Brain & spine最新文献

{"title":"Current state of the art of traditional and minimal invasive epilepsy surgery approaches","authors":"Fabian Winter ,&nbsp;Marie T. Krueger ,&nbsp;Daniel Delev ,&nbsp;Tom Theys ,&nbsp;Dirk MP Van Roost ,&nbsp;Kostas Fountas ,&nbsp;Olaf E.M.G. Schijns ,&nbsp;Karl Roessler","doi":"10.1016/j.bas.2024.102755","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102755","url":null,"abstract":"<div><h3>Introduction</h3><p>Open resective surgery remains the main treatment modality for refractory epilepsy, but is often considered a last resort option due to its invasiveness.</p></div><div><h3>Research question</h3><p>This manuscript aims to provide an overview on traditional as well as minimally invasive surgical approaches in modern state of the art epilepsy surgery.</p></div><div><h3>Materials and methods</h3><p>This narrative review addresses both historical and contemporary as well as minimal invasive surgical approaches in epilepsy surgery. Peer-reviewed published articles were retrieved from PubMed and Scopus. Only articles written in English were considered for this work. A range of traditional and minimally invasive surgical approaches in epilepsy surgery were examined, and their respective advantages and disadvantages have been summarized.</p></div><div><h3>Results</h3><p>The following approaches and techniques are discussed: minimally invasive diagnostics in epilepsy surgery, anterior temporal lobectomy, functional temporal lobectomy, selective amygdalohippocampectomy through a transsylvian, transcortical, or subtemporal approach, insulo-opercular corticectomies compared to laser interstitial thermal therapy, radiofrequency thermocoagulation, stereotactic radiosurgery, neuromodulation, high intensity focused ultrasound, and disconnection surgery including callosotomy, hemispherotomy, and subpial transections.</p></div><div><h3>Discussion and conclusion</h3><p>Understanding the benefits and disadvantages of different surgical approaches and strategies in traditional and minimal invasive epilepsy surgery might improve the surgical decision tree, as not all procedures are appropriate for all patients.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000110/pdfft?md5=4cb746ee6b619469417314d687c58162&pid=1-s2.0-S2772529424000110-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140014403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis","authors":"Hantz Filbert C. Siy,&nbsp;Michael Louis A. Gimenez","doi":"10.1016/j.bas.2024.102773","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102773","url":null,"abstract":"<div><h3>Introduction</h3><p>TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on mortality is about 10% across all ages. Amantadine hydrochloride is one of the most commonly prescribed medications for patients undergoing inpatient neurorehabilitation who have disorders of consciousness.⁶ It is a dopamine (DA) receptor agonist and a N-Methyl-D-aspartate (NMDA) receptor antagonist via dopamine release and dopamine reuptake inhibition. The current study will synthesize the current available evidence and show the effect of Amantadine in functional improvement after TBI.</p></div><div><h3>Research question</h3><p>Does Amantadine have an effect on functional improvement of TBI patients?</p></div><div><h3>Material and methods</h3><p>This systematic review included all randomized placebo-controlled trials that compare the use of Amantadine versus placebo for functional improvement of patients after TBI. Outcome measures included DRS, GCS and/or GOS scores.</p></div><div><h3>Results</h3><p>Three studies with a total of 281 patients were included in the quantitative analyses. GRADE assessments show that there was a high certainty of evidence for functional improvement in terms of DRS scores.</p></div><div><h3>Discussion and conclusion</h3><p>Evidence of this review show that the use of Amantadine may have a beneficial effect on functional outcome in moderate to severe traumatic brain injuries among adult patients. Given the still-limited body of knowledge, more relevant studies must be made exploring the impact of Amantadine therapies on promoting functional recovery within the brain injury rehabilitation care continuum, with the goals of achieving larger sample sizes and establishing the early- or later-treatment beneficial effects.