Neurological Disorders Research Articles

Current perspective on the problem of autoimmune gastritis.

Currently, there is an increase in autoimmune diseases, in particular, against the background of a decrease in the incidence of helicobacter gastritis, the number of patients with autoimmune gastritis is increasing. This is an autoimmune disease in which the acid-producing mucous membrane of the stomach is destroyed due to the loss of parietal cells, with their replacement by atrophic and metaplastic tissue. This leads to malabsorption of iron, vitamin B12, deficiency conditions, anaemias, neurological disorders and the development of malignant tumours. It is not fully known what the trigger of aggression is, but it is assumed that the autoimmune process can occur due to the interaction of genetic and environmental factors. Also, the relationship of Helicobacter pylori infection with the development of autoimmune gastritis has not been fully studied. Diagnosis of autoimmune gastritis is based on serological markers, but the leading diagnostic method is esophagogastroduodenoscopy with biopsy. There are a number of endoscopic signs that make it possible to suspect autoimmune gastritis (reverse atrophy, the presence of islands of a conserved acid-producing mucous membrane, viscous mucus, protrusions in the stomach body, which are currently called "white globe appereance", glomus-like lesions, which are proliferation of enterochromaffin-like cells). Atrophy of the gastric mucosa is found in the biopsy material, and three stages of inflammation of the fundal mucosa may also be present. Patients with autoimmune gastritis have an increased risk of developing malignant neoplasms, namely neuroendocrine tumours of type 1 and adenocarcinoma, and therefore regular monitoring is necessary in order to detect these formations early. However, the follow-up intervals are not definitively defined. Most sources indicate the need for gastroscopy once every 1-3 years.

A New Instrument to Define Parental Fear Regarding Feeding Their Children: A Reliability and Validity Study.

This study aimed to develop the 'Fear of Feeding My Child- A Parental Report (FF-PR)', which measures the parental fear of feeding their children, and to determine its reliability and validity. The study consists of the developmental phase and reported the content validity, internal consistency, test-retest reliability, construct, criterion, and discriminant validity. The study included two groups; 'Group I (N = 90)' who had a neurological disorder and their parents, and 'Group II (N = 60)' who were typically developing children without any feeding and swallowing problems and their parents. Limited literature review, clinical experience, and parental interviews have been used in creating the item pool. A panel of 7 experts assessed the content validity in two Delphi rounds. Cronbach's α measured the internal consistency of each item. The test-retest reliability was determined using the FF-PR scores given by the parents in Group I one week apart. Confirmatory factor analysis was used to measure the construct validity. The Nordic Orofacial Screening Test (NOT-S), Dysphagia Disorder Survey (DDS), and the Turkish version of the Feeding-Swallowing Impact Survey (T-FS-IS) were used for the criterion validity of the FF-PR. The discriminant validity of the FF-PR was determined by comparing the FF-PR scores of the groups and using the receiver-operating characteristic (ROC) curve. The content validity index was 0.92. The Cronbach's α was found to be high (test: 0.966, retest: 0.969). The FF-PR had an excellent chi-square fit (χ2/df = 123.075/127 p = 0.582) and according to the fit indices; the FF-PR was found to have a good fit. There was a low-moderate correlation between FF-PR and NOT-S (r = 0.335 - 0.462, p < 0.001) and DDS (r = 0.461 - 0.535, p < 0.001) and a moderate-high correlation between FF-PR and T-FS-IS (r = 0.501 - 0.807, p < 0.001). The FF-PR total and subscale scores were higher in Group I than in Group II. In conclusion, the FF-PR scale is a valid and reliable tool for measuring parental fear about feeding their child.

P2Y1R-IGFBP2 signaling: new contributor to astrocyte-neuron communication.

In a recent article published in Nature Communications (Shigetomi et al Nat Commun 15(1):6525, 2024), Shigetomi et al. identified that upregulated astrocytic purinergic P2Y1 receptors (P2Y1R), acting via the downstream molecule, insulin-like growth factor binding protein 2 (IGFBP2), play a crucial role in neuronal hyperexcitability. In epilepsy and stroke models, P2Y1R-IGFBP2 signaling was found to mediate astrocyte-driven neuronal hyperexcitability and so is a new contributor to astrocyte-neuron communication. Thus, IGFBP2 could be an alternative target for treating the effects of upregulated P2Y1R activity in reactive astrocytes in neurological diseases.

