Neurological Sciences最新文献

Introduction: The Corsi Block Tapping Test, or Corsi Span (CS), is a widely used task to measure visuospatial short-term and working memory. The same setup can be used to administer the Corsi SupraSpan Learning (CSSL) and Recall (CSSR), tests assessing visuospatial long-term memory. While the CS has relatively recent normative data, those of the CSSL are outdated For CSSR, no normative data are available. Given this critical lack, our study aimed to provide updated norms for CS, CSSL, and specifically for the recall delayed phase (CSSR).

Materials and methods: A sample of 340 healthy participants, aged between 20 and 89, took part in the study. Norms were developed using a regression approach and defined using rank equivalent scores and percentiles.

Results: Age and education influenced Corsi's Span, while SupraSpan Learning and Recall were influenced by age, education, and span. The comparison with previous norms for Span and SupraSpan Learning shows a high level of agreement.

Conclusions: This study provides integrated norms to evaluate visuospatial memory in all aspects of immediate recall, long-term learning and delayed recall. Its use is needed to assess specific neuropsychological deficits, dissociate visuospatial versus verbal memory deficits and allow the evaluation of memory in patients with limited verbal abilities.

Introduction: Parkinson's disease (PD) is characterized by the progressive loss of dopaminergic neurons in the substantia nigra, but dopamine also plays a role in the pathophysiology of migraine.

Objective: The aim of this study is to assess lifetime and previous year prevalence rates of headache in PD patients compared with controls.

Patients and methods: We enrolled 101 patients (57 M and 44 W) and 101 controls (62 M and 39 W), comparable for age and gender, who underwent a semi-structured questionnaire to assess the occurrence and the features of headache, and Beck Depression Inventory (BDI).

Results: We did not find any significant differences in the overall prevalence of lifetime and last 12-month headache between the two groups, as well as lifetime and last year tension-type headache (TTH) and migraine. Patients, especially those suffering from migraine and treated with dopamine agonists (DA), more frequently showed headache remission after the onset of motor symptoms compared to the age-related remission observed in controls (p = 0.001). Patients affected by headache were less frequently treated with DA in comparison with those without (p = 0.051). Depression of mood was more severe among PD patients with migraine than with TTH (p = 0.021). PD patients with headache exhibiting the akinetic-rigid subtype more frequently reported motor fluctuations than those presenting with tremor-dominant disease (p = 0.040).

Conclusions: The prevalence of headache in PD follows that described in the general population, but dopaminergic pathway degeneration, loss of dopamine activation on the trigeminal-vascular system, and DA treatment might favor migraine improvement and remission in PD patients.

Background: Automatic prediction of seizures is a major goal in the field of epilepsy. However, the high variability of Electroencephalogram (EEG) signals in different patients limits the use of prediction models in clinical applications.

Methods: This paper proposes a patient-independent seizure prediction model, named MFCC-CNN, to improve the generalization ability. MFCC-CNN model introduces Mel-Frequency Cepstrum Coefficients (MFCC) features and Linear Predictive Cepstral Coefficients (LPCC) features concentrated in the low frequency region, which contains more detailed information. Convolutional neural network (CNN) is used to construct a seizure prediction model.

Results: Experimental results showed that the proposed model obtained accuracy of 96 $\%$ , sensitivity of 92 $\%$ , specificity of 84 $\%$ and F1-score of 85 $\%$ for 24 cases in CNHB-MIT dataset. The overall performance of MFCC-CNN model is better than the other models.

Conclusion: MFCC-CNN model does not need to be specifically customized for different patients. As a patient-independent seizure prediction model, it has good generalization ability.

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease marked by motor neuron degeneration, leading to muscle weakness and paralysis, with no effective treatments available. Early diagnosis could slow disease progression and optimize treatment. MicroRNAs (miRNAs) are being investigated as potential biomarkers due to their regulatory roles in cellular processes and stability in biofluids. However, variability across studies complicates their diagnostic utility in ALS. This study aims to identify significantly dysregulated miRNAs in ALS through meta-analysis to elucidate disease mechanisms and improve diagnostic strategies.

