{"id":"f96b247a-27e5-4507-8d2c-025fb669eec0","slug":"from-the-bench-to-the-bedside-brain-machine-interfaces-in-spinal-cord-injury-the-blood-brain-barrier-andneurodegeneration-using-the-hippocampus-to-improve-cognition-metabolism-a","title":"From the bench to the bedside: Brain–machine interfaces in spinal cord injury, the blood–brain barrier, and\nneurodegeneration, using the hippocampus to improve cognition, metabolism, and epilepsy, and understanding axonal death","authors":["Rich Everson","Jason S. Hauptman"],"abstract":"Background: Memory loss and dementia, particularly Alzheimer's disease, are increasingly prevalent as the population ages. The hippocampus plays a crucial role in memory formation, with abnormal activity patterns observed in patients with amnestic mild cognitive impairment (aMCI). Recent studies suggest that increased hippocampal activity may not be beneficial and could contribute to cognitive impairment. Methods: A clinical trial was conducted to evaluate the cognitive effects of pharmacologically reducing elevated hippocampal activity in aMCI patients using levetiracetam. The study involved two treatment phases with a washout period, where aMCI patients received levetiracetam or placebo, while control patients received placebo in both phases. Functional magnetic resonance imaging was utilized alongside a behavioral task to assess cognitive performance. Results: Pharmacologic treatment with levetiracetam significantly reduced elevated hippocampal activity to near baseline levels, leading to fewer errors in identifying images as 'old' and an increase in correct responses for 'similar' images. Other cognitive and neuropsychological tests showed no significant changes, and the effects of treatment reversed within four weeks after discontinuation. Conclusion: The study provides evidence that elevated hippocampal activity in aMCI patients is not a beneficial compensatory mechanism, but rather a factor contributing to cognitive impairment. Regulation of this hyperactivity with levetiracetam appears to have cognitive benefits, suggesting a potential therapeutic avenue for aMCI. Keywords: Hippocampus, Cognitive impairment, Levetiracetam, Amnestic mild cognitive impairment, Neurodegeneration, Memory loss, Functional MRI","thumbnailUrl":null,"publishDate":"2012-09-13T00:00:00.000Z","doi":"10.4103/2152-7806.101002","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/f96b247a-27e5-4507-8d2c-025fb669eec0/pdf"}