α-Synuclein fibrils enhance HIV-1 infection of human T cells, macrophages and microglia

HIV-associated neurocognitive disorders (HAND) and viral reservoirs in the brain remain a significant challenge. Despite their importance, the mechanisms allowing HIV-1 entry and replication in the central nervous system (CNS) are poorly understood. Here, we show that α-synuclein and (to a lesser extent) Aβ fibrils associated with neurological diseases enhance HIV-1 entry and replication in human T cells, macrophages, and microglia. Additionally, an HIV-1 Env-derived amyloidogenic peptide accelerated amyloid formation by α-synuclein and Aβ peptides. Mechanistic studies show that α-synuclein and Aβ fibrils interact with HIV-1 particles and promote virion attachment and fusion with target cells. Despite an overall negative surface charge, these fibrils facilitate interactions between viral and cellular membranes. The enhancing effects of human brain extracts on HIV-1 infection correlated with their binding to Thioflavin T, a dye commonly used to stain amyloids. Our results suggest a detrimental interplay between HIV-1 and brain amyloids that may contribute to the development of neurodegenerative diseases.

Emotional Impact of Changes in Activity Participation in Individuals with Parkinson’s Disease

Symptoms associated with Parkinson’s Disease, motor and non-motor, impact daily life and can lead to participation changes in meaningful occupations and social activities. The purpose of this study was to understand the emotional impact of changes in activity participation in people with Parkinson’s Disease. The study utilized a mixed-method design with a questionnaire and interview. Participants experienced significant negative emotions associated with decreased social participation and increased difficulty with meaningful occupations. Findings indicate the need for occupational therapy to address emotional needs to enhance engagement in meaningful occupations and quality of life in individuals with neurological disorders.

MicroRNA Expression Profile in Acute Ischemic Stroke

Acute ischemic stroke with large vessel occlusion (LVO) continues to present a considerable challenge to global health, marked by substantial morbidity and mortality rates. Although definitive diagnostic markers exist in the form of neuroimaging, their expense, limited availability, and potential for diagnostic delay can often result in missed opportunities for life-saving interventions. Despite several past attempts, research efforts to date have been fraught with challenges likely due to multiple factors, such as the inclusion of diverse stroke types, variable onset intervals, differing pathobiologies, and a range of infarct sizes, all contributing to inconsistent circulating biomarker levels. In this context, microRNAs (miRNAs) have emerged as a promising biomarker, demonstrating potential as biomarkers across various diseases, including cancer, cardiovascular conditions, and neurological disorders. These circulating miRNAs embody a wide spectrum of pathophysiological processes, encompassing cell death, inflammation, angiogenesis, neuroprotection, brain plasticity, and blood–brain barrier integrity. This pilot study explores the utility of circulating exosome-enriched extracellular vesicle (EV) miRNAs as potential biomarkers for anterior circulation LVO (acLVO) stroke. In our longitudinal prospective cohort study, we collected data from acLVO stroke patients at four critical time intervals post-symptom onset: 0–6 h, 6–12 h, 12–24 h, and 5–7 days. For comparative analysis, healthy individuals were included as control subjects. In this study, extracellular vesicles (EVs) were isolated from the plasma of participants, and the miRNAs within these EVs were profiled utilizing the NanoString nCounter system. Complementing this, a scoping review was conducted to examine the roles of specific miRNAs such as miR-140-5p, miR-210-3p, and miR-7-5p in acute ischemic stroke (AIS). This review involved a targeted PubMed search to assess their influence on crucial pathophysiological pathways in AIS, and their potential applications in diagnosis, treatment, and prognosis. The review also included an assessment of additional miRNAs linked to stroke. Within the first 6 h of symptom onset, three specific miRNAs (miR-7-5p, miR-140-5p, and miR-210-3p) exhibited significant differential expression compared to other time points and healthy controls. These miRNAs have previously been associated with neuroprotection, cellular stress responses, and tissue damage, suggesting their potential as early markers of acute ischemic stroke. This study highlights the potential of circulating miRNAs as blood-based biomarkers for hyperacute acLVO ischemic stroke. However, further validation in a larger, risk-matched cohort is required. Additionally, investigations are needed to assess the prognostic relevance of these miRNAs by linking their expression profiles with radiological and functional outcomes.

