Pub Date : 2024-01-12DOI: 10.3390/neurolint16010010
Shakiba Hassanzadeh, Linlin Gao, Anthony M Alvarado, Paul J Camarata, Nelli S Lakis, Mohammad Haeri
Cavernous angiomas (CAs) are benign vascular malformations predominantly seen in the brain parenchyma and therefore referred to as intra-axial. Extra-axial dural-based cavernous angiomas, on the other hand, are rare vascular lesions found outside of the brain parenchyma. They occur in the middle fossa and may be easily misdiagnosed as meningiomas due to their extra-axial location. In addition, CAs that are located outside the middle fossa, such as in the convexity, have a better prognosis since they are more surgically accessible. Surgical resection is the main treatment of choice in CAs. However, other options, such as embolization and radiotherapy, may also be considered therapeutic choices or additive treatment options. The pathogenesis of CA and the involvement of other factors (genetics or environmental factors) are still unknown and require further investigation. We are presenting a young man who presented for evaluation of seizure-like events without any family history of neurologic conditions. The physical examination was unremarkable except for a slightly antalgic gait. Imaging studies showed an extra-axial left tentorial mass suggestive of a meningioma, hemangiopericytoma, or other extra-axial lesions. The lesion was resected where its vascular nature was mentioned initially, and the histology proved the diagnosis of cavernous angioma. Here we give an overview of the known pathogenesis, causes, clinical features, and diagnostic and therapeutic options in CA. Better knowledge about CA, its causes, clinical features, and treatment options would help clinicians in early diagnosis and patient management.
海绵状血管瘤(CA)是一种良性血管畸形,主要出现在脑实质内,因此被称为轴内海绵状血管瘤。而轴外硬脑膜海绵状血管瘤则是在脑实质外发现的罕见血管病变。它们发生在中窝,由于位于轴外,很容易被误诊为脑膜瘤。此外,位于中窝外(如凸部)的 CA 预后较好,因为它们更容易进行手术。手术切除是治疗 CA 的主要选择。不过,栓塞和放射治疗等其他方法也可作为治疗选择或辅助治疗选择。CA的发病机制和其他因素(遗传或环境因素)的参与尚不清楚,需要进一步研究。我们在此介绍一名因癫痫发作样事件前来就诊的年轻男子,他没有任何神经系统疾病的家族史。体格检查除步态略有蹒跚外,其他均无异常。影像学检查显示,他的左侧蝶骨轴外肿块提示脑膜瘤、血管瘤或其他轴外病变。病变切除后,组织学检查证实了海绵状血管瘤的诊断。在此,我们将概述 CA 的已知发病机制、病因、临床特征以及诊断和治疗方案。更好地了解海绵状血管瘤、其病因、临床特征和治疗方案将有助于临床医生进行早期诊断和患者管理。
{"title":"Extra-Axial Cavernous Angioma: A Case Report and Review of the Literature.","authors":"Shakiba Hassanzadeh, Linlin Gao, Anthony M Alvarado, Paul J Camarata, Nelli S Lakis, Mohammad Haeri","doi":"10.3390/neurolint16010010","DOIUrl":"10.3390/neurolint16010010","url":null,"abstract":"<p><p>Cavernous angiomas (CAs) are benign vascular malformations predominantly seen in the brain parenchyma and therefore referred to as intra-axial. Extra-axial dural-based cavernous angiomas, on the other hand, are rare vascular lesions found outside of the brain parenchyma. They occur in the middle fossa and may be easily misdiagnosed as meningiomas due to their extra-axial location. In addition, CAs that are located outside the middle fossa, such as in the convexity, have a better prognosis since they are more surgically accessible. Surgical resection is the main treatment of choice in CAs. However, other options, such as embolization and radiotherapy, may also be considered therapeutic choices or additive treatment options. The pathogenesis of CA and the involvement of other factors (genetics or environmental factors) are still unknown and require further investigation. We are presenting a young man who presented for evaluation of seizure-like events without any family history of neurologic conditions. The physical examination was unremarkable except for a slightly antalgic gait. Imaging studies showed an extra-axial left tentorial mass suggestive of a meningioma, hemangiopericytoma, or other extra-axial lesions. The lesion was resected where its vascular nature was mentioned initially, and the histology proved the diagnosis of cavernous angioma. Here we give an overview of the known pathogenesis, causes, clinical features, and diagnostic and therapeutic options in CA. Better knowledge about CA, its causes, clinical features, and treatment options would help clinicians in early diagnosis and patient management.