Neuronal damage in hydrocephalus and its restoration by shunt insertion in experimental hydrocephalus: a study involving the neurofilament-immunostaining method

Aoyama, Yuichi; Kinoshita, Yoshimasa; Yokota, Akira; Hamada, Tetsuo

doi:10.3171/ped.2006.104.5.332

Cited by 35 publications

(30 citation statements)

References 48 publications

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“…There was also a significant effect of the number of shunt revisions (F [3,70] = 2.95, p = 0.039) but not of age (F [1,70] = 2.96, p = 0.09) on RD along the parietal pathways. Post hoc pairwise comparisons indicated that the RD (adjusted for age) along the frontal pathways in cases of 2-4 shunt revisions was significantly higher than for cases of no shunt revisions (t [44] = 2.45, p = 0.016).…”

Section: Radial Diffusivitymentioning

confidence: 83%

“…Whereas shunt revision had a statistically significant effect on FA along the frontal pathways (F [3,70] For the parietal pathways, number of shunt revisions …”

Section: Fractional Anisotropymentioning

confidence: 99%

“…28 In animal models of hydrocephalus, partial restoration of impaired axonal connectivity to cortical regions is observed after shunt intervention. 3,15 In a longitudinal study of children with hydrocephalus, preshunt increases in FA were observed within the internal capsule, and these changes also normalized after shunting. 1 Thus, the observed patterns in DTI metrics in the present study may stem from WM alterations similar to those found in individuals with acutely enlarged ventricles due to untreated hydrocephalus.…”

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confidence: 99%

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Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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OBJECT No previous reports exist that have evaluated the relationships of white matter (WM) integrity with the number of shunt revisions, ventricular volume after shunting, and cognition in medically stable children who have spina bifida and hydrocephalus (SBH). The authors hypothesized that enlarged ventricles and a greater number of shunt revisions decrease WM integrity in children. METHODS In total, 80 children (mean age 13.7 years) who had SBH underwent MRI and IQ testing. Probabilistic diffusion tractography was performed to determine mean diffusion tensor imaging (DTI) metrics along the frontal and parietal tectocortical pathways. The DTI metrics were evaluated for significant correlation with a composite IQ measure and with the total number of shunt revisions and the total lateral ventricular volume obtained through semiautomated parcellation of T1-weighted MRI scans. RESULTS An enlargement in total lateral ventricle volume and an increase in the number of shunt revisions were both associated with higher fractional anisotropy (FA) and with lower radial diffusivity (RD) along both frontal and parietal tectocortical pathways. Children who had not undergone a shunt revision had on average a greater lateral ventricle volume and higher FA and lower RD along frontal and parietal pathways than those who had undergone multiple shunt revisions. The mean DTI metrics along parietal pathways predicted IQ scores, but intellectual ability was not significantly correlated with ventricular volume or with the number of lifetime shunt revisions. CONCLUSIONS Significant changes in DTI metrics were observed as a function of ventricular volume. An increased lateral ventricle volume was associated with elevated FA and decreased RD. Given that the participants were medically stable at the time of the MRI examination, the results suggested that those who have enlarged ventricles show a DTI pattern consistent with axonal compression due to increased intracranial pressure (ICP) in attenuated hydrocephalus. Although limited by a cross-sectional design, the study's findings suggest that DTI metrics may serve as sensitive indicators for chronic, mild hydrocephalus in the absence of overt clinical symptoms due to increased ICP. Having enlarged ventricles and undergoing multiple shunt revisions did not affect intellectual ability in children with SBH.

