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Joosub N, Kruger G, Basson P. A neuropsychological rehabilitation service delivery model for South African adults with acquired brain injury (RSDM-SA). Front Rehabil Sci 2024; 4:1175963. [PMID: 38681901 PMCID: PMC11045952 DOI: 10.3389/fresc.2023.1175963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/24/2023] [Indexed: 05/01/2024]
Abstract
In low- and- middle- income countries (LMICs) such as South Africa, a high number of Acquired Brain Injuries (ABIs) and a lack of accessibility to healthcare lead to many survivors of brain injury not receiving the level of healthcare and rehabilitation required. Further, in LMICs life-saving or acute care is prioritized with an inadequate focus on the lifelong effects of ABI. This study used Program Theory to develop a Rehabilitation Service Delivery Model for South African Adults with Acquired Brain Injury (RSDM-SA) that caters for the unique nuances of a resource-constrained and culturally diverse context. The RSDM-SA has four interdependent levels, namely (i) Integration of Relevant Aspects of Explanatory Frameworks (ii) South African Contextual Influences on the Model (iii) Systemic Role players Necessary for the Model and (iv) Evidence-Based Guidelines in a Holistic Rehabilitation Process. The Model is a valuable resource in guiding future research endeavors and its contribution lies in the Model's focus on quality, accessibility, relevance, and efficiency, all of which are needed in healthcare internationally.
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Affiliation(s)
- Noorjehan Joosub
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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152
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Kelidari M, Abedi F, Hayes AW, Jomehzadeh V, Karimi G. The protective effects of protocatechuic acid against natural and chemical toxicants: cellular and molecular mechanisms. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-03072-0. [PMID: 38607443 DOI: 10.1007/s00210-024-03072-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
Protocatechuic acid (PCA) is a water-soluble polyphenol compound that is extracted from certain fruits and plants or obtained from glucose fermentation. Several in vivo and in vitro studies have determined that PCA has protective effects against the toxicity of natural and chemical toxicants. We searched these articles in PubMed, Google Scholar, and Scopus with appropriate keywords from inception up to August 2023. Forty-nine studies were found about protective effects of PCA against drug toxicity, metal toxicity, toxins, chemical toxicants, and some other miscellaneous toxicants. PCA indicates these protective effects by suppression of oxidative stress, inflammation, and apoptosis. PCA reduces reactive oxygen/nitrogen species (RONS) and enhances the level of antioxidant parameters mainly through the activation of the Nrf-2 signaling pathway. PCA also decreases the levels of inflammatory mediators via downregulating the TLR-4-mediated IKBKB/NF-κB and MAPK/Erk signaling pathways. In addition, PCA inhibits apoptosis by lowering the expression of Bax, caspase-3, and caspase-9 along with enhancing the level of the antiapoptotic protein Bcl-2. Further evaluation, especially in humans, is necessary to confirm PCA as a potential therapeutic approach to intervene in such toxicities.
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Affiliation(s)
- Mahdieh Kelidari
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshad Abedi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Wallace Hayes
- College of Public Health, University of South Florida, Tampa, FL, USA
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, USA
| | - Vahid Jomehzadeh
- Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholamreza Karimi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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153
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Han Y, Jing Y, Shi Y, Mo H, Wan Y, Zhou H, Deng F. The role of language-related functional brain regions and white matter tracts in network plasticity of post-stroke aphasia. J Neurol 2024:10.1007/s00415-024-12358-5. [PMID: 38607432 DOI: 10.1007/s00415-024-12358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
The neural mechanisms underlying language recovery after a stroke remain controversial. This review aimed to summarize the plasticity and reorganization mechanisms of the language network through neuroimaging studies. Initially, we discussed the involvement of right language homologues, perilesional tissue, and domain-general networks. Subsequently, we summarized the white matter functional mapping and remodeling mechanisms associated with language subskills. Finally, we explored how non-invasive brain stimulation (NIBS) promoted language recovery by inducing neural network plasticity. It was observed that the recruitment of right hemisphere language area homologues played a pivotal role in the early stages of frontal post-stroke aphasia (PSA), particularly in patients with larger lesions. Perilesional plasticity correlated with improved speech performance and prognosis. The domain-general networks could respond to increased "effort" in a task-dependent manner from the top-down when the downstream language network was impaired. Fluency, repetition, comprehension, naming, and reading skills exhibited overlapping and unique dual-pathway functional mapping models. In the acute phase, the structural remodeling of white matter tracts became challenging, with recovery predominantly dependent on cortical activation. Similar to the pattern of cortical activation, during the subacute and chronic phases, improvements in language functions depended, respectively, on the remodeling of right white matter tracts and the restoration of left-lateralized language structural network patterns. Moreover, the midline superior frontal gyrus/dorsal anterior cingulate cortex emerged as a promising target for NIBS. These findings offered theoretical insights for the early personalized treatment of aphasia after stroke.
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Affiliation(s)
- Yue Han
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yuanyuan Jing
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yanmin Shi
- Health Management (Physical Examination) Center, The Second Norman Bethune Hospital of Jilin University, Changchun, China
| | - Hongbin Mo
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yafei Wan
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Hongwei Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, China.
| | - Fang Deng
- Department of Neurology, The First Hospital of Jilin University, Changchun, China.
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154
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Rekik A, Santoro C, Poplawska-Domaszewicz K, Qamar MA, Batzu L, Landolfo S, Rota S, Falup-Pecurariu C, Murasan I, Chaudhuri KR. Parkinson's disease and vitamins: a focus on vitamin B12. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02769-z. [PMID: 38602571 DOI: 10.1007/s00702-024-02769-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
Parkinson's disease (PD) has been linked to a vast array of vitamins among which vitamin B12 (Vit B12) is the most relevant and often investigated specially in the context of intrajejunal levodopa infusion therapy. Vit B12 deficiency, itself, has been reported to cause acute parkinsonism. Nevertheless, concrete mechanisms through which B12 deficiency interacts with PD in terms of pathophysiology, clinical manifestation and progression remains unclear. Recent studies have suggested that Vit B12 deficiency along with the induced hyperhomocysteinemia are correlated with specific PD phenotypes characterized with early postural instability and falls and more rapid motor progression, cognitive impairment, visual hallucinations and autonomic dysfunction. Specific clinical features such as polyneuropathy have also been linked to Vit B12 deficiency specifically in context of intrajejunal levodopa therapy. In this review, we explore the link between Vit B12 and PD in terms of physiopathology regarding dysfunctional neural pathways, neuropathological processes as well as reviewing the major clinical traits of Vit B12 deficiency in PD and Levodopa-mediated neuropathy. Finally, we provide an overview of the therapeutic effect of Vit B12 supplementation in PD and posit a practical guideline for Vit B12 testing and supplementation.
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Affiliation(s)
- Arwa Rekik
- Department of Neurology of Sahloul Hospital, Sousse, Tunisia.
- Faculty of Medicine of Sousse, Sousse, Tunisia.
| | - Carlo Santoro
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Karolina Poplawska-Domaszewicz
- Department of Neurology, Poznan University of Medical Sciences, 60-355, Poznan, Poland
- Parkinson's Foundation Center of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Mubasher Ahmad Qamar
- Parkinson's Foundation Center of Excellence, King's College Hospital, Denmark Hill, London, UK
- Division of Neuroscience, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 9RT, UK
| | - Lucia Batzu
- Parkinson's Foundation Center of Excellence, King's College Hospital, Denmark Hill, London, UK
- Division of Neuroscience, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 9RT, UK
| | - Salvatore Landolfo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Silvia Rota
- Parkinson's Foundation Center of Excellence, King's College Hospital, Denmark Hill, London, UK
- Division of Neuroscience, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 9RT, UK
| | - Cristian Falup-Pecurariu
- Faculty of Medicine, Transilvania University of Brasov, 500036, Brasov, Romania
- Department of Neurology, County Clinic Hospital, Brasov, Romania
| | - Iulia Murasan
- Faculty of Medicine, Transilvania University of Brasov, 500036, Brasov, Romania
| | - Kallol Ray Chaudhuri
- Parkinson's Foundation Center of Excellence, King's College Hospital, Denmark Hill, London, UK
- Division of Neuroscience, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 9RT, UK
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155
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V S, Pattanaik A, Marate S, Mani RS, Pai AR, Mukhopadhyay C. Guillain-barré syndrome (GBS) with antecedent chikungunya infection: a case report and literature review. Neurol Res Pract 2024; 6:21. [PMID: 38600592 PMCID: PMC11008014 DOI: 10.1186/s42466-024-00315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/04/2024] [Indexed: 04/12/2024] Open
Abstract
Guillain-Barré Syndrome (GBS) is an autoimmune neuropathy. Antecedent infections have been seen to be significant triggering factors for developing GBS. Among them, arboviral infections are rapidly gaining importance as significant triggers, especially in the areas where they are endemic. Chikungunya, an arboviral infection that usually causes a self-limiting acute febrile illness can lead to GBS as one its severe complications. Herein, we describe a case of a 21-year-old female who presented with weakness in all four limbs and paresthesia. Nerve conduction study and cerebrospinal fluid (CSF) analysis showed axonal, demyelinating motor and sensory neuropathy with albuminocytological dissociation indicating Acute Motor and Sensory Axonal Neuropathy (AMSAN) variant of GBS. Serum IgM antibodies against ganglioside GM1 were detected. Anti-Chikungunya IgM antibodies were found in both serum and CSF samples. The patient was initiated with Intravenous Immunoglobulin (IVIG) therapy. In view of hypoxia, she was intubated and was on mechanical ventilation. After 2 weeks of being comatose, the patient gradually improved and was discharged with no sequelae.A literature review on antecedent infections in GBS is presented alongside the case report to better understand the association of GBS with antecedent infections, especially the endemic arboviral infections like Chikungunya, Dengue and Zika. This will help in reinforcing the significance of having robust surveillance and public health control measures for infectious diseases.
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Affiliation(s)
- Sreelakshmi V
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Amrita Pattanaik
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Srilatha Marate
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Reeta S Mani
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Karnataka, Bengaluru, India
| | - Aparna R Pai
- Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Chiranjay Mukhopadhyay
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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156
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Wiestler B, Bison B, Behrens L, Tüchert S, Metz M, Griessmair M, Jakob M, Schlegel PG, Binder V, von Luettichau I, Metzler M, Johann P, Hau P, Frühwald M. Human-Level Differentiation of Medulloblastoma from Pilocytic Astrocytoma: A Real-World Multicenter Pilot Study. Cancers (Basel) 2024; 16:1474. [PMID: 38672556 PMCID: PMC11048511 DOI: 10.3390/cancers16081474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Medulloblastoma and pilocytic astrocytoma are the two most common pediatric brain tumors with overlapping imaging features. In this proof-of-concept study, we investigated using a deep learning classifier trained on a multicenter data set to differentiate these tumor types. We developed a patch-based 3D-DenseNet classifier, utilizing automated tumor segmentation. Given the heterogeneity of imaging data (and available sequences), we used all individually available preoperative imaging sequences to make the model robust to varying input. We compared the classifier to diagnostic assessments by five readers with varying experience in pediatric brain tumors. Overall, we included 195 preoperative MRIs from children with medulloblastoma (n = 69) or pilocytic astrocytoma (n = 126) across six university hospitals. In the 64-patient test set, the DenseNet classifier achieved a high AUC of 0.986, correctly predicting 62/64 (97%) diagnoses. It misclassified one case of each tumor type. Human reader accuracy ranged from 100% (expert neuroradiologist) to 80% (resident). The classifier performed significantly better than relatively inexperienced readers (p < 0.05) and was on par with pediatric neuro-oncology experts. Our proof-of-concept study demonstrates a deep learning model based on automated tumor segmentation that can reliably preoperatively differentiate between medulloblastoma and pilocytic astrocytoma, even in heterogeneous data.
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Affiliation(s)
- Benedikt Wiestler
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- TranslaTUM, Center for Translational Cancer Research, Technical University of Munich, 81675 Munich, Germany
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Brigitte Bison
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (B.B.); (L.B.)
