Articles: brain.
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Meta Analysis Comparative Study
A Meta-Analysis of Medication Reduction and Motor Outcomes After Awake Versus Asleep Deep Brain Stimulation for Parkinson Disease.
There remains significant debate regarding the performance of deep brain stimulation (DBS) procedures for Parkinson disease (PD) under local or general anesthesia. The aim of this meta-analysis was to compare the clinical outcomes between "asleep" DBS (general anesthesia) and "awake" DBS (local anesthesia) for PD. ⋯ There was no significant difference in the primary motor outcomes and LEDD improvement between asleep vs awake DBS. The variables of target selection and MER use had no statistically significant impact on outcome. We find that asleep techniques are both safe and effective compared with the awake technique.
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Clinical guidelines direct healthcare professionals toward evidence-based practices. Evaluating guideline impact can elucidate information penetration, relevance, effectiveness, and alignment with evolving medical knowledge and technological advancements. As the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors marks its 40th anniversary in 2024, this article reflects on the tumor guidelines established by the Section over the past decade and explores their impact on other publications, patents, and information dissemination. ⋯ Non-Functioning Pituitary Adenoma led Mendeley reads. News, patent, or policy publications were led by low-grade glioma at 1.5/year. Our study shows that the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors guidelines go beyond citations in peer-reviewed publications to include patents, online engagement, and information dissemination to the public.
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Attention deficit hyperactivity disorder (ADHD) is one of the most frequent and disabling neurodevelopmental disorders. Recent research on cerebral blood flow (CBF) has enhanced understanding of the underlying pathophysiology in neuropsychiatric disorders. This systematic review aims to synthesize the existing literature on CBF anomalies among individuals with ADHD in comparison to controls. ⋯ This review highlights diverse CBF anomalies in ADHD. The most consistently reported findings suggest hypoperfusion during resting state in prefrontal and temporal areas, along with the basal ganglia, while there is a hyperperfusion in frontal, parietal and occipital regions. Further research, including longitudinal studies, is essential to develop a comprehensive understanding of CBF implications in ADHD.
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Surgery endangers the integrity of the body through a continuous stream of noxious stimuli. General anesthesia helps patients cope with the surgery situation. In the first part of our literature review, we present our new knowledge about nociception as described by Sherrington. ⋯ Maintaining the unconscious state created by anesthetics during surgery is only possible by continuously counteracting nociception. Finally, we present the role of the opioid receptor system in antinociception. Understanding all these processes can help expand our knowledge about nociception, pain and formation of consciousness.
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Bayesian brain theory, a computational framework grounded in the principles of Predictive Processing (PP), proposes a mechanistic account of how beliefs are formed and updated. This theory assumes that the brain encodes a generative model of its environment, made up of probabilistic beliefs organized in networks, from which it generates predictions about future sensory inputs. The difference between predictions and sensory signals produces prediction errors, which are used to update belief networks. In this article, we introduce the fundamental principles of Bayesian brain theory, and show how the brain dynamics of prediction are associated with the generation and evolution of beliefs.