Browsing by Author "Toth, Cory"

Now showing 1 - 9 of 9
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    Absence of clinical relationship between oxidized low density lipoproteins and diabetic peripheral neuropathy: a case control study
    (BioMed Central, 2014-02-12) Rosales-Hernandez, Alma; Cheung, Audrey; Podgorny, Peter; Chan, Cynthia; Toth, Cory
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    An investigation of the role of insulin deficiency and loss of pi3k-akt signaling in the pathogenesis of the diabetic brain.
    (2012-08-30) Derakhshan, Fatemeh; Toth, Cory
    Type 1 diabetes mellitus (DM) is associated with cognitive dysfunction, cerebral atrophy and white matter abnormalities composing diabetic leukoencephalopathy (DLE). Insulin deficiency contributes to these deficits and is amenable to replacement with intervention using intranasal insulin (I-I) delivery. An important insulin-mediated signalling pathway is propagated through phosphatidylinositol 3-kinase (PI3K) and Akt. We hypothesized that blockade of the PI3K-Akt pathway would prevent I-I’s beneficial effects in mice with DLE, and that this blockade would contribute to development of similar dysfunction in non-diabetic mice. Transgenic mice overexpressing cerebral Akt were expected to be protected from cognitive and white matter changes associated with DM. We interrogated the PI3K-Akt signalling pathway in a mouse model of Streptozotocin- induced type 1 DM over 7 months of life. Diabetic and non-diabetic mice received daily I-I (or intranasal-saline (I-S) for controls) concurrently with intranasal delivery of a PI3K inhibitor (Wortmannin) or an Akt inhibitor (API2). Mice were tested weekly for cognitive function, using a battery of behavioural tests, and endpoint magnetic resonance imaging (MRI). DM mice receiving I-I were protected from cognitive decline, while those mice receiving I-I along with either Wortmannin or API2 were subject to cognitive decline. Interestingly, non-DM mice receiving Wortmannin also developed significant cognitive dysfunction. Akt overexpressing transgenic diabetic mice were protected from cognitive decline. These results suggesting the importance of the PI3K-Akt pathway in DLE in the mouse model of DM.
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    Cannabinoid-mediated modulation of neuropathic pain and microglial accumulation in a model of murine type I diabetic peripheral neuropathic pain
    (BioMed Central, 2010-03-17) Toth, Cory; Jedrzejewski, Nicole M.; Ellis, Connie L.; Frey, William H.
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    Comparison of central versus peripheral delivery of pregabalin in neuropathic pain states
    (BioMed Central, 2012-01-11) Martinez, Jose A.; Kasamatsu, Manami; Rosales-Hernandez, Alma; Hanson, Leah R.; H Frey, William; Toth, Cory
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    Ndel1 promotes axon regeneration via intermediate filaments
    (Public Library of Science, 2008-04-23) Toth, Cory; Shim, Su Yeon; Wang, Jian; Jiang, Yulan; Neumayer, Gernot; Belzil, Camille; Liu, Wei-Qiao; Martinez, Jose; Zochodne, Douglas; Nguyen, Minh Dang
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    The Impact of Enrollment in a Specialized Interdisciplinary Neuropathic Pain Clinic
    (2011-01-01) Garven, Alex; Brady, Shauna; Wood, Susan; Hatfield, Melinda; Bestard, Jennifer; Korngut, Lawrence; Toth, Cory
    BACKGROUND: Chronic pain clinics have been created because of the increasing recognition of chronic pain as a very common, debilitating condition that requires specialized care. Neuropathic pain (NeP) is a multifaceted, specialized form of chronic pain that often requires input from multiple disciplines for assessment and management.OBJECTIVE: To determine the impact of an interdisciplinary clinic for evaluation and treatment of patients with NeP.METHODS: Patients with heterogeneous etiologies for NeP were prospectively evaluated using an interdisciplinary approach every six months. Diagnostic evaluation, comorbidity evaluation, education, and pharmacological and/or nonpharmacological management were completed. Severity (visual analogue scale) and features of pain (Modified Brief Pain Inventory), sleep difficulties (Medical Outcomes Study – Sleep Scale), mood/anxiety disruption (Hospital Anxiety and Depression Scale), quality of life (European Quality-of-Life Five-Domain index), health care resources use, patient satisfaction (Pain Treatment Satisfaction Scale and Neuropathic Pain Symptom Inventory) and self-perceived change in well-being (Patient Global Impression of Change scale) were examined at each visit.RESULTS: Pain severity only decreased after one year of follow-up, while anxiety and quality-of-life indexes improved after six months. Moderate improvements of sleep disturbance, less frequent medication use and reduced health care resource use were observed during enrollment at the NeP clinic.DISCUSSION: Despite the limitations of performing a real-world, uncontrolled study, patients with NeP benefit from enrollment in a small interdisciplinary clinic. Education and a complete diagnostic evaluation are hypothesized to lead to improvements in anxiety and, subsequently, pain severity. Questions remain regarding the long-term maintenance of these improvements and the optimal structure of specialized pain clinics.
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