Current Issue : October-December Volume : 2025 Issue Number : 4 Articles : 5 Articles
Background: Cervical degenerative disease is a common condition associated with significant morbidity, often presenting as neck pain, radiculopathy, or myelopathy. Its growing incidence, particularly in the aging population, has led to an increased demand for surgical interventions aimed at relieving neural compression and restoring spinal stability. Objective: This study aims to evaluate surgical outcomes in patients with degenerative cervical conditions, with a particular focus on the role of intraoperative neurophysiological monitoring (IONM) in preventing adverse neurological events both immediately postoperatively and at long-term follow-up. Methods: A retrospective analysis was performed on patients who underwent cervical spine surgery for degenerative conditions between January 2021 and June 2024. Data collected included demographics, comorbidities, surgical details, and intraoperative neurophysiological monitoring. Surgical outcomes were assessed using the modified Rankin Scale (mRS), Odom’s Criteria, and the modified Japanese Association (mJOA) score. Results: Key findings demonstrated that advanced age and the presence of preoperative myelopathy were significantly associated with poorer postoperative outcomes across all evaluated measures. Conversely, factors such as gender, surgical approach, and the number of treated levels did not significantly influence recovery. Although intraoperative neurophysiological monitoring (IONM) did not show an immediate effect on postoperative outcomes, it was linked to prognostic value for long-term neurological status, suggesting a potential protective role in preserving neurological function. Conclusions: This study identifies age, preoperative functional status, and myelopathy as crucial predictors of postoperative recovery in cervical spine surgery for degenerative disease. These findings underscore the importance of early intervention in patients with myelopathy and highlight the complex role of IONM in improving long-term neurological outcomes. IONM changes may help identify patients at higher risk of poor recovery who could benefit from intensive postoperative rehabilitation. Further prospective studies are warranted to elucidate the complex interactions between patient characteristics and surgical factors in optimizing postoperative recovery....
Childhood trauma encompasses various subtypes, and evidence suggests that neurodevelopmental damage diers across these subtypes. However, the specic impact of childhood emotional neglect (CEN), a distinct subtype of childhood trauma, on the microstructural integrity of brain white maer remains unclear. Therefore, the present study aims to investigate the eects of CEN on the microstructure of brain white maer in young adults using diusion tensor imaging. After administering online questionnaires, conducting interviews, and obtaining diagnoses from specialized physicians, we recruited 20 young adults with a history of CEN and 20 young adults with no history of childhood trauma. Using automating ber tract quantication (driven by a diusion tensor model), we traced the 20 primary white maer bers and divided each ber into 100 nodes for analysis. Group dierences in fractional anisotropy (FA) at each node of each ber were then examined. The results revealed that the FA values at nodes 1–35 of the right thalamic radiation were consistently lower in the emotional neglect group compared to the control group (after FEW correction, cluster threshold = 22, p-threshold = 0.005). These ndings suggest an association between CEN and reduced FA values in the right thalamic radiation, indicating alterations in brain white maer. Overall, our results contribute to the theoretical understanding of how “experience shapes the brain,” providing new insights into the neurostructural consequences of childhood emotional neglect....
Background and Objectives: Depression is a multifactorial mental health disorder involving inflammation, oxidative stress, neuroplasticity deficits, and metabolic dysfunction. Emerging research suggests that vitamin K, beyond its classical roles in coagulation and bone metabolism, may influence neurobiological processes relevant to mood regulation. This systematic review evaluates the association between vitamin K and depressive symptoms and explores potential underlying mechanisms. Materials and Methods: A systematic search was conducted across PubMed, Scopus, Cochrane Library, ScienceDirect, and Google Scholar, following PRISMA 2020 guidelines. Eligible studies included human or animal research examining associations between vitamin K status (dietary intake or serum levels) and depression-related outcomes. Fourteen studies met the inclusion criteria: eleven observational studies, one randomized controlled trial (RCT), and two preclinical animal studies. Results: Most observational studies reported an inverse association between vitamin K intake or serum levels and depressive symptoms across diverse populations. One small RCT demonstrated modest improvements in depression scores following vitamin K2 (menaquinone-7) supplementation in women with polycystic ovary syndrome. Two preclinical studies using non-depression models reported behavioral improvements and reduced oxidative stress following vitamin K2 administration. Conclusions: While preliminary findings suggest a potential role for vitamin K in pathways relevant to depression, the current evidence is limited by cross-sectional designs, lack of isoform-specific analyses, and the absence of depression-focused preclinical models. Mechanisms including inflammation reduction, oxidative stress modulation, sphingolipid regulation, and vitamin K-dependent protein signaling (e.g., GAS6 and osteocalcin) were discussed based on indirect evidence and require further investigation in depression-specific contexts....