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Lars Behrens
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (B.B.); (L.B.)
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Stefanie Tüchert
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Marie Metz
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Michael Griessmair
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Marcus Jakob
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, 93053 Regensburg, Germany;
| | - Paul-Gerhardt Schlegel
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children’s Hospital Würzburg, 97080 Würzburg, Germany;
| | - Vera Binder
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatrics, Dr. Von Hauner Children’s Hospital, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Irene von Luettichau
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kinderklinik München Schwabing, Children’s Cancer Research Center, TUM School of Medicine and Health, Technical University of Munich, 80333 Munich, Germany;
| | - Markus Metzler
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
| | - Pascal Johann
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Swabian Children’s Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (P.J.); (M.F.)
| | - Peter Hau
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Michael Frühwald
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Swabian Children’s Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (P.J.); (M.F.)
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157
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Balla Y, Hashi AS, Osman AA, Hassan MS, Mutlu E. Cerebral Venous Sinus Thrombosis as an Initial Presentation of Nephrotic Syndrome: A Case Report. Vasc Health Risk Manag 2024; 20:177-181. [PMID: 38623542 PMCID: PMC11018128 DOI: 10.2147/vhrm.s458539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
Cerebral sinovenous thrombosis (CSVT) encompasses a spectrum of disorders involving thrombosis of the cerebral venous system. As shown by previous epidemiological studies, the prevalence of cerebral sinovenous thrombosis is 4-7 cases per million people. Nephrotic syndrome was very rarely associated with thrombosis cerebral veins or sinuses. Hypercoagulability and thrombotic complications in nephrotic syndrome are most commonly seen in deep veins of the lower extremities and renal veins. Our case highlights a unique scenario in which cerebral sinovenous thrombosis was the initial presentation of nephrotic syndrome in a patient that was not an important past medical or surgical problem. The patient was brought to the emergency department with severe headache, vomiting, altered mental status, and generalized body swelling. Laboratory results showed proteinuria, hypoalbuminemia and hyperlipidemia. Non-contrast brain CT demonstrated hemorrhagic venous infarct associated with vasogenic edema. A subsequent brain MR venogram demonstrated occlusion of superior sagittal and right transverse sinuses. She was managed with low molecular weight heparin and intervenous corticosteroids then shifted to rivaroxaban and oral steroids, respectively, which resulted in massive clinical improvement and resolution of thrombus.
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Affiliation(s)
- Yassir Balla
- Department of Internal Medicine, Somali-Sudanese Specialized hospital, Mogadishu, Somalia
| | - Abdullahi Said Hashi
- Department of Anesthesiology and Reanimation, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Ahmed Adam Osman
- Department of Radiology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
- Faculty of Medicine and Surgery, University of Somalia, Mogadishu, Somalia
| | - Mohamed Sheikh Hassan
- Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Eren Mutlu
- Department of Radiology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
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158
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Pérez-Mora S, Pérez-Ishiwara DG, Salgado-Hernández SV, Medel-Flores MO, Reyes-López CA, Rodríguez MA, Sánchez-Monroy V, Gómez-García MDC. Entamoeba histolytica: In Silico and In Vitro Oligomerization of EhHSTF5 Enhances Its Binding to the HSE of the EhPgp5 Gene Promoter. Int J Mol Sci 2024; 25:4218. [PMID: 38673804 PMCID: PMC11050682 DOI: 10.3390/ijms25084218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Throughout its lifecycle, Entamoeba histolytica encounters a variety of stressful conditions. This parasite possesses Heat Shock Response Elements (HSEs) which are crucial for regulating the expression of various genes, aiding in its adaptation and survival. These HSEs are regulated by Heat Shock Transcription Factors (EhHSTFs). Our research has identified seven such factors in the parasite, designated as EhHSTF1 through to EhHSTF7. Significantly, under heat shock conditions and in the presence of the antiamoebic compound emetine, EhHSTF5, EhHSTF6, and EhHSTF7 show overexpression, highlighting their essential role in gene response to these stressors. Currently, only EhHSTF7 has been confirmed to recognize the HSE as a promoter of the EhPgp5 gene (HSE_EhPgp5), leaving the binding potential of the other EhHSTFs to HSEs yet to be explored. Consequently, our study aimed to examine, both in vitro and in silico, the oligomerization, and binding capabilities of the recombinant EhHSTF5 protein (rEhHSTF5) to HSE_EhPgp5. The in vitro results indicate that the oligomerization of rEhHSTF5 is concentration-dependent, with its dimeric conformation showing a higher affinity for HSE_EhPgp5 than its monomeric state. In silico analysis suggests that the alpha 3 α-helix (α3-helix) of the DNA-binding domain (DBD5) of EhHSTF5 is crucial in binding to the major groove of HSE, primarily through hydrogen bonding and salt-bridge interactions. In summary, our results highlight the importance of oligomerization in enhancing the affinity of rEhHSTF5 for HSE_EhPgp5 and demonstrate its ability to specifically recognize structural motifs within HSE_EhPgp5. These insights significantly contribute to our understanding of one of the potential molecular mechanisms employed by this parasite to efficiently respond to various stressors, thereby enabling successful adaptation and survival within its host environment.
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Affiliation(s)
- Salvador Pérez-Mora
- Laboratorio de Biomedicina Molecular 1, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico; (S.P.-M.); (D.G.P.-I.); (S.V.S.-H.); (M.O.M.-F.)
| | - David Guillermo Pérez-Ishiwara
- Laboratorio de Biomedicina Molecular 1, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico; (S.P.-M.); (D.G.P.-I.); (S.V.S.-H.); (M.O.M.-F.)
| | - Sandra Viridiana Salgado-Hernández
- Laboratorio de Biomedicina Molecular 1, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico; (S.P.-M.); (D.G.P.-I.); (S.V.S.-H.); (M.O.M.-F.)
| | - María Olivia Medel-Flores
- Laboratorio de Biomedicina Molecular 1, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico; (S.P.-M.); (D.G.P.-I.); (S.V.S.-H.); (M.O.M.-F.)
| | - César Augusto Reyes-López
- Laboratorio de Bioquímica Estructural, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico;
| | - Mario Alberto Rodríguez
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del IPN (Cinvestav), Mexico City 07360, Mexico;
| | - Virginia Sánchez-Monroy
- Sección de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - María del Consuelo Gómez-García
- Laboratorio de Biomedicina Molecular 1, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico; (S.P.-M.); (D.G.P.-I.); (S.V.S.-H.); (M.O.M.-F.)
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159
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Oprea E, Elosegi JA. Minipolymyoclonus revealing Hirayama disease. Rev Neurol (Paris) 2024:S0035-3787(24)00482-X. [PMID: 38604891 DOI: 10.1016/j.neurol.2024.02.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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El Brouzi MY, Lamtai M, Zghari O, El Hamzaoui A, Rezqaoui A, Hadch Z, Fath N, Ouichou A, El Hessni A, Mesfioui A. Melatonin is a Neuroprotective and Antioxidant Agent against Neurotoxicity Induced by an Intrahippocampal Injection of Nickel in Rats. Neurotox Res 2024; 42:24. [PMID: 38598025 DOI: 10.1007/s12640-024-00700-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/27/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024]
Abstract
The investigation into the hippocampal function and its response to heavy metal exposure is crucial for understanding the mechanisms underlying neurotoxicity, this can potentially inform strategies for mitigating the adverse effects associated with heavy metal exposure. Melatonin is an essential neuromodulator known for its efficacy as an antioxidant. In this study, we aimed to determine whether melatonin could protect against Nickel (Ni) neurotoxicity. To achieve this, we performed an intracerebral injection of Ni (300 µM NiCl2) into the right hippocampus of male Wistar rats, followed by melatonin treatment. Based on neurobehavioral and neurobiochemical assessments, our results demonstrate that melatonin efficiently enhances Ni-induced behavioral dysfunction and cognitive impairment. Specifically, melatonin treatment positively influences anxious behavior, significantly reduces immobility time in the forced swim test (FST), and improves learning and spatial memory abilities. Moreover, neurobiochemical assays revealed that melatonin treatment modulates the Ni-induced alterations in oxidative stress balance by increasing antioxidant enzyme activities, such as superoxide dismutase (SOD) and catalase (CAT). Additionally, we observed that melatonin significantly attenuated the increased levels of lipid peroxidation (LPO) and nitric oxide (NO). In conclusion, the data from this study suggests that melatonin attenuates oxidative stress, which is the primary mechanism responsible for Ni-induced neurotoxicity. Considering that the hippocampus is the main structure involved in the pathology associated with heavy metal intoxication, such as Ni, these findings underscore the potential therapeutic efficacy of melatonin in mitigating heavy metal-induced brain damage.
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Affiliation(s)
- Mohamed Yassine El Brouzi
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco.
| | - Mouloud Lamtai
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Oussama Zghari
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Abdelghafour El Hamzaoui
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Ayoub Rezqaoui
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Zahra Hadch
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Nada Fath
- Compared Anatomy Unit, School of Veterinary Medicine, Hassan II Institute of Agronomy and Veterinary Medicine, Rabat, Morocco
| | - Ali Ouichou
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Aboubaker El Hessni
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
| | - Abdelhalem Mesfioui
- Laboratory of Biology and Health, Neuro-Immunology and Behavior Unit, Faculty of Science, Ibn Tofail University, Kénitra, Morocco
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Taddei S, Tsabedze N, Tan RS. β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications. Curr Med Res Opin 2024; 40:15-23. [PMID: 38597065 DOI: 10.1080/03007995.2024.2318058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/07/2024] [Indexed: 04/11/2024]
Abstract
β-blockers are a heterogeneous class, with individual agents distinguished by selectivity for β1- vs. β2- and α-adrenoceptors, presence or absence of partial agonist activity at one of more β-receptor subtype, presence or absence of additional vasodilatory properties, and lipophilicity, which determines the ease of entry the drug into the central nervous system. Cardioselectivity (β1-adrenoceptor selectivity) helps to reduce the potential for adverse effects mediated by blockade of β2-adrenoceptors outside the myocardium, such as cold extremities, erectile dysfunction, or exacerbation of asthma or chronic obstructive pulmonary disease. According to recently updated guidelines from the European Society of Hypertension, β-blockers are included within the five major drug classes recommended as the basis of antihypertensive treatment strategies. Adding a β-blocker to another agent with a complementary mechanism may provide a rational antihypertensive combination that minimizes the adverse impact of induced sympathetic overactivity for optimal blood pressure-lowering efficacy and clinical outcomes benefit.
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Affiliation(s)
- Stefano Taddei
- Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nqoba Tsabedze
- Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ru-San Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore
- Cardiovascular Sciences, Duke NUS Medical School, Singapore
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Coutinho JM, van de Munckhof A, Aguiar de Sousa D, Poli S, Aaron S, Arauz A, Conforto AB, Krzywicka K, Hiltunen S, Lindgren E, Sánchez van Kammen M, Shu L, Bakchoul T, Belder R, van den Berg R, Boumans E, Cannegieter S, Cano-Nigenda V, Field TS, Fragata I, Heldner MR, Hernández-Pérez M, Klok FA, Leker RR, Lucas-Neto L, Molad J, Nguyen TN, Saaltink DJ, Saposnik G, Sharma P, Stam J, Thijs V, van der Vaart M, Werring DJ, Wong Ramos D, Yaghi S, Yeşilot N, Tatlisumak T, Putaala J, Jood K, Arnold M, Ferro JM. Reducing the global burden of cerebral venous thrombosis: An international research agenda. Int J Stroke 2024:17474930241242266. [PMID: 38494462 DOI: 10.1177/17474930241242266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Due to the rarity of cerebral venous thrombosis (CVT), performing high-quality scientific research in this field is challenging. Providing answers to unresolved research questions will improve prevention, diagnosis, and treatment, and ultimately translate to a better outcome of patients with CVT. We present an international research agenda, in which the most important research questions in the field of CVT are prioritized. AIMS This research agenda has three distinct goals: (1) to provide inspiration and focus to research on CVT for the coming years, (2) to reinforce international collaboration, and (3) to facilitate the acquisition of research funding. SUMMARY OF REVIEW This international research agenda is the result of a research summit organized by the International Cerebral Venous Thrombosis Consortium in Amsterdam, the Netherlands, in June 2023. The summit brought together 45 participants from 15 countries including clinical researchers from various disciplines, patients who previously suffered from CVT, and delegates from industry and non-profit funding organizations. The research agenda is categorized into six pre-specified themes: (1) epidemiology and clinical features, (2) life after CVT, (3) neuroimaging and diagnosis, (4) pathophysiology, (5) medical treatment, and (6) endovascular treatment. For each theme, we present two to four research questions, followed by a brief substantiation per question. The research questions were prioritized by the participants of the summit through consensus discussion. CONCLUSIONS This international research agenda provides an overview of the most burning research questions on CVT. Answering these questions will advance our understanding and management of CVT, which will ultimately lead to improved outcomes for CVT patients worldwide.
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Affiliation(s)
- Jonathan M Coutinho
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Anita van de Munckhof
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Diana Aguiar de Sousa
- Stroke Center, Centro Hospitalar Universitário Lisboa Central, Institute of Anatomy, Faculdade de Medicina, Universidade de Lisboa, and L Lopes Lab, Instituto de Medicina Molecular JLA, Lisbon, Portugal
| | - Sven Poli
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | - Antonio Arauz
- Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico
| | - Adriana B Conforto
- LIM-44, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Katarzyna Krzywicka
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Sini Hiltunen
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Erik Lindgren
- Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Mayte Sánchez van Kammen
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Liqi Shu
- Brown University, Providence, RI, USA
| | - Tamam Bakchoul
- Centre for Clinical Transfusion Medicine, Medical Faculty of Tübingen, University of Tübingen, Tübingen, Germany
| | - Rosalie Belder
- Netherlands Thrombosis Foundation, Voorschoten, The Netherlands
| | - René van den Berg
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Suzanne Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vanessa Cano-Nigenda
- Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico
| | - Thalia S Field
- Vancouver Stroke Program, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Isabel Fragata
- Stroke Center, Centro Hospitalar Universitário Lisboa Central, Institute of Anatomy, Faculdade de Medicina, Universidade de Lisboa, and L Lopes Lab, Instituto de Medicina Molecular JLA, Lisbon, Portugal
- NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Mirjam R Heldner
- Inselspital Bern, University Hospital and University of Bern, Bern, Switzerland
| | | | - Frederikus A Klok
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Ronen R Leker
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Lia Lucas-Neto
- North Lisbon University Hospital Center and Lisbon Medical School, Lisbon, Portugal
| | | | | | | | - Gustavo Saposnik
- Stroke Outcomes & Decision Neuroscience Research Unit, University of Toronto, Toronto, ON, Canada
| | - Pankaj Sharma
- Royal Holloway University of London, London, United Kingdom
| | - Jan Stam
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Vincent Thijs
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | | | - David J Werring
- UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Diana Wong Ramos
- Portugal AVC-União de Sobreviventes, Familiares e Amigos, Portugal
| | | | - Nilüfer Yeşilot
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jukka Putaala
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katarina Jood
- Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Marcel Arnold
- Inselspital Bern, University Hospital and University of Bern, Bern, Switzerland
| | - José M Ferro
- Hospital da Luz, University of Lisbon, Lisbon, Portugal
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Parmar ST, Deshpande C, Kadam DS. Role of physical therapy intervention in acute disseminated encephalomyelitis. BMJ Case Rep 2024; 17:e257339. [PMID: 38589237 PMCID: PMC11015239 DOI: 10.1136/bcr-2023-257339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
We reported a case of a school-going child, diagnosed with acute disseminated encephalomyelitis (ADEM) who presented with symptoms such as high fever, acute hemiplegia and ataxia and was referred for physiotherapeutic intervention. This case report aims to document the assessment and management of ADEM from the intensive care unit to the home setting by physical therapy. Also, the child developed ventilator-associated pneumonia and a right lower motor neuron facial injury for which the child was referred to paediatric physical therapy. Since then, continuing for 8 months has helped the child to be independent in all aspects of mobility with no complaints. The child showed improvement in WeeFIM scores and Sunnybrook facial grading after 99 sessions of intensive physical therapy for approximately 83 hours along with the home programme. It has been proven an efficient treatment method along with other medical lines of treatment for neurological impairment associated with ADEM.
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164
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Patel P, Thakkar K, Shah D, Shah U, Pandey N, Patel J, Patel A. Decrypting the multifaceted peripheral neuropathy based on molecular pathology and therapeutics: a comprehensive review. Arch Physiol Biochem 2024:1-12. [PMID: 38588401 DOI: 10.1080/13813455.2024.2336916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
CONTEXT Peripheral neuropathy (PN) is a multifaceted complication characterized by nerve damage due to oxidative stress, inflammatory mediators, and dysregulated metabolic processes. Early PN manifests as sensory changes that develop progressively in a "stocking and glove" pattern. METHODS AND MECHANISMS A thorough review of literature has been done to find the molecular pathology, clinical trials that have been conducted to screen the effects of different drugs, current treatments and novel approaches used in PN therapy. Diabetic neuropathy occurs due to altered protein kinase C activity, elevated polyol pathway activity in neurons, and Schwann cells-induced hyperglycemia. Other causes involve chemotherapy exposure, autoimmune ailments, and chronic ethanol intake. CONCLUSION Symptomatic treatments for neuropathic pain include use of tricyclic antidepressants, anticonvulsants, and acetyl-L-carnitine. Patients will have new hope if clinicians focus on novel therapies including gene therapy, neuromodulation techniques, and cannabidiol as an alternative to traditional medications, as management is still not ideal.
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Affiliation(s)
- Praysha Patel
- Ramanbhai Patel College of Pharmacy, CHARUSAT, Changa, Gujarat, India
| | - Krishna Thakkar
- Ramanbhai Patel College of Pharmacy, CHARUSAT, Changa, Gujarat, India
| | - Div Shah
- Ramanbhai Patel College of Pharmacy, CHARUSAT, Changa, Gujarat, India
| | - Umang Shah
- Ramanbhai Patel College of Pharmacy, CHARUSAT, Changa, Gujarat, India
| | - Nilesh Pandey
- Health Science Center, Louisiana State University, Shreveport, LA, USA
| | - Jayesh Patel
- Consultant, Vascular surgeon, Shree Krishna Hospital, Karamsad, Gujarat, India
| | - Alkeshkumar Patel
- Ramanbhai Patel College of Pharmacy, CHARUSAT, Changa, Gujarat, India
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165
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Summers D, Spencer K, Okasaki C, Huber JE. An Examination of Cognitive Heterogeneity in Parkinson Disease: The Dual-Syndrome Hypothesis. J Speech Lang Hear Res 2024; 67:1127-1135. [PMID: 38446552 DOI: 10.1044/2024_jslhr-23-00621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE Cognitive impairment is one of the most debilitating nonmotor symptoms in Parkinson disease (PD), and its presentation is heterogeneous. One proposed model to explain cognitive variability in PD is the dual-syndrome hypothesis. This hypothesis delineates two cognitive profiles, a "fronto-striatal" profile and a "posterior cortical" profile according to symptom presentation, associated motor phenotype, and risk for dementia. The current study examined the dual-syndrome hypothesis in individuals with idiopathic PD to evaluate the existence of these profiles, determine the association with the motor phenotype (tremor dominant vs. postural instability/gait disorder), and assess the relative risk for dementia. METHOD A retrospective examination was conducted using data from the Parkinson's Progression Markers Initiative database at baseline (within 2 years of diagnosis) and 5 years after baseline. Descriptive categorizations, cluster analyses, generalized linear mixed models, and logistic regressions were used to address the research questions. RESULTS There was emerging evidence of cognitive profiles; however, these were not fully supported by cluster analyses. Baseline cognitive profile was associated with later motor phenotype, and as predicted, dementia risk was greatest in persons with baseline posterior cortical impairments. CONCLUSION The current results provide mixed support for the dual-syndrome hypothesis, with some evidence that the posterior cortical cognitive profile is associated with postural instability and gait disorder as well as greater dementia risk.
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Affiliation(s)
- Dale Summers
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Connie Okasaki
- Quantitative Ecology and Resource Management, University of Washington, Seattle
| | - Jessica E Huber
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
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166
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Grønbæk-Thygesen M, Hartmann-Petersen R. Cellular and molecular mechanisms of aspartoacylase and its role in Canavan disease. Cell Biosci 2024; 14:45. [PMID: 38582917 PMCID: PMC10998430 DOI: 10.1186/s13578-024-01224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/24/2024] [Indexed: 04/08/2024] Open
Abstract
Canavan disease is an autosomal recessive and lethal neurological disorder, characterized by the spongy degeneration of the white matter in the brain. The disease is caused by a deficiency of the cytosolic aspartoacylase (ASPA) enzyme, which catalyzes the hydrolysis of N-acetyl-aspartate (NAA), an abundant brain metabolite, into aspartate and acetate. On the physiological level, the mechanism of pathogenicity remains somewhat obscure, with multiple, not mutually exclusive, suggested hypotheses. At the molecular level, recent studies have shown that most disease linked ASPA gene variants lead to a structural destabilization and subsequent proteasomal degradation of the ASPA protein variants, and accordingly Canavan disease should in general be considered a protein misfolding disorder. Here, we comprehensively summarize the molecular and cell biology of ASPA, with a particular focus on disease-linked gene variants and the pathophysiology of Canavan disease. We highlight the importance of high-throughput technologies and computational prediction tools for making genotype-phenotype predictions as we await the results of ongoing trials with gene therapy for Canavan disease.
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Affiliation(s)
- Martin Grønbæk-Thygesen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200N, Copenhagen, Denmark.
| | - Rasmus Hartmann-Petersen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200N, Copenhagen, Denmark.
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167
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Zhang J, Ling L, Xiang L, Li W, Bao P, Yue W. Role of the gut microbiota in complications after ischemic stroke. Front Cell Infect Microbiol 2024; 14:1334581. [PMID: 38644963 PMCID: PMC11026644 DOI: 10.3389/fcimb.2024.1334581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Ischemic stroke (IS) is a serious central nervous system disease. Post-IS complications, such as post-stroke cognitive impairment (PSCI), post-stroke depression (PSD), hemorrhagic transformation (HT), gastrointestinal dysfunction, cardiovascular events, and post-stroke infection (PSI), result in neurological deficits. The microbiota-gut-brain axis (MGBA) facilitates bidirectional signal transduction and communication between the intestines and the brain. Recent studies have reported alterations in gut microbiota diversity post-IS, suggesting the involvement of gut microbiota in post-IS complications through various mechanisms such as bacterial translocation, immune regulation, and production of gut bacterial metabolites, thereby affecting disease prognosis. In this review, to provide insights into the prevention and treatment of post-IS complications and improvement of the long-term prognosis of IS, we summarize the interaction between the gut microbiota and IS, along with the effects of the gut microbiota on post-IS complications.
