Diseases Of Peripheral Nervous System Research Articles

The PNS Nurse Program: A Health Care Support Concept for Patients With Immune-Mediated Peripheral Nervous System Diseases.

Immune-mediated peripheral nervous system (PNS) disorders pose diagnostic and therapeutic challenges, necessitating collaborative, patient-centered care. Limited access to specialized centers leads to delayed diagnosis and care, as seen during the COVID-19 pandemic. To address these challenges, accessible specialized care is crucial. On-site support plays a vital role in advising and assisting patients and caregivers, enabling multidisciplinary care for PNS diseases. The PNS Nurse Education Program tackles these complexities, using specialized nurses experienced in multiple sclerosis and Parkinson disease. Focusing on peripheral neuroimmunologic disorders, PNS nurses monitor disease severity, optimize communication, and provide therapeutic support in the recently started era of available immunotherapies. Collaboration with other healthcare sectors and support groups further enhances patient care. Ultimately, the PNS Nurse Education Program aims to bridge the gap between complex treatments and limited specialized care, improving patient outcomes and relieving burdens on patients, caregivers, and healthcare systems.

L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review.

L-carnitine (LC), a vital nutritional supplement, plays a crucial role in myocardial health and exhibits significant cardioprotective effects. LC, being the principal constituent of clinical-grade supplements, finds extensive application in the recovery and treatment of diverse cardiovascular and cerebrovascular disorders. However, controversies persist regarding the utilization of LC in nervous system diseases, with varying effects observed across numerous mental and neurological disorders. This article primarily aims to gather and analyze database information to comprehensively summarize the therapeutic potential of LC in patients suffering from nervous system diseases while providing valuable references for further research. A comprehensive search was conducted in PubMed, Web Of Science, Embase, Ovid Medline, Cochrane Library and Clinicaltrials.gov databases. The literature pertaining to the impact of LC supplementation on neurological or psychiatric disorders in patients was reviewed up until November 2023. No language or temporal restrictions were imposed on the search. A total of 1479 articles were retrieved, and after the removal of duplicates through both automated and manual exclusion processes, 962 articles remained. Subsequently, a meticulous re-screening led to the identification of 60 relevant articles. Among these, there were 12 publications focusing on hepatic encephalopathy (HE), while neurodegenerative diseases (NDs) and peripheral nervous system diseases (PNSDs) were represented by 9 and 6 articles, respectively. Additionally, stroke was addressed in five publications, whereas Raynaud's syndrome (RS) and cognitive disorder (CD) each had three dedicated studies. Furthermore, migraine, depression, and amyotrophic lateral sclerosis (ALS) each accounted for two publications. Lastly, one article was found for other symptoms under investigation. In summary, LC has demonstrated favorable therapeutic effects in the management of HE, Alzheimer's disease (AD), carpal tunnel syndrome (CTS), CD, migraine, neurofibromatosis (NF), PNSDs, RS, and stroke. However, its efficacy appears to be relatively limited in conditions such as ALS, ataxia, attention deficit hyperactivity disorder (ADHD), depression, chronic fatigue syndrome (CFS), Down syndrome (DS), and sciatica.

Neuroimaging Markers for Differential Diagnosis Between Multifocal Motor Neuropathy and Multifocal Acquired Demyelinating Sensory and Motor Neuropathy

Introduction. Similar asymmetric patterns of motor disorders and neurophysiological changes complicate the differential diagnosis between multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) as two chronic dysimmune neuropathies with significantly different treatment approaches. The lack of specific paraclinical markers often result in misdiagnosis and selection of ineffective specific therapy. Identification of specific neuroimaging biomarkers to differentiate these conditions may improve diagnostic approaches.
 Objective: To identify neuroimaging markers for the differential diagnosis between MMN and MADSAM.
 Materials and methods. The study included 65 participants, particularly 30 individuals with MMN and 35 individuals with MADSAM followed up in the Center of Peripheral Nervous System Diseases, Research Center of Neurology, Moscow, Russia. We retrospectively analyzed their clinical and epidemiological characteristics as well as ultrasonography and magnetic resonance imaging (MRI) findings.
 Results. Ultrasonography was performed on the peripheral nerves of the upper extremities, the spinal nerves, and the brachial plexus. The results showed that participants with MADSAM had significantly greater cross-sectional areas (CSAs) and a higher incidence of intraneural ultrasonographic abnormalities compared to participants with MMN. CSA thresholds of the median nerves were identified using ROC analysis to differentiate between MMN and MADSAM. MRI scans of the brachial plexus revealed no abnormalities in 41.4% of the individuals with MMN and 27.3% of the individuals with MADSAM. Meanwhile, STIR hyperintense signal from the brachial plexus was most typical ( 70%) for the MADSAM group.
 Conclusions. This was the first detailed comparative analysis of neuroimaging findings in a large sample of patients with either MMN or MADSAM in Russia. Ultrasonographic markers for differential diagnosis have been determined. The advantages and limitations of ultrasonography and MRI of the brachial plexus and the spinal and peripheral nerves in diagnosing multifocal chronic dysimmune neuropathies have been demonstrated.

