Neuroscience Institute Research Articles

Plasma Oligomeric Amyloid‐β partially mediates the effects of Diabetes Mellitus on Cognition in Mild Cognitive Impairment

AbstractBackgroundOligomeric amyloid‐beta (OAβ) is postulated to be the major neurotoxic species that is implicated in the pathophysiology of Alzheimer’s disease (AD). Emerging evidence suggest that plasma OAβ levels are higher in AD compared to cognitively unimpaired individuals and correlate well with AD biomarkers. Diabetes Mellitus (DM) is consistently linked to cognitive dysfunction and epidemiological studies show that patients with DM have an increased risk of AD. While cerebral amyloid deposition is hypothesized to be the link between AD and DM, the association of OAβ and DM on cognition among mild cognitive impairment (MCI) remains unknown. Here, we aim to evaluate the effects of plasma OAβ levels and DM on cognition among MCI patients from a memory clinic in Singapore.MethodIn this retrospective cross‐sectional study, 54 MCI patients (mean age 68.31, 44.4% males) stratified by DM diagnosis, underwent cognitive assessment and plasma OAβ measurements using the Multimer Detection System‐Oligomeric Aβ (MDS‐OAβ) in National Neuroscience Institute Singapore between 2019 to 2021. Multiple linear regression models evaluated the main effects of OAβ and DM on cognition while mediation analysis evaluated the effect of DM on cognition mediated via OAβ. All analyses were controlled for age, sex, education.Result13 (24.1%) of the total MCI cohort had DM and OAβ levels were higher in DM patients (0.68 vs 0.53 ng/ml, p=0.023).OAβ levels were associated with lower MMSE scores (β= ‐4.08, p=0.004) while DM was associated with lower MMSE (β = ‐1.26, p=0.046) and MoCA (β = ‐1.83, p=0.025) scores. Plasma OAβ partially mediates the effect of DM on MoCA scores (Figure 1).ConclusionThe effect of DM on poorer global cognition is partially mediated by higher plasma OAβ levels. While these results need to be replicated in a larger cohort, our findings suggest that optimizing DM control among MCI may reduce the burden of OAβ and improve cognition.

In Memoriam: Hamit Ziya Gökalp, 1929 to 2022.

In Memoriam: Hamit Ziya Gökalp, 1929 to 2022.

The Utility of Brain CT in Highlighting the Etiological Patterns and Incidental Findings of Traumatic Brain Injury

Aim: To find the utility of brain CT in highlighting the etiological patterns and incidental findings of traumatic brain injury. Methods: From January 2022 to March 2022, 110 patients presenting to emergency department of Pakistan Institute of Neurosciences with brain traumatic injury was present in this study. Patients go through long clinical evaluation and computed tomography on every trauma criteria. Results: The most affected age (group) was 30 to 42 years (37.05%) male (78.2%) to female (21.8%) ratio was 8:2. Injuries were predominantly caused by RTA (72.7%), less commonly caused by fall (11.8%), pedestrial (6.4%), assault (5.5%), and sports (3.6%). Among those with RTA less than 6% people was wearing helmet. The common CT scan evaluation was brain contusion (35%), fracture (13%), Edema (13%), SDH (10%), EDH (8%), SAH (4%), pneumocephalus (5%) and others (3%). Prediction of true prevalence of incidental findings is tough. In this study, we found that enlarged cisterna magna (3.6%) and calcification (3.6%) were the common incidental (findings), and brain tumor (0.9%) and hydrocephalus (0.9%). Conclusion: Road traffic accidents (RTA) are a major cause of TBI. This can be avoided by wearing helmet, but it is less used. Moreover, there is a proper need to put strict system amongst hospitals citywide to lessen the effects of severe TBI. At last every person had to check up on themselves for any minor physical or mental change. Keywords: Traumatic Brain Injury, CT scan, Etiological patterns, Incidental findings.

