Showing papers in "Behavioural Neurology in 2021"

Limonene through Attenuation of Neuroinflammation and Nitrite Level Exerts Antidepressant-Like Effect on Mouse Model of Maternal Separation Stress

Abstract: Background and Aim. Depression is a social problem with high economic burden in the society. Finding an effective agent with high efficacy and few side effects is therefore needed. Involvement of neuroimmune response as well as nitric oxide (NO) has been determined in the pathophysiology of depression. Limonene is a terpene with various pharmacological properties. Thus, we aimed to evaluate antidepressant-like effect of limonene on a mouse model of maternal separation (MS) focusing on neuroinflammation and NO level in the hippocampus. Methods. Mice were randomly divided into experimental groups as follows: the control group received normal saline and MS groups received normal saline, limonene (10 and 20 mg/kg), L-NAME (10 mg/kg), L-arginine (L-arg) (75 mg/kg), limonene (10 mg/kg) plus L-NAME, and limonene (20 mg/kg) plus L-arg. Behavioral tests including the forced swimming test (FST), open field test (OFT), and splash test were performed. Finally, serum and hippocampal nitrite levels as well as the expression of inflammatory genes (IL-1β and TNF-α) in the hippocampus were measured. Results. We showed that MS caused depressive-like behavior. Treatment of MS mice with limonene reduced the duration of immobility time in FST and increases the grooming activity time in the splash test. Limonene also reduces serum and brain nitrite levels and reduces the expression of IL-1β and TNF-α in the hippocampus. We found that L-NAME potentiated the effects of a subeffective dose of limonene. Conclusion. We concluded that the antidepressant-like effects of limonene are probably mediated through inhibition of neuroinflammation and attenuation of nitrite levels in the hippocampus.

Patient Behavioral Analysis with Smart Healthcare and IoT

Abstract: Patient behavioral analysis is the key factor for providing treatment to patients who may suffer from various difficulties including neurological disease, head trauma, and mental disease. Analyzing the patient’s behavior helps in determining the root cause of the disease. In traditional healthcare, patient behavioral analysis has lots of challenges that were much more difficult. The patient behavior can be easily analyzed with the development of smart healthcare. Information technology plays a key role in understanding the concept of smart healthcare. A new generation of information technologies including IoT and cloud computing is used for changing the traditional healthcare system in all ways. Using Internet of Things in the healthcare institution enhances the effectiveness as well as makes it more personalized and convenient to the patients. The first thing that will be discussed in the article is the technologies that have been used to support the smart class, and further, there will be a discussion on the existing problems with the smart healthcare system and how these problems can be solved. This study can provide essential information about the role of smart healthcare and IoT in maintaining behavior of patent. Various biomarkers are maintained properly with the help of these technologies. This study can provide effective information about importance of smart health system. This smart healthcare is conducted with the involvement of proper architecture. This is treated as effective energy efficiency architecture. Artificial intelligence is used increasingly in healthcare to maintain diagnosis and other important factors of healthcare. This application is also used to maintain patient engagement, which is also included in this study. Major hardware components are also included in this technology such as CO sensor and CO2 sensor.

Use of Deep-Learning Genomics to Discriminate Healthy Individuals from Those with Alzheimer's Disease or Mild Cognitive Impairment.

Abstract: Objectives Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder and the most common form of dementia in the elderly. Certain genes have been identified as important clinical risk factors for AD, and technological advances in genomic research, such as genome-wide association studies (GWAS), allow for analysis of polymorphisms and have been widely applied to studies of AD. However, shortcomings of GWAS include sensitivity to sample size and hereditary deletions, which result in low classification and predictive accuracy. Therefore, this paper proposes a novel deep-learning genomics approach and applies it to multitasking classification of AD progression, with the goal of identifying novel genetic biomarkers overlooked by traditional GWAS analysis. Methods In this study, we selected genotype data from 1461 subjects enrolled in the Alzheimer's Disease Neuroimaging Initiative, including 622 AD, 473 mild cognitive impairment (MCI), and 366 healthy control (HC) subjects. The proposed deep-learning genomics (DLG) approach consists of three steps: quality control, coding of single-nucleotide polymorphisms, and classification. The ResNet framework was used for the DLG model, and the results were compared with classifications by simple convolutional neural network structure. All data were randomly assigned to one training/validation group and one test group at a ratio of 9 : 1. And fivefold cross-validation was used. Results We compared classification results from the DLG model to those from traditional GWAS analysis among the three groups. For the AD and HC groups, the accuracy, sensitivity, and specificity of classification were, respectively, 98.78 ± 1.50%, 98.39% ± 2.50%, and 99.44% ± 1.11% using the DLG model, while 71.38% ± 0.63%, 63.13% ± 2.87%, and 85.59% ± 6.66% using traditional GWAS. Similar results were obtained from the other two intergroup classifications. Conclusion The DLG model can achieve higher accuracy and sensitivity when applied to progression of AD. More importantly, we discovered several novel genetic biomarkers of AD progression, including rs6311 and rs6313 in HTR2A, rs1354269 in NAV2, and rs690705 in RFC3. The roles of these novel loci in AD should be explored in future research.

Upper and Lower Limb Motor Function Correlates with Ipsilesional Corticospinal Tract and Red Nucleus Structural Integrity in Chronic Stroke: A Cross-Sectional, ROI-Based MRI Study.

