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Brain and Nerve = Shinkei Kenkyu No... Mar 2024Based on a recent review by Krohn et al, the respiratory center and its regulatory mechanisms are described. Although the respiratory control centers in the medulla and... (Review)
Review
Based on a recent review by Krohn et al, the respiratory center and its regulatory mechanisms are described. Although the respiratory control centers in the medulla and pons ensure rhythmic respiration, maintaining and regulating respiration involves a complex network of peripheral chemoreceptors, vagal nerves, and central chemoreceptors. This review discusses the pathophysiology of respiratory disorders in neuromuscular diseases and evaluation and treatment methods based on the anatomy of the respiratory network.
Topics: Humans; Respiration; Neuromuscular Diseases; Respiratory Insufficiency; Medulla Oblongata; Pons
PubMed: 38514105
DOI: 10.11477/mf.1416202594 -
Current Neuropharmacology 2017Diffuse intrinsic pontine gliomas (DIPGs) are invariably fatal tumors found in the pons of elementary school aged children. These tumors are grade II-IV gliomas, with a... (Review)
Review
Diffuse intrinsic pontine gliomas (DIPGs) are invariably fatal tumors found in the pons of elementary school aged children. These tumors are grade II-IV gliomas, with a median survival of less than 1 year from diagnosis when treated with standard of care (SOC) therapy. Nanotechnology may offer therapeutic options for the treatment of DIPGs. Multiple nanoparticle formulations are currently being investigated for the treatment of DIPGs. Nanoparticles based upon stable elements, polymer nanoparticles, and organic nanoparticles are under development for the treatment of brain tumors, including DIPGs. Targeting of nanoparticles is now possible as delivery techniques that address the difficulty in crossing the blood brain barrier (BBB) are developed. Theranostic nanoparticles, a combination of therapeutics and diagnostic nanoparticles, improve imaging of the cancerous tissue while delivering therapy to the local region. However, additional time and attention should be directed to developing a nanoparticle delivery system for treatment of the uniformly fatal pediatric disease of DIPG.
Topics: Animals; Antineoplastic Agents; Brain Stem Neoplasms; Glioma; Humans; Nanoparticles; Nanotechnology; Pons
PubMed: 26903150
DOI: 10.2174/1570159x14666160223121002 -
Acta Neurochirurgica Mar 2022The horizontal fissure approach is a workhorse for brainstem lesions in the central and dorsolateral pons and middle cerebellar peduncle (MCP). The cerebellopontine...
BACKGROUND
The horizontal fissure approach is a workhorse for brainstem lesions in the central and dorsolateral pons and middle cerebellar peduncle (MCP). The cerebellopontine fissure is a V-shaped fissure with a superior and inferior limb between the cerebellum, pons, and MCP. The horizontal or petrosal fissure is at the apex of the cerebellopontine fissure and extends laterally to divide the petrosal surface of the cerebellum into superior and inferior parts. Splitting this fissure exposes the posterolateral aspect of the MCP without excessive retraction or transgression of the cerebellum.
METHOD
We demonstrate and describe the horizontal fissure operative approach to the middle cerebellar peduncle for resection of a pontine cavernoma with illustrative figures and operative video.
CONCLUSION
Splitting the horizontal (petrosal) fissure of the cerebellum brings the middle cerebellar peduncle into view behind the root entry zone of the trigeminal nerve, providing an expanded, safe corridor to the central and dorsolateral pons.
Topics: Cerebellum; Hemangioma, Cavernous; Humans; Middle Cerebellar Peduncle; Pons; Trigeminal Nerve
PubMed: 34643805
DOI: 10.1007/s00701-021-05015-7 -
Multiple Sclerosis and Related Disorders Feb 2018
Topics: Humans; Inflammation; Pons
PubMed: 29291480
DOI: 10.1016/j.msard.2017.12.019 -
World Neurosurgery Jun 2020In this article, we describe a new safe entry point for the posterolateral pons.
OBJECTIVE
In this article, we describe a new safe entry point for the posterolateral pons.
METHODS
To show the adjacent anatomy and measure the part of the interpeduncular sulcus that can be safely accessed, we first performed a review of the literature regarding the pons anatomy and its surgical approaches. Thereafter, 1 human cadaveric head and 15 (30 sides) human brainstems with attached cerebellums were bilaterally dissected with the fiber microdissection technique. A clinical correlation was made with an illustrative case of a dorsolateral pontine World Health Organization grade I astrocytoma.
RESULTS
The safe distance for accessing the interpeduncular sulcus was found to extend from the caudal end of the lateral mesencephalic sulcus to the point at which the intrapontine segment of the trigeminal nerve crosses the interpeduncular sulcus. The mean distance was 8.2 mm (range, 7.15-8.85 mm). Our interpeduncular sulcus safe entry zone can be exposed through a paramedian infratentorial supracerebellar approach. When additional exposure is required, the superior portion of the quadrangular lobule of the cerebellar hemispheric tentorial surface can be removed. In the presented case, surgical resection of the tumor was performed achieving a gross total resection, and the patient was discharged without neurologic deficit.