A review on recent advances on nobiletin in central and peripheral nervous system diseases

In recent years, the role of nobiletin in neuronal disorders has received extensive attention. However, the study of nobiletin in the peripheral nervous system is limited. Nobiletin, as a compound with high fat solubility, high bioavailability and low toxicity, has been extensively studied. Accumulating scientific evidence has shown that nobiletin has a variety of biological functions in the nervous system, such as inhibiting the expression of inflammatory factors, reducing the neurotoxic response, improving the antioxidant capacity, promoting the survival of nerve cells, promoting axon growth, reducing blood‒brain barrier permeability, reducing brain oedema, promoting cAMP response element binding protein expression, improving memory, and promoting mild depolarization of nerve cell mitochondria to improve antioxidative stress capacity. Accumulating studies have shown that nobiletin also protects enteric nervous system, spinal cord and sciatic nerve. To explore the new therapeutic potential of nobiletin in the nervous system, recent and relevant research progress is reviewed in this article. This will provide a new research idea for nobiletin in the nervous system.

Neuron-Schwann cell interactions in peripheral nervous system homeostasis, disease, and preclinical treatment.

Schwann cells (SCs) have a critical role in the peripheral nervous system. These cells are able to support axons during homeostasis and after injury. However, mutations in genes associated with the SCs repair program or myelination result in dysfunctional SCs. Several neuropathies such as Charcot-Marie-Tooth (CMT) disease, diabetic neuropathy and Guillain-Barré syndrome show abnormal SC functions and an impaired regeneration process. Thus, understanding SCs-axon interaction and the nerve environment in the context of homeostasis as well as post-injury and disease onset is necessary. Several neurotrophic factors, cytokines, and regulators of signaling pathways associated with proliferation, survival and regeneration are involved in this process. Preclinical studies have focused on the discovery of therapeutic targets for peripheral neuropathies and injuries. To study the effect of new therapeutic targets, modeling neuropathies and peripheral nerve injuries (PNIs) in vitro and in vivo are useful tools. Furthermore, several in vitro protocols have been designed using SCs and neuron cell lines to evaluate these targets in the regeneration process. SCs lines have been used to generate effective myelinating SCs without success. Alternative options have been investigated using direct conversion from somatic cells to SCs or SCs derived from pluripotent stem cells to generate functional SCs. This review will go over the advantages of these systems and the problems associated with them. In addition, there have been challenges in establishing adequate and reproducible protocols in vitro to recapitulate repair SC-neuron interactions observed in vivo. So, we also discuss the mechanisms of repair SCs-axon interactions in the context of peripheral neuropathies and nerve injury (PNI) in vitro and in vivo. Finally, we summarize current preclinical studies evaluating transgenes, drug, and novel compounds with translational potential into clinical studies.

Homozygous Mutations in GDAP1 and MFN2 Genes Resulted in Autosomal Recessive Forms of Charcot-Marie-Tooth Disease in Consanguineous Pakistani Families.

