Common Neurological Disorder Research Articles

The Role of Calcium and Iron Homeostasis in Parkinson's Disease.

Calcium and iron are essential elements that regulate many important processes of eukaryotic cells. Failure to maintain homeostasis of calcium and iron causes cell dysfunction or even death. PD (Parkinson's disease) is the second most common neurological disorder in humans, for which there are currently no viable treatment options or effective strategies to cure and delay progression. Pathological hallmarks of PD, such as dopaminergic neuronal death and intracellular α-synuclein deposition, are closely involved in perturbations of iron and calcium homeostasis and accumulation. Here, we summarize the mechanisms by which Ca2+ signaling influences or promotes PD progression and the main mechanisms involved in ferroptosis in Parkinson's disease. Understanding the mechanisms by which calcium and iron imbalances contribute to the progression of this disease is critical to developing effective treatments to combat this devastating neurological disorder.

Cilostazol protects against degenerative cervical myelopathy injury and cell pyroptosis via TXNIP-NLRP3 pathway

Degenerative cervical myelopathy (DCM) is one of the most common and serious neurological diseases. Cilostazol has protective effects of anterior horn motor neurons and prevented the cell apoptosis. However, there was no literatures of Cilostazol on DCM. In this study, we established the DCM rat model to detect the effects of Cilostazol. Meanwhile, the neurobehavioral assessments, histopathology changes, inflammatory cytokines, Thioredoxin-interacting protein (TXNIP), NOD‑like receptor pyrin domain containing 3 (NLRP3) and pro-caspase-1 expressions were detected by Basso, Beattie, and Bresnahan score assessment, Hematoxylin and Eosin Staining, Enzyme-linked immunosorbent assay, immunofluorescence and Western blotting, respectively. After treated with Cilostazol, the Basso, Beattie, and Bresnahan (BBB) score, inclined plane test and forelimb grip strength in DCM rats were significantly increased meanwhile the histopathology injury and inflammatory cytokines were decreased. Additionally, TXNIP, NLRP3 and pro-caspase-1 expressions levels were decreased in Cilostazol treated DCM rats. Interestingly, the using of siTXNIP significantly changed inflammatory cytokines, TXNIP, NLRP3 and pro-caspase-1 expressions, however there was no significance between siTXNIP and Cilostazol + siTXNIP group. These observations showed that Cilostazol rescues DCM injury and ameliorates neuronal destruction mediated by TXNIP/NLRP3/caspase-1 and pro-inflammatory cytokines. As a result of our study, these findings provide further evidence that Cilostazol may represent promising therapeutic candidates for DCM.

Recent advances in the use of optical coherence tomography in neuro-ophthalmology: A review.

Optical coherence tomography (OCT) is an in vivo imaging modality that provides non-invasive, high resolution and fast cross-sectional images of the optic nerve head, retina and choroid. OCT angiography (OCTA) is an emerging tool. Itis a non-invasive, dye-free imaging approach of visualising the microvasculature of the retina and choroid by employing motion contrast imaging for blood flow detection and is gradually receiving attention for its potential roles in various neuro-ophthalmic and retinal conditions. We will review the clinical utility of the OCT in the management of various common neuro-ophthalmic and neurological disorders. We also review some of the OCTA research findings in these conditions. Finally, we will discuss the limitations of OCT as well as introduce other emerging technologies.

Associations between Serum Mineral Nutrients, Gut Microbiota, and Risk of Neurological, Psychiatric, and Metabolic Diseases: A Comprehensive Mendelian Randomization Study.

