scholarly journals WHAT ADVANCEMENTS IN CLINICAL NEUROSCIENCES NEED TO OCCUR IN THE NEXT 10 YEARS?

2020 ◽  
Author(s):  
Emily Panteli ◽  
Gary Brennan
Keyword(s):  
Focal Epilepsy ◽  
Hippocampal Sclerosis ◽  
Seizure Threshold ◽  
Bibliographic Databases ◽  
Mossy Fibre ◽  
Medical Subject Headings ◽  
Transcriptional Dysregulation ◽  
Gene Dysregulation ◽  
Brain Changes ◽  
Latent Phase

Introduction: Temporal lobe epilepsy (TLE) is the commonest focal epilepsy. Acquired TLE is considered to occur as the result of a 3-phase process called epileptogenesis. Firstly, an ‘epileptogenic event’ occurs, for example traumatic brain injury. Next follows a latent period whereby hyperexcitable networks form and lower the seizure threshold. Finally, TLE emerges. The objective of this review is to investigate how gene dysregulation drives hyperexcitability during epileptogenesis. Methods: Searches were conducted using keywords and medical subject headings on bibliographic databases and complemented by Google searches and manual revision of reference lists of retrieved articles. Results: Multiple pathogenic processes occur during the latent phase of epileptogenesis, before acquired TLE is diagnosed. These are hippocampal sclerosis, synaptic reorganisation including mossy fibre sprouting, neuroinflammation, aberrant neurogenesis and astrogliosis. Furthermore, epigenetic signalling pathways including DNA methylation, histone modifications, transcriptional and post-transcriptional dysregulation drive these pathogenic brain changes. Discussion: The epigenetic pathways that drive pathogenic brain changes following epileptogenic events are potential therapeutic targets for novel antiepileptic drugs. Targeting molecular pathways could prevent many cases of acquired TLE by halting epileptogenesis in the latent phase, meaning new therapies for acquired TLE have the potential to be antiepileptogenic rather than simply anticonvulsant.

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

Structural and Functional MRI Brain Changes in Patients with Schizophrenia Following Electroconvulsive Therapy: A Systematic Review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yuchao Jiang ◽  
Mingjun Duan ◽  
Hui He ◽  
Dezhong Yao ◽  
Cheng Luo
Keyword(s):  
Systematic Review ◽  
Functional Mri ◽  
Electroconvulsive Therapy ◽  
Brain Regions ◽  
Parahippocampal Gyrus ◽  
Medical Subject Headings ◽  
Therapeutic Mechanisms ◽  
Brain Changes ◽  
Meta Analyses ◽  
Induced Changes

Background: Schizophrenia (SZ) is a severe psychiatric disorder typically characterized by multidimensional psychotic syndromes. Electroconvulsive therapy (ECT) is a treatment option for medication-resistant patients with SZ or to resolve acute symptoms. Although the efficacy of ECT has been demonstrated in clinical use, its therapeutic mechanisms in the brain remain elusive. Objective: This study aimed to summarize brain changes on structural magnetic resonance imaging (sMRI) and functional MRI (fMRI) after ECT. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was carried out. The PubMed and Medline databases were systematically searched using the following medical subject headings (MeSH): (electroconvulsive therapy OR ECT) AND (schizophrenia) AND (MRI OR fMRI OR DTI OR DWI). Results: This review yielded 12 MRI studies, including 4 with sMRI, 5 with fMRI and 3 with multimodal MRI. Increases in volumes of the hippocampus and its adjacent regions (parahippocampal gyrus and amygdala) as well as insula and frontotemporal regions were noted after ECT. fMRI studies found ECT-induced changes in different brain regions/networks, including the hippocampus, amygdala, default model network, salience network and other regions/networks that are thought to highly correlate with the pathophysiologic characteristics of SZ. The results of the correlation between brain changes and symptom remissions are inconsistent Conclusion: Our review provides evidence supporting ECT-induced brain changes on sMRI and fMRI in SZ and explores the relationship between these changes and symptom remission.

Locating the Best Available Research

2016 ◽  
pp. 49-68
Author(s):  
John C. Norcross ◽  
Thomas P. Hogan ◽  
Gerald P. Koocher ◽  
Lauren A. Maggio
Keyword(s):  
Behavioral Health ◽  
Search Engines ◽  
Information Sources ◽  
Research Evidence ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Online Search ◽  
Medical Subject Headings ◽  
Controlled Vocabularies ◽  
Test Information

This chapter reviews unfiltered information sources, which contain “virtually everything” published, without filter or fetter. Unfiltered information can be found in a wide variety of online search tools and bibliographic databases, such as MEDLINE, PsycINFO, and CINAHL, and is generally the basis for all other kinds of research evidence. This chapter also introduces specialized evidence-based search engines. A weakness of unfiltered information is that it needs to be analyzed and synthesized, which can prove time-consuming. To facilitate the retrieval of unfiltered information, the chapter describes the advanced approach of using controlled vocabularies such as medical subject headings (MeSH). The chapter concludes by covering resources for accessing evidence on behavioral health tests and measures, including test reviews, test information databases, and test publishers.

