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Medical Science Monitor : International... Apr 2017Although cigarette smoking is a leading cause of preventable mortality, tobacco is consumed by approximately 22% of the adult population worldwide. Smoking is also a... (Review)
Review
Although cigarette smoking is a leading cause of preventable mortality, tobacco is consumed by approximately 22% of the adult population worldwide. Smoking is also a risk factor for cardiovascular disease, affects brain processing, and is a recognized risk factor for Alzheimer disease (AD). Tobacco toxins (e.g., nicotine at high levels) inhaled in smoke may cause disorders resulting in preclinical brain changes. Researchers suggest that there are differences in brain volume between smokers and non-smokers. This review examines these differences in brain grey matter volume (GMV). In March/April 2015, MedLine, Embase, and PsycINFO were searched using the terms: "grey matter" AND "voxel-based" AND "smoking" AND "cigarette". The 4 studies analyzed found brain GMV decreases in smokers compared to non-smokers. Furthermore, sex-specific differences were found; while the thalamus and cerebellum were affected in both sexes, decreased GMV in the olfactory gyrus was found only in male smokers. Age-group differences were also found, and these may suggest pre-existing abnormalities that lead to nicotine dependence in younger individuals. Only 1 study found a positive correlation between number of pack-years smoked and GMV. Smoking decreases GMV in most brain areas. This decrease may be responsible for the cognitive impairment and difficulties with emotional regulation found in smokers compared with non-smokers.
Topics: Adult; Brain; Central Nervous System; Cerebellum; Cigarette Smoking; Cognition; Female; Gray Matter; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Middle Aged; Sex Characteristics; Smokers; Tobacco Use Disorder
PubMed: 28426638
DOI: 10.12659/msm.901870 -
World Neurosurgery Oct 2022
Meta-Analysis
Topics: Cerebellum; Cerebral Angiography; Humans; Intracranial Aneurysm; Vertebral Artery
PubMed: 36192858
DOI: 10.1016/j.wneu.2022.07.038 -
Neurosurgical Review Mar 2024The anterior inferior cerebellar artery (AICA) plays a crucial role in cerebellar blood supply, and AICA aneurysms are relatively rare, comprising less than 1-1.5% of... (Review)
Review
INTRODUCTION
The anterior inferior cerebellar artery (AICA) plays a crucial role in cerebellar blood supply, and AICA aneurysms are relatively rare, comprising less than 1-1.5% of all brain aneurysms. Understanding their clinical scenarios, management approaches, and outcomes is essential. This systematic review analyzes data from 86 studies to comprehensively explore AICA aneurysms.
MATERIALS AND METHODS
The process of obtaining relevant research, which includes patients with AICA aneurysms, was carried out using the PubMed, Web of Science, and Scopus databases. This review exclusively included extensive papers written in English. The search included the MeSH phrases "Anterior inferior cerebellar artery aneurysm" and "AICA aneurysm." Microsurgical and endovascular treatments were compared using statistical analysis, exploring demographics, risk factors, treatment modalities, and clinical outcomes.
RESULTS
The review includes 85 case reports and one retrospective study, totaling 140 patients. The study reveals a diverse patient profile with a slight female predominance (65%), a mean age of 50.7 years, and an 82.86% prevalence of no identified risk factors. Ruptured aneurysms accounted for 55%, with microsurgery and endovascular procedures accounting for 70.71% and 27.86%, respectively. The mortality rate was 2.86%, and no significant differences were found in rebleed, recurrence, or mortality rates between treatment groups.
CONCLUSION
Microsurgical and endovascular interventions demonstrate comparable effectiveness, with microsurgery showing superiority in specific situations. Therefore, tailoring treatment is crucial to individual patient needs. Subgroup analyses highlight demographic-specific trends, guiding clinicians in managing this rare pathology.
Topics: Humans; Aneurysm, Ruptured; Basilar Artery; Cerebellum; Intracranial Aneurysm; Retrospective Studies
PubMed: 38448736
DOI: 10.1007/s10143-024-02338-8 -
Ultraschall in Der Medizin (Stuttgart,... Feb 2023To conduct a systematic review and meta-analysis of published nomograms for fetal vermis biometry. (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis of published nomograms for fetal vermis biometry.
