M. Tena Suck, Daniel Rocandio Hernández, Alma Ortiz Plata, S. Moreno-Jimenez, Jose Sandoval, M. Castillejos-López, J. Flores
Introduction: Methods: 47 patients were emergency operated on due to pituitary apoplexy during the pandemic time. The patients were divided into two groups according to PCR COVID-19 positive vs negative test. Histopathology all cases showed varying degrees of necrosis, microthrombi formation secondary to inflammation, and endothelial cells injuries in association with TNFa, TNFk, FVIII, DPGF, HIF1a, Il6, Il10, Il17, DPGF, CD3, CD4, CD8, CD20, CD68, CD163, ACE2, and antiCOV immunoexpression. Results: 24 women and 23 men, age ranges from 21 to 76 years (mean 42.25±13.38), 14 (36%) presented positive COVID19 tests, and 30 (64%) were covid negative. 15 were already recurrences, 4 recurrences in the same year, and 4 died during the pandemic time. 9 (30%) showed histological data of stroke, of which necrosis around <25% were 8 (47%), 25-50% were 2 (12%) and >50% were 8 (45%). Weak vascular changes in 4 (24%), moderate in 7 (65%) and severe in 1, moderate, and intense in 1 (6%) were observed. Conclusions: Apoplexy in a previously diagnosed macro-PAD in the setting of a recent COVID-19 infection. The patients who presented with histological features of pituitary tumor infarction alone had less severe clinical features on presentation, a longer course before presentation, and a better outcome than those presenting with hemorrhagic infarction or frank hemorrhage. Hyperactivated and dysregulated immune cells pose a substantial danger for exacerbated tissue damage. COVID-19 may increase the risk of pituitary apoplexy, and we should be vigilant for signs of this. A more insidious pathological link between COVID-19 and apoplexy may exist in addition to severe inflammatory response.
{"title":"Pituitary adenomas and COVID-19 related disease in pandemic time: Clinical, pathological, immunohistochemical, and ultrastructure analysis","authors":"M. Tena Suck, Daniel Rocandio Hernández, Alma Ortiz Plata, S. Moreno-Jimenez, Jose Sandoval, M. Castillejos-López, J. Flores","doi":"10.33425/2692-7918.1033","DOIUrl":"https://doi.org/10.33425/2692-7918.1033","url":null,"abstract":"Introduction: Methods: 47 patients were emergency operated on due to pituitary apoplexy during the pandemic time. The patients were divided into two groups according to PCR COVID-19 positive vs negative test. Histopathology all cases showed varying degrees of necrosis, microthrombi formation secondary to inflammation, and endothelial cells injuries in association with TNFa, TNFk, FVIII, DPGF, HIF1a, Il6, Il10, Il17, DPGF, CD3, CD4, CD8, CD20, CD68, CD163, ACE2, and antiCOV immunoexpression. Results: 24 women and 23 men, age ranges from 21 to 76 years (mean 42.25±13.38), 14 (36%) presented positive COVID19 tests, and 30 (64%) were covid negative. 15 were already recurrences, 4 recurrences in the same year, and 4 died during the pandemic time. 9 (30%) showed histological data of stroke, of which necrosis around <25% were 8 (47%), 25-50% were 2 (12%) and >50% were 8 (45%). Weak vascular changes in 4 (24%), moderate in 7 (65%) and severe in 1, moderate, and intense in 1 (6%) were observed. Conclusions: Apoplexy in a previously diagnosed macro-PAD in the setting of a recent COVID-19 infection. The patients who presented with histological features of pituitary tumor infarction alone had less severe clinical features on presentation, a longer course before presentation, and a better outcome than those presenting with hemorrhagic infarction or frank hemorrhage. Hyperactivated and dysregulated immune cells pose a substantial danger for exacerbated tissue damage. COVID-19 may increase the risk of pituitary apoplexy, and we should be vigilant for signs of this. A more insidious pathological link between COVID-19 and apoplexy may exist in addition to severe inflammatory response.