthesizes current interventional therapies for PAP, focusing on mechanisms, clinical efficacy and practical application. Methods: A literature search was conducted in PubMed, EMBASE, Scopus and Web of Science databases for studies published between 2015 and 2025. Relevant articles on peripheral nerve interventions as well as different neuromodulation techniques were included. Results: Peripheral interventions (such as alcohol neurolysis, radiofrequency ablation (RFA) and cryoneurolysis (CNL)) and neuromodulation techniques (including spinal cord stimulation (SCS), dorsal root ganglion (DRG) stimulation and cauda equina stimulation (CES)) demonstrate promising outcomes for PAP. Peripheral nerve stimulation (PNS) shows favorable safety and efficacy profiles and may help prevent the chronification of pain. Conclusions: Contemporary interventional therapies represent valuable options in the multidisciplinary management of PAP. Nevertheless, further research is required to standardize clinical algorithms, optimize therapeutic decision-making and improve long-term outcomes and quality of life for individuals with PAP. Full article

Nerve injury caused by chemotherapy drugs is a common side effect. How to reduce this kind of nerve injury and promote neuron recovery is of great significance. In this study, we found that tumor necrosis factor-α (TNF-α) promoted the recovery of dorsal root ganglion (DRG) neuron from cisplatin-induced injury. On DRG neurons cultured in vitro, we found that TNF-α promoted neurite regeneration after cisplatin injury. In addition, TNF-α accelerated the removal of DNA damage and promoted the regeneration of mitochondria on DRG neurons. Study of the mechanism showed that this effect of TNF-α was independent from the NGF signaling pathway and occurred mostly through the activation of TNFR2 receptors, together with nucleus translocation of p65 and upregulation of NF-κB expression. This study provides a new theoretical basis and therapeutic strategy for the treatment of nerve injury caused by chemotherapy drugs. Full article

The electrically evoked compound action potential (ECAP) is a crucial physiological signal used by clinicians to evaluate auditory nerve functionality. Clean ECAP recordings help to accurately estimate auditory neural activity patterns and ECAP magnitudes, particularly through the panoramic ECAP (PECAP) framework. However, noise—especially in low-signal-to-noise ratio (SNR) conditions—can lead to significant errors in parameter estimation. This study proposes a two-stage preprocessing denoising (TSPD) algorithm to address this issue and enhance ECAP signals. First, an ECAP matrix is constructed using the forward-masking technique, representing the signal as a two-dimensional image. This matrix undergoes spatial noise reduction via an improved spatial median (I-Median) filter. In the second stage, the denoised matrix is vectorized and further processed using a log-spectral amplitude (LSA) Wiener filter for spectral domain denoising. The enhanced vector is then reconstructed into the ECAP matrix for parameter estimation using PECAP. The above integrated spatial-spectral denoising framework is denoted as PECAP-TSPD in this work. Evaluations are conducted using a simulation-based ECAP model mixed with simulated and experimental noise, designed to emulate the spatial characteristics of real ECAPs. Three objective quality measures—namely, normalized root mean square error (RMSE), two-dimensional correlation coefficient (TDCC), and structural similarity index (SSIM)—are used. Simulated and experimental results show that the proposed PECAP-TSPD method has the lowest average RMSE of PECAP magnitudes (1.952%) and auditory neural patterns (1.407%), highest average TDCC (0.9988), and average SSIM (0.9931) compared to PECAP (6.446%, 5.703%, 0.9859, 0.8997), PECAP with convolutional neural network (CNN)-based denoising mask (PECAP-CNN) (9.700%, 7.111%, 0.9766, 0.8832), and PECAP with improved median filtering (PECAP-I-Median) (4.515%, 3.321%, 0.9949, 0.9470) under impulse noise conditions. Full article

