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Dysembryoplastic neuroepithelioma tumors (DNETs) are rare glioneuronal tumors usually present with partial epilepsy. We analyzed the surgical curative effect of DNETs based on imaging classification. The clinical, neuroimaging, seizure history, neuropathological data, and other medical records of 21 cases of cerebral hemisphere DNETs were collected and analyzed retrospectively. According to the magnetic resonance imaging (MRI) classification of Chassoux, these cases were divided into 8 cases of type I (thylakoid type), 6 cases of type II (nodular type), and 7 cases of type III (dysplasia). All patients received detailed preoperative evaluation and underwent surgical treatment. We statistically compared the postoperative seizure outcome of different DNET MRI types by Engel classification. All tumors were surgically removed and pathologically diagnosed as DNETs. The follow-up period was 5–68 months Engel class I outcome was achieved in all type I cases, 3 (50%) type II cases, and 3 (42.9%) type III cases. The postoperative seizure outcome of MRI type I was better than that of type II and III. Based on the MRI classification of DNET by Chassoux, the postoperative epilepsy control of type I is better than that of type II and type III, which may be related to the residual FCD around the tumor of type II and type III. Thus, the MRI classification of DNET can contribute to the preoperative design of the resection plan. Total resection of type I and extended resection of type II, as well as type III, will help to improve the postoperative seizure-free rate in DNET. [ABSTRACT FROM AUTHOR]

To study the feasibility of plasma extracellular vesicles (EVs) miRNAs as diagnostic biomarkers for Parkinson's disease (PD). Plasma EVs were isolated from 30 PD patients and 30 age- and sex-matched healthy controls. Plasma EVs miRNAs were analysed by qRT-PCR. SH-SY5Y cells were induced by different concentrations of 1-Methyl-4-phenil-pyridinium (MPP+) to obtain PD cellular model. The levels of miRNAs and α-synuclein (α-syn) in PD cellular model were analysed by qRT-PCR and Western blot. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic usefulness of the miRNAs in plasma EVs for PD. The gene ontology (GO) and KEGG pathways of the target genes of miRNAs were analysed by softwares. The level of hsa-miR-30c-2-3p in plasma EVs was significantly higher in PD patients than that in controls, and the levels of hsa-miR-15b-5p, hsa-miR-138-5p, hsa-miR-338-3p, hsa-miR-106b-3p and hsa-miR-431-5p in plasma EVs were lower in PD patients than that in controls. When compared with the control group, the area under the curve (AUC) values for hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p, hsa-miR-431-5p, hsa-miR-338-3p and hsa-miR-106b-3p were all greater than 0.6. The target genes of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-338-3p were enriched in dopaminergic synapse and PD pathway. The hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p, hsa-miR-106b-3p, hsa-miR-338-3p and hsa-miR-431-5p may be used as potential biomarkers for the diagnosis of PD, and the combined diagnostic accuracy of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-106b-3p was better. The target genes of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-338-3p may regulate the expression of dopamine by dopaminergic synapse and PD pathway. Isolation and identification of plasma EVs. The miRNAs in plasma EVs may be used as potential biomarkers for the diagnosis of PD. When SH-SY5Y cells were induced by different concentrations of MPP+, the levels of miRNAs and α-syn changed gradually. The target genes of miRNAs were enriched in dopaminergic synapse and PD pathway. The target genes of miRNAs may regulate the expression of dopamine. [ABSTRACT FROM AUTHOR]

We reviewed our institutional experience during a 10-year period for improvement of safety and efficacy of stereotactic biopsy procedures. We performed a retrospective review of inpatient summaries, stereotactic worksheets and radiologic investigations of 208 consecutive patients, who underwent MRI-guided stereotactic biopsies between March 2010 and March 2020. The overall diagnostic yield was 96.2%. CT-confirmed intracranial hemorrhage occurred in 17 patients (8.2%), and the overall mortality rate was 0.5%. Combined MRS and PWI helped target selection in 27 cases (13.0%), the diagnostic yield was 100%. The results of the regression analysis revealed that non-diagnostic biopsy specimen significantly correlated with the cystic trait (p<.01) and edema of lesions (p<.05). Enhancement (p<.01) is shown to be an important factor for obtaining a diagnostic biopsy. Furthermore, the edema trait of lesions (p<.01) showed the important factors of hemorrhage. The radiological features of lesions and use of the most suitable MRI sequences during biopsy planning are recommended ways to improve the diagnostic yield and safety of this technique. [ABSTRACT FROM AUTHOR]

Purpose: Parkinson's disease is a progressive disorder. To investigate the biochemical alterations in the striatum of rats with different stages of Parkinson's disease induced by proteasomal inhibition, we quantified neurochemical profiles of the striatum using proton magnetic resonance spectroscopyusing 9.4 T ultra-high field imaging. Methods: In this study, 10 μg/2 μl lactacystin, a selective proteasome inhibitor, was unilaterally injected stereotaxically into the left substantia nigra pars compacta of rats. An equal volume of saline was injected into the same region and side in the control group. Changes in motor behaviour were observed. The morphological changes of tyrosine hydroxylase-positive cells in substantia nigra pars compacta were visualized using immunohistochemistry. Tyrosine hydroxylase-positive nerve fibers were quantified. Alterations of N-acetylaspartate, choline, creatine, taurine in the different stages of Parkinson's disease rats were detected using proton magnetic resonance spectroscopy. Results: Application of in vivo 1H magnetic resonance spectroscopy was repeated in both the six Parkinson's disease rats and the six control rats across three time points during the first, second and fourth weekend after administration. In Parkinson's disease rats, increased N-acetylaspartate and decreased taurine concentrations were observed in the left striatum at the first week after administration. The increased N-acetylaspartate and choline concentrations were observed at the second weekend. At the fourth weekend, increased creatine concentrations in the left side were observed, while other metabolites were not significantly changed. Conclusions: Neurochemical alterations occurred in the striatum during different stages of the Parkinson's disease model in rats. Also, 9.4 T 1H magnetic resonance spectroscopy may be a useful tool for elucidating the progression of Parkinson's disease through the variation of these metabolites. [ABSTRACT FROM AUTHOR]

