Digital Commons Network^™

Tourette Syndrome Research Highlights From 2023 [Version 2; Peer Review: 3 Approved], Andreas Hartmann, Per Andrén, Cyril Atkinson-Clement, Virginie Czernecki, Cécile Delorme, Nanette Mol Debes, Simon Morand-Beaulieu, Kirsten Müller-Vahl, Peristera Paschou, Natalia Szejko, Apostolia Topaloudi, Kevin J Black

2020-Current year OA Pubs

In this, the tenth annual update for the F1000Research Tics collection, we summarize research reports from 2023 on Gilles de la Tourette syndrome and other tic disorders. The authors welcome article suggestions and thoughtful feedback from readers.

Protocol For A Pilot Clinical Trial Of The Senolytic Drug Combination Dasatinib Plus Quercetin To Mitigate Age-Related Health And Cognitive Decline In Mental Disorders [Version 2; Peer Review: 1 Approved, 2 Approved With Reservations], Abigail Schweiger, Breno Diniz, Ginger Nicol, Julie Schweiger, Andes E Dasklakis-Perez, Eric J Lenze

2020-Current year OA Pubs

BACKGROUND: Major depressive disorder (MDD) and schizophrenia are linked to accelerated aging leading to reduced lifespan, health span and cognitive decline. Cellular senescence, in which cells lose proliferative capacity and develop a senescence-associated secretory phenotype (SASP), plays a role in this process. Emerging research suggests that the senolytic regimen of dasatinib+quercetin (D+Q) reduces senescent cells, potentially mitigating age-related health and cognitive decline. This pilot study aims to assess the feasibility and safety of D+Q in older adults with schizophrenia, schizoaffective disorder, and treatment-resistant depression (TRD).

METHODS: This single-center study will recruit 30 participants total aged 50 years or older with …

Characterization And Z-Score Calculation Of Cardiovascular Magnetic Resonance Imaging Parameters In Patients After The Fontan Operation: A Fontan Outcome Registry Using Cardiovascular Magnetic Resonance Examinations Study, Tarek Alsaied, Manish Aggarwal, Et Al.

2020-Current year OA Pubs

BACKGROUND: Cardiac magnetic resonance (CMR) offers valuable hemodynamic insights post-Fontan, but is limited by the absence of normative single ventricle data. The Fontan Outcomes Registry using CMR Examinations (FORCE) is a large international Fontan-specific CMR registry. This study used FORCE registry data to evaluate expected CMR ventricular size/function and create Fontan-specific z-scores adjusting for ventricular morphology (VM) in healthier Fontan patients.

METHODS: "Healthier" Fontan patients were defined as patients free of adverse outcomes, who are New York Heart Association class I, have mild or less valve disease, and < 30% aortopulmonary collateral burden. General linear modeling was performed on 70% of the dataset to create z-scores for volumes and function. Models were tested using the remainder (30%) of the data. The z-scores were compared between children and adults. The z-scores were also compared between "healthier" Fontan and patients with adverse outcomes (death, listing for transplantation, or multiorgan disease).

RESULTS: The "healthier" Fontan population included 885 patients (15.0 ± 7.6 years) …

Classification Of Ipsc-Derived Cultures Using Convolutional Neural Networks To Identify Single Differentiated Neurons For Isolation Or Measurement, Purva Patel, Lina K. Mohammad Ali, Uma Kaushik, Malllory Wright, Kaylee Green, Jason E. Waligorski, Colin L. Kremitzki, Graham W. Bachman, Serena N. Elia, William J. Buchser

2020-Current year OA Pubs

No abstract provided.

Selective Breast/Gynecologic Pathology Fellowship Training In The United States: Experience Of Program Directors, Mohamed Mokhtar Desouki, Ian S Hagemann, Thaer Khoury, Oluwole Fadare, Rohit Bhargava, Jennifer L Clark, Michael T Deavers, Julie M Jorns, Ashraf Khan, Ediz F Cosar, Rouzan G Karabakhtsian, Molly E Klein, Andre Pinto, Muhammad Ali

2020-Current year OA Pubs

Published data on combined breast and gynecologic [breast/gyn] surgical pathology fellowship training programs are limited. Our study aimed to survey the landscape of such fellowships in the United States (US), including specific information about their characteristics and the educational activities therein. Using web searches, we identified programs offering combined breast/gyn surgical pathology fellowship training. We developed a 26-item questionnaire asking program directors to report on the characteristics of their fellowship training structure. The search revealed 25 academic based programs offering one-year combined breast/gyn fellowship training, predominantly located (40 %) in the Northeast area. The following data was obtained: 44 % …

Cathepsin C Role In Inflammatory Gastroenterological, Renal, Rheumatic, And Pulmonary Disorders, Ali A Aghdassi, Christine Pham, Lukas Zierke, Vincent Mariaule, Brice Korkmaz, Moez Rhimi

2020-Current year OA Pubs

Cathepsin C (CatC, syn. Dipeptidyl peptidase I) is a lysosomal cysteine proteinase expressed in several tissues including inflammatory cells. This enzyme is important for maintaining multiple cellular functions and for processing immune cell-derived proteases. While mutations in the CatC gene were reported in Papillon-Lefèvre syndrome, a rare autosomal recessive disorder featuring hyperkeratosis and periodontitis, evidence from clinical and preclinical studies points toward pro-inflammatory effects of CatC in various disease processes that are mainly mediated by the activation of neutrophil serine proteinases. Moreover, tumor-promoting effects were ascribed to CatC. The aim of this review is to highlight current knowledge of the …

Ct-Based Online Adaptive Radiotherapy Improves Target Coverage And Organ At Risk (Oar) Avoidance In Stereotactic Body Radiation Therapy (Sbrt) For Prostate Cancer, Michael Waters, Alex Price, Eric Laugeman, Lauren Henke, Geoff Hugo, Hayley Stowe, Neal Andruska, Randall Brenneman, Yao Hao, Olga Green, Clifford Robinson, Hiram Gay, Jeff Michalski, Brian C Baumann

2020-Current year OA Pubs

INTRODUCTION: Stereotactic body radiation therapy (SBRT) is an emerging treatment modality for clinically localized prostate cancer (PCa). Online daily adaptive radiotherapy (ART) could potentially improve the therapeutic ratio of prostate SBRT by accounting for inter-fraction variation in target and OAR volumes. To our knowledge, no group has evaluated the clinical utility of a novel AI-augmented CT-based ART system for prostate SBRT. In this study we hypothesized that adaptive prostate SBRT plans would result in improved target coverage and lower dose to OARs in comparison to unadapted treatment plans.

METHODS: Seven patients with favorable intermediate to oligometastatic PCa treated with 5-fx …

Pralsetinib In Patients With Advanced/Metastatic Rearranged During Transfection (Ret)-Altered Thyroid Cancer: Updated Efficacy And Safety Data From The Arrow Study, Vivek Subbiah, Douglas Adkins, Et Al.

2020-Current year OA Pubs

No abstract provided.

The Response Of Dual-Leucine Zipper Kinase (Dlk) To Nocodazole: Evidence For A Homeostatic Cytoskeletal Repair Mechanism, Laura Devault, Chase Mateusiak, John Palucki, Michael Brent, Jeffrey Milbrandt, Aaron Diantonio

2020-Current year OA Pubs

Genetic and pharmacological perturbation of the cytoskeleton enhances the regenerative potential of neurons. This response requires Dual-leucine Zipper Kinase (DLK), a neuronal stress sensor that is a central regulator of axon regeneration and degeneration. The damage and repair aspects of this response are reminiscent of other cellular homeostatic systems, suggesting that a cytoskeletal homeostatic response exists. In this study, we propose a framework for understanding DLK mediated neuronal cytoskeletal homeostasis. We demonstrate that low dose nocodazole treatment activates DLK signaling. Activation of DLK signaling results in a DLK-dependent transcriptional signature, which we identify through RNA-seq. This signature includes genes likely …

Shared Decision-Making During Virtual Care Regarding Rheumatologic And Chronic Conditions: Qualitative Study Of Benefits, Pitfalls, And Optimization, Lisa Zickuhr, Catherine Mccarthy, Emma Nolan-Thomas, Tiffany Westrich-Robertson, Elizabeth A Baker, Janice L Hanson

2020-Current year OA Pubs

OBJECTIVE: Virtual care (VC) is an accepted modality of care delivery, and shared decision-making (SDM) benefits patients with rheumatologic and chronic conditions (RCCs). Unfortunately, research suggests reduced quality of SDM during VC. This study explores the benefits and shortcomings of SDM regarding RCCs during VC with suggestions for optimally using VC during SDM.

METHODS: Following Stiggelbout's framework for SDM, we conducted focus groups of patients with RCCs and providers to understand their experiences with SDM during VC, probing for facilitating and challenging factors. We conducted content analysis of the transcripts, defining themes, and inductively reasoned to identify relationships among themes. …

Arid1a Loss Is Associated With Increased Nrf2 Signaling In Human Head And Neck Squamous Cell Carcinomas, Vinh Nguyen, Travis P. Schrank, Michael B. Major, Bernard E. Weissman

2020-Current year OA Pubs

Prior to the next generation sequencing and characterization of the tumor genome landscape, mutations in the SWI/SNF chromatin remodeling complex and the KEAP1-NRF2 signaling pathway were underappreciated. While these two classes of mutations appeared to independently contribute to tumor development, recent reports have demonstrated a mechanistic link between these two regulatory mechanisms in specific cancer types and cell models. In this work, we expand upon these data by exploring the relationship between mutations in BAF and PBAF subunits of the SWI/SNF complex and activation of NRF2 signal transduction across many cancer types. ARID1A/B mutations were strongly associated with NRF2 transcriptional …

Reference Ranges For Left Modified Myocardial Performance Index: Systematic Review And Meta-Analysis, Katherine H Bligard, Michelle Doering, Shay Porat, Joshua I Rosenbloom

2020-Current year OA Pubs

INTRODUCTION: The modified myocardial performance index (mod-MPI) is a noninvasive Doppler-derived metric used to evaluate fetal cardiac function. However, the reference ranges for mod-MPI in normal fetuses are not clearly defined, which limits the use of this technology in fetuses with potential cardiac compromise. Thus, we aimed to perform a systematic review and meta-analysis of published mod-MPI reference ranges across gestation.

METHODS: The published literature was systematically searched, and all published articles in any language that provided values for the left ventricular mod-MPI obtained in low-risk, singleton fetuses were considered eligible for further review. All retrieved titles and abstracts were …

Social Relationships, Amyloid Burden, And Dementia: The Aric-Pet Study, Renée C Groechel, Albert C Liu, Chelsea Liu, David S Knopman, Silvia Koton, Anna M Kucharska-Newton, Pamela L Lutsey, Thomas H Mosley, Priya Palta, A Richey Sharrett, Keenan A Walker, Dean F Wong, Rebecca F Gottesman

2020-Current year OA Pubs

INTRODUCTION: This study aimed to assess whether social relationships in mid-life reduce the risk of dementia related to amyloid burden.

METHODS: Participants in the Atherosclerosis Risk in Communities (ARIC) study were assessed for social support and isolation (visit 2; 1990-1992). A composite measure, "social relationships," was generated. Brain amyloid was evaluated with florbetapir positron emission tomography (PET); (visit 5; 2012-2014). Incident dementia cases were identified following visit 5 through 2019 using ongoing surveillance. Relative contributions of mid-life social relationships and elevated brain amyloid to incident dementia were evaluated with Cox regression models.

RESULTS: Among 310 participants without dementia, strong mid-life …

Hippocampal Volumes In Uk Biobank Are Associated With Apoe Only In Older Adults, Ariya Chaloemtoem, Vera Thornton, Yoonhoo Chang, Andrey P Anokhin, Michaël E Belloy, Janine Bijsterbosch, Brian A Gordon, Sarah M Hartz, Laura J Bierut

2020-Current year OA Pubs

INTRODUCTION: The hippocampus atrophies with age and is implicated in neurodegenerative disorders including Alzheimer's disease (AD). We examined the interplay between age and apolipoprotein E (

METHODS: Using neuroimaging data from 37,463 UK Biobank participants, we applied linear regression to quantify the association of age and

RESULTS: Total hippocampal volume declined with age, with significant differences by

DISCUSSION: The association of

HIGHLIGHTS: Apolipoprotein E (

The Association Of Dementia Risk Symptoms And Functional Activity In Adults With Down Syndrome, Selena E Washington, Amy E Bodde, Brian C Helsel, Rebecca M Bollinger, Nora Smith, Lauren T Ptomey, Beau Ances, Susan L Stark

2020-Current year OA Pubs

INTRODUCTION: Adults with Down syndrome (DS) have an increased risk of Alzheimer's disease (AD) dementia, often showing neuropathological indicators by age 40. Physical function and activities of daily living (ADLs) are understudied areas of function that may inform dementia risk. We investigated associations among age, physical function (gait/balance, grip strength, and lower extremity strength), ADLs, and dementia risk symptoms in adults with DS. We hypothesized that compromised physical function and lower independence with ADLs would be associated with an informant/caregiver-reported measure of dementia risk symptoms.

METHODS: A secondary analysis for this cross-sectional study was completed using data from two academic …

Brainqcnet: A Deep Learning Attention-Based Model For The Automated Detection Of Artifacts In Brain Structural Mri Scans, Mélanie Garcia, Nico Dosenbach, Clare Kelly

2020-Current year OA Pubs

Analyses of structural MRI (sMRI) data depend on robust upstream data quality control (QC). It is also crucial that researchers seek to retain maximal amounts of data to ensure reproducible, generalizable models and to avoid wasted effort, including that of participants. The time-consuming and difficult task of manual QC evaluation has prompted the development of tools for the automatic assessment of brain sMRI scans. Existing tools have proved particularly valuable in this age of Big Data; as datasets continue to grow, reducing execution time for QC evaluation will be of considerable benefit. The development of Deep Learning (DL) models for …

Clinical, Laboratory, And Orbital Imaging Features Of Giant Cell Arteritis In Comparison To Non-Arteritic Anterior Ischemic Optic Neuropath: A Single Center Case Series, Rami W Eldaya, Yi-Hsien Yeh, Leanne Stunkel, Matthew S Parsons, Gregory P Van Stavern

2020-Current year OA Pubs

BACKGROUND: Giant cell arteritis (GCA) is the most common vasculitis in patients older than 50 years and is considered a "do not miss" diagnosis. However, it remains a diagnostic challenge given overlapping clinical syndromes such as non-arteritic anterior ischemic optic neuropathy (NAION) and poorly explored imaging findings.

MATERIALS AND METHODS: In this retrospective study between the time period of January 2013 and December 2021, a total of 13 consecutive patients with a pathological diagnosis of GCA and 8 patients with clinical diagnosis of NAION were isolated. Demographic and clinical data for each patient were collected, including pertinent laboratory data. Pertinent …

Leishmania Major Surface Components And Dkk1 Signalling Via Lrp6 Promote Migration And Longevity Of Neutrophils In The Infection Site, Olivia C Ihedioha, Haley Q Marcarian, Anutr Sivakoses, Stephen M Beverley, Diane Mcmahon-Pratt, Alfred L M Bothwell

2020-Current year OA Pubs

BACKGROUND: Host-related factors highly regulate the increased circulation of neutrophils during

RESULTS: In this study, we further explored the potential role of DKK1-LRP6 signalling in the migration and longevity of activated neutrophils in the infection site using BALB/c mice with PMNs deficient in LRP6 (LRP6

CONCLUSION: Our results suggest that DKK1 signalling and

Unraveling The Role Of Hif And Epigenetic Regulation In Pulmonary Arterial Hypertension: Implications For Clinical Research And Its Therapeutic Approach, Ankita Mitra, Dan Yi, Zhiyu Dai, Vinicio De Jesus Perez

2020-Current year OA Pubs

Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling with high pulmonary pressure, which ultimately leads to right heart failure and premature death. Emerging evidence suggests that both hypoxia and epigenetics play a pivotal role in the pathogenesis of PAH development. In this review article, we summarize the current developments in regulation of hypoxia inducible factor (HIF) isoforms in PAH vascular remodeling and the development of suitable animal models for discovery and testing of HIF pathway-targeting PAH therapeutics. In addition, we also discuss the epigenetic regulation of HIF-dependent isoforms in PAH and its therapeutic potential from a new perspective …

Surviving Septic Patients Endotyped With A Functional Assay Demonstrate Active Immune Responses, Adam D Price, Andrew H Walton, Sydney Miles, Richard S Hotchkiss, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Sepsis is a complex clinical syndrome characterized by a heterogenous host immune response. Historically, static protein and transcriptomic metrics have been employed to describe the underlying biology. Here, we tested the hypothesis that

METHODS: This prospective, observational study of patient samples collected from the SPIES consortium included patients at five health systems enrolled over 17 months, with 46 healthy control patients, 68 ICU patients without sepsis, and 107 ICU patients with sepsis. Whole blood was collected on day 1, 4, and 7 of ICU admission. Outcomes included in-hospital and 180-day mortality and non-favorable discharge disposition defined by skilled nursing …

Perspectives Of Traditional Herbal Medicines In Treating Retinitis Pigmentosa, Shihui Liu, Toshihiko Matsuo, Chie Matsuo, Takumi Abe, Jinghua Chen, Chi Sun, Qing Zhao

2020-Current year OA Pubs

Medicinal plants, also known as herbs, have been discovered and utilized in traditional medical practice since prehistoric times. Medicinal plants have been proven rich in thousands of natural products that hold great potential for the development of new drugs. Previously, we reviewed the types of Chinese traditional medicines that a Tang Dynasty monk Jianzhen (Japanese: Ganjin) brought to Japan from China in 742. This article aims to review the origin of Kampo (Japanese traditional medicine), and to present the overview of neurodegenerative diseases and retinitis pigmentosa as well as medicinal plants in some depth. Through the study of medical history …

Reinforcement Learning In Motor Skill Acquisition: Using The Reward Positivity To Understand The Mechanisms Underlying Short- And Long-Term Behavior Adaptation, Mariane F B Bacelar, Keith R Lohse, Juliana O Parma, Matthew W Miller

2020-Current year OA Pubs

INTRODUCTION: According to reinforcement learning, humans adjust their behavior based on the difference between actual and anticipated outcomes (i.e., prediction error) with the main goal of maximizing rewards through their actions. Despite offering a strong theoretical framework to understand how we acquire motor skills, very few studies have investigated reinforcement learning predictions and its underlying mechanisms in motor skill acquisition.

METHODS: In the present study, we explored a 134-person dataset consisting of learners' feedback-evoked brain activity (reward positivity; RewP) and motor accuracy during the practice phase and delayed retention test to investigate whether these variables interacted according to reinforcement learning …

Best Practices In Robotic Magnetic Navigation-Guided Catheter Ablation Of Cardiac Arrhythmias, A Position Paper Of The Society For Cardiac Robotic Navigation, Anna M E Noten, Daniel H Cooper, Et Al.

2020-Current year OA Pubs

PREAMBLE: Robotic magnetic navigation (RMN)-guided catheter ablation (CA) technology has been used for the treatment of cardiac arrhythmias for almost 20 years. Various studies reported that RMN allows for high catheter stability, improved lesion formation and a superior safety profile. So far, no guidelines or recommendations on RMN-guided CA have been published.

PURPOSE: The aim of this consensus paper was to summarize knowledge and provide recommendations on management of arrhythmias using RMN-guided CA as treatment of atrial fibrillation (AF) and ventricular arrhythmias (VA).

METHODOLOGY: An expert writing group, performed a detailed review of available literature, and drawing on their own …

Simplified Methods For Variance Estimation In Microbiome Abundance Count Data Analysis, Yiming Shi, Lili Liu, Jun Chen, Kristine M Wylie, Todd N Wylie, Molly J Stout, Chan Wang, Haixiang Zhang, Ya-Chen T Shih, Xiaoyi Xu, Ai Zhang, Sung Hee Park, Hongmei Jiang, Lei Liu

2020-Current year OA Pubs

The complex nature of microbiome data has made the differential abundance analysis challenging. Microbiome abundance counts are often skewed to the right and heteroscedastic (also known as overdispersion), potentially leading to incorrect inferences if not properly addressed. In this paper, we propose a simple yet effective framework to tackle the challenges by integrating Poisson (log-linear) regression with standard error estimation through the Bootstrap method and Sandwich robust estimation. Such standard error estimates are accurate and yield satisfactory inference even if the distributional assumption or the variance structure is incorrect. Our approach is validated through extensive simulation studies, demonstrating its effectiveness …

The Risks Of Unconcern: Low Sensitivity To Threat Can Have Unfortunate Consequences, Stephen L Ristvedt

2020-Current year OA Pubs

Each one of us is confronted with warnings of danger or threats to wellbeing in our everyday life, whether in the form of certain road signs, Public Service Announcements, ominous changes in bodily functioning, or cautionary tales heard from family or friends. There is great inter-individual variation in how people respond to such threats, with some people habitually tending to ignore or dismiss them, often to their peril. The first purpose of the present paper is to review several studies showing that individuals-most often men-who score very low on measures of trait anxiety are more likely to engage in behaviors …

