Neurological Lesions Research Articles

Risk factors of instrumentation failure after laminectomy and posterior cervical fusions (PCF)

BackgroundFor patients with multilevel degenerative cervical myelopathy, laminectomy and posterior cervical fusions (PCF) with instrumentation are widely accepted techniques for symptom relief. However, hardware failure is not rare and results in neck pain or even permanent neurological lesions. There are no in-depth studies of hardware-related complications following laminectomy and PCF with instrumentation.MethodsThe present study was a retrospective, single centre, observational study. Patients who underwent laminectomy and PCF with instrumentation in a single institution between January 2019 and January 2021 were included. Patients were divided into hardware failure and no hardware failure group according to whether there was a hardware failure. Data, including sex, age, screw density, end vertebra (C7 or T1), cervical sagittal alignment parameters (C2-C7 cervical lordosis, C2-C7 sagittal vertical axis, T1 slope, Cervical lordosis correction), regional Hounsfield units (HU) of the screw trajectory and osteoporosis status, were collected and compared between the two groups.ResultsWe analysed the clinical data of 56 patients in total. The mean overall follow-up duration was 20.6 months (range, 12–30 months). Patients were divided into the hardware failure group (n = 14) and no hardware failure group (n = 42). There were no significant differences in the general information (age, sex, follow-up period) of patients between the two groups. The differences in fusion rate, fixation levels, and screw density between the two groups were not statistically significant (p > 0.05). The failure rate of fixation ending at T1 was lower than that at C7 (9% vs. 36.3%) (p = 0.019). The regional HU values of the pedicle screw (PS) and lateral mass screw (LMS) in the failure group were lower than those in the no failure group (PS: 267 ± 45 vs. 368 ± 43, p = 0.001; LMS: 308 ± 53 vs. 412 ± 41, p = 0.001). The sagittal alignment parameters did not show significant differences between the two groups before surgery or at the final follow-up (p > 0.05). The hardware failure rate in patients without osteoporosis was lower than that in patients with osteoporosis (14.3% vs. 57.1%) (p = 0.001).ConclusionsOsteoporosis, fixation ending at C7, and low regional HU value of the screw trajectory were the independent risk factors of hardware failure after laminectomy and PCF. Future studies should illuminate if preventive measures targeting these factors can help reduce hardware failure and identified more risk factors, and perform long-term follow-up.

Течение энтеровирусной инфекции у детей в Краснодарском крае на современном этапе

Objective. To determine the clinical and epidemiologic features of the course of enterovirus infection (EVI) in Krasnodar Krai. Patients and methods. We analyzed the case histories of children who were treated in the State Budgetary Institution "SKDIB" of Krasnodar from January 2020 to November 2023. For the period from 01.01.2020 to 30.06.2022, out of 1560 patients with suspected acute infectious pathology, EVI was detected in 98 children, of whom boys accounted for 59.2% (n = 58), girls – 40.8% (n = 40). After removal of restrictions on new coronavirus infection from 01.07.2022 to November 2023, EVI was detected in 366 out of 2607 examined patients, of which boys accounted for 55.3% (n = 202), girls – 44.7% (n = 164). Most children (231, 63.1%) came from organized groups. In all forms of EVI, nasopharyngeal swabs, feces, and vesicle contents were examined by polymerase chain reaction; enterovirus RNA was detected in all patients. Molecular typing of enteroviruses was performed in the Federal Budgetary Institution "Center of Hygiene and Epidemiology in Krasnodar Krai". Results. It was revealed that exanthem and neurological forms prevailed during the given periods of observation.Of neurological lesions of EVI, enteroviral meningitis remains the leading form, which as an independent form occurred in 66.9% of cases, in combination with herpangina, exanthema, diarrhea – in 33.1%. The incidence rate of enteroviral meningitis for the period from 07.2022 to 11.2023 is 36.6%, the proportion of encephalitis increased to 2.7%. In the age structure of EVI cases for the period from 01.2020 to 06.2022, the main share was children aged 1 to 3 years old (42, 41.1%), for the period 07.2022–11.2023 – children from 4 to 6 years old (219, 59.9%). Conclusion. All age groups of children were involved in the epidemic process, but children aged 1 to 3 years (45.9%) and 7 to 14 years (22.4%) were sick more often, with the highest number of cases registered in preschool and school educational organizations. The greatest risk of developing severe forms of EVI is observed in children from risk groups. In recent years, there are still risks of epidemic rise in the incidence of exanthem and minor forms of EVI associated with the spread of Coxsackie A6, A16 and other viruses of the Coxsackie A and B species, the probability of spread of enterovirus A71 and possible resumption of circulation of EUNO 30 virus cannot be excluded. Key words: children, enterovirus infection, enteroviral exanthema, enteroviral meningitis, clinic

