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Wu Y, Gu D, Li J, Li J, Hou G. Role of the gut microbiota in cefoperazone/sulbactam-induced epilepsy in mice with chronic renal failure. Ren Fail 2024; 46:2371551. [PMID: 38938213 PMCID: PMC11216236 DOI: 10.1080/0886022x.2024.2371551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/18/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVES The mechanism of cefoperazone/sulbactam-induced epilepsy in chronic kidney disease (CKD) patients is not yet clear. We hypothesized that cefoperazone/sulbactam-induced epilepsy could be based on two main factors: neurotoxicity caused by drug accumulation after renal failure and an abnormal gut microbiota (GM). METHODS A chronic renal failure (CRF) model in mice was established, and then different doses of cefoperazone/sulbactam were injected to induce epilepsy in mice. Normal mouse feces for fecal microbiota transplantation (FMT) were collected. We observed the changes in feces, mental state, and activity of each group of mice. After killing, we collected kidneys and colon for H&E staining. We collected mouse feces for the 16S RNA sequencing of bacteria. RESULTS All CRF mice injected with different concentrations of cefoperazone/sulbactam experienced grade-V seizures and eventually died, whereas normal control mice did not. However, after FMT intervention, the time of epilepsy onset and death in mice was delayed. Early FMT intervention resulted in more mice surviving (p = .0359). Moreover, the villi in the mucosal of group-CS layer fell off, goblet cells missed, and crypts disappeared. The mucosal layer and submucosa were clearly separated. The morphology of intestinal tissue of the CFS and FS group was improved. After FMT, the changes of the GM were observed. CONCLUSIONS The GM may be involved in the epilepsy induced by cefoperazone/sulbactam in CRF mice. FMT can delay the onset of epilepsy in CRF mice induced by cefoperazone/sulbactam, and the earlier the intervention, the better the effect.
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Affiliation(s)
- Yulu Wu
- Department of Nephrology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
| | - Donghua Gu
- Department of Pathology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
| | - Jie Li
- Department of Nephrology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
| | - Jing Li
- Department of Neurology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
| | - Guocun Hou
- Department of Nephrology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
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White DR, Palmieri PA. There is 'no cure for caregiving': the experience of women caring for husbands living with Parkinson's disease. Int J Qual Stud Health Well-being 2024; 19:2341989. [PMID: 38657183 PMCID: PMC11044767 DOI: 10.1080/17482631.2024.2341989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Parkinson's disease is a progressive neurodegenerative disorder. The majority of the nearly 9 million people living with Parkinson's disease are men. As such, caregiving is often assumed by wives as the disease progresses. However, there is little research about the lived experience of wives as they transition to caregivers. OBJECTIVE To describe the lived experience of wife caregivers of male spouses living at home with Parkinson's disease. METHODS A descriptive phenomenological study. Semi-structured interviews were recorded and transcribed for analysis in Atlas.ti using Colaizzi's method. RESULTS Thirteen women, aged 50 to 83 years, were interviewed. Five themes emerged from the analysis, (1) caregiver who? (2) taking it day by day, (3) not sure what to do next, (4) just too much, and (5) caring is your soul's growth, to support the central theme "there is no cure for caregiving." CONCLUSION Transitioning from wife to caregiver was a gradual but difficult process. Although the wife caregivers wanted to be part of the health care team, they remained outsiders. Clinicians need to recognize the wives as care coordinators linking medical management with home care. Policy makers need to develop reimbursement models that provide wife caregivers with support groups, education programs, and telemental health services.
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Affiliation(s)
- Dawn R. White
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- Benerd College, University of the Pacific, Stockton, CA, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
| | - Patrick A. Palmieri
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- College of Nursing and Health Sciences, Excelsior University, Albany, NY, USA
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
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AL-Hashem FH, Bashir SO, Dawood AF, Aboonq MS, Bin-Jaliah I, Al-Garni AM, Morsy MD. Vanillylacetone attenuates cadmium chloride-induced hippocampal damage and memory loss through up-regulation of nuclear factor erythroid 2-related factor 2 gene and protein expression. Neural Regen Res 2024; 19:2750-2759. [PMID: 38595292 PMCID: PMC11168521 DOI: 10.4103/1673-5374.391300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/01/2023] [Accepted: 12/07/2023] [Indexed: 04/11/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202412000-00030/figure1/v/2024-04-08T165401Z/r/image-tiff Memory loss and dementia are major public health concerns with a substantial economic burden. Oxidative stress has been shown to play a crucial role in the pathophysiology of hippocampal damage-induced memory impairment. To investigate whether the antioxidant and anti-inflammatory compound vanillylacetone (zingerone) can protect against hippocampal damage and memory loss induced by cadmium chloride (CdCl2) administration in rats, we explored the potential involvement of the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, which is known to modulate oxidative stress and inflammation. Sixty healthy male Wistar rats were divided into five groups: vehicle-treated (control), vanillylacetone, CdCl2, vanillylacetone + CdCl2, vanillylacetone + CdCl2 + brusatol (a selective pharmacological Nrf2 inhibitor) groups. Vanillylacetone effectively attenuated CdCl2-induced damage in the dental gyrus of the hippocampus and improved the memory function assessed by the Morris Water Maze test. Additionally, vanillylacetone markedly decreased the hippocampal tissue levels of inflammatory biomarkers (interleukin-6, tumor necrosis factor-α, intracellular cell adhesive molecules) and apoptosis biomarkers (Bax and cleaved caspase-3). The control and CdCl2-treated groups treated with vanillylacetone showed reduced generation of reactive oxygen species, decreased malondialdehyde levels, and increased superoxide dismutase and glutathione activities, along with significant elevation of nuclear Nrf2 mRNA and protein expression in hippocampal tissue. All the protective effects of vanillylacetone were substantially blocked by the co-administration of brusatol (a selective Nrf2 inhibitor). Vanillylacetone mitigated hippocampal damage and memory loss induced by CdCl2, at least in part, by activating the nuclear transcription factor Nrf2. Additionally, vanillylacetone exerted its potent antioxidant and anti-inflammatory actions.
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Affiliation(s)
- Fahaid H. AL-Hashem
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Salah O. Bashir
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Amal F. Dawood
- Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, P.O.Box 84428, Riyadh 11671, Saudi Arabia
| | - Moutasem S. Aboonq
- Department of Physiology, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Ismaeel Bin-Jaliah
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Mohamed D. Morsy
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Titisari N, Fauzi A, Abdul Razak IS, Mohd Noor MH, Samsulrizal N, Ahmad H. Dietary menhaden fish oil supplementation suppresses lipopolysaccharide-induced neuroinflammation and cognitive impairment in diabetic rats. PHARMACEUTICAL BIOLOGY 2024; 62:447-455. [PMID: 38753370 PMCID: PMC11100436 DOI: 10.1080/13880209.2024.2351933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
CONTEXT Menhaden fish oil (FO) is widely recognized for inhibiting neuroinflammatory responses and preserving brain function. Nevertheless, the mechanisms of FO influencing brain cognitive function in diabetic states remain unclear. OBJECTIVE This study examines the potential role of FO in suppressing LPS-induced neuroinflammation and cognitive impairment in diabetic animals (DA). MATERIALS AND METHODS Thirty male Wistar rats were divided into 5 groups: i) DA received LPS induction (DA-LPS); ii) DA received LPS induction and 1 g/kg FO (DA-LPS-1FO); iii) DA received LPS induction and 3 g/kg FO (DA-LPS-3FO); iv) animals received normal saline and 3 g/kg FO (NS-3FO) and v) control animals received normal saline (CTRL). Y-maze test was used to measure cognitive performance, while brain samples were collected for inflammatory markers and morphological analysis. RESULTS DA received LPS induction, and 1 or 3 g/kg FO significantly inhibited hyperglycaemia and brain inflammation, as evidenced by lowered levels of pro-inflammatory mediators. Additionally, both DA-LPS-1FO and DA-LPS-3FO groups exhibited a notable reduction in neuronal damage and glial cell migration compared to the other groups. These results were correlated with the increasing number of entries and time spent in the novel arm of the Y-maze test. DISCUSSION AND CONCLUSION This study indicates that supplementation of menhaden FO inhibits the LPS signaling pathway and protects against neuroinflammation, consequently maintaining cognitive performance in diabetic animals. Thus, the current study suggested that fish oil may be effective as a supporting therapy option for diabetes to avoid diabetes-cognitive impairment.
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Affiliation(s)
- Nurina Titisari
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Veterinary Physiology, Faculty of Veterinary Medicine, Universitas Brawijaya, East Java, Indonesia
| | - Ahmad Fauzi
- Department of Clinical Pathology, Faculty of Veterinary Medicine, Universitas Brawijaya, East Java, Indonesia
| | - Intan Shameha Abdul Razak
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Mohd Hezmee Mohd Noor
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Hafandi Ahmad
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
- Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Selangor, Malaysia
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Rasheed U, Khan S, Khalid M, Noor A, Zafar S. A systemic analysis of Creutzfeldt Jakob disease cases in Asia. Prion 2024; 18:11-27. [PMID: 38323574 PMCID: PMC10854368 DOI: 10.1080/19336896.2024.2311950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
Creutzfeldt Jakob Disease (CJD) is a rapidly progressive, fatal neurodegenerative disorder, also known as a subacute spongiform encephalopathy. There are three major subtypes of CJD i.e. Sporadic CJD, which occurs for reasons unbeknown to science (85% of known cases), Genetic or Familial CJD which is characterized by the presence of mutations in the human prion protein (PRNP) gene (10-15% cases) and Iatrogenic CJD that occurs via accidental transmission through medical and surgical procedures (1-2% cases). CJD cases occur globally with 1 case per one million population/year. Considerable data is available related to the incidence and prevalence of CJD in Europe and America. However, the global surveillance database is yet to include Asia even though several Asian countries have their own CJD monitoring units. sCJD is the highest among all CJD cases in Asia. China (1957) and Japan (1705) have reported more cases of sCJD than any Asian country and Hong Kong (1) has reported the least. On the other hand, gCJD is highest in Japan (370) and least in India (2). Our analysis establishes the presence of all variants of CJD across Asia. However, in most Asian countries in general and Southeast Asian countries in particular, CJD cases are misdiagnosed and often underreported. Since Asia is the most populated continent in the world, the actual global prevalence of CJD cannot be estimated until and unless these countries are accounted for. Concrete and reliable surveillance networks are needed across Asia to evaluate the prevalence and incidence of CJD in the region. [Figure: see text]The graphical abstract demonstrates the prevalence of CJD cases in the world and systematically analyses the incidence of CJD in Asian countries between the year 1986-2022. Highest number of cases were reported in Japan followed by China. The study emphasizes the need for assimilation of Asian data in global prevalence.
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Affiliation(s)
- Urwah Rasheed
- Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology, Islamabad, Pakistan
| | - Sana Khan
- Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology, Islamabad, Pakistan
| | - Minahil Khalid
- Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology, Islamabad, Pakistan
| | - Aneeqa Noor
- Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology, Islamabad, Pakistan
| | - Saima Zafar
- Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology, Islamabad, Pakistan
- Clinical Department of Neurology, University Medical Centre Göttingen and the German Centre for Neurodegenerative Diseases (DZNE), Robert, Germany
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Stopera CJ, Bartlett MJ, Liu C, Esqueda A, Parmar R, Heien ML, Sherman SJ, Falk T. Differential effects of opioid receptor antagonism on the anti-dyskinetic and anti-parkinsonian effects of sub-anesthetic ketamine treatment in a preclinical model. Neuropharmacology 2024; 257:110047. [PMID: 38889877 DOI: 10.1016/j.neuropharm.2024.110047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
Sub-anesthetic ketamine treatment has been shown to be an effective therapy for treatment-resistant depression and chronic pain. Our group has previously shown that sub-anesthetic ketamine produces acute anti-parkinsonian, and acute anti-dyskinetic effects in preclinical models of Parkinson's disease (PD). Ketamine is a multifunctional drug and exerts effects through blockade of N-methyl-d-aspartate receptors but also through interaction with the opioid system. In this report, we provide detailed pharmacokinetic rodent data on ketamine and its main metabolites following an intraperitoneal injection, and second, we explore the pharmacodynamic properties of ketamine in a rodent PD model with respect to the opioid system, using naloxone, a pan-opioid receptor antagonist, in unilateral 6-hydroxydopamine-lesioned male rats, treated with 6 mg/kg levodopa (l-DOPA) to establish a model of l-DOPA-induced dyskinesia (LID). As previously reported, we showed that ketamine (20 mg/kg) is highly efficacious in reducing LID and now report that the magnitude of this effect is resistant to naloxone (3 and 5 mg/kg). The higher naloxone dose of 5 mg/kg, however, led to an extension of the time-course of the LID, indicating that opioid receptor activation, while not a prerequisite for the anti-dyskinetic effects of ketamine, still exerts an acute modulatory effect. In contrast to the mild modulatory effect on LID, we found that naloxone added to the anti-parkinsonian activity of ketamine, further reducing the akinetic phenotype. In conclusion, our data show opioid receptor blockade differentially modulates the acute anti-parkinsonian and anti-dyskinetic actions of ketamine, providing novel mechanistic information to support repurposing ketamine for individuals with LID.