Abstract: Background Structural integrity of the ipsilesional corticospinal tract (CST) is important for upper limb motor recovery after stroke. However, additional neuromechanisms associated with motor function poststroke are less well understood, especially regarding the lower limb. Objective To investigate the neural basis of upper/lower limb motor deficits poststroke by correlating measures of motor function with diffusion tensor imaging-derived indices of white matter integrity (fractional anisotropy (FA), mean diffusivity (MD)) in primary and secondary motor tracts/structures. Methods Forty-three individuals with chronic stroke (time poststroke, 64.4 ± 58.8 months) underwent a comprehensive motor assessment and MRI scanning. Correlation and multiple regression analyses were performed to examine relationships between FA/MD in a priori motor tracts/structures and motor function. Results FA in the ipsilesional CST and red nucleus (RN) was positively correlated with motor function of both the affected upper and lower limb (r = 0.36-0.55, p ≤ 0.01), while only ipsilesional RN FA was associated with gait speed (r = 0.50). Ipsilesional CST FA explained 37.3% of the variance in grip strength (p < 0.001) and 31.5% of the variance in Arm Motricity Index (p = 0.004). Measures of MD were not predictors of motor performance. Conclusions Microstructural integrity of the ipsilesional CST is associated with both upper and lower limb motor function poststroke, but appears less important for gait speed. Integrity of the ipsilesional RN was also associated with motor performance, suggesting increased contributions from secondary motor areas may play a role in supporting chronic motor function and could become a target for interventions.

Revisiting Apathy in Alzheimer's Disease: From Conceptualization to Therapeutic Approaches.

Abstract: Apathy is a neurobehavioral syndrome characterized by impaired motivation for goal-directed behaviors and cognitive activity, alongside blunted affect. Apathy is a common neuropsychiatric syndrome in Alzheimer's disease (AD), with a 5-year prevalence over 70%. Apathy also serves as a prognostic indicator, correlating with the progression of AD. Despite advances in its conceptualization and understanding of its neural basis, there is very limited empirical evidence to support the available strategies for the treatment of apathy in AD. Given its complex pathophysiology, including distinct substrates for different apathy dimensions (affective, cognitive, and behavioral), it is unlikely that a single pharmacological or nonpharmacological strategy will be effective for all cases of apathy in AD. High-quality evidence research is needed to better understand the role of specific strategies aiming at a personalized approach.

Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis.

Abstract: Background. The purpose of this meta-analysis was to assess the clinical efficacy of etoricoxib in comparison with traditional NSAIDs for postoperative pain after third molar surgery. Methods. The quality of studies found in PubMed and Google Scholar was evaluated with Cochrane Collaboration’s risk of bias tool. Data on total consumption of rescue analgesics, number of patients using rescue analgesics, global assessment of study treatments, and adverse effects were extracted exclusively from high-quality clinical trials. Each meta-analysis was performed with the Review Manager Software 5.3 for Windows. Results. The qualitative analysis showed that etoricoxib has better analgesic activity when compared with ibuprofen (2 clinical trials) and diclofenac (1 clinical trial). A similar analgesic efficacy between etoricoxib and nonselective Cox-2 NSAIDs was informed in 3/8 studies (2 compared to ibuprofen and 1 to naproxen sodium). Moreover, the number of patients requiring rescue analgesics in the postoperative period showed a statistical difference in favor of etoricoxib when compared to NSAIDs. Conclusion. Etoricoxib significantly reduces the number of patients needing rescue analgesics compared to NSAIDs after third molar surgery.

Chronic Inhibition of FAAH Reduces Depressive-Like Behavior and Improves Dentate Gyrus Proliferation after Chronic Unpredictable Stress Exposure

Abstract: Symptoms of depressive disorders such as anhedonia and despair can be a product of an aberrant adaptation to stress conditions. Chronic unpredictable stress model (CUS) can generate an increase in the activity of the hypothalamic-pituitary-adrenal axis (HPA) and induce a reduction of neurotrophin signaling and the proliferation of neural progenitors in the adult dentate gyrus, together with increased oxidative stress. Levels of the endocannabinoid anandamide (AEA) seem to affect these depression-by-stress-related features and could be modulated by fatty acid amide hydrolase (FAAH). We aimed to evaluate the effects of FAAH inhibitor, URB597, on depressive-like behavior and neural proliferation of mice subjected to a model of CUS. URB597 was administered intraperitoneally at a dose of 0.2 mg/kg for 14 days after CUS. Depressive-like behaviors, anhedonia, and despair were evaluated in the splash and forced swimming tests, respectively. Alterations at the HPA axis level were analyzed using the relative weight of adrenal glands and serum corticosterone levels. Oxidative stress and brain-derived neurotrophic factor (BDNF) were also evaluated. Fluorescence immunohistochemistry tests were performed for the immunoreactivity of BrdU and Sox2 colabeling for comparison of neural precursors. The administration of URB597 was able to reverse the depressive-like behavior generated in mice after the model. Likewise, other physiological responses associated with CUS were reduced in the treated group, among them, increase in the relative weight of the adrenal glands, increased oxidative stress, and decreased BDNF and number of neural precursors. Most of these auspicious responses to enzyme inhibitor administration were blocked by employing a cannabinoid receptor antagonist. In conclusion, the chronic inhibition of FAAH generated an antidepressant effect, promoting neural progenitor proliferation and BDNF expression, while reducing adrenal gland weight and oxidative stress in mice under the CUS model.

BDNF Protein and BDNF mRNA Expression of the Medial Prefrontal Cortex, Amygdala, and Hippocampus during Situational Reminder in the PTSD Animal Model.

