Neurology Research International最新文献

Background: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that affects cognitive performance and leads to depression and decreased quality of life (QOL). The current study aims to assess the effects of cognitive rehabilitation versus donepezil therapy on memory, attention, depression, and QOL in MS patients compared to placebo and control groups.

Methods: Eighty MS patients were randomly selected from parallel randomized trials and divided into four groups: A: cognitive rehabilitation (10 sessions of 120 minutes), B: control (no intervention), C: donepezil (10 mg daily), and D: placebo. Patients received the intervention for three months. They were assessed for cognitive status, depression, and QOL prior to the intervention and immediately after that using abbreviated mental test (AMT), prospective and retrospective memory questionnaire (PRMQ), everyday memory questionnaire (EMQ), digit span, MSQOL-54, and second edition Beck depression inventory (BDI). We compared scores between groups after the intervention, as well as the progression of scores in every single group.

Result: s. The cognitive rehabilitation group showed improvement in EMQ, RPMQ, digit span, physical and mental health subscales of MSQOL54, and depression (P < 0.05). We observed the same effect for donepezil except for the digit span test (P = 0.15). Intergroup comparison of scores showed the superiority of cognitive rehabilitation over donepezil in digit span, depression, and mental health scores.

Conclusion: Both donepezil and cognitive rehabilitation effectively improve memory performance, attention, depression, and QOL in MS patients. Cognitive rehabilitation is superior altogether. This study is registered with the Iranian registry of clinical trials http://clinicaltrials.gov/ct2/show/IRCT2016042227522N1.

Objectives: Impairment of static and dynamic posture control is common after stroke. It is found to be a predictor and an essential component for balance, walking ability, and activities of daily living (ADL) outcomes. Studies investigating effect of physical therapy techniques with an aim to improve trunk function after stroke are limited. This study aimed at studying the effect of task-specific training on trunk control and balance in patients with subacute stroke.

Methods: In this randomized controlled trail, thirty-four patients were alienated into two equal groups. The study group (n = 17) received task-specific training, and the control group (n = 17) received conventional physical therapy based on the neurodevelopmental technique. Task-specific training was applied through two phases with criteria of progression based on Chedoke-McMaster Stroke Assessment postural control stages. The interventions were applied in a dosage of 60 min per session, three times a week for ten weeks. Static and dynamic balance were measured by the trunk impairment scale (TIS), postural assessment scale (PAS), and functional reach test (FRT). Laser-guided digital goniometer was used to measure the trunk ranges of motions (ROM) as a secondary outcome.

Results: Significant differences between the baseline and the follow-up measures including TIS, PAS, FRT, and trunk (ROM) were found in both groups (P ≤ 0.05). In-between group comparison also showed significant differences between the results of both groups indicating more improvements among patients representing the study group.

Conclusion: Task-specific training may be effective in improving the static and dynamic postural control and trunk ranges of motion among subacute stroke patients.

The emergence and spread of the highly contagious novel coronavirus disease (COVID-19) have triggered the greatest public health challenge of the last century. Aside from being a primary respiratory disease, acute ischemic stroke has emerged as a complication of the disease. While current evidence shows COVID-19 could cause ischemic stroke especially in severe disease, there are similarities in the risk factors for severe COVID-19 as well as ischemic stroke, underscoring the complex relationship between these two conditions. The pandemic has created challenges for acute stroke care. Rapid assessment and time-sensitive interventions required for optimum outcomes in acute stroke care have been complicated by COVID-19 due to the need for disease transmission preventive measures. The purpose of this article is to explore the putative mechanisms of ischemic stroke in COVID-19 and the clinical characteristics of COVID-19 patients who develop ischemic stroke. In addition, we discuss the challenges of managing acute ischemic stroke in the setting of COVID-19 and review current management guidelines. We also highlighted potential areas for future research.

Background: There is limited information and research carried out regarding the prevalence of poststroke depression (PSD) in the study area. Psychiatric disorders complicate a significant proportion of patients suffering from stroke. This of course have a great negative impact on our knowledge about poststroke depression in Ethiopia, and poststroke depression complicates a significant number of stroke patients and their rehabilitation.

Methods: A cross-sectional study on all patients aged above 18 years and diagnosed with stroke in the past two years who attended the neurology follow-up clinics of Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) was done by using a structured questionnaire containing Patient Health Questionnaire-9 (PHQ-9) depression screening tool.