Recent observational studies have reported associations between serum mineral nutrient levels, gut microbiota composition, and neurological, psychiatric, and metabolic diseases. However, the causal effects of mineral nutrients on gut microbiota and their causal associations with diseases remain unclear and require further investigation. This study aimed to identify the associations between serum mineral nutrients, gut microbiota, and risk of neurological, psychiatric, and metabolic diseases using Mendelian randomization (MR). We conducted an MR study using the large-scale genome-wide association study (GWAS) summary statistics of 5 serum mineral nutrients, 196 gut microbes at the phylum, order, family, and genus levels, and a variety of common neurological, psychiatric, and metabolic diseases. Initially, the independent causal associations of mineral nutrients and gut microbiota with diseases were examined by MR. Subsequently, the causal effect of mineral nutrients on gut microbiota was estimated to investigate whether specific gut microbes mediated the association between mineral nutrients and diseases. Finally, we performed sensitivity analyses to assess the robustness of the study results. After correcting for multiple testing, we identified a total of 33 causal relationships among mineral nutrients, gut microbiota, and diseases. Specifically, we found 4 causal relationships between 3 mineral nutrition traits and 3 disease traits, 15 causal associations between 14 gut microbiota traits and 6 disease traits, and 14 causal associations involving 4 mineral nutrition traits and 15 gut microbiota traits. Meanwhile, 118 suggestive associations were identified. The current study reveals multiple causal associations between serum mineral nutrients, gut microbiota, risk of neurological, psychiatric, and metabolic diseases, and potentially provides valuable insights for subsequent nutritional therapies.

Hybrid architecture based intelligent diagnosis assistant for GP

As the first point of contact for patients, General Practitioners (GPs) play a crucial role in the National Health Service (NHS). An accurate primary diagnosis from the GP can alleviate the burden on specialists and reduce the time needed to re-confirm the patient’s condition, allowing for more efficient further examinations. However, GPs have broad but less specialized knowledge, which limits the accuracy of their diagnosis. Therefore, it is imperative to introduce an intelligent system to assist GPs in making decisions. This paper introduces two data augmentation methods, the Complaint Symptoms Integration Method and Symptom Dot Separating Method, to integrate essential information into the Integration dataset. Additionally, it proposes a hybrid architecture that fuses the features of words from different representation spaces. Experiments demonstrate that, compared to commonly used pre-trained attention-based models, our hybrid architecture delivers the best classification performance for four common neurological diseases on the enhanced Integration dataset. For example, the classification accuracy of the BERT+CNN hybrid architecture is 0.897, which is a 5.1% improvement over both BERT and CNN with 0.846. Finally, this paper develops an AI diagnosis assistant web application that leverages the superior performance of this architecture to help GPs complete primary diagnosis efficiently and accurately.

The effect of transcranial alternating current stimulation on functional recovery in patients with stroke: a narrative review.

Stroke is a common neurological disorder worldwide that can cause significant disabilities. Transcranial alternating current stimulation (tACS) is an emerging non-invasive neuromodulation technique that regulates brain oscillations and reshapes brain rhythms. This study aimed to investigate the effect of tACS on functional recovery in patients with stroke. The MEDLINE (PubMed), Cochrane Library, Embase, SCOPUS, and Web of Science databases were searched for English-language articles on tACS and stroke, published up to October 20, 2023. The following key search phrases were combined to identify potentially relevant articles: 'tACS,' 'transcranial alternating current stimulation,' 'stroke,' 'cerebral infarct,' and 'intracerebral hemorrhage.' The inclusion criteria for study selection were as follows: (1) studies involving patients with stroke and (2) studies that used tACS for functional recovery. A total of 34 potentially relevant studies were identified. Five articles were included in this review after reading the titles and abstracts and assessing their eligibility based on the full-text articles. Among the included studies, one investigated the improvement in overall functional status in patients with stroke after tACS, and two investigated the effect of tACS on motor function and gait patterns. Moreover, one study reported the efficacy of tACS on aphasia recovery, and one study evaluated the effect of tACS on hemispatial neglect. Our findings suggest that tACS improves functional recovery in patients with stroke. The application of tACS was associated with improved overall functional recovery, sensorimotor impairment, aphasia, and hemispatial neglect. The potential clinical application of tACS should be supported by high-quality, evidence-based studies.

