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1.
Heart Rhythm ; 20(3): 407-413, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36464126

ABSTRACT

BACKGROUND: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, direct-to-patient, self-applied ECG patch use has substantially increased. There are limited data comparing clinic with self-applied electrocardiogram (ECG) patches. OBJECTIVE: The purpose of this study was to compare rates of ECG patch return, percentages of time patches yielded analyzable data (analyzable time), and percentages of prescribed time ECG patches were worn between clinic and self-applied ECG patches before and during COVID-19. METHODS: A retrospective analysis of patients prescribed an ECG patch during "pre-COVID" (March 1, 2019, through March 1, 2020) and "COVID" (April 4, 2020, through April 1, 2021) years was performed. ECG patch return rates, mean percentages of analyzable time, and mean percentages of prescribed wear time were compared between clinic and self-applied groups. RESULTS: Among the 29,093 ECG patch prescriptions (19% COVID self-applied), the COVID self-applied group had a lower return rate (90.8%) than did both clinic-applied groups (COVID: 97.1%; pre-COVID: 98.1%; P < .001). Among the 28,048 ECG patches (17.5% self-applied) returned for analysis, the COVID self-applied group demonstrated a lower mean percentage of analyzable time (95.9% ± 8.2%) than did both clinic-applied groups (COVID: 96.6% ± 6.6%; pre-COVID 96.6% ± 7.4%; P < .001). There were no differences in the mean percentage of prescribed wear time between groups (pre-COVID clinic-applied: 96.7% ± 34.3%; COVID clinic-applied: 97.4% ± 39.8%; COVID self-applied: 98.1% ± 52.1%; P = .09). CONCLUSION: Self-applied ECG patches were returned at a lower rate and had a statistically lower percentage of analyzable time than clinic-applied patches. However, there were no differences between groups in mean percentages of prescribed wear time, and mean percentages of analyzable time were >95% in all groups.


Subject(s)
COVID-19 , Data Accuracy , Humans , Retrospective Studies , Electrocardiography
2.
Am Heart J Plus ; 13: 100084, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35036973

ABSTRACT

BACKGROUND: Coronavirus infection is the cause of the current world-wide pandemic. Cardiovascular complications occur in 20-30% of patients with COVID-19 infection including myocardial injury and arrhythmias. Current understanding of specific arrhythmia type and frequency is limited. OBJECTIVE: We aimed to analyze arrhythmia type and frequency in patients with COVID infection, identifying arrhythmia patterns over time during hospitalization and post discharge utilizing a patch based mobile cardiac telemetry system. METHODS: A prospective cohort study during the COVID-19 pandemic was performed. We included in our study patients hospitalized with COVID-19 infection who had a patch-based mobile telemetry device placed for cardiac monitoring. RESULTS: Quantitative reports for 59 patients were available for analysis. Arrhythmias were detected in 72.9% of patients and at a consistent frequency throughout the monitoring period in 52.9%-89.5% of patients daily. The majority of arrhythmias were SVT (59.3% of patients) and AF (22.0%). New onset AF was noted in 15.0% of all patients and was significantly associated with older age (OR 1.4 for 5 yrs. difference; 95% CI 1.03-2.13). Of 9 patients who were discharged with continued patch monitoring, 7 (78%) had arrhythmic events during their outpatient monitoring period. CONCLUSION: In COVID-19 patients arrhythmias were observed throughout hospitalization with a consistent daily frequency. Patients continued to exhibit cardiac arrhythmias after hospital discharge of a type and frequency similar to that seen during hospitalization. These findings suggest that the risk of arrhythmia associated with COVID infection remains elevated throughout the hospital course as well as following hospital discharge.

