Cortical synapse organization supports a range of dynamic states on multiple spatial and temporal scales, from synchronous slow wave activity (SWA), characteristic of deep sleep or anesthesia, to fluctuating, asynchro...
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PURPOSE:Pediatric hydrocephalus is the most common cause of surgically treatable neurological disease in children. Controversies exist whether endoscopic third ventriculostomy (ETV) or cerebrospinal fluid (CSF) shunt ...
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PURPOSE:Pediatric hydrocephalus is the most common cause of surgically treatable neurological disease in children. Controversies exist whether endoscopic third ventriculostomy (ETV) or cerebrospinal fluid (CSF) shunt placement is the most appropriate treatment for pediatric hydrocephalus. This study aimed to compare the risk of re-operation and death between the two procedures.
METHODS:We performed a retrospective population-based cohort study and included patients younger than 20-years-old who underwent CSF shunt or ETV for hydrocephalus from the Taiwan National Health Insurance Research Database.
RESULTS:A total of 3,555 pediatric patients from 2004 to 2017 were selected, including 2,340 (65.8%) patients that received CSF shunt placement and 1215 (34.2%) patients that underwent ETV. The incidence of all-cause death was 3.31 per 100 person-year for CSF shunt group and 2.52 per 100 person-year for ETV group, with an adjusted hazard ratio (HR) of 0.79 (95% confidence interval [CI] = 0.66-0.94, p = 0.009). The cumulative incidence competing risk for reoperation was 31.2% for the CSF shunt group and 26.4% for the ETV group, with an adjusted subdistribution HR of 0.82 (95% CI = 0.70-0.96, p = 0.015). Subgroup analysis showed that ETV was beneficial for hydrocephalus coexisting with brain or spinal tumor, central nervous system infection, and intracranial hemorrhage.
CONCLUSION:Our data indicates ETV is a better operative procedure for pediatric hydrocephalus when advanced surgical techniques and instruments are available.
Alzheimer's disease (AD) is the leading cause of dementia, presenting a significant unmet medical need worldwide. The pathogenesis of AD involves various pathophysiological events, including the accumulation of am...
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Alzheimer's disease (AD) is the leading cause of dementia, presenting a significant unmet medical need worldwide. The pathogenesis of AD involves various pathophysiological events, including the accumulation of amyloid and tau, neuro-inflammation, and neuronal injury. Clinical trials focusing on new drugs for AD were documented in 2020, but subsequent developments have emerged since then. Notably, the US-FDA has approved Aducanumab and Lecanemab, both antibodies targeting amyloid, marking the end of a nearly two-decade period without new AD drugs. In this comprehensive report, we review all trials listed in ***, elucidating their underlying mechanisms and study designs. Ongoing clinical trials are investigating numerous promising new drugs for AD. The main trends in these trials involve pathophysiology-based, disease-modifying therapies and the recruitment of participants in earlier stages of the disease. These trends underscore the significance of conducting fundamental research on pathophysiology, prevention, and intervention prior to the occurrence of brain damage caused by AD.
Background Outdoor air pollution exposure is associated with structural and functional brain differences, and an increased risk for psychopathology. Although the neural mechanisms remain unclear, air pollutants may im...
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Background Outdoor air pollution exposure is associated with structural and functional brain differences, and an increased risk for psychopathology. Although the neural mechanisms remain unclear, air pollutants may impact mental health by altering brain regions implicated in psychopathology, such as the amygdala. Here, we examine the association between ambient air pollution exposure and amygdala subregion volumes in 9–10-year-olds. Methods Cross-sectional data from 4,473 (55.4% male) Adolescent Brain Cognitive Development SM (ABCD) Study® participants were leveraged. Air pollution exposure was estimated based on each participant’s primary residential address. Using the CIT168 atlas, we quantified total amygdala and 9 subregion volumes from T1- and T2-weighted images. We investigated associations between criteria pollutants (i.e., fine particulate matter [PM 2.5 ], nitrogen dioxide, and ground-level ozone), 15 PM 2.5 components, and amygdala subregion volumes and relative volume fractions using both single-pollutant linear mixed-effects regression and partial least squares correlation (PLSC) co-exposure modeling approaches. Results No significant associations were detected using single-pollutant models. Rather, in examining mixtures of exposures with PLSC, one latent dimension (52% variance explained) captured a positive association between calcium and several basolateral subregions. Latent dimensions were also identified for amygdala relative volume fractions (ranging from 30% to 82% variance explained), with PM 2.5 and component co-exposure associated with increases in lateral, but decreases in medial and central, relative volume fractions. Conclusions Fine particulate matter and its components are associated with distinct amygdala differences, potentially playing a role in risk for adolescent mental health problems.
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