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Brzecka A, Martynowicz H, Daroszewski C, Majchrzak M, Ejma M, Misiuk-Hojło M, Somasundaram SG, Kirkland CE, Kosacka M. The Modulation of Adipokines, Adipomyokines, and Sleep Disorders on Carcinogenesis. J Clin Med 2023; 12:jcm12072655. [PMID: 37048738 PMCID: PMC10094938 DOI: 10.3390/jcm12072655] [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: 02/19/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Obesity and sarcopenia, i.e., decreased skeletal muscle mass and function, are global health challenges. Moreover, people with obesity and sedentary lifestyles often have sleep disorders. Despite the potential associations, metabolic disturbances linking obesity, sarcopenia, and sleep disorders with cancer are neither well-defined nor understood fully. Abnormal levels of adipokines and adipomyokines originating from both adipose tissue and skeletal muscles are observed in some patients with obesity, sarcopenia and sleep disorders, as well as in cancer patients. This warrants investigation with respect to carcinogenesis. Adipokines and adipomyokines may exert either pro-carcinogenic or anti-carcinogenic effects. These factors, acting independently or together, may significantly modulate the incidence and progression of cancer. This review indicates that one of the possible pathways influencing the development of cancer may be the mutual relationship between obesity and/or sarcopenia, sleep quantity and quality, and adipokines/adipomyokines excretion. Taking into account the high proportion of persons with obesity and sedentary lifestyles, as well as the associations of these conditions with sleep disturbances, more attention should be paid to the individual and combined effects on cancer pathophysiology.
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Affiliation(s)
- Anna Brzecka
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland
| | - Helena Martynowicz
- Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Cyryl Daroszewski
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland
| | - Maciej Majchrzak
- Department of Thoracic Surgery, Wroclaw Medical University, Ludwika Pasteura 1, Grabiszyńska105, 53-439 Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Siva G. Somasundaram
- Department of Biological Sciences, Salem University, 223 West Main Street, Salem, WV 26426, USA
| | - Cecil E. Kirkland
- Department of Biological Sciences, Salem University, 223 West Main Street, Salem, WV 26426, USA
| | - Monika Kosacka
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland
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Waliszewska-Prosół M, Bladowska J, Ejma M, Koziorowska-Gawron E, Budrewicz S. Brain Magnetic Resonance Imaging Findings in Patients with Myoclonus Epilepsy Associated with Ragged-Red Fibers: A 6-Year Follow-Up Study. Neurol India 2021; 69:1121-1122. [PMID: 34507478 DOI: 10.4103/0028-3886.325340] [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] [Indexed: 11/04/2022]
Affiliation(s)
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
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Ejma M, Madetko N, Brzecka A, Alster P, Budrewicz S, Koszewicz M, Misiuk-Hojło M, Tomilova IK, Somasundaram SG, Kirkland CE, Aliev G. The Role of Stem Cells in the Therapy of Stroke. Curr Neuropharmacol 2021; 20:630-647. [PMID: 34365923 PMCID: PMC9608230 DOI: 10.2174/1570159x19666210806163352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 01/25/2021] [Revised: 04/19/2021] [Accepted: 06/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Stroke is a major challenge in neurology due to its multifactorial genesis and irreversible consequences. Processes of endogenous post-stroke neurogenesis, although insufficient, may indicate possible direction of future therapy. Multiple research considers stem-cell-based approaches in order to maximize neuroregeneration and minimize post-stroke deficits. Objective: Aim of this study is to review current literature considering post-stroke stem-cell-based therapy and possibilities of inducing neuroregeneration after brain vascular damage. Methods: Papers included in this article were obtained from PubMed and MEDLINE databases. The following medical subject headings (MeSH) were used: “stem cell therapy”, “post-stroke neurogenesis”, “stem-cells stroke”, “stroke neurogenesis”, “stroke stem cells”, “stroke”, “cell therapy”, “neuroregeneration”, “neurogenesis”, “stem-cell human”, “cell therapy in human”. Ultimate inclusion was made after manual review of the obtained reference list. Results: Attempts of stimulating neuroregeneration after stroke found in current literature include supporting endogenous neurogenesis, different routes of exogenous stem cells supplying and extracellular vesicles used as a method of particle transport. Conclusion: Although further research in this field is required, post stroke brain recovery supported by exogenous stem cells seems to be promising future therapy revolutionizing modern neurology.
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Affiliation(s)
- Maria Ejma
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213. Poland
| | - Natalia Madetko
- Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warszawa. Poland
| | - Anna Brzecka
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Grabiszynska 105, 53-439 Wroclaw. Poland
| | - Piotr Alster
- Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warszawa. Poland
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213. Poland
| | - Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213. Poland
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wroclaw Medical University, 50-556 Wroclaw, Borowska 213. Poland
| | - Irina K Tomilova
- Department of Biochemistry, Ivanovo State Medical Academy, Avenue Sheremetyevsky 8, Ivanovo, 153012. Russian Federation
| | - Siva G Somasundaram
- Department of Biological Sciences, Salem University, Salem, WV, 26426. United States
| | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, 26426. United States
| | - Gjumrakch Aliev
- Wroclaw Medical University, Department of Pulmonology and Lung Oncology, Wroclaw. Poland
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Koszewicz M, Markowska K, Waliszewska-Prosol M, Poreba R, Gac P, Szymanska-Chabowska A, Mazur G, Wieczorek M, Ejma M, Slotwinski K, Budrewicz S. The impact of chronic co-exposure to different heavy metals on small fibers of peripheral nerves. A study of metal industry workers. J Occup Med Toxicol 2021; 16:12. [PMID: 33858451 PMCID: PMC8048227 DOI: 10.1186/s12995-021-00302-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/25/2020] [Accepted: 04/03/2021] [Indexed: 12/14/2022] Open
Abstract
Background Chronic exposure to heavy metals affects various organs, among them the brain and peripheral nerves. Polyneuropathy is mainly length-dependent with predominantly sensory symptoms. There have been few studies on small fiber neuropathy due to heavy metal intoxication. Methods We investigated 41 metal industry workers, mean age 51.3 ± 10.5 years, with at least 5 years’ professional exposure to heavy metals, and 36 age- and sex-matched healthy controls. We performed neurological examinations, and assessed blood levels of cadmium, lead, and zinc protoporphyrin, urine levels of arsenic, standard, sensory and motor electrophysiological tests in the ulnar and peroneal nerves, sympathetic skin responses from the palm and foot, and quantitative sensation testing from dermatomes C8 and S1. Discussion The results of standard conduction tests of all nerves significantly differed between groups. The latency of sympathetic skin responses achieved from the foot was also statistically significantly prolonged in the study group. Significant differences were seen in both C8 and S1 regions for temperature and pain thresholds, and for vibratory threshold only in the S1 region, while the dispersions of low and high temperatures were important exclusively in the C8 region. Conclusions We can conclude that co-exposure to many heavy metals results in explicit impairment of peripheral nerves. The lesion is more pronounced within small fibers and is predominantly connected with greater impairment of temperature-dependent pain thresholds. The evaluation of small fiber function should be considered in the early diagnosis of toxic polyneuropathy or in low-dose exposure to heavy metals.
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Affiliation(s)
- Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
| | - Katarzyna Markowska
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | | | - Rafał Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Paweł Gac
- Department of Hygiene, Wroclaw Medical University, J. Mikulicza-Radeckiego 7, 50-345, Wroclaw, Poland
| | - Anna Szymanska-Chabowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Malgorzata Wieczorek
- Faculty of Earth Sciences and Environmental Management, University of Wroclaw, Plac Uniwersytecki 1, 50-137, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Krzysztof Slotwinski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Slawomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
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Koziorowska-Gawron E, Koszewicz M, Bladowska J, Ejma M, Budrewicz S. Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report. Medicine (Baltimore) 2021; 100:e25261. [PMID: 33832088 PMCID: PMC8036019 DOI: 10.1097/md.0000000000025261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/04/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presented case of OMS with a severe course and complete reversibility of neurological symptoms in a pregnant woman. This report includes videos and a literature review. PATIENT CONCERNS A 30-year-old woman in the 12th week of pregnancy developed severe nausea and vomiting, after several days balance and gait disorders appeared. On admission to hospital, neurological examination revealed opsoclonus, dysarthria, myoclonic jerks with ataxia of the trunk and limbs with inability to sit, stand or walk. DIAGNOSIS Well-known causes of OMS were excluded. Although in our patient the idiopathic origin of the disorder was taken under consideration, diagnosis of opsoclonus-myoclonus related to the pregnancy was highly likely. INTERVENTIONS After administration of steroids and benzodiazepines the patient improved. OUTCOMES In the 6th month of pregnancy, after termination of immunotherapy, she recovered completely and was able to sit, stand and walk independently. In the 39th week of pregnancy, she delivered a healthy child. LESSONS We confirm that understanding of clinical symptoms and rare causes of OMS contributes to early diagnosis and therapy, which ensures an optimal outcome. One probable cause of OMS could be a physiological change to immune system regulation during pregnancy. The relationship between OMS and pregnancy remains uncertain and needs further investigation.
