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Liu Z, Zhang X, Yu B, Wang J, Lu X. Effectiveness on level of consciousness of non-invasive neuromodulation therapy in patients with disorders of consciousness: a systematic review and meta-analysis. Front Hum Neurosci 2023; 17:1129254. [PMID: 37292582 PMCID: PMC10246452 DOI: 10.3389/fnhum.2023.1129254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Background Disorders of consciousness (DoC) commonly occurs secondary to severe neurological injury. A considerable volume of research has explored the effectiveness of different non-invasive neuromodulation therapy (NINT) on awaking therapy, however, equivocal findings were reported. Objective The aim of this study was to systematically investigate the effectiveness on level of consciousness of different NINT in patients with DoC and explore optimal stimulation parameters and characteristics of patients. Methods PubMed, Embase, Web of Science, Scopus, and Cochrane central register of controlled trials were searched from their inception through November 2022. Randomized controlled trials, that investigated effectiveness on level of consciousness of NINT, were included. Mean difference (MD) with 95% confidence interval (CI) was evaluated as effect size. Risk of bias was assessed with revised Cochrane risk-of-bias tool. Results A total of 15 randomized controlled trials with 345 patients were included. Meta-analysis was performed on 13 out of 15 reviewed trials indicating that transcranial Direct Current Stimulation (tDCS), Transcranial Magnetic Stimulation (TMS), and median nerve stimulation (MNS) all had a small but significant effect (MD 0.71 [95% CI 0.28, 1.13]; MD 1.51 [95% CI 0.87, 2.15]; MD 3.20 [95%CI: 1.45, 4.96]) on level of consciousness. Subgroup analyses revealed that patients with traumatic brain injury, higher initial level of consciousness (minimally conscious state), and shorter duration of prolonged DoC (subacute phase of DoC) reserved better awaking ability after tDCS. TMS also showed encouraging awaking effect when stimulation was applied on dorsolateral prefrontal cortex in patients with prolonged DoC. Conclusion tDCS and TMS appear to be effective interventions for improving level of consciousness of patients with prolonged DoC. Subgroup analyses identified the key parameters required to enhance the effects of tDCS and TMS on level of consciousness. Etiology of DoC, initial level of consciousness, and phase of DoC could act as significant characteristics of patients related to the effectiveness of tDCS. Stimulation site could act as significant stimulation parameter related to the effectiveness of TMS. There is insufficient evidence to support the use of MNS in clinical practice to improve level of consciousness in patients with coma. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=337780, identifier: CRD42022337780.
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Affiliation(s)
| | | | | | | | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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2
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Kannan P, Bello UM. The efficacy of different forms of acupuncture for the treatment of nocturnal enuresis in children: A systematic review and meta-analysis. Explore (NY) 2021; 18:488-497. [PMID: 34893441 DOI: 10.1016/j.explore.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 09/14/2021] [Accepted: 11/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The efficacy of different forms of acupuncture for the treatment of nocturnal enuresis in children is not known. OBJECTIVE To determine the efficacy of different forms of acupuncture, such as manual acupuncture, laser/electroacupuncture, acupoint injection, and moxibustion, for the treatment of nocturnal enuresis. METHODS A literature search was conducted on Medline, EMBASE, Web of Science, CINAHL, PubMed, Physiotherapy Evidence Database, and Scopus from database inception to September 2020. The Cochrane risk of bias tool was utilised to evaluate the risk of bias in each included study. The quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation tool. RESULTS Thirteen trials (n = 890) were included. Meta-analyses revealed significantly greater numbers of children reporting improved nocturnal enuresis in the moxibustion (p = 0.004), acupoint injection (p = 0.020), and laser acupuncture (p = 0.001) groups than in the control groups. Meta-analyses showed no significant differences in the numbers of children reporting the complete cure of nocturnal enuresis between laser acupuncture and desmopressin (p = 0.57). CONCLUSIONS The review identified moxibustion, acupoint injections, and laser acupuncture as effective treatments for nocturnal enuresis in children. However, the evidence for these interventions is limited and of very-low-grade quality. The effects of laser acupuncture compared with desmopressin remain inconclusive.
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Affiliation(s)
- Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Umar M Bello
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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3
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Poznański RR, Brändas EJ. Panexperiential materialism: A physical exploration of qualitativeness in the brain. ADVANCES IN QUANTUM CHEMISTRY 2020. [DOI: 10.1016/bs.aiq.2020.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Suditu N, Negru I, Miron A, Novac B, Ciuta C. Is nocturnal enuresis a predisposing factor for the overactive bladder? Turk J Med Sci 2019; 49:703-709. [PMID: 31203588 PMCID: PMC7018347 DOI: 10.3906/sag-1604-116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background/aim This study aimed to perform a limited observational study to ascertain whether there is statistical support that nocturnal enuresis (NE) is a predisposing factor in the development of overactive bladder (OAB). Materials and methods The authors recruited patients diagnosed with OAB over a period of twelve months, and those who declared a history of NE were asked additional questions regarding the features of their NE. Results A total of 285 patients were diagnosed with overactive bladder, and 98 (34.38%) of them had previously displayed NE symptoms that had diminished before reaching the median age of 9.83. Separation of patients by sex revealed a male majority (58.16%). Additionally, most patients had urban origins (75.51%). The median time span from remission of NE to diagnosis of OAB was 24.79 years, and the median age at which patients began to suffer was 31.80 years. Behavioral factors (smoking, alcohol consumption) and psychological and infectious factors (past history of urinary tract infection) were identified at varying degrees. Conclusion The presence of NE in a third of the patients who developed over time OAB and the earlier onset of OAB for these patients suggests a causal physiopathological relationship between NE and OAB. The preponderance of urban patients confirms the existence of acquired urban triggering factors of OAB (nutritious, social, or professional).
