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Tag: Neuro

  • Brain imaging pinpoints mental illness biomarkers.

    Brain imaging pinpoints mental illness biomarkers.

    Newswise — Philadelphia, November 9, 2023  Research and treatment of psychiatric disorders are stymied by a lack of biomarkers – objective biological or physiological markers that can help diagnose, track, predict, and treat diseases. In a new study, researchers use a very large dataset to identify predictive brain imaging-based biomarkers of mental illness in adolescents. The work appears in Biological Psychiatry, published by Elsevier.

    Traditionally, psychiatric disorders such as depression have been diagnosed based on symptoms according to subjective assessments. The identification of biomarkers to aid in diagnosis and treatment selection would greatly advance treatments.

    In the current study, the investigators used brain imaging data from the Adolescent Brain Cognitive Development (ABCD) Study of nearly 12,000 children aged 9 to 10 at the beginning of the study. Modern neuroimaging techniques, including resting-state functional connectivity (rsFC) analysis, allow researchers to investigate the organization of brain circuits through their interaction with one another over time.

    Yihong Yang, PhD, senior author of the study, at the Neuroimaging Research Branch, National Institute on Drug Abuse, said, “Using a functional MRI dataset, we identified a brain connectivity variate that is positively correlated with cognitive functions and negatively correlated with psychopathological measures.”

    Cognition has long been studied in the context of mental disorders, and recent research has pointed to shared neurobiology between the two, as supported in this new study.

    This brain-based variate predicted how many psychiatric disorders were identified in participants at the time of the scan and over the following two years. It also predicted the transition of diagnosis across disorders over the two-year follow-up period.”

    Dr. Yang added, “These findings provide evidence for a transdiagnostic brain-based measure that underlies individual differences in developing psychiatric disorders in early adolescence.”

    John Krystal, MD, Editor of Biological Psychiatry, said of the work, “Mental illness in adolescence has emerged as a cardinal public health challenge in the post-COVID era. More than ever before, we would benefit from better ways to identify adolescents at risk. This study uses data from the landmark ABCD Study to illustrate how neuroimaging data could illuminate risk for mental illness across the spectrum of diagnoses.”

    Dr. Yang added, “Finding biomarkers of mental illnesses, rather than relying on symptoms, may provide a more precise means of diagnosis, and thereby aligning psychiatric diagnosis with other medical diagnoses.”

    Elsevier

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  • Mice’s Eating and Drinking Preferences Explored.

    Mice’s Eating and Drinking Preferences Explored.

    Newswise — Making decisions is hard. Even when we know what we want, our choice often leaves something else on the table. For a hungry mouse, every morsel counts. But what if the decision is more consequential than choosing between crumbs and cheese?

    Stanford researchers investigated how mice resolve conflicts between basic needs in a study published in Nature on Nov. 8. They presented mice that were both hungry and thirsty with equal access to food and water and watched to see what happened next.

    The behavior of the mice surprised the scientists. Some gravitated first toward water, while others chose food. Then, with seemingly “random” periods of indulgence, they switched back and forth. In their study, PhD candidate Ethan Richman, lead author of the paper, and colleagues in the departments of Biology, Psychiatry and Behavioral Sciences, and Bioengineering explored why. This work builds on years of collaboration between co-senior authors Karl Deisseroth, the D.H. Chen Professor at Stanford Medicine, and Liqun Luo, the Ann and Bill Swindells Professor in the School of Humanities and Sciences, to understand how the brain keeps the body alive.

    Buridan’s what?

    “There’s this old philosophical quandary called Buridan’s Ass,” explained Richman, “where you have a donkey that is equally hungry and thirsty and equally far from food and water.” The concept was posited by philosophers Aristotle, Jean Buridan, and Baruch Spinoza, in different forms. The question was whether the donkey would choose one need over the other or remain stubbornly in the middle.

    But animals are constantly making choices. We must satisfy our needs to maintain homeostasis. Richman and colleagues wanted to know how the brain directs traffic through conflicting signals to flout Buridan. They call their behavioral experiment “Buridan’s Assay.”

    If hunger or thirst directly motivated a mouse to eat or drink, it would switch as soon as one need outweighed the other. When needs were equal, the mouse would be stuck. This is not what the researchers observed. “Our data indicate that thirst and hunger don’t act as direct forces on behavior,” said Richman. “Instead, they modulate behavior more indirectly. They’re influencing what we think of as the current goal of the mouse.”

    A mouse’s goal

    We often think of choices as a decisive moment. The researchers wanted to understand when and where choices between food and water originate in the brain. Using recent advances in recording technology, they monitored activity from individual neurons spread across the mouse brain.

    To their surprise, neuron activity patterns throughout the brain predicted the mouse’s choice, even before it was presented with options. “Instead of a single moment of choice, the mouse’s brain is constantly broadcasting its current goal,” said Richman. “Outcomes of the hardest choices you make – when options are closely balanced in importance, but the categories are fundamentally different – may have to do with the state your brain happened to be in, even before the choice was presented,” said Deisseroth. “That’s an interesting outcome and it helps us understand aspects of human behavior better.”

    Exploring the random

    The researchers found that hungry and thirsty mice often make the same choice repeatedly before suddenly switching. “In eating mode, the mouse will just eat and eat. In drinking mode, it will drink and drink,” said Luo. “But there is an aspect of randomness that causes them to switch between these two. That way, in the long run, they fulfill both needs, even if at any given time they are only choosing one.”

    To test this apparent randomness, the researchers ran another experiment, this time with hungry mice. As the mice ate, scientists introduced thirst through a technique called optogenetics. With optogenetics, they used light to activate neurons causing thirst. Sometimes the mice switched to water, and sometimes they ignored it and kept eating. The level of thirst was the same each time, leading the researchers to conclude there is a key randomness influencing the mouse’s goal.

    The scientists were perplexed by the interplay between this randomness and the relative intensities of hunger and thirst. To better understand it, they turned to mathematical modeling. Inspired by a conceptual resemblance between their results and a distant field of physics, the researchers borrowed, tweaked, and simulated several equations.

    “We were extremely surprised and excited to find that a few simple equations from a seemingly unrelated discipline could closely predict aspects of mouse behavior and brain activity,” said Richman. The results of their modeling suggested that the brain activity relating to the mouse’s goal is constantly in motion. It gets trapped by needs like hunger and thirst. To escape and transition from one goal to another, the mouse relies on a lucky series of random activity.

    This work establishes the importance of the brain’s shifting baseline state when it comes to decision-making. In the future, the researchers will explore what sets the tone and why decisions don’t always make sense.

    Beyond Buridan

    “In terms of Buridan’s Ass, we can say that the donkey’s mind is made up before it is given a choice,” says Richman, “and if it has to wait, then its choice may spontaneously switch.” Clinical applications for this work in the human context are a bit more complex. “As a psychiatrist, I often think about how we make healthy (adaptive) or harmful (maladaptive) decisions,” said Deisseroth. (Maladaptive behaviors impact people’s ability to make decisions in their best interest and they are common in psychiatric disorders.) “It’s very hard for family and friends to see loved ones act against their own survival drives. It may help to understand the choices made as reflecting the underlying dynamical landscape of the patient’s brain, affected by the disorder more than by the patient’s conscious volition.”

    Although this work might not explain human behavior, it begins to reveal an important framework for decision-making. “This is basic discovery science that depends on pretty advanced neuro-engineering, but at the core we address universal questions that people think about and experience all the time,” said Deisseroth. “It’s exciting to develop and apply modern tools to address these very old, deep, and personal questions.”

    Additional Stanford co-authors include former undergraduate student Nicole Ticea, BS ’20, who is now a PhD student at Stanford, and former graduate student William E. Allen, PhD ’19, who is now at Harvard University. Deisseroth is also professor of bioengineering and of psychiatry and behavioral sciences, and a member of Stanford Bio-X and the Wu Tsai Neurosciences Institute. Luo is also a professor of biology, a faculty fellow at Sarafan ChEM-H, and a member of Stanford Bio-X, the Stanford Cancer Institute, and the Wu Tsai Neurosciences Institute. Deisseroth and Luo are both are investigators of the Howard Hughes Medical Institute.

    This work was funded by the National Science Foundation, the National Institutes of Health, and the Gatsby Foundation.

    Stanford University

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  • Does Your Neighborhood Affect Your Care After a Stroke?

    Does Your Neighborhood Affect Your Care After a Stroke?

    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, NOVEMBER 1, 2023

    Newswise — MINNEAPOLIS – People who live in neighborhoods with lower socioeconomic status are less likely to receive clot-busting medications or undergo clot-removing procedures after they have a stroke than people who live in neighborhoods with higher socioeconomic status, according to a study published in the November 1, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

    “These treatments can greatly reduce death and disability from stroke, but previous studies have shown that few people actually receive the treatments,” said study author Amy Ying Xin Yu, MD, of the University of Toronto in Canada. “We wanted to see how socioeconomic disparities play a role, especially in an area where everyone has access to universal health care.”

    The study looked at all people living in Ontario, Canada, who had an ischemic stroke during a five-year period, for a total of 57,704 people. Ischemic stroke is caused by a blockage of blood flow to the brain and is the most common type of stroke.

    The study looked to see how many of those people were treated with clot-busting drugs or surgery to remove blood clots.

    Researchers also looked at participants’ neighborhoods and divided them into five groups based on their neighborhoods’ socioeconomic status, which was determined by factors such as the percentage of adults without a high school diploma, unemployment rate and income level.

    A total of 17% of those living in the neighborhoods with the lowest socioeconomic status were treated, compared to 20% of those living in the neighborhoods with the highest socioeconomic status.

    When researchers took into account other factors that could affect treatment, such as age, high blood pressure and diabetes, they found that people in the neighborhoods with the lowest socioeconomic status were 24% less likely to be treated than people in the neighborhoods with the highest socioeconomic status. There was no difference in treatment between the neighborhood with the lowest status and the middle three neighborhoods.

