Neurosciences最新文献

Objectives: To investigate whether Persons with MS (pwMS) in Saudi Arabia want to discuss their long-term prognosis (LTP) and the factors influencing this decision using a self-administered online questionnaire.

Methods: In this cross-sectional study, an online questionnaire was distributed from December 2022 to July 2023 across Saudi Arabia to determine pwMS interest in discussing their LTP. Participants included patients over 18 years, of any gender, diagnosed with MS. A nonprobability convenience sampling technique was used, with questionnaires sent through MS organizations and channels.

Results: Almost two-thirds (66-68%) of the 375 respondents reported that their LTP had never been discussed during neurologist appointments and expressed uncertainty about it. Additionally, 23.5% noted discrepancies in information provided by different neurologists. Most (81.6%) expressed a desire for a prognostic tool at diagnosis. In this study, MS patients' desire to learn about a tool for assessing long-term prognosis was significantly associated with age, education level (p<0.001), and gender (p=0.02). A higher percentage of women (65.7%) showed interest in learning about the tool compared to men (34.3%).

Conclusion: While more than half of pwMS are curious about their prognosis, only about one-third have optimal discussions about LTP with neurologists. Many desire information on prognostic tools. Further research is needed to assess patients' knowledge of their prognosis and improve communication with physicians.

Objectives: To explore the concerns among females in Riyadh city with multiple sclerosis (MS) regarding motherhood and pregnancy outcomes.

Methods: In this cross-sectional study, data were collected using an online questionnaire. Women who were aged 18-50 years and diagnosed with MS by a neurologist and had a disease duration of at least one year were included. The questionnaire consisted of 7 sections designed to collect information on the respondents' sociodemographic characteristics; past and current medical history; pre-pregnancy, pregnancy, and postpartum concerns; physical and psychological concerns about parenthood; and psychological and social support.

Results: A total of 176 women were included in the final analysis. Fatigue was the most common MS symptom, reported by 85.2% of the respondents, and 58% of the respondents had concerns about their disease and medication having adverse effects on their pregnancy and fetal outcomes. We found a statistically significant association between the level of perceived social support and patient care during pregnancy and concerns that they would not be able to prepare food for their children (p=0.037, respectively).

Conclusion: We have identified several significant concerns of Saudi women with MS related to various aspects of pregnancy, delivery, and fetal outcomes. These concerns may be linked to a lack of adequate knowledge on the subject. Thus, receiving appropriate counseling, information, and support could greatly benefit these women and result in a more positive and comfortable pregnancy and delivery experience.

Objectives: To rank the cognitive tasks commonly used in clinical practices based on their difficulties in healthy adults while walking. Dual tasks have been widely used in clinical settings for different purposes such as detecting early cognitive impairments and identifying fall risk factors among the population of neurological diseases.

Methods: This cross-sectional study, conducted from January to March 2021, included a sample of 26 healthy adults who were asked to demonstrate six different cognitive tasks at random while performing a gait speed test. An accelerometer positioned on the lower back at the umbilical level was used to measure participants' sway. After each task, participants rated the task's difficulty using the perceived difficulty scale.

Results: (1) The cognitive tasks showed no significant effect on sway (p> 0.05). (2) A statistically significant effect was observed for the cognitive tasks on perceived difficulty scale rating. (3) Statistically significant correlations were found between the perceived difficulty scale and the acceleration measures.

Conclusion: This study was able to rank the cognitive tasks based on the participants' perceived difficulty scale. Furthermore, significant correlations were identified between the perceived difficulty and the sway measurements.

Objectives: To evaluate adherence to the guidelines in managing thunderclap headache (TCH) at King Abdullah Medical City Specialist Hospital (KAMC) in Makkah. A thunderclap headache, a severe and sudden onset headache, often signals a subarachnoid hemorrhage (SAH). The International Classification of Headache Disorders, 3rd edition (ICHD-3), recommends a diagnostic approach for TCH, including computed tomography (CT), lumbar puncture (LP), vascular studies, and magnetic resonance imagining (MRI).

Methods: This retrospective cohort study included adult patients presenting with TCH, as defined by ICHD-3, from December 2018 to June 2023. Non-probability convenience sampling was used to select patients.

Results: Of 377 initial records, 173 patients met the inclusion criteria. The mean age was 52.6 years, with males comprising 57.2%. Hypertension (39.9%) and diabetes mellitus (20.2%) were common comorbidities. Key clinical features included nausea/vomiting (41.0%) and loss of consciousness (27.7%). Compliance with ICHD-3 guidelines was 96.5%, with 99.3% undergoing CT within 6 hours. Most patients (91.3%) were diagnosed with hemorrhagic conditions, primarily SAH (85.5%), with a recovery rate of 89.2%. However, 8.1% of patients died, primarily due to complications like rebleeding and infection.