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 1","pages":"162-185"},"PeriodicalIF":3.2,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stroke is a significant cause of mortality and chronic morbidity caused by cardiovascular disease. Respiratory muscles can be affected in stroke survivors, leading to stroke complications, such as respiratory infections. Respiratory function can be assessed using pulmonary function tests (PFTs). Data regarding PFTs in stroke survivors are limited. We reviewed the correlation between PFTs and stroke severity or degree of disability. Furthermore, we reviewed the PFT change in stroke patients undergoing a respiratory muscle training program. We searched PubMed until September 2023 using inclusion and exclusion criteria in order to identify studies reporting PFTs post-stroke and their change after a respiratory muscle training program. Outcomes included lung function parameters (FEV1, FVC, PEF, MIP and MEP) were measured in acute or chronic stroke survivors. We identified 22 studies of stroke patients, who had undergone PFTs and 24 randomised controlled trials in stroke patients having PFTs after respiratory muscle training. The number of patients included was limited and studies were characterised by great heterogeneity regarding the studied population and the applied intervention. In general, PFTs were significantly reduced compared to healthy controls and predicted normal values and associated with stroke severity. Furthermore, we found that respiratory muscle training was associated with significant improvement in various PFT parameters and functional stroke parameters. PFTs are associated with stroke severity and are improved after respiratory muscle training.
{"title":"Pulmonary Function Tests Post-Stroke. Correlation between Lung Function, Severity of Stroke, and Improvement after Respiratory Muscle Training.","authors":"Fotios Drakopanagiotakis, Konstantinos Bonelis, Paschalis Steiropoulos, Dimitrios Tsiptsios, Anastasia Sousanidou, Foteini Christidi, Aimilios Gkantzios, Aspasia Serdari, Styliani Voutidou, Chrysoula-Maria Takou, Christos Kokkotis, Nikolaos Aggelousis, Konstantinos Vadikolias","doi":"10.3390/neurolint16010009","DOIUrl":"10.3390/neurolint16010009","url":null,"abstract":"<p><p>Stroke is a significant cause of mortality and chronic morbidity caused by cardiovascular disease. Respiratory muscles can be affected in stroke survivors, leading to stroke complications, such as respiratory infections. Respiratory function can be assessed using pulmonary function tests (PFTs). Data regarding PFTs in stroke survivors are limited. We reviewed the correlation between PFTs and stroke severity or degree of disability. Furthermore, we reviewed the PFT change in stroke patients undergoing a respiratory muscle training program. We searched PubMed until September 2023 using inclusion and exclusion criteria in order to identify studies reporting PFTs post-stroke and their change after a respiratory muscle training program. Outcomes included lung function parameters (FEV<sub>1</sub>, FVC, PEF, MIP and MEP) were measured in acute or chronic stroke survivors. We identified 22 studies of stroke patients, who had undergone PFTs and 24 randomised controlled trials in stroke patients having PFTs after respiratory muscle training. The number of patients included was limited and studies were characterised by great heterogeneity regarding the studied population and the applied intervention. In general, PFTs were significantly reduced compared to healthy controls and predicted normal values and associated with stroke severity. Furthermore, we found that respiratory muscle training was associated with significant improvement in various PFT parameters and functional stroke parameters. PFTs are associated with stroke severity and are improved after respiratory muscle training.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 1","pages":"139-161"},"PeriodicalIF":3.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-11DOI: 10.3390/neurolint16010008
A. Montoya-Pedrón, Carmen María Ocaña Montoya, J. E. Santos Toural, Tania Acosta Lee, M. Sánchez-Hechavarría, Erislandis López-Galán, G. Muñoz-Bustos
The usefulness of Contingent Negative Variation (CNV) potential as a biomarker of neurocognitive disorders due to possible Alzheimer’s disease, is based on its possible physiological correlates. However, its application in the diagnostic evaluation of these disorders is still incipient. The aim of this study is to characterize the patterns of cognitive processing of information in the domain of nonspecific global attention, by recording potential CNV in a group of patients with neurocognitive disorders due to possible Alzheimer’s disease. An experimental study of cases and controls was carried out. The sample included 39 patients classified according to DSM-5 with a neurocognitive disorder subtype possibly due Alzheimer’s disease, and a Control Group of 53 subjects with normal cognitive functions. CNV potential was registered using standard protocol. The analysis of variance obtained significant differences in mean values and confidence intervals of total CNV amplitude between the three study groups. The late CNV segment amplitudes makes it possible to discriminate between the level of mild and major dysfunction in the group of patients. The CNV total amplitudes of potential allows for effective discrimination between normal cognitive functioning and neurocognitive disorders due to possible Alzheimer’s disease.