Background: Parkinson Disease (PD) is a progressive neurodegenerative disorder. Current therapeutic trials investigate treatments that can potentially modify the disease course. Testing their efficiency requires outcome assessments that are relevant to patients’ daily lives, which include gait and balance. Home-based examinations may enhance patient compliance and, in addition, produce more reliable results by assessing patients more regularly in their familiar surroundings. Objective: The objective of this pilot study was to assess the feasibility of a home-based outcome assessment designed to video record the Timed up and Go (vTUG) test via a study-specific smartphone app for patients with PD. Methods: 28 patients were recruited and asked to perform at home each week a set of three consecutive vTUG tests, over a period of 12 weeks using an app. The videos were subjected to a manual review to ascertain the durations of the individual vTUG phases, as well as to identify any errors or deviations in the setup that might have influenced the result. To evaluate the usability and user-friendliness of the vTUG and app, the System Usability Scale (SUS) and User Experience Questionnaire (UEQ) were administered to patients at the study end. Results: 19 patients completed the 12-week study, 17 of which recorded 10 videos or more. A total of 706 vTUGs with complete timings were recorded. Random Forest Regression yielded “time to walk up” as the most important segment of the vTUG for predicting the total time. Variance of vTUG total time was significantly higher between weeks than it was between the three consecutive vTUGs at one time point [F(254,23) = 6.50, p < 0.001]. The correlation between vTUG total time and UPDRS III total score was weak (r = 0.24). The correlation between vTUG and a derived gait subscore (UPDRS III items 9–13) was moderate (r = 0.59). A linear mixed-effects model revealed a significant effect of patient-reported motion status on vTUG total time. Including additional variables such as UPDRS III gait subscore, footwear and chairs used further improved the model fit. Conclusions: Assessment of gait and balance by home-based vTUG is feasible. Factors influencing the read-out were identified and could be better controlled for future use and longitudinal trials....
Background and Objectives: Extant research on the relationship between fatigue and depression in people with rheumatic diseases portrays a divergent picture. While caring for persons with this medical condition, one issue that represents individual confidence in carrying out specific tasks, namely self-efficacy level, has attracted significant attention. Yet, the information regarding whether self-efficacy may pose a clue linking these two major symptoms is still unknown. The aim of this study, therefore, is to examine whether selfefficacy mediates the association between fatigue and depressive symptoms among persons with rheumatoid arthritis (RA). Materials and Method: A cross-sectional study of 224 females with RA from a hospital in Taiwan was conducted between January and October 2023. We then distributed anonymous self-reported questionnaires instructing participants to provide information on their demographic characteristics, levels of fatigue, self-efficacy, and depressive symptoms. The bootstrap via PROCESS macro in SPSS was executed to analyze if self-efficacy would mediate the effect of fatigue on emergence of depressive symptoms. Results: For those participants captured at baseline, a negative association was noted between fatigue and self-efficacy, as well as between self-efficacy and depressive symptoms. Results of the mediation analysis revealed a remarkable indirect effect of fatigue on depressive symptoms through self-efficacy, with a regression coefficient of 0.21 (95% confidence intervals: 0.06–0.37). Conclusions: This work extends current understanding of the roles that fatigue and self-efficacy play in predicting depression among people with RA and further clarified the potential mediating role of self-efficacy in buffering against depressive symptomatology. Interventions that extend from the management of fatigue and further incorporate the improvement of self-efficacy sense into the stereotypical therapy should greatly mitigate the distressing symptoms for patients with RA....
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