Brain and nerve = Shinkei kenkyū no shinpo
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Neuropathic pain is often a consequence of nerve injury through surgery, bone compression, diabetes or infection. This type of pain can be so severe that even light touching can be intensely painful. Unfortunately, this state is generally resistant to currently available treatments. ⋯ The activated microglia express P2X4 after nerve injury, which can be stimulated by endogenous ATP, resulting in the release of BDNF which is one of key molecules involving in neuropathic pain. The microglia also express many molecules that were reported to be connected in the pain. Understanding the key roles of these ATP receptors in microglia may lead to new strategies for the management of intractable chronic pain.
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Increasing evidence indicates the importance of neuron-astrocyte interaction in synaptic function. However, structural evidence is scarce compared to abundant information from electrophysiological studies. Meticulous studies using serial electron microscopic technique in hippocampal CAI and cerebellum provided the earliest knowledge about three-dimensional close relationship between synapses and glial processes. ⋯ In the next step any astrocytic structural changes around mature synapses correlated with plastic change of synaptic efficacy, such as long-term potentiation, should be investigated. Structural relationship between axon terminals and astrocytic processes should also be revealed. Furthermore, in vivo time-lapse imaging of synapseastrocyte pairs will soon be accomplished, as techniques of in vivo two-photon imaging showed remarkable progress recently.
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Recently, the introduction of 3 tesla (3T) magnetic resonance (MR) system for more sophisticated clinical applications has yielded in important benefits, especially in neuroradiology. The aim of this article is to illustrate the practical scientific applications of the 3T system in the neuroradiological filed. From the clinical point of view, we focused on the usefulness of 3T system for the diagnosis of several neurological disorders, such as brain tumors, vascular lesions, hemorrhagic lesions, acute cerebral infarcts and degenerative diseases. ⋯ This finding should not be mistaken for multiple system atrophy. 3T MR system indeed offers new potential because of a substantial increase in signal intensity provided by the higher magnetic field. Routine neuroradiologic imaging would benefit from higher magnetic field. However, It is required that extended knowledge of clinical data in comparison with 1.5T system to elucidate the efficacy of 3T system in the neuroradiology.
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Vagus nerve stimulation (VNS) and stereotactic radiosurgery (SRS) represent novel and less invasive therapeutics for medically intractable epilepsy. VNS ushered in the recent advancement in clinical application of electrical stimulation therapy for epilepsy. Chronic stimulation of the left vagus nerve with implanted generator and electrodes inhibits seizure susceptibility of the cerebral cortices. ⋯ A randomized clinical trial using the dose of 20 or 24 Gy is ongoing in the United States. SRS for intractable epilepsy associated with hypothalamic hamartoma has been advocated because of a high surgical morbidity, but further study is needed for standardization of the treatment. Substitute use of SRS for other surgical technique like callosotomy or disconnection of epileptic focus seems to be another direction worth pursuing.
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X-linked adrenoluekodystrophy (X-ALD) is a clinically heterogenous disorder ranging from the rapidly progressive childhood cerebral form to the milder adrenomyeloneuropathy in adults, and some persons with ALD protein (ALDP) defects may remain asymptomatic for life. Hematopoietic cell transplantation (HCT) is currently the only effective therapy for cerebral X-ALD. Stem cell sources for transplantation are bone marrow, peripheral blood and cord blood. ⋯ More than 90% of early stage patients have survived with good quality of life for a long term, whereas patients with advanced disease had the higher mortality rate during transplant procedures and the neurological abnormalities progressed in most of them. Patients with a parietal-occipital lobe pattern of demyelination demonstrated a greater mean loss of performance IQ (PIQ) points than patients with a frontal lobe pattern of demyelination. Thus, boys with early-stage disease benefit from HCT, whereas boys with advanced disease may be candidates for experimental therapies.