Battery Of Neurological Tests Research Articles

Diagnostic performance and clinical applicability of plasma pTau181 to predict dementia risk in a large real‐world cohort of a memory clinic

AbstractBackgroundThe Alzheimer Association has recently remarked the diagnostic and prognostic revolution that plasma biomarkers will mean for AD diagnosis, and highlighting the need of further research to translate them as a realistic option in the clinical practice. However, many studies to date have assessed them in research cohorts. Here we evaluated the diagnostic performance and clinical applicability of plasma pTau181 as a predictive marker of dementia risk in a real‐world memory clinic cohort.MethodThe ACE cohort encompass 1649 patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), AD dementia and other dementias, with a complete battery of neurological tests, biochemistry data, and paired CSF and plasma samples of the Ace Alzheimer Center Barcelona memory clinic. CSF AB42, AB40, pTau181 and tTau, and plasma pTau181 were measured using the Lumipulse G1200 automatic platform (Fujirebio Inc.). Complete cohort were divided in the Testing cohort (n = 1000) and Validation cohort (n = 649).ResultPlasma pTau181 significantly correlated (P<0.0001) with CSF pTau181 in MCI, AD dementia and other dementias, but not in SCD. Sex appeared not significant in plasma pTau181 levels, whereas age significantly influenced in the biomarker’s performance. ROC curve of A+T+ patients vs rest showed an AUC = 0.8250 and P<0.0001. Specifically for MCI patients, ROC curve of MCI A+T+ vs MCI A‐T‐ showed and AUC = 0.8874 and P<0.0001. A cut off value of 1.300 pg/ml of plasma pTau181 exhibited a 93.6% sensibility, 72.4% specificity, 77.8% precision and only 8.3% of false negatives in MCI patients. Hazard ratio of survival of conversion analysis showed that MCI patients above this cut off value exhibited a 4.570 higher risk to convert to dementia than MCI under the cut off value. Validation cohort confirmed these findings.ConclusionPlasma pTau181 could be useful as a pre‐screening biomarker of MCI patients with high risk to progress to dementia. However, positive patients will also require a CSF/PET confirmatory test. Plasma pTau181 by itself does not present a suitable performance in SCD patients. Another biomarker or a combination of biomarkers would be needed to this population. Further studies are need to obtain more clinical data and improve the biomarker performance to finally substitute CSF/PET biomarkers.

Therapeutic efficacy of matrix metalloproteinase-12 suppression on neurological recovery after ischemic stroke: Optimal treatment timing and duration.

We recently showed that the post-ischemic induction of matrix metalloproteinase-12 (MMP-12) in the brain degrades tight junction proteins, increases MMP-9 and TNFα expression, and contributes to the blood-brain barrier (BBB) disruption, apoptosis, demyelination, and infarct volume development. The objectives of this study were to (1) determine the effect of MMP-12 suppression by shRNA-mediated gene silencing on neurological/functional recovery, (2) establish the optimal timing of MMP-12shRNA treatment that provides maximum therapeutic benefit, (3) compare the effectiveness of acute versus chronic MMP-12 suppression, and (4) evaluate potential sex-related differences in treatment outcomes. Young male and female Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion and reperfusion. Cohorts of rats were administered either MMP-12shRNA or scrambled shRNA sequence (control) expressing plasmids (1 mg/kg; i.v.) formulated as nanoparticles. At designated time points after reperfusion, rats from various groups were subjected to a battery of neurological tests to assess their reflex, balance, sensory, and motor functions. Suppression of MMP-12 promoted the neurological recovery of stroke-induced male and female rats, although the effect was less apparent in females. Immediate treatment after reperfusion resulted in a better recovery of sensory and motor function than delayed treatments. Chronic MMP-12 suppression neither enhanced nor diminished the therapeutic effects of acute MMP-12 suppression, indicating that a single dose of plasmid may be sufficient. We conclude that suppressing MMP-12 after an ischemic stroke is a promising therapeutic strategy for promoting the recovery of neurological function.