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Affiliation(s)
- Jinwei Zhang
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Ling Ling
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Lei Xiang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Wenxia Li
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Pengnan Bao
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Wei Yue
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
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168
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Wagner M, Sobczyński M, Wiśniewski A, Matusiak Ł, Kuśnierczyk P, Jasek M. Polymorphisms in the CD6-ALCAM axis may modulate psoriasis risk and outcomes. Hum Immunol 2024:110797. [PMID: 38580538 DOI: 10.1016/j.humimm.2024.110797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/15/2024] [Accepted: 03/27/2024] [Indexed: 04/07/2024]
Abstract
The fact that CD6, along with its ligand - ALCAM, plays a role in regulating T cell activation makes the genes encoding these molecules promising candidates for research in T cell-mediated diseases such as psoriasis vulgaris (PsV). Our study aimed to determine whether CD6 (rs17824933C>G, rs11230563C>T and rs12360861G>A) and ALCAM (rs6437585C>T, rs11559013G>A) polymorphisms may affect psoriasis susceptibility and severity (assessed by Psoriasis Area and Severity Index (PASI)). Moreover, the presence of HLA-C*06:02, the strongest psoriasis risk factor in the Caucasian population, was also investigated. 273 patients diagnosed with psoriasis vulgaris and 256 blood donors with no history of PsV or other dermatoses were included in this study. Genotyping of the investigated polymorphisms was carried out using the allelic discrimination method with the application of TaqMan SNP Genotyping Assays. We observed the association of rs17824933G allele with a higher psoriasis risk in HLA-C*06:02(+) individuals (CG + GG vs CC, OR = 1.87, CI95% = 1.03; 3.37, p = 0.0350). Furthermore, we found a difference in average PASI score among groups of patients divided according to the number of CD6 and ALCAM polymorphic sites with minor alleles (F2,173 = 6.159, p = 0.0026). Collectively, our findings suggest that polymorphisms of CD6-ALCAM axis genes may modulate psoriasis risk and outcomes.
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Affiliation(s)
- Marta Wagner
- Laboratory of Genetics and Epigenetics of Human Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
| | - Maciej Sobczyński
- Department of Bioinformatics and Genomics, Faculty of Biotechnology, University of Wrocław, Wrocław, Poland.
| | - Andrzej Wiśniewski
- Laboratory of Immunogenetics and Tissue Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wrocław, Poland.
| | - Piotr Kuśnierczyk
- Laboratory of Immunogenetics and Tissue Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
| | - Monika Jasek
- Laboratory of Genetics and Epigenetics of Human Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
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169
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Zhou X, Zhong X, Dong L. Air embolism caused by peripheral superficial vein catheterization: A case report. Medicine (Baltimore) 2024; 103:e37640. [PMID: 38579042 PMCID: PMC10994460 DOI: 10.1097/md.0000000000037640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/27/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Air embolization is usually an iatrogenic complication that can occur in both veins and arteries. Intravenous air embolization is mainly associated with large central vein catheters and mechanical ventilation. A 59-year-old woman was sent to our hospital with spontaneous cerebral hemorrhage and treated conservatively with a left forearm peripheral venous catheter infusion drug. After 48 hours, the patient's oxygen saturation decreased to 92 % with snoring breathing. Computer tomography of the head and chest revealed scattered gas in the right subclavian, the right edge of the sternum, the superior vena cava, and the leading edge of the heart shadow. METHODS She was sent to the intensive care unit for high-flow oxygen inhalation and left-side reclining instantly. As the patient was at an acute stage of cerebral hemorrhage and did not take the Trendelenburg position. RESULTS The computed tomography (CT) scan after 24 hours shows that the air embolism subsides. CONCLUSION SUBSECTIONS Air embolism can occur in any clinical scenario, suggesting that medical staff should enhance the ability to identify and deal with air embolism. For similar cases in clinical practice, air embolism can be considered.
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Affiliation(s)
- Xiaoxiao Zhou
- The Department of Neurosurgery, The First People’s Hospital of Huzhou, Zhejiang, China
| | - XingMing Zhong
- The Department of Neurosurgery, The First People’s Hospital of Huzhou, Zhejiang, China
| | - Liying Dong
- The Department of Nursing, The First People’s Hospital of Huzhou, Zhejiang, China
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170
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Shahsavar P, Ghazvineh S, Raoufy MR. From nasal respiration to brain dynamic. Rev Neurosci 2024; 0:revneuro-2023-0152. [PMID: 38579456 DOI: 10.1515/revneuro-2023-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
While breathing is a vital, involuntary physiological function, the mode of respiration, particularly nasal breathing, exerts a profound influence on brain activity and cognitive processes. This review synthesizes existing research on the interactions between nasal respiration and the entrainment of oscillations across brain regions involved in cognition. The rhythmic activation of olfactory sensory neurons during nasal respiration is linked to oscillations in widespread brain regions, including the prefrontal cortex, entorhinal cortex, hippocampus, amygdala, and parietal cortex, as well as the piriform cortex. The phase-locking of neural oscillations to the respiratory cycle, through nasal breathing, enhances brain inter-regional communication and is associated with cognitive abilities like memory. Understanding the nasal breathing impact on brain networks offers opportunities to explore novel methods for targeting the olfactory pathway as a means to enhance emotional and cognitive functions.
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Affiliation(s)
- Payam Shahsavar
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Sepideh Ghazvineh
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
- Faculty of Medical Sciences, 41616 Institute for Brain Sciences and Cognition, Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
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171
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Zhao Y, Wu W, Wu J, Shen B, Cao Y, Xu Y. Risk factors and intervention of caregiver burden in Parkinson's disease: a systematic review and meta-analysis. Qual Life Res 2024:10.1007/s11136-024-03616-0. [PMID: 38573387 DOI: 10.1007/s11136-024-03616-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE This study summarized characteristics and risk factors of caregiver burden in PD patients and used meta-analysis to verify the effectiveness of the intervention on caregiver burden. METHODS Systematic review and meta-analysis were conducted. RESULTS Forty-nine articles that involved 5387 caregivers of patients with PD were included in this study. Results of systematic review indicated that Zarit burden Inventory (ZBI) was the most used scale to measure the caregiver burden. All scales revealed caregivers of PD patients had mild to moderate caregiver burden. For the PD patients with longer disease duration, severer disease severity, more negative emotion and cognition impairment, their caregivers intended to have higher caregiver burden. The caregiver with negative emotion and who spent more time on caregiving indicated higher caregiver burden than the others. The caregiver burden was not improved after deep brain stimulation (DBS). Meta-analysis showed that cognitive behavior therapy and palliative care had no significant effect to reduce caregiver burden in PD patients' caregiver. CONCLUSION Caregivers of PD patients experienced mild to moderate caregiver burden. Demographic factor, diseased-related factor and negative emotional factor were the risk factors of caregiver burden. Health education and care support for long-term management after DBS surgery should be provided for patients and caregivers to decrease caregiver burden.
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Affiliation(s)
- Yan Zhao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Wenxiang Wu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Jianjun Wu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Bin Shen
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yanpei Cao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
| | - Yafang Xu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
- National Center for Neurological Disorders, Shanghai, China.
- Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China.
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172
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Ambrosanio M, Troisi Lopez E, Polverino A, Minino R, Cipriano L, Vettoliere A, Granata C, Mandolesi L, Curcio G, Sorrentino G, Sorrentino P. The Effect of Sleep Deprivation on Brain Fingerprint Stability: A Magnetoencephalography Validation Study. Sensors (Basel) 2024; 24:2301. [PMID: 38610512 PMCID: PMC11014248 DOI: 10.3390/s24072301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
This study examined the stability of the functional connectome (FC) over time using fingerprint analysis in healthy subjects. Additionally, it investigated how a specific stressor, namely sleep deprivation, affects individuals' differentiation. To this aim, 23 healthy young adults underwent magnetoencephalography (MEG) recording at three equally spaced time points within 24 h: 9 a.m., 9 p.m., and 9 a.m. of the following day after a night of sleep deprivation. The findings indicate that the differentiation was stable from morning to evening in all frequency bands, except in the delta band. However, after a night of sleep deprivation, the stability of the FCs was reduced. Consistent with this observation, the reduced differentiation following sleep deprivation was found to be negatively correlated with the effort perceived by participants in completing the cognitive task during sleep deprivation. This correlation suggests that individuals with less stable connectomes following sleep deprivation experienced greater difficulty in performing cognitive tasks, reflecting increased effort.
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Affiliation(s)
- Michele Ambrosanio
- Department of Economics, Law, Cybersecurity and Sports Sciences (DiSEGIM), University of Naples “Parthenope”, 80035 Nola, Italy
| | - Emahnuel Troisi Lopez
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy
| | - Arianna Polverino
- Institute of Diagnosis and Treatment Hermitage Capodimonte, 80145 Naples, Italy
| | - Roberta Minino
- Department of Medical, Movement and Wellness Sciences (DiSMMEB), University of Naples “Parthenope”, 80133 Naples, Italy
| | - Lorenzo Cipriano
- Department of Medical, Movement and Wellness Sciences (DiSMMEB), University of Naples “Parthenope”, 80133 Naples, Italy
| | - Antonio Vettoliere
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy
| | - Carmine Granata
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, 80133 Naples, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Giuseppe Sorrentino
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy
- Institute of Diagnosis and Treatment Hermitage Capodimonte, 80145 Naples, Italy
- Department of Medical, Movement and Wellness Sciences (DiSMMEB), University of Naples “Parthenope”, 80133 Naples, Italy
| | - Pierpaolo Sorrentino
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy
- Institut de Neurosciences des Systèmes, Aix-Marseille Université, 13005 Marseille, France
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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173
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Hamidpour SK, Amiri M, Ketabforoush AHME, Saeedi S, Angaji A, Tavakol S. Unraveling Dysregulated Cell Signaling Pathways, Genetic and Epigenetic Mysteries of Parkinson's Disease. Mol Neurobiol 2024:10.1007/s12035-024-04128-1. [PMID: 38573414 DOI: 10.1007/s12035-024-04128-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
Parkinson's disease (PD) is a prevalent and burdensome neurodegenerative disorder that has been extensively researched to understand its complex etiology, diagnosis, and treatment. The interplay between genetic and environmental factors in PD makes its pathophysiology difficult to comprehend, emphasizing the need for further investigation into genetic and epigenetic markers involved in the disease. Early diagnosis is crucial for optimal management of the disease, and the development of novel diagnostic biomarkers is ongoing. Although many efforts have been made in the field of recognition and interpretation of the mechanisms involved in the pathophysiology of the disease, the current knowledge about PD is just the tip of the iceberg. By scrutinizing genetic and epigenetic patterns underlying PD, new avenues can be opened for dissecting the pathology of the disorder, leading to more precise and efficient diagnostic and therapeutic approaches. This review emphasizes the importance of studying dysregulated cell signaling pathways and molecular processes associated with genes and epigenetic alterations in understanding PD, paving the way for the development of novel therapeutic strategies to combat this devastating disease.
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Affiliation(s)
- Shayesteh Kokabi Hamidpour
- Department of Cell and Molecular Biology, Faculty of Biological Science, Kharazmi University, Tehran, Iran
| | - Mobina Amiri
- Department of Cell and Molecular Biology, Faculty of Biological Science, Kharazmi University, Tehran, Iran
| | | | - Saeedeh Saeedi
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA
| | - Abdolhamid Angaji
- Department of Cell and Molecular Biology, Faculty of Biological Science, Kharazmi University, Tehran, Iran
| | - Shima Tavakol
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, 1449614535, Iran.
- Department of Research and Development, Tavakol BioMimetic Technologies Company, Tehran, Iran.
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174
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Duraisamy AJ, Liu R, Sureshkumar S, Rose R, Jagannathan L, da Silva C, Coovadia A, Ramachander V, Chandrasekar S, Raja I, Sajnani M, Selvaraj SM, Narang B, Darvishi K, Bhayal AC, Katikala L, Guo F, Chen-Deutsch X, Balciuniene J, Ma Z, Nallamilli BRR, Bean L, Collins C, Hegde M. Focused Exome Sequencing Gives a High Diagnostic Yield in the Indian Subcontinent. J Mol Diagn 2024:S1525-1578(24)00063-1. [PMID: 38582400 DOI: 10.1016/j.jmoldx.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/11/2023] [Accepted: 03/01/2024] [Indexed: 04/08/2024] Open
Abstract
The genetically isolated yet heterogeneous and highly consanguineous Indian population has shown a higher prevalence of rare genetic disorders. However, there is a significant socioeconomic burden for genetic testing to be accessible to the general population. In the current study, we analyzed next-generation sequencing data generated through focused exome sequencing from individuals with different phenotypic manifestations referred for genetic testing to achieve a molecular diagnosis. Pathogenic or likely pathogenic variants are reported in 280 of 833 cases with a diagnostic yield of 33.6%. Homozygous sequence and copy number variants were found as positive diagnostic findings in 131 cases (15.7%) because of the high consanguinity in the Indian population. No relevant findings related to reported phenotype were identified in 6.2% of the cases. Patients referred for testing due to metabolic disorder and neuromuscular disorder had higher diagnostic yields. Carrier testing of asymptomatic individuals with a family history of the disease, through focused exome sequencing, achieved positive diagnosis in 54 of 118 cases tested. Copy number variants were also found in trans with single-nucleotide variants and mitochondrial variants in a few of the cases. The diagnostic yield and the findings from this study signify that a focused exome test is a good lower-cost alternative for whole-exome and whole-genome sequencing and as a first-tier approach to genetic testing.
