Neurology International最新文献

Background: The Improved Health Care in Neurology and Psychiatry-Longer Life (IHCNP) study was an 18-month prospective, observational, non-interventional research study focused on patients with mild cognitive impairment (MCI) following ischemic stroke.

Objectives: Our secondary analysis of the IHCNP data aimed to document the progression of MCI in this patient group.

Methods: A total of 100 patients from Romania were recruited, all of whom underwent cognitive assessments using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Rey Auditory Verbal Learning Test (RAVLT). Clinical evaluations were also conducted as part of the study. Baseline cognitive scores were recorded, and subsequent follow-ups documented cognitive changes over time.

Results: At baseline, cognitive scores indicated mild impairment, with averages of MMSE 25.41, MoCA 23.27, and RAVLT 33.63. By the end of the study, patients exhibited a significant cognitive decline, with MMSE scores dropping by 8.7%, MoCA by 10.0%, and RAVLT by 29.5% (p < 0.0001 for all measures), reflecting the progressive nature of MCI post-stroke.

Conclusions: These findings highlight the importance of early diagnosis and intervention to mitigate cognitive decline in post-stroke patients. The study underscores the need for ongoing cognitive monitoring to improve patient outcomes and manage MCI progression effectively.

Therapeutic treatment of nervous system disorders has represented one of the significant challenges in medicine for the past several decades. Technological and medical advances have made it possible to recognize different neurological disorders, which has led to more precise identification of potential therapeutic targets, in turn leading to research into developing drugs aimed at these disorders. In this sense, recent years have seen an increase in exploration of the therapeutic effects of various metabolites extracted from Maca (Lepidium meyenii), a plant native to the central alpine region of Peru. Among the most important secondary metabolites contained in this plant are macamides, molecules derived from N-benzylamides of long-chain fatty acids. Macamides have been proposed as active drugs to treat some neurological disorders. Their excellent human tolerance and low toxicity along with neuroprotective, immune-enhancing, and and antioxidant properties make them ideal for exploration as therapeutic agents. In this review, we have compiled information from various studies on macamides, along with theories about the metabolic pathways on which they act.

Background/objectives: Pattern glare, associated with cortical hyperexcitability, induces visual distortions and discomfort, particularly in individuals susceptible to migraines or epilepsy. While previous research has primarily focused on transient EEG responses to patterned stimuli, this study aims to investigate how continuous presentation of pattern-glare stimuli affects neural adaptation over both fine (seconds) and coarse (entire experiment) temporal scales.

Methods: EEG recordings were obtained from 40 healthy participants exposed to horizontal square-wave gratings at three spatial frequencies presented continuously for three seconds each across multiple trials. Participants' susceptibility to visual stress, headaches, and discomfort was assessed using questionnaires before and during the experiment. The experiment employed a two-by-two design to evaluate habituation (exponentially decreasing response) and sensitisation (exponentially increasing response) effects at two different time granularities. Mass univariate analysis with cluster-based permutation tests was conducted to identify significant brain response changes during the period of constant stimulation, which we call the DC-shift period.

Results: Significant effects were observed during the DC-shift period, indicating sustained hyper-excitation to the medium-pattern glare stimulus. In particular, the mean/intercept analysis revealed a consistent positive-going response to the medium stimulus throughout the DC-shift period, suggesting continued neural engagement. Participants reporting higher discomfort exhibited sensitisation at fine temporal granularity and habituation at coarser temporal granularity. These effects were predominantly localised to the right posterior scalp regions.

Conclusions: The study demonstrates that individuals sensitive to pattern-glare stimuli exhibit dynamic neural adaptation characterised by short-term sensitisation and long-term habituation. These findings enhance the understanding of cortical hyperexcitability mechanisms and may inform future interventions for visual-stress-related conditions, such as migraines and epilepsy. Further research is needed to explore the underlying neural processes and validate these effects in clinical populations.