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Affiliation(s)
| | - Irina Negru
- Department of Surgery, Arcadia Hospital, Iaşi, Romania
| | - Adelina Miron
- Department of Urology and Kidney Transplant, “Dr. C.I. Parhon” Clinical Hospital, Iaşi, Romania
| | - Bogdan Novac
- Department of Urology and Kidney Transplant, “Dr. C.I. Parhon” Clinical Hospital, Iaşi, Romania
| | - Catalin Ciuta
- Department of Urology and Kidney Transplant, “Dr. C.I. Parhon” Clinical Hospital, Iaşi, Romania
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Harsay HA, Cohen MX, Spaan M, Weeda WD, Nieuwenhuis S, Ridderinkhof KR. Error blindness and motivational significance: Shifts in networks centering on anterior insula co-vary with error awareness and pupil dilation. Behav Brain Res 2017; 355:24-35. [PMID: 29107022 DOI: 10.1016/j.bbr.2017.10.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/29/2017] [Accepted: 10/25/2017] [Indexed: 12/23/2022]
Abstract
This investigation aims to further our understanding of the brain mechanisms underlying the awareness of one's erroneous actions. While all errors are registered as such in the rostral cingulate zone, errors enter awareness only when the anterior insula cortex is activated. Aware but not unaware errors elicit autonomic nervous system reactivity. Our aim is to investigate the hypothesis that activation in the insula during error awareness is related to autonomic arousal and to inter-regional interactions with other areas of the brain. To examine the role of the anterior insula in error awareness, we assessed its functional connectivity to other brain regions along with autonomic nervous system reactivity in young healthy participants who underwent simultaneous pupil-diameter and functional magnetic resonance imaging measurements while performing a complex and error-prone task. Error blindness was associated with failures to engage sufficient autonomic reactivity. During aware errors increased pupil-diameter along with increased task-related activation within, and increased connectivity between anterior insula and task-related networks suggested an increased capacity for action-control information transfer. Increased pupil-diameter during aware errors was furthermore associated with decreased activation of the default-mode network along with decreased insular connectivity with regions of the default mode system, possibly reflecting decreased task-irrelevant information processing. This shifting mechanism may be relevant to a better understanding of how the brain and the autonomic nervous system interact to enable efficient adaptive behavior during cognitive challenge.
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Affiliation(s)
- Helga A Harsay
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael X Cohen
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Marcus Spaan
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter D Weeda
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands; Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Sander Nieuwenhuis
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands; Department of Psychology, Leiden University, Leiden, The Netherlands
| | - K Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain & Cognition (ABC), University of Amsterdam, The Netherlands.
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Sinha R, Raut S. Management of nocturnal enuresis - myths and facts. World J Nephrol 2016; 5:328-338. [PMID: 27458562 PMCID: PMC4936340 DOI: 10.5527/wjn.v5.i4.328] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 04/06/2016] [Accepted: 05/10/2016] [Indexed: 02/06/2023] Open
Abstract
Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.
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7
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Luijpen MW, Swaab DF, Sergeant JA, Scherder EJA. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Self-Efficacy and Mood in Elderly with Mild Cognitive Impairment. Neurorehabil Neural Repair 2016; 18:166-75. [PMID: 15375277 DOI: 10.1177/0888439004268785] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In previous studies, transcutaneous electrical nerve stimulation (TENS) has been applied to patients with either Alzheimer’s disease (AD) or incipient dementia, resulting in an enhancement in memory and verbal fluency. Moreover, affective behavior was shown to improve. Based on the positive effects of TENS in AD, it was hypothesized that TENS would improve self-efficacy in nondemented elderly with mild cognitive impairment (MCI) who live in a residential home. Four outcome measures, that is, a Dutch translation of the General Self-Efficacy Scale (Algemene Competentie Schaal), the Groninger Activity Restriction Scale, the Philadelphia Geriatric Center Morale Scale, and the Geriatric Depression Scale, were administered. Overall, the results suggest that the experimental group showed a mild improvement in self-efficacy and mood. In contrast, the placebo group showed a considerable reduction in self-efficacy and an increase in depression. Limitations of the present study and suggestions for future research are discussed.
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Affiliation(s)
- Marijn W Luijpen
- Department of Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands.
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Efficacy of Acupuncture in Children with Nocturnal Enuresis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:320701. [PMID: 26167190 PMCID: PMC4488007 DOI: 10.1155/2015/320701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/30/2015] [Accepted: 01/31/2015] [Indexed: 12/15/2022]
Abstract
Background. Nocturnal enuresis (NE) is recognized as a widespread health problem in young children and adolescents. Clinical researches about acupuncture therapy for nocturnal enuresis are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking. Objective. This study aims to assess the effectiveness of acupuncture therapy for nocturnal enuresis. Materials and Methods. A comprehensive literature search of 8 databases was performed up to June 2014; randomized controlled trials which compared acupuncture therapy and placebo treatment or pharmacological therapy were identified. A meta-analysis was conducted. Results. This review included 21 RCTs and a total of 1590 subjects. The overall methodological qualities were low. The results of meta-analysis showed that acupuncture therapy was more effective for clinical efficacy when compared with placebo or pharmacological treatment. Adverse events associated with acupuncture therapy were not documented. Conclusion. Based on the findings of this study, we cautiously suggest that acupuncture therapy could improve the clinical efficacy. However, the beneficial effect of acupuncture might be overstated due to low methodological qualities. Rigorous high quality RCTs are urgently needed.
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ZHONG YINGJUN, FENG ZHEN, WANG LIANG, WEI TIANQI. Wake-promoting actions of median nerve stimulation in TBI-induced coma: An investigation of orexin-A and orexin receptor 1 in the hypothalamic region. Mol Med Rep 2015; 12:4441-4447. [DOI: 10.3892/mmr.2015.3898] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 05/08/2015] [Indexed: 11/06/2022] Open
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Lei J, Wang L, Gao G, Cooper E, Jiang J. Right Median Nerve Electrical Stimulation for Acute Traumatic Coma Patients. J Neurotrauma 2015; 32:1584-9. [PMID: 25664378 DOI: 10.1089/neu.2014.3768] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The right median nerve as a peripheral portal to the central nervous system can be electrically stimulated to help coma arousal after traumatic brain injury (TBI). The present study set out to examine the efficacy and safety of right median nerve electrical stimulation (RMNS) in a cohort of 437 comatose patients after severe TBI from August 2005 to December 2011. The patients were enrolled 2 weeks after their injury and assigned to the RMNS group (n=221) receiving electrical stimulation for 2 weeks or the control group (n = 216) treated by standard management according to the date of birth in the month. The baseline data were similar. After the 2-week treatment, the RMNS-treated patients demonstrated a more rapid increase of the mean Glasgow Coma Score, although statistical significance was not reached (8.43 ± 4.98 vs. 7.47 ± 5.37, p = 0.0532). The follow-up data at 6-month post-injury showed a significantly higher proportion of patients who regained consciousness (59.8% vs. 46.2%, p = 0.0073). There was a lower proportion of vegetative persons in the RMNS group than in the control group (17.6% vs. 22.0%, p = 0.0012). For persons regaining consciousness, the functional independence measurement (FIM) score was higher among the RMNS group patients (91.45 ± 8.65 vs. 76.23 ± 11.02, p < 0.001). There were no unique complications associated with the RMNS treatment. The current study, although with some limitations, showed that RMNS may serve as an easy, effective, and noninvasive technique to promote the recovery of traumatic coma in the early phase.