Objective: The purpose of this study was to evaluate the accuracy and feasibility of magnetic resonance (MR)-guided periradicular nerve root injection therapy (PRT) using a 0.55 T magnetic resonance imaging (MRI) system with fast dynamic imaging in a phantom. Methods: Five radiologists with varying levels of experience in PRT performed nine randomly assigned PRT procedures: three under MR guidance, three under CT guidance using a fully integrated laser navigation system, and three under conventional CT guidance, all on a specialized phantom of the lumbar spine. The PRTs were assessed by two experienced neuroradiologists with expertise in interventions, using a scale of 1–5, as follows: 5 = excellent to very good, 4 = good, 3 = satisfactory 2 = bad, 1 = very bad. The puncture time and total intervention time were noted. Results: All procedures were technically successful. The subjective evaluation of the PRTs showed similar results with a median of 5 for all three guidance systems. Additionally, there was no significant difference with respect to pure puncture time (the period after needle path determination) among all PRTs (Mean ± SD): MR-guided 178 ± 117 s, CT-guided with laser system 186 ± 73 s, and the conventional CT-guided 218 ± 91 s (p = 0.482). However, the total procedure time including planning images was significantly higher for MR-guided PRT (700 ± 182 s) compared to CT guidance with laser system (366 ± 85 s) and conventional CT guidance (358 ± 150 s; p = 0.012). Conclusions: Real-time MRI-guided lumbosacral periradicular injection therapy utilizing a 0.55 T MRI system is feasible with similar puncture times to CT guidance but consumes more intervention time due to the duration of planning sequences. Limitation: The study utilized a stationary phantom made of homogeneous material, which provides an incomplete representation of real tissue properties and motion complexity applied to human beings. Full article

Background: Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease that leads to nerve atrophy. Ultrasonography has a significant role in the diagnosis of ALS. Aim: We aimed to sonographically assess the size of all peripheral nerves and cervical nerve roots in ALS compared to controls. Methods: We searched MEDLINE (PubMed), Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Scopus using comprehensive MeSH terms for the keywords nerve, ultrasound, and ALS. We extracted data regarding cross-sectional area (CSA) or diameter for the following nerves: vagus, phrenic, tibial, fibular, sural, radial, ulnar, and median nerves, and the roots of C5, C6, C7, and C8 in both ALS patients and controls. Results: Our study included 2683 participants, of which 1631 were ALS patients (mean age = 60.36), 792 were healthy controls (mean age = 57.79), and 260 were patients with other neurological disorders. ALS patients had significantly smaller nerve size compared to controls. Nerve size differences were observed in the vagus nerve [MD = −0.23], phrenic nerve [MD = −0.25], C5 nerve root [SMD = −0.94], C6 nerve root [SMD = −1.56], C7 nerve root [SMD = −1.18], C8 nerve root [MD = −1.9], accessory nerve [MD = −0.32], sciatic nerve [MD = −11], tibial nerve [MD = −0.68], sural nerve [MD = −0.32,], ulnar nerve [MD = −0.80], and median nerve [MD = −1.21]. Conclusions: Our findings showed that ALS patients have a sonographically smaller nerve size than healthy controls. Therefore, this is a potential marker for neuronal diseases. Full article

Background/Objectives: Coronectomy is an alternative to complete third molar extraction to reduce the risk of inferior alveolar nerve injury. This systematic review of systematic reviews evaluates re-intervention rate, timing, and indications after mandibular third molar coronectomy. Methods: A systematic search following PRISMA guidelines was conducted across Scopus, MEDLINE/PubMed, BioMed Central, Web of Science, Cochrane Library and PROSPERO. Studies reporting re-intervention rates after at least six months from coronectomy were included. Data extraction focused on re-intervention timing, indications, and complications. Results: Six systematic reviews, including 5896 subjects and 7913 successful coronectomies (not requiring immediate tooth extractions), were analyzed. The overall re-intervention rate was 4.45%, with timing ranging from six months to ten years (mean: 10.4 months). Root exposure (16.76%) was the primary cause, followed by infection (4.55%) and pain (2.84%). Root migration (12.20%) was common, while inferior alveolar nerve injury remained rare (0.76%). Conclusions: Coronectomy is a viable alternative in high-risk cases, with a low re-intervention rate. Root migration and exposure require long-term follow-up. Standardized imaging protocols and refined re-intervention criteria are needed. Full article

