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Mohan UR, Zhang H, Ermentrout B, Jacobs J. The direction of theta and alpha travelling waves modulates human memory processing. Nat Hum Behav 2024:10.1038/s41562-024-01838-3. [PMID: 38459263 DOI: 10.1038/s41562-024-01838-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/24/2024] [Indexed: 03/10/2024]
Abstract
To support a range of behaviours, the brain must flexibly coordinate neural activity across widespread brain regions. One potential mechanism for this coordination is a travelling wave, in which a neural oscillation propagates across the brain while organizing the order and timing of activity across regions. Although travelling waves are present across the brain in various species, their potential functional relevance has remained unknown. Here, using rare direct human brain recordings, we demonstrate a distinct functional role for travelling waves of theta- and alpha-band (2-13 Hz) oscillations in the cortex. Travelling waves propagate in different directions during separate cognitive processes. In episodic memory, travelling waves tended to propagate in a posterior-to-anterior direction during successful memory encoding and in an anterior-to-posterior direction during recall. Because travelling waves of oscillations correspond to local neuronal spiking, these patterns indicate that rhythmic pulses of activity move across the brain in different directions for separate behaviours. More broadly, our results suggest a fundamental role for travelling waves and oscillations in dynamically coordinating neural connectivity, by flexibly organizing the timing and directionality of network interactions across the cortex to support cognition and behaviour.
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Affiliation(s)
- Uma R Mohan
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD, USA
| | | | - Bard Ermentrout
- Department of Mathematics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York City, NY, USA.
- Department of Neurological Surgery, Columbia University, New York City, NY, USA.
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Kiani-Alikhan S, Gower R, Craig T, Wedner HJ, Kinaciyan T, Aygören-Pürsün E, Banerji A, Bernstein JA, Anderson J, Collis P, Johnston DT, Desai B, Tomita D, Gagnon R, Tachdjian R, Soteres DF, Farkas H, Caballero T, McNeil D, Jacobs J, Lumry WR. Once-Daily Oral Berotralstat for Long-Term Prophylaxis of Hereditary Angioedema: The Open-Label Extension of the APeX-2 Randomized Trial. J Allergy Clin Immunol Pract 2024; 12:733-743.e10. [PMID: 38122865 DOI: 10.1016/j.jaip.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/20/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Berotralstat is a first-line, once-daily oral plasma kallikrein inhibitor approved for prophylaxis of hereditary angioedema (HAE) attacks in patients 12 years or older. OBJECTIVE This analysis examined the safety and effectiveness of long-term prophylaxis with berotralstat. METHODS APeX-2 was a phase 3, parallel-group, multicenter trial in patients with HAE caused by C1-inhibitor deficiency (NCT03485911). Part 1 was a randomized, double-blind, placebo-controlled evaluation of 150 and 110 mg of berotralstat over 24 weeks. In part 2, berotralstat-treated patients continued the same treatment, and placebo-treated patients were re-randomized to 150 or 110 mg of berotralstat for 24 weeks. In part 3, all patients were treated with open-label berotralstat at 150 mg, which could be continued for up to an additional 4 years. In part 3, the primary endpoint was long-term safety and tolerability. Secondary endpoints included HAE attack rates and quality of life (QoL). RESULTS Eighty-one patients entered part 3. Treatment-emergent adverse events (TEAEs) occurred in 82.7% of patients, with most being mild or moderate in severity. The most common TEAEs were nasopharyngitis, urinary tract infection, abdominal pain, arthralgia, coronavirus infection, and diarrhea. Drug-related TEAEs occurred in 14.8% of patients, but none were serious. For patients who completed 96 weeks of berotralstat treatment (n = 70), the mean (standard error) change in attack rate from baseline was -2.21 (0.20) attacks/mo. Clinically meaningful improvements in QoL were also observed, with the largest improvements in the functioning domain. CONCLUSION Berotralstat was generally well tolerated, provided rapid and sustained reductions in HAE attacks and improved QoL over 96 weeks.
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Affiliation(s)
- Sorena Kiani-Alikhan
- Department of Immunology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Timothy Craig
- Department of Medicine and Pediatrics, Penn State University, Hershey Medical Center, Hershey, Pa
| | - H James Wedner
- Division of Allergy and Immunology, John T. Milliken Department of Medicine, Washington University School of Medicine, St. Louis, Mo
| | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Emel Aygören-Pürsün
- Department for Children and Adolescents, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Aleena Banerji
- Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass
| | - Jonathan A Bernstein
- Division of Immunology, Rheumatology, and Allergy, Department of Medicine, University of Cincinnati and Bernstein Clinical Research Center, Cincinnati, Ohio
| | - John Anderson
- Clinical Research Center of Alabama, an affiliate of AllerVie Health, Birmingham, Ala
| | | | | | | | | | - Rémi Gagnon
- Clinique Spécialisée en Allergie de la Capitale, Québec, QC, Canada
| | - Raffi Tachdjian
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, Calif
| | | | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Teresa Caballero
- Allergy Department, La Paz University Hospital, IdiPAZ Group 44, CSUR Angioedema Hereditario HULP, Madrid, Spain
| | | | - Joshua Jacobs
- Allergy & Asthma Clinical Research, Walnut Creek, Calif
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Kunz L, Staresina BP, Reinacher PC, Brandt A, Guth TA, Schulze-Bonhage A, Jacobs J. Ripple-locked coactivity of stimulus-specific neurons and human associative memory. Nat Neurosci 2024; 27:587-599. [PMID: 38366143 PMCID: PMC10917673 DOI: 10.1038/s41593-023-01550-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/11/2023] [Indexed: 02/18/2024]
Abstract
Associative memory enables the encoding and retrieval of relations between different stimuli. To better understand its neural basis, we investigated whether associative memory involves temporally correlated spiking of medial temporal lobe (MTL) neurons that exhibit stimulus-specific tuning. Using single-neuron recordings from patients with epilepsy performing an associative object-location memory task, we identified the object-specific and place-specific neurons that represented the separate elements of each memory. When patients encoded and retrieved particular memories, the relevant object-specific and place-specific neurons activated together during hippocampal ripples. This ripple-locked coactivity of stimulus-specific neurons emerged over time as the patients' associative learning progressed. Between encoding and retrieval, the ripple-locked timing of coactivity shifted, suggesting flexibility in the interaction between MTL neurons and hippocampal ripples according to behavioral demands. Our results are consistent with a cellular account of associative memory, in which hippocampal ripples coordinate the activity of specialized cellular populations to facilitate links between stimuli.
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Affiliation(s)
- Lukas Kunz
- Department of Epileptology, University Hospital Bonn, Bonn, Germany.
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Bernhard P Staresina
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Peter C Reinacher
- Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Fraunhofer Institute for Laser Technology, Aachen, Germany
| | - Armin Brandt
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tim A Guth
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
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Frauscher B, Mansilla D, Abdallah C, Astner-Rohracher A, Beniczky S, Brazdil M, Gnatkovsky V, Jacobs J, Kalamangalam G, Perucca P, Ryvlin P, Schuele S, Tao J, Wang Y, Zijlmans M, McGonigal A. Learn how to interpret and use intracranial EEG findings. Epileptic Disord 2024; 26:1-59. [PMID: 38116690 DOI: 10.1002/epd2.20190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/21/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
Epilepsy surgery is the therapy of choice for many patients with drug-resistant focal epilepsy. Recognizing and describing ictal and interictal patterns with intracranial electroencephalography (EEG) recordings is important in order to most efficiently leverage advantages of this technique to accurately delineate the seizure-onset zone before undergoing surgery. In this seminar in epileptology, we address learning objective "1.4.11 Recognize and describe ictal and interictal patterns with intracranial recordings" of the International League against Epilepsy curriculum for epileptologists. We will review principal considerations of the implantation planning, summarize the literature for the most relevant ictal and interictal EEG patterns within and beyond the Berger frequency spectrum, review invasive stimulation for seizure and functional mapping, discuss caveats in the interpretation of intracranial EEG findings, provide an overview on special considerations in children and in subdural grids/strips, and review available quantitative/signal analysis approaches. To be as practically oriented as possible, we will provide a mini atlas of the most frequent EEG patterns, highlight pearls for its not infrequently challenging interpretation, and conclude with two illustrative case examples. This article shall serve as a useful learning resource for trainees in clinical neurophysiology/epileptology by providing a basic understanding on the concepts of invasive intracranial EEG.
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Affiliation(s)
- B Frauscher
- Department of Neurology, Duke University Medical Center and Department of Biomedical Engineering, Duke Pratt School of Engineering, Durham, North Carolina, USA
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, Montreal, Québec, Canada
| | - D Mansilla
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, Montreal, Québec, Canada
- Neurophysiology Unit, Institute of Neurosurgery Dr. Asenjo, Santiago, Chile
| | - C Abdallah
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, Montreal, Québec, Canada
| | - A Astner-Rohracher
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - S Beniczky
- Danish Epilepsy Centre, Dianalund, Denmark
- Aarhus University, Aarhus, Denmark
| | - M Brazdil
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Member of the ERN-EpiCARE, Brno, Czechia
- Behavioral and Social Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - V Gnatkovsky
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - J Jacobs
- Department of Paediatrics and Department of Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - G Kalamangalam
- Department of Neurology, University of Florida, Gainesville, Florida, USA
- Wilder Center for Epilepsy Research, University of Florida, Gainesville, Florida, USA
| | - P Perucca
- Epilepsy Research Centre, Department of Medicine (Austin Health), University of Melbourne, Melbourne, Victoria, Australia
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, Victoria, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - P Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne University Hospital, Lausanne, Switzerland
| | - S Schuele
- Department of Neurology, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - J Tao
- Department of Neurology, The University of Chicago, Chicago, Illinois, USA
| | - Y Wang
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
- Wilder Center for Epilepsy Research, University of Florida, Gainesville, Florida, USA
| | - M Zijlmans
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - A McGonigal
- Department of Neurosciences, Mater Misericordiae Hospital, Brisbane, Queensland, Australia
- Mater Research Institute, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
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Maurer M, Lumry WR, Li HH, Aygören-Pürsün E, Busse PJ, Jacobs J, Nurse C, Ahmed MA, Watt M, Yu M. Lanadelumab in Patients 2 to Less Than 12 Years Old With Hereditary Angioedema: Results From the Phase 3 SPRING Study. J Allergy Clin Immunol Pract 2024; 12:201-211.e6. [PMID: 37730089 DOI: 10.1016/j.jaip.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Symptoms of hereditary angioedema (HAE) often first occur during childhood, and HAE attacks in children can be severe and substantially affect health-related quality of life (HRQoL). However, there are no approved long-term prophylaxis treatments for children aged less than 6 years. OBJECTIVE The SPRING Study (NCT04070326) evaluated the safety, pharmacokinetics, and efficacy of lanadelumab and HRQoL in patients aged 2 to less than 12 years. METHODS Over 52 weeks of treatment, patients aged 2 to less than 6 years received lanadelumab 150 mg every 4 weeks (Q4W) and patients aged 6 to less than 12 years received 150 mg every 2 weeks (Q2W) but could switch to Q4W if they were attack-free for 26 weeks. RESULTS We enrolled 21 patients (aged 2 to less than 6 years: n = 4; aged 6 to less than 12 years: n = 17), 20 of whom completed the study. There were no reported serious treatment-emergent adverse events or discontinuations resulting from such events. Treatment-emergent adverse events were reported for 17 patients (81.0%). The most common TEAE was injection site pain. Overall systemic exposure was comparable for both age groups. The mean (SD) attack rate during treatment decreased by 94.8% from baseline (1.84 [1.53] to 0.08 [0.17] attacks/mo), and 16 (76.2%) patients were attack-free. The attack rate reduction in both age groups was similar during the first 26-week fixed-dosing treatment. Seven patients switched from Q2W to Q4W and remained attack-free. A large, clinically meaningful increase in the Pediatric Quality of Life Inventory Generic Core Scale Total Score and a large increase in the Pediatric Quality of Life Inventory Generic Core Scale-Family Impact Module Total Score from baseline to end of study (better HRQoL) were observed. CONCLUSIONS Findings support safety, efficacy, and improved HRQoL with lanadelumab 150 mg Q2W and Q4W regimens for the prevention of HAE attacks in patients aged 2 to less than 12 years.