3.
Neurobiol Dis ; 89: 126-35, 2016 May.
Article in English | MEDLINE | ID: mdl-26850918

ABSTRACT

UNLABELLED: Sensory processing deficits are common in autism spectrum disorders, but the underlying mechanisms are unclear. Fragile X Syndrome (FXS) is a leading genetic cause of intellectual disability and autism. Electrophysiological responses in humans with FXS show reduced habituation with sound repetition and this deficit may underlie auditory hypersensitivity in FXS. Our previous study in Fmr1 knockout (KO) mice revealed an unusually long state of increased sound-driven excitability in auditory cortical neurons suggesting that cortical responses to repeated sounds may exhibit abnormal habituation as in humans with FXS. Here, we tested this prediction by comparing cortical event related potentials (ERP) recorded from wildtype (WT) and Fmr1 KO mice. We report a repetition-rate dependent reduction in habituation of N1 amplitude in Fmr1 KO mice and show that matrix metalloproteinase-9 (MMP-9), one of the known FMRP targets, contributes to the reduced ERP habituation. Our studies demonstrate a significant up-regulation of MMP-9 levels in the auditory cortex of adult Fmr1 KO mice, whereas a genetic deletion of Mmp-9 reverses ERP habituation deficits in Fmr1 KO mice. Although the N1 amplitude of Mmp-9/Fmr1 DKO recordings was larger than WT and KO recordings, the habituation of ERPs in Mmp-9/Fmr1 DKO mice is similar to WT mice implicating MMP-9 as a potential target for reversing sensory processing deficits in FXS. Together these data establish ERP habituation as a translation relevant, physiological pre-clinical marker of auditory processing deficits in FXS and suggest that abnormal MMP-9 regulation is a mechanism underlying auditory hypersensitivity in FXS. SIGNIFICANCE: Fragile X Syndrome (FXS) is the leading known genetic cause of autism spectrum disorders. Individuals with FXS show symptoms of auditory hypersensitivity. These symptoms may arise due to sustained neural responses to repeated sounds, but the underlying mechanisms remain unclear. For the first time, this study shows deficits in habituation of neural responses to repeated sounds in the Fmr1 KO mice as seen in humans with FXS. We also report an abnormally high level of matrix metalloprotease-9 (MMP-9) in the auditory cortex of Fmr1 KO mice and that deletion of Mmp-9 from Fmr1 KO mice reverses habituation deficits. These data provide a translation relevant electrophysiological biomarker for sensory deficits in FXS and implicate MMP-9 as a target for drug discovery.


Subject(s)
Adaptation, Physiological , Auditory Cortex/physiopathology , Evoked Potentials, Auditory , Fragile X Mental Retardation Protein/physiology , Fragile X Syndrome/metabolism , Fragile X Syndrome/physiopathology , Matrix Metalloproteinase 9/metabolism , Acoustic Stimulation , Animals , Auditory Cortex/metabolism , Disease Models, Animal , Fragile X Mental Retardation Protein/genetics , Matrix Metalloproteinase 9/genetics , Mice , Mice, Knockout , Up-Regulation
4.
Acta Neurochir Suppl ; 121: 285-9, 2016.
Article in English | MEDLINE | ID: mdl-26463962

ABSTRACT

Traumatic brain injury (TBI), the foremost cause of morbidity and mortality in persons under 45 years of age worldwide, leads to about 200,000 victims requiring hospitalization and approximately 52,000 deaths per year in the United States. TBI is characterized by cerebral edema leading to raised intracranial pressure, brain herniation, and subsequent death. Current therapies for TBI treatment are often ineffective, thus novel therapies are needed. Recent studies have shown that an osmotic transport device (OTD) is capable of reducing brain water content and improving survival in mice with severe cerebral edema. Here we compare the effects of a craniectomy and an OTD plus craniectomy on neurological function in mice after TBI. Animals treated with a craniectomy plus an OTD had significantly better neurological function 2 days after TBI compared with those treated with craniectomy only. This study suggests that an OTD for severe brain swelling may improve patient functional outcome. Future studies include a more comprehensive neurological examination, including long-term memory tests.


Subject(s)
Brain Edema/therapy , Brain Injuries, Traumatic/therapy , Decompressive Craniectomy , Equipment and Supplies , Osmosis , Animals , Behavior, Animal , Brain Edema/etiology , Brain Edema/physiopathology , Brain Injuries, Traumatic/complications , Brain Injuries, Traumatic/physiopathology , Disease Models, Animal , Female , Mice
5.
ASN Neuro ; 7(5)2015.
Article in English | MEDLINE | ID: mdl-26489685