Pharmacological Investigation of Anticonvulsant Effect of Artemisia Vulgaris on Pentylenetetrazole-Induced Epileptic Seizures in Zebrafish Experimental Model

Background:: Epilepsy is the most common neurological disorder, characterized by abnormal, unpredictable, and recurrent seizures. In the alternative medicine system, Artemisia vulgaris has been used to treat epileptic symptoms since its inception. However, scientific evidence concerning its effect on the treatment of epileptic seizures is not available. Objective:: The objective of the study is to evaluate the anti-convulsant potential of Artemisia vulgaris in zebrafish experimental models. Methods:: Zebrafish larvae and adult zebrafish were used as experimental models. Briefly, larvae and adult zebrafish were exposed to 0.5% of the test medicine Artemisia vulgaris mother tincture (ϕ) and its potencies (6CH, 30CH), and valproic acid for 1 hour. After 1 hour of exposure, they were exposed to pentylenetetrazole to record different seizure scores from 1 to 5 using ANY maze video tracking software. Results:: Artemisia vulgaris 30CH in zebrafish larvae and Artemisia vulgaris 6CH and 30CH in adult zebrafish delayed the latency score from score 1 to score 5 and were found effective against PTZinduced locomotor activity and seizure duration and intensity. Conclusion:: In conclusion, Artemisia vulgaris (6CH and 30CH) has the potential to be a novel treatment for symptomatic epileptic seizures and could be a potential alternative drug candidate for symptomatic treatment of epilepsy.

Vitamin d levels in pediatric epilepsy patients on the anti-epileptic drugs at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Background: Epilepsy is a common neurological disorder of childhood repeatedly necessitating prolonged use of anticonvulsants. This study was done to evaluate the status of vitamin D in epileptic children. We targeted to describe the prevalence and risk factors for vitamin D deficiency among children with epilepsy. 
 Methods: A hospital-based descriptive cross-sectional study design with prospective data collection was used among children with epilepsy on anti-epileptic drugs attending the Pediatric Neurology Clinic and their primary caretakers. For this study, a sample of 226 children and adolescents were included in the study and a blood sample for the determination of serum vitamin D was taken. The participants were interviewed, and medical records were thoroughly reviewed. Descriptive statistics and binary logistic regression analysis was done to assess determinants of vitamin D deficiency. . 
 Results: In this study, the prevalence of vitamin D deficiency was found to be 42%. Children on polytherapy (AOR = 4.3 (1.2 - 16)), 3 or more AEDs (AOR = 0.1 (0.0 - 0.8)), female sex (AOR = 1.8 (1.7 - 2.6)), age >15 years (AOR = 2.12 (1.0 - 1.5)), 4 months of exclusive breastfeeding (AOR = 5.6 (4.9 - 36)), family diet (AOR = 0.3 (0.1 - 0.8)) and non-ambulation (AOR = 1.7 (1.8 - 3.6)) were factors associated with being in the vitamin D deficiency group.
 Conclusion: According to this study patients who take Anti-Epilepsy drugs are at a higher risk of a poor vitamin D status. Based on this finding, the need for timely and appropriate vitamin D supplementation and periodic follow-up seems to be very evident.

A New Perspective in the Treatment of Ischemic Stroke: Ferroptosis.

Ischemic stroke is a common neurological disease. Currently, there are no Food and Drug Administration-approved drugs that can maximize the improvement in ischemic stroke-induced nerve damage. Hence, treating ischemic stroke remains a clinical challenge. Ferroptosis has been increasingly studied in recent years, and it is closely related to the pathophysiological process of ischemic stroke. Iron overload, reactive oxygen species accumulation, lipid peroxidation, and glutamate accumulation associated with ferroptosis are all present in ischemic stroke. This article focuses on describing the relationship between ferroptosis and ischemic stroke and summarizes the relevant substances that ameliorate ischemic stroke-induced neurological damage by inhibiting ferroptosis. Finally, the problems in the treatment of ischemic stroke targeting ferroptosis are discussed, hoping to provide a new direction for its treatment.

