98 research outputs found

    A Unified Functional Network Target for Deep Brain Stimulation in Obsessive-Compulsive Disorder

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    BACKGROUND: Multiple deep brain stimulation (DBS) targets have been proposed for treating intractable obsessive-compulsive disorder (OCD). Here, we investigated whether stimulation effects of different target sites would be mediated by one common or several segregated functional brain networks. METHODS: First, seeding from active electrodes of 4 OCD patient cohorts (N = 50) receiving DBS to anterior limb of the internal capsule or subthalamic nucleus zones, optimal functional connectivity profiles for maximal Yale-Brown Obsessive Compulsive Scale improvements were calculated and cross-validated in leave-one-cohort-out and leave-one-patient-out designs. Second, we derived optimal target-specific connectivity patterns to determine brain regions mutually predictive of clinical outcome for both targets and others predictive for either target alone. Functional connectivity was defined using resting-state functional magnetic resonance imaging data acquired in 1000 healthy participants. RESULTS: While optimal functional connectivity profiles showed both commonalities and differences between target sites, robust cross-predictions of clinical improvements across OCD cohorts and targets suggested a shared network. Connectivity to the anterior cingulate cortex, insula, and precuneus, among other regions, was predictive regardless of stimulation target. Regions with maximal connectivity to these commonly predictive areas included the insula, superior frontal gyrus, anterior cingulate cortex, and anterior thalamus, as well as the original stereotactic targets. CONCLUSIONS: Pinpointing the network modulated by DBS for OCD from different target sites identified a set of brain regions to which DBS electrodes associated with optimal outcomes were functionally connected-regardless of target choice. On these grounds, we establish potential brain areas that could prospectively inform additional or alternative neuromodulation targets for obsessive-compulsive disorder

    Palaeo-environmental evolution of Central Asia during the Cenozoic: new insights from the continental sedimentary archive of the Valley of Lakes (Mongolia)

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    The Valley of Lakes basin (Mongolia) contains a unique continental sedimentary archive, suitable for constraining the influence of tectonics and climate change on the aridification of Central Asia in the Cenozoic. We identify the sedimentary provenance, the (post)depositional environment and the palaeo-climate based on sedimentological, petrographical, mineralogical, and (isotope) geochemical signatures recorded in authigenic and detrital silicates as well as soil carbonates in a sedimentary succession spanning from ~34 to 21 Ma. The depositional setting was characterized by an ephemeral braided river system draining prograding alluvial fans, with episodes of lake, playa or open-steppe sedimentation. Metamorphics from the northern adjacent Neoarchean to late Proterozoic hinterlands provided a continuous influx of silicate detritus to the basin, as indicated by K-Ar ages of detrital muscovite (~798-728 Ma) and discrimination function analysis. The authigenic clay fraction is dominated by illite-smectite and “hairy” illite (K-Ar ages of ~34-25 Ma), which formed during coupled petrogenesis and precipitation from hydrothermal fluids originating from major basalt flow events (~32-29 and ~29-25 Ma). Changes in hydroclimate are recorded in [delta]18O and [delta]13C profiles of soil carbonates and in silicate mineral weathering patterns, indicating that comparatively humid to semi-arid conditions prevailed in the late(st) Eocene, changing into arid conditions in the Oligocene and back to humid to semi-arid conditions in the early Miocene. Aridification steps are indicated at ~34-33, ~31, ~28 and ~23 Ma and coincide with some episodes of high-latitude ice-sheet expansion inferred from marine deep-sea sedimentary records. This suggests that long-term variations in the ocean-atmosphere circulation patterns due to pCO2 fall, reconfiguration of ocean gateways and ice-sheet expansion in Antarctica could have impacted the hydroclimate and weathering regime in the basin. We conclude that the aridification in Central Asia was triggered by reduced moisture influx by westerly winds driven by Cenozoic climate forcing and the exhumation of the Tian Shan and Altai Mountains and modulated by global climate events

    Home parenteral nutrition with an omega-3-fatty-acid-enriched MCT/LCT lipid emulsion in patients with chronic intestinal failure (the HOME study):study protocol for a randomized, controlled, multicenter, international clinical trial

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    BACKGROUND: Home parenteral nutrition (HPN) is a life-preserving therapy for patients with chronic intestinal failure (CIF) indicated for patients who cannot achieve their nutritional requirements by enteral intake. Intravenously administered lipid emulsions (ILEs) are an essential component of HPN, providing energy and essential fatty acids, but can become a risk factor for intestinal-failure-associated liver disease (IFALD). In HPN patients, major effort is taken in the prevention of IFALD. Novel ILEs containing a proportion of omega-3 polyunsaturated fatty acids (n-3 PUFA) could be of benefit, but the data on the use of n-3 PUFA in HPN patients are still limited. METHODS/DESIGN: The HOME study is a prospective, randomized, controlled, double-blind, multicenter, international clinical trial conducted in European hospitals that treat HPN patients. A total of 160 patients (80 per group) will be randomly assigned to receive the n-3 PUFA-enriched medium/long-chain triglyceride (MCT/LCT) ILE (Lipidem/Lipoplus® 200 mg/ml, B. Braun Melsungen AG) or the MCT/LCT ILE (Lipofundin® MCT/LCT/Medialipide® 20%, B. Braun Melsungen AG) for a projected period of 8 weeks. The primary endpoint is the combined change of liver function parameters (total bilirubin, aspartate transaminase and alanine transaminase) from baseline to final visit. Secondary objectives are the further evaluation of the safety and tolerability as well as the efficacy of the ILEs. DISCUSSION: Currently, there are only very few randomized controlled trials (RCTs) investigating the use of ILEs in HPN, and there are very few data at all on the use of n-3 PUFAs. The working hypothesis is that n-3 PUFA-enriched ILE is safe and well-tolerated especially with regard to liver function in patients requiring HPN. The expected outcome is to provide reliable data to support this thesis thanks to a considerable number of CIF patients, consequently to broaden the present evidence on the use of ILEs in HPN. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03282955. Registered on 14 September 2017

    Counter-current chromatography for the separation of terpenoids: A comprehensive review with respect to the solvent systems employed

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    Copyright @ 2014 The Authors.This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.Natural products extracts are commonly highly complex mixtures of active compounds and consequently their purification becomes a particularly challenging task. The development of a purification protocol to extract a single active component from the many hundreds that are often present in the mixture is something that can take months or even years to achieve, thus it is important for the natural product chemist to have, at their disposal, a broad range of diverse purification techniques. Counter-current chromatography (CCC) is one such separation technique utilising two immiscible phases, one as the stationary phase (retained in a spinning coil by centrifugal forces) and the second as the mobile phase. The method benefits from a number of advantages when compared with the more traditional liquid-solid separation methods, such as no irreversible adsorption, total recovery of the injected sample, minimal tailing of peaks, low risk of sample denaturation, the ability to accept particulates, and a low solvent consumption. The selection of an appropriate two-phase solvent system is critical to the running of CCC since this is both the mobile and the stationary phase of the system. However, this is also by far the most time consuming aspect of the technique and the one that most inhibits its general take-up. In recent years, numerous natural product purifications have been published using CCC from almost every country across the globe. Many of these papers are devoted to terpenoids-one of the most diverse groups. Naturally occurring terpenoids provide opportunities to discover new drugs but many of them are available at very low levels in nature and a huge number of them still remain unexplored. The collective knowledge on performing successful CCC separations of terpenoids has been gathered and reviewed by the authors, in order to create a comprehensive document that will be of great assistance in performing future purifications. © 2014 The Author(s)
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