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  • Author or Editor: Haiyan Zhangx
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Establishment of a novel risk prediction model for recompression of augmented vertebrae at the thoracolumbar junction and modified puncture technique for prevention: a multicenter retrospective study

Weibo Yu, Xiaobing Jiang, Haiyan Zhang, Zhensong Yao, Yuanming Zhong, Fubo Tang, and Daozhang Cai

OBJECTIVE

Recompression of augmented vertebrae (RCAV) is often seen after percutaneous kyphoplasty (PKP), especially at the thoracolumbar junction. The authors aimed to develop and validate a risk prediction model (nomogram) for RCAV and to evaluate the efficacy of a modified puncture technique for RCAV prevention after PKP for thoracolumbar osteoporotic vertebral fractures (OVFs).

开云体育世界杯赔率

Patients who underwent PKP for single thoracolumbar OVFs (T10–L2) between January 2016 and October 2020 were reviewed and followed up for at least 2 years. All patients were randomly divided into a training group (70%) and a validation group (30%). Relevant potential data affecting recompression were collected. Predictors were screened by using binary logistic regression analysis to construct the nomogram. Calibration and receiver operating characteristic curves were used to evaluate the consistency of the prediction models. Finally, the efficacy of the modified puncture technique for prevention of RCAV in OVF patients with a preoperative intravertebral cleft (IVC) was further demonstrated through binary logistic regression analysis.

RESULTS

Overall, 394 patients were included and 116 of them (29.4%) sustained RCAV. The independent risk factors included decreased bone mineral density, lower level of serum 25-hydroxy vitamin D3, larger C7–S1 sagittal vertical axis (SVA), preoperative IVC, and solid-lump cement distribution. The area under the curve (AUC) of the prediction model was 0.824 in the training group and 0.875 in the validation group patients. The calibration curve indicated the predictive power of this nomogram, with the preoperative IVC having the highest prediction accuracy (AUC 0.705). The modified puncture technique significantly reduced the incidence of RCAV by enhancing bone cement distribution into a sufficiently diffused distribution in OVF patients with preoperative IVC.

CONCLUSIONS

The nomogram prediction model had satisfactory accuracy and clinical utility for identification of patients at low and high risk of postoperative RCAV. Patients at high risk of postoperative RCAV might benefit from the target puncture technique and vitamin D supplementation as well as effective antiosteoporotic therapies.

InJournal of Neurosurgery: Spine Publish Before Print

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Habenula deep brain stimulation for intractable schizophrenia: a pilot study

Yuhan Wang, Chencheng Zhang, Yingying Zhang, Hengfen Gong, Jun Li, Haiyan Jin, Dianyou Li, Dengtang Liu, and Bomin Sun

Schizophrenia is a psychiatric disorder associated with significant morbidity and mortality. Although antipsychotic medications and electroconvulsive therapy can be used to manage the clinical symptoms of schizophrenia, a substantial portion (10%–30%) of patients do not clinically respond to these treatments or cannot tolerate the side effects. Recently, deep brain stimulation (DBS) has emerged as a promising safe and effective therapeutic intervention for various psychiatric disorders. Here, the authors explore the utility of DBS of the habenula (HB) in the clinical management of 2 young adult male patients with severe, chronic, and treatment-resistant schizophrenia. After HB DBS surgery, both patients experienced improvements in clinical symptoms during the first 6 months of treatment. However, only 1 patient retained the clinical benefits and reached a favorable outcome at 12-month follow-up. The symptoms of the other patient subsequently worsened and became so profound that he needed to be hospitalized at 10-month follow-up and withdrawn from further study participation. It is tentatively concluded that HB DBS could ultimately be a relatively safe and effective surgical intervention for certain patients with treatment-resistant schizophrenia.

In神经外科佛cus Volume 49 (2020): Issue 1 (Jul 2020): Brain-Machine Interface

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Expression profile of long noncoding RNAs in human cerebral aneurysms: a microarray analysis

Hao Li, Haiyan Yue, Yajing Hao, Haowen Li, Shuo Wang, Lanbing Yu, Dong Zhang, Yong Cao, and Jizong Zhao

OBJECTIVE

The pathogenesis of cerebral aneurysms (CAs) remains largely unknown. Long noncoding RNAs (lncRNAs) were reported recently to play crucial roles in many physiological and biological processes. Here, the authors compared the gene-expression profiles of CAs and their control arteries to investigate the potential functions of lncRNAs in the formation of CAs.

