Brainstem Dotaz Zobrazit nápovědu
Inhibitory neurotransmission plays a substantial role in encoding of auditory cues relevant for sound localization in vertebrates. While the anatomical organization of the respective afferent auditory brainstem circuits shows remarkable similarities between mammals and birds, the properties of inhibitory neurotransmission in these neural circuits are strikingly different. In mammals, inhibition is predominantly glycinergic and endowed with fast kinetics. In birds, inhibition is mediated by gamma-Aminobutiric acid (GABA) and too slow to convey temporal information. A further prominent difference lies in the mechanism of inhibition in the respective systems. In auditory brainstem neurons of mammals, [Cl(-)](i) undergoes a developmental shift causing the actions of GABA and glycine to gradually change from depolarization to the 'classic' hyperpolarizing-inhibition before hearing onset. Contrary to this, in the mature avian auditory brainstem Cl(-) homeostasis mechanisms accurately adjust the Cl(-) gradient to enable depolarizing, but still very efficient, shunting inhibition. The present review considers the mechanisms underlying development of the Cl(-) homeostasis in the auditory system of mammals and birds and discusses some open issues that require closer attention in future studies.
- MeSH
- chloridy metabolismus MeSH
- druhová specificita MeSH
- GABA metabolismus MeSH
- glycin metabolismus MeSH
- homeostáza MeSH
- lidé MeSH
- lokalizace zvuku MeSH
- mozkový kmen metabolismus MeSH
- nervový útlum * MeSH
- sluchová dráha metabolismus MeSH
- sluchové kmenové evokované potenciály MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- chloridy MeSH
- GABA MeSH
- glycin MeSH
In a group of 195 consecutively examined patients with brainstem neurological symptomatology parameters of the wave III BAEPs were pathological in 20 patients. In 70% of them the clinical symptomatology and/or the cranial computed tomography examination results pointed to a lesion at the level of pontomedullary junction and lower pons Varoli where according to the recent opinion the possible generators of this BAEP wave are situated (superior olivary complex, nuclei cochleares, corpus trapezoideum). These results support the supposed localization of possible generators of the wave III BAEPs.
- MeSH
- audiometrie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mozkový kmen patofyziologie MeSH
- nemoci mozku patofyziologie MeSH
- sluchové kmenové evokované potenciály * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
In the Czech Republic, the first implantation of a stimulation electrode into the brainstem was performed on 11 January 1999 in the Department of ORL, Head and Neck Surgery, The First Medical Faculty, Charles University in Prague, University Hospital Motol. The selected patient was a 40-year-old woman with neurofibromatosis type 2 (NF2) who had previously undergone bilateral vestibular schwannoma surgery. Both tumours had been radically removed, the left-sided tumour in 1987, the right-sided one in 1988. She had been completely deaf since the last operation, i.e., for 11 years. The surgery was realized by the international cooperation of three teams. Placement of the electrode pad of the Nucleus CI21 + 1M system on the ventral and dorsal cochlear nuclei was performed. Electrically evoked auditory brainstem responses (EABRs) proved the correct position of the electrode array. The post-operative course was uneventful. Six weeks after the surgery the patient received her speech processor. Since that time, the patient already absolved several sessions of a speech processor tune-up. She uses the device as an aid in lip-reading. No adverse or pathological side effects have been observed. The patient was the 45th person in Europe to receive an ABI and the first in the Czech Republic.
- MeSH
- centrální nedoslýchavost komplikace chirurgie MeSH
- dospělí MeSH
- implantace protézy * MeSH
- lidé MeSH
- mozkový kmen chirurgie MeSH
- neurofibromatóza 2 komplikace chirurgie MeSH
- nucleus cochlearis * MeSH
- odezírání MeSH
- sluchové kmenové evokované potenciály MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Panic disorder has been associated with altered serotonin metabolism in the brainstem raphe. The aim of study was to evaluate the BR echogenicity on transcranial sonography (TCS) in panic disorder. A total of 96 healthy volunteers were enrolled in the "derivation" cohort, and 26 healthy volunteers and 26 panic disorder patients were enrolled in the "validation" cohort. TCS echogenicity of brainstem raphe and substantia nigra was assessed on anonymized images visually and by means of digitized image analysis. Significantly reduced brainstem raphe echogenicity was detected more frequently in panic disorder patients than in controls using both visual (68% vs. 31%) and digitized image analysis (52% vs. 12%). The optimal cut-off value of digitized brainstem raphe echogenicity indicated the diagnosis of panic disorder with a sensitivity of 64% and a specificity of 73%, and corresponded to the 30th percentile in the derivation cohort. Reduced brainstem raphe echogenicity was associated with shorter treatment duration, and, by trend, lower severity of anxiety. No relationship was found between echogenicity of brainstem raphe or substantia nigra and age, gender, severity of panic disorder, or severity of depression. Patients with panic disorder exhibit changes of brainstem raphe on TCS suggesting an alteration of the central serotonergic system.