Metanalysis of the Diagnostic Performance of Western Blot for the Early Diagnosis of Congenital Toxoplasmosis

BACKGROUND: Congenital toxoplasmosis is an infection caused by the Toxoplasma gondii a protozoa obligate intracellular parasite that appears after a mother´s primary infection occurs during pregnancy. The congenital infection can cause severe symptoms such as: hydrocephalus, intracranial calcifications, seizures, hepatosplenomegaly, and chorioretinitis, leading to irreversible neurological and ocular lesions. Its early diagnosis is critical to obtain good outcomes after treatment where the western blot is considered as the gold standard. Western blot discriminate antibodies for specific proteins of the microorganism enabling differentiation between antibodies transmitted by mother from those elaborated by the newborn (compared immunological profiles) and can be obtained commercially or be elaborated by the clinical laboratory test (“house made”). However, there is not metanalysis about the diagnostic properties of the test that can support evidence-based recommendations for its use. METHODS: The research terms used were: “congenital toxoplasmosis” and “western blot”. Databases for bibliographic searches were PubMed and Scopus, without restriction of date or language. Selection criteria were studies of evaluation of the diagnostic performance of western blot assay that included newborn with a definitive diagnosis of congenital infection by Toxoplasma according to the European network case definition (IgG anti-Toxoplasma persistent at 10 months of age) and controls that were defined by IgG antibodies that disappears in the serum of children in absence of treatment before six months of age. Screening and literature selection was done by the four researchers and disagreement were settled by reaching a consensus by discussion with mentor to avoid the erroneous exclusion of eligible articles. The PRISMA statement (http://www.prisma-statement.org/) was followed for quality assessment of the manuscript. The data were organized in an evidence table matrix, and sensitivity, specificity, and diagnostic odds ratio (DOR) index were calculated. RESULTS: Of 44 articles related to the search terms were found in literature databases, 10 fulfill criteria to be included in the metanalysis. The sensitivity obtained was 93.8 (95 CI: 79.2-98.4) and the specificity of 96.6% (95 CI: 89.8-98.9). However, heterogeneity was observed between the studies. Causes for heterogeneity were the different methods to elaborate the western blot assay. Commercial methods showed better performance that homemade methods. The results suggest that better accuracy can be obtained by using standardized commercial test. CONCLUSION: In conclusion, the meta-analysis supports the use of the Western Blot test as an effective method for the diagnosis of congenital toxoplasmosis in terms of sensitivity and specificity. However, further research is needed to establish more accuracy regarding sensitivity and specificity in the diagnosis in different settings by using well standardized assays.

Subependymal giant cell astrocytoma, report of a rare case

Tuberous sclerosis complex (TSC) is a rare genetic disease that is inherited autosomal dominantly and may be associated with subependymal giant cell astrocytoma (SEGA) in 10-20% of cases. Different phenotypes are related to the form of lesions in different parts of the body, including skin, brain, kidneys, lungs, and heart. The age of the patient, the location of the tumor, and associated skin or neurological lesions may guide the pathologist for a definite diagnosis. Here we report a case of SEGA in an adolescent with TSC. Neurological clues including seizure and mental retardation, facial angiofibroma, renal mass, and histopathology examination of the brain tumor culminated in the diagnosis of TSC and SEGA.