Multidomain interventions for the prevention of dementia and cognitive decline: A Cochrane systematic review and meta‐analysis

AbstractBackgroundWith no effective pharmacological therapies, risk factor modification may be a suitable intervention for dementia prevention. To date, no single‐domain intervention has convincingly shown to reduce the risk of developing dementia. Targeting more than one risk factor might have additive or even synergistic effects. In this Cochrane systematic review, we investigated the effect of multidomain intervention studies on the prevention of dementia and cognitive declineMethodWe searched ALOIS (the Cochrane Dementia and Cognitive Improvement Group's register), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science Core Collection, LILACS, and ClinicalTrials.gov from origin to April 2020. We included randomized controlled trials (RCTs) targeting at least two dementia risk factors simultaneously, with >400 participants and >12 months of follow‐up. Data were pooled using random‐effect models. This abstract is based on a pre‐peer review version of a Cochrane Review (protocol DOI: 10.1002/14651858.CD013572).ResultThe search identified 13.039 studies. Nine RCTs fulfilled the inclusion criteria and could be included in the review and meta‐analysis; two studies reported incident dementia as outcome, all nine studies reported a measure for cognitive decline. Overall pooled risk ratio (RR) for dementia was 0.94 (95% confidence interval (CI) 0.76‐1.18, I2<10%) and standardised mean difference (SMD) for cognitive decline measured with a neurological test battery (NTB) 0.03 (95% CI 0.01‐0.06, I2<10%). SMD in mini‐mental state examination (MMSE) score was 0.00 (95% CI ‐0.03‐0.04). Subgroup analyses suggested modest favourable outcomes on cognitive decline (NTB) for participants with worse baseline cognitive status (SMD 0.06 (0.01‐ 0.11) for low baseline MMSE vs. SMD 0.01 (‐0.01‐0.04) for high baseline MMSE), though this difference was not significant (p=0.12). There was no difference between groups with respect to adverse events (mortality, cardiovascular disease and stroke). The overall quality of evidence was moderate to high.ConclusionMultidomain interventions did not improve the overall risk of dementia. There was a modest effect on cognitive decline measured with a NTB, though this effect was not convincingly supported by other cognitive assessment scores. Future research in populations at increased risk could have important implications for dementia prevention strategies.

Education and income might protect the brain differently against white matter lesions in aging

AbstractBackgroundA lower socioeconomic status (SES) is associated with poorer cognitive health in old age and with more white matter lesions in the brain. It is not clear whether education and income, the two major components of SES, contribute differently to cognitive health, given that education is believed to build up a cognitive reserve. Aim of the study was to investigate how education and income independently contribute to cognitive functioning and brain white matter in aging.MethodParticipants (age 40‐80 years) of the representative population‐based LIFE‐Adult study completed the CERAD neurological test battery and underwent MR scanning (n=2,385 without neurological diseases). The association between education and income on cognitive performance and white matter lesions was analyzed via generalized linear regression modelling adjusted for age, gender, APOE e4 allele and household size. We further tested whether health (heart disease, high blood pressure, elevated blood lipids, diabetes, depression) could explain the associations.ResultHigher education as well as higher income were significantly associated with better performance in the CERAD and fewer total white matter hypointensities (WMH). Only higher education was associated with a lower Fazekas scale score, while only higher income was associated with fewer periventricular WMH. With increasing age, the protective effect of both, higher education and higher income, on performance in the Trail Making Test B and the total white matter volume increased. Older age additionally increased the protective effect of higher income on fewer total and periventricular WMH. The age‐related association between income and periventricular WMH was largely explained by high blood pressure.ConclusionOur findings suggest that higher education and higher income may protect cognitive functioning by a smaller loss of white matter in aging. While education is associated with WMH in general, income is specifically associated with periventricular WMH, an ageing‐related association that seems to be related to blood pressure. As none of the other health indicators explained our findings, more research is necessary to investigate what aspects of low educational attainment and low income bring about WMH.

Oral supplementation of Ficus religiosa leaf extract adversely affects the selected behavioral aspects of male albino mice

Ficus religiosa has been extensively used in traditional medicine for the treatment of gonorrhea, diarrhea, dysentery, leucorrhea, menorrhagia, vaginal and other urogenital disorders, haemorrhoids and ulcers, but limited information is available regarding their effect on behavior. The present study was designed to demonstrate the effect of F. religiosa leaf extract on the selected behavioral aspect of albino mice. Four weeks old albino mice of both genders were orally treated with 50 mg ml−1 solvent kg−1 body weight of F. religiosa leaf extract for seven days while the control animals were treated with saline (0.9% NaCl) solution. A battery of neurological tests (rota rod, open field, light dark box, elevated plus maze and novel object recognition) was conducted in all subjects. Female mice treated with F. religiosa leaf extract had significantly reduced rota rod performance in comparison with the control. Male mice treated with leaf extract had significantly reduced transition frequency during light dark box test while during elevated plus maze test, male mice remained mobile for less time and had reduced rotations than their control group. Male mice treated with leaf extract had significantly reduced line crossing and failed to recognize the old object during the second trial of novel object recognition test. Our results indicated that oral supplementation of F. religiosa leaf extract for seven days had significantly reduced the exploratory behavior and object recognition capacity of male mice and neuromuscular coordination of females, indicating gender specific effects of the applied ethanolic leaf extract.