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Affiliation(s)
| | - Ruby Liu
- Revvity Omics, Pittsburgh, Pennsylvania
| | | | - Rajiv Rose
- PerkinElmer Genomics, Revvity Omics, Chennai, India
| | | | | | | | | | | | - Indu Raja
- PerkinElmer Genomics, Revvity Omics, Chennai, India
| | | | | | | | | | | | | | - Fen Guo
- Revvity Omics, Pittsburgh, Pennsylvania
| | | | | | | | | | - Lora Bean
- Revvity Omics, Pittsburgh, Pennsylvania
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175
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Wanninayake L, Rajapaksha D, Nair N, Gunarathne K, Ranawaka U. Guillain-Barre syndrome of acute motor axonal neuropathy (AMAN) type associated with herpes zoster: a case report. BMC Neurol 2024; 24:109. [PMID: 38570806 PMCID: PMC10988903 DOI: 10.1186/s12883-024-03607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
Guillain Barre syndrome (GBS) following Varicella zoster is a rare presentation and has only been reported in a few cases around the world. Of the reported cases, the type of GBS is not specified in the majority, and where specified is of the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) type. We report a case of acute motor axonal neuropathy (AMAN) type GBS following herpes zoster in a 27-year-old male who presented with bilateral lower limb weakness and left sided lower motor neuron type facial nerve palsy a week after herpes zoster infection.
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Affiliation(s)
- Leonard Wanninayake
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | | | - Narmada Nair
- Colombo North Teaching Hospital, Ragama, Sri Lanka
| | | | - Udaya Ranawaka
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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176
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Agrawal M, Singh VK, Verma A, Pathak A, Kumar A, Joshi D, Mishra VN, Chaurasia RN. Clinico-radiological factors associated with aphasia outcome in post stroke patients: A prospective follow up study from eastern part of India. J Clin Neurosci 2024; 123:130-136. [PMID: 38574684 DOI: 10.1016/j.jocn.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/05/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Aphasia is a language disorder acquired secondary to brain damage. This study aims to evaluate clinical and radiological profile of patients with post stroke aphasia and factors affecting its recovery. METHODS We conducted a prospective study of patients with first left Middle or Anterior Cerebral Artery infarct or Intracerebral Hemorrhage (ICH) with aphasia admitted within 14 days of stroke onset. Aphasia Quotient (AQ) was assessed at 2 weeks (AQ1) and 3 months (AQ2) using Western Aphasia Battery-Hindi version. Magnetic Resonance Imaging of brain with Diffusion Tensor Imaging (DTI) of bilateral Arcuate Fasciculus (AF) and Corticospinal Tract was done at admission, and stroke volume, Laterality Indices of Fractional Anisotropy (LI-FA), Mean Diffusivity (LI-MD), Radial Diffusivity (LI-RD), Axial Diffusivity (LI-AD) and Apparent Diffusion Coefficient (LI-ADC) were obtained. RESULTS 36 patients [8 ICH and 28 Acute Ischemic Stroke (AIS)] were included. AQ1 and AQ2 were significantly higher in subcortical stroke than cortical. AQ2 and increase in AQ scores (including its subscores) were significantly higher in ICH than AIS. National Institutes of Health Stroke Scale score at admission and volume of stroke had significant negative correlation with AQ1 and AQ2. Laterality Index of Fractional Anisotropy of Arcuate Fasciculus [LI-FA (AF)] had significant positive correlation with AQ2 and naming score at 3 months. Laterality Index of Mean Diffusivity of Arcuate Fasciculus [LI-MD (AF)] had significant negative correlation with AQ1, AQ2 and all subcomponents of AQ2. Significant positive correlation was seen between improvements in Modified Rankin Scale score and AQ. CONCLUSION The study shows that DTI can be used to predict severity of aphasia at follow up and recovery in language and motor functions occur in parallel.
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Affiliation(s)
- Mukund Agrawal
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Varun Kumar Singh
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Ashish Verma
- Department of Radiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Abhishek Pathak
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Anand Kumar
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Deepika Joshi
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Vijaya Nath Mishra
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Rameshwar Nath Chaurasia
- Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
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177
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Jarek DJ, Mizerka H, Nuszkiewicz J, Szewczyk-Golec K. Evaluating p-tau217 and p-tau231 as Biomarkers for Early Diagnosis and Differentiation of Alzheimer's Disease: A Narrative Review. Biomedicines 2024; 12:786. [PMID: 38672142 PMCID: PMC11048667 DOI: 10.3390/biomedicines12040786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
The escalating prevalence of Alzheimer's disease (AD) highlights the urgent need to develop reliable biomarkers for early diagnosis and intervention. AD is characterized by the pathological accumulation of amyloid-beta plaques and tau neurofibrillary tangles. Phosphorylated tau (p-tau) proteins, particularly p-tau217 and p-tau231, have been identified as promising biomarker candidates to differentiate the disease progression from preclinical stages. This narrative review is devoted to a critical evaluation of the diagnostic accuracy, sensitivity, and specificity of p-tau217 and p-tau231 levels in the detection of AD, measured in plasma, serum, and cerebrospinal fluid, compared to established biomarkers. Additionally, the efficacy of these markers in distinguishing AD from other neurodegenerative disorders is examined. The significant advances offered by p-tau217 and p-tau231 in AD diagnostics are highlighted, demonstrating their unique utility in early detection and differential diagnosis. This comprehensive analysis not only confirms the excellent diagnostic capabilities of these markers, but also deepens the understanding of the molecular dynamics of AD, contributing to the broader scientific discourse on neurodegenerative diseases. This review is aimed to provide key information for researchers and clinicians across disciplines, filling interdisciplinary gaps and highlighting the role of p-tau proteins in revolutionizing AD research and clinical practice.
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Affiliation(s)
- Dorian Julian Jarek
- Student Research Club of Medical Biology and Biochemistry, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland;
| | - Hubert Mizerka
- Student Research Club of Medical Biology and Biochemistry, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland;
| | - Jarosław Nuszkiewicz
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland;
| | - Karolina Szewczyk-Golec
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland;
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178
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Li N, Li YL, Shao JM, Wang CH, Li SB, Jiang Y. Optimizing early neurological deterioration prediction in acute ischemic stroke patients following intravenous thrombolysis: a LASSO regression model approach. Front Neurosci 2024; 18:1390117. [PMID: 38633265 PMCID: PMC11022961 DOI: 10.3389/fnins.2024.1390117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Acute ischemic stroke (AIS) remains a leading cause of disability and mortality globally among adults. Despite Intravenous Thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) emerging as the standard treatment for AIS, approximately 6-40% of patients undergoing IVT experience Early Neurological Deterioration (END), significantly impacting treatment efficacy and patient prognosis. Objective This study aimed to develop and validate a predictive model for END in AIS patients post rt-PA administration using the Least Absolute Shrinkage and Selection Operator (LASSO) regression approach. Methods In this retrospective cohort study, data from 531 AIS patients treated with intravenous alteplase across two hospitals were analyzed. LASSO regression was employed to identify significant predictors of END, leading to the construction of a multivariate predictive model. Results Six key predictors significantly associated with END were identified through LASSO regression analysis: previous stroke history, Body Mass Index (BMI), age, Onset to Treatment Time (OTT), lymphocyte count, and glucose levels. A predictive nomogram incorporating these factors was developed, effectively estimating the probability of END post-IVT. The model demonstrated robust predictive performance, with an Area Under the Curve (AUC) of 0.867 in the training set and 0.880 in the validation set. Conclusion The LASSO regression-based predictive model accurately identifies critical risk factors leading to END in AIS patients following IVT. This model facilitates timely identification of high-risk patients by clinicians, enabling more personalized treatment strategies and optimizing patient management and outcomes.
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Affiliation(s)
- Ning Li
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China
| | - Ying-Lei Li
- Department of Emergency Medicine, Baoding No.1 Central Hospital, Baoding, China
| | - Jia-Min Shao
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China
| | - Chu-Han Wang
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China
| | - Si-Bo Li
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China
| | - Ye Jiang
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China
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179
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Yu H, Feng R, Chen F, Wu Z, Li D, Qiu X. Rapid FRET Assay for the Early Detection of Alpha-Synuclein Aggregation in Parkinson's Disease. ACS Chem Neurosci 2024; 15:1378-1387. [PMID: 38506367 DOI: 10.1021/acschemneuro.3c00617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Alpha-synuclein (α-Syn) is a key protein of Parkinson's disease (PD). Oligomers formed by misfolding and aggregation of α-Syn can cause many pathological phenomena and aggravate the development of PD. Therefore, sensitive and accurate detection of oligomers is essential to understanding the pathology of PD and beneficial to screening and developing new drugs against PD. Here, we demonstrated a simple and sensitive method to detect the early aggregation of α-Syn via Förster resonance energy transfer (FRET) technology. We performed systematic investigations of the FRET sensitizations, efficiencies, and donor-to-acceptor distances during α-Syn aggregation, which was proved to be more sensitive to reflect small distance changes in the early stage of α-Syn aggregation, especially for α-Syn oligomers. The FRET assays were also applied to study the influence of Ser129 phosphorylation (pS129) on the aggregation rate of α-Syn. Our results showed that pS129 modification promotes α-Syn aggregation and enhances the ability of preformed fibrils to induce monomer aggregation. pS129 also increased the cytotoxicity of α-Syn. These results are of great significance for a better understanding of the pathological mechanisms of PD and future PD drug development.
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Affiliation(s)
- Hang Yu
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Rui Feng
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Fenglin Chen
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Zuodong Wu
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Dehai Li
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Xue Qiu
- Key Laboratory of Marine Drug, Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
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180
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Clarke MT, Remesal L, Lentz L, Tan DJ, Young D, Thapa S, Namuduri SR, Borges B, Kirn G, Valencia J, Lopez ME, Lui JH, Shiow LR, Dindot S, Villeda S, Sanders SJ, MacKenzie TC. Prenatal delivery of a therapeutic antisense oligonucleotide achieves broad biodistribution in the brain and ameliorates Angelman syndrome phenotype in mice. Mol Ther 2024; 32:935-951. [PMID: 38327047 DOI: 10.1016/j.ymthe.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
Angelman syndrome (AS), an early-onset neurodevelopmental disorder characterized by abnormal gait, intellectual disabilities, and seizures, occurs when the maternal allele of the UBE3A gene is disrupted, since the paternal allele is silenced in neurons by the UBE3A antisense (UBE3A-AS) transcript. Given the importance of early treatment, we hypothesized that prenatal delivery of an antisense oligonucleotide (ASO) would downregulate the murine Ube3a-AS, resulting in increased UBE3A protein and functional rescue. Using a mouse model with a Ube3a-YFP allele that reports on-target ASO activity, we found that in utero, intracranial (IC) injection of the ASO resulted in dose-dependent activation of paternal Ube3a, with broad biodistribution. Accordingly, in utero injection of the ASO in a mouse model of AS also resulted in successful restoration of UBE3A and phenotypic improvements in treated mice on the accelerating rotarod and fear conditioning. Strikingly, even intra-amniotic (IA) injection resulted in systemic biodistribution and high levels of UBE3A reactivation throughout the brain. These findings offer a novel strategy for early treatment of AS using an ASO, with two potential routes of administration in the prenatal window. Beyond AS, successful delivery of a therapeutic ASO into neurons has implications for a clinically feasible prenatal treatment for numerous neurodevelopmental disorders.