Electromyographic Patterns in Children presented as Floppy Baby: Experience in a Neurophysiology Laboratory of a Tertiary care hospital in Bangladesh

Introduction: Electromyography (EMG) is an invaluable diagnostic tool to reach a diagnosis in patients with hypotonia. The objective of this study was to observe the EMG patterns in children presented as floppy baby. Methods: It was a cross-sectional study conducted in the neurophysiology department of the National Institute of Neurosciences and hospital over 4 years. Floppy children, aged 1 month to 5 years, referred to the laboratory for EMG were enrolled in the study. Hypotonia due to acute flaccid paralysis or children having drugs that could cause decreased muscle tone were excluded from the study. Thereafter, children were categorized into groups of central, peripheral, and uncategorized/mixed hypotonia. EMG was done in all patients and an electro-diagnostic impression was made. Results: Out of 72 patients, 54.17% were male and 45.83% were female. Their average age of performing EMG was 26.81±18.12 months. Clinically it was observed that central and peripheral hypotonia were present in 18.05% and 70.83% of cases respectively and in 11.11% of cases, hypotonia could not be differentiated. EMG revealed Spinal muscular atrophy (SMA) in 38.89% of cases, followed by myopathy (26.39%), peripheral neuropathy (9.72%), and neuromuscular disorder (2.78%). In 19.44% of cases, EMG findings remained normal. Conclusion: Hypotonia of peripheral origin was the most common EMG finding in floppy children. SMA is the commonest electro-diagnostic impression followed by myopathy. J Bangladesh Coll Phys Surg 2022; 40: 240-245

Graham Thornicroft: the struggle against stigma in mental health

When asked to lead the Lancet Commission on ending stigma and discrimination in mental health, Professor Sir Graham Thornicroft of the Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, set down a key principle. “The very nature of the topic meant that people with lived experience of mental health conditions had to be central to it”, he says. So he invited Charlene Sunkel to act as Commission Co-Chair. Sunkel is Founder and Chief Executive Officer of the Global Mental Health Peer Network and has lived experience with schizophrenia.

First person – Salil Sukumaran

ABSTRACTFirst Person is a series of interviews with the first authors of a selection of papers published in Disease Models & Mechanisms, helping researchers promote themselves alongside their papers. Salil Sukumaran is first author on ‘ Abnormalities in migration of neural precursor cells in familial bipolar disorder’, published in DMM. Salil is a senior scientific officer in the lab of Biju Viswanath at the Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India, investigating the role of cellular migration in bipolar disorder.

Editorial introductions.

