Neurology Research International最新文献

Stroke is one of the leading causes of mortality and morbidity worldwide, and its burden is particularly high in low- and middle-income countries. In Morocco, epidemiological data on stroke subtypes, risk factors, symptoms and early outcomes remain limited. The objective of this study was to better understand stroke profiles in Morocco and identify the predictors of haemorrhagic stroke and poor in-hospital prognosis. A retrospective observational study was conducted including 360 patients admitted to Hospital Mohamed V, Meknes, Morocco. Sociodemographic information, vascular risk factor, clinical presentation, stroke subtype and in-hospital outcomes were collected. Comparisons were made among patients with ischaemic stroke, haemorrhagic stroke and transient ischaemic attack (TIA). Multivariate logistic regression analyses were performed to identify the independent predictor of haemorrhagic stroke and separately predictors of poor prognosis among ischaemic stroke patients. Ischaemic stroke was the most prevalent subtype (94.2%), followed by haemorrhagic stroke (4.7%) and TIA (1.1%). The mean age was 67.6 ± 13.0 years. The most common vascular risk factors were hypertension (68.6%), diabetes (35.8%) and cardiopathy (51.4%). Diabetes was more frequent among ischaemic stroke patients, while hypertension characterized all haemorrhagic stroke cases. Male sex independently predicted haemorrhagic stroke (OR = 3.27; 95% CI: 1.11-9.65; p = 0.032). However, diabetes showed a strong inverse association (OR = 0.082; 95% CI: 0.011-0.636; p = 0.017). Overall, in-hospital prognosis for ischaemic stroke was favourable in 86.7% of cases, and sequalae occurred in 6.2% and mortality in 7.1%. Disturbance of consciousness showed a borderline association with poor prognosis (OR = 2.41; 95% CI: 0.93-6.23; p = 0.070). However, age, sex, hypertension, diabetes and cardiopathy were not independent predictors. The findings indicate that most strokes in Morocco are ischaemic and primarily linked to vascular risk factors, particularly hypertension and diabetes. Male sex increases the likelihood of haemorrhagic stroke, while diabetes shifts risk toward ischaemic stroke. Early neurological severity-especially altered consciousness-is the strongest prognostic indicator.

This study aims to establish normative reference values for nerve conduction studies specific to the Bangladeshi population. Data were collected from 258 healthy subjects, grouped by age and sex. Both motor and sensory nerves of the upper and lower limbs were assessed. Using the ordinary least square (OLS) regression method, it is seen that for the left median motor nerve, the mean distal latency is 3.01 ± 0.34 ms, amplitude 18.05 ± 4.73 μV, and conduction velocity 59.67 ± 6.64 m/s. For the left median sensory nerve, the latency is 2.30 ± 0.25 ms, the amplitude is 60.82 ± 23.95 μV, and the velocity is 55.87 ± 4.48 m/s. The findings of this study were compared with previously published international data, revealing significant differences. These results provide neurophysicians with population-specific reference values, enhancing diagnostic accuracy, enabling earlier detection of nerve conduction abnormalities, and guiding more targeted and effective treatment strategies for nerve disorders in Bangladesh.

This prospective study evaluated the impact of nursing interventions based on the Chronic Illness Trajectory Framework (CITF) on anxiety, depression, mental toughness, sleep quality, and ALSFRS-R scores in amyotrophic lateral sclerosis (ALS) patients to enhance care strategies. Eighty ALS patients were enrolled from the Department of Neurology at the First Hospital of Shanxi Medical University between February 2023 and March 2024. Participants were randomly assigned to an intervention group (CITF-based nursing interventions) or a control group (standard care). Over an 8-week period, the intervention group demonstrated significantly lower anxiety and depression scores, higher mental toughness, and improved sleep quality compared to the control group (p < 0.05). Additionally, the intervention group achieved higher ALSFRS-R scores (31.63 ± 3.54 vs. 29.58 ± 3.38) (p < 0.05). These findings indicate that CITF-based nursing interventions effectively reduce negative emotional states, enhance mental resilience, improve sleep quality, and boost overall quality of life in ALS patients. Based on this study, nurses can integrate CITF-based interventions into standard ALS care to enhance patients' emotional well-being and functional outcomes. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500108691.

Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc). In addition to postural instability, rigidity, tremor, and bradykinesia, patients will experience depression and/or anxiety at any time during PD. Nortriptyline, as a dual reuptake inhibitor of norepinephrine and serotonin, inhibits alpha-synuclein aggregation and may play an important role in improving the pathological effects of PD.

