Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Thalamic Diseases ; therapy

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed

BACKGROUND: In terms of localizing value, the clinical features of small lesion confined to thalamus are of great interest. The clinical manifestations frequently comprise hemiparesis, hemianesthesia, and neuropsychological abnormalities and the main cause of thalamic infarct is thought to be an arteriolopathy. To better understand the relationship between the location of thalamic lesion and clinical features, we studied the charateristics of patients with thalamogeniculate artery(TGA) territory infarction, which is most common site of thalamic infarction. METHODS: We reviewed 732 ischemic stroke patient registered to our stroke database over 4-year period. On the basis of MRI, we identified 33 cases of small thalamic infarction(<2cm). Among them, 21 cases had a lesion purely confined to TGA territory. RESULTS: The clinical type of manifestations were sensorimotor(10), pure sensory(7), hemiataxia+sensory(2), hemiataxia+ sensorimotor(1) and involunatry movement(1), respectively. No cases had neuropsychological abnormalities. Only 19% of total cases developed classical Dejerine-Roussy syndrome on short term follow-up. Most patients had hypertension and/or diabetes with the absence of large vessel abnormalities on MRA, but none had the cardioembolic source. CONCLUSION: The lesion sizes of pure sensory thalamic infarction were relatively small. The classical Dejerine-Roussy syndrome had been originally described as the effect of TGA occlusion but uncommon in our series.
Arteries* ; Follow-Up Studies ; Humans ; Hypertension ; Infarction* ; Magnetic Resonance Imaging ; Paresis ; Stroke ; Thalamic Diseases ; Thalamus

No abstract available.
Brain* ; Technetium Tc 99m Exametazime* ; Thalamic Diseases* ; Tomography, Emission-Computed, Single-Photon*

This paper states the essentials of the treatment based on syndrome differentiation practiced by professor WANG Ju-yi's and his experience in clinic. The understanding of basic theory is a key for clinical practices using meridian theory. Based on the understanding of mutual transformations among six meridians, six qi, six zang, and six fu, the theory of meridians and collaterals can be applied to daily acupuncture clinical practices. Doctors should follow the processes of observing meridian, inspection of meridian, selection meridian, selection acupoints in the clinical practices. This paper lists the clinical examples of treating patients with thalamic lesion by using the method of diagnosis and examination practiced by professor WANG Ju-yi's.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Thalamic Diseases ; diagnosis ; therapy

Acupuncture Points ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Sensation Disorders ; etiology ; therapy ; Stroke ; complications ; Thalamic Diseases ; complications

We analyzed the clinical courses of 93 consecutive patients with gangliothalmic hemorrhage for the first three weeks after the ictus and investigated the factors affecting the clinical course and the final outcome. The clinical status was assessed daily using the Glasgow Coma Score (GCS) and patients were divided into two groups according to the clinical course; Group I included those who improved and Group II consisted of patients who deteriorated. There were 44 patients (47.3%) in Group I and 49 patients (52.7%) in group II. Each group was subdivided into the conservative group and the surgical group. In Group I only eight patients (18.2%) received surgery while twenty-five patients (51.0%) received surgery in Group II. Clinical features and computed tomography characteristics of these four groups were compared. Our results suggested that the surgery is rarely required for patients 1) whose GCS values are 12 or more without deterioration; 2) with hematomas smaller than 3 cm in diameter or 20 ml in volume; 3) with midline shifts of less than 3 mm, and 4) whose subtypes of the hematomas are P1, P2a, T1, T2a, and T2b. For proper comparison of the results of medical and surgical treatment, the patient population should include the patients 1) who became deteriorated progressively regardless of initial GCS values; 2) whose GCS values are below 12; 3) with hematomas larger than at least 3cm in diameter or 20ml in volume; 4) with midline shift of more than 3mm, and 5) whose subtypes of the hematoma are P2b or GT.
Adult ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage/classification/pathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Thalamic Diseases/classification/pathology/*surgery ; Time Factors ; Tomography, X-Ray Computed