Seizure detection via reservoir computing in MoS2-based charge trap memory devices.

Neurological disorders are a substantial global health burden, affecting millions of people worldwide. A key challenge in developing effective treatments and preventive measures is the realization of low-power wearable systems with early detection capabilities. Traditional strategies rely on machine learning algorithms, but their computational demands often exceed what miniaturized systems can provide. Neuromorphic computing, inspired by the human brain, demonstrated capabilities of on-chip computing with low power consumption. In this context, bidimensional (2D) semiconductors hold notable promise, thanks to their unique electronic properties, atomic-scale thickness, and scalability, making them ideal for low-power applications. This work presents a neuromorphic reservoir computing system exploiting MoS2-based charge trap memories (CTMs) for processing of electrophysiological signals. Real-time seizures detection is achieved, thanks to the nonlinear integration of local-field potential (LFP) recorded from in vitro rodent models of ictogenesis. The results support MoS2-based CTMs for low-power biomedical devices in clinical diagnosis and treatment of epilepsy.

Exploring the Link Between Renal Function Fluctuations Within the Physiological Range and Serum/CSF Levels of NfL, GFAP, tTAU, and UCHL1

Impaired renal function can influence biomarker levels through mechanisms involving blood–brain barrier integrity and clearance pathways; however, the impact of variations within normal renal function remains unclear. The main aim of this study was to determine whether adjustment for the specific level of renal function is necessary when renal function remains within physiological levels. We studied n = 183 patients (NID n = 122; other neurological diseases n = 39; somatoform controls n = 22) who underwent lumbar puncture at University Hospital Frankfurt. Serum and cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), total tau protein (tTAU), and ubiquitin C-terminal hydrolase-L1 (UCHL1) were measured using the single molecule array (SIMOA) technique. Estimated glomerular filtration rate (eGFR) correlated negatively with CSF GFAP (r = −0.217, p = 0.004) and serum NfL (r = −0.164, p = 0.032). Patients with impaired renal function exhibited higher CSF NfL (p = 0.036) and CSF GFAP (p = 0.026) levels. However, these findings did not remain significant after adjusting for BMI and age. Importantly, in patients with normal renal function, no significant correlations with eGFR and biomarker levels were observed after adjustment. Our findings indicate that serum and CSF concentrations of NfL, GFAP, tTAU, and UCHL1 are not significantly affected by fluctuations in physiological kidney function but emphasize the importance of considering comorbidities in impaired renal function when interpreting biomarker levels.

Clinical characteristics of bullous pemphigoid patients of different ages and the possible mechanism.

Bullous pemphigoid (BP) is an acquired autoimmune bullous disease that often occurs in elderly patients. Some BP patients with early age of disease onset were observed to have difficulty in receiving applicable disease control. It remains challenging for clinicians to choose the appropriate treatment for these patients. This study aimed to analyze the differences between patients of different ages at disease onset and further explore the possible mechanism of these differences between patients of different ages. A total of 215 BP patients seen at the dermatology department of Peking Union Medical College Hospital between January 2009 and September 2020 were included. The patients were allocated to five groups according to the age at disease onset. Clinical data were collected through medical records and telephone follow-up interviews. Analyses of anti-BP180 antibody subclasses, anti-BP230 antibodies, complement fixation, serum cytokine levels, and single nucleotide polymorphisms (SNPs) were conducted. Nearly 52% of patients under 60 were misdiagnosed on their first visit, often presenting with oral mucosal involvement. The anti-BP180 immunoglobulin (Ig) E titers and C3 deposition increased in patients under 60 (p = 0.044 and p = 0.014, respectively), while the anti-BP230 IgG titers decreased (p = 0.043). The hospitalization rate of patients under 50 was significantly higher than that of patients aged 80 and older (p < 0.001). The patients under 60 had a significantly higher serum concentration of interleukin (IL)-13, tumor necrosis factor (TNF)-α, and interferon gamma (IFN-γ) (p < 0.005, respectively). We observed significant differences in the distribution of genotypes or alleles of TNF-α rs1799964, TNF-α rs1800630, and IFN-γ rs2069705. Approximately one-third of the elderly patients suffered from neurological diseases. Elderly patients usually presented with peripheral eosinophilia (p = 0.013). No significant difference was identified in the recurrence rate and complement-activating capacity among the age groups. In conclusion, the early age of BP onset was associated with a more severe clinical presentation, higher titers of anti-BP180 IgE, lower titers of anti-BP230 IgG, and significantly higher serum concentrations of IL-13, TNF-α, and IFN-γ. It may also be associated with the presence of SNPs of cytokines, including TNF-α rs1799964, TNF-α rs1800630, and IFN-γ rs2069705 variants.

