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Biomedical subjects

Spiros Konitsiotis

Publications and source records attributed to Spiros Konitsiotis.

6 recordsLinked to original sources

Levetiracetam in tardive dyskinesia: an open label study.

Levetiracetam (LEV), a novel antiepileptic drug, has demonstrated antidyskinetic effect in preclinical animal models of Parkinson's disease (PD) and in one open label study in PD patients with levodopa-induced dyskinesia. The acute antidyskinetic effects of LEV in patients with tardive dyskinesia were evaluated in an open label study. Eight patients received oral LEV (1,000 mg/day) for 1 month and blinded evaluations were performed at baseline and at the end of the treatment period. A significant reduction of the abnormal movements was recorded while psychiatric symptoms did not worsen and the adverse event profile was benign. LEV may be efficacious for the treatment of tardive dyskinesia and deserves further clinical testing.

Adult↗

EEG transient event detection and classification using association rules.

In this paper, a methodology for the automated detection and classification of transient events in electroencephalographic (EEG) recordings is presented. It is based on association rule mining and classifies transient events into four categories: epileptic spikes, muscle activity, eye blinking activity, and sharp alpha activity. The methodology involves four stages: 1) transient event detection; 2) clustering of transient events and feature extraction; 3) feature discretization and feature subset selection; and 4) association rule mining and classification of transient events. The methodology is evaluated using 25 EEG recordings, and the best obtained accuracy was 87.38%. The proposed approach combines high accuracy with the ability to provide interpretation for the decisions made, since it is based on a set of association rules.

Algorithms↗

Novel pharmacological strategies for motor complications in Parkinson's disease.

In advanced Parkinson's disease, the combination of disease progression and levodopa therapy leads to the development of motor problems complicating the therapeutic response, known as motor response complications. The nonphysiological, pulsatile stimulation produced by most currently available dopaminergic therapies triggers a complicated series of responses resulting in the dysregulation of glutamate receptors and many other neurotransmitter systems on striatal neurons. Although a number of novel compounds that provide a more continuous dopaminergic stimulation are becoming available, no practical way to accomplish this in a truly physiological manner currently exists. Novel strategies for pharmacological intervention with the use of nondopaminergic treatments, with drugs targeting selected transmitter receptors expressed on striatal neurons appear more promising. These include NMDA or AMPA antagonists, or drugs acting on 5-hydroxytryptamine subtype 2A, alpha2-adrenergic, adenosine A2A and cannabinoid CB1 receptors. Future strategies may also target pre- and postsynaptic components that regulate firing pattern, like synaptic vesicle proteins, or nonsynaptic gap junction communication mechanisms, or drugs with actions at the signal transduction systems that modulate the phosphorylation state of NMDA receptors. These new therapeutic strategies, alone or in combination, hold the promise of providing effective control or reversal of motor response complications.

Administration, Cutaneous↗

Spontaneous intracranial hypotension: morphological findings and CSF flow dynamics studied by MRI.

We report on a case of spontaneous intracranial hypotension (SIH) presenting with classic MR findings, such as diffuse smooth thickening and intense contrast enhancement of the dura matter, increased size of the pituitary gland and downward displacement of the brain. In this case an engorgement of the cavernous sinuses is reported as an additional imaging finding of SIH. Moreover, phase-contrast MR study of the CSF flow dynamics revealed at the level of the aqueduct a decrease of the systolic and diastolic flow volume of CSF. A normalization of the flow volume was observed when SIH subsided.

Adult↗

Complications of a trophic xenotransplant approach in parkinsonian monkeys.

Various restorative cell transplantation strategies have been investigated to substitute for lost dopamine (DA) neurons or to enhance DA synthesis in Parkinson's disease. Intracerebral implantation of engineered cells encapsulated in a semipermeable polymer membrane constitutes one way to deliver bioactive substances unable to cross the blood-brain barrier while avoiding the need for long-term immunosuppression. Glial cell line-derived neurotrophic factor (GDNF) has shown trophic effects on DA neurons but effective and sustained delivery within the brain parenchyma remains problematic. The long-term efficacy and late complications of a xenotransplant approach utilizing GDNF-expressing encapsulated baby hamster kidney (BHK) cells were examined. Each of five MPTP-lesioned parkinsonian cynomolgus monkeys received five devices containing active or inert cells grafted bilaterally in the striatum in a two-stage procedure 9 months apart and animals were sacrificed 4 months later for analyses. No definite motor benefit was observed, DA levels were comparable between GDNF- and control cell-implanted striata, and tyrosine hydroxylase (TH) immunoreactivity in the substantia nigra showed no consistent recovery. Cell viability and GDNF synthesis in the explanted devices were negligible. The brain tissue surrounding all implants showed an intense immune reaction with prominent "foreign body" inflammatory infiltrates. Membrane biophysics, the cell type used, and the extended period of time the devices remained in situ may have contributed to the negative outcome and should be addressed in future investigations using this approach.

Animals↗