Neurosciences最新文献

Objectives: To investigate the factors that contribute to the development of cerebral edema after aneurysm clipping in individuals with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: A total of 232 patients with aSAH caused by rupture and treated with aneurysm clipping were included in the retrospective analysis of clinical data. Postoperatively, the participants were categorized into two groups based on the presence or absence of cerebral edema: a complication group (n=33) and a non-complication group (n=199).A comparison was made between the overall data of the 2 groups.

Results: In the complication group, there were higher proportions of patients experiencing recurrent bleeding, aneurysm in the posterior circulation, Fisher grade III-IV, World Federation of Neurosurgical Societies (WFNS) grade II, Hunt-Hess grade III-IV, concomitant hypertension, duration from onset to operation ≥12 h, and concomitant hematoma compared to the non-complication group (p<0.05). Cerebral edema after aneurysm clipping was associated with several risk factors including repeated bleeding, aneurysm in the back of the brain, Fisher grade III-IV, WFNS grade II, Hunt-Hess grade III-IV, simultaneous high blood pressure and hematoma, and a duration of at least 12 hours from the start of symptoms to the surgical procedure (p<0.05).

Conclusion: In patients with aSAH, the risk of cerebral edema after aneurysm clipping is increased by recurrent bleeding, aneurysm in the posterior circulation, Fisher grade III-IV, WFNS grade II, Hunt-Hess grade III-IV, concomitant hypertension and hematoma, and duration of ≥12 h from onset to operation.

Objectives: The brain and spinal cord, constituting the central nervous system (CNS), could be impacted by an inflammatory disease known as multiple sclerosis (MS). The convolutional neural networks (CNN), a machine learning method, can detect lesions early by learning patterns on brain magnetic resonance image (MRI). We performed this study to investigate the diagnostic performance of CNN based MRI in the identification, classification, and segmentation of MS lesions.

Methods: PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, and Google Scholar were used to retrieve papers reporting the use of CNN based MRI in MS diagnosis. The accuracy, the specificity, the sensitivity, and the Dice Similarity Coefficient (DSC) were evaluated in this study.

Results: In total, 2174 studies were identified and only 15 articles met the inclusion criteria. The 2D-3D CNN presented a high accuracy (98.81, 95% CI: 98.50-99.13), sensitivity (98.76, 95% CI: 98.42-99.10), and specificity (98.67, 95% CI: 98.22-99.12) in the identification of MS lesions. Regarding classification, the overall accuracy rate was significantly high (91.38, 95% CI: 83.23-99.54). A DSC rate of 63.78 (95% CI: 58.29-69.27) showed that 2D-3D CNN-based MRI performed highly in the segmentation of MS lesions. Sensitivity analysis showed that the results are consistent, indicating that this study is robust.

Conclusion: This metanalysis revealed that 2D-3D CNN based MRI is an automated system that has high diagnostic performance and can promptly and effectively predict the disease.

Parkinson's disease (PD) is a complex neurodegenerative motor disorder caused by the loss of dopaminergic neurons in the substantia nigra pars compacta. The substantia nigra is neither the first nor the only brain region affected by PD. Recent and old studies have shown that PD does not only affect the CNS; in fact, autonomic innervation in the GIT, skin, and olfactory system was found to be affected by α-synuclein pathology outside the CNS, affecting patients' quality of life. In the gastrointestinal system, dysphagia, constipation, and bacterial overgrowth in the small intestine are common in patients with PD. In addition, several skin conditions were reported in PD, including seborrheic dermatitis, rosacea, melanoma, and others. Finally, olfactory system dysfunction, such as reduced touch sensation and smell, was associated with motor abnormalities. Further high-quality studies are needed to develop reliable tests that could help in the early diagnosis of PD.

Objectives: To evaluate the genetic polymorphisms in IL-2 and IL-2RA genes in schizophrenia (SCZ) patients by comparing them with healthy controls.

Methods: A sample of 127 patients with SCZ and 100 healthy volunteers were included in the case-control study. These individuals were consecutively selected from the Malazgirt State Hospital Psychiatry Outpatient Clinic in Mus, Turkey, over the three months from October 2020 to December 2020. The Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV) was used to confirm the diagnosis according to the DSM-5 criteria. In addition, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine gene polymorphisms from DNA material.

Results: Our findings indicated significant differences in the IL-2 genotype and allele frequencies between SCZ patients and the healthy control group. Specifically, the frequency of the homozygous GG genotype was notably higher in SCZ patients compared to the control group. Conversely, when comparing the IL-2RA genotype and allele frequencies of SCZ patients with the control group, no statistically significant differences were observed between the 2 groups. When compared to individuals with other genotypes, interaction analysis indicated that carriers of the GG/AG (IL-2/IL-2RA) genotype demonstrated a significantly increased risk of SCZ.

Conclusion: In light of the analyses, our study indicates that while the IL-2 genotype polymorphism may be considered a risk factor for developing SCZ, the IL-2RA variant was not associated with SCZ among Turkish patients.

Objectives: To observe the accuracy of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans in evaluating neurological disorders.

Methods: This retrospective research used CT or MRI to diagnose and characterize brain disorders. Patients' records suffering from neurological disorders were considered eligible for inclusion, regardless of the time of appearance of symptoms, the severity of their symptoms, or their final clinical diagnosis. The exclusion criteria for this study involved patients who did not undergo either a CT or MRI scan. A chi-square test was performed to observe the association between the study variables. A total of 3155 cases were analyzed.

Results: The most prevalent comorbid was dyslipidemia 670 (21.6%) followed by hypertension 548 (17.6%). Overall brain disorders were confirmed in 2426 (77%) patients. It was observed that half of the patients 1543 (48.9%) were diagnosed with stroke. It was found that the accuracy of CT and MRI was 78% and 74% respectively. The association of modalities, patient type, and gender with the confirmation of diseases was not found significant (p=>0.05).

Conclusion: Our study revealed that CT and MRI were accurate by more than 75% and no difference was between both techniques to detect neurological disorders.

Objectives: To assess the frequency of adverse effects among pediatric and adult patients and the clinical variables associated with a higher probability of developing side effects.

Methods: This retrospective study enrolled pediatric and adult patients who underwent Vagus nerve stimulation (VNS) implantation at our institution and had documented follow-up during clinic visits for at least 6 months after implantation. Data collected included demographic information, epilepsy diagnosis, and device data.

Results: A total of 43 patients with drug-resistant epilepsy who received a VNS device at our institution were enrolled. The median follow-up period was 12 months. Fourteen patients (32.55%) reported no side effects from VNS therapy. Side effects ranged from mild to severe, with significant side effects observed in 8 patients. Data on therapy efficacy were collected, and 10 patients (23.26%) reported no change in seizure frequency following device implantation.

Conclusion: This study demonstrates that VNS is an important adjunct treatment option for epilepsy patients. Dysphagia and dyspnea can be significant adverse effects leading to treatment discontinuation, aspiration pneumonia, intensive care unit (ICU) admission, and prolonged hospital stay. These effects are more frequent in patients with symptomatic generalized epilepsy, global developmental delay at baseline, previous ICU admissions, abnormal brain magnetic resonance imaging findings, and seizures with multiple semiologies.