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Affiliation(s)
- Carolyn J Stopera
- Graduate Interdisciplinary Program in Neuroscience, The University of Arizona, Tucson, AZ, 85724, USA.
| | | | - Chenxi Liu
- Department of Chemistry & Biochemistry, The University of Arizona, Tucson, AZ, 85721, USA.
| | - Alexander Esqueda
- Department of Neurology, The University of Arizona, Tucson, AZ, 85724, USA.
| | - Raveena Parmar
- Department of Pharmacology, The University of Arizona, Tucson, AZ, 85724, USA.
| | - M Leandro Heien
- Department of Chemistry & Biochemistry, The University of Arizona, Tucson, AZ, 85721, USA.
| | - Scott J Sherman
- Department of Neurology, The University of Arizona, Tucson, AZ, 85724, USA.
| | - Torsten Falk
- Graduate Interdisciplinary Program in Neuroscience, The University of Arizona, Tucson, AZ, 85724, USA; Department of Neurology, The University of Arizona, Tucson, AZ, 85724, USA; Department of Pharmacology, The University of Arizona, Tucson, AZ, 85724, USA.
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Yen VT. Prenatal diagnosis of Joubert syndrome: A case report. Radiol Case Rep 2024; 19:4369-4374. [PMID: 39165313 PMCID: PMC11334561 DOI: 10.1016/j.radcr.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/03/2024] [Indexed: 08/22/2024] Open
Abstract
Joubert syndrome (JS) is a rare autosomal recessive disorder with brain stem and cerebellar malformations. Early diagnosis through Magnetic Resonance Imaging (MRI) and ultrasonography (US) is crucial for managing this condition. This report presents a JS case diagnosed at 24 weeks of pregnancy. A 25-year-old gravida 2, para 1 woman was referred at 24 weeks' gestation for suspected posterior fossa abnormalities. Ultrasound revealed normal cerebellar hemispheres but significant abnormalities in the cerebellar vermis, including the molar tooth sign and polydactyly, suggesting JS. The fetal MRI confirmed these findings. Following specialist consultations, the patient opted to terminate the pregnancy. A stillborn female infant was delivered, and genomic DNA sequencing identified a frameshift deletion in the AHI1 gene. Early prenatal diagnosis of JS is crucial for informed pregnancy management. The combination of ultrasonography, MRI, and genomic DNA sequencing proved effective for diagnosis.
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Affiliation(s)
- Vu T.H Yen
- Department of Radiology, Diamond Healthcare center, Ho Chi Minh city, Vietnam
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Cournoyer M, Gauthier AC, Maldera A, Maso FD, Mathieu ME. Effect of physical activity on olfaction acuity: A systematic review. Physiol Behav 2024; 284:114648. [PMID: 39059598 DOI: 10.1016/j.physbeh.2024.114648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 07/28/2024]
Abstract
Olfaction acuity, which includes detection thresholds, discrimination and identification, appears to decline with age, obesity, and various neurological disorders. Knowing that smell influences energy intake, there is a growing interest in protecting this sense. Physical activity could be a key intervention to counteract the loss of olfaction. This systematic review aims to explore the literature on the effect of physical activity on olfaction acuity. The search strategy consisted of using index terms and keywords in MEDLINE, EMBASE, EBM Reviews - Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, and Web of Science search engine. Data from 17 trials involving 10,861 participants showed that physical activity improved olfaction thresholds, discrimination, identification and perceived intensity. Regular practice of physical activity seemed to have better effects on olfaction components than acute exercise. Although this review has clarified the evidence on the effects of physical activity on olfaction, better methodological consistency is needed.
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Affiliation(s)
- Mathieu Cournoyer
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Alexandre-Charles Gauthier
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Alice Maldera
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Fabien Dal Maso
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Montreal, Canada; Centre Interdisciplinaire de Recherche sur le Cerveau et l'Apprentissage, Montreal, QC, Canada
| | - Marie-Eve Mathieu
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Montreal, Canada; Centre de Recherche Azrieli du CHU Sainte-Justine, Montreal, Canada.
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Ohira K, Kanai D, Inoue Y. Myelitis preceding anti-N-terminal of α-enolase antibody-positive Hashimoto's encephalopathy. Radiol Case Rep 2024; 19:4392-4396. [PMID: 39165314 PMCID: PMC11334564 DOI: 10.1016/j.radcr.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 08/22/2024] Open
Abstract
Hashimoto's encephalopathy is an autoimmune disease characterized by diverse clinical and imaging manifestations, often presenting considerable challenges in its diagnosis, especially when myelitis occurs before the onset of encephalopathy. Anti-N-terminal of α-enolase antibodies targeting the N-terminal of α-enolase are specific serum markers of Hashimoto's encephalopathy; however, studies analyzing their association with myelitis are lacking. Herein, we describe the case of a patient with myelitis who later developed encephalopathy. Owing to positivity for anti-N-terminal of α-enolase antibodies in the serum, a diagnosis of Hashimoto's encephalopathy was made. Detecting anti-NAE antibodies can be useful in diagnosing myelitis of unknown etiology.
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Affiliation(s)
- Kenji Ohira
- Department of Radiology, Japanese Red Cross Society Shizuoka Hospital, 8-2 Otemachi, Aoi Ward, Shizuoka City, Shizuoka Prefecture, 420-0853, Japan
| | - Daisuke Kanai
- Department of Radiology, Japanese Red Cross Society Shizuoka Hospital, 8-2 Otemachi, Aoi Ward, Shizuoka City, Shizuoka Prefecture, 420-0853, Japan
| | - Yukio Inoue
- Department of Radiology, Japanese Red Cross Society Shizuoka Hospital, 8-2 Otemachi, Aoi Ward, Shizuoka City, Shizuoka Prefecture, 420-0853, Japan
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Manisha KY, Fasaludeen A, Poulose P, Menon R, Thomas B, Nair SS, Cherian A, Divya KP, Sundaram S. Spectrum of Leukodystrophy and Genetic Leukoencephalopathy in Indian Population Diagnosed by Clinical Exome Sequencing and Clinical Utility. Neurol Genet 2024; 10:e200190. [PMID: 39184309 PMCID: PMC11343561 DOI: 10.1212/nxg.0000000000200190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 07/18/2024] [Indexed: 08/27/2024]
Abstract
Background and Objectives Next-generation sequencing (NGS) has expedited the diagnostic process and unearthed many rare disorders in leukodystrophy (LD) and genetic leukoencephalopathy (gLE). Despite the progress in genomics, there is a paucity of data on the distribution of genetic white matter disorders (WMDs) and the diagnostic utility of NGS-based assays in a clinical setting. This study was initiated to explore the clinical, radiologic, and genetic spectrum of LD and gLE in the Indian population and also to estimate the diagnostic yield of clinical exome sequencing (CES). Methods This is a retrospective descriptive analysis of patients with a diagnosis of genetic WMDs from a single tertiary referral center who had CES performed as part of the diagnostic evaluation between January 2016 and December 2021. The demographic, clinical, radiologic, and genetic data were collected. The variants were classified using the American College of Medical Genetics and Genomics criteria. Pathogenic and likely pathogenic variants were included in the calculation of the diagnostic yield. Results In the study period, 138 patients were clinically diagnosed with either LD or gLE, of which 86 patients underwent CES. Pathogenic variants, likely pathogenic variants, and variants of uncertain significance with phenotype match were seen in 40 (41.8%), 13 (29.1%), and 15 (15.2%) patients, respectively. The mean age at onset in these 68 patients was 6.35 years (range 1 month-39 years), and 38 (55.9%) were male. LDs and gLE were diagnosed in 31 and 37 patients, respectively. 56 patients (71.8%) had autosomal recessive inheritance. The common clinical presentations were developmental delay (23.5%), psychomotor regression (20.6%), progressive myoclonic epilepsy syndrome (19.1%), and spastic ataxia (14.7%). Myelin disorders (48.5%) and leuko-axonopathies (41.2%) were the commonest type of disorders. The most frequently identified genes were ARSA, CLN5, ABCD1, CLN6, TPP1, HEXA, and L2HGDH. The diagnostic yield of the study was 61.6% (53/86), which increased to 79.1% when VUS with phenotype match were included. Discussion This study demonstrated a high diagnostic yield from proband-only CES in the evaluation of genetic WMDs and should be considered as a first-line investigation for genetic diagnosis. Classification of Evidence This study provides Class IV evidence that proband-only clinical exome sequencing is a useful "first-line investigation" for patients with genetic white matter disorders.
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Affiliation(s)
- Karamala Yalapalli Manisha
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Alfiya Fasaludeen
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Prashanth Poulose
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Ramshekhar Menon
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Bejoy Thomas
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Sruthi S Nair
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Ajith Cherian
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Kalikavil Puthanveedu Divya
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Soumya Sundaram
- From the Department of Neurology (K.Y.M., A.F., P.P., S.S.N., A.C., K.P.D.); Pediatric Neurology and Neurodevelopmental Disorders (R.M., S.S.); and Department of Imaging Sciences and Intervention Radiology (B.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
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11
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Shenoy R, Nickels L, Krishnan G. Naming in a multilingual context: Norms for the ICMR-Manipal colour picture corpus in Kannada from the Indian context. Behav Res Methods 2024; 56:7602-7620. [PMID: 38914789 DOI: 10.3758/s13428-024-02439-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/26/2024]
Abstract
There have been many published picture corpora. However, more than half of the world's population speaks more than one language and, as language and culture are intertwined, some of the items from a picture corpus designed for a given language in a particular culture may not fit another culture (with the same or different language). There is also an awareness that language research can gain from the study of bi-/multilingual individuals who are immersed in multilingual contexts that foster inter-language interactions. Consequently, we developed a relatively large corpus of pictures (663 nouns, 96 verbs) and collected normative data from multilingual speakers of Kannada (a southern Indian language) on two picture-related measures (name agreement, image agreement) and three word-related measures (familiarity, subjective frequency, age of acquisition), and report objective visual complexity and syllable count of the words. Naming labels were classified into words from the target language (i.e., Kannada), cognates (borrowed from/shared with another language), translation equivalents, and elaborations. The picture corpus had > 85% mean concept agreement with multiple acceptable names (1-7 naming labels) for each concept. The mean percentage name agreement for the modal name was > 70%, with H-statistics of 0.89 for nouns and 0.52 for verbs. We also analyse the variability of responses highlighting the influence of bi-/multilingualism on (picture) naming. The picture corpus is freely accessible to researchers and clinicians. It may be used for future standardization with other languages of similar cultural contexts, and relevant items can be used in languages from different cultures, following suitable standardization.
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Affiliation(s)
- Rajath Shenoy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Gopee Krishnan
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
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12
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Moura J, Samões R, Sousa AP, Figueiroa S, Mendonça T, Abreu P, Guimarães J, Melo C, Sousa R, Soares M, Correia AS, Marques IB, Perdigão S, Alves I, Felgueiras H, Nzwalo H, Mendes I, Almeida V, Boleixa D, Carneiro P, Neves E, Silva AM, Sá MJ, Santos E. Prognostic factors associated with disability in a cohort of neuromyelitis optica spectrum disorder and MOG-associated disease from a nationwide Portuguese registry. J Neurol Sci 2024; 464:123176. [PMID: 39146881 DOI: 10.1016/j.jns.2024.123176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 08/08/2024] [Accepted: 08/11/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION Neuromyelitis optica spectrum disorders (NMOSD) and MOG-associated disease (MOGAD) are an increasingly recognized group of demyelinating disorders of the central nervous system. Previous studies suggest that prognosis is predicted by older age at onset, number of relapses, the severity of the first attack and autoantibody status. OBJECTIVE To study prognostic factors associated with disability progression and additional relapses in the 3-year follow-up of a national NMOSD/MOGAD cohort. RESULTS Out of 180 of the initial Portuguese cohort, data on 82 patients was available at the end of the follow-up period (2019-2022). Two patients died. Twenty (24.4%) patients had one or more attack in this period (25 attacks in total), mostly transverse myelitis (TM) (56.0%) or optic neuritis (32.0%). MOGAD was significantly associated with a monophasic disease course (p = 0.03), with milder attacks (p = 0.01), while AQP4 + NMOSD was associated with relapses (p = 0.03). The most common treatment modalities were azathioprine (38.8%) and rituximab (18.8%). AQP4 + NMOSD more frequently required chronic immunosuppressive treatment, particularly rituximab (p = 0.01). Eighteen (22.5%) had an EDSS ≥6 at the end of the follow-up. AQP4 + NMOSD (p < 0.01) and the occurrence of transverse myelitis (TM) during disease (p = 0.04) correlated with an EDSS≥6 at the end of the follow-up period. MOGAD was significantly associated with an EDSS<6 (p < 0.01), and MOG+ cases that reached an EDSS>6 were significantly older (64.0 ± 2.8 versus 31.0 ± 17.1, p = 0.017). A bivariate logistic regression model including the serostatus and TM attacks during disease history successfully predicted 72.2% of patients that progressed to an EDSS≥6. CONCLUSION This study highlights that myelitis predict increased disability (EDSS≥6) in NMOSD/MOGAG and AQP4 positivity is associated with increased disability.