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Affiliation(s)
- Jin Lei
- 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .,2 Shanghai Institute of Head Trauma , Shanghai, China
| | - Lei Wang
- 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .,2 Shanghai Institute of Head Trauma , Shanghai, China
| | - Guoyi Gao
- 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .,2 Shanghai Institute of Head Trauma , Shanghai, China
| | - Edwin Cooper
- 3 Department of Neurological Surgery, University of Virginia Health System , Charlottesville, Virginia
| | - Jiyao Jiang
- 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .,2 Shanghai Institute of Head Trauma , Shanghai, China
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11
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Copeptin as a Novel Biomarker in Nocturnal Enuresis. Urology 2013; 82:1120-3. [DOI: 10.1016/j.urology.2013.05.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/02/2013] [Accepted: 05/08/2013] [Indexed: 11/22/2022]
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12
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Nemoto C, Murakawa M, Hakozaki T, Imaizumi T, Isosu T, Obara S. Effects of dexmedetomidine, midazolam, and propofol on acetylcholine release in the rat cerebral cortex in vivo. J Anesth 2013; 27:771-4. [DOI: 10.1007/s00540-013-1589-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 02/26/2013] [Indexed: 12/29/2022]
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Abstract
Nocturnal enuresis is common problem in children with a prevalence as high as 20% among children aged 5. Though nocturnal enuresis does not directly impose imminent danger to a patient's life, children with enuresis and their parents can be psychologically suffering in day-to-day life, including in school activities. Therefore, it is important to provide an explanation regarding the cause of nocturnal enuresis, how to approach the disorder, the course, and the outlook leading to the planned treatment. The cause of enuresis is considered to be a mismatch between nocturnal diuresis and nocturnal bladder capacity, nocturnal polyuria due to a lack of circadian change in antidiuretic hormones, and a developmental delay in the voiding mechanisms. Therefore, patients can be classified as the type associated with a large amount of urine at night (polyuria type), the type that is associated with a functionally small bladder capacity (bladder type), the type associated with both the aforementioned (mixed type), or the type that does not fall under any of these (normal type). Based on this logic, although the International Children's Continence Society has issued the standardization document, in which the enuresis alarm and desmopressin therapy are recommended as the first line treatment, a different tack has been taken in Japan, where the therapeutic strategy is plotted depending on the type of enuresis; pharmacotherapy for enuretic children aged 6 years or older includes desmopressin acetate for polyuria type, anticholinergic agents for bladder type, and a combination of these agents for mixed type.
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Affiliation(s)
- Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Osaka, Japan.
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Croizier S, Amiot C, Chen X, Presse F, Nahon JL, Wu JY, Fellmann D, Risold PY. Development of posterior hypothalamic neurons enlightens a switch in the prosencephalic basic plan. PLoS One 2011; 6:e28574. [PMID: 22194855 PMCID: PMC3241628 DOI: 10.1371/journal.pone.0028574] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 11/10/2011] [Indexed: 12/24/2022] Open
Abstract
In rats and mice, ascending and descending axons from neurons producing melanin-concentrating hormone (MCH) reach the cerebral cortex and spinal cord. However, these ascending and descending projections originate from distinct sub-populations expressing or not “Cocaine-and-Amphetamine-Regulated-Transcript” (CART) peptide. Using a BrdU approach, MCH cell bodies are among the very first generated in the hypothalamus, within a longitudinal cell cord made of earliest delaminating neuroblasts in the diencephalon and extending from the chiasmatic region to the ventral midbrain. This region also specifically expresses the regulatory genes Sonic hedgehog (Shh) and Nkx2.2. First MCH axons run through the tractus postopticus (tpoc) which gathers pioneer axons from the cell cord and courses parallel to the Shh/Nkx2.2 expression domain. Subsequently generated MCH neurons and ascending MCH axons differentiate while neurogenesis and mantle layer differentiation are generalized in the prosencephalon, including telencephalon. Ascending MCH axons follow dopaminergic axons of the mesotelencephalic tract, both being an initial component of the medial forebrain bundle (mfb). Netrin1 and Slit2 proteins that are involved in the establishment of the tpoc and mfb, respectively attract or repulse MCH axons. We conclude that first generated MCH neurons develop in a diencephalic segment of a longitudinal Shh/Nkx2.2 domain. This region can be seen as a prosencephalic segment of a medial neurogenic column extending from the chiasmatic region through the ventral neural tube. However, as the telencephalon expends, it exerts a trophic action and the mfb expands, inducing a switch in the longitudinal axial organization of the prosencephalon.