    “Our study underscores the need for tailored interventions to address socioeconomic disparities in access to acute stroke treatments, including educational and outreach programs to increase awareness about the signs and symptoms of stroke in various languages and efforts to distribute resources more equitably across neighborhoods,” Yu said. “Further research is needed to examine the specific causes of these disparities, so we can find ways to address the larger systemic issues that need to be improved to better serve people from under-resourced neighborhoods.”

    A limitation of the study was that researchers did not have information on other factors that could affect stroke treatment, such as the time symptoms started or how severe the stroke was.

    The study was supported by ICES, a health research institute in Ontario; the Heart and Stroke Foundation of Canada; PSI Foundation; and Ontario Health Data Platform.

    Learn more about stroke at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

    American Academy of Neurology (AAN)

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  • Scientists reveal structures of neurotransmitter transporter

    Scientists reveal structures of neurotransmitter transporter

    Newswise — (Memphis, Tenn – November 1, 2023) Neurons talk to each other using chemical signals called neurotransmitters. Scientists at St. Jude Children’s Research Hospital have drawn on structural biology expertise to determine structures of vesicular monoamine transporter 2 (VMAT2), a key component of neuronal communication. By visualizing VMAT2 in different states, scientists now better understand how it functions and how the different shapes the protein takes influence drug binding — critical information for drug development to treat hyperkinetic (excess movement) disorders such as Tourette syndrome. The work was published today in Nature.    

    How our neurons talk to each other 

    Chemical compounds called monoamines, which include dopamine, serotonin and adrenaline, play a central role in neuronal communication. These molecules affect how the brain works, controlling our emotions, sleep, movement, breathing, circulation and many other functions. Monoamines are neurotransmitters (signaling molecules) produced and released by neurons, but before they can be released, they must first be packaged into vesicles.  

    Vesicles are cellular compartments that store neurotransmitters before they are released at the synapses (the junction through which chemical signals pass from one neuron to another). Think of vesicles as the cargo ships of the neuronal cell — neurochemicals are packed inside them and taken to where they need to go. VMATs are proteins on the membrane of these vesicles that move monoamines into the space within, acting like loading cranes for the cargo ships.  

    “VMATs are transporters that are required for packing these monoamine neurotransmitters into synaptic vesicles,” explained co-corresponding author Chia-Hsueh Lee, Ph.D., St. Jude Department of Structural Biology.   

    Once the VMAT has packed the vesicle with monoamines, the “cargo ship” moves towards the synaptic gap (the space between neurons), where it releases the chemical compounds.  

    The many faces of monoamine transporters 

    There are two types of VMAT: VMAT1 and VMAT2. VMAT1 is more specialized, found only in neuroendocrine cells, whereas VMAT2 is found throughout the neuronal system and has significant clinical relevance.   

    “We knew that VMAT2 is physiologically very important,” Lee said. “This transporter is a target for pharmacologically relevant drugs used in the treatment of hyperkinetic disorders such as chorea and Tourette Syndrome.” 

    Despite their importance, the structure of VMAT2, which would allow researchers to investigate how it works fully, had remained elusive. Lee and his team used cryo-electron microscopy (cryo-EM) to obtain structures of VMAT2 bound to the monoamine serotonin and the drugs tetrabenazine and reserpine, which are used to treat chorea and hypertension, respectively. This was no easy feat.  

    “VMAT2 is a small membrane protein,” explained co-first author Yaxin Dai, PhD., St. Jude Department of Structural Biology. “This makes it a very challenging target for cryo-EM structure determination.”  

    Despite the difficulty and using some clever tricks, the team captured multiple structures of VMAT2 that allowed them to tease out how the protein functions and investigate how exactly those drugs work. “VMAT transporters adopt multiple conformations [shapes] while transporting their substrate. This is called alternating access transport, where the protein is either “outward” or “inward” facing,” explained co-first author Shabareesh Pidathala, Ph.D., St. Jude Department of Structural Biology. “To completely gain mechanistic understanding at an atomic level, we needed to capture multiple conformations of this transporter.”  

    Answering a 40-year-old question 

    The researchers discovered this dynamic mechanism means multiple opportunities for drugs to bind. They confirmed that reserpine and tetrabenazine bind two different conformations of VMAT2. “30 or 40 years of pharmacological research had suggested that these two drugs bind to the transporter in different ways,” said Pidathala, “but nobody knew the atomic details of how this works. Our structures nicely demonstrate that these two drugs stabilize two different conformations of the transporter to block its activity.” 

    The structure of VMAT2 with serotonin bound allowed the researchers to pinpoint specific amino acids that interact with the neurotransmitter and drive transport. “We believe this is a common mechanism that this transporter uses to engage all the monoamines,” said Lee.  

    While this work offers a huge leap forward in understanding monoamine transport, Lee and his team are delving deeper into its mechanism. For example, the intake of monoamines into vesicles is fueled by protons moving in the other direction. “We identified amino acids that are important for this proton-dependent process,” Lee said, “but we still don’t know how exactly protons drive this transport. Determining this mechanism is our future direction, which will help us to fully appreciate how this transporter works.”  

    Authors and funding 

    The study’s other first author is Shuyun Liao of the School of Life Sciences, Peking University. The study’s co-corresponding author is Zhe Zhang of the School of Life Sciences, Peking University. Other authors include Xiao Li and Chi-Lun Chang of St. Jude, and Changkun Long of the School of Life Sciences, Peking University.  

    The study was supported by grants from National Institutes of Health (R01GM143282), the National Key Research and Development Program of China (2021YFA1302300), the National Natural Science Foundation of China (32171201), the SLS-Qidong innovation fund, the Li Ge-Zhao Ning Life Science Youth Research Foundation, the State Key Laboratory of Membrane Biology of China, and ALSAC, the fundraising and awareness organization of St. Jude. 

     

    St. Jude Children’s Research Hospital 

    St. Jude Children’s Research Hospital is leading the way the world understands, treats and cures childhood cancer, sickle cell disease and other life-threatening disorders. It is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. Treatments developed at St. Jude have helped push the overall childhood cancer survival rate from 20% to 80% since the hospital opened more than 60 years ago. St. Jude shares the breakthroughs it makes to help doctors and researchers at local hospitals and cancer centers around the world improve the quality of treatment and care for even more children. To learn more, visit stjude.org, read St. Jude Progress blog, and follow St. Jude on social media at @stjuderesearch.   

    St. Jude Children’s Research Hospital

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  • Hidden way for us to feel touch uncovered by Imperial researchers

    Hidden way for us to feel touch uncovered by Imperial researchers

    Newswise — Previously, touch was thought to be detected only by nerve endings present within the skin and surrounding hair follicles. This new research from Imperial College London has found that that cells within hair follicles – the structures that surround the hair fibre – are also able to detect the sensation in cell cultures.

    The researchers also found that these hair follicle cells release the neurotransmitters histamine and serotonin in response to touch – findings that might help us in future to understand histamine’s role in inflammatory skin diseases like eczema.

    Lead author of the paper Dr Claire Higgins, from Imperial’s Department of Bioengineering, said: “This is a surprising finding as we don’t yet know why hair follicle cells have this role in processing light touch. Since the follicle contains many sensory nerve endings, we now want to determine if the hair follicle is activating specific types of sensory nerves for an unknown but unique mechanism.”

    A touchy subject

    We feel touch using several mechanisms: sensory nerve endings in the skin detect touch and send signals to the brain; richly innervated hair follicles detect the movement of hair fibres; and sensory nerves known as C-LTMRs, that are only found in hairy skin, process emotional, or ‘feel-good’ touch.

    Now, researchers may have uncovered a new process in hair follicles. To carry out the study, the researchers analysed single cell RNA sequencing data of human skin and hair follicles and found that hair follicle cells contained a higher percentage of touch-sensitive receptors than equivalent cells in the skin. 

    They established co-cultures of human hair follicle cells and sensory nerves, then mechanically stimulated the hair follicle cells, finding that this led to activation of the adjacent sensory nerves.

    They then decided to investigate how the hair follicle cells signalled to the sensory nerves. They adapted a technique known as fast scan cyclic voltammetry to analyse cells in culture and found that the hair follicle cells were releasing the neurotransmitters serotonin and histamine in response to touch.

    When they blocked the receptor for these neurotransmitters on the sensory neurons, the neurons no longer responded to the hair follicle cell stimulation. Similarly, when they blocked synaptic vesicle production by hair follicle cells, they were no longer able to signal to the sensory nerves.

    They therefore concluded that in response to touch, hair follicle cells release that activate nearby sensory neurons.

    The researchers also conducted the same experiments with cells from the skin instead of the hair follicle. The cells responded to light touch by releasing histamine, but they didn’t release serotonin.

    Dr Higgins said: “This is interesting as histamine in the skin contributes to inflammatory skin conditions such as eczema, and it has always been presumed that immune cells release all the histamine. Our work uncovers a new role for skin cells in the release of histamine, with potential applications for eczema research.”

    The researchers note that the research was performed in cell cultures, and will need to be replicated in living organisms to confirm the findings. The researchers also want to determine if the hair follicle is activating specific types of sensory nerves. Since C-LTMRs are only present within hairy skin, they are interested to see if the hair follicle has a unique mechanism to signal to these nerves that we have yet to uncover.

    This work was funded by Engineering and Physical Research Council (EPSRC, part of UKRI), Proctor & Gamble, Wellcome Trust, and Biotechnology and Biological Sciences Research Council (BBSRC, part of UKRI).

    Imperial College London

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  • Case Western Reserve School of Medicine postdoctoral fellow Marissa Scavuzzo wins coveted 2023 Eppendorf & Science Prize for Neurobiology for glial cell research

    Case Western Reserve School of Medicine postdoctoral fellow Marissa Scavuzzo wins coveted 2023 Eppendorf & Science Prize for Neurobiology for glial cell research

    Newswise — CLEVELAND—Marissa Scavuzzo, a postdoctoral fellow at the Case Western Reserve University School of Medicine, has won the 2023 Eppendorf & Science Prize for Neurobiology for research in how glial cells in the intestine’s nervous system operate.