Objective: This study investigated the effects of nortriptyline combined with L-DOPA and benserazide on behavioral, histological, and biochemical changes in a rat model of PD. Methods. Forty-nine rats were randomly assigned to seven groups. Except for the control and sham groups, five other groups underwent stereotactic surgery for the 6-OHDA lesion. We performed a tail suspension swing test and an apomorphine-induced rotation test after 1 week to confirm the PD model. After gradual treatment with three doses (5, 10, and 20 mg/kg) of nortriptyline combined with L-DOPA and benserazide, the elevated plus-maze test and open field test were performed to determine motor activities, anxiety, and depression. Tissue alterations were evaluated through Nissl staining, tyrosine hydroxylase immunohistochemistry, and Golgi-Cox staining, whereas oxidative stress levels were determined by analyzing malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAC) markers.

Results: Our results demonstrate that 10 mg/kg of nortriptyline in combination with L-DOPA and benserazide significantly improved motor activity and reduced the anxiety- and depression-like behaviors of PD. Histological findings also suggested a protective effect of nortriptyline on dopaminergic neurons in the SNpc. Furthermore, the findings from the antioxidant evaluation and the structure of CA1 hippocampal neurons indicated that a dosage of 10 mg/kg of nortriptyline might provide the greatest supportive benefit.

Conclusion: Nortriptyline at 10 mg/kg offers a promising adjunctive therapy for alleviating both motor and nonmotor symptoms of PD. However, higher doses may induce anxiogenic effects, suggesting the need for careful dose optimization.

Background: Cerebral palsy (CP) is the most common physical disability in childhood, often resulting from early brain injury. Preterm birth (< 37 weeks gestation) is a critical risk factor for CP due to the vulnerability of the immature brain. Despite advances in neonatal care, the risk of CP remains elevated among preterm infants, especially those born very preterm. Existing meta-analyses are limited by outdated data or methodological gaps.

Objective: To provide an updated, comprehensive synthesis of the association between preterm birth and CP risk in children, utilizing recent high-quality observational studies worldwide.

Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. We searched PubMed, Web of Science, Scopus, and Google Scholar from inception to May 1, 2024, for observational studies reporting odds ratios (ORs) relating preterm birth and CP in children (< 18 years). Studies were screened independently by two reviewers. Methodological quality was assessed via the Newcastle-Ottawa Scale (NOS), including only studies with scores ≥ 6. A fixed-effects meta-analysis was performed given low heterogeneity (I ² = 28.04%). Publication bias was evaluated using Egger's test.

Results: Sixteen studies encompassing diverse geographic regions and 30,000+ participants were included. The pooled OR for CP in preterm versus term children was 1.02 (95% CI: 0.72-1.31, p < 0.0001), indicating a significantly increased risk associated with preterm birth. No evidence of publication bias was detected (Egger's p = 0.4783). The methodological rigor and consistency of findings across varied populations strengthen the evidence for a global association.

Conclusions: While the pooled estimate for the broad preterm birth category was not statistically significant, subgroup analyses confirm that the risk of CP increases significantly with the degree of prematurity. These findings reinforce the need for targeted neurodevelopmental monitoring and early interventions in preterm populations, particularly for those born at lower gestational ages, alongside public health strategies to reduce preterm birth incidence. Future research should stratify risks by degree of prematurity and explore biological modifiers to optimize preventive care.

Cerebrovascular accident is a neurological disease, characterised by acute onset that lasts for more than 24 h, leading to motor, sensory and cognitive impairments or even death. High-intensity interval training is a type of aerobic training that presents an increase of the > 80% of maximum heart rate, aiming to improve VO₂ peak, leading to improvements in various health-related parameters. The purpose of this study was to examine the effectiveness of high-intensity interval training on aerobic and functional capacity for poststroke survivors. Two investigators searched the electronic databases MEDLINE/PUBMED, Cochrane Controlled Trials Register and EBSCO, until August 2024. In this review, 11 studies met the eligible criteria and were included. The statistical analysis was conducted by pooling the mean, standard deviation, and 95% confidence intervals. For the establishment of meta-analysis, the heterogeneity statistical index I ² was used. From the 11 included studies, 458 stroke survivors were extracted. HIIT yield improvements were observed in VO₂ peak (p value = 0.001, 95% CI: 1.72-4.06), 6MWT (p value < 0.001, 95% CI = 38.55-149.41), 10MWT (p value < 0.01, 95% CI = 0.20-0.36), BBS (p value < 0.01, 95% CI = 3.43-7.51), EQ-5D (p value = 0.001, 95% CI = 3.67-15.13), and cognition (p value = 0.009, 95% CI = 0.41-2.89). No significant difference was presented for HR (p value = 0.58, 95% CI = -11.82-21.10), TUG (p value = 0.055, 95% CI = -2.25 to 0.02) and step count (p value = 0.71, 95% CI = -1479-2163). High-intensity interval training is a safe rehabilitation method affecting positively the aerobic capacity and the majority of motor function of stroke survivors.