Endovascular Brain-Computer Interfaces in Poststroke Paralysis.

Stroke is a leading cause of paralysis, most frequently affecting the upper limbs and vocal folds. Despite recent advances in care, stroke recovery invariably reaches a plateau, after which there are permanent neurological impairments. Implantable brain-computer interface devices offer the potential to bypass permanent neurological lesions. They function by (1) recording neural activity, (2) decoding the neural signal occurring in response to volitional motor intentions, and (3) generating digital control signals that may be used to control external devices. While brain-computer interface technology has the potential to revolutionize neurological care, clinical translation has been limited. Endovascular arrays present a novel form of minimally invasive brain-computer interface devices that have been deployed in human subjects during early feasibility studies. This article provides an overview of endovascular brain-computer interface devices and critically evaluates the patient with stroke as an implant candidate. Future opportunities are mapped, along with the challenges arising when decoding neural activity following infarction. Limitations arise when considering intracerebral hemorrhage and motor cortex lesions; however, future directions are outlined that aim to address these challenges.

Functional popliteal angle tests improve identification of short hamstring muscle–tendon length in patients with a central neurological lesion

This study introduces a functional exercise protocol to improve the identification for short hamstring muscle–tendon length (HMTL), a common contributor to crouch gait in patients with central neurological lesions (CNL). The functional exercise protocol incorporates a knee extension movement with hip in a flexed position, while standing on one leg (functional popliteal angle test) and walking with large steps to the current standard protocol (walking at comfortable speed and as fast as possible). The main aim was to establish whether the new protocol allows better determination of maximum HMTLs and diagnostics of short HMTL in patients with a CNL. Lower limb 3D marker position data from 39 patient limbs and 10 healthy limbs performing the exercises were processed in OpenSim to extract HMTLs. The new protocol provoked significantly larger HMTLs compared to the current standard protocol. The total number of limbs classified as having too short HMTLs reduced from 16 to 4 out of a total of 30 limbs walking in crouch. The new protocol improves determination of maximum HMTL, thereby improving short HMTL diagnostics and identification of patients in need of lengthening treatment. Inter-individual variability observed among patients, indicating the need to include all exercises for comprehensive diagnosis.

Methylene blue as an adjuvant during cardiopulmonary resuscitation: an experimental study in rats

IntroductionMethylene Blue (MB) has been shown to attenuate oxidative, inflammatory, myocardial, and neurological lesions during ischemia-reperfusion and has great potential during cardiac arrest. This study aimed to determine the effects of MB combined with epinephrine during cardiac arrest on myocardial and cerebral lesions. MethodThirty-eight male Wistar rats were randomly assigned to four groups: the sham group (SH, n = 5), and three groups subjected to cardiac arrest (n = 11/group) and treated with EPI 20 µg.kg−1 (EPI), EPI 20 µg.kg−1 + MB 2 mg.kg−1 (EPI + MB), or saline 0.9% 0.2 ml (CTL). Ventricular fibrillation was induced by direct electrical stimulation in the right ventricle for 3 minutes, and anoxia was maintained for 5 minutes. Cardiopulmonary Resuscitation (CPR) consisted of medications, ventilation, chest compressions, and defibrillation. After returning to spontaneous circulation, animals were observed for four hours. Blood gas, troponin, oxidative stress, histology, and TUNEL staining measurements were analyzed. Groups were compared using generalized estimating equations. ResultsNo differences in the Returning of Spontaneous Circulation (ROSC) rate were observed among the groups (EPI: 63%, EPI + MB: 45%, CTL: 40%, p = 0.672). The mean arterial pressure immediately after ROSC was higher in the EPI+MB group than in the CTRL group (CTL: 30.5 [5.8], EPI: 63 [25.5], EPI+MB: 123 [31] mmHg, p = 0.007). Serum troponin levels were high in the CTL group (CTL: 130.1 [333.8], EPI: 3.70 [36.0], EPI + MB: 43.7 [116.31] ng/mL, p < 0.05). ConclusionThe coadministration of MB and epinephrine failed to yield enhancements in cardiac or brain lesions in a rodent model of cardiac arrest.