ABSTRACT

Aquaporin-4 (AQP4) is a bidirectional water channel that is found on astrocytes throughout the central nervous system. Expression is particularly high around areas in contact with cerebrospinal fluid, suggesting that AQP4 plays a role in fluid exchange between the cerebrospinal fluid compartments and the brain. Despite its significant role in the brain, the overall spatial and region-specific distribution of AQP4 has yet to be fully characterized. In this study, we used Western blotting and immunohistochemical techniques to characterize AQP4 expression and localization throughout the mouse brain. We observed AQP4 expression throughout the forebrain, subcortical areas, and brainstem. AQP4 protein levels were highest in the cerebellum with lower expression in the cortex and hippocampus. We found that AQP4 immunoreactivity was profuse on glial cells bordering ventricles, blood vessels, and subarachnoid space. Throughout the brain, AQP4 was expressed on astrocytic end-feet surrounding blood vessels but was also heterogeneously expressed in brain tissue parenchyma and neuropil, often with striking laminar specificity. In the cerebellum, we showed that AQP4 colocalized with the proteoglycan brevican, which is synthesized by and expressed on cerebellar astrocytes. Despite the high abundance of AQP4 in the cerebellum, its functional significance has yet to be investigated. Given the known role of AQP4 in synaptic plasticity in the hippocampus, the widespread and region-specific expression pattern of AQP4 suggests involvement not only in fluid balance and ion homeostasis but also local synaptic plasticity and function in distinct brain circuits.


Subject(s)
Aquaporin 4/metabolism , Astrocytes/metabolism , Brain/metabolism , Animals , Aquaporin 4/genetics , Blotting, Western , Immunohistochemistry , Mice , Mice, Knockout , Microscopy, Confocal
6.
Biomed Opt Express ; 6(5): 1812-27, 2015 May 01.
Article in English | MEDLINE | ID: mdl-26137382

ABSTRACT

Optical coherence tomography (OCT) is a high resolution, minimally invasive imaging technique, which can produce depth-resolved cross-sectional images. In this study, OCT was used to detect changes in the optical properties of cortical tissue in vivo in mice during the induction of global (pentylenetetrazol) and focal (4-aminopyridine) seizures. Through the use of a confidence interval statistical method on depth-resolved volumes of attenuation coefficient, we demonstrated localization of regions exhibiting both significant positive and negative changes in attenuation coefficient, as well as differentiating between global and focal seizure propagation.

7.
J Neurotrauma ; 31(23): 1948-54, 2014 Dec 01.
Article in English | MEDLINE | ID: mdl-24959845

ABSTRACT

Traumatic brain injury (TBI) is significant, from a public health standpoint, because it is a major cause of the morbidity and mortality of young people. Cerebral edema after a TBI, if untreated, can lead to devastating damage of the remaining tissue. The current therapies of severe TBI (sTBI), as outlined by the Brain Trauma Foundation, are often ineffective, thus a new method for the treatment of sTBI is necessary. Herein, the reduction of cerebral edema, after TBI, using an osmotic transport device (OTD) was evaluated. Controlled cortical impact (CCI) was performed on adult female CD-1 mice, and cerebral edema was allowed to form for 3 h, followed by 2 h of treatment. The treatment groups were craniectomy only, craniectomy with a hydrogel, OTD without bovine serum albumin (BSA), and OTD. After CCI, brain water content was significantly higher for animals treated with a craniectomy only, craniectomy with a hydrogel, and OTD without BSA, compared to that of control animals. However, when TBI animals were treated with an OTD, brain water content was not significantly higher than that of controls. Further, brain water content of TBI animals treated with an OTD was significantly reduced, compared to that of untreated TBI animals, TBI animals treated with a craniectomy and a hydrogel, and TBI animals treated with an OTD without BSA. Here, we demonstrate the successful reduction of cerebral edema, as determined by brain water content, after TBI using an OTD. These results demonstrate proof of principle for direct water extraction from edematous brain tissue by direct osmotherapy using an OTD.


