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Status epilepticus after intracranial neurosurgery: incidence and risk stratification by perioperative clinical features.

J Neurosurg 2021 May 14:1-13. Epub 2021 May 14.

Departments of1Neurosurgery and.

Objective: Status epilepticus (SE) is associated with significant mortality, cost, and risk of future seizures. In one of the first studies of SE after neurosurgery, the authors assess the incidence, risk factors, and outcome of postneurosurgical SE (PNSE).

Methods: Neurosurgical admissions from the MarketScan Claims and Encounters database (2007 through 2015) were assessed in a longitudinal cross-sectional sample of privately insured patients who underwent qualifying cranial procedures in the US and were older than 18 years of age. Read More

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Cerebrospinal fluid and intraoperative squash cytology of childhood ependymoma.

Acta Biomed 2021 May 12;92(2):e2021107. Epub 2021 May 12.

PEDIATRICIAN ONCOLOGIST.

Ependymomas are glial neoplasms of central nervous system originated from the ependymal lining of the brain ventricles and spinal cord central canal, and rarely exfoliated into cerebrospinal fluid (CSF). In this case we report the cytomorphological and immunocytomorphological features of ependymoma in CSF and intraoperative squash preparations, confirmed by histology. Case report. Read More

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Comparison of Transthecal Approach With Traditional Conservative Approach for Primary Closure After Incidental Durotomy in Anterior Lumbar Tear.

Int J Spine Surg 2021 May 13. Epub 2021 May 13.

Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Incidental durotomies (IDs) are frequent complications of spinal surgeries which are mostly posterior or lateral. Anterior IDs are rare; however, they may lead to severe complications. We compared the transthecal approach with the conservative approach for primary closure after durotomy in anterior lumbar dural tear to assess the efficacy of these approaches to decrease postsurgical complications and clinical outcomes. Read More

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Compartmentalization of cerebrospinal fluid inflammation across the spectrum of untreated HIV-1 infection, central nervous system injury and viral suppression.

PLoS One 2021 13;16(5):e0250987. Epub 2021 May 13.

Department of Neurology, University of California San Francisco, San Francisco, CA, United States of America.

Objective: To characterize the evolution of central nervous system (CNS) inflammation in HIV-1 infection applying a panel of cerebrospinal fluid (CSF) inflammatory biomarkers to grouped subjects representing a broad spectrum of systemic HIV-1 immune suppression, CNS injury and viral control.

Methods: This is a cross-sectional analysis of archived CSF and blood samples, assessing concentrations of 10 functionally diverse soluble inflammatory biomarkers by immunoassays in 143 HIV-1-infected subjects divided into 8 groups: untreated primary HIV-1 infection (PHI); four untreated groups defined by their blood CD4+ T lymphocyte counts; untreated patients presenting with subacute HIV-associated dementia (HAD); antiretroviral-treated subjects with ≥1 years of plasma viral suppression; and untreated elite controllers. Twenty HIV-1-uninfected controls were included for comparison. Read More

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Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre.

Korean J Neurotrauma 2021 Apr 18;17(1):15-24. Epub 2021 Mar 18.

Department of Neurosurgery, Faculty of Medicine, Kasr Al-Ainy Medical College, Cairo, Egypt.

Objective: Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons.

Methods: Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Read More

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The consequences of the edge-effect in a commercial enzyme-linked immunosorbent assay (ELISA) for the diagnosis of Lyme neuroborreliosis.

J Clin Microbiol 2021 May 12. Epub 2021 May 12.

Department of Infectious Diseases Research, Diagnostics and laboratory Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.

The diagnosis of Lyme neuroborreliosis (LNB) is based on neurological symptoms, cerebrospinal fluid (CSF) pleocytosis, and intrathecally produced -specific antibodies. In most cases, the presence of intrathecally produced -specific antibodies is determined by using an enzyme-linked immunosorbent assay (ELISA). The edge-effect is a known phenomenon in ELISAs and can negatively influence the assay reproducibility, repeatability, as well as index calculations of sample pairs which are tested in the same run. Read More

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Assessing the role of a tissue-based assay in the diagnostic algorithm of autoimmune encephalitis.