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Affiliation(s)
- Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
| | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Md
| | - Emel Aygören-Pürsün
- Department for Children and Adolescents, Angioedema Centre, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Paula J Busse
- Division of Allergy and Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joshua Jacobs
- Allergy and Asthma Clinical Research, Walnut Creek, Calif
| | | | - Mariam A Ahmed
- Takeda Development Center Americas, Inc, Lexington, Mass
| | - Maureen Watt
- Takeda Development Center Americas, Inc, Lexington, Mass
| | - Ming Yu
- Takeda Development Center Americas, Inc, Lexington, Mass
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Mentias A, Keshvani N, Sumarsono A, Desai R, Khan MS, Menon V, Hsich E, Bress AP, Jacobs J, Vasan RS, Fonarow GC, Pandey A. Patterns, Prognostic Implications, and Rural-Urban Disparities in Optimal GDMT Following HFrEF Diagnosis Among Medicare Beneficiaries. JACC Heart Fail 2023:S2213-1779(23)00597-8. [PMID: 37943222 DOI: 10.1016/j.jchf.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Patterns and disparities in guideline-directed medical therapy (GDMT) uptake for heart failure with reduced ejection fraction (HFrEF) across rural vs urban regions are not well described. OBJECTIVES This study aims to evaluate patterns, prognostic implications, and rural-urban differences in GDMT use among Medicare beneficiaries following new-onset HFrEF. METHODS Patients with a diagnosis of new-onset HFrEF in a 5% Medicare sample with available data for Part D medication use were identified from January 2015 through December 2020. The primary exposure was residence in rural vs urban zip codes. Optimal triple GDMT was defined as ≥50% of the target daily dose of beta-blockers, ≥50% of the target daily dose of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker or any dose of sacubitril/valsartan, and any dose of mineralocorticoid receptor antagonist. The association between the achievement of optimal GDMT over time following new-onset HFrEF diagnosis and risk of all-cause mortality and subsequent HF hospitalization was also evaluated using adjusted Cox models. The association between living in rural vs urban location and time to optimal GDMT achievement over a 12-month follow-up was assessed using cumulative incidence curves and adjusted Fine-Gray subdistribution hazard models. RESULTS A total of 41,296 patients (age: 76.7 years; 15.0% Black; 27.6% rural) were included. Optimal GDMT use over the 12-month follow-up was low, with 22.5% initiated on any dose of triple GDMT and 9.1% on optimal GDMT doses. Optimal GDMT on follow-up was significantly associated with a lower risk of death (HR: 0.89 [95% CI: 0.85-0.94]; P < 0.001) and subsequent HF hospitalization (HR: 0.93 [95% CI: 0.87-0.98]; P = 0.02). Optimal GDMT use at 12 months was significantly lower among patients living in rural (vs urban) areas (8.4% vs 9.3%; P = 0.02). In adjusted analysis, living in rural (vs urban) locations was associated with a significantly lower probability of achieving optimal GDMT (HR: 0.92 [95% CI: 0.86-0.98]; P = 0.01 Differences in optimal GDMT use following HFrEF diagnosis accounted for 16% of excess mortality risk among patients living in rural (vs urban) areas. CONCLUSIONS Use of optimal GDMT following new-onset HFrEF diagnosis is low, with substantially lower use noted among patients living in rural vs urban locations. Suboptimal GDMT use following new-onset HFrEF was associated with an increased risk of mortality and subsequent HF hospitalization.
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Affiliation(s)
- Amgad Mentias
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Neil Keshvani
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew Sumarsono
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | - Venu Menon
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Eileen Hsich
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adam P Bress
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Joshua Jacobs
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Ramachandran S Vasan
- School of Public Health, Department of Population Health, and Division of Cardiology, Long School of Medicine, University of Texas San Antonio, San Antonio, Texas, USA
| | - Gregg C Fonarow
- Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, California, USA
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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7
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Zabeh E, Foley NC, Jacobs J, Gottlieb JP. Beta traveling waves in monkey frontal and parietal areas encode recent reward history. Nat Commun 2023; 14:5428. [PMID: 37669966 PMCID: PMC10480436 DOI: 10.1038/s41467-023-41125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
Brain function depends on neural communication, but the mechanisms of this communication are not well understood. Recent studies suggest that one form of neural communication is through traveling waves (TWs)-patterns of neural oscillations that propagate within and between brain areas. We show that TWs are robust in microarray recordings in frontal and parietal cortex and encode recent reward history. Two adult male monkeys made saccades to obtain probabilistic rewards and were sensitive to the (statistically irrelevant) reward on the previous trial. TWs in frontal and parietal areas were stronger in trials that followed a prior reward versus a lack of reward and, in the frontal lobe, correlated with the monkeys' behavioral sensitivity to the prior reward. The findings suggest that neural communication mediated by TWs within the frontal and parietal lobes contribute to maintaining information about recent reward history and mediating the impact of this history on the monkeys' expectations.
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Affiliation(s)
- Erfan Zabeh
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Nicholas C Foley
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY, USA.
- Department of Neurological Surgery, Columbia University, New York, NY, USA.
| | - Jacqueline P Gottlieb
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA.
- Department of Neuroscience, Columbia University, New York, NY, USA.
- Kavli Institute for Brain Science, Columbia University, New York, NY, USA.
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Sluka KA, Wager TD, Sutherland SP, Labosky PA, Balach T, Bayman EO, Berardi G, Brummett CM, Burns J, Buvanendran A, Caffo B, Calhoun VD, Clauw D, Chang A, Coffey CS, Dailey DL, Ecklund D, Fiehn O, Fisch KM, Frey Law LA, Harris RE, Harte SE, Howard TD, Jacobs J, Jacobs JM, Jepsen K, Johnston N, Langefeld CD, Laurent LC, Lenzi R, Lindquist MA, Lokshin A, Kahn A, McCarthy RJ, Olivier M, Porter L, Qian WJ, Sankar CA, Satterlee J, Swensen AC, Vance CG, Waljee J, Wandner LD, Williams DA, Wixson RL, Zhou XJ. Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures. Pain 2023; 164:1912-1926. [PMID: 37326643 PMCID: PMC10436361 DOI: 10.1097/j.pain.0000000000002938] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 06/17/2023]
Abstract
ABSTRACT Chronic pain affects more than 50 million Americans. Treatments remain inadequate, in large part, because the pathophysiological mechanisms underlying the development of chronic pain remain poorly understood. Pain biomarkers could potentially identify and measure biological pathways and phenotypical expressions that are altered by pain, provide insight into biological treatment targets, and help identify at-risk patients who might benefit from early intervention. Biomarkers are used to diagnose, track, and treat other diseases, but no validated clinical biomarkers exist yet for chronic pain. To address this problem, the National Institutes of Health Common Fund launched the Acute to Chronic Pain Signatures (A2CPS) program to evaluate candidate biomarkers, develop them into biosignatures, and discover novel biomarkers for chronification of pain after surgery. This article discusses candidate biomarkers identified by A2CPS for evaluation, including genomic, proteomic, metabolomic, lipidomic, neuroimaging, psychophysical, psychological, and behavioral measures. Acute to Chronic Pain Signatures will provide the most comprehensive investigation of biomarkers for the transition to chronic postsurgical pain undertaken to date. Data and analytic resources generatedby A2CPS will be shared with the scientific community in hopes that other investigators will extract valuable insights beyond A2CPS's initial findings. This article will review the identified biomarkers and rationale for including them, the current state of the science on biomarkers of the transition from acute to chronic pain, gaps in the literature, and how A2CPS will address these gaps.
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Affiliation(s)
- Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Tor D. Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH
| | - Stephani P. Sutherland
- Department of Biostatistics, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD
| | - Patricia A. Labosky
- Office of Strategic Coordination, Division of Program Coordination, Planning and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Tessa Balach
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, IL
| | - Emine O. Bayman
- Clinical Trials and Data Management Center, Department of Biostatistics, University of Iowa, Iowa City, IA
| | - Giovanni Berardi
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Chad M. Brummett
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
| | - John Burns
- Division of Behavioral Sciences, Rush Medical College, Chicago, IL
| | | | - Brian Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD
| | - Vince D. Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, and Emory University, Atlanta, GA
| | - Daniel Clauw
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
| | - Andrew Chang
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
| | - Christopher S. Coffey
- Clinical Trials and Data Management Center, Department of Biostatistics, University of Iowa, Iowa City, IA
| | - Dana L. Dailey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Dixie Ecklund
- Clinical Trials and Data Management Center, Department of Biostatistics, University of Iowa, Iowa City, IA
| | - Oliver Fiehn
- University of California, Davis, Davis, CA, United States
| | - Kathleen M. Fisch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA, United States
- Center for Computational Biology and Bioinformatics, University of California San Diego, San Diego, CA, United States
| | - Laura A. Frey Law
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Richard E. Harris
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
| | - Timothy D. Howard
- Department of Biochemistry, Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
- Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
| | - Joshua Jacobs
- Department of Orthopedic Surgery, Rush Medical College, CHicago, IL
| | - Jon M. Jacobs
- Environmental and Molecular Sciences Laboratory, Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | | | | | - Carl D. Langefeld
- Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
- Department of Biostatistics and Data Science, Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
| | - Louise C. Laurent
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA, United States
| | - Rebecca Lenzi
- Office of Strategic Coordination, Division of Program Coordination, Planning and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Martin A. Lindquist
- Department of Biostatistics, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD
| | | | - Ari Kahn
- Texas Advanced Computing Center, University of Texas, AUstin, TX
| | | | - Michael Olivier
- Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
- Department of Internal Medicine, Center for Precision Medicine, Wake Forest School of Medicine, Winstom-Salem, NC
| | - Linda Porter
- National Institute of Neurological Disorders and Stroke, Bethesda, MD
- Office of Pain Policy and Planning National Institutes of Health, Bethesda, MD
| | - Wei-Jun Qian
- Environmental and Molecular Sciences Laboratory, Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | - Cheryse A. Sankar
- National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | | | - Adam C. Swensen
- Environmental and Molecular Sciences Laboratory, Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | - Carol G.T. Vance
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Jennifer Waljee
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
| | - Laura D. Wandner
- National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - David A. Williams
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
| | | | - Xiaohong Joe Zhou
- Center for MR Research and Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
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9
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Gedankien T, Tan RJ, Qasim SE, Moore H, McDonagh D, Jacobs J, Lega B. Acetylcholine modulates the temporal dynamics of human theta oscillations during memory. Nat Commun 2023; 14:5283. [PMID: 37648692 PMCID: PMC10469188 DOI: 10.1038/s41467-023-41025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 08/17/2023] [Indexed: 09/01/2023] Open
Abstract
The cholinergic system is essential for memory. While degradation of cholinergic pathways characterizes memory-related disorders such as Alzheimer's disease, the neurophysiological mechanisms linking the cholinergic system to human memory remain unknown. Here, combining intracranial brain recordings with pharmacological manipulation, we describe the neurophysiological effects of a cholinergic blocker, scopolamine, on the human hippocampal formation during episodic memory. We found that the memory impairment caused by scopolamine was coupled to disruptions of both the amplitude and phase alignment of theta oscillations (2-10 Hz) during encoding. Across individuals, the severity of theta phase disruption correlated with the magnitude of memory impairment. Further, cholinergic blockade disrupted connectivity within the hippocampal formation. Our results indicate that cholinergic circuits support memory by coordinating the temporal dynamics of theta oscillations across the hippocampal formation. These findings expand our mechanistic understanding of the neurophysiology of human memory and offer insights into potential treatments for memory-related disorders.
