Neurological Research最新文献

Objectives: This study aims to investigate the association of global cognitive with chronic conditions, physical impairment, olfactory function, socio-demographics and other factors among older adults in the urban community, West Jakarta.

Materials and methods: The cross-sectional study involved 334 older adults aged 60 years and older who resided in urban community Jakarta, Indonesia. Trained interviewers visited and evaluated the respondents in the sub-district office. Cognitive function is examined using Montreal Cognitive Assessment-Indonesian Version (MoCA-INA). Respondents were clinically examined using a standardized protocol, which included medical history, general physical examination, cognitive assessment, and blood test for diabetes.

Results: Global cognitive impairment was significantly associated with being female (adjusted odd ratio [AOR]: 1.99, 95% CI: 1.14-3.50) and low education (AOR: 4.79, 95% CI: 2.80-8.18). Moreover diabetes, impaired balance, and olfactory dysfunction have AOR:3.23 (95% CI: 1.39-7.51), 2.55% (95% CI: 1.07-6.07), and 2.26 (95% CI: 1.32-3.85) respectively.

Conclusion: This paper highlights that cognitively impaired and diabetic as well as low education subject in urban community, West Jakarta, Indonesia. Global cognitive impairment was associated with being female, having obtained low levels of education, having diabetes, impaired balance and olfactory dysfunction.

Introduction: Subarachnoid hemorrhage (SAH) is a neurological emergency with a high mortality rate. The phagocytic and homeostatic functions of microglial cells play a crucial role after SAH. This study aims to investigate the mechanism of CD22-mediated abnormal microglial phagocytosis in brain injury caused by SAH.

Materials and methods: BV2 microglial cells were exposed to 10 µM oxyhemoglobin for 24 hours to establish an in vitro SAH model. After CD22 knockdown, cell viability was assessed using the cell counting kit-8. The microglial phagocytic function was evaluated using pHrodo Red E.coli BioParticles and fluorescence microscopy. The expression levels of Kruppel-like factor 4 (KLF4), miR-150-3p, and CD22 were analyzed by real-time quantitative reverse transcription polymerase chain reaction and Western blot analysis. The binding relationship of KLF4 to the miR-150-3p promoter and the binding relationship of miR-150-3p to the CD22 3'UTR sequence were analyzed. Overexpression of KLF4 and inhibition of miR-150-3p in SAH cells were conducted to validate the mechanism.

Results: SAH inhibited the microglial phagocytic function. CD22 was overexpressed in the SAH cell model. CD22 inhibition increased the microglial phagocytic function. miR-150-3p targeted and inhibited CD22 expression. Overexpression of miR-150-3p resulted in downregulation of CD22 and increased phagocytic function in microglial cells. KLF4 bound to the miR-150-3p promoter and promoted miR-150-3p expression. Overexpression of KLF4 reversed the inhibitory effect of miR-150-3p inhibition on phagocytic function in SAH cell model.

Conclusion: KLF4 enhances the microglial phagocytic function in SAH by promoting miR-150-3p and inhibiting CD22.

Background: Traumatic brain injury (TBI) is a major cause of morbidity and mortality, particularly among young individuals. This study investigates the correlation between the dynamic of Red Cell Distribution Width to Lymphocyte Ratio (RDWLR) and clinical outcomes in patients with moderate to severe TBI.

Methods: A retrospective analysis was conducted on 405 consecutive patients with moderate to severe TBI admitted between July 2018 and July 2023. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS), categorized into favorable (GOS 4,5) and unfavorable outcomes (GOS 1,2,3). Data on demographics, clinical presentation, radiological findings, and laboratory tests were collected. Binary logistic regression analyzed the independent associations between variables, including changes in RDWLR over four days.

Results: Among the 405 patients, 53.1% were male, with an average age of 33.21 years. ROC curve analysis identified a delta RDWLR threshold of 0.001. Of the patients, 67.1% had low delta RDWLR, while 33.8% had high delta RDWLR. Multivariate analysis showed that Glasgow Coma Scale (GCS) (OR 3.22; p < 0.001), light reflex (OR 1.87; p = 0.025), Rotterdam CT score (OR 2.33; p = 0.025), and change in RDWLR (OR 1.68; p = 0.031) were significantly associated with poor clinical outcomes.

Conclusions: These findings suggest that delta RDWLR has potential as as a prognostic indicator of poor clinical outcomes in patients with moderate to severe traumatic brain injury (TBI), providing a cost-effective biomarker for clinical prognosis. However, further validation through prospective multicenter studies is needed.

