Dopaminergic, serotonergic, and noradrenergic deficits in Parkinson disease

OBJECTIVE: People with Parkinson disease (PD) frequently develop dementia, which is associated with neocortical deposition of alpha-synuclein (α-syn) in Lewy bodies and Lewy neurites. In addition, neuronal loss and deposition of aggregated α-syn also occur in multiple subcortical nuclei that project to neocortical, limbic, and basal ganglia regions. Therefore, we quantified regional deficits in innervation from these PD-affected subcortical nuclei, by measuring the neurotransmitters and neurotransmitter transporter proteins originating from projections of dopaminergic neurons in substantia nigra pars compacta, serotonergic neurons in dorsal raphé nuclei, noradrenergic neurons in locus coeruleus, and cholinergic neurons in nucleus basalis of Meynert. METHODS: High-performance liquid chromatography and novel enzyme-linked immunosorbent assays were performed to quantify dopaminergic, serotonergic, noradrenergic, and cholinergic innervation in postmortem brain tissue. Eight brain regions from 15 PD participants (with dementia and Braak stage 6 α-syn deposition) and six age-matched controls were tested. RESULTS: PD participants compared to controls had widespread reductions of dopamine transporter in caudate, amygdala, hippocampus, inferior parietal lobule (IPL), precuneus, and visual association cortex (VAC) that exceeded loss of dopamine, which was only significantly reduced in caudate and amygdala. In contrast, PD participants had comparable deficits of both serotonin and serotonin transporter in caudate, middle frontal gyrus, IPL, and VAC. PD participants also had significantly reduced norepinephrine levels for all eight brain regions tested. Vesicular acetylcholine transporter levels were only quantifiable in caudate and hippocampus and did not differ between PD and control groups. INTERPRETATION: These results demonstrate widespread deficits in dopaminergic, serotonergic, and noradrenergic innervation of neocortical, limbic, and basal ganglia regions in advanced PD with dementia

Particle simulation of lower hybrid wave propagation in fusion plasmas

Global particle simulations of the lower hybrid (LH) waves have been carried out using fully kinetic ions and drift kinetic electrons with a realistic electron-to-ion mass ratio. The LH wave frequency, mode structure, and electron Landau damping from the electrostatic simulations agree very well with the analytic theory. Linear simulation of the propagation of a LH wave-packet in the toroidal geometry shows that the wave propagates faster in the high field side than the low field side, in agreement with a ray tracing calculation. This poloidal asymmetry arises from the non-conservation of the poloidal mode number due to the non-uniform magnetic field. In contrast, the poloidal mode number is conserved in the cylindrical geometry with the uniform magnetic field.Physics, Fluids & PlasmasPhysics, NuclearSCI(E)[email protected]

The Use of Laryngeal Mask Airway in Vitreoretinal Surgery

Purpose: To study the efficiency and utility of laryngeal mask airway (LMA) compared to endotracheal intubation (ETI) in vitreoretinal surgery. Methods: A retrospective chart review was conducted on vitreoretinal surgery cases using LMA or ETI from 2014-2018. 278 vitreoretinal surgery patients (139 LMA patients, 139 ETI patients) were included from one health system and two surgeons. Operating room efficiency and airway complications were analyzed using Cohcran-Armitage Trend, Wilcoxon Rank Sum, Chi-Square, and Two-Sample t-Tests. Results: Compared to ETI, LMA patients had a statistically significant faster time to successful airway insertion (3 minutes faster), time to case start (8 minutes faster), and total time in operating room (25 minutes faster). These trends remained statistically significant after subanalysis by type of vitreoretinal surgery and American Society of Anesthesiologists (ASA) score. Demographics were balanced by age and gender. No complications occurred with LMA No patients were converted from LMA to ETI. Conclusions: LMA is an efficient and safe alternative to ETI for vitreoretinal surgery

Kinetic particle simulations in a global toroidal geometry

The gyrokinetic toroidal code has been upgraded for global simulations by coupling the core and scrape-off layer regions across the separatrix with field-aligned particle-grid interpolations. A fully kinetic particle pusher for high frequency waves (ion cyclotron frequency and beyond) and a guiding center pusher for low frequency waves have been implemented using cylindrical coordinates in a global toroidal geometry. The two integrators correctly capture the particle orbits and agree well with each other, conserving energy and canonical angular momentum. As a verification and application of this new capability, ion guiding center simulations have been carried out to study ion orbit losses at the edge of the DIII-D tokamak for single null magnetic separatrix discharges. The ion loss conditions are examined as a function of the pitch angle for cases without and with a radial electric field. The simulations show good agreement with past theoretical results and with the experimentally observed feature in which high energy ions flow out along the ion drift orbits and then hit the divertor plates. A measure of the ion direct orbit loss fraction shows that the loss fraction increases with the ion energy for DIII-D in the initial velocity space. Finally, as a further verification of the capability of the new code, self-consistent simulations of zonal flows in the core region of the DIII-D tokamak were carried out. All DIII-D simulations were performed in the absence of turbulence