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Affiliation(s)
- Sophie Croizier
- EA3922, Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France
- IFR133, Université de Franche-Comté, Besançon, France
| | - Clotilde Amiot
- EA3922, Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France
- IFR133, Université de Franche-Comté, Besançon, France
| | - Xiaoping Chen
- Department of Neurology, School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Françoise Presse
- UMR 6097 CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, Université Nice-Sophia Antipolis, Valbonne, France
| | - Jean-Louis Nahon
- UMR 6097 CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, Université Nice-Sophia Antipolis, Valbonne, France
| | - Jane Y. Wu
- Department of Neurology, School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Dominique Fellmann
- EA3922, Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France
- IFR133, Université de Franche-Comté, Besançon, France
| | - Pierre-Yves Risold
- EA3922, Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France
- IFR133, Université de Franche-Comté, Besançon, France
- * E-mail:
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Nevéus T. Nocturnal enuresis-theoretic background and practical guidelines. Pediatr Nephrol 2011; 26:1207-14. [PMID: 21267599 PMCID: PMC3119803 DOI: 10.1007/s00467-011-1762-8] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 12/24/2010] [Accepted: 01/04/2011] [Indexed: 02/07/2023]
Abstract
Nocturnal polyuria, nocturnal detrusor overactivity and high arousal thresholds are central in the pathogenesis of enuresis. An underlying mechanism on the brainstem level is probably common to these mechanisms. Enuretic children have an increased risk for psychosocial comorbidity. The primary evaluation of the enuretic child is usually straightforward, with no radiology or invasive procedures required, and can be carried out by any adequately educated nurse or physician. The first-line treatment, once the few cases with underlying disorders, such as diabetes, kidney disease or urogenital malformations, have been ruled out, is the enuresis alarm, which has a definite curative potential but requires much work and motivation. For families not able to comply with the alarm, desmopressin should be the treatment of choice. In therapy-resistant cases, occult constipation needs to be ruled out, and then anticholinergic treatment-often combined with desmopressin-can be tried. In situations when all other treatments have failed, imipramine treatment is warranted, provided the cardiac risks are taken into account.
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Affiliation(s)
- Tryggve Nevéus
- Uppsala University Children's Hospital, 751 85 Uppsala, Sweden.
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16
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Kushikata T, Yoshida H, Kudo M, Kudo T, Hirota K. Changes in plasma orexin A during propofol–fentanyl anaesthesia in patients undergoing eye surgery. Br J Anaesth 2010; 104:723-7. [DOI: 10.1093/bja/aeq098] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Scherder EJA, Vuijk PJ, Swaab DF, van Someren EJW. Estimating the effects of right median nerve stimulation on memory in Alzheimer's disease: a randomized controlled pilot study. Exp Aging Res 2008; 33:177-86. [PMID: 17364906 DOI: 10.1080/03610730701238915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The goal of the present study was to examine possible effects of right median nerve stimulation (RMNS) on memory in patients in a relatively early stage of probable Alzheimer's disease (AD). Seventeen AD patients were randomly assigned to an experimental group (n = 8) and a control group (n = 9) and treated with RMNS and sham RMNS, respectively, for 30 min a day, 5 days a week, for 6 weeks. Neuropsychological tests were used to assess memory processes. The results show that the various aspects of memory did not respond positively to RMNS. A study with a much longer treatment period is suggested before firm conclusions about the ineffectiveness of RMNS on memory in AD can be drawn.
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Affiliation(s)
- Erik J A Scherder
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
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Van Dijk KRA, Luijpen MW, Van Someren EJW, Sergeant JA, Scheltens P, Scherder EJA. Peripheral electrical nerve stimulation and rest-activity rhythm in Alzheimer's disease. J Sleep Res 2007; 15:415-23. [PMID: 17118098 DOI: 10.1111/j.1365-2869.2006.00548.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rest-activity rhythm disruption is a prominent clinical feature of Alzheimer's disease (AD). The origin of the altered rest-activity rhythm is believed to be degeneration of the suprachiasmatic nucleus (SCN). In accordance with the 'use it or lose it' hypothesis of Swaab [Neurobiol Aging 1991, 12: 317-324] stimulation of the SCN may prevent age-related loss of neurons and might reactivate nerve cells that are inactive but not lost. Previous studies with relatively small sample sizes have demonstrated positive effects of peripheral electrical nerve stimulation on the rest-activity rhythm in AD patients. The present randomized, placebo-controlled, parallel-group study was meant to replicate prior findings of electrical stimulation in AD in a substantially larger group of AD patients. The experimental group (n = 31) received peripheral electrical nerve stimulation and the placebo group (n = 31) received sham stimulation. Effects of the intervention on the rest-activity rhythm were assessed by using wrist-worn actigraphs. Near-significant findings on the rest-activity rhythm partially support the hypothesis that neuronal stimulation enhances the rest-activity rhythm in AD patients. Interestingly, post-hoc analyses revealed significant treatment effects in a group of patients who were not using acetylcholinesterase inhibitors concomitantly. We conclude that more research is needed before firm general conclusions about the effectiveness of electrical stimulation as a symptomatic treatment in AD can be drawn. In addition, the present post-hoc findings indicate that future studies on non-pharmacological interventions should take medication use into account.
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Affiliation(s)
- Koene R A Van Dijk
- Department of Neurocognition, Faculty of Psychology, Maastricht University, Maastricht, The Netherlands.
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Scherder EJA, van Tol MJ, Swaab DF. High-Frequency Cranial Electrostimulation (CES) in Patients with Probable Alzheimer’s Disease. Am J Phys Med Rehabil 2006; 85:614-8. [PMID: 16788393 DOI: 10.1097/01.phm.0000223221.17301.50] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a previous study, low-frequency cranial electrostimulation did not improve cognition and (affective) behavior in patients with probable Alzheimer's disease. In the present study, 21 Alzheimer's disease patients, divided into an experimental (n = 11) and a control group (n = 10), were treated for 30 mins/day, 5 days/wk, for 6 wks with high-frequency cranial electrostimulation. Similar to the previous study, no improvements on cognition and (affective) behavior were found.
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Affiliation(s)
- Erik J A Scherder
- Institute of Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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Cooper EB, Scherder EJA, Cooper JB. Electrical treatment of reduced consciousness: experience with coma and Alzheimer's disease. Neuropsychol Rehabil 2006; 15:389-405. [PMID: 16350980 DOI: 10.1080/09602010443000317] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The right median nerve can be stimulated electrically to help arouse the central nervous system for persons with reduced levels of consciousness. The mechanisms of central action include increased cerebral blood flow and raised levels of dopamine. There is 11 years of experience in the USA of using nerve stimulation for acute coma after traumatic brain injury. There is a much longer period of experience by neurosurgeons in Japan with implanted electrodes on the cervical spinal cord for persons in the persistent vegetative state (PVS). But the use of right median nerve electrical stimulation (RMNS) for patients in the subacute and chronic phases of coma is relatively new. Surface electrical stimulation to treat anoxic brain injury as well as traumatic brain injury is evolving. Novel applications of electrical stimulation in Amsterdam have produced cognitive behavioural effects in persons with early and mid-stage Alzheimer's disease employing transcutaneous electrical nerve stimulation (TENS). Improvements in short-term memory and speech fluency have also been noted. Regardless of the aetiology of the coma or reduced level of awareness, electrical stimulation may serve as a catalyst to enhance central nervous system functions. It remains for the standard treatments and modalities to retrain the injured brain emerging from reduced levels of consciousness.