Long-term effects of levetiracetam and valproic acid on laboratory parameters in childhood epilepsy

Epilepsy is the most common neurological disorder in childhood which often requires long-term or sometimes lifelong treatment. In this study, we aimed to evaluate the change in hematological and biochemical laboratory parameters at the 24th month compared to the treatment baseline values in pediatric epilepsy patients receiving levetiracetam (LEV) and valproic acid (VPA) monotherapy. Complete blood count panel, biochemical and hormonal parameters were investigated retrospectively at baseline and at 24 months in patients diagnosed with epilepsy at the Balikesir University Medical Faculty pediatric neurology clinic, Türkiye, and started on LEV and VPA monotherapy between 01.08.2019 and 01.08.2022. Forty-nine patients were using LEV and 14 VPA. A statistically significant difference in terms of the complete blood count parameters mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) was observed in the cases using LEV between baseline and the 24th month of treatment (p=0.006, p=0.004). Among the cases using VPA, significant differences between baseline and the 24th month of treatment were determined in the complete blood count parameters red blood cell (RBC), MCV, and monocyte (MON)% values (p=0.004, p=0.022, and p=0.01). In conclusion, epilepsy treatment is a lengthy process in pediatric patients, and patients need to be monitored using hematological and biochemical parameters at specific intervals in terms of potential seizure drug side effects.

Determining the effect of hypertension and diabetes following stroke in tertiary hospital, Aljouf, Saudi Arabia.

Background: Stroke is a common neurological disorder with a high prevalence. The aim of this study was to determine the risk factor, prevalence, and association of types of strokes among diabetes and hypertension patients.
 Methods: A retrospective study was conducted in King Abdul Aziz, Qurayyat, Sakaka, and Tubarjal hospitals among stroke patients including both sexes within the age > 40 years. Type of stroke was identified by brain computed tomography scans or magnetic resonance imaging and risk factors for stroke and other details were noted on a checklist.
 Results: Out of 226 stroke patients considered for the present study, in which 48% were males and 52% were females. All lived in the Aljouf region. Most of the patients had risk factors which included Hypertension 49 (21.68%), Diabetes Mellitus 44 (19.46%), Combined (Hypertension and diabetes) 111 (49.11%), and Hyperlipidemia 22 (9.75%). Stroke patients > 60 years of age group showed a higher prevalence of ischemic stroke (p=0.001). The combined risk factor group also showed more prevalence of ischemic stroke (49.11%).
 Conclusion: Patient having both risk factor Hypertension and diabetes mellitus were major association with ischemic stroke. Majority of the patients with ischemic stroke age at onset > 60 year and irrespectively affected both males and females were equally.
 Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 171-178

Knowledge and attitude on epilepsy among neurology patients and their attendants: Mixed methods research at a tertiary hospital

Abstract Background: Epilepsy is a recurrent and common neurological disorder with less awareness about epilepsy among the public. Sociocultural attitudes have a role to play in epilepsy management. This could be due to misconceptions of the public on witnessing an epileptic seizure. Hence, the current study evaluated knowledge, attitude, and perception of neurology outpatient department and inpatients and their caregivers, at the tertiary care hospital in South India. Materials and Methods: A mixed methods research with a single hospital-based, cross-sectional, quantitative study and the phenomenological type of qualitative study with focused group discussion were performed. A purposive sampling technique was used to select a total of 140 participants for the quantitative study using the Public Attitudes toward Epilepsy questionnaire. Results: Among 140 participants, although 80% have heard of epilepsy through witnessing the episode or mass media, 42% were unaware of it. Seventy percent do not know about triggering factors, or measures to prevent injury during epilepsy and 55% do not know the first aid measures. Forty-nine percent had an unfavorable attitude about epilepsy. Thirty-eight percent of the participants still believe that epilepsy is a kind of insanity. Only 48% believe that person with epilepsy can have a normal life like others. Conclusion: Knowledge and attitude toward epilepsy have improved, however, it is found to be low despite increased literacy rate and access to technology. Community-based health educational campaigns by medical fraternities will be beneficial to alleviate negative attitudes and improve knowledge about epilepsy among the public.

Microenvironment-responsive nanosystems for ischemic stroke therapy.