Subject(s)
Brain Edema/therapy , Brain Injuries/complications , Brain/metabolism , Osmosis/physiology , Animals , Brain Edema/etiology , Brain Edema/metabolism , Brain Injuries/metabolism , Disease Models, Animal , Female , Mice
8.
Neurophotonics ; 1(2): 025004, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25674578

ABSTRACT

Cerebral edema develops in response to a variety of conditions, including traumatic brain injury and stroke, and contributes to the poor prognosis associated with these injuries. This study examines the use of optical coherence tomography (OCT) for detecting cerebral edema in vivo. Three-dimensional imaging of an in vivo water intoxication model in mice was performed using a spectral-domain OCT system centered at 1300 nm. The change in attenuation coefficient was calculated and cerebral blood flow was analyzed using Doppler OCT techniques. We found that the average attenuation coefficient in the cerebral cortex decreased over time as edema progressed. The initial decrease began within minutes of inducing cerebral edema and a maximum decrease of 8% was observed by the end of the experiment. Additionally, cerebral blood flow slowed during late-stage edema. Analysis of local regions revealed the same trend at various locations in the brain, consistent with the global nature of the cerebral edema model used in this study. These results demonstrate that OCT is capable of detecting in vivo optical changes occurring due to cerebral edema and highlights the potential of OCT for precise spatiotemporal detection of cerebral edema.

9.
Nanomedicine ; 9(8): 1135-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23969102

ABSTRACT

Laser-based diagnostics and therapeutics show promise for many neurological disorders. However, the poor transparency of cranial bone (calvaria) limits the spatial resolution and interaction depth that can be achieved, thus constraining opportunity in this regard. Herein, we report preliminary results from efforts seeking to address this limitation through use of novel transparent cranial implants made from nanocrystalline yttria-stabilized zirconia (nc-YSZ). Using optical coherence tomography (OCT) imaging of underlying brain in an acute murine model, we show that signal strength is improved when imaging through nc-YSZ implants relative to native cranium. As such, this provides initial evidence supporting the feasibility of nc-YSZ as a transparent cranial implant material. Furthermore, it represents a crucial first step towards realization of an innovative new concept we are developing, which seeks to eventually provide a clinically-viable means for optically accessing the brain, on-demand, over large areas, and on a chronically-recurring basis, without need for repeated craniectomies. FROM THE CLINICAL EDITOR: In this study, transparent nanocrystalline yttria-stabilized-zirconia is used as an experimental "cranium prosthesis" material, enabling the replacement of segments of cranial bone with a material that allows for optical access to the brain on a recurrent basis using optical imaging methods such as OCT.


Subject(s)
Bone Substitutes/chemistry , Nanoparticles/chemistry , Prostheses and Implants , Skull/surgery , Yttrium/chemistry , Zirconium/chemistry , Animals , Light , Mice , Optical Imaging , Skull/anatomy & histology
10.
Neurochem Int ; 63(7): 638-51, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23376026

ABSTRACT

It is estimated that one in 26 people will develop epilepsy in their lifetime, amounting to almost 12 million people in the United States alone (Hesdorffer et al., 2011). Epilepsy is a group of conditions characterized by sporadic occurrence of seizures and unconsciousness. This severely limits the ability to perform everyday tasks and leads to increased difficulty with learning and memory, maintenance of steady employment, driving, and overall socioeconomic integration. A greater understanding of the cellular and molecular mechanisms underlying seizures and epilepsy is necessary, as it may lead to novel antiepileptic treatments. In this chapter, we will review the current literature surrounding the involvement of glial cells in epilepsy with particular emphasis on review of human tissue studies and some possible underlying mechanisms. Based on the current evidence and hypotheses of glial mechanisms in epilepsy, novel therapeutic opportunities for the treatment of epilepsy will also be presented.


Subject(s)
Cell Transplantation , Epilepsy/therapy , Neuroglia/cytology , Adenosine/metabolism , Aquaporins/metabolism , Calcium/metabolism , Epilepsy/metabolism , Glucose/metabolism , Humans , Neuroglia/metabolism , Neuroglia/pathology , Potassium Channels/metabolism , Receptors, Glutamate/metabolism
11.
J Vis Exp ; (69): e50053, 2012 Nov 19.
Article in English | MEDLINE | ID: mdl-23183913

ABSTRACT

Optical coherence tomography (OCT) is a biomedical imaging technique with high spatial-temporal resolution. With its minimally invasive approach OCT has been used extensively in ophthalmology, dermatology, and gastroenterology. Using a thinned-skull cortical window (TSCW), we employ spectral-domain OCT (SD-OCT) modality as a tool to image the cortex in vivo. Commonly, an opened-skull has been used for neuro-imaging as it provides more versatility, however, a TSCW approach is less invasive and is an effective mean for long term imaging in neuropathology studies. Here, we present a method of creating a TSCW in a mouse model for in vivo OCT imaging of the cerebral cortex.