Charcot-Marie-Tooth disease (CMT) is a heritable neurodegenerative disease of peripheral nervous system diseases in which more than 100 genes and their mutations are associated. Two consanguineous families Dera Ghazi Khan (PAK-CMT1-DG KHAN) and Layyah (PAK-CMT2-LAYYAH) with multiple CMT-affected subjects were enrolled from Punjab province in Pakistan. Basic epidemiological data were collected for the subjects. Nerve conduction study (NCS) and electromyography (EMG) were performed for the patients. Whole-exome sequencing (WES) followed by Sanger sequencing was applied to report the genetic basic of CMT. The NCS findings revealed that sensory and motor nerve conduction velocities for both families were <38 m/s. EMG presented denervation, neuropathic motor unit potential, and reduced interference pattern of peripheral nerves. WES identified that a novel nonsense mutation (c. 226 G>T) in GADP1 gene and a previously known missense mutation in MFN2 gene (c. 334 G>A) cause CMT4A (Charcot-Marie-Tooth disease type 4A) in the PAK-CMT1-DG KHAN family and CMT2A (Charcot-Marie-Tooth disease type 2A) in the PAK-CMT2-LAYYAH family, respectively. Mutations followed Mendelian pattern with autosomal recessive mode of inheritance. Multiple sequence alignment by Clustal Omega indicated that mutation-containing domain in both genes is highly conserved, and in situ analysis revealed that both mutations are likely to be pathogenic. We reported that a novel nonsense mutation and a previously known missense mutation in GAPD1 gene and MFN2 gene, respectively, cause CMT in consanguineous Pakistani families.

Rehabilitation of Peripheral Neuropathies: From Lexical Analysis of the Literature to Identification of Clinical Protocols.

Peripheral nervous system diseases are a complex and heterogenous group of diseases affecting the different nerves with various severity and impact on quality of life. The current literature does not provide a structured guide for the rehabilitation of these conditions. We performed a lexical literature evaluation based on graph theory to clarify this topic. We performed a search on PubMed and calculated the frequencies of the words indicating rehabilitation approaches, nerves, and diseases. We found the usefulness of exercises and different physical agents, like laser and ultrasound therapy and neuromuscular stimulation vibration therapy. Orthoses are useful for entrapment, trauma, and hereditary diseases. Correct knowledge and assessment of the neuropathies are fundamental for the therapeutic decision and to guide rehabilitation. Despite the usefulness shown by the different approaches to modulating pain, improving muscle strength and endurance, and ameliorating balance and the sensory system, further studies are needed to define the best-personalized protocols.

Neutrophil biology in injuries and diseases of the central and peripheral nervous systems.

The role of inflammation in nervous system injury and disease is attracting increased attention. Much of that research has focused on microglia in the central nervous system (CNS) and macrophages in the peripheral nervous system (PNS). Much less attention has been paid to the roles played by neutrophils. Neutrophils are part of the granulocyte subtype of myeloid cells. These cells, like macrophages, originate and differentiate in the bone marrow from which they enter the circulation. After tissue damage or infection, neutrophils are the first immune cells to infiltrate into tissues and are directed there by specific chemokines, which act on chemokine receptors on neutrophils. We have reviewed here the basic biology of these cells, including their differentiation, the types of granules they contain, the chemokines that act on them, the subpopulations of neutrophils that exist, and their functions. We also discuss tools available for identification and further study of neutrophils. We then turn to a review of what is known about the role of neutrophils in CNS and PNS diseases and injury, including stroke, Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, spinal cord and traumatic brain injuries, CNS and PNS axon regeneration, and neuropathic pain. While in the past studies have focused on neutrophils deleterious effects, we will highlight new findings about their benefits. Studies on their actions should lead to identification of ways to modify neutrophil effects to improve health.

Peripherin is a biomarker of axonal damage in peripheral nervous system disease.