MATERIALS AND METHODS
A structured literature search was conducted to identify studies that reported normal measurements of the fetal vermis. A customized quality assessment tool was used to review the selected articles. Random effects meta-analysis was used to calculate normal ranges for vermian craniocaudal diameter, anteroposterior diameter, and surface area.
RESULTS
A total of 21 studies were included for qualitative review and 3 studies were included for quantitative synthesis. The 3 included articles comprised a total of 10 910 measurements from gestational ages 17-35 weeks. The quality assessment demonstrated that there was generally poor reporting regarding maternal characteristics and neonatal outcomes. Except for one article with a large sample size, the mean number of fetuses per week of gestational age was 15.9, with the lowest number being 5. There was significant statistical heterogeneity. Non-visualization rates ranged from 0-35.4 %. The craniocaudal diameter (reported in 3 articles) increased from a mean of 7.90 mm (95 % confidence interval [CI] 7.42, 8.38) at 17 weeks to 21.90 mm (95 % CI 20.63, 23.16) at 35 weeks gestation. The anteroposterior diameter (reported in 2 articles) increased from 6.30 mm (95 % CI 5.42, 7.18) at 17 weeks to 15.85 (95 %CI 15.49, 16.21) at 32 weeks.
CONCLUSION
Reference ranges for vermis biometry across gestation based on meta-analysis of existing references are provided. However, because many of the underlying studies suffered from significant methodological issues, the ranges should be used with caution.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Infant; Reference Values; Cerebellar Vermis; Fetus; Gestational Age; Ultrasonography, Prenatal; Biometry
PubMed: 33836547
DOI: 10.1055/a-1408-1998 -
Archives of Disease in Childhood. Fetal... Jul 2020To determine (1) the incidence of neurodevelopmental impairment (NDI) in necrotising enterocolitis (NEC), (2) the impact of NEC severity on NDI in these babies and (3)... (Meta-Analysis)
Meta-Analysis
AIM
To determine (1) the incidence of neurodevelopmental impairment (NDI) in necrotising enterocolitis (NEC), (2) the impact of NEC severity on NDI in these babies and (3) the cerebral lesions found in babies with NEC.
METHODS
Systematic review: three independent investigators searched for studies reporting infants with NDI and a history of NEC (PubMed, Medline, Cochrane Collaboration, Scopus). Meta-analysis: using RevMan V.5.3, we compared NDI incidence and type of cerebral lesions between NEC infants versus preterm infants and infants with medical vs surgical NEC.
RESULTS
Of 10 674 abstracts screened, 203 full-text articles were examined. In 31 studies (n=2403 infants with NEC), NDI incidence was 40% (IQR 28%-64%) and was higher in infants with surgically treated NEC (43%) compared with medically managed NEC (27%, p<0.00001). The most common NDI in NEC was cerebral palsy (18%). Cerebral lesions: intraventricular haemorrhage (IVH) was more common in NEC babies (26%) compared with preterm infants (18%; p<0.0001). There was no difference in IVH incidence between infants with surgical NEC (25%) and those treated medically (20%; p=0.4). The incidence of periventricular leukomalacia (PVL) was significantly increased in infants with NEC (11%) compared with preterm infants (5%; p<0.00001).
CONCLUSIONS
This study shows that a large proportion of NEC survivors has NDI. NEC babies are at higher risk of developing IVH and/or PVL than babies with prematurity alone. The degree of NDI seems to correlate to the severity of gut damage, with a worse status in infants with surgical NEC compared with those with medical NEC.
TRIAL REGISTRATION NUMBER
CRD42019120522.
Topics: Cerebellum; Enterocolitis, Necrotizing; Humans; Incidence; Infant, Newborn; Neurodevelopmental Disorders
PubMed: 31801792
DOI: 10.1136/archdischild-2019-317830 -
Stereotactic and Functional Neurosurgery 2020Direct targeting methods for stereotactic neurosurgery in the treatment of essential tremor have been the subject of active research over the past decade but have not... (Meta-Analysis)
Meta-Analysis
Direct targeting methods for stereotactic neurosurgery in the treatment of essential tremor have been the subject of active research over the past decade but have not yet been systematically reviewed. We present a clinically oriented topic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses Group guidelines. Our focus is studies using advanced magnetic resonance imaging (MRI) techniques (ultrahigh-field structural MRI, diffusion-weighted imaging, diffusion-tensor tractography, and functional MRI) for patient specific, in vivo identification of the ventral intermediate nucleus and the dentato-rubro-thalamic tract.