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Affiliation(s)
- E B Cooper
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
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Sawaguchi T, Kato I, Franco P, Sottiaux M, Kadhim H, Shimizu S, Groswasser J, Togari H, Kobayashi M, Nishida H, Sawaguchi A, Kahn A. Apnea, glial apoptosis and neuronal plasticity in the arousal pathway of victims of SIDS. Forensic Sci Int 2005; 149:205-17. [PMID: 15749363 DOI: 10.1016/j.forsciint.2004.10.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Of 27,000 infants whose sleep-wake characteristics were studied under the age of 6 months, 38 died unexpectedly 2-12 weeks after the sleep recording in a pediatric sleep laboratory. Of these infants, 26 died of sudden infant death syndrome (SIDS), and 12 of definitely identified causes. The frequency and duration of sleep apneas were analysed. Sleep recordings and brainstem histopathology were studied to elucidate the possible relationship between sleep apnea and neuropathological changes within the arousal system. Immunohistochemical analyses were conducted using tryptophan hydroxylase (TrypH), a serotonin synthesizing enzyme, and growth-associated phosphoprotein 43 (GAP43), a marker of synaptic plasticity. The terminal-deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method was used for apoptosis. The pathological and physiological data were correlated for each infant. In the SIDS victims, statistically significant positive correlations were seen between the number of TrypH-positive neurons in the dorsal raphe nucleus of the midbrain and the duration of central apneas (p = 0.03), between the number of TUNEL-positive glial cells in the pedunculopontine tegmental nucleus (PPTN) and the average number of spines in GAP43-positive neurons in the PPTN (p = 0.04). These findings in the dorsal raphe nucleus of the midbrain and PPTN, that play important roles in the arousal pathway suggest a possible link between changes in arousal and SIDS.
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Affiliation(s)
- T Sawaguchi
- Department of Legal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku, 162-8666 Tokyo, Japan.
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22
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Jonsdottir S, Bouma A, Sergeant JA, Scherder EJA. Effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type. Neurorehabil Neural Repair 2005; 18:212-21. [PMID: 15537992 DOI: 10.1177/1545968304270759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). METHODS Twenty-two children diagnosed with ADHD-CT received TENS treatment during 6 weeks, 2 times 30 min a day. Neuropsychological tests were administered to assess cognition, parent/teacher behavioral rating scales were used to measure behavior, and actigraphy was used to assess the rest-activity rhythm. RESULTS TENS appeared to have a moderate beneficial influence on cognitive functions that load particularly on executive function. There was also improvement in behavior as measured by parent/teacher behavioral rating scales. Moreover, motor restlessness during sleep and motor activity during the day decreased by TENS. CONCLUSIONS The effects of TENS in children with ADHD are modest but encouraging and warrant further research.
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Affiliation(s)
- Solveig Jonsdottir
- Department of Child and Adolescent Psychiatry, Landspitali-University Hospital, Reykjavík, Iceland.
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Iwasaki H, Koyama Y, Tanaka Y, Kawauchi A, Jodo E, Kayama Y, Miki T. Modulation by desmopressin of neuronal activity in brainstem micturition center. Urology 2004; 63:994-8. [PMID: 15135006 DOI: 10.1016/j.urology.2003.11.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2003] [Accepted: 11/25/2003] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the effect of desmopressin (DDAVP) on bladder contraction and on the neurons that fire in relation to spontaneous bladder contraction (bladder-related neurons) in and around Barrington's nucleus, the micturition center. DDAVP is used for the treatment of nocturnal enuresis because of its antidiuretic action, but the mechanism of this action has not been proved. METHODS Urethane-anesthetized Sprague-Dawley male rats (n = 20) were used. DDAVP was infused intravenously or as an intracerebroventricular infusion into the lateral ventricle. RESULTS We encountered three types of bladder-related neurons: those that fired before the start of the contraction (type E1), those that fired synchronous with the bladder contraction (type E2), and those that fired during bladder relaxation (type I). Intravenous infusion caused inhibition in three of five type E1 neurons, excitation in two of five type E2 neurons, and excitation (one neuron) and inhibition (one neuron) of four type I neurons. With intracerebroventricular infusion into the lateral ventricle, two of four type E1 neurons were inhibited, and one of seven type E2 neurons and three of four type I neurons were excited. Bladder contraction was suppressed in 4 of 12 rats by intravenous infusion and in 2 of 8 rats by intracerebroventricular infusion into the lateral ventricle. In all cases, when the bladder contraction was suppressed, an electroencephalogram of larger amplitude and slower frequency appeared. CONCLUSIONS DDAVP seems to regulate bladder activity by affecting bladder-related neurons in the micturition center.
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Affiliation(s)
- Hiroshi Iwasaki
- Department of Physiology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Pedunculopontine nucleus and basal ganglia: distant relatives or part of the same family? Trends Neurosci 2004; 27:585-8. [DOI: 10.1016/j.tins.2004.07.009] [Citation(s) in RCA: 231] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sawaguchi T, Franco P, Kadhim H, Groswasser J, Sottiaux M, Nishida H, Kahn A. The correlation between microtubule-associated protein 2 in the brainstem of SIDS victims and physiological data on sleep apnea. PATHOPHYSIOLOGY 2004. [DOI: 10.1016/j.pathophys.2004.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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The presence of TATA-binding protein in the brainstem, correlated with sleep apnea in SIDS victims. PATHOPHYSIOLOGY 2004. [DOI: 10.1016/j.pathophys.2004.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kushikata T, Hirota K, Yoshida H, Kudo M, Lambert DG, Smart D, Jerman JC, Matsuki A. Orexinergic neurons and barbiturate anesthesia. Neuroscience 2004; 121:855-63. [PMID: 14580935 DOI: 10.1016/s0306-4522(03)00554-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Orexins (OXs) regulate sleep with possible interactions with brain noradrenergic neurons. In addition, noradrenergic activity affects barbiturate anesthesia. As we have also recently reported that OXs selectively evoke norepinephrine release from rat cerebrocortical slices we hypothesized that barbiturate anesthesia may result from of an interaction with central orexinergic systems. To test this hypothesis, we performed a series of in vivo and in vitro studies in rats. In vivo, the effects of i.c.v. OX A, B and SB-334867-A (OX1 receptor antagonist) on pentobarbital, thiopental or phenobarbital-induced anesthesia times (loss of righting reflex) was assessed. In vitro effects of barbiturates and SB-334867-A on OX-evoked norepinephrine release from cerebrocortical slice was examined. In Chinese hamster ovary cells expressing human OX1/OX2 receptors OX A- and B-evoked increases in intracellular Ca2+ were measured with and without barbiturates. OX A and B significantly decreased pentobarbital, thiopental and phenobarbital anesthesia times by 15-40%. SB-334867-A increased thiopental-induced anesthesia time by approximately by 40%, and reversed the decrease produced by OX A. In vitro, all anesthetic barbiturates inhibited OX-evoked norepinephrine release with clinically relevant IC50 values. A GABAA antagonist, bicuculline, did not modify the inhibitory effects of thiopental and the GABAA agonist, muscimol, did not inhibit norepinephrine release. In addition there was no interaction of barbiturates with either OX1 or OX2 receptors. Collectively our data suggest that orexinergic neurons may be an important target for barbiturates, and GABAA, OX1 and OX2 receptors may not be involved in this interaction.
