Hong Shen

Harbin Medical University, Charbin, Heilongjiang Sheng, China

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Publications (13)16.87 Total impact

  • Chinese medical journal 03/2014; 127(6):1187-8. · 0.90 Impact Factor
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    ABSTRACT: We evaluated the long-term outcome of epilepsy surgery in drug-resistant epilepsy patients, and investigated preoperative factors associated with postoperative long-term surgical outcome. We performed a retrospective study of 379 patients who received epilepsy surgeries from 2000 to 2010. Patients had completed a minimum of 2-year and up to 12-year follow-up. Preoperative evaluations, surgical outcomes and clinical data of patients were collected and analyzed. We found that the epilepsy surgery was effective in drug-resistant patients and the long-term outcome of epilepsy surgery was satisfactory. The bipolar electro-coagulation could improve the surgical outcome when the epileptogenic focus was on the functional cortex. Results of the 2-year follow-up showed that preoperative seizure characteristics including the history of febrile seizure, seizure frequency, and location, quantity and range of seizure foci were significantly associated with the surgical outcome. The surgery procedure including the surgery type and the extent of resection also affected outcome. Abnormal head or hippocampus MRI, inconsistent results of preoperative investigations, seizure types, and pathology type might also be predictors of long-term surgical outcome.
    Epilepsy research 01/2014; · 2.48 Impact Factor
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    ABSTRACT: Purpose Hippocampal sclerosis (HS), the most common feature of mesial temporal lobe epilepsy (MTLE), is widely accepted as surgical indication for refractory epilepsy. Pathological hallmarks in hippocampal dentate gyrus (DG), including granule cell loss (GCL) and granule cell dispersion (GCD), are known to be closely related to the status epilepticus and spontaneous seizure. Our aim was to assess the association between volumetric changes in the hippocampal CA4/DG determined with 3-Tesla (3 T) magnetic resonance imaging (MRI) and the postoperative seizure outcomes in MTLE patients with or without dentate gyrus pathology (DGP). Methods High-resolution T2-weighted and T1-weighted three-dimensional (3D) MRI scans were performed on 39 MTLE patients before surgery with a 3 T Philips scanner. ITK-SNAP software was used for segmentation and volumetry of the CA4/DG segment, and NASP software was used for 3D reconstructions of the CA4/DG region. Immunostaining for Neuronal Nuclei (NeuN) was performed on resected hippocampal specimens after surgery to verify the accuracy of CA4/DG segmentation and histopathological changes in DG. Results The CA4/DG subfield could be precisely segmented with high-resolution 3 T MRI, and confirmed by comparison of NeuN-immunoreactive slices with MRI results. MTLE patients with DGP showed smaller CA4/DG volume and favorable postoperative seizure outcomes. Conclusion The volumetry of CA4/DG was associated with the pathological changes in DG in MTLE patients. The volumetry of CA4/DG with preoperative 3 T MRI could predict the postoperative seizure outcomes in those patients.
    Epilepsy Research. 01/2014;
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    ABSTRACT: Purpose Surgery is regarded as a common treatment option for patients with mesial temporal lobe epilepsy (MTLE) as a result of hippocampal sclerosis (HS). However, approximately one-third of patients with intractable epilepsy did not become seizure-free after tailored resection strategies. It would be compelling to identify predictive factors of postoperative seizure outcomes. Our aim was to assess the correlation between HS classification and long-term postoperative seizure outcome in patients with MTLE due to HS. Methods To investigate HS classification, semi-quantitative analysis and immunohistochemical staining of neuronal nuclei (NeuN) were performed on 100 postoperative hippocampal specimens. All patients had a 1-7 year postoperative follow-up. The postoperative seizure outcome was evaluated using ILAE outcome classification. Results Three types of HS were recognized. The highest incidence of initial precipitating injury (IPI) was noted in the HS ILAE type 1 group (53.1%). The most favorable long-term seizure outcome was also noted in the HS ILAE type 1 group. The shortest epilepsy duration was recorded in the HS ILAE type 2 group (mean epilepsy duration = 6.64 ± 5.83 years). The completely seizure free rate of patients in all groups declined with an increase in time. Conclusions Our study for the first time demonstrated a significant correlation between HS ILAE types and long-term postoperative seizure outcome in patients with MTLE due to HS. Therefore, HS ILAE types have predictive value in long-term seizure outcome following epilepsy surgery.