Result: Of 84 patients who were eligible for the study, 32.2% of patients have depressive symptoms. Women (OR 0.001, 95% CI 0.12-0.87) and aphasic patients (OR 0.034, 95% CI 0.19-1.27) were more likely to have depressive symptoms.

Conclusion: Depressive symptoms after stroke are common in Ethiopian patients. Our study demonstrates female and aphasic patients are more likely to screen positive for PSD. Hence, screening all poststroke patients with different screening tools is practical, and further studies are needed to assess the validity of these screening tools and also to assess PSD as a predictor of stroke outcome.

Introduction: Nonadherence to antiepileptic medication is the extent of a patient's passive failure to follow the prescribed therapeutic regimen. The prevalence and impact of nonadherence to antiepileptic medication are high globally. The main purpose of this study was to assess nonadherence to antiepileptic medications and its associated factors among epileptic patients at the University of Gondar Referral Hospital, Gondar, Ethiopia, 2019.

Methods: An institutional-based cross-sectional study was conducted among 365 epileptic patients at the University of Gondar Referral Hospital, who were selected by a systematic random sampling technique. Data were collected by face to face interviews using a structured pretested questionnaire. Data were entered into EPI Info version 7 and then exported to SPSS version 22 for analysis. The data were described by descriptive statistics. Binary logistic regression analysis was used as a model, and variables with a p value of less than 0.05 were considered as statistically significant with nonadherence to antiepileptic medications.

Results: A total of 356 epileptic patients participated in the study yielding a response rate of 97.5%. The overall prevalence of nonadherence to antiepileptic medications among epileptic patients attending at the University of Gondar Referral Hospital was 38.5% (95% CI: 33.1-43.8). Divorced and/or widowed marital status (AOR: 3.38 (95% CI: 1.54, 7.44)), treatment duration of 3-5 years (AOR = 3.58 (95% CI: 1.38, 9.29)), treatment duration of 5 and above years (AOR: 3.49 (95% CI: 1.53, 7.95)), comorbidity (AOR: 2.42 (95% CI: 1.08, 5.43)), side effects of antiepileptic medications (AOR: 3.36 (95% CI: 1.67, 6.74)), absence of health information (AOR: 1.98 (95% CI: 1.11, 3.52)), epilepsy-related stigma (AOR: 2.81 (95% CI: 1.57, 5.02)), and negative attitude towards antiepileptic medications (AOR: 2.46 (95% CI: 1.36, 4.45)) were significantly associated with nonadherence to antiepileptic medications.

Conclusions: Prevalence of nonadherence to antiepileptic medications among epileptic patients at the University of Gondar Referral Hospital was found to be high. Hence, giving health information about epilepsy and its management will help to reduce antiepileptic medications' nonadherence.

Introduction: The primary objective of our study was to determine the nature of medication beliefs and their association with adherence to antiseizure medications (ASMs) among elderly epilepsy patients. Our secondary objective was to enhance the psychometric properties and factor structure parameters of the Beliefs about Medications Questionnaire (BMQ) adapted to epilepsy and affected aged subjects.

Methods: A population-based survey was performed in which older adults (≥60 years of age) were invited for a free face-to-face consultation with the specialists as well as for the collection of necessary data. The eligible subjects were those who are affected with epilepsy and having epileptic seizures of any type. In addition, the participants were required to be of any sex, currently under treatment with ASMs, resident of Tehran, and able and interested to participate independently. All were carefully examined with a reasonably detailed case-history examination. Two Persian questionnaires used were Medication Adherence Rating Scale (MARS) and BMQ. Those with a MARS score of ≥6 were considered as adherent to ASMs. All data were described in descriptive terms. We did a group comparison of means and proportions for all possible independent variables between adherents and nonadherents. Then, we did a hierarchical multiple linear regression. For this, independent variables were categorized into three different blocks: (a) sociodemographic block (Block-1), (b) treatment side-effect block (Block-2), and (c) BMQ block that included ten items of the BMQ scale (Block-3). We also did a forward step-wise linear regression by beginning with an empty model. We also estimated the psychometric properties and factor structure parameters of BMQ and its two subdomains.

