Context Prolactin, a hormone synthesized by the anterior pituitary gland demonstrates promise as a neuroprotective agent, however, its role in humans and in vivo during injury is not fully understood. Objective To investigate whether elevated levels of prolactin attenuate injury to the retinal nerve fiber layer (RNFL) following compression of the optic chiasm in patients with a prolactin secreting pituitary macroadenoma (i.e., prolactinoma). Design setting and participants A retrospective cross-sectional study of all pituitary macroadenoma patients treated at a single institution between 2009 and 2019. Main outcome measure(s) Primary outcome measures included RNFL thickness, mean deviation, and prolactin levels for both prolactin-secreting and non-secreting pituitary macroadenoma patients. Results Sixty-six patients met inclusion criteria for this study (14 prolactin-secreting and 52 non-secreting macroadenoma patients). Of 52 non-secreting macroadenoma patients, 12 had moderate elevation of prolactin secondary to stalk effect. Patients with moderate elevation in prolactin demonstrated increased RNFL thickness compared to patients with normal prolactin levels (p < 0.01). Additionally, a significant positive relation between increasing levels of prolactin and RNFL thickness was identified in patients with moderate prolactin elevation (R = 0.51, p-value = 0.035). No significant difference was identified between prolactinoma patients and those with normal prolactin levels. Conclusions Moderately increased serum prolactin is associated with increased RNFL thickness when compared to controls. These associations are lost when serum prolactin is < 30 ng/ml or elevated in prolactinomas. This suggests a neuroprotective effect of prolactin at moderately increased levels in preserving retinal function during optic chiasm compression.

Background Diffusion Tensor Imaging (DTI) has shown measurable changes in the brains of patients with persistent post-concussive syndrome (PCS). Because of inconsistent results in univariate DTI metrics among patients with mild traumatic brain injury (mTBI), currently, there is no single objective and reliable MRI index for the clinical decision-making for patients with PCS.Objectives The aim of this study was to evaluate the performance of a newly developed post-concussive syndrome index (PCSI) derived from machine learning of multiparametric MRI data, to classify and differentiate subjects with mTBI and PCS history from those without history of mTBI.Methods Data were retrospectively extracted from 139 patients aged between 18 and 60 years with PCS who had MRI examinations obtained 2 weeks to 1-year post-mTBI, as well as MRI data from 333 subjects without a history of head trauma. The performance of the PCSI was assessed by comparing patients with a clinical diagnosis of PCS to control subjects. The PCSI values for patients with PCS were compared based on mechanism of injury, time interval from injury to MRI examination, gender, prior concussion history, loss of consciousness, and reported symptoms.Results Patients with mTBI had a mean PCSI value of 0.57, compared to the control group, which had a mean PCSI value of 0.12 (p = 8.42e− 23) with accuracy of 88%, sensitivity of 64%, and specificity of 95% respectively. No statistically significant differences were found in PCSI values when comparing by mechanism of injury, gender, or loss of consciousness.Conclusion The PCSI for individuals aged between 18 and 60 years was able to accurately identify patients with post-concussive injuries from 2 weeks to 1-year post-mTBI and differentiate them from controls. The study's results suggest that the multiparametric MRI-based PCSI has great potential as an objective clinical tool to support the diagnosis, treatment, and follow-up care of those with post-concussive syndrome. Future research is required to investigate the replicability of this method using other types of clinical MRI scanners.

INTRODUCTION:The clinical outcomes after revascularization for arterial occlusive disease are associated with sex differences. Although these sex differences are associated with neointimal hyperplasia, sex differences in arterial identity during remodeling are not known. We characterized sex differences in vessel identity, including the arterial determinant Ephrin-B2, that occur during arterial remodeling after injury. METHODS: Carotid balloon injury was performed in male and female Sprague-Dawley rats, with or without preceding gonadectomy. Balloon injury was performed on the left common carotid artery, and the contralateral artery was used for control. Ultrasonography was used to assess hemodynamics, and wall composition was assessed using histology, immunofluorescence, and Western blot (day 14).

difference (P ¼ .0095) in the fluorescent signal output when comparing vessels injected with unlabeled MSCs vs DiR-labeled MSCs was observed (Fig 2). Conclusions: The preliminary Results of this study establish the affinity of intra-arterially introduced MSCs in adhering to vessel walls in the porcine model. Further tests are necessary to determine the potential role of MSC adherence in promoting arterial recovery and prolonging patency after acute injury such as balloon angioplasty.