{"title":"Contingent Negative Variation in the Evaluation of Neurocognitive Disorders Due to Possible Alzheimer’s Disease","authors":"A. Montoya-Pedrón, Carmen María Ocaña Montoya, J. E. Santos Toural, Tania Acosta Lee, M. Sánchez-Hechavarría, Erislandis López-Galán, G. Muñoz-Bustos","doi":"10.3390/neurolint16010008","DOIUrl":"https://doi.org/10.3390/neurolint16010008","url":null,"abstract":"The usefulness of Contingent Negative Variation (CNV) potential as a biomarker of neurocognitive disorders due to possible Alzheimer’s disease, is based on its possible physiological correlates. However, its application in the diagnostic evaluation of these disorders is still incipient. The aim of this study is to characterize the patterns of cognitive processing of information in the domain of nonspecific global attention, by recording potential CNV in a group of patients with neurocognitive disorders due to possible Alzheimer’s disease. An experimental study of cases and controls was carried out. The sample included 39 patients classified according to DSM-5 with a neurocognitive disorder subtype possibly due Alzheimer’s disease, and a Control Group of 53 subjects with normal cognitive functions. CNV potential was registered using standard protocol. The analysis of variance obtained significant differences in mean values and confidence intervals of total CNV amplitude between the three study groups. The late CNV segment amplitudes makes it possible to discriminate between the level of mild and major dysfunction in the group of patients. The CNV total amplitudes of potential allows for effective discrimination between normal cognitive functioning and neurocognitive disorders due to possible Alzheimer’s disease.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"1 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139438150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.3390/neurolint16010007
A. Babuci, V. Palarie, I. Catereniuc, Zinovia Zorina, Sergiu Visnevschi, Diana Heimes, S. Lehtman, P. Kämmerer
(1) Background: Considering that the specialty literature supplies only general data about the variability of the cervical branch of the facial nerve, this study aimed to determine this branch’s variation and individual peculiarities depending on the nerve branching pattern and anthropometric type of the head. (2) Methods: The study was conducted on 75 hemifaces of adult formalized cadavers. Ahead of anatomical dissection, each head was measured to establish the anthropometric type, according to Franco and colleagues. The branching patterns were then distributed according to the Davis classification. (3) Results: The number of cervical branches (CB) of the facial nerve varied from one to five branches, with the following rate: 1 CB (61.3%), 2 CB (28%), 3 CB (6.7%), 4 CB (2.7%), and 5 CB (1.3%). Seven branching patterns of the facial nerve were revealed: Type I in 18.7%, Type II in 14.7%, Type III in 20%, Type IV in 14.6%, Type V in 5.3%, Type VI in 18.7%, and Type NI in 8% (bizarre types). According to the branching pattern, the mean numbers of the cervical branches were as follows: Type I—1.6 ± 1.02; Type II—1.4 ± 0.50; Type III—1.4 ± 0.50; Type IV—1.4 ± 0.67; Type V—2.0 ± 1.41; Type VI—1.8 ± 1.12; and Type-NI—1.8 ± 0.75; p = 0.599. According to the anthropometric type of the head, the mean number of CB in the mesocephalic type (MCT) was 1.5 ± 0.82, in the dolichocephalic type (DCT), 1.7 ± 0.87, and in the brachycephalic type, (BCT) 1.8 ± 1.04; p = 0.668. (4) Conclusions: The cervical branch of the facial nerve varies depending on the facial nerve branching pattern and the anthropometric type of the head. The highest degree of variation was characteristic of BCT and Type V and the lowest, of MCT and Types II, III, and IV.
