Protective effect and mechanism of Lactobacillus on cerebral ischemia reperfusion injury in rats

The present study was designed to investigate the protective effects and mechanism of inactivated lactobacillus (ILA) on cerebral ischemia reperfusion injury (CIRI) in rats. In this experiment, 30 male Sprague Dawley rats were randomly divided into control group, IRI groups, and ILA group. A middle cerebral artery occlusion and reperfusion model was prepared. The rats were killed after 24 hours of recovery of blood flow of cerebral ischemia resulting from 60-min occlusion. The cerebral infarction volume and neurological scores were assayed by staining and behavioral observation. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assayed by biochemical kits. Cell apoptosis was assayed by Tunnel and the Toll-like receptor (TLR)-4, IkB, and A20 were assayed by western blot. The neurobehavioral scores in IRI rats were significantly lower compared to the control group while ILA improved the neurobehavioral scores of the ILA groups. The cerebral infarction volume and neural cell apoptosis of rats in the ILA groups decreased significantly compared with those in the IRI group. In addition, MDA level in the ILA groups decreased whereas SOD activity increased compared to the IRI group. Moreover, ILA also inhibited the expression of TLR-4 and promoted the expression of IkB and A20. ILA inhibited the apoptosis of neural cells, decreased cerebral infarction volume, and reduced oxidative stress through inhibition of TLR-4/NF-kappa B signaling, improving neurobehavioral scores. Thus from the present study it was concluded that ILA has protective effect on CIRI.

LXW7 ameliorates focal cerebral ischemia injury and attenuates inflammatory responses in activated microglia in rats

Inflammation plays a pivotal role in ischemic stroke, when activated microglia release excessive pro-inflammatory mediators. The inhibition of integrin αvβ3 improves outcomes in rat focal cerebral ischemia models. However, the mechanisms by which microglia are neuroprotective remain unclear. This study evaluated whether post-ischemic treatment with another integrin αvβ3 inhibitor, the cyclic arginine-glycine-aspartic acid (RGD) peptide-cGRGDdvc (LXW7), alleviates cerebral ischemic injury. The anti-inflammatory effect of LXW7 in activated microglia within rat focal cerebral ischemia models was examined. A total of 108 Sprague-Dawley rats (250–280 g) were subjected to middle cerebral artery occlusion (MCAO). After 2 h, the rats were given an intravenous injection of LXW7 (100 μg/kg) or phosphate-buffered saline (PBS). Neurological scores, infarct volumes, brain water content (BWC) and histology alterations were determined. The expressions of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], and Iba1-positive activated microglia, within peri-ischemic brain tissue, were assessed with ELISA, western blot and immunofluorescence staining. Infarct volumes and BWC were significantly lower in LXW7-treated rats compared to those in the MCAO + PBS (control) group. The LXW7 treatment lowered the expression of pro-inflammatory cytokines. There was a reduction of Iba1-positive activated microglia, and the TNF-α and IL-1β expressions were attenuated. However, there was no difference in the Zea Longa scores between the ischemia and LXW7 groups. The results suggest that LXW7 protected against focal cerebral ischemia and attenuated inflammation in activated microglia. LXW7 may be neuroprotective during acute MCAO-induced brain damage and microglia-related neurodegenerative diseases.

Aplicación de técnicas avanzadas de neuroimágenes en rehabilitación motora / Application of advanced neuroimaging in motor rehabilitation

Introducción. La resonancia magnética funcional es una técnica no invasiva que permite el mapeo cerebral y la visualización de redes de conectividad. La hemiparesia posterior a un accidente cerebrovascular constituye un buen modelo biológico para estudiar los cambios en la conectividad cerebral. El uso de este modelo se puede expandir si se obtiene información antes y después de la rehabilitación neurológica. Objetivo. Presentar los hallazgos por neuroimágenes funcionales de un paciente con accidente cerebrovascular antes y después del tratamiento de rehabilitación neurológica. Materiales y métodos. Como parte del protocolo de rehabilitación neurológica se tomaron imágenes de resonancia antes y después del tratamiento con un equipo que operaba a 1,5 T. Se obtuvieron imágenes volumétricas potenciadas en T1, imágenes de difusión para tractografía, imágenes de resonancia funcional con el paciente en reposo y haciendo movimientos de pinza con la mano derecha. Resultados. Se obtuvieron mapas funcionales antes y después de la terapia, los cuales se presentan conjuntamente con las imágenes de conectividad estructural obtenidas mediante tractografía. Se observó que los cambios clínicos estaban acompañados de cambios en los patrones de activación obtenidos por resonancia magnética funcional. Conclusión. La versatilidad que ofrece la resonancia magnética permite conocer el estado funcional y estructural del cerebro, generando así nuevas posibilidades de diagnóstico y pronóstico en pacientes que reciben rehabilitación neurológica, con lo que se pueden cuantificar y develar ciertos procesos dinámicos de plasticidad neuronal posteriores a una lesión, que son propios del sistema nervioso central.

Introduction: Functional magnetic resonance imaging is a noninvasive technique that allows mapping and visualizing of brain connectivity networks. The hemiparesis after a stroke is a good biological model to study changes in brain connectivity. This model can be expanded if information is obtained before and after neurorehabilitation therapy. Objective: To present the functional neuroimaging findings in a patient with stroke before and after performing neurorehabilitation therapy. Materials and methods: As part of the neurorehabilitation protocol, resonance imaging was performed before and after treatment with an equipment operating at 1.5 T. Volumetric T1-weighted images, diffusion images for tractography, functional resonance images with the patient at rest and with the patient performing pincer movement with the right hand were obtained. Results: Functional maps before and after therapy were obtained, which are presented together with structural connectivity images obtained by tractography. Clinical changes can be seen accompanied by changes in activation patterns obtained by functional magnetic resonance imaging. Conclusion: The versatility of magnetic resonance imaging allows further knowledge of the structural and functional state of the brain generating new possibilities for diagnosis and prognosis in patients undergoing neurorehabilitation therapy. Neurological rehabilitation processes can be quantified and they can reveal certain postlesional neuroplasticity dynamic processes that the central nervous system possesses.

