Hyperbaric Oxygen Therapy Associated with Ventricular-Subcutaneous Shunt Promotes Neuroprotection in Young Hydrocephalic Rats.

Hydrocephalus is characterized by the accumulation of CSF within the cerebral ventricles and the subarachnoid space. Ventricular volume can progressively increase and generate serious damage to the nervous system, with cerebral hypoxia/ischemia as one of the most important factors involved. Hyperbaric oxygen therapy (HBOT) improves oxygen supply to tissues, which can reduce the progression of lesions secondary to ventricular enlargement. We evaluated whether HBOT associated with CSF diversion can promote neuroprotective effects to structures damaged by ventriculomegaly and understand its role. Seven-day-old male Wistar Hannover rats submitted to hydrocephalus by intracisternal injection of 15% kaolin were used. The animals were divided into six groups, with ten animals in each: control, control associated with hyperbaric therapy, hydrocephalic without treatment, hydrocephalic treated with hyperbaric oxygen therapy, hydrocephalic treated with CSF deviation, and hydrocephalic treated with hyperbaric oxygen therapy associated with CSF deviation. To assess the response to treatment, behavioral tests were performed such as modified Morris water maze and object recognition, evaluation by transcranial ultrasonography, histology by Hematoxylin-Eosin and Luxol Fast Blue, immunohistochemistry for GFAP, Ki-67, Caspase-3, COX-2, NeuN and SOD1, and biochemical ELISA assay for GFAP and MBP. The results show that the association of treatments exerts neuroprotective effects such as neurobehavioral improvement, preservation of periventricular structures, antioxidant effect, and reduction of damage resulting from ischemia and the neuroinflammatory process. We conclude that HBOT has the potential to be used as an adjuvant treatment to CSF deviation surgery in experimental hydrocephalus.

Transcranial ultrasonography as a reliable instrument for the measurement of the cerebral ventricles in rats with experimental hydrocephalus: a pilot study.

PURPOSES: Demonstrate that transcranial ultrasonography (TUS) scanning is viable and useful as a diagnostic method in experimental hydrocephalus, as well as to compare measurements of cerebral and ventricular width obtained from TUS scans of hydrocephalic rats with post-mortem anatomical specimens, aiming for the development of accurate criteria to establish ventricular enlargement and progression of hydrocephalus subsequently. METHODS: Thirty-five male Wistar rats were used. Following hydrocephalus induction, they underwent a transcranial ultrasound scan to measure cerebral and ventricular dimensions, in the fourth and 21 post-induction days. By the end of the experiments, measurements obtained from TUS scans were compared with actual values as seen in the post-mortem specimens of each animal. RESULTS: Ventricular dilation could be clearly visualized in hydrocephalic animals. We performed intraclass correlation coefficient and linear regression analyses that have demonstrated a precise correlation between measurements of TUS scans and post-mortem specimens; we have found a similarity of 0,95 for the cerebral diameter and 0,97 for ventricular width. CONCLUSIONS: Transcranial ultrasonography is a useful and reliable diagnostic tool for experimental hydrocephalus; also, it can be used to assess the progression of ventriculomegaly in animal models of hydrocephalus.

Protocolo intensivo de reabilitação para o desenvolvimento neuropsicomotor em uma criança com microcefalia: um estudo de caso / Intensive rehabilitation protocol for neuropsychomotor development in a child with microcephaly: a case report

A microcefalia é uma doença de origem multifatorial podendo ser desenvolvida de forma congênita ou por causas ambientais. Ela atinge os ossos da calota craniana, causando o fechamento prematuro das fontanelas, no qual restringe o espaço interno do crânio, que em consequência afeta o crescimento e desenvolvimento normal do encéfalo, levando a disfunções neuropsicomotoras leves, moderadas ou graves. Desta forma, este estudo tem como objetivo avaliar o desenvolvimento neuropsicomotor de uma criança com microcefalia, antes e após um protocolo fisioterapêutico intensivo. Trata-se de relato de caso no qual foram avaliados os marcos motores e os níveis de função apresentados pelo paciente, antes e após um protocolo fisioterapêutico intensivo, realizado por um período de 30 dias consecutivos. Foram obtidos importantes resultados no controle de cervical, alinhamento de cabeça em linha média, manuseio de objetos, elevação das mãos à boca e alinhamento postural. Desta forma, conclui-se que o protocolo fisioterapêutico intensivo é uma alternativa eficaz que auxilia e potencializa o desenvolvimento neuropsicomotor da criança

Microcephaly is a multifactorial disease that can be developed congenitally or due to environmental causes. It affects the skullcap bones, causing premature fontanelles closure, in which it restricts the internal skull space, which consequently affects the growth and normal development of the brain, leading to mild, moderate or severe neuropsychomotor disorders. Thus, this study aims to evaluate the neuropsychomotor development of a child with microcephaly, before and after an intensive physical therapy protocol. This is a case report in which the motor milestones and function levels were evaluated before and after an intensive physical therapy protocol performed for a consecutive 30 days period. Important results were obtained in cervical control, midline head alignment, object handling, lifting hands to mouth and postural alignment. Thus, it is concluded that the intensive physical therapy protocol is an effective alternative that helps and enhances the child's neuropsychomotor development

Effective Parameters for Gait Analysis in Experimental Models for Evaluating Peripheral Nerve Injuries in Rats.