Blood biomarker profiles in young-onset neurocognitive disorders: A cohort study.

Young-onset neurocognitive symptoms result from a heterogeneous group of neurological and psychiatric disorders which present a diagnostic challenge. To identify such factors, we analysed the Biomarkers in Younger-Onset Neurocognitive Disorders cohort, a study of individuals <65 years old presenting with neurocognitive symptoms for a diagnosis and who have undergone cognitive and biomarker analyses. Sixty-five participants (median age at assessment of 56 years, 45% female) were recruited during their index presentation to the Royal Melbourne Hospital Neuropsychiatry Centre, a tertiary specialist service in Melbourne, Australia, and categorized as either early-onset Alzheimer's disease (n = 18), non-Alzheimer's disease neurodegeneration (n = 23) or primary psychiatric disorders (n = 24). Levels of neurofilament light chain, glial fibrillary acidic protein and phosphorylated-tau 181, apolipoprotein E genotype and late-onset Alzheimer's disease polygenic risk scores were determined. Information-theoretic model selection identified discriminatory factors. Neurofilament light chain, glial fibrillary acidic protein and phosphorylated-tau 181 levels were elevated in early-onset Alzheimer's disease compared with other diagnostic categories. A multi-omic model selection identified that a combination of cognitive and blood biomarkers, but not the polygenic risk score, discriminated between early-onset Alzheimer's disease and primary psychiatric disorders (area under the curve ⩾ 0.975, 95% confidence interval: 0.825-1.000). Phosphorylated-tau 181 alone significantly discriminated between early-onset Alzheimer's disease and non-Alzheimer's disease neurodegeneration causes (area under the curve = 0.950, 95% confidence interval: 0.877-1.00). Discriminating between early-onset Alzheimer's disease, non-Alzheimer's disease neurodegeneration and primary psychiatric disorders causes of young-onset neurocognitive symptoms is possible by combining cognitive profiles with blood biomarkers. These results support utilizing blood biomarkers for the work-up of young-onset neurocognitive symptoms and highlight the need for the development of a young-onset Alzheimer's disease-specific polygenic risk score.

From rarity to reality: Poland's first case of neurological Erdheim-Chester Disease with cerebellar manifestations.

From rarity to reality: Poland's first case of neurological Erdheim-Chester Disease with cerebellar manifestations.

Epilepsy and employment: A qualitative interview study with heads of human resources and occupational physicians in Austria - A call for legislative optimization according to the WHO Intersectoral Global Action Plan.

People with epilepsy (PWEs) often face difficulties in obtaining or keeping employment. To determine the views on this topic of the heads of human resources (HHRs) and occupational physicians (OCPs). Twelve HHRs and five OCPs underwent a telephone interview concerning the opportunities and limitations of job applications for PWEs. The interviews were performed in May 2020, in the federal state of Salzburg, Austria, and they were analyzed using the qualitative method of content analysis (Kuckartz). The legal situation was investigated according to Global target 5.2 of the Intersectoral Global Action Plan (IGAP) on epilepsy and other neurological disorders 2022-2031 by WHO. Employers were confident that employees with epilepsy could be managed well in a positive company culture and with first responders in place. The Austrian law predisposes to uncertainty among both employers and employees. In particular, it allows only retrospective juridical clarification of health-related questions in the job interview. The authors developed a classification system of workplaces, with "D0" (D-zero) meaning no health or financial danger, for example, office workers and "D1" posing still no health hazard but includes regular work with cash, for example, salespersons. "D2" means potential medical implications for the person with epilepsy or any other person at the workplace, for example, industrial worker. Measures taken to abandon the risk in D2 workplaces, for example, a total sheath for a machine, leads to reclassification as "D2-0." With D2, OCPs evaluate the applicant's medical fitness for the job without disclosing medical details to the employer. The "compartment model of medical information in the job application process" guarantees that OCPs are the only persons who learn about the applicant's medical details. The practical and simple classification of workplaces according to the D-system, and the concept of making medical information accessible only to OCPs may diminish stigma and discrimination in the working world for PWEs.