Valid, responsive blood biomarkers specific to peripheral nerve damage would improve management of peripheral nervous system (PNS) diseases. Neurofilament light chain (NfL) is sensitive for detecting axonal pathology but is not specific to PNS damage, as it is expressed throughout the PNS and CNS. Peripherin, another intermediate filament protein, is almost exclusively expressed in peripheral nerve axons. We postulated that peripherin would be a promising blood biomarker of PNS axonal damage. We demonstrated that peripherin is distributed in sciatic nerve, and to a lesser extent spinal cord tissue lysates, but not in brain or extra-neural tissues. In the spinal cord, anti-peripherin antibody bound only to the primary cells of the periphery (anterior horn cells, motor axons and primary afferent sensory axons). In vitro models of antibody-mediated axonal and demyelinating nerve injury showed marked elevation of peripherin levels only in axonal damage and only a minimal rise in demyelination. We developed an immunoassay using single molecule array technology for the detection of serum peripherin as a biomarker for PNS axonal damage. We examined longitudinal serum peripherin and NfL concentrations in individuals with Guillain-Barré syndrome (GBS, n = 45, 179 time points), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP, n = 35, 70 time points), multiple sclerosis (n = 30), dementia (as non-inflammatory CNS controls, n = 30) and healthy individuals (n = 24). Peak peripherin levels were higher in GBS than all other groups (median 18.75 pg/ml versus < 6.98 pg/ml, P < 0.0001). Peak NfL was highest in GBS (median 220.8 pg/ml) and lowest in healthy controls (median 5.6 pg/ml), but NfL did not distinguish between CIDP (17.3 pg/ml), multiple sclerosis (21.5 pg/ml) and dementia (29.9 pg/ml). While peak NfL levels were higher with older age (rho = +0.39, P < 0.0001), peak peripherin levels did not vary with age. In GBS, local regression analysis of serial peripherin in the majority of individuals with three or more time points of data (16/25) displayed a rise-and-fall pattern with the highest value within the first week of initial assessment. Similar analysis of serial NfL concentrations showed a later peak at 16 days. Group analysis of serum peripherin and NfL levels in GBS and CIDP patients were not significantly associated with clinical data, but in some individuals with GBS, peripherin levels appeared to better reflect clinical outcome measure improvement. Serum peripherin is a promising new, dynamic and specific biomarker of acute PNS axonal damage.

Combination Gene Delivery Reduces Spinal Cord Pathology in Rats With Peripheral Neuropathic Pain

Although peripheral neuropathic pain is caused by peripheral nerve injury, it is not simply a peripheral nervous system disease. It causes abnormalities in both the central and peripheral nervous systems. Pathological phenomena, such as hyperactivation of sensory neurons and inflammation, are observed in both the dorsal root ganglion and spinal cord. Pain signals originating from the periphery are transmitted to the brain via the SC, and the signals are modulated by pathologically changing SC conditions. Therefore, the modulation of SC pathology is important for peripheral NP treatment. We investigated the effects of KLS-2031 (recombinant adeno-associated viruses expressing glutamate decarboxylase 65, glial cell-derived neurotrophic factor, and interleukin-10) delivered to the dorsal root ganglion on aberrant neuronal excitability and neuroinflammation in the SC of rats with peripheral NP. Results showed that KLS-2031 administration restored excessive excitatory transmission and inhibitory signals in substantia gelatinosa neurons. Moreover, KLS-2031 restored the in vivo hypersensitivity of wide dynamic range neurons and mitigated neuroinflammation in the SC by regulating microglia and astrocytes. Collectively, these findings demonstrated that KLS-2031 efficiently suppressed pathological pain signals and inflammation in the SC of peripheral NP model, and is a potential novel therapeutic approach for NP in clinical settings. PerspectiveOur study demonstrated that KLS-2031, a combination gene therapy delivered by transforaminal epidural injection, not only mitigates neuroinflammation but also improves SC neurophysiological function, including excitatory-inhibitory balance. These findings support the potential of KLS-2031 as a novel modality that targets multiple aspects of the complex pathophysiology of neuropathic pain.

CatWalk XT gait parameters: a review of reported parameters in pre-clinical studies of multiple central nervous system and peripheral nervous system disease models.

Automated gait assessment tests are used in studies of disorders characterized by gait impairment. CatWalk XT is one of the first commercially available automated systems for analyzing the gait of rodents and is currently the most used system in peer-reviewed publications. This automated gait analysis system can generate a large number of gait parameters. However, this creates a new challenge in selecting relevant parameters that describe the changes within a particular disease model. Here, for the first time, we performed a multi-disorder review on published CatWalk XT data. We identify commonly reported CatWalk XT gait parameters derived from 91 peer-reviewed experimental studies in mice, covering six disorders of the central nervous system (CNS) and peripheral nervous system (PNS). The disorders modeled in mice were traumatic brain injury (TBI), stroke, sciatic nerve injury (SNI), spinal cord injury (SCI), Parkinson's disease (PD), and ataxia. Our review consisted of parameter selection, clustering, categorization, statistical evaluation, and data visualization. It suggests that certain gait parameters serve as potential indicators of gait dysfunction across multiple disease models, while others are specific to particular models. The findings also suggest that the more site-specific the injury is, the fewer parameters are reported to characterize its gait abnormalities. This study strives to present a clearly organized picture of gait parameters used in each one of the different mouse models, potentially helping novel CatWalk XT users to apply this information to similar or related mouse models they are working on.

