Archives of Neuroscience
Year:2020 | Volume:7 | Issue:3|Papers Count:12

Context: Osteopontin (OPN) is a matrix phosphoprotein expressed by a variety of tissues and cells, including the immune system and the nervous system. Previous studies have shown that OPN may have a role in neurodegenerative diseases, including multiple sclerosis, Parkinson’ s disease, and Alzheimer’ s disease. Objectives: The present study aimed to systematically review studies investigating the role of OPN in amyotrophic lateral sclerosis (ALS) patients or the disease animal model. Evidence Acquisition: We searched the Cochrane Library, PubMed, Web of Science, and Scopus to find relevant articles published up to January 20, 2019. Both human and animal model studies of ALS were considered. Results: A total of nine articles (four human studies and five animal model studies) were included. Two of the human studies reported that the CSF levels of OPN were higher among ALS patients compared to controls. The other two human studies found that OPN levels in cortical neurons did not differ significantly between ALS cases and the non-neurological control group. One of the studies found that the expression level of OPN in astrocytes was similar between ALS patients and the control group, but the level of microglial OPN significantly increased in ALS cases. Four of the animal model studies reported that the expression of OPN mRNA in spinal cord microglia significantly increased during the disease progression. The remaining animal model study found that OPN was selectively expressed by fast fatigue-resistant and slow motor neurons (MNs), which are resistant to ALS, and that the OPN expression was low among fast-fatigable MNs. Conclusions: Prompt microglial activation is a hallmark pathology of ALS, and OPN is among the most widely expressed proteins by these activated glial cells. Therefore, OPN might have a role in ALS pathogenesis. The existing evidence is not sufficient to justify whether OPN has a neurotoxic or neuroprotective role in ALS. We encourage researchers to investigate the role of OPN in ALS pathogenesis more extensively.

Introduction: Ultrasound-guided nerve blocks have enhanced our abilities to selectively and effectively suppress certain nerves to accomplish specific goals, including blockade a localized seizure muscle movement without affecting the seizure threshold or level of the consciousness. Case Presentation: This is a case report of the blockade of the movement of a chewing muscle by the continuous (catheter-based) mandibular nerve block in a 27 years old man with high-frequency partial seizures in facial muscles who was a candidate for seizure focus ablation. An out-of-plane approach was used to insert a catheter near the mandibular nerve to provide intermittent or continuous peripheral nerve block. This report demonstrated that a continuous block of the mandibular nerve could effectively facilitate the seizure focus mapping and ablation. Conclusions: We can selectively suppress the contractures of a certain muscle in partial seizures by a continuous block of the responsible nerve. This blockade can facilitate seizure focus mapping and ablation.

Background: Spreading depolarization is associated with the extension of lesion size and complications in some important neurological diseases such as stroke, epilepsy, migraine, and traumatic brain injury. Objectives: This study aimed to reveal some molecular aspects of spreading depolarization and suggesting new therapeutic targets for its control by changing the function of different astrocytic and neuronal ion channels. Methods: The effects of nortriptyline on spreading depolarization in cortical and hippocampal tissues and on the electrophysiological properties of CA1 hippocampal pyramidal neurons were assessed by extra-and intracellular recording, following washing rat brain slices by the drug. Results: Nortriptylinemadea significant increase in the amplitude of spreading depolarization in corticalandhippocampal tissues relative to control but did not change the duration significantly in each of the tissues. No significant difference was found in the effects of spreading depolarization on the electrophysiological properties of the CA1 pyramidal neurons between nortriptyline and control groups. Conclusions: The stimulating effect of nortriptyline on spreading depolarization is probably related to the augmentation of extracellular potassium collection in the cortex and hippocampus due to inhibition of astrocytic potassium scavenging function. This change can make more neurons prone to depolarization and increase the overall amplitude of spreading depolarization waves. Further studies should assess the effect of enhancing the clearance function of astrocyte-specific inwardly rectifying potassium channels, Kir4. 1, or preventing other factors contributing to spreading depolarization on control of the process.

Context: Mortality related to intubation occurs as a result of multiple factors such as patient’ s condition, operator’ s skills, equipment use, intubation time, duration of laryngoscopy and intubation, and drugs and dosage used for endotracheal intubation (ETI). Objectives: This systematic review and meta-analysis aimed to determine mortality related to intubation and the overall intensive care unit (ICU) mortality rate in adult general ICUs. Methods: We performed a systematic review and meta-analysis on randomized clinical trials and cohort and cross-sectional research from three electronic databases with hand searching. The studies reported mortality related to intubation and the overall ICU mortality rate in adult general ICUs. Our search resulted in 28 published articles without any restriction on date and language. The systematic review and meta-analysis was performed to examine mortality related to intubation and the overall ICU mortality rate. Results: We found 7, 866 articles in the literature review from the three databases based on our keywords, of which 28 studies were eligible to include in the study. We observed that mortality related to intubation and the overall ICU mortality rate in intubated patients were 1% and 30%, respectively. Conclusions: This was the first comprehensive systematic review on mortality related to intubation and the overall ICU mortality rate in adult general ICUs, which showed the current care of ETI. However, it was associated with increased complications, which may increase mortality.