Ophthalmic Artery Obstruction and Cerebral Infarction Following Periocular Injection of Autologous Fat

We report a case of ophthalmic artery obstruction combined with brain infarction following periocular autologous fat injection. The patient, a 44-year-old woman, visited our hospital for decreased visual acuity in her left eye and dysarthria one hour after receiving an autologous fat injection in the periocular area. Her best corrected visual acuity for the concerned eye was no light perception. Also, a relative afferent pupillary defect was detected in this eye. The left fundus exhibited widespread retinal whitening with visible emboli in several retinal arterioles. Diffusion-weighted magnetic resonance imaging of the brain showed a hyperintense lesion at the left insular cortex. Therefore, we diagnosed ophthalmic artery obstruction and left middle cerebral artery infarction due to fat emboli. The patient was managed with immediate ocular massage, carbon dioxide, and oxygen therapy. Following treatment, dysarthria improved considerably but there was no improvement in visual acuity.

Síndrome biopercular producido por lesión unilateral / Biopercular syndrome caused by unilateral ischemia: report of one case

Biopercular syndrome is a labio-facio-pharyngeal-laryngeal-gloso-masticatory diplegia, with automatic dissociation of movements. Ischemia is the most common etiology when it occurs bilaterally in the opercular area, but it has been also described in patients with bilateral subcortical lesions. There arefew cases described with unilateral lesions. We report a 76-year-old woman who developed a biopercular syndrome caused by unilateral ischemic lesion ofthe right middle cerebral artery confirmed by magnetic resonance imaging and cerebral SPECT.

Idiopathic chronic subdural hematoma, MCA infarct and cortical atrophy with status epilepticus in infants.

Spontaneous chronic subdural hematomas in infants are extremely rare. A very limited number of cases are known and reported in literature. The clinical presentation can be myriad varying from asymptomatic cases to gross neurological deficits. We report the cases of 2 infants who presented to us with repeated episodes of generalized tonic clonic seizures since birth. No etiology could be established for either of them. Subsequent imaging revealed chronic subdural hematoma, MCA infarct and cortical atrophy in both the cases. Both the cases improved following evacuation of the chronic subdural hematoma. One of the infants had secondary craniosynostosis for which additional coronal suturectomy had to be done. The management of such cases and a brief review of literature are discussed.

La enfermedad neurológica de Georg Friedrich Hãndel / The neurological disorder of Georg Friedrich Hãndel

Georg Friedrich Hãndel, a musical genius, was affected since his middle age by several attacks, during a period of 20 years, of upper right limb palsies, abnormal speech followed by amaurosis in his contralateral eye and then is both eyes. He underwent three unsuccessful operations due to a wrong diagnosis of cataracts. We discuss the possible differential diagnoses. Considering his clear vascular profile, the most plausible hypothesis is cerebrovascular disease with embolic infarcts from stenotic left internal carotid artery to the left middle cerebral and retinal arteries.

Canine model of ischemic stroke with permanent middle cerebral artery occlusion: clinical and histopathological findings

The aim of the present study was to assess the clinical and histopathological findings in a canine model of ischemic stroke. Cerebral ischemic stroke was induced by middle cerebral artery occlusion in four healthy beagle dogs using silicone plugs. They showed neurological signs of forebrain dysfunction such as reduced responsiveness, head turning, circling, postural reaction deficits, perceptual deficits, and hemianopsia. These signs gradually regressed within 4 weeks without therapy. On magnetic resonance imaging, T2 hyperintensity and T1 hypointensity were found in the cerebral cortex and basal ganglia. These lesions were well-defined and sharply demarcated from adjacent brain parenchyma with a homogenous appearance. No abnormalities of the cerebrospinal fluid were observed. At necropsy, atrophic and necrotic lesions were observed in the cerebral cortex. The cerebral cortex, basal ganglia, and thalamus were partially unstained with triphenyl-tetrazolium chloride. Histopathologically, typical features of infarction were identified in cortical and thalamic lesions. This study demonstrates that our canine model resembles the conditions of real stroke patients.

Environmental reduplication in a patient with right middle cerebral artery occlusion.

Environmental reduplication or reduplicative paramnesia is one of the content-specific delusions (CSD) which is characterized by reduplication of places. CSD has been reported in focal and diffuse cerebral disorders. A focal lesion such as frontal lobes and the right hemispheric lesion have been documented The authors describe a 66 year-old woman who had a delusion of misidentification for place one month after right middle cerebral artery occlusion. The patient did not have any history of schizophrenia or other psychiatric diseases. The patient believed that her car, furniture and house were duplicated. She also mentioned that her son and friends tried to takeover all of her properties and told everyone that she was insane. The prominent cortical signs were tactile and visual neglect. Neuropsychological assessments revealed poor attention but she had neither confusion nor dementia. Clock drawing and construction tests revealed visuospatial impairment which was compatible with non-dominant hemispheric abnormality. MRI showed evidence of cerebral infarction in the right middle cerebral artery territory. Only one similar patient who had an intracerbral hematoma of the right frontal lobe has been reported in the literature. The role of occipito-parietal and fronto-temporal lobes or their connections in environmental reduplication is proposed.