    Glial cells are considered support cells in the brain and help control and safeguard neurons. It is unclear what they do in the gut.

    The goal of Scavuzzo’s research is to understand the role of enteric glia in a healthy gut and how they respond to dietary, environmental or genetic changes. Her research could lead to the development of novel and efficient medicines that may benefit millions of people with gastrointestinal illnesses.

    “It’s still surreal,” Scavuzzo, the HHMI Hanna H. Gray Fellow in the School of Medicine’s Department of Genetics and Genome Sciences, said of the coveted award. “I am grateful to Eppendorf and Science for their recognition of my work, and will be forever grateful to my postdoctoral mentor, Dr. Paul Tesar, who played a crucial role in fostering my research in his lab. My long-term research goal is to understand the molecular underpinnings of enteric glia’s functional states in both health and disease.”

    “Marissa is a superstar,” said Tesar, professor of genetics and genome sciences and the Donald and Ruth Weber Goodman Professor of Innovative Therapeutics at School of Medicine. “I am so proud of her for receiving this prestigious award that recognizes her groundbreaking science.”

    Since 2002, the annual Eppendorf & Science Prize for Neurobiology has honored early-career scientists for groundbreaking research. Scavuzzo is the 22nd recipient of this international prize, which is awarded jointly by the journal Science  and Eppendorf SE, a leading Germany-based life-science company that develops, makes and sells systems for use in laboratories worldwide..

    Researchers age 35 and younger who have made outstanding contributions to neurobiological research based on methods of molecular and cell biology are invited to apply. The winner is awarded $25,000 and is able to publish an essay published in Science.

    “Eppendorf and the journal Science have awarded this prestigious prize for over 20 years. Many awardees have gone on to become leading scientists in their field,” said Alex Jahns, Eppendorf’s vice president of corporate citizenship and governmental affairs. “Congratulations to Marissa on her amazing achievement in winning this year’s award.”

    “The support from the School of Medicine has been critical to the success of my research,” Scavuzzo said, “and continued collaborations with colleagues will help advance my work towards my goal in the future.”

    ###

    Case Western Reserve University is one of the country’s leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing and social work. About 6,000 undergraduate and 6,300 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.

     

    Case Western Reserve University

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  • Potential brain cancer survival boost with anti-anxiety medication.

    Potential brain cancer survival boost with anti-anxiety medication.

    Newswise — A new research study shows that cerebrospinal fluid reduces current treatment efficacy in brain cancer and identifies new therapeutic opportunities.

    Cerebrospinal fluid, the clear colourless liquid that protects the brain, also may be a factor that makes brain cancers resistant to treatment, Australian researchers led by Associate Professor Cedric Bardy at the South Austraila Health and Medical Research Institute (SAHMRI) and Flinders University reveal in the journal Science Advances.

    Reporting how this occurs, the study in high-profile journal Science Advances shows that a decades-old anti-anxiety drug can improve the effectiveness of chemo-radiotherapy towards glioblastoma, or GBM, the most common and lethal brain cancer.

    Brain cancers kill more children and adults under 40 than any other cancer. They are resistant to therapies that kill cancers elsewhere in the body. The study team speculates that unique brain features might contribute to this.

    The collaborative Australian team of neurobiologists, neurosurgeons and oncologists tested the effect of the precious resource of human cerebrospinal fluid on the growth of tumour cells collected from 25 local patients with glioblastoma.

    Among their findings, the tumour cells quickly changed their identity and became more resistant to radiation and the drug temozolomide, which are mainstays of glioblastoma therapy.

    Associate Professor Cedric Bardy says, “Glioblastoma kills so many people who are otherwise fit, healthy and young, within months. This is a horrible disease, and the treatments available are just not effective enough despite serious side effects.

    “This study helps us understand the limitations of the current chemotherapies and provides new hope for repurposing a class of drugs that could be added to the standard of care. We are working hard now to try this on patients in a clinical trial.”

    Investigating the molecular basis for these changes, the team found glioblastoma cells exposed to cerebrospinal fluid were more resistant to ferroptosis, a form of therapy-induced cell death.

    Importantly, they showed that trifluoperazine, an anti-anxiety drug used since the 1950s, could re-sensitise glioblastoma cells to both therapies. In contrast, trifluoperazine was found not to harm healthy brain cells. The researchers concluded that combining trifluoperazine with standard care may improve GBM patient survival.

    The paper – ‘Human cerebrospinal fluid affects chemoradiotherapy sensitivities in tumor cells from patients with glioblastoma’ (2023) BW Str27inger, MI De Silva, Z Greenberg, AN Puerta, R Adams, B Milky, M Zabolocki, M van den Hurk, LM Ebert, CF Bishop, SJ Conn, G Kichenadasse, MZ Michael, RJ Ormsby, S Poonoose and C Bardy  – is published in Science Advances journal. DOI: 10.1126/sciadv.adf1332

    https://www.science.org/doi/10.1126/sciadv.adf1332

    Flinders University

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  • Uncovering insights into the early stages of schizophrenia.

    Uncovering insights into the early stages of schizophrenia.

    Newswise — Philadelphia, October 24, 2023 – Schizophrenia is a severe neuropsychiatric disease that remains poorly understood and treated. Schizophrenia onset is typically in adolescence or early adulthood, but its underlying causes are thought to involve neurodevelopmental abnormalities. Because human prenatal and postnatal brain tissue is exceedingly difficult to procure and therefore study, researchers have had limited opportunities to identify early disease mechanisms, especially during the critical prenatal period. Now, a pair of studies that appear in Biological Psychiatry, published by Elsevier, use new technology to study schizophrenia in models of early human brain development.

    The first study used a unique approach involving three-dimensional brain organoids, which are known to recapitulate fetal brain development. The researchers, led by first author Ibrahim A. Akkouh, PhD, and senior author Srdjan Djurovic, PhD, both at Oslo University Hospital, collected skin cells from 14 patients with schizophrenia and 14 healthy controls and generated induced pluripotent stem cells (iPSCs), which they then manipulated to develop into brain-like cortical spheroids.

    The organoids grown from patients and controls differed in their expression of thousands of genes – in line with the finding that the genetic influences on schizophrenia are many and very small. However, among the genes, those associated with neuronal axons stood out as a group.

    Dr. Akkouh explained, “We identified persistent axonal dysregulation as an early contribution to disease risk.”

    Importantly, the researchers assessed organoid maturation at several time points, which enabled them to establish the persistent nature of the disturbances throughout development.

    Dr. Akkouh added, “Our findings provide novel and hitherto inaccessible insights into the molecular basis of schizophrenia during early brain development.”

    In the second study, researchers led by Roy H. Perlis, PhD, at Harvard Medical School, focused on a particular genetic risk locus. The schizophrenia risk locus 15q11.2, a particular chromosomal region containing four genes, has a penetrance of over 10%, translating to a doubling of risk for schizophrenia among people carrying an unusual copy number of this genetic region. One gene in the locus, CYFIP1, has been associated with synaptic function in neurons and confers increased risk for neurodevelopmental disorders including schizophrenia and autism.

    CYFIP1 is highly expressed in microglia, the brain’s own immune cells, but its function there is unknown. Microglia are known to carry out synaptic pruning, in which they “eat” excess synaptic structures, a process critical to healthy brain development.

    Dr. Perlis and colleagues collected blood cells from healthy volunteers and isolated iPSCs, which they then manipulated to differentiate into microglia-like cells. The researchers then used CRISPR technology to remove functional CYFIP1 from the cells.

    Dr. Perlis said of the work, “Our findings suggest that changes in the behavior and function of microglia due to aberrant CYFIP1 function, such as through coding or copy number variants, could affect microglial processes such as synaptic pruning, homeostatic surveillance, and neuronal maintenance, which are critical for proper brain development and function. This could contribute to CYFIP1-related neurodevelopmental and psychiatric disorders resulting in part from microglia dysfunction. Among the specific disorders linked to variation in CYFIP1 are both autism and schizophrenia.”

    John Krystal, MD, Editor of Biological Psychiatry, commented, “The biology of schizophrenia is very complex and yet two themes represented by these two studies seem to be very important: the increased rate of elimination of glutamatergic synapses during development, and disturbances in the signaling properties of these glutamate synapses. These two disturbances could perturb circuit function in ways that are critical to development of symptoms and cognitive impairments associated with schizophrenia.”

    Dr. Perlis added, “More broadly, our findings highlight the importance of looking beyond neurons to understand risk genes. While finding risk loci may be the first step in understanding the role of genes in brain diseases, it’s only a first step; figuring out the relevant cell type, and what those genes are doing, is absolutely critical in moving from association to – we hope – actual treatments.”

    Elsevier

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  • Brain Immune Cell to Neuron Conversion Aids Post-Stroke Mouse Recovery.

    Brain Immune Cell to Neuron Conversion Aids Post-Stroke Mouse Recovery.

    Newswise — Fukuoka, Japan – Researchers at Kyushu University have discovered that turning brain immune cells into neurons successfully restores brain function after stroke-like injury in mice. These findings, published on October 10 in PNAS, suggest that replenishing neurons from immune cells could be a promising avenue for treating stroke in humans.

    Stroke, and other cerebrovascular diseases, occur when blood flow to the brain is affected, causing damage to neurons. Recovery is often poor, with patients suffering from severe physical disabilities and cognitive problems. Worldwide, it’s one of the most common causes for needing long-term care.

    “When we get a cut or break a bone, our skin and bone cells can replicate to heal our body. But the neurons in our brain cannot easily regenerate, so the damage is often permanent,” says Professor Kinichi Nakashima, from Kyushu University’s Graduate School of Medical Sciences. “We therefore need to find new ways to replace lost neurons.”

    One possible strategy is to convert other cells in the brain into neurons. Here, the researchers focused on microglia, the main immune cells in the central nervous system. Microglia are tasked with removing damaged or dead cells in the brain, so after a stroke, they move towards the site of injury and replicate quickly.

    “Microglia are abundant and exactly in the place we need them, so they are an ideal target for conversion,” says first author, Dr. Takashi Irie from Kyushu University Hospital.