Dual-probe sandwich for Lewy body detection on nano-composite modified dielectric surface to determine Parkinson's disease

Parkinson's disorder (PD) is a chronic and central nervous system disorder that occurs when neurons in the area of the brain impairs or dies, in particular, it affects the dopamine-producing neurons. People having PD also loose chemical messenger norepinephrine, which involves in regulating the main function of physiological systems, such as heart rate and blood pressure. Researchers are working on to identify PD with a suitable biomarker and alpha-synuclein is the presynaptic neuronal protein, in the neurological lesions (Lewy bodies). This research was focused to develop an alpha-synuclein biosensor on an iron oxide (IO) nanomaterial-modified interdigitated electrode surface. Anti-alpha-synuclein aptamer was attached on IO through the amine-linker and aggregated alpha-synuclein was sandwiched between aptamer and antibody. To enhance the analytical performance, antibody was modified with gold nanoparticles and reached the detection limit of 10 aM, determined on a linear range between 101 and 107 aM [y = 2.5812×-0.0081; R2 = 0.9729]. Further, control molecules failed to increase the current responses indicating the specific detection of alpha-synuclein and the CSF-spiked alpha-synuclein increases the current responses, confirming the selective detection.

Case Report: Bell’s palsy: a neurological manifestation of COVID-19 infection

Background Coronavirus (COVID-19) is the causative agent of the most recent pandemic that hit the globe and has been the cause of a vast range of symptoms, including neurological symptoms. Bell’s palsy is an acute peripheral facial paralysis commonly associated with viral infections. Case presentation This case report describes a patient with incidental COVID-19 infection that led to acute unilateral peripheral facial paralysis, Bell’s palsy. Our patient is a 35-year-old male with no known comorbidities who was presenting with upper respiratory tract infection symptoms and was found to be positive for COVID-19. Soon after the onset of symptoms, he also developed right-sided facial weakness in association with his symptoms. A thorough examination revealed a peripheral neurological lesion. The diagnosis of Bell’s palsy secondary to COVID-19 virus infection was through the exclusion of other possible causes. Conclusions This case report suggests a potential link between Bell’s palsy and COVID-19, highlighting the importance of a comprehensive understanding of the neurological manifestations of COVID-19. Further research is essential to determine the significance of neuropathies in COVID-19 and enhance treatment strategies.

A review on thromboembolic events and neurological lesions in patients with β-thalassemia

Β-thalassemia is the severe form of genetic illnesses which decreases the hemoglobin synthesis. One of the major complications in thalassemic syndromes, including β-thalassemia major and intermedia is thromboembolic events. In addition, thromboembolic events are more common in non-transfusion-dependent thalassemia than those in well-transfusion-dependent β-thalassemia. A combination of hypercoagulable states including, abnormalities in red blood cells, and platelet, antithrombin III, protein C, and protein S, and splenectomy are involved in thrombotic events, but thromboembolic events can be prevented and treated in these patients via blood transfusion, hydroxyurea, anticoagulants, and aspirin. Moreover, recent studies have demonstrated the involvement of the brain lesion in β-thalassemia patients. The involvement of vascular events of brain in patients with β-thalassemia intermedia is 29-83%, but the rate of asymptomatic brain lesions in the healthy people is 0-11%. In addition, neurological complications which have been attributed to various factors are chronic hypoxia, iron overload, bone marrow expansion, and desferrioxamine neurotoxicity. This review evaluated thromboembolic events and neurological lesions in patients with β-thalassemia and its probable curative therapy.