Current Opinion in Neurology was launched in 1988. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of neurology is divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Luis QuerolLuis QuerolLuis Querol (Valencia, 1980) graduated in Medicine at the University of Oviedo, Spain, and completed his residency in Neurology at the Santa Creu i Sant Pau Hospital in Barcelona. In 2009, he joined the group of Prof. Isabel Illa where he developed his doctoral thesis on the role of autoantibodies in immune-mediated neuropathies. In 2012, he worked as an associate researcher in the group of Dr Kevin O’Connor, Department of Neurology, Yale University (USA), where he developed projects related to autoantibodies in multiple sclerosis and myasthenia gravis. He completed his PhD in Medicine at the Universidad Autónoma de Barcelona, Spain, in 2013 thanks to studies that identified anti-contactin antibodies in a specific subgroup of patients with CIDP, in what is the first clinically useful marker detected in CIDP. Since then, he has led the auoimmune neurology clinics at Hospital Sant Pau in Barcelona and has continued a fruitful scientific production in the field of autoantibodies and biomarkers in autoimmune neurological disorders. Ichizo NishinoIchizo NishinoDr Ichizo Nishino, FAAN, FANA, is Director of Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP). He obtained his M.D. in 1989 and Ph.D. in 1998 from Kyoto University, Japan. After five years of training in clinical neurology and six years of research fellowship, including two years at Columbia University, he was appointed to his current position in 2001. By now, he has published more than 600 PubMed-listed papers in the field, including the reports of gene discoveries for MNGIE and Danon disease, and the report of a new muscle disease – megaconial congenital muscular dystrophy (OMIM: 602541) whose causative was also later identified by his own group. His laboratory functions as a nationwide referral center for muscle disease, providing diagnostic analyses for muscle pathology and genetic diagnosis. His lab receives around 80% of muscle biopsies performed in Japan (1103 cases in 2021) and he signs out all cases. As a result, more than 22,000 frozen muscle biopsy samples have been accumulated in his muscle repository, which is one of the largest collections of the patient's muscles. Currently, Dr Nishino is a Visiting Professor at six universities: University of Yamanashi (Japan), Shinshu University (Japan), Kaohsiung Medical University (Taiwan), Fu Jen Catholic University (Taiwan), Peking University First Hospital (China), and Siriraj Hospital Mahidol University (Thailand). He is also serving as President of Asian-Oceanian Myology Center and Executive Board member in several societies including World Muscle Society. Albert LudolphAlbert LudolphAlbert Ludolph is currently Professor of Neurology, Chair and Director of the Department of Neurology, University of Ulm, Ulm, Germany and Speaker of the Site Ulm of the German Center for Neurodegenerative diseses (DZNE, Helmholtz Society). He obtained his M.D. from the University of Mainz, Germany, in 1981 and is a boarded neurologist and psychiatrist (education from University of Münster, Germany). His research focusses on translational work in neurodegenerative diseases; his work is mirrored by more than 600 PubMed-listed papers. His specific focus of interests are motor neuron diseases, Huntington's disease and frontotemporal dementias. The Department of Neurology in Ulm is an international referral center in particular for patients with ALS/MND. In the past his research focused on neurotoxicological and neuropharmacological research in humans, but also non-human primates. He was involved and initiated studies of neurogenetics of ALS, of the epidemiology of the disease (established registers in Southern Germany, Egypt and Mongolia), of the definition of the neuroanatomical sequence of events describing ALS and FTD, the development of biomarkers in ALS and FTD and beyond, and several drug trials, including investigator-initiated interventions. In recent years he tried to define the preclinical period of ALS including the role of the hypothalamus and its metabolic consequences.

Autologous Bone Graft vs PEEK Cage in Patients with Cervical Spondylotic Myelopathy

Background: Cervical spine stenosis is one of the most common degenerative changes of cervical spondylotic myelopathy (CSM) and results in severe dysfunction of the cervical spinal cord. The conventional treatment of such degenerative cervical spine conditions is anterior cervical discectomy and fusion (ACDF). Strut graft remains the gold standard in ACDF with excellent patient recovery but has many shortcomings. Polyetheretherketone (PEEK) cages have recently become popular as a replacement for strut grafts in patients undergoing ACDF.
 Objective: This study was carried out to compare the clinical and radiographic outcomes of autologous bone grafts versus PEEK cages in patients undergoing ACDF surgery.
 Materials and Methods: It was a randomized controlled trial conducted at the Neurosurgery Department Punjab Institute of Neurosciences for three years. Patients who consented to be a part of this study and fulfilled our predefined inclusion criteria were recruited and randomized into 2 groups. One group underwent ACDF with auto bone graft whereas the other group underwent ACDF with PEEK cage.
 Results: A total of 198 subjects were included in this study. The mean age was calculated as 47.60 ± 9.17 years in the PEEK cage group and 46.74 ± 8.87 years in the Autologous bone graft group. Males accounted for 59.6% of the study population. The fusion rate was found to be higher in the PEEK cage group with a p-value of 0.002.
 Conclusion: PEEK cages are superior to strut grafts as they have lesser morbidity after ACDF surgery in patients with CSM.

Outcome of autologous bone graft versus polyetheretherketone cages in anterior cervical discectomy and fusion surgery