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Affiliation(s)
- Maria T Clarke
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA
| | - Laura Remesal
- Department of Anatomy, University of California San Francisco, San Francisco, California, USA
| | - Lea Lentz
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - David Young
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA; Institute for Molecular and Cell Biology, Agency for Science, Technology and Research, 138632, Singapore, Singapore
| | - Slesha Thapa
- BioMarin Pharmaceutical, San Rafael, California, USA
| | - Shalini R Namuduri
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA
| | - Beltran Borges
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA
| | - Georgia Kirn
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jasmine Valencia
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA
| | | | - Jan H Lui
- BioMarin Pharmaceutical, San Rafael, California, USA
| | | | - Scott Dindot
- Department of Veterinary Pathobiology, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Saul Villeda
- The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Department of Anatomy, University of California San Francisco, San Francisco, California, USA
| | - Stephan J Sanders
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA; Institute of Developmental and Regenerative Medicine, Department of Paediatrics, University of Oxford, Oxford OX3 7TY, United Kingdom
| | - Tippi C MacKenzie
- Department of Surgery, University of California San Francisco, San Francisco, California, USA; The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, California, USA; Center for Maternal-Fetal Precision Medicine, University of California San Francisco, San Francisco, California, USA.
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Xiong Y, Ma X, He B, Zhi J, Liu X, Wang P, Zhou Z, Liu D. Multifaceted Effects of Subchronic Exposure to Chlorfenapyr in Mice: Implications from Serum Metabolomics, Hepatic Oxidative Stress, and Intestinal Homeostasis. J Agric Food Chem 2024; 72:7423-7437. [PMID: 38502791 DOI: 10.1021/acs.jafc.3c09682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
As chlorfenapyr is a commonly used insecticide in agriculture, the health risks of subchronic exposure to chlorfenapyr remained unclear. This study aimed to extensively probe the health risks from subchronic exposure to chlorfenapyr at the NOAEL and 10-fold NOAEL dose in mice. Through pathological and biochemical examinations, the body metabolism, hepatic toxicity, and intestinal homeostasis were systematically assessed. After 12 weeks, a 10-fold NOAEL dose of chlorfenapyr resulted in weight reduction, increased daily food intake, and blood lipid abnormalities. Concurrently, this dosage induced hepatotoxicity and amplified oxidative stress in hepatocytes, a finding further supported in HepG2 cells. Moreover, chlorfenapyr resulted in intestinal inflammation, evidenced by increased inflammatory factors (IL-17a, IL-10, IL-1β, IL-6, IL-22), disrupted immune cells (RORγt, Foxp3), and compromised intestinal barriers (ZO-1 and occludin). By contrast, the NOAEL dose presented less toxicity in most evaluations. Serum metabolomic analyses unveiled widespread disruptions in pathways related to hepatotoxicity and intestinal inflammation, including NF-κB signaling, Th cell differentiation, and bile acid metabolism. Microbiomic analysis showed an increase in Lactobacillus, a decrease in Muribaculaceae, and diminished anti-inflammatory microbes, which further propelled the inflammatory response and leaded to intestinal inflammation. These findings revealed the molecular mechanisms underlying chlorfenapyr-induced hepatotoxicity and intestinal inflammation, highlighting the significant role of the gut microbiota.
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Affiliation(s)
- Yabing Xiong
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Xiaoran Ma
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Bingying He
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Jianwen Zhi
- Department of Proctology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Xueke Liu
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Peng Wang
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Zhiqiang Zhou
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Donghui Liu
- Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
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182
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Lunia P, Krishnan K, Irani F, Hundal JS, Arastu S, Vonk JMJ, Sunderaraman P. A scoping review of neuropsychological assessment for Asian Indians in the United States - research and clinical recommendations. Clin Neuropsychol 2024:1-21. [PMID: 38565847 DOI: 10.1080/13854046.2024.2327674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
Objective: There is an increasing focus on understanding health disparities among various cultural groups in the United States. The need for heterogeneity in norms and test stimuli across ethnically diverse individuals are being increasingly recognized. However, to date it remains unknown whether and to what extent differences in cognitive norms and tests exist in Asian Indians, a fast-growing population in the U.S. It is essential to understand these differences to improve diagnostic accuracy and provide timely and appropriate clinical care. Method: In this study, we conducted a scoping review of available cognitive tests that were normed, developed, or adapted for Asian Indians living in the U.S. Results: The results suggested a paucity of norms and tests specifically examining cognition in this community. Conclusions: Based on the findings, we provide suggestions for research directions focusing on the development of culturally sensitive neuropsychological tools, normative data representative of this demographic, and interventions addressing healthcare access barriers. Overall, this review provides readers with relevant clinical information to immediately enhance patient care as well as provide actionable items in research to improve the future utility of neuropsychology for Asian Indians in the United States.
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Affiliation(s)
- Palak Lunia
- Thomas Jefferson Medical Center, Philadelphia, PA, USA
| | - Kamini Krishnan
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA
| | | | | | - Sana Arastu
- Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jet M J Vonk
- Memory and Aging Center, Department of Neurology, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Preeti Sunderaraman
- Department of Neurology, Medical Campus, Boston, MA, USA
- The Framingham Heart Study - Brain Aging Program, Framingham, MA, USA
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183
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Lin CL, Lane HY, Sun CK, Chen MH, Lee CY, Li L, Lee JJ, Yeh PY. Effects of chronic daily headache with subclinical depression on brain volume: A systematic review and meta-analysis. Eur J Pain 2024. [PMID: 38563383 DOI: 10.1002/ejp.2270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND OBJECTIVE The relationship between chronic daily headache (CDH), depression symptoms, and brain volume remains unclear. METHODS To investigate the effects of CDH on brain volume and the impact of depressive symptoms (DSs) as well as the effects of demography and medication overuse, PubMed, Embase, and Web of Science databases were systematically searched using appropriate keyword strings to retrieve observational studies from inception to May 2023. RESULTS Two distinct comparisons were made in CDH patients: (1) those with DSs versus their pain-free counterparts and (2) those without DSs versus pain-free controls. The first comprised nine studies enrolling 225 CDH patients with DSs and 234 controls. Beck depression inventory, Hamilton depression scale, and Hospital anxiety/depression scale were used to assess DSs, revealing significantly more DSs in CDH patients with DSs compared to their controls (all p < 0.05). Besides, the second analysed four studies involving 117 CDH patients without DSs and 155 comparators. Compared to CDH patients without DSs, those with DSs had a smaller brain volume than controls (p = 0.03). Furthermore, CDH patients with DSs who did not overuse medications showed a smaller right cerebral cortical volume than overusers (p = 0.003). A significant inverse correlation between female prevalence and brain volume (p = 0.02) was revealed using regression analysis. CONCLUSIONS Pain-induced persistent depressive symptoms not only incur structural alterations but also encompass affective-motivational changes, involving medication use and gender-specific health concerns. SIGNIFICANCE This study highlighted the importance of an integrated CDH treatment, emphasizing psychological interventions for the affective-motivational component alongside pain management.
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Affiliation(s)
- Chih-Lung Lin
- Department of Neurosurgery, Asia University Hospital, Taichung, Taiwan
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiao-Yu Lee
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Lin Li
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jia-Jie Lee
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Pin-Yang Yeh
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
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184
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Kim HJ, Gil YE, Kim JS. Subjective BPPV revisited: identification of positional nystagmus with a new maneuver. J Neurol 2024:10.1007/s00415-024-12347-8. [PMID: 38564054 DOI: 10.1007/s00415-024-12347-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Hyun-Jae Kim
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Young-Eun Gil
- Department of Neurology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Soo Kim
- Department of Neurology, Dizziness Center, and Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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185
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Hu Y, Zou F, Lu W. Sex hormones and neuromyelitis optica spectrum disorder: a bidirectional Mendelian randomization study. Neurol Sci 2024:10.1007/s10072-024-07501-z. [PMID: 38565746 DOI: 10.1007/s10072-024-07501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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186
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Fadul A, Fadul MH, Demir G, Safieh M, Lebbe A, Falamrz F, Mohamed A, Hamad N, Akbar RA. Brucella infection presenting as infective endocarditis complicated by embolic stroke. IDCases 2024; 36:e01937. [PMID: 38601430 PMCID: PMC11004057 DOI: 10.1016/j.idcr.2024.e01937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/03/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024] Open
Abstract
Brucellosis (undulant fever) is a zoonotic infection caused by Brucella species. It typically presents with fever, malaise, night sweats, and arthralgia. One of its rare complications is infective endocarditis, which occurs in approximately 1.3% of patients and can be further complicated by embolic stroke. This report describes a rare occurrence of Brucella endocarditis presenting as an embolic stroke. A 34-year-old male presented with sudden left-sided weakness and fever. He reported headaches, fever, and generalized weakness in the preceding week. The patient worked on a farm and hence had animal contact. A neurological exam showed left-sided facial weakness, and power of 0/5 and 1/5 in the left upper and lower extremities, respectively. CT scan of the head revealed a right middle cerebral artery (MCA) territory infarct with penumbra and a right MCA occlusion. He underwent a cerebral artery thrombectomy with successful recanalization. However, he continued to have fever and high inflammatory markers. Echocardiography showed aortic valve vegetation and blood cultures grew Brucella melitensis. A multidisciplinary meeting was held to determine the optimal management, which included a course of rifampicin and doxycycline.
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Affiliation(s)
- Abdalla Fadul
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Gokhan Demir
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Safieh
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nabiel Hamad
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Raza A. Akbar
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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187
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Cervera-Negueruela M, Chee L, Cimolato A, Valle G, Tschopp M, Menke M, Papazoglou A, Raspopovic S. Bionic blink improves real-time eye closure in unilateral facial paralysis. J Neural Eng 2024; 21:026020. [PMID: 38507808 DOI: 10.1088/1741-2552/ad35e7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/20/2024] [Indexed: 03/22/2024]
Abstract
Facial paralysis is the inability to move facial muscles thereby impairing the ability to blink and make facial expressions. Depending on the localization of the nerve malfunction it is subcategorised into central or peripheral and is usually unilateral. This leads to health deficits stemming from corneal dryness and social ostracization.Objective: Electrical stimulation shows promise as a method through which to restore the blink function and as a result improve eye health. However, it is unknown whether a real-time, myoelectrically controlled, neurostimulating device can be used as assistance to this pathological condition.Approach: We developed NEURO-BLINK, a wearable robotic system, that can detect the volitional healthy contralateral blink through electromyography and electrically stimulate the impaired subcutaneous facial nerve and orbicularis oculi muscle to compensate for lost blink function. Alongside the system, we developed a method to evaluate optimal electrode placement through the relationship between blink amplitude and injected charge.Main results: Ten patients with unilateral facial palsy were enrolled in the NEURO-BLINK study, with eight completing testing under two conditions. (1) where the stimulation was cued with an auditory signal (i.e. paced controlled) and (2) synchronized with the natural blink (i.e. myoelectrically controlled). In both scenarios, overall eye closure (distance between eyelids) and cornea coverage measured with high FPS video were found to significantly improve when measured in real-time, while no significant clinical changes were found immediately after use.Significance: This work takes steps towards the development of a portable medical device for blink restoration and facial stimulation which has the potential to improve long-term ocular health.