    Seizure 01/2014; · 2.00 Impact Factor
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    ABSTRACT: Background: We investigated the rate of corpus callosum (CC) atrophy and its association with cognitive decline in early Alzheimer's disease (AD). Methods: We used publicly available longitudinal MRI data corresponding to 2 or more visits from 137 subjects characterized using the Clinical Dementia Rating (CDR) score. We classified these subjects into 3 groups according to the progression of their cognitive status: a healthy control group (CDR 0→0, n = 72), a decliner group (CDR 0→0.5, n = 14) and an AD group (CDR 0.5→0.5/1, n = 51). We measured the CC area on the midsagittal plane and calculated the atrophy rate between 2 or more visits. The correlation between the CC atrophy rate and annualized Mini Mental State Examination (MMSE) change was also analyzed. Results: The results indicated that the baseline CC area was larger in the healthy control group compared to the AD group, whereas the CC atrophy rate was higher in the AD group relative to the control and decliner groups. The CC atrophy rate was also correlated with the annualized MMSE change in AD patients (p < 0.05). Conclusion: Callosal atrophy is present even in early AD and subsequently accelerates, such that the rate of CC atrophy is associated with cognitive decline in AD patients. © 2013 S. Karger AG, Basel.
    Dementia and Geriatric Cognitive Disorders 10/2013; 37(3-4):214-222. · 2.79 Impact Factor
  • Chinese medical journal 04/2013; 126(7):1390-1. · 0.90 Impact Factor
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    ABSTRACT: Status epilepticus (SE) causes neuronal loss and apoptosis by inducing several apoptosis-regulatory genes. Two such genes, cysteinyl aspartate-specific protease-3 (caspase-3), an apoptosis activator, and B-cell leukemia-2 (Bcl-2), an apoptosis suppressor, are tightly regulated for their expression and activation. Statins, inhibitors of HMG-CoA reductase, have been recently recognized as neuroprotective drugs. However, their underlying mechanisms are still unclear. In this study, we examined the neuroprotective effects of simvastatin in a rat model of SE induced by kainic acid (KA). Feeding of simvastatin for 3 days after kainate injection rescued SE-induced neuronal apoptosis, as determined by histological examination of brain sections at the level of the dorsal hippocampus. Semi-quantitative RT-PCR showed that SE treatment markedly increased caspase-3 mRNA expression and reduced Bcl-2 mRNA expression in the hippocampus. Similarly, western blot analysis and immunohistochemical analysis of the rat hippocampus demonstrated that under SE treatment, caspase-3 protein levels significantly increased and peaked at 72 h, whereas Bcl-2 protein levels decreased from 6-24 h following SE. Interestingly, simvastatin could reverse the aforementioned SE-induced changes, suggesting that the neuroprotective effects of simvastatin against neuronal apoptosis may be achieved by inhibiting caspase-3 expression and increasing Bcl-2 expression.
    International Journal of Molecular Medicine 07/2012; · 1.96 Impact Factor
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    ABSTRACT: Spontaneous intracerebellar hemorrhage (SCH) accounts for 10% of intracerebral hemorrhages. Up to now stereotactic aspiration and thrombolysis of SCH was less reported. The aim of this study was to assess the effect and feasibility of the method, and to refine the clinical protocol. Eighteen patients with SCH were treated by stereotactic aspiration and thrombolysis and reviewed in this report. The 3-mm axial stereotactic computed tomography slices throughout the hematoma were obtained. Those images were then transferred to the workstation. The trajectory of catheter was designed to go through the main axis of the hematoma. Under local anesthesia a catheter was directed stereotactically into the hematoma through a burr hole. Hematoma thrombolysis and clot drainage was followed by instillation of urokinase (10,000 U) every 12 hours. The catheter was removed when the majority of hematoma was evacuated. Initial SCH volume was reduced by an average of 86% and the average final hematoma volume was 2.8 ml. At 3-month follow-up, 13 patients (72%) had achieved good recovery. At 6-month follow-up, 12 patients (67%) had achieved good recovery. Stereotactic aspiration and thrombolysis of SCH was a simple, feasible and effective method to treat moderate and some benign SCH that less respond to medical treatment.