Adeno-associated virus (AAV)-mediated gene delivery has been proposed to be an essential tool of gene therapy for various brain diseases. Among several cell types in the brain, astrocyte has become a promising therapeutic target for brain diseases, as more and more contribution of astrocytes in pathophysiology has been revealed. Until now, genetically targeting astrocytes has been possible by utilizing the glial fibrillary acidic protein (GFAP) promoter. In some brain areas including thalamus, however, the GFAP expression in astrocytes is reported to be low, making it difficult to genetically target astrocytes using GFAP promoter. To study the function of astrocytes in thalamus, which serves as a relay station, there is a great need for identifying an alternative astrocyte-specific promoter in thalamus. Recently, a new astrocyte-specific promoter of ALDH1L1 has been identified. However, it has not been examined in thalamus. Here we developed and characterized an AAV vector expressing Cre recombinase under the human ALDH1L1 promoter, AAV-hALDH1L1-Cre. To test the cell-type specific expression of AAV-hALDH1L1-Cre, AAV virus was injected into several brain regions of Ai14 (RCL-tdTomato) mouse, which reports Cre activity by tdTomato expression. In thalamus, we observed that tdTomato was found mostly in astrocytes (91.71%), with minimal occurrence in neurons (2.67%). In contrast, tdTomato signal was observed in both neurons and astrocytes of the amygdala (neuron: 68.13%, astrocyte: 28.35%) and hippocampus (neuron: 76.25%, astrocyte: 18.00%), which is consistent with the previous report showing neuronal gene expression under rat ALDH1L1 promoter. Unexpectedly, tdTomato was found mostly in neurons (91.98%) with minimal occurrence in astrocytes (6.66%) of the medial prefrontal cortex. In conclusion, hALDH1L1 promoter shows astrocyte-specificity in thalamus and may prove to be useful for targeting thalamic astrocytes in mouse.
Amygdala ; Animals ; Astrocytes ; Brain ; Brain Diseases ; Dependovirus ; Gene Expression* ; Genetic Therapy ; Glial Fibrillary Acidic Protein ; Hippocampus ; Humans* ; Mice* ; Neurons ; Prefrontal Cortex ; Rats ; Recombinases ; Thalamus* ; Ventral Thalamic Nuclei

OBJECTIVETo observe therapeutic features of thalamic pain by mind Calming, blood activating and pain relief acupuncture and Carbamazepine.

METHODSCrossover trial design was adopted. Eleven patients with confirmed diagnosis of thalamic pain were randomly assigned to two groups according to the minimal unbalance index method, i.e., Group I (Six patients received acupuncture first and then Western medicine.) and Group II (Five patients received Western medicine first and then acupuncture). The therapeutic course for each group was ten days. There was a ten-day elution phase between the two therapeutic methods. The total therapeutic course was thirty days. Eleven patients were enrolled in the two groups for statistical analysis. The therapeutic efficacy was assessed with visual analogue scale (VAS) and the pain assessment scale of Anderson Cancer Center in the USA (MD Pain Evaluation value) respectively. The VAS and MD values of the two groups were recorded every day to get the dynamic curve.

RESULTSThe VAS and MD values obviously decreased in the two groups after treatment (P<0.05). The pain curves of the two groups showed a declining trend during the treatment. A gradual and stable descending process was shown in the acupuncture group. But a greater decrease first appeared in the Western medicine group, then a comparatively greater decrease occurred after one platform stage, showing ladder-shaped curve.

CONCLUSIONSCumulative potency may be the main analgesic effects of acupuncture. Western medicine may possibly play a role by rapid initiate effect.

Acupuncture Analgesia ; methods ; Aged ; Carbamazepine ; therapeutic use ; Cross-Over Studies ; Female ; Headache ; therapy ; Humans ; Male ; Middle Aged ; Pain Management ; Pain Measurement ; Thalamic Diseases ; therapy ; Treatment Outcome

The incidence rate of anxiety and depression is significantly higher in patients with inflammatory bowel diseases (IBD) than in the general population. The mechanisms underlying dextran sulfate sodium (DSS)-induced depressive-like behaviors are still unclear. We clarified that IBD mice induced by repeated administration of DSS presented depressive-like behaviors. The paraventricular thalamic nucleus (PVT) was regarded as the activated brain region by the number of c-fos-labeled neurons. RNA-sequencing analysis showed that lipocalin 2 (Lcn2) was upregulated in the PVT of mice with DSS-induced depressive behaviors. Upregulating Lcn2 from neuronal activity induced dendritic spine loss and the secreted protein induced chemokine expression and subsequently contributed to microglial activation leading to blood-brain barrier permeability. Moreover, Lcn2 silencing in the PVT alleviated the DSS-induced depressive-like behaviors. The present study demonstrated that elevated Lcn2 in the PVT is a critical factor for DSS-induced depressive behaviors.
Mice ; Humans ; Animals ; Lipocalin-2/genetics* ; Midline Thalamic Nuclei ; Brain ; Inflammatory Bowel Diseases ; Proto-Oncogene Proteins c-fos ; Mice, Inbred C57BL