Perfil proteômico hipocampal em epilepsia do lobo temporal

In this study we used proteomics approaches to obtain the protein profile of human epileptic hippocampi (N=6) and control hippocampi obtained from autopsy (N=6). We used two-dimensional gel electrophoresis (2-D) coupled to HPLC and Mass spectroscopy (MALDI-TOF) to identify proteins differentially expressed. Nine proteins were differentially expressed comparing the hippocampus of patients with the hippocampus of control. Proteins that were increased in the hippocampus of patients with TLE were: isoform 1 of serum albumin, HSP 70, dihydropyrimidinase-related protein 2, isoform 1 of myelin basic protein, proton ATPase catalytic subunit A, and dihydrolipoyllysine-residue acethyltransferase component of pyruvate dehydrogenase complex. The expression of isoform 3 of spectrin alpha chain (fodrin) was down-regulated while the proteins glutathione S-transferase P and the DJ-1 (PARK7) were detected only in the hippocampus of patients with TLE. Taken together, our results provide evidence supporting a direct link between metabolic disturb and oxidative damage related to pathophysiology of TLE. Besides, indicates biomarkers for further investigations as therapies targeted to epilepsy.No presente estudo empregou-se o método de proteômica para obter a expressão diferencial de proteínas em hipocampo de pacientes com epilepsia do lobo temporal (ELT) (N=6) comparado a hipocampos controle obtidos por meio de autópsia (N=6). O estudo foi feito por meio de eletroforese bidimensional, acoplada a HPLC e espectroscopia de massa. As proteínas que tiveram expressão aumentada no hipocampo de pacientes com ELT foram: isoforma-1 da soroalbumina, HSP70, diidropirimidinase-2, isoforma-1 da proteína básica da mielina, subunidade catalítica A da próton ATPase, glutationa S-transferase P, proteína DJ-1 (PARK7), e resíduo diidropolilisina do componente acetil-transferase do complexo da piruvato desidrogenase. A expressão da isoforma-3 da cadeia alfa da espectrina (fodrina) foi menor no hipocampo de pacientes com epilepsia do lobo temporal e as proteínas glutationa S-transferase P e PARK7 foram detectadas somente no tecido epiléptico. Assim, nossos resultados trazem evidencias sobre a direta relação entre distúrbio metabólico e dano oxidativo na patofisiologia da ELT. Além disto, o estudo indica biomarcadores para futuras investigações como alvos terapêuticos para epilepsia.UNIFESP Departamento de Neurologia e NeurocirurgiaUNIFESP Departamento de Microbiologia, Imunologia e ParasitologiaFaculdade de Medicina da Universidade de São Paulo Instituto do Coração Departamento de Anatomia PatológicaUNIFESP, Depto. de Neurologia e NeurocirurgiaUNIFESP, Depto. de Microbiologia, Imunologia e ParasitologiaSciEL

Diffuse Intrinsic Brainstem Tumor in an Infant: A Case of Therapeutic Efficacy With Vinorelbine

Brainstem gliomas constitute 10% to 20% of all pediatric tumors of the central nervous system, and diffusely infiltrative brainstem gliomas are the most common brainstem tumors associated with a poor prognosis. A small subset of these tumors is benign, showing low-grade features on histology. the role of chemotherapy in the management of these tumors is ill defined, especially in the neonates. There are anecdotal reports of spontaneous remission, but the natural history of these tumors does not support a wait-and-see approach. Thus, we report a successful experience of chemotherapy in a 4-month-old girl with a diffuse brainstem fibrillary astrocytoma, treated with vinorelbine (30 mg/m(2)/d on days 0, 8, and 22), a vinca alkaloid that has shown activity against glioma. Our experience suggests that vinorelbine may be effective in pediatric low-grade gliomas as this patient showed significant clinical improvement over a short period of time.Universidade Federal de São Paulo, GRAACC, IOP, Dept Pediat Oncol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, GRAACC, IOP, Dept Neurol & Neurosurg, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, GRAACC, IOP, Dept Pathol, BR-04023062 São Paulo, BrazilHosp Sick Children, Div Hematol Oncol, Toronto, ON M5G 1X8, CanadaUniversidade Federal de São Paulo, GRAACC, IOP, Dept Pediat Oncol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, GRAACC, IOP, Dept Neurol & Neurosurg, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, GRAACC, IOP, Dept Pathol, BR-04023062 São Paulo, BrazilWeb of Scienc