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Affiliation(s)
| | | | - Joanna Bladowska
- Department of General, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
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6
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Waliszewska-Prosół M, Ejma M. Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis. J Immunol Res 2021; 2021:3258942. [PMID: 33763490 PMCID: PMC7946475 DOI: 10.1155/2021/3258942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/18/2021] [Accepted: 02/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The present study was aimed to evaluate parameters of visual and brainstem auditory evoked potentials (VEP, BAEP) in euthyreotic Hashimoto's thyroiditis (HT) patients without central nervous system involvement. METHODS 100 HT patients (92 women, 8 men), mean age 46.9 years, and 50 healthy controls. They underwent a neurological examination, thyroid hormone levels, thyroid autoantibody titers, and brain imaging. Latencies and amplitudes of the N75, P100, and N145 component of VEP and the I-V components of BAEP were analyzed. RESULTS The neurological examination revealed in 31 patients signs of increased neurovegetative excitability. Brain resonance imaging showed no abnormalities in HT patients. The mean P100, relative P100, and N145 VEP latencies were significantly longer, and P100 amplitude significantly higher in HT patients than the controls. HT patients also had a longer mean wave BAEP V latency and mean wave III-V and I-V interpeak latencies, and significantly lower mean wave I and V amplitudes. Abnormal VEP and BAEP were recorded in 34% of the patients. There were no statistically significant correlations between the mean VEP parameters and thyroid profile and the applied dose of L-thyroxine. There was a relationship between the level of TSH and the wave BAEP III-V interpeak latency. CONCLUSIONS There were changes in the brain's bioelectrical activity in one-third of the patients with HT without nervous system involvement. The increased amplitude of the VEP may indicate increased cerebral cortex activity. Disorders of the brain's bioelectrical activity in the course of HT may be associated with an autoimmune process.
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Affiliation(s)
| | - Maria Ejma
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
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7
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Waliszewska-Prosół M, Bladowska J, Budrewicz S, Sąsiadek M, Dziadkowiak E, Ejma M. The evaluation of Hashimoto's thyroiditis with event-related potentials and magnetic resonance spectroscopy and its relation to cognitive function. Sci Rep 2021; 11:2480. [PMID: 33510336 PMCID: PMC7843607 DOI: 10.1038/s41598-021-82281-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/19/2021] [Indexed: 11/09/2022] Open
Abstract
Thyroid dysfunction is very often accompanied by cognitive and affective disorders. The frequency of these disorders in patients with compensated Hashimoto's thyroiditis (HT) is unknown. The aim of the present study was to evaluate brain dysfunction in euthyroid HT patients by means of event-related potentials (ERP) and magnetic resonance spectroscopy (MRS) and to correlate it with cognitive function. 68 patients with HT (59 female, 9 male) and 45 healthy controls were included in the study. All the patients underwent ERP including an analysis of N200 and P300 response parameters. MRS voxels were located in the posterior cingulate gyrus (PCG) and the left parietal white matter (PWM). The NAA/Cr, mI/Cr, and Cho/Cr ratios were analysed. The ERP parameters, MRS metabolite ratios and hormonal concentrations (TSH, fT3, fT4) as well as TGAb and TPOAb titer were also correlated. There was a significant prolongation of the latencies of N200 and P300 potentials and a significant decrease of P300 amplitude in HT patients than in the control group. There was a significant positive correlation between the mI/Cr ratio in the PCG area and P300 latencies. NAA/Cr ratio in the PCG region showed significant negative correlations with all N200 latencies. The results may suggest brain dysfunction in neurologically asymptomatic HT patients. ERPs undergo significant changes in patients with HT and may, in combination with MRS, constitute an important element in the recognition and monitoring of cognitive functions in this group of patients.
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Affiliation(s)
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Edyta Dziadkowiak
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
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Brzecka A, Madetko N, Nikolenko VN, Ashraf GM, Ejma M, Leszek J, Daroszewski C, Sarul K, Mikhaleva LM, Somasundaram SG, Kirkland CE, Bachurin SO, Aliev G. Sleep Disturbances and Cognitive Impairment in the Course of Type 2 Diabetes-A Possible Link. Curr Neuropharmacol 2020; 19:78-91. [PMID: 32148197 PMCID: PMC7903492 DOI: 10.2174/1570159x18666200309101750] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 10/20/2019] [Revised: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
There is an increasing number of patients worldwide with sleep disturbances and diabetes. Various sleep disorders, including long or short sleep duration and poor sleep quality of numerous causes, may increase the risk of diabetes. Some symptoms of diabetes, such as painful peripheral neuropathy and nocturia, or associated other sleep disorders, such as sleep breathing disorders or sleep movement disorders, may influence sleep quality and quantity. Both sleep disorders and diabetes may lead to cognitive impairment. The risk of development of cognitive impairment in diabetic patients may be related to vascular and non-vascular and other factors, such as hypoglycemia, hyperglycemia, central insulin resistance, amyloid and tau deposits and other causes. Numerous sleep disorders, e.g., sleep apnea, restless legs syndrome, insomnia, and poor sleep quality are most likely are also associated with cognitive impairment. Adequate functioning of the system of clearance of the brain from toxic substances, such as amyloid β, i.e. glymphatic system, is related to undisturbed sleep and prevents cognitive impairment. In the case of coexistence, sleep disturbances and diabetes either independently lead to and/or mutually aggravate cognitive impairment.
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Affiliation(s)
- Anna Brzecka
- Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Madetko
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Vladimir N Nikolenko
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russian Federation
| | - Ghulam M Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Leszek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Cyryl Daroszewski
- Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Wroclaw, Poland
| | - Karolina Sarul
- Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Wroclaw, Poland
| | - Liudmila M Mikhaleva
- Research Institute of Human Morphology,3 Tsyurupy Street, Moscow, 117418, Russian Federation
| | - Siva G Somasundaram
- Department of Biological Sciences, Salem University, Salem, WV, 26426, United States
| | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, 26426, United States
| | - Sergey O Bachurin
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, 142432, Russian Federation
| | - Gjumrakch Aliev
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russian Federation
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Koszewicz M, Jaroch J, Brzecka A, Ejma M, Budrewicz S, Mikhaleva LM, Muresanu C, Schield P, Somasundaram SG, Kirkland CE, Avila-Rodriguez M, Aliev G. Dysbiosis is one of the risk factor for stroke and cognitive impairment and potential target for treatment. Pharmacol Res 2020; 164:105277. [PMID: 33166735 DOI: 10.1016/j.phrs.2020.105277] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 08/25/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
More than 50 million people have various forms of cognitive impairment basically caused by neurodegenerative diseases, such as Alzheimer's, Parkinson's, and cerebrovascular diseases as well as stroke. Often these conditions coexist and exacerbate one another. The damaged area in post-stroke dementia may lead to neurodegenerative lesions. Gut microbiome functions like an endocrine organ by generating bioactive metabolites that can directly or indirectly impact human physiology. An alteration in the composition and function of intestinal flora, i.e. gut dysbiosis, is implicated in neurodegenerative and cerebrovascular diseases. Additionally, gut dysbiosis may accelerate the progression of cognitive impairment. Dysbiosis may result from obesity; metabolic disorders, cardiovascular disease, and sleep disorders, Lack of physical activity is associated with dysbiosis as well. These may coexist in various patterns in older people, enhancing the risk, incidence, and progression of cerebrovascular lesions, neurodegenerative disorders, and cognitive impairment, creating a vicious circle. Recently, it has been reported that several metabolites produced by gut microbiota (e.g., trimethylamine/trimethylamine N-oxide, short-chain fatty acids, secondary bile acids) may be linked to neurodegenerative and cerebrovascular diseases. New treatment modalities, including prebiotic and probiotics, may normalize the gut microbiota composition, change the brain-gut barrier, and decrease the risk of the pathology development. Fecal microbiota transplantation, sometimes in combination with other methods, is used for remodeling and replenishing the symbiotic gut microbiome. This promising field of research is associated with basic findings of bidirectional communication between body organs and gut microbiota that creates new possibilities of pharmacological treatments of many clinical conditions. The authors present the role of gut microbiota in physiology, and the novel therapeutic targets in modulation of intestinal microbiota Personalized therapies based on their personal genome make up could offer benefits by modulating microbiota cross-talk with brain and cardiovascular system. A healthy lifestyle, including pre and probiotic nutrition is generally recommended. Prevention may also be enhanced by correcting gut dysbiosis resulting a reduced risk of post-stroke cognitive impairment including dementia.
