scholarly journals Cingulate Gyrus Access with Focused Ultrasound Ablation

2021 ◽  
Author(s):  
Brian Dalm ◽  
Francesco Sammartino ◽  
James Mossner
Keyword(s):  
Focused Ultrasound ◽  
Terminally Ill ◽  
Anterior Cingulate ◽  
Neurosurgical Procedures ◽  
Cingulate Gyrus ◽  
Number Of Patients ◽  
Surgical Incisions ◽  
Inpatient Settings ◽  
Ultrasound Ablation ◽  
Pain Patients

Cancer is associated with pain in a high number of patients. The higher the stage of cancer the more likely there is an associated pain condition. With terminally ill cancer pain patients, ablative neurosurgical procedures can significantly improve pain and transition patients out of inpatient settings and into post hospital care settings. These procedures require surgical incisions which poses a risk in this delicate population. The current study aims to determine if the ExAblate system has the capability of reaching the anterior cingulate gyrus, a common site for targeting cancer associated pain in terminally ill patients.

In-vivo topography of structural alterations of the anterior cingulate gyrus in schizophrenia

2007 ◽  
Vol 40 (05) ◽  
Author(s):  
T Zetzsche ◽  
UW Preuss ◽  
T Frodl ◽  
D Watz ◽  
G Schmitt ◽  
...  
Keyword(s):  
Anterior Cingulate ◽  
Cingulate Gyrus ◽  
Anterior Cingulate Gyrus ◽  
Structural Alterations

Technical and radiographic considerations for magnetic resonance imaging–guided focused ultrasound capsulotomy

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Benjamin Davidson ◽  
Karim Mithani ◽  
Yuexi Huang ◽  
Ryan M. Jones ◽  
Maged Goubran ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Neurosurgical Procedures ◽  
Lesion Volume ◽  
Angle Of Incidence ◽  
Resonance Imaging ◽  
Radiographic Findings ◽  
Compulsive Disorder ◽  
Skull Thickness

OBJECTIVEMagnetic resonance imaging–guided focused ultrasound (MRgFUS) is an emerging treatment modality that enables incisionless ablative neurosurgical procedures. Bilateral MRgFUS capsulotomy has recently been demonstrated to be safe and effective in treating obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Preliminary evidence has suggested that bilateral MRgFUS capsulotomy can present increased difficulties in reaching lesional temperatures as compared to unilateral thalamotomy. The authors of this article aimed to study the parameters associated with successful MRgFUS capsulotomy lesioning and to present longitudinal radiographic findings following MRgFUS capsulotomy.METHODSUsing data from 22 attempted MRgFUS capsulotomy treatments, the authors investigated the relationship between various sonication parameters and the maximal temperature achieved at the intracranial target. Lesion volume and morphology were analyzed longitudinally using structural and diffusion tensor imaging. A retreatment procedure was attempted in one patient, and their postoperative imaging is presented.RESULTSSkull density ratio (SDR), skull thickness, and angle of incidence were significantly correlated with the maximal temperature achieved. MRgFUS capsulotomy lesions appeared similar to those following MRgFUS thalamotomy, with three concentric zones observed on MRI. Lesion volumes regressed substantially over time following MRgFUS. Fractional anisotropy analysis revealed a disruption in white matter integrity, followed by a gradual return to near-baseline levels concurrent with lesion regression. In the patient who underwent retreatment, successful bilateral lesioning was achieved, and there were no adverse clinical or radiographic events.CONCLUSIONSWith the current iteration of MRgFUS technology, skull-related parameters such as SDR, skull thickness, and angle of incidence should be considered when selecting patients suitable for MRgFUS capsulotomy. Lesions appear to follow morphological patterns similar to what is seen following MRgFUS thalamotomy. Retreatment appears to be safe, although additional cases will be necessary to further evaluate the associated safety profile.

scholarly journals Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

2021 ◽  
Vol 29 (4) ◽  
pp. 224-229 ◽  
Author(s):  
E. R. de Koning ◽  
M. J. Boogers ◽  
J. Bosch ◽  
M. de Visser ◽  
M. J. Schalij ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Cardiac Symptoms ◽  
Emergency Medical ◽  
Time Period ◽  
Number Of Patients ◽  
St Elevation ◽  
Pain Patients ◽  
Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