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000298/pdfft?md5=90439e715248683847cecce8d54f55ef&pid=1-s2.0-S2772529424000298-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140031316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostication or predestination?","authors":"José Pedro Lavrador,&nbsp;Savvas Vlachos","doi":"10.1016/j.bas.2024.102793","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102793","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000493/pdfft?md5=5a5f9fc44804f9a596972a48bfc48264&pid=1-s2.0-S2772529424000493-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140328772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of uncertainty of PRx time trends","authors":"Erta Beqiri ,&nbsp;Michal M. Placek ,&nbsp;Ka Hing Chu ,&nbsp;Joseph Donnelly ,&nbsp;Giada Cucciolini ,&nbsp;Virginia Motroni ,&nbsp;Claudia A. Smith ,&nbsp;Marek Czosnyka ,&nbsp;Peter Hutchinson ,&nbsp;Peter Smielewski","doi":"10.1016/j.bas.2024.102795","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102795","url":null,"abstract":"<div><h3>Introduction</h3><p>PRx can be used as surrogate measure of Cerebral Autoregulation (CA) in traumatic brain injury (TBI) patients. PRx can provide means for individualising cerebral perfusion pressure (CPP) targets, such as CPPopt. However, a recent Delphi consensus of clinicians concluded that consensus could not be reached on the accuracy, reliability, and validation of any current CA assessment method.</p></div><div><h3>Research question</h3><p>We aimed to quantify the short-term uncertainty of PRx time-trends and to relate this to other physiological measurements.</p></div><div><h3>Material and methods</h3><p>Intracranial pressure (ICP), arterial blood pressure (ABP), end-tidal CO₂ (EtCO₂) high-resolution recordings of 911 TBI patients were processed with ICM + software. Hourly values of metrics that describe the variability within modalities derived from ABP, ICP and EtCO₂, were calculated for the first 24h of neuromonitoring. Generalized additive models were used to describe the time trend of the variability in PRx. Linear correlations were studied for describing the relationship between PRx variability and the other physiological modalities.</p></div><div><h3>Results</h3><p>The time profile of variability of PRx decreases over the first 12h and was higher for average PRx ∼0. Increased variability of PRx was not linearly linked with average ABP, ICP, or CPP. For coherence between slow waves of ABP and ICP &gt;0.7, the variability in PRx decreased (R = −0.47, p &lt; 0.001).</p></div><div><h3>Discussion and conclusion</h3><p>PRx is a highly variable parameter. PRx short-term dispersion was not related to average ICP, ABP or CPP. The determinants of uncertainty of PRx should be investigated to improve reliability of individualised CA assessment in TBI patients.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000511/pdfft?md5=5f136c6605137604530aac354e2b366c&pid=1-s2.0-S2772529424000511-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evidence based conceptual framework for the multifactorial understanding of proximal junctional kyphosis","authors":"Pearce B. Haldeman ,&nbsp;Samuel R. Ward ,&nbsp;Joseph Osorio ,&nbsp;Bahar Shahidi","doi":"10.1016/j.bas.2024.102807","DOIUrl":"10.1016/j.bas.2024.102807","url":null,"abstract":"<div><h3>Introduction</h3><p>Adult spinal deformity (ASD) is a debilitating pathology that arises from a variety of etiologies. Spinal fusion surgery is the mainstay of treatment for those who do not achieve symptom relief with conservative interventions. Fusion surgery can be complicated by a secondary deformity termed proximal junctional kyphosis (PJK).</p></div><div><h3>Research question</h3><p>This scoping review evaluates the modern body of literature analyzing risk factors for PJK development and organizes these factors according to a multifactorial framework based on mechanical, tissue or demographic components.</p></div><div><h3>Materials and methods</h3><p>An extensive search of the literature was performed in PubMed and Embase back to the year 2010. Articles were assessed for quality. All risk factors that were evaluated and those that significantly predicted the development of PJK were compiled. The frequency that a risk factor was predictive compared to the number of times it was evaluated was calculated.</p></div><div><h3>Results</h3><p>150 articles were reviewed. 