Subject(s)
Cerebral Cortex/anatomy & histology , Skull/surgery , Tomography, Optical Coherence/methods , Animals , Female , Image Processing, Computer-Assisted/methods , Mice
12.
Biomed Opt Express ; 3(11): 2700-6, 2012 Nov 01.
Article in English | MEDLINE | ID: mdl-23162709

ABSTRACT

The most common technology for seizure detection is with electroencephalography (EEG), which has low spatial resolution and minimal depth discrimination. Optical techniques using near-infrared (NIR) light have been used to improve upon EEG technology and previous research has suggested that optical changes, specifically changes in near-infrared optical scattering, may precede EEG seizure onset in in vivo models. Optical coherence tomography (OCT) is a high resolution, minimally invasive imaging technique, which can produce depth resolved cross-sectional images. In this study, OCT was used to detect changes in optical properties of cortical tissue in vivo in mice before and during the induction of generalized seizure activity. We demonstrated that a significant decrease (P < 0.001) in backscattered intensity during seizure progression can be detected before the onset of observable manifestations of generalized (stage-5) seizures. These results indicate the feasibility of minimally-invasive optical detection of seizures with OCT.

13.
Brain Res ; 1481: 71-8, 2012 Oct 24.
Article in English | MEDLINE | ID: mdl-22960114

ABSTRACT

Glioblastoma multiforme is a very aggressive and common form of brain tumor. Current therapies consist of a combination of surgical removal, chemotherapy and radiation therapy. These drastic treatments still leave a current prognosis of median survival of less than 1 year. Lack of effectiveness of these treatments has left researchers looking for alternative forms of treatment. A significant alternative currently being investigated is the use of the immune system to potentially target and eliminate tumor cells directly. Stabilin-1, a scavenger receptor expressed by macrophages, has the potential in inhibiting tumor growth by binding and internalizing secreted protein acidic and rich in cysteine (SPARC). SPARC is known to be upregulated in the tumor microenvironment and is involved in extracellular matrix remodeling, cell proliferation and migration. Decreasing SPARC expression using siRNA has been shown to decrease tumor invasiveness and survival. We investigated the phenotype of stabilin-1 expressing immune cells in the tumor environment and demonstrated a transient population of alternatively activated macrophages expressing stabilin-1 in the tumor environment and the disappearance of that population as the tumor progresses.


Subject(s)
Brain Neoplasms/immunology , Cell Adhesion Molecules, Neuronal/genetics , Cell Adhesion Molecules, Neuronal/immunology , Glioblastoma/immunology , Macrophages/immunology , Tumor Microenvironment/immunology , Animals , Brain Neoplasms/genetics , Brain Neoplasms/pathology , CD40 Antigens/genetics , Cell Adhesion Molecules, Neuronal/metabolism , Cell Line, Tumor , Disease Progression , Female , Gene Expression Regulation, Neoplastic/immunology , Glioblastoma/genetics , Glioblastoma/pathology , Glycoproteins/genetics , Glycoproteins/immunology , Mice , Mice, Inbred C57BL , Osteonectin , RNA, Small Interfering/genetics , Tumor Suppressor Proteins/genetics , Tumor Suppressor Proteins/immunology , Up-Regulation/immunology
14.
J Neurosurg ; 116(6): 1389-94, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22462505