Objective: To investigate the association between lipid profiles and disease severity/cranial nerve involvement in Guillain-Barré syndrome (GBS), providing evidence for early clinical intervention. Methods: This retrospective study enrolled 182 GBS patients (148 males and 34 females) admitted to the First Affiliated Hospital of Shihezi University from December 2019 to April 2024. Patients were stratified into mild (Hughes Functional Disability Scale [HFDS] 1-3) and severe (HFDS 4-6) groups. Multivariate logistic regression (adjusted for age, sex, and antecedent infections) was used to analyze independent associations of low-density lipoprotein cholesterol (LDL-C) and apolipoprotein A (ApoA) with disease severity and cranial nerve involvement. ROC curve analysis determined predictive thresholds. Results: Disease severity: each 1 mmol/L increase in LDL elevated severe disease risk by 2.5-fold (OR = 2.503, p=0.009) and each 0.1 g/L decrease in ApoA reduced severe disease risk by 99.6% (OR = 0.004, p < 0.001). Cranial nerve involvement: LDL ≥ 2.355 mmol/L significantly increased cranial nerve involvement risk (OR = 1.925, p=0.018). Predictive thresholds: LDL ≥ 2.215 mmol/L optimally predicted severe disease and ApoA ≤ 1.071 g/L indicated higher probability of mild disease. Conclusion: Elevated LDL and reduced ApoA are independent risk factors for GBS progression and cranial nerve involvement. Combined detection may aid early identification of high-risk patients. Dyslipidemia likely exacerbates GBS pathology through neuroinflammatory mechanisms, suggesting targeted lipid regulation as a potential therapeutic strategy.

Introduction: Due to anti-inflammatory, antioxidant, immune-modulating, and antiaging properties of astaxanthin, it has been used to treat spinal cord injuries (SCIs). In this meta-analysis study, the effects of astaxanthin on SCI in animal models were investigated. Method: Scopus, PubMed, Web of Science, and Google Scholar databases were searched based on keywords related to astaxanthin and SCI. The primary screening of articles based on the title and abstract and the secondary screening based on the full text of the articles according to inclusion and exclusion criteria were performed. After extracting the data, statistical analysis was done using STATA software. A standardized mean difference (SMD) was used to analyze the results of the reported studies. Subgroup analysis and quality control of articles was also performed. Result: The overall results showed that astaxanthin has a strong effect (SMD = 3.34; 95% CI: 1.90 to 4.78; p < 0.001) on improving motor function after SCI especially when administered in multiple doses over consecutive days. Astaxanthin has a strong effect on reducing lipid peroxidation and increasing antioxidants. Treatment with astaxanthin increased the number of spinal cord neurons and spared white matter. Conclusion: Astaxanthin has the potential to be used as an adjuvant in improving motor behavior, and it is suggested to conduct clinical studies on it.

Background: Parkinson's disease is a neurodegenerative disorder that affects balance and increases the risk of falling by compromising vestibular signal processing. Objectives: This study aims to assess the impact of vestibular-oriented balance training on postural control and fall risk among people in the middle stages of PD. Methods: Forty middle-stage individuals with PD were assigned to the vestibular-oriented balance training (study group) or the traditional balance training (control group). Outcome measures including Functional Gait Assessment (FGA) and modified Clinical Test of Sensory Interaction on Balance (mCTSIB) using the Biodex Balance System were measured before, immediately after and 4 weeks after treatment. Results: There was a significant group interaction by time for all outcome measures (p < 0.001). The results showed that the difference in the FGA and mCTSIB scores from baseline was significant between the two groups at all time points (p < 0.001). The study group showed significant sustained improvements in the FGA score overtime, while the control group had a significant improvement at Week 8 but that did not last to Week 12. In mCTSIB, the study group improved significantly in all test conditions (p < 0.001), while the control group showed significant improvement only in Conditions 1 and 2, without lasting effects at Week 12 (p > 0.05). Conclusions: The findings indicate that the implementation of vestibular-oriented balance training during the middle stage of PD might have a notable and lasting impact on both postural control and the risk of falls.