{"title":"Variability of the Cervical Branch Depending on the Facial Nerve Branching Pattern and Anthropometric Type of the Head","authors":"A. Babuci, V. Palarie, I. Catereniuc, Zinovia Zorina, Sergiu Visnevschi, Diana Heimes, S. Lehtman, P. Kämmerer","doi":"10.3390/neurolint16010007","DOIUrl":"https://doi.org/10.3390/neurolint16010007","url":null,"abstract":"(1) Background: Considering that the specialty literature supplies only general data about the variability of the cervical branch of the facial nerve, this study aimed to determine this branch’s variation and individual peculiarities depending on the nerve branching pattern and anthropometric type of the head. (2) Methods: The study was conducted on 75 hemifaces of adult formalized cadavers. Ahead of anatomical dissection, each head was measured to establish the anthropometric type, according to Franco and colleagues. The branching patterns were then distributed according to the Davis classification. (3) Results: The number of cervical branches (CB) of the facial nerve varied from one to five branches, with the following rate: 1 CB (61.3%), 2 CB (28%), 3 CB (6.7%), 4 CB (2.7%), and 5 CB (1.3%). Seven branching patterns of the facial nerve were revealed: Type I in 18.7%, Type II in 14.7%, Type III in 20%, Type IV in 14.6%, Type V in 5.3%, Type VI in 18.7%, and Type NI in 8% (bizarre types). According to the branching pattern, the mean numbers of the cervical branches were as follows: Type I—1.6 ± 1.02; Type II—1.4 ± 0.50; Type III—1.4 ± 0.50; Type IV—1.4 ± 0.67; Type V—2.0 ± 1.41; Type VI—1.8 ± 1.12; and Type-NI—1.8 ± 0.75; p = 0.599. According to the anthropometric type of the head, the mean number of CB in the mesocephalic type (MCT) was 1.5 ± 0.82, in the dolichocephalic type (DCT), 1.7 ± 0.87, and in the brachycephalic type, (BCT) 1.8 ± 1.04; p = 0.668. (4) Conclusions: The cervical branch of the facial nerve varies depending on the facial nerve branching pattern and the anthropometric type of the head. The highest degree of variation was characteristic of BCT and Type V and the lowest, of MCT and Types II, III, and IV.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"54 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.3390/neurolint16010006
Roy A Poblete, Charlotte Zhong, Anish Patel, Grace Kuo, Philip Sun, Jiayu Xiao, Zhaoyang Fan, N. Sanossian, A. Towfighi, Patrick D. Lyden
Traumatic brain injury (TBI) is a common diagnosis requiring acute hospitalization. Long-term, TBI is a significant source of health and socioeconomic impact in the United States and globally. The goal of clinicians who manage TBI is to prevent secondary brain injury. In this population, post-traumatic cerebral infarction (PTCI) acutely after TBI is an important but under-recognized complication that is associated with negative functional outcomes. In this comprehensive review, we describe the incidence and pathophysiology of PTCI. We then discuss the diagnostic and treatment approaches for the most common etiologies of isolated PTCI, including brain herniation syndromes, cervical artery dissection, venous thrombosis, and post-traumatic vasospasm. In addition to these mechanisms, hypercoagulability and microcirculatory failure can also exacerbate ischemia. We aim to highlight the importance of this condition and future clinical research needs with the goal of improving patient outcomes after TBI.