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"8 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73726922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amyotrophic lateral sclerosis (ALS) is a non-demyelinating neurodegenerative disease mostly found in adults between 40 to 60 years old. This disease is usually prevalent in males, however it’s irrespective to the different genders. ALS is progressive and within 2-5 years of diagnosis ulimately ends with death. The majority of ALS cases is sporadic (90%) and is recorded without any defined aetiology. The other 10-12% of cases is recognized from mutations in more than 20 genes. The genes reported to cause ALS are Superoxide Dismutase 1 (SOD1), TAR DNA Binding Protein (TDP), Fused in Sarcoma, (FUS), Chromosome 9 Open Reading Frame 72 (c9orf72) and Vesicle-Associated Membrane-ProteinAssociated Protein B (VAPB). Furthermore, abnormal lipid metabolism with higher LDL/HDL ratio was reported in ALS patients. The aetiology of ALS is shown in the schematic diagram below (Figure 1) Due to the multi-nature of ALS causative factors and symptoms, there is no specific therapy for ALS today. However, this paper will touch on potential therapies that are in practice or may come up in the future. The goal is to maintain and improve the function of motor neuron, the well-being and quality of life for ALS patients. Until then, we have to rely on the symptomatic treatment and rehabilitative measures to support the patient’s quality of life.
{"title":"Therapeutic interventions of Amyotrophic Lateral Sclerosis (ALS)","authors":"A. Chakraborty, Anil Diwan","doi":"10.33425/2692-7918.1032","DOIUrl":"https://doi.org/10.33425/2692-7918.1032","url":null,"abstract":"Amyotrophic lateral sclerosis (ALS) is a non-demyelinating neurodegenerative disease mostly found in adults between 40 to 60 years old. This disease is usually prevalent in males, however it’s irrespective to the different genders. ALS is progressive and within 2-5 years of diagnosis ulimately ends with death. The majority of ALS cases is sporadic (90%) and is recorded without any defined aetiology. The other 10-12% of cases is recognized from mutations in more than 20 genes. The genes reported to cause ALS are Superoxide Dismutase 1 (SOD1), TAR DNA Binding Protein (TDP), Fused in Sarcoma, (FUS), Chromosome 9 Open Reading Frame 72 (c9orf72) and Vesicle-Associated Membrane-ProteinAssociated Protein B (VAPB). Furthermore, abnormal lipid metabolism with higher LDL/HDL ratio was reported in ALS patients. The aetiology of ALS is shown in the schematic diagram below (Figure 1) Due to the multi-nature of ALS causative factors and symptoms, there is no specific therapy for ALS today. However, this paper will touch on potential therapies that are in practice or may come up in the future. The goal is to maintain and improve the function of motor neuron, the well-being and quality of life for ALS patients. Until then, we have to rely on the symptomatic treatment and rehabilitative measures to support the patient’s quality of life.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"29 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83073766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cavum septum pellucidum (CSP) is a rare condition when the septum pellucidum remains open to the inner ventricles within the brain. In many cases, CSP and the associated anatomical structure cavum vergae is thought to lead to anti-social and psychotic behaviour which poses a problem to those working in legal services. Controversy surrounds the possibility of congenital versus acquired conditions when CSP is found in those with repeated traumatic brain injuries such as professional athletes, American pro-footballers and professional and amateur boxers. Collecting police evidence and presenting expert testimony in the Courts is problematical when there is confusion over the acquisition of CSP. Treatment is compounded by differing presentations often involving psychosis which makes it a challenge to correctly place individuals within health service provision and penal institutions as well as offering appropriate treatment and criminal justice.