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Affiliation(s)
- Tamara Gedankien
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - Ryan Joseph Tan
- Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, 75390, USA
| | - Salman Ehtesham Qasim
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Haley Moore
- Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, 75390, USA
| | - David McDonagh
- Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, 75390, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA.
- Department of Neurological Surgery, Columbia University, New York, NY, 10032, USA.
| | - Bradley Lega
- Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, 75390, USA.
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10
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Olivier B, Boulle N, Jacobs J, Obiora OL, MacMillan C, Liebenberg J, McErlain-Naylor S. Kinematic differences between left- and right-handed cricket fast bowlers during the bowling action. S Afr J Sports Med 2023; 35:v35i1a15144. [PMID: 38249757 PMCID: PMC10798611 DOI: 10.17159/2078-516x/2023/v35i1a15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Background Despite differences between left- and right-handed athletes in other sports, minimal evidence exists regarding biomechanical similarities and differences between left- and right-handed cricket fast bowlers performing an equivalent task. Objectives This study aimed to compare the kinematics between left and right-handed fast bowlers performing an equivalent task (i.e. bowling 'over the wicket' to a batter of the same handedness as the bowler). Methods Full body, three-dimensional kinematic data for six left-handed and 20 right-handed adolescent, male, fast bowlers were collected using the Xsens inertial measurement system. Time-normalised joint and segment angle time histories from back foot contact to follow-through ground contacts were compared between groups via statistical parametric mapping. Whole movement and subphase durations were also compared. Results Left-handed players displayed significantly more trunk flexion from 49%-56% of the total movement (ball release occurred at 54%; p = 0.037) and had shorter back foot contact durations on average (0.153 vs 0.177 s; p = 0.036) compared to right-handed players. Conclusion Left- and right-handed bowlers displayed similar sagittal plane kinematics but appeared to use non-sagittal plane movements differently around the time of ball release. The kinematic differences identified in this study can inform future research investigating the effect of hand dominance on bowling performance and injury risk.
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Affiliation(s)
- B Olivier
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - N Boulle
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - J Jacobs
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - OL Obiora
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - C MacMillan
- Sport Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
| | - J Liebenberg
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - S McErlain-Naylor
- School of Sport, Exercise and Health Sciences, Loughborough University,
United Kingdom
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11
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Jacobs J, Vozar TM, Thornton K, Elliott KL, Holmberg JR. What to expect when you're expecting… and in recovery: Highlighting the need to develop training for perinatal mental health providers. Gen Hosp Psychiatry 2023; 83:172-178. [PMID: 37244211 DOI: 10.1016/j.genhosppsych.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023]
Affiliation(s)
- J Jacobs
- The Graduate School of Professional Psychology, University of Denver, USA.
| | | | - K Thornton
- Colorado Department of Public Health and Environment, USA
| | - K L Elliott
- The Graduate School of Professional Psychology, University of Denver, USA
| | - J R Holmberg
- The Graduate School of Professional Psychology, University of Denver, USA
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12
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Donoghue T, Cao R, Han CZ, Holman CM, Brandmeir NJ, Wang S, Jacobs J. Single neurons in the human medial temporal lobe flexibly shift representations across spatial and memory tasks. Hippocampus 2023; 33:600-615. [PMID: 37060325 PMCID: PMC10231142 DOI: 10.1002/hipo.23539] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/16/2023]
Abstract
Investigations into how individual neurons encode behavioral variables of interest have revealed specific representations in single neurons, such as place and object cells, as well as a wide range of cells with conjunctive encodings or mixed selectivity. However, as most experiments examine neural activity within individual tasks, it is currently unclear if and how neural representations change across different task contexts. Within this discussion, the medial temporal lobe is particularly salient, as it is known to be important for multiple behaviors including spatial navigation and memory, however the relationship between these functions is currently unclear. Here, to investigate how representations in single neurons vary across different task contexts in the medial temporal lobe, we collected and analyzed single-neuron activity from human participants as they completed a paired-task session consisting of a passive-viewing visual working memory and a spatial navigation and memory task. Five patients contributed 22 paired-task sessions, which were spike sorted together to allow for the same putative single neurons to be compared between the different tasks. Within each task, we replicated concept-related activations in the working memory task, as well as target-location and serial-position responsive cells in the navigation task. When comparing neuronal activity between tasks, we first established that a significant number of neurons maintained the same kind of representation, responding to stimuli presentations across tasks. Further, we found cells that changed the nature of their representation across tasks, including a significant number of cells that were stimulus responsive in the working memory task that responded to serial position in the spatial task. Overall, our results support a flexible encoding of multiple, distinct aspects of different tasks by single neurons in the human medial temporal lobe, whereby some individual neurons change the nature of their feature coding between task contexts.
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Affiliation(s)
| | - Runnan Cao
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
| | - Claire Z. Han
- Department of Biomedical Engineering, Columbia University
| | | | | | - Shuo Wang
- Department of Radiology, Washington University in St. Louis
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University
- Department of Neurological Surgery, Columbia University
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13
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Han CZ, Donoghue T, Cao R, Kunz L, Wang S, Jacobs J. Using multi-task experiments to test principles of hippocampal function. Hippocampus 2023; 33:646-657. [PMID: 37042212 PMCID: PMC10249632 DOI: 10.1002/hipo.23540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/13/2023]
Abstract
Investigations of hippocampal functions have revealed a dizzying array of findings, from lesion-based behavioral deficits, to a diverse range of characterized neural activations, to computational models of putative functionality. Across these findings, there remains an ongoing debate about the core function of the hippocampus and the generality of its representation. Researchers have debated whether the hippocampus's primary role relates to the representation of space, the neural basis of (episodic) memory, or some more general computation that generalizes across various cognitive domains. Within these different perspectives, there is much debate about the nature of feature encodings. Here, we suggest that in order to evaluate hippocampal responses-investigating, for example, whether neuronal representations are narrowly targeted to particular tasks or if they subserve domain-general purposes-a promising research strategy may be the use of multi-task experiments, or more generally switching between multiple task contexts while recording from the same neurons in a given session. We argue that this strategy-when combined with explicitly defined theoretical motivations that guide experiment design-could be a fruitful approach to better understand how hippocampal representations support different behaviors. In doing so, we briefly review key open questions in the field, as exemplified by articles in this special issue, as well as previous work using multi-task experiments, and extrapolate to consider how this strategy could be further applied to probe fundamental questions about hippocampal function.
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Affiliation(s)
- Claire Z. Han
- Department of Biomedical Engineering, Columbia University
| | | | - Runnan Cao
- Department of Radiology, Washington University in St. Louis
| | - Lukas Kunz
- Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
| | - Shuo Wang
- Department of Radiology, Washington University in St. Louis
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University
- Department of Neurological Surgery, Columbia University
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14
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Frauscher B, Bénar CG, Engel JJ, Grova C, Jacobs J, Kahane P, Wiebe S, Zjilmans M, Dubeau F. Neurophysiology, Neuropsychology, and Epilepsy, in 2022: Hills We Have Climbed and Hills Ahead. Neurophysiology in epilepsy. Epilepsy Behav 2023; 143:109221. [PMID: 37119580 DOI: 10.1016/j.yebeh.2023.109221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
Since the discovery of the human electroencephalogram (EEG), neurophysiology techniques have become indispensable tools in our armamentarium to localize epileptic seizures. New signal analysis techniques and the prospects of artificial intelligence and big data will offer unprecedented opportunities to further advance the field in the near future, ultimately resulting in improved quality of life for many patients with drug-resistant epilepsy. This article summarizes selected presentations from Day 1 of the two-day symposium "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". Day 1 was dedicated to highlighting and honoring the work of Dr. Jean Gotman, a pioneer in EEG, intracranial EEG, simultaneous EEG/ functional magnetic resonance imaging, and signal analysis of epilepsy. The program focused on two main research directions of Dr. Gotman, and was dedicated to "High-frequency oscillations, a new biomarker of epilepsy" and "Probing the epileptic focus from inside and outside". All talks were presented by colleagues and former trainees of Dr. Gotman. The extended summaries provide an overview of historical and current work in the neurophysiology of epilepsy with emphasis on novel EEG biomarkers of epilepsy and source imaging and concluded with an outlook on the future of epilepsy research, and what is needed to bring the field to the next level.
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Affiliation(s)
- B Frauscher
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
| | - C G Bénar
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - J Jr Engel
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - C Grova
- Multimodal Functional Imaging Lab, PERFORM Centre, Department of Physics, Concordia University, Montreal, QC, Canada; Multimodal Functional Imaging Lab, Biomedical Engineering Department, McGill University, QC, Canada; Montreal Neurological Institute and Hospital, Neurology and Neurosurgery Department, McGill University, Montreal, QC, Canada
| | - J Jacobs
- Department of Pediatric and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - P Kahane
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institute Neurosciences, Department of Neurology, 38000 Grenoble, France
| | - S Wiebe
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - M Zjilmans
- Stichting Epilepsie Instellingen Nederland, The Netherlands; Brain Center, University Medical Center Utrecht, The Netherlands
| | - F Dubeau
- Montreal Neurological Institute and Hospital, Neurology and Neurosurgery Department, McGill University, Montreal, QC, Canada
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15
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Khachatryan A, Phillips FM, Lanman TH, Andersson GBJ, Jacobs J, Kurtz S, Pratt S. 183 Proposed Classification System of Radiographic Bone Changes After Cervical Disc Replacement. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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16
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Akbari R, Valdes C, Moguillansky D, Saidi A, Reid J, Bleiweis M, Jacobs J, Peek G, Al-Ani M, Parker A, Vilaro J, Aranda J, Ahmed M. Combined Heart Liver Transplant versus Heart Transplant Alone in Failed Fontan Adult Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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17
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Donoghue T, Cao R, Han CZ, Holman CM, Brandmeir NJ, Wang S, Jacobs J. Single neurons in the human medial temporal lobe flexibly shift representations across spatial and memory tasks. bioRxiv 2023:2023.02.22.529437. [PMID: 36865334 PMCID: PMC9980106 DOI: 10.1101/2023.02.22.529437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Investigations into how individual neurons encode behavioral variables of interest have revealed specific representations in single neurons, such as place and object cells, as well as a wide range of cells with conjunctive encodings or mixed selectivity. However, as most experiments examine neural activity within individual tasks, it is currently unclear if and how neural representations change across different task contexts. Within this discussion, the medial temporal lobe is particularly salient, as it is known to be important for multiple behaviors including spatial navigation and memory, however the relationship between these functions is currently unclear. Here, to investigate how representations in single neurons vary across different task contexts in the MTL, we collected and analyzed single-neuron activity from human participants as they completed a paired-task session consisting of a passive-viewing visual working memory and a spatial navigation and memory task. Five patients contributed 22 paired-task sessions, which were spike sorted together to allow for the same putative single neurons to be compared between the different tasks. Within each task, we replicated concept-related activations in the working memory task, as well as target-location and serial-position responsive cells in the navigation task. When comparing neuronal activity between tasks, we first established that a significant number of neurons maintained the same kind of representation, responding to stimuli presentations across tasks. Further, we found cells that changed the nature of their representation across tasks, including a significant number of cells that were stimulus responsive in the working memory task that responded to serial position in the spatial task. Overall, our results support a flexible encoding of multiple, distinct aspects of different tasks by single neurons in the human MTL, whereby some individual neurons change the nature of their feature coding between task contexts.