Background: Multiple sclerosis (MS) affects muscle strength and postural stability. However, the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS is not well known. The aim of the study was to examine the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS patients.

Materials and methods: The study included 21 mild-stage MS patients with an EDSS score of 4 or less and 21 healthy controls. The concentric and isometric strength of knee flexors and extensors was measured with the Biodex System 4 Dynamometer, and postural stability with the Biodex Balance System under eyes-open and eyes-closed conditions on a rigid surface.

Results: Mild-stage MS patients had reduced concentric strength of knee extensors and flexors and increased postural sway compared with healthy controls (p < 0.05). Isometric strength of knee extensors and flexors in mild stage MS patients were similar to healthy controls (p > 0.05). There was a moderate positive correlation between concentric strength of knee extensors and flexors and isometric strength of knee flexors and open-eye postural stability indexes in mild stage multiple sclerosis patients (p < 0.05).

Conclusions: While isometric strength of knee extensors and flexors was preserved, concentric strength of knee extensors and flexors was decreased, and postural stability was adversely affected in mild stage MS patients. The increase in the strength of the knee muscles was associated with an increase in their postural sway in mild stage MS patients.

Objectives: Migraine represents the prevailing form of primary headache with no fully described etiology and pathophysiology. This study aimed to assess the association between vitamin B12 serum levels and both chronic and episodic migraine.

Patients and methods: This study was conducted as a case-control study, including 90 migraineurs, divided into 48 with episodic migraine and 42 with chronic migraine as the case group, and 90 matched healthy participants as the control group. The serum level of vitamin B12 was measured using enzyme-linked immunosorbent assay (ELISA) for all subjects. Its association with the Migraine Disability Assessment (MIDAS) scale and migraine attack severity, measured using the Visual Analog Scale (VAS), was analyzed.

Results: Migraineurs exhibited a notable reduction in serum vitamin B12 levels compared to the control group (243.97 ± 124.85 pg/ml vs. 302.69 ± 143.69 pg/ml, p = 0.014). Furthermore, chronic migraine patients had significantly lower serum vitamin B12 levels when compared to episodic migraine patients (202.7 ± 75.62 pg/ml vs. 269.17 ± 143.31 pg/ml, p = 0.026). A significant negative correlation was found between serum vitamin B12 levels and the severity of migraine attacks, as measured by the VAS (r = -0.407, p = 0.036).

Conclusion: The current study highlighted that vitamin B12 deficiency is highly associated with migraine and its severity. Further interventional research is highly recommended to investigate the potential causality of this association.

Objective: Obesity may negatively affect the physical health and cognitive functions of individuals and delay their reaction time to stimuli. However, the association among obesity, cognitive functions, and reaction times is yet to be fully elucidated. The aim of this study was to assess the effect of obesity on cognitive functions and visual and auditory reaction times in adults.

Methods: Data of 100 participants (50 obese and 50 normal) were analyzed in the study. Anthropometric parameters and 24-h dietary recall data were recorded. The Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive functions, Simple Reaction Time Task (SRTT)-Visual and SRTT-Auditory were used to assess visual and auditory reaction times of the participants, respectively.

Results: The mean MoCA score of the obese was significantly lower than normal (17.46 and 25.22, respectively; p < 0.001). In addition, the mean auditory (p < 0.001) and visual (p < 0.05) reaction times of obese were significantly longer than normal. Similarly, this condition was also observed for the fastest and lowest values of auditory and visual reaction times. Additionally, obesity caused a decrease in the MoCA score (β = -0.762; p < 0.001) and delayed visual (β = 0.423; p < 0.001) and auditory (β = 0.590; p < 0.001) reactions. The negative effect of obesity was maintained after controlling for potential factors (MoCA, β = -0.594; p < 0.001; SRTT-Auditory, β = 0.409; p < 0.01; SRTT-Visual, β = 0.330; p < 0.05).

Conclusion: Obese participants showed worse cognitive, auditory and visual performance. Additional research will be necessary in the future to shed light on the fundamental mechanisms involved.

Purpose: This study aims to examine the impact of cognitive fatigue on balance among individuals with multiple sclerosis (MS) without cognitive impairment.