Background: Numerous studies have evaluated the effect that mindfulness-based interventions (MBIs) have on multiple health outcomes. For its part, stress is a natural response to environmental disturbances and within the associated metabolic responses, alterations in cortisol levels and their measurement in different tissues are a way to determine the stress state of an individual. Therefore, it has been proposed that MBIs can modify cortisol levels.

Methods and results: The objective of this systematic review was to analyze and summarize the different studies that have evaluated the effect of MBIs on cortisol levels. The following databases were consulted: MEDLINE, AMED, CINAHL, Web of Science, Science Direct, PsycINFO, SocINDEX, PubMed, the Cochrane Library and Scopus. The search terms "mindfulness", "mindfulness-based interventions" and "cortisol" were used (and the search was limited to studies from January 1990 to May 2024). In order to reduce selection bias, each article was scrutinized using the JBI Critical Appraisal Checklist independently by two authors. We included those studies with specified intervention groups with at least one control group and excluded duplicate studies or those in which the intervention or control group was not adequately specified. Significant changes in cortisol following MBIs were found in 25 studies, while 10 found no changes. The small sample size, lack of randomization, blinding, and probable confounding and interaction variables stand out in these studies.

Conclusion: MBIs have biological plausibility as a means of explaining a positive effect on cortisol levels; however, the weakness of the studies and the absence of robust designs makes it difficult to establish a causal association between both variables.

Registration number: INPLASY2024110017.

Background/objectives: One of the first-line disease-modifying treatments of multiple sclerosis (MS) is Glatiramer Acetate (GA), which requires daily or three-times-weekly subcutaneous injections. Disease progression, while slowed, still occurs with time. Increasing the impact of the treatment while decreasing the frequency of injections would be ideal. The mechanism of action of GA remains undefined. We developed an alternate approach, KGYY₆, whose mechanism of action targets the CD40 receptor with promising results in an Experimental Autoimmune Encephalomyelitis (EAE) model.

Methods: GA and a CD40-targeting peptide, KGYY₆, were formulated as slow-release particles used to treat EAE in C57BL/6 mice.

Results: Compared to liquid formulations, the particle formulations vastly improved drug efficacy in both cases, which would be advantageous in treating MS. GA is a combination of randomly generated peptides, in the size range of 5000-9000 Da, using the amino acids E, A, Y, and K. This approach introduces batch differences that impacts efficacy, a persistent problem with GA. KGYY₆ is generated in a controlled process and has a motif, K-YY, which could be generated when manufacturing GA. When testing two different lots of GA or KGYY₆, the latter performed equally well across lots, while GA did not.

Conclusions: Slow-release formulations of both GA and KGYY₆ vastly improve the efficacy of both, and KGYY₆ is more consistent in efficacy across different lots.

Background: The study aimed to identify Mild Cognitive Impairment (MCI) as an alert clinical manifestation of increased probability of major acute vascular events (MVEs), such as Ischemic Stroke and heart attack.

Methods: In a longitudinal study, 181 (M = 81, F = 100; mean age of 75.8 ± 8.69 years) patients were enrolled and divided into three groups based on diagnosis: Subjective Cognitive Impairment (SCI), amnestic MCI Single Domain (aMCI-SD), and amnestic MCI More Domain (aMCI-MD). Clinical assessment and the presence of vascular risk factors were collected.

Results: The distribution of MVEs showed a higher incidence in the first two years of follow-up of 7.4% in SCI, 12.17% in aMCI-SD, and 8.57% in aMCI-MD. Acute Myocardial Infarction showed a major incidence in one year of follow-up (41%) and in two years of follow-up (29%). Also, Ischemic Stroke showed a major incidence in one year of follow-up (30%) and in two years of follow-up (40%). A statistically significant difference in the progression to dementia was shown (SCI 3.75%; aMCI-SD 10.43%; aMCI-MD 37%; p-value < 0.001).

Conclusions: MCI is considered an expression of the systemic activation of mechanisms of endothelial damage, representing a diagnosis predictive of increased risk of MVEs.

