Article
Medicine, Research & Experimental
Daniel E. Killeen, Samuel L. Barnett, Bruce E. Mickey, Jacob B. Hunter, Brandon Isaacson, Joe Walter Kutz
Summary: The study revealed that patients with tumor volume >3 cm(3) had worse facial nerve outcomes 12 months following surgical resection. Tumor volume was identified as a key factor affecting facial nerve function outcomes.
Review
Medicine, General & Internal
Leonardo Franz, Gino Marioni, Antonio Mazzoni, Cosimo de Filippis, Elisabetta Zanoletti
Summary: This narrative review provides an update on the patho-physiological and clinical issues related to facial nerve damage in oto-neurological and skull base surgery. The occurrence of intraoperative facial nerve damage is associated with the anatomical relationship between tumor and nerve, the trajectory of the surgical corridor, and the boundaries of the resection margins. Mechanisms such as stretching, compression, devascularization, and heating may contribute to intraoperative facial nerve damage and nerve regeneration disorders.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Clinical Neurology
Yang Sun, Jianhua Yang, Tang Li, Kaiming Gao, Xiaoguang Tong
Summary: This study has established a new nomogram for predicting the rates of poor facial nerve outcomes after vestibular schwannoma surgery, which includes significant prognostic factors. The nomogram showed good discrimination and calibration in the validation cohort.
FRONTIERS IN NEUROLOGY
(2022)
Article
Otorhinolaryngology
Yin Ren, Bridget MacDonald, Kareem O. Tawfik, Marc S. Schwartz, Rick A. Friedman
Summary: Clinical predictors of facial nerve outcomes after microsurgical resection of vestibular schwannoma were identified, indicating excellent outcomes can be achieved with this procedure. Gross total resection and >= 100-mu V intraoperative FN electromyographic response were found to predict excellent FN outcomes.
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
(2021)
Editorial Material
Clinical Neurology
Ufuk Erginoglu, Walid Elshamy, Mustafa K. Baskaya
Summary: Preserving facial nerve function is crucial in translabyrinthine approach for vestibular schwannoma surgery. Anatomical variations in the facial nerve are rare but can be associated with congenital abnormalities. We present a rare case of vestibular schwannoma with a bifurcated facial nerve. The patient had a successful postoperative recovery with Grade I outcome. This case highlights the importance of identifying and preserving the facial nerve during vestibular schwannoma resection.
WORLD NEUROSURGERY
(2022)
Article
Otorhinolaryngology
Catherine Sobieski, Daniel E. Killeen, Samuel L. Barnett, Bruce E. Mickey, Jacob B. Hunter, Brandon Isaacson, Joe Walter Kutz
Summary: Facial nerve outcomes one year after microsurgical resection are poorer in patients with NF2 tumors compared to sporadic tumors, particularly for tumors with a volume greater than 3 cm³ and those classified as NF2 tumors.
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
(2021)
Article
Clinical Neurology
Felix Arlt, Johannes Kasper, Dirk Winkler, Katja Jaehne, Michael Karl Fehrenbach, Juergen Meixensberger, Caroline Sander
Summary: Intraoperative neurophysiological monitoring is crucial in vestibular schwannoma surgery to prevent nerve injury. Repeated direct nerve stimulation and a detected decreased amplitude might show facial nerve function deterioration.
FRONTIERS IN NEUROLOGY
(2022)
Article
Otorhinolaryngology
Francesco Gazia, Angela Callejo, Marta Perez-Grau, Susana Lareo, Jose Prades, Francesc Roca-Ribas, Emilio Amilibia
Summary: The study evaluates the ability of pre- and intraoperative factors related to electromyography and direct electrical stimulation of the facial nerve to predict facial nerve function in the short and long term after cerebellopontine angle tumor resection. Results show correlations between tumor size, minimum stimulation threshold, compound muscle action potential, and facial function in both short and long term. Higher immediate facial paralysis grades correspond to a higher risk of poor outcomes after one year.