Abstract: Whether BDNF protein and BDNF mRNA expression of the medial prefrontal cortex (mPFC; cingulated cortex area 1 (Cg1), prelimbic cortex (PrL), and infralimbic cortex (IL)), amygdala, and hippocampus (CA1, CA2, CA3, and dentate gyrus (DG)) was involved in fear of posttraumatic stress disorder (PTSD) during the situational reminder of traumatic memory remains uncertain. Footshock rats experienced an inescapable footshock (3 mA, 10 s), and later we have measured fear behavior for 2 min in the footshock environment on the situational reminder phase. In the final retrieval of situational reminder, BDNF protein and mRNA levels were measured. The results showed that higher BDNF expression occurred in the Cg1, PrL, and amygdala. Lower BDNF expression occurred in the IL, CA1, CA2, CA3, and DG. BDNF mRNA levels were higher in the mPFC and amygdala but lower in the hippocampus. The neural connection analysis showed that BDNF protein and BDNF mRNA exhibited weak connections among the mPFC, amygdala, and hippocampus during situational reminders. The present data did not support the previous viewpoint in neuroimaging research that the mPFC and hippocampus revealed hypoactivity and the amygdala exhibited hyperactivity for PTSD symptoms. These findings should be discussed with the previous evidence and provide clinical implications for PTSD.

Choline Intake Correlates with Cognitive Performance among Elder Adults in the United States.

Abstract: Objective This research attempted to explore the neuroprotective effect of choline and establish evidence for future dietary recommendations and nutritional interventions to maintain a proper cognitive function among elders aged >60 years in the US. Method This cross-sectional study retrieved data of 2,393 eligible elderly participants from the 2011-2014 National Health and Nutrition Examination Survey. Combining dietary and supplement choline intake, total choline intake was evaluated using the 24-hour dietary recall method and the dietary supplement questionnaire. Total choline intake was categorized into tertiles, which ranged at 399.50 mg/day (T3). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning subtest, Animal Fluency (AF) test, and Digit Symbol Substitution test (DSST) was used to measure cognitive function. Participants who scored the lowest 25th percentile in each cognitive test were classified in the low cognitive function (LC) group. Logistic regression models were implemented to examine the association between total choline intake and the incidence of LC. Results In the CERAD test, the risk of LC was significantly lower in T2 than T1 (OR: 0.668, 95% CI: 0.493-0.904, and P = 0.006) when adjusted for age, gender, BMI, alcohol consumption, and hypertension. Similarly, T2 was associated with a significantly lower risk of LC when assessed by the AF test (OR: 0.606, 95% CI: 0.580-0.724, and P Conclusion Total choline intake at 187.06-399.50 mg/day reduces the risk of LC by approximately 50% compared to intake at

Ensemble Classification Approach for Sarcasm Detection.

Abstract: Cognitive science is a technology which focuses on analyzing the human brain using the application of DM. The databases are utilized to gather and store the large volume of data. The authenticated information is extracted using measures. This research work is based on detecting the sarcasm from the text data. This research work introduces a scheme to detect sarcasm based on PCA algorithm, - means algorithm, and ensemble classification. The four ensemble classifiers are designed with the objective of detecting the sarcasm. The first ensemble classification algorithm (SKD) is the combination of SVM, KNN, and decision tree. In the second ensemble classifier (SLD), SVM, logistic regression, and decision tree classifiers are combined for the sarcasm detection. In the third ensemble model (MLD), MLP, logistic regression, and decision tree are combined, and the last one (SLM) is the combination of MLP, logistic regression, and SVM. The proposed model is implemented in Python and tested on five datasets of different sizes. The performance of the models is tested with regard to various metrics.

Mild Gait Impairment and Its Potential Diagnostic Value in Patients with Early-Stage Parkinson's Disease.

Abstract: Methods 32 patients with early-stage PD and 30 healthy control subjects (HC) were enrolled All participants completed the instrumented stand and walk test, and gait data was collected using wearable sensors Results We observed increased variability of stride length (SL) (P < 0001), stance phase time (StPT) (P = 0004), and swing phase time (SwPT) (P = 0011) in PD There were decreased heel strike (HS) (P = 0001), range of motion of knee (P = 0036), and hip joints (P < 0001) in PD In symmetry analysis, no difference was found in any of the assessed gait parameters between HC and PD Only total steps (AUC = 0763, P < 0001), SL (AUC = 0701, P = 0007), SL variability (AUC = 0769, P < 0001), StPT variability (AUC = 0712, P = 0004), and SwPT variability (AUC = 0688, P = 0011) had potential diagnostic value When these five gait parameters were combined, the predictive power was found to increase, with the highest AUC of 0802 (P < 0001) Conclusions Patients with early-stage PD presented increased variability but still symmetrical gait pattern Some specific gait parameters can be applied to diagnose early-stage PD which may increase diagnosis accuracy Our findings are helpful to improve patient's quality of life

Normative and Equated Data of the Original and Basic Versions of the Montreal Cognitive Assessment among Community Dwelling Saudi Arabians.

Abstract: Introduction Currently, there are standard and basic versions of the MoCA, the latter designed for those with lower educational achievements. Community-based normative data on these versions of the MoCA from Arabic populations are deficient, and there is little data demonstrating how both scales perform in comparison. We aim to obtain normative performances from both versions and equate the measures of both scales. Methods Community-based recruitment of healthy volunteers ≥ 18 years of age. Participants underwent testing with both versions. Demographic data was collected with regard to age, gender, years of education, diabetes, and hypertension. Regression analysis was performed to determine significance of variables, and the circle-arc equating method was used to equate the two scores from each scale. Results 311 participants were included in the study. The mean (sd) age was 45.8 (15.96), females were 184 (59.16%), and the duration of education was 12.7 (5.67) years. The mean scores on the MoCA-A and MoCA-B were 21.47 (4.53) and 24.37 (4.71) (P < 0.0001), respectively. Multivariate regression showed significance of age and years of education in both versions (both variables with P < 0.0001). Correlation coefficient between the two scales was 0.77 (P < 0.0001). The largest equated difference between both MoCA versions was four points in those scoring from 10-20 on the MoCA-A. Conclusion We present normative data from a large Saudi Arabian community-based sample with two different MoCA tests, and an equating graph is presented to determine the corresponding expected performance between the two scales.

