Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 6 Articles
Background/Objectives: The aim of this study was a video-based observational assessment of movement strategies during supine position transfers in patients with hemiparesis following a first-ever ischemic stroke. Methods: The study included 51 participants (n = 51), covering 20 healthy individuals (n = 20) and 31 patients (n = 31) after their first ischemic stroke with hemiparesis. All participants underwent observational kinematic analysis of supine mobility using video recording and time-lapse analysis. The assessment focused on the time required to complete the task, the number of pelvic movements, the presence of trunk translation, spinal flexion, and pelvic mobility across three planes. Results: In the control group, transfers followed a consistent and repetitive sequence in both directions, typically involving trunk translation, spinal flexion, pelvic elevation, and symmetrical movement of both upper and lower limbs. In contrast, post-stroke patients demonstrated altered, asymmetrical, and less efficient movement patterns. These movement strategies were consistent across the hemiparetic group and characterized typical motor responses following stroke. The average transfer time in the study group was approximately three times longer than in the control group. The average number of pelvic movements was 7.2 ± 2.44 in healthy individuals and 16.71 ± 13.52 in post-stroke patients. Conclusions: Supine transfers should be routinely assessed in patients after stroke and included as a key focus in physiotherapy goals. The movement patterns required for such transfers represent a distinct component of complex motor function. Both qualitative and quantitative aspects of their execution may have a significant impact on functional independence in individuals with hemiparesis. Identifying typical transfer patterns in hemiparetic patients may offer valuable guidance for early post-stroke rehabilitation planning, particularly in preventing maladaptive compensatory strategies....
Background Relapse remains a major challenge in substance use disorder (SUD) Cognitive-behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are effective in reducing relapse and improving quality of life (QoL) for individuals with SUD. This study aimed to develop, culturally adapt, and evaluate the feasibility and preliminary efficacy of an integrated psychotherapeutic program for individuals with opioid use disorder (OUD) in Egypt, and to identify predictors of relapse. Methods A quasi-experimental study was conducted to compare the effectiveness of either an integrated intervention combining CBT-based relapse prevention, MI, MBCT, family psychoeducation, peer support, and twelvestep facilitation, or treatment-as-usual (TAU). Feasibility outcomes included recruitment, retention, and adherence. Clinical outcomes relapse rates, Addiction Severity Index (ASI) scores, and WHOQOL-BREF scores were assessed at baseline, 3 months, and 6 months. Predictors of relapse were examined using Cox regression. Results The integrated program showed high feasibility, with 90% retention and strong adherence, and demonstrated clear superiority over TAU. Relapse rates were significantly lower at 3 and 6 months (33.3% vs. 66.7% and 44.4% vs. 77.8%; p = 0.001). Participants exhibited significant reductions in all ASI domains and all WHOQOLBREF dimensions. Survival analysis confirmed a substantially lower relapse hazard, while multivariate modelling identified unemployment, illiteracy, unmarried status, higher opioid dose, repeated detoxification attempts, and poor adherence as independent predictors of relapse. Conclusions The culturally adapted, integrated psychotherapeutic program is a feasible and promising intervention, associated with reduced relapse rates, significant improvements in addiction severity, and enhanced quality of life over six months. These findings support the implementation of culturally tailored, multimodal psychological interventions for OUD in low- and middle-income countries like Egypt....
In less than 30 years, Deep Brain Stimulation (DBS) has evolved from an antiparkinsonian rescue intervention into a flexible neuromodulatory therapy with the potential for personalized, adaptive, and enhancement-focused interventions. In this review we collected evidence from seven areas: (i) modern eligibility criteria, and ways to practically improve on these, outside of ‘Core Assessment Program of Surgical Interventional Therapies in Parkinson’s Disease’ (CAPSIT-PD); (ii) cost-effectiveness, where long-horizon models now show positive incremental net monetary benefit for Parkinson’s disease, and rechargeable-devices lead the way in treatment-resistant depression and obsessive–compulsive disorder; (iii) anatomical targets, from canonical subthalamic nucleus (STN)/globus pallidus internus (GPi) sites, to new dual-node and cortical targets; (iv) mechanistic theories from informational lesions, antidromic cortical drive, and state-dependent network modulation made possible by optogenetics and computational modeling; (v) psychiatric and metabolic indications, and early successes in subcallosal and nucleus-accumbens stimulation for depression, obsessive–compulsive disorder (OCD), anorexia nervosa, and schizophrenia; (vi) procedure- and hardware-related safety, summarized through five reviews, showing that the risks were around 4% for infection, 4–5% for revision surgery, 3% for lead malposition or fracture, and 2% for intracranial hemorrhage; and (vii) future directions in connectomics, closed-loop sensing, and explainable machine learning pipelines, which may change patient selection, programming, and long-term stewardship. Overall, the DBS is entering a “third wave” focused on a better understanding of neural circuits, the integration of AI-based adaptive technologies, and an emphasis on cost-effectiveness, in order to extend the benefits of DBS beyond the treatment of movement disorders, while remaining sustainable for healthcare systems....