Method: A total 50 individuals with MS aged 20-50 years, without cognitive impairment and with an Expanded Disability Status Scale (EDSS) score of 0-4, participated in the study. Participants were randomly assigned to either a control group (CG) or a study group (SG). The CG rested for 30 minutes, while the SG engaged in cognitive activities lasting 30-45 minutes to induce cognitive fatigue. Cognitive fatigue was assessed using the Visual Analog Scale (VAS) before and after the tasks. Balance was evaluated using clinical tests: the Functional Reach Test (FRT) and the Single Leg Stance Test (SLST), as well as laboratory assessments including the Modified Clinical Test of Sensory Integration and Balance (mCTSIB) and Limits of Stability (LOS) with static posturography.

Results: Within-group analyses showed a significant increase in cognitive fatigue on the VAS in the SG (p < 0.001). In the mCTSIB, the SG showed significant changes in firm/eyes open, foam/eyes open, and composite scores, while between-group differences were observed only in firm/eyes open and foam/eyes open conditions (p < 0.005). No significant differences were found between groups in LOS, FRT, or SLST outcomes (p > 0.05).

Conclusion: In individuals with MS, the impact observed only in the eyes-open static balance condition suggests that dynamic balance and eyes-closed static balance parameters rely more on automatic mechanisms compared to the eyes-open condition and are not influenced by cognitive fatigue.

Introduction: Tranexamic acid (TA) is an anticoagulant drug that is used worldwide. However, the adverse effects of TA may insult the nervous system. This study aimed to investigate the dual effects of TA on SH-SY5Y cells, including its detrimental and neuroprotective effects.

Methods: SH-SY5Y cells were treated with various concentrations of TA and exposed to H2O2 for 24 hours. The neuroprotective effects of TA were evaluated in H2O2-challenged cells. To assess the neuroprotective effects of TA, SH-SY5Y cells were pretreated with TA for 12 hours and then exposed to H2O2 for 24 hours. Cell viability was assessed using the MTT assay. Flow cytometry was used to evaluate cellular apoptosis. The expression of Bax, Bcl-2, and Caspase-3 genes was analyzed by real-time PCR. Additionally, Akt phosphorylation was evaluated using western blotting.

Results: At high concentrations, TA reduced cell viability and induced apoptosis by up-regulating BAX and Caspase-3 gene expression and down-regulating BCL-2 transcript. Furthermore, Akt phosphorylation was reduced following TA treatment. TA exhibited protective effects against H2O2-induced cell stress by down-regulating Bax and Caspase-3 gene expression, up-regulating Bcl-2 expression, and increasing the p-AKT/AKT ratio.

Conclusion: Our findings demonstrated that TA exerts its neuroprotective effect at lower concentrations, but induces apoptosis in SH-SY5Y cells at high concentrations.

Background: It has been suggested that smokers have higher recanalization rate, lower risk of cerebral hemorrhage and better prognosis than non-smokers (smoking paradox) after reperfusion therapy in patients with acute ischemic stroke (IS). This study aimed to assess the effects of smoking on recanalization, intracranial hemorrhage, and clinical outcomes in patients with acute IS following reperfusion therapy.

Methods: Patients were categorized into smokers and non-smokers, with data collected on types of reperfusion therapy, demographics, medication use, comorbidities, stroke etiology, mRS and NIHSS scores, TICI and ECASS classifications.

Results: The study involved 662 patients (344 men and 318 women) treated with rtPA and/or thrombectomy. Smoking was more prevalent among men. Smokers were typically younger, had lower hypertension rates, lower systolic blood pressure, and higher triglyceride and HDL levels compared to non-smokers. They exhibited a higher incidence of cardioembolic strokes and strokes with known causes but a lower incidence of small vessel occlusion. Smokers had higher GCS scores and more posterior cerebral circulation strokes upon hospital admission. NIHSS scores were lower at admission and on the third day, and poor outcome rates (mRS) were lower at both hospital admission and three months post-stroke for smokers. However, smokers who developed hemorrhagic complications had a higher frequency of parenchymal hematoma according to ECASS classification.

Conclusions: Our findings did not support claims that smoking increases recanalization rates, reduces cerebral hemorrhage risk, or improves clinical outcomes. Further prospective studies with larger samples are needed to explore smoking's impact on stroke outcomes.

Sinking Skin Flap Syndrome(SSFS) is a rare and specific complication following decompressive craniectomy(DC). Another condition, known as syndrome of the trephined(ST), shares many similarities in clinical symptoms and signs with this condition, yet they are fundamentally different. Therefore, they should be considered as two distinct diseases, and their respective concepts should not be used interchangeably as synonyms. Due to a lack of understanding of ST and SSFS, many existing clinical studies often conflate their concepts. Our study further explores and understands the clinical symptoms and radiological features of this condition through typical cases, thereby aiding in the diagnosis and treatment of such diseases.