Malignant Triton Tumors (MTTs) are rare, high-grade malignant peripheral nerve sheath tumors (MPNSTs) frequently associated with Type 1 Neurofibromatosis (NF1). NF1, an autosomal dominant disorder, predisposes approximately 10% of affected individuals to developing MPNSTs, with 50% of these tumors occurring in NF1 patients, while others arise sporadically or in association with radiation exposure. MTTs predominantly affect anatomical regions rich in large nerves, such as the limbs, spinal root, and cranial nerves. Mediastinal presentations are exceedingly rare, posing significant diagnostic and therapeutic challenges. Current treatment strategies include surgical resection, chemotherapy, radiotherapy, and lung-sparing procedures for metastatic disease. Molecular studies of MPNSTs have revealed that NF1 mutations lead to dysregulation of the RAS signalling pathway, while epigenetic alterations (e.g., SUZ12/EED mutations) further contribute to tumor progression. Dysregulated phylogenetically conserved pathways, including Wnt/beta-catenin and non-canonical SHH signalling, play a role in sarcoma progression and Schwann cell transformation. Recent advances in miRNA research highlight their involvement in tumor invasion and progression, with dysregulated miRNA expression and chromatin remodeling contributing to the pathogenesis of these neoplasms. However, the distinct molecular profiles for MTTs remain incompletely understood. Further investigation of the genetic and epigenetic landscape is essential for improving our understanding and identifying potential therapies. Herein, we present a single-center retrospective case series of three patients with an intrathoracic triton tumor treated at our University Hospital between 2000 and 2024, serving as a starting point for future insights into MPNST pathobiology. Full article

Since its discovery, TRPC6 has been associated with a variety of physiological and pathophysiological processes in different tissues. It functions as a non-selective cation channel and belongs to the group of TRP channels. Its importance in the development of pain hypersensitivity is becoming increasingly apparent. This condition has already been associated with increased expression of TRPC6 in dorsal root ganglia. Apart from the fact that most of the evidence has been obtained from samples of animal origin, it remains unclear whether the channel is also expressed in peripheral nerves outside the dorsal root ganglia. The aim of this work was therefore to examine peripheral nerves from human samples for TRPC6. For this purpose, samples of both the sciatic and ulnar nerves were taken from a total of eight body donors and analyzed by immunohistochemistry. Both longitudinal and transverse sections were obtained from the samples and stained. In total, 43 of 48 histological sections showed a positive immunosignal. There were no major differences between the sciatic and ulnar nerves with regard to staining. There was a slight difference in the staining intensity of transverse and longitudinal sections. The longitudinal sections of both nerves were consistently colored slightly more intensely. However, the inter-individual differences between the donors were more pronounced. Interestingly, the samples of a donor who suffered from chronic pain syndrome during his lifetime were particularly strongly stained. This is consistent with the knowledge gained to date, largely from animal experiments, that the channel shows increased expression in pain conditions in dorsal root ganglia. In the future, TRPC6 could therefore be a target in pain therapy. Full article

Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes mellitus for which effective treatments remain undeveloped. Metabolic changes and inflammation are proposed as primary mechanisms underlying DPN pathogenesis. Our previous studies demonstrate that exogenous pyruvate plays a crucial role in maintaining glycolysis-tricarboxylic acid cycle flux under high-glucose conditions and also exhibits anti-inflammatory properties. To evaluate its therapeutic potential, we assessed whether pyruvate administration could restore DPN in vivo and in vitro. We assessed casual blood glucose levels, body weight, motor and sensory nerve conduction velocities, mechanical sensitivity, and intraepidermal nerve fiber density in streptozotocin-induced diabetic C57/BL/6J mice that received drinking water with or without sodium pyruvate (10 mg/mL) from 2 to 13 weeks after diabetes induction. In addition, we evaluated neurite length in ND7/23 cells, a dorsal root ganglion neuron cell line, under high-glucose conditions. Pyruvate administration in diabetic mice alleviated mechanical sensitivity deficits and improved intraepidermal nerve fiber density. Additionally, neurite length in ND7/23 cells was inhibited under high-glucose conditions but was fully restored by supplementation with high concentrations (10 mM) of pyruvate. These findings suggest that exogenous pyruvate may be a promising therapeutic candidate for DPN. Full article