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Affiliation(s)
- Mar Cervera-Negueruela
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Lauren Chee
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Andrea Cimolato
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Giacomo Valle
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Markus Tschopp
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel Menke
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anthia Papazoglou
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Stanisa Raspopovic
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
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188
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Clemente-Suárez VJ, Redondo-Flórez L, Beltrán-Velasco AI, Belinchón-deMiguel P, Ramos-Campo DJ, Curiel-Regueros A, Martín-Rodríguez A, Tornero-Aguilera JF. The Interplay of Sports and Nutrition in Neurological Health and Recovery. J Clin Med 2024; 13:2065. [PMID: 38610829 PMCID: PMC11012304 DOI: 10.3390/jcm13072065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
This comprehensive review explores the dynamic relationship between sports, nutrition, and neurological health. Focusing on recent clinical advancements, it examines how physical activity and dietary practices influence the prevention, treatment, and rehabilitation of various neurological conditions. The review highlights the role of neuroimaging in understanding these interactions, discusses emerging technologies in neurotherapeutic interventions, and evaluates the efficacy of sports and nutritional strategies in enhancing neurological recovery. This synthesis of current knowledge aims to provide a deeper understanding of how lifestyle factors can be integrated into clinical practices to improve neurological outcomes.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | | | - Pedro Belinchón-deMiguel
- Department of Nursing and Nutrition, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Agustín Curiel-Regueros
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
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189
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Sobierajska-Rek A, Jabłońska-Brudło J, Dąbrowska A, Wojnicz W, Meyer-Szary J, Wierzba J. Timed rolling and rising tests in Duchenne muscular dystrophy ambulant boys: a feasibility study. Minerva Pediatr (Torino) 2024; 76:208-216. [PMID: 38639735 DOI: 10.23736/s2724-5276.21.05977-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND Functional activities are extensively used in motor assessments of patients with Duchenne muscular dystrophy. The role of timed items has been reported as an early prognostic factor for disease progression. However, there are two functional activities that are not widely assessed in clinical practice among Duchenne muscular dystrophy patients: rolling and bed rising. This study aimed to investigate whether the 360-degree roll (roll) and supine to sit-to-edge (bed rise) measurements are feasible tools reflecting the functional status of ambulatory DMD children by establishing possible correlations between validated measures: the Vignos Scale (VS), timed rise from floor and the 6-Minute Walk Test (6MWT). METHODS A total of 32 ambulant boys with DMD were assessed using timed items, the 6MWT and VS. RESULTS The roll and bed rise are correlated with each other. The 6MWT, the floor rise and VS are correlated with the roll and with the bed rise. CONCLUSIONS Findings offer preliminary empirical evidence addressing feasibility and safety of roll and bed rise measurements. There is a potential clinical utility of these tests in assessing functional status of DMD ambulant patients.
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Affiliation(s)
- Agnieszka Sobierajska-Rek
- Department of Rehabilitation Medicine, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland -
| | - Joanna Jabłońska-Brudło
- Department of Rehabilitation Medicine, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Aneta Dąbrowska
- Department of Rehabilitation Medicine, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wiktoria Wojnicz
- Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gdansk, Poland
| | - Jarosław Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Defects, Medical University of Gdansk, Gdansk, Poland
| | - Jolanta Wierzba
- Department of Pediatric and Internal Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
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190
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Rohani P, Shervin Badv R, Sohouli MH, Guimarães NS. The efficacy of low glycemic index diet on seizure frequency in pediatric patients with epilepsy: A systematic review and meta-analysis. Seizure 2024; 117:150-158. [PMID: 38422595 DOI: 10.1016/j.seizure.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Despite extensive research examining the effect of a low glycemic index (LGI) diet on the frequency of seizures in patients with epilepsy, the findings are inconclusive. Hence, we performed a systematic review and meta-analysis in order to clarify the potential effect of a low glycemic index (LGI) diet on the frequency of seizures in children. METHODS A systematic review and meta-analysis written in accordance with the PRISMA checklist was realized using a comprehensive systematic search in four electronic databases until October 2023 without time or language restrictions. A random effects model was employed to combine the data. The main outcomes were analyzed using weight mean difference (WMD) and 95 % confidence interval (95 % CI). In total, 13 studies met the eligible criteria and were included. RESULTS The publications included in this study were published between 2005 and 2021. The duration of the interventions in the studies included in this analysis ranged from 6 to 58 weeks. Our findings indicated that the pooled efficacy rate for < 50 %, ≥ 50 %, > 90 % seizure reduction in patients with epilepsy receiving a low glycemic index diet was 39 % (95 % CI: 26, 52), 34 % (95 % CI: 23, 45), and 19 % (95 % CI: 13, 25), respectively. It seems that the efficacy of this ketogenic diet in reducing seizures is greater during a shorter intervention period than 12 weeks. CONCLUSION This systematic review and meta-analysis suggests that the low glycemia index diet can be beneficial as a treatment for epilepsy in pediatric patients.
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Affiliation(s)
- Pejman Rohani
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nathalia Sernizon Guimarães
- Professor at Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100, Brazil
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191
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Kispotta S, Das D, Prusty SK. A recent update on drugs and alternative approaches for parkinsonism. Neuropeptides 2024; 104:102415. [PMID: 38402775 DOI: 10.1016/j.npep.2024.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024]
Abstract
Parkinson's disease, often known as PD, is a more common age-related neurological disorder that affects a huge number of older adults worldwide. Parkinson's disease is predominantly a movement-related pathosis and is distinguished by the deposition of intra-neuronal aggregates, as the alpha-synuclein gene is expressed as Lewy bodies (LB) causing dopaminergic neurons to die. Stress in early life may contribute to the development of depression, and depression in patients may result in the development of Parkinson's disease as they mature. Depression is a non-motor condition that leads to motor symptoms, such as Parkinson's disease. PD Patients are currently utilizing a variety of other therapies like utilizing nutritional supplements, herbal remedies, vitamins, and massage. When a patient's functional ability is impaired, drug treatment is usually initiated according to the individual's condition and the severity of signs and symptoms. The current marketed anti-Parkinson drugs, has low brain distribution and failing to repair dopaminergic neurons or delaying the progression of the disease these negative effects were unavoidable. To overcome these disadvantages, this review considers the inclusion of drugs used in Parkinson's disease, focusing on strategies to reuse existing compounds to speed up drug development, their capacity to traverse the BBB, and drug dispersion in the brain. We look at cellular therapies and repurposed drugs. We also investigate the mechanisms, effectiveness, as well as safety of several new medications that are being repositioned for Parkinson's disease pharmacotherapy. In this study, we focus on global trends in Parkinson's disease research. We hope to raise awareness about the present state of major factors for disability worldwide, including yearly prevalence's from international and national statistics. The pathophysiology of Parkinsonism and also analyze existing therapies for Parkinson's disease, moreover new and innovative drug therapies, and to assess the prospects for disease modification.
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Affiliation(s)
- Sneha Kispotta
- School of Pharmaceutical Sciences, Siksha O Anusandhan Deemed to be University, Bhubaneswar, India.
| | - Debajyoti Das
- School of Pharmaceutical Sciences, Siksha O Anusandhan Deemed to be University, Bhubaneswar, India.
| | - Shakti Ketan Prusty
- School of Pharmaceutical Sciences, Siksha O Anusandhan Deemed to be University, Bhubaneswar, India.
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Erdogan B, Ata N, Caglayan M, Gözükara MG, Gemcioglu E, Sokmen FC, Yilmaz N, Celik O, Ayvali MO, Ulgu MM, Birinci S. Association between hyponatremia, inflammation, and mortality in patients undergoing peritoneal dialysis: A nationwide observations. Ther Apher Dial 2024; 28:265-271. [PMID: 38093682 DOI: 10.1111/1744-9987.14092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/26/2023] [Accepted: 11/17/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Hyponatremia is the most common electrolyte disorder often present in peritoneal dialysis (PD) patients. The aim of this retrospective study was to investigate the effect of hyponatremia on mortality in patients undergoing PD. METHODS The health records of adult individuals with an inserted PD catheter identified via the centralized national e-health database were used. RESULTS The mean age of the 846 patients included in the study was 52.48 years (±14.6). The mean sodium level was 136.51 mEq/L. Sodium levels <137 mEq/L were associated with higher death risk independent of comorbidities. There was a 0.821 times less reduction in mortality for each mEq /L increase in serum sodium. CONCLUSION Our study provides evidence that monitoring and adjusting serum sodium levels is crucial in managing PD patients with hyponatremia, as low serum sodium level was found to be a significant and independent predictor of mortality.
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Affiliation(s)
- Bulent Erdogan
- Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Republic of Turkey Ministry of Health, Ankara, Turkey
| | - Murat Caglayan
- Department of Medical Biochemistry, Etlik City Hospital, Ankara, Turkey
| | - Melih Gaffar Gözükara
- Department of Public Health, Ankara Yıldırım Beyazıt University-Faculty of Medicine, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine, Ankara Etlik City Hospital, Ankara, Turkey
| | - Fevzi Coskun Sokmen
- Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuray Yilmaz
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | - Osman Celik
- Republic of Turkey Ministry of Health, Ankara, Turkey
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Prust ML, Forman R, Ovbiagele B. Addressing disparities in the global epidemiology of stroke. Nat Rev Neurol 2024; 20:207-221. [PMID: 38228908 DOI: 10.1038/s41582-023-00921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/18/2024]
Abstract
Stroke is the second leading cause of death and the third leading cause of disability worldwide. Though the burden of stroke worldwide seems to have declined in the past three decades, much of this effect reflects decreases in high-income countries (HICs). By contrast, the burden of stroke has grown rapidly in low-income and middle-income countries (LMICs), where epidemiological, socioeconomic and demographic shifts have increased the incidence of stroke and other non-communicable diseases. Furthermore, even in HICs, disparities in stroke epidemiology exist along racial, ethnic, socioeconomic and geographical lines. In this Review, we highlight the under-acknowledged disparities in the burden of stroke. We emphasize the shifting global landscape of stroke risk factors, critical gaps in stroke service delivery, and the need for a more granular analysis of the burden of stroke within and between LMICs and HICs to guide context-appropriate capacity-building. Finally, we review strategies for addressing key inequalities in stroke epidemiology, including improvements in epidemiological surveillance and context-specific research efforts in under-resourced regions, development of the global workforce of stroke care providers, expansion of access to preventive and treatment services through mobile and telehealth platforms, and scaling up of evidence-based strategies and policies that target local, national, regional and global stroke disparities.
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Affiliation(s)
- Morgan L Prust
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
| | - Rachel Forman
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Bruce Ovbiagele
- Department of Neurology, University of California-San Francisco School of Medicine, San Francisco, CA, USA
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Bu S, Pang H, Li X, Zhao M, Wang J, Liu Y, Yu H, Fan G. Structural and Functional Alterations of Motor-Thalamus in Different Motor Subtype of Parkinson's Disease: An Individual Study. Acad Radiol 2024; 31:1605-1614. [PMID: 37863779 DOI: 10.1016/j.acra.2023.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/23/2023] [Accepted: 09/24/2023] [Indexed: 10/22/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate the structural and functional alterations occurring within bilateral premotor thalamus (mPMtha) in motor subtypes of Parkinson's disease (PD). MATERIALS AND METHODS Sixty-one individuals with instability and gait difficulty (PIGD) subtype, 60 individuals with tremor-dominant (TD) subtype and 66 healthy controls (HCs) participated in the study. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) and 3D T1-weighted (3DT1) scans. Functional connectivity (FC) analysis and Voxel-based morphometry (VBM) analysis were performed to evaluate the function and volume of mPMtha. Additionally, correlations between motor performance and FC values, volumes were examined separately. Support vector machine (SVM) model based on FC values and thalamic volumes was conducted to assist in the clinical diagnosis of PD motor subtype. RESULTS Compared to HCs and PIGD, TD subtype showed increased FC between the bilateral mPMtha and left middle occipital gyrus, left inferior parietal lobule (IPL). While PIGD subtype demonstrated decreased FC between right mPMtha and precentral gyrus (PreCG), supramarginal, IPL and superior parietal lobule. FC of bilateral mPMtha with the identified regions were significantly correlated with motor performance scores in PD patients. The SVM classification based on FC values demonstrated a high level of efficiency (AUC=0.874). The volumes of the bilateral mPMtha were indifferent among three groups. CONCLUSION We noted distinct FC alterations of mPMtha in TD and PIGD subtypes, and these changes were correlated with motor performance. Furthermore, the machine learning based on statistically significant FC might be served as an alternative approach for automatically classifying PD motor subtypes individually.
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Affiliation(s)
- Shuting Bu
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Huize Pang
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Xiaolu Li
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Mengwan Zhao
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Juzhou Wang
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Yu Liu
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.)
| | - Hongmei Yu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China (H.Y.)
| | - Guoguang Fan
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, PR China (S.B., H.P., X.L., M.Z., J.W., Y.L., G.F.).
