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Objective: Magnetic resonance‐guided laser interstitial thermal therapy (MRgLITT) is a novel tool and a minimally invasive treatment to drug‐resistant epilepsy (DRE). The focus of this research was to evaluate the effectiveness and safety of the newly developed dual‐wavelength dual‐output MRgLITT system LaserRO within two probe trajectories in treating DRE patients. Methods: This is a retrospective analysis conducted at a single center, examining patients with DRE who received treatment with the LaserRO MRgLITT system. The system utilizes a sophisticated laser technology that can be configured as conventional single output for single wavelength or innovative dual outputs for dual wavelengths. The study involved a comprehensive review of patient information, encompassing demographics, seizure history, details related to the surgical parameters, and the subsequent clinical results. Primary outcome was post‐operation seizure outcome defined as Engel Scale Class at the end of follow‐up time. Results: This study included a total of eight DRE patients received MRgLITT surgery between August 2022 and October 2023. Out of these, there were four mesial temporal lobe epilepsy (MTLE), three focal cortical dysplasia (FCD), and one cavernous malformation (CM) patients. Within the two probe trajectories, seven patients had single wavelength (980 or 1064 nm) laser treatment and one patient had dual‐wavelength (980 and 1064 nm) laser treatment. The median age of the patients was 27 (22–31) years, with a median follow‐up period of 9.7 (8.4–12.1) months. The mean BMI was recorded at 20.24 ± 2.95 kg/m2, and epilepsy history was 13 ± 6 years. The median intraoperative blood loss was 5 (5–9) mL, operation time was 231 (169–254) minutes, and length of stay (LOS) was 3 (3–5) days. The mean ablation volume ratio was 96.52% ± 3.67%. In terms of outcomes, over a median follow‐up time of 9.7 (range 8.4–12.1) months, there were two patients got Engel I, five patients got seizure‐free, and one patient decreased 75% seizure. Importantly, no serious complications following the procedures occurred. Conclusions: The preliminary results indicate that the MRgLITT procedure, which operates dual‐output laser with single or dual wavelengths (980/1064 nm) within the two trajectories, is both effective and safe as a minimally invasive approach for different types of DRE patients. [ABSTRACT FROM AUTHOR]

The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury. Regulation of shifting microglia polarization from M1 (neurotoxic and proinflammatory type) to M2 (neuroprotective and anti-inflammatory type) after spinal cord injury appears to be crucial. Tryptanthrin possesses an anti-inflammatory biological function. However, its roles and the underlying molecular mechanisms in spinal cord injury remain unknown. In this study, we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro. Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway. Additionally, we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury, inhibited neuronal loss, and promoted tissue repair and functional recovery in a mouse model of spinal cord injury. Finally, using a conditional co-culture system, we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress–related neuronal apoptosis. Taken together, these results suggest that by targeting the cGAS/STING/NF-κB axis, tryptanthrin attenuates microglia–derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype. [ABSTRACT FROM AUTHOR]

The blood-brain barrier (BBB) is a selectively semi-permeable layer, crucial in shielding the brain from external pathogens and toxic substances while maintaining ionic homeostasis and sufficient nutrient supply. However, it poses a significant challenge for drugs to penetrate the BBB in order to effectively target brain tumors. Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a minimally invasive technique that employs thermal energy to cauterize intracranial lesions with the potential to temporarily disrupt the BBB. This further opens a possible therapeutic window to enhance patient outcomes. Here, we review the impact of MRg-LITT on BBB and blood tumor barrier (BTB) and the duration of the BBB disruption. Studies have shown that MRg-LITT is effective due to its minimally invasive nature, precise tumor targeting, and low complication rates. Although the disruption duration varies across studies, the average peak disruption is within the initial two weeks post-ablation period and subsequently exhibits a gradual decline. However, further research involving larger groups with extended follow-up periods is required to determine disruption duration more accurately. In addition, evaluating toxicity and glymphatic system disruption is crucial to circumvent potential risks associated with this procedure., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Published by IMR Press.)