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Affiliation(s)
| | - Runnan Cao
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
| | - Claire Z Han
- Department of Biomedical Engineering, Columbia University
| | | | | | - Shuo Wang
- Department of Radiology, Washington University in St. Louis
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University
- Department of Neurological Surgery, Columbia University
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18
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Craig T, Magerl M, Reshef A, Li H, Jacobs J, Bernstein J, Farkas H, Yang W, Stroes E, Ohsawa I, Tachdjian R, Manning M, Lumry W, Saguer IM, Aygören-Pürsün E, Ritchie B, Sussman G, Anderson J, Kawahata K, Suzuki Y, Staubach P, Treudler R, Feuersenger H, Wieman L, Jacobs I. Efficacy and Safety of Subcutaneous Garadacimab for the Prophylaxis of Hereditary Angioedema Attacks in Adults and Adolescent Patients with HAE: Results from a Multicenter, Placebo-Controlled Phase 3 Trial. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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19
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Maurer M, Anderson J, Aygören-Pürsün E, Bouillet L, Baeza ML, Chapdelaine H, Cohn D, Du-Thanh A, Fain O, Farkas H, Greve J, Guilarte M, Hagin D, Hakl R, Jacobs J, Kessell A, Kiani-Alikhan S, Králíčková P, Li H, Bellfill RL, Magerl M, Manning M, Reshef A, Ritchie B, Spadaro G, Staevska M, Staubach P, Stobiecki M, Sussman G, Tarzi M, Valerieva A, Yang W, Jouvin MH, Crabbé R, van Leeuwen S, Chen H, Zhu L, Knolle J, Lesage A, Lu P, Riedl M. Efficacy And Safety Of Bradykinin B2 Receptor Inhibition With Oral PHVS416 In Treating Hereditary Angioedema Attacks: Results Of RAPIDe-1 Phase 2 Trial. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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20
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Jacobs J, Hoyte F, Spahn J, Ambrose C, Martin N, Vong S, Caveney S, Cook B, Colice G. Tezepelumab Efficacy By SNOT-22 Score In Patients With Severe, Uncontrolled Asthma And Comorbid Nasal Polyps In NAVIGATOR. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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21
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Suez D, Wasserman R, Darter A, Perez E, Jacobs J, Siri D, Patterson D, Offenberger J, Lumry W, Scarupa M. Approach to Identification of Patients with Activated Phosphoinositide-3 Kinase Delta Syndrome (APDS). J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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22
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Qasim SE, Mohan UR, Stein JM, Jacobs J. Neuronal activity in the human amygdala and hippocampus enhances emotional memory encoding. Nat Hum Behav 2023; 7:754-764. [PMID: 36646837 DOI: 10.1038/s41562-022-01502-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 11/25/2022] [Indexed: 01/17/2023]
Abstract
Emotional events comprise our strongest and most valuable memories. Here we examined how the brain prioritizes emotional information for storage using direct brain recording and deep brain stimulation. First, 148 participants undergoing intracranial electroencephalographic (iEEG) recording performed an episodic memory task. Participants were most successful at remembering emotionally arousing stimuli. High-frequency activity (HFA), a correlate of neuronal spiking activity, increased in both the hippocampus and the amygdala when participants successfully encoded emotional stimuli. Next, in a subset of participants (N = 19), we show that applying high-frequency electrical stimulation to the hippocampus selectively diminished memory for emotional stimuli and specifically decreased HFA. Finally, we show that individuals with depression (N = 19) also exhibit diminished emotion-mediated memory and HFA. By demonstrating how direct stimulation and symptoms of depression unlink HFA, emotion and memory, we show the causal and translational potential of neural activity in the amygdalohippocampal circuit for prioritizing emotionally arousing memories.
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Affiliation(s)
- Salman E Qasim
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Uma R Mohan
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD, USA
| | - Joel M Stein
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY, USA. .,Department of Neurological Surgery, Columbia University, New York, NY, USA.
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Abstract
Judaism offers a rich body of traditional beliefs and practices surrounding end-of-life, death, mourning, and the afterlife. A more detailed understanding of these topics might prove helpful to clinicians seeking guidance for how best to care for Jewish patients, to anyone supporting dying individuals, or to anyone interested in learning more about the subject. The objectives of this chapter are to examine Jewish approaches to key bioethical issues surrounding palliative care, to analyze meaning-making rituals following a loss, at a funeral, and throughout mourning, and to explore Jewish beliefs in an afterlife. Research was collected from sacred texts, legal codes, modern rabbinic responsa literature, and secondary sources. Core, guiding principles include human beings' creation "in the image of God," an obligation to save life, an obligation to mitigate pain, a prohibition against self-harm and hastening death, respect for the dead, and ritualized mourning periods ("shiva," "shloshim," and "shanah"), which feature special liturgy ("kaddish") and practices. Judaism is a religion that values thorough questioning, debate, and argumentation. It also encompasses diverse cultural and ethnic backgrounds, and various denominations. Many Jews are also unaffiliated with a movement or rarely engage with traditional law altogether. For all of these reasons, no summary can comprehensively encapsulate the wide range of opinions that exist around any given topic. That said, what follows is a detailed overview of traditional Jewish approaches to artificial nutrition/hydration, extubation, dialysis, euthanasia and more. It also outlines rituals surrounding and following death. Finally, views and beliefs of the afterlife are presented, as they often serve to imbue meaning and comfort in times of grief, uncertainty, and transition.
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Affiliation(s)
- Joshua Jacobs
- B'nai Jeshurun Congregation, 27501 Fairmont Boulevard, OH, 44124, Pepper Pike, USA
| | - Patricia Jacobs
- Lynn Cancer Institute, 701 NW 13th Street, Boca Raton, FL, 33486, USA.
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Hermiller MS, Mohan UR, Jacobs J. Frequency-specific response in the human hippocampal-cortical network to intracranial theta-burst stimulation. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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25
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Mohan UR, Zhang H, Jacobs J. Direct cortical stimulation modulates propagation directions of traveling wave in humans. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Kowalczyk W, Romanelli L, Atkins M, Hillen H, Bravo González-Blas C, Jacobs J, Xie J, Soheily S, Verboven E, Moya IM, Verhulst S, de Waegeneer M, Sansores-Garcia L, van Huffel L, Johnson RL, van Grunsven LA, Aerts S, Halder G. Hippo signaling instructs ectopic but not normal organ growth. Science 2022; 378:eabg3679. [DOI: 10.1126/science.abg3679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Hippo signaling pathway is widely considered a master regulator of organ growth because of the prominent overgrowth phenotypes caused by experimental manipulation of its activity. Contrary to this model, we show here that removing Hippo transcriptional output did not impair the ability of the mouse liver and
Drosophila
eyes to grow to their normal size. Moreover, the transcriptional activity of the Hippo pathway effectors Yap/Taz/Yki did not correlate with cell proliferation, and hyperactivation of these effectors induced gene expression programs that did not recapitulate normal development. Concordantly, a functional screen in
Drosophila
identified several Hippo pathway target genes that were required for ectopic overgrowth but not normal growth. Thus, Hippo signaling does not instruct normal growth, and the Hippo-induced overgrowth phenotypes are caused by the activation of abnormal genetic programs.
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Affiliation(s)
- W. Kowalczyk
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - L. Romanelli
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - M. Atkins
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Biological Sciences, Sam Houston State University, Huntsville, TX, USA
| | - H. Hillen
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - C. Bravo González-Blas
- VIB Center for Brain and Disease Research and KU Leuven Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - J. Jacobs
- VIB Center for Brain and Disease Research and KU Leuven Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - J. Xie
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - S. Soheily
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - E. Verboven
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - I. M. Moya
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
- Facultad de Ingeniería y Ciencias Aplicadas, Universidad de Las Américas, Quito, Ecuador
| | - S. Verhulst
- Department for Cell Biology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel-Jette, Belgium
| | - M. de Waegeneer
- VIB Center for Brain and Disease Research and KU Leuven Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - L. Sansores-Garcia
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - L. van Huffel
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
| | - R. L. Johnson
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L. A. van Grunsven
- Department for Cell Biology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel-Jette, Belgium
| | - S. Aerts
- VIB Center for Brain and Disease Research and KU Leuven Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - G. Halder
- VIB Center for Cancer Biology and KU Leuven Department of Oncology, KU Leuven, Leuven, Belgium
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27
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Mathur S, Jacobs J, Ambrose C, Martin N, Colice G, Lindsley A, Martin N. ASTHMA EXACERBATIONS BEFORE AND AFTER TEZEPELUMAB TREATMENT: A POOLED ANALYSIS OF PATHWAY AND NAVIGATOR STUDIES. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Lumry W, Jacobs J, Li H, Milligan S, O'Connor M, Raasch J, Riedl M. DEVELOPMENT OF THE PATIENT-IMPORTANT OUTCOMES NATIONAL DATA REPOSITORY (PIONEER) FOR HEREDITARY ANGIOEDEMA (HAE). Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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29
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Abstract
Episodic memories, or consciously accessible memories of unique events, represent a key aspect of human cognition. Evidence from rodent models suggests that the neural representation of these complex memories requires cooperative firing of groups of neurons on short time scales, organized by gamma oscillations. These co-firing groups, termed "neuronal assemblies," represent a fundamental neurophysiological unit supporting memory. Using microelectrode data from neurosurgical patients, we identify neuronal assemblies in the human MTL and show that they exhibit consistent organization in their firing pattern based on gamma phase information. We connect these properties to memory performance across recording sessions. Finally, we describe how human neuronal assemblies flexibly adjust over longer time scales. Our findings provide key evidence linking assemblies to human episodic memory for the first time.
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Affiliation(s)
- Gray Umbach
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Ryan Tan
- Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, 75235, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - Brad E Pfeiffer
- Department of Neuroscience, University of Texas Southwestern, Dallas, TX, 75235, USA
| | - Bradley Lega
- Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, 75235, USA.