Investigation of the neurological prognosis after traumatic cervical spinal cord injury in Rasoul Akram Hospital in the period 2011-2016

Background: Cervical spine trauma may be associated with neurological disorders depending on the mechanism of trauma, the cross-sectional area affected by the trauma, and the severity of the trauma;the occurence of these neurological disorders may also affect the surgical treatment prognosis. The aim of the present study was to investigate the neurological prognosis after traumatic cervical spinal cord injury. Materials and Methods: In this retrospective study, the intended data were collected through the admission hospital records and imaging archives of Rasoul Akram Hospital during 2011-2016. The records of patients who were treated for cervical spinal cord injury in the last year were collected and then age, gender, and other variables were extracted for each patient. The data were entered into the SPSS software and the results were reported. Results: The results showed that falls (41.2%) and motorcycle accidents (54.9%) were the most common cause of trauma, andthat the lower level of the cervical spine (C3-C7) was most commonly affected. The overall prevalence of neurological lesions at the time of admission to the department room was 29.4%, and 7.8% had died during hospitalization and before surgery. Predictive factors for neurological disorders were female sex, direct trauma during fightsand trauma to the lower cervical area. Conclusion: The present results indicate that the prevalence of complications and neurologic disorders after cervical spinal cord injuries is approximately 30% and that the extent of these complications in these patients is related to gender, trauma mechanism, and cross-sectional area of ‌‌ the injured cervical spine.

Spinal cord injury dysregulates fibro-adipogenic progenitors miRNAs signaling to promote neurogenic heterotopic ossifications

Neurogenic heterotopic ossifications are intramuscular bone formations developing following central nervous system injury. The pathophysiology is poorly understood and current treatments for this debilitating condition remain unsatisfying. Here we explored the role of miRNAs in a clinically relevant mouse model that combines muscle and spinal cord injury, and in patients’ cells. We found an osteo-suppressive miRNAs response in injured muscle that was hindered when the spinal cord injury was associated. In isolated fibro-adipogenic progenitors from damaged muscle (cells at the origin of ossification), spinal cord injury induced a downregulation of osteo-suppressive miRNAs while osteogenic markers were overexpressed. The overexpression of selected miRNAs in patient’s fibro-adipogenic progenitors inhibited mineralization and osteo-chondrogenic markers in vitro. Altogether, we highlighted an osteo-suppressive mechanism involving multiple miRNAs in response to muscle injury that prevents osteogenic commitment which is ablated by the neurologic lesion in heterotopic ossification pathogenesis. This provides new research hypotheses for preventive treatments.

Functional and Structural Neurological and Vascular Lesions in Short and Long-Term Hemodialyzed Patients

Functional and Structural Neurological and Vascular Lesions in Short and Long-Term Hemodialyzed Patients

The Curved Presplitting Technique in a Totally Edentulous Atrophic Mandible: A Surgical Case Report.

The management of horizontally fully edentulous atrophic ridges is a common problem in dental implantology. This case report describes an alternative modified two-stage presplitting technique. The patient was referred for an implant-supported rehabilitation of their edentulous mandible. CBCT scans showed a mean available bone width of about 3 mm. At the first stage, four linear corticotomies were performed using a piezoelectric surgical device. At the second surgical stage 4 weeks later, bone expansion was performed, and four implants were placed in the interforaminal area. The healing process was uneventful. No fractures of the buccal wall and no neurologic lesions were observed. Postoperative CBCT scans showed a mean bone width gain of about 3.7 mm. Implants were uncovered 6 months after the second surgery, and 1 month later, a fixed provisional screw-retained prosthesis was delivered. This approach could be used as a reconstructive technique that avoids using grafts and reduces treatment times, possible complications, postsurgical morbidity, and costs by exploiting the patient's native bone as much as possible. Considering the limitations of a case report, randomized controlled clinical trials are needed to confirm the results and validate this technique.