J Neuroimmunol 2021 Apr 30;356:577601. Epub 2021 Apr 30.

Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy; UOC Neurologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy. Electronic address:

Tissue-based assay (TBA) is a widely-used method to detect neural autoantibodies, but the diagnostic accuracy for autoimmune encephalitis (AE) has not yet been adequately measured. We retrospectively evaluated the sensitivity and specificity of an indirect immunofluorescence TBA (IIF-TBA) in 159 patients with suspected AE. Serum and cerebrospinal fluid (CSF) specimens were collected and tested from December 2012 to September 2020. Read More

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Evaluation of the molecular bacterial load assay for detecting viable Mycobacterium tuberculosis in cerebrospinal fluid before and during tuberculous meningitis treatment.

Tuberculosis (Edinb) 2021 Apr 29;128:102084. Epub 2021 Apr 29.

Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam; Nuffield Department of Medicine, University of Oxford, United Kingdom. Electronic address:

New tools to monitor treatment response and predict outcome from tuberculous meningitis (TBM) are urgently required. We retrospectively evaluated the 16S rRNA-based molecular bacterial load assay (MBLA) to quantify viable Mycobacterium tuberculosis in serial cerebrospinal fluid (CSF) from adults with TBM. 187 CSF samples were collected before and during the first two months of treatment from 99 adults TBM, comprising 56 definite, 43 probable or possible TBM, and 18 non-TBM and preserved at -80°C prior to MBLA. Read More

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Optimizing outcomes for haploidentical hematopoietic stem cell transplantation in severe aplastic anemia with intensive GVHD prophylaxis: a review of current findings.

Expert Rev Hematol 2021 May 10:1-7. Epub 2021 May 10.

National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.

: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has resulted in increased levels of disease-free survival in severe aplastic anemia (SAA). Haploidentical transplantation (haplo-SCT) was previously not recommended due to unacceptable incidences of graft-versus-host disease (GvHD) and graft failures. With the advent of intensive GvHD prophylaxis strategies, the outcomes obtained with haplo-SCT for SAA have gradually improved. Read More

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Plasma and cerebrospinal fluid inflammation and the blood-brain barrier in older surgical patients: the Role of Inflammation after Surgery for Elders (RISE) study.

J Neuroinflammation 2021 Apr 30;18(1):103. Epub 2021 Apr 30.

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Background: Our understanding of the relationship between plasma and cerebrospinal fluid (CSF) remains limited, which poses an obstacle to the identification of blood-based markers of neuroinflammatory disorders. To better understand the relationship between peripheral and central nervous system (CNS) markers of inflammation before and after surgery, we aimed to examine whether surgery compromises the blood-brain barrier (BBB), evaluate postoperative changes in inflammatory markers, and assess the correlations between plasma and CSF levels of inflammation.

Methods: We examined the Role of Inflammation after Surgery for Elders (RISE) study of adults aged ≥ 65 who underwent elective hip or knee surgery under spinal anesthesia who had plasma and CSF samples collected at baseline and postoperative 1 month (PO1MO) (n = 29). Read More

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Viscosity Measurement Sensor: A Prototype for a Novel Medical Diagnostic Method Based on Quartz Crystal Resonator.

Sensors (Basel) 2021 Apr 13;21(8). Epub 2021 Apr 13.

Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain.

Viscosity variation in human fluids, such as Synovial Fluid (SF) or Cerebrospinal Fluid (CSF), can be used as a diagnostic factor; however, the sample volume obtained for analysis is usually small, making it difficult to measure its viscosity. On the other hand, Quartz Crystal Resonators (QCR) have been used widely in sensing applications due to their accuracy, cost, and size. This work provides the design and validation of a new viscosity measurement system based on quartz crystal resonators for low volume fluids, leading to the development of a sensor called "ViSQCT" as a prototype for a new medical diagnostic tool. Read More

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Low Detection Rate of H3K27M Mutations in Cerebrospinal Fluid Obtained from Lumbar Puncture in Newly Diagnosed Diffuse Midline Gliomas.

Diagnostics (Basel) 2021 Apr 9;11(4). Epub 2021 Apr 9.

Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8585, Japan.

Recent studies have suggested the feasibility of detecting H3K27M mutations in the cerebrospinal fluid of diffuse midline glioma (DMG) patients. However, cerebrospinal fluid from patients in these studies were collected mainly during biopsy, ventriculo-peritoneal shunt procedures or postmortem. We assessed circulating tumor DNA (ctDNA) extracted from cerebrospinal fluid (CSF) and plasma in a series of 12 radiographically suspected and/or pathologically confirmed diffuse midline glioma patients and assessed for K27M mutation using digital droplet PCR. Read More

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TGFβ1, MMPs and cytokines profiles in ocular surface: Possible tear biomarkers for pseudoexfoliation.

PLoS One 2021 29;16(4):e0249759. Epub 2021 Apr 29.

Hyderabad Eye Research Foundation (HERF), L.V. Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India.

Purpose: Pseudoexfoliation (PXF) is a unique form of glaucoma characterized by accumulation of exfoliative material in the eyes. Changes in tear profile in disease stages may give us insights into molecular mechanisms involved in causing glaucoma in the eye.

Methods: All patients were categorized into three main categories; pseudoexfoliation (PXF), pseudoexfoliation glaucoma (PXG) and cataract, which served as control. Read More

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Metagenomic sequencing as a pathogen-agnostic clinical diagnostic tool for infectious diseases: a systematic review and meta-analysis of diagnostic test accuracy studies.

J Clin Microbiol 2021 Apr 28. Epub 2021 Apr 28.

Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK

Metagenomic sequencing is frequently claimed to have the potential to revolutionise microbiology through rapid species identification and antimicrobial resistance (AMR) prediction. We assess progress towards this. We perform a systematic review and meta-analysis of all published literature on culture-independent metagenomic sequencing for pathogen-agnostic infectious disease diagnostics to August 12, 2020. Read More

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The role of sperm in inducing genomic changes in the implantation: An experimental study.

Andrologia 2021 Apr 28:e14077. Epub 2021 Apr 28.

Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.

Endometrial receptivity and implantation are important topics in reproductive sciences. No evidence was found to support sperm involvement in endometrial receptivity and its associated factors. This study aimed to explore the effect of the normal human spermatozoa-endometrium cell interaction in regulating genes in the endometrial receptivity pathway. Read More

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Neurocognitive function among HIV-infected children on protease inhibitor -based versus non-protease inhibitor based antiretroviral therapy in Uganda: a pilot study.

BMC Pediatr 2021 Apr 26;21(1):198. Epub 2021 Apr 26.

Department of Paediatrics, University of Minnesota, Minneapolis, MN, USA.

Background: HIV infection is associated with significant neurocognitive deficits making maximization of cognitive function among children receiving antiretroviral therapy (ART) a public health imperative. Non-protease inhibitors (non-PIs) achieve higher drug levels in the cerebral spinal fluid (CSF) compared to PIs, potentially leading to better neurocognitive function by reducing CSF viral load and inflammation. ART that maximises children's neurodevelopment and school achievement could result in improved quality of life and productivity as adults, but little research to date has examined whether non-PI ART is associated with better neurocognitive outcomes. Read More

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Early Rearing Conditions Affect Monoamine Metabolite Levels During Baseline and Periods of Social Separation Stress: A Non-human Primate Model ().

Front Hum Neurosci 2021 9;15:624676. Epub 2021 Apr 9.

Department of Psychology, Brigham Young University, Provo, UT, United States.

A variety of studies show that parental absence early in life leads to deleterious effects on the developing CNS. This is thought to be largely because evolutionary-dependent stimuli are necessary for the appropriate postnatal development of the young brain, an effect sometimes termed the "experience-expectant brain," with parents providing the necessary input for normative synaptic connections to develop and appropriate neuronal survival to occur. Principal among CNS systems affected by parental input are the monoamine systems. Read More

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Real-world SARS CoV-2 testing in Northern England during the first wave of the COVID-19 pandemic.

J Infect 2021 Apr 21. Epub 2021 Apr 21.

Department of Virology, Public Health England (PHE) Manchester, Oxford Road, Manchester M13 9WL, UK.