Brain reactivity to humorous films is affected by insomnia

SLEEP ◽  
2021 ◽  
Author(s):  
Ernesto Sanz-Arigita ◽  
Yannick Daviaux ◽  
Marc Joliot ◽  
Bixente Dilharreguy ◽  
Jean-Arthur Micoulaud-Franchi ◽  
...  
Keyword(s):  
Emotional Reactivity ◽  
Brain Activity ◽  
Brain Network ◽  
Anterior Cingulate ◽  
Neural Representation ◽  
Cingulate Gyrus ◽  
Anterior Cingulate Gyrus ◽  
Left Caudate ◽  
Neural Reactivity ◽  
The Right

Abstract Study objectives Emotional reactivity to negative stimuli has been investigated in insomnia, but little is known about emotional reactivity to positive stimuli and its neural representation. Methods We used 3T fMRI to determine neural reactivity during the presentation of standardized short, 10-40-s, humorous films in insomnia patients (n=20, 18 females, aged 27.7 +/- 8.6 years) and age-matched individuals without insomnia (n=20, 19 females, aged 26.7 +/- 7.0 years), and assessed humour ratings through a visual analogue scale (VAS). Seed-based functional connectivity was analysed for left and right amygdala networks: group-level mixed-effects analysis (FLAME; FSL) was used to compare amygdala connectivity maps between groups. Results fMRI seed-based analysis of the amygdala revealed stronger neural reactivity in insomnia patients than in controls in several brain network clusters within the reward brain network, without humour rating differences between groups (p = 0.6). For left amygdala connectivity, cluster maxima were in the left caudate (Z=3.88), left putamen (Z=3.79) and left anterior cingulate gyrus (Z=4.11), while for right amygdala connectivity, cluster maxima were in the left caudate (Z=4.05), right insula (Z=3.83) and left anterior cingulate gyrus (Z=4.29). Cluster maxima of the right amygdala network were correlated with hyperarousal scores in insomnia patients only. Conclusions Presentation of humorous films leads to increased brain activity in the neural reward network for insomnia patients compared to controls, related to hyperarousal features in insomnia patients, in the absence of humor rating group differences. These novel findings may benefit insomnia treatment interventions.

scholarly journals Focused ultrasound ablation of a large canine oral tumor achieves efficient tumor remission: a case report

2021 ◽  
Vol 38 (1) ◽  
pp. 552-560
Author(s):  
Ashish Ranjan ◽  
Deepan Kishore ◽  
Harshini Ashar ◽  
Tina Neel ◽  
Akansha Singh ◽  
...  
Keyword(s):  
Case Report ◽  
Focused Ultrasound ◽  
Oral Tumor ◽  
Ultrasound Ablation ◽  
Tumor Remission ◽  
Focused Ultrasound Ablation

scholarly journals Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions

2021 ◽  
Vol 10 (16) ◽  
pp. 3468
Author(s):  
Naomi I. Kremer ◽  
Rik W. J. Pauwels ◽  
Nicolò G. Pozzi ◽  
Florian Lange ◽  
Jonas Roothans ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Focused Ultrasound ◽  
Neurosurgical Procedures ◽  
Drug Resistant ◽  
Long Term Outcomes ◽  
Future Directions ◽  
Ventral Intermediate Nucleus ◽  
Deep Brain

Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In particular cases, radiofrequency thalamotomy, focused ultrasound and radiosurgery are proven alternatives to DBS. Besides, other DBS targets, such as the posterior subthalamic area (PSA) or the dentato-rubro-thalamic tract (DRT), may be appraised as well. In this review, the clinical characteristics and pathophysiology of tremor syndromes, as well as long-term outcomes of DBS in different targets, will be summarized. The effectiveness and safety of lesioning procedures will be discussed, and an evidence-based clinical treatment approach for patients with drug-resistant tremor will be presented. Lastly, the future directions in the treatment of severe tremor syndromes will be elaborated.

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