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Affiliation(s)
- João Moura
- Neurology Service, Department of Neurosciences, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
| | - Raquel Samões
- Neurology Service, Department of Neurosciences, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, Porto, Portugal
| | - Ana Paula Sousa
- Neurology Service, Department of Neurosciences, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Sónia Figueiroa
- Neuropediatrics Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Teresa Mendonça
- Neurology Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro Abreu
- Neurology Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Joana Guimarães
- Neurology Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Claúdia Melo
- Neuropediatrics Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Raquel Sousa
- Neuropediatrics Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Mafalda Soares
- Neurology Service, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - Ana Sofia Correia
- Neurology Service, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | | | - Sandra Perdigão
- Neurology Service, Hospital de Viana do Castelo/Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
| | - Ivânia Alves
- Neurology Service, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Helena Felgueiras
- Neurology Service, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Hipólito Nzwalo
- Neurology Unit, Hospital do Litoral Alentejano, Santiago do Cacém, Portugal
| | - Irene Mendes
- Neurology Service, Hospital Garcia da Orta, Almada, Portugal
| | - Vânia Almeida
- Neurology Service, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Daniela Boleixa
- Departamento de Ensino, Formação e Investigação (DEFI), Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Paula Carneiro
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, Porto, Portugal; Immunology Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Esmeralda Neves
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, Porto, Portugal; Immunology Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Ana Martins Silva
- Neurology Service, Department of Neurosciences, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, Porto, Portugal
| | - Maria José Sá
- Neurology Service, Centro Hospitalar Universitário São João, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade de Fernando Pessoa, Porto, Portugal
| | - Ernestina Santos
- Neurology Service, Department of Neurosciences, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, Porto, Portugal
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Yang HY, Wu SH, Zhang S, Zou HX, Wang LB, Lin LZ, Gui ZH, Zeng XW, Yang BY, Liu RQ, Dong GH, Hu LW. Association between outdoor light at night exposure and executive function in Chinese children. ENVIRONMENTAL RESEARCH 2024; 257:119286. [PMID: 38824987 DOI: 10.1016/j.envres.2024.119286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/11/2024] [Accepted: 05/29/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Recent evidences highlight the potential impact of outdoor Light at Night (LAN) on executive function. However, few studies have investigated the association between outdoor LAN exposure and executive function. METHODS We employed data from 48,502 Chinese children aged 5-12 years in a cross-sectional study conducted in Guangdong province during 2020-2021, to examine the association between outdoor LAN and executive function assessed using the validated parent-completed Behavior Rating Inventory of Executive Function. We assessed children's outdoor LAN exposure using the night-time satellite images based on the residential addresses. We used generalized linear mixed models to estimate the association between outdoor LAN exposure and executive function scores and executive dysfunction. RESULTS After adjusting for potential covariates, higher quintiles of outdoor LAN exposure were associated with poorer executive function. Compared to the lowest quintile (Q1), all higher quintiles of exposure showed a significant increased global executive composite (GEC) score with β (95% confidence intervals, CI) of 0.58 (0.28, 0.88) in Q2, 0.59 (0.28, 0.9) in Q3, 0.85 (0.54, 1.16) in Q4, and 0.76 (0.43, 1.09) in Q5. Higher quintiles of exposure were also associated with higher risks for GEC dysfunction with odd ratios (ORs) (95% CI) of 1.34 (1.18, 1.52) in Q2, 1.40 (1.24, 1.59) in Q3, 1.40 (1.23, 1.59) in Q4, and 1.39 (1.22, 1.58) in Q5. And stronger associations were observed in children aged 10-12 years. CONCLUSIONS Our study suggested that high outdoor LAN exposure was associated with poor executive function in children. These findings suggested that future studies should determine whether interventions to reduce outdoor LAN exposure can have a positive effect on executive function.
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Affiliation(s)
- Han-Yu Yang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Si-Han Wu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shuo Zhang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hong-Xing Zou
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Le-Bing Wang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Zi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhao-Huan Gui
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao-Wen Zeng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ru-Qing Liu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Wen Hu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Yen VT. Prenatal sonographic diagnosis and postnatal outcomes of fetal intracranial hemorrhage: Two case report. Radiol Case Rep 2024; 19:4066-4072. [PMID: 39076884 PMCID: PMC11284951 DOI: 10.1016/j.radcr.2024.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/31/2024] Open
Abstract
Intracranial hemorrhage (ICH) in pregnancy, estimated at 1 in 10,000 cases, presents significant diagnostic challenges prenatally despite advanced imaging techniques such as ultrasonography (US) and magnetic resonance imaging (MRI). Detecting ICH is crucial for pregnancy management and future treatment decisions aimed at improving fetal survival and reducing brain damage. This report presents the diagnosis and outcomes of 2 cases of prenatal ICH. The first case involves a 30-year-old pregnant woman with irregular prenatal care diagnosed with ICH at 32 weeks of gestation via US and MRI. She chose to continue the pregnancy, delivering a 3160 g male infant at 36 weeks via cesarean section. Following NICU care including resuscitation and ventriculoperitoneal shunt placement, the infant was discharged. Subsequent examinations showed a reduction in ventricle size. In the second case, a 27-year-old woman taking acenocoumarol for a mechanical heart valve developed fetal subdural hemorrhage detected by US and MRI. She opted to terminate the pregnancy, resulting in a stillborn male infant weighing 1530 g. Fetal ICH presents with varying severity and prognostic implications, diagnosed and graded using US. Fetal cranial MRI may help clarify the etiology. Management remains controversial, with termination of pregnancy potentially warranted in severe cases due to poor prognosis. Further research is needed to refine management and improve outcomes in fetal ICH.
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Affiliation(s)
- Vu T.H Yen
- Department of Radiology, Diamond Healthcare center, Ho Chi Minh city, Vietnam
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15
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Thomas T, Dasgupta J. A narrative review of community-based dementia care in India: experiences, challenges, and policy initiatives. Curr Opin Psychiatry 2024; 37:370-375. [PMID: 38726806 DOI: 10.1097/yco.0000000000000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE OF REVIEW India is facing a significant increase in the aging population who are at risk for dementia. This review evaluates recent literature on community-based care, focusing on caregiver experiences, challenges and policy initiatives. RECENT FINDINGS Dementia care in India is traditionally provided by family members who take on the role of caregivers. Studies on caregiver experiences have reflected high caregiving burden and related impact on their mental health. During the pandemic, caregivers experienced several unprecedented challenges in providing care, emphasizing the need for more research on community-based dementia care across the country. Telehealth and online caregiver training were identified as viable alternatives to support community dementia care. However, it may not be a feasible mode of delivery suitable across the Indian context, underscoring the need for culturally relevant and acceptable interventions. India is currently undertaking concerted policy efforts for dementia care through multiple initiatives like the National Program for Healthcare of the Elderly, the Mental Healthcare Act, and initiatives like the Atal Vayo Abhyuday Yojna. These initiatives aim to address the healthcare requirements of the elderly; nevertheless, a comprehensive evaluation of their impact is yet to be discerned. SUMMARY There is a need for comprehensive research, to inform evidence-based policy and improve dementia care systems in India. Addressing gaps in existing dementia care capacities and healthcare initiatives, along with tailoring interventions to India's diverse contexts are critical for effective community care for dementia.
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Affiliation(s)
| | - Jayashree Dasgupta
- Samvedna Care, Gurugram, India
- Global Brain Health Institute, Trinity College, Dublin
- Chitkara University, Punjab, India
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16
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Savage NJ, McKell JS. Sonographic Measurement of Median Nerve Cross-Sectional Area to Determine Severity of Carpal Tunnel Syndrome: A Cautionary Tale. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1645-1659. [PMID: 38778784 DOI: 10.1002/jum.16486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Evaluate the diagnostic accuracy of median nerve cross-sectional area (CSA) to determine the severity of carpal tunnel syndrome (CTS) vs the presence of CTS across existing electrodiagnostic-based (EDX) classification systems. METHODS Retrospective analysis of cross-sectional patient data. Receiver operating characteristic (ROC) analysis was used to determine CSA cutoff values and associated diagnostic likelihood ratios for all consolidated and binary EDX-based classifications of CTS severity. Identification of CSA cutoff values associated with likelihood ratios capable of achieving conclusive (but at least moderate) shifts in diagnostic probability. RESULTS Binary categorizations of CTS (ie, "Normal" vs "Absent") were statistically superior to consolidated categorizations of CTS severity (ie, "Normal," "Mild," "Moderate," or "Severe"). Binary categorizations established consistent CSA cutoff values across all EDX-based classifications examined and achieved conclusive shifts in diagnostic probability based on the following values of distal CSA or delta CSA: <7 or <1 mm2 to rule out and >13 or >7 mm2 to rule in CTS, respectively. Additionally, the following values of distal CSA and delta CSA may be used in certain circumstances because they produce only small shifts in diagnostic probability: ≤10 or ≤3 mm2 to rule out and ≥11 or ≥4 mm2 to rule in CTS, respectively. CONCLUSIONS Using median nerve CSA to categorize the severity of CTS is not recommended based on lack of consistent and meaningful shifts in diagnostic probability. Rather, binary categorizations to rule out or rule in CTS based on the proposed CSA cutoff values consistently provided conclusive shifts in diagnostic probability across all EDX-based classifications examined.
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Affiliation(s)
- Nathan J Savage
- Department of Physical Therapy, Winston-Salem State University, Winston-Salem, North Carolina, USA
| | - John S McKell
- Department of Physical Therapy, McKell Therapy Group, LLC, Orem, Utah, USA
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Loftus JR, Wassef C, Ellika S. Chiari I Deformity: Beyond 5 mm below the Foramen Magnum. Radiographics 2024; 44:e230227. [PMID: 39115997 DOI: 10.1148/rg.230227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Although originally described as a consecutive series of pathologic changes, Chiari syndrome represents a spectrum of disease divided into two subsets: development deformities of the paraxial mesoderm manifesting after birth (types 0-1.5) and true congenital malformations due to failure of neural tube closure present in utero (types 2-5). Heterogeneity among patients with a Chiari deformity and incomplete understanding of its pathophysiologic characteristics have led to inconsistency in radiologic reporting and difficulty in defining appropriate management strategies tailored to an individual patient's condition. The radiologist is tasked with going beyond the criteria for cerebellar tonsillar herniation to define an individual patient's disease state, determine candidacy for surgery, and assist in selecting the proper surgical approach. In addition, the radiologist must be able to identify conditions that result in cerebellar tonsillar herniation that are not related to Chiari deformity to avoid inappropriate surgery. Last, the radiologist must be able to interpret postoperative imaging examinations to assess for adequacy of treatment and complications. The authors summarize recent literature regarding the pathophysiologic basis of Chiari 1 and related deformities and detail the ideal morphologic and physiologic imaging assessment, focusing on Chiari 1 and related deformities (Chiari 0, 0.5, and 1.5). Also discussed are surgical techniques and "pearls" of postsurgical imaging, including complications that must be recognized. This review provides clarity to a commonly encountered but less understood condition to optimize outcomes for patients with Chiari 1 and related deformities. ©RSNA, 2024 Supplemental material is available for this article. See the invited commentary by Huisman in this issue.
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Affiliation(s)
- James Ryan Loftus
- From the Department of Imaging Sciences, New York University Langone Health, 550 1st Ave, New York, NY 10016 (J.R.L.); and Departments of Neurosurgery (C.W.) and Imaging Sciences (S.E.), University of Rochester Medical Center, Rochester, NY
| | - Catherine Wassef
- From the Department of Imaging Sciences, New York University Langone Health, 550 1st Ave, New York, NY 10016 (J.R.L.); and Departments of Neurosurgery (C.W.) and Imaging Sciences (S.E.), University of Rochester Medical Center, Rochester, NY
| | - Shehanaz Ellika
- From the Department of Imaging Sciences, New York University Langone Health, 550 1st Ave, New York, NY 10016 (J.R.L.); and Departments of Neurosurgery (C.W.) and Imaging Sciences (S.E.), University of Rochester Medical Center, Rochester, NY
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Zhang M, Zhao H, Lu N, Zhang S. Predictive value of interleukin-6 combined with serum neuron-specific enolase on the prognosis of acute ischemic stroke. Clin Neurol Neurosurg 2024; 244:108406. [PMID: 38968812 DOI: 10.1016/j.clineuro.2024.108406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE To explore the prognostic value of interleukin-6 (IL-6) combined with serum neuron specific enolase (NSE) in arterial atherosclerotic ischemic stroke. METHODS 116 patients with arterial atherosclerotic ischemic stroke admitted to the emergency ward of our Hospital were retrospectively analyzed. According to the score of modified Rankin scale (mRS) at 90 days after discharge, the patients were divided into the poor prognosis group (mRS > 2, n = 32) and the good prognosis group (mRS ≤ 2, n = 84). Activities of Daily Living (ADL) was used to evaluate the level of independence in activities of daily living after treatment. RESULTS The NIHSS score (14.91 ± 5.20 vs. 9.43 ± 4.30, P < 0.001), IL-6 (11.30 ± 3.11 vs. 6.75±1.28, P < 0.001) and NSE levels (12.47 ± 4.69 vs. 6.42 ± 1.32, P<0.001) in poor prognosis group were higher than those in the good prognosis group. At 90 days post-discharge, 100 % of the good prognosis group had ADL scores over 60, while in the poor prognosis group, 46.88 % scored 40-60, 40.63 % scored 20-40, 9.38 % scored under 20, and 3.13 % died. The AUC of NSE was 0.906 (95 % CI: 0.847-0.965, P < 0.001), the best cut-off value was 7.445 ng/mL, and the sensitivity and specificity were 75.0 % and 82.1 %, respectively. The AUC for IL-6 combined with NSE increased to 0.965 (95 %CI: 0.934-0.997, P < 0.001), and the sensitivity and specificity increased to 80.2 % and 92.9 %, respectively. CONCLUSION IL-6 ≥ 6.805 pg/mL and NSE ≥ 7.445 ng/mL were independently associated with poor prognosis in patients with AIS, and the combined testing of the two indicators had a higher predictive value. These results suggested that the combined assay of IL-6 and NSE could be a novel marker for predicting poor prognosis in AIS.
