Restorative Neurology and Neuroscience - Volume 38, issue 3

Article Type: Other

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 187-187, 2020

Authors: Chokron, Sylvie | Dubourg, Lucas | Garric, Clémentine | Martinelli, Fiora | Perez, Céline

Article Type: Research Article

Abstract: The most common visual defect to follow a lesion of the retrochiasmal pathways is homonymous hemianopia (HH), whereby patients are blind to the contralesional visual field of each eye. Homonymous hemianopia has been studied in terms of its deleterious consequences on perceptual, cognitive and motor tasks as well as because it represents an interesting model of vision loss after a unilateral lesion of the occipital lobe. From a behavioral perspective, in addition to exhibiting a severe deficit in their contralesional visual field, HH patients can also exhibit dissociations between perception and awareness. Firstly , HH patients suffering from anosognosia …may be unaware of their visual field defect. Secondly , HH patients can present with unconscious visual abilities in the blind hemifield, a phenomenon referred to as blindsight . Thirdly , recent reports demonstrate that HH patients can suffer from a subtle deficit in their ipsilesional visual field that they are unaware of, a condition called sightblindness (i.e. the reverse case of ‘blindsight ’). Finally, HH patients may also exhibit visual hallucinations in their blind field; however, such patients are not systematically aware that their perceptions are unreal. In this review, we provide an overview of the visual-field losses in HH patients after a left or right unilateral occipital lesion. Furthermore, we explore the implications of these four phenomena for models of visual processing and rehabilitation of visual field defects in HH patients. Finally, in contrast to the traditional view that HH is solely a visual-field defect , we discuss why this deficit is an interesting model for studying the dissociation between perception and awareness. Show more

Keywords: Homonymous hemianopia, blindsight, anosognosia, hallucinations, awareness, occipital lobe

DOI: 10.3233/RNN-190951

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 189-201, 2020

Authors: Léné, Paul | Ouerfelli-Ethier, Julie | Fournet, Romain | Laurin, Anne-Sophie | Gosselin, Frédéric | Khan, Aarlenne Zein

Article Type: Research Article

Abstract: Background: Central vision loss, such as in the case of age-related macular degeneration (AMD), has a a major negative impact on patients’ quality of life. However, some patients have shown spontaneous adaptive strategies development, mostly relying on their peripheral vision. Objective: This study assesses eye movement and eccentric visual function adaptive behaviors of a healthy population in the presence of simulated central vision loss. We wished to determine how central vision loss affects eye movements, specifically the foveal-target alignment. Methods: Fifteen healthy participants (7 females, M  = 21.69, SD  = 2.13) discriminated the orientation of a Gabor relative …to the vertical located at 12 deg of eccentricity to the right of fixation, in the presence of a gaze-contingent artificial central scotoma either visible or invisible. The artificial central scotoma was 4° diameter in order to simulate an earlier stage of degenerative disease while still impairing foveal vision. The target’s orientation varied between 10° counter-clockwise and 10° clockwise. Each participant performed four blocks of 75 trials each per day over 10 days, the first day being a baseline without scotoma. Results: We found changes in the endpoints of the 1st saccade over the practice days. The most common pattern was a gradual upward shift. We also observed a significant increase in discrimination performance over the 9 days of practice. We did not find any difference linked to the scotoma types. Conclusions: These findings suggest that the presence of an artificial central scotoma combined with a challenging discrimination task induces both changes in saccade planning mechanisms, resulting in a new eccentric-target alignment, and improvements in eccentric visual functions. This demonstrates the potential of this research paradigm to understand and potentially improve visual function in patients with central vision loss. Show more

Keywords: Age macular degeneration, preferred retinal locus, attentional shift, central vision loss, vision loss adaptation

DOI: 10.3233/RNN-190957

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 203-222, 2020

Authors: Limoli, Paolo Giuseppe | Limoli, Celeste Silvana Serena | Morales, Marco Ulises | Vingolo, Enzo Maria

Article Type: Research Article

Abstract: Purpose: To assess whether treatment with the Limoli Retinal Restoration Technique (LRRT) can be performed in patients with retinitis pigmentosa (RP), grafting the autologous cells in a deep scleral pocket above the choroid of each eye to exert their beneficial effect on the residual retinal cells. Methods: The patients were subjected to a complete ophthalmological examination, including best corrected visual acuity (BCVA), close-up visus measurements, spectral domain-optical coherence tomography (SD-OCT), microperimetry (MY), and electroretinography (ERG). Furthermore, the complete ophthalmological examination was carried out at baseline (T0) and at 6 months (T180) after surgery. The Shapiro–Wilk test was used …to assess the normality of distribution of the investigated parameters. A mixed linear regression model was used to analyse the difference in all the studied parameters at T0 and T180, and to compare the mean change between the two groups. All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). Results: LRRT treatment was performed in 34 eyes of 25 RP patients recruited for the study. The eyes were classified in two groups on the basis of foveal thickness (FT) assessed by SD-OCT: 14 eyes in Group A (FT≤190μ m) and the remaining 20 ones in Group B (FT > 190μ m). Although it had not reached the statistical significance, Group B showed a better improvement in BCVA, residual close-up visus and sensitivity than Group A. Conclusions: Previous studies have described the role of LRRT in slowing down retinal degenerative diseases. Consequently, this surgical procedure could improve the clinical and rehabilitative prognostic parameters in RP patients. On the other hand, further clinical research and studies with longer follow-up will be needed to evaluate its efficacy. Show more