Abstract WMP46: Exosomes Derived From Bone Marrow Mesenchymal Stem Cells of Type Two Diabetes Rats Promotes Neurorestoration After Stroke in Type Two Diabetic Rats

Background and Purpose: Roughly 1 in every 3 stroke patients is diabetic and suffers from an increased risk of stroke recurrence, worse prognosis, and exacerbated vascular and white matter (WM) injury that hinders long term recovery. Hence, there is a critical need to develop therapeutic strategies specifically to improve neurological functional outcome after stroke in the diabetic population. We investigated the neurorestorative effects of treatment of stroke in rats with type 2 diabetes mellitus (T2DM) with bone marrow stem cell (MSC) derived exosomes (T2DM-MSC-Exo) and the mechanisms underlying the therapeutic effect. Methods: Adult male Wistar rats were induced with T2DM using a combination of high fat diet and low dose Streptozotocin and were subjected to transient middle cerebral artery occlusion (MCAo). Three days after MCAo, rats were randomized (n=10/group) and treated via tail-vein injection with: 1) phosphate-buffered-saline (PBS); or 2) T2DM-MSC-Exo (3х10 11 ). A battery of neurological tests was performed and rats were sacrificed at 28 days after stroke for immunohistochemical evaluation. Results: In T2DM rats, stroke treatment using T2DM-MSC-Exo initiated at a delayed time point (3 days after stroke) significantly (p<0.05 vs. PBS treated T2DM-MCAo rats) improves functional outcome, reduces blood brain barrier (BBB) leakage and hemorrhage, but does not affect blood glucose or lesion volume. Delayed stroke treatment with T2DM-MSC-Exo in T2DM rats, significantly (p<0.05) increases axon and myelin density, increases oligodendrocytes and oligodendrocyte progenitor cell numbers in the ischemic border zone compared to PBS treated T2DM-MCAo rats. Treatment of T2DM stroke rats with T2DM-MSC-Exo significantly (p<0.05) increases the expression of ATP-binding cassette transporter 1 (ABCA1) and Insulin-like growth factor 1 receptor (IGFR1) compared to PBS treated T2DM-MCAo rats. Conclusion: Delayed treatment of T2DM stroke using T2DM-MSC-Exo significantly promotes long term neurological functional recovery and neurorestorative effects. These beneficial effects may be mediated by a decrease in BBB leakage and hemorrhage, increase in axon and myelin density, and up regulation of the ABCA1-IGFR1 pathway.

Creatine monohydrate supplementation for 10 weeks mediates neuroprotection and improves learning/memory following neonatal hypoxia ischemia encephalopathy in female albino mice

Currently there are no uniform standard treatments for newborn suffering from cerebral hypoxia-ischemia (HI) and to find new and effective strategies for treating the HI injury remains a key direction for future research. Present study was designed to demonstrate that optimal dose (1 or 3%) of creatine monohydrate (Cr) for the treatment of neonatal HI in female albino mice. On postnatal day 10, animals were subjected to left carotid artery ligation followed by 8% hypoxia for 25 minutes. Following weaning on postnatal day 20, mice were divided into three treatments on the basis of diet supplementation (Normal rodent diet, 1% and 3% creatine supplemented diet) for 10 week. A battery of neurological tests (Rota rod, open field and Morris water maze) was used to demonstrate effect of Cr supplementation on neurofunction and infarct size following HI. Open field test results indicated that Cr supplementation had significantly improved locomotory and exploratory behavior in subjects. It was observed that Cr treated mice showed better neuromuscular coordination (rota rod) and improved spatial memory (Morris Water Maze test). A significant affect of creatine supplementation in reducing infarct size was also observed. Post hoc analysis of post hoc multiple comparisons revealed that mice supplemented with 3% Cr for 10 weeks performed better during Morris water maze test while 1% Cr supplementation improved the exploratory behavior and gain in body weight than control group indicating that Cr supplementation has the potential to improve the neurofunction following neonatal brain damage.This article is part of a Special Issue entitled SI: Brain and Memory.