    Chinese medical journal 06/2011; 124(11):1610-5. · 0.90 Impact Factor
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    ABSTRACT: We evaluated the effectiveness of computed tomography (CT)-guided stereotatic implantation of Ommaya reservoir in the management of brain abscess. Forty-five patients with brain abscesses were treated with CT-guided stereotatic implantation of Ommaya reservoir and followed up between September 1998 and February 2008. The Glasgow Outcome Scale (GOS) was use to evaluate the effectiveness of the Ommaya Reservoir treatment. The GOS score at 3-months post-operation was 5 for 41 patients (91.1%), 4 for 2 patients (4.4%) and 3 for 2 patients (4.4%), respectively. The results suggest that the CT-guided stereotatic implantation of Ommaya reservoir is a potential technique that can be safely used to treat the brain abscess.
    British Journal of Neurosurgery 12/2010; 25(5):636-40. · 0.86 Impact Factor
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    ABSTRACT: Hippocampal stem cells (HSCs) are considered promising donor cells to promote reorganization of degenerated regions of the injured hippocampus in the epileptic brain. However, the efficacy of HSC grafting for repairing injured hippocampus remains unclear. To address this issue, we transplanted neonatal rat HSCs into the right hippocampus in rats with kainite acid (KA)-induced epilepsy. The activity of the hippocampus and amygdala nucleus was monitored with electroencephalogram (EEG) throughout 24 weeks posttransplantation. Rats with grafted HSCs exhibited reduced frequency of epileptic wave discharge and a 50% decrease in the amplitude of discharge. At 1, 4, 8, and 24 weeks posttransplantation, the aberrant mossy fiber sprouting (MFS) was evaluated with Timm's stain and the number of CA3 pyramidal neurons was analyzed with Nissl staining. Aberrant MFS induced by KA-lesion was notably suppressed by HSC grafts beginning 4 weeks posttransplantation, and was most effective by 8 weeks. In addition, the loss of CA3 pyramidal neurons was partially restored and reached the most recovery at 8 weeks. Taken together, these results suggest that HSCs derived from the postnatal hippocampus offer a promising reparative effect on KA-induced epileptic brain.
    The International journal of neuroscience 10/2010; 120(10):647-54. · 0.86 Impact Factor
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    ABSTRACT: The subthalamic nucleus (STN) is widely recognized as one of the most important and commonly targeted nuclei in stereotactic and functional neurosurgery. The success of STN surgery depends on accuracy in target determination. Construction of a digitalized atlas of STN based on stereotactic MRI will play an instrumental role in the accuracy of anatomical localization. The aim of this study was to investigate the three-dimensional (3D) target location of STN in stereotactic space and construct a digitalized atlas of STN to accomplish the visualization of the STN on stereotactic MRI, thus providing clinical guidance on the precise anatomical localization of STN. One hundred and twenty healthy people volunteered to be scanned by 1.5 Tesla MRI scanning with 1-mm-thick slice in the standard stereotactic space between 2005 and 2006. One adult male was selected for 3D reconstruction of STN. The process of 3D reconstruction included identification, manual segmentation, extraction, conservation and reconstruction. There was a significant correlation between the coordinates and age (P < 0.05). The volume of left STN was significantly larger than the right STN, and there was a significant negative correlation between volume and age (P < 0.05). The surface of the STN nucleus after 3D reconstruction appeared smooth, natural and realistic. The morphological feature of STN on the individual brain could be visualized directly in 3D. The 3D reconstructed STN could be rotated, zoomed and displayed at any direction in the stereotactic space. The anteroposterior diameter of the STN nucleus was longer than the vertical and transverse diameters in 3D space. The 3D reconstruction of STN manifested typical structure of the "dual lens". The visualization of individual brain atlas based on stereotactic MRI is feasible. However, software for automated segmentation, extraction and registration of MR images need to be further developed.