Objective:To compare the outcome of autologous bone graft versus PEEK cages in ACDF surgery in terms of clinical performance and radiographic features.
 Methodology:This study was conducted at Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan from April 2020 to December 2022. In this study patients were randomized into two equal groups i.e. Group A (autologous bone graft) and Group B (PEEK cage).
 Results: Total of 98 patients was included in the study. The mean age of cases was 49.88 ± 17.83 years. There were 58(59.18%) male and 40(40.82%) female cases. 25(25.51%) cases who had C3-C4 involved, 48(48.98%) patients had C5-C6 and 25(25.51%) cases had C5 region involved. The mean disc height at 6th months in PEEK group was 6.71 ± 0.46 mm and in bone graft group was 6.33 ± 0.47 mm, p-value < 0.05. The mean operative time in PEEK group (2.07 ± 0.42) was statistically less than bone graft group (3.23 ± 0.36), p-value < 0.05. The average blood loss was also statistically less in PEEK group as compared to bone graft. The mean hospital stay in PEEK group was 2.92 ± 0.61 days as compared to bone graft was 5.48 ± 1.90 days, p-value < 0.05.
 Conclusion:Outcome of ACDF surgery PEEK cages are better than autologous bone graft in terms of clinical performance and radiological features. Hence PEEK cages can be opted in future to have better outcome and higher patient’s satisfaction.

P272 Fungal brain abscess in the era of COVID 19: an experience from a tertiary care Neurosciences Institute in South India

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMIntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is ruling the world for more than 2 years since 2020. In 2021, the second wave of COVID-19 attributed to the ‘delta variant’ swept across India, causing significant morbidity and mortality. In addition, the epidemic of COVID-19-associated mucormycosis affected the Indian subcontinent specifically, with a whopping 41 512 cases and 3554 deaths attributed to this dreadful disease.MethodsThe single-center retrospective cross-sectional study was aimed to determine the impact of COVID-19 on fungal brain abscess cases at a non-COVID tertiary care Neurosciences Institute in South India. The study included all cases diagnosed with fungal brain abscess microbiologically (microscopy and/or fungal culture), supported by radiological findings or by histopathological examination. Cases of brain abscess which were negative for fungal elements by microscopy, culture, and imaging were excluded from the study. Fungal culture was done on routine mycological media as per standard procedures. Fungal identification was done by microscopic morphology, MALDI-TOF MS, and ITS sequencing.ResultsA total of 406 cases of brain abscess were recorded between January 2020 and April 2022. Out of these, 26 (6.4%) were cases of fungal brain abscess. In 2020, three out of 153 (2%) cases had a fungal etiology, while it was 10.4% (22/211) in 2021 and 0.24% (1/42) till April 2022. Overall, a male preponderance was observed (20/26, 77% were males). The cases had an even distribution from 6 to 62 years, with no predilection in any particular age group. The most common underlying comorbidity was type 2 diabetes mellitus (13/26, 50%). Four cases had a past history of COVID-19. Radiological suspicion of fungal infection was present in all the cases. Mycological examination (wet mount and 20% KOH mount) of brain abscess pus from all the cases revealed fungal elements. Out of 26 cases, 23 cases showed hyaline, broad aseptate hyphae, 2 showed melanized septate hyphae and 1 showed budding yeast cells with pseudohyphae and arthroconidia on direct microscopy. Culture positivity was observed in 15 cases (57.7%). Out of 23 suspected cases of rhinocerebral mucormycosis based on clinical, radiological, and direct microscopic findings, fungal culture was positive in 13 cases, all of which were identified as Rhizopus arrhizus. Out of two cases that showed melanized hyphae in direct microscopy, one grew a dematiaceous mold that was identified as Cladophialophora bantiana. The other melanized fungus failed to grow in culture. The single case of brain abscess caused by a yeast-like fungus was attributed to Trichosporon dohaense, identified by ITS sequencing. It was initially misidentified as T. ovoides/T. mucoides by VITEK MS due to lack of mass spectral database for T. dohaense.ConclusionsA significant increase in the incidence of fungal brain abscess has been observed in the COVID-19 era, particularly with each new wave of infection. Clinical features along with imaging and mycological findings are crucial in making an early diagnosis and decision regarding antifungal therapy. Accurate identification to the species level is necessary to guide optimal antifungal therapy as several species exhibit emerging resistance to antifungal drugs.

Impact of integrated yoga therapy on cognitive impairment and cardiac dysfunction in relation to quality of life in breast cancer patients undergoing chemotherapy: Study protocol for a two-arm randomized controlled trial.