ABSTRACT

OBJECT: Cerebral edema is a significant cause of morbidity and mortality in many disease states. Current therapies of cerebral edema are often ineffective in treating severe edema. Here, the authors develop a hollow fiber-hydrogel device (HFHD) for direct surface contact-based treatment of severe cerebral edema. METHODS: Brain edema was induced in adult mice via water intoxication by intraperitoneal water administration (30% body weight). Control mice received no treatment. A distinct group of mice was treated with craniectomy but no device application (craniectomy only). A third experimental group was treated with craniectomy and HFHD application. The HFHD contained a lumen solution of 350 g/L bovine serum albumin in room-temperature artificial CSF at pH 7.4. Survival and brain water content were assessed as end points. RESULTS: Craniectomy and application of the HFHD enhanced survival in animals with severe cerebral edema. Animals treated with a craniectomy and HFHD (n = 5) survived up to 5 hours longer than animals treated with craniectomy only (n = 5) (p < 0.001) or no treatment (n = 5) (p < 0.001). Animals treated with craniectomy and HFHD (n = 5) had a survival rate of 80% within the observation period (360 minutes), whereas no animal treated with craniectomy only (n = 5) or no treatment (n = 5) survived longer than 50 and 33 minutes, respectively. Statistical significance was observed for the survival rate between the animals treated with a craniectomy + HFHD (n = 5) versus those treated with craniectomy only (n = 5) (p < 0.001), and craniectomy + HFHD versus no treatment (n = 5) (p < 0.001). Histological analysis demonstrated no significant cell loss in the cortex subjacent to HFHD application. CONCLUSIONS: Here, the authors demonstrate the feasibility of their HFHD to treat cerebral edema in this model. These results indicate that controlled water extraction from edematous brain tissue can be performed and can lead to increased survival compared with craniectomy only. Further studies remain to be performed to further optimize the HFHD and to test it in more clinically relevant models, such as traumatic brain injury.


Subject(s)
Brain Edema/therapy , Decompressive Craniectomy/instrumentation , Disease Models, Animal , Drainage/instrumentation , Hydrogels , Prostheses and Implants , Animals , Brain Edema/pathology , Cerebral Cortex/pathology , Equipment Design , Feasibility Studies , Female , Humans , Mice , Water Intoxication/pathology , Water Intoxication/therapy
15.
Exp Neurol ; 235(1): 246-55, 2012 May.
Article in English | MEDLINE | ID: mdl-22361023

ABSTRACT

Recent evidence suggests that astrocytes may be a potential new target for the treatment of epilepsy. The glial water channel aquaporin-4 (AQP4) is expressed in astrocytes, and along with the inwardly-rectifying K(+) channel K(ir)4.1 is thought to underlie the reuptake of H(2)O and K(+) into glial cells during neural activity. Previous studies have demonstrated increased seizure duration and slowed potassium kinetics in AQP4(-/-) mice, and redistribution of AQP4 in hippocampal specimens from patients with chronic epilepsy. However, the regulation and role of AQP4 during epileptogenesis remain to be defined. In this study, we examined the expression of AQP4 and other glial molecules (GFAP, K(ir)4.1, glutamine synthetase) in the intrahippocampal kainic acid (KA) model of epilepsy and compared behavioral and histologic outcomes in wild-type mice vs. AQP4(-/-) mice. Marked and prolonged reduction in AQP4 immunoreactivity on both astrocytic fine processes and endfeet was observed following KA status epilepticus in multiple hippocampal layers. In addition, AQP4(-/-) mice had more spontaneous recurrent seizures than wild-type mice during the first week after KA SE as assessed by chronic video-EEG monitoring and blinded EEG analysis. While both genotypes exhibited similar reactive astrocytic changes, granule cell dispersion and CA1 pyramidal neuron loss, there were an increased number of fluorojade-positive cells early after KA SE in AQP4(-/-) mice. These results indicate a marked reduction of AQP4 following KA SE and suggest that dysregulation of water and potassium homeostasis occurs during early epileptogenesis. Restoration of astrocytic water and ion homeostasis may represent a novel therapeutic strategy.


Subject(s)
Aquaporin 4/metabolism , Astrocytes/metabolism , Hippocampus/metabolism , Seizures/metabolism , Status Epilepticus/metabolism , Animals , Aquaporin 4/genetics , Glial Fibrillary Acidic Protein/genetics , Glial Fibrillary Acidic Protein/metabolism , Kainic Acid , Male , Mice , Neurons/metabolism , Seizures/chemically induced , Seizures/genetics , Status Epilepticus/chemically induced , Status Epilepticus/genetics
16.
Epilepsy Res ; 98(2-3): 264-8, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21996149

ABSTRACT

We investigated the role of aquaporin-4 in the development of cerebral edema following kainic acid-induced status epilepticus (SE) using specific gravimetry and T2 MRI techniques at 6 h, 1 day, 4 days and 7 days after SE. Our results indicate significantly greater tissue edema and T2 MRI changes in AQP4(-/-) compared to AQP4(+/+) mice that peaks at about 1 day after SE (greater in hippocampus relative to cortex). These results have implications for the mechanisms of edema formation and clearance following intense seizure activity.