CONCLUSIONS
The interpeduncular sulcus safe entry zone provides an alternative direct route for treating intrinsic pathologic entities situated in the posterolateral tegmen of the pons between the superior and middle cerebellar peduncles. The surgical corridor provided by this entry point avoids most eloquent neural structures, thereby preventing surgical complications.
Topics: Humans; Microdissection; Microsurgery; Middle Cerebellar Peduncle; Neurosurgical Procedures; Pons
PubMed: 32217179
DOI: 10.1016/j.wneu.2020.03.084 -
Journal of Stroke and Cerebrovascular... Aug 2022There are scarce data regarding pontine arteries anatomy, which is the basis for ischemic lesions following their occlusion. The aim of this study was to examine pontine...
OBJECTIVES
There are scarce data regarding pontine arteries anatomy, which is the basis for ischemic lesions following their occlusion. The aim of this study was to examine pontine vasculature and its relationships with the radiologic and neurologic features of pontine infarctions.
MATERIALS AND METHODS
Branches of eight basilar arteries and their twigs, including the larger intrapontine branches, were microdissected following an injection of a 10% mixture of India ink and gelatin. Two additional brain stems were prepared for microscopic examination after being stained with luxol fast blue and cresyl violet. Finally, 30 patients with pontine infarctions underwent magnetic resonance imaging (MRI) in order to determine the position and size of the infarctions.
RESULTS
The perforating arteries, which averaged 5.8 in number and 0.39 mm in diameter, gave rise to paramedian and anteromedial branches, and also to anterolateral twigs (62.5%). The longer leptomeningeal and cerebellar arteries occasionally gave off perforating and anterolateral twigs, and either the lateral or posterior branches. Occlusion of some of these vessels resulted in the paramedian (30%), anterolateral (26.7%), lateral (20%), and combined infarctions (23.3%), which were most often isolated and unilateral, and rarely bilateral (10%). They were located in the lower pons (23.3%), middle (10%) or rostral (26.7%), or in two or three portions (40%). Each type of infarction usually produced characteristic neurologic signs. The clinical significance of the anatomic findings was discussed.
CONCLUSIONS
There was a good correlation between the intrapontine vascular territories, the position, size and shape of the infarctions, and the type of neurologic manifestations.
Topics: Basilar Artery; Brain Stem Infarctions; Humans; Infarction; Magnetic Resonance Imaging; Pons
PubMed: 35777083
DOI: 10.1016/j.jstrokecerebrovasdis.2022.106613 -
Acta Radiologica (Stockholm, Sweden :... Aug 2022The morphological changes in the pons and cerebellum of neonates experiencing profound asphyxia in the early period of life remain to be clarified.
BACKGROUND
The morphological changes in the pons and cerebellum of neonates experiencing profound asphyxia in the early period of life remain to be clarified.
PURPOSE
To assess the changes in the size of the pons and cerebellum during the first two weeks of life in term neonates with pontine and cerebellar injury caused by hypoxic-ischemic encephalopathy in comparison with a control group.
MATERIAL AND METHODS
Two groups were investigated: a group with pontine/cerebellar injury (PCI) (n = 10) demonstrated by magnetic resonance imaging (MRI) diffusion-weighted imaging; and a control group without PCI - focal-multifocal white matter injury and a normal pattern (n = 24). The anteroposterior diameter (APD) and height of the pons and cerebellar vermis, and the transverse width of the cerebellum were measured twice in the first and second weeks of life. Differences between the groups were analyzed statistically using paired and unpaired Student's t-test at a significance level of < 0.05.
RESULTS
In the PCI group, the pontine APD and cerebellar vermian height were significantly decreased in the second week. An increase of pons and cerebellar size was evident during the first two weeks of life in the control groups.
CONCLUSION
Infants with PCI and profound asphyxia show rapid decreases in pontine APD and cerebellar vermian height within the first two weeks of life.
Topics: Asphyxia; Cerebellum; Diffusion Magnetic Resonance Imaging; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Pons
PubMed: 34259022
DOI: 10.1177/02841851211030777 -
The Journal of Neuroscience : the... Jun 2021Coordination of skilled movements and motor planning relies on the formation of regionally restricted brain circuits that connect cortex with subcortical areas during...
Coordination of skilled movements and motor planning relies on the formation of regionally restricted brain circuits that connect cortex with subcortical areas during embryonic development. Layer 5 neurons that are distributed across most cortical areas innervate the pontine nuclei (basilar pons) by protrusion and extension of collateral branches interstitially along their corticospinal extending axons. Pons-derived chemotropic cues are known to attract extending axons, but molecules that regulate collateral extension to create regionally segregated targeting patterns have not been identified. Here, we discovered that and are expressed in the cortex and the basilar pons in a region-specific and mutually exclusive manner, and that their repulsive activities are essential for segregating collateral extensions from corticospinal axonal tracts in mice. Specifically, and forward and reverse inhibitory signals direct collateral extension such that -positive frontal and occipital cortical areas extend their axon collaterals into the -negative rostral part of the basilar pons, whereas -positive parietal cortical areas extend their collaterals into the -negative caudal part of the basilar pons. Together, our results provide a molecular basis that explains how the corticopontine projection connects multimodal cortical outputs to their subcortical targets. Our findings put forward a model in which region-to-region connections between cortex and subcortical areas are shaped by mutually exclusive molecules to ensure the fidelity of regionally restricted circuitry. This model is distinct from earlier work showing that neuronal circuits within individual cortical modalities form in a topographical manner controlled by a gradient of axon guidance molecules. The principle that a shared molecular program of mutually repulsive signaling instructs regional organization-both within each brain region and between connected brain regions-may well be applicable to other contexts in which information is sorted by converging and diverging neuronal circuits.