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30
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Liu AA, Henin S, Abbaspoor S, Bragin A, Buffalo EA, Farrell JS, Foster DJ, Frank LM, Gedankien T, Gotman J, Guidera JA, Hoffman KL, Jacobs J, Kahana MJ, Li L, Liao Z, Lin JJ, Losonczy A, Malach R, van der Meer MA, McClain K, McNaughton BL, Norman Y, Navas-Olive A, de la Prida LM, Rueckemann JW, Sakon JJ, Skelin I, Soltesz I, Staresina BP, Weiss SA, Wilson MA, Zaghloul KA, Zugaro M, Buzsáki G. A consensus statement on detection of hippocampal sharp wave ripples and differentiation from other fast oscillations. Nat Commun 2022; 13:6000. [PMID: 36224194 PMCID: PMC9556539 DOI: 10.1038/s41467-022-33536-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/21/2022] [Indexed: 02/05/2023] Open
Abstract
Decades of rodent research have established the role of hippocampal sharp wave ripples (SPW-Rs) in consolidating and guiding experience. More recently, intracranial recordings in humans have suggested their role in episodic and semantic memory. Yet, common standards for recording, detection, and reporting do not exist. Here, we outline the methodological challenges involved in detecting ripple events and offer practical recommendations to improve separation from other high-frequency oscillations. We argue that shared experimental, detection, and reporting standards will provide a solid foundation for future translational discovery.
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Affiliation(s)
- Anli A Liu
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Neuroscience Institute, NYU Langone Medical Center, New York, NY, USA
| | - Simon Henin
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Saman Abbaspoor
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Anatol Bragin
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Elizabeth A Buffalo
- Department of Physiology and Biophysics, Washington National Primate Center, University of Washington, Seattle, WA, USA
| | - Jordan S Farrell
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - David J Foster
- Department of Psychology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Loren M Frank
- Kavli Institute for Fundamental Neuroscience, Center for Integrative Neuroscience and Department of Physiology, University of California San Francisco, San Francisco, CA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Tamara Gedankien
- Department of Biomedical Engineering, Department of Neurological Surgery, Columbia University, New York, NY, USA
| | - Jean Gotman
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Jennifer A Guidera
- Kavli Institute for Fundamental Neuroscience, Center for Integrative Neuroscience and Department of Physiology, University of California San Francisco, San Francisco, CA, USA
- Medical Scientist Training Program, Department of Bioengineering, University of California, San Francisco, San Francisco, CA, USA
| | - Kari L Hoffman
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Department of Neurological Surgery, Columbia University, New York, NY, USA
| | - Michael J Kahana
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lin Li
- Department of Biomedical Engineering, University of North Texas, Denton, TX, USA
| | - Zhenrui Liao
- Department of Neuroscience, Columbia University, New York, NY, USA
| | - Jack J Lin
- Department of Neurology, Center for Mind and Brain, University of California Davis, Oakland, CA, USA
| | - Attila Losonczy
- Department of Neuroscience, Columbia University, New York, NY, USA
| | - Rafael Malach
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
| | | | - Kathryn McClain
- Neuroscience Institute, NYU Langone Medical Center, New York, NY, USA
| | - Bruce L McNaughton
- The Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Yitzhak Norman
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | | | - Jon W Rueckemann
- Department of Physiology and Biophysics, Washington National Primate Center, University of Washington, Seattle, WA, USA
| | - John J Sakon
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ivan Skelin
- Department of Neurology, Center for Mind and Brain, University of California Davis, Oakland, CA, USA
| | - Ivan Soltesz
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Bernhard P Staresina
- Department of Experimental Psychology, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Shennan A Weiss
- Brookdale Hospital Medical Center, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Matthew A Wilson
- Department of Brain and Cognitive Sciences and Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kareem A Zaghloul
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, MD, USA
| | - Michaël Zugaro
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
| | - György Buzsáki
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA.
- Neuroscience Institute, NYU Langone Medical Center, New York, NY, USA.
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31
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Jacobs J, L'hoyes W, Lauwens L, Weltens C, Voigt JU, Wildiers H, Neven P, Herrmann J, Thijs L, Staessen J, Janssens S, Van Aelst L. Mortality and major adverse cardiac events in women with breast cancer receiving radiotherapy: a 10-year cohort study of patients and population controls. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Treatment for breast cancer (BC) frequently involves radiotherapy. Guidelines recommend screening for cardiac adverse events starting 10 years after radiotherapy. The rationale for recommending this interval is unclear and informed the objective of this study.
Objectives
Study cardiovascular event rates in the first decade following curative radiotherapy for breast cancer, the time frame before guidelines recommend screening.
Methods
We performed a monocentric, retrospective study enrolling all women with unilateral BC in 2007–2008, who received radiotherapy as part of their curative treatment. We compared event rates during 10 years follow-up with an age and risk factor-matched control population (FLEMENGHO population).
Results
We included 1095 BC patients (median age 55y, IQR: 47–66y). Two hundred and eighteen (19.9%) women died. Cancer and cardiovascular mortality accounted for 107 (49.1%) and 22 (10.1%) deaths, respectively. The incidence of coronary artery disease was similar compared to age and risk-matched women [risk ratio 0.75 (95% CI 0.48–1.18)], yet heart failure (HF) [risk ratio 1.97 (95% CI 1.19–3.25)] and atrial fibrillation or flutter (AF) (risk ratio 1.82 (95% CI 1.07–3.08) occurred more often. Age [HR 1.040 (95% CI 1.012–1.069)], tumor grade [HR 1.646 (95% CI 1.103–2.458)], and neo-adjuvant treatment setting [HR 3.079 (95% CI 1.432–6.620)] were risk factors for mortality; hormonal therapy [HR 0.007 (95% CI 0.001–0.042)] proved protective. Risk factors for MACE were mean heart dose [HR 1.079 (95% CI 1.012–1.151], hormonal therapy, history of cardiovascular disease [HR 2.771 (95% CI 1.253–6.126)], and Mayo Clinic Cardiotoxicity Risk Score [HR 2.547 (95% CI 1.538–4.217)]. While mean heart dose [HR 1.141 (95% CI 1.017–1.282)] and cardiovascular history [HR 3.374 (95% CI 1.259–9.043] clearly associated with new onset HF, only a trend towards higher AF burden with increasing mean heart dose could be observed.
Conclusions
Ten-year mortality following curative treatment for unilateral BC was mainly cancer-related. HF and AF constituted significantly increased risks in the first decade following irradiation. Mean heart dose, pre-existing cardiovascular diseases, and Mayo Clinic Cardiotoxicity Risk Score were risk factors for early cardiac mortality and adverse events and should guide early dedicated cardio-oncological follow-up.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Jacobs
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - W L'hoyes
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - L Lauwens
- University Hospitals (UZ) Leuven, Radiation Oncology , Leuven , Belgium
| | - C Weltens
- University Hospitals (UZ) Leuven, Radiation Oncology , Leuven , Belgium
| | - J U Voigt
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - H Wildiers
- University Hospitals (UZ) Leuven, Medical Oncology , Leuven , Belgium
| | - P Neven
- University Hospitals (UZ) Leuven, Gynaecology , Leuven , Belgium
| | - J Herrmann
- Mayo Clinic, Cardiology , Rochester , United States of America
| | - L Thijs
- University of Leuven, Cardiovascular sciences , Leuven , Belgium
| | - J Staessen
- University of Leuven, Cardiovascular sciences , Leuven , Belgium
| | - S Janssens
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - L Van Aelst
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
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32
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Laenens D, Yu Y, Santens B, Jacobs J, Beuselinck B, Bechter O, Wauters E, Staessen J, Janssens S, Van Aelst L. Incidence of cardiovascular events in patients treated with immune checkpoint inhibitors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In rare cases, immune checkpoint inhibitors (ICIs) cause immune-mediated myocarditis. However, the true incidence of other major adverse cardiovascular events (MACE) following ICI treatment remains unknown, mainly because late occurring side effects are rarely reported in prospective clinical trials.
Purpose
To identify the incidence and risk factors of MACE in a real-life ICI-treated cancer cohort and to compare the incidence with non-ICI-treated cancer patients and population controls.
Methods
In total, 672 ICI-treated patients were included. The primary endpoint was MACE, a composite of acute coronary syndrome, heart failure, stroke and transient ischemic attack. Secondary outcomes were acute coronary syndrome and heart failure separately. Incidence rates were compared between groups after matching according to age, sex, cardiovascular history and cancer type.
Results
Incidence of MACE was 10.3% during a median time of follow-up of 13 months (IQR 6 to 22). In multivariable analysis, a history of heart failure (hazard ratio (HR): 2.27; 95% confidence interval (CI): 1.03 to 5.04; p=0.043) and valvular heart disease (HR 3.01; 95% CI: 1.05 to 8.66; p=0.041) remained significantly associated with MACE.
Cumulative incidence rates were significantly higher in the matched ICI group (rate at full range of follow-up (rate): 8.51; 95% CI: 6.18 to 11.4) compared with the cancer cohort not exposed to ICI (rate: 5.20; 95% CI: 3.56 to 7.35; p=0.032) and the population controls (rate: 2.55; 95% CI: 2.16 to 2.99; p<0.001) mainly driven by a higher risk of heart failure events (Figure 1).
Conclusions
Cardiovascular events during and after ICI treatment are more common than currently appreciated. Patients at risk are those with a history of cardiovascular disease. Compared with matched cancer and population controls, MACE incidence rates are significantly higher, suggesting a potential harmful effect of ICI treatment besides the underlying risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Laenens
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - Y Yu
- University of Leuven, Public Health and Primary Care , Leuven , Belgium
| | - B Santens
- University of Leuven, Cardiovascular Sciences , Leuven , Belgium
| | - J Jacobs
- University of Leuven, Cardiovascular Sciences , Leuven , Belgium
| | - B Beuselinck
- University Hospitals (UZ) Leuven, Medical Oncology , Leuven , Belgium
| | - O Bechter
- University Hospitals (UZ) Leuven, Medical Oncology , Leuven , Belgium
| | - E Wauters
- University Hospitals (UZ) Leuven, Pneumology , Leuven , Belgium
| | - J Staessen
- University of Leuven, Biomedical Sciences Group , Leuven , Belgium
| | - S Janssens
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - L Van Aelst
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
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33
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Shackles C, Jacobs J, Herman K, Rundback J. Abstract No. 520 Recanalization of complex SFA/popliteal artery CTOs utilizing rendezvous techniques from an anterior fluoroscopically guided, retrograde popliteal access. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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34
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Das A, Myers J, Mathura R, Shofty B, Metzger BA, Bijanki K, Wu C, Jacobs J, Sheth SA. Spontaneous neuronal oscillations in the human insula are hierarchically organized traveling waves. eLife 2022; 11:76702. [PMID: 35616527 PMCID: PMC9200407 DOI: 10.7554/elife.76702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
The insula plays a fundamental role in a wide range of adaptive human behaviors, but its electrophysiological dynamics are poorly understood. Here, we used human intracranial electroencephalographic recordings to investigate the electrophysiological properties and hierarchical organization of spontaneous neuronal oscillations within the insula. We analyzed the neuronal oscillations of the insula directly and found that rhythms in the theta and beta frequency oscillations are widespread and spontaneously present. These oscillations are largely organized along the anterior–posterior (AP) axis of the insula. Both the left and right insula showed anterior-to-posterior decreasing gradients for the power of oscillations in the beta frequency band. The left insula also showed a posterior-to-anterior decreasing frequency gradient and an anterior-to-posterior decreasing power gradient in the theta frequency band. In addition to measuring the power of these oscillations, we also examined the phase of these signals across simultaneous recording channels and found that the insula oscillations in the theta and beta bands are traveling waves. The strength of the traveling waves in each frequency was positively correlated with the amplitude of each oscillation. However, the theta and beta traveling waves were uncoupled to each other in terms of phase and amplitude, which suggested that insular traveling waves in the theta and beta bands operate independently. Our findings provide new insights into the spatiotemporal dynamics and hierarchical organization of neuronal oscillations within the insula, which, given its rich connectivity with widespread cortical regions, indicates that oscillations and traveling waves have an important role in intrainsular and interinsular communications.