{"title":"Conundrum of Cavum Septum Pellucidum in Expert Witness Testimony, Police Evidence And Neurobehavioural Consequence: Affecting Legal Practice And Criminal Justice?","authors":"S. Thompson","doi":"10.33425/2692-7918.1029","DOIUrl":"https://doi.org/10.33425/2692-7918.1029","url":null,"abstract":"Cavum septum pellucidum (CSP) is a rare condition when the septum pellucidum remains open to the inner ventricles within the brain. In many cases, CSP and the associated anatomical structure cavum vergae is thought to lead to anti-social and psychotic behaviour which poses a problem to those working in legal services. Controversy surrounds the possibility of congenital versus acquired conditions when CSP is found in those with repeated traumatic brain injuries such as professional athletes, American pro-footballers and professional and amateur boxers. Collecting police evidence and presenting expert testimony in the Courts is problematical when there is confusion over the acquisition of CSP. Treatment is compounded by differing presentations often involving psychosis which makes it a challenge to correctly place individuals within health service provision and penal institutions as well as offering appropriate treatment and criminal justice.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"57 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90496088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper reviews the possible link between hip fracture and cognitive decline and dementia. There is a growing body of clinical research literature that indicates that cognitive decline is associated with the presence of delirium and that delirium is a predictor of dementia. Hip fracture is thought to be an independent factor that may lead to cognitive decline and dementia. It is suggested that cost implications should not become an obstacle to determining the best course of rehabilitation when delirium signals the need for preventive measures to protect the welfare of patients with hip fracture.
{"title":"Hip Fracture As A Potential Contributor To Cognitive Decline And Dementia","authors":"S. Thompson","doi":"10.33425/2692-7918.1030","DOIUrl":"https://doi.org/10.33425/2692-7918.1030","url":null,"abstract":"This paper reviews the possible link between hip fracture and cognitive decline and dementia. There is a growing body of clinical research literature that indicates that cognitive decline is associated with the presence of delirium and that delirium is a predictor of dementia. Hip fracture is thought to be an independent factor that may lead to cognitive decline and dementia. It is suggested that cost implications should not become an obstacle to determining the best course of rehabilitation when delirium signals the need for preventive measures to protect the welfare of patients with hip fracture.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"110 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87714902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cláudia Amaro dos Santos, Telmo Pequito, A. Fonseca
Introduction: Cardiovascular diseases are presented as a set of diseases that affect the cardiovascular system because of inappropriate lifestyles or unhealthy, they are consistent in risk might be modifiable through a proper disease management factor. Aim: Assess the perceptions of patients with acute myocardial infarction about this heart disease and risk factors associated. Also, identify the risk factors that can be improved to manage the disease. Design: Observational and prospective study. Methods: The survey was conducted in a Cardiac Intensive Care Unit of a Central Hospital, with inclusion of all patients admitted on a period of two months. Nineteen patients were studied with a clinical diagnosis of Acute Myocardial Infarction. Results: The analysis of the questionnaires showed that, approach the subject has a justified and reasoned relevance. The high prevalence of risk factors that can be modified highlighted the need for intervention in patients with non-modifiable risk factors. Conclusion: Patients with acute myocardial infarction do not have a correct perception of the disease and associated factors. Many of the risk factors present in patients with acute myocardial infarction are likely to be modified by an appropriate disease management, with a patient-centred care.
{"title":"The patient-centered care for patients with acute myocardial infarction: what can be improved the disease management","authors":"Cláudia Amaro dos Santos, Telmo Pequito, A. Fonseca","doi":"10.33425/2692-7918.1028","DOIUrl":"https://doi.org/10.33425/2692-7918.1028","url":null,"abstract":"Introduction: Cardiovascular diseases are presented as a set of diseases that affect the cardiovascular system because of inappropriate lifestyles or unhealthy, they are consistent in risk might be modifiable through a proper disease management factor. Aim: Assess the perceptions of patients with acute myocardial infarction about this heart disease and risk factors associated. Also, identify the risk factors that can be improved to manage the disease. Design: Observational and prospective study. Methods: The survey was conducted in a Cardiac Intensive Care Unit of a Central Hospital, with inclusion of all patients admitted on a period of two months. Nineteen patients were studied with a clinical diagnosis of Acute Myocardial Infarction. Results: The analysis of the questionnaires showed that, approach the subject has a justified and reasoned relevance. The high prevalence of risk factors that can be modified highlighted the need for intervention in patients with non-modifiable risk factors. Conclusion: Patients with acute myocardial infarction do not have a correct perception of the disease and associated factors. Many of the risk factors present in patients with acute myocardial infarction are likely to be modified by an appropriate disease management, with a patient-centred care.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"51 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72489076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carbon monoxide poisoning is potentially significant in terms of mortality rates, and survivors can have serious deleterious neurological consequences. Diagnosis may be hampered because of symptoms that are similar to other benign conditions. Neuropsychological assessment is complicated due to the need to assess potentially global brain dysfunction. Assessment recommendations are presented and discussed together with an overview of treatment options.