    Chinese medical journal 10/2009; 122(20):2438-43. · 0.90 Impact Factor
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    ABSTRACT: Vagus nerve stimulation (VNS) therapy has been widely recognized as an effective alternative for the treatment of refractory epilepsy. However, the precise mechanism of VNS is poorly understood. The purpose of this study was to observe the long-term interictal EEG changes induced by VNS, and to investigate the probable mechanism of action of VNS in achieving seizure control. Eight patients with VNS were selected from two epilepsy centers in China (Harbin and Shanghai) between 2001 and 2004. We studied the clinical efficacy by long-term follow-up, ranging from 37 to 81 months (mean 55.8 months). Moreover, serial EEGs were performed at the different time (preoperative baseline, 3, 6, 12, and 24 months after VNS initiation) and the different states of VNS stimulator ("activation", "deactivation" and "reactivation"). A > or = 50% seizure reduction was achieved in 12.5%, 62.5%, 75%, 62.5% and 75% of the total patients (n=8) at 6, 12, 18, 24 and 36 months of post-VNS, respectively. The results revealed a statistically significant progressive decrease in the number of IEDs (interictal epileptiform discharges) on EEG with time (P<0.01). Significant correlation had been highlighted after 6 months of VNS stimulation, between the reduction of seizure frequency and the decreasing of IEDs (P<0.01). Furthermore, statistically significant difference of IEDs was seen when comparing the state of "deactivation" with the states of "activation" and "reactivation", respectively (P<0.01). However, there was no significant difference in IEDs between "activation" and "reactivation" (P>0.05). VNS is an efficient, well-tolerated therapy for refractory epilepsy. It can induce progressive electrophysiological effect on epileptiform activity over time. This may reflect the mechanism of chronic action of VNS with desynchronization of EEG in achieving seizure control.
    Journal of the neurological sciences 06/2009; 284(1-2):96-102. · 2.32 Impact Factor
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    ABSTRACT: To observe the microstructure of the cell membrane of epileptic neurons using atomic force microscopy (AFM). Model of epileptic neurons was established by subjecting the neurons culture for 14 days in vitro to magnesium-free media treatment for 3 h. Patch clamp technique was applied to record the electrophysiological activity of the epileptic neurons. AFM was performed to observe and measure the microstructure of the cell membrane of the epileptic neuron. After a 3-hour treatment with magnesium-free media, the epileptic neurons displayed sustained epileptiform discharge, which continued after the neurons were returned to normal medium culture on day 14. Under AFM scanning size of 80 microm x 80 microm and 2 microm x 2 microm, no obvious difference in the morphology of the cell membrane was noted between epileptic and normal neurons; under the scanning size of 500 nm x 500 nm, small pits occurred in the cell membrane in both groups, but no significant difference was found in the dimension of the pits between the two groups (the diameter and depth of the pits was 114.86-/+9.33 nm and 5.71-/+0.69 nm in epileptic neurons, and 116.4-/+9.13 nm and 5.69-/+0.71 nm in the control neurons, respectively, P>0.05). AFM provides a new method for observing neuronal membrane microstructure at nanometer resolutions. No significant alterations occur in the membrane of the neurons after a 3-hour magnesium-free media treatment.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 05/2007; 27(4):501-4.

Publication Stats

14 Citations
16.87 Total Impact Points

Institutions

  • 2007–2014
    • Harbin Medical University
      • Department of Neurosurgery
      Charbin, Heilongjiang Sheng, China