Keywords: Autograft, cell surgery, embryonic stem cells (ESC), foveal thickness, growth factor (GF), induced pluripotent stem cells (iPSCs), Limoli retinal restoration technique (LRRT), mesenchymal cell (MSC), retinitis pigmentosa (RP)

DOI: 10.3233/RNN-190970

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 223-237, 2020

Authors: Perin, Cecilia | Viganò, Barbara | Piscitelli, Daniele | Matteo, Barbara Maria | Meroni, Roberto | Cerri, Cesare Giuseppe

Article Type: Research Article

Abstract: Background: Around 253 million people worldwide suffer from irreversible visual damage. Numerous studies have been carried out in order to unveil the effects of electrical stimulation (ES) as a useful tool for rehabilitation for different visual conditions and pathologies. Objective: This systematic review aimed to 1) examine the current evidence of ES efficacy for the treatment of visual pathologies and 2) define the corresponding degree of the recommendation of different ES techniques. Methods: A systematic review was conducted in MEDLINE and Cochrane Library database to collect documents published between 2000 and 2018. For each study, Level …of Evidence of Effectiveness of ES as well as the Class of Quality for the treatment of different visual pathologies were determined. Results: Thirty-eight articles were included. Studies were grouped according to the pathology treated and the type of stimulation administered. The first group included studies treating pre-chiasmatic pathologies (age-related macular degeneration, macular dystrophy, retinal artery occlusion, retinitis pigmentosa, glaucoma, optic nerve damage, and optic neuropathy) using pre-chiasmatic stimulation; the second group included studies treating both pre-chiasmatic pathologies (amblyopia, myopia) and post-chiasmatic pathologies or brain conditions (hemianopsia, brain trauma) by means of post-chiasmatic stimulation. In the first group, repetitive transorbital alternating current stimulation (rtACS) reached level A recommendation, and transcorneal electrical stimulation (tcES) reached level B. In the second group, both high-frequency random noise stimulation (hf-RNS) and transcranial direct current stimulation (tDCS) reached level C recommendation. Conclusions: Study’s findings suggest conclusive evidence for rtACS treatment. For other protocols results are promising but not conclusive since the examined studies assessed different stimulation parameters and endpoints. A comparison of the effects of different combinations of these variables still lacks in the literature. Further studies are needed to optimize existing protocols and determine if different protocols are needed for different diseases. Show more

Keywords: Electrical stimulation, transcorneal electrical stimulation (tcES), repetitive transorbital alternating current stimulation (rtACS), high-frequency random noise stimulation (hf-RNS), transcranial direct current stimulation (tDCS), visual damage, hypovision

DOI: 10.3233/RNN-190948

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 239-250, 2020

Article Type: Other

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 251-251, 2020

Authors: Park, Hyeng-Kyu | Song, Min-Keun | Kim, Wang-In | Han, Jae-Young

Article Type: Research Article

Abstract: Background: The effect of combined repetitive transcranial magnetic stimulation (rTMS) and scalp acupuncture stimulation (SAS) on middle cerebral artery occlusion (MCAO) mice has not yet been reported. The regulation of gene expression after combined stimulation remains unclear. Objective: To analyze gene expression patterns through ribonucleic acid (RNA) sequencing. Methods: Thirty-six 8-weeks-old C57BL/6J male mice weighing 50–60 grams were used for this experiment. The MCAO was induced with 60-min occlusion and subsequent reperfusion of the middle cerebral artery. Experimental mice were randomly assigned to four groups, with nine mice in each group, as follows: control group (no …treatment), SAS group (10 minutes SAS), rTMS group (1 Hz rTMS), and combined group (1 Hz rTMS and SAS). Stimulation was performed from the 3rd day to the 7th day after the induction of MCAO. All mice were sacrificed, and brain tissues were taken from the motor area of the MCAO lesion. We analyzed their gene expression profiles using RNA sequencing technology. Results: After stimulation, the grip strength increased in the SAS and rTMS group compared to the control and combined group. The nuclear factor kappa-light-chain-enhancer of activated B cells (NFκ B) was the key up-regulated protein in the SAS group while src homologus and collagene gene (SHC) and p90 ribosomal protein S6 kinases (p90RSK) were key up-regulated proteins in the rTMS group. However, the C-terminal src kinase-homologous kinase (CHK) was down-regulated whereas p90RSK was up-regulated in the combined group based on the RNA sequencing analysis. Conclusions: Each stimulation method showed different patterns with neurotrophin signaling pathway including NFκ B, SHC, p90RSK, and CHK. These can be used in further mechanistic studies about gene expression related to neurorecovery. Show more