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Affiliation(s)
- T Kushikata
- Department of Anesthesiology, University of Hirosaki School of Medicine, Zaifu-cho 5, Hirosaki, Japan 036-8562.
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Sawaguchi T, Patricia F, Kadhim H, Groswasser J, Sottiaux M, Nishida H, Kahn A. The presence of TATA-binding protein in the brainstem, correlated with sleep apnea in SIDS victims. Early Hum Dev 2003; 75 Suppl:S109-18. [PMID: 14693397 DOI: 10.1016/j.earlhumdev.2003.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Recent reports have indicated that the presence of transcription factors and RNA polymerase decreases in rat brains that suffer perinatal asphyxia from hypoxia. As hypoxia has been proposed as a causative factor in the Sudden Infant Death Syndrome (SIDS), the correlation between TATA-binding protein (TBP) in the brainstem of SIDS victims as a marker of transcription and the incidence of sleep apnea was investigated. MATERIALS AND METHODS A total of 38 infants, including 26 cases of SIDS, died under 6 months of age, in a cohort of 27,000 infants studied prospectively to characterize their sleep-wake behavior. The frequency and duration of sleep apnea was analyzed. Brainstem material was collected and immunohistochemistry of TBP was carried out. The density of TBP-positive neurons was measured quantitatively. Correlation analyses were carried out between the density of TBP-positive neurons and the data concerning sleep apnea. RESULTS One SIDS-specific positive correlation occurred between the density of TBP-positive neurons in the dorsal raphe nucleus of the midbrain and the duration of central apnea (p=0.049) and two SIDS-specific negative correlations between the density of TBP-positive neurons in the pars compacta and dissipata of the pedunculopontine tegmentum nucleus (PPTNc, PPTNd) in the midbrain and the duration of apnea (p=0.035). CONCLUSIONS The significant correlation between the findings of TBP-positive neurons in the midbrain arousal pathway and the characteristics of sleep apnea in SIDS victims is in agreement with the both association of apnea and arousal phenomenon in pathophysiology of SIDS.
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Affiliation(s)
- Toshiko Sawaguchi
- Department of Legal Medicine, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666, Japan.
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Liu Q, Wong-Riley MTT. Postnatal changes in cytochrome oxidase expressions in brain stem nuclei of rats: implications for sensitive periods. J Appl Physiol (1985) 2003; 95:2285-91. [PMID: 12909612 DOI: 10.1152/japplphysiol.00638.2003] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Previously, we reported that cytochrome oxidase (CO) activity in the rat pre-Bötzinger complex (PBC) exhibited a plateau on postnatal days (P) 3-4 and a prominent decrease on P12 (Liu and Wong-Riley, J Appl Physiol 92: 923-934, 2002). These changes were correlated with a concomitant reduction in the expression of glutamate and N-methyl-d-aspartate receptor subunit 1 and an increase in GABA, GABAB, glycine receptor, and glutamate receptor 2. To determine whether changes were limited to the PBC, the present study aimed at examining the expression of CO in a number of brain stem nuclei, with or without known respiratory functions from P0 to P21 in rats: the ventrolateral subnucleus of the solitary tract nucleus, nucleus ambiguus, hypoglossal nucleus, nucleus raphe obscurus, dorsal motor nucleus of the vagus nerve, medial accessory olivary nucleus, spinal nucleus of the trigeminal nerve, and medial vestibular nucleus (MVe). Results indicated that, in all of the brain stem nuclei examined, CO activity exhibited a general increase with age from P0 to P21, with MVe having the slowest rise. Notably, in all of the nuclei examined except for MVe, there was a plateau or decrease at P3-P4 and a prominent rise-fall-rise pattern at P11-P13, similar to that observed in the PBC. In addition, there was a fall-rise-fall pattern at P15-P17 in these nuclei, instead of a plateau pattern in the PBC. Our data suggest that the two postnatal periods with reduced CO activity, P3-P4 and especially P12, may represent common sensitive periods for most of the brain stem nuclei with known or suspected respiratory control functions.