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Affiliation(s)
- Mingming Zhang
- Department of Emergency, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China
| | - Hongmin Zhao
- Department of General Practice, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China
| | - Na Lu
- Department of Emergency, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China
| | - Sui Zhang
- Hepatology Center, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China.
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Chen P, Zhou Q, Zhao X, Chen Y, Lin Z, Wang M, Yang Z, Liu W. Extraocular muscle volume on time-of-flight magnetic resonance angiography in patients with myasthenia gravis. Muscle Nerve 2024; 70:379-386. [PMID: 38948953 DOI: 10.1002/mus.28192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 06/02/2024] [Accepted: 06/11/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION/AIMS Despite being a prominent feature of myasthenia gravis (MG), extraocular muscle (EOM) has received little attention in clinical research. The aim of this study was to examine EOM volume in patients with MG and controls using time-of-flight magnetic resonance angiography (TOF-MRA). METHODS EOM volumes (overall and individual rectus muscles) were calculated using TOF-MRA images and compared between MG patients (including subgroups) and controls. The correlation between EOM volume and disease duration was examined. Predictive equations for the selected parameters were developed using multiple linear regression analysis. RESULTS EOM volume was lower in MG patients than controls, especially in MG patients with ophthalmoparesis (MG-O). MG-O exhibited a moderate negative correlation between EOM volume and disease duration. Multiple linear regression showed that disease duration and EOM status (ophthalmoparesis or not) account for 48.4% of EOM volume. DISCUSSION Patients with MG show atrophy of the EOMs, especially those with ophthalmoparesis and long disease duration.
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Affiliation(s)
- Pei Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, Guangzhou, China
- National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Qin Zhou
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxiao Zhao
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingqian Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhongqiang Lin
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, Guangzhou, China
- National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Mengzhu Wang
- MR Scientific Marketing, Siemens Healthineers Ltd, Guangzhou, China
| | - Zhiyun Yang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weibin Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, Guangzhou, China
- National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
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20
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Trinchillo A, Esposito M, Terranova C, Rizzo V, Fabbrini G, Ferrazzano G, Belvisi D, Erro R, Barone P, Bono F, Di Biasio F, Bentivoglio AR, Lettieri C, Altavista MC, Scaglione CLM, Albanese A, Mascia MM, Muroni A, Pisani A, Berardelli A, Defazio G. Oromandibular dystonia: from onset to spread a multicenter italian study. Neurol Sci 2024; 45:4341-4348. [PMID: 38536550 DOI: 10.1007/s10072-024-07488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/19/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND Detailed information about the epidemiological and phenomenological differences among the aetiological subtypes of oromandibular dystonia (OMD) is lacking. Moreover, the OMD tendency to spread to other body sites has never been investigated. AIM To compare the main demographic and clinical features of OMD in different aetiological groups and assess the risk of spread. MATERIALS AND METHODS We retrospectively analysed data from patients contained in the Italian Dystonia Registry. The risk of spread was assessed by Kaplan Meyer curves and Cox regression analysis. RESULTS The study included 273 patients (175 women) aged 55.7 years (SD 12.7) at OMD onset. Female predominance was observed. Idiopathic dystonia was diagnosed in 241 patients, acquired dystonia in 22. In 50/273 patients, dystonia started in the oromandibular region (focal OMD onset); in 96/273 patients the onset involved the oromandibular region and a neighbouring body site (segmental/multifocal OMD onset); and in 127/273 patients OMD was a site of spread from another body region. Sensory trick (ST) and positive family history predominated in the idiopathic group. No dystonia spread was detected in the acquired group, whereas spread mostly occurred within the first five years of history in 34% of the focal OMD onset idiopathic patients. Cox regression analysis revealed ST as a significant predictor of spread (HR, 12.1; 95% CI, 2.5 - 18.8; P = 0.002). CONCLUSION This large study provides novel information about the clinical phenomenology of idiopathic and acquired OMD. We pointed out a possible role of oestrogens in favouring dystonia development. Moreover, we described for the first time the association between ST and dystonia spread, revealing possible common pathophysiological mechanisms. Our findings may be suggested as a referral point for future pathophysiological and therapeutic studies on OMD.
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Affiliation(s)
- Assunta Trinchillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, "Federico II" University, Naples, Italy.
| | | | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vincenzo Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, SA, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, SA, Italy
| | - Francesco Bono
- Academic Hospital - A.O.U. "R. Dulbecco", Catanzaro, Italy
| | | | - Anna Rita Bentivoglio
- Clinical Neurology Unit - Movement Disorders, University of Rome "Università Cattolica del Sacro Cuore", Hospital of Rome "Agostino Gemelli", Rome, Italy
| | - Christian Lettieri
- Clinical Neurology Unit "S. Maria Della Misericordia" University, Hospital of Udine, Udine, Italy
| | | | | | - Alberto Albanese
- Clinical Institute, Department of Neurology, "Humanitas", Milan, Italy
| | | | - Antonella Muroni
- Neurology Unit, University Hospital of Cagliari, Cagliari, Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy
| | - Giovanni Defazio
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
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21
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Li ZR, Wang YY, Wang ZH, Qin QL, Huang C, Shi GS, He HY, Deng YH, He XY, Zhao XM. The positive role of transforming growth factor-β1 in ischemic stroke. Cell Signal 2024; 121:111301. [PMID: 39019338 DOI: 10.1016/j.cellsig.2024.111301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
Ischemic stroke is one of the most disabling and fatal diseases around the world. The damaged brain tissues will undergo excessive autophagy, vascular endothelial cells injury, blood-brain barrier (BBB) impairment and neuroinflammation after ischemic stroke. However, there is no unified viewpoint on the underlying mechanism of brain damage. Transforming growth factor-β1 (TGF-β1), as a multi-functional cytokine, plays a crucial role in the intricate pathological processes and helps maintain the physiological homeostasis of brain tissues through various signaling pathways after ischemic stroke. In this review, we summarize the protective role of TGF-β1 in autophagic flux, BBB, vascular remodeling, neuroinflammation and other aspects after ischemic stroke. Based on the review, we believe that TGF-β1 could serve as a key target for treating ischemic stroke.
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Affiliation(s)
- Zi-Rong Li
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Yong-Yan Wang
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Zi-Han Wang
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Qi-Lin Qin
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Cheng Huang
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Guang-Sen Shi
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Hong-Yun He
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China; Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, China.
| | - Yi-Hao Deng
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China.
| | - Xiu-Ying He
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, China.
| | - Xiao-Ming Zhao
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, China; Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, China.
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22
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Löscher W. Mammalian models of status epilepticus - Their value and limitations. Epilepsy Behav 2024; 158:109923. [PMID: 38944026 DOI: 10.1016/j.yebeh.2024.109923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/01/2024]
Abstract
Status epilepticus (SE) is a medical and neurologic emergency that may lead to permanent brain damage, morbidity, or death. Animal models of SE are particularly important to study the pathophysiology of SE and mechanisms of SE resistance to antiseizure medications with the aim to develop new, more effective treatments. In addition to rodents (rats or mice), larger mammalian species such as dogs, pigs, and nonhuman primates are used. This short review describes and discusses the value and limitations of the most frequently used mammalian models of SE. Issues that are discussed include (1) differences between chemical and electrical SE models; (2) the role of genetic background and environment on SE in rodents; (3) the use of rodent models (a) to study the pathophysiology of SE and mechanisms of SE resistance; (b) to study developmental aspects of SE; (c) to study the efficacy of new treatments, including drug combinations, for refractory SE; (d) to study the long-term consequences of SE and identify biomarkers; (e) to develop treatments that prevent or modify epilepsy; (e) to study the pharmacology of spontaneous seizures; (4) the limitations of animal models of induced SE; and (5) the advantages (and limitations) of naturally (spontaneously) occurring SE in epileptic dogs and nonhuman primates. Overall, mammalian models of SE have significantly increased our understanding of the pathophysiology and drug resistance of SE and identified potential targets for new, more effective treatments. This paper was presented at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in April 2024.
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Affiliation(s)
- Wolfgang Löscher
- Translational Neuropharmacology Lab, NIFE, Department of Experimental Otology of the ENT Clinics, Hannover Medical School, Hannover, Germany.
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23
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Szmidel M, Hunn M, Neal A, Laing J, Broadley L, Wittayacharoenpong T, O'brien T, Gutman M. Vascular imaging for Stereoelectroencephalography: A safety and planning study. J Clin Neurosci 2024; 127:110762. [PMID: 39079420 DOI: 10.1016/j.jocn.2024.110762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/30/2024] [Accepted: 07/19/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Stereoelectroencephalography (SEEG) is a procedure used to localize the epileptogenic zone in patients with medically refractory epilepsy, involving the stereotactic implantation of electrodes into brain parenchyma. Magnetic Resonance Imaging (MRI), Digital Subtraction Angiography, and Computed Tomography have been used preoperatively to prevent Intracranial Hemorrhage (ICH) by identifying electrode-vessel conflicts (EVC's) on planned electrode trajectories. There is variation in the use of Digital Subtraction Angiography and non-invasive sequences for vascular planning. Digital Subtraction Angiography provides high spatial resolution, but carries risks of arterial dissection, groin and retroperitoneal hematoma, and a 0.5-1.9% risk of stroke. Our group has incorporated Intravenous Cone Beam Computed Tomography (CBCT A/V) Brain into our SEEG workflow, given its effective implementation in other neurosurgical domains. Primary aims include validating the safety of our CBCT A/V sequence for SEEG planning and determining if CBCT A/V is comparable to other modalities in detecting EVC's. Secondary aims include elucidating the relationship of conflicting vessel calibre with ICH incidence in SEEG using CBCT A/V imaging. METHODS A single-center retrospective study was conducted of 20 patients who underwent preoperative CBCT A/V Brain and MRI Brain with gadolinium enhancement, encompassing 273 electrode implantations from August 2020 - July 2023. The incidence and grade of post-implant, post-explant symptomatic ICH and asymptomatic ICH was noted. The total number of EVC's identifiable on MRI and CBCT A/V was recorded, along with average diameter of conflicting vessels. RESULTS Across 20 patients and 273 implanted electrodes, there were four ICH events, where two were symptomatic and two were asymptomatic. The mean diameter of EVC's across all patients was 1.4 mm (±0.5). A significant difference (P < 0.0001) was observed between the number of EVC's that CBCT A/V could identify (20) compared to MRI (6). Two EVC's were identified in the region of two symptomatic ICH's, with the mean diameter of these conflicted vessels being 1.5 mm (±0.4). The two symptomatic ICH-associated EVC's were observed on CBCT A/V but not MRI. CONCLUSIONS In our series, CBCT A/V demonstrates an acceptable safety profile for SEEG planning compared to other imaging modalities. CBCT A/V identified significantly more EVC's compared to MRI, including those contributing to transient symptomatic intracranial hemorrhage. A conflicting vessel calibre of less than 1.2 mm on CBCT A/V did not contribute to ICH in our SEEG series.
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Affiliation(s)
- Matthew Szmidel
- Department of Neurosurgery, Alfred Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Alfred Hospital, Melbourne, VIC, Australia; Monash University, VIC, Australia.
| | - Martin Hunn
- Department of Neurosurgery, Alfred Hospital, Melbourne, VIC, Australia.
| | - Andrew Neal
- Department of Neuroscience, Alfred Hospital, Melbourne, VIC, Australia; Epilepsy Unit, Alfred Hospital, Melbourne, VIC, Australia.
| | - Joshua Laing
- Department of Neuroscience, Alfred Hospital, Melbourne, VIC, Australia; Epilepsy Unit, Alfred Hospital, Melbourne, VIC, Australia; The University of Melbourne, VIC, Australia.
| | - Lisa Broadley
- Department of Radiology, Alfred Hospital, Melbourne, VIC, Australia.
| | | | - Terence O'brien
- Department of Neuroscience, Alfred Hospital, Melbourne, VIC, Australia.
| | - Matthew Gutman
- Department of Neurosurgery, Alfred Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Alfred Hospital, Melbourne, VIC, Australia; Monash University, VIC, Australia.