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
(2022)
Article
Oncology
Giuseppe Di Perna, Raffaele De Marco, Bianca Maria Baldassarre, Enrico Lo Bue, Fabio Cofano, Pietro Zeppa, Luca Ceroni, Federica Penner, Antonio Melcarne, Diego Garbossa, Michele Maria Lanotte, Francesco Zenga
Summary: This retrospective study aimed to investigate the impact of morphologic and neurophysiological factors on the short- and long-term facial nerve function after vestibular schwannoma resection. A multiparametric score, Facial Nerve Outcome Score (FNOS), was developed and shown to be a reliable predictor of facial nerve function.
FRONTIERS IN ONCOLOGY
(2023)
Article
Medicine, Research & Experimental
Candace E. Hobson, Joe Saliba, Nopawan Vorasubin, Robert H. Lyles, Bill Mastrodimos, Roberto A. Cueva
Summary: This study shows that the position of vestibular schwannoma relative to the IAC axis can be used along with tumor size to predict postoperative facial outcomes. A greater proportion of tumor posterior to the IAC axis was associated with significantly better facial outcomes.
Article
Neurosciences
Kathrin Machetanz, Florian Grimm, Ruth Schaefer, Leonidas Trakolis, Helene Hurth, Patrick Haas, Alireza Gharabaghi, Marcos Tatagiba, Georgios Naros
Summary: This study introduces a cost-effective custom-made EMG biofeedback system for facial rehabilitation, demonstrating its good application potential in both healthy subjects and patients with facial palsy. There is a correlation between electrophysiological measurements and clinical outcomes.
FRONTIERS IN NEUROSCIENCE
(2022)
Review
Medicine, Research & Experimental
Longping Yao, Baoyan Wang, Fengfei Lu, Xiaozheng He, Guohui Lu, Shizhong Zhang
Summary: The facial nerve, a mixed nerve, has sensory and motor fibers, with its main branch located in the cerebellopontine angle. Facial nerve dysfunction can occur in skullbase tumors and Bell's palsy, with recovery outcomes varying between the two. Recent advances in MRI technology have allowed for better visualization of the facial nerve in the presence of large tumors.
EUROPEAN JOURNAL OF MEDICAL RESEARCH
(2023)
Article
Medicine, Research & Experimental
Isaac D. Erbele, Micah L. Klumpp, Moises A. Arriaga
Summary: Preoperative functional testing cannot reliably predict the presence of intracranial facial schwannomas. Hearing is better in facial schwannomas, especially in lower frequencies, while patients with vestibular schwannomas have worse hearing outcomes.
Article
Clinical Neurology
Bridget MacDonald, Yin Ren, Bita Shahrvini, Kareem O. Tawfik, Omid Moshtaghi, Marc S. Schwartz, Rick A. Friedman
Summary: This study aimed to analyze the characteristics and functional changes of delayed facial nerve palsy following resection of vestibular schwannoma (VS). The results showed that intraoperative electromyographic facial nerve response, tumor size, surgical approach, and extent of resection may play a role in the development of delayed facial nerve palsy. Most patients were able to recover near-normal function after experiencing delayed facial nerve palsy.
OTOLOGY & NEUROTOLOGY
(2022)
Article
Clinical Neurology
Mohamed Elsayed, Huan Jia, Baptiste Hochet, Olivier Sterkers, Renato Torres, Yann Nguyen, Isabelle Bernat, Ghizlene Lahlou, Michel Kalamarides
Summary: Decision-making for large sporadic vestibular schwannomas resection can be guided by intraoperative monitoring of maximal facial nerve amplitude and latency response to optimize post-operative results. Tumors were removed through retrosigmoid or translabyrinthine approaches in patients with normal preoperative FN function, achieving some tumor removal while maintaining a certain decrease in amplitude. Good postoperative facial nerve function and significant hearing preservation were achieved after 6 months, with no significant difference observed between TR and NTR+STR procedures.
ACTA NEUROCHIRURGICA
(2021)
Article
Neurosciences
Jin Li, Dan Cao, Vasileios Dimakopoulos, Weiyang Shi, Shan Yu, Lingzhong Fan, Lennart Stieglitz, Lukas Imbach, Johannes Sarnthein, Tianzi Jiang
Summary: This study recorded intracranial EEG from the anterior and posterior hippocampi in humans to investigate the involvement and functional connections of these subregions in working memory (WM) processing. The results showed elevated low-frequency activity and increased theta/alpha band phase synchronization between anterior and posterior subregions during WM maintenance. Correct WM trials were associated with unidirectional influence from the posterior to the anterior hippocampus, while WM errors were associated with bidirectional interactions between the two subregions. These findings suggest that theta/alpha band synchrony within the hippocampus supports successful WM via a posterior to anterior influence.