Objectives: SARS-CoV-2 emerged in South Asia in 2019 and has resulted in a global pandemic. Public Health England (PHE) Manchester rapidly escalated testing for SARS-CoV-2 in the highest COVID-19 incidence location in England. The results of the PHE Manchester SARS-CoV-2 surveillance during the first wave are presented. Read More

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Prognostic value of amyloid/tau/neurodegeneration (ATN) classification based on diagnostic cerebrospinal fluid samples for Alzheimer's disease.

Alzheimers Res Ther 2021 Apr 20;13(1):84. Epub 2021 Apr 20.

Department of Neurology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.

Objective: The primary study objective of this retrospective academic memory clinic-based observational longitudinal study was to investigate the prognostic value of a cerebrospinal fluid (CSF)-based ATN classification for subsequent cognitive decline during the 3 years following lumbar puncture in a clinical, real-life setting. The secondary objective was to investigate the prognostic value of CSF biomarkers as continuous variables.

Methods: Data from 228 patients (median age 67 (47-85) years), who presented at the Neurology Memory Clinic UZ/KU Leuven between September 2011 and December 2016, were included with a follow-up period of up to 36 months. Read More

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The effect of pre-analytical handling on the stability of fractalkine, monocyte chemoattractant protein 1 (MCP1), interleukin 6 and interleukin 8 in samples of human cerebrospinal fluid.

J Immunol Methods 2021 Apr 18;494:113057. Epub 2021 Apr 18.

Pain Research Group, Pain Center, Odense University Hospital, Heden 9, Odense DK-5000, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, Odense DK-5000, Denmark.

Cytokine networks in cerebrospinal fluid (CSF) are important to our understanding of several neuroinflammatory diseases. Knowledge about optimal handling of samples is limited but important to minimize bias and reduce costs in CSF biomarker studies. The aim of this study was to examine the effect of storage temperature and time delay from CSF sample collection until freezing on the concentration of 11 different cytokines thought to be associated with chronic pain. Read More

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Twice Negative PCR in a Patient With Herpes Simplex Virus Type 1 (HSV-1) Encephalitis.

Neurohospitalist 2021 Jan 22;11(1):66-70. Epub 2020 Jul 22.

Division of Neurology, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.

Untreated herpes simplex virus type 1 (HSV-1) encephalitis is associated with high mortality. Missed cases can have devastating consequences. Detection of HSV-1 in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) is reported to have high sensitivity and specificity and is considered the diagnostic gold standard for HSV-1 encephalitis. Read More

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January 2021

Cytokines and Water Distribution in Anorexia Nervosa.

Mediators Inflamm 2021 2;2021:8811051. Epub 2021 Apr 2.

Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.

In patients with anorexia nervosa (AN), decreased intracellular (ICW), extracellular (ECW), and total body water (TBW) as well as changes in serum cytokine concentrations have been reported. In this exploratory study, we measured body composition and serum cytokine levels in patients with AN ( = 27) and healthy controls (HCs; = 13). Eating disorder symptom severity was assessed using the Eating Disorder Examination-Questionnaire (EDE-Q). Read More

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In-depth site-specific analysis of N-glycoproteome in human cerebrospinal fluid (CSF) and glycosylation landscape changes in Alzheimer's disease (AD).

Mol Cell Proteomics 2021 Apr 13:100081. Epub 2021 Apr 13.

Department of Chemistry, University of Wisconsin, Madison, WI, 53705, USA; School of Pharmacy, University of Wisconsin, Madison, WI, 53705, USA. Electronic address:

As the body fluid that directly interchanges with the extracellular fluid of central nervous system (CNS), cerebrospinal fluid (CSF) serves as a rich source for CNS-related disease biomarker discovery. Extensive proteome profiling has been conducted for CSF, but studies aimed at unraveling site-specific CSF N-glycoproteome are lacking. Initial efforts into site-specific N-glycoproteomics study in CSF yield limited coverage, hindering further experimental design of glycosylation-based disease biomarker discovery in CSF. Read More

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IV and oral fosfomycin pharmacokinetics in neonates with suspected clinical sepsis.