Methods: We systematically searched PubMed, Google Scholar, and the Cochrane Library, following predefined inclusion and exclusion criteria. The primary effect measure was the standardized mean difference (SMD) with a 95% confidence interval, analyzed using a random-effects model. Additionally, we used network pharmacology to examine the targets of dysregulated miRNAs and their roles in ALS pathology.

Results: Analysing 34 studies, we found significant upregulation of hsa-miR-206, hsa-miR-133b, hsa-miR-23a, and hsa-miR-338-3p, and significant downregulation of hsa-miR-218, hsa-miR-21-5p, and hsa-let-7b-5p in ALS patients. These miRNAs are involved in ALS pathophysiology, including stress granule formation, nuclear pore complex, SMCR8 and Sig1R dysfunction, histone methyltransferase complex alterations, and MAPK signaling perturbation, highlighting their critical role in ALS progression.

Conclusion: This study identifies several dysregulated miRNAs in ALS patients, offering insights into their role in the disease and potential as diagnostic biomarkers. These findings enhance our understanding of ALS mechanisms and may inform future diagnostic strategies. Validating these results and exploring miRNA-based interventions are crucial for improving ALS diagnosis and treatment outcomes.

Background: Magnetic resonance guided focused ultrasound (MRgFUS) is a non-invasive therapeutic technique that utilizes focused ultrasound waves to generate heat at specific tissue targets within the brain. This emerging technology holds promise for its precision and potential benefits in comparison to traditional surgical interventions. This investigation involves a scoping review, summarizing insights from various studies that explore the advantages, limitations, and outcomes associated with MRgFUS in the treatment of dystonia.

Methods: This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. Data available on MRgFUS use in the management of different types of dystonia were extracted.

Results: There is limited data available (n = 11). In the surveyed literature, MRgFUS has consistently shown clinical benefit in patients with dystonia. It is an emerging avenue of treatment and has its challenges.

Conclusion: This scoping review highlighted the early but encouraging applications of MRgFUS in dystonia management. While data was limited, existing studies consistently demonstrated positive clinical outcomes. The non-invasive and precise nature of MRgFUS positions it as a promising avenue for further research, despite the challenges associated with its emergent status. This review sets the stage for future inquiries, emphasizing its potential as a valuable tool in dystonia treatment.

Introduction: This study investigates the significance of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCHL-1) in cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) and peripheral neuropathy (PN).

Methods: We included 41 MS patients, 35 PN patients, and 36 controls across 5 sites. MS patient data included lesion counts, disease activity, albumin quotient, and Expanded Disability Status Scale (EDSS) scores. PN patients included those with acute and chronic inflammatory demyelinating polyneuropathy and sensorimotor neuropathy based on nerve conduction studies. CSF concentrations of GFAP and UCHL-1 were measured using the MILLIPLEX Map Human Neuroscience Magnetic Bead Panel 1.

Results: Both GFAP and UCHL-1 levels were significantly higher in the two patient groups compared to controls. In the MS group, GFAP showed a strong correlation with disease duration, EDSS score, non-enhancing lesions, and the CSF/blood albumin quotient. UCHL-1 levels were significantly higher in patients with active disease (gadolinium-enhancing lesions). The combination of UCHL-1 and GFAP improved diagnostic accuracy (AUC 0.895, 95% CI 0.780-1.000) compared to the independent measurement of either marker for indicating Gd-negative lesions. In the PN group, CSF GFAP levels were significantly lower in patients with purely demyelinating neuropathy compared to those with axonal or mixed neuropathy.

Conclusion: GFAP serves as a sensitive marker for axonal damage in PN, while UCHL-1 closely correlates with disease activity in MS patients.

Introduction: Bowel and bladder symptoms are frequent in people with Multiple Sclerosis (PwMS) and early diagnosis and treatment become crucial to improve their quality of life (QoL). The study aims to design a multidisciplinary questionnaire for screening bladder and bowel symptoms in PwMS.