JOURNAL OF NEUROSCIENCE
(2022)
Letter
Clinical Neurology
Christian Eisenring, Ville Vasankari, Mika Niemela, Lennart H. Stieglitz, Markus F. Oertel
CLINICAL NEUROLOGY AND NEUROSURGERY
(2022)
Article
Clinical Neurology
Lennart H. Stieglitz, Sujitha Mahendran, Markus F. Oertel, Christian R. Baumann
Summary: This study reports a successful case of bilateral MRgHiFUS pallidotomy for peak-dose dyskinesia in a patient with Parkinson's disease (PD). The treatment decision was based on the patient's reluctance toward brain implants and pump therapies as well as limited access to a deep brain stimulation center in his home country.
MOVEMENT DISORDERS CLINICAL PRACTICE
(2022)
Article
Neurosciences
Ece Boran, Peter Hilfiker, Lennart Stieglitz, Johannes Sarnthein, Peter Klaver
Summary: The involvement of the medial temporal lobe (MTL) in working memory is controversial, but recent research has found that persistent neural firing in the hippocampus during maintenance is related to workload. This study recorded single neuron firing in 13 epilepsy patients while they performed a visual working memory task. The results showed that performance was almost perfect for low workload and dropped at high workload, suggesting that high workload exceeded working memory capacity. Maintenance neurons in the MTL were identified, and more of them were found in the hippocampus for trials with correct performance compared to incorrect performance. Maintenance neurons showed increased firing in the hippocampus and entorhinal cortex for high workload. Population firing in the entorhinal cortex and hippocampus accurately predicted workload during the maintenance period. The data suggest that persistent neural firing in the MTL supports performance and workload of multiple items in working memory, beyond working memory capacity.
Article
Biology
Vasileios Dimakopoulos, Pierre Megevand, Lennart H. Stieglitz, Lukas Imbach, Johannes Sarnthein
Summary: This study investigates the direction of information flow between the auditory cortex and hippocampus during working memory tasks. The results reveal that the information flow is from the auditory cortex to the hippocampus while participants hear letters, but it is reversed during the maintenance of these letters in memory.
Article
Neurosciences
Oliver Bichsel, Lennart Stieglitz, Markus Oertel, Christian Baumann, Roger Gassert, Lukas Imbach
Summary: This study investigated the local field potential (LFP) in the subthalamic nucleus (STN) in Parkinson's disease (PD) patients using deep brain stimulation (DBS) electrodes. The results showed changes in beta-burst activity during movement and self-paced motor control, highlighting the importance of beta-burst modulation in movement generation. These findings support the use of adaptive DBS based on beta-bursts for more effective treatment.
NEUROBIOLOGY OF DISEASE
(2022)
Article
Multidisciplinary Sciences
Manuela Costa, Diego Lozano-Soldevilla, Antonio Gil-Nagel, Rafael Toledano, Carina R. Oehrn, Lukas Kunz, Mar Yebra, Costantino Mendez-Bertolo, Lennart Stieglitz, Johannes Sarnthein, Nikolai Axmacher, Stephan Moratti, Bryan A. Strange
Summary: The amygdala plays a crucial role in the encoding of emotional memory, with its theta phase synchronizing with gamma activity and neuronal firing in the hippocampus. This study provides evidence of the neural dynamics underlying amygdala-hippocampal communication during emotional memory encoding. The findings suggest that the amygdala theta phase coordinates transient amygdala-hippocampal gamma coherence to facilitate aversive memory encoding, which may have implications for understanding psychiatric disorders.
NATURE COMMUNICATIONS
(2022)
Article
Clinical Neurology
Jana C. Buenzli, Esther Werth, Christian R. Baumann, Anina Belvedere, Roland Renzel, Lennart H. Stieglitz, Lukas L. Imbach
Summary: In this study, the impact of continuous deep brain stimulation (DBS) on sleep in epilepsy patients was investigated. The findings showed that continuous high-frequency DBS leads to more consolidated and deeper slow wave sleep (SWS). The location of the stimulation contact within the anterior nucleus of the thalamus (ANT) was also found to be related to the changes in SWS.