{"title":"Carbon monoxide poisoning: Recommendations for neuropsychological assessment","authors":"S. Thompson","doi":"10.33425/2692-7918.1031","DOIUrl":"https://doi.org/10.33425/2692-7918.1031","url":null,"abstract":"Carbon monoxide poisoning is potentially significant in terms of mortality rates, and survivors can have serious deleterious neurological consequences. Diagnosis may be hampered because of symptoms that are similar to other benign conditions. Neuropsychological assessment is complicated due to the need to assess potentially global brain dysfunction. Assessment recommendations are presented and discussed together with an overview of treatment options.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"36 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80038501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nevine M. El Nahas, Tamer Roushdy, H. Shokri, R. Moustafa, Ahmed M. Elsayed, Randa M. Amin, A. Ashour, E. H. Abd Eldayem, G. Elhawary, Ahmed M. Elbokl
Highlights• In healthy adults, the lateralized readiness potential (LRP) is localized to the hemisphere contralateral to a moving limb.• In stroke, the LRP can lateralize contra-, or ipsilateral to the paretic limb depending on the stage of recovery.• Identification of hemisphere of recovery can guide further measures for enhancing brain plasticity. BACKGROUND Event related cortical potentials related to motor action are referred to as movement related cortical potentials. The late component of which is the readiness potential (RP) and its polarity is more negative in the hemisphere responsible for planning of motor action. This lateralized nature of RP during unilateral hand movement is studied as lateralized readiness potential (LRP) by calculating the contralateral-minus-ipsilateral difference wave for each hand. OBJECTIVE The aim was to identify the hemisphere contributing to motor recovery in acute and chronic stroke patients through recording LRPs. METHODS Twenty-nine cases with cerebrovascular stroke (15 acute and 14 chronic) were included in the study. EEG was recorded in response to self-cued button presses by the paretic side to obtain the averaged LRP amplitude. The hemisphere with greater negativity was considered the side of recovery. Functional recovery was assessed by Fugl Meyer test. RESULTS In acute cases, recovery was more related to LRP activity in the contralesional hemisphere (73% ), whereas lateralization was equal in chronic cases; 50% in either group. LRP amplitude was higher in the contralesional hemisphere (p = 0.02). Functional recovery assessed by the Fugl Meyer test (FM) was similar whether recovery was ipsi- or contralesional. CONCLUSIONS Early after stroke, motor recovery is more likely to involve compensatory activity in the contralesional hemisphere, while in the chronic phase, the ipsilesional hemisphere may recover its function and become more active. Further research is needed to verify if the technique mentioned in our study could be used to guide customized NIBS protocols tailoring the optimal site and parameters for each patient.