Classification of seizures and epilepsy

2019 ◽  
pp. 935-944
Author(s):  
Andrew McEvoy ◽  
Tim Wehner ◽  
Victoria Wykes
Keyword(s):  
Focal Epilepsy ◽  
Focal Cortical Dysplasia ◽  
Hippocampal Sclerosis ◽  
Epileptic Seizures ◽  
Recurrence Risk ◽  
Medical Emergency ◽  
Unprovoked Seizure ◽  
Generalized Seizures ◽  
The Brain

Epileptic seizures are transient neurologic alterations due to abnormal excessive or synchronous neuronal cerebral activity. They may cause subjective symptoms (aura), and objective autonomic, behavioural, or cognitive alterations in any combination. Focal seizures are initially generated in one circumscribed area in the brain, whereas generalized seizures involve bihemispheric neuronal networks from the seizure onset. Epilepsy is a brain disease defined by the occurrence of two unprovoked seizures more than 24 h apart or one unprovoked seizure with underlying pathological or genetic factors resulting in a similar recurrence risk. Focal epilepsy syndromes are best classified by aetiology or anatomical area of origin. A seizure that does not self-terminate results in status epilepticus, and constitutes a medical emergency that requires immediate treatment. Focal cortical dysplasia and hippocampal sclerosis are the commonest aetiologies of epilepsy amenable to surgical treatment and are reviewed here. The limbic pathway may be involved in seizure propagation, and the anatomy is described.

scholarly journals Contribution of a positive psychology-based conceptual framework in reducing physician burnout and improving well-being: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shahrzad Bazargan-Hejazi ◽  
Anaheed Shirazi ◽  
Andrew Wang ◽  
Nathan A. Shlobin ◽  
Krystal Karunungan ◽  
...  
Keyword(s):  
Positive Psychology ◽  
Conceptual Framework ◽  
English Language ◽  
Internship And Residency ◽  
Well Being ◽  
Bibliographic Databases ◽  
Free Text ◽  
Multidimensional Model ◽  
Physician Burnout ◽  
Medical Subject Headings

Abstract Background The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. Methods Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). Results Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. Conclusion Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.

scholarly journals Transplantation of Mesenchymal Stem Cells in Treating Patients with Severe COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Stem Cells ◽  
Clinical Trials ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Bibliographic Databases ◽  
Human Mscs ◽  
Medical Subject Headings ◽  
Human Organ ◽  
Mesenchymal Stem Cell Transplantation ◽  
Meeting Abstract

The objective of the study is to perform a critical review, exploration, and strong summary of the roles of mesenchymal stem cell transplantation in treating various diseases, including COVID-19. A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including Scien Direct, PubMed, Scopus, ISI Web of Science, and websites of the news. The search was applied to the articles that were published between January 2020 and April 2020. Needed article information was extracted from each article by : 1) direct information including journal (research article, review article, meeting abstract, conference abstract, correspondence, author index, editorial board meeting abstract, discussion), book chapter, title, authors, abstract, full text documents of candidate studies, websites of the news, publishing year; 2) study period; 3) research (study) method used; 4) types of mesenchymal stem cells; and 5) types of human organ system disorder or disease studied. With strict literature search and screening processes, it yielded 6 articles from 76 articles of initial literature databases and websites of the news (January 2020 to April 2020). Anti-inflammatory and immunomodulatory properties of MSCs in the treatment of respiratory diseases were confirmed by at least 17 clinical studies and more than 70 clinical trials are registered in this issue that are available at: https:// www.clinicaltrials.gov. MSC transplantation improves the treatment outcome of COVID-19 patients may be due to controlling inflammatory response and promoting tissue regeneration and repair. In conclusion, Human MSCs are currently being evaluated as a stem cell treatment for a number of diseases, particularly severe COVID-19 and have been demonstrated to be safe in clinical trials. There are some promising reports to apply MSCs therapy to treat COVID-19. MSCs may possibly be one of the most ideal therapeutics, or a combination of treatment to treat patients with COVID-19. Nevertheless, further studies are urgently needed to investigate and optimize a number of variables in the human MSC culture environment by developing a bioprocess that can be operated in accordance with the Good Manufacturing Product (GMP).