Ischemic stroke, a common neurological disorder caused by impaired blood supply to the brain, presents a therapeutic challenge. Conventional treatments like thrombolysis and neuroprotection drugs lack ideal drug delivery systems, limiting their effectiveness. Selectively delivering therapies to the ischemic cerebral tissue holds great potential for preventing and/or treating ischemia-related pathological symptoms. The unique pathological microenvironment of the brain after ischemic stroke, characterized by hypoxia, acidity, and inflammation, offers new possibilities for targeted drug delivery. Pathological microenvironment-responsive nanosystems, extensively investigated in tumors with hypoxia-responsive systems as an example, could also respond to the ischemic cerebral microenvironment and achieve brain-targeted drug delivery and release. These emerging nanosystems are gaining traction for ischemic stroke treatment. In this review, we expound on the cerebral pathological microenvironment and clinical treatment strategies of ischemic stroke, highlight various stimulus-responsive materials employed in constructing ischemic stroke microenvironment-responsive nano delivery systems, and discuss the application of these microenvironment-responsive nanosystems in microenvironment regulation for ischemic stroke treatment.

A Study to Assess the Psychosocial Concerns and Coping Strategies of Parents of Mentally Challenged Attending Special Schools in Malappuram District, Kerala

Aim: The aim of the study is to explore the psychosocial concerns of parents of intellectually challenged children, to determine the coping mechanisms adopted by the parents, and to associate the psychosocial concerns of parents of mentally challenged people using the chosen demographic factors.Introduction: Mental retardation is among the most common neurologic disorder which makes certain limits in mental, cognitive, and group activities.Materials and Methods: Aquantitative non-experimental research approach based on the transaction-based model of stress and coping by Lazarus and Folkman was used. Totally 150 parents of mentally challenged children at VKM Special School, Valanchery, RICCCH, Manjeri Head Office and Good Hope School, Manjeri, were selected as a sample by purposive sampling. The tools used were demographic pro forma, a structured questionnaire on psychosocial concerns, and the David L Tobin Rating Scale for coping strategies.Results: Only 3.33% of parents got 10 out of 10 scores, 29.33% is the highest positive response, and no parents scored positive responses 1 and 2. 41.33% of the parents maintained an average social support strategy, and 45.33% had average social withdrawal strategy. There is a significant association (P < 0.05) of psychosocial concerns with their demographic variables such as the age of the parent, area of residence, monthly income, and gender of the child.Conclusion: Parents should be motivated to score positive responses by 100% with adequate support. They should be aware of improving coping ability and the actively available multidisciplinary training. Adequate measures to be taken to enhance the bridging between the child and the society.

Exploring causal correlations between plasma proteins and peripheral neuropathy: a Mendelian randomization.

Peripheral neuropathy (PN) is a common neurological disorder, and circulating plasma proteins with causal genetic evidence are a major source of therapeutic targets. This study identifies several potential plasma proteins that are causally related to PN risk, providing new insights into protein-mediated pathogenesis of PN and potential targets for novel therapies. To identify potential therapeutic targets for PN, we employed two-sample Mendelian randomization (MR) to identify plasma proteins associated with six common PN. First, we screened for proteins related to PN using genome-wide association studies (GWAS), obtaining genetic data on plasma proteomes from 35,559 Icelanders. Summary data for six common PN, including Carpal Tunnel Syndrome (CTS), Trigeminal Neuralgia (TN), Alcoholic Neuropathy (AIP), Drug-induced Neuropathy (DIP), Diabetic Neuropathy (DP), and Guillain-Barré syndrome (GBS), were obtained from the FinnGen database. Two-sample MR and colocalization analyses were then conducted to further identify protein-PN pairs with presumed causal relationships. Enrichment analysis of positive proteins revealed potential biological processes and pathways. Based on drug-gene interaction analysis, we ultimately identified causal proteins associated with PN that could serve as potential drug targets for treating PN. Through MR analysis, we identified eight proteins (UBC12, SEM4C, IL23R, Prothrombin, CBS, Microglobulin, MATN4, COLEC12) with causal relationships to PN. We found that UBC12 is a protective factor for DP and CTS, while the remaining proteins are risk factors. Further colocalization analysis showed a posterior probability of hypothesis 4 (PPH4) less than 0.75, indicating no positive colocalization results were found. From the pathway enrichment analysis, we discovered that the proteins were mainly concentrated in pathways related to defense response to bacterium, receptor signaling pathway via STAT, cell killing, negative regulation of cytokine production, and leukocyte mediated immunity. Finally, in Drug-Gene Interaction database (DGIdb), we identified three protein-coding genes (IL23R, F2, CBS) as potential drug targets for PN. Mendelian randomization studies confirm the causal relationship between genetically predicted PN-related risk and genetically predicted plasma protein abundance. Plasma proteins, as biomarkers associated with PN, can provide potential drug targets for etiological intervention research in PN.