High Methionine Diet-Induced Alzheimer’s Disease like Symptoms Are Accompanied by 5-Methylcytosine Elevated Levels in the Brain

Abstract: Background Excessive or insufficient intake of methionine (Met) causes neuronal dysfunction, neurodegeneration, cerebrovascular dysfunction, vascular leakage, and short-term memory loss, which result in the occurrence of Alzheimer's disease- (AD-) like symptoms. Objective To determine the relationship between high methionine diets (HMD) induced AD-like symptoms and 5-methylcytosine (5-mC) level. Methods C57BL/6J mice were randomly divided into two groups: the control group (Maintain diets) and the model group (2% HMD). Mice were fed with 2% HMD for 9 weeks. Animals were weighed and food intake was recorded weekly. Open field test, nesting ability test, Y maze test, new object recognition test, and Morris water maze test were used to detect the motor, learning, and memory ability. Hematoxylin-eosin (HE) staining was used to observe the damage of cells in hippocampus and cortex. Immunofluorescence (IF) staining was used to detect the expression and distribution of amyloid-β 1-40 (Aβ 1-40), amyloid-β 1-42 (Aβ 1-42), and 5-methylcytosine (5-mC) in hippocampus and cortex. Western blotting (WB) was used to determine the expression of Aβ and DNA methyltransferases- (DNMTs-) related proteins in the cortex. Enzyme-linked immunosorbent assay (ELISA) was performed to detect homocysteine (Hcy) level (ELISA). Results Feeding of HMD decreased the body weight and food intake of mice. Behavioral testing revealed that HMD caused learning, memory, and motor ability impairment in the mice. HE staining results showed that HMD feeding caused damage of hippocampal and cortical neurons, along with disordered cell arrangement, and loss of neurons. Furthermore, HMD increased the contents of Aβ 1-40, Aβ 1-42, and 5-mC in the hippocampus and cortex. WB results showed that HMD increased the expression of Aβ production-related proteins, such as amyloid precursor protein (APP) and beta-secretase 1 (BACE1), and decreased the expression of Aβ metabolism-related protein in the cortex, including insulin-degrading enzyme (IDE) and neprilysin (NEP). Additionally, the decreased expression of DNA methyltransferase1 (DNMT1) was observed in HMD-treated mice, but there was no significant change of DNMT3a level. ELISA results showed that HMD increased the levels of Hcy in serum. Conclusion Our result suggested that the HMD can cause neurotoxicity, leading to AD-like symptoms in mice, which may be related to 5-mC elevated.

Apathy, Cognitive Impairment, and Social Support Contribute to Participation in Cognitively Demanding Activities Poststroke.

Abstract: Importance. Individuals with chronic stroke experience decreased participation in activities with cognitive demands across all areas of occupation. Objective. To understand the extent to which apathy, cognition, and social support predict participation in activities with cognitive demands. Design. Prospective, quantitative correlational, cross-sectional study. Setting. Outpatient treatment centers and community stroke support groups located in St. Louis, MO, and Boston, MA. Participants. 81 community-dwelling - month poststroke with and without aphasia. Measures. Participants completed the Activity Card Sort (ACS), Apathy Evaluation Scale (AES), Medical Outcomes Study Social Support Survey (MOS-SSS), and Delis-Kaplan Executive Function System (DKEFS) Design Fluency and Trail-Making subtests. Results. Cognitive deficits limit participation in activities with high cognitive demands. Apathy and positive social interaction influence participation, regardless of high or low cognitive demands. Poststroke aphasia did not impact return to participation in activities with high and low cognitive demands. Conclusions and Relevance. Cognitive deficits seen poststroke contribute to participation only for activities with high cognitive demands. Apathy has a significant and negative influence on participation overall. Social support is a modifiable contextual factor that can facilitate participation. Poststroke apathy can be detrimental to participation but is not well recognized. The availability of companionship from others to enjoy time with can facilitate participation.

Factors Affecting E-Shopping Behaviour: Application of Theory of Planned Behaviour.

Abstract: E-shopping is a rapidly growing phenomenon among different individuals who intend to shop online. However, a trust deficit in the E-shopping environment has always been a critical issue in the brick-and-click mode of shopping, being one of the main reasons for E-cart abandonment in E-commerce. This empirical study is aimed at investigating the perceived effect of website trust on E-shopping intentions and behaviour, drawing upon the theory of planned behaviour (TPB). Data were collected through self-administered questionnaires from working adults who shop for garments online. Structural equation modelling was used to evaluate the model fit and assumptions. Our findings suggest that website trust and E-shopping attitude play substantial roles in building E-shopping intentions and actual behaviours. Both are the significant predictors of the behaviour mediated by E-shopping intentions. However, E-shopping intentions did not mediate between subjective norms and E-shopping behaviour, when working adults decide to purchase garments online.

Effect of a Multistage Educational Skill-Based Program on Nurse's Stress and Anxiety in the Intensive Care Setting: A Randomized Controlled Trial.