Article
Multidisciplinary Sciences
Jin Li, Dan Cao, Shan Yu, Xinyu Xiao, Lukas Imbach, Lennart Stieglitz, Johannes Sarnthein, Tianzi Jiang
Summary: Both the hippocampus and amygdala play important roles in working memory processing, but their specific functions in working memory are still unclear. In this study, intracranial EEG was recorded from epilepsy patients' amygdala and hippocampus during a working memory task, and their representations during the encoding and maintenance periods were compared. The results showed functional specialization and interaction within the amygdala-hippocampus circuit, with distinct mnemonic representations in the amygdala decreasing from encoding to maintenance, and more similar but stable representations in the hippocampus. The encoding and maintenance of working memory were associated with bidirectional information flow between the amygdala and hippocampus in low-frequency bands (1-40 Hz). Decoding accuracy on working memory load was higher when using representational features from the amygdala during encoding and from the hippocampus during maintenance, as well as information flow from the amygdala during encoding and from the hippocampus during maintenance.
NATURE COMMUNICATIONS
(2023)
Article
Clinical Neurology
Sandra Fernandes Dias, Christina Graf, Elisabeth Jehli, Markus Florian Oertel, Julia Mahler, Marianne Schmid Daners, Lennart Henning Stieglitz
Summary: Using gait sensors in the home environment can help diagnose patients with iNPH and differentiate them from healthy controls. The analysis of gait parameters showed significant differences between iNPH patients and healthy controls. Comparisons before and after surgery revealed improvements in gait for iNPH patients, and there were significant differences in gait between patients with a positive response to VP-shunt and those with no response.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Giovanna Aiello, Debora Ledergerber, Tena Dubcek, Lennart Stieglitz, Christian Baumann, Rafael Polania, Lukas Imbach
Summary: This study provides a detailed neurofunctional characterization of the interaction between the anterior nucleus of the thalamus (ANT) and the cortex, revealing the mechanisms of ANT deep brain stimulation (DBS) therapy and proposing electrophysiological biomarkers as predictors of treatment efficacy. It delivers crucial information for optimizing clinical DBS responses in patients with drug-resistant epilepsy.
Article
Clinical Neurology
Philippe Schucht, Andreas Nowacki, Armin Osmanagic, Michael Murek, Werner J. Z'Graggen, Matteo Montalbetti, Juergen Beck, Lennart Stieglitz, Andreas Raabe
Summary: This study aimed to evaluate the feasibility of using space-expanding flaps to protect the brain during decompressive hemicraniectomy (DCE) for malignant infarction of the medial cerebral artery. The results showed that the concurrent use of space-expanding flaps was safe and effective in reducing brain shift and preventing complications.
JOURNAL OF NEUROSURGERY
(2023)
Article
Clinical Neurology
Johannes Sarnthein, Victor E. Staartjes, Luca Regli
Summary: This study presents the results of long-term implementation of a prospective patient registry in neurosurgery and evaluates the validity of the Clavien-Dindo grade (CDG) for complication classification. The registry successfully captured patient data and recorded a significant number of complications. The CDG demonstrated construct validity as a measure of complication classification in neurosurgery.
Letter
Clinical Neurology
Markus F. Oertel, Luca Regli, Lennart H. Stieglitz
OPERATIVE NEUROSURGERY
(2022)
Article
Clinical Neurology
Deepak K. Ravi, Christian R. Baumann, Elena Bernasconi, Michelle Gwerder, Niklas K. Ignasiak, Mechtild Uhl, Lennart Stieglitz, William R. Taylor, Navrag B. Singh
Summary: This study systematically investigated changes in gait asymmetry and dyscoordination in PD patients 6 months postoperatively, revealing that STN-DBS increased step time asymmetry and phase coordination index, with higher effects in PIGD subgroup compared to tremor dominant subtype. The study suggests subtype-associated differences in treatment response.
NEUROREHABILITATION AND NEURAL REPAIR
(2021)