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Affiliation(s)
- Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213, Poland
| | - Joanna Jaroch
- Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wrocław, Bartla 5, Poland; Department of Cardiology, Lower Silesian Specialist Hospital, Fieldorfa 2, 54-049 Wroclaw, Poland
| | - Anna Brzecka
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, 53-439, Wroclaw, Grabiszynska 105, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213, Poland
| | - Slawomir Budrewicz
- Department of Neurology, Wroclaw Medical University, 50-556 Wrocław, Borowska 213, Poland
| | - Liudmila M Mikhaleva
- Federal State Budgetary Institution «Research Institute of Human Morphology», 3, Tsyurupy Str., Moscow, 117418, Russian Federation
| | - Cristian Muresanu
- Research Center for Applied Biotechnology in Diagnosis and Molecular Therapies, Str. Trifoiului nr. 12 G, 400478, Cluj-Napoca, Romania
| | - Pamela Schield
- School of Education & Athletics, Salem University, Salem, WV 26426, United States
| | | | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, USA
| | - Marco Avila-Rodriguez
- Health Sciences Faculty, Clinic Sciences Department, University of Tolima, 730006 Ibague, Colombia
| | - Gjumrakch Aliev
- Federal State Budgetary Institution «Research Institute of Human Morphology», 3, Tsyurupy Str., Moscow, 117418, Russian Federation; I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russia; Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, 142432, Russia; GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX, 78229, USA.
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10
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Ejma M, Madetko N, Brzecka A, Guranski K, Alster P, Misiuk-Hojło M, Somasundaram SG, Kirkland CE, Aliev G. The Links between Parkinson's Disease and Cancer. Biomedicines 2020; 8:biomedicines8100416. [PMID: 33066407 PMCID: PMC7602272 DOI: 10.3390/biomedicines8100416] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 09/09/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022] Open
Abstract
Epidemiologic studies indicate a decreased incidence of most cancer types in Parkinson’s disease (PD) patients. However, some neoplasms are associated with a higher risk of occurrence in PD patients. Both pathologies share some common biological pathways. Although the etiologies of PD and cancer are multifactorial, some factors associated with PD, such as α-synuclein aggregation; mutations of PINK1, PARKIN, and DJ-1; mitochondrial dysfunction; and oxidative stress can also be involved in cancer proliferation or cancer suppression. The main protein associated with PD, i.e., α-synuclein, can be involved in some types of neoplastic formations. On the other hand, however, its downregulation has been found in the other cancers. PINK1 can act as oncogenic or a tumor suppressor. PARKIN dysfunction may lead to some cancers’ growth, and its expression may be associated with some tumors’ suppression. DJ-1 mutation is involved in PD pathogenesis, but its increased expression was found in some neoplasms, such as melanoma or breast, lung, colorectal, uterine, hepatocellular, and nasopharyngeal cancers. Both mitochondrial dysfunction and oxidative stress are involved in PD and cancer development. The aim of this review is to summarize the possible associations between PD and carcinogenesis.
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Affiliation(s)
- Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland; (M.E.); (N.M.); (K.G.)
| | - Natalia Madetko
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland; (M.E.); (N.M.); (K.G.)
| | - Anna Brzecka
- Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland;
| | - Konstanty Guranski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland; (M.E.); (N.M.); (K.G.)
| | - Piotr Alster
- Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warszawa, Poland;
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;
| | - Siva G. Somasundaram
- Department of Biological Sciences, Salem University, Salem, WV 26426, USA; (S.G.S.); (C.E.K.)
| | - Cecil E. Kirkland
- Department of Biological Sciences, Salem University, Salem, WV 26426, USA; (S.G.S.); (C.E.K.)
| | - Gjumrakch Aliev
- Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, 119991 Moscow, Russia
- Research Institute of Human Morphology, Russian Academy of Medical Science, Street Tsyurupa 3, 117418 Moscow, Russia
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, 142432 Moscow Region, Russia
- GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX 78229, USA
- Correspondence: or ; Tel.: +1-210-442-8625 or +1-440-263-7461
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11
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Waliszewska-Prosół M, Sebastian A, Wiland P, Budrewicz S, Dziadkowiak E, Ejma M. Brainstem auditory evoked potentials in patients with primary Sjögren's syndrome without central nervous system involvement. Clin Rheumatol 2020; 40:991-997. [PMID: 32809145 PMCID: PMC7895790 DOI: 10.1007/s10067-020-05344-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Primary Sjögren's syndrome (pSS) is an autoimmune, multisystem exocrinopathy characterized by dysfunction of the exocrine glands. Central nervous system (CNS) involvement is estimated to be present in 10-60% patients with pSS. The present study aimed to evaluate brainstem auditory evoked potentials (BAEP) in pSS patients without central nervous system involvement, and without otolaryngological abnormalities. METHOD Thirty-six pSS patients (35 women, 1 man, mean age 48 years old) and 40 healthy volunteers were investigated. BAEP, brain imaging, laboratory parameters, and clinical neurological and otolaryngological examinations were performed. RESULTS Abnormal BAEP were recorded in 16.7% patients. The mean wave BAEP I and V latency and mean wave III-V and I-V interpeak latencies were significantly longer in pSS patients than the controls. There were no statistically significant correlations between BAEP parameters and laboratory tests. None of the patients was found having the abnormalities on brain imaging. CONCLUSIONS This study confirms that in pSS patients without clinical central nervous system impairment, auditory pathway disturbances could be found. Disorders of brain bioelectrical activity may be a consequence of ongoing autoimmune process. Key Points • BAEP abnormalities confirmed the clinically observed involvement of the central nervous system in patients with pSS. • Brain bioelectrical activity dysfunctions in pSS patients may be a consequence of ongoing inflammatory and/or immunological processes.
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Affiliation(s)
| | - Agata Sebastian
- Department of Rheumatology and Internal Diseases, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Polska
| | - Piotr Wiland
- Department of Rheumatology and Internal Diseases, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Polska
| | - Sławomir Budrewicz
- Department of Neurology, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Edyta Dziadkowiak
- Department of Neurology, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Maria Ejma
- Department of Neurology, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Poland
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Abstract
INTRODUCTION Pure word deafness is a rare neurological disorder linked with an inability to comprehend speech. The precise localization of damage is still unclear. CASE PRESENTATION A 72-year-old woman presented with acute verbal contact disturbances, disorientation, and anxiety. In the neurological examination a slight right hemiparesis was found, together with a pure word deafness (PWD) in neuropsychological tests. Neuroimages confirmed bilateral ischemic lesions in the superior temporal gyrus (STG) acute in the left hemisphere. CONCLUSIONS Our case suggested that bilateral, symmetric lesions in the region of STG could cause pure world deafness. The diversity and severity of symptoms confirm the necessity of pure world deafness classification for subtypes.