Conclusion: High adherence to ICHD-3 guidelines in TCH management led to favorable outcomes, demonstrating the effectiveness of systematic evaluation. The study highlights the importance of timely intervention and suggests that demographic factors may not significantly influence TCH outcomes. Further research should explore guideline adherence in varied settings.

Marchiafava-Bignami disease (MBD) is a rare neurological disorder typically occurring in alcoholic patients. The main disease mechanism is hypothesized to be vitamin B-complex deficiency due to malnutrition. In the literature, there have been few reported cases of the disease occurring in patients who have undergone bariatric surgery. This paper presents a case study of a 45-year-old non-alcoholic female who underwent a laparoscopic sleeve gastrectomy presenting with progressive worsening weakness of her lower limbs and slurred speech. Her condition continued to deteriorate, and she became mute and bedbound. The MRI revealed distinctive characteristics consistent with MBD. The diagnosis was confirmed following the exclusion of all other possible diagnoses. She was treated with multivitamins and had a significant improvement. Additionally, we conduct a review of similar cases of this condition occurring after bariatric surgery. This report sheds light on the occurrence of this uncommon condition after the bariatric procedures.

Objectives: To investigate the potential utility of the C-reactive protein-to-albumin ratio (CAR) and the systemic immune-inflammatory index (SII) as a biomarker in distinguishing between BPPV and acute cerebellar infarction (ACI) due to posterior inferior cerebellar artery (PICA) involvement.

Methods: The data of 2545 patients registered in our hospital database between 2017 and 2024 with a diagnosis of vertigo were retrospectively analyzed and 102 patients with benign paroxysmal positional vertigo (BPPV) and 100 patients with ACI were included in the study. Mann-Whitney U test, Chi-square test, or Fisher's exact test were used to compare variables between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to investigate the predictive value of the data.

Results: The CAR and SII values were significantly higher in the ACI group compared to the BPPV group (p<0.001, p<0.001, respectively). The areas under the ROC curve (AUC) were as follows: CAR=0.768 (95% CI, 0.705-0.832), white blood cell count (WBC)=0.735 (95% CI, 0.667-0.802), monocytes=0.622 (95% CI, 0.544-0.699), red cell distribution width-standard deviation (RDW-SD)=0.600 (95% CI, 0.522-0.678), SII=0.674 (95% CI, 0.599-0.748), and neutrophil-to-lymphocyte ratio (NLR)=0.687 (95% CI, 0.613-0.761).

Conclusion: CAR and SII could be useful biomarkers to differentiate between ACI and BPPV in vertigo patients, but further validation is needed in larger studies.

Objectives: To identify a key Long chain non-coding RNAs (lncRNAs) related to PD and provide a new perspective on the role of LncRNAs in Parkinson's disease (PD) pathophysiology.

Methods: Our study involved analyzing gene chips from the substantia nigra and white blood cells, both normal and PD-inclusive, in the Gene Expression Omnibus (GEO) database, utilizing a weighted gene co-expression network analysis (WGCNA). The technique of WGCNA facilitated the examination of differentially expressed genes (DEGs) in the substantia nigra and the white blood cells of individuals with PD. When merged with clinical data, gene modules containing crucial clinical details were chosen for network integration in GO and KEGG enrichment analysis.

Results: A pair of LncRNA modules were identified. The crucial component in GSE7621 was the turquoise module. The DEGs were acquired using GSE133347. GO functions focused on phosphatidylinositol phosphate binding, inflammatory responses, and the regulation of nerves and synapses. KEGG analyses were largely enriched within the P13K-Akt, FaxO, mTOR, Oxytocin, and cGMP-PKG signaling pathways. A Venn diagram revealed that the two key LncRNA were CH17-189H20.1 and RP11-168O16.1.

Conclusion: Using the WGCNA method, we obtained PD-related modules, identified biologically significant gene modules, obtained core LncRNAs, and found potential target genes for enrichment analysis. The objective of our research was to advance more detailed and efficient treatment methods for lncRNAs associated with PD.

The hippocampus, noted as (HC), plays a crucial role in the processes of learning, memory formation, and spatial navigation. Recent research reveals that this brain region can undergo structural and functional changes due to environmental exposures, including stress, noise pollution, sleep deprivation, and microgravity. This review synthesizes findings from animal and human studies, emphasizing the HC's plasticity in response to these factors. It examines changes in volume, architecture, neurogenesis, synaptic plasticity, and gene expression and highlights critical periods of vulnerability to environmental influences impacting cognition and behavior. It also investigates underlying mechanisms such as glucocorticoid signaling, epigenetic alterations, and neural circuit adaptations. Understanding how the HC reacts to various environmental exposures is vital for developing strategies to enhance cognitive resilience and mitigate negative effects on this crucial brain region. Further research is needed to identify protective and risk factors and create effective interventions.