In vitro myelination using explant culture of dorsal root ganglia: An efficient tool for analyzing peripheral nerve differentiation and disease modeling.

Peripheral nerves conducting motor and somatosensory signals in vertebrate consist of myelinated and unmyelinated axons. In vitro myelination culture, generated by co-culturing Schwann cells (SCs) and dorsal root ganglion (DRG) neurons, is an indispensable tool for modeling physiological and pathological conditions of the peripheral nervous system (PNS). This technique allows researchers to overexpress or downregulate molecules investigated in neurons or SCs to evaluate the effect of such molecules on myelination. In vitro myelination experiments are usually time-consuming and labor-intensive to perform. Here we report an optimized protocol for in vitro myelination using DRG explant culture. We found that our in vitro myelination using DRG explant (IVMDE) culture not only achieves myelination with higher efficiency than conventional in vitro myelination methods, but also can be used to observe Remak bundle and non-myelinating SCs, which were unrecognizable in conventional methods. Because of these characteristics, IVMDE may be useful in modeling PNS diseases, including Charcot Marie Tooth disease (CMT), in vitro. These results suggest that IVMDE may achieve a condition more similar to peripheral nerve myelination observed during physiological development.

Neuro-COVID is a Common Complication of SARS-CoV-2 Infections and Merits Prospective Evaluation

We read with interest the article by Tan et al. on a cross-sectional, observational, mono-canter study of 156 COVID-19 patients [1]. Among these 156 in-hospital patients collected between July and December 2021, 23.7% had neurological complications from the infection, which included stroke, encephalitis, or encephalopathy [1]. Diabetic patients were at an increased risk for neuro-COVID. Unvaccinated patients had a 4.25 fold increased risk of developing neurological complications compared to unvaccinated patients [1]. The risk of developing neurological complications from COVID-19 was increased by 18% among those with leucocytosis [1]. It was concluded that patients with diabetes, leucocytosis, and being unvaccinated are at increased risk of developing neuro-COVID. The study is excellent but has limitations that raise concerns and require discussion. We disagree that muscle weakness and numbness are exclusively manifestations of ischemic stroke. Muscle weakness and sensory disturbances are not only due to central nervous system (CNS) disease but also involvement of the peripheral nervous system (PNS). We should know whether all patients with weakness and numbness also had a stroke on cerebral imaging. Did truly all patients undergo cerebral imaging when stroke was suspected? It is not comprehensible why patients with seizures were delineated from those with status epilepticus. Status epilepticus is a seizure type, why these two entities should not be evaluated separately. Surprisingly, not a single patient with PNS disease was detected among the 156 COVID-19 patients. We should know the reason why no patients with Guillain-Barre syndrome plexitis, large or small fiber neuropathy, myasthenia, myopathy, myositis, or rhabdomyolysis was detected. Were the included patients not prospectively investigated for PNS disease? A stroke mechanism not considered in the study is endotheliopathy. There are indications that SASR-CoV-2 infections can be complicated by endothelialitis, which increases the risk of thrombosis and vessel occlusion. Another pathophysiological mechanism not considered is arterial dissection. Supposing that SARS-CoV-2 causes damage of the vascular wall, it is conceivable that also dissection occurs. Several patients with dissection during a SARS-CoV-2 infection have been report [2]. We disagree with the notion that critical ill polyneuropathy is a direct consequence of a SARS-CoV-2 infection [1]. Critical ill polyneuropathy is iatrogenic and therefore should be excluded from the evaluation. Leucocytosis is multifactorial. Therefore, we should know how alternative causes of the COVID-19 infection were ruled out as causes of leucocytosis. We should know how many of the included patients were smokers, received steroids, were under stress, had a chronic infection, colitis ulcerosa, a fungal infection, a parasitic infection, were pregnant, had an allergy, or had a malignancy. A limitation of the study is that no definition of the term “encephalopathy” was provided. It should be explained whether encephalopathy means seizures, leukoencephalopathy, encephalitis, confusion, or neuropsychological deficits in the absence of morphological abnormalities on cerebral imaging. If encephalopathy is regarded as a post-ictal condition, it should be told if these patients were classified into both the “seizures” group and the “encephalopathy” group. If encephalopathy resulted from metabolic dysfunction, we should be informed what kind of metabolic derangement resulted in encephalopathy. How many of the included patients had diabetes or hyperglycemic crisis on admission? Seizures in COVID-19 patients are commonly symptomatic manifestations of stroke, encephalitis, or venous sinus thrombosis (VST). Therefore, we should know how many of those with seizures also had morphological abnormalities on MRI. The sentence “Anosmia and dysgeusia were less associated with neurological complications” is not comprehensible because anosmia and dysgeusia are classical neurological complication already. Overall, the interesting study has limitations that call the results and their interpretation into question. Clarifying these weaknesses would strengthen the conclusions and could improve the study. Neurological complications of SARS-CoV-2 infections are manifold and may be recognised only if an appropriate number of patients is investigated or if multi-center or multinational studies with a high number of patients are undertaken and if COVID-19 patients are prospectively and comprehensibly investigated for CNS and PNS disease having started after onset of COVID-19.