BackgroundChemotherapy-related cognitive impairment (CRCI) and cardiac dysfunction (CRCD) are common adverse effects seen in breast cancer patients undergoing chemotherapy. Even though these effects significantly influence daily functioning and overall quality of life, effective strategies to avoid and/or mitigate these adverse effects remain elusive. Yoga as a Mind-body intervention has been used increasingly by cancer patients and has undergone empirical investigations as a potential intervention for patients with cancer. Furthermore, yoga is associated with improved cognition and cardiac functioning in healthy older adults and subjects with cognitive and cardiac impairments. Accordingly, in the current study, yoga holds promise as an intervention to prevent/manage CRCI and CRCD with improved overall QOL in women receiving chemotherapy for breast cancer.MethodsThe study is a two-arm, randomized controlled trial. Women diagnosed with stage I-III breast cancer and awaiting neo-adjuvant or adjuvant chemotherapy will be recruited from a tertiary care center in Bangalore, India. Following recruitment, subjects are randomized to the intervention group (integrated yoga therapy intervention during chemotherapy) or the control group (standard care during chemotherapy). The study’s primary outcome is to measure the quality of life (cognitive domain) using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The other primary objectives will include cognitive functioning using neuropsychological test battery and cardiac autonomic function testing using heart rate variability. Secondary outcomes are Brain-derived neurotrophic factor (BDNF), brain function (functional MRI), Echocardiography, serum cortisol, Functional assessment of cancer therapy-cognition (FACT-Cog V3), perceived stress scale and Ryff Scales of Psychological Well-Being. Assessments take place before, during and after chemotherapy; 16-weeks post chemotherapy and 1-year post-baseline.DiscussionYoga is a promising intervention for preventing and/or managing chemotherapy-related adverse effects (CRAE) and enhancing the quality of life among breast cancer patients. The findings from this study may also help understand the inner mechanisms involved in the protective and restorative effects of yoga on CRAE and support the use of yoga prophylactically for breast cancer patients. In addition, the results of this study could help chemotherapy-exposed individuals with other solid cancer types who have cognitive and cardiac issues.Ethics and DisseminationThe study is approved by the ethics committee of the HealthCare Global Enterprises Ltd. Hospital (EC/434/19/01) and National Institute of Mental Health and Neurosciences (NIMH/DO/ETHICS SUB-COMMITTEE (BS&NS) 9th MEETING/2018).Clinical Trial Registration http://ctri.nic.in/Clinicaltrials/advancesearchmain.php, identifier CTRI/2020/10/028446.

Commentary: Intellectual Property Protection in Neurosurgery: An Overview.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Correspondence: Catherine A. Mazzola, MD, NJ Pediatric Neuroscience Institute, 131 Madison Avenue, Third Floor, Morristown, NJ07960, USA. Email: [email protected]

Madjid Samii: Omagium

Prof. Madjid Samii is an internationally recognized neurosurgeon who has conquered the highest levels of 21st-century neurosurgery. Born in Iran, he decided to take medical courses at the University of Mainz, Hanover, Germany. He earned his medical degree in 1963, marking the highest achievable score, and started his residency, guided by Emeritus Professor Dr Kurt Schurmann. Numerous various surgeries and studies that reshaped the field of neurosurgery describe his career. Starting with a publication regarding a new technique, pneumencephalotomography, he has steadily been ascending, studying and writing about cranial nerves, developing the surgery of the skull base and proving that the transnasal approach is preferred in clivus chondromas. Prof. Madjid Samii founded, 1990, the Foundation of National and Continental Skull Base Societies, and since 2001, he has been the Honorary President of the World Federation of Neurosurgery Societies(WFNS). Not only was he successful in his scientific path, but he also gave an example for the future generation of what astonishing results can be obtained with hard work, commitment, and a leader's spirit. He wanted to take worldwide neurosurgery to a whole new level, so he came up with an idea, the concept of an international neuro-excellence centre, which quickly became the reality of the International Neuroscience Institute of Hanover.

