Search

Purpose Spinal cord injury (SCI) destroys the sensorimotor pathway and induces brain plasticity. However, the effect of treatment-induced spinal cord tissue regeneration on brain functional reorganization remains unclear. This study was designed to investigate the large-scale functional interactions in the brains of adult female Rhesus monkeys with injured and regenerated thoracic spinal cord.Materials and methods Resting-state functional magnetic resonance imaging (fMRI) combined with Granger Causality analysis (GCA) and motor behaviour analysis were used to assess the causal interaction between sensorimotor cortices, and calculate the relationship between causal interaction and hindlimb stepping in nine Rhesus monkeys undergoing lesion-induced spontaneous recovery (injured, n = 4) and neurotrophin-3/chitosan transplantation-induced regeneration (NT3-chitosan, n = 5) after SCI.Results The results showed that the injured and NT3-chitosan-treated animals had distinct spatiotemporal features of brain functional reorganization. The spontaneous recovery followed the model of “early intra-hemispheric reorganization dominant, late inter-hemispheric reorganization dominant”, whereas regenerative therapy animals showed the opposite trend. Although the variation degree of information flow intensity was consistent, the tendency and the relationship between local neuronal activity properties and coupling strength were different between the two groups. In addition, the injured and NT3-chitosan-treated animals had similar motor adjustments but various relationship modes between motor performance and information flow intensity.Conclusions Our findings show that brain functional reorganization induced by regeneration therapy differed from spontaneous recovery after SCI. The influence of unique changes in brain plasticity on the therapeutic effects of future regeneration therapy strategies should be considered. Key messagesNeural regeneration elicited a unique spatiotemporal mode of brain functional reorganization in the spinal cord injured monkeys, and that regeneration does not simply reverse the process of brain plasticity induced by spinal cord injury (SCI).Independent “properties of local activity – intensity of information flow” relationships between the injured and treated animals indicating that spontaneous recovery and regenerative therapy exerted different effects on the reorganization of the motor network after SCI.A specific information flow from the left thalamus to the right insular can serve as an indicator to reflect a heterogeneous “information flow – motor performance” relationship between injured and treated animals at similar motor adjustments.

Objective To analyze the merits and demerits, and main points of anesthetic management of different anesthesia regimens for deep brain stimulation (DBS) in movement disorders. Methods Recorded and summarized general information of 365 patients with movement disorders: 1) Local anesthesia combined with hypnoanalgesia: concentration of 1% lidocaine or 0.5% ropivacaine of local infiltration anesthesia, intravenous fentanyl (0.05-0.10 mg) and droperidol (1-2 mg) assisted sedation, analgesia. 2) Local anesthesia combined with intravenous anesthesia: local anesthesia implemented as above, in addition to intravenous fentanyl (0.05-0.10 mg), propofol 2-4 mg/(kg·h), midazolam 0.02-0.03 mg/kg. 3) Endotracheal intubation and general anesthesia: local anesthesia first, then anesthesia was induced with midazolam 0.03-0.05 mg/kg, fentanyl 2-3 μ g/kg, etomidate 0.10-0.20 mg/kg, vecuronium 0.10 mg/kg or rocuronium 0.70 mg/kg. Endotracheal intubation, was performed for mechanical ventilation after implementation. Anesthesia was maintained with continuous intravenous infusion of propofol 2-4 mg/(kg·h) and remifentanil 0.05 - 0.10 μ g/(kg·min). 4) Laryngeal mask anesthesia: firstly local anesthesia was performed as above. Then anesthesia was induced with midazolam 0.02-0.03 mg/kg, fentanyl 1-2 μg/kg, etomidate 0.10-0.20 mg/kg, vecuronium 0.10 mg/kg or rocuronium 0.70 mg/kg. Anesthesia maintenance was the same as the above. Recorded the incidence of intraoperative complications of four anesthesia regimens for deep brain stimulation. Results For local anesthesia combined with hypnoanalgesia (17.65%, 3/17) and local anesthesia combined with intravenous anesthesia (22.45%, 11/49), the incidence rate of respiratory depression was higher than the other two anesthesia (0/44, 0/255). The difference was not significant. The incidence of decreased blood pressure and increased blood pressure was higher in endotracheal intubation and general anesthesia group (29.55% and 13.64% ) than in laryngeal mask anesthesia group (8.24% and 0.78%). The difference was statistically significant (P = 0.000). Conclusion The condition of movement disorders patients is usually complex. Appropriate anesthesia regimens should be selected according to individual preoperative condition, concurrent diseases and operation requirements. Laryngeal mask anesthesia for DBS seems to be superior to other anesthesia regimens. DOI：10.3969/j.issn.1672⁃6731.2011.06.011

Spinal cord injury (SCI) often leads to permanent loss of motor, sensory, and autonomic functions.We have previously shown that neurotrophin3 (NT3)-loaded chitosan biodegradable material allowed for prolonged slow release of NT3 for 14 weeks under physiological conditions. Here we report that NT3-loaded chitosan, when inserted into a 1-cm gap of hemisectioned and excised adult rhesus monkey thoracic spinal cord, elicited robust axonal regeneration. Labeling of cortical motor neurons indicated motor axons in the corticospinal tract not only entered the injury site within the biomaterial but also grew across the 1-cm-long lesion area and into the distal spinal cord. Through a combination of magnetic resonance diffusion tensor imaging, functional MRI, electrophysiology, and kinematics-based quantitative walking behavioral analyses, we demonstrated that NT3-chitosan enabled robust neural regeneration accompanied by motor and sensory functional recovery. Given that monkeys and humans share similar genetics and physiology, our method is likely translatable to human SCI repair. [ABSTRACT FROM AUTHOR]