Depression is a mental disorder that depicts a wide variety of symptoms, including mood and cognitive alterations, as well as recurrent thoughts of death or suicide. It could become the second leading cause of premature death or disability worldwide. Treatments with conventional antidepressants have several limitations in terms of effectiveness, side effects, and high costs. Therefore, medicinal plants such as Mucuna pruriens are potent candidates for treating depressive disorders. This review shows a compendium of evidence supporting the antidepressant effect of the Mucuna pruriens plant in diverse animal models. This includes the mechanisms of action underlying the antidepressant activity of the treatment concerning dopamine, serotonin, norepinephrine, reactive oxygen species, nitric oxide, cortisol, and inflammation. Clinical trials are needed to study the efficacy and safety of Mucuna pruriens for depression.

Background/Objectives-Parkinson's disease (PD) is the second most common neurodegenerative disorder caused by the destruction of neurons in the substantia nigra of the brain. Clinical diagnosis of this disease, based on monitoring motor symptoms, often leads to a delayed start of PD therapy and control, where over 60% of dopaminergic nerve cells are damaged in the brain substantia nigra. The search for simple and stable characteristics of EEG recordings is a promising direction in the development of methods for diagnosing PD and methods for diagnosing the preclinical stage of PD development. Methods-42 subjects participated in work, of which 4 female/10 male patients were included in the group of patients with non-motor disorders, belonging to the risk group for developing PD (median age: 62 years, height: 164 cm, weight: 70 kg, pulse: 70, BPsys and BPdia: 143 and 80)/(median age: 68 years, height: 170 cm, weight: 73.9 kg, pulse: 75, BPsys and BPdia: 143 and 82). The first control group of healthy participants included 6 women (median age: 33 years, height: 161 cm, weight: 66 kg, pulse: 80, BPsys and BPdia: 110 and 80)/8 men (median age: 36.3 years, height: 175 cm, weight: 69 kg, pulse: 78, BPsys and BPdia: 120 and 85). The second control group of healthy participants included 8 women (median age: 74 years, height: 164 cm, weight: 70 kg, pulse: 70, BPsys and BPdia: 145 and 82)/6 men (median age: 51 years, height: 172 cm, weight: 72.5 kg, pulse: 74, BPsys and BPdia: 142 and 80). Wavelet oscillatory pattern estimation is performed on patients' nocturnal sleep recordings without separating them into sleep stages. Results-Amplitude characteristics of oscillatory activity in patients without motor disorders and the prodromal PD stage are significantly reduced both in terms of changes in the number of patterns and in terms of their duration. This pattern is especially pronounced for high-frequency activity, in frequency ranges close to 40 Hz. Conclusions-The success of the analysis of the electrical activity of the brain, performed over the entire duration of the night recording, makes it promising to further use during daytime monitoring the concept of oscillatory wavelet patterns in patients with non-motor disorders, belonging to the risk group for developing PD. The daytime monitoring system can become the basis for developing screening tests to detect neurodegenerative diseases as part of routine medical examinations.

Background and objectives: Leprosy primarily affects peripheral nerves, leading to significant neurological complications such as polyneuritis, mononeurosis, and autonomic dysfunction, which contribute to severe disabilities and impaired quality of life for patients. This scoping review aims to investigate the neurological manifestations and main treatments of leprosy patients.

Materials and methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases. This review has been registered on OSF (n) PQBYH.

Results: Neurological complications of leprosy, such as neuropathy and paralysis, necessitate accurate diagnosis and treatment, as immunological reactions can exacerbate nerve damage. Various studies highlight the effectiveness of personalized therapies, such as corticosteroids, multi-drug therapy (MDT), and surgical interventions, in improving symptoms and neurological function in leprosy patients.

Conclusions: Managing neurological complications of leprosy necessitates careful diagnosis and treatment, as many patients experience unresolved peripheral neuropathy despite multidrug therapy. Future research should focus on improving diagnostic tools, exploring the link between neuropathic pain and psychological issues, and developing effective vaccines and treatments to enhance patient outcomes.