Riassunto
Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno,M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore,progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis,itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied,thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for "evidence-based medicine" is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe"Decadeof limitsoffeasibility,especiallywherecontrolledthe- theBrain". Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide,accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control,paincontrol,aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology,forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree%ocientpreventionin many of these processes involve the major tra- thefuture,themeasuresthatstandrightatthefore- mitters. Furthermore,biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells,bone-marrowcells,macrophages,andother withthemoretask-speci?c,intensive,andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade,andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients.
Contenuti
A. Evidence based neurorehabilitation Hömberg, V.: • Evidence based medicine in neurological rehabilitation – a critical review von Wild, K. R. H., Wenzla¤, P. in cooperation with the TBI Study Council: • Quality management in traumatic brain injury (TBI). Lessons from the prospective study in 6.800 patients after acute TBI in respect of neurorehabilitation Pagni, C. A., Zenga, F.: • Posttraumatic epilepsy with special emphasis on prophylaxis and prevention Prosiegel, M., Höling, R., Heintze, M., Wagner-Sonntag, E., Wiseman, K.: • Swallowing therapy – a prospective study on patients with neurogenic dysphagia due to unilateral paresis of the vagal nerve, Avellis’ syndrome, Wallenberg’s syndrome, posterior fossa tumours and cerebellar hemorrhage Prigatano, G. P.: • Impaired self-awareness after moderately severe to severe traumatic brain injury von Steinbuechel, N., Petersen, C., Bullinger, M., the QOLIBRI Group: • Assessment of health-related quality of life in persons after traumatic brain injury – development of the Qolibri, a specific measure B. Re-engineering of brain lesions Barlati, S., Barbon, A.: • RNA editing: a molecular mechanism for the fine modulation of neuronal transmission Pizzi, M., Sarnico, I., Boroni, F., Benetti, A., Benarese, M., Spano, P. F.: • Inhibition of IkBa phosphorylation prevents glutamate-induced NF-kB activation and neuronal cell death Seitz, R. J., Kleiser, R., Bu¨ tefisch, C. M.: • Reorganization of cerebral circuits in human brain lesion Liepert, J.: • Transcranial magnetic stimulation in neurorehabilitation Wilson, J. T. L.: • Is there impairment of a specific frontal lobe circuit in head injury? Dinse, H. R.: • Treating the aging brain: cortical reorganization and behavior Prosiegel, M., Ho¡§ ling, R., Heintze, M., Wagner-Sonntag, E., Wiseman, K.: • The localization of central pattern generators for swallowing in humans . a clinical-anatomicalstudy on patients with unilateral paresis of the vagal nerve, Avellis¡¯ syndrome, Wallenberg¡¯s syndrome, posterior fossa tumours and cerebellar hemorrhage Gharabaghi, A., Tatagiba, M.: • Functional regeneration of the axotomized auditory nerve with combined neurotrophic and antiinhibitory strategies Tatagiba, M., Gharabaghi, A.: • Electrically evoked hearing perception by functional neurostimulation of the central auditory system Foffani, G., Ardolino, G., Rampini, P., Tamma, F., Caputo, E., Egidi, M., Cerutti, S., Barbieri, S., Priori, A.: • Physiological recordings from electrodes implanted in the basal ganglia for deep brain stimulation in Parkinson¡¯s disease. The relevance of fast subthalamic rhythms Yamamoto, T., Kobayashi, K., Kasai, M., Oshima, H., Fukaya, C., Katayama, Y.: • DBS therapy for the vegetative state and minimally conscious state Mehdorn, H. M., Pinsker, M. O., Volkmann, J., Hamel, W., Schrader, B., Stiller, U., Herzog, J., Deuschl, G.: • Deep brain stimulation for idiopathic or secondary movement disorders. Pagni, C. A., Altibrandi, M. G., Bentivoglio, A., Caruso, G., Cioni, B., Fiorella, C., Insola, A., Lavano, A., Maina, R., Mazzone, P., Signorelli, C. D., Sturiale, C., Valzania, F., Zeme, S., Zenga, F.: • Extradural Motor Cortex Stimulation (EMCS) for Parkinson¡¯s disease. History and first results by the study group of the Italian neurosurgical society Samadani, U., Reyes-Moreno, I., Buchfelder, M.: • Endocrine dysfunction following traumatic brain injury: mechanisms, pathophysiology and clinical correlations Hoffmann, B., Sepehrnia, A.: • Taylored implants for alloplastic cranioplasty . clinical and surgical considerations Zitnay, G. A.: • Lessons from National and International TBI Societies and Funds like NBIRTT C. Re-engineering of spinal cord lesions Brunelli, G. A.: • Brachial plexus surgery (Honorary lecture) Stamate, T., Budurca, A. R., Lazar, A. N., Tamas, C., Stamate,
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