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24
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Panahi P, Mirzohreh ST, Zafardoust H, Khamnian Z, Alizadeh M. Navigating the waves: A systematic review of telemedicine interventions and health service access challenges in epilepsy during COVID-19. Epilepsy Behav 2024; 158:109934. [PMID: 39079379 DOI: 10.1016/j.yebeh.2024.109934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/13/2024] [Accepted: 06/30/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has dramatically reshaped the landscape of healthcare delivery, prompting a surge in the adoption of telemedicine as a means to ensure continuity of care. During the pandemic, patients with epilepsy experienced difficulties accessing healthcare and obtaining necessary medications, with a substantial percentage facing obstacles in acquiring anti-seizure medication and reaching healthcare professionals. Disruptions in the supply and distribution of medication, due to COVID-19-related actions, further caused more problems for people with epilepsy and their caregivers like increasing seizure frequency. The pandemic has also accelerated the adoption of telemedicine, with evidence suggesting its potential benefits in various medical fields. In this systematic review and meta-analysis, we aim to investigate the challenges faced by patients with epilepsy during the COVID-19 pandemic, including healthcare access and medication acquisition, as well as evaluate changes in seizure frequency. Additionally, we will synthesize existing evidence on the use of telemedicine to address the healthcare needs of these patients, exploring its advantages and limitations. METHODS This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using Joanna Briggs Institute (JBI). Following rigorous application of eligibility criteria, relevant data, covering both telemedicine-related and health service access information, were methodically extracted and organized using Microsoft Excel spreadsheets. The analytical procedures were executed through the utilization of Comprehensive Meta-Analysis (CMA) software. RESULTS A total of 70 articles included in this review. Regarding difficulties in accessing healthcare, 34% of PWE and 41% of caregivers experienced cancelled, changed or postponed appointments. Following issues with obtaining medicine, 13% of patients and 16% of caregivers had difficulties in medicine availability and 11% of patients and 10% of caregivers in medicine accessibility. A very high rate of 90% satisfaction with telemedicine was reported by PWE. 17.6% of PWE experienced an escalation, 9% a decrease and 67% no changes in seizure frequency. CONCLUSION This review and meta-analysis revealed that telemedicine and virtual communications have been helpful but not sufficient for meeting healthcare needs for PWE during the COVID-19 pandemic. Additionally, there was a significant increase in seizure frequency among PWE who had difficulty obtaining medicine and access to healthcare.
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Affiliation(s)
| | | | | | - Zhila Khamnian
- Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahasti Alizadeh
- Faculty of Medicine, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Iran.
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25
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Vosoughi AR, Barbosa NB, Micieli J, Margolin E. Unilateral Pendular Nystagmus in Multiple Sclerosis: A Case Series. J Neuroophthalmol 2024; 44:414-418. [PMID: 37486916 DOI: 10.1097/wno.0000000000001944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
BACKGROUND Acquired pendular nystagmus is most often seen in patients with demyelinating disease. Although it is often bilateral, rare cases may be monocular. There is paucity of data on the spectrum of clinical presentation, underlying mechanism, and response to treatment in patients with monocular pendular nystagmus. METHODS Retrospective case series of patients with monocular pendular nystagmus seen in 2 tertiary neuro-ophthalmology clinics between January 2019 and June 2022. All patients underwent a complete neuro-ophthalmological assessment and MRI. RESULTS We describe 5 patients (3 women) aged 31-49 with monocular pendular nystagmus. All had a diagnosis of multiple sclerosis. Three patients had horizontal and 2 had vertical pendular nystagmus. The Snellen visual acuity in the eye with pendular nystagmus varied from 20/20 to 20/200. Two patients were asymptomatic and 3 suffered visually debilitating oscillopsia. Treatment response was available for 2 patients, both of which responded well to treatment with memantine. The pendular nystagmus was observed in the eye with worse visual acuity in 4 of 5 cases (80%). Three patients had bilateral pontine lesions, and 2 had unilateral pontine lesion ipsilateral to the side of nystagmus. CONCLUSIONS Monocular pendular nystagmus in adults is seen most often in patients with multiple sclerosis. Asymmetry in brainstem lesions and afferent visual input may be the culprit. Treatment with memantine may result in significant improvement in symptomatic patients.
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Affiliation(s)
- Amir R Vosoughi
- Max Rady College of Medicine (ARV), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Ophthalmology and Vision Sciences (NBB, JM, EM), University of Toronto, Toronto, Canada; and Division of Neurology (JM, EM), Department of Medicine, University of Toronto, Toronto, Canada
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26
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Romano A, Gasparro R, Campana MD, Pinchera B, Di Crescenzo RM, Del Guercio D, Sarcinella M, Tatullo M, Sammartino G. COVID-19 as a critical risk factor for osteonecrosis of the jaw: diagnostic challenge and surgical treatment. Curr Probl Surg 2024; 61:101555. [PMID: 39168534 DOI: 10.1016/j.cpsurg.2024.101555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Antonio Romano
- Department of Neuroscience, Reproductive Science and Dentistry, Oral and Maxillofacial Surgery Section, University of Naples Federico II, Naples, Italy
| | - Roberta Gasparro
- Department of Neuroscience, Reproductive Science and Dentistry, Oral and Maxillofacial Surgery Section, University of Naples Federico II, Naples, Italy.
| | - Maria Domenica Campana
- Department of Neuroscience, Reproductive Science and Dentistry, Oral and Maxillofacial Surgery Section, University of Naples Federico II, Naples, Italy
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, Infectious Disease Section, University of Naples Federico II, Naples, Italy
| | - Rosa Maria Di Crescenzo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Donatella Del Guercio
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Marco Sarcinella
- Department of Neuroscience, Reproductive Science and Dentistry, Oral and Maxillofacial Surgery Section, University of Naples Federico II, Naples, Italy
| | - Marco Tatullo
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari ALDO MORO, Bari, Italy
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive Science and Dentistry, Oral and Maxillofacial Surgery Section, University of Naples Federico II, Naples, Italy
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27
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Hu Y, Zou F, Lu W. Sex hormones and neuromyelitis optica spectrum disorder: a bidirectional Mendelian randomization study. Neurol Sci 2024; 45:4471-4479. [PMID: 38565746 DOI: 10.1007/s10072-024-07501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Females are considered to have an increased susceptibility to neuromyelitis optica spectrum disorder (NMOSD) than males, especially aquaporin-4 (AQP4) antibody positive NMOSD, indicating that sex hormones may be involved in the NMOSD pathogenesis. However, the causality between sex hormones and NMOSD still remains unclear. METHODS Based on the genome-wide association study (GWAS) data of three sex hormones (estradiol (E2), progesterone (PROG) and bioavailable testosterone (BAT)), sex hormone-binding globulin (SHBG), age of menarche, age of menopause, and NMOSD (total, AQP4 + and AQP4 -), we performed a two-sample bidirectional Mendelian randomization (MR) study. Sex-stratified GWAS data of E2, PROG, BAT, and SHBG was obtained for gender-specific MR analysis. Causal inferences were based on the inverse variance weighted method, MR-Egger regression, and weighted median method. The reverse MR analysis was also performed to assess the impact of NMOSD on hormone levels. RESULTS PROG in females had aggravative effects on NMOSD (P < 0.001), especially AQP4 - NMOSD (P < 0.001). In the reverse MR analysis, total NMOSD was found to decrease the level of BAT (P < 0.001) and increase the level of SHBG (P = 0.001) in females. CONCLUSION Findings of this MR analysis revealed mutual causal associations between sex hormones and NMOSD, which provided novel perspectives about the gender-related pathogenesis of NMOSD.
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Affiliation(s)
- Yaxian Hu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Fei Zou
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
- Research Center of Digestive Disease, Central South University, Changsha, 410011, China
- Clinical Research Center for Digestive Disease in Hunan Province, Changsha, 410011, China
| | - Wei Lu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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28
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Cherian KE, Cherian J, Vinodhini D, Paul TV. Clinical Characteristics, Therapeutic Options, and Outcomes in Hyperphosphatemic Tumoral Calcinosis: A Systematic Review. Calcif Tissue Int 2024; 115:215-228. [PMID: 38951179 DOI: 10.1007/s00223-024-01247-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/15/2024] [Indexed: 07/03/2024]
Abstract
This systematic review was performed to understand better the myriad presentations, various therapeutic options, response to therapy, and its clinical outcomes in hyperphosphatemic tumoral calcinosis (HTC). Full texts were selected according to strict inclusion criteria. All case reports of HTC wherein baseline phosphate was measured, treatment offered was mentioned, and information on follow-up and response to therapy that were available were included. A total of 43 of 188 eligible studies (N = 63 patients) met the inclusion criteria. A list of desired data was extracted and graded for methodological quality. A total of 63 individuals (Males = 33) were included from the 43 eligible case studies. The median age of the patients was 18 (IQR 8-32) years. The most frequently involved sites were the hip/gluteal region (34/63; 53.9%) followed by the elbow/forearm (26/63; 41.2%), and the shoulder (18/63; 28.5%). Three patients had conjunctival calcific deposits. The mean (SD) phosphate was 6.9 (1.1) mg/dL. Among the subjects, 36/63 (57.1%) underwent surgical excision with some form of medical therapy. Two patients underwent only surgical excision (2.1%). One patient was maintained on follow-up (1.6%) and 24/63 (38.1%) patients were treated with medical measures. The median (IQR) follow-up duration was 3 (1-9) years. Regression or reduction in lesion size was reported in 19/63 (30.2%) subjects; 20/63 (31.7%) showed progression, 24/63 (38.1%) had features of stable disease, and mortality was reported in 3 patients (4.7%). We report for the first time a detailed description of the clinical and therapeutic response of HTC. A combination of medical measures aimed at lowering serum phosphate appears to be the cornerstone of treatment, although clinical responses may vary.
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Affiliation(s)
| | | | | | - Thomas Vizhalil Paul
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
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29
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Kamel RM, Dantata BA, Halilu H, Ahmed HM, Muzaffar KH, Maria NT, Alsadeq HR. Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study. Eur J Obstet Gynecol Reprod Biol X 2024; 23:100319. [PMID: 39035702 PMCID: PMC11260330 DOI: 10.1016/j.eurox.2024.100319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Female sexual dysfunction (FSD) is a common health problem that is inadequately investigated in Arabic countries, especially Saudi Arabia. Aim To assess the prevalence and trace predictors of FSD in Saudi women who suffered from migraine headaches comparable to healthy women. Patients and methods A prospective cross-sectional, controlled study involved 400 Saudi women complaining of migraine (Case Group) and another 400 healthy-looking Saudi women (Control Group) during three months; from January 1st, to March 31st 2023, in Jeddah city, Saudi Arabia. Data was collected by using a pre-structured Female Sexual Function Index (FSFI) questionnaire, Female Sexual Distress Scale (FSDS), Migraine Screen Questionnaire (MS-Q), with an evaluation of the severity of pain by Visual Analogue Scale (VAS), and its impact on daily activity by using both; Headache Impact Test (HIT-6) and Migraine Disability Assessment (MIDAS) Questionnaire. Results A total of 800 Saudi women were recruited. Their ages ranged from 18 to 45 years old. Women with abnormally low FSFI scores were 375 (93.75 %) out of 400 with migraine and 85 (21.25 %) out of 400 without migraine. The lowest FSFI scores were mainly for desire (2.75 ± 1.05) and arousal domains (3.0 ± 1.12) followed by sexual satisfaction (3.25 ± 1.30) and orgasmic domains (3.5 ± 1.15). The foremost predictive factor behind low FSFI scores and associated FSD in our study was migraine (P < 0.00001). Additional predictors of statistical significance were low educational level (P < 0.01), urban residency (P < 0.02), high parity (P < 0.02), chronic illness such as diabetes (P < 0.01), and bad habits such as smoking (P < 0.03). Conclusion A significant correlation exists between migraine and female sexual dysfunction (FSD). Desire and arousal dysfunctions were the most significantly affected domains followed by satisfaction and orgasmic problems.