开云体育世界杯赔率

前瞻性病例对照研究是为了我dentify the changes in expression of lncRNAs and mRNAs between 12 saccular CA samples (case group) and 12 paired superficial temporal artery samples (control group). Microarray analysis was performed to investigate the expression of lncRNAs and messenger RNAs (mRNAs), and reverse-transcription quantitative polymerase chain reaction was used to validate the microarray analysis findings. Then, an lncRNA target-prediction program and gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were applied to explore potential lncRNA functions.

RESULTS

A comparison between the case and control groups revealed that 1518 lncRNAs and 2545 mRNAs were expressed differentially. By using target-prediction program analysis, the authors constructed a complex network consisting of 2786 matched lncRNA-mRNA pairs, in which ine1 mRNA was potentially targeted by one to tens of lncRNAs, and vice versa. The results of further gene ontology and KEGG pathway analyses indicated that lncRNAs were involved mainly in regulating immune/inflammatory processes/pathways and vascular smooth muscle contraction, both of which are known to have crucial pathobiological relevance in terms of CA formation.

CONCLUSIONS

By comparing CAs with their control arteries, the authors created an expression profile of lncRNAs in CAs and propose here their possible roles in the pathogenesis of CAs. The results of this study provide novel insight into the mechanisms of CA pathogenesis and shed light on developing new therapeutic intervention for CAs in the future.

InJournal of Neurosurgery Volume 127: Issue 5 (Nov 2017)

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Value of functional connectivity in outcome prediction for pallidal stimulation in Parkinson disease

Yijie Lai, Naying He, Hongjiang Wei, Lifu Deng, Haiyan Zhou, Jun Li, Marcus Kaiser, Chencheng Zhang, Dianyou Li, and Bomin Sun

OBJECTIVE

Functional connectivity shows the ability to predict the outcome of subthalamic nucleus deep brain stimulation (DBS) in Parkinson disease (PD). However, evidence supporting its value in predicting the outcome of globus pallidus internus (GPi) DBS remains scarce. In this study the authors investigated patient-specific functional connectivity related to GPi DBS outcome in PD and established connectivity models for outcome prediction.

开云体育世界杯赔率

The authors reviewed the outcomes of 21 patients with PD who received bilateral GPi DBS and presurgical functional MRI at the Ruijin Hospital. The connectivity profiles within cortical areas identified as relevant to DBS outcome in the literature were calculated using the intersection of the volume of tissue activated (VTA) and the local structures as the seeds. Combined with the leave-one-out cross-validation strategy, models of the optimal connectivity profile were constructed to predict outcome.

RESULTS

Connectivity between the pallidal areas and primary motor area, supplementary motor area (SMA), and premotor cortex was identified through the literature as related to GPi DBS outcome. The similarity between the connectivity profile within the primary motor area, SMA, pre-SMA, and premotor cortex seeding from the VTA-GPi intersection from an out-of-sample patient and the constructed in-sample optimal connectivity profile predicts GPi DBS outcome (R = 0.58, p = 0.006). The predictions on average deviated by 13.1% ± 11.3% from actual improvements. On the contrary, connectivity profiles seeding from the GPi (R = −0.12, p = 0.603), the VTA (R = 0.23, p = 0.308), the VTA outside the GPi (R = 0.12, p = 0.617), or other local structures were found not to be predictive.

CONCLUSIONS

The results showed that patient-specific functional connectivity seeding from the VTA-GPi intersection could help in GPi DBS outcome prediction. Reproducibility remains to be determined across centers in larger cohorts stratified by PD motor subtype.

InJournal of Neurosurgery Volume 138: Issue 1 (Jan 2023)

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Pallidal deep brain stimulation combined with capsulotomy for Tourette’s syndrome with psychiatric comorbidity

Chencheng Zhang, Zhengdao Deng, Yixin Pan, Jing Zhang, Kristina Zeljic, Haiyan Jin, Odin van der Stelt, Hengfen Gong, Shikun Zhan, Dianyou Li, and Bomin Sun

OBJECTIVE

A current challenge is finding an effective and safe treatment for severely disabled patients with Tourette’s syndrome (TS) and comorbid psychiatric disorders, in whom conventional treatments have failed. The authors aimed to evaluate the utility of globus pallidus internus deep brain stimulation (GPi-DBS) combined with bilateral anterior capsulotomy in treating these clinically challenging patients.