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Affiliation(s)
| | - Maria Ejma
- Department of Neurology, Medical University , Wroclaw, Poland
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13
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Dziadkowiak E, Ejma M, Wieczorek M, Pec P, Slotwinski K, Budrewicz S, Zimny A, Koszewicz M. The assessment of sensory pathway in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Dziadkowiak E, Ejma M, Wieczorek M, Pec P, Slotwinski K, Budrewicz S, Zimny A, Koszewicz M. P39-S Multimodal evoked potentials in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Prosół MW, Sebastian A, Dziadkowiak E, Wiland P, Budrewicz S, Ejma M. P35-F Brainstem auditory evoked potentials in patients with primary Sjögren’s syndrome. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Bladowska J, Pawłowski T, Fleischer-Stępniewska K, Knysz B, Małyszczak K, Żelwetro A, Rymer W, Inglot M, Waliszewska-Prosół M, Ejma M, Podgórski P, Zimny A, Sąsiadek M. Interferon-free therapy as the cause of white matter tracts and cerebral perfusion recovery in patients with chronic hepatitis C. J Viral Hepat 2019; 26:635-643. [PMID: 30702208 DOI: 10.1111/jvh.13069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/01/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to assess cerebral microstructural and perfusion changes in patients with chronic hepatitis C virus (HCV) infection before and after interferon-free therapy, using advanced magnetic resonance (MR) techniques. Eleven HCV-positive patients underwent diffusion tensor imaging (DTI) and perfusion-weighted imaging (PWI) using a 1.5T MR unit, before and 24 weeks after completion of interferon-free therapy. DTI fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from 14 white matter tracts. PWI values of relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) were assessed from 8 areas, including basal ganglia, and cortical and white matter locations. In HCV-positive patients therapy with ombitasvir, paritaprevir boosted with ritonavir and dasabuvir, with or without ribavirin, was scheduled. Cognitive tests were used to assess cognitive function. We found increased FA values after interferon-free therapy compared to values obtained before treatment in HCV patients in almost all white matter tracts. We also observed elevated rCBV values in basal ganglia after therapy. There were significant correlations between improvement in the score of cognitive tests and increased FA values in both inferior fronto-occipital fascicles and left posterior cingulum after treatment. Liver fibrosis regression in elastography, APRI and improvement in cognitive tests were observed. This is the first report of interferon-free therapy as the cause of white matter tracts recovery as well as cerebral perfusion improvement in HCV-infected patients, indicating better functioning of frontal lobes after interferon-free treatment.
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Affiliation(s)
- Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Fleischer-Stępniewska
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wroclaw, Poland
| | - Brygida Knysz
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Małyszczak
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Weronika Rymer
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wroclaw, Poland
| | - Małgorzata Inglot
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wroclaw, Poland
| | | | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Przemysław Podgórski
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Zimny
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
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Ejma M, Urbanowski P, Brodowski M, Guranski K, Hendrich B, Krajewska M. Brain vessel anomalies in autosomal dominant polycystic kidney disease. Natl Med J India 2019; 32:189. [PMID: 32129319 DOI: 10.4103/0970-258x.278698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Pawel Urbanowski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Miroslaw Brodowski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Konstanty Guranski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Barbara Hendrich
- Department of Radiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Magdalena Krajewska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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18
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Marciniewicz E, Podgórski P, Pawłowski T, Małyszczak K, Fleischer-Stępniewska K, Knysz B, Waliszewska-Prosół M, Żelwetro A, Rymer W, Inglot M, Ejma M, Sąsiadek M, Bladowska J. Evaluation of brain volume alterations in HCV-infected patients after interferon-free therapy: A pilot study. J Neurol Sci 2019; 399:36-43. [PMID: 30769221 DOI: 10.1016/j.jns.2019.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 12/21/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 12/20/2022]
Abstract
The study was performed to evaluate cerebral volume changes in HCV-infected subjects before and after interferon-free therapy with direct-acting antiviral agents (DAA). We aimed also to estimate the impact of successful DAA therapy on the neuropsychological state of patients. Eleven HCV genotype 1 (GT1) patients treated with ombitasvir/paritaprevir (boosted with ritonavir) and dasabuvir, with or without ribavirin underwent brain magnetic resonance (MR) before and 24 weeks after completion of therapy. All patients achieved sustained viral response. Precise automatic parcellation was made using the fully-available software FreeSurfer 6.0. Statistically significant volume deceleration six months after treatment was found in the subcallosal cingulate gyrus, transverse frontopolar gyri and sulci, anterior segment of the circular sulcus of the insula and horizontal ramus of the anterior segment of the lateral sulcus. After DAA therapy we found statistically significant improvement in the performance of all three tasks of the Rey Complex Figure Test that permits the evaluation of different functions (attention, planning, working,memory). Additionally, significant amelioration in Percentage Conceptual Level Responses in The Wisconsin Card Sorting Test (a neurocognitive test for assessing intellectual functioning) was also discovered. Successful interferon-free therapy may lead to transient cerebral atrophy, probably by reducing neuroinflammation and oedema. This is the first pilot study of the alterations in brain volume after successful interferon-free therapy in chronic HCV patients. Longitudinal follow-up study is needed to observe further effects of therapy on cerebral structures volume changes.
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Affiliation(s)
- Ewelina Marciniewicz
- Department of General Radiology, Interventional Radiology and Neuroradiology, Radiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Przemysław Podgórski
- Department of General Radiology, Interventional Radiology and Neuroradiology, Radiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, L. Pasteura 10, 50-367 Wroclaw, Poland.
| | - Krzysztof Małyszczak
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, L. Pasteura 10, 50-367 Wroclaw, Poland
| | - Katarzyna Fleischer-Stępniewska
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Koszarowa 5, 51-149 Wroclaw, Poland
| | - Brygida Knysz
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Koszarowa 5, 51-149 Wroclaw, Poland
| | | | - Agnieszka Żelwetro
- The Institute of Psychology, University of Wroclaw, J.W. Dawida 1, 50-527 Wroclaw, Poland
| | - Weronika Rymer
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Koszarowa 5, 51-149 Wroclaw, Poland.
| | - Małgorzata Inglot
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Koszarowa 5, 51-149 Wroclaw, Poland.
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Radiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Radiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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19
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Bladowska J, Waliszewska-Prosół M, Ejma M, Sąsiadek M. The metabolic alterations within the normal appearing brain in patients with Hashimoto's thyroiditis are correlated with hormonal changes. Metab Brain Dis 2019; 34:53-60. [PMID: 30242734 PMCID: PMC6351519 DOI: 10.1007/s11011-018-0318-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 09/17/2018] [Indexed: 11/25/2022]
Abstract
Hashimoto's thyroiditis (HT) is the most common autoimmune disease in humans usually associated with subsequent hypothyroidism. The purpose of the study was to assess metabolic alterations within the normal appearing brain in subjects with HT using MR spectroscopy (MRS) and to correlate MRS measurements with hormonal concentrations. Fifty-five HT patients (mean age 43.5 yrs) and 30 healthy controls (mean age 42.5 yrs) were examined with the use of a 1.5 T MR scanner. There were no signs of central nervous system involvement in the studied group. The MRS examinations were performed using the single voxel method. The voxels were placed in the left parietal white matter (PWM) and the posterior cingulate gyrus (PCG). The NAA/Cr, Cho/Cr, and mI/Cr ratios were calculated. The correlations between metabolite ratios and hormonal concentrations (TSH, fT3, fT4) as well as anti-TG and anti-TPO levels were also assessed. We found significantly (p < 0.05) decreased NAA/Cr ratios in PCG and PWM in HT subjects compared to the control group. There were no other significant differences in metabolite ratios. We observed significant positive correlations between the NAA/Cr ratio in PCG as well as the PWM and fT3 level. There was also a significant negative correlation between the Cho/Cr ratio in the PCG and fT4 level. MRS could be a sensitive biomarker capable of depicting early cerebral metabolic disturbances associated with HT. Our findings may indicate the reduction of neuronal activity within the normal appearing brain in patients with HT as well as suggesting that there is a possible biological association between thyroid dysfunction and cerebral metabolic changes.
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Affiliation(s)
- Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | | | - Maria Ejma
- Department of Neurology, Wrocław Medical University, ul. Borowska 213, 50-556, Wrocław, Poland
| | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
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20
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Jezowska K, Waliszewska-Prosól M, Ejma M, Szewczyk P. Hemispheric cerebral oedema due to intracranial dural arteriovenous fistula. Natl Med J India 2018; 31:252. [PMID: 31134940 DOI: 10.4103/0970-258x.258235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Klaudia Jezowska
- Department of Neurology, Interventional Radiology and Neuroradiology Wroclaw Medical University Wroclaw, Poland
| | - Marta Waliszewska-Prosól
- Department of Neurology, Interventional Radiology and Neuroradiology Wroclaw Medical University Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Interventional Radiology and Neuroradiology Wroclaw Medical University Wroclaw, Poland
| | - Pawel Szewczyk
- Department of General Radiology, Interventional Radiology and Neuroradiology Wroclaw Medical University Wroclaw, Poland
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21
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Brzecka A, Leszek J, Ashraf GM, Ejma M, Ávila-Rodriguez MF, Yarla NS, Tarasov VV, Chubarev VN, Samsonova AN, Barreto GE, Aliev G. Sleep Disorders Associated With Alzheimer's Disease: A Perspective. Front Neurosci 2018; 12:330. [PMID: 29904334 PMCID: PMC5990625 DOI: 10.3389/fnins.2018.00330] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [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: 10/26/2017] [Accepted: 04/30/2018] [Indexed: 12/12/2022] Open
Abstract
Sleep disturbances, as well as sleep-wake rhythm disturbances, are typical symptoms of Alzheimer's disease (AD) that may precede the other clinical signs of this neurodegenerative disease. Here, we describe clinical features of sleep disorders in AD and the relation between sleep disorders and both cognitive impairment and poor prognosis of the disease. There are difficulties of the diagnosis of sleep disorders based on sleep questionnaires, polysomnography or actigraphy in the AD patients. Typical disturbances of the neurophysiological sleep architecture in the course of the AD include deep sleep and paradoxical sleep deprivation. Among sleep disorders occurring in patients with AD, the most frequent disorders are sleep breathing disorders and restless legs syndrome. Sleep disorders may influence circadian fluctuations of the concentrations of amyloid-β in the interstitial brain fluid and in the cerebrovascular fluid related to the glymphatic brain system and production of the amyloid-β. There is accumulating evidence suggesting that disordered sleep contributes to cognitive decline and the development of AD pathology. In this mini-review, we highlight and discuss the association between sleep disorders and AD.
