Showing papers by "Walter Paulus published in 2023"
TL;DR: Chen et al. as mentioned in this paper provided a comprehensive review of the clinical diagnostic utility of transcranial magnetic stimulation (TMS) in neurological diseases, including stroke, myelopathy, and Alzheimer's disease.
8 citations
TL;DR: Owolabi et al. as mentioned in this paper proposed a neurological quadrangle, which aims to provide equitable and effective surveillance, prevention, acute care and rehabilitation of neurological disorders globally, with an emphasis on building global synergies and fostering a "neurological revolution" across four key pillars.
Abstract: The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization’s new Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022–2031, presents an opportunity to rethink the delivery of neurological services. In this Perspective, we highlight the global burden of neurological disorders and propose pragmatic solutions to enhance neurological health, with an emphasis on building global synergies and fostering a ‘neurological revolution’ across four key pillars — surveillance, prevention, acute care and rehabilitation — termed the neurological quadrangle. Innovative strategies for achieving this transformation include the recognition and promotion of holistic, spiritual and planetary health. These strategies can be deployed through co-design and co-implementation to create equitable and inclusive access to services for the promotion, protection and recovery of neurological health in all human populations across the life course. In this Perspective, Owolabi et al. propose strategies to improve brain health and address the growing global burden of neurological disorders. They present a new framework — the neurological quadrangle — which aims to provide equitable and effective surveillance, prevention, acute care and rehabilitation of neurological disorders globally.
3 citations
TL;DR: In this paper , the authors investigated the relationship between myocardial remodeling and natriuretic peptide (NP) levels in patients with heart failure with preserved ejection fraction (HFpEF).
Abstract: In heart failure with preserved ejection fraction (HFpEF), natriuretic peptide (NP) levels are frequently lower. In several trials, the outcome differed between patients with low and high NP levels. This suggests that NP could be used to identify distinct stages of left ventricular (LV) remodeling and myocardial tissue composition. This study investigated cardiac remodeling/dysfunction and myocardial tissue characteristics assessed by echocardiography and cardiac magnetic resonance (CMR) in HFpEF patients in relation to NP levels. Clinical and echocardiographic data of 152 HFpEF patients were derived from outpatient visits. A total of 71 HFpEF patients underwent CMR-derived T1-mapping. Multivariable regression analyses were performed to examine the association of NT-proBNP categories ( median) and NT-proBNP as continuous variable with echocardiography and CMR-derived T1-mapping. Mean age was 71 ± 9, 93% of patients were women and median NT-proBNP was 195 pg/mL, with 35% of patients below the diagnostic cut-off value (<125 pg/mL). Patients with high NT-proBNP had comparable LV systolic function and LV relaxation but significantly worse LV stiffness and left atrial function compared with patients with low NT-proBNP. Higher NT-proBNP was significantly associated with higher LV stiffness and extracellular volume fraction (ECV) (β = 1.82, 95% CI: 0.19;3.44, p = 0.029). Higher NT-proBNP levels identify HFpEF patients with worse LV stiffness because of more severe myocardial extracellular matrix remodeling, representing an advanced stage of HFpEF.
1 citations
TL;DR: Temporal interference stimulation (TIS) aims at targeting deep brain areas during transcranial electrical alternating current stimulation (tACS) by generating interference fields at depth as mentioned in this paper .
Abstract: Temporal interference stimulation (TIS) aims at targeting deep brain areas during transcranial electrical alternating current stimulation (tACS) by generating interference fields at depth. Although its modulatory effects have been demonstrated in animal and human models and stimulation studies, direct experimental evidence is lacking for its utility in humans (in vivo). Herein, we directly test and compare three different structures: firstly, we perform peripheral nerve and muscle stimulation quantifying muscle twitches as readout, secondly, we stimulate peri-orbitally with phosphene perception as a surrogate marker, and thirdly, we attempt to modulate the mean power of alpha oscillations in the occipital area as measured with electroencephalography (EEG). We found strong evidence for stimulation efficacy on the modulated frequency in the PNS, but we found no evidence for its utility in the CNS. Possible reasons for failing to activate CNS targets could be comparatively higher activation thresholds here or inhibitory stimulation components to the carrier frequency interfering with the effects of the modulated signal.
TL;DR: Pua et al. as mentioned in this paper reported early stage myocardial alterations in hypertension and patients with hypertension with diabetes, including increased concentricity, replacement fibrosis and higher extracellular volume fraction.
Abstract: In this issue of the journal, Pua et al 1 provide us with fascinating data on myocardial remodeling in patients with asymptomatic hypertension and in patients with asymptomatic hypertension with diabetes. Using a combined cardiac magnetic resonance imaging and biomarker approach, they reported early stage myocardial alterations in hypertension and patients with hypertension with diabetes. These consisted of (1) increased concentricity in patients with hypertension with diabetes; (2) more replacement fibrosis and higher extracellular volume fraction (ECV) in patients with hypertension with diabetes than in hypertension; (3) serum NT-proBNP (N-terminal pro-B-type natriuretic peptide) and GDF-15 (growth differentiation factor 15) being associated with replacement fibrosis and ECV in, respectively, hypertension and patients with hypertension with diabetes; (4) increased activity of inflammatory response and immune cell trafficking in pathway analysis of serum proteins in patients with hypertension with diabetes.