Abstract: Background Psychological problems such as stress and anxiety are prevalent among working nurses in the intensive care units (ICUs). This study was aimed at investigating the effects of three skill-based educational programs on stress and anxiety among critical care nurses. Methods Using a randomized controlled trial, 160 nurses were assigned to four groups including one control and three intervention groups. A standard skill-based educational program was delivered to three intervention groups using booklet, booklet+oral presentation, and booklet+oral presentation+clinical teaching over a period of one month to reduce different types of stress and anxiety. The control group received routine education only. Perceived stress, state anxiety, trait anxiety, and work-related stress were assessed at baseline and three times after the intervention (15 days, 3 months, and 21 months). Repeated-measure analysis of variance was used for data analysis. Results There was no significant change in the control group in terms of study variables during follow-up assessments, whereas measures of stress and anxiety were reduced after intervention in the trial groups except trait anxiety. Nurses in the mixed-method group (booklet+oral presentation+clinical teaching) showed less stress and anxiety during follow-ups. Although the stress and anxiety scores decreased in the first and second follow-ups, there was no significant reduction in the third follow-up. Conclusions To improve the mental health and performance of the intensive care unit nurses, knowledge-based and skill-based training programs seem useful. Continuous training may help to maintain the effectiveness of these programs over time.

Behavioral Assessment of Unilateral Spatial Neglect with the Catherine Bergego Scale (CBS) Using the Kessler Foundation Neglect Assessment Process (KF-NAP) in Patients with Subacute Stroke during Rehabilitation in Japan.

Abstract: The Kessler Foundation Neglect Assessment Process (KF-NAP) is an assessment tool for unilateral spatial neglect (USN), which is the scoring method for the Catherine Bergego Scale (CBS) based on detailed instructions This study is aimed at determining the reliability and validity of the Japanese version of the KF-NAP (KF-NAP-J), evaluating the improvement of neglect assessment with KF-NAP-J, and comparing it with the original CBS for subacute stroke patients We assessed subacute stroke patients admitted to our intensive rehabilitation hospital Two KF-NAP-trained occupational therapists (OTs) assessed 22 patients Before implementing the KF-NAP at the hospital, two other OTs assessed the other 23 patients using the CBS We evaluated the interrater reliability of the KF-NAP and CBS using intraclass correlation coefficients (ICC) for the total scores, weighted kappa statistics for each subscale, and internal consistency using Cronbach's alpha We assessed the validity of the KF-NAP against the Behavioral Inattention Test (BIT) and Functional Independence Measure (FIM) using Spearman's correlation coefficient The reliability of both the KF-NAP and CBS was excellent The weighted kappa results demonstrated that each subscale was in better agreement with the KF-NAP than with the CBS In the KF-NAP, all eight subscales in which weighted kappa could be calculated were in significant agreement, and two were almost in perfect agreement The KF-NAP moderately correlated with the subscales of BIT and FIM representing USN and activities of daily living The USN detection rates of KF-NAP and BIT in the KF-NAP group were 636% and 227%, respectively These results suggest that the KF-NAP, as well as the CBS, is useful to assess USN, which strongly impacts the rehabilitation outcomes in subacute stroke patients

Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study.

Abstract: Methods Patients with stroke were compared and correlated from overall and three periods (1-3 months, 4-6 months, and >6 months). Fugl-Meyer assessment for the upper extremity (FMA-UE) and action research and arm test (ARAT) were used to compare the UE motor status between patients with PSA and without PSA through a cross-sectional study among 435 patients. Then, the correlations between the evaluation scale scores of UE motor status and language function of patients with PSA were analyzed in various dimensions, and the language subfunction most closely related to UE motor function was analyzed by multiple linear regression analysis. Results We found that the scores of FMA-UE and ARAT in patients with PSA were 14 points ((CI) 10 to 18, p < 0.001) and 11 points lower ((CI) 8 to 13, p < 0.001), respectively, than those without PSA. Their FMA-UE (r = 0.70, p < 0.001) and ARAT (r = 0.62, p < 0.001) scores were positively correlated with language function. Regression analysis demonstrated that spontaneous speech ability may account for UE motor function (R2 = 0.51, p < 0.001; R2 = 0.42, p < 0.001). Consistent results were also obtained from the analyses within the three time subgroups. Conclusion Stroke patients with PSA have worse UE motor performance. UE motor status and language function showed positive correlations, in which spontaneous speech ability significantly accounts for the associations.

Association between Serum 25-Hydroxyvitamin D Level and Stroke Risk: An Analysis Based on the National Health and Nutrition Examination Survey.

Abstract: Background. To analyze the association between serum 25-hydroxyvitamin D level (25(OH)D) and stroke risk based on the National Health and Nutrition Examination Survey (NHANES). Methods. Between 2007 and 2018, the baseline information of participants from NHNES was collected. Univariate analysis was used to identify the covariates. Multivariate logistic regression model was used to analyze the association between serum 25(OH)D level and the stroke risk. Results. Of the 8,523 participants, there were 310 participants with stroke and 8,213 participants without stroke. The multivariate logistic analysis showed that serum 25(OH)D deficiency (odds ratio (OR): 1.993, 95% confidence intervals (CI): 1.141-3.481, and ) was the significant risk factors for stroke. Subgroup analysis showed that non-Hispanic whites with serum 25(OH)D deficiency (OR: 2.501, 95% CI: 1.094-5.720, and ) and insufficiency (OR: 1.853, 95% CI: 1.170-2.934, and ) were associated with a higher risk of stroke than those with normal 25(OH)D levels. Conclusions. Serum 25(OH)D deficiency may be associated with an increased risk of stroke.

Peripheral Nerve Regeneration Using Different Germ Layer-Derived Adult Stem Cells in the Past Decade.