    In prior research, the team demonstrated that they could induce microglia to develop into neurons in the brains of healthy mice. Now, Dr. Irie and Professor Nakashima, along with Lecturer Taito Matsuda and Professor Noriko Isobe from Kyushu University Graduate School of Medical Sciences, showed that this strategy of replacing neurons also works in injured brains and contributes to brain recovery.

    To conduct the study, the researchers caused a stroke-like injury in mice by temporarily blocking the right middle cerebral artery – a major blood vessel in the brain that is commonly associated with stroke in humans. A week later, the researchers examined the mice and found that they had difficulties in motor function and had a marked loss of neurons in a brain region known as the striatum. This part of the brain is involved in decision making, action planning and motor coordination.

    The researchers then used a lentivirus to insert DNA into microglial cells at the site of the injury. The DNA held instructions for producing NeuroD1, a protein that induces neuronal conversion. Over the subsequent weeks, the infected cells began developing into neurons and the areas of the brain with neuron loss decreased. By eight weeks, the new induced neurons had successfully integrated into the brain’s circuits.

    At only three weeks post-infection, the mice showed improved motor function in behavioral tests. These improvements were lost when the researchers removed the new induced neurons, providing strong evidence that the newly converted neurons directly contributed to recovery.

    “These results are very promising. The next step is to test whether NeuroD1 is also effective at converting human microglia into neurons and confirm that our method of inserting genes into the microglial cells is safe,” says Professor Nakashima.

    Furthermore, the treatment was conducted in mice in the acute phase after stroke, when microglia were migrating to and replicating at the site of injury. Therefore, the researchers also plan to see if recovery is also possible in mice at a later, chronic phase.

    Kyushu University

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  • Research Reveals Deep Neural Networks’ Unique Perception of the World.

    Research Reveals Deep Neural Networks’ Unique Perception of the World.

    Newswise — CAMBRIDGE, MA — Human sensory systems are very good at recognizing objects that we see or words that we hear, even if the object is upside down or the word is spoken by a voice we’ve never heard.

    Computational models known as deep neural networks can be trained to do the same thing, correctly identifying an image of a dog regardless of what color its fur is, or a word regardless of the pitch of the speaker’s voice. However, a new study from MIT neuroscientists has found that these models often also respond the same way to images or words that have no resemblance to the target.

    When these neural networks were used to generate an image or a word that they responded to in the same way as a specific natural input, such as a picture of a bear, most of them generated images or sounds that were unrecognizable to human observers. This suggests that these models build up their own idiosyncratic “invariances” — meaning that they respond the same way to stimuli with very different features.

    The findings offer a new way for researchers to evaluate how well these models mimic the organization of human sensory perception, says Josh McDermott, an associate professor of brain and cognitive sciences at MIT and a member of MIT’s McGovern Institute for Brain Research and Center for Brains, Minds, and Machines.

    “This paper shows that you can use these models to derive unnatural signals that end up being very diagnostic of the representations in the model,” says McDermott, who is the senior author of the study. “This test should become part of a battery of tests that we as a field are using to evaluate models.”

    Jenelle Feather PhD ’22, who is now a research fellow at the Flatiron Institute Center for Computational Neuroscience, is the lead author of the open-access paper, which appears today in Nature Neuroscience. Guillaume Leclerc, an MIT graduate student, and Aleksander Mądry, the Cadence Design Systems Professor of Computing at MIT, are also authors of the paper.

    Different perceptions

    In recent years, researchers have trained deep neural networks that can analyze millions of inputs (sounds or images) and learn common features that allow them to classify a target word or object roughly as accurately as humans do. These models are currently regarded as the leading models of biological sensory systems.

    It is believed that when the human sensory system performs this kind of classification, it learns to disregard features that aren’t relevant to an object’s core identity, such as how much light is shining on it or what angle it’s being viewed from. This is known as invariance, meaning that objects are perceived to be the same even if they show differences in those less important features.

    “Classically, the way that we have thought about sensory systems is that they build up invariances to all those sources of variation that different examples of the same thing can have,” Feather says. “An organism has to recognize that they’re the same thing even though they show up as very different sensory signals.”

    The researchers wondered if deep neural networks that are trained to perform classification tasks might develop similar invariances. To try to answer that question, they used these models to generate stimuli that produce the same kind of response within the model as an example stimulus given to the model by the researchers.

    They term these stimuli “model metamers,” reviving an idea from classical perception research whereby stimuli that are indistinguishable to a system can be used to diagnose its invariances. The concept of metamers was originally developed in the study of human perception to describe colors that look identical even though they are made up of different wavelengths of light.

    To their surprise, the researchers found that most of the images and sounds produced in this way looked and sounded nothing like the examples that the models were originally given. Most of the images were a jumble of random-looking pixels, and the sounds resembled unintelligible noise. When researchers showed the images to human observers, in most cases the humans did not classify the images synthesized by the models in the same category as the original target example.

    “They’re really not recognizable at all by humans. They don’t look or sound natural and they don’t have interpretable features that a person could use to classify an object or word,” Feather says.

    The findings suggest that the models have somehow developed their own invariances that are different from those found in human perceptual systems. This causes the models to perceive pairs of stimuli as being the same despite their being wildly different to a human.

    Idiosyncratic invariances

    The researchers found the same effect across many different vision and auditory models. However, each of these models appeared to develop their own unique invariances. When metamers from one model were shown to another model, the metamers were just as unrecognizable to the second model as they were to human observers.

    “The key inference from that is that these models seem to have what we call idiosyncratic invariances,” McDermott says. “They have learned to be invariant to these particular dimensions in the stimulus space, and it’s model-specific, so other models don’t have those same invariances.”

    The researchers also found that they could induce a model’s metamers to be more recognizable to humans by using an approach called adversarial training. This approach was originally developed to combat another limitation of object recognition models, which is that introducing tiny, almost imperceptible changes to an image can cause the model to misrecognize it.

    The researchers found that adversarial training, which involves including some of these slightly altered images in the training data, yielded models whose metamers were more recognizable to humans, though they were still not as recognizable as the original stimuli. This improvement appears to be independent of the training’s effect on the models’ ability to resist adversarial attacks, the researchers say.

    “This particular form of training has a big effect, but we don’t really know why it has that effect,” Feather says. “That’s an area for future research.”

    Analyzing the metamers produced by computational models could be a useful tool to help evaluate how closely a computational model mimics the underlying organization of human sensory perception systems, the researchers say.

    “This is a behavioral test that you can run on a given model to see whether the invariances are shared between the model and human observers,” Feather says. “It could also be used to evaluate how idiosyncratic the invariances are within a given model, which could help uncover potential ways to improve our models in the future.”

    ###

    Massachusetts Institute of Technology (MIT)

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  • MD Anderson Research Highlights: ESMO 2023 Special Edition

    MD Anderson Research Highlights: ESMO 2023 Special Edition

    ABSTRACTS: LBA71, 1088MO, 95MO, LBA48, 1082O, 1085O, LBA34, 243MO

    Newswise — MADRID ― The University of Texas MD Anderson Cancer Center’s Research Highlights provides a glimpse into recent basic, translational and clinical cancer research from MD Anderson experts.

    This special edition features upcoming oral presentations by MD Anderson researchers at the 2023 European Society for Medical Oncology (ESMO) Congress focused on clinical advances across a variety of cancer types. Highlights include a combination strategy for EGFR-mutant metastatic lung cancer, updated results for a Phase II study on immunotherapy for skin cancer, a promising drug for bile duct cancer, pre-surgical treatment options for resectable melanoma, concurrent intrathecal and intravenous treatment for leptomeningeal disease, a triplet combination for melanoma brain metastases, promising results for an antibody drug conjugate targeting HER2, and the option to eliminate surgery for a subset of breast cancer patients. More information on ESMO content from MD Anderson can be found at MDAnderson.org/ESMO.

    In addition to the studies summarized below, forthcoming press releases will feature the following late-breaking and oral presentations:

    • Results from the Phase III CheckMate 77T study evaluating neoadjuvant nivolumab plus chemotherapy vs. neoadjuvant placebo plus chemotherapy followed by surgery and adjuvant nivolumab for untreated, resectable stage II-IIIB non-small cell lung cancer (Abstract LBA1)
    • Results from the Phase III DUO-E trial for newly diagnosed advanced or recurrent endometrial cancer (Abstract LBA41)
    • Results from the Phase III THOR study on erdafitinib vs. pembrolizumab in pretreated patients with advanced or metastatic urothelial cancer (Abstract 2359O)
    • Subgroups from the Phase III THOR study on erdafitinib vs. chemotherapy in patients with advanced or metastatic urothelial cancer with select FGFR alterations (Abstract 2362MO

    Combination treatment prolongs survival in patients with EGFR-mutant lung cancer (Abstract LBA71)  
    Osimertinib, an EGFR inhibitor, is the current standard first-line treatment for patients with metastatic EGFR-mutant non-small cell lung cancer (NSCLC), yet there is a need to identify improved treatments to enhance its initial efficacy. In the randomized Phase II RAMOSE trial, researchers led by Xiuning Le, M.D., Ph.D., found combining osimertintib with ramucirumab, an anti-VEGF treatment, significantly prolonged progression-free survival (PFS). The median PFS was 24.8 months in the combination arm compared to 15.6 months for those who received osimertintib alone. The combination also demonstrated a favorable safety profile. This study suggests osimertinib plus ramucirumab should be considered as a first-line treatment option for patients with EGFR-mutant metastatic NSCLC. Le will present the updated findings on October 21.