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Affiliation(s)
- Anup Das
- Department of Biomedical Engineering, Columbia University, New York, United States
| | - John Myers
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
| | - Raissa Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
| | - Ben Shofty
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
| | - Brian A Metzger
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
| | - Kelly Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
| | - Chengyuan Wu
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, United States
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, United States
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, United States
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35
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Berardi G, Frey-Law L, Sluka KA, Bayman EO, Coffey CS, Ecklund D, Vance CGT, Dailey DL, Burns J, Buvanendran A, McCarthy RJ, Jacobs J, Zhou XJ, Wixson R, Balach T, Brummett CM, Clauw D, Colquhoun D, Harte SE, Harris RE, Williams DA, Chang AC, Waljee J, Fisch KM, Jepsen K, Laurent LC, Olivier M, Langefeld CD, Howard TD, Fiehn O, Jacobs JM, Dakup P, Qian WJ, Swensen AC, Lokshin A, Lindquist M, Caffo BS, Crainiceanu C, Zeger S, Kahn A, Wager T, Taub M, Ford J, Sutherland SP, Wandner LD. Multi-Site Observational Study to Assess Biomarkers for Susceptibility or Resilience to Chronic Pain: The Acute to Chronic Pain Signatures (A2CPS) Study Protocol. Front Med (Lausanne) 2022; 9:849214. [PMID: 35547202 PMCID: PMC9082267 DOI: 10.3389/fmed.2022.849214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic pain has become a global health problem contributing to years lived with disability and reduced quality of life. Advances in the clinical management of chronic pain have been limited due to incomplete understanding of the multiple risk factors and molecular mechanisms that contribute to the development of chronic pain. The Acute to Chronic Pain Signatures (A2CPS) Program aims to characterize the predictive nature of biomarkers (brain imaging, high-throughput molecular screening techniques, or "omics," quantitative sensory testing, patient-reported outcome assessments and functional assessments) to identify individuals who will develop chronic pain following surgical intervention. The A2CPS is a multisite observational study investigating biomarkers and collective biosignatures (a combination of several individual biomarkers) that predict susceptibility or resilience to the development of chronic pain following knee arthroplasty and thoracic surgery. This manuscript provides an overview of data collection methods and procedures designed to standardize data collection across multiple clinical sites and institutions. Pain-related biomarkers are evaluated before surgery and up to 3 months after surgery for use as predictors of patient reported outcomes 6 months after surgery. The dataset from this prospective observational study will be available for researchers internal and external to the A2CPS Consortium to advance understanding of the transition from acute to chronic postsurgical pain.
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Affiliation(s)
- Giovanni Berardi
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Laura Frey-Law
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Emine O. Bayman
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Christopher S. Coffey
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Dixie Ecklund
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Carol G. T. Vance
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Dana L. Dailey
- Department of Physical Therapy, St. Ambrose University, Davenport, IA, United States
| | - John Burns
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Asokumar Buvanendran
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Robert J. McCarthy
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Joshua Jacobs
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Xiaohong Joe Zhou
- Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| | - Richard Wixson
- NorthShore Orthopaedic and Spine Institute, NorthShore University HealthSystem, Skokie, IL, United States
| | - Tessa Balach
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, IL, United States
| | - Chad M. Brummett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Daniel Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Douglas Colquhoun
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
| | - Richard E. Harris
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
| | - David A. Williams
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Andrew C. Chang
- Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Jennifer Waljee
- Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Kathleen M. Fisch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Kristen Jepsen
- Institute of Genomic Medicine Genomics Center, University of California, San Diego, La Jolla, CA, United States
| | - Louise C. Laurent
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Michael Olivier
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Timothy D. Howard
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, Davis, CA, United States
| | - Jon M. Jacobs
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Panshak Dakup
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Wei-Jun Qian
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Adam C. Swensen
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Anna Lokshin
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Martin Lindquist
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Brian S. Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ari Kahn
- Texas Advanced Computing Center, The University of Texas at Austin, Austin, TX, United States
| | - Tor Wager
- Presidential Cluster in Neuroscience, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Margaret Taub
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - James Ford
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Stephani P. Sutherland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Laura D. Wandner
- National Institute of Neurological Disorders and Stroke, The National Institutes of Health, Bethesda, MD, United States
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Philip J, Powers E, Jacobs J, Peek G, Hernandez-Rivera J, Brock M, Bleiweis M. VAD Support of High-Risk Infants with HLHS: Comparison of Rescue VAD After Prior Palliation versus Primary VAD Insertion. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Jacobs J, Schroder J, Boston U, Zuckermann A. First Report of Pediatric Outcomes from the GUARDIAN Registry: Multi-Center Analysis of Advanced Organ Preservation for Pediatric Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Zessin P, Jacobs J, Justice MM, Mullenix MK, Dillard LL, Rodning SP, Tigue AA. 29 Cotton Gin Trash Processing, Quality and Safety Impacts on Feeding Recommendations for Beef Cattle. J Anim Sci 2022. [DOI: 10.1093/jas/skac028.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Cotton gin trash is a byproduct of the cotton industry that consists of any remaining plant material leftover after the ginning process. The objective of this study was to determine intake, animal performance, and safety of using loose or baled gin trash in beef cattle diets. Sixteen crossbred, non-lactating, gestating cows and 8 crossbred, gestating heifers were randomly assigned to one of two groups consisting of 8 cows and 4 heifers per group for a 60-day intake trial utilizing the Calan Gate ® system. After a training period, each group was assigned to receive one of two dietary treatments: 1) ad libitum baled cotton gin trash or 2) ad libitum loose cotton gin trash, each with 2.2 kg of a 50:50 mixture of corn gluten feed and soyhull pellets per day to meet nutritional requirements for their stage of production. Animal body weight (BW) and body condition scores (BCS) were recorded at days 0, 30, and 60. Jugular blood samples were collected weekly to monitor clinical animal immune responses due to feeding cotton gin trash containing cotton defoliant residue (4.84 ppm and 1.98 ppm tribufos for baled and loose, respectively). Intake was greater (P < 0.0001) for cattle consuming loose than baled gin trash. All cattle maintained or gained BW across treatments during the trial. On average throughout the study cattle consuming baled gin trash had greater BCS (P = 0.0173) than cattle fed loose gin trash, although animals maintained a BCS of 6 or greater during the study. Red blood cell count, hemoglobin, hematocrit, and white blood cell count were within normal ranges for beef cattle during the trial. Cotton gin trash in either loose or baled form can be used to maintain non-lactating, bred cows with little additional energy supplementation, providing an outlet for cotton byproduct usage in beef operations in the Southeast United States.
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Banerji A, Bernstein JA, Johnston DT, Lumry WR, Magerl M, Maurer M, Martinez‐Saguer I, Zanichelli A, Hao J, Inhaber N, Yu M, Riedl MA, Hébert J, Ritchie B, Sussman G, Yang W, Aygören‐Pürsün E, Magerl M, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz R, Kiani‐Alikhan S, Anderson J, Banerji A, Baptist A, Bernstein J, Busse P, Craig T, Davis‐Lorton M, Gierer S, Gower R, Harris D, Jacobs J, Johnston D, Li H, Lockey R, Lugar P, Lumry W, Manning M, McNeil D, Melamed I, Otto W, Rehman S, Riedl M, Schwartz L, Shapiro R, Sher E, Smith A, Soteres D, Tachdjian R, Wedner H, Weinstein M, Zafra H. Long-term prevention of hereditary angioedema attacks with lanadelumab: The HELP OLE Study. Allergy 2022; 77:979-990. [PMID: 34287942 PMCID: PMC9292251 DOI: 10.1111/all.15011] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/06/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
Background The aim was to evaluate long‐term effectiveness and safety of lanadelumab in patients ≥12 y old with hereditary angioedema (HAE) 1/2 (NCT02741596). Methods Rollover patients completing the HELP Study and continuing into HELP OLE received one lanadelumab 300 mg dose until first attack (dose‐and‐wait period), then 300 mg q2wks (regular dosing stage). Nonrollovers (newly enrolled) received lanadelumab 300 mg q2wks from day 0. Baseline attack rate for rollovers: ≥1 attack/4 weeks (based on run‐in period attack rate during HELP Study); for nonrollovers: historical attack rate ≥1 attack/12 weeks. The planned treatment period was 33 months. Results 212 patients participated (109 rollovers, 103 nonrollovers); 81.6% completed ≥30 months on study (mean [SD], 29.6 [8.2] months). Lanadelumab markedly reduced mean HAE attack rate (reduction vs baseline: 87.4% overall). Patients were attack free for a mean of 97.7% of days during treatment; 81.8% and 68.9% of patients were attack free for ≥6 and ≥12 months, respectively. Angioedema Quality‐of‐Life total and domain scores improved from day 0 to end of study. Treatment‐emergent adverse events (TEAEs) (excluding HAE attacks) were reported by 97.2% of patients; most commonly injection site pain (47.2%) and viral upper respiratory tract infection (42.0%). Treatment‐related TEAEs were reported by 54.7% of patients. Most injection site reactions resolved within 1 hour (70.2%) or 1 day (92.6%). Six (2.8%) patients discontinued due to TEAEs. No treatment‐related serious TEAEs or deaths were reported. Eleven treatment‐related TEAEs of special interest were reported by seven (3.3%) patients. Conclusion Lanadelumab demonstrated sustained efficacy and acceptable tolerability with long‐term use in HAE patients.
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Affiliation(s)
- Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Department of Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Jonathan A. Bernstein
- Division of Immunology/Allergy Section Department of Internal Medicine University of Cincinnati, and Bernstein Clinical Research Center Cincinnati Ohio USA
| | | | | | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité–Universitätsmedizin Berlin Berlin Germany
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité–Universitätsmedizin Berlin Berlin Germany
| | | | - Andrea Zanichelli
- Department of Internal Medicine ASST Fatebenefratelli Sacco, Ospedale Luigi Sacco‐University of Milan Milan Italy
| | - James Hao
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Neil Inhaber
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Ming Yu
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Marc A. Riedl
- Division of Rheumatology, Allergy and Immunology University of California San Diego La Jolla California USA
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Lorusso ND, Mohan UR, Jacobs J. Jose Delgado: A controversial trailblazer in neuromodulation. Artif Organs 2022; 46:531-540. [PMID: 35199350 DOI: 10.1111/aor.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/29/2021] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
Dr. Jose Delgado performed audacious demonstrations utilizing brain stimulation to instantly change behavior in animals. These feats spark ethical debates to this day. However, behind his controversial career is an important legacy of neurological discoveries and technological innovation. Delgado pioneered techniques in causally manipulating brain patterns and behavior with electrical stimulation and developed innovative, closed-loop neural devices. His inventive devices and techniques were ahead of his time and remain relevant to the field of neuromodulation today.