Epidemiologic Features and Surgical Treatment of Spontaneous Pyogenic Spondylodiscitis in Bangladesh

Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our country it is not infrequent. High level of clinical suspicion is necessary for diagnoses of spontaneous pyogenic spondylodiscitis. There is no study regarding this issue in Bangladesh. Objective: The objective of this study was to see the epidemiological feature and types of surgical treatment of spontaneous pyogenic spondylodiscitis in Bangladesh Materials and Methods: This is a retrospective observational study. This study was done in the Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. The study period was January, 2016 to July, 2021 for a period of 5.5 years. 17 patients who were undergone surgery included in the study. The data were collected from questionnaires and hospital records and analyzed. Results: In our study the highest incidence was found in 4th (23.52%) and 6th (29.42%) decade of life which was around 53%. The male to female ratio was about 2: 1.The present study showed the most common involvement was in lumbar region (35.31%), in dorsal and sacral region it was 23.52% and the cervical region in 17.65%. Regarding surgical treatment in cervical region both anterior (with fixation) and posterior approach was done, in dorsal, lumbar and sacral region posterior approach with or without fixation was done. Conclusion: In Bangladesh the incidence of Spontaneous pyogenic spondylodiscitis is relative high. It is more common in advance age with male predominance. Most frequently affected region was lumber. Surgical technique was individualized for every case. Bang. J Neurosurgery 2022; 11(2): 64-69

Editorial introductions.

Editorial introductions.

Components of Metabolic Syndrome and Stroke: A Case-Control Study in Bangladesh

Background: Stroke is increasingly recognized as a global public health concern which is one of the leading causes of death and disability. Metabolic syndrome increases the risk of developing stroke. Recently, studies have been undergone world-wide on metabolic syndrome and stroke but studies are yet limited among Bangladeshi population. Thus, the aim of this study was to investigate the relationship between metabolic syndrome and stroke in Bangladeshi population. Methods: This center-based case-control study was conducted from January 2020 to January 2021 among 66 cases and 66 age and sex matched controls at National Institute of Neurosciences and Hospital (NINS), Dhaka, Bangladesh. Participants were interviewed by a pre-tested semi-structured questionnaire. A checklist was used to document waist circumference, blood pressure and reports of biochemical investigations. Results: Mean age of the cases was 54.36 ± 9.94 years and controls was 52.66 ± 9.03 years. Among the components of metabolic syndrome, hypertension (p < 0.05, OR 1.51, 95% CI 1.04-2.19), elevated triglyceride (p < 0.05, OR 1.74, 95% CI 1.21-2.50) and reduced HDL (p = 0.018, OR 2.436, 95% CI 1.066-5.566) were associated with stroke. The proportion of abdominal obesity in cases was 22.7% while a higher proportion was found in controls (30.3%). This study revealed a significant association between metabolic syndrome and stroke (χ2 = 7.891, p <0.05, OR 0.354, 95% CI 0.17- 0.74). Conclusion: This study showed that components of metabolic syndrome were more prevalent in stroke.

Controversies in Stroke: Should Patients With Embolic Stroke of Undetermined Source Undergo Intensive Heart Rhythm Monitoring With an Implantable Loop Recorder?