{"title":"Lateralized readiness potentials can identify hemisphere of recovery in stroke patients.","authors":"Nevine M. El Nahas, Tamer Roushdy, H. Shokri, R. Moustafa, Ahmed M. Elsayed, Randa M. Amin, A. Ashour, E. H. Abd Eldayem, G. Elhawary, Ahmed M. Elbokl","doi":"10.3233/rnn-211222","DOIUrl":"https://doi.org/10.3233/rnn-211222","url":null,"abstract":"Highlights• In healthy adults, the lateralized readiness potential (LRP) is localized to the hemisphere contralateral to a moving limb.• In stroke, the LRP can lateralize contra-, or ipsilateral to the paretic limb depending on the stage of recovery.• Identification of hemisphere of recovery can guide further measures for enhancing brain plasticity.\u0000\u0000\u0000BACKGROUND\u0000Event related cortical potentials related to motor action are referred to as movement related cortical potentials. The late component of which is the readiness potential (RP) and its polarity is more negative in the hemisphere responsible for planning of motor action. This lateralized nature of RP during unilateral hand movement is studied as lateralized readiness potential (LRP) by calculating the contralateral-minus-ipsilateral difference wave for each hand.\u0000\u0000\u0000OBJECTIVE\u0000The aim was to identify the hemisphere contributing to motor recovery in acute and chronic stroke patients through recording LRPs.\u0000\u0000\u0000METHODS\u0000Twenty-nine cases with cerebrovascular stroke (15 acute and 14 chronic) were included in the study. EEG was recorded in response to self-cued button presses by the paretic side to obtain the averaged LRP amplitude. The hemisphere with greater negativity was considered the side of recovery. Functional recovery was assessed by Fugl Meyer test.\u0000\u0000\u0000RESULTS\u0000In acute cases, recovery was more related to LRP activity in the contralesional hemisphere (73% ), whereas lateralization was equal in chronic cases; 50% in either group. LRP amplitude was higher in the contralesional hemisphere (p = 0.02). Functional recovery assessed by the Fugl Meyer test (FM) was similar whether recovery was ipsi- or contralesional.\u0000\u0000\u0000CONCLUSIONS\u0000Early after stroke, motor recovery is more likely to involve compensatory activity in the contralesional hemisphere, while in the chronic phase, the ipsilesional hemisphere may recover its function and become more active. Further research is needed to verify if the technique mentioned in our study could be used to guide customized NIBS protocols tailoring the optimal site and parameters for each patient.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46413723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Baroni, G. Magro, Carlotta Martinuzzi, Laura Brondi, S. Masiero, Giada Milani, G. Zani, Antonella Bergonzoni, N. Basaglia, S. Straudi
BACKGROUND Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. OBJECTIVE To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. METHODS 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. RESULTS Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. CONCLUSIONS Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.
{"title":"Combined effects of cerebellar tDCS and task-oriented circuit training in people with multiple sclerosis: A pilot randomized control trial.","authors":"Andrea Baroni, G. Magro, Carlotta Martinuzzi, Laura Brondi, S. Masiero, Giada Milani, G. Zani, Antonella Bergonzoni, N. Basaglia, S. Straudi","doi":"10.3233/RNN-211245","DOIUrl":"https://doi.org/10.3233/RNN-211245","url":null,"abstract":"BACKGROUND\u0000Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition.\u0000\u0000\u0000OBJECTIVE\u0000To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis.\u0000\u0000\u0000METHODS\u000016 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded.\u0000\u0000\u0000RESULTS\u0000Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS.\u0000\u0000\u0000CONCLUSIONS\u0000Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"17 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41308027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Ranganathan, Carson Doherty, M. Gussert, Eva Kaplinski, M. Koje, C. Krishnan
BACKGROUND Despite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific basis for different interventions as one critical factor that has led to suboptimal study outcomes. OBJECTIVE To understand the content of current therapeutic interventions in terms of their active ingredients. METHODS We conducted an analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020. RESULTS There were three primary findings: (i) consistent with prior reports, most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) most therapeutic interventions mentioned multiple active ingredients and there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach. CONCLUSION These results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.