{"title":"Post-Traumatic Cerebral Infarction: A Narrative Review of Pathophysiology, Diagnosis, and Treatment","authors":"Roy A Poblete, Charlotte Zhong, Anish Patel, Grace Kuo, Philip Sun, Jiayu Xiao, Zhaoyang Fan, N. Sanossian, A. Towfighi, Patrick D. Lyden","doi":"10.3390/neurolint16010006","DOIUrl":"https://doi.org/10.3390/neurolint16010006","url":null,"abstract":"Traumatic brain injury (TBI) is a common diagnosis requiring acute hospitalization. Long-term, TBI is a significant source of health and socioeconomic impact in the United States and globally. The goal of clinicians who manage TBI is to prevent secondary brain injury. In this population, post-traumatic cerebral infarction (PTCI) acutely after TBI is an important but under-recognized complication that is associated with negative functional outcomes. In this comprehensive review, we describe the incidence and pathophysiology of PTCI. We then discuss the diagnostic and treatment approaches for the most common etiologies of isolated PTCI, including brain herniation syndromes, cervical artery dissection, venous thrombosis, and post-traumatic vasospasm. In addition to these mechanisms, hypercoagulability and microcirculatory failure can also exacerbate ischemia. We aim to highlight the importance of this condition and future clinical research needs with the goal of improving patient outcomes after TBI.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"13 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-03DOI: 10.3390/neurolint16010005
Aviraj S. Deshmukh, S. Priola, Aris H. Katsanos, G. Scalia, Aderaldo Costa Alves, Abhilekh Srivastava, Christine Hawkes
Intracranial aneurysms represent a major global health burden. Rupture of an intracranial aneurysm is a catastrophic event. Without access to treatment, the fatality rate is 50% in the first 30 days. Over the last three decades, treatment approaches for intracranial aneurysms have changed dramatically. There have been improvements in the medical management of aneurysmal subarachnoid haemorrhage, and there has been an evolution of treatment strategies. Endovascular therapy is now the mainstay of the treatment of ruptured intracranial aneurysms based on robust randomised controlled trial data. There is now an expansion of treatment indications for unruptured intracranial aneurysms to prevent rupture with both microsurgical clipping and endovascular treatment. Both microsurgical and endovascular treatment modalities have evolved, in particular with the introduction of innovative endovascular treatment options including flow diversion and intra-saccular flow disruption. These novel therapies allow clinicians to treat more complex and previously untreatable aneurysms. We aim to review the evolution of treatment strategies for intracranial aneurysms over time, and discuss emerging technologies that could further improve treatment safety and functional outcomes for patients with an intracranial aneurysm.
{"title":"The Management of Intracranial Aneurysms: Current Trends and Future Directions","authors":"Aviraj S. Deshmukh, S. Priola, Aris H. Katsanos, G. Scalia, Aderaldo Costa Alves, Abhilekh Srivastava, Christine Hawkes","doi":"10.3390/neurolint16010005","DOIUrl":"https://doi.org/10.3390/neurolint16010005","url":null,"abstract":"Intracranial aneurysms represent a major global health burden. Rupture of an intracranial aneurysm is a catastrophic event. Without access to treatment, the fatality rate is 50% in the first 30 days. Over the last three decades, treatment approaches for intracranial aneurysms have changed dramatically. There have been improvements in the medical management of aneurysmal subarachnoid haemorrhage, and there has been an evolution of treatment strategies. Endovascular therapy is now the mainstay of the treatment of ruptured intracranial aneurysms based on robust randomised controlled trial data. There is now an expansion of treatment indications for unruptured intracranial aneurysms to prevent rupture with both microsurgical clipping and endovascular treatment. Both microsurgical and endovascular treatment modalities have evolved, in particular with the introduction of innovative endovascular treatment options including flow diversion and intra-saccular flow disruption. These novel therapies allow clinicians to treat more complex and previously untreatable aneurysms. We aim to review the evolution of treatment strategies for intracranial aneurysms over time, and discuss emerging technologies that could further improve treatment safety and functional outcomes for patients with an intracranial aneurysm.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"32 36","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139388759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-28DOI: 10.3390/neurolint16010004
Silvia De Ieso, Giulia Di Rauso, F. Cavallieri, Daniela Beltrami, Alessandro Marti, Manuela Napoli, R. Pascarella, A. Feletti, V. Fioravanti, Giulia Toschi, Vittorio Rispoli, Francesca Antonelli, Annette Puzzolante, Giacomo Pavesi, F. Gasparini, Franco Valzania
Severe non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson’s Disease (PD) who developed symptomatic brain edema after STN-DBS surgery treated with intravenous steroids with a specific profile of reversible cognitive alterations. Patients were both assessed with a comprehensive neuropsychological battery including attention, memory, visuo-spatial and executive tasks. They were also briefly assessed for emotional and behavioural alterations, and for possible limitations in the activities of daily living. Normative data for an Italian population were available for all neuropsychological tests. The patients were firstly assessed before the surgery (baseline) as soon as they became symptomatic for the post-surgery edema and a few more times in follow-up up to ten months. In all patients we observed the resolution of cognitive deficits within six months after surgery with the corresponding reabsorption of edema at brain CT scans. The appearance of post-DBS edema is a fairly frequent and clinically benign event. However, in some rare cases it can be very marked and lead to important clinical—albeit transient—disturbances. These events can compromise, at least from a psychological point of view, the delicate path of patients who undergo DBS and can prolong the post-operative hospital stay. In this setting it could be helpful to perform a brain CT scan in 2–3 days with the aim of detecting the early appearance of edema and treating it before it can constitute a relevant clinical problem.