57.3% of papers were of low quality. 76% of risk factors analyzed were focusing on the mechanical contribution to development of PJK versus only 5% were focusing on the tissue-based contribution. Risk factors that were most frequently predictive compared to how often they were analyzed were Hounsfield Units of vertebrae, UIV disc degeneration, paraspinal muscle cross sectional area and fatty infiltration, ligament augmentation, instrument characteristics, postoperative hip and lower extremity radiographic metrics, and postoperative teriparatide supplementation.</p></div><div><h3>Discussion and conclusion</h3><p>This review finds a multifactorial framework accounting for mechanical, patient and tissue-based risk factors will improve the understanding of PJK development.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000638/pdfft?md5=31ff91ebec3667a62a4758bd8a79fbb8&pid=1-s2.0-S2772529424000638-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing image normalization techniques in an end-to-end model for automated modic changes classification from MRI images","authors":"Andrea Cina ,&nbsp;Daniel Haschtmann ,&nbsp;Dimitrios Damopoulos ,&nbsp;Nicolas Gerber ,&nbsp;Markus Loibl ,&nbsp;Tamas Fekete ,&nbsp;Frank Kleinstück ,&nbsp;Fabio Galbusera","doi":"10.1016/j.bas.2023.102738","DOIUrl":"https://doi.org/10.1016/j.bas.2023.102738","url":null,"abstract":"<div><h3>Introduction</h3><p>Modic Changes (MCs) are MRI alterations in spine vertebrae's signal intensity. This study introduces an end-to-end model to automatically detect and classify MCs in lumbar MRIs. The model's two-step process involves locating intervertebral regions and then categorizing MC types (MC0, MC1, MC2) using paired T1-and T2-weighted images. This approach offers a promising solution for efficient and standardized MC assessment.</p></div><div><h3>Research question</h3><p>The aim is to investigate how different MRI normalization techniques affect MCs classification and how the model can be used in a clinical setting.</p></div><div><h3>Material and methods</h3><p>A combination of Faster R–CNN and a 3D Convolutional Neural Network (CNN) is employed. The model first identifies intervertebral regions and then classifies MC types (MC0, MC1, MC2) using paired T1-and T2-weighted lumbar MRIs. Two datasets are used for model development and evaluation.</p></div><div><h3>Results</h3><p>The detection model achieves high accuracy in identifying intervertebral areas, with Intersection over Union (IoU) values above 0.7, indicating strong localization alignment. Confidence scores above 0.9 demonstrate the model's accurate levels identification. In the classification task, standardization proves the best performances for MC type assessment, achieving mean sensitivities of 0.83 for MC0, 0.85 for MC1, and 0.78 for MC2, along with balanced accuracy of 0.80 and F1 score of 0.88.</p></div><div><h3>Discussion and conclusion</h3><p>The study's end-to-end model shows promise in automating MC assessment, contributing to standardized diagnostics and treatment planning. Limitations include dataset size, class imbalance, and lack of external validation. Future research should focus on external validation, refining model generalization, and improving clinical applicability.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529423010263/pdfft?md5=5c4b4b0fbead3bbed18f403c823c0e95&pid=1-s2.0-S2772529423010263-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature","authors":"Björn Sommer ,&nbsp;Ina Konietzko ,&nbsp;Maximilian Niklas Bonk ,&nbsp;Tina Schaller ,&nbsp;Bruno Märkl ,&nbsp;Klaus Henning Kahl ,&nbsp;Georg Stüben ,&nbsp;Johannes Zenk ,&nbsp;Ehab Shiban","doi":"10.1016/j.bas.2023.102740","DOIUrl":"https://doi.org/10.1016/j.bas.2023.102740","url":null,"abstract":"<div><h3>Introduction</h3><p>The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus.</p></div><div><h3>Research question</h3><p>Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction.</p></div><div><h3>Material and methods</h3><p>In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and December 2022. Complications were analysed with regards to the type of skull base reconstruction.</p></div><div><h3>Results</h3><p>Eleven patients were identified (2 female, 9 male, age (median, SD) 64 ± 14.1 years (range 38–81). There were nine cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 22.5 ± 28 months (range: 5–78), progression free survival was 17.0 ± 20.3 months (range: 11–78). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 50% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group.</p></div><div><h3>Discussion and conclusion</h3><p>The structural reinforcement of structural bone chip grafting might provide additional support of the ASB and prevent CSF leakage or encephalocele. Especially in large (&gt;10 cm²) bone defects of advanced sinonasal malignancies extending into the middle cranial fossa, the full armamentarium of reconstruction possibilities should be considered.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529423010287/pdfft?md5=1929edb78ddeeb681331d505531debe0&pid=1-s2.0-S2772529423010287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent perception of telemetric intracranial pressure monitoring in children - A qualitative case study","authors":"Sarah Hornshøj Pedersen ,&nbsp;Sara Duus Gustafsen ,&nbsp;Marianne Juhler ,&nbsp;Rikke Guldager","doi":"10.1016/j.bas.2024.102820","DOIUrl":"10.1016/j.bas.2024.102820","url":null,"abstract":"<div><h3>Introduction</h3><p>Telemetric monitoring of intracranial pressure (ICP) in children with a complex cerebrospinal disorder might help parents distinguish acute and potential life-threatening symptoms of hydrocephalus from other illnesses.</p></div><div><h3>Research question</h3><p>What is patient and parent perceptions of system utility of telemetric ICP monitoring, and how does a long-term telemetric implant influence daily life of both patients and their families?</p></div><div><h3>Material and methods</h3><p>A qualitative case study design with a focus group interview including parents of children with a complex cerebrospinal fluid disorder and an implanted telemetric ICP sensor.</p></div><div><h3>Results</h3><p>Three parents participated. Based on thematic analysis, three themes were created: ‘Daily living with telemetric ICP monitoring’, ‘Parenting a child with a CSF disorder’, and ‘The healthy sibling’. The ICP sensor provided the parents with security and made them trust their intuition, while the possibility of home monitoring ensured stability for the entire family and had a calming effect on healthy siblings. Home monitoring was seen as the system's greatest advantages, whereas size, weight, and functionality of the external monitoring equipment were highlighted as disadvantages.</p></div><div><h3>Discussion and conclusion</h3><p>All parents supported the telemetric ICP sensor as a valued tool in treatment guidance of their child and stated that advantages exceeded disadvantages. It was stated that the possibility of conducting ICP measurements at home reduced the need for acute hospital admissions, which consequently led to a more stable daily life for the entire family. Suggestions regarding technical improvements with focus on more compatible external monitoring equipment were raised by all parents included.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000766/pdfft?md5=8025452735175c5fe031e0ba963ba485&pid=1-s2.0-S2772529424000766-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Surgery Of Brain Tumors In Language Areas: The Role Of Preoperative Brain Mapping In Patients Not Eligible For Awake Surgery","authors":"Giovanni Raffa ,&nbsp;Giuseppina Marzano ,&nbsp;Antonello Curcio ,&nbsp;Shervin Espahpodinea ,&nbsp;Antonino Germanò ,&nbsp;Filippo Flavio Angileri","doi":"10.1016/j.bas.2024.103405","DOIUrl":"10.1016/j.bas.2024.103405","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial food dyes are toxic: Neurobehavioral implications in children","authors":"Gokul Sudhakaran","doi":"10.1016/j.bas.2024.102869","DOIUrl":"10.1016/j.bas.2024.102869","url":null,"abstract":"<div><p>Emerging research highlights the potential neurobehavioral impacts of synthetic food dyes on children, prompting a reevaluation of their safety and regulatory standards. This letter discusses recent findings that associate synthetic food dyes with adverse behavioral outcomes, such as hyperactivity, particularly in children with or without identified behavioral disorders. It calls for updated regulatory guidelines that reflect current research, advocating for protecting children's behavioral health.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424001255/pdfft?md5=c2a7bb6e402a5fd66fe4eb87a66f19e5&pid=1-s2.0-S2772529424001255-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}