    Pre-surgical immunotherapy improves patient outcomes in advanced operable cutaneous squamous cell carcinoma (Abstract 1088MO) Patients with cutaneous squamous cell carcinoma (CSCC), the second most common form of skin cancer, typically present with early-stage disease that can be treated with surgery alone, though a subset with more advanced disease will require radiation in addition to surgery. In a one year follow-up to a multicenter Phase II study led by Neil D. Gross, M.D., neoadjuvant (pre-surgical) immunotherapy given to patients with advanced resectable CSCC demonstrated favorable survival outcomes with a median follow-up duration of 18.7 months. The study included 79 participants treated with neoadjuvant cemiplimab followed by curative-intent surgery. Based on treatment response, patients were offered up to 48 weeks of adjuvant cemiplimab, radiation therapy or observation only. Estimated 12-month event-free survival was 89%. Notably, none of the 40 patients with a pathological complete response (pCR) experienced recurrence. The results indicate that neoadjuvant cemiplimab followed by surgery is a viable treatment option for advanced, operable CSCC. A Phase III trial is planned to test this novel approach. Gross will present updated findings on Oct. 21.

    Tinengotinib delivers promising efficacy in patients with advanced cholangiocarcinoma (Abstract 95MO) Current FGFR inhibitor (FGFRi) therapies for patients with refractory or relapsed cholangiocarcinoma (CCA), or bile duct cancer, can lead to secondary FGFR2 mutations and treatment resistance. To address this, researchers led by Milind Javle, M.D., evaluated the efficacy and safety of tinengotinib, a next-generation FGFR2 inhibitor with unique target binding to overcome acquired resistance mutations. This Phase II trial enrolled patients who had received at least one prior line of chemotherapy, including those with prior FGFRi therapy. Patients with FGFR2 kinase domain mutations had the best overall response rate (ORR) at 44%. The ORR in patients with FGFR2-altered CCA was 29% and the disease control rate was 90%. For patients with prior FGFRi treatment, the ORR was 31%. The findings suggest tinengotinib may have a potential role in treating CCA patients with FGFR2 fusions, including those with prior FGFRi treatment. Researchers have launched the Phase III study of tinengotinib to further investigate this therapy. Javle will present the findings on Oct. 21.

    Perioperative immunotherapy improved outcomes in patients with late-stage melanoma (Abstract LBA48) 
    Patients with advanced melanoma face a significant risk of relapse even after surgery. Adding immunotherapy to surgery is considered more effective than surgery alone, but the proper timing of treatment is still unclear. In a follow-up analysis of a Phase II study led by Sapna Patel, M.D., researchers found neoadjuvant (pre-surgery) plus adjuvant (post-surgery) pembrolizumab lowered the chance of disease recurrence, progression or death, compared to adjuvant pembrolizumab alone for patients with stage IIIB-IV melanoma. Among those who had surgery and were evaluable for response, more than half had a major pathological response, which includes pathologic complete and near complete responses. These results suggest that perioperative (pre- and post-surgical) pembrolizumab should be considered when treating late-stage operable melanoma. Patel will present the updated findings on Oct. 23.  

    Intrathecal and intravenous immunotherapy improves survival in patients with leptomeningeal disease (Abstract 1082O) Leptomeningeal disease (LMD) occurs when cancer cells from tumors migrate into the cerebrospinal fluid (CSF) and leptomeninges, part of the lining of the brain and spinal cord. LMD can be challenging to diagnose and treat, and patients face poor survival rates. A recent proof-of-concept study showed that intrathecal (IT) nivolumab, which is administered directly into the CSF, along with intravenous (IV) immunotherapy helped improve survival in patients with LMD. Building upon this, Isabella Glitza Oliva, M.D., Ph.D., and colleagues continued the combination therapy in an IT dose expansion study. The median overall survival (OS) was 7.5 months, with a landmark OS rate of 68%, 54% and 35% at 3, 6 and 12 months, respectively. This study demonstrates the safety and efficacy of this combination of IT and IV therapy among 50 patients treated, confirming its feasibility and supporting ongoing clinical evaluation to further improve outcomes in this underserved patient population. Glitza Oliva will present updated clinical outcomes on Oct. 23.

    Triplet combination is safe and demonstrates clinical benefit in patients with refractory melanoma brain metastases (Abstract 1085O) While many patients with melanoma brain metastases (MBM) respond well to immune checkpoint blockade, many fail to respond or subsequently develop resistance, leaving them with limited systemic treatment options and a poor prognosis. In this Phase II study,a  research led by Elizabeth Burton examined the safety and efficacy of atezolizumab, bevacizumab and cobimetinib in 20 patients with treatment refractory MBM. The intracranial (IC) response rate and IC benefit rate were 38% and 53%, respectively. Safety was consistent with expectations, with 18 patients experiencing treatment-related adverse events (TRAEs) and 7 (35%) experiencing grade 3/4 TRAEs. Although the median PFS was 1.8 months, the median OS was 9.3 months. Eleven patients (55%) received treatment beyond progression, including stereotactic radiosurgery, after evaluation by MD Anderson’s multidisciplinary Brain Metastasis Clinic. These results, which highlight the tolerability of the combination, merit further clinical evaluation and underscore the importance of integrating multidisciplinary care into the evaluation of novel therapeutic strategies in this patient population. Burton will present updated findings on Oct. 23.

    Primary analysis of Phase II data of trastuzumab deruxtecan continues to show promising signals (Abstract LBA34) Trastuzumab deruxtecan (T-DXd), an antibody drug conjugate targeting HER2, has been approved for use in HER2-positive breast cancer, gastric cancer and HER2-mutant lung cancer. In the DESTINY-PanTumor02 study led by Funda Meric-Bernstam, M.D., T-DXd also showed potential as a treatment option in several other cancers, especially gynecological cancers. The objective response rate (ORR) across all patients was 37.1% with a duration of response of 11.3 months, but among patients with the highest levels of HER2 expression, ORR was 61.3% with a duration of 22.1 months. These data support the potential role of T-DXd as a tumor-agnostic therapy for patients with hard-to-treat HER2-expressing solid tumors that currently have limited treatment options. Interim data from this trial were presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting. Meric-Bernstam will present the primary analysis on Oct. 23.

    Eliminating surgery in select breast cancer patients shows low risk of cancer recurrence (Abstract 243MO)
    Approximately 60% of early-stage triple-negative and HER2-positive breast cancers have a positive response to chemotherapy. An exceptional response to chemotherapy is a strong indicator of a favorable prognosis and can be accurately confirmed through a minimally invasive image-guided vacuum-assisted core biopsy (VACB). In a Phase II trial led by Henry Kuerer, M.D., Ph.D., 50 patients underwent a VACB after completing chemotherapy. Previous reports of this research showed no breast cancer recurrence within two years. VACB identified a complete absence of cancer in 31 patients and, over three years, there were no recurrences in the same breast. The three-year disease-free survival and overall survival rates were both 100%. This study suggests that, for carefully selected breast cancer patients, avoiding surgery carries a minimal risk of disease recurrence. Further investigation and clinical trials are essential to validate this approach. Kuerer will present the three-year findings on Oct. 23.

     

    – 30 –

    University of Texas MD Anderson Cancer Center

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  • Deep brain stimulation boosts neurons and memory in Rett animals.

    Deep brain stimulation boosts neurons and memory in Rett animals.

    Newswise — A recent study from the lab of Dr. Jianrong Tang, associate professor at Baylor College of Medicine and principal investigator at the Jan and Dan Duncan Neurological Research Institute (Duncan NRI) at Texas Children’s Hospital shows that deep brain stimulation (DBS) of a specific brain region results in a significant and sustained improvement of memory in Rett mice. Moreover, they found that this treatment promotes the generation of new healthy neurons in these mice.

    The study, published in the journal Brain Stimulation, provides crucial preclinical evidence that supports the development of DBS as a feasible treatment for Rett syndrome patients.

    Rett syndrome (RTT) is a rare but devastating neurodevelopmental disorder that causes regression of motor, social, cognitive, and language skills along with the development of autistic behaviors and seizures. It is caused by mutations in the X-linked gene that encodes the methyl-CpG-binding protein 2 (MeCP2) protein and thus, primarily affects young girls. Since the loss of cognitive skills is one of the tragic aspects of this condition, there has been intense interest in developing therapeutic approaches to mitigate this loss.

    Forniceal DBS induces significant and sustained improvements in learning and memory among RTT mice

    DBS is a neurosurgical procedure that involves the placement of a medical device called a neurostimulator to send electrical signals through the electrodes that have been implanted in targeted brain regions to treat various neurological conditions such as movement disorders (e.g. Parkinson’s, tremors, dystonia),  neuropsychiatric disorders (e.g. obsessive-compulsive disorders, depression), and epilepsy.

    “Inspired by a study which showed that stimulation of the fornix region of the hippocampus improved memory in Alzheimer’s disease, a few years ago we performed forniceal DBS in a mouse model of RTT and found that two weeks of a specific regimen of this treatment improved learning and memory in female RTT mice,” Dr. Jianrong Tang said. “While those findings demonstrated the potential of DBS to mitigate learning and memory deficits in RTT, it was not clear how long the benefits of this treatment would last.”

    Their goal in this study was to address that question. Using well-established behavioral assays, they discovered that DBS improved contextual fear memory in RTT mice and these beneficial effects persisted for 6 to 9 weeks after the treatment. Further, repeated DBS – specifically in the fornix, not other brain regions – maintained the contextual memory improvement in RTT mice.

    Forniceal DBS induces the production of new hippocampal neurons in adult RTT mice

    Adult hippocampal neurogenesis – the process of forming new neurons in specialized regions of the hippocampus of adult animals – is critical for the neurons to ‘learn and remember’.

    Previous studies from the Tang lab revealed that right after the DBS treatment, there was a significant formation of new neurons in specialized regions of the hippocampus. Since it takes anywhere between 2-5 weeks for newborn neurons to be mature and functionally integrate into the neural networks, this correlated with improved contextual memory in these mice three weeks later. Here, they found this close correspondence between the DBS-induced birth of new neurons and improvements in contextual memory persisted several weeks after the treatment as well.

    Forniceal DBS promotes a neuroprotective environment with healthy neurons

    In female mice that carry one copy of defective MECP2, the expression of this gene is switched off/inactivated in some neurons. This means some newborn neurons in RTT mice will be healthy and have MeCP2 while others may not express MeCP2. Interestingly, the Duncan NRI team found that forniceal DBS preferentially induced the birth of more healthy neurons with MeCP2 in Rett mutants.