{"title":"Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study","authors":"Silvia De Ieso, Giulia Di Rauso, F. Cavallieri, Daniela Beltrami, Alessandro Marti, Manuela Napoli, R. Pascarella, A. Feletti, V. Fioravanti, Giulia Toschi, Vittorio Rispoli, Francesca Antonelli, Annette Puzzolante, Giacomo Pavesi, F. Gasparini, Franco Valzania","doi":"10.3390/neurolint16010004","DOIUrl":"https://doi.org/10.3390/neurolint16010004","url":null,"abstract":"Severe non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson’s Disease (PD) who developed symptomatic brain edema after STN-DBS surgery treated with intravenous steroids with a specific profile of reversible cognitive alterations. Patients were both assessed with a comprehensive neuropsychological battery including attention, memory, visuo-spatial and executive tasks. They were also briefly assessed for emotional and behavioural alterations, and for possible limitations in the activities of daily living. Normative data for an Italian population were available for all neuropsychological tests. The patients were firstly assessed before the surgery (baseline) as soon as they became symptomatic for the post-surgery edema and a few more times in follow-up up to ten months. In all patients we observed the resolution of cognitive deficits within six months after surgery with the corresponding reabsorption of edema at brain CT scans. The appearance of post-DBS edema is a fairly frequent and clinically benign event. However, in some rare cases it can be very marked and lead to important clinical—albeit transient—disturbances. These events can compromise, at least from a psychological point of view, the delicate path of patients who undergo DBS and can prolong the post-operative hospital stay. In this setting it could be helpful to perform a brain CT scan in 2–3 days with the aim of detecting the early appearance of edema and treating it before it can constitute a relevant clinical problem.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"35 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent discoveries suggest links between abnormalities in cell morphogenesis in the brain and the functional deficiency of molecules controlling signal transduction in glial cells such as oligodendroglia. Rnd2 is one such molecule and one of the Rho family monomeric GTP-binding proteins. Despite the currently known functions of Rnd2, its precise roles as it relates to cell morphogenesis and disease state remain to be elucidated. First, we showed that signaling through the loss of function of the rnd2 gene affected the regulation of oligodendroglial cell-like morphological differentiation using the FBD-102b cell line, which is often utilized as a differentiation model. The knockdown of Rnd2 using the clustered regularly interspaced palindromic repeats (CRISPR)/CasRx system or RNA interference was shown to slow morphological differentiation. Second, the knockdown of Prag1 or Fyn kinase, a signaling molecule acting downstream of Rnd2, slowed differentiation. Rnd2 or Prag1 knockdown also decreased Fyn phosphorylation, which is critical for its activation and for oligodendroglial cell differentiation and myelination. Of note, hesperetin, a citrus flavonoid with protective effects on oligodendroglial cells and neurons, can recover differentiation states induced by the knockdown of Rnd2/Prag1/Fyn. Here, we showed that signaling through Rnd2/Prag1/Fyn is involved in the regulation of oligodendroglial cell-like morphological differentiation. The effects of knocking down the signaling cascade molecule can be recovered by hesperetin, highlighting an important molecular structure involved in morphological differentiation.
