Increased expression of matrix metalloproteinase-9 in patients with temporal lobe epilepsy

Aim: The molecular mechanism of epileptogenesis in temporal lobe epilepsy is still unclear. Experimental studies have suggested that matrix metalloproteinases have important roles in this process, but human studies are limited. The aim of this study was to assess the expression of MMP-9, MMP-2 and their tissue inhibitors (TIMP-1 and TIMP-2) in patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS). Material and Methods: The tissue samples from temporal neocortex and hippocampus were obtained from patients with temporal lobe epilepsy with hippocampal sclerosis who had undergone anterior temporal lobectomy for recurrent medically resistant seizures. Immunohistochemical methods were used to determine the expression of MMP-9, MMP-2 and their tissue inhibitors. Tissue samples were also analyzed with transmission electron microscopy. Results: The immunoreactivity for MMP-9 both in hippocampal and temporal neocortical neurons was stronger than that of MMP-2. Additionally, there was a mild reaction for its tissue inhibitor TIMP-1 as with TIMP-2. The TEM analysis of the hippocampus revealed that there was apparent ultra-structural damage on the pericarya and neuropil of some neurons. There was obvious damage in the mitochondria and the nuclear membrane. Conclusion: The preliminary results of this study revealed that MMP-9 may have a role in patients with drug resistant TLE-HS

Parkinson hastalarında subtalamik çekirdek derin beyin stimülasyonunun fiziksel, emosyonel, kognitif fonksiyon ve günlük yaşam aktiviteleri üzerine etkisi

Aim: To describe effectiveness of deep brain stimulation of subthalamic nucleus (DBS STN) on physical, emotional, cognitive functions and daily activities in Parkinson's patients. Material and Methods: Ten patients (51.20 ±10.20 yr.) were assessed three times. The Time Up and Go Test, 12 m Walking Test and Chair Stand Test were used to assess mobility and balance. Purdeu Pegboard and hand writing tests were used to evaluate hand function. The Hospital Anxiety and Depression Scale (HAD) was used to detect depressive symptoms and anxiety score. The Unified Parkinson\'s Disease Rating Scale (UPDRS) and Hoehn &Yahr Scale were also used. The Schwab and England Test was used to evaluate the daily activities (ADL). Results: The results showed that all the patients' mobility and balance ability improved after surgery (p<0.05). Depressive symptoms/anxiety scores were found to be lower than before surgery (p<0.05). There were differences in terms of ADL and UPDRS scores after surgery (p<0.05). At six month after surgery; depressive symptoms decreased by 78%. ADL and UPDRS motor and total scores improved by 190%, 72%, and 78% respectively. Conclusion: STN DBS is an effective treatment to improve physical functioning, emotional status and daily activities in Parkinson's patients. However, it did not show any positive effect on cognitive function

Effects of the hippocampal deep brain stimulation on cortical epileptic discharges in penicillin - induced epilepsy model in rats

Aim: Experimental and clinical studies have revealed that hippocampal DBS can control epileptic activity, but the mechanism of action is obscure and optimal stimulation parameters are not clearly defined. The aim was to evaluate the effects of high frequency hippocampal stimulation on cortical epileptic activity in penicillin-induced epilepsy model. Material and Methods: Twenty-five Sprague-Dawley rats were implanted DBS electrodes. In group-1 (n=10) hippocampal DBS was off and in the group-2 (n=10) hippocampal DBS was on (185 Hz, 0.5V, 1V, 2V, and 5V for 60 sec) following penicillin G injection intracortically. In the control group hippocampal DBS was on following 8μl saline injection intracortically. EEG recordings were obtained before and 15 minutes following penicillin-G injection, and at 10th minutes following each stimulus for analysis in terms of frequency, amplitude, and power spectrum. Results: High frequency hippocampal DBS suppressed the acute penicillin-induced cortical epileptic activity independent from stimulus intensity. In the control group, hippocampal stimulation alone lead only to diffuse slowing of cerebral bioelectrical activity at 5V stimulation. Conclusion: Our results revealed that continuous high frequency stimulation of the hippocampus suppressed acute cortical epileptic activity effectively without causing secondary epileptic discharges. These results are important in terms of defining the optimal parameters of hippocampal DBS in patients with epilepsy

A case report of surgically treated drug resistant epilepsy associated with subependymal nodular heterotopia

Subependymal nodular heterotopia (SNH) is a cortical development malformation that is commonly associated with medically resistant epilepsy. Cases of SNH are challenging to treat surgically because there are typically multiple nodules, which may be involved in epileptogenesis. Moreover, dual pathology may exist in these patients. Here, we present a case with unilateral subependymal heterotopic nodules associated with ipsilateral hippocampal atrophy. Invasive and non-invasive work-ups revealed that the hippocampus was the actual ictal onset zone and that the SNH was not involved. An anterior temporal lobectomy was carried out, and postoperative seizure outcome was class Ia at the end of 2 years. The case demonstrates that SNH may not play a major role in patients with dual pathology. However, direct electroencephalography (EEG) recording from areas of SNH and other possible epileptogenic regions is indispensable in defining the ictal onset zone and avoiding poor surgical outcomes. (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved

Late onset continuous verbal perseveration after glial tumor surgery: A rare ictal phenomenon

Objective: Perseveration is a rarely observed symptom during the course of neurosurgical diseases. As all perseverations are not uniform, determination of the corresponding brain regions is of great importance prior to deciding whether it represents a destructive or an irritative process. Clinical Presentation: A right-handed 33-year-old patient with a subtotally excised left temporoparietal low-grade astrocytoma was readmitted 9 months later with a complaint of new-onset continuous verbal perseveration which is primarily a sign of a non-dominant hemisphere abnormality. Repeat magnetic resonance imaging showed no change in the residual tumor size or in the edema. No new tumor focus was detected. Discussion: The patient's electroencephalogram indicated a contralateral right-sided epileptic focus. The carbamezapine dosage was increased and the perseverations subsided rapidly. Conclusion: The late-onset ictal perseveration did not imply tumor progression and was triggered by the focus on the contralateral hemisphere, most probably caused by radiotherapy

Angiogenesis in neurological disorders: A review

Angiogenesis, recruitment of new blood vessels, is an essential component of the metastatic pathway. These vessels provide the principal route by which tumor cells exit the primary tumor site and enter the circulation. For many tumors, the vascular density can provide a prognostic indicator of metastatic potential, with the highly vascular primary tumors having a higher incidence of metastasis than poorly vascular tumors. The discovery and characterization of tumor-derived angiogenesis modulators greatly contributed to our understanding of how tumors regulate angiogenesis. However, although angiogenesis appears to be a rate-limiting event in tumor growth and metastatic dissemination, a direct connection between the induction of angiogenesis and the progression to tumor malignancy is less well understood. In this review, we discuss the observations concerning the modulation of angiogenesis and their implications in various neurological disorders, as well as their potential impact on cancer therapy. © W. S. Maney & Son Ltd 2012

Effects of excess vitamin B6 intake on serum lipid profile and cerebral cortex in rats

Aim: The present study was undertaken to investigate the effects of dietary excess of vitamin B6 on certain blood parameters [serum total cholesterol, high density lipoprotein (HDL) cholesterol and total lipid] and the cerebral cortex. Materials and Methods: A total of 36 albino rats were included in the study. Saline solution was administered to control groups (CG-10, n = 6 for 10 days; CG-15, n = 6 for 15 days; CG-20, n = 6 for 20 days). The experimental groups (EG-10, n = 6; EG-15, n = 6; EG-20, n = 6) received 5 mg/kg vitamin B6 daily for 10 days, 15 days and 20 days, respectively. Serum total cholesterol, HDL cholesterol and total lipid levels were measured and compared in CGs and EGs. The cerebral cortex tissue samples were examined by electron microscopy. Results: The total serum cholesterol levels were significantly lower (P &lt; 0.05) although serum HDL levels were significantly higher (P &lt; 0.01) in all EGs. Total serum lipid levels were higher in EG-15 and EG-20 groups than in CGs. The structural degenerations in the perikaryon and neuropil were found prominent in EG-15 and EG-20 groups but not in EG-10. Marked damage in the neuronal and neuropilic structure was observed in rats who received long-term high doses of vitamin B6. Based on these results, a relationship between cerebral cortex damage and serum total lipid and HDL levels in the EG-15 and EG-20 groups is suggested. Conclusions: Dietary excess of vitamin B6 intake reduces serum total cholesterol levels, but not serum HDL and total lipid levels, and also causes cerebral cortex damage in long-term treatment. Thus, a careful diet plan and monitoring of vitamin B 6 dose are recommended in patients who are supplemented with this vitamin. © TÜBİTAK

The Importance of Cerebellar Involvement in Identifying the Prognosis in Patients with Progressive Multiple Sclerosis

Background: Cerebellar involvement is one of the bad prognostic factors in patients with multiple sclerosis (MS). Objective: In this study the importance of demographic and clinical features as well as localization of lesions seen in the magnetic resonance imaging (MRI), which possibly have a role in the occurence of severe cerebellar symptoms were investigated in patients with secondary and primary progressive MS (SPMS, PPMS). Material and Method: Thirty-two MS patients (29 SPMS, 3 PPMS) with high cerebellar functional system (FS) score (3-5) were compared with 20 MS patients (18 SPMS, 2 PPMS) with low cerebellar FS (0-2). Results: The number of relapses that have occurred before transformation to secondary progressive form was higher in patients with severe cerebellar involvement than patients with moderate cerebellar involvement. Furthermore, not only cerebellar FS scores but also other FS scores were higher in the group of patients with severe cerebellar signs. The number of patients who have MRI lesions localised to mesencephalon, cerebellum and superior pedincule was higher in patients with severe cerebellar involvement (p<0.05) and among these localizations cerebellum reached the highest statistical significance (p<0.001). Conclusions: These results suggested that the evaluation of lesion load at mesencephalon, cerebellum and their connections with MRI could provide additional data in defining the prognosis of MS