Materials and methods: The Bowel and Bladder Symptoms Screening in Multiple Sclerosis (BBSS-MS) questionnaire for screening bowel and bladder symptoms was designed in Italian following a three-steps process. In the first step, a dedicated board of experts identified a pool of items, which will be analysed for content, clarity, and consistency during the second step. During the third step, the relevance of each item was evaluated through a two-round process following the Delphi method. For each round of the Delphi method, medians, the 25th and 75th percentiles, and the IQR of the score for each statement were calculated. Stata 16.1 software was used to conduct all analyses.

Results: The Board identified 22 items to include in the BBSS-MS, based on existing questionnaire and clinical expertise. After discussing about the comprehensibility and clarity of items, the first version of the BBSS-MS composed of 22 items was proposed. Following, a Panel of 44 experts scored the relevance of each question and all the questions reached the score to be included in the questionnaire. The final 21-item version of the BBSS-MS was proposed.

Discussion and conclusion: To our knowledge, the BBSS-MS represents the first self-reported hybrid questionnaire for screening bladder and bowel symptoms in an Italian MS population.

Introduction: The influence of COVID19 vaccination on the risk of different neurological diseases has been subject of intense investigation. No large scale results have been published so far in the population of around 10 million people of Lombardia in Italy.

Methods: Linkable administrative health databases from the Lombardia region were used. By using the adapted self controlled case series (SCCS) method for event dependent exposures, we estimated the relative incidence of different neurological diseases following pre-specified windows at risk after vaccination and after COVID-19 infection in the over-12 population of Lombardia. Follow-up time before vaccination (Pre-Vax period) was compared with follow-up time 0-28 days (high-risk period) from the day of vaccination as well as for COVID infection. The SCCS model was fitted using a conditional Poisson regression model to estimate the relative incidences (RI) and their 95% Confidence Intervals (CI).

Results: The 28-day post-vaccination period was associated with a significant increase in the occurrence of ischemic stroke, cerebral haemorrhage, TIAs and myelitis (IRR 1.44, 1.50, 1.67 and 2.65 respectively). When the risk conferred by COVID19 infection was assessed in the same cohort, significant IRR were greater in the occurrence of ischemic stroke, cerebral haemorrhage, and TIAs (IRR 5.6, 3.62, 6.83) and includes also Multiple Sclerosis, neuromyelitis, and polymyositis (5.25, 8.81, 5.67).

Conclusions: Our data suggest that the increased risk of non-inflammatory CNS disorders following COVID-19 vaccination is lower than the risk conferred by COVID-19 infection, and that COVID-19 infection increases the risk of some inflammatory and non inflammatory neurological disorders.

Background and objectives: The incidence of ischemic stroke in young adults has increased substantially. There are limited data in the literature concerning the short-term clinical outcome in young adults with acute stroke after revascularization treatment. Due to the lack of available data on gender differences short-term clinical outcome, we designed the present study.

Materials and methods: We collected data from 127 patients aged 50 years or younger consecutively admitted to the Stroke-Unit of "Cardarelli" Hospital in Naples between August 2017 and September 2022 due to ischemic stroke. All of them underwent thrombolysis and/or endovascular treatment.

Results and conclusions: Smoking, hypertension, and dyslipidemia emerged as the most prevalent risk factors. A gender-based analysis revealed that the history of stroke was the only statistically significant factor more frequently observed in the female group. The leading stroke etiology was "cardioembolism," succeeded by strokes of "other determined origin", "undetermined etiology," "large-artery atherosclerosis," and "small-artery occlusion." Concerning reperfusion therapy, intravenous thrombolysis ranked as the most utilized treatment, followed by "bridging" therapy (combining intravenous thrombolytic therapy with thrombectomy) and primary mechanical thrombectomy. Notably, the average NIHSS scores 7 days post-revascularization were lower among females compared to males, constituting a statistically significant distinction. Nevertheless, no statistically significant correlation surfaced between gender and treatment type in NIHSS mean values at admission, 2 hours, 24 hours post-revascularization, or 7 days post-revascularization. This suggests that the observed disparity in mean NIHSS score between male and female groups after 7 days may potentially stem from other factors, such as endogenous estrogens.