Objective: This study addressed the benefit of intraoperative magnetic resonance imaging (iMRI) compared with conventional neuronavigation-guided resection in patients with gliomas.Research Design and Methods: The Medline, PubMed, Cochrane, and Google Scholar databases were searched up to 26 September 2015. Randomized controlled trials (RCTs), two-arm prospective studies, and retrospective studies in patients with glioblastoma/glioma who had received surgical treatment were included.Main Outcome Measures: The primary outcome measures were the extent of tumor resection and tumor size reduction for using iMRI-guided or conventional neuronavigation-guided neurosurgery. Secondary outcomes included impact of surgery on 6 month progression-free survival (PFS), 12 month overall survival (OS) rates and surgical duration.Results: We found that iMRI was associated with greater rate of gross total resection (rGTR) compared with conventional neuronavigation procedures (3.16, 95% confidence interval [CI] 2.07-4.83, P < .001). We found no difference between the two neuronavigation approaches in extent of resection (EOR), tumor size reduction, or time required for surgery (P values ≥.065). Intraoperative MRI was associated with a higher rate of progression-free survival (PFS) compared with conventional neuronavigation (odds ratio, 1.84; 95% CI 1.15-2.95; P = .012), but the rate of overall survival (OS) between groups was similar (P = .799). Limitations of the study included the fact that data from non-RCTs was used, the small study population, and heterogeneity of outcomes across studies.Conclusions: Our findings indicate that iMRI more frequently resulted in more complete resections leading to improved PFS in patients with malignant gliomas. [ABSTRACT FROM AUTHOR]

Objective: To analyze the outcome in subjects with bacterial brain abscesses (BBAs) treated by operation and shorter antimicrobial duration than usual at a single center over a four-year period. Methods: Retrospective review was conducted on a series of 55 patients with BBAs surgically treated and managed by prospective antimicrobial protocol of shorter antimicrobial duration than usual. Sixty-one abscesses were diagnosed and surgically managed in 55 patients. Open craniotomy excision was the treatment of choice for 58.2% of the patients, whereas 31.8% of the cases were managed through stereotactically guided aspiration. Intravenous antimicrobial agents were given to all patients emipirically or changed later according to culture results. Intravenous antimicrobial administration was discontinued without following oral therapy when the patients' body temperature was continuously normal for 10–14 days after surgery and neuroimaging showed the resolution of BBAs at the same time [Follow-up CT or MRI showed no residue cavity, or the diffusion wedge images (DWI) showed the signal in the residue cavity was as low as the signal of cerebral spinal fluid]. Results: The mean total antimicrobial duration was 21.7 days (10–66 days), and the mean antimicrobial duration after operation was 19.2 days (10–64 days). Follow-up found there were two patients whose BBAs recurred and died 4–5 months after primary BBAs controlled. Follow-up data of the remaining 53 patients were available with a mean follow-up time of 36 months (12–58 months). Outcome was favorable in 65.5% of the subjects. General morbidity was 18.2%, and recurrence and mortality stood at 3.6%, respectively. Conclusions: This case series showed the short-course intravenous antimicrobial administration can be considered to be a standard therapy for bacterial brain abscess in the surgically treated group, and the thermal curve and DWI are the two paramount indicators that can safely evaluate the antimicrobial times for the treatment of BBAs. [ABSTRACT FROM AUTHOR]

Objectives: For patients with intraventricular hemorrhage (IVH) accompanied by obstructive hydrocephalus, external ventricular drainage (EVD) alone is proven to be often insufficient, and lumbar drainage (LD) is proven promising but considered contraindicative in the acute phase. The objective was to analyze the safety and feasibility of treatment for IVH with early continuous LD (CLD) in addition to open EVD regardless of the presence of acute obstructive hydrocephalus. Methods: In this prospective study, 10 consecutive patients with moderate to severe IVH received emergency EVD and early CLD insertion regardless of the presence of obstructive hydrocephalus or blood clots in the third and fourth ventricles. During the whole course of treatment, the EVD was kept open at a safe height until replaced by CLD alone. When the drained CSF from CLD was nearly normal, gradual weaning of the CLD was attempted. Ventriculoperitoneal (VP) shunt would be performed if there was evidence of communicating hydrocephalus. Results: In all the cases, EVD could be safely replaced by CLD alone. There was no evidence of axial herniation or infection, and no requirement of EVD revision. After CLD weaning, only two patients underwent VP shunt procedure. Follow-up study on 3 months and 6 months demonstrated that 7 (70%) patients had good (Glasgow Outcome Scale (GOS) 4 to 5) outcome and 1 (10%) patient died 1 month after discharge due to renal failure. Conclusions: Results suggest that this new therapy which combines EVD with early CLD insertion is safe and easy to manage moderate to severe IVH with obstructive hydrocephalus. [ABSTRACT FROM AUTHOR]