Demystifying the effect of modafinil in epilepsy

Universidade Federal de São Paulo, Dept Psychobiol, BR-04024002 São Paulo, BrazilPontificia Univ Catolica Rio Grande do Sul PUCRS, Fac Biociencias, Lab Neurobiol & Desenvolvimento, Porto Alegre, RS, BrazilUniversidade Federal de São Paulo, Dept Expt Neurol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Expt Neurol, BR-04024002 São Paulo, BrazilWeb of Scienc

Melhora em função motora e necessidade reduzida de shunts pós-natais em crianças submetidas a cirurgia fetal uterina da mielomeningocele

Objective To compare neuromotor development between patients who did and those who did not undergo intrauterine myelomeningocele repair. Methods Children with myelomeningocele aged between 3.5 and 6 years who did undergo intrauterine repair (Group A, n=6) or not (Group B; n=7) were assessed for neuromotor development at both anatomical and functional levels, need for orthoses, and cognitive function. Results Intrauterine myelomeningocele repair significantly improved motor function. The functional level was higher than the anatomical level by 2 or more spinal segments in all children in Group A and 2 children in Group B, with a significant statistical difference between groups (p<0.05). Five children in Group A and one in Group B were community ambulators. Conclusion Despite the small sample, it was observed that an improvement of motor function and decreased need for postnatal shunting in the 6 children who had undergone intrauterine myelomeningocele repair.Objetivo Comparar o desenvolvimento neuromotor de pacientes submetidos à cirurgia fetal intrauterina da mielomeningocele ao de pacientes não submetidos ao procedimento. Métodos Foram avaliados: o desenvolvimento neuromotor (descrevendo o nível anatômico e motor funcional), o tipo de marcha, a necessidade de órteses e o nível cognitivo de crianças com mielomeningocele entre 3,5 e 6 anos de idade, submetidas (Grupo A; n=6) ou não submetidas (Grupo B; n=7) à cirurgia fetal intra-uterina. Resultados A função motora apre-sentou melhora significante, com nível funcional mais elevado em dois ou mais segmentos em relação ao nível anatômico em todas as crianças do Grupo A e em duas crianças do Grupo B, com diferença estatística entre os grupos (p<0.05). Cinco crianças do Grupo A e uma do grupo B eram deambuladoras comunitárias. Conclusão Apesar da pequena amostragem, nos 6 casos de cirurgia prenatal observouse melhora da função motora e menor necessidade de shunts pós-natais

Epilepsy-induced electrocardiographic alterations following cardiac ischemia and reperfusion in rats

The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. in addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode

Pre-surgical evaluation and surgical treatment in children with extratemporal epilepsy

Introduction This review summarizes some patterns of pre-surgical evaluation and surgical treatment of extratemporal epilepsy in pediatric patients with medically refractory seizures, whose ictal behavior is variable. the most effective treatment for intractable partial epilepsy is a focal cortical resection with excision of the epileptogenic zone (the area of ictal onset and initial seizure propagation). This might be risky, though, in the case of a widespread lesion, sometimes encroaching one or more lobes, given the risk to the functional cerebral cortex. An anterior temporal lobectomy might prove more effective then in preventing seizures with fewer potential complications. If partial extratemporal epilepsy is associated with pharmaco-resistant seizures, the preoperative evaluation and operative strategy are determined according to the epileptogenic zone and to the relationship between a substrate-directed disorder and eloquent areas. the pediatric treatment of extratemporal epilepsy is aimed at controlling the seizures, avoiding morbidity, and improving the patient's quality of life through psychosocial integration. Since the immature brain is more plastic than when mature, the recovery of functions after surgery is greater in children than in adults.Recommendation Early surgery is recommended for children with intractable epilepsy, and is now accepted as an important therapeutic modality also for children with chronic epilepsy.Conclusion Technological advances in the last two decades, mainly in neuroimaging, have led many medical centers to consider surgical treatment of epilepsy, accuracy being granted by MRI-based neuronavigation systems-an interface between the lesion seen in the preoperative magnetic resonance imaging (MRI) and the operative field, often invisible to the surgeon.Universidade Federal de São Paulo, Dept Neurol Neurocirurgia, Disciplina Neurocirurgia, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol Neurocirurgia, Disciplina Neurocirurgia, BR-04024002 São Paulo, BrazilWeb of Scienc