Chronic inflammatory demyelinating polyneuropathy associated with active systemic lupus erythematous: Anifrolumab as a potentially successful add-on therapy to intravenous immunoglobulins.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired, autoimmune peripheral neuropathy, rarely reported as being associated with systemic lupus erythematous (SLE). We report the case of 53-year-old women with a long history of SLE, diagnosed with CIDP during a lupus flare beginning with progressive muscle weakness of lower and upper limbs, without affection of the central nervous system. She received treatment with steroids, intravenous immunoglobulins and anifrolumab and showed clinical and immunological improvement. It is important to take into account the presence of peripheral neurological disorders in patients with SLE, considering CIDP as an uncommon manifestation. Controlling severe active disease is an imperative issue to manage this neurological manifestation which has a serious impact on health-related quality of life and physical function.

Biofluid-Permeable and Erosion-Resistant Wireless Neural-Electronic Interfaces for Neurohomeostasis Modulation.

Neural-electronic interfaces through delivering electroceuticals to lesions and modulating pathological endogenous electrical environments offer exciting opportunities to treat drug-refractory neurological disorders. Such an interface should ideally be compatible with the neural tissue and aggressive biofluid environment. Unfortunately, no interface specifically designed for the biofluid environments is available so far; instead, simply stacking an encapsulation layer on silicon-based substrates makes them susceptible to biofluid leakage, device malfunction, and foreign-body reactions. Here, we developed a biofluid-permeable and erosion-resistant wireless neural-electronic interface (BNEI) that is composed of a flexible 3D interconnected poly(l-lactide) fibrous network with a dense and axially aligned piezoelectrical molecular chain arrangement architecture. The organized molecular chain structure enhances the tortuous pathway and longitudinal piezoelectric coefficient of poly(l-lactide) fibers, improves their water barrier properties, and enables efficient conversion of low-intensity acoustic vibrations transmitted in biofluids into electrical signals, achieving long-term stable and wireless neuromodulation. A 3-month clinical trial demonstrated that the BNEI can effectively accelerate the pathological cascade in peripheral neuropathy for nerve regeneration and transcranially modulate cerebellar-cerebral circuit dynamics, suppressing seizures in temporal lobe epilepsy. The BNEI can be a clinically scalable approach for wireless neuromodulation that is broadly applicable to the modulation of neurohomeostasis in both the peripheral and central nervous systems.

Evaluation of the effects of carbamazepine-loaded chitosan-coated PLGA-Zein nanoparticles on pilocarpine-induced seizure model in zebrafish larvae: Developmental toxicity and behavioral assays.

Epilepsy, the most common neurological disorder worldwide, is characterized by sudden paroxysmal brain activity, which can be generalized or focal. Extensive research has explored various treatment strategies for this condition. Our study employed a pilocarpine (PL)-induced seizure model in zebrafish (Danio rerio) embryos and larvae to assess the effects of carbamazepine (CBZ)-loaded chitosan-coated PLGA-Zein nanoparticles (NPs) over 96 hours. We evaluated the developmental toxicity (mortality, malformation, and larval hatching), behavioral changes (sensorimotor reflexes), and histopathological and immunohistochemical alterations in brain tissue, focusing on 5-hydroxytryptamine receptor 4 (5HT4), and brain and muscle ARNT-Like 1 (BMAL1) expressions. Our findings revealed high mortality and malformation rates in groups treated with pure CBZ (PL+CBZ 50 and PL+CBZ 100). These groups also exhibited delayed hatching and impaired sensorimotor reflexes. In contrast, the CBZ-NP-treated groups (PL+CBZ NP 50 and PL+CBZ NP 100) showed hatching rates comparable to the control group, with significantly lower mortality and malformation rates compared to pure CBZ-treated groups. Moreover, intense cytoplasmic expression of 5HT4 and BMAL1 was observed in neuropils of the PL+CBZ 100 group. This study highlights the potential of CBZ-loaded NPs in reducing developmental toxicity and adverse neurological effects associated with pure CBZ treatment in seizure models.