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Affiliation(s)
- Remah M. Kamel
- Professor of Obstetrics & Gynaecology, General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Baraatu A. Dantata
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Hadiza Halilu
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Hafsah M. Ahmed
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Khadijah H. Muzaffar
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Nishat T. Maria
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
| | - Hussain R. Alsadeq
- Medical Interns from the General Medicine Practice Program, Batterjee Medical College (BMC), Jeddah 21442, Saudi Arabia
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Bentil HJ, Daang EM, Guyer AE, Yuan H, Adu-Afarwuah S, Amponsah B, Manu A, Mensah MO, Demuyakor ME, Arnold CD, Oaks BM, Prado E, Hastings PD. Assessing Children's Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana. Dev Psychobiol 2024; 66:e22535. [PMID: 39106340 DOI: 10.1002/dev.22535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/03/2024] [Accepted: 07/19/2024] [Indexed: 08/09/2024]
Abstract
The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low- and middle-income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8-10 years in Ghana during two visits, 1 week apart. Completeness of ANS data ranged from 80% to 100% across all tasks. There was low-to-moderate test-retest reliability of video mood induction (VMI) emotion ratings and balloon analog risk task (BART) pumps (r = 0.34-0.52). VMI elicited higher targeted emotion ratings in Visit 2 than Visit 1. Respiratory sinus arrhythmia (RSA) was higher, and pre-ejection period (PEP) was longer at Visit 2 than Visit 1 for baseline and both tasks. RSA was higher at baseline than during the VMI anger scene at Visit 1, whereas PEP was shorter at baseline than during all VMI emotion scenes at Visit 2. RSA was higher at baseline than during BART at both visits. In conclusion, ANS data collection within evocative and arousing challenge tasks was feasible in Ghana, and the tasks were generally reliable and effective in eliciting target emotions and risk-taking behavior in this sample.
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Affiliation(s)
- Helena J Bentil
- Institute of Global Nutrition, University of California, Davis, California, USA
| | - Enya M Daang
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Amanda E Guyer
- Department of Human Ecology, Center for Mind and Brain, University of California, Davis, USA
| | - Haiying Yuan
- Institute of Global Nutrition, University of California, Davis, California, USA
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | | | - Adom Manu
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mavis Osipi Mensah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | | | - Charles D Arnold
- Institute of Global Nutrition, University of California, Davis, California, USA
| | - Brietta M Oaks
- Department of Nutrition, University of Rhode Island, Kingston, Rhode Island, USA
| | - Elizabeth Prado
- Institute of Global Nutrition, University of California, Davis, California, USA
| | - Paul D Hastings
- Department of Psychology, Center for Brain and Mind, University of California, Davis, USA
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31
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Burish MJ, Guirguis AB, Schindler EAD. Managing Cluster Headache in Patients with Medical, Psychiatric, and Surgical Comorbidities. Curr Neurol Neurosci Rep 2024; 24:439-452. [PMID: 39017830 DOI: 10.1007/s11910-024-01362-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE OF REVIEW What should a provider know about medications and other treatments in patients with cluster headache who have medical, psychiatric, and surgical comorbidities? What conversations should providers have with patients about living with and managing cluster headache? RECENT FINDINGS While the number of treatments used in cluster headache is relatively small, numerous considerations were identified related to managing patients with comorbidities. Many of these touch on cardiac, cardiovascular, and cerebrovascular health, but full histories are needed to guide safe and effective treatment. Both older and newer treatments may be contraindicated in certain patients with cluster headache or should be considered carefully. In addition to incorporating medical, psychiatric, and surgical histories in the management plan, collaboration with other providers may be beneficial. Providers should also inquire about patient practices and discuss participation in clinical trials that might be a good fit for the individual.
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Affiliation(s)
- Mark J Burish
- Department of Neurosurgery, McGovern Medical School at UTHealth Houston, Houston, TX, USA
| | - Alexander B Guirguis
- Veteran Health Administration Headache Center of Excellence, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Emmanuelle A D Schindler
- Veteran Health Administration Headache Center of Excellence, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
- VA Connecticut Healthcare System, Neurology Service, MS 127, 950 Campbell Avenue, West Haven, CT, 06516, USA.
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Briciu C, Leucuța D, Popa A, Latiș A, Pop TL, Tomuță I, Man SC, Lazăr C, Voștinaru S, Iurian S. Acceptability of compounded preparations - A Romanian pediatric hospital perspective. Eur J Pharm Biopharm 2024; 202:114383. [PMID: 38936783 DOI: 10.1016/j.ejpb.2024.114383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
Compounded medicines are widely used, especially for pediatric patients. The aim of this study was to evaluate children's acceptability of compounded preparations and to provide information regarding compounding practices' characteristics in a Romanian hospital setting. An observational, cross-sectional, and retrospective study was conducted in three Clinical Pediatric Departments (Emergency Clinical Hospital for Children, Cluj-Napoca). The study population comprised patients under 18 years old taking at least one compounded medication. Study data was collected mainly through an interviewer-administered questionnaire and medicine acceptability was assessed based on the children's first reaction to the preparations using a 3-point facial hedonic scale. A total of 162 compounded medications were evaluated. A positive/negative reaction was reported for 20.83%/58.33%, 20.63%/49.21%, and 66.67%/7.41% of oral, oromucosal and cutaneous dosage forms. Although patient disapproval was recorded for various reasons, medication administration was successful in over 75% of cases. Factors such as fewer steps required for intake of a dose, capsule dosage form, no additional food/drink immediately after drug intake, medication perceived as "easy/very easy" to swallow, were correlated with a better acceptability of oral preparations. This study highlights the importance of identifying factors that can improve the acceptability of compounded preparations and, subsequently, treatment outcomes in pediatric patients.
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Affiliation(s)
- Corina Briciu
- "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Clinical Pharmacy, Cluj-Napoca, Romania
| | - Daniel Leucuța
- "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Informatics and Biostatistics, Cluj-Napoca, Romania
| | - Adina Popa
- "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Clinical Pharmacy, Cluj-Napoca, Romania.
| | - Ana Latiș
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Tudor Lucian Pop
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania; "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Medicine, Second Pediatric Discipline, Mother and Child Department, Cluj-Napoca, Romania
| | - Ioan Tomuță
- "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Technology and Biopharmacy, Cluj-Napoca, Romania
| | - Sorin Claudiu Man
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania; "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Medicine, Third Pediatric Discipline, Mother and Child Department, Cluj-Napoca, Romania
| | - Călin Lazăr
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania; "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Medicine, First Pediatric Discipline, Mother and Child Department, Cluj-Napoca, Romania
| | | | - Sonia Iurian
- "Iuliu Hațieganu" University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Technology and Biopharmacy, Cluj-Napoca, Romania
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Korad S, Mündel T, Perry BG. The effects of habitual resistance exercise training on cerebrovascular responses to lower body dynamic resistance exercise: A cross-sectional study. Exp Physiol 2024; 109:1478-1491. [PMID: 38888986 DOI: 10.1113/ep091707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Dynamic resistance exercise (RE) produces sinusoidal fluctuations in blood pressure with simultaneous fluctuations in middle cerebral artery blood velocity (MCAv). Some evidence indicates that RE may alter cerebrovascular function. This study aimed to examine the effects of habitual RE training on the within-RE cerebrovascular responses. RE-trained (n = 15, Female = 4) and healthy untrained individuals (n = 15, Female = 12) completed four sets of 10 paced repetitions (15 repetitions per minute) of unilateral leg extension exercise at 60% of predicted 1 repetition maximum. Beat-to-beat blood pressure, MCAv and end-tidal carbon dioxide were measured throughout. Zenith, nadir and zenith-to-nadir difference in mean arterial blood pressure (MAP) and mean MCAv (MCAvmean) for each repetition were averaged across each set. Two-way ANOVA was used to analyse dependent variables (training × sets), Bonferroni corrected t-tests were used for post hoc pairwise comparisons. Group age (26 ± 7 trained vs. 25 ± 6 years untrained, P = 0.683) and weight (78 ± 15 vs. 71 ± 15 kg, P = 0.683) were not different. During exercise average MAP was greater for the RE-trained group in sets 2, 3 and 4 (e.g., set 4: 101 ± 11 vs. 92 ± 7 mmHg for RE trained and untrained, respectively, post hoc tests all P = < 0.012). Zenith MAP and zenith-to-nadir MAP difference demonstrated a training effect (P < 0.039). Average MCAvmean and MCAvmean zenith-to-nadir difference was not different between groups (interaction effect P = 0.166 and P = 0.459, respectively). Despite RE-trained individuals demonstrating greater fluctuations in MAP during RE compared to untrained, there were no differences in MCAvmean. Regular RE may lead to vascular adaptations that stabilise MCAv during RE.
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Affiliation(s)
- Stephanie Korad
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
- Department of Kinesiology, Brock University, St Catharines, Ontario, Canada
| | - Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
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Xia J, Yu C, Li L, Pan J. Arterial transit artifacts and carotid Plaque-RADS may predict symptoms in patients with carotid stenosis. Magn Reson Imaging 2024; 111:131-137. [PMID: 38703972 DOI: 10.1016/j.mri.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
AIM To analyze the correlation of carotid stenosis severity, the Plaque Reporting and Data System (RADS) score, arterial transit artifacts (ATAs), and cerebral blood flow (CBF) with clinical cerebral ischemic symptoms in patients with carotid artery stenosis (CAS). MATERIALS AND METHODS Sixty-one patients with unilateral internal carotid artery stenosis or occlusion (≥50% stenosis) diagnosed by ultrasound, Computed Tomography(CT) angiography, or Magnetic Resonance(MR) angiography in Yichang City Central People's Hospital from January 2022 to February 2024 were retrospectively enrolled and divided into two groups according to the presence or absence of symptoms. Both groups underwent MR plaque imaging and arterial spin labeling (ASL)-based 3.0 T MRI to compare the differences in stenosis degree, Plaque-RADS score, ATA grade, and CBF between the two groups. Binary regression analysis was used to identify the parameters with statistically significant differences between the two groups and to evaluate their diagnostic efficacy using the area under the workup curve of the subjects. RESULTS The Plaque-RADS score, ATA grade, and CBF differences in the anterior cerebral artery(ACA)blood supply region were correlated with symptoms, and the areas under the ROC curves for the CBF differences in the ACA blood supply region, Plaque-RADS score, ATA grade and a joint model that combines all three to predict symptoms in CAS patients were 0.672, 0.796, 0.788 and 0.919, respectively. CONCLUSIONS CBF, Plaque-RADS and ATAs were identified as independent risk factors for symptoms in patients with CAS and have a certain predictive value for symptoms, and the combined predictive value is greater, potentially providing a more effective imaging modality for clinical treatment and evaluation.
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Affiliation(s)
- Juan Xia
- The First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
| | - Chengxin Yu
- The First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China.
| | - Liang Li
- Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
| | - Junlong Pan
- Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
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35
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Oprea E, Elosegi JA. Minipolymyoclonus revealing Hirayama disease. Rev Neurol (Paris) 2024; 180:704-705. [PMID: 38604891 DOI: 10.1016/j.neurol.2024.02.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/29/2024] [Accepted: 02/20/2024] [Indexed: 04/13/2024]
Affiliation(s)
- E Oprea
- Neurology Division, cliniques universitaires Saint-Luc, Bruxelles, Belgium.
| | - J-A Elosegi
- Neurology Division, CHU Ambroise-Paré, Mons, Belgium
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36
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Robak T, Puła A, Braun M, Robak E. Extramedullary and extranodal manifestations in chronic lymphocytic leukemia - an update. Ann Hematol 2024; 103:3369-3383. [PMID: 39052034 DOI: 10.1007/s00277-024-05854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/15/2024] [Indexed: 07/27/2024]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a common leukemia characterized by clonal expansion of mature CD5+/CD23 + B cells in the blood, bone marrow (BM) and lymphoid tissues. CLL can undergo extramedullary and extranodal infiltration, with one study noting an incidence of only 0.3 per 100,000 people, and in 17.6% of CLL patients in another report. The most common extranodal sites of leukemic involvement are the skin and central nervous system; however, other organs, including liver, lungs, kidney, gastrointestinal tract, bone, prostate and heart, are occasionally involved. The prognostic significance of extra-medullary CLL is still under debate, but the prognosis in such patients seems to be better in the era of novel targeted drugs. Following a diagnosis of extranodal CLL, survival appears to depend on the site of infiltration. This review presents an overview of CLL in patients with extramedullary and extranodal leukemic lesions, focusing on its epidemiology, pathogenesis, prognosis, clinical characteristics and treatment results.
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Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Ciołkowskiego 2, Lodz, 93-510, Poland.
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland.
| | - Anna Puła
- Department of Hematology, Medical University of Lodz, Ciołkowskiego 2, Lodz, 93-510, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
| | - Marcin Braun
- Department of Pathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland
| | - Ewa Robak
- Department of Dermatology, Medical University of Lodz, Lodz, Poland
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37
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Yimenicioğlu S, Ekici A. Hot water epilepsy with alone and spontaneous seizures in childhood. Epilepsy Res 2024; 205:107418. [PMID: 39003967 DOI: 10.1016/j.eplepsyres.2024.107418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/10/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES Hot water epilepsy (HWE) is a type of epilepsy that primarily affects children. This study was aimed to evaluate the clinical, electroencephalogram (EEG), neuroimaging findings, and treatment options in children with HWE. METHODS The medical records of 24 patients who had HWE were evaluated retrospectively. RESULTS There were 2767 patients diagnosed with epilepsy during the seven-year period, and 0.86 % of the patients had HWE. The median age of the patients was three (range 1.2-7 years), with a male predominance (male/female ratio: 7.1). Six patients (25 %) had HWE with spontaneous seizures (HWESS) and 18 patients (75 %) had HWE alone (HWEA). 11 patients had focal onset seizures, 13 patients had generalized onset seizures. EEG abnormalities were found in 7 patients (29.2 %). Three patients (12.5 %) had nonspecific MRI findings. Developmental abnormalities (autism spectrum disorder, learning disability and speech disturbance.) were detected in 8 patients (33.3 %). Only one patient's (4.2 %) seizure could be controlled by changing bathroom habits. Twenty-three patients (95.8 %) were given antiepileptic drugs. 18 of 24 patients had come for follow-up visits for two years, nine of them used monotherapy and seizures did not recur. The treatment response was 55.5 %. Oxcarbazepine (8 patients, 33.3 %) and valproic acid (7 patients, 29.2 %) were the most chosen two drugs for HWE. The genetic tests performed were not accepted relevant to the patients' clinical conditions and epilepsy. CONCLUSION The frequency of the HWE was not as high in the literature. Male predominance, EEG abnormalities may be seen. Changing bath room habits did not improve the treatment as a first line management, all the patients except one used antiepileptic drug treatment. Until now, there has been no study in Turkey showing the frequency of HWE exclusively in children.