- Klíčová slova
- Brainstem raphe, Panic disorder, Transcranial sonography,
- MeSH
- depresivní poruchy komplikace diagnostické zobrazování MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozkový kmen diagnostické zobrazování MeSH
- nuclei raphe diagnostické zobrazování MeSH
- panická porucha komplikace diagnostické zobrazování MeSH
- senzitivita a specificita MeSH
- substantia nigra diagnostické zobrazování MeSH
- ultrasonografie dopplerovská transkraniální metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Auditory function in Fischer 344 (F344) and Long Evans (LE) rats was monitored during their lifespan by evaluating hair cell loss, middle-ear compliance and the recording of otoacoustic emissions and auditory brainstem responses. The results revealed a faster deterioration of hearing function in F344 rats compared with LE rats, resulting in larger hearing threshold shifts, a decrease in the latency and amplitude of click-evoked auditory brainstem responses, diminution of the distortion product otoacoustic emissions and a decrease in middle-ear compliance. However, hair cell loss, observed only at the most basal and apical parts of the organ of Corti, was comparable in older individuals of both rat strains. The results suggest involvement of cochlear (stria vascularis) and extracochlear (middle-ear) pathological changes during ageing. Thus, F344 rats represent a complex mix of conductive hearing loss (with low-frequency threshold shift, declining parameters of the middle-ear admittance and asymmetric otoacoustic emissions) and sensorineural hearing loss (with a decrease in the amplitudes of auditory brainstem response and a high-frequency threshold shift).
- MeSH
- kochlea cytologie fyziologie MeSH
- krysa rodu Rattus MeSH
- potkani inbrední F344 MeSH
- potkani Long-Evans MeSH
- sluch fyziologie MeSH
- sluchové kmenové evokované potenciály MeSH
- sluchové testy MeSH
- sluchový práh fyziologie MeSH
- stárnutí patologie fyziologie MeSH
- vláskové buňky cytologie fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Cavernomas are vascular hamartomas made up of thin-walled, grossly dilated blood vessels lined with endothelium. Between 4 and 35 % (mean 15 %) of cerebral cavernomas are located in the brainstem making resection of these lesions one of the most challenging tasks in neurosurgery. METHODS: Patients with cavernomas within the brainstem or deep supratentorial structures were chosen from our prospectively collected database of operated patients with brain cavernomas. The timespan of treatment was between January 1998 and June 2012. Primary outcome was defined as percentage of patients with favourable outcome (Glasgow Outcome Scale (GOS) 4 or 5) at 1 year. Secondary outcome was defined as operation-related morbidity and mortality (drop at least 1 point on GOS at 1 year). RESULTS: A total of 37 patients underwent surgery. The mean age was 34.7 ± 11.7 years. The male to female ratio was 19:16. Thirty-two patients had a solitary lesion and 12 patients harboured multiple lesions. The Glasgow outcome score 4 or 5 was achieved after 34 operations (89.5 %). The mean follow-up was 39 months. We experienced two early post-operative deaths (5.3 %) and decrease in the Glasgow outcome scale postoperatively in 4 patients (10.5 %). CONCLUSIONS: • Favourable outcome was achieved in 89.5 % of cases. • Although M&M appears to be relatively high, surgery is method of choice for surgically accessible lesion which has bled for the first time due to reported high rebleed rate and high probability of poor outcome after cavernoma rebleed. • Radiosurgery should be reserved for those lesions which are deemed unresectable and where surgical intervention is considered favourable to observation alone.