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Affiliation(s)
- Anna Brzecka
- Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Leszek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Nagendra S. Yarla
- Department of Biochemistry and Bioinformatics, School of Life Sciences, Institute of Science, Gandhi Institute of Technology and Management University, Visakhapatnam, India
| | - Vadim V. Tarasov
- Institute for Pharmaceutical Science and Translational Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vladimir N. Chubarev
- Institute for Pharmaceutical Science and Translational Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anna N. Samsonova
- Institute of Physiologically Active Compounds of the Russian Academy of Sciences, Chernogolovka, Russia
| | - George E. Barreto
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Gjumrakch Aliev
- Institute of Physiologically Active Compounds of the Russian Academy of Sciences, Chernogolovka, Russia
- GALLY International Biomedical Research and Consulting LLC, San Antonio, TX, United States
- School of Health Science and Healthcare Administration, University of Atlanta, Johns Creek, GA, United States
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23
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Obara K, Waliszewska-Prosół M, Budrewicz S, Szewczyk P, Ejma M. Severe course of neuromyelitis optica in a female patient with chronic C hepatitis. Neurol Neurochir Pol 2018; 52:397-400. [PMID: 29454471 DOI: 10.1016/j.pjnns.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/22/2017] [Revised: 01/20/2018] [Accepted: 01/29/2018] [Indexed: 11/24/2022]
Abstract
Neuromyelitis optica (NMO) is a rare, disabling, recurring inflammatory demyelinating disease affecting the spinal cord and optic nerves with predominance in women. We present the case of a female patient with chronic C hepatitis, who, despite treatment, developed severe symptoms of NMO during pregnancy and postpartum.
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Affiliation(s)
- Krystian Obara
- Department of Neurology, Wrocław Medical University, Poland
| | | | | | - Paweł Szewczyk
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Poland
| | - Maria Ejma
- Department of Neurology, Wrocław Medical University, Poland
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24
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Nittner-Marszalska M, Kowal A, Szewczyk P, Guranski K, Ejma M. Wasp Venom Immunotherapy in a Patient With Immune-Mediated Inflammatory Central Nervous System Disease: Is it Safe? J Investig Allergol Clin Immunol 2017; 27:127-129. [PMID: 28398199 DOI: 10.18176/jiaci.0126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Nittner-Marszalska
- Department of Internal Diseases and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Kowal
- Department of Pulmonology, Wroclaw Medical University, Wroclaw, Poland
| | - P Szewczyk
- Department of Radiology, Wroclaw Medical University, Wroclaw, Poland
| | - K Guranski
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - M Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
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25
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Koszewicz M, Michalak S, Bilinska M, Budrewicz S, Zaborowski M, Slotwinski K, Podemski R, Ejma M. Profile of autonomic dysfunctions in patients with primary brain tumor and possible autoimmunity. Clin Neurol Neurosurg 2016; 151:51-54. [PMID: 27788421 DOI: 10.1016/j.clineuro.2016.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 08/09/2016] [Revised: 10/13/2016] [Accepted: 10/21/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Cerebral lesion due to different neurological conditions could be complicated by autonomic dysfunction, reported in the literature as a sympathetic hyperactivity. The mechanisms of dysautonomia still remains partial. The aim of the study was to assess the profile of autonomic dysfunction in patient with primary brain tumors, with attempt to estimate the additional factors in pathogenesis of dysautonomia. MATERIAL AND METHODS Neurological examinations, the Low's autonomic disorder questionnaire, electrophysiological autonomic tests (Heart Rate Variability test at rest and during deep breathing, spectral analysis of R-R intervals, sympathetic skin response test), studies of peripheral nerves, blood sampling collection for antibodies were done in 33 patients with recognized primary brain tumors. RESULTS The averaged Low's Questionnaire score in the patients group was significantly higher than in the controls, systolic blood pressure was increased, heart rate tended to be higher without significance, but heart rate variability was severe low, LF/HF ratio also tended to be higher in the patients group. In SSR test the amplitude of responses from hand and foot was significantly lower without changes in their latencies. We found changes in the electrophysiological tests of peripheral nerves, and positive anti-neural antibodies in 5 patients. CONCLUSIONS The results of the study indicated to the sympathetic nervous system hyperactivity in patients with primary brain tumors. Local brain lesion with high intracranial pressure, additional peripheral nerve damage probably in the course of autoimmunity, and direct influence of autoimmunity to the central part of autonomic nervous system are possible in the pathogenesis of dysautonomia.
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Affiliation(s)
- Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Slawomir Michalak
- Department of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland; Neuroimmunological Unit, Miroslaw Mossakowski Medical Research Center of the Polish Academy of Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.
| | - Malgorzata Bilinska
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Slawomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Mikolaj Zaborowski
- Division of Gynecologic Oncology, Department of Gynecology, Obstetrics and Gynecologic Oncology, Poznan University of Medical Sciences, Polna 33, 60-535 Poznan, Poland.
| | - Krzysztof Slotwinski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Ryszard Podemski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
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Zub LW, Waliszewska-Prosól M, Szczepañski T, Woÿniak Z, Ejma M. Spinal metastases of glioblastoma multiforme in a patient with polyneuropathy. Natl Med J India 2016; 29:246. [PMID: 28051009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Leslaw W Zub
- Department of Neurosurgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | | | - Tomasz Szczepañski
- Department of Neurosurgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Zdzislaw Woÿniak
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Koszewicz M, Michalak S, Bilinska M, Budrewicz S, Zaborowski M, Slotwinski K, Podemski R, Ejma M. Is peripheral paraneoplastic neurological syndrome possible in primary brain tumors? Brain Behav 2016; 6:e00465. [PMID: 27186442 PMCID: PMC4851647 DOI: 10.1002/brb3.465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/14/2016] [Accepted: 03/07/2016] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Systemic malignant diseases cause the induction of autoimmunity, for example, paraneoplastic syndromes. There are no proofs of paraneoplastic syndromes in primary brain tumors. The aim of the study was to evaluate the involvement of the peripheral nervous system, together with an assessment of onconeuronal and antineural antibodies as indicators of humoral immune response against nervous system in patients with primary brain tumors. MATERIALS AND METHODS Clinical examinations, electrophysiological studies of peripheral nerves (motor and sensory conduction velocity studies, conduction velocity distribution tests, thermal and vibratory quantitative sensory tests, and sympathetic skin response tests) and muscles, blood sampling collection (assessment of onconeuronal, and antineural antibodies) were performed on 33 patients with newly recognized primary brain tumors within 2-4 days after their admission to our department. RESULTS We revealed statistically significant changes of peripheral nerves, more pronounced in the peroneal nerve in standard and conduction velocity distribution tests, as well as in sympathetic skin responses. We revealed significantly higher vibratory thresholds, and pain thresholds for cold and warm in the upper and lower limbs in the study group than in the controls. In five patients, we have identified anti-neuroendothelium, anti-GFAP, anti-MAG, anti-PCNA, and anti-Ro52 antibodies. CONCLUSIONS In patients with primary brain tumors, electrophysiological changes in peripheral nerves, together with the presence of the antineural antibodies suggest an autoimmune humoral response, and make the diagnosis of paraneoplastic neurological syndrome possible.