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Affiliation(s)
| | - Uma R Mohan
- Department of Biomedical Engineering, Columbia University, New York, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, USA.,Department of Neurological Surgery, Columbia University, New York, USA
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Jacobs J, Guler I, Janssens S, Van Aelst L. Predictability of cardiotoxicity at a Belgian cardio-oncology clinic without mandatory physician referral. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and purpose
Increased morbidity and mortality caused by side-effects of cancer treatment on cardiovascular function mandates careful monitoring and shared decision-making in cardio-oncology clinics. We report the experience of the cardio-oncology clinic at a large Belgian tertiary care center, without mandatory physician referral, and investigated the predictability of cardiotoxicity based on pre-existing cardiovascular risk factors, specific cancer treatment and existing risk scores of the American Society of Clinical Oncology (ASCO) and Mayo Clinic.
Methods
We included all patients seen at the outpatient cardio-oncology clinic between May 2018 and September 2020. We defined cardiotoxicity as a decline in ejection fraction (EF) of 10% in asymptomatic patients and 5% in symptomatic patients. Approval of the ethical committee was obtained (S65084).
Results
The majority were women (68%), with almost half (44%) having metastatic disease. Mean age was 63.4±16.0 years. The most frequent oncological diagnoses were breast cancer (33%) and haematological diseases (24%). Patients most frequently received radiation therapy (42%), anthracyclines (39%) and antimetabolites (35%). Mean follow-up was 443±245 days.
Receiver operating characteristic (ROC) analysis of predictors of cardiotoxicity showed an area under the curve (AUC) of 0.580 (CI 95% bootstrap: 0.525–0.642) for cardiovascular risk factors alone, and an AUC of 0.613 (CI 95% bootstrap: 0.550–0.676) when treatment was added to the model. The ASCO risk score poorly predicted cardiotoxicity (sensitivity 64%, specificity 52%). The Mayo Clinic cardiotoxicity risk score was the best predictor of cardiotoxicity with an AUC of 0.685 (CI 95% bootstrap: 0.625–0.743).
Discussion
Classic cardiovascular risk factors alone, or in combination with the proposed cancer treatment cannot adequately predict cardiotoxicity risk. The Mayo Clinic Cardiotoxicity Risk score outperformed the ASCO risk score but requires further refinement to enhance adequate cardiovascular risk prediction. For future model building, we hypothesize that an all-comer population of oncological patients should be used as a derivation cohort, regardless of previous or current cardiac issues, risk factors or type of therapy. Admittedly, individual susceptibility due to genetic, epigenetic and environmental predisposition cannot be adequately incorporated into a risk score and emphasizes the need for individual cardiotoxicity risk evaluation using bed to bench tools such as the use of induced pluripotent stem cell derived cardiac or vascular cells to assess the susceptibility of individual patients to cancer drug-induced cardiovascular toxicities. In the absence of adequate risk prediction tools, we advocate standardized screening of all patients before oncological treatment starts.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Cardiotoxicity
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Affiliation(s)
- J Jacobs
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - I Guler
- KU Leuven, Leuven biostatistics and statistical bioinformatics Centre (L-Biostat)., Leuven, Belgium
| | - S Janssens
- University Hospitals (UZ) Leuven, Leuven, Belgium
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Corren J, Saini SS, Gagnon R, Moss MH, Sussman G, Jacobs J, Laws E, Chung ES, Constant T, Sun Y, Maloney J, Hamilton JD, Ruddy M, Wang CQ, O'Brien MP. Short-Term Subcutaneous Allergy Immunotherapy and Dupilumab are Well Tolerated in Allergic Rhinitis: A Randomized Trial. J Asthma Allergy 2021; 14:1045-1063. [PMID: 34429614 PMCID: PMC8379710 DOI: 10.2147/jaa.s318892] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background Subcutaneous immunotherapy (SCIT) has been proven as an effective therapy against some allergens for seasonal allergic rhinitis (SAR) patients unresponsive to intranasal corticosteroids and/or antihistamines but carries risk of systemic allergic reactions. Dupilumab blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation in multiple diseases. Objective To evaluate the efficacy and safety of SCIT+dupilumab vs SCIT alone. Methods This phase 2a, multicenter, double-blind, placebo-controlled parallel-group study conducted in 103 adults with grass pollen-induced SAR (NCT03558997) randomized patients 1:1:1:1 to SCIT, dupilumab (300 mg every 2 weeks), SCIT+dupilumab, or placebo. SCIT was administered using an 8-week cluster protocol followed by 8 weeks of maintenance injections. Primary endpoint was change from pre-treatment baseline in area under the curve (AUC) in total nasal symptom score (TNSS) 0-1 h following nasal allergen challenge (NAC) with timothy grass extract at Week 17. Results Although 16 weeks of treatment with SCIT+dupilumab did not significantly improve TNSS AUC (0-1 h) following NAC at Week 17 vs SCIT (least squares mean -56.76% vs -52.03%), a higher proportion of SCIT+dupilumab-treated patients (61.5%) achieved SCIT maintenance dose vs SCIT (46.2%). A lower proportion of SCIT+dupilumab-treated patients (7.7%) required epinephrine rescue treatment vs SCIT (19.2%). There were significantly fewer withdrawals in the SCIT+dupilumab group than in the SCIT group (n = 2 [7.7%] vs n = 8 [30.8%]; P = 0.0216); the majority of SCIT group withdrawals were due to SCIT-related intolerability, compared with no discontinuations from the SCIT+dupilumab group. Conclusion In SAR patients, 16 weeks of SCIT+dupilumab may improve SCIT tolerability but did not incrementally reduce post-allergen challenge nasal symptoms compared with SCIT alone. Clinical Study Number NCT03558997.
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Affiliation(s)
- Jonathan Corren
- Departments of Medicine and Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Sarbjit S Saini
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA
| | - Remi Gagnon
- Clinique Spécialisée en Allergie de la Capitale, Québec, QC, Canada
| | - Mark H Moss
- Departments of Medicine and Pediatrics, Division of Allergy, Pulmonary and Critical Care, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gordon Sussman
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joshua Jacobs
- Allergy and Asthma Clinical Research, Inc, Walnut Creek, CA, USA
| | | | | | | | - Yiping Sun
- Regeneron Pharmaceuticals, Inc, Tarrytown, NY, USA
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Dedulle A, Fitousi N, Jacobs J, Marshall NW, Bosmans H. A methodology to estimate the patient diameter and thickness from thoracic and abdominal projection radiographs of adult patients. Phys Med Biol 2021; 66. [PMID: 34157703 DOI: 10.1088/1361-6560/ac0d8c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/22/2021] [Indexed: 11/12/2022]
Abstract
Patient dose management systems can be part of a department's quality management tools to estimate items such as the radiation burden in specific groups or list dose outliers for further follow up. Patient size information could improve both aspects, but is not generally available. A new metric is proposed to estimate patient size for thorax and abdominal projection radiography from parameters available in thedicomheader and therefore accessible by dose management software. The tested hypothesis was that an attenuation metric, related to the ratio of detector air-kerma to incident air-kerma, inversely correlates with patient size. Such a metric was defined and then worked out for thorax and abdomen projection radiography. Input material consisted of the thorax or abdominal radiographs of 137 cases, completed with a recent CT scan as ground truth size. From the CT, the water equivalent diameter (WED) and water equivalent thickness (WET) were calculated. The correlation between the attenuation metric and the patient size was established separately for thorax and abdomen. Validation of the attenuation metric predicting the patient size was performed using extra sets of examinations on three more radiographic x-ray devices, with available CT scan. The attenuation metric had a good correlation (R2) of 0.91 and 0.84 with the WED for thorax and abdomen respectively. The corresponding values for the WET were 0.89 and 0.78. Validation of the methodology on the devices with standardized exposure index in thedicomheaders showed that the WED could be estimated within ±15% and the WET within ±30% for thorax and abdomen examinations. The ground truth and estimated size were found statistically equivalent. An attenuation metric based ondicomtags allows to estimate the patient size in projection radiography. This could now be implemented in patient dose management systems.
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Affiliation(s)
- A Dedulle
- Research Department, Qaelum NV, Leuven, B-3001, Belgium.,Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, University of Leuven, Leuven, B-3000, Belgium
| | - N Fitousi
- Research Department, Qaelum NV, Leuven, B-3001, Belgium
| | - J Jacobs
- Research Department, Qaelum NV, Leuven, B-3001, Belgium
| | - N W Marshall
- Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, University of Leuven, Leuven, B-3000, Belgium.,Department of Radiology, University Hospitals Leuven, Leuven, B-3000, Belgium
| | - H Bosmans
- Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, University of Leuven, Leuven, B-3000, Belgium.,Department of Radiology, University Hospitals Leuven, Leuven, B-3000, Belgium
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Jacobs J, Neeno T. The importance of recognizing and managing a rare form of angioedema: hereditary angioedema due to C1-inhibitor deficiency. Postgrad Med 2021; 133:639-650. [PMID: 33993830 DOI: 10.1080/00325481.2021.1905364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The majority of angioedema cases encountered in clinical practice are histamine-mediated (allergic); however, some cases are bradykinin-related (non-allergic) and do not respond to standard anti-allergy medications. Among bradykinin-related angioedema, hereditary angioedema (HAE) is a rare, but chronic and debilitating condition. The majority of HAE is caused by deficiency (type 1) or abnormal function (type 2) of the naturally occurring protein, C1-inhibitor (C1-INH)-a major inhibitor of proteases in the contact (kallikrein-bradykinin cascade), fibrinolytic pathway, and complement systems. Failure to recognize HAE and initiate appropriate intervention can lead to years of pain, disability, impaired quality of life (QoL) and, in cases of laryngeal involvement, it can be life-threatening. HAE must be considered in the differential diagnosis of non-urticarial angioedema, particularly for patients with a history of recurrent angioedema attacks, family history of HAE, symptom onset in childhood/adolescence, prodromal signs/symptoms before swellings, recurrent/painful abdominal symptoms, and upper airway edema. Management strategies for HAE include on-demand treatment for acute attacks, short-term prophylaxis prior to attack-triggering events/procedures, and long-term or routine prophylaxis for attack prevention. Patients should be evaluated at least annually to assess need for routine prophylaxis. HAE specific medications like plasma-derived and recombinant C1-INH products, kallikrein inhibitors, and bradykinin B2 receptor antagonists, have improved management of HAE. While the introduction of intravenous C1-INH represented a major breakthrough in routine HAE prophylaxis, some patients fail to achieve adequate control and others have psychological barriers or experience complications related to intravenous administration. Subcutaneous (SC) C1-INH, SC monoclonal antibody (mAb)-based therapies, and an oral kallikrein inhibitor offer effective alternatives for HAE attack prevention and may facilitate self-administration. HAE management should be individualized, with QoL improvement being a key goal. This can be achieved with broader availability of existing options for routine prophylaxis, including greater global availability of C1-INH(SC), mAb-based therapy, oral treatments, and multiple on-demand therapies.