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Section: Radial Diffusivitymentioning

confidence: 83%

“…Whereas shunt revision had a statistically significant effect on FA along the frontal pathways (F [3,70] For the parietal pathways, number of shunt revisions …”

Section: Fractional Anisotropymentioning

confidence: 99%

mentioning

confidence: 99%

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Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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“…Neuronal cytoskeleton disruption and axonal transport alteration, which are hallmarks of CNS injury, have been demonstrated in the early stages of both TBI and hydrocephalus (Chovanes et al 1988;Aoyama et al 2006;Kupina et al 2003). …”

Section: Introductionmentioning

confidence: 99%

“…ICP control is the mainstay of hydrocephalic management and neuronal recovery can occur if ICP is restored to the normal range in the early stages of the disease process (Aoyama et al 2006). The magnitude of neuronal restoration in hydrocephalus is known to be inversely proportional to the duration of pressure elevation, suggesting that the phenomenon of neuronal tolerance to irreversible injury is lost over time (Boillat et al 1997).…”

Section: Introductionmentioning

confidence: 99%

Protective role of endothelial nitric oxide synthase following pressure-induced insult to the optic nerve

Balaratnasingam

Morgan

et al. 2009

Brain Research

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. In this paper we use the pig optic nerve, a typical central white matter tract, to study the time-dependent sequence of NOS isoform change following pressure elevation. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT TITLE: PROTECTIVE ROLE OF ENDOTHELIAL NITRIC OXIDE SYNTHASE FOLLOWING PRESSURE-INDUCED INSULT TO THE OPTIC NERVE AuthorsThe timing of NOS isoform change in relationship to structural and functional changes to axons and glial cells is also discussed. This study demonstrates that endothelial cell nitric oxide synthase (ecNOS), an enzyme that plays a protective role in the CNS, is up-regulated in a time-dependent manner after pressure elevation.ecNOS levels increase after axonal and astrocyte injury, suggesting that it might be a compensatory response that is initiated in an effort to preserve CNS function.Inducible NOS (iNOS) and neuronal NOS (nNOS), which are known to have a deleterious effect on the CNS, were not detected in this study. The increase in ecNOS demonstrated in this study is significantly different to the increase in iNOS and nNOS previously demonstrated following traumatic brain injury. Changes in ecNOS levels may therefore be important in the development of neuronal tolerance in the early stages of CNS diseases such as hydrocephalus. 3A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT IntroductionRaised intracranial pressure (ICP), which is commonly associated with traumatic brain injury (TBI) and hydrocephalus, can have a deleterious impact on central nervous system (CNS) structure and function (Prins et al. 1996;Sainte-Rose C 1996).Neuronal cytoskeleton disruption and axonal transport alteration, which are hallmarks of CNS injury, have been demonstrated in the early stages of both TBI and hydrocephalus (Chovanes et al. 1988;Aoyama et al. 2006;Kupina et al. 2003).However, the neuronal prognosis and long term neurological morbidity for each of these conditions is known to be vastly different. ICP control is the mainstay of A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTIn this paper we report time-dependent NOS isoform changes following pressure elevation using optic nerves where axonal transport, cytoskeleton protein and astrocyte changes have been previously documented. Our experimental design has allowed us to correlate the sequence of neuronal and glial cell changes with individual NOS isoform changes following pressure elevation. By comparing changes between regions of absolute pressure increase and regions of pressure gradient increase we have also been able to determine the influence of important phy...

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Neuropathology and structural changes in hydrocephalus

Bigio¹

2010

Dev Disabil Res Revs

202

161

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In the context of spina bifida, hydrocephalus is usually caused by crowding of the posterior fossa with obstruction to cerebrospinal fluid flow from the forth ventricle, and less often by malformation of the cerebral aqueduct. Enlargement of the cerebral ventricles causes gradual destruction of periventricular white matter axons. Motor, sensory, visual, and memory systems may be disturbed through involvement of the long projection axons, periventricular structures including the corpus callosum, and the fimbria-fornix pathway. Secondary changes occur in neuronal cell bodies and synapses, but there is minimal death of neurons. The clinical syndrome of hydrocephalic brain dysfunction is thus due to subcortical disconnection. Some of the brain dysfunction is reversible by shunting, probably through restoration of cerebral blood flow and normalization of the extracellular environment. However, destroyed axons cannot be restored.

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Neuronal damage in hydrocephalus and its restoration by shunt insertion in experimental hydrocephalus: a study involving the neurofilament-immunostaining method

Cited by 35 publications

References 48 publications

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Protective role of endothelial nitric oxide synthase following pressure-induced insult to the optic nerve

Neuropathology and structural changes in hydrocephalus

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