Abstract: Peripheral nerve injuries (PNIs) are some of the most common types of traumatic lesions affecting the nervous system. Although the peripheral nervous system has a higher regenerative ability than the central nervous system, delayed treatment is associated with disturbances in both distal sensory and functional abilities. Over the past decades, adult stem cell-based therapies for peripheral nerve injuries have drawn attention from researchers. This is because various stem cells can promote regeneration after peripheral nerve injuries by differentiating into neural-line cells, secreting various neurotrophic factors, and regulating the activity of in situ Schwann cells (SCs). This article reviewed research from the past 10 years on the role of stem cells in the repair of PNIs. We concluded that adult stem cell-based therapies promote the regeneration of PNI in various ways.

BDNF Genetic Variant and Its Genotypic Fluctuation in Major Depressive Disorder.

Abstract: Major depressive disorder (MDD) still has an unknown etiology and mechanisms. Many studies have been conducted seeking to associate and understand the connection of different genetic variants to this disease. Researchers have extensively studied the brain-derived neurotrophic factor (BDNF) Val66Met genetic variant in MDD; yet, their findings remain inconsistent. This systematic review sought to verify the GG (Val/Val) genotype frequency fluctuation in different populations with MDD. For this, we searched in different databases and, after applying the eligibility criteria, selected 17 articles. Most studies demonstrate the higher frequency of the ancestral (wild) GG (Val/Val) genotype, although associations of the polymorphic A (Met) allele, changes in BDNF protein serum levels, or both were also found in MDD, whether related to the disease's development or other factors. Nevertheless, despite these findings, disagreements between several studies are seen. For this reason, further BDNF Val66Met genetic variant studies should not only bridge the gap in the knowledge of this polymorphism's role in MDD's different facets but also analyze the genotypic and phenotypic heterogeneity in different populations to help provide a better quality of life for patients.

The Effects of Light-to-Moderate Alcohol Consumption on the Cognitive Function of Community Nondemented Male Elderly: A Cohort Study.

Abstract: Aim To investigate the effects of light-to-moderate drinking on the cognitive function of the elderly in a large elderly community cohort Although heavy drinking is linked with impaired brain functions, the effects of light-to-moderate drinking on the cognitive function of the elderly are still controversial Methods A total of 1469 nondemented elderly men from 15 research centers in 8 cities and provinces were included and divided into two groups: drinking (531 subjects) and nondrinking (938 subjects) Cognitive functions were assessed by the Beijing version of the Montreal Cognitive Assessment (MoCA) at baseline and one-year follow-up Results There was no difference in total cognitive scores between the light-to-moderate drinking and nondrinking groups at baseline and follow-up Nonalcohol users performed better naming and abstraction function at baseline and better naming function at follow-up There was no difference in cognitive performance decline and new-onset dementia rates at follow-up Conclusions Light-to-moderate alcohol consumption had no significant impact on the overall cognitive function and the risk of dementia in elderly men

Assessment of Attentional Functioning in Health Professionals of a Brazilian Tertiary Referral Hospital for COVID-19.

Abstract: This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-hour daily shifts are common for hospital employees in Brazil. A MANCOVA was performed to examine between-group differences, using age, sleep quality, sex, education level, previous COVID-19 infection, and profession as covariates. Of 124 participants, 80 had substantial exposure and 44 had minimal exposure to COVID-19. The overall MANCOVA reached statistical significance ( P = 0.048 ). Post hoc ANCOVA analysis showed that the substantial exposure group had a statistically significantly higher intraindividual variability of reaction time of all correct target responses ( P = 0.017 , Cohe n ’ s δ = − 0.55 ). This result remained after removing those with a previous COVID-19 infection ( P = 0.010 , Cohe n ’ s δ = − 0.64 ) and after matching groups for sample size ( P = 0.004 , Cohe n ’ s δ = − 0.81 ). No other variables reached statistical significance. Concluding, hospital professionals with a substantial level of exposure to patients with COVID-19 show a significant attention decrement and, thus, may be at a higher risk of accidental SARS-CoV-2 infection.

Treatment Outcome of Epileptic Patients Receiving Antiepileptic Drugs in Ethiopia: A Systematic Review and Meta-Analysis.

Abstract: Background. The prevalence and incidence rate of epilepsy were found to be higher in low- and middle-income countries. Uncontrolled epilepsy has a high risk of disability, stigma, discrimination, human rights violations, and premature death. The available studies of controlled seizure in Ethiopia have showed inconsistent results which calls for systematic review and meta-analysis. Therefore, this review intended to show the pooled prevalence of controlled seizure among people with epilepsy receiving antiepileptic drugs at outpatient department. Methods. A systematic literature search was conducted using PubMed/Medline, Science Direct, PsycINFO, Hinnarri databases, and Google Scholar for grey literatures. Data were extracted with structured format prepared using Microsoft Excel and exported to Stata/MP 16.0 software for analyses. The test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Results. A total of 23 primary studies were included in the review showing the pooled prevalence of controlled seizure to be 46% (95% CI: 35, 56). A subgroup analysis of the primary studies showed a considerable variation in magnitude of seizure freedom by study regions, age groups, and seizure-free period. The highest prevalence was found in Addis Ababa 52% (95% CI: 29, 75), pediatric patients 77% (95% CI: 71, 83), and a seizure-free period of less than six months 58% (95% CI: 32, 83). On the other hand, the lowest prevalence of controlled seizure was found in Tigray 27% (95% CI: 11, 65), adult patients 43% (95% CI: 32, 54), and a seizure-free period of six or more 41% (95% CI: 32, 51). Higher frequency of seizure before treatment (2.23, 95% CI: 1.15, 3.31) and medication nonadherence (2.7, 95% CI: 1.25, 4.15) had statistically significant association with uncontrolled seizure. Conclusion. In this review, the prevalence of controlled seizure was found to be low. This warrants that clinicians should give more focus to epileptic patients regarding monitoring and evaluation of treatment outcome of epilepsy and factors that affect seizure control in routine clinical services. The use of standardized definition of controlled seizure, designing strategies to identify pharmacoresistant epilepsy and its treatment, and increasing medication adherence are recommended in Ethiopia. The review protocol has been registered with PROSPERO registration number CRD42021215302 .