HomeStrokeVol. 53, No. 10Controversies in Stroke: Should Patients With Embolic Stroke of Undetermined Source Undergo Intensive Heart Rhythm Monitoring With an Implantable Loop Recorder? No AccessArticle CommentaryRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessArticle CommentaryRequest AccessFull TextControversies in Stroke: Should Patients With Embolic Stroke of Undetermined Source Undergo Intensive Heart Rhythm Monitoring With an Implantable Loop Recorder? Anthony S. Kim, Hooman Kamel, Richard A. Bernstein, Monika Manchanda and Fan Z. Caprio Anthony S. KimAnthony S. Kim Correspondence to: Anthony S. Kim, MD, MAS, UCSF Weill Institute of Neurosciences, Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, 675 Nelson Rising Lane, Room 411B, San Francisco, CA 94143. Email E-mail Address: [email protected] https://orcid.org/0000-0002-8095-6517 UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco (A.S.K.). Search for more papers by this author , Hooman KamelHooman Kamel https://orcid.org/0000-0002-5745-0307 Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine‚ New York (H.K.). Search for more papers by this author , Richard A. BernsteinRichard A. Bernstein Department of Neurology, Feinberg School of Medicine, Northwestern University‚ Chicago‚ IL (R.A.B., M.M.). Search for more papers by this author , Monika ManchandaMonika Manchanda https://orcid.org/0000-0002-7619-1339 Department of Neurology, Feinberg School of Medicine, Northwestern University‚ Chicago‚ IL (R.A.B., M.M.). Search for more papers by this author and Fan Z. CaprioFan Z. Caprio https://orcid.org/0000-0001-6992-7582 Department of Neurology, University of New Mexico‚ Albuquerque (F.Z.C.). Search for more papers by this author Originally published24 Aug 2022https://doi.org/10.1161/STROKEAHA.122.037342Stroke. 2022;53:3243–3247is corrected byCorrection to: Controversies in Stroke: Should Patients With Embolic Stroke of Undetermined Source Undergo Intensive Heart Rhythm Monitoring With an Implantable Loop Recorder?FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Sources of Funding and Disclosures, see page 3246.Correspondence to: Anthony S. Kim, MD, MAS, UCSF Weill Institute of Neurosciences, Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, 675 Nelson Rising Lane, Room 411B, San Francisco, CA 94143. Email anthony.[email protected]edu

Alzheimer’s Disease and Melatonin/Testosterone/Estrogens: Neurophysiological and Neuroendocrinological Routing of Longevity

Alzheimer’s disease is the evolutionary, genetic and epigenetic routing of Homo sapiens , with the introduction of the ADNM - 365/22/77 (Alzheimer’s Disease & Nuclear Medicine) rehabilitation program and medical and social neurocommunications and accompaniments (Research Institute of Neuroscience, 2022). Innovative neuromodulation methods in combined neuroendocrine therapy/rehabilitation (drug, non-pharmacological, etc.) predict the protection of brain aging. To restore circadian neuroplasticity of the brain, a multimodal scheme was introduced: circadian glasses, functional nutrition and physical activity. A combined and hybrid cluster has been developed and implemented in the diagnosis, treatment, prevention and rehabilitation of cognitive impairment and cognitive disorders. Bioelectromagnetic characteristics of light exposure to the visual analyzer, is the strongest synchronizing signal for the circadian system and optimal operation of Homo sapiens brain. Optimization of neurobiological and chronomedicine processes is possible with the circadian production of melatonin and ensuring its long-term concentration in the human body. Sex hormones have numerous protective and antioxidant effects in the adult brain, increasing neural function and resistance and promoting neuronal survival. As the body ages, there is a relatively rapid loss of ovarian hormones in women after menopause and a gradual but indeed significant decrease in testosterone in men. Reproductive aging in both men and women has a negative effect on neural function and represents a significant age-related risk factor for neurodegenerative diseases, primarily Alzheimer's disease. A key positive factor in all studies is the age of initiation of menopausal hormone therapy, early initiation of menopausal hormone therapy is protective against Alzheimer's disease. Neuroendocrinological multimodal methods make it possible to significantly increase the duration of an active and high-quality healthy life of a person. The start time of exogenous estrogen therapy was also highly significantly associated with the risk of dementia: if hormone replacement therapy began in the first 5 years after the onset of menopause, the risk of developing Alzheimer’s disease was significantly lower. In addition, estrogens act in the brain, regulating a wide range of behaviors and physiological functions in both sexes.

Science Visualization: Approaches and Resources for Making Communication Simple but Not Simplistic.