{"title":"Investigating the Protective Effects of a Citrus Flavonoid on the Retardation Morphogenesis of the Oligodendroglia-like Cell Line by Rnd2 Knockdown.","authors":"Shoya Fukatsu, Yuki Miyamoto, Yu Oka, Maki Ishibashi, Remina Shirai, Yuki Ishida, Shin Endo, Hironori Katoh, Junji Yamauchi","doi":"10.3390/neurolint16010003","DOIUrl":"10.3390/neurolint16010003","url":null,"abstract":"<p><p>Recent discoveries suggest links between abnormalities in cell morphogenesis in the brain and the functional deficiency of molecules controlling signal transduction in glial cells such as oligodendroglia. Rnd2 is one such molecule and one of the Rho family monomeric GTP-binding proteins. Despite the currently known functions of Rnd2, its precise roles as it relates to cell morphogenesis and disease state remain to be elucidated. First, we showed that signaling through the loss of function of the <i>rnd2</i> gene affected the regulation of oligodendroglial cell-like morphological differentiation using the FBD-102b cell line, which is often utilized as a differentiation model. The knockdown of Rnd2 using the clustered regularly interspaced palindromic repeats (CRISPR)/CasRx system or RNA interference was shown to slow morphological differentiation. Second, the knockdown of Prag1 or Fyn kinase, a signaling molecule acting downstream of Rnd2, slowed differentiation. Rnd2 or Prag1 knockdown also decreased Fyn phosphorylation, which is critical for its activation and for oligodendroglial cell differentiation and myelination. Of note, hesperetin, a citrus flavonoid with protective effects on oligodendroglial cells and neurons, can recover differentiation states induced by the knockdown of Rnd2/Prag1/Fyn. Here, we showed that signaling through Rnd2/Prag1/Fyn is involved in the regulation of oligodendroglial cell-like morphological differentiation. The effects of knocking down the signaling cascade molecule can be recovered by hesperetin, highlighting an important molecular structure involved in morphological differentiation.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 1","pages":"33-61"},"PeriodicalIF":3.2,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.3390/neurolint16010002
T. Ercoli, Caterina Francesca Bagella, C. Frau, Elisa Ruiu, Sabrine Othmani, Giansalvo Gusinu, C. Masala, L. Sechi, Paolo Solla, Giovanni Defazio
Olfactory dysfunction is a prevalent non-motor symptom in Parkinson’s disease (PD), affecting approximately 65–90% of subjects. PD patients may also report odor perception in the absence of any external source, often referred to as olfactory hallucinations (OHs) or phantosmia. This study aims to explore the current understanding of OHs in PD and offer a comprehensive overview of their prevalence and characteristics. We conducted a systematic search of the literature published on PubMed from inception to July 2023 regarding OHs in PD, following PRISMA guidelines. From the 2875 studies identified through database searching, 29 studies fulfilled the necessary criteria and underwent data extraction. The frequency of OHs in PD patients varies widely, ranging from 0.5% to 18.2%, with female prevalence ranging from 36% to 75% of the patients. Olfactory experiences may vary widely, ranging from pleasant scents to unpleasant odors. Several studies have indicated the concurrent presence of other types of hallucinations alongside phantosmia, especially visual and auditory hallucinations. OHs in PD are a type of hallucination that has been largely overlooked. To gain a deeper understanding of OHs in PD patients, the next crucial step should involve the development and validation of a dedicated questionnaire.