A new exercise protocol for improving diagnostics of short hamstring muscle-tendon length in patients with a central neurological lesion

A new exercise protocol for improving diagnostics of short hamstring muscle-tendon length in patients with a central neurological lesion

Vulnerability Scale for People with Motor Disabilities After an Acquired Neurological Lesion

Introduction: After an acquired neurological lesion, some people are in situations of greater vulnerability to complications and comorbidities, which can exert impacts on their life and health, compromise their quality of life, and lead to hospitalizations and premature death. Identifying the vulnerability situation can guide nurses in the development of actions to prevent complications, comorbidities, and other conditions after the neurological lesion. Objective: To validate a scale to identify the vulnerability situation of people with motor disabilities after an acquired neurological lesion (Escala de Vulnerabilidade de Pessoas com Deficiência, EVU-PcD). Materials and method: The article presents a methodological development and psychometric study with a quantitative approach. The construct validity stages were as follows: application of the Vulnerability Scale for people with motor disabilities after an acquired neurological lesion (EVU-PcD) and reliability and confirmatory factor analysis. EVU-PcD, initially with 38 items, was applied to 102 individuals with acquired motor disabilities. Reliability was assessed using Cronbach’s alpha from 0.7 to 0.9. In the confirmatory factor analysis, the structural equations model for latent variables a path diagram was used. Results: The overall Cronbach’s alpha coefficient was 0.86, which was considered excellent. The fit indices, chi-square ratio (1.63), root mean square of approximation errors (0.08) and parsimonious fit quality index (0.61) presented acceptable indicators of adequacy to the final model with three domains and 28 items. Conclusions: The final factor structure of the EVU-PcD scale with 28 items showed satisfactory reliability and validity results to identify the vulnerability of people with motor disabilities after an acquired neurological lesion.

Temporal acoustic properties of the sibilant fricative /s/ for the differential diagnosis of dysarthria and apraxia of speech in Spanish speakers

ABSTRACT Dysarthria and Apraxia of Speech (AoS) are motor speech disorders in which neurological lesions differentially affect motor control, possibly leading to noticeable differences in articulation and consequently sound production. Among the sounds requiring greater motor capacity because of its articulatory complexity is the voiceless alveolar sibilant fricative /s/. The aim of this study was to identify acoustic variables able to distinguish between dysarthria and AoS, and between these disorders and normal speech in Spanish speakers. The production of this fricative was acoustically examined in 28 individuals with motor neurological disorders (20 with dysarthria, 8 with AoS) and in 28 neurologically healthy persons. Participants repeated 12 monosyllabic words containing the fricative plus one of the five Spanish vowels. The variables measured were absolute durations of the fricative, vowel, and fricative+vowel sequence, along with the vowel-to-fricative duration ratio. Findings indicate that duration of the fricative can distinguish between controls and speakers with dysarthria, but not between controls and speakers with AoS. Measures related to vowel duration served to distinguish between speakers with dysarthria and speakers with AoS and between each of them and controls. Further, speakers with dysarthria and those with AoS differed from each other and from controls in terms of articulatory variability; speakers with dysarthria showing most variability. In the latter participants, articulatory variability was higher for unrounded segments, vowels and fricatives, while in speakers with AoS this variability was higher for rounded segments. These observations are discussed within a framework of motor control models.

Ulnar-Sided Upper Extremity Traumatic Wounds: What Should We Expect to Find?