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Affiliation(s)
- Qiuli Liu
- Department of Cell Biology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Sawaguchi T, Patricia F, Kadhim H, Groswasser J, Sottiaux M, Nishida H, Kahn A. The correlation between microtubule-associated protein 2 in the brainstem of SIDS victims and physiological data on sleep apnea. Early Hum Dev 2003; 75 Suppl:S87-97. [PMID: 14693395 DOI: 10.1016/j.earlhumdev.2003.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Microtubule-associated protein 2(MAP2), a cytoskeletal protein of the neuron, is a marker of early ischemic neuronal damage. As a chronic hypoxic situation exists in the brains of victims of the sudden infant death syndrome (SIDS), the correlation between MAP2-positive neurons or dendritic spines in the brainstem and sleep apnea was investigated in SIDS, which is still the main cause of postneonatal infant death. MATERIALS AND METHODS 27,000 infants were studied prospectively to characterize their sleep-wake behavior and amongst these, 38 infants died under 6 months of age. They included 26 cases of SIDS. The frequency and duration of sleep apneae were analyzed. The brainstem material was collected and immunohistochemistry of MAP2 was carried out. The density of MAP2-positive neurons, dendrites and dendritic spines were measured quantitatively. Correlation analyses were carried out between the MAP2-associated pathological data and the physiological data of sleep apnea. RESULTS One negative correlation between the density of MAP2-positive dendrites in the pars compacta of pedunculo-pontine tegmentum nucleus (PPTNc) and the duration of obstructive apnea (p=0.017) and two SIDS-specific positive correlations between the density of MAP2-positive dendrites in the pars dissipata of pedunculo-pontine tegmentum nucleus (PPTNd) and the duration of central apnea (p=0.005) and between the dorsal raphe and the frequency of obstructive apnea were found in SIDS victims. The density of MAP2-positive dendritic spines in PPTNc was significantly higher in SIDS than in control (p=0.034). CONCLUSIONS The significant correlations with the MAP2-positive findings in the midbrain arousal pathway and the characteristics of sleep apnea in SIDS victims were in agreement with the association with apnea and arousal-deficiency in SIDS.
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Affiliation(s)
- Toshiko Sawaguchi
- Department of Legal Medicine,Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666, Japan.
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van Dijk KRA, Scherder EJA, Scheltens P, Sergeant JA. Effects of transcutaneous electrical nerve stimulation (TENS) on non-pain related cognitive and behavioural functioning. Rev Neurosci 2003; 13:257-70. [PMID: 12405228 DOI: 10.1515/revneuro.2002.13.3.257] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An extensive search through nine electronic bibliographic databases (PubMed, Cochrane Library, Web of Science, ERIC, PsychINFO, Psyndex, Cinahl, Biological Abstracts, Rehabdata) was performed in order to review the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on non-pain related cognitive and behavioural functioning. Eight studies were identified on neglect due to stroke, six studies on Alzheimer's disease (AD), one study on aging, and two studies on coma due to traumatic brain injury. The results of the various studies revealed that TENS has a variety of effects. These consist of enhancement of somatosensory functioning, visuo-spatial abilities and postural control in neglect, improved memory, affective behaviour and rest-activity rhythm in AD and acceleration of awakening in coma. Effectiveness of TENS is discussed in relation to various stimulation parameters: duration, frequency, pulse width and intensity. It is argued that arousal may underlie the beneficial influence of TENS in various conditions. Finally, suggestions are offered for future research.
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Affiliation(s)
- Koene R A van Dijk
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
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Ni Y, Goldman D, Hoffman B, Brooks PJ. Overexpression of an epitope-tagged serotonin transporter in serotonin neurons of the dorsal raphe nucleus using a defective HSV-1 vector. Behav Brain Res 2003; 138:133-43. [PMID: 12527444 DOI: 10.1016/s0166-4328(02)00239-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The serotonin transporter (5HTT) plays a central role in serotonin neurotransmission. Abnormalities of 5HTT function have been implicated in depression, anxiety and alcohol intake. To better understand the functional role of this important molecule, we have utilized a viral vector approach to overexpress the 5HTT in regions of the rat brain. We have constructed a bicistronic defective herpes virus (HSV-1) vector that expresses both an epitope-tagged 5HTT as well as beta-galactosidase (beta-GAL) as a marker for infected cells. The vector was capable of conferring serotonin uptake activity to Vero cells in culture, indicating transfer of a functional 5HTT. Injection of the 5HTT virus into the rat brain resulted in a dense focus of specific 125I RTI-55 binding at the injection site, indicating that the virally expressed 5HTT can also bind ligand when expressed in the brain. We were also able to overexpress an epitope tagged 5HTT in serotonergic neurons in the dorsal raphe nucleus (DRN) using this approach. These data demonstrate that the levels of the 5HTT in 5HT neurons can be manipulated in the adult rodent brain using an HSV-1 vector.
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Affiliation(s)
- Yajin Ni
- Section of Molecular Neurobiology, Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD 20892-8110, USA.
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Sawaguchi T, Franco P, Kato I, Shimizu S, Kadhim H, Groswasser J, Sottiaux M, Togari H, Kobayashi M, Nishida H, Sawaguchi A, Kahn A. Interaction between apnea, prone sleep position and gliosis in the brainstems of victims of SIDS. Forensic Sci Int 2002; 130 Suppl:S44-52. [PMID: 12350300 DOI: 10.1016/s0379-0738(02)00138-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Among 27,000 infants studied prospectively to characterize their sleep-wake behavior, 38 infants died suddenly and unexpectedly under 6 months of age. Of these, 26 died from sudden infant death syndrome (SIDS), 5 from congenital cardiac abnormalities, 2 from infected pulmonary dysplasia, 2 from septic shock with multi-organ failure, 1 from a prolonged seizure, 1 from prolonged neonatal hypoxemia, and 1 from meningitis and brain infarction. The frequency and duration of apneas recorded some 3-12 weeks prior to the infants' death were analyzed. The brainstem materials were collected and studied in an attempt to elucidate the relationship between sleep apnea, and prone sleep position and gliosis in some nuclei associated with cardiorespiratory characteristics, such as nucleus ambiguus in the medulla oblongata and the solitary nucleus, as well as structures associated with arousal phenomenon, such as the reticular formation, the superior central nucleus and the nucleus raphe magnus in the pons, the dorsal raphe nuclei in the midbrain and medulla oblongata, periaqueductal gray matter in midbrain, and locus ceruleus. Gliosis was estimated as the density of glial fibrillary acidic protein (GFAP)-positive reactive astrocytes. Variant-covariant analyses were carried out using the characteristics of apnea as an independent variable and sleep position and gliosis as dependent variables. A significant association was found only in the frequency of obstructive apnea and prone position (P<0.001) and gliosis in the raphe nuclei in the midbrain (P<0.001). Although prone position is a well-known risk factor for SIDS, the frequency of obstructive apnea has not been associated with the prone sleep position. The observed relation between prone sleep and the density of gliosis does not relate to epidemiological findings. Further studies are needed to investigate the unexpected statistical association.
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Affiliation(s)
- Toshiko Sawaguchi
- Department of Legal Medicine, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666, Japan.