{"title":"Phantosmia in Parkinson’s Disease: A Systematic Review of the Phenomenology of Olfactory Hallucinations","authors":"T. Ercoli, Caterina Francesca Bagella, C. Frau, Elisa Ruiu, Sabrine Othmani, Giansalvo Gusinu, C. Masala, L. Sechi, Paolo Solla, Giovanni Defazio","doi":"10.3390/neurolint16010002","DOIUrl":"https://doi.org/10.3390/neurolint16010002","url":null,"abstract":"Olfactory dysfunction is a prevalent non-motor symptom in Parkinson’s disease (PD), affecting approximately 65–90% of subjects. PD patients may also report odor perception in the absence of any external source, often referred to as olfactory hallucinations (OHs) or phantosmia. This study aims to explore the current understanding of OHs in PD and offer a comprehensive overview of their prevalence and characteristics. We conducted a systematic search of the literature published on PubMed from inception to July 2023 regarding OHs in PD, following PRISMA guidelines. From the 2875 studies identified through database searching, 29 studies fulfilled the necessary criteria and underwent data extraction. The frequency of OHs in PD patients varies widely, ranging from 0.5% to 18.2%, with female prevalence ranging from 36% to 75% of the patients. Olfactory experiences may vary widely, ranging from pleasant scents to unpleasant odors. Several studies have indicated the concurrent presence of other types of hallucinations alongside phantosmia, especially visual and auditory hallucinations. OHs in PD are a type of hallucination that has been largely overlooked. To gain a deeper understanding of OHs in PD patients, the next crucial step should involve the development and validation of a dedicated questionnaire.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"28 15","pages":""},"PeriodicalIF":3.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139166179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.3390/neurolint16010001
Maria E. Brinia, Ioanna Kapsali, Nikolaos Giagkou, Vasileios Constantinides
Background: Various MRI markers—including midbrain and pons areas (Marea, Parea) and volumes (Mvol, Pvol), ratios (M/Parea, M/Pvol), and composite markers (magnetic resonance imaging Parkinsonism Indices 1,2; MRPI 1,2)—have been proposed as imaging markers of Richardson’s syndrome (RS) and multiple system atrophy–Parkinsonism (MSA-P). A systematic review/meta-analysis of relevant studies aiming to compare the diagnostic accuracy of these imaging markers is lacking. Methods: Pubmed and Scopus were searched for studies with >10 patients (RS, MSA-P or CBS) and >10 controls with data on Marea, Parea, Mvol, Pvol, M/Parea, M/Pvol, MRPI 1, and MRPI 2. Cohen’s d, as a measure of effect size, was calculated for all markers in RS, MSA-P, and CBS. Results: Twenty-five studies on RS, five studies on MSA-P, and four studies on CBS were included. Midbrain area provided the greatest effect size for differentiating RS from controls (Cohen’s d = −3.10; p < 0.001), followed by M/Parea and MRPI 1. MSA-P had decreased midbrain and pontine areas. Included studies exhibited high heterogeneity, whereas publication bias was low. Conclusions: Midbrain area is the optimal MRI marker for RS, and pons area is optimal for MSA-P. M/Parea and MRPIs produce smaller effect sizes for differentiating RS from controls.
{"title":"Planimetric and Volumetric Brainstem MRI Markers in Progressive Supranuclear Palsy, Multiple System Atrophy, and Corticobasal Syndrome. A Systematic Review and Meta-Analysis","authors":"Maria E. Brinia, Ioanna Kapsali, Nikolaos Giagkou, Vasileios Constantinides","doi":"10.3390/neurolint16010001","DOIUrl":"https://doi.org/10.3390/neurolint16010001","url":null,"abstract":"Background: Various MRI markers—including midbrain and pons areas (Marea, Parea) and volumes (Mvol, Pvol), ratios (M/Parea, M/Pvol), and composite markers (magnetic resonance imaging Parkinsonism Indices 1,2; MRPI 1,2)—have been proposed as imaging markers of Richardson’s syndrome (RS) and multiple system atrophy–Parkinsonism (MSA-P). A systematic review/meta-analysis of relevant studies aiming to compare the diagnostic accuracy of these imaging markers is lacking. Methods: Pubmed and Scopus were searched for studies with >10 patients (RS, MSA-P or CBS) and >10 controls with data on Marea, Parea, Mvol, Pvol, M/Parea, M/Pvol, MRPI 1, and MRPI 2. Cohen’s d, as a measure of effect size, was calculated for all markers in RS, MSA-P, and CBS. Results: Twenty-five studies on RS, five studies on MSA-P, and four studies on CBS were included. Midbrain area provided the greatest effect size for differentiating RS from controls (Cohen’s d = −3.10; p < 0.001), followed by M/Parea and MRPI 1. MSA-P had decreased midbrain and pontine areas. Included studies exhibited high heterogeneity, whereas publication bias was low. Conclusions: Midbrain area is the optimal MRI marker for RS, and pons area is optimal for MSA-P. M/Parea and MRPIs produce smaller effect sizes for differentiating RS from controls.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":" 16","pages":""},"PeriodicalIF":3.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138961505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}