HomeStrokeVol. 53, No. 9Science Visualization: Approaches and Resources for Making Communication Simple but Not Simplistic No AccessResearch ArticleRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessResearch ArticleRequest AccessFull TextScience Visualization: Approaches and Resources for Making Communication Simple but Not Simplistic Kathryn Hayward, PhD and Aaron Davis, PhD Kathryn HaywardKathryn Hayward Correspondence to: Kathryn S. Hayward, PhD, Departments of Physiotherapy and Medicine, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Austin Hospital, Level 5 Harold Stokes Bldg, Heidelberg, 3084 Australia. Email E-mail Address: [email protected] https://orcid.org/0000-0001-5240-3264 Departments of Physiotherapy and Medicine, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Australia (K.H.). Search for more papers by this author and Aaron DavisAaron Davis https://orcid.org/0000-0002-1477-7406 UniSA Creative, University of South Australia, Adelaide (A.D.). Search for more papers by this author Originally published1 Aug 2022https://doi.org/10.1161/STROKEAHA.122.037668Stroke. 2022;53:e431–e434FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Sources of Funding and Disclosures, see page e434.Correspondence to: Kathryn S. Hayward, PhD, Departments of Physiotherapy and Medicine, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Austin Hospital, Level 5 Harold Stokes Bldg, Heidelberg, 3084 Australia. Email kate.[email protected]edu.au

Effect of Time Spent in Rehabilitation on Activity Limitation and Impairment After Stroke: A Cochrane Review Summary

HomeStrokeVol. 53, No. 8Effect of Time Spent in Rehabilitation on Activity Limitation and Impairment After Stroke: A Cochrane Review Summary No AccessArticle CommentaryRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessArticle CommentaryRequest AccessFull TextEffect of Time Spent in Rehabilitation on Activity Limitation and Impairment After Stroke: A Cochrane Review Summary Beth Clark, BSc, Jill Whitall, PhD, Gert Kwakkel, PhD, Jan Mehrholz, PhD, Sean Ewings, PhD and Jane Burridge, PhD Beth ClarkBeth Clark Correspondence to: Beth Clark, BSc, Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Bldg 67, Southampton, United Kingdom. Email E-mail Address: [email protected] https://orcid.org/0000-0003-4493-166X School of Health Sciences, Faculty of Environmental and Life Sciences (B.C., J.B.), University of Southampton, United Kingdom. Search for more papers by this author , Jill WhitallJill Whitall Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland Baltimore (J.W.). Search for more papers by this author , Gert KwakkelGert Kwakkel https://orcid.org/0000-0002-4041-4043 Department of Rehabilitation Medicine Amsterdam, Amsterdam Institute of Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Centre, the Netherlands (G.K.). Search for more papers by this author , Jan MehrholzJan Mehrholz https://orcid.org/0000-0002-7180-5434 Department of Public Health, Dresden Medical School, Technical University Dresden, Germany (J.M.). Search for more papers by this author , Sean EwingsSean Ewings https://orcid.org/0000-0001-7214-4917 Southampton Statistical Sciences Research Institute (S.E.), University of Southampton, United Kingdom. Search for more papers by this author and Jane BurridgeJane Burridge https://orcid.org/0000-0003-3497-6725 School of Health Sciences, Faculty of Environmental and Life Sciences (B.C., J.B.), University of Southampton, United Kingdom. Search for more papers by this author Originally published25 Jul 2022https://doi.org/10.1161/STROKEAHA.121.038017Stroke. 2022;53:e388–e389"Effect of Time Spent in Rehabilitation on Activity Limitation and Impairment After Stroke: A Cochrane Review Summary." Stroke, 53(8), pp. e388–e389FootnotesFor Sources of Funding and Disclosures, see page e389.Correspondence to: Beth Clark, BSc, Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Bldg 67, Southampton, United Kingdom. Email b.a.[email protected]ac.ukReference1. Clark B, Whitall J, Kwakkel G, Mehrholz J, Ewings S, Burridge J. The effect of time spent in rehabilitation on activity limitation and impairment after stroke.Cochrane Database Syst Rev. 2021;CD012612. doi: 10.1002/14651858.CD012612Google Scholar Previous Back to top Next FiguresReferencesRelatedDetails August 2022Vol 53, Issue 8 Advertisement Article InformationMetrics © 2022 American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.121.038017 Originally publishedJuly 25, 2022 Keywordsstrokeactivities of daily livingrecovery of functionadultstroke rehabilitationPDF download Advertisement SubjectsCerebrovascular Disease/Stroke