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Affiliation(s)
- Magdalena Koszewicz
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
| | - Slawomir Michalak
- Department of Neurochemistry and Neuropathology Poznan University of Medical Sciences Poznan Poland; Neuroimmunological Unit Miroslaw Mossakowski Medical Research Center of the Polish Academy of Sciences Wroclaw Poland
| | - Malgorzata Bilinska
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
| | - Slawomir Budrewicz
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
| | - Mikolaj Zaborowski
- Division of Gynecologic Oncology Department of Gynecology, Obstetrics and Gynecologic Oncology Poznan University of Medical Sciences Poznan Poland
| | - Krzysztof Slotwinski
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
| | - Ryszard Podemski
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
| | - Maria Ejma
- Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland
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Budrewicz S, Szewczyk P, Bladowska J, Podemski R, Koziorowska-Gawron E, Ejma M, Słotwiński K, Koszewicz M. The possible meaning of fractional anisotropy measurement of the cervical spinal cord in correct diagnosis of amyotrophic lateral sclerosis. Neurol Sci 2015; 37:417-21. [PMID: 26590991 PMCID: PMC4789300 DOI: 10.1007/s10072-015-2418-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 07/28/2015] [Accepted: 11/03/2015] [Indexed: 12/11/2022]
Abstract
Diagnosis of amyotrophic lateral sclerosis (ALS) is based on clinical criteria and electrophysiological tests (electromyography, and transcranial magnetic stimulation). In the search for ALS biomarkers, the role of imaging procedures is currently emphasized, especially modern MR techniques. MR procedures were performed on 15 ALS patients and a sex- and age-matched control group. The MR examinations were performed with a 1.5-T MR unit, and the protocol consisted of sagittal T1-weighed images, sagittal and axial T2-weighed images, and sagittal T2-weighed FAT SAT images followed by an axial diffusion tensor imaging (DTI) sequence of the cervical spinal cord. FA values in individual segments of the cervical spinal cord were decreased in the ALS group in comparison with the control group. After comparing FA values for anterior, posterior, and lateral corticospinal columns, the greatest difference was observed between the C2 and C5 segments. Spinal cord assessment with the use of FA measurements allows for confirmation of the motor pathways lesion in ALS patients. The method, together with clinical criteria, could be helpful in ALS diagnosis, assessment of clinical course, or even the effects of new drugs. The results also confirmed the theory of the generalized character of ALS.
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Affiliation(s)
- Slawomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Pawel Szewczyk
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Ryszard Podemski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Ewa Koziorowska-Gawron
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Krzysztof Słotwiński
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
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Waliszewska- Prosol M, Ejma M, Bladowska J, Koszewicz M, Budrewicz S, Slotwinski K, Podemski R. Electrophysiological visual pathway assessment in correlation with brain mr and mr-spectroscopy in patients with hashimoto’s disease. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Koszewicz M, Michalak S, Budrewicz S, Zaborowski M, Slotwinski K, Podemski R, Ejma M. Neuropathy in patients with confirmed antineural antibodies in the course of primary brain tumors — Case series. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dziadkowiak E, Sebastian A, Wiland P, Waliszewska-Prosół M, Wieczorek M, Zagrajek M, Ejma M. Endogenous event-related potentials in patients with primary Sjögren's syndrome without central nervous system involvement. Scand J Rheumatol 2015; 44:487-94. [PMID: 26271272 DOI: 10.3109/03009742.2015.1032345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Endogenous cognitive event-related potentials (CERPs) reflect higher-level processing of sensory information and can be used to evaluate cognitive functions. The aim of this paper was to determine whether there are any abnormalities in the electrophysiological parameters of CERPs in patients with primary Sjögren's syndrome (pSS) but without symptoms of central nervous system (CNS) involvement or mental disorder. The analysis of CERP parameters was then correlated with the clinical status of the patients and with some of the immunological parameters in the patient group. METHOD Thirty consecutive patients with pSS (29 females, one male) were included in the study. All the patients underwent CERP examination. RESULTS There was a significant prolongation of the latency of P300 and N200 potentials in patients with pSS. Abnormalities in electrophysiological parameters of CERPs correlated with the duration of the disease, salivary gland abnormalities, and elevated erythrocyte sedimentation rate (ESR) values. Patients with coexisting chronic fatigue syndrome (CFS) had larger P300 amplitudes. There were no statistically significant changes in the electrophysiological parameters of CERPs in patients with pSS dependent on the presence of peripheral nervous system (PNS) lesions, skin changes, arthritis, abnormalities in white blood cells and the immune system or the levels of blood lipids. CONCLUSIONS The results of the study suggest the presence of a minor cognitive dysfunction in patients with pSS without symptoms of CNS involvement or mental disorder. Cognitive dysfunction correlated with the disease duration time and the severity of inflammatory changes (salivary gland abnormalities and inflammatory markers in the blood). Further and larger longitudinal studies are necessary for confirmation of this correlation.
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Affiliation(s)
- E Dziadkowiak
- a Department of Neurology , Wrocław Medical University , Poland
| | - A Sebastian
- b Department of Rheumatology , Wrocław Medical University , Poland
| | - P Wiland
- b Department of Rheumatology , Wrocław Medical University , Poland
| | | | - M Wieczorek
- c Department of Geography and Regional Development , University of Wrocław , Poland
| | - M Zagrajek
- a Department of Neurology , Wrocław Medical University , Poland
| | - M Ejma
- a Department of Neurology , Wrocław Medical University , Poland
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Chilińska A, Ejma M, Turno-Kręcicka A, Guranski K, Misiuk-Hojlo M. Analysis of retinal nerve fibre layer, visual evoked potentials and relative afferent pupillary defect in multiple sclerosis patients. Clin Neurophysiol 2015; 127:821-826. [PMID: 26251105 DOI: 10.1016/j.clinph.2015.06.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 03/15/2015] [Revised: 06/24/2015] [Accepted: 06/27/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to analyse retinal nerve fibre layer (RNFL), pattern-reversal visual evoked potentials (pVEPs) and relative afferent pupillary defect (RAPD) changes in multiple sclerosis (MS) patients with the consideration of past optic neuritis (ON). METHODS Ophthalmological, neurological, OCT, RNFL and pVEP studies were conducted in 59 MS patients. RAPD tests were performed in 47 of them. Control group consisted of 28 healthy volunteers. RESULTS Abnormal RNFL was found in 59% of cases of eyes with ON and 28% of eyes without ON. In eyes with ON, significantly lower RNFL values were indicated in the temporal and lower quadrants. Elongation of pVEP latency was found in 83% of eyes with ON and 60% of eyes without ON. The average value of pVEP latency was larger and the amplitude was lower in the subgroup of eyes with RNFL at the borderline or below the norm. RAPD was observed only in eyes with ON and with RNFL thinning. No association was found between the RAPD and pVEP parameters. CONCLUSIONS VEPs were more frequently abnormal than RNFL in MS patients. RNFL damage in eyes without ON may indicate neurodegenerations in CNS of MS patients; it can also be the consequence of subclinical ON. SIGNIFICANCE An analysis of RNFL and VEP can be useful for evaluating the optic nerve in MS patients.
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Affiliation(s)
- Adriana Chilińska
- Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Marta Misiuk-Hojlo
- Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
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Abstract
Obesity remains an important risk factor of cardiovascular and cerebrovascular diseases. However, it has been observed that increased body fat and body mass index predicted longer survival after the occurrence of a cardiovascular event. This observation has been named the obesity paradox. Initially, the term obesity paradox referred to the observation of the better outcome of cardiovascular diseases, such as heart failure and coronary heart disease, in obese patients as compared to underweight and normal-weight patients. Recently, similar, although fewer, observations confirm the occurrence of the obesity paradox in patients with acute cerebrovascular diseases. The underlying reasons for the protective effects of excessive body fat tissue against the consequences of acute cardiovascular and cerebrovascular diseases are poorly understood. The effect of preconditioning may be associated with the obesity paradox. The issue of the correlation between obesity and better survival of patients with cardiovascular and cerebrovascular diseases still remains largely unexplored. Debates for and against the obesity paradox continue.
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Affiliation(s)
- Anna Brzecka
- Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Poland
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Kowalczyk E, Waliszewska-Prosol M, Pokryszko-Dragan A, Nowakowska-Kotas M, Sebastian A, Ejma M. P485: Event-related potentials in patients with primary Sjögren’s syndrome. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Glioblastoma multiforme (glioblastoma multiforme - GBM) is the most malignant tumor classified by WHO. It is also the most common primary CNS tumor with a very aggressive course and unfavourable prognosis, usually develops in adults, and is typically located supratentorially in the fronto-temporal region. However, the literature describes an unusual position of GBM (e.g. spinal cord, pons, pineal region), familial gliomas unconnected with the family of gliomas predisposed to the occurrence of syndromes, unusual glioma and metastatic sites, gliomas transplanted with organs. In this paper, based on the available literature, the authors discuss an unusual and rare form of glioblastoma multiforme.