Background: Upper limb traumatic injuries have a significant impact on social and professional life; however, there is still a paucity of studies focusing on the injuries of the ulnar border of the forearm, wrist and hand. Methods: We designed a retrospective single-blinded study, including all patients with deep traumatic wounds affecting the ulnar side of the forearm, wrist or hand, that received surgical treatment from 2006 until 2016. A characterisation of the sample, assessment of concomitant injuries and clinical outcomes, as well as neurological and functional evaluation were performed. Results: We obtained a sample of 61 patients, 69% with injuries affecting the wrist and 90% of patients with a neurological lesion, most frequently of the ulnar nerve lesion (UNL). Concomitant injuries included tendinous lesions, more frequently of the flexor carpi ulnaris (64%) and fractures (13%). And 39% of patients presented an ulnar artery lesion, without significant differences in outcomes regarding the completion of arteriorrhaphy or not. At the end of the 8.6 years follow-up, 34% of patients had no deficits; however, patients with UNL showed worse functional scores and greater risk of sequelae. Besides motor function compromise, sensory deficits were also associated with worst functional outcomes. Conclusions: The UNL subgroup showed important impairment of the first ray, probably related to the level of UNL. Furthermore, besides the implications of the motor sequelae, sensory deficits were also associated with worst functional scores. Due to the high percentage of neurovascular and tendinous lesions in ulnar-sided upper extremity wounds, the authors recommend surgical exploration of these lesions. Level of Evidence: Level IV (Therapeutic).

Giant sacral schwannoma in a neurofibromatosis type 2 patient

BackgroundNeurofibromatosis type 2 is an autosomal dominant disorder, mainly characterized by multiple neurological lesions, such as schwannomas, meningiomas, neurofibromas and intramedullary ependymomas. Schwannomas are usually small circumscribed lesion. Sacral location of a schwannoma with cystic change is a very rare finding. We are presenting one such case with giant cystic schwannoma with fluid–fluid levels in sacral region.Case presentationWe present a case of 13-year-old female patient, presenting with pelvic pain and gradually progressive bilateral lower limb weakness. On MRI, giant cystic schwannoma with internal fluid–fluid levels was noted in sacral region, extending anteriorly into the presacral region, causing mass effects on pelvic organs, which explained the cause of her symptoms. She also showed the presence of bilateral vestibular schwannoma and multiple small cerebral lesions, leading to the diagnosis of neurofibromatosis type 2.ConclusionsOur current case of neurofibromatosis type 2, diagnosed by presence of bilateral vestibular schwannoma, shows atypically large sacral cystic schwannomas and cerebral subcortical lesions, probably representing glial microhamartomas. Sacral schwannomas can be of giant size with cystic changes and fluid–fluid levels, mimicking aneurismal bone cyst, as in current case.

Increased CCL-5 (RANTES) Gene Expression in the Choroid Plexus of Dogs with Canine Leishmaniosis

Visceral canine leishmaniasis (CanL) can cause several clinical manifestations, including neurological lesions. Few reports have characterized the lesions observed in the central nervous system (CNS) during CanL; however, its pathogenesis remains unclear. The choroid plexus (CP) is a specialized structure responsible for the production and secretion of cerebrospinal fluid (CSF) and considered an interface between the peripheral immune system and CNS. It can allow the passage of inflammatory cells or pathogens and has the potential to act as a source of inflammatory mediators in several diseases. Thus, this study aimed to evaluate the role of CP as a possible route of inflammatory cells in the development of brain lesions in dogs with CanL, as well as its association with blood–CSF barrier (BCSFB) dysfunction. Samples were collected from 19 dogs that were naturally infected with CanL. We evaluated the histopathological lesions in the brain and investigated the gene expression of the cytokines. Capture enzyme-linked immunosorbent assay (ELISA) was used to evaluate the presence of the same cytokines in the CSF. Biochemical analysis was performed to compare the presence of albumin in the serum and CSF. Indirect ELISA was performed to measure the presence of anti-Leishmania antibodies in the CSF, which would suggest the disruption of the BCSFB. Histopathological evaluation of the dogs’ brains revealed mild-to-severe inflammatory infiltrates, mainly in the CP and meninges. We also detected the presence of anti-Leishmania antibodies and albumin in the CSF, as well as Leishmania DNA in the CP. The gene expression of CCL-5 was increased in the CP of infected dogs compared with that of controls, and there was a tendency for the increase in the gene expression of CXCL-10. Thus, our findings confirm the disfunction of the BCSFB during CanL and suggest that the chemokines CCL-5 and CXCL-10 can be responsible for the recruitment of inflammatory cells found in CP.