Specific features of the morphology of the spinal nodes of homeothermal vertebrate animals in the comparative and anatomical series

Scientific studies that reflect the evolutionary morphology of the nervous system, namely the spinal nodes of homoeothermic vertebrates, allow us to identify specific patterns, trends, and criteria that relate to the structural organization of the organ at the population and cellular levels of their organization. The evolutionary direction of research into the macro- and microstructure of spinal cord nodes provides an opportunity to investigate the patterns of formation of optimal relationships of their structural components: nerve and glial cells, capillaries concerning the level of development of the organism, and their motor activity. The article contains the results of the morphometric characteristics of the spinal nodes of warm-blooded vertebrates in a comparative aspect: class Aves – Birds (Gallus gallus, forma domestica L., 1758 – domestic chicken); class Mammalia – Mammals (Oryctolagus cuniculus L., 1758 – European krill, Canis lupus familiaris L., 1758 – domestic dog, Sus scrofa, forma domestica L., 1758 – domestic pig, Bos taurus taurus L., 1758 – domestic bull). When performing this work, complex research methods were used: anatomical, neurohistological, morphometric, and statistical. The morphological study of the structural components of the organs of the nervous system was studied on histological sections by the method of light microscopy following the requirements of the international principles of the “European Convention for the Protection of Vertebrate Animals Used in Experiments and for Other Scientific Purposes” (Strasbourg, 1986), a decision of the First National Congress on Bioethics (Kyiv, 2001), Law of Ukraine No. 692 “On the Protection of Animals from Cruel Treatment” (3447-IV) dated February 21, 2006. For histological examination, the newly selected material was immediately fixed in a 10% aqueous neutral formalin solution, with a fixation period of 30 days, followed by step-by-step embedding in paraffin. Using a sled microtome, histological sections with a thickness of 6–10 μm were obtained. The general histological structure and microstructural changes in histological preparations were studied under a light microscope MC (Micros Austria) at magnifications from 70 to 600 times. Photomicrographs of histological preparations were carried out using a CAM V200 video camera mounted in a Micros MC microscope. The work aims to conduct a complex morpho-functional study of spinal nodes in a comparative anatomical series of representatives of higher vertebrates. It was investigated that in phylogenesis, a particular structural and morphofunctional rearrangement of the central and peripheral nervous system organs, namely the spinal nodes, takes place. They differ in shape and size. It was established that the neurocytic organization of the spinal cord nodes of all species of animals studied is characterized by the presence of large, medium, and small nerve cells. Adaptation to various living conditions of animals was formed based on morphometric indicators (the volume of neurocytes and their nuclei), their morphological structures, the density of nerve cells per 0.1 mm2, the number of glial cells per 0.1 mm2, an indicator of nuclear-cytoplasmic ratio, degree of polymorphism chromatophilia. Nissl staining of histopreparations of spinal nodes of homoothermic animals showed that the neuroplasm of nerve cells contains well-defined depths of basophilic substance, compared with lower animals, as evidence of a higher degree of development in nerve cells of the protein-synthesizing apparatus. According to the method of impregnation of spinal cord nodes with silver nitrate in all studied animals, a different intensity of coloring of nerve cells is revealed: dark, light-dark, light, which is related to the peculiarities of species and age neuromorphology, the morphofunctional state of the nervous system and the type of higher nervous activity. The obtained morpho-functional features of the organs of the nervous system are essential not only for evolutionary and comparative morphology but also for developing issues of physiology, pathology, and treatment of peripheral nervous system diseases.