Keywords: Cerebral infarction, Scalp acupuncture, Transcranial magnetic stimulation, RNA sequencing, gene expression

DOI: 10.3233/RNN-190963

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 253-263, 2020

Authors: Ye, Fei | Bao, Guan-Shui | Xu, Heng-Shi | Deng, Pan-Pan

Article Type: Research Article

Abstract: Objective: This study aimed to analyze the correlation between platelet (PLT) count and the modified Rankin scale (mRS) in patients with cerebral infarction (CI) at the later stage of rehabilitation, which can be used to guide the secondary prevention strategy of CI. Methods: A total of 180 CI patients were divided into three groups according to PLT count: low PLT group (<125×109 /L), medium PLT group (126– 225×109 /L) and high PLT group (>226×109 /L). The mRS was evaluated after three months and one year, respectively, and the difference in long-term prognosis between groups was analyzed. The mRS …is an ordered scale coded from 0 (no symptoms at all) through 5 (severe disability) 6 (death). Results: Finally, a total of 99 patients had complete data. The results of the multiple comparisons among the three groups were as follows: the analysis of variance of the mRS at three months after onset yielded F  = 6.714 and P  = 0.002, and the difference was statistically significant. The mRS was lowest in the medium PLT group (2.09±1.465), and neurological function recovery was the best. After one year, the mRS for the medium PLT group was the lowest (1.49±1.523), with F  = 6.860 and P  = 0.002. The repeated measures analysis of variance revealed that the effect of continuous rehabilitation was significant in the interval from three months to one year after onset (F  = 35.528, P  < 0.001). This was very significant, especially for patients taking aspirin (F  = 50.908, P  < 0.001). However, for patients who did not take aspirin, the effect of continuous rehabilitation was not obvious during the nine months, and the difference between the results of two mRS measurements was not statistically significant (F  = 1.089, P  = 0.308). Conclusions: Patients with a PLT count of 126– 225×109 /L had the lowest mRS between three months and one year after onset, but had the best recovery of nerve function. Patients who persisted in taking aspirin continued to significantly recover during the 9-month period, from three months to one year after onset. Aspirin is not only a secondary preventive drug, but also an important drug to promote the rehabilitation of CI patients. Show more

Keywords: Cerebral infarction, late rehabilitation, platelet count, modified Rankin score, aspirin

DOI: 10.3233/RNN-200993

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 265-270, 2020

Authors: Liang, Ce. | Ni, Guang-Xiao. | Shi, Xu-Liang. | Jia, Lin. | Wang, Ya-li.

Article Type: Research Article

Abstract: Background: Astragaloside IV (AS-IV) is one of the main active ingredients of Astragalusmembranaceus. Studies have shown that AS-IV stimulates angiogenesis, including cell proliferation, migration, and neovascularization. However, the relevant mechanism remains unclear. Objective: This study aims to investigate whether AS-IV activates the HIF/VEGF/Notch signaling pathway through miRNA-210 to promote angiogenesisafter ischemic stroke. Methods: The present study established a rat model of middle cerebral artery occlusion (MCAO) and cultured human umbilical vein endothelial cells (HUVECs) under hypoxic conditions in vitro to investigate the role of AS-IV in promoting angiogenesis and reveal its underlying mechanism. Through in …vivo studies, the area of cerebral infarction was determined by 2,3,5-triPhenyltetrazolium chloride (TTC) staining. Immunofluorescence staining and RT-qPCR were used to detect the expression changes of miRNA-210 and ephrinA3 in the ischemic cortex after ischemia. Through in vitro studies, cell proliferation was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Subsequently, angiogenesis experiments were performed to observe the angiogenic ability. Results: Results revealed that AS-IV significantly reduced infarct size, promoted cell proliferation and ductal formation, and inhibited the expression of the target gene ephrinA3 by increasing the expression of miRNA-210 and inducing activation of the HIF-VEGF-Notch signaling pathway. Conclusions: AS-IV promotes cerebral protection following angiogenesis and ischemic brain injury. The specific mechanism was activating the HIF/VEGF/Notch signaling pathway via miRNA-210. Show more

Keywords: Astragaloside IV, HIF/VEGF/Notch signaling pathway, miRNA-210, angiogenesis, ischemic stroke

DOI: 10.3233/RNN-201001

Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 271-282, 2020