Prevalence of Depressive Symptoms and Its Associated Factors among People Living with HIV Attending Public Hospitals of Nekemte Town, Western Ethiopia, 2021.

Abstract: Background. Depressive symptoms are the most common mental illness among people living with HIV/AIDS. Depressive symptoms impact negatively on the course of HIV infection and can lead to suicide and increased risk of mortality when it is a severe form. Although depressive symptoms are common among HIV/AIDS patients, only a few studies have been conducted in Ethiopia and no study, particularly at Nekemte town public hospitals. Therefore, this study was aimed at assessing the prevalence and risk factors for depressive symptoms among people living with HIV/AIDS attending Nekemte town public hospitals, Western Ethiopia. Methods. An institution-based cross-sectional study design was conducted on 425 HIV/AIDS patients at Nekemte town public hospitals, from March 30 to May 30, 2019. Data were collected through interviews and patient document reviews. The nine-item Patient Health Questionnaire (PHQ-9) was used to collect information concerning depressive symptoms and was defined by a PHQ-9 score ≥ 5 . HIV stigma and discrimination scales were used to measure stigma. Social support was described by a sum score of the Oslo3 social support scale (OSS-3). The collected data was entered into EpiData Windows version 4.1 and then exported to Statistical Package for the Social Sciences (SPSS) Windows version 24.0 for analysis. All variables found to be significant at the bivariable level ( p value < 0.25) were entered into a multivariable logistic regression model. p values of <0.05 and 95% confidence level were used to determine statistical significance. Results. Out of the total of 384 study participants who participated in the study, 165 (42.96%) had depressive symptoms. Self-reported sleeping problems ( AOR = 7.04 , 95% CI: 3.23, 15.33), CD4 level of <200 ( AOR = 5.45 , 95% CI: 2.06, 14.42), poor social support ( AOR = 2.79 , 95% CI: 1.17, 6.67), and perceived stigma ( AOR = 9.11 , 95% CI: 1.17, 17.33) were significantly associated with depressive symptoms among HIV/AIDS patients at Nekemte town public hospitals. Conclusion. The level of depressive symptoms among HIV/AIDS patients in this study was high. Self-reported sleeping problems, CD4 level, social support, and perceived stigma were found to be significantly associated with depressive symptoms among HIV patients. Health care professionals should have to strengthen the linkage of mental health with antiretroviral therapy (ART) clinic to early detect and treat depressive symptoms.

Association between Genetic Variants in DUSP15, CNTNAP2, and PCDHA Genes and Risk of Childhood Autism Spectrum Disorder

Abstract: Objective. Genetic factors play an important role in the development of autism spectrum disorder (ASD). This case-control study was to determine the association between childhood ASD and single nucleotide polymorphisms (SNPs) rs3746599 in the DUSP15 gene, rs7794745 in the CNTNAP2 gene, and rs251379 in the PCDHA gene in a Chinese Han population. Methods. Genotypes of SNPs were examined in DNA extracted from blood cells from 201 children with ASD and 200 healthy controls. The Children Autism Rating Scale (CARS) was applied to evaluate the severity of the disease and language impairment. The relationship between SNPs and the risk of ASD or the severity of the disease was determined by logistic regression and one-way ANOVA. Results. The genotype G/G of rs3746599 in the DUSP15 gene was significantly associated with a decreased risk of ASD (odds ratio , 95% confidence interval (CI): 0.42-0.99, ). The T allele of rs7794745 in the CNTNAP2 gene was associated with an increased risk of ASD ( , 95% CI: 1.01-1.77, ). The SNP rs251379 was not associated with ASD. Though none of the SNPs examined were associated with ASD severity, rs7794745 was associated with severity of language impairment. Conclusions. Our findings suggest that both rs3746599 in the DUSP15 gene and rs7794745 in the CNTNAP2 gene are associated with risk of childhood ASD, and rs7794745 is also related to the severity of language impairment in autistic children from a Chinese Han population.

Protective Effects and Mechanisms of Dendrobium nobile Lindl. Alkaloids on PC12 Cell Damage Induced by Aβ25-35.