Topics: Cerebellar Nuclei; Deep Brain Stimulation; Diffusion Tensor Imaging; Essential Tremor; Female; Humans; Magnetic Resonance Imaging; Male; Neural Pathways; Red Nucleus; Stereotaxic Techniques; Thalamus
PubMed: 32403112
DOI: 10.1159/000507030 -
European Neurology 2024This study aimed to comprehensively evaluate the therapeutic efficacy of cerebellar repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of... (Meta-Analysis)
Meta-Analysis
Effects of Cerebellar Repetitive Transcranial Magnetic Stimulation in the Treatment of Post-Stroke Dysphagia: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.
INTRODUCTION
This study aimed to comprehensively evaluate the therapeutic efficacy of cerebellar repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of post-stroke dysphagia (PSD).
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed, Cochrane Library, Embase, and Web of Science to identify relevant randomized controlled trials (RCTs) investigating the application of cerebellar rTMS in the treatment of PSD. Inclusion and exclusion criteria were rigorously applied during the screening process, and pertinent characteristics of the included RCTs were meticulously extracted. The I2 statistic was employed to assess heterogeneity, and meta-analysis was conducted using Stata 17 software. The Cochrane Risk of Bias 2 tool and PEDro scale were utilized to evaluate bias risk and literature quality.
RESULTS
Our analysis encompassed a total of 5 RCTs involving 673 patients with dysphagia who met the inclusion criteria. The findings indicated a significant positive impact of cerebellar rTMS when combined with traditional swallowing exercises on PSD, demonstrating superior efficacy compared to conventional swallowing exercises in isolation. Furthermore, the study revealed no statistically significant differences based on stimulation site (unilateral vs. bilateral cerebellum), stimulation mode (rTMS vs. intermittent theta-burst stimulation), and stimulation frequency (5 Hz vs. 10 Hz).
CONCLUSION
The amalgamation of cerebellar rTMS with conventional swallowing exercises demonstrates notable efficacy, surpassing the outcomes achievable with traditional exercises alone. The sustained effectiveness observed underscores the potential of cerebellar rTMS as an innovative avenue in the field of neurorehabilitation for PSD. This study contributes valuable insights into the prospect of utilizing cerebellar rTMS as an adjunctive therapeutic strategy in the management of PSD, emphasizing its relevance for further exploration and clinical application.
Topics: Humans; Deglutition Disorders; Transcranial Magnetic Stimulation; Randomized Controlled Trials as Topic; Stroke; Cerebellum; Stroke Rehabilitation
PubMed: 38432194
DOI: 10.1159/000538130 -
Cerebellum (London, England) Apr 2021Huntington's disease (HD) is a rare neurological disorder characterized by progressive motor, cognitive, and psychiatric disturbances. Although striatum degeneration...
Huntington's disease (HD) is a rare neurological disorder characterized by progressive motor, cognitive, and psychiatric disturbances. Although striatum degeneration might justify most of the motor symptoms, there is an emerging evidence of involvement of extra-striatal structures, such as the cerebellum. To elucidate the cerebellar involvement and its afferences with motor, psychiatric, and cognitive symptoms in HD. A systematic search in the literature was performed in MEDLINE, LILACS, and Google Scholar databases. The research was broadened to include the screening of reference lists of review articles for additional studies. Studies available in the English language, dating from 1993 through May 2020, were included. Clinical presentation of patients with HD may not be considered as the result of an isolated primary striatal dysfunction. There is evidence that cerebellar involvement is an early event in HD and may occur independently of striatal degeneration. Also, the loss of the compensation role of the cerebellum in HD may be an explanation for the clinical onset of HD. Although more studies are needed to elucidate this association, the current literature supports that the cerebellum may integrate the natural history of neurodegeneration in HD.
Topics: Cerebellum; Humans; Huntington Disease
PubMed: 33029762
DOI: 10.1007/s12311-020-01198-4 -
Neuropsychology Review Sep 2020The cerebellum facilitates and modulates cognitive functions using forward and inverse internal models to predict and control behavior, respectively. Despite... (Meta-Analysis)
Meta-Analysis
Cerebellar Contributions to Proactive and Reactive Control in the Stop Signal Task: A Systematic Review and Meta-Analysis of Functional Magnetic Resonance Imaging Studies.