开云体育世界杯赔率

The authors conducted a retrospective review of the clinical history and outcomes of 10 severely disabled patients with treatment-refractory TS and a psychiatric comorbidity, who had undergone GPi-DBS combined with bilateral anterior capsulotomy in their hospital. At the time of surgery, patients presented mainly with obsessive-compulsive disorder and affective disorders. Clinical outcome assessments of tic and psychiatric symptoms, as well as of general adaptive functioning and quality of life, were performed at the time of surgery and at 6, 12, and between 24 and 96 months postsurgery.

RESULTS

After surgery, all patients showed significant progressive improvements in tic and psychiatric symptoms, along with improvements in general adaptive functioning and quality of life. Tic alleviation reached 64% at 12 months and 77% at the last follow-up on the Yale Global Tic Severity Scale. At the final follow-up, patients had functionally recovered and displayed no or only mild tic and psychiatric symptoms. All patients tolerated treatment reasonably well, with no serious side effects.

CONCLUSIONS

GPi-DBS combined with bilateral anterior capsulotomy seems to offer major clinical benefits to severely disabled patients with otherwise treatment-refractory TS and psychiatric comorbidities.

InJournal of Neurosurgery Volume 131: Issue 6 (Dec 2019)

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High wall shear stress beyond a certain range in the parent artery could predict the risk of anterior communicating artery aneurysm rupture at follow-up

Xin Zhang, Tamrakar Karuna, Zhi-Qiang Yao, Chuan-Zhi Duan, Xue-Min Wang, Shun-Ting Jiang, Xi-Feng Li, Jia-He Yin, Xu-Ying He, Shen-Quan Guo, Yun-Chang Chen, Wen-Chao Liu, Ran Li, and Hai-Yan Fan

OBJECTIVE

Among clinical and morphological criteria, hemodynamics is the main predictor of aneurysm growth and rupture. This study aimed to identify which hemodynamic parameter in the parent artery could independently predict the rupture of anterior communicating artery (ACoA) aneurysms by using multivariate logistic regression and two-piecewise linear regression models. An additional objective was to look for a more simplified and convenient alternative to the widely used computational fluid dynamics (CFD) techniques to detect wall shear stress (WSS) as a screening tool for predicting the risk of aneurysm rupture during the follow-up of patients who did not undergo embolization or surgery.

开云体育世界杯赔率

一百六十二名患者窝藏ACoA aneurysms (130 ruptured and 32 unruptured) confirmed by 3D digital subtraction angiography at three centers were selected for this study. Morphological and hemodynamic parameters were evaluated for significance with respect to aneurysm rupture. Local hemodynamic parameters were obtained by MR angiography and transcranial color-coded duplex sonography to calculate WSS magnitude. Multivariate logistic regression and a two-piecewise linear regression analysis were performed to identify which hemodynamic parameter independently characterizes the rupture status of ACoA aneurysms.

RESULTS

Univariate analysis showed that WSS (p < 0.001), circumferential wall tension (p = 0.005), age (p < 0.001), the angle between the A1and A2segments of the anterior cerebral artery (p < 0.001), size ratio (p = 0.023), aneurysm angle (p < 0.001), irregular shape (p = 0.005), and hypertension (grade II) (p = 0.006) were significant parameters. Multivariate analyses showed significant association between WSS in the parent artery and ACoA aneurysm rupture (p = 0.0001). WSS magnitude, evaluated by a two-piecewise linear regression model, was significantly correlated with the rupture of the ACoA aneurysm when the magnitude was higher than 12.3 dyne/cm2(HR 7.2, 95% CI 1.5–33.6, p = 0.013).

CONCLUSIONS

WSS in the parent artery may be one of the reliable hemodynamic parameters characterizing the rupture status of ACoA aneurysms when the WSS magnitude is higher than 12.3 dyne/cm2．分析表明,每个额外的unit of WSS (even with a 1-unit increase of WSS), there was a 6.2-fold increase in the risk of rupture for ACoA aneurysms.

InJournal of Neurosurgery Volume 131: Issue 3 (Sep 2019)

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