The clinical differences between traumatic and NOS chronic subdural hematoma.

Chronic subdural hematoma (CSDH) is a common neurologic disorder with increasing incidence, which can be preceded by head trauma or occur in the absence of trauma. In order to deeply understand the clinical characteristics of this disease, we conducted this retrospective study to explore the clinical differences between traumatic and not otherwise specified (NOS) CSDH. According to the inclusion and exclusion criteria, 168 traumatic CSDH patients and 133 NOS CSDH patients were recruited from January 2015 to October 2023 in our cohort. The collected data and compared parameters including baseline clinical features and radiological outcomes of hematoma within 24 h of hospital admission, as well as the treatment method and clinical outcome of traumatic and NOS CSDH patients. Compared to NOS CSDH patients, the average age was younger, epilepsy was more frequent, asymptomatic cases were more common, and the taking of anticoagulants and antiplatelet drugs were rarer in traumatic CSDH patients (all P < 0.05). However, no differences were found in the radiological presentations of hematoma at admission, the treatment methods and clinical outcomes of traumatic and NOS CSDH patients (all P > 0.05). Traumatic CSDH patients were more likely to be asymptomatic or have seizures, while NOS CSDH were more common in elder people and in individuals with the history of taking anticoagulants and antiplatelet drugs. The treatment methods and clinical outcomes were similar in traumatic and NOS CSDH patients.

Parental Knowledge, Attitudes, and Practice toward their Epileptic Children, Baghdad, Iraq 2022

Background: Epilepsy is one of the most common neurological disorders. People who know less about epilepsy tend to have negative ideas about the disease. KAP of parents on epilepsy is crucial, especially to children below 13, as the child in this stage mostly depends on parents to get the answers to their concerns. Still, the over-protection from their families will create insecurity and reduce their self-esteem when they grow older. Objectives: To assess the knowledge, attitude, and practice (KAP) and measure their association with sociodemographic characteristics. Methods: A cross-sectional study involved 107 parents with children who were diagnosed and received treatment for epilepsy. This study was conducted in the consultation clinics in the Children Welfare Teaching Hospital, Medical City in Baghdad-Iraq, from January through July 2022. A questionnaire was developed and filled out through direct interviews with the participants. The questionnaire was composed of five parts. The first part included primary sociodemographic data. The second part concerns the particular child’s basic characteristics and epilepsy history. The third part concerns the parents' knowledge about child epilepsy. The fourth part concerns parents' attitudes toward children with epilepsy. The fifth part is concerned with the practice of parents toward child epilepsy. Results: Good knowledge, attitude, and practices were seen among 61 (57.0%), 70 (65.4%), and 90 (84.1%) parents, respectively. Good parents’ knowledge of epilepsy was significantly associated with higher education (college) and with fewer family Members (&lt;5) (P&lt;0.001 and P=0.0002), respectively. In addition, a good parents’ attitude towards epilepsy was significantly associated with higher education (college) (P=0.015). Conclusion: About half of the parents have good knowledge, two third have a good attitude, and most have good practices towards epilepsy. Received: April. 2023 Accepted: Jul. 2023 Published: Jan 2024

Machine learning for the detection and diagnosis of cognitive impairment in Parkinson's Disease: A systematic review.