    Moreover, DBS treatment also induced the production of a key neurotrophin -brain-derived neurotrophic factor(BDNF) – which is a neuroprotective molecule essential for the survival and growth of neurons as well as for their plasticity i.e., their ability to learn and remember.

    “The findings from this study are very promising. We found forniceal DBS not only results in a significant and long-lasting improvement to memory in Rett animals, but that it also promotes a favorable neuroprotective environment in the brain and leads to the production of more healthy neurons – which together suggests DBS could be an excellent therapy to treat Rett patients,” Dr. Tang said.

    Others involved in the study were Qi Wang, Bin Tang, Shuang Hao, Zhenyu Wu and Tingting Yang. They are affiliated with the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Baylor College of Medicine. The study was funded by the National Institute of Neurological Disorders and Stroke, a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to Baylor College of Medicine Intellectual and Developmental Disabilities Research Center (IDDRC), Neuroconnectivity Core, Circuit Modulation Core, Neurovisualization Core, In Situ Hybridization Core, the In Vivo Neurophysiology Core of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, the Chao Family Foundation, and the Cockrell Family Foundation.

    Texas Children’s Hospital

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  • Commonly Used Herbicide is Harmful to Adolescent Brain Function

    Commonly Used Herbicide is Harmful to Adolescent Brain Function

    Newswise — Herbicides are the most used class of pesticides worldwide, with uses in agriculture, homes and industry. Exposures to two of the most popular herbicides were associated with worse brain function among adolescents, according to a study led by researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego.

    In the Oct. 11, 2023 online issue of Environmental Health Perspectives, the researchers reported measuring metabolite concentrations of two commonly used herbicides — glyphosate and 2,4-dichlorophenoxyacetic acid (2,4-D) — and the insect repellent DEET in urine samples collected in 2016 from 519 adolescents, aged 11 to 17, living in the agricultural county of Pedro Moncayo, Ecuador. Researchers also assessed neurobehavioral performance in five areas: attention and inhibitory control, memory and learning, language, visuospatial processing, and social perception.

    “Many chronic diseases and mental health disorders in adolescents and young adults have increased over the last two decades worldwide, and exposure to neurotoxic contaminants in the environment could explain a part of this increase,” said senior author Jose Ricardo Suarez, M.D., Ph.D., M.P.H., associate professor in the Herbert Wertheim School of Public Health.

    Among the findings:

    • Glyphosate, a nonselective herbicide used in many crops, including corn and soy, and for vegetation control in residential settings, was detected in 98 percent of participants.
    • 2,4-D, a broadleaf herbicide used on lawns, aquatic sites, and agricultural crops, was detected in 66 percent of participants.
    • Higher amounts of 2,4-D in urine were associated with lower neurobehavioral performance in the domains of attention and inhibitory control, memory and learning, and language.
    • Glyphosate concentration in urine was associated with lower scores in social perception only, while DEET metabolites were not associated with neurobehavioral performance.

    Following the introduction of genetically modified, glyphosate-resistant “Roundup-ready” crops in 1996 and 2,4-D resistant crops in 2014, there have been substantial increases in glyphosate and 2,4-D use, making them the most widely used herbicides in the world, wrote the authors.

    “There is considerable use of herbicides and insecticides in agricultural industries in both developed and developing nations around the world, raising exposure potential for children and adults, especially if they live in agricultural areas, but we don’t know how it impacts each stage of life,” said first author Briana Chronister, doctoral candidate in the UC San Diego – San Diego State University Joint Doctoral Program in Public Health.

    Previous studies have linked exposure to some of the most used insecticides to altered neurocognitive performance while other insecticides may also affect mood and brain development. Today, 20 percent of adolescents and 26 percent of young adults have diagnosable mental health conditions such as anxiety, depression, impulsivity, aggression or learning disorders.

    The authors reported that 2,4-D was negatively associated with performance in all five neurobehavioral areas, but statistically significant associations were observed with attention and inhibitory control, memory and learning, and language. Glyphosate had a significant negative association only with social perception, a test that measures the ability to recognize emotions, while DEET metabolites were not associated with neurobehavioral alterations.

    “Hundreds of new chemicals are released into the market each year, and more than 80,000 chemicals are registered for use today,” said Suarez. “Sadly, very little is known about the safety and long-term effects on humans for most of these chemicals. Additional research is needed to truly understand the impact.”

    This research is a study within ESPINA: The Study of Secondary Exposures to Pesticides Among Children and Adolescents, a prospective cohort study funded by the National Institute of Environmental Health Sciences, part of the National Institutes of Health, the National Institute of Occupational Safety and Health, and other private funding sources. ESPINA aims to understand the effect of pesticide exposures on the development of humans from childhood thru adulthood.

    In 2022, Suarez and his team completed year 14 of follow-up of study participants with plans to evaluate whether the observed associations persist into early adulthood.

    Co-authors include: Kun Yang, Audrey R. Yang, Tuo Lin, Xin Tu, Harvey Checkoway, Jose Suarez-Torres, Sheila Gahagan, and Raeanne C. Moore, UC San Diego; Dolores Lopez-Paredes and Danilo Martinez, Fundación Cimas del Ecuador; and Dana Barr, Emory University.

    This research was funded, in part, by the National Institutes of Health (R01ES025792, R01ES030378, R21ES026084, U2CES026560, P30ES019776, 5T32MH122376).

    Disclosures: The authors do not have any conflicts of interest to report.

    DOI: 10.1289/EHP11383

    University of California San Diego

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  • Jet lag disorder associated with shift work can lead to brain changes increasing appetite

    Jet lag disorder associated with shift work can lead to brain changes increasing appetite

    Newswise — Scientists have uncovered why night shift work is associated with changes in appetite in a new University of Bristol-led study. The findings, published in Communications Biology, could help the millions of people that work through the night and struggle with weight gain.

    Scientists from Bristol and the University of Occupational and Environmental Health in Japan, sought to understand how ‘circadian misalignment’ — a phenomenon commonly associated with ‘jet-lag’ whereby the body’s biological clock is disrupted — affects the hormones responsible for regulating appetite.

    Prevalent in night shift workers, in this new study, the international team reveal how circadian misalignment can profoundly alter the brain’s regulation of hormones controlling hunger to the detriment of metabolic health.

    The team focused on glucocorticoid hormones in the adrenal gland which regulate many physiological functions including metabolism and appetite. Glucocorticoids are known to directly regulate a group of brain peptides controlling appetitive behaviour, with some increasing appetite (orexigenic) and some decreasing appetite (anorexigenic).

    In an experiment using animal models, comprising a control group and a out-of-phase ‘jet-lagged’ group, the team found misalignment between light and dark cues led the out-of-phase group’s orexigenic hypothalamic neuropeptides (NPY) to become dysregulated, driving an increased desire to eat significantly more during the inactive phase of the day.

    Strikingly, the team discovered that rats in the control group ate 88.4% of their daily intake during their active phase, and only 11.6% during their inactive phase. In contrast, the ‘jet-lagged’ group consumed 53.8% of their daily calories during their inactive phase (without an increase in activity during this time). This equated to nearly five-times more (460% more) than what the control group consumed during the inactive phase.  These results show that it is timing of consumption that has been affected.

    This new discovery revealed how completely, and significantly, disordered the neuropeptides become when daily glucocorticoid levels are out of synch with light and dark cues.  However, the authors suggest the neuropeptides identified in this study may be promising targets for drug treatments adapted to treat eating disorders and obesity.

    Dr Becky Conway-Campbell, Research Fellow in Bristol Medical School: Translational Health Sciences (THS) and the study’s senior author, said: “For people working throughout the night, a reversed body clock can play havoc with their health.

    “For those who are working night shifts long-term, we recommend they try to maintain daylight exposure, cardiovascular exercise and mealtimes at regulated hours. However, internal brain messages to drive increased appetite are difficult to override with ‘discipline’ or ‘routine’ so we are currently designing studies to assess rescue strategies and pharmacological intervention drugs. We hope our findings also provide new insight into how chronic stress and sleep disruption leads to caloric overconsumption.”

    Stafford Lightman, Professor of Medicine at Bristol Medical School: THS and co-senior author on the study, added: “The adrenal hormone corticosterone, which is normally secreted in a circadian manner, is a major factor in the daily control of brain peptides that regulate appetite. Furthermore when we disturb the normal relationship of corticosterone with the day to night light cycle it results in abnormal gene regulation and appetite during the period of time that the animals normally sleep.

    “Our study shows that when we disturb our normal bodily rhythms this in turn disrupts normal appetite regulation in a way that is at least in part a result of desynchrony between adrenal steroid hormone production and the timing of the light and dark cycle.”

    Dr Benjamin Flynn, one of the study’s co-authors who conducted the study while at Bristol but is now based at the University of Bath, added: “This is further evidence of how phase shift ‘jet-lag’ affects feeding behaviours and neuronal gene expression – data important for shift work co-morbidity research.”

    This research was funded by the Medical Research Council.

    Paper

    ‘Phase-shifting the circadian glucocorticoid profile induces disordered feeding behaviour by dysregulating hypothalamic neuropeptide gene expression’ by M Yoshimura, B Flynn, Y Kershaw, Z Zhao, Ueta, S Lightman, R Conway-Campbell et al. in Communications Biology [open access]

    University of Bristol

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  • Both High and Low HDL Cholesterol Tied to Increased Risk of Dementia

    Both High and Low HDL Cholesterol Tied to Increased Risk of Dementia

    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, OCTOBER 4, 2023

    Newswise — MINNEAPOLIS – Having either high or low levels of high-density lipoprotein (HDL) cholesterol, or “good” cholesterol, is tied to a small increased risk of dementia in older adults, according to a study published in the October 4, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. This study does not prove that high or low levels of HDL cholesterol cause dementia; it only shows an association.

