Neurological Problems Research Articles

A View on the Emerging Concern of Oropouche Fever in Brazil and Its Diagnosis

ABSTRACTOropouche fever has gained prominence due to its outbreaks and health consequences, particularly in Latin American countries. In addition to the more common symptoms of fever and nausea, Oropouche has been reported to cause neurological and gastrointestinal problems. However, Oropouche remains a neglected disease that needs improved detection methods. The purpose of this letter is to raise awareness of this infectious disease and the methods that can be used to detect and ultimately control it.

The Effects of Resveratrol in a Randomized Clinical Trial on Drug-Induced Hyperlipidemia and Psychiatric Factors in People Living with HIV

Introduction: People living with HIV (PLHIV) suffer from a range of consequences related to infection, including hyperlipidemia and neurologic and sleep disorders. Supplements containing phenolic compounds with high antioxidant properties can reduce these side effects. Resveratrol is a phenolic compound that improves the symptoms of diabetes, cancer, and viral infections. This study aimed to evaluate the effects of resveratrol on hyperlipidemia and neurological problems in PLHIV in Iran. Method: In this double-blind, randomized clinical trial, 41 PLHIV were randomly assigned to two groups: a placebo group (n=21) and a resveratrol group (n=20). Triglyceride and cholesterol levels were determined for all the subjects before and one month after they used the medication. Additionally, standard questionnaires were used to evaluate the quality of sleep, stress, depression, and quality of life of the participants. The data were analyzed via analysis of covariance in Stata 17.0. Results: The study population did not significantly differ in terms of age (p=0.49), sex (p=0.09), marital status (p=0.90), level of education (p=0.90), duration of HIV infection (p=0.54), or mode of HIV transmission (p=0.51). The administration of resveratrol did not affect psychological parameters or blood cholesterol (p=0.091) or triglyceride (p=0.932) levels. Conclusion: The administration of resveratrol did not affect cholesterol or triglyceride levels or the rates of depression, anxiety, sleep quality, or quality of life in PLHIV. The resveratrol supplementation in a large-scale clinical study involving more patients for a longer course of treatment may have had more significant effects on the serum levels of lipids and psychological factors. result: The study population did not have significant age differences (p=0.49), gender (p=0.09), marital status (p=0.90), level of education (p=0.90), duration of HIV infection (p=0.54), and mode of HIV transmission (p=0.51). Administration of resveratrol did not affect psychological parameters and blood cholesterol (p=0.091) and triglycerides (p=0.932) levels.

TRATAMENTO FARMACOLÓGICO COMO PROFILAXIA DA CEFALEIA PRIMÁRIA DO TIPO MIGRÂNEA: UMA ANÁLISE DA EFICÁCIA DOS MEDICAMENTOS

INTRODUCTION: Migraine headache is a neurological problem, varying in form and intensity, being a disruptive factor in the lives of those affected. OBJECTIVE: To present the main prophylactic pharmacological treatments for migraine, evaluating their effects and safety in comparison to other treatments. METHODS: The search was carried out through the VHL in the MEDLINE and LILACS databases, using studies from the last 5 years and with full text available in English and Portuguese. Of the 200 articles initially evaluated, 61 were selected to compose the final corpus of the study. RESULTS: 32 treatments were found available for migraine prophylaxis, with emphasis on monoclonal antibodies to the peptide related to the calcitonin gene, which reduce the frequency, duration and intensity of migraine attacks, providing a comparative improvement in relation to conventional therapies. Medications such as beta-blockers, angiotensin II antagonists, antiepileptics and onabotulinumtoxinA have also demonstrated efficacy in obtaining positive responses to migraine treatment. CONCLUSION: Evidence suggests that, due to the multiple therapeutic approaches to migraine, personalized treatment is necessary, considering the individual response to the intervention and the risk of damage in the care plan.

