Brain research bulletin
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Brain research bulletin · Mar 2009
Descending pathways from activated locus coeruleus/subcoeruleus following unilateral hindpaw inflammation in the rat.
We have previously shown that the descending pathways from the locus coeruleus (LC)/subcoeruleus (SC) to the spinal cord are activated during peripheral inflammation, and that activation of this coeruleospinal system decreases development of hyperalgesia. Anatomical evidence suggests that the descending modulation system from the LC/SC should be active bilaterally during inflammation when the LC/SC either ipsilateral or contralateral to the site of inflammation is activated. ⋯ A difference in PWL between the bilateral and the unilateral LC/SC-lesioned rats was not observed in the contralateral non-inflamed paw. The result suggests that in the LC/SC both ipsilateral and contralateral to the inflamed paw, only neurons which project to the dorsal horn ipsilateral to the inflamed paw were activated following peripheral inflammation.
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Brain research bulletin · Feb 2009
Long-term follow-up of DBS of thalamus for tremor and STN for Parkinson's disease.
In 1994 we commenced deep brain stimulation (DBS) of the thalamus for patients with severe tremor. This was done under the guidance of Professor Alim Benabid from Grenoble, France, who pioneered the technique. In the beginning we commenced DBS of the thalamus for patients with severe tremulous Parkinson's disease, essential tremor, and in one case, severe post-traumatic tremor. ⋯ We were the second unit in Australia to become established for these procedures. A total of 45 patients have undergone STN DBS and have been followed up on a regular basis by the same neurologist (DOS). The surgical complications and long-term complications, including hardware problems will be reviewed retrospectively, as well as the long-term benefits of these surgical procedures.
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Brain research bulletin · Feb 2009
Multi-target strategy for Parkinsonian patients: the role of deep brain stimulation in the centromedian-parafascicularis complex.
The intra-laminar (IL) thalamic complex, composed of centromedian (CM) and parafascicular (Pf) nucleus, is a strategic crossroad for the activity of the basal ganglia and is recently regaining its position has a putative neurosurgical target for Parkinsonian syndromes. The multi-target approach we have encouraged since the late nineties has allowed the combined implantation of a standard target (the subthalamic nucleus-STN or the internal pallidus-GPi) plus an innovative one (CM/Pf) in well-identified Parkinson's disease (PD) patients; hence, it is possible to study, in the same PD patients, the specific target-mediated effects on different clinical signs. ⋯ Yet, CM/Pf acts very powerfully on tremor and contributes to the long-term management of l-Dopa-induced involuntary movements. The lack of cognitive deficits and psychic impairment associated with the improvement of their quality of life, in our small cohort of CM/Pf implanted patients, reinforces the notion of CM/Pf as a safe and attractive area for surgical treatment of advanced PD, possibly affecting not only motor but also associative functions.
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Brain research bulletin · Jan 2009
ReviewClinical relevance of gait research applied to clinical trials in spinal cord injury.
The restoration of walking function following SCI is extremely important to consumers and has stimulated a response of new treatments by scientists, the pharmaceutical industry and clinical entrepreneurs. Several of the proposed interventions: (1) the use of functional electrical stimulation (FES) and (2) locomotor training have been examined in clinical trials and recent reviews of the scientific literature. Each of these interventions is based on research of human locomotion. ⋯ In addition to measures of walking function developed for FES interventions, the first randomized multicenter clinical trial on locomotor training in subacute SCI was recently published with an extensive review of these measures. In this study outcome measures of motor strength (impairment), balance, Walking Index for SCI (WISCI), speed, 5min walk (walking capacities) and locomotor functional independence measure (L-FIM), a disability measure all showed improvement in walking function based on the strategy of the response of activity based plasticity to step training. Although the scientific basis for this intervention will be covered in other articles in this series, the evolution of clinical outcome measures of walking function continues to be important for the determination of effectiveness in clinical trials.