The cerebellum facilitates and modulates cognitive functions using forward and inverse internal models to predict and control behavior, respectively. Despite neuroimaging evidence that regions of the cerebellum are active during executive function (EF) tasks in general, little is known about the cerebellum's role in specific EFs and their underlying neural networks. Inhibitory control specifically may be facilitated by cerebellar internal models predicting responses during proactive control (withholding), and controlling responses during reactive control (inhibiting). The stop signal task (SST) is an inhibitory control task often used in neuroimaging studies to measure neural responses to both proactive and reactive control. Thus, in this review, we examine evidence for the cerebellum's role in inhibitory control by reviewing studies of healthy adults that utilized the SST in event-related functional magnetic resonance imaging (fMRI) experiments. Twenty-one studies that demonstrated cerebellar results were eligible for review, including 749 participants, 28 contrasts, and 38 cerebellar clusters. We also performed activation likelihood estimation (ALE) meta-analysis of contrasts derived from reviewed studies. This review illustrates evidence for the cerebellum participating in inhibitory control independent of motor control. Most significant cerebellar clusters were located in the left posterior cerebellum, suggesting that it communicates with the established cortical right-lateralized inhibitory control network. Cerebellar activity was most consistently observed for contrasts that measured proactive control, and ALE analysis confirmed that left Crus I is most likely to be activated in studies of proactive control measuring monitoring and anticipation. Results suggest that the left posterior cerebellum may communicate with right frontal and parietal cortices, using forward models to predict appropriate responses. Reactive control contrasts indicated a possible role for cerebellar regions in enhancing inhibition efficiency through inverse models, but ALE meta-analysis did not confirm this hypothesis. Limitations in the current literature, clinical implications, and directions for future research are discussed.
Topics: Adult; Brain Mapping; Cerebellum; Cognition; Female; Humans; Image Processing, Computer-Assisted; Inhibition, Psychological; Magnetic Resonance Imaging; Male; Nerve Net; Psychomotor Performance
PubMed: 32189178
DOI: 10.1007/s11065-020-09432-w -
Child's Nervous System : ChNS :... Jun 2020Cerebellar mutism (CM) is a condition that occurs predominantly in children, after posterior fossa surgery (PFS). It is characterized by motor, speech, and behavioral...
PURPOSE
Cerebellar mutism (CM) is a condition that occurs predominantly in children, after posterior fossa surgery (PFS). It is characterized by motor, speech, and behavioral disorders. Despite widespread use of intraoperative neurophysiological monitoring (IONM), little is known about the neurophysiological aspects involved in the pathophysiology of CM. We reviewed the IONM literature to identify working hypotheses aimed to investigate intraoperatively the circuits involved in CM.
METHODS
A systematic review of the literature was conducted using PubMed central database. Papers describing the use of IONM techniques in the cerebellum were selected, thoroughly reviewed, and discussed.
RESULTS AND DISCUSSION
Only two studies reported the use of intraoperative neurophysiology of the cerebellum, suggesting a possible somatotopic motor organization of the cerebellar cortex. In addition, extra-operative studies using transcranial magnetic stimulation showed the possibility to modulate-possibly through the dentato-thalamic-cortical (DTC) pathway-primary motor cortex output using an appropriate cerebellar stimulus. In theory, the preservation of this either inhibitory or facilitatory modulation may predict the preservation of this pathway, while a loss of the effect may indicate an injury to the pathway, and predict a CM. Analogously, in the extra-operative setting, the comparison of pre-operative and post-operative transcranial magnetic stimulation of the cerebellum may predict the onset of CM whenever a pre-existing modulatory effect is lost as a result of surgery.
CONCLUSION
Virtually, no data exist on the intraoperative neurophysiology of the cerebellum. This limited knowledge, nevertheless, offers a unique opportunity to pediatric neurosurgeons to develop and test working hypotheses on the pathophysiology of CM, through the use of IONM.
Topics: Cerebellum; Child; Humans; Intraoperative Neurophysiological Monitoring; Motor Cortex; Neurophysiology; Neurosurgical Procedures
PubMed: 32246192
DOI: 10.1007/s00381-020-04565-y