Topics: Animals; Axon Guidance; Ephrin-A5; Female; Male; Mice; Mice, Inbred C57BL; Neocortex; Neural Pathways; Pons; Receptor, EphA7
PubMed: 33906900
DOI: 10.1523/JNEUROSCI.0367-20.2021 -
The American Journal of Psychiatry Jun 2015Heavy alcohol use during adolescence may alter the trajectory of normal brain development. The authors measured within-subject changes in regional brain morphometry over...
OBJECTIVE
Heavy alcohol use during adolescence may alter the trajectory of normal brain development. The authors measured within-subject changes in regional brain morphometry over longer intervals and in larger samples of adolescents than previously reported and assessed differences between adolescents who remained nondrinkers and those who drank heavily during adolescence as well as differences between the sexes.
METHOD
The authors examined gray and white matter volume trajectories in 134 adolescents, of whom 75 transitioned to heavy drinking and 59 remained light drinkers or nondrinkers over roughly 3.5 years. Each underwent MRI scanning two to six times between ages 12 and 24 and was followed for up to 8 years. The volumes of the neocortex, allocortex, and white matter structures were measured using atlas-based parcellation with longitudinal registration. Linear mixed-effects models described differences in trajectories of heavy drinkers and nondrinkers over age; secondary analyses considered the contribution of other drug use to identified alcohol use effects.
RESULTS
Heavy-drinking adolescents showed accelerated gray matter reduction in cortical lateral frontal and temporal volumes and attenuated white matter growth of the corpus callosum and pons relative to nondrinkers. These results were largely unchanged when use of marijuana and other drugs was examined. Male and female drinkers showed similar patterns of development trajectory abnormalities.
CONCLUSIONS
Longitudinal analysis enabled detection of accelerated typical volume decline in frontal and temporal cortical volumes and attenuated growth in principal white matter structures in adolescents who started to drink heavily. These results provide a call for caution regarding heavy alcohol use during adolescence, whether heavy drinking is the sole cause or one of several in these alterations in brain development.
Topics: Adolescent; Age Factors; Alcohol-Related Disorders; Brain; Brain Mapping; Cerebral Cortex; Child; Corpus Callosum; Ethanol; Female; Gray Matter; Humans; Longitudinal Studies; Male; Neocortex; Organ Size; Pons; White Matter; Young Adult
PubMed: 25982660
DOI: 10.1176/appi.ajp.2015.14101249 -
AJNR. American Journal of Neuroradiology Oct 2023An MRI of the fetus can enhance the identification of perinatal developmental disorders, which improves the accuracy of ultrasound. Manual MRI measurements require...
BACKGROUND AND PURPOSE
An MRI of the fetus can enhance the identification of perinatal developmental disorders, which improves the accuracy of ultrasound. Manual MRI measurements require training, time, and intra-variability concerns. Pediatric neuroradiologists are also in short supply. Our purpose was developing a deep learning model and pipeline for automatically identifying anatomic landmarks on the pons and vermis in fetal brain MR imaging and suggesting suitable images for measuring the pons and vermis.
MATERIALS AND METHODS
We retrospectively used 55 pregnant patients who underwent fetal brain MR imaging with a HASTE protocol. Pediatric neuroradiologists selected them for landmark annotation on sagittal single-shot T2-weighted images, and the clinically reliable method was used as the criterion standard for the measurement of the pons and vermis. A U-Net-based deep learning model was developed to automatically identify fetal brain anatomic landmarks, including the 2 anterior-posterior landmarks of the pons and 2 anterior-posterior and 2 superior-inferior landmarks of the vermis. Four-fold cross-validation was performed to test the accuracy of the model using randomly divided and sorted gestational age-divided data sets. A confidence score of model prediction was generated for each testing case.
RESULTS
Overall, 85% of the testing results showed a ≥90% confidence, with a mean error of <2.22 mm, providing overall better estimation results with fewer errors and higher confidence scores. The anterior and posterior pons and anterior vermis showed better estimation (which means fewer errors in landmark localization) and accuracy and a higher confidence level than other landmarks. We also developed a graphic user interface for clinical use.
CONCLUSIONS
This deep learning-facilitated pipeline practically shortens the time spent on selecting good-quality fetal brain images and performing anatomic measurements for radiologists.
Topics: Pregnancy; Female; Humans; Child; Deep Learning; Retrospective Studies; Magnetic Resonance Imaging; Pons; Cerebellar Vermis
PubMed: 37652583
DOI: 10.3174/ajnr.A7978