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Karpa KD, Cavanaugh JE, Lakoski JM. Duloxetine pharmacology: profile of a dual monoamine modulator. CNS DRUG REVIEWS 2002; 8:361-76. [PMID: 12481192 PMCID: PMC6741700 DOI: 10.1111/j.1527-3458.2002.tb00234.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dysregulation within central monoaminergic systems is believed to underlie the pathology of depression. Drugs that selectively inhibit the reuptake of central monoamines have been used clinically to alleviate symptoms of depressive illnesses. Duloxetine, a novel compound currently under investigation for the treatment of depression, binds selectively with high affinity to both norepinephrine (NE) and serotonin (5-HT) transporters and lacks affinity for monoamine receptors within the central nervous system. It has been suggested that dual inhibition of monoamine reuptake processes may offer advantages over other antidepressants currently in use. In preclinical studies, duloxetine mimics many physiologic effects of antidepressants. Consistent with other antidepressants, duloxetine, by acute administration, elevates extracellular monoamine levels, while by chronic administration it does not alter basal monoamine levels. Like the selective serotonin reuptake inhibitor, fluoxetine, by microiontophoretic application, duloxetine inhibits neuronal cell firing. However, in comparison with fluoxetine, duloxetine is a more potent serotonin reuptake inhibitor. Furthermore, in behavioral experiments, duloxetine attenuates immobility in forced swim tests in animal models of depression to a greater extent than several other commonly used antidepressants. In a six-week open label uncontrolled study, duloxetine was evaluated in patients with a history of depression. Duloxetine was effective in treating depression as determined by marked reduction in Hamilton Depression Rating scores. Adverse effects reported during duloxetine treatment were minor and similar to those of other antidepressants. In an eight-week multicenter, double-blind, placebo-controlled study in patients with a major depressive disorder, duloxetine was effective as an antidepressant, particularly in patients with greater symptom severity. Only limited data are available regarding the pharmacokinetic profile of duloxetine in humans, although a half-life of 10 to 15 h has been reported. Studies conducted in healthy human subjects confirm the preclinical profile of duloxetine as an inhibitor of 5-HT and NE reuptake. Taken together, existing data suggest that duloxetine is a novel and effective antidepressant.
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Affiliation(s)
- Kelly D. Karpa
- Departments of Pharmacology and Anesthesiology, Pennsylvania State College of Medicine, Hershey, PA, USA
| | - Jane E. Cavanaugh
- Departments of Environmental Health and Pharmacology, University of Washington, Seattle, USA
| | - Joan M. Lakoski
- Departments of Pharmacology and Anesthesiology, Pennsylvania State College of Medicine, Hershey, PA, USA
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Yamao Y, Koyama Y, Akihiro K, Yukihiko K, Tsuneharu M. Discrete regions in the laterodorsal tegmental area of the rat regulating the urinary bladder and external urethral sphincter. Brain Res 2001; 912:162-70. [PMID: 11532432 DOI: 10.1016/s0006-8993(01)02725-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In urethane anesthetized rats, the laterodorsal tegmental area was stimulated systematically with a carbon fiber electrode to clarify regions regulating the urinary bladder and/or the external urethral sphincter. Contraction of the former was monitored by bladder pressure and that of the latter by electromyogram. Stimulation of a small area around the ventrolateral edge of the central gray in a plane at the junction of the mesencephalon and pons, where cholinergic neurons in the laterodorsal tegmental nucleus formed the largest mass, induced contraction only of the bladder. Arranged in tandem rostrocaudally with this bladder site, a very small area whose stimulation induced contraction only of the sphincter was found also at the ventrolateral edge of the central gray in a plane slightly caudal to the above. Slightly lateral and caudal to this sphincter site, there were sites the stimulation of which induced contraction of both the bladder and sphincter. It was thus shown physiologically that there were discrete sites in the laterodorsal tegmental area regulating the bladder and sphincter independently.
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Affiliation(s)
- Y Yamao
- Department of Physiology, Fukushima Medical University School of Medicine, 1 Hikari-ga-oka, 960-1295, Fukushima, Japan
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E. J. A. Scherder, S. Van Deursen,. Effects of TENS and methylphenidate in tuberculous meningo-encephalitis. Brain Inj 2001. [DOI: 10.1080/02699050116780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Watanabe H, Kawauchi A. Locus coeruleus function in enuresis. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY. SUPPLEMENTUM 1999; 202:14-7; discussion 18-9. [PMID: 10573784 DOI: 10.1080/00365599950510111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
There are four neuronal networks projecting to many areas of the brain. All networks relate closely to arousal and sleep function. Among the four networks, the noradrenaline projection network, originating from the locus coeruleus (LC), is the system most typically responsible for arousal. This study shows that the LC is activated by the stimulation of bladder distension only while the patient is in deep sleep, not in light sleep. This finding corresponds with the mechanism of enuresis type I in our classification of enuresis, based on overnight simultaneous monitoring using electroencephalography and cystometry. The importance of arousal and sleep systems in the pathogenesis of enuresis is also discussed.
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Affiliation(s)
- H Watanabe
- 3rd Department of Basic Medicine, Meiji University of Oriental Medicine (Graduate School), Kyoto, Japan
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Wang YM, Xu F, Gainetdinov RR, Caron MG. Genetic approaches to studying norepinephrine function: knockout of the mouse norepinephrine transporter gene. Biol Psychiatry 1999; 46:1124-30. [PMID: 10560019 DOI: 10.1016/s0006-3223(99)00245-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Norepinephrine is an important chemical messenger in the nervous system. It regulates affective states, learning and memory, endocrine and autonomic functions. It has been implicated in depression, aggression, and addiction, as well as cardiac and thermal dysregulation. The norepinephrine transporter functions by uptaking norepinephrine back into the cell for cyclic use, and is a direct target of a number of antidepressants and psychostimulants. Functional deletion (knockout) of monamine transporters results in increases in extracellular levels of neurotransmitters, thereby prolonging their actions. For the norepinephrine transporter knockout mice, this altered state of the norepinephrine system should simulate the therapeutic effects of norepinephrine selective antidepressants and some of the effects of psychostimulants. Careful use of such an animal model can hopefully provide valuable insight into the multiple roles norepinephrine plays in normal and pathological physiology.
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Affiliation(s)
- Y M Wang
- Howard Hughes Medical Institute, Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA
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