Long term creatine monohydrate supplementation, following neonatal hypoxic ischemic insult, improves neuromuscular coordination and spatial learning in male albino mouse

Creatine is known to rescue animals following brain damage. Present study was designed to demonstrate the effect of long term (15 week) supplementation of 2% creatine monohydrate (Cr), following neonatal hypoxic ischemic insult, on learning and memory formation in male albino mouse. Albino mice pups were subjected to right common carotid artery ligation followed by 8% hypoxia for 25 minutes. Following weaning, animals were separated and grouped on the basis of dietry supplementation for 15 weeks followed by a battery of neurological tests including Morris water maze, open field and rota rod. It was observed that HI mice fed on 2% Cr for 15 weeks performed better than their littermates mice on normal rodent diet during water maze (learning and memory) and rotating rod (neuro-muscular coordination and balance) test while the results of open field test remained unaffected. It was also observed that Cr treated animals had a reduced brain infarct volume than untreated but this difference did not reached statistical significance. We have also observed an overall increase in body weight in Cr treated mice during the study. Over all our results are indicating that long term Cr supplementation is beneficial for male albino following hypoxic ischemic insult.

Pre-emptive parecoxib and post-operative cognitive function in elderly patients.

ABSTRACT Background: To investigate the effect of pre-emptive parecoxib sodium, given in addition to routine analgesic treatment, on post-operative cognitive function in elderly patients. Methods: Seventy elderly patients were included, who were 65-82 years of age, 48-75 kg of weight, and ASA grade I-II. Preoperative mini mental state examination (MMSE) score was ≥21 points. Patients were randomly divided into two groups: control group (group C) and parecoxib sodium group (group P). Before induction of general anesthesia, 40 mg of parecoxib sodium was injected intravenously in group P and the same volume of saline was injected in group C. Patient-controlled intravenous analgesia (PCIA) containing fentanyl and tramadol was used for post-operative pain control. A 3 ml blood sample was obtained from the peripheral vein one day before surgery, 1, 4, 24, and 72 h after surgery, and plasma cortisol, IL-6 and S100β concentrations were measured. Cognitive function was evaluated by measuring the MMSE score and a neurological test battery within 72 h after surgery. The occurrence of post-operative cognitive dysfunction (POCD), the dosage of fentanyl and tramadol used in PCIA, and the rate of additional fentanyl administration were recorded. Results: Compared to group C, post-operative plasma cortisol concentration decreased, the amount of fentanyl and tramadol used in PCIA was reduced, the rate of additional fentanyl administration decreased, and the rate of POCD was reduced in group P (P < 0.05). Conclusion: Pre-emptive analgesia with 40 mg of parecoxib sodium can reduce the incidence of POCD in elderly patients.

A systematic review of the influence of occupational organophosphate pesticides exposure on neurological impairment

ObjectiveThe aim of this study was to conduct a systematic review of the published literature and to estimate whether or not there is a causal relationship between occupational exposure to...

Neurological abnormalities in a mercury exposed population among indigenous Wayana in Southeast Suriname.

The indigenous Wayana community of Puleowime (Apetina) in Suriname is susceptible to the effects of mercury because they consume large amounts of fish compared to mainstream communities. Small-scale and artisanal gold mining activities occur at numerous sites in eastern and southeastern Suriname placing the Wayana at risk from exposure to mercury released into the environment. A previous community-led risk assessment study showed that the Wayana were at a high lifetime risk of adverse effects from exposure to mercury. Subsequent to this earlier study, the residents of Puleowime requested assistance in a community-led follow-up research project to determine for themselves whether there were health impacts associated with exposure to mercury contamination. Neurotoxic effects consistent with methylmercury exposure were documented in an exposed population through a battery of neurological tests. Although the specific motor and cognitive batteries were not exactly the same, similar associations were observed between neurologic impairment and hair mercury concentrations compared to other studies in the Amazonia region where mean hair mercury levels were in the subacute range.