Parkinson's Disease is the second most common neurological disease in over 60s. Cognitive impairment is a major clinical symptom, with risk of severe dysfunction up to 20 years post-diagnosis. Processes for detection and diagnosis of cognitive impairments are not sufficient to predict decline at an early stage for significant impact. Ageing populations, neurologist shortages and subjective interpretations reduce the effectiveness of decisions and diagnoses. Researchers are now utilising machine learning for detection and diagnosis of cognitive impairment based on symptom presentation and clinical investigation. This work aims to provide an overview of published studies applying machine learning to detecting and diagnosing cognitive impairment, evaluate the feasibility of implemented methods, their impacts, and provide suitable recommendations for methods, modalities and outcomes. To provide an overview of the machine learning techniques, data sources and modalities used for detection and diagnosis of cognitive impairment in Parkinson's Disease, we conducted a review of studies published on the PubMed, IEEE Xplore, Scopus and ScienceDirect databases. 70 studies were included in this review, with the most relevant information extracted from each. From each study, strategy, modalities, sources, methods and outcomes were extracted. Literatures demonstrate that machine learning techniques have potential to provide considerable insight into investigation of cognitive impairment in Parkinson's Disease. Our review demonstrates the versatility of machine learning in analysing a wide range of different modalities for the detection and diagnosis of cognitive impairment in Parkinson's Disease, including imaging, EEG, speech and more, yielding notable diagnostic accuracy. Machine learning based interventions have the potential to glean meaningful insight from data, and may offer non-invasive means of enhancing cognitive impairment assessment, providing clear and formidable potential for implementation of machine learning into clinical practice.

Effectiveness of repeated injections of botulinum toxin A on gait and fatigue in adults with spastic paraparesis secondary to multiple sclerosis.

Multiple sclerosis (MS) is the most common neurologic disease in young adults. Spasticity is one of its most disabling symptoms, with botulinum toxin A type A (BoNT-A) being one of the treatments of choice for this symptom. We assessed the response to abobotulinumtoxinA in improving walking ability and fatigue in patients with spastic paraparesis caused by MS. We performed a real-world, multicenter, prospective, open-label low-intervention trial in 84 patients with MS and spastic paraparesis of the lower limbs infiltrated with abobotulinumtoxinA (LINITOX study). The response of spasticity, walking ability and fatigue is analyzed in 4 cycles of ultrasound-guided injection in the lower limbs. The patients improved their walking ability by an average of 11.34% meters measured with 6-Minute Walk Test (6MWT), and decreased the percentage of fatigue by 6.86% (4.66 percentage points less), in the 12-Item Multiple Sclerosis Walking Scale (MSWS-12) 4 weeks after abobotulinumtoxinA injection, both values are statistically significant. This improvement seems to persist over time, throughout the cycles. We found improved walking ability and less fatigue in patients with MS-related spastic paresis of the lower limbs after injection of abobotulinumtoxinA.

Potential causal link between dietary intake and epilepsy: a bidirectional and multivariable Mendelian randomization study.

Epilepsy is a common neurological disease, and dietary intake has been suggested as a potential modifiable risk factor. However, the causality of associations between dietary intake and epilepsy remains uncertain. This study aimed to investigate the potential causal relationships between various dietary intakes and epilepsy using Mendelian randomization (MR) analysis. A two-sample MR approach was employed, utilizing genetic variants associated with dietary factors as instrumental variables (IVs). Genome-Wide Association Study (GWAS) summary data on dietary intakes were obtained from the UK Biobank, while data on epilepsy were sourced from the European Bioinformatics Institute. The number of genetic variants used as IVs varied for each dietary factor. Inverse-variance weighted (IVW), weighted median, MR-Egger, and Bayesian weighted MR (BWMR) methods were used to assess causality. Multivariable MR (MVMR) was performed, adjusting for potential confounders. Sensitivity analyses were conducted to evaluate the robustness of the findings. The study identified a significant inverse association between non-oily fish intake and epilepsy risk (OR = 0.281, 95% CI: 0.099-0.801, p = 0.018) using the IVW method. This finding was corroborated by the BWMR analysis (OR = 0.277, 95% CI: 0.094-0.814, p = 0.020). The MVMR analysis further confirmed the protective effect of non-oily fish intake on epilepsy risk after adjusting for potential confounders. In the reverse MR analysis, epilepsy was associated with reduced water intake (OR = 0.989, 95% CI: 0.980-0.997, p = 0.011). The present MR study provides evidence of a causal, protective relationship between non-oily fish intake and reduced epilepsy risk. Additionally, the findings suggest that epilepsy may influence water intake patterns. These results contribute to our understanding of the role of dietary factors in epilepsy and may inform dietary recommendations for the management and prevention of this condition.