Grey matter abnormality in progressive multifocal leucoencephalopathy

Progressive multifocal leucoencephalopathy (PML) is a demyelinating white matter disease that most often affects immunocompromised people infected by JC virus. The diagnostic gold standard is demonstrable viral DNA or protein from histopathological tissue. However, there are few detailed descriptions of cortical grey matter involvement on neuroimaging. Here we describe the histopathological correlate of cerebral grey matter involvement and radiological accompaniment in a patient with biopsy proven PML.

Phenotype Expression Variability in Children with GABRB3 Heterozygous Mutations

GABRB3 gene is a recently identified gene located in 15q12 chromosome and encodes for gamma-aminobutyric acid (GABA) receptor subunit beta-3 protein, which is linked to the GABAA receptor. The gene is believed to share a role in inhibitory GABAergic synapses, GABA iron-gated channel function, and possible cellular response to histamine. The β3 subunit is expressed in cerebral grey matter, thalami, hippocampi, and cerebellum, among other structures. Faulty GABRB3 function is linked to several neurological disorders and clinical syndromes. However, the spectrum of such disorders is not yet well known. We present three case reports highlighting the potentially expanding clinical phenotype and variable expression in children with mutated GABRB3 gene.

Brain MRI findings in a dog with late onset epileptic seizure after portosystemic shunt attenuation

A female Tibetan terrier aged five years and six months presented 23 months after portosystemic shunt attenuation due to generalised tonic–clonic epileptic seizure activity. Repeat MRI of the brain showed symmetrical T2-weighted hyperintense lesions affecting the cerebral grey matter bilaterally suggestive of cerebral atrophy and polioencephalomalacia. Cerebral atrophy and polioencephalomalacia could develop after successful attenuation of portosystemic shunt surgery.

B-09 Cerebral Grey Matter After Out-Of-Hospital Cardiac Arrest In Good Outcome Survivors

Objective The purpose of this study was to evaluate the impact of out-of-hospital cardiac arrest (OHCA) on cognitive functioning and brain volumes, in good outcome survivors. Method Participants were medically stable OHCA survivors. Two control groups were also recruited: patients who experienced myocardial infarction (MI), and healthy controls (HC) with no history of cardiovascular disease. Neuropsychological assessment was conducted using the Neuropsychological Assessment Battery (NAB). Imaging was performed on a 3T Siemens Trio MRI scanner. Cerebral grey matter volume (GM; measured by voxel-based morphometry in SPM12) results are presented. Results Participants (nOHCA = 9, nMI = 19, nHC = 13) ranged in age from 30 to 85 years. When controlling for age, whole-brain analyses revealed decreased GM in anterior cingulate cortex, bilateral hippocampus in the OHCA and in the MI group compared to the HC group. In addition, the MI group had decreased GM compared to the HC in the thalamus and the right dorsolateral prefrontal cortex (p < .001). No significant differences in GM were observed between the MI and OHCA groups. The hippocampus was selected as a region-of-interest for further analyses. The Total NAB Index was correlated with hippocampal GM in the OHCA group but not in the MI group (rOHCA = .78, p = .014). Conclusions Results revealed select areas of GM reduction in OHCA and MI groups, suggesting a contribution of cardiovascular disease to observed atrophy. Reductions are related to cognitive performance only in the cardiac arrest group which may suggest that these volume losses represent clinically meaningful changes.

Electroacupuncture for pain relief in labour inhibits spinal p38 MAPK-mediated prostaglandin E2 release and uterine prostaglandin E2 receptor expression in rats

Background: p38 mitogen-activated protein kinase (p38 MAPK) activation involves the release of prostaglandin E2 (PGE2) and hyperalgesia. We have previously reported that electroacupuncture (EA) relieves labour pain, but the potential mechanisms remain unclear. Objective: To observe the effects of EA on labour pain intensity, serum PGE2 levels and the p38 MAPK signalling pathway in rats during labour. Methods: Female rats copulated with male rats to induce pregnancy, and then received castor oil to trigger labour. During labour, rats remained untreated (Control group, n=30) or were treated with remifentanil (n=30) or EA at Jiaji (n=30) or SP6+LI4 (n=30), respectively. The warm water tail-flick test was used to assess labour pain. Serum PGE2 levels were measured by ELISA. Protein expression of prostaglandin E2 receptor (PGER2), p38 MAPK and phospholipase A2 (PLA2) were analysed by Western blotting, and mRNA levels were measured by real-time PCR. Results: EA treatment at Jiaji or SP6+LI4 significantly relieved labour pain, decreased serum PGE2 levels and inhibited protein and gene expression of PGER2 in the myometrium. Moreover, EA reduced protein expression of PLA2 and p38 MAPK, and inhibited phosphorylation of p38 MAPK in the lumbar spinal cord but not in the cerebral grey matter. Additionally, EA markedly decreased mRNA levels of p38 MAPK in the lumbar spinal cord and significantly reduced PLA2-IV mRNA levels in both the lumbar spinal cord and cerebral grey matter. Conclusions: This study indicates that EA relieves labour pain through, at least in part, inhibition of spinal p38 MAPK-mediated PGE2 release and uterine PGER2 expression in rats.