Effect ofGABABReceptor Antagonist (CGP35348) on Learning and Memory in Albino Mice

The present study was designed to demonstrate the potential effect of CGP 35348 (GABAB receptor antagonist) on the learning, memory formation, and neuromuscular coordination in albino mouse. Mice were intrapertoneally injected with 1 mg CGP 35348/mL of distilled water/Kg body weight, while the control animals were injected with equal volume of saline solution. A battery of neurological tests was applied following the intrapertoneal injections. Results of rota rod indicated that CGP 35348 had no effect on neuromuscular coordination in both male (P = 0.528) and female (P = 0.125) albino mice. CGP 35348 treated females demonstrated poor exploratory behavior during open filed for several parameters (time mobile (P = 0.04), time immobile (P = 0.04), rotations (P = 0.04), and anticlockwise rotations (P = 0.038)). The results for Morris water maze (MWM) retention phase indicated that CGP 35348 treated male mice took shorter latency to reach the hidden platform (P = 0.04) than control indicating improved memory. This observation was complemented by the swim strategies used by mice during training days in MWM as CGP 35348 treated males used more direct and focal approach to reach the platform as the training proceeded.

Carnitine palmitoyltransferase 1C deficiency causes motor impairment and hypoactivity

Carnitine palmitoyltransferase 1c (CPT1C), a brain-specific protein localized in the endoplasmic reticulum of neurons, is expressed in almost all brain regions, but its only known functions to date are involved in the hypothalamic control of energy homeostasis and in hippocampus-dependent spatial learning. To identify other physiological and behavioral functions of this protein, we performed a battery of neurological tests on Cpt1c-deficient mice. The animals showed intact autonomic and sensory systems, but some motor disturbances were observed. A more detailed study of motor function revealed impaired coordination and gait, severe muscle weakness, and reduced daily locomotor activity. Analysis of motor function in these mice at ages of 6–24 weeks showed that motor disorders were already present in young animals and that impairment increased progressively with age. Analysis of CPT1C expression in different motor brain areas during development revealed that CPT1C levels were low from birth to postnatal day 10 and then rapidly increased peaking at postnatal day 21, which suggests that CPT1C plays a relevant role in motor function during and after weaning. As CPT1C is known to regulate ceramide levels, we measured these biolipids in different motor areas in adult mice. Cerebellar, striatum, and motor cortex extracts from Cpt1c knockout mice showed reduced levels of ceramide and its derivative sphingosine when compared to wild-type animals. Our results indicate that altered ceramide metabolism in motor brain areas induced by Cpt1c deficiency causes progressive motor dysfunction from a young age.

Neuropsychological findings from older premutation carrier males and their noncarrier siblings from families with fragile X syndrome.

Carriers of the FMR1 premutation allele are at a significantly increased risk for a late-onset neurodegenerative disorder, fragile X-associated tremor/ataxia syndrome (FXTAS). The primary features of FXTAS are late-onset intention tremor and gait ataxia. Previous reports have shown global deficits in neuropsychological measures among males with FXTAS, particularly those related to executive functioning. The purpose of this study was to investigate the neuropsychological profile among older males with the premutation who are at risk for FXTAS. Premutation carriers, 66 with motor symptoms and 23 without, and 18 noncarrier siblings were recruited from pedigrees diagnosed with fragile X syndrome, all over age 50. Subjects were examined with a neurological test battery to identify symptoms of FXTAS and a neuropsychological test battery to investigate cognitive and behavioral profiles. Linear regression and ANCOVA were used to determine the effect of the premutation on outcome measures adjusting for age and education. We identified a significant decrease in scores of general intelligence and a marginally significant decrease in scores of logical memory among premutation carrier males with motor symptoms compared to the noncarrier male siblings. We did not identify deficits in executive functioning in our sample of premutation carrier males with motor symptoms. Similar to other reports, we found that the FMR1 premutation is associated with deficits in general intelligence and memory among older males with symptoms of FXTAS. However, our results differed in that we found no evidence of premutation-associated executive dysfunction. We provide possible explanations for this difference.