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Affiliation(s)
- Maria Ejma
- Klinika Neurologii, Uniwersytet Medyczny we Wrocławiu
| | | | - Anna Hofman
- Klinika Neurologii, Uniwersytet Medyczny we Wrocławiu
| | - Joanna Bladowska
- Zakład Radiologii Ogólnej, Zabiegowej i Neuroradiologii, Uniwersytet Medyczny we Wrocławiu
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Waliszewska-Prosół M, Bladowska J, Hałoń A, Podemski R, Dołgan A, Ejma M. An older woman after a first generalized seizure. Primary central nervous system lymphoma of the B cell. Eur Neurol 2013; 70:366-8. [PMID: 24296858 DOI: 10.1159/000353283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/27/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Marta Waliszewska-Prosół
- Department and Clinic of Neurology, Interventional Radiology and Neuroradiology, Wroclaw, Poland
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Ejma M, Koszewicz M, Podemski R, Marianska K, Budrewicz S, Turek T. Anatomical variation of the vertebral artery clinically mimicking myasthenia gravis. Neurol Sci 2011; 32:715-7. [PMID: 21544664 DOI: 10.1007/s10072-011-0594-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 04/15/2011] [Indexed: 11/25/2022]
Abstract
Cranial nerve palsy, most commonly trigeminal, abducens, or facial, caused by compression of an ectatic or elongated intracranial artery is a well-known phenomenon. Symptoms of brain stem compression by an abnormal artery have rarely been reported (Tomasello et al. Neurosurgery 56(suppl 1):117-124, 2005). The authors present a 59-year-old woman with intermittent ptosis of the right eye, diplopia and swallowing disturbances, enhanced after physical effort, implying myasthenia gravis. Typical diagnostic procedures, e.g. repetitive nerve stimulation tests, acetylcholine receptor antibodies level were within normal limit. Neurogenic changes from the orbicularis oculi muscle were found in EMG. MRI and angio-CT revealed anatomical variation of the vertebral artery (elongated and arcuate route), causing intermittent signs of brain stem lesion. We point out the similarity of the clinical symptoms of myasthenia gravis and vascular brain stem compression by abnormal vertebral artery. The two diseases require completely different therapeutic proceedings.
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Affiliation(s)
- Maria Ejma
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
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Ejma M, Misiuk-Hojło M, Gorczyca WA, Podemski R, Szymaniec S, Kuropatwa M, Rogozińska-Szczepka J, Bartnik W. Antibodies to 46-kDa retinal antigen in a patient with breast carcinoma and cancer-associated retinopathy. Breast Cancer Res Treat 2007; 110:269-71. [PMID: 17851760 DOI: 10.1007/s10549-007-9721-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 07/29/2007] [Accepted: 07/30/2007] [Indexed: 11/29/2022]
Abstract
Cancer-associated retinopathy (CAR) is a rare paraneoplastic syndrome usually associated with small-cell lung carcinoma and serum autoantibodies against recovering. We report the breast cancer woman with visual impairments and electrophysiological abnormalities characteristic of CAR. Her serum contained high-titer antibodies against alpha-enolase but not against other retinal proteins. This suggests that anti-enolase antibodies could be responsible for the development of CAR symptoms.
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Affiliation(s)
- Maria Ejma
- Department of Neurology, Wrocław Medical University, Wrocław, Poland.
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Misiuk-Hojło M, Ejma M, Gorczyca WA, Szymaniec S, Witkowska D, Fortuna W, Miedzybrodzki R, Rogozińska-Szczepka J, Bartnik W. Cancer-associated retinopathy in patients with breast carcinoma. Arch Immunol Ther Exp (Warsz) 2007; 55:261-5. [PMID: 17659379 PMCID: PMC2766466 DOI: 10.1007/s00005-007-0026-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 05/28/2007] [Indexed: 12/14/2022]
Abstract
Introduction: Cancer-associated retinopathy (CAR) is a paraneoplastic neurological syndrome resulting in progressive loss of vision and clinical signs of retinal degeneration. It is associated with various types of cancer and is also considered to be an autoimmune disorder that involves cross-reaction between autoantibodies and retinal proteins. The aim of this study was to establish whether immunoreactivity to retinal antigens (RAs) observed in patients with breast cancer is accompanied by any visual impairments. Materials and Methods: Sera of 295 patients with diagnosed breast cancer were screened for the presence of anti-RAs antibodies using immunoblotting. Cellular immunoreactivity to RAs present in retinal extracts and to purified recoverin and arrestin was determined by means of a lymphocyte proliferation assay. Six patients with high-titer antibodies to RAs then underwent ophthalmic and neurological examinations. Results: Four serum samples contained high-titer antibodies to a 46-kDa protein, most probably retinal α-enolase, three had antibodies to a 48-kDa protein identified as retinal arrestin, while 56-, 43-, 41-, and 34-kDa antigens were recognized only by one serum sample each. Moreover, weak cellular response to all the RAs tested was observed in one patient and another patient responded only to retinal extract. Two of the examined patients displayed symptoms of CAR. Conclusions: Immunoreactivity to RAs in patients with breast cancer may also be present in cases without clinical signs of CAR.
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Affiliation(s)
- Marta Misiuk-Hojło
- Department of Ophthalmology, Wrocław Medical University, Chałubińskiego 2a, 50-368, Wrocław, Poland.
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Koziorowska-Gawron E, Gawron W, Podemski R, Ejma M, Pokryszko-Dragan A, Koziorowska M. P12.14 Clinical and videonystagmographic evaluation of balance organ in patients with multiple sclerosis. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ejma M, Brzecka A, Podemski R, Misiuk-Hojło M. [Influence of nocturnal hypoxemia on the function of the visual tract in the course of the obstructive sleep apnea syndrome]. Neurol Neurochir Pol 2005; 39:181-7. [PMID: 15981153] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND PURPOSE In patients with obstructive sleep apnea (OSA) syndrome the episodes of upper airway obstruction lead to hypoxemia during sleep. The aim of the study was to establish the influence of sleep hypoxemia on the function of the visual tract in OSA patients. MATERIAL AND METHODS The latency and amplitude of wave P100 of visual evoked potentials have been studied in 35 patients with OSA syndrome (mean apnea index 48+/-19). The diagnosis of OSA was established on the basis of continuous recordings of the respiratory function during sleep with additional full polysomnography in 17 patients. RESULTS Mean absolute latency of P100 was longer in OSA patients than in healthy controls (117.0+/-8.8 ms vs. 104.3+/-4.6 ms, p<0.001). The differences in the amplitude of P100 were not significant (5.9+/-2.6 mV in OSA patients and 7.62+/-3.04 mV in healthy persons). In 60% of patients the latency of P100 exceeded 118 ms; in this group of patients the mean SaO2 during sleep apneas was lower than in patients with normal P100 latency (46+/-15% vs. 69+/-10%, p<0.05). Full polysomnographic studies revealed that in patients with prolonged latencies as compared with patients with normal P100 latencies there were lower: minimal SaO2 during NREM sleep (63+/-12% vs. 78+/-8%, p<0.05), as well as mean and minimal SaO2 during REM sleep (53+/-15% vs. 80+/-5% and 46+/-15% vs. 69+/-10%, p<0.05), without differences in apnea index or apnea duration. CONCLUSIONS In patients with OSA syndrome the electrophysiological abnormalities suggesting damage of the optical tract may develop probably as a consequence of profound sleep hypoxemia.
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Affiliation(s)
- Maria Ejma
- Katedra i Klinika Neurologii, Akademia Medyczna we Wrocławiu.