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Affiliation(s)
- Joshua Jacobs
- Department of Clinical Research, Allergy and Asthma Clinical Research, Inc., Walnut Creek, CA, USA
| | - Teresa Neeno
- Department of Internal Medicine, Northern CA VA Health Care System, Martinez Outpatient Clinic, Martinez, CA, USA
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Abstract
Knowing where we are, where we have been, and where we are going is critical to many behaviors, including navigation and memory. One potential neuronal mechanism underlying this ability is phase precession, in which spatially tuned neurons represent sequences of positions by activating at progressively earlier phases of local network theta oscillations. Based on studies in rodents, researchers have hypothesized that phase precession may be a general neural pattern for representing sequential events for learning and memory. By recording human single-neuron activity during spatial navigation, we show that spatially tuned neurons in the human hippocampus and entorhinal cortex exhibit phase precession. Furthermore, beyond the neural representation of locations, we show evidence for phase precession related to specific goal states. Our findings thus extend theta phase precession to humans and suggest that this phenomenon has a broad functional role for the neural representation of both spatial and non-spatial information.
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Affiliation(s)
- Salman E Qasim
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Itzhak Fried
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA.
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Samelko L, Caicedo M, McAllister K, Jacobs J, Hallab NJ. Metal-induced delayed type hypersensitivity responses potentiate particle induced osteolysis in a sex and age dependent manner. PLoS One 2021; 16:e0251885. [PMID: 34003868 PMCID: PMC8130946 DOI: 10.1371/journal.pone.0251885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022] Open
Abstract
It is widely recognized that innate macrophage immune reactions to implant debris are central to the inflammatory responses that drive biologic implant failure over the long term. Less common, adaptive lymphocyte immune reactions to implant debris, such as delayed type hypersensitivity (DTH), can also affect implant performance. It is unknown which key patient factors, if any, mediate these adaptive immune responses that potentiate particle/macrophage mediated osteolysis. The objective of this investigation was to determine to what degree known adaptive immune responses to metal implant debris can affect particle-induced osteolysis (PIO); and if this pathomechanism is dependent on: 1) innate immune danger signaling, i.e., NLRP3 inflammasome activity, 2) sex, and/or 3) age. We used an established murine calvaria model of PIO using male and female wild-type C57BL/6 vs. Caspase-1 deficient mice as well as young (12–16 weeks old) vs. aged (18–24 months old) female and male C57BL/6 mice. After induction of metal-DTH, and Cobalt-alloy particle (ASTM F-75, 0.4um median diameter) calvaria challenge, bone resorption was assessed using quantitative micro-computed tomography (micro-CT) analysis and immune responses were assessed by measuring paw inflammation, lymphocyte transformation test (LTT) reactivity and adaptive immune cytokines IFN-gamma and IL-17 (ELISA). Younger aged C57BL/6 female mice exhibited the highest rate and severity of metal sensitivity lymphocyte responses that also translated into higher PIO compared to any other experimental group. The absence of inflammasome/caspase-1 activity significantly suppressed DTH metal-reactivity and osteolysis in both male and female Caspase-1 deficient mice. These murine model results indicate that young female mice are more predisposed to metal-DTH augmented inflammatory responses to wear debris, which is highly influenced by active NLRP3 inflammasome/caspase-1 danger signaling. If these results are clinically meaningful for orthopedic patients, then younger female individuals should be appropriately assessed and followed for DTH derived peri-implant complications.
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Affiliation(s)
- Lauryn Samelko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States of America
| | - Marco Caicedo
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States of America
| | - Kyron McAllister
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States of America
| | - Joshua Jacobs
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States of America
| | - Nadim James Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States of America
- * E-mail:
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Gendo K, Orden T, Tevrizian A, Jacobs J, Mozelsio N, Gilbert K, Lodewick M. Food Sublingual Immunotherapy Using Consistent, Cheaper and Customizable Oral Immunotherapy Solutions. J Asthma Allergy 2021; 14:467-470. [PMID: 33981149 PMCID: PMC8109147 DOI: 10.2147/jaa.s307853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
Food SLIT (sublingual immunotherapy) is a food desensitization method with a daily maintenance dose of <10 mg for up to 5 years. Many protocols use commercially available skin test extracts. Oral immunotherapy (OIT) treatment solutions have consistent protein concentrations, are comparatively cheaper and customizable and therefore were adapted for use in a published SLIT dosing schedule.
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Affiliation(s)
- Karna Gendo
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Tony Orden
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Allyson Tevrizian
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Joshua Jacobs
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Nancy Mozelsio
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Katherine Gilbert
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
| | - Matthew Lodewick
- Allergy and Asthma Medical Group of the Bay Area, Walnut Creek, CA, 94598, USA
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Sluka K, Law LF, Coffey C, Bayman E, Ecklund D, Vance C, Dailey D, Wager T, Lindquist M, Kahn A, Burns J, McCarthy R, Jacobs J, Buvanendran A, Zhou X, Brummett C, Clauw D, Williams D. Conceptual Design and Protocol for the Acute to Chronic Pain Signatures Program (A2CPS). The Journal of Pain 2021. [DOI: 10.1016/j.jpain.2021.03.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Muroya S, Ohde S, Takahashi O, Jacobs J, Fukui T. Differences in clinical knowledge levels between residents in two post-graduate rotation programmes in Japan. BMC Med Educ 2021; 21:226. [PMID: 33882929 PMCID: PMC8059995 DOI: 10.1186/s12909-021-02651-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In Japan, between 2010 and 2020, there were two post-graduate training curricula for post-graduate medical education, as follows: comprehensive rotation programmes (CRPs), which require rotation in at least seven clinical departments; and limited rotation programmes (LRPs), which require rotation in fewer clinical departments. The curriculum that should be used for standardized Japanese post-graduate training has long been debated. Multiple studies show that post-graduate trainees who trained with CRPs were more satisfied and confident and gained more clinical experience than those who trained with LRPs. However, a comparison of objective measurements of the clinical knowledge of Japanese post-graduate trainees has not been reported. The aim of this study is to objectively measure and compare the clinical knowledge of trainees in CRPs and LRPs using a component of the Professional and Linguistic Assessment Board test (PLAB test). METHODS A nationwide cross-sectional study was conducted in February and March 2020. Post-graduate trainees who graduated from medical school were voluntarily recruited from general hospitals in Japan. To objectively measure the trainees' basic clinical knowledge, the PLAB test was adapted from the UK. The cut-off point was set at 63%, as recommended by the UK General Medical Council. A statistical analysis was conducted to determine whether post-graduate programme differences contributed to the trainees' test scores. RESULTS Twenty-two facilities volunteered to participate after recruitment, and 97 trainees from 19 facilities participated in the study. Thirty-one participants (32%) were in a CRP, and 66 participants (68%) were in an LRP. According to multiple logistic regression, the adjusted odds ratio of CRP trainees being in the high-scoring group was 5.16 (95% CI: 1.28-20.73, p<0.05). Mean differences in the scores in paediatrics, mental health and neurology were statistically higher among CRP trainees than LRP trainees. CONCLUSION Post-graduate trainees who were in a CRP had better basic clinical competence knowledge (PLAB test) scores and performed better when tested in a wider range of subspecialties. Not only exam performance but also clinical performance and the longitudinal trend of trainees' competency in post-graduate medical training should be evaluated in future studies.
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Affiliation(s)
- Saki Muroya
- Graduate School of Public Health, St. Luke's International University, OMURA Susumu & Mieko Memorial, St. Luke's Center for Clinical, Academia 5th Floor, 3-6 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan
- Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-shi, 183-0003, Tokyo, Japan
| | - Sachiko Ohde
- Graduate School of Public Health, St. Luke's International University, OMURA Susumu & Mieko Memorial, St. Luke's Center for Clinical, Academia 5th Floor, 3-6 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan.
| | - Osamu Takahashi
- Graduate School of Public Health, St. Luke's International University, OMURA Susumu & Mieko Memorial, St. Luke's Center for Clinical, Academia 5th Floor, 3-6 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan
- Department of General Internal Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, 104-8560, Tokyo, Japan
| | - Joshua Jacobs
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, WA, 99202-2131, Spokane, USA
| | - Tsuguya Fukui
- Graduate School of Public Health, St. Luke's International University, OMURA Susumu & Mieko Memorial, St. Luke's Center for Clinical, Academia 5th Floor, 3-6 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan
- Department of General Internal Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, 104-8560, Tokyo, Japan
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Lumry WR, Weller K, Magerl M, Banerji A, Longhurst HJ, Riedl MA, Lewis HB, Lu P, Devercelli G, Jain G, Maurer M, Hébert J, Ritchie B, Sussman G, Yang WH, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz RH, Anderson J, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Li HH, Lockey RF, Lugar P, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Radojicic C, Rehman SM, Schwartz LB, Shapiro R, Sher E, Smith AM, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H. Impact of lanadelumab on health-related quality of life in patients with hereditary angioedema in the HELP study. Allergy 2021; 76:1188-1198. [PMID: 33258114 PMCID: PMC8247292 DOI: 10.1111/all.14680] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
Background An objective of the phase 3 HELP Study was to investigate the effect of lanadelumab on health‐related quality of life (HRQoL) in patients with hereditary angioedema (HAE). Methods Patients with HAE‐1/2 received either lanadelumab 150 mg every 4 weeks (q4wks; n = 28), 300 mg q4wks (n = 29), 300 mg every 2 weeks (q2wks; n = 27), or placebo (n = 41) for 26 weeks (days 0–182). The Angioedema Quality of Life Questionnaire (AE‐QoL) was administered monthly, consisting of four domain (functioning, fatigue/mood, fears/shame, nutrition) and total scores. The generic EQ‐5D‐5L questionnaire was administered on days 0, 98, and 182. Comparisons were made between placebo and (a) all lanadelumab‐treated patients and (b) individual lanadelumab groups for changes in scores (day 0–182) and proportions achieving the minimal clinically important difference (MCID, −6) in AE‐QoL total score. Results Compared with the placebo group, the lanadelumab total group demonstrated significantly greater improvements in AE‐QoL total and domain scores (mean change, −13.0 to −29.3; p < 0.05 for all); the largest improvement was in functioning. A significantly greater proportion of the lanadelumab total group achieved the MCID (70% vs 37%; p = 0.001). The lanadelumab 300 mg q2wks group had the highest proportion (81%; p = 0.001) and was 7.2 times more likely to achieve the MCID than the placebo group. Mean EQ‐5D‐5L scores at day 0 were high in all groups, indicating low impairment, with no significant changes at day 182. Conclusion Patients with HAE‐1/2 experienced significant and clinically meaningful improvements in HRQoL measured by AE‐QoL following lanadelumab treatment in the HELP Study.
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Affiliation(s)
- William R. Lumry
- Allergy Asthma Research Associates Research Center Dallas TX USA
| | - Karsten Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General HospitalHarvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation TrustCambridge, and University College London Hospitals London UK
| | - Marc A. Riedl
- Division of Rheumatology Allergy & Immunology University of California San Diego La Jolla CA USA
| | | | - Peng Lu
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | | | - Gagan Jain
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
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