Self-Report Methods for Cambridge Neurological Test Battery (CANTAB) strategies

Self-report measures represent an important means to augment brain activation studies by providing important insight into participant strategies for completing cognitive tasks. Triangulating self-report data with brain scans and performance data promises to yield a more complete picture of brain activity (Jack &amp; Roepstorff, 2002). The current exploratory study investigated the feasibility of using self-report measures following performance on two Cambridge Neurological Test Battery (CANTAB) inventories: The Delayed Match to Sample and the Cambridge Gambling Task. In this study, we obtained written and spoken descriptions of strategies used to complete the CANTAB tasks. We found that participants were comfortable reporting strategies. There were commonalities, as well as idiosyncratic strategies for completing the two inventories across eight participants. Next steps include linking reported strategies with performance to determine how descriptive self-reports correlate with actual behavior. In addition, approaches to developing alternative means of self-report for studies of brain function under stress are discussed.

Autologous Bone Marrow Mononuclear Cells Enhance Recovery after Acute Ischemic Stroke in Young and Middle-Aged Rats

We investigated intra-arterially administered autologous bone marrow mononuclear cells (MNCs) in rats with acute ischemic stroke. Long Evans rats (2 to 3 months or 12 months old) underwent tandem reversible common carotid artery (CCA)/middle cerebral artery (MCA) occlusion (CCAo/MCAo) for 3 h and then 24 h later underwent tibial bone marrow harvest. Ten million or 4 million cells were re-injected by an intra-carotid infusion. Control animals underwent marrow needle insertion and then saline injection into the carotid artery. Animals were assessed on a battery of neurological tests. MNCs in the ischemic brain were tracked using Q-dot nanocrystal labeling. Infarct volume and cytokines in the ischemia-affected brain were analyzed. Cell-treated animals in the younger and older groups showed improvement from 7 to 30 days after stroke compared with vehicle-treated animals. MNCs significantly reduced infarct volume compared with saline. There was a significant reduction in tumor necrosis factor-alpha, interleukin-1alpha (IL-1alpha), IL-beta, IL-6, and a significant increase in IL-10 in injured brains harvested from the cell-treated groups compared with saline controls. Labeled MNCs were found in the peri-infarcted area at 1 h and exponentially decreased over the ensuing week after injection. Autologous bone marrow MNCs can be safely harvested from rodents after stroke, migrate to the peri-infarct area, enhance recovery, and modulate the post-ischemic inflammatory response.

Detection of early FXTAS motor symptoms using the CATSYS computerised neuromotor test battery

Background:Carriers of the FMR1 premutation allele are at a significantly increased risk for a late-onset neurodegenerative disorder, fragile X-associated tremor/ataxia syndrome (FXTAS). This disorder is distinct from fragile X syndrome...

Early-Onset Alzheimer's Gets Name Change

Early-Onset Alzheimer's Gets Name Change

A simple, efficient tool for assessment of mice after unilateral cortex injury

A refined battery of neurological tests, SNAP (Simple Neuroassessment of Asymmetric Impairment), was developed and validated to efficiently assess neurological deficits induced in a mouse model of traumatic brain injury. Four to 7-month old mice were subjected to unilateral controlled cortical impact or sham injury (craniectomy only). Several behavioral tests (SNAP, beam walk, foot fault, and water maze) were used to assess functional deficits. SNAP was unique among these in that it required no expensive equipment and was performed in less than 5 min per mouse. SNAP demonstrated a high level of sensitivity and specificity as determined by receiver-operator characteristics curve analysis. Interrater reliability was good, as determined by Cohen's Kappa method and by comparing the sensitivity and specificity across various raters. SNAP detected deficits in proprioception, visual fields, and motor strength in brain-injured mice at 3 days, and was sensitive enough to detect magnitude and recovery of injury. The contribution of individual battery components changed as a function of time after injury, however, each was important to the overall SNAP score. SNAP provided a sensitive, reliable, time-efficient and cost-effective means of assessing neurological deficits in mice after unilateral brain injury.

Low back pain: Differential diagnosis, prognosis and treatment

From January 2002 to February 2003, 137 patients complaining of low back pain were treated at the Institute for Orthopedic Surgery "Banjica", Belgrade, Serbia. There were 89 male and 48 female patients aged 13 to 77, mean age 42.2. Their condition was diagnosed through use of radiography, CT, MRI, EMNG, standard battery of neurological tests, and laboratory analyses (urine and blood analysis). Surgical treatment was performed on 39 patients; all other patients received some form of non-surgical care (physical therapy, medication or corset). Treatment efficacy was evaluated by use of the visual analog scales (VAS) and the Oswestry index, before and after treatment. The use Wilcoxon's pair test revealed statistically significant difference between before and after treatment data on VAS and Oswestry index for all patients.