Background: B-group vitamins can potentially contribute to migraine prophylaxis through various mechanisms. We conducted a quasi-experimental study to assess the efficacy and tolerability of a combination of vitamins B1, B6, and B12 (Neurobion) for prophylaxis of menstruation-related migraine attacks. Methods: Women diagnosed with menstrual-related migraine, both chronic and episodic headaches, were enrolled. The patients began Neurobion therapy one week before the menstruation cycle, and repeated the injection for three consecutive months; each ampoule contained 100 mg of vitamins B1 and B6 as well as 1000  g of vitamin B12. Neurobion was used as an add-on therapy for patients receiving the same prophylactic therapy during the last two months before the start of the study. The outcome parameter examined the severity of menstrual-related migraine attacks on a 10-point visual analog scale (VAS). Results: Three hundred eighty-three patients (169 with chronic migraine and 214 with episodic migraine) were included in the final analysis. The patients received treatment with a combination of vitamins B1, B6, and B12 with positive results. The mean intensity of menstrual-related migraine attacks was reduced from 6. 7 on the 10-point VAS to 3. 2 (P < 0. 001) in patients with chronic migraine. The mean severity of menstrual-related migraine attacks was also reduced from 7. 2 to 3. 7 in patients with episodic migraine (P < 0. 001). There was no significant difference in the reduction of headache severity between the two groups of migraineurs (P = 0. 985). Conclusions: Neurotropic vitamins, including pyridoxine, thiamine, and cyanocobalamin yielded significant reductions in the severity of menstrual-related migraine attacks. Neurobion as a combination of vitamins B1, B6, and B12 appears to be well-tolerated and beneficial as an adjuvant in treatment and prophylaxis of menstrual-related migraine attacks. Further large-scale trials with long-term follow-up will be required to confirm our results.

Background: Diabetes is an important risk factor of extra and intracranial stenosis and hence can cause cerebrovascular stroke, In Egypt, prevalence of asymptomatic extra and intracranial blood vessels stenosis in diabetic patients is still unknown, Objectives: To estimate the prevalence of asymptomatic extra and intracranial vessels stenosis, Methods: 100 Patients with Type-2 Diabetes (T2D) were recruited consecutively from diabetes clinic of the department of internal medicine at Assiut University Hospitals in the period from 1st January 2016 to 31st January 2017, A detailed history was obtained for all participant, As well, thorough-out physical and neurologic examination were carried out for patients, All patients underwent extra cranial and transcranial colour coded ultrasound by two independent investigators, Patients with history of cerebrovascular stroke and transient ischemic attacks were excluded, Results: 36% of patients had increased IMT, 6% had stenosis 50-69% and 2% had stenosis  70%, There was a positive correlation between age and increased IMT (r = 0, 272) (P = 0, 006) and between uncontrolled DM and increased IMT (r = 0, 211) (P = 0, 035), 26% of patients had stenosis of < 50% in vertebral artery (21% in V0 segment, 5% in V1 segment); being male and uncontrolled diabetes escalate the stenosis risk, MCA pulsatility index was found to be higher among old diabetics in comparison to younger diabetics and control group (r =-0, 225) (P =-0, 025), Also, the longer the time since T2D onset, the higher was MCA PSV (r = 0, 244) (P = 0, 014), Conclusions: The cerebral blood vessels atherosclerotic changes (mainly extracranial) are higher among diabetics in comparison to healthy controls.

Context: Bispectral Index (BIS) was introduced in 1960 to monitor the depth of anesthesia in the operating rooms. It has been recently used to monitor the sedation in the critically ill patients hospitalized in intensive care and neurocritical care units (NCCU). Evidence Acquisition: Patients in the NCCU, particularly those with prolonged mechanical ventilation require appropriate adjustments in the administration of sedative drugs. Similarly, those who require neuro protection with barbiturates need to be closely monitored in the depth of their coma. Results: BISmaybe a useful tool in this situation, andit can also help shorten the duration of mechanical ventilation by determining the appropriate time to eliminate patients from mechanical ventilation. We conducted a literature search to evaluate the utility of BIS monitoring in the NCCU patients with subarachnoid hemorrhage, intracranial hemorrhage, coma, cerebral hypoxia, status epilepticus and traumatic brain injury. Conclusions: BIS monitoring may be a useful adjunct to take care of the patients. However, further studies with a larger population and better design are required to substantiate the role of BIS monitoring in the care of NCCU patients.

“ Leave me alone! Let me have a sound sleep tonight. I feel scared. I do repent for my evil work. I am being receptive and no longer arrogant. Help me. Savemyskin andmy soul. I am being punished for my perversion. ” Yelled the writer at the top of his lungs in his nightmarish dream. Oneof his guardswhowereonduty for the writer’ s protection came in and said, “ Is anything wrong? ” The writer got up from his bed and said, “ No, things are fine. I just had a bad dream. ”..