- MeSH
- dospělí MeSH
- Glasgowská stupnice následků MeSH
- kavernózní hemangiom centrálního nervového systému patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozkový kmen krevní zásobení patologie chirurgie MeSH
- nádory mozkového kmene krevní zásobení patologie chirurgie MeSH
- neurochirurgické výkony metody MeSH
- pooperační komplikace prevence a kontrola MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers. Hemorrhagic risk reduction, risk factors of post-SRS hemorrhage, and clinical outcomes were retrospectively analyzed. Most patients had a single (165/170 patients) brainstem CCMs treated; the majority of CCMs (165/181) presented with bleeding. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM (HR: 0.17, p < 0.001) using recurrent multivariate analysis. The annual hemorrhage rate decreased from 14.8 per 100 CCM-years before SRS to 2.3 after treatment. Using univariate Cox-analysis, the probability of a new hemorrhages after SRS was reduced for patient older than 35 years (HR = 0.21, p = 0.002) and increased with a margin dose > 13 Gy (HR = 2.57, p = 0.044). Adverse radiation effect (ARE) occurred in 9 patients (5.3%) and was symptomatic in four (2.4%). At a median follow-up of 3.4 years (Inter-quartile range: 5.4), 13 patients (8.0%) had a worsened clinical status, with the treated CCM being the cause in 5.6% (10) of the patients. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM and conveyed this benefit with a low risk of advrse radiation effects (ARE) and worsening clinical status.
- Klíčová slova
- Cerebral cavernous malformation, Hemorrhagic, Stereotactic radiosurgery, brainstem,
- MeSH
- dítě MeSH
- dospělí MeSH
- kavernózní hemangiom centrálního nervového systému * chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozkový kmen * MeSH
- nádory mozkového kmene radioterapie chirurgie patologie MeSH
- předškolní dítě MeSH
- radiochirurgie * metody škodlivé účinky MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. OBJECTIVE: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. METHODS: This study used data from MSBase registry. Patients with early cerebellar/brainstem presentations were identified as those with cerebellar/brainstem relapse(s) or functional system score ⩾ 2 in the initial 2 years. Early pyramidal presentation was chosen as a comparator. Andersen-Gill models were used to compare cumulative hazards of (1) disability progression events and (2) relapses between patients with and without early cerebellar/brainstem symptoms. Mixed effect models were used to estimate the associations between early cerebellar/brainstem presentations and expanded disability status scale (EDSS) scores. RESULTS: The study cohort consisted of 10,513 eligible patients, including 2723 and 3915 patients with early cerebellar and brainstem symptoms, respectively. Early cerebellar presentation was associated with greater hazard of progression events (HR = 1.37, p < 0.001) and EDSS (β = 0.16, p < 0.001). Patients with early brainstem symptoms had lower hazard of progression events (HR = 0.89, p = 0.01) and EDSS (β = -0.06, p < 0.001). Neither presentation was associated with changes in relapse risk. CONCLUSION: Early cerebellar presentation is associated with unfavourable outcomes, while early brainstem presentation is associated with favourable prognosis. These presentations may be used as MS prognostic markers and guide therapeutic approach.
- Klíčová slova
- Multiple sclerosis, brainstem, cerebellar, disability outcome, early symptomatology, prognostic marker,
- MeSH
- kohortové studie MeSH
- lidé MeSH
- mozkový kmen MeSH
- postižení * MeSH
- posuzování pracovní neschopnosti MeSH
- progrese nemoci MeSH
- roztroušená skleróza * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
This paper presents a rate-code model of binaural interaction inspired by recent neurophysiological findings. The model consists of a peripheral part and a binaural part. The binaural part is composed of models of the medial superior olive (MSO) and the lateral superior olive (LSO), which are parts of the auditory brainstem. The MSO and LSO model outputs are preprocessed in the interaural time difference (ITD) and interaural level difference (ILD) central stages, respectively, which give absolute values of the predicted lateralization at their outputs, allowing a direct comparison with psychophysical data. The predictions obtained with the MSO and LSO models are compared with subjective data on the lateralization of pure tones and narrowband noises, discrimination of the ITD and ILD, and discrimination of the phase warp. The lateralization and discrimination experiments show good agreement with the subjective data. In the case of the phase-warp experiment, the models agree qualitatively with the subjective data. The results demonstrate that rate-code models of MSO and LSO can be used to explain psychophysical data considering lateralization and discrimination based on binaural cues.
- MeSH
- diskriminace (psychologie) MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokalizace zvuku * MeSH
- modely neurologické * MeSH
- mozkový kmen fyziologie MeSH
- sluchové kmenové evokované potenciály MeSH
- ucho fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- afázie diagnóza patofyziologie MeSH
- dítě MeSH
- dysartrie diagnóza patofyziologie MeSH
- lidé MeSH
- mozkový kmen patofyziologie MeSH
- předškolní dítě MeSH
- sluchové kmenové evokované potenciály fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH