Neurosurgery Commons^™

Dual Enhancement In The Radiosensitivity Of Prostate Cancer Through Nanoparticles And Chemotherapeutics, Nolan Jackson, Iona Hill, Abdulaziz Alhussan, Kyle Bromma, Jessica Morgan, Belal Abousaida, Yasmin Zahra, Yuri Mackeyev, Wayne Beckham, Steven Herchko, Sunil Krishnan, Devika Basnagge Chithrani

Faculty, Staff and Student Publications

BACKGROUND: Radiotherapy (RT) is an essential component in the treatment regimens for many cancer patients. However, the dose escalation required to improve curative results is hindered due to the normal tissue toxicity that is induced. The introduction of radiosensitizers to RT treatment is an avenue that is currently being explored to overcome this issue. By introducing radiosensitizers into tumor sites, it is possible to preferentially enhance the local dose deposited. Gold nanoparticles (GNPs) are a potential candidate that have shown great promise in increasing the radiosensitivity of cancer cells through an enhancement in DNA damage. Furthermore, docetaxel (DTX) is a …

Lack Of Better Functional Outcome In Young Border Hispanic Patients With Acute Ischemic Stroke After Endovascular Thrombectomy Compared To Older Patients: A Retrospective Chart Review, Saisree Ravi, Sohum Desai, Sherief Ghozy, Wondwossen Tekle, Ameer E. Hassan

MEDI 9331 Scholarly Activities Clinical Years

Shortened Abstract:

Previous data indicates that young acute ischemic stroke patients have better prognosis after endovascular thrombectomy, while Hispanic patients are associated with poorer outcomes. Our goal is to study the interaction between age and Hispanic status to assess functional outcomes after endovascular thrombectomy in young versus older patients in a predominantly Hispanic population with a high prevalence of diabetes mellitus and obesity.

Our Hispanic population demonstrates no differences in sICH, mortality, and functional independence between young and older acute ischemic stroke patients after endovascular thrombectomy.

Fatty Acid Therapy And Implications For Spinal Cord Injury Treatment: A Literature Review, Philippe J. Dentino

MEDI 9331 Scholarly Activities Clinical Years

Introduction: Spinal Cord Injuries (SCI) are catastrophic injury to spinal neurons that cause a tremendous socioeconomic and public health burden on individuals globally. The role of fatty acids in treatment of SCI is not well understood and poorly standardized across treatment provision. This review seeks to explore the role of fatty acids in neurorecovery and propose emerging themes in SCI treatment with fatty acids.

Methods: A PICO was designed and online databases were searched for relevant articles. A total of 55 studies were deemed appropriate for the review and summarized into thematic elements including ) Cellular Transport 2) Neuroprotection 3) …

From Shops To Bins: A Case Study Of Consumer Attitudes And Behaviours Towards Plastics In A Uk Coastal City, Stephanie Lucy Northen, Laura Karoliina Nieminen, Serena Cunsolo, Steven Kator Iorfa, Keiron Philip Roberts, Stephen Fletcher

Faculty, Staff and Student Publications

Understanding the use behaviours of plastic items within households is important to enable informed policy development, particularly with the emerging and developing global plastic treaty. A survey of 400 permanent residents in Portsmouth aimed to identify the general trends in single-use plastic product (SUPP) use and disposal, and their personal motivations and barriers to reducing and recycling plastic. This included identifying common influencers of attitudes such as environmental values, situational characteristics, psychological factors and the individual demographic characteristics of residents. Key factors in consumer behaviour were found to be product availability, affordability and convenience. Often, less conveniently recycled plastics more …

Copy Number Alterations Of Aggressive Pituitary Neuroendocrine Tumors, Grace Zhang

Scripps Senior Theses

Pituitary neuroendocrine tumors (PitNETs) are tumors of the pituitary gland. Although most are benign, they can cause severe morbidity if compression of surrounding tissue and/or endocrinopathies occur.

Aggressive PitNETs are notably detrimental and difficult to predict, and their effects are further exacerbated by challenges in treatment. Although histological studies can detect certain markers of tumor aggressiveness, they are insufficient at wholly predicting PitNET aggressiveness, making the clinical behavior of PitNETs challenging to determine. Since treatment of aggressive tumors also remains suboptimal, this further results in negative impacts on health and quality of life.

Genetic markers, such as copy number variations …

Comparison Of Physics-Based Deformable Registration Methods For Image-Guided Neurosurgery, Nikos Chrisochoides, Yixun Liu, Fotis Drakopoulos, Andriy Kot, Panos Foteinos, Christos Tsolakis, Emmanuel Billias, Olivier Clatz, Nicholas Ayache, Andrey Fedorov, Alex Golby, Peter Black, Ron Kikinis

Computer Science Faculty Publications

This paper compares three finite element-based methods used in a physics-based non-rigid registration approach and reports on the progress made over the last 15 years. Large brain shifts caused by brain tumor removal affect registration accuracy by creating point and element outliers. A combination of approximation- and geometry-based point and element outlier rejection improves the rigid registration error by 2.5 mm and meets the real-time constraints (4 min). In addition, the paper raises several questions and presents two open problems for the robust estimation and improvement of registration error in the presence of outliers due to sparse, noisy, and incomplete …

Premature Senescence And Cardiovascular Disease Following Cancer Treatments: Mechanistic Insights, Ashita Jain, Diego Casanova, Alejandra Valdivia Padilla, Angelica Paniagua Bojorges, Sivareddy Kotla, Kyung Ae Ko, Venkata S K Samanthapudi, Khanh Chau, Minh T H Nguyen, Jake Wen, Selina L Hernandez Gonzalez, Shaefali P Rodgers, Elizabeth A Olmsted-Davis, Dale J Hamilton, Cielito Reyes-Gibby, Sai-Ching J Yeung, John P Cooke, Joerg Herrmann, Eduardo N Chini, Xiaolei Xu, Syed Wamique Yusuf, Momoko Yoshimoto, Philip L Lorenzi, Brain Hobbs, Sunil Krishnan, Efstratios Koutroumpakis, Nicolas L Palaskas, Guangyu Wang, Anita Deswal, Steven H Lin, Jun-Ichi Abe, Nhat-Tu Le

Faculty, Staff and Student Publications

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality, especially among the aging population. The "response-to-injury" model proposed by Dr. Russell Ross in 1999 emphasizes inflammation as a critical factor in atherosclerosis development, with atherosclerotic plaques forming due to endothelial cell (EC) injury, followed by myeloid cell adhesion and invasion into the blood vessel walls. Recent evidence indicates that cancer and its treatments can lead to long-term complications, including CVD. Cellular senescence, a hallmark of aging, is implicated in CVD pathogenesis, particularly in cancer survivors. However, the precise mechanisms linking premature senescence to CVD in cancer survivors remain …

An Individual Data-Driven Virtual Resection Model Based On Epileptic Network Dynamics In Children With Intractable Epilepsy: A Magnetoencephalography Interictal Activity Application, Pablo Cuesta, Ricardo Bruña, Ekta Shah, Christopher Laohathai, Stephanie Garcia-Tarodo, Michael Funke, Gretchen Von Allmen, Fernando Maestú

Faculty, Staff and Student Publications

Epilepsy surgery continues to be a recommended treatment for intractable (medication-resistant) epilepsy; however, 30-70% of epilepsy surgery patients can continue to have seizures. Surgical failures are often associated with incomplete resection or inaccurate localization of the epileptogenic zone. This retrospective study aims to improve surgical outcome through in silico testing of surgical hypotheses through a personalized computational neurosurgery model created from individualized patient's magnetoencephalography recording and MRI. The framework assesses the extent of the epileptic network and evaluates underlying spike dynamics, resulting in identification of one single brain volume as a candidate for resection. Dynamic-locked networks were utilized for virtual …

A Phase 3b Study For Management Of Ocular Side Effects In Patients With Epidermal Growth Factor Receptor-Amplified Glioblastoma Receiving Depatuxizumab Mafodotin, Colin J Vize, Stella K Kim, Tim Matthews, Marian Macsai, Ryan Merrell, Sigmund Hsu, Madan Gopal Kundu, Jennifer Yoon, Emma Kennedy, Madhavi Pai, Earle Bain, Andrew B Lassman, Golnaz Moazami

Faculty, Staff and Student Publications

INTRODUCTION: The Understanding New Interventions with GBM ThErapy (UNITE) study was designed to assess the effect of prophylaxis for ocular side effects (OSEs) in patients with glioblastoma receiving the antibody-drug conjugate (ADC) depatuxizumab mafodotin. UNITE (NCT03419403) was a phase 3b, open-label, randomized, exploratory study performed at 18 research sites in 5 countries.

METHODS: The study enrolled adult patients with epidermal growth factor receptor-amplified, histologically confirmed, newly diagnosed supratentorial glioblastoma or grade IV gliosarcoma, and a Karnofsky Performance Status ≥70, receiving depatuxizumab mafodotin. All patients were administered depatuxizumab mafodotin during concurrent radiotherapy and temozolomide and with adjuvant temozolomide. Ninety patients were …

Radiolabeled Nanomaterial For Cancer Diagnostics And Therapeutics: Principles And Concepts, Muskan Goel, Yuri Mackeyev, Sunil Krishnan

Faculty, Staff and Student Publications

In the last three decades, radiopharmaceuticals have proven their effectiveness for cancer diagnosis and therapy. In parallel, the advances in nanotechnology have fueled a plethora of applications in biology and medicine. A convergence of these disciplines has emerged more recently with the advent of nanotechnology-aided radiopharmaceuticals. Capitalizing on the unique physical and functional properties of nanoparticles, radiolabeled nanomaterials or nano-radiopharmaceuticals have the potential to enhance imaging and therapy of human diseases. This article provides an overview of various radionuclides used in diagnostic, therapeutic, and theranostic applications, radionuclide production through different techniques, conventional radionuclide delivery systems, and advancements in the delivery …

Proton Therapy With Concurrent Chemotherapy For Thoracic Esophageal Cancer: Toxicity, Disease Control, And Survival Outcomes, Michael S Rutenberg, Bradford S Hoppe, Jason S Starr, Ziad Awad, Mathew Thomas, Christopher G Morris, Perry Johnson, Randal H Henderson, Jeremy C Jones, Bharatsinh Gharia, Steven Bowers, Herbert C Wolfsen, Sunil Krishnan, Stephen J Ko, Hani M Babiker, Romaine C Nichols

Faculty, Staff and Student Publications

PURPOSE: When treating esophageal cancer with radiation therapy, it is critical to limit the dose to surrounding structures, such as the lung and/or heart, as much as possible. Proton radiation therapy allows a reduced radiation dose to both the heart and lungs, potentially reducing the risk of cardiopulmonary toxicity. Here, we report disease control, survival, and toxicity outcomes among patients with esophageal cancer treated with proton radiation therapy and concurrent chemotherapy (chemoradiation therapy; CRT) with or without surgery.

MATERIALS AND METHODS: We enrolled 17 patients with thoracic esophageal carcinoma on a prospective registry between 2010 and 2021. Patients received proton …

Editorial: Modulation Of Microglia Reactivity And Plasticity In Cns Injury, Zhenyan He, Hailiang Tang, Jiping Tang, Xuying He, Ningbo Xu, Devin W Mcbride

Faculty, Staff and Student Publications

No abstract provided.

Behavioral Improvements Following Lesion Resection For Pediatric Epilepsy: Pediatric Psychosurgery?, Huy Dang, Abdul Basit Khan, Nisha Gadgil, Himanshu Sharma, Cristina Trandafir, Fatema Malbari, Howard L Weiner

Faculty, Staff and Students Publications

Introduction: Resection of brain lesions associated with refractory epilepsy to achieve seizure control is well accepted. However, concurrent behavioral effects of these lesions such as changes in mood, personality, and cognition and the effects of surgery on behavior have not been well characterized. We describe 5 such children with epileptogenic lesions and significant behavioral abnormalities which improved after surgery.

Case descriptions: Five children (ages 3-14 years) with major behavioral abnormalities and lesional epilepsy were identified and treated at our center. Behavioral problems included academic impairment, impulsivity, self-injurious behavior, and decreased social interaction with diagnoses of ADHD, oppositional defiant disorder, and …

Future Directions In Psychiatric Neurosurgery: Proceedings Of The 2022 American Society For Stereotactic And Functional Neurosurgery Meeting On Surgical Neuromodulation For Psychiatric Disorders, Frederick L Hitti, Alik S Widge, Patricio Riva-Posse, Donald A Malone, Michael S Okun, Maryam M Shanechi, Kelly D Foote, Sarah H Lisanby, Elizabeth Ankudowich, Srinivas Chivukula, Edward F Chang, Aysegul Gunduz, Clement Hamani, Ashley Feinsinger, Cynthia S Kubu, Winston Chiong, Jennifer A Chandler, Rafael Carbunaru, Binith Cheeran, Robert S Raike, Rachel A Davis, Casey H Halpern, Nora Vanegas-Arroyave, Dejan Markovic, Sarah K Bick, Cameron C Mcintyre, R Mark Richardson, Darin D Dougherty, Brian H Kopell, Jennifer A Sweet, Wayne K Goodman, Sameer A Sheth, Nader Pouratian

Faculty, Staff and Students Publications

OBJECTIVE: Despite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30-40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward. A follow-up meeting in 2022 aimed to review the current state of the field and to identify critical barriers and milestones for progress. …

Postsurgical Morbidity And Mortality Favorably Informs Deep Brain Stimulation For New Indications Including Schizophrenia And Schizoaffective Disorder, Judith M Gault, Patrick Hosokawa, Daniel Kramer, Elyn R Saks, Paul S Appelbaum, John A Thompson, Ann Olincy, Nicola Cascella, Akira Sawa, Wayne Goodman, Nidal Moukaddam, Sameer A Sheth, William S Anderson, Rachel A Davis

Faculty, Staff and Students Publications

BACKGROUND: Deep brain stimulation (DBS) shows promise for new indications like treatment-refractory schizophrenia in early clinical trials. In the first DBS clinical trial for treatment refractory schizophrenia, despite promising results in treating psychosis, one of the eight subjects experienced both a symptomatic hemorrhage and an infection requiring device removal. Now, ethical concerns about higher surgical risk in schizophrenia/schizoaffective disorder (SZ/SAD) are impacting clinical trial progress. However, insufficient cases preclude conclusions regarding DBS risk in SZ/SAD. Therefore, we directly compare adverse surgical outcomes for all surgical procedures between SZ/SAD and Parkinson's disease (PD) cases to infer relative surgical risk relevant to …

Preoperative Tractography Algorithm For Safe Resection Of Tumors Located In The Descending Motor Pathways Zone, Edgar G Ordonez-Rubiano, Jason M Johnson, Nadin Abdalá-Vargas, Oscar F Zorro, Jorge H Marin-Munoz, Ricardo Álvarez-Tobián, Valeria Forlizzi, Carlos Castillo Rangel, Sabino Luzzi, Alvaro Campero, Javier G Patiño-Gómez, Matias Baldoncini

Faculty, Staff and Student Publications

BACKGROUND: Diffusion tensor imaging (DTI) tractography facilitates maximal safe resection and optimizes planning to avoid injury during subcortical dissection along descending motor pathways (DMPs). We provide an affordable, safe, and timely algorithm for preoperative DTI motor reconstruction for gliomas adjacent to DMPs.

METHODS: Preoperative DTI reconstructions were extracted from a prospectively acquired registry of glioma resections adjacent to DMPs. The surgeries were performed over a 7-year period. Demographic, clinical, and radiographic data were extracted from patients' electronic medical records.