The Role of Acupuncture and Stem Cell Therapy in Enhancing Stroke Recovery

Stroke is an acute neurological disorder caused by disrupted blood flow to the brain, depriving cells of oxygen. From 1990 to 2019, it was the world’s second-leading cause of death and the third-leading cause of combined death and disability. Acupuncture plays a role in stem cell treatment by activating the body's natural recovery processes through physical stimulation, aiding the recovery and rehabilitation of stroke patients. Several studies have explored combining stem cell therapy with acupuncture, yielding promising results in improving patient outcomes. This review assesses the effectiveness of combining acupuncture with stem cell therapy for stroke recovery. Analysis of seven randomized controlled trials shows that both stem cell transplantation and acupuncture contribute to the rehabilitation of stroke patients. When applied together, this combined therapy improves the survival, retention, and functional differentiation of implanted stem cells, creating a synergistic effect that amplifies the benefits of each treatment and compensates for their individual limitations. Key acupuncture points for this combination therapy include GV20, GV14, LI11, ST36, and GV26, with treatment durations ranging from 10 to 22 days.

Impact of Fatty Acid Supplementation on Migraine Outcomes: A Systematic Review and Meta-analysis.

Migraines are a prevalent neurological condition that significantly impacts the quality of life. Although narrative reviews and clinical trials suggest the potential effects of fatty acid supplementation as a promising approach for migraine prophylaxis, the findings remain inconsistent. The aim was to evaluate the efficacy of fatty acid supplementation on migraine clinical outcomes through a systematic review and meta-analysis. This systematic review and meta-analysis was conducted using electronic databases including Medline, Scopus, Web of Science, and CINAHL from their inception up to October 7, 2024. Studies meeting the PICOS criteria were included: adults diagnosed with migraine, dietary supplementation with fatty acids, assessing migraine clinical outcomes, and only randomized controlled trials. Methodological quality and risk of bias were assessed independently by 2 reviewers using the Cochrane Risk of Bias 2 tool. Meta-analyses were conducted using Review Manager software. A random-effects model was applied to account for heterogeneity among studies. A standardized mean difference (SMD) of 0.2, 0.5, and 0.8 was interpreted as small, moderate, and large effects, respectively. Six randomized controlled trials, including 407 participants with chronic migraines, were analyzed. Interventions varied, including omega-3 supplementation with or without omega-6 restriction, lasting from 8 to 16 weeks, and 1 trial assessing alpha-lipoic acid. The overall risk of bias was assessed as low. The pooled analysis demonstrated significant reductions in headache intensity (SMD = -1.77; 95% CI: -3.32 to -0.21; P = .03), headache duration (SMD = -0.77; 95% CI: -1.05 to -0.50; P < .00001), headache frequency (SMD = -1.91; 95% CI: -2.61 to -1.21; P < .00001), and HIT-6 score (SMD = -2.44; 95% CI: -4.13 to -0.76; P = .004). This meta-analysis provides moderate evidence that fatty acid supplementation, particularly omega-3, improves migraine clinical outcomes. Additional high-quality, randomized controlled trials are needed to confirm these findings, particularly for the promising effects of alpha-lipoic acid. PROSPERO registration no. CRD42024592084.

Nonconvulsive status epilepticus in patients under intensive care: Should we view epilepsy as a sleep disorder?