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Panicker P, Iype T, Appireddy R, Ajithan A, Lijimol AS, Sasikumar A, Dileep R, Vijaya N, Booth C, Rajagopal MR. Palliative care needs of stroke patients at a tertiary care center in South India. J Neurosci Rural Pract 2024; 15:349-356. [PMID: 38746512 PMCID: PMC11090594 DOI: 10.25259/jnrp_7_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/03/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India. Materials and Methods Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months. Results Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up. Conclusion There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.
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Affiliation(s)
- Praveen Panicker
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Thomas Iype
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Ramana Appireddy
- Department of Neurology, Queens University, Queens University School of Medicine, Kingston, Ontario, Canada
| | - Ayana Ajithan
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - A. S. Lijimol
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - Asha Sasikumar
- Department of Nursing, Government Medical College Thiruvananthapuram, Medical College, Thiruvananthapuram, Kerala, India
| | - R. Dileep
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Nirmala Vijaya
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - Chris Booth
- Department of Oncology, Queens University, Queens University School of Medicine, Kingston, Ontario, Canada
| | - M. R. Rajagopal
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
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Kostopoulou S, Varveri AP, Nikoloudi M, Tsilika E, Parpa E, Zygogianni A, Mystakidou K. Exploring the occurrence and the risk factors of the desire for hastened death and depression in people with early-stage dementia in Greece. Palliat Support Care 2024; 22:265-273. [PMID: 37427608 DOI: 10.1017/s1478951523001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
OBJECTIVES To assess the factors associated with desire for hastened death and depression in early-stage dementia as well as the association between them. Also, to explore the mediator and moderator role of age in the relationship between depression and desire for hasten death. METHODS A prospective cross-sectional study including 100 patients diagnosed with early-stage dementia from a rehabilitation center between December 2018 and July 2019. Measurement tools used were the Mini-Mental State Examination, the Greek Montreal Cognitive Assessment, the Greek Schedule of Attitudes toward Hastened Death, and the Geriatric Depression Scale-15 item. Patients diagnosed with dementia as a result of Stroke history were excluded. RESULTS Factors of multifactorial analysis significantly associated with desire for hastened death were as follows: age (p = 0.009), marital status (p = 0.001), and depression (p < 0.001). The factor significantly associated with depression was age (p = 0.001). Also, a mediation/moderation analysis has shown that depression and age are significant predictors of desire for hasten death. SIGNIFICANCE OF RESULTS The desire for hastened death and depression in people diagnosed with early-stage dementia includes many components. Younger patients, men, higher educated patients, single, childless, and those with higher depression scores had higher desire for hastened death, while men and older patients had higher scores of desire for depression. Our study provides important information about the desire for hastened death and depression in early-stage dementia, their risk factors, and their association.
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Affiliation(s)
- Sotiria Kostopoulou
- Pain Relief and Palliative Care Unit, Aretaieion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Maria Nikoloudi
- Pain Relief and Palliative Care Unit, Aretaieion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Eleni Tsilika
- Health Psychologist, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Efi Parpa
- Pain Relief and Palliative Care Unit, Aretaieion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Anna Zygogianni
- Radiation Oncology, Department of Radiology, Areteion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Aretaieion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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197
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Zhang Y, Li Y, He L. Correlation between migraine and cerebral small vessel disease: A case-control study. Eur J Pain 2024; 28:551-564. [PMID: 37985464 DOI: 10.1002/ejp.2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Microcirculatory pathology is one of the pathophysiological theories of migraine, which may present as visually subclinical lesions. Image markers of cerebral small vessel disease (CSVD) have been investigated in elderly migraineurs. However, past studies looked at only part of image features, and the conclusions may have been hindered by confounding factors. The relationship between migraine and CSVD signs needs reliable demonstrations. METHODS We conducted a case-control study by recruiting episodic young migraineurs from a tertiary headache centre, with tension-type headache (TTH) and healthy controls. Distinct image features of microvascular damage and baseline characteristics across groups were assessed, and multivariate linear regression was performed to evaluate the risk factors for image abnormalities in migraineurs. RESULTS Forty-eight migraineurs, 32 TTHs and 49 healthy controls were included. The median age was 32 year-old. 58.7% of the participants were female. The Scheltens score and volume of white matter hyperintensities (WMHs) in migraineurs, and the number of Virchow-Robin spaces (VRSs) in both migraineurs and TTHs were different from those in normal controls. No lacunar infarct-like lesions (ILLs) or cerebral microbleeds (CMBs) were found. Age, education level (high level: β = -2.23, lobar WMHs), attack duration (long duration: β = 3.81, lobar WMHs) and attack frequency were independent risk factors for Scheltens score and volume of WMH in migraineurs. Migraine aura (β = -2.389), attack frequency and education level were correlated with the number of VRSs. CONCLUSIONS Migraine was associated with WMHs and VRSs. Aura, attack duration, attack frequency, age and education level were risk factors for image abnormalities of CVSD in migraineurs. SIGNIFICANCE This study provides a novel and comprehensive landscape of CSVD MRI features in young migraineurs, and it fills the blank of CMBs and VRSs which received less attention, with more persuasive, more reliable and stronger evidence of the association between CSVD and migraine. Our results also imply some new feature of TTH and the possible pathophysiology of the migraine course as well as new clues for the early management of migraine in terms of visual brain damage.
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Affiliation(s)
- Yanan Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yanbo Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Cancer Epigenetics and Genomics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Hwang DY, Kim KS, Muehlschlegel S, Wartenberg KE, Rajajee V, Alexander SA, Busl KM, Creutzfeldt CJ, Fontaine GV, Hocker SE, Madzar D, Mahanes D, Mainali S, Sakowitz OW, Varelas PN, Weimar C, Westermaier T, Meixensberger J. Guidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage. Neurocrit Care 2024; 40:395-414. [PMID: 37923968 PMCID: PMC10959839 DOI: 10.1007/s12028-023-01854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND The objective of this document is to provide recommendations on the formal reliability of major clinical predictors often associated with intracerebral hemorrhage (ICH) neuroprognostication. METHODS A narrative systematic review was completed using the Grading of Recommendations Assessment, Development, and Evaluation methodology and the Population, Intervention, Comparator, Outcome, Timing, Setting questions. Predictors, which included both individual clinical variables and prediction models, were selected based on clinical relevance and attention in the literature. Following construction of the evidence profile and summary of findings, recommendations were based on Grading of Recommendations Assessment, Development, and Evaluation criteria. Good practice statements addressed essential principles of neuroprognostication that could not be framed in the Population, Intervention, Comparator, Outcome, Timing, Setting format. RESULTS Six candidate clinical variables and two clinical grading scales (the original ICH score and maximally treated ICH score) were selected for recommendation creation. A total of 347 articles out of 10,751 articles screened met our eligibility criteria. Consensus statements of good practice included deferring neuroprognostication-aside from the most clinically devastated patients-for at least the first 48-72 h of intensive care unit admission; understanding what outcomes would have been most valued by the patient; and counseling of patients and surrogates whose ultimate neurological recovery may occur over a variable period of time. Although many clinical variables and grading scales are associated with ICH poor outcome, no clinical variable alone or sole clinical grading scale was suggested by the panel as currently being reliable by itself for use in counseling patients with ICH and their surrogates, regarding functional outcome at 3 months and beyond or 30-day mortality. CONCLUSIONS These guidelines provide recommendations on the formal reliability of predictors of poor outcome in the context of counseling patients with ICH and surrogates and suggest broad principles of neuroprognostication. Clinicians formulating their judgments of prognosis for patients with ICH should avoid anchoring bias based solely on any one clinical variable or published clinical grading scale.
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Affiliation(s)
- David Y Hwang
- Division of Neurocritical Care, Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB# 7025, Chapel Hill, NC, 27599-7025, USA.
| | - Keri S Kim
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Susanne Muehlschlegel
- Division of Neurosciences Critical Care, Departments of Neurology and Anesthesiology/Critical Care Medicine, Johns Hopkins Medicine, Baltimore, MD, USA
| | | | | | | | - Katharina M Busl
- Departments of Neurology and Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Gabriel V Fontaine
- Departments of Pharmacy and Neurosciences, Intermountain Health, Salt Lake City, UT, USA
| | - Sara E Hocker
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Dominik Madzar
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Dea Mahanes
- Departments of Neurology and Neurosurgery, UVA Health, Charlottesville, VA, USA
| | - Shraddha Mainali
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Oliver W Sakowitz
- Department of Neurosurgery, Neurosurgery Center Ludwigsburg-Heilbronn, Ludwigsburg, Germany
| | | | - Christian Weimar
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
- BDH-Klinik Elzach, Elzach, Germany
| | - Thomas Westermaier
- Department of Neurosurgery, Helios Amper-Kliniken Dachau, University of Wuerzburg, Würzburg, Germany
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Burish M. Cluster Headache, SUNCT, and SUNA. Continuum (Minneap Minn) 2024; 30:391-410. [PMID: 38568490 DOI: 10.1212/con.0000000000001411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This article reviews the epidemiology, clinical features, differential diagnosis, pathophysiology, and management of three types of trigeminal autonomic cephalalgias: cluster headache (the most common), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). LATEST DEVELOPMENTS The first-line treatments for trigeminal autonomic cephalalgias have not changed in recent years: cluster headache is managed with oxygen, triptans, and verapamil, and SUNCT and SUNA are managed with lamotrigine. However, new successful clinical trials of high-dose prednisone, high-dose galcanezumab, and occipital nerve stimulation provide additional options for patients with cluster headache. Furthermore, new genetic and imaging tests in patients with cluster headache hold promise for a better understanding of its pathophysiology. ESSENTIAL POINTS The trigeminal autonomic cephalalgias are a group of diseases that appear similar to each other and other headache disorders but have important differences. Proper diagnosis is crucial for proper treatment.
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200
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Hershfeld B, Wolin S, Echevarria AC, Dauer JH. Pseudoulnar palsy with concurrent wrist drop: case report. Ann Med Surg (Lond) 2024; 86:2322-2325. [PMID: 38576987 PMCID: PMC10990295 DOI: 10.1097/ms9.0000000000001879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Pseudoulnar palsy, characterized by weakness in the fourth and fifth digits, is a condition typically attributed to infarction of the medial aspect of the precentral gyrus's "hand knob." This anatomical site is located in the primary motor cortex of the brain, in the posterior lobe of the frontal cortex. This report presents a novel case of pseudoulnar nerve palsy in conjunction with wrist drop stemming from an infarction of the hand knob gyrus. Case presentation A 78-year-old female with hypertension and hyperlipidemia experienced sudden right wrist weakness and impaired mobility in her fourth and fifth digits. Clinical examinations, including neuroimaging, supported the diagnosis of an infarction in the medial precentral gyrus. Brain MRI confirmed the diagnosis of an acute infarction in the medial precentral gyrus. The patient was treated with enoxaparin, aspirin, and dexamethasone, and was discharged after symptom improvement. Clinical discussion Unlike the classical presentations, this case highlights the co-occurrence of ulnar and radial deficits following a unique infarction pattern. The distinct presentation of right pseudoulnar palsy with wrist drop was caused by an infarction at the level of the medial aspect of the hand knob. Conclusion This case underscores the importance of considering the central causes of peripheral-like deficits, especially in older individuals with vascular risk factors, emphasizing the significance of early intervention in mitigating potential long-term consequences. This report contributes to the evolving understanding of central neurological presentations, and serves as a reminder of the need for a comprehensive diagnostic approach.
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Affiliation(s)
- Benjamin Hershfeld
- New York Institute of Technology College of Osteopathic Medicine, Glen Head
| | - Sydney Wolin
- New York Institute of Technology College of Osteopathic Medicine, Glen Head
| | - Alexandra C. Echevarria
- Northwell Health Department of Orthopedic Surgery, NorthShore University Hospital, Manhasset
| | - Jan H. Dauer
- Northwell Health Department of Emergency Medicine, Plainview Hospital, Plainview, NY
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