Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Background: Although the most serious consequence of neuronal ischemia is acute neuronal death, mounting\nevidence suggests similarities between stroke and neurodegenerative disease. Brain atrophy visualized on structural\nMRI and pathological cerebrospinal fluid (CSF) concentrations of microtubule-associated protein tau (T-tau) and\nphosphorylated microtubule-associated protein tau indicate neurofibrillary degeneration. We aimed to explore the\nassociation between CSF T-tau and brain atrophy 1 year post-stroke.\nMethods: We included 210 patients with first-ever ischemic stroke or transitory ischemic attack without pre-existing\ncognitive impairment. After 12 months, subjects underwent MRI, and CSF biomarkers were assessed. Using SIENAX\n(part of FSL), ventricular CSF volume and total brain volume were estimated and normalized for subject head size.\nThe association between T-tau as explanatory variable and ventricular and total brain volume as outcome variables\nwere studied using linear regression.\nResults: One hundred eighty-two patients completed the follow-up. Forty-four had a lumbar puncture. Of these, 31\nhad their MRI with identical scan parameters. Mean age was 70.2 years (SD 11.7). Ventricular volume on MRI was\nsignificantly associated with age, but not with gender. In the multiple regression model, there was a significant\nassociation between T-tau and both ventricular (beta 0.44, 95% CI 376.3, 394.9, p = 0.021) and global brain volume\n(beta âË?â??0.50, 95% CI âË?â??565.9, âË?â??78.3, p = 0.011). There was no significant association between CSF T-tau 1 year poststroke\nand baseline volumes.\nConclusion: T-tau measured 1 year post-stroke is associated with measures of brain atrophy. The findings indicate\nthat acute stroke may enhance or trigger tau-linked neurodegeneration with loss of neurons....
Seizures are one of the common causes for hospital admissions in children with significant mortality andmorbidity. This study was\nconducted to study the prevalence and clinicodemographic profile of children with seizures in a tertiary care hospital of western\nNepal. This prospective cross-sectional study conducted over a period of 2 years included all admitted children (2 monthsââ?¬â??16 years)\nwith seizures. Among 4962 admitted children, seizures were present in 3.4% (...
Background: Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and\nbrainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under\ndifferent stimuli of external emotions.\nMethods: This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited\nto answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression\ninventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of\nDisgust, Erotica, Fear, Happiness, and Sadness.\nResults: The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters.\nCompared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness\nand sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged\nES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness.\nMoreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I.\nConclusions: The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was\nindependent of the patient�s ongoing emotions. Our study thus provides some hints to distinguish the two types\nof bipolar disorders....
Objective: One patient received oral levodopa during a study aiming for better\nunderstanding of the basal ganglia and of the mechanisms of deep brain\nstimulation of the subthalamic nucleus (STN DBS) with and without intravenous\n(IV) levodopa infusion in patients with Parkinson�s disease (PD). The\nresults from oral and IV levodopa treatment are presented. Methods: Five patients\nwith advanced PD were included in the original study. During planned\nSTN DBS surgery microdialysis probes were implanted in the right putamen\nand in the right and left globus pallidus interna (Gpi). During the study, microdialysis\nwas performed continuously and STN DBS, with and without IV levodopa\ninfusion, was performed according to a specific protocol. After DBS\nsurgery, but before STN DBS was started, one patient received oral levodopa/\nbenserazide and entacapone tablets out of protocol due to distressing parkinsonism.\nResults: The levodopa levels increased prompt in the central nervous\nsystem after the first PD medication intakes but declined after the last. Immediately\nthe levodopa seemed to be metabolized to dopamine (DA) since the\nlevels of DA correlated well with levodopa concentrations. Left STN DBS\nseemed to increase DA levels in left Gpi and right STN DBS seemed to increase\nDA levels in right Gpi while all STN stimulation seemed to increase the\nDA levels in right putamen. There was no obvious effect on levodopa levels.\nConclusions: The results indicate that PD patients still have capacity to metabolize\nlevodopa to DA despite advanced disease with on-off symptoms and\nprobably pronounced nigral degeneration. STN DBS seems to increase DA\nlevels with a more pronounced effect on ipsilateral structures in striatum....
We report here a patient in whom the effects of a cerebellum mass may have led to development of obsessive-compulsive disorder\n(OCD). A 33-year-old woman showed symptoms of OCD, including obsessive worry about infection from tainted blood and\nrepetitive confirmation, which worsened during pregnancy. She had comprehension in regard to her illness and no evidence of\ncognitive dysfunction and did notmeet other DSM-5 criteria such as depression. One month after giving childbirth, the symptoms\nworsened, while headache and dizziness also developed. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score was 34.The\npatient was examined for a headache and a posterior cranial fossameningioma was found. Following resection of the meningioma,\nthe OCD symptoms were remarkably reduced (Y-BOCS score 10).There is only one previous report of pure OCD associated with\na cerebellar mass and the present findings should help to elucidate the mechanism....
Background: The effectiveness of creatine in treating Parkinson�s disease (PD) has not been conclusively\ndetermined. Therefore, we performed a meta-analysis to address this issue.\nMethods: The Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, and other databases were\nsearched, and outcomes measured by the Total Unified Parkinson�s Disease Rating Scale (UPDRS) and the Schwab &\nEngland Scale were analyzed.\nResults: Five randomized controlled trials (RCTs) were selected, and 1339 participants were included in the analysis.\nThere were no significant differences between the control and treatment groups in the total, mental, activities of daily\nliving (ADL), or motor UPDRS scores, but an improvement in Schwab & England Scale scores was observed.\nConclusions: Creatine has no observed benefit in PD patients, although more correlated studies are still needed....
Background: Several studies have indicated that obsessive-compulsive disorder (OCD) is a common comorbidity in\npatients with psychotic disorders, but there is sparse knowledge about the relationship between symptoms of OCD\nand psychotic symptoms. Metacognitions which guides thinking and coping is theorized to be a transdiagnostic\ncomponent central for development and maintenance of psychological disorders, OCD and psychosis included. The\naim of the study was therefore to explore how symptoms of OCD and metacognitions relate to symptoms of\npsychosis. Our main hypotheses were that metacognitions would be significantly related to all symptoms of\npsychological distress, and that there is considerable overlap between symptoms of psychosis and OCD.\nMethods: Community controls (N = 194) completed an internet survey measuring levels of paranoid ideation,\npredisposition to hallucinations, symptoms of OCD, depression, anxiety, and metacognitions. Correlations and\nhierarchical multiple linear regression analyses were used to unveil the relationship between symptoms and beliefs.\nResults: Symptoms of OCD showed a strong positive correlation with symptoms of psychosis, and the relationships\nwere still significant after controlling for symptoms of anxiety and depression. Metacognitions also showed strong\npositive correlations with all symptom measures. Metacognition and OCD-symptoms accounted for 53.8% of the\nvariance in paranoid ideation and 43.8% of predisposition to hallucinations. There was a large overlap between\nsymptoms of psychosis, OCD-symptoms, and metacognitions (30.2ââ?¬â??37.3%).\nConclusions: In general, the results suggest considerable overlap between paranoid ideation, predisposition to\nhallucinations, and OCD and metacognitive beliefs in a non-clinical sample. Further experimental- and clinical\nstudies are needed in order to explore metacognitive models of OCD and psychosis....
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