Nonconvulsive status epilepticus (NCSE) was initially described in patients with typical and atypical absence status epilepticus (ASE) characterized by states of confusion varying in severity and in focal epilepsies with or without alteration of consciousness. Continuous EEG monitoring of critically ill patients has further refined the classification of NCSE into two main categories: with coma and without coma. Hypnotic, soporific or somniferous epileptic seizures do not exist. On the contrary, patients usually awaken when seizures occur during sleep, and their eyes remain open during ASE. Excessive sleepiness and coma alone are not ictal signs but are observed in the postictal phase of convulsive seizures. On the other hand, excessive sleepiness evolving into coma is a cardinal sign of metabolic/toxic encephalopathies with triphasic waves evolving to burst suppression patterns and ultimately to cerebral inactivity and death. NCSE alone does not directly cause coma. Comas are related to the underlying etiology, patient age and comorbidities, as well as the administration of intravenous sedative drugs to control epileptic seizures. In cases of severe brain injury, NCSE can explain the failure to awaken after the withdrawal of anesthetics and is only an aggravating factor of the neurological condition. In typical ASE, which is characterized by sustained, rhythmic, bilateral, synchronous and unreactive discharges with evolving spatiotemporal patterns (the best example of NCSE), there is no vigilance impairment. This contrasts with metabolic/toxic encephalopathies, which exhibit monomorphic generalized periodic discharges in which patients may become comatose and die. The extended concept of NCSE in comatose patients may lead to an inflated assessment of NCSE, implying a potentially worse prognosis compared to convulsive status epilepticus.

Prevalence and Pattern of Neurological Disorders amongst Children Attending the Neurology Clinic of a Private Paediatric Hospital in Southern Nigeria

Aim: Neurologic disorders are a common cause of morbidity and disability in children worldwide. There is a dearth of knowledge of neurologic disorders in private health facilities thus this study was done to determine the prevalence and pattern of these disorders. Study Design: It was a retrospective study. Place and Duration of Study: This study was carried out in a private paediatric hospital in Southern Nigeria over 1-year between 1st January, 2023 and 31th December, 2023. Methodology: Data was extracted from the hospital’s health management system and analysed. Results: Of the 22,965 outpatient clinic visits during the study period, 203 had neurological disorders giving a prevalence rate of 0.9% with slight female predominance 107(52.7). Most common age group was 1 - &lt; 5 years (43.4%). Single neurologic disorders predominated 123 (63.4%). Commonest neurological disorders were seizure disorder (54.6%), autism spectrum disorder (24.3%) and attention deficit hyperactive disorder (11.3%) with the commonest risk factors for neurologic disorders being severe perinatal asphyxia (42.1%) and severe neonatal jaundice (42.1%). There were significantly more males than females with seizure disorder (P value .013) whereas cerebral palsy was significantly more in females (P value .002). Seizure disorder and learning disorder were significantly more in children ³ 5years (P value of .001 &amp; .030 respectively) whereas cerebral palsy and speech impairment were significantly more in children &lt; 5years (P value of &lt; .001 &amp; .030 respectively). Conclusion: The prevalence of neurologic disorders was low, being 0.9% with children under 5 years being mostly affected. Commonest neurologic disorders were seizure disorder, autism spectrum disorder and attention deficit hyperactive disorder while perinatal asphyxia and neonatal jaundice were the commonest risk factors. Public enlightenment campaigns about neurologic disorders and the availability of care would improve the outcome of affected children.

Probiotics Encapsulated via Biological Macromolecule for Neurological Therapy and Functional Food: A Review.

Probiotics are live microorganisms that confer health benefits to humans, offering significant potential for preventing and treating various diseases. Neurological disorders, driven by multifaceted factors and linked to high disability rates, have become a growing global concern, particularly in the context of an aging population. Recent studies emphasize a strong connection between dysbiosis of the gut microbiota and neurological disorders. Probiotics have emerged as promising therapeutic interventions due to their ability to modulate the gut microbiota and influence the production of key metabolites, such as short-chain fatty acids and neurotransmitters, crucial for neurological health. However, probiotic viability is often compromised, limiting their therapeutic efficacy. We propose that developing high-activity probiotic formulations, coupled with innovative delivery strategies, holds considerable promise for advancing neurological treatments. Encapsulation systems have proven effective in enhancing probiotic stability and efficacy. This review discusses advances in probiotic delivery using biological macromolecule-based encapsulation, addressing key challenges in maintaining viability during production, storage, and digestion. It also highlights emerging delivery systems, such as microencapsulation, aimed at improving stability and therapeutic effectiveness. Additionally, the review explores the potential of functional foods enriched with probiotics for neurological health. Future research should explore clinical applications of encapsulated probiotics and support the development of functional foods to enhance neurological health.