{"title":"Scientific basis and active ingredients of current therapeutic interventions for stroke rehabilitation.","authors":"R. Ranganathan, Carson Doherty, M. Gussert, Eva Kaplinski, M. Koje, C. Krishnan","doi":"10.3233/RNN-211243","DOIUrl":"https://doi.org/10.3233/RNN-211243","url":null,"abstract":"BACKGROUND\u0000Despite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific basis for different interventions as one critical factor that has led to suboptimal study outcomes.\u0000\u0000\u0000OBJECTIVE\u0000To understand the content of current therapeutic interventions in terms of their active ingredients.\u0000\u0000\u0000METHODS\u0000We conducted an analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020.\u0000\u0000\u0000RESULTS\u0000There were three primary findings: (i) consistent with prior reports, most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) most therapeutic interventions mentioned multiple active ingredients and there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach.\u0000\u0000\u0000CONCLUSION\u0000These results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43558715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Kovalchuk, R. Mychasiuk, A. Muhammad, S. Hossain, Abhijit Ghose, C. Kirkby, E. Ghasroddashti, O. Kovalchuk, B. Kolb
PURPOSE In recent years, much effort has been focused on developing new strategies for the prevention and mitigation of adverse radiation effects on healthy tissues and organs, including the brain. The brain is very sensitive to radiation effects, albeit as it is highly plastic. Hence, deleterious radiation effects may be potentially reversible. Because radiation exposure affects dendritic space, reduces the brain's ability to produce new neurons, and alters behavior, mitigation efforts should focus on restoring these parameters. To that effect, environmental enrichment through complex housing (CH) and exercise may provide a plausible avenue for exploration of protection from brain irradiation. CH is a much broader concept than exercise alone, and constitutes exposure of animals to positive physical and social stimulation that is superior to their routine housing and care conditions. We hypothesized that CHs may lessen harmful neuroanatomical and behavioural effects of low dose radiation exposure. METHODS We analyzed and compared cerebral morphology in animals exposed to low dose head, bystander (liver), and scatter irradiation on rats housed in either the environmental enrichment condos or standard housing. RESULTS Enriched condo conditions ameliorated radiation-induced neuroanatomical changes. Moreover, irradiated animals that were kept in enriched CH condos displayed fewer radiation-induced behavioural deficits than those housed in standard conditions. CONCLUSIONS Animal model-based environmental enrichment strategies, such as CH, are excellent surrogate models for occupational and exercise therapy in humans, and consequently have significant translational possibility. Our study may thus serve as a roadmap for the development of new, easy, safe and cost-effective methods to prevent and mitigate low-dose radiation effects on the brain.
{"title":"Complex housing partially mitigates low dose radiation-induced changes in brain and behavior in rats.","authors":"Anna Kovalchuk, R. Mychasiuk, A. Muhammad, S. Hossain, Abhijit Ghose, C. Kirkby, E. Ghasroddashti, O. Kovalchuk, B. Kolb","doi":"10.3233/RNN-211216","DOIUrl":"https://doi.org/10.3233/RNN-211216","url":null,"abstract":"PURPOSE\u0000In recent years, much effort has been focused on developing new strategies for the prevention and mitigation of adverse radiation effects on healthy tissues and organs, including the brain. The brain is very sensitive to radiation effects, albeit as it is highly plastic. Hence, deleterious radiation effects may be potentially reversible. Because radiation exposure affects dendritic space, reduces the brain's ability to produce new neurons, and alters behavior, mitigation efforts should focus on restoring these parameters. To that effect, environmental enrichment through complex housing (CH) and exercise may provide a plausible avenue for exploration of protection from brain irradiation. CH is a much broader concept than exercise alone, and constitutes exposure of animals to positive physical and social stimulation that is superior to their routine housing and care conditions. We hypothesized that CHs may lessen harmful neuroanatomical and behavioural effects of low dose radiation exposure.\u0000\u0000\u0000METHODS\u0000We analyzed and compared cerebral morphology in animals exposed to low dose head, bystander (liver), and scatter irradiation on rats housed in either the environmental enrichment condos or standard housing.\u0000\u0000\u0000RESULTS\u0000Enriched condo conditions ameliorated radiation-induced neuroanatomical changes. Moreover, irradiated animals that were kept in enriched CH condos displayed fewer radiation-induced behavioural deficits than those housed in standard conditions.\u0000\u0000\u0000CONCLUSIONS\u0000Animal model-based environmental enrichment strategies, such as CH, are excellent surrogate models for occupational and exercise therapy in humans, and consequently have significant translational possibility. Our study may thus serve as a roadmap for the development of new, easy, safe and cost-effective methods to prevent and mitigate low-dose radiation effects on the brain.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46725661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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