Protein Quality Malnutrition, Mark J Manary, Donna R Wegner, Kenneth Maleta

2020-Current year OA Pubs

Protein quality refers to the evaluation of a food or a diet based on its amino acid composition, protein digestibility, and protein bioavailability. When these parameters are specified, either through direct measurement or estimation, the amino acids provided by the diet are compared to those required by a healthy individual, and based on this comparison, an adequacy ratio or score is assigned. Two widely used protein quality scoring systems are the protein digestibility-corrected amino acid score (PDCAAS) and the digestible indispensable amino acid score (DIAAS), neither of which account for the dietary source of the protein. In malnourished children, metabolic …

The Potential Impact Of Exercise On Affect And Neuroinflammation In Older Adults Living With Fibromyalgia: A Scoping Review, Taylor L Taylor, Fitzgerald Dodds, Mckenna Tharpe, Emily L Zumbro, Michael Hankes, Raymond Jones, Deanna Rumble, Lisa Antoine, Kristen Allen-Watts, Andrew Sims, Reshu Chandra, Burel R Goodin, Jarred Younger, Thomas W Buford

2020-Current year OA Pubs

INTRODUCTION: Fibromyalgia (FM) is a widespread chronic pain condition with prevalence increasing in older adults. Older adults living with FM experience longer pain symptom durations that can negatively impact their quality of life. Affect and neuroinflammation are potential factors that can exacerbate pain symptoms. Exercise is a recommended intervention to manage pain symptoms; however, adherence limitations persist. Drawing on the Biopsychosocial Framework of Chronic Pain, this scoping review explores how exercise impacts factors related to neuroinflammation and affect, and how these factors contribute to exercise adherence in older adults living with FM.

METHODS: We conducted a scoping search of articles …

Awareness, Use, Motivations And Methods Of Accessing Genetic Testing In 2022 In The United States, Sukh Makhnoon, Minjae Lee, Tanushree Prasad, Alexa Badalamenti, Tami Gurley, Erika A Waters, Celette Sugg Skinner

2020-Current year OA Pubs

INTRODUCTION: Awareness, access, and use of clinical and direct-to-consumer (DTC) genetic tests has increased in recent years with documented disparities in these services. We provide updated data on test awareness and use, and report novel data on motivations and methods for accessing genetic tests.

METHODS: Nationally representative data from the 2022 Health Information National Trends Survey (HINTS 6) were used to assess awareness and use of ancestry, personal trait, specific disease, and carrier testing by sociodemographic characteristics, examine reasons for undergoing tests, and methods of accessing them.

RESULTS: Overall, 81.4% of respondents were aware and 40.0% had undergone testing. Only …

Campylobacter Colonization And Undernutrition In Infants In Rural Eastern Ethiopia — A Longitudinal Community-Based Birth Cohort Study, Dehao Chen, Nurmohammad Shaik, Mark J Manary, Et Al.

2020-Current year OA Pubs

BACKGROUND:

METHODS: We followed a birth cohort of 106 infants in rural smallholder households in eastern Ethiopia up to 13 months of age. We measured anthropometry, surveyed sociodemographic determinants, and collected stool and urine samples. A short survey was conducted during monthly visits, infant stool samples were collected, and

RESULTS: The

CONCLUSION: This study found that most determinants associated with increased

The Role Of Brainstem Biopsy And Targeted Therapies In Pediatric Diffuse Midline Glioma/Diffuse Intrinsic Pontine Glioma, Shehryar R Sheikh, Violette M R Recinos, Eric M Thompson, Ross Mangum, Mariah Wright-Nadkarni, Bradley Gampel, Neha J Patel

2020-Current year OA Pubs

Pediatric diffuse midline glioma (DMG), including diffuse intrinsic pontine glioma (DIPG), are aggressive brainstem tumors with a dire prognosis, traditionally diagnosed based on MRI characteristics. The recognition that molecular characteristics may determine prognosis and response to therapy has led to a reevaluation of biopsy necessity. This comprehensive review addresses the evolving role of brainstem biopsies in diagnosing and managing these tumors - both within the context of a clinical trial and in routine clinical care. We examine practice variability around brainstem biopsies for DMG/DIPG, revealing a global inconsistency in biopsy application and perceptions amongst providers. We show that safety profiles …