UW Neurological Surgery Recent PubMed Publications

A man in his late 50s was referred by a speech and language therapist for consideration of a palatal lift prosthesis (PLP) to improve his speech intelligibility. He presented with hypokinetic dysarthria characterised by reduced loudness, breathy voice and hypernasality. The patient had a diagnosis of progressive muscular dystrophy and mobilised in a motorised wheelchair. He was dependent for dressing and bathing, but independent for grooming. He had no cognitive impairment and provided his own...

Fentanyl is a potent synthetic opioid widely used perioperatively and illicitly as a drug of abuse ^(1,2). It is well established that fentanyl acts as a μ-opioid receptor agonist, signaling through Gα(i/o) intracellular pathways to inhibit electrical excitability, resulting in analgesia and respiratory depression ^(3,4). However, fentanyl uniquely also triggers muscle rigidity, including respiratory muscles, hindering the ability to execute central respiratory commands or to receive external...

CONCLUSIONS: Prophylaxis with 8 mg oral dexamethasone meaningfully reduced IRRs and can be readily implemented in clinical practice.

CONCLUSION: While age ≥80 increases mortality and disability in patients with AIS and low ASPECTS, select elderly patients may still benefit from EVT when clinical factors are considered, supporting individualized treatment and better patient selection for future trials.

CONCLUSIONS: Age-specific CAVD rates did not differ between Māori and Europeans, though Māori had a higher proportion of advanced cardiac impairment, which is likely unrelated to CAVD. Differences in population structure likely explain the difference in overall prevalence of CAVD. The improving life expectancy in Māori may lead to increasing incidence of CAVD, thus strategies to improve detection and medical management of CAVD should begin as soon as possible.

CONCLUSIONS: Transgender women are a high-priority population for reaching End the HIV Epidemic goals. Findings have the potential to improve individual and population health outcomes by generating significant improvements in viral suppression among transgender women and guiding service provision and public policy.

CONCLUSION: This study demonstrated that dd-cfDNA was applicable to Black recipients with a robust ability to detect antibody-mediated rejection, as compared to White and Hispanic recipients.

Long-term risks of gene therapy are not fully understood. In this study, we evaluated safety outcomes in 783 patients over more than 2,200 total patient-years of observation from 38 T cell therapy trials. The trials employed integrating gammaretroviral or lentiviral vectors to deliver engineered receptors to target HIV-1 infection or cancer. Eighteen patients (2.3%) developed secondary malignancies after treatment, with a median onset of 1.94 years (range: 51 d to 14 years). Where possible,...

The persistent Na^(+) current (I(NaP)) is thought to play important roles in many brain regions including the generation of inspiration in the ventral respiratory column (VRC) of mammals. The characterization of the slow inactivation of I(NaP) requires long-lasting voltage steps (>1 s), which will increase intracellular Na^(+) and activate the Na^(+)/K^(+)-ATPase pump current (I(Pump)). Thus, I(Pump) may contribute to the previously measured slow inactivation of I(NaP) and the generation of the...

BACKGROUND: Contingency management (CM) is an intervention for alcohol use disorder (AUD) that reinforces abstinence, as confirmed by alcohol biomarkers. CM is usually brief (12-16 weeks) despite evidence that longer interventions have better long-term outcomes. Most CM models are in-person which can also be a barrier for treatment. Studies of longer duration telehealth-based CM models are needed.

CONCLUSION: Faster hospital arrival to arterial puncture time is associated with higher odds of successful reperfusion in late window stroke patients.

Disorders of the pulmonic valve (PV) receive considerably less attention than other forms of valvular heart disease. Due to the dramatically improved survival of children with congenital heart disease over the last 5 decades, there has been a steady increase in the prevalence of adults with congenital heart disease, which necessitates that clinicians become familiar with the anatomy and the evaluation of right ventricular outflow tract and PV anomalies. A multimodality imaging approach using...

CONCLUSIONS: P3 engagement (dollars accrued) was strongly related to lower odds of PrEP nonadherence. Intrapersonal measures operating through P3 engagement (indirect effect, eg, anxious symptoms) suggest possible pathways to improve PrEP adherence DHI efficacy in YSGMMSM via effective engagement. Conversely, the direct effects observed in this study may reflect existing structural disparity (eg, race and ethnicity) or behavioral dispositions toward technology (eg, tracking health via phone...

CONCLUSION: The highest anticholinergic burden was associated with greater WMH burden among older individuals who received an MRI due to clinical indications. The lack of a demonstrated dose-response relationship warrants further research into biological mechanisms underlying the link between anticholinergic use and WMH burden.

Diffuse intrinsic pontine glioma (DIPG) is a fatal central nervous system (CNS) tumor that confers a median survival of 11 months. As B7-H3 is expressed on pediatric CNS tumors, we conducted BrainChild-03, a single-center, dose-escalation phase 1 clinical trial of repetitive intracerebroventricular (ICV) dosing of B7-H3-targeting chimeric antigen receptor T cells (B7-H3 CAR T cells) for children with recurrent or refractory CNS tumors and DIPG. Here we report results from Arm C, restricted to...

No abstract

Spinal cord trauma leads to the destruction of the highly organized cytoarchitecture that carries information along the axis of the spinal column. Currently, there are no clinically accepted strategies that can help regenerate severed axons after spinal cord injury (SCI). Hydrogels are soft biomaterials with high water content that are widely used as scaffolds to interface with the central nervous system (CNS). Here, we examine a simple and reproducible method that results in consistently...

We examined DA activity in the medial prefrontal cortex (mPFC) and nucleus accumbens core (NAcc) in two Different Rat Models of Attention-Deficit/Hyperactivity Disorder: Spontaneously Hypertensive Rats (SHR) Versus Lphn3 Knockout Rats. We examined baseline stimulation-evoked phasic DA release, half-life, and DA autoreceptor (DAR) functioning in the mPFC and NAcc, as well as the response to nomifensine (10 mg/kg, IP), a DA transporter (DAT) blocker, on these measures in the NAcc. Both rat models...

CONCLUSION: Transitioning from routine to indication-based CSF sampling in aSAH patients with an EVD reduced sampling frequency and associated costs without increasing infection rates.

CONCLUSION: The digital BSP atlas provides a quantitative representation of the BSP in a standard space which will accelerating the process of requesting brain tissue, allows for the refinement of protocols, and the coordination of neuroimaging information with neuropathology sample. Future directions of this work include customizable visualizations, training software, and website backend to identify corresponding samples from free-form text with arbitrary neuroscience terms. This research is...