    “Previous studies on this topic have been inconclusive and this study is especially informative because of the large number of participants and long follow-up,” said study author Maria Glymour, ScD, of Boston University. “This information allowed us to study the links with dementia across the range of cholesterol levels and achieve precise estimates even for people with cholesterol levels that are quite high or quite low.”

    The study involved 184,367 people from the Kaiser Permanente Northern California Health Plan, with an average age of 70 who did not have dementia at the beginning of the study. For research purposes, they filled out a survey on their health behaviors and had their cholesterol levels measured during routine health care visits an average of 2.5 times in the following two years. They were then followed within the Kaiser healthcare system via electronic health records for an average of nine years. During that time, 25,214 people developed dementia.

    The average HDL cholesterol level was 53.7 milligrams per deciliter (mg/dL). Healthy levels are considered to be above 40 mg/dL for males and above 50 mg/dL for females. Participants were divided into five groups based on their HDL cholesterol levels. People with the highest levels of HDL cholesterol had a 15% higher rate of dementia compared to those in the middle group. Those with the lowest levels had a 7% higher rate of dementia compared to those in the middle group.

    These results took into account other factors that could affect the risk of dementia, such as alcohol use, high blood pressure, cardiovascular disease and diabetes.

    The researchers found only a slight association between low-density lipoprotein, or “bad” cholesterol, and the risk of dementia.

    “The elevation in dementia risk with both high and low levels of HDL cholesterol was unexpected, but these increases are small, and their clinical significance is uncertain,” Glymour said. “In contrast, we found no association between LDL cholesterol and dementia risk in the overall study cohort. Our results add to evidence that HDL cholesterol has similarly complex associations with dementia as with heart disease and cancer.”

    A limitation of the study was that people volunteered to take part in the survey, so they may not be representative of the larger population.

    The study was supported by the National Institute on Aging and the National Institutes of Health.  

    Learn more about dementia at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

    American Academy of Neurology (AAN)

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  • Cats purr differently than previously thought

    Cats purr differently than previously thought

    Newswise — A recent investigation led by voice scientist Christian T. Herbst from the University of Vienna, published in Current Biology, delivers novel insights into how cats produce their purring sounds. A special ‚pad‘ embedded in the vocal folds might explain why the cats can produce these low-frequency sounds.

    Cats are vocal creatures: they meow, screech, and purr. From a voice production point of view, the meows and the screeches are not special. Their sound is generated in the cat’s larynx or “voice box” just like vocalization in humans and many other mammals. In contrast, cat purrs were long believed to be exceptional. Research dating back half a century suggests that the purrs are produced by a special mechanism – through cyclical contraction and relaxation of the muscles in the vocal folds within the larynx, requiring constant neural input and control from the brain.

    A recent study, led by Austrian voice scientist Christian T. Herbst at the University of Vienna, now demonstrates that these cyclic muscle contractions are not needed to generate cat purrs. Data from a controlled laboratory experiment shows that the domestic cat larynx can produce impressively low-pitched sounds at purring frequencies without any cyclical neural input or repetitive muscle contractions being needed. The observed sound production mechanism is strikingly similar to human “creaky voice” or “vocal fry”.

    “Anatomical investigations revealed a unique ‘pad’ within the cats’ vocal folds that may explain how such a small animal, weighing only a few kilograms, can regularly produce sounds at those incredibly low frequencies (20-30 Hz, or cycles per second) – far below even than lowest bass sounds produced by human voices”, says Herbst. The study’s findings – while not constituting an outright falsification of the previous theory – are a clear indicator that the current understanding of cat purring is incomplete, and warrants further research.

    About the study: Contributors include researchers from the Department of Behavioral and Cognitive Biology, University of Vienna, Austria; the Institute of Morphology, University of Veterinary Medicine Vienna, Austria; Palacký University Olomouc, Czech Republic; and the Research Institute of Organic Agriculture FiBL, Switzerland.

    University of Vienna

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  • Rapid Telehealth Consults Improve Care for Rural Patients With Stroke

    Rapid Telehealth Consults Improve Care for Rural Patients With Stroke

    Newswise — Minutes matter when a patient may have had a stroke, but being far from a physician with advanced training in neurology no longer needs to be a barrier to rapid diagnosis and intervention.

    Telestroke programs are designed to improve access to the limited number of specialists, regardless of the geographic isolation of patients who may have experienced a stroke. Telestroke, or stroke telemedicine, is a form of telehealth in which physicians with advanced training in stroke care use technology to provide immediate consultation to a local healthcare professional to recommend diagnostic imaging and treatment for patients with stroke at an originating site. Patients who present within 4.5 hours of when they were last known to be well may be eligible for thrombolytic drug therapy or endovascular intervention, often measured as door-to-needle time. 

    After launching a telestroke consultation program, Essentia Health, an integrated health system serving patients in Minnesota, Wisconsin and North Dakota, increased the percentage of patients receiving thrombolytics in less than 60 minutes and decreased the average door-to-needle time.

    Use of Telestroke to Improve Access to Care for Rural Patients With Stroke Symptoms” describes how Essentia Health’s program ensures that patients are evaluated rapidly to expedite decisions about their course of treatment. The article is published in the October issue of Critical Care Nurse (CCN).

    Essentia Health initiated the telestroke program in fall 2019, with coverage provided by a team of four interventional neurologists, three of whom work in the system’s Comprehensive Stroke Center in Fargo, North Dakota. In addition to this center, telestroke services are provided to five other acute stroke-ready hospitals throughout rural areas in the upper Midwest.

    Through the telestroke program, neurology consultations are available to all of the sites 24 hours a day, every day of the year, and can be used for both inpatient and emergency department stroke activations at each of the facilities.

    The team developed a tiered stroke alert algorithm and telestroke workflow chart to help healthcare professionals at rural sites determine eligibility for telestroke consultation to decide the treatment plan.

    The algorithm categorized strokes as level I to III according to the symptoms and time when the patient was last known to be well. Telestroke consults were most often used for patients with level I stroke alerts since they were within the timeframe when they may be eligible for thrombolytic drug therapy or endovascular intervention.

    Once staff members determine whether a telestroke consultation will be initiated, they refer to the step-by-step workflow chart, which specifies actions needed for each member of the multidisciplinary team.

    Co-author Chelsey Kuznia, BSN, RN, SCRN, is the stroke program manager for Essentia Health’s Comprehensive Stroke Center in Fargo, one of only two such facilities in North Dakota.

    “Regardless of the type of stroke, rapid diagnosis and intervention are critical for improving survival rates and reducing the long-term effects of stroke,” she said. “People living in rural areas not only have increased stroke risk factors, but they also face challenges to getting the advanced care they need in a timely way, which leads to higher rates of disability and death.”

    In 2022, telestroke connections for 42 patients were completed, with a stroke diagnosis confirmed in 25 of them (61%). Fourteen of the patients with confirmed stroke received thrombolytic therapy while others were not eligible, either because of patient-related contraindications or because more than 4.5 hours had elapsed since their last-known well time.

    Of the 25 patients with confirmed stroke, 18 (72%) were discharged home, while three were discharged to skilled nursing facilities, one to an inpatient rehabilitation unit, one to hospice and two died.

    The year prior to implementation of the telestroke program, 11 of 15 eligible patients (73%) received thrombolytic therapy in less than 60 minutes, with a mean door-to-needle time of 61 minutes. During the year after implementation, the results improved: 11 of 12 eligible patients (92%) received thrombolytic therapy in less than 60 minutes, and the mean door-to-needle time decreased to 38 minutes.

    As the American Association of Critical-Care Nurses’ bimonthly clinical practice journal for acute and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients. Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org.

    About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in acute, progressive and critical care settings. CCN enjoys a circulation of about 130,000 and can be accessed at http://ccn.aacnjournals.org/.

    About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with about 130,000 members and nearly 200 chapters in the United States.

    American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme

    American Association of Critical-Care Nurses (AACN)

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  • October 2023 Issue of Neurosurgical Focus: “Management and Controversies of Antithrombotic Medication in Neurosurgery”

    October 2023 Issue of Neurosurgical Focus: “Management and Controversies of Antithrombotic Medication in Neurosurgery”

    Newswise — Rolling Meadows, IL (October 1, 2023). The October issue of Neurosurgical Focus (Vol. 55, No. 4 [https://thejns.org/focus/view/journals/neurosurg-focus/55/4/neurosurg-focus.55.issue-4.xml]) presents 20 articles on the management and controversies of antithrombotic medication in neurosurgery.

     Topic Editors: Jehuda Soleman, R. Loch Macdonald, David Seiffge, and Ladina Greuter

    The October issue of Neurosurgical Focus includes a wide variety of articles on the use of antithrombotic medication in neurosurgery. The topic editors of the issue write that their goal is to “to successfully highlight the importance of this topic within the neurosurgical community, showing its growing role in almost all age groups and subspecialities of neurosurgery.” 