Background: Electroconvulsive therapy (ECT) is a well-established intervention for severe and treatment-resistant psychiatric disorders, yet its use in adolescents remains limited, particularly in Europe. Data on its safety and effectiveness in this population are scarce. This study aimed to evaluate the clinical outcomes and tolerability of ECT in adolescents diagnosed with schizophrenia and schizoaffective disorder. Methods: We conducted a retrospective observational case series of 22 adolescents (mean age 16.7 ± 1.3 years) treated with ECT between 2017 and 2024 at a university psychiatric department. Diagnoses included paranoid schizophrenia (n = 15), catatonic schizophrenia (n = 2), and schizoaffective disorder (n = 5). Symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS) before and after the ECT course. Adverse events were evaluated based on daily clinical monitoring and medical records. Results: The overall response rate, defined as ≥50% reduction in total PANSS score, was 82% (schizophrenia: 82%; schizoaffective disorder: 80%). Mean PANSS total score decreased from 158.0 ± 22.6 to 72.1 ± 20.7 (p < 0.0001). Improvements were most pronounced in the general psychopathology and positive symptom domains. No serious adverse events were observed. The most common transient side effects were headache (41%), memory complaints (27%), and somnolence (22%). Conclusions: ECT appears to be an effective and safe treatment option for adolescents with treatment-resistant schizophrenia and schizoaffective disorder. These findings add to the limited European evidence base and support considering ECT earlier in the treatment course of severe adolescent psychosis. Larger, prospective studies with long-term follow-up are warranted to confirm these results....
Introduction: Onychophagia, commonly known as nail-biting, is a chronic and repetitive behaviour disorder characterised by a compulsive/habitual nature. Obsessive–compulsive disorder (OCD) and onychophagia present a noteworthy intersection in clinical psychiatry. With a paucity of clinical investigations on this topic, we decided to perform a study on onychophagia in OCD. Materials and Methods: In this cross-sectional investigation, the sample comprised patients (aged 18 years and older) having a primary diagnosis of OCD (DSM-5) and a score on the Yale–Brown Obsessive–Compulsive Scale of at least 16 (moderate OCD). Individuals were referred to the Department of Neuroscience at the University of Turin. Analysis of the data was performed using JASP (Version 0.16.3), a freely available statistical programme created by the University of Amsterdam (JASP Team, 2022). Statistical value was set at p < 0.05. Results: Our sample consisted of 603 individuals with OCD, and onychophagia was present in 52 of the cases, with a prevalence of 8.6% (95% CI: 6.5–11.2%). Individuals with OCD and onychophagia had some specific clinical features compared to patients with only OCD. The main difference was detected in terms of the presence of autism spectrum disorder (ASD): in the group of patients having OCD and onychophagia, a prevalence of ASD as high as 96.2% was identified, compared to 18.0% in the OCD-without-onychophagia group. Discussion: Onychophagia is a relatively common problem in patients with OCD, with almost one individual out of ten experiencing this issue. OCD and onychophagia, when both present, might define a peculiar clinical phenotype with specific characteristics. The extremely high frequency of ASD in patients with OCD and onychophagia (96.2%) might be very useful information for clinicians, who should pay particular attention to screening for autism in this cohort of individuals....
Background Multiple sclerosis (MS) is an autoimmune neurodegenerative disorder frequently associated with migraines, complicating management. Ultrasound-guided greater occipital nerve block (GONB) shows promise for migraine relief in MS, but its efficacy remains under investigation. The aim of this study was to assess the effectiveness of ultrasound-guided GONB in chronic, treatment-resistant migraines among MS patients, focusing on frequency, intensity, duration, quality of life, and potential predictors of response. In an uncontrolled single-arm pilot study, 20 MS patients with refractory migraines were selected from March to September 2024 and received ultrasound-guided GONB. Demographics, MRI findings, and migraine outcomes were recorded and assessed over 3 months, Follow-up assessments occurred at 2 weeks (for side effects), and then at 1-, 2-, and 3-months post-procedure. Results Participants (mean age 36.7, 70% female, 85% relapsing–remitting MS) showed initial reductions in migraine frequency, duration, intensity, and medication use. By 3 months, improvements in intensity (p = 0.001) and medication use (p = 0.002) persisted, while frequency and duration regressed. HIT-6 scores improved (p < 0.001), but MIDAS scores did not. No predictors of response were identified. Although the single-arm design limits attribution of effects to the intervention. Conclusion Ultrasound-guided GONB provided short-term benefits in migraine outcomes, with lasting improvements in intensity, medication use, and quality of life, though long-term efficacy and predictors remain unclear. The type of the study with absence of a control group makes it difficult to establish the true effectiveness of GONB compared with other migraine therapies....
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