OBJECTIVE: Chronic constriction injury (CCI) of the sciatic nerve is a peripheral nerve injury widely used to induce mononeuropathy. This study used machine learning methods to identify the best gait analysis parameters for evaluating peripheral nerve injuries. METHODS: Twenty-eight male Wistar rats (weighing 270±10 g), were used in the present study and divided into the following 4 groups: CCI with 4 ligatures around the sciatic nerve (CCI-4L; n=7), a modified CCI model with 1 ligature (CCI-1L; n=7), a sham group (n=7), and a healthy control group (n=7). All rats underwent gait analysis 7 and 28 days postinjury. The data were evaluated using Kinovea and WeKa software (machine learning and neural networks). RESULTS: In the machine learning analysis of the experimental groups, the pre-swing (PS) angle showed the highest ranking in all 3 analyses (sensitivity, specificity, and area under the receiver operating characteristics curve using the Naive Bayes, k-nearest neighbors, radial basis function classifiers). Initial contact (IC), step length, and stride length also performed well. Between 7 and 28 days after injury, there was an increase in the total course time, step length, stride length, stride speed, and IC, and a reduction in PS and IC-PS. Statistically significant differences were found between the control group and experimental groups for all parameters except speed. Interactions between time after injury and nerve injury type were only observed for IC, PS, and IC-PS. CONCLUSION: PS angle of the ankle was the best gait parameter for differentiating nonlesions from nerve injuries and different levels of injury.

Aerobic exercise in adolescence results in an increase of neuronal and non-neuronal cells and in mTOR overexpression in the cerebral cortex of rats.

Better cognitive performance and greater cortical and hippocampal volume have been observed in individuals who undertook aerobic exercise during childhood and adolescence. One possible explanation for these beneficial effects is that juvenile physical exercise enables better neural development and hence more cells and neuronal circuitries. It is probable that such effects occur through intracellular signaling proteins associated with cell growth, proliferation and survival. Based on this information, we evaluated the number of neuronal and non-neuronal cells using isotropic fractionation and the expression and activation of intracellular proteins (ERK, CREB, Akt, mTOR and p70S6K) in the cerebral cortex and hippocampal formation of the rats submitted to a physical exercise program on a treadmill during adolescence. Results showed that physical exercise increases the number of neuronal and non-neuronal cortical cells and hippocampal neuronal cells in adolescent rats. Moreover, mTOR overexpression was found in the cortical region of exercised adolescent rats. These findings indicate a significant cellular proliferative effect of aerobic exercise on the cerebral cortex in postnatal development.

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service.

OBJECTIVE: Characterize the social profile and the need of information from patients with refractory epilepsy. METHOD: A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. RESULTS: Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. CONCLUSION: As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service / O contexto social e a necessidade de informações de pacientes com epilepsia: avaliando um serviço terciário de referência

Objective Characterize the social profile and the need of information from patients with refractory epilepsy. Method A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Results Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. Conclusion : As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge. .

Objetivo : Caracterizar o perfil social e a necessidade de informações por parte de pacientes com epilepsia refratária. Método Um questionário semi-estruturado foi aplicado a 103 pacientes para investigar aspectos sociodemográficos, farmacoterapia e quaisquer dúvidas sobre epilepsia. Resultados Os pacientes mostraram-se altamente dependentes de um fornecimento gratuito e acessível de drogas antiepilépticas. Sessenta e oito por cento da população estava desempregada, e 26% confirmaram receber algum benefício social devido à epilepsia. Vinte e nove por cento da população alcançou ensino médio. Oitenta e cinco por cento dos pacientes tinha ao menos uma dúvida sobre epilepsia; tratamento e aspectos gerais da epilepsia foram os principais temas. Conclusão Tal qual observado em países desenvolvidos, pacientes com epilepsia refratária em países em desenvolvimento também apresentam altas taxas de desemprego e baixos níveis educacionais. Os resultados são preocupantes no que diz respeito à necessidade de informações sobre epilepsia por parte dos pacientes e seus familiares, apontando a necessidade de se investir em estratégias que solucionem esta deficiência de conhecimento. .