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42
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Gorczyca WA, Ejma M, Witkowska D, Misiuk-Hojło M, Kuropatwa M, Mulak M, Szymaniec S. Retinal antigens are recognized by antibodies present in sera of patients with multiple sclerosis. Ophthalmic Res 2004; 36:120-3. [PMID: 15017109 DOI: 10.1159/000076892] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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: 04/28/2003] [Accepted: 01/07/2004] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis (MS) is frequently accompanied by visual symptoms including those related to retinal disorders. Since they may be a consequence of an autoimmune reaction, we examined whether sera of patients with diagnosed MS and changes in visual-evoked potentials contain antibodies against retinal antigens (retAgs). Immunoblot analysis revealed that MS sera recognized mainly a 46-kD antigen, a 41-kD antigen, retinal arrestin, to a smaller extent also 70-, 56-, 43-, and 36-kD proteins. Patients whose sera showed the highest reactivity with 41- and 46-kD antigens had deficiencies in visual acuity, visual fields, ophthalmoscopy, and electroretinograms. Our observation suggests that antibodies to these retAgs may play a role in the origin of ophthalmologic impairment in MS.
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Affiliation(s)
- Wojciech A Gorczyca
- L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław Medical University, Wrocław, Poland.
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Gurański K, Podemski R, Ejma M. [Restless legs syndrome]. Pol Merkur Lekarski 2001; 11:526-9. [PMID: 11899854] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The authors present recent data about epidemiology, pathogenesis and clinical features of idiopathic and symptomatic restless legs syndrome. A new aspects of pharmacological treatment and modification of daily activity are also described.
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Affiliation(s)
- K Gurański
- Katedra i Klinika Neurologii Akademii Medycznej we Wrocławiu
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44
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Ejma M, Podemski R, Pokryszko A. [Neurological complications in patients with chronic renal failure]. Pol Merkur Lekarski 1998; 5:173-7. [PMID: 10101489] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
On the basis of current literature and their own experiences, the authors present the most common symptoms and syndromes of dysfunction of central and peripheral nervous system which appear in patients with chronic renal insufficiency. Current views on patomechanism of neural dysfunction due to renal failure in dialysed and non-dialysed patients are discussed.
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Affiliation(s)
- M Ejma
- Katedry i Kliniki Neurologii Akademii Medycznej we Wrocławiu
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45
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Nizankowska MH, Turno-Krecicka A, Misiuk-Hojło M, Ejma M, Chełstowska J, Szczesna-Borzemska D, Sasiadek M. [Coexistence of migraine and glaucoma-like visual field defects]. Klin Oczna 1998; 99:121-6. [PMID: 9379663] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Functional and morphological evaluation of the optic nerve heads in patients suffering from migraine. MATERIAL AND METHODS 21 patients--13 women and 8 men (mean age 40 +/- 10) with neurologically confirmed diagnosis of common and classic migraine were examined. The headache history was obtained by standard questions. The patients suffered from migraine from 2 to 30 years and the frequency of attacks was from < 10 to > 100/year. Ophthalmologic examination involved evaluation of visual acuity, anterior segment, irido-corneal angle, retina and optic disc. In all cases optic disc photography, diurnal tension curve and two central visual field examinations with Octopus 101 programm G2 were performed. RESULTS In all cases IOP was normal (< 21 mm Hg). In 4 eyes (2 patients) there was early glaucomatous-like damage of the optic disc, without visual field defect. In most of these patients the optic nerve head looked normal, in part of them slightly pale. In 28% patients glaucomatous-like visual field defects were found (MD-3.9 dB to 6.6 dB). There was statistically significant relationship between increase of MD and frequency of migraine attacks (Mann-Withney U test, a = 0.05). CONCLUSIONS Static perimetry of the central visual field has high diagnostic value in ocular vasospastic syndrome. Functional dysregulation of the optic nerve head circulation in patients with migraine might be involved in the pathogenesis of normal-tension glaucoma.
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46
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Nizankowska MH, Misiuk-Hojło M, Turno-Krecicka A, Ejma M, Chełstowska J. [Central visual field in patients with multiple sclerosis without symptoms of optic neuritis]. Klin Oczna 1996; 98:27-31. [PMID: 9019571] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To estimate central visual field (30 degrees) of patients suffering from multiple sclerosis (SM). SM was confirmed by magnetic resonance imaging. MATERIAL AND METHODS There was no posterior optic neuritis in the history of the disease. The visual acuity of examined the 28 eyes was 1,0. The results of static perimetry were analysed by regression analysis. RESULTS There were significant relationships between mean sensitivity (MS) and duration of the disease, stage of the disease (in Kurtzke gradation scale) and age. Mean defect (MD) was significantly higher in the upper half of central visual field and between 15-30 degrees (p < 0.05). We observed positive relationships between MD, short time fluctuation (STF) and corrected loss variance (CLV). We found negative correlations between MS, MD, CLV and STF. Mean reliability factor RF was < 10%. CONCLUSION Static perimetry seems to be a useful test in early diagnosis and monitoring of optic nerve neuropathy in SM.
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47
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Nizankowska MH, Turno-Krecicka A, Misiuk-Hojło M, Ejma M, Batycka-Ugorska I. [Early diagnosis of optic nerve neuropathy in multiple sclerosis]. Klin Oczna 1996; 98:21-5. [PMID: 9019570] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To evaluate diagnostic sensitivity of clinical tests in optic demyelinating neuropathy. MATERIAL AND METHODS We examined 21 persons (38 eyes) with confirmed sclerosis multiplex (SM) with no episodes of posterior optic neuritis in the history of the disease. The examination method included: Static perimetry of central visual field (30 degrees, by Octopus 101), pattern visual evoked potentials (p VEP), colour photographs of optic disc and magnetic resonance imaging (MR) of central nervous system, optic nerves and optic chiasm. Visual acuity and colour vision were normal. RESULTS There was statistically significant elongation in the latency of P 100 in pattern VEP (> 118 ms, 3 x SD), and significant reduction in mean light sensitivity (MS) in central visual field. MRI revealed demyelinisation in cortex and/or spinal cord of all patients and demyelinating lesion in optic nerve of one patient. There was no Gd-DTPA enhancement. In statistical analysis there was no correlation between results of pattern VEP, IMR, morphology of optic disc, and duration of SM, stage of the disease (in Kurtzke gradation scale) or age of patient. In regression analysis there were statistically significant relationships (p < 0.05) between results of central static perimetry, duration and stage of disease.
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48
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Bilińska M, Usnarska-Zubkiewicz L, Ejma M, Martynów R, Bieszczad M. [Polyneuropathy in non-Hodgkin lymphoma]. Neurol Neurochir Pol 1995; 29:343-52. [PMID: 7566409] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In a group of patients with non-Hodgkin lymphoma axonal sensorimotor polyneuropathy was found in 15%. It appeared in the treated patients, those receiving doses of oncovin. Polyneuropathy was not correlated with the type of malignancy. Treatment seems to be the important factor which can cause polyneuropathy.
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Affiliation(s)
- M Bilińska
- Katedry i Kliniki Neurologii AM we Wrocławiu
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49
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Ejma M, Bieszczad M, Podemski R, Bilińska M, Usnarska-Zubkiewicz L. [Visual and somatosensory evoked potentials in the patients with non-Hodgkin lymphoma]. Neurol Neurochir Pol 1995; 29:353-61. [PMID: 7566410] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Visual (VEPs) and somatosensory (SEPs) evoked potentials in a group of 33 patients (mean age 49 years) with non-Hodgkin lymphoma (n-HL) without CNS involvement were recorded. There were 24% of patients with pathological VEPs and 30% of patients with pathological SEPs. Pathological VEPs and SEPs were both recorded in 42% of patients. In comparison to the controls the statistically significant prolongation of mean latencies of VEPs, SEPs and transit time to cortex were found in the group of n-HL patients. These abnormalities were noted much more often in patients with long duration of the disease and with intermediate type of malignancy. In the untreated patients evoked potentials were normal. In 6 patients despite normal neurological status and normal eeg the evoked potentials were abnormal. The evoked potentials examination seems to be very sensitive method of afferent pathways involvement estimation and can be used for diagnosis and prognosis in n-HL patients. This method reveals CNS lesions more often than physical examination or eeg.
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Affiliation(s)
- M Ejma
- Katedry i Kliniki Neurologii AM we Wrocławiu
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50
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Bieszczad M, Ejma M, Martynów R, Sasiadek M, Nowakowska B. [Multiple sclerosis coexisting with myasthenia]. Neurol Neurochir Pol 1995; 29:77-83. [PMID: 7596482] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In a male patient multiple sclerosis was found to coexist with myasthenia. The symptoms of muscle fatiguability and of central nervous system damage developed at the same time. Multiple sclerosis was the predominating disease, especially in later stage of the disease. The authors discuss the possibility of a common immunological substrate for both conditions.
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Affiliation(s)
- M Bieszczad
- Katedry i Kliniki Neurologii AM we Wrocławiu
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