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Affiliation(s)
- Sevgi Yimenicioğlu
- Department of Pediatric Neurology, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey.
| | - Arzu Ekici
- Department of Pediatric Neurology, Health Ministry Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
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Alowaysi M, Baadhaim M, Al-Shehri M, Alzahrani H, Badkok A, Attas H, Zakri S, Alameer S, Malibari D, Hosawi M, Daghestani M, Al-Ghamdi K, Muharraq M, Zia A, Tegne J, Alfadhel M, Aboalola D, Alsayegh K. Derivation of two iPSC lines (KAIMRCi004-A, KAIMRCi004-B) from a Saudi patient with Biotin-Thiamine-responsive Basal Ganglia Disease (BTBGD) carrying homozygous pathogenic missense variant in the SCL19A3 gene. Hum Cell 2024; 37:1567-1577. [PMID: 38980565 PMCID: PMC11341592 DOI: 10.1007/s13577-024-01097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
The neurometabolic disorder known as biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare autosomal recessive condition linked to bi-allelic pathogenic mutations in the SLC19A3 gene. BTBGD is characterized by progressive encephalopathy, confusion, seizures, dysarthria, dystonia, and severe disabilities. Diagnosis is difficult due to the disease's rare nature and diverse clinical characteristics. The primary treatment for BTBGD at this time is thiamine and biotin supplementation, while its long-term effectiveness is still being investigated. In this study, we have generated two clones of induced pluripotent stem cells (iPSCs) from a 10-year-old female BTBGD patient carrying a homozygous mutation for the pathogenic variant in exon 5 of the SLC19A3 gene, c.1264A > G (p.Thr422Ala). We have confirmed the pluripotency of the generated iPS lines and successfully differentiated them to neural progenitors. Because our understanding of genotype-phenotype correlations in BTBGD is limited, the establishment of BTBGD-iPSC lines with a homozygous SLC19A3 mutation provides a valuable cellular model to explore the molecular mechanisms underlying SLC19A3-associated cellular dysfunction. This model holds potential for advancing the development of novel therapeutic strategies.
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Affiliation(s)
- Maryam Alowaysi
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Moayad Baadhaim
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohammad Al-Shehri
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hajar Alzahrani
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Amani Badkok
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hanouf Attas
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Samer Zakri
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Seham Alameer
- Clinical Biomedical Genetics, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Dalal Malibari
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Manal Hosawi
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mustafa Daghestani
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Pathology and Laboratory Medicine, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Khalid Al-Ghamdi
- Forensic Laboratories, Criminal Evidence Department, Jeddah, Saudi Arabia
| | - Mohammed Muharraq
- Forensic Laboratories, Criminal Evidence Department, Jeddah, Saudi Arabia
| | - Asima Zia
- Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Jesper Tegne
- Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Majid Alfadhel
- Department of Genetics and Precision Medicine, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Medical Genomics Research, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Doaa Aboalola
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Khaled Alsayegh
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
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Gurung B, Bhutia TD, Chettri S, Mummadi MK, Bondre VP. Thiamine Responsive Acute Infantile Encephalopathy. Indian J Pediatr 2024; 91:964-966. [PMID: 37880470 DOI: 10.1007/s12098-023-04889-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
This retrospective study was conducted to describe clinical and investigational findings and to determine the effect of thiamine treatment on mortality in patients admitted with acute non-infectious encephalopathy to a hospital in Sikkim between October 2019 and March 2021. Amongst 37 included patients the median age was 4 mo (IQR 3-5), 62.2% were males, 75% were exclusively breastfed infants, 67.6% and 89.2% patients had ophthalmologic and respiratory abnormalities respectively. Multisystem involvement was common. Bilateral basal ganglia involvement was noted in 75% of neuroimaging. Biochemical thiamine deficiency was confirmed in one infant. None of the 11 patients who received thiamine died whereas 20 among 26 patients who did not receive thiamine died [case fatality rate (CFR) 76.9%]. Thiamine treatment was significantly associated with reduced odds of mortality (aOR 0.046, 95% CI 0.0024-0.86, p 0.039). In patients with acute non-infectious encephalopathy and bilateral basal ganglia involvement thiamine use was associated with decreased mortality.
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Affiliation(s)
- Birendra Gurung
- Department of Pediatrics, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, 737101, India
| | - Tsultem Doma Bhutia
- Department of Pediatrics, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, 737101, India.
- Department of Pediatrics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
| | - Subhash Chettri
- Department of Pediatrics, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, 737101, India
- Department of Pediatrics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Mahesh Kumar Mummadi
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Vijay P Bondre
- Encephalitis Group, ICMR- National Institute of Virology, Pune, Maharashtra, India
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40
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Winsor AA, Richards C, Seri S, Liew A, Bagshaw AP. Quality of life in children with epilepsy: The role of parental mental health and sleep disruption. Epilepsy Behav 2024; 158:109941. [PMID: 39024683 DOI: 10.1016/j.yebeh.2024.109941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 06/14/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Parents of children with epilepsy (CWE) are at increased risk of mental health difficulties including anxiety and depression, as well as sleep difficulties. From both the child's and parent's perspectives, health-related quality of life has been shown to be strongly related to parental mental health. However, there is no literature on parental sleep as a predictor of child health-related quality of life. The role of parental variables has been assessed in relation to epilepsy-specific variables (e.g., seizure severity, anti-seizure medications) and how these relate to health-related quality of life, but prior studies have failed to consider the role of co-occurring conditions which are prevalent in CWE. The current study aims to assess how common anxiety symptoms, depression symptoms and sleep problems are in parents of CWE; and to determine the impact these parental variables as well as child co-occurring conditions have on health-related quality of life in CWE. METHODS 33 CWE aged 4-14 years old were recruited from two hospitals and parents were asked to complete a series of questionnaires assessing both child and parental variables. RESULTS It was found that 33.3 % and 12.0 % of parents of CWE experienced clinically significant anxiety and depression symptoms respectively. In addition 67.9 % of parents presented with significant sleep problems. In initial analysis, parental anxiety symptoms, depression symptoms and sleep problems were all significantly predictive of child health-related quality of life. However when co-occurring child sleep problems and neurodevelopmental characteristics were included, parental variables were no longer significantly predictive of child health-related quality of life. CONCLUSION These results suggest that child co-occurrences mediate the relationship between parental variables and child health-related quality of life. The current data highlight the need for a systemic approach to epilepsy management and suggest that support for co-occurrences could benefit health-related quality of life for children and their parents.
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Affiliation(s)
- Alice A Winsor
- Centre for Human Brain Health, University of Birmingham, UK; School of Psychology, University of Birmingham, UK; Maurice Wohl Clinical Neuroscience Institute, King's College London, UK.
| | | | - Stefano Seri
- Children's Epilepsy Surgery Programme, Birmingham Children's Hospital, UK; Aston Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Ashley Liew
- Evelina London Children's Hospital, South London and Maudsley NHS Foundation Trust, UK; University of Warwick, UK
| | - Andrew P Bagshaw
- Centre for Human Brain Health, University of Birmingham, UK; School of Psychology, University of Birmingham, UK
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Ma Q, Chen G, Li Y, Guo Z, Zhang X. The molecular genetics of PI3K/PTEN/AKT/mTOR pathway in the malformations of cortical development. Genes Dis 2024; 11:101021. [PMID: 39006182 PMCID: PMC11245990 DOI: 10.1016/j.gendis.2023.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/07/2023] [Accepted: 04/30/2023] [Indexed: 07/16/2024] Open
Abstract
Malformations of cortical development (MCD) are a group of developmental disorders characterized by abnormal cortical structures caused by genetic or harmful environmental factors. Many kinds of MCD are caused by genetic variation. MCD is the common cause of intellectual disability and intractable epilepsy. With rapid advances in imaging and sequencing technologies, the diagnostic rate of MCD has been increasing, and many potential genes causing MCD have been successively identified. However, the high genetic heterogeneity of MCD makes it challenging to understand the molecular pathogenesis of MCD and to identify effective targeted drugs. Thus, in this review, we outline important events of cortical development. Then we illustrate the progress of molecular genetic studies about MCD focusing on the PI3K/PTEN/AKT/mTOR pathway. Finally, we briefly discuss the diagnostic methods, disease models, and therapeutic strategies for MCD. The information will facilitate further research on MCD. Understanding the role of the PI3K/PTEN/AKT/mTOR pathway in MCD could lead to a novel strategy for treating MCD-related diseases.
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Affiliation(s)
- Qing Ma
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Guang Chen
- Department of Urology, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Ying Li
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
- Department of Child and Adolescent Health, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Zhenming Guo
- Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai 200120, China
| | - Xue Zhang
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
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Gemici Karaaslan HB, Turkkan E, Goksoy Topal E, Karaaslan F, Dag H, Arica V. Association of depression and social anxiety symptom scores with disease characteristics in pediatric patients with chronic immune thrombocytopenia: a cross-sectional study. Int J Hematol 2024; 120:356-364. [PMID: 39090520 DOI: 10.1007/s12185-024-03826-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 07/11/2024] [Accepted: 07/21/2024] [Indexed: 08/04/2024]
Abstract
Patients with ITP have been reported to experience higher levels of depression and anxiety than their healthy counterparts. The limited research conducted on this subject in the pediatric age group has demonstrated that patients have psychosocial difficulties, and their quality of life is adversely affected. The correlation of depressive symptoms with disease characteristics of cITP has never been investigated. This was a cross-sectional study in patients being treated for cITP. Communication with participants was done during routine outpatient visits or by telephone or e-mail, and a survey about demographics and the Children's Depression Inventory (CDI) and the Social Anxiety Scale for Children-Revised (SAS-CR) was administered prospectively. A total of 56 children with cITP were recruited. The mean CDI score was 17 (SD: ± 9.44). Approximately half of the patients had higher CDI scores than healthy Turkish children. Older age, time since diagnosis, a number of hospitalizations (both total and within the last year) were positively correlated with CDI scores. There was no significant correlation between SAS-CR scores and disease characteristics. Depressive symptom scores were higher in children with cITP compared with healthy children in this study. Psychological needs may be overlooked in the medical management of children with cITP.
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Affiliation(s)
- Hatice Betul Gemici Karaaslan
- Department of Pediatrics, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
| | - Emine Turkkan
- Department of Pediatrics, Division of Pediatric Hematology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Evrim Goksoy Topal
- Department of Pediatrics, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Fatih Karaaslan
- Department of Pediatrics, Istanbul Yeni Yuzyil University, Medical Faculty, Istanbul, Turkey
| | - Huseyin Dag
- Department of Pediatrics, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Vefik Arica
- Department of Pediatrics, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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Mungul D, Bila N, Petr G, Satterberg K, Knueven A. Serotonin syndrome: A rare yet crucial diagnosis. JAAPA 2024; 37:21-26. [PMID: 39162652 DOI: 10.1097/01.jaa.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
ABSTRACT Serotonin syndrome is a rare, life-threatening toxidrome caused by serotonergic agents. This syndrome classically presents with a combination of mental status changes, autonomic hyperactivity, and neuromuscular abnormalities. However, diagnosing the condition is difficult because of its variable symptoms at presentation. As a result, serotonin syndrome often is underreported, making it harder to understand, recognize, and treat. Patients with this condition may present to primary or urgent care or an ED, and may become acutely symptomatic during an inpatient admission. Clinicians must be able to identify at-risk patients and intervene to prevent potentially lethal complications.