Subject(s)
Aquaporin 4/metabolism , Brain Edema/etiology , Brain Edema/metabolism , Status Epilepticus/complications , Animals , Aquaporin 4/deficiency , Brain Edema/pathology , Brain Mapping , Cerebral Cortex/metabolism , Disease Models, Animal , Hippocampus/metabolism , Kainic Acid/toxicity , Magnetic Resonance Imaging , Male , Mice , Mice, Knockout , Status Epilepticus/chemically induced , Time Factors , Water/metabolism
17.
J Biomed Opt ; 16(1): 011015, 2011.
Article in English | MEDLINE | ID: mdl-21280902

ABSTRACT

We present an approach for rapidly and quantitatively mapping tissue absorption and scattering spectra in a wide-field, noncontact imaging geometry by combining multifrequency spatial frequency domain imaging (SFDI) with a computed-tomography imaging spectrometer (CTIS). SFDI overcomes the need to spatially scan a source, and is based on the projection and analysis of periodic structured illumination patterns. CTIS provides a throughput advantage by simultaneously diffracting multiple spectral images onto a single CCD chip to gather spectra at every pixel of the image, thus providing spatial and spectral information in a single snapshot. The spatial-spectral data set was acquired 30 times faster than with our wavelength-scanning liquid crystal tunable filter camera, even though it is not yet optimized for speed. Here we demonstrate that the combined SFDI-CTIS is capable of rapid, multispectral imaging of tissue absorption and scattering in a noncontact, nonscanning platform. The combined system was validated for 36 wavelengths between 650-1000 nm in tissue simulating phantoms over a range of tissue-like absorption and scattering properties. The average percent error for the range of absorption coefficients (µa) was less than 10% from 650-800 nm, and less than 20% from 800-1000 nm. The average percent error in reduced scattering coefficients (µs') was less than 5% from 650-700 nm and less than 3% from 700-1000 nm. The SFDI-CTIS platform was applied to a mouse model of brain injury in order to demonstrate the utility of this approach in characterizing spatially and spectrally varying tissue optical properties.


Subject(s)
Brain Chemistry , Brain Injuries/diagnosis , Nephelometry and Turbidimetry/instrumentation , Oxygen/analysis , Spectrum Analysis/instrumentation , Tomography, X-Ray Computed/instrumentation , Animals , Equipment Design , Equipment Failure Analysis , Mice , Phantoms, Imaging , Reproducibility of Results , Sensitivity and Specificity , Systems Integration
18.
J Neurosurg ; 114(2): 470-7, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20205509

ABSTRACT

OBJECT: Cerebral edema is a significant cause of morbidity and mortality in diverse disease states. Currently, the means to detect progressive cerebral edema in vivo includes the use of intracranial pressure (ICP) monitors and/or serial radiological studies. However, ICP measurements exhibit a high degree of variability, and ICP monitors detect edema only after it becomes sufficient to significantly raise ICP. The authors report the development of 2 distinct minimally invasive fiberoptic near-infrared (NIR) techniques able to directly detect early cerebral edema. METHODS: Cytotoxic brain edema was induced in adult CD1 mice via water intoxication by intraperitoneal water administration (30% body weight intraperitoneally). An implantable dual-fiberoptic probe was stereotactically placed into the cerebral cortex and connected to optical source and detector hardware. Optical sources consisted of either broadband halogen illumination or a single-wavelength NIR laser diode, and the detector was a sensitive NIR spectrometer or optical power meter. In one subset of animals, a left-sided craniectomy was performed to obtain cortical biopsies for water-content determination to verify cerebral edema. In another subset of animals, an ICP transducer was placed on the contralateral cortex, which was synchronized to a computer and time stamped. RESULTS: Using either broadband illumination with NIR spectroscopy or single-wavelength laser diode illumination with optical power meter detection, the authors detected a reduction in NIR optical reflectance during early cerebral edema. The time intervals between water injection (Time Point 0), optical trigger (defined as a 2-SD change in optical reflectance from baseline), and defined threshold ICP values of 10, 15 and 20 mm Hg were calculated. Reduction in NIR reflectance occurred significantly earlier than any of the ICP thresholds (p < 0.001). Saline-injected control mice exhibited a steady baseline optical signal. There was a significant correlation between reflectance change and tissue specific gravity of the cortical biopsies, further validating the dual-fiberoptic probe as a direct measure of cerebral edema. CONCLUSIONS: Compared with traditional ICP monitoring, the aforementioned minimally invasive NIR techniques allow for the significantly earlier detection of cerebral edema, which may be of clinical utility in the identification and thus early treatment of cerebral edema.