Results: Of all (N = 123, mean age: 63.3 years, 74.0% males), 78.0% were adherent (mean score: 7.0, 95% CI 6.2-7.8) to ASMs. The MARS scores were not different between males and females. The mean BMQ score was 23.4 (95% CI 19.8-27.0) with the mean need score of 20.0 (95% CI 18.0-22.0) and mean concern score of 16.5 (95% CI 14.3-18.7). A positive need-concern differential was 20.4%. Upon hierarchical regression, the adjusted R ² for Block-1 was 33.8%, and it was 53.8% for Block-2 and 92.2% for Block-3. Upon forward step-wise linear regression, we found that "ASMs disrupt my life" (ß -1.9, ES = -1.1, p=0.008) as the only belief associated with adherence. The alpha coefficient of BMQ was 0.81.

Conclusions: Ours is one of the very few studies that evaluated medication beliefs and their association with adherence to ASMs among elderly epilepsy patients in a non-western context. In our context, medication beliefs are likely to have an independent role in effecting adherence to ASMs, particularly the concern that "ASMs disrupt life." Treating physicians should cultivate good conscienc

Background: Children with sickle cell anemia are at a higher risk of developing neurological sequelae like abnormal intellectual functioning, poor academic performance, abnormal fine motor functioning, and attentional deficits. There is a paucity of data about neurocognitive impairment among children with sickle cell anemia in Tanzania. Recognition of the magnitude of neurocognitive impairment will help to provide insight in the causative as well as preventive aspects of the same. Therefore, this study was carried out to determine the prevalence and factors associated with neurocognitive impairment in children with sickle cell anemia.

Methods: This is a cross-sectional comparative study between children with SCA and a control group of the hemoglobin AA sibling. It was carried out in Muhimbili National Hospital during a five-month period. The Rey-Osterrieth Complex Figure test (ROCF) which is used to test memory and visual special functions and KOH block design tools that have been previously validated through another study locally were used. Additional information on demographic characteristics was also collected using a predetermined questionnaire. Proportions and comparisons of means were used to examine associations between neurocognitive impairment and independent variables for associated factors.

Results: A total of 313 children were included in the final analysis. Among all the participants, the majority of the participants in the sickle cell group were of the age group 14-15 years (45.9%). In the comparison group, the majority were of the age group 9-10 years (43.8%). The neurocognitive scores in children with sickle cell anemia were significantly different from the normal siblings. In the copy ROCF, the neurocognitive function in SCA participants was 68.2% below the mean as compared to 45% of their counterparts, p ≤ 0.001. Additionally, there was no difference in memory in children with SCA compared to normal siblings (14.8% vs. 12.5%, respectively, p=0.606). Children with SCA had a higher proportion of impaired IQ (85.4%) as compared to children without SCA (72.5%), and the difference was statistically significant, p=0.009. Factors associated with neurocognitive impairment were age above 13 years, BMI, and absenteeism from school. Conclusion and Recommendation. Children with SCA had more impairment in terms of copying and IQ. We recommend assessment at the younger age group, increased sample size in future studies, and long-term cohort follow-up.

Background: Currently, diabetic retinopathy (DR) has a wide recognition as a neurovascular rather than a microvascular diabetic complication with an increasing need for enhanced detection approaches. Pattern-reversal visual evoked potentials (PRVEPs) test, as an objective electrophysiological measure of the optic nerve and retinal function, can be of great value in the detection of diabetic retinal changes.

Objectives: The use of two sizes of checkerboard PRVEPs testing to detect any neurological changes in persons with type 2 diabetes mellitus (T2DM) with and without a clinically detected DR. Also, to compare the results according to the candidate age, duration, and glycemic status of T2DM.

Methods: This study included 50 candidates as group A with T2DM and did not have a clinically detected DR and 50 candidates as group B with T2DM and had a clinically detected early DR and 50 candidates as controls who were neither diabetic nor had any other medical or ophthalmic condition that might affect PRVEPs test results. The PRVEPs were recorded in the consultant unit of ophthalmology in Almawani Teaching Hospital. Monocular PRVEPs testing of both eyes was done by using large (60 min) and small (15 min) checks to measure N75 latency and P100 latency and amplitude.

Results: There was a statistically significant P100 latency delay and P100 amplitude reduction in both groups A and B in comparison with the controls. The difference between groups A and B was also significant. In both test results of groups A and B, the proportions of abnormal P100 latency were higher than those of P100 amplitude with a higher abnormal proportions in 15 min test.

Conclusions: The PRVEP test detected neurological changes, mainly as conductive alterations affecting mostly the foveal region prior to any overt DR clinical changes, and these alterations were heightened by the presence of DR clinical changes.

[This corrects the article DOI: 10.1155/2018/5496408.].