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Affiliation(s)
- Daniel Mungul
- At the time this article was written, Daniel Mungul, Nick Bila, Grace Petr, and Katie Satterberg were students in the PA program at Rush University in Chicago, Ill. Alyssa Knueven is an assistant professor and director of clinical education in the PA program at Rush University. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Farrar Z, Afshar A, Zare A, Mussin NM, Kaliyev AA, Zhilisbayeva KR, Mahdipour M, Tamadon A. Tissue clearing and three-dimensional imaging of intact tissues: a review on FACT protocol. J Histotechnol 2024; 47:126-142. [PMID: 38752929 DOI: 10.1080/01478885.2024.2352695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/03/2024] [Indexed: 08/31/2024]
Abstract
FACT is a developed technique for clearing tissues that does not use acrylamide. Since the removal of lipids is crucial for transparency and efficient antibody staining throughout the tissue, especially for microscopy and imaging, it is a harmful process that can cause the loss of important biological molecules such as proteins. The FACT technique overcomes this by chemically bonding the membrane and intracellular proteins with the extracellular matrix, creating a massive 3D hydrogel matrix and providing structural support to fortify the tissue during processing. Compared to other acrylamide-based techniques, the FACT technique requires less labor and harmful chemicals and is therefore considered a more suitable option. In this study, we describe the complete FACT protocol for antibody staining and imaging of whole-cleared tissues while preserving structure and improving image quality. The protocol includes tissue perfusion, fixation, clearing, antibody staining, refractive index matching (RIM) (), microscopy, and imaging. The timing for each step varies depending on the size, weight, and type of tissue, as well as the type of immunostaining. We provide an example of the FACT protocol using mouse brain tissue, which demonstrates its suitability for molecular interrogation analysis of large tissues. The FACT technique has been successfully performed on different types of tissues, making it a favorable choice for a variety of applications.
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Affiliation(s)
- Zohreh Farrar
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Alireza Afshar
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Zare
- Department of Research and Development, PerciaVista R&D Co., Shiraz, Iran
| | - Nadiar M Mussin
- Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Asset A Kaliyev
- Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Kulyash R Zhilisbayeva
- Department of Scientific Work, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Mahdi Mahdipour
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Tamadon
- Department of Research and Development, PerciaVista R&D Co., Shiraz, Iran
- Department of Natural Sciences, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Zheng XW, Fang YY, Lin JJ, Luo JJ, Li SJ, Aschner M, Jiang YM. Signal Transduction Associated with Mn-induced Neurological Dysfunction. Biol Trace Elem Res 2024; 202:4158-4169. [PMID: 38155332 DOI: 10.1007/s12011-023-03999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/04/2023] [Indexed: 12/30/2023]
Abstract
Manganese (Mn) is a heavy metal that occurs widely in nature and has a vital physiological role in growth and development. However, excessive exposure to Mn can cause neurological damage, especially cognitive dysfunction, such as learning disability and memory loss. Numerous studies on the mechanisms of Mn-induced nervous system damage found that this metal targets a variety of metabolic pathways, for example, endoplasmic reticulum stress, apoptosis, neuroinflammation, cellular signaling pathway changes, and neurotransmitter metabolism interference. This article reviews the latest research progress on multiple signaling pathways related to Mn-induced neurological dysfunction.
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Affiliation(s)
- Xiao-Wei Zheng
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China
| | - Yuan-Yuan Fang
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China
| | - Jun-Jie Lin
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China
| | - Jing-Jing Luo
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China
| | - Shao-Jun Li
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China.
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China.
| | - Michael Aschner
- The Department of Molecular Pharmacology at Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Yue-Ming Jiang
- Toxicology Department, School of Public Health, Guangxi Medical University, 22 Shuang-Yong Rd., Nanning, 530021, Guangxi, China.
- Key Laboratory of Prevention and Control of Highly Prevalent Diseases in Guangxi Colleges and Universities, Medical University of Guangxi, Nanning, 530021, China.
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Maggi G, Barone A, Mastromarino C, Santangelo G, Vitale C. Prevalence and clinical profile of patients with restless legs syndrome in Parkinson's disease: A meta-analysis. Sleep Med 2024; 121:275-286. [PMID: 39033665 DOI: 10.1016/j.sleep.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/16/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a sensorimotor disorder of sleep/wake regulation characterized by an urge to move the legs accompanied by a wide range of sensory symptoms, mainly affecting the lower limbs. An increased incidence of RLS has been demonstrated in Parkinson's disease (PD) and has been associated with severe motor and non-motor manifestations. We aimed to provide a reliable estimate of RLS prevalence and the clinical features associated with its occurrence in PD (PD-RLS). METHODS We performed a systematic literature search up to January 2024 using PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with or without RLS, and these proportions were used to estimate the prevalence of PD-RLS. Clinical profile associated with PD-RLS was explored by comparing the clinical characteristics of PD patients with and without RLS. RESULTS Forty-six studies were included in the meta-analysis. Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients and was associated with female sex, mixed motor phenotype, worse motor disturbances and functional disability, and a wide range of non-motor symptoms such as sleep disorders, cognitive and autonomic dysfunctions, and more severe neuropsychiatric manifestations. Sensitivity analyses indicated significant associations of PD-RLS with variables related to dopaminergic therapy. No association was found with serum ferritin, serum iron and hemoglobin levels. CONCLUSIONS The prevalence of PD-RLS exceeds that reported in the general population, suggesting the existence of a relationship between the two disorders. Dopaminergic treatment seems to play an ambivalent role relieving, worsening or "mimicking" RLS manifestations. However, the clinical profile of PD-RLS patients, characterized by a greater severity of non-motor symptoms, also suggests that neurotransmitter systems other than the dopaminergic one are involved in PD-RLS etiology.
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Affiliation(s)
- Gianpaolo Maggi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Angelo Barone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Clara Mastromarino
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carmine Vitale
- Department of Medical, Motor and Wellness Sciences, University "Parthenope", Naples, Italy; ICS Maugeri Hermitage Napoli, 80145, Naples, Italy
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Verma A, Pathak P, Mishra AK, Upadhya S. Factors linked with perceived stigma amid people with Epilepsy -across sectional study. Epilepsy Res 2024; 205:107428. [PMID: 39116512 DOI: 10.1016/j.eplepsyres.2024.107428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/20/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVES People with epilepsy (PWE) continue to suffer from discrimination and often bear the negative attitudes surrounding this condition. The aim of the study was to assess the frequency of perceived stigma and factors associated with it among PWE in tertiary care centre. MATERIAL AND METHODS A hospital-based, cross-sectional study was conducted using the Kilifi Stigma Scale of Epilepsy (KSSE) to assess the stigma associated with epilepsy and factors related to stigma. RESULTS A total of 260 consecutive PWE were recruited, with a mean age of 28.12±9.96 years. The majority of subjects had primarily or secondarily generalized seizures (85 %), and most of PWE don't know the cause of epilepsy (79.2 %) and feel that epilepsy is a contagious disease. Those with contagious beliefs felt more stigma (27.7 %). Stigma was perceived by 28.5 % of subjects using KSSE. Stigma was more perceived in those who had primarily or secondarily generalized seizures (23.9 %) and longer durations of anti-seizure medication (ASM) (24.4 %). Injury during a seizure was reported in 30 % of subjects and were more stigmatized (p<.01). CONCLUSION Perceived stigma in PWE was found to be correlated with contagious beliefs. There is a need for awareness and educational programs by healthcare professionals at different levels to support and encourage positive beliefs, dispel myths about epilepsy, and inform PWEs of the fact that it is not a contagious disease.
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Affiliation(s)
- Archana Verma
- Department of Neurology, All India Institute of Medical Sciences Raebareli, Munshiganj, Munshiganj, Dalmau Road, Raebareli, Uttar Pradesh 229405, India.
| | - Pooja Pathak
- Department of community Medicine, MVASMC Ghazipur (U.P.), India.
| | - Ashutosh Kumar Mishra
- Department of Neurology, All India Institute of Medical Sciences Raebareli, Munshiganj, Munshiganj, Dalmau Road, Raebareli, Uttar Pradesh 229405, India.
| | - Sachin Upadhya
- Department of Neurology, All India Institute of Medical Sciences Raebareli, Munshiganj, Munshiganj, Dalmau Road, Raebareli, Uttar Pradesh 229405, India.
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Tao Y, Luo J, Tian J, Peng S, Wang H, Cao J, Wen Z, Zhang X. The role of robot-assisted training on rehabilitation outcomes in Parkinson's disease: a systematic review and meta-analysis. Disabil Rehabil 2024; 46:4049-4067. [PMID: 37818694 DOI: 10.1080/09638288.2023.2266178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/14/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE The study aims to assess the efficacy of robot-assisted rehabilitation training on upper and lower limb motor function and fatigue in Parkinson's disease (PD), and to explore the best-acting robotic rehabilitation program. METHODS We searched studies in seven databases and the search period was from the build to 30 June 2023. Two researchers independently screened studies and assessed the quality of the studies for data extraction. RESULTS A total of 21 studies were included, 18 studies related to lower limbs rehabilitation and 3 studies related to upper limbs rehabilitation, involving a total of 787 participants. The results showed that robot-assisted rehabilitation significantly improved indicators of lower limb motor function UPDRS Part III (WMD = -3.58, 95% CI = -5.91 to -1.25, p = 0.003) and BBS (WMD = 4.24, 95% CI = 2.88 to 5.54, p < 0.001), as well as non-motor symptoms of fatigue (WMD = -13.39, 95% CI = -17.92 to -8.86, p < 0.001) in PD patients. At the level of upper limb function, there was no statistically significant difference in the outcome measures of PFS (WMD = -0.25, 95% CI = -4.44 to 3.93, p = 0.9) and BBT (WMD = 1.73, 95% CI = -2.85 to 6.33, p = 0.458). CONCLUSION Robot-assisted rehabilitation significantly improved motor function, fatigue, and balance confidence in PD patients, but current evidence doesn't show that intelligent rehabilitation systems improve upper limb function. In particular, robotics combined with virtual reality worked best.
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Affiliation(s)
- Yanmin Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingsong Luo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Tian
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sihan Peng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, China
| | - Jun Cao
- Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Ang T, Kundu N, Patel S, Tong JY, Selva D. Non-infectious hypertrophic pachymeningitis associated with orbital inflammatory disease: a pooled analysis. Orbit 2024:1-10. [PMID: 39192754 DOI: 10.1080/01676830.2024.2390609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/05/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE To describe four cases of non-infectious hypertrophic pachymeningitis (HP)-associated with orbital inflammatory disease (OID). This study summarises the clinico-radiological features, outcomes, and management of HP-associated OID. METHODS Retrospective case-series of patients with radiological evidence of HP and OID. Comprehensive literature review of all published English-language non-infectious causes of HP-associated OID. Reference lists were screened for inclusion of relevant articles. RESULTS Thirty-seven cases of HP-associated OID (Mean age: 49.2 ± 17.4 years old; Male: 15) were identified, including four cases from our institution. Aetiologies included ANCA-associated vasculitis (12/37), non-specific/idiopathic (11/37), IgG4/multifocal fibrosclerosis (11/37), neurosarcoidosis (1/37), inflammatory myofibroblastic tumour (1/37), and giant cell arteritis (1/37). Orbital pain, headache, visual deterioration, and cranial nerve palsies were common clinical presentations. Both "focal" and "diffuse" HP were observed, with the most common sign of orbital involvement being an inflammatory orbital mass, typically with orbital apex involvement. Orbital myositis and dacryoadenitis were less common. The cavernous sinus was the most common site of extra-orbital inflammation. There was no single differentiating specific radiological feature between non-specific and specific forms of HP-associated OID. CONCLUSION The clinico-radiological manifestations of HP-associated OID differ from those described in isolated HP or OID. There is no single specific radiological marker differentiating non-specific/idiopathic disease from secondary causes; however, the co-existence of HP in OID should prompt suspicion of an underlying cause. The disease may be refractory or resistant to initial treatment, although guidelines surrounding its management and the long-term prognosis remain to be determined.
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Affiliation(s)
- Terence Ang
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Naman Kundu
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Sandy Patel
- Department of Medical Imaging, The Royal Adelaide Hospital, Adelaide, Australia
| | - Jessica Y Tong
- Department of Ophthalmology, The Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Department of Ophthalmology, The Royal Adelaide Hospital, Adelaide, Australia
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Guo P, Sun W, Song LX, Cao WY, Li JP. Multimodal imaging for the diagnosis of oligodendroglioma associated with arteriovenous malformation: A case report. World J Radiol 2024; 16:348-355. [DOI: 10.4329/wjr.v16.i8.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND The rare co-occurrence of oligodendroglioma and arteriovenous malformation (AVM) in the same intracranial location.
CASE SUMMARY In a 61-year-old man presenting with progressive headaches, is described in this case study. Preoperative multimodal imaging techniques (computed tomography, magnetic resonance imaging, magnetic resonance spectroscopy, digital subtraction angiography, and computed tomography angiography) were employed to detect hemorrhage, cystic and solid lesions, and arteriovenous shunting in the right temporal lobe. The patient underwent right temporal craniotomy for lesion removal, and postoperative pathological analysis confirmed the presence of oligodendroglioma (World Health Organization grade II, not otherwise specified) and AVM.
CONCLUSION The preoperative utilization of multimodal imaging examination can help clinicians reduce the likelihood of misdiagnosis or oversight of these conditions, and provides important information for subsequent treatment. This case supports the feasibility of craniotomy for the removal of glioma with AVM.
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Affiliation(s)
- Peng Guo
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wei Sun
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Ling-Xie Song
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wen-Yu Cao
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jin-Ping Li
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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