Subject(s)
Brain Edema/diagnosis , Spectroscopy, Near-Infrared/methods , Water Intoxication/complications , Animals , Aquaporin 4/genetics , Brain Edema/etiology , Intracranial Pressure , Mice , Mice, Knockout
19.
Ann Neurol ; 67(6): 794-801, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20517941

ABSTRACT

OBJECTIVE: Spinal cord injury (SCI) is accompanied by disruption of the blood-spinal cord barrier and subsequent extravasation of fluid and proteins, which results in edema (increased water content) at the site of injury. However, the mechanisms that control edema and the extent to which edema impacts outcome after SCI are not well elucidated. METHODS: Here, we examined the role of aquaporin-4 (AQP4) water channels after experimental contusion injury in mice, a clinically relevant animal model of SCI. RESULTS: Mice lacking AQP4 (AQP4(-/-) mice) exhibited significantly impaired locomotor function and prolonged bladder dysfunction compared with wild-type (WT) littermates after contusion SCI. Consistent with a greater extent of functional deterioration, AQP4(-/-) mice showed greater neuronal loss and demyelination, with prominent cyst formation, which is generally absent in mouse SCI. The extent of spinal cord edema, as expressed by percentage water content, was persistently increased above control levels in AQP4(-/-) mice but not WT mice at 14 and 28 days after injury. Immunohistochemical analysis indicated that blood vessels in the vicinity of the lesion core had incomplete barrier function because of sparse tight junctions. INTERPRETATION: These results suggest that AQP4 plays a protective role after contusion SCI by facilitating the clearance of excess water, and that targeting edema after SCI may be a novel therapeutic strategy.


Subject(s)
Aquaporin 4/metabolism , Spinal Cord Injuries/genetics , Spinal Cord Injuries/prevention & control , Animals , Apoptosis/genetics , Aquaporin 4/deficiency , Disease Models, Animal , Edema/etiology , Fibronectins/metabolism , In Situ Nick-End Labeling/methods , Locomotion/drug effects , Locomotion/genetics , Mice , Mice, Knockout , Movement Disorders/etiology , Psychomotor Performance/physiology , Recovery of Function/genetics , Spinal Cord Injuries/complications , Spinal Cord Injuries/pathology , Time Factors , Urinary Bladder Diseases/etiology
20.
Neuron Glia Biol ; 3(4): 287-97, 2007 Nov.
Article in English | MEDLINE | ID: mdl-18634561

ABSTRACT

Recent studies have implicated glial cells in novel physiological roles in the CNS, such as modulation of synaptic transmission, so it is possible that glial cells might have a functional role in the hyperexcitability that is characteristic of epilepsy. Indeed, alterations in distinct astrocyte membrane channels, receptors and transporters have all been associated with the epileptic state. This paper focuses on the potential roles of the glial water channel aquaporin-4 (AQP4) in modulating brain excitability and in epilepsy. We review studies of seizure phenotypes, K(+) homeostasis and extracellular space physiology of mice that lack AQP4 (AQP4(-/-) mice) and discuss the human studies demonstrating alterations of AQP4 in specimens of human epilepsy tissue. We conclude with new studies of AQP4 regulation by seizures and discuss its potential role in the development of epilepsy (epileptogenesis). Although many questions remain unanswered, the available data indicate that AQP4 and its molecular partners might represent important new therapeutic targets.

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