Sjogren’s syndrome symptoms and treatment: a literature review

Monika Bružaitė1 1Vilnius University, Faculty of Medicine, Vilnius, Lithuania Abstract Background. Sjogren’s syndrome is an autoimmune rheumatic disease that affects the body’s exocrine glands. Salivary and lacrimal glands are the most affected, systemic damage to the body is also possible. The incidence is 3.5-13.1 cases per 100,000 population. People of any age can suffer from this disease and symptoms usually appear in people between the ages of 45 and 55. Sjogren’s syndrome usually affects several organ systems, so the symptoms can be very diverse and significantly impair the quality of life. Aim: to review the scientific literature on the symptoms, treatment and burden of Sjogren’s syndrome. Methodology. Publications were searched in English using „PubMed” database. There were selected publications discussing Sjogren’s syndrome symptoms and treatment options, which were published during 2017-2022. After reviewing all the inclusion and exclusion criteria, 27 scientific articles were included in this literature review. Results. Sjogren’s syndrome is a chronic autoimmune rheumatic disease associated with a high patient burden. Patients with Sjogren’s syndrome experience higher dental costs, are more likely to experience dental caries, mouth ulcers and halitosis. The most troublesome symptom for patients is dry eyes. Patients with Sjogren’s syndrome may experience peripheral neuropathy and central nervous system disease. The disease can also be manifested by cough, shortness of breath and inflammation of the upper respiratory tract. There is currently no cure for Sjogren’s syndrome, so treatment aims to reduce distressing symptoms and improve quality of life. Conclusions. Sjogren’s syndrome can affect various organ systems. The most common symptoms are damaged eyes, mouth and dryness of the mucous membranes. The quality of life of the sick is considered to be particularly poor. The choice of treatment for Sjogren’s syndrome has not fundamentally changed in recent years – the decision is determined by the patient’s co-morbidities, the manifestation of symptoms, as well as the severity of damage to internal organs. Keywords: Sjogren’s, Sjogren’s syndrome, xerostomia, keratoconjuctyvitis sicca. Full article https://doi.org/10.53453/ms.2023.2.12

Neurological Disorders in Pug Dogs: a Retrospective Study of 285 Cases (2013 – 2020) from a Single Referral Hospital in the United Kingdom

Pugs are commonly affected by neurological disorders and this retrospective observational study aims to describe what pathologies were more commonly diagnosed, their diagnostic approach and clinical features. This study was performed in a single referral hospital in the United Kingdom (UK). Medical records of pugs referred to the Neurology &amp; Neurosurgery department from 2013 to 2020 were retrieved. Signalment, presenting complaint, presence of pain at neurological examination and diagnostic tests were recorded. Final diagnosis was classified as: encephalopathies, myelopathies or peripheral nervous system (PNS) disease. Descriptive and univariate statistical analysis were performed. A total of 285 records were included in the study. The most common presenting complaints were: ambulatory paraparesis (27.6%), seizures (20.3%), ataxia (16.4%), spinal pain (10.1%) and vestibular signs (5.6%). Myelopathies were diagnosed in 64.7% of pugs, while encephalopathies and PNS disease in 29.7% and 5.3% of pugs respectively. Different types of intervertebral disc diseases (IVDDs; 44.3%), spinal arachnoid diverticulum (SAD; 22.2%) and vertebral malformations (VMs; 18.9%) were the most prevalent myelopathies. Idiopathic epilepsy (IE; 44.7%) and meningoencephalitis of unknown aetiology (MUA; 29.4%) were the most common encephalopathies. Peripheral vestibular syndrome (60%) and masticatory muscle myositis (20%) were the most prevalent PNS diseases. Pugs with IVDDs were more likely to be painful than pugs diagnosed with SAD and VMs. In this study, IVDDs, SAD and VMs were the most represented myelopathies, while IE and MUA the most prevalent encephalopathies. SAD and VMs were found to be non-painful myelopathies, as opposed to IVDDs being painful. These results may be used as a guide reflecting the prevalence of neurological diseases in a larger population of pugs.