RESULTS: Nineteen patients (12 male) underwent preoperative tractography between January 1, 2013, and May 31, 2020. The average age was 44.5 …

Role Of Microrna-34a In Blood-Brain Barrier Permeability And Mitochondrial Function In Ischemic Stroke, Cole T Payne, Sidra Tabassum, Silin Wu, Heng Hu, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Over the past decade, there has been an uptick in the number of studies conducting research on the role of microRNA (miRNA) molecules in stroke. Among these molecules, miR-34a has emerged as a significant player, as its levels have been observed to exhibit a substantial rise following ischemic events. Elevated levels of miR-34a have been found to have multiple effects, including the modulation of inflammatory molecules involved in the post-stroke recovery process, as well as negative effects on the blood-brain barrier (BBB) permeability. Interestingly, the increase of miR-34a appears to increase BBB permeability post stroke, through the negative effect on …

Cerebellar High-Grade Glioma: A Translationally Oriented Review Of The Literature, Ashley L B Raghu, Jason A Chen, Pablo A Valdes, Walid Ibn Essayed, Elizabeth Claus, Omar Arnaout, Timothy R Smith, E Antonio Chiocca, Pier Paolo Peruzzi, Joshua D Bernstock

Faculty, Staff and Student Publications

World Health Organization (WHO) grade 4 gliomas of the cerebellum are rare entities whose understanding trails that of their supratentorial counterparts. Like supratentorial high-grade gliomas (sHGG), cerebellar high-grade gliomas (cHGG) preferentially affect males and prognosis is bleak; however, they are more common in a younger population. While current therapy for cerebellar and supratentorial HGG is the same, recent molecular analyses have identified features and subclasses of cerebellar tumors that may merit individualized targeting. One recent series of cHGG included the subclasses of (1) high-grade astrocytoma with piloid features (HGAP, ~31% of tumors); (2) H3K27M diffuse midline glioma (~8%); and (3) …

Lipid-Nanoparticle-Mediated Delivery Of Docetaxel Prodrug For Exploiting Full Potential Of Gold Nanoparticles In The Treatment Of Pancreatic Cancer, Abdulaziz Alhussan, Nolan Jackson, Sarah Eaton, Nancy Dos Santos, Ingrid Barta, Josh Zaifman, Sam Chen, Yuen Yi C Tam, Sunil Krishnan, Devika B Chithrani

Faculty, Staff and Student Publications

Current chemoradiation therapy suffers from normal tissue toxicity. Thus, we are proposing incorporating gold nanoparticles (GNPs) and docetaxel (DTX), as they have shown very promising synergetic radiosensitization effects. Here, we explored the effect of a DTX prodrug encapsulated in lipid nanoparticles (LNP_DTX-P) on GNP uptake in pancreatic cancer models in vitro and in vivo. For the in vitro experiment, a pancreatic cancer cell line, MIA PaCa-2, was cultured and dosed with 1 nM GNPs and 45 nM free DTX or an equivalent dose of LNP_DTX-P. For the in vivo experiment, MIA PaCa-2 cells were implanted subcutaneously …

A Rare Case Of Extra-Ventricular Supra-Sellar Neurocytoma – A Diagnostic Conundrum, Rohan Karkra, Suchitha Satish, Peri Keerthi

Digital Journal of Clinical Medicine

The brain and its associated structures are often the primary source or site of metastases for many tumors. Neurocytoma is a relatively rare neuronal neoplasm, first described as an intra-ventricular tumor that is not known to be very aggressive. It constitutes less than 0.5% of CNS neoplasms. Extraventricular Neurocytoma (EVN) is an extremely rare variant, of which only 12 cases have ever been reported in the supra-sellar region. In all of these 12 cases, the patient was initially misdiagnosed; hence, this condition is a diagnostic conundrum. Grossly, the tumor is firm and smooth with extensive blood supply and fibrous tissue. …