J Antimicrob Chemother 2021 Apr 14. Epub 2021 Apr 14.

Infection, Immunity and Inflammation, Great Ormond Street Institute of Child Health, University College London, London, UK.

Background: Fosfomycin has the potential to be re-purposed as part of a combination therapy to treat neonatal sepsis where resistance to current standard of care (SOC) is common. Limited data exist on neonatal fosfomycin pharmacokinetics and estimates of bioavailability and CSF/plasma ratio in this vulnerable population are lacking.

Objectives: To generate data informing the appropriate dosing of IV and oral fosfomycin in neonates using a population pharmacokinetic analysis of plasma and CSF data. Read More

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The Anaesthetic Biobank of Cerebrospinal fluid: a unique repository for neuroscientific biomarker research.

Ann Transl Med 2021 Mar;9(6):455

Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Background: The pathophysiology of numerous central nervous system disorders remains poorly understood. Biomarker research using cerebrospinal fluid (CSF) is a promising way to illuminate the neurobiology of neuropsychiatric disorders. CSF biomarker studies performed so far generally included patients with neurodegenerative diseases without an adequate control group. Read More

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[Aseptic meningitis due to mumps vaccine. Case report and review of the literature].

Rev Chilena Infectol 2020 Dec;37(6):769-774

Hospital Clínico San Borja Arriarán, Santiago, Chile.

We report the case of an older infant with no prior morbidity that approximately 3 weeks after receiving MMR vaccination (measles, mumps, rubella) was hospitalized for feverish symptoms, increased parotid volume and compromised consciousness. Aseptic meningitis was diagnosed, detecting pleocytosis in the CSF, predominantly mononuclear, and confirming by molecular biology, presence of parotid virus in CSF. A study was carried out by the Institute of Public Health of Chile, where serology (IgM and IgG) was positive. Read More

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December 2020

Heterogeneity of Cerebrospinal Fluid Biomarkers Profiles in Individuals with Distinct Levels of Cognitive Decline: A Cross-Sectional Study.

J Alzheimers Dis 2021 Apr 5. Epub 2021 Apr 5.

Laboratory of Neuroscience, Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.

Background: Decreased cerebrospinal fluid (CSF) concentrations of the amyloid-β (Aβ), along with increased total (T-tau) and phosphorylated tau protein (P-tau), are widely accepted as core biomarkers of Alzheimer's disease (AD) pathology. Nonetheless, there are a few remaining caveats that still preclude the full incorporation of AD biomarkers into clinical practice.

Objective: To determine the frequency of clinical-biological mismatches in a clinical sample of older adults with varying degrees of cognitive impairment. Read More

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Simultaneous Detection of Six Isoforms of Tau Protein in Human Cerebrospinal Fluid by Multidimensional Mass Spectrometry-Based Targeted Proteomics.

J Proteome Res 2021 May 12;20(5):2299-2307. Epub 2021 Apr 12.

School of Pharmacy, Nanjing Medical University, Nanjing 211166, China.

Abnormal expression of Tau protein can cause the development of Alzheimer's disease (AD). So far, much evidence has demonstrated that Tau has multiple isoforms. These isoforms are suggested to have distinct physiological roles and contribute unequally to the progress of AD. Read More

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Acute Hemorrhagic Encephalitis Related to COVID-19.

Neurol Clin Pract 2021 Apr;11(2):e147-e151

Department of Clinical Neurological Sciences (AC, RBJ, CJ, DBD, DAS), Schulich School of Medicine and Dentistry, Western University; Department of Physical Medicine and Rehabilitation (CSB), Schulich School of Medicine and Dentistry, Western University; Department of Medical Imaging (MSM), Schulich School of Medicine and Dentistry, Western University; Department of Medicine (KJB), Schulich School of Medicine and Dentistry, Western University; and Department of Epidemiology and Biostatistics (DAS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Purpose Of Review: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most critical public health challenge in recent history. In this report, we present a case of suspected acute hemorrhagic encephalitis with bilateral intracranial hemorrhages associated with coronavirus disease 2019 (COVID-19) infection.

Recent Findings: A 48-year-old female COVID-19-positive patient developed acute changes in her neurologic status. Read More

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