Using Human iPSC-Derived Peripheral Nervous System Disease Models for Drug Discovery.

Induced pluripotent stem cells (IPSCs), with their remarkable ability to differentiate into various cell types, including peripheral nervous system cells such as neurons and glial cells, offer an excellent platform for in vitro disease modeling. These iPSC-derived disease models have proven valuable in drug discovery, as they provide more precise simulations of a patient's disease state and allow for the assessment of potential therapeutic effectiveness and safety.

Evaluación funcional tras SARS-CoV-2 crítico. Estudio de cohortes de la unidad de rehabilitación en un hospital de tercer nivel

IntroductionSARS-COV-2 pneumonia is a highly contagious respiratory disease that causes respiratory, physical and psychological dysfunctions. We present the results of patient assessment when they were discharged from the ICU. Material and methodCohort study of patients affected by SARS-COV-2 pneumonia admitted to the intensive care unit from 01/10/2020 to 31/07/2021. We collect sociodemographic data, personal history, ICU and hospital stay, Barthel, FAC and mMRC (pre-admission/initial assessment/discharge), development of osteomuscular and/or neurological pathology and need for rehabilitation treatment. ResultsA total of 341 patients were evaluated, of which 224 met criteria. The average age was 63 years (68.75% men). Mean ICU/hospital stay were 27/44 days. They were assessed by physiatry, after that, we provide a guide developed by physiatry, solving doubts about the disease and setting exercises of intensity and progressive difficulty, to be carried out during the admission and at home. Neurological pathology was present at 42.86% patients, of whom a 83.33% were peripheral nervous system disease. The total of the sample needed respiratory physiotherapy and a 72.32% motor physiotherapy. ConclusionsIn our study, a high number of patients have needed rehabilitation treatment in order to get functional recovery, highlighting the development of post-COVID neurological pathology. SARS-COV-2 generates other complications, not only respiratory, subsidiary to be assessed and treated by rehabilitation services for a comprehensive recovery that minimizes sequelae.

Peroneal nerve palsy (injury) in fibullar tunnel syndrome

While compression neuropathies of the nerves of the lower limbs are not a common pathology, peroneal nerve neuropathy is the most common of them. Peroneal nerve compression most commonly occurs at or around the head of the fibula, but can also occur in the lower leg, ankle, or foot. Neurophysiological and neuroimaging methods are effective in diagnosing peroneal nerve compression and determining the type of damage. The first line of therapy is lifestyle modification, avoidance of compressive postures, ankle joint orthotics, treatment of knee joint instability when detected, kinesiotherapy. An important role in the correction of symptoms is played using anticholinesterase drugs, the effectiveness of which in diseases of peripheral nervous system has been shown in a number of domestic studies. If conservative treatment fails, surgical treatment is recommended. The diagnosis of peroneal neuropathy is associated with a good prognosis and most patients experience complete recovery of nerve function.

HDACi: The Columbus' Egg in Improving Cancer Treatment and Reducing Neurotoxicity?

Histone deacetylases (HDACs) are a group of enzymes that modify gene expression through the lysine acetylation of both histone and non-histone proteins, leading to a broad range of effects on various biological pathways. New insights on this topic broadened the knowledge on their biological activity and even more questions arose from those discoveries. The action of HDACs is versatile in biological pathways and, for this reason, inhibitors of HDACs (HDACis) have been proposed as a way to interfere with HDACs' involvement in tumorigenesis. In 2006, the first HDACi was approved by FDA for the treatment of cutaneous T-cell lymphoma; however, more selective HDACis were recently approved. In this review, we will consider new information on HDACs' expression and their regulation for the treatment of central and peripheral nervous system diseases.