    Contents of the October issue: 

    • “Introduction. Antithrombotic medication in neurosurgery: management and controversies of a growing clinical dilemma” by Jehuda Soleman et al.
    • “Impact of premorbid oral anticoagulant use on survival in patients with traumatic intracranial hemorrhage” by David Botros et al.
    • “Effect of perioperative anticoagulant prophylaxis in patients with traumatic subdural hematoma and a history of anticoagulant use: a propensity-matched National Trauma Data Bank analysis” by Sam H. Jiang et al.
    • “Interaction of admission platelet count with current medications and the risk for chronic subdural recurrence” by Shawn R. Eagle et al.
    • “The implications of antithrombotic agents on subdural hematoma evacuation: what does “reversal” truly entail?” by Danielle D. Dang et al.
    • “Perioperative continuation or ultra-early resumption of antithrombotics in elective neurosurgical cranial procedures” by Jonathan Rychen et al.
    • “Stroke risk related to intentional discontinuation of antithrombotic therapy for invasive procedures” by Nobuyuki Mitsui et al.
    • “Anticoagulation for the treatment of septic cerebral venous sinus thrombosis in the setting of pediatric sinogenic and otogenic intracranial infections” by Pearl A. Sutter et al.
    • “Cilostazol for the management of moyamoya disease: a systematic review of the early evidence, efficacy, safety, and future directions” by Aidin Abedi et al.
    • “Safety of dual antiplatelet therapy in the acute phase of aneurysmal subarachnoid hemorrhage: a propensity score–matched study” by Farid Qoorchi Moheb Seraj et al.
    • “Does the clopidogrel CYP2C19 genotype assay predict postprocedure stenosis in cerebral aneurysms treated with a flow diverter?” by Austin J. Allen et al.
    • “Delayed ischemic events with low-dose prasugrel medication for stent-assisted coil embolization in intracranial aneurysm patients” by Hyun Ho Choi et al.
    • “Thrombocyte transfusion and rebleeding rate in patients using antiplatelet agents before aneurysmal subarachnoid hemorrhage” by Martina Sebök et al.
    • “To use or not to use antithrombotics in unruptured cerebrovascular malformations? A systematic review focusing on this clinical and surgical dilemma” by Andrea Bianconi et al.
    • “Bleeding risk evaluation in cerebral cavernous malformation, the role of medications, and hemorrhagic factors: a case-control study” by Alba Scerrati et al.
    • “Examining the safety profile of a standard dose tranexamic acid regimen in spine surgery” by Joshua Setliff et al.
    • “Safety and comparative efficacy of initiating low-molecular-weight heparin within 24 hours of injury or surgery for venous thromboembolism prophylaxis in patients with spinal cord injury: a prospective TRACK-SCI registry study” by Austin Lui et al.
    • “Systematic review and meta-analysis of topical tranexamic acid in spine surgery” by Chiemela Izima et al.
    • “Safety and functional outcomes of early antiplatelet therapy within 24 hours following mechanical thrombectomy for secondary prevention in emergent large-vessel occlusion strokes: a registry study” by Hepzibha Alexander et al.
    • “Effect of chronic antiplatelet therapy on clinical outcomes of endovascular thrombectomy for treatment of acute ischemic stroke” by Alis J. Dicpinigaitis et al.
    • “Association of tirofiban with improvement of functional outcomes of direct thrombectomy for acute anterior circulation occlusion: a retrospective, nonrandomized, multicenter, real-world study” by Qiaochu Guan et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

    ***

    Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

     ###

     The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

    Journal of Neurosurgery

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  • October 2023 Issue of Neurosurgical Focus: Video: “Intradural Spinal Tumors”

    October 2023 Issue of Neurosurgical Focus: Video: “Intradural Spinal Tumors”

    Newswise — Rolling Meadows, IL (October 1, 2023). The October issue of Neurosurgical Focus: Video (Vol. 9, No. 2 [https://thejns.org/video/view/journals/neurosurg-focus-video/9/2/neurosurg-focus-video.9.issue-2.xml]) presents 21 videos demonstrating techniques related to the treatment of intradural spinal tumors.

    Topic Editors: Michelle J. Clarke, Paul McCormick, Mark Bilsky, and Praveen Mummaneni

    The October issue of Neurosurgical Focus: Video is dedicated to the topic of intradural spinal tumors. The editors of this month’s issue present a selection of videos that “showcases both classic and novel techniques to treat these diverse lesions. Demonstrated surgical techniques include microsurgical resection, endoscopic techniques, and minimally invasive surgeries, providing a comprehensive overview of the state-of-the-art practices in this specialized area.”

    Contents of the October issue: 

    • “Introduction. Intradural spine tumor surgery” by Michelle J. Clarke et al.
    • “Dorsal cervical approach for recurrent intradural anaplastic ependymoma” by Maxwell T. Laws et al.
    • “Cervical ependymoma en bloc resection” by Matheus A. Bannach et al.
    • “Spinal cord tractography and neuromonitoring-based surgical strategy for intramedullary ependymoma” by Corentin Dauleac et al.
    • “The precise midline myelotomy through anatomical posterior median septum by dissecting dorsal column in microsurgical resection of ependymoma (2-dimensional operative video)” by Jun-Hoe Kim and Chun Kee Chung
    • “Resection of intradural intramedullary subependymoma of the cervicothoracic spine: 2-dimensional operative video” by Joshua Vignolles-Jeong et al.
    • “Surgical resection of recurrent intramedullary subependymoma of the cervical spinal cord” by Jennifer L. Perez et al.
    • “Anterolateral upper cervical approach for ventral C1–C2 meningioma” by Serdar Rahmanov et al.
    • “Surgical resection of an intradural extramedullary spinal tumor” by Joseph Yunga Tigre et al.
    • “Intramedullary sclerosing meningioma: operative video” by Giada Garufi et al.
    • “A rapid clinical deterioration of a cervical exophytic intradural intramedullary sporadic hemangioblastoma diagnosed during pregnancy” by Ufuk Erginoglu et al.
    • “Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors” by Harsh Deora and Madhusudhan Nagesh
    • “Location-specific technical nuances of spinal meningioma resection: an operative video case series” by Wilson A. M. Fisher et al.
    • “Technical nuances for the resection of cervical dumbbell schwannomas” by Brandon M. Wilkinson et al.
    • “Thoracic laminectomy and midline myelotomy for resection of a spinal ependymoma” by Lea Scherschinski et al.
    • “Resection of a large thoracolumbar intradural ependymoma: a 2D operative video” by Daniel M. Aaronson et al.
    • “Removal of a thoracic intramedullary epidermoid tumor in a child” by Marianna Di Costanzo et al.
    • “Robot-assisted T12 pediculectomy and resection of a ventral thoracic meningioma” by Mahmudur Rahman et al.
    • “Minimally-invasive tubular resection of thoracolumbar intradural schwannoma” by Maya Harary et al.
    • “Resection of a large multisegmental filum terminale ependymoma through a multisegmental hemilaminectomy” by Paawan Bahadur Bhandari
    • “Tandem resection of multiple spinal schwannomas” by Joseph S. Bell et al.
    • “Surgical resection of lumbar intradural metastatic renal cell carcinoma” by Mohamed Macki et al.

     Please join us in viewing the videos in this month’s issue of Neurosurgical Focus: Video.

     ***

    Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

     ###

    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

    Journal of Neurosurgery

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  • True Progression or Pseudoprogression in Glioblastoma Patients?

    True Progression or Pseudoprogression in Glioblastoma Patients?

    Newswise — MIAMI, FLORIDA (STRICTLY EMBARGOED UNTIL SEPT. 29, 2023 AT 5PM ET) – Is it true progression or pseudoprogression in tumor growth?

    That’s the critical question for radiation and medical oncologists treating patients with glioblastoma, the most common and aggressive form of brain cancer. Distinguishing between these types of progression is vitally important for treatment management.

    “Knowing if it’s true progression, indicative of a poor response to treatment, or pseudoprogression, a favorable response that may look worse due to swelling or tumor necrosis, is essential for clinicians,” said Eric Mellon, MD, PhD, a radiation oncologist and researcher with Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. “That knowledge can guide us in adjusting current treatment in real time.”

    He and his research colleagues are presenting results from two recent studies on this topic at ASTRO 2023, the annual meeting of the American Society for Radiation Oncology, Oct. 1-4, in San Diego.

    One study was designed to determine if daily monitoring of tumor changes during a course of radiation therapy could result in early prediction of treatment response. The MRI-guided linear accelerator systems, known as MR-linac, that deliver radiation therapy allow for this type of monitoring and detection of patterns within these volume changes. 

    Sylvester researchers used sophisticated analytical and machine learning tools, including a linear fitting model to test their prediction theory on a prospective cohort of glioblastoma patients undergoing chemoradiation for their cancers.

    “The model was trained to predict between no progression, pseudoprogression and true progression, and the results were cross-validated,” explained Kaylie Cullison, an MD/PhD student who is conducting her PhD research in Mellon’s Sylvester laboratory, is the study’s first author, and will present the data at ASTRO 2023. 

    Of the 28 patients analyzed in the study, 11 had no tumor growth on first diagnostic MRI after treatment (no progression), five were found to have pseudoprogression based on long-term stability of MRI findings, and 12 had true progression determined by continuing tumor growth beyond six months, tissue sampling showing active malignancy or rapid death.

    The model achieved an overall accuracy of 86%, when predicting three outcome classes (no progression, true progression and pseudoprogression), and an accuracy of 93% when predicting between no progression versus any kind of progression.

    “We identified patterns of tumor behavior during therapy that were indicative of differences in growth patterns between true progression and pseudoprogression,” said Mellon, co-leader of Sylvester’s Neuro-Oncology Site Disease Group who leads numerous clinical trials for brain tumors. “These volume changes during treatment may be early markers of treatment response.”

    Next steps, according to Mellon and Cullison, include automating real-time tumor monitoring by using a deep-learning solution for volume delineation on daily treatment scans.

    Their other study, conducted simultaneously with the above one, sought to determine the predictive value of weekly delta-radiomic features extracted from MR-linac systems used for treating glioblastoma patients.

    Whereas radiomics focus on quantitative features extracted from medical images to correlate with various biological features and clinical endpoints for cancer diagnosis, prognosis and clinical decisions, delta radiomics extend that analysis by examining feature variation at different time points, usually before and after therapy.

    In this case, however, the acquisition time points were during therapy. Sylvester researchers deployed supervised machine learning with a sophisticated classification model to predict true progression or pseudoprogression outcomes. Their model included 41 variables – 39 tumor texture features plus lesion volume and mean lesion intensity – per time point to generate the predictions.

    Of the 10 most prognostic features, 90% happened during an early time point, suggesting that prognostic changes in the underlying tumor microenvironment occur within the first 15 treatment sessions (or first half of treatment).

    “Our findings support the theory that delta-radiomic features from MR-linac radiotherapy can predict treatment response during therapy, which is earlier than current methods,” concluded Mellon. “And doing so would allow physicians to intensify current treatment for poorly responding patients.”       

    Mellon and Cullison say future research should include a larger patient cohort and the use of MR-linac systems with multiparametric MRI to further test the model’s prognostic value.

    # # #

    Sylvester Comprehensive Cancer Center

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