PM2.5, PM2.5-related air pollutants, health hazards and impacts on respiratory and cardiovascular disorders and diseases: systematic review and meta-analysis

2019 ◽  
Vol 6 (3) ◽  
pp. 40-48
Author(s):  
Attapon Cheepsattayakorn ◽  
Ruangrong Cheepsattayakorn
Keyword(s):  
Endothelial Cells ◽  
Air Pollutants ◽  
Meta Analysis ◽  
Clean Energy ◽  
Health Hazards ◽  
Bibliographic Databases ◽  
Medical Subject Headings ◽  
Meeting Abstract

The objective of the study is to perform a critical review, exploration, and strong summary of the relationships between personal and ambient concentrations of mainly particulate matter with diameter of 2.5µm or less with the measures of cardiopulmonary health. A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including Scien Direct, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between 2017 and early 2019. Needed article information was extracted from each article by: direct information including journal (research article, review article, meeting abstract, conference abstract, correspondence, author index, editorial board meeting abstract, discussion), book chapter, title, authors, abstract, full text documents of candidate studies, publishing year. Study period, Research (study) method used, types of air pollutants variables studied; Types of organ system disorder or disease studied The conclusions made about the health hazards, impacts on humans or animal models, novel therapeutics, and economic loss. With strict literature search and screening processes, it yielded 140 articles (2017=45; 2018=61; and early 2019=34 articles) from 3,968 articles of initial literature database (1952-early 2019). The main compositions of air pollutants are PM, particularly PM2.5 and PM10, O3, CO, SO2, and NOx. Exposure to O3 is frequently associated with respiratory tract inflammation, whereas exposure to PM, CO, No2, and SO2 is related to pulmonary edema, respiratory and cardiovascular hospitalizations, and cardiopulmonary mortality. Any compromise to endothelial cells, the key components of lung barrier integrity contributes to vascular leakage and inflammation. Endothelial cells could be the target of PM exposure. The various effects on various disease entities contribute to hypothesize that Melatonin might protect the lung integrity against PM2.5-induced acute lung injury. Bufei Huoxue (BFHX) could reduce secretory immunoglobulin A (sIgA) and collagen fibers deposition in lung, thus, improved pulmonary function. In conclusion, identification of various crucial signaling pathway involving PM-induced cardiopulmonary disorders and diseases may assist in the development of effective therapeutics, including clean energy use, clean industrialization, proper agriculture, high land use diversity, and proper urbanization for reduction of the air pollution.

Interictal psychosis following temporal lobe surgery: dentate gyrus pathology

2014 ◽  
Vol 44 (14) ◽  
pp. 3037-3049 ◽  
Author(s):  
M. Thom ◽  
M. Kensche ◽  
J. Maynard ◽  
J. Liu ◽  
C. Reeves ◽  
...  
Keyword(s):  
Dentate Gyrus ◽  
Temporal Lobe ◽  
Granule Cell ◽  
Cellular Response ◽  
Granule Cells ◽  
De Novo ◽  
Hippocampal Sclerosis ◽  
Mossy Fibre ◽  
Cannabinoid Type 1 Receptor ◽  
Cell Dispersion

BackgroundDe novointerictal psychosis, albeit uncommon, can develop in patients following temporal lobe surgery for epilepsy. Pathological alterations of the dentate gyrus, including cytoarchitectural changes, immaturity and axonal reorganization that occur in epilepsy, may also underpin co-morbid psychiatric disorders. Our aim was to study candidate pathways that may be associated with the development of interictal psychosis post-operatively in patients with hippocampal sclerosis (HS).MethodA total of 11 patients with HS who developed interictal psychosis (HS-P) post-operatively were compared with a matched surgical HS group without psychosis (HS-NP). Resected tissues were investigated for the extent of granule cell dispersion, mossy fibre sprouting and calbindin expression in the granule cells. We quantified doublecortin, mini-chromosome maintenance protein 2 (MCM2) and reelin-expressing neuronal populations in the dentate gyrus as well as the distribution of cannabinoid type 1 receptor (CBR1).ResultsThe patterns of neuronal loss and gliosis were similar in both groups. HS-P patients demonstrated less mossy fibre sprouting and granule cell dispersion (p < 0.01) and more frequent reduction in calbindin expression in granule cells. There were no group differences in the densities of immature MCM2, doublecortin and reelin-positive cells. CBR1 labelling was significantly lower in Cornu ammonis area CA4 relative to other subfields (p < 0.01); although reduced staining in all hippocampal regions was noted in HS-P compared with HS-NP patients, the differences were not statistically significant.ConclusionsThe alterations in dentate gyrus pathology found in HS-P patients could indicate underlying differences in the cellular response to seizures. These mechanisms may predispose to the development of psychosis in epilepsy and warrant further investigation.

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