Abstract: Background Aβ deposition abnormally in the mitochondria can damage the mitochondrial respiratory chain and activate the mitochondrial-mediated apoptosis pathway, resulting in AD-like symptoms. Objective To observe the protective effects of Dendrobium nobile Lindl. alkaloids (DNLA) on Aβ 25-35-induced oxidative stress and apoptosis in PC12 cells explore its possible protective mechanisms. Methods PC12 cells were treated with DNLA with different concentrations (0.035 mg/L, 0.3 mg/L, and 3.5 mg/L) for 6 h, followed by administration with Aβ 25-35 (10 μM) for 24 h. MTT assay and flow cytometer observe the effect of DNLA on Aβ 25-35-induced cytotoxicity and apoptosis of PC12 cell. Based on the mitochondrial apoptosis pathway to study the antiapoptotic effect of DNLA on this model and its relationship with oxidative stress, flow cytometer detected the level of reactive oxygen species (ROS), and ELISA kits were used to detect superoxide dismutase activity (SOD) and glutathione (GSH) content in cells. The JC-1 fluorescent staining observed the effect of DNLA on the mitochondrial membrane potential (MMP) with inverted immunofluorescence microscopy. Western blot was used to detect the levels of mitochondrial apoptosis pathway-related protein and its major downstream proteins Bax, Bcl-2, cleaved-caspase-9, and cleaved-caspase-3. Results DNLA can significantly improve the viability and apoptosis rate of PC12 cell damage induced by Aβ 25-35. It also can restore the reduced intracellular ROS content and MMP, while SOD activity and GSH content increase significantly. The expression of apoptosis-related protein Bax, cleaved-caspase-9, and cleaved-caspase-3 decreased when the Bcl-2 protein expression was significantly increased. Conclusion These findings suggest that it can significantly inhibit the apoptosis of PC12 cell damage induced by Aβ 25-35. The mechanism may reduce the level of cellular oxidative stress and thus inhibit the mitochondrial-mediated apoptosis pathway.

Serotonin 2 Receptors, Agomelatine, and Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease.

Abstract: There are nearly 50 million Alzheimer's disease (AD) patients worldwide, 90% of whom develop behavioral and psychological symptoms of dementia (BPSD), which increase the mortality rate of patients, and impose an economic and care burden on families and society. As a neurotransmitter and neuromodulator, serotonin is involved in the regulation of psychoemotional, sleep, and feeding functions. Accumulating data support the importance of serotonin in the occurrence and development of BPSD. Studies have shown that reduction of serotonin receptors can increase depression and mental symptoms in AD patients. At present, there is no drug treatment for AD approved by the US Food and Drug Administration. Among them, agomelatine, as a new type of antidepressant, can act on serotonin 2 receptors to improve symptoms such as depression and anxiety. At present, research on BPSD is still in the preliminary exploratory stage, and there are still a lot of unknowns. This review summarizes the relationship between serotonin 2 receptors, agomelatine, and BPSD. It provides a new idea for the study of the pathogenesis and treatment of BPSD.

Histopathological and Biochemical Assessment of Neuroprotective Effects of Sodium Valproate and Lutein on the Pilocarpine Albino Rat Model of Epilepsy.

Abstract: Epilepsy is one of the most frequent neurological disorders characterized by an enduring predisposition to generate epileptic seizures. Oxidative stress is believed to directly participate in the pathways of neurodegenerations leading to epilepsy. Approximately, one-third of the epileptic patients who suffer from seizures do not receive effective medical treatment. Sodium valproate (SVP) is a commonly used antiepileptic drug (AED); however, it has toxic effects. Lutein (L), a carotenoid, has potent antioxidant and anti-inflammatory properties. The aim of this study was to determine the neuroprotective effect of sodium valproate (SVP) and lutein (L) in a rat model of pilocarpine- (PLC-) induced epilepsy. To achieve this aim, fifty rats were randomly divided into five groups. Group I: control, group II: received PLC (400 mg/kg intraperitoneally), group III: received PLC + SVP (500 mg/kg orally), group IV: received PLC + SVP + L (100 mg/kg orally), and group V: received (PLC + L). Racine Scale (RC) and latency period to onset seizure were calculated. After eight weeks, the hippocampus rotarod performance and histological investigations were performed. Oxidative stress was investigated in hippocampal homogenates. Results revealed that SVP and L, given alone or in combination, reduced the RC significantly, a significant delay in latency to PLC-kindling onset, and improved rotarod performance of rats compared with the PLC group. Moreover, L was associated with a reduction of oxidative stress in hippocampal homogenate, a significant decrease in serum tumor necrosis factor-alpha (TNF-α) level, and inhibition of cerebral injury and displayed antiepileptic properties in the PLC-induced epileptic rat model. Data obtained from the current research elucidated the prominent neuroprotective, antioxidant, and anti-inflammatory activities of lutein in this model. In conclusion, lutein cotreatment with AEDs is likely to be a promising strategy to improve treatment efficacy in patients suffering from epilepsy.

Association between Congenital Cytomegalovirus Infection and Brain Injury in Neonates: A Meta-analysis of Cohort Studies.

Abstract: Objective. To assess association between congenital cytomegalovirus (CMV) infection and brain injury in neonates. Methods. The literatures from inception to November 4, 2020, were searched through PubMed, Embase, Cochrane Library, and Web of Science. Heterogeneity test was conducted for each indicator and measured by statistics. If , the random effects model was applied; otherwise, the fixed effects model was used. Sensitivity analysis was performed for all models. Weighed mean difference (WMD) was used as the effect size for measurement data, and risk ratio (RR) was as the effect indicator. Results. A total of 13 studies, including 4,262 congenital CMV infection neonates, were enrolled in this study. Our results showed that the rate of hearing impairment (RR: 2.105, 95% CI: (1.115, 3.971), ), sensorineural hearing loss (SNHL) (RR: 17.051, 95% CI: (6.201, 46.886), ), and microcephaly (RR: 2.283, 95% CI: (1.325, 3.935), P =0.003) in neonates infected congenital CMV was higher than that in control group. Conclusion. The risks of hearing impairment, SNHL, and microcephaly in neonates during childhood may be associated with congenital CMV infection. It is necessary to establish neonatal screening programs and comprehensive diagnostic tests for patients to reduce the risk of adverse brain damage to the congenital CMV infection as early as possible and to improve the prognosis of the newborn.