ABSTRACT
ObjectiveTo investigate the application and safety of stereoelectroencephalography (SEEG) in invasive preoperation evaluation of drug-refractory epilepsy (DRE). MethodsWe retrospectively analyzed the clinical data of patients with DRE who underwent SEEG implantation in Shenzhen Second People's Hospital and Shenzhen University General Hospital between Aug. 2016. and Nov. 2018. The suspicious epileptogenic focus and propagation path was proposed based on the non-invasive preoperative evaluation, and then the implantation protocol of the SEEG electrodes was designed. Finally, according to the SEEG and electrical stimulation results, the resection or thermocoagulation of suspicious epileptogenic focus was done. ResultsA total of 359 electrodes were implanted in 31 DRE patients, with an average of 11.58 per patient. There were 13 electrodes (3.62%) failed to be implanted, with no additional electrode implantation. One case of intracranial hemorrhage was noted after operation, and there was no intracranial infection or cerebrospinal fluid leakage. Twenty patients received epileptogenic zone resection, 8 received epileptic network radiofrequency thermocoagulation, 1 with epileptic foci in the eloquent cortex underwent vagus nerve stimulation, and 2 received no operation. Thirty-one DRE patients were followed up for 6-30 months, with an average of (11.68±7.46) months. Of the 20 patients who underwent epileptogenic zone resection, 17 patients (85.00%, 17/20) had grade I ILAE (International League Against Epilepsy), 2 (10.00%, 2/20) had grade II, and 1 (5.00%, 1/20) had grade III. For the 8 patients undergoing epileptic network radiofrequency thermocoagulation, 6 (75.00%, 6/8) had grade IILAE and 2 (25.00%, 2/8) had grade III. There was no significant difference in outcome between the two treatments (P=0.61). For 13 patients with negative magnetic resonance imaging (MRI), 10 (76.92%, 10/13) had grade I ILAE, 2 (15.38%, 2/13) had grade II, and 1 (7.69%, 1/13) had grade III; for 15 MRI-positive patients, 13 (86.67%, 13/15) had grade I ILAE and 2 (13.33%, 2/15) had grade III. There was no significant difference in outcome between MRI-positive patients and MRI-negative patients (P=0.64). ConclusionSurgical treatment of DRE patient under the guidance of SEEG is safe and effective, and SEEG can improve the accuracy of epileptogenic foci localization, no matter in MRI positive or MRI negative patients.
ABSTRACT
Objective: To study the anti-proliferation effects of thiazolidinedione compounds-troglitazone, which is a high affinity ligand of PPAR-γ, on rat pituitary adenoma GH3 cell line and explore the related mechanisms. Methods: GH3 cells were separately treated with troglitazone (10-7, 10-6 and 10-5 mol/L), dimethyl sulfoxide (DMSO) (DMSO control group) and phenol red- and serum-free F-12 medium (blank group). MTT was used to examine the cell growth in each group and FACS was used to detect the distribution of cell cycle. Semi-quantitative RT-PCR method was utilized to determine the expression of CyclinDi mRNA. ANOVA was used for statistical analysis. Results: The 72 h treatment with troglitazone inhibited GH3 cell proliferation in a dose-dependent manner. The treatment also induced cell cycle arrest in G1/S phase and significantly decreased the expression of CyclinD1 mRNA as compared to the other 2 groups (P< 0.05). Conclusion: Troglitazone can obviously inhibit the proliferation of GH3 cells; the molecular mechanism may be the decrease of CyclinD1 mRNA due to binding to PPAR-γ.
ABSTRACT
<p><b>BACKGROUND</b>Previous brain imaging studies suggested that the brain activity underlying the perception of chronic pain may differ from that underlying acute pain. To investigate the brain regions involved in chronic spontaneous pain due to brachial plexus avulsion (BPA), fluorine-(18)fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) scanning was applied to determine the glucose metabolic changes in patients with pain due to BPA.</p><p><b>METHODS</b>Six right-handed patients with chronic spontaneous pain due to left-BPA and twelve right-handed age- and sex-matched healthy control subjects participated in the (18)F-FDG PET study. The patients were rated by visual analog scale (VAS) during scanning and Hamilton depression scale and Hamilton anxiety scale after scanning. Statistical parametric mapping 2 (SPM2) was applied for data analysis.</p><p><b>RESULTS</b>Compared with healthy subjects, the patients had significant glucose metabolism decreases in the right thalamus and SI (P < 0.001, uncorrected), and significant glucose metabolism increases in the right orbitofrontal cortex (OFC) (BA11), left rostral insula cortex and left dorsolateral prefrontal cortex (DLPFC) (BA10/46) (P < 0.001, uncorrected).</p><p><b>CONCLUSION</b>These findings suggest that the brain areas involved in emotion, attention and internal modulation of pain may be related to the chronic spontaneous pain due to BPA.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Brachial Plexus , Wounds and Injuries , Brain , Metabolism , Chronic Disease , Glucose , Metabolism , Pain , Pain Measurement , Positron-Emission Tomography , Methods , Prefrontal Cortex , Metabolism , Thalamus , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To review the literature on the use of brain imaging, including functional magnetic resonance imaging (fMRI), positron emission tomography (PET), magnetic resonance spectroscopy (MRS) and voxel-based morphometry (VBM) in investigation of the activity in diverse brain regions that creates and modulates chronic neuropathic pain.</p><p><b>DATA SOURCES</b>English literatures from January 1, 2000 to July 31, 2007 that examined human brain activity in chronic neuropathic pain were accessed through MEDLINE/CD ROM, using PET, fMRI, VBM, MRS and receptor binding.</p><p><b>STUDY SELECTION</b>Published articles about the application of fMRI, PET, VBM, MRS and chronic neuropathic pain were selected.</p><p><b>DATA EXTRACTION</b>Data were mainly extracted from 40 representative articles as the research basis.</p><p><b>RESULTS</b>The PET studies suggested that spontaneous neuropathic pain is associated with changes in thalamic activity. Both PET and fMRI have been used to investigate the substrate of allodynia. The VBM demonstrated that brain structural changes are involved in chronic neuropathic pain, which is not seen in a matched control group. However, the results obtained had a large variety, which may be due to different pain etiology, pain distribution, lesion tomography, symptoms and stimulation procedures.</p><p><b>CONCLUSIONS</b>Application of the techniques of brain imaging plays a very important role in the study of structural and functional reorganization in patients with neuropathic pain. However, a unique "pain matrix" has not been defined. Future studies should be conducted using a prospective longitudinal research design, which would guarantee the control for many confounding factors.</p>