Background: Fatigue, sleep disorders, and anxiety are common symptoms in multiple sclerosis (MS) patients. MS reduced the quality of life by these symptoms in patients. Studies have shown that foot reflexology may reduce some problems of this disease. Objectives: The present randomized controlled trial study investigated the effect of reflexologyonfatigue, sleep quality, andanxiety in patients with multiple sclerosis. Methods: This study included 63 patients with MS referred to Arak MS society in 2018-2019. Reflexology and placebo intervention had applied twice a week for 4 weeks, and each session lasted about 30-40 minutes. Fatigue Impact scale (FIS), Pittsburgh sleep quality index (PSQI) and state-trait anxiety inventory (STAI) was used for data collection before and after the intervention. A significant statistical level was considered 0. 05. Data were analyzed using the SPSS software (V. 16. 0). Results: Significant improvement was observed in physical fatigue (P = 0. 042), sleep quality (P = 0. 001) and anxiety (P = 0. 034) in the reflexology group after the intervention. Fatigue Impact Scale (FIS) revealed a decrease in fatigue level in MS patients, but these alterations were not significant (P = 0. 134). Conclusions: Reflexology is a non-invasive, simple, affordable, and low-cost nursing intervention that can be helpful in reducing physical fatigue, anxiety, and improving sleep quality of people with MS.

Background: Motor imagery training is a cognitive process in which an internal representation of amovementis activated in working memory. The movement is mentally rehearsed, without any physical activity. Task-specific training emphasizes the repetitive practice of skilled movement to enhance functional abilities in hemiparesis. Objectives: To investigate whether task specific training preceded by motor imagery or task specific training alone was more effective for facilitating sit to stand in patients with stroke. Methods: Thirty male patients with stroke were selected from the Cairo University Outpatient Clinic; the median age of participants was 54. 5  3. 51 years and they were divided equally into two groups. Patients in study group A (n = 15) received motor imagery training for 15 minutes followed by task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The control group B (n = 15) received task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The Fugl-Meyer section of the lower extremity (FMA-LE), Timed up and go test (TUG), and Biodex Balance system were assessed before and after treatment. Results: The results were highly significant for all variables including FMA-LE, TUG and Biodex Balance system in favor of the study group, post treatment. (P = 0. 0004, P = 0. 0001 and P = 0. 0001, respectively). Conclusions: Motor imagery training results in greater improvement in sit to stand ability when used in conjunction with task specific training, rather than task specific training alone.

Background: Parkinson’ s disease is the second most frequently reported neurodegenerative disease, behind Alzheimer’ s disease. In Morocco, enough information are not available about its prevalence, progression, and characteristics, particularly in Southern regions of the country. Objectives: The current study aimed to investigate gender and age differences in the sociodemographic and clinical profile of Parkinson’ s disease patients in southern Morocco. Methods: A cross-sectional descriptive study was conducted on a selected cohort of 180 patients, previously diagnosed with Parkinson’ s. Results: The results showed that the onset of the disease was earlier in females compared to males. Besides, we found that the prevalence of rigidity symptoms was slightly higher in younger patients and in patients aged 61 to 70 years old, at the onset of the disease. Importantly, the results showed that the initial symptoms of males were different than females. According to the Hoehn and Yahr scale, the majority (82. 6%) of patients of both genders were in the early stage of the disease. Additional statistical analyses, confirmed that the severity of the disease was strongly related to gender (P = 0. 02). Conclusions: The findings confirmed that males and females had different clinical motor characteristics in the initial symptoms and progression of Parkinson’ s disease. Nevertheless, experimental studies should be conducted to arrive at a real understanding of what underlies these differences.

Background: One of the most frequent complaints that emergency medical services (EMS) deal with is seizure. The missions of EMS on these cases may lead to transferring the patient to the emergency department (ED). Objectives: Therefore, the present study was conducted to compare the short-term outcome of transported versus not-transported cases. Methods: Our population sample was selected retrospectively from medical records in TehranEMScenter for 6 months in which the plan was transferring to a specific hospital. The cases were divided into transported or not-transported. Wextracted and compared the cases’ demographic data, vital signs, conducted prehospital management, patient disposition, and their short-term outcome. Results: We evaluated 486 cases, 173 of whom were males (35. 6%) and the mean age of patients was 34. 8 32. 0 years old. 329 (67. 7%) and157 (32. 3%)werein the not-transportedandthe transportedgroup, respectively. Amongall not-transported cases, wecould follow 172 patients, 52 of whomhad gone to hospital during the next 72 hours. 22 out of the 52 cases were discharged from ED the same day. Overall, the ED discharge rate was significantly more in the transported group (P < 0. 001). Short-term mortality had no significant difference in the two study groups (P = 1. 00). Conclusions: Most of the not-transported patients did not go to the hospital during further 72 hours, and some were hospitalized. Most of the patients transported to the hospital were discharged from the ED. The short-term mortality rate was not different.