Diário da Espinha

Neuroinflammatory demyelinating diseases, such as Multiple Sclerosis (MS), can lead to significant neurodegeneration, causing debilitating neurological symptoms. Siponimod, a selective sphingosine-1-phosphate receptor modulator, has shown promise in the treatment of MS by modulating immune cell trafficking and reducing neuroinflammation. In this study, we investigated the effect of siponimod on brain and spinal cord imaging markers of neurodegeneration using a murine model of demyelination caused by Theiler's Murine Encephalomyelitis Virus (TMEV). Through comprehensive neuroimaging analysis, we evaluated the impact of siponimod on demyelination-associated neurodegeneration, providing insights into its potential as a therapeutic intervention in demyelinating diseases.

Cerebrospinal Fluid (CSF) is a clear, colorless fluid that plays a crucial role in the Central Nervous System (CNS). It serves as a protective cushion, providing mechanical support to the brain and spinal cord, while also participating in waste clearance and chemical signaling. This article provides a comprehensive overview of CSF, including its composition, production, circulation, functions, and clinical significance in various neurological disorders. Cerebrospinal Fluid (CSF) is a vital component of the central nervous system, enveloping the brain and spinal cord in a protective cushion. Its multifaceted role encompasses mechanical protection, metabolic support, waste clearance, and chemical communication. Understanding the fundamental concepts of CSF is essential for comprehending its importance in maintaining CNS homeostasis and its implications for neurological health.

Acute spinal cord transection is a devastating injury that can lead to profound functional impairment and altered physiological responses throughout the body. Recent studies have shown that boldine, a natural alkaloid found in the leaves and bark of boldo tree (Peumus boldus), exhibits neuroprotective properties. However, the systemic effects of boldine on lipidomic signatures in the context of acute spinal cord transection remain poorly understood. This article explores the potential impact of boldine on male mouse serum lipidomic profiles following acute spinal cord transection, shedding light on its therapeutic potential beyond its direct neuroprotective effects.

Spinal Cord Simulators (SCS) are routinely placed in cases medically refractory to pain. Paddle leads are placed under general anesthesia using fluoroscopy and Intraoperative Neuromonitoring (IONM) for midline placement with adequate coverage. After a successful trial of the SCS device with the patient, the implant of paddle leads is ordered for permanent placement in the epidural place under general anesthesia. The leads are implanted based on area of pain, but typically, not proximal to C3-4 levels of the spine. In the case we discuss, our patient was experiencing pain in the shoulders and arms, but additionally had occasional headaches in the occipital region. Therefore, the SCS device was trialed to extend up to the C3-4 levels. Because the patient had a partially successful trail with >50% reduction in pain but remaining headaches, the procedure planned was for placement of permanent paddle leads extending up to the C1-2 levels with Intraoperative Neuromonitoring (IONM).