Rehabilitation Teams Across the Disaster: A Field Report

Background and Objectives: The article highlights the crucial role of rehabilitation teams in managing disasters. While the importance of rehabilitation in the post-disaster phase is well-recognized, the article underscores the need for greater emphasis on pre-disaster planning and mitigation efforts. Case Presentation: A case study on the 2017 Kermanshah earthquake illustrates the challenges and successes of physiotherapy in disaster relief. The Iranian Physiotherapy Association (IPA) swiftly established a temporary clinic staffed by volunteers. Physiotherapy addressed a range of injuries, including soft tissue and neurological problems. Challenges in delivering physiotherapy services during emergencies include resource constraints, accessibility issues, and infrastructure damage. Conclusion: The article concludes that improvements in these areas can significantly enhance physiotherapy services during crises, leading to better recovery outcomes for survivors. Increased collaboration of rehabilitation teams and implementing research, may improve disaster preparedness and response.

Recent Advancements and SAR Studies of Synthetic Coumarins as MAO-B Inhibitors: An Updated Review.

The oxidative deamination of a wide range of endogenous and exogenous amines is catalyzed by a family of enzymes known as monoamine oxidases (MAOs), which are reliant on flavin-adenine dinucleotides. Numerous neurological conditions, such as Parkinson's disease (PD) and Alzheimer's disease (AD), are significantly correlated with changes in the amounts of biogenic amines in the brain caused by MAO. Hydrogen peroxide, reactive oxygen species, and ammonia, among other toxic consequences of this oxidative breakdown, can harm brain cells' mitochondria and cause oxidative damage. The prime objective of this review article was to highlight and conclude the recent advancements in structure-activity relationships of synthetic derivatives of coumarins for MAO-B inhibition, published in the last five years' research articles. The literature (between 2019 and 2023) was searched from platforms like Science Direct, Google Scholar, PubMed, etc. After going through the literature, we have found a number of coumarin derivatives being synthesized by researchers for the inhibition of MAO-B for the management of diseases associated with the enzyme such as Alzheimer's Disease and Parkinson's Disease. The effect of these coumarin derivatives on the enzyme depends on the substitutions associated with the structure. The structure-activity relationships of the synthetic coumarin derivatives that are popular nowadays have been described and summarized in the current study. The results revealed the updated review on SAR studies of synthetic coumarins as MAO-B inhibitors, specifically for Alzheimer's Disease and Parkinson's Disease. The patents reported on coumarin derivatives as MAO-B inhibitors were also highlighted. Recently, coumarins, a large class of chemicals with both natural and synthetic sources, have drawn a lot of attention because of the vast range of biological actions they have that are linked to neurological problems. Numerous studies have demonstrated that chemically produced and naturally occurring coumarin analogs both exhibited strong MAO-B inhibitory action. Coumarins bind to MAO-B reversibly thereby preventing the breakdown of neurotransmitters like dopamine leading to the inhibition of the enzyme A number of MAO-B blockers have been proven to be efficient therapies for treating neurological diseases like Alzheimer's Disease and Parkinson's Disease. To combat these illnesses, there is still an urgent need to find effective treatment compounds.

Subclinical hypothyroidism and plasma levels of commonly prescribed anti-seizure medications

Background: Epilepsy remains the most common neurological problem worldwide. Most commonly prescribed antiseizure medications (ASMs) like phenytoin, sodium valproate, and carbamazepine show high inter-individual variability in bioavailability due to genetic and epigenetic factors resulting in either therapeutic failure or toxicity. In our study, we aim to determine the association between subclinical hypothyroidism and the plasma levels of these commonly prescribed ASMs, leading to either therapeutic failure or adverse drug reactions. Methods: We collected demographic data, details about the antiepileptic medication, and plasma levels of ASMs (phenytoin, carbamazepine, and sodium valproate) from patients on antiseizure medications who came for routine therapeutic drug monitoring (TDM). High-performance liquid chromatography (HPLC) estimated plasma levels of the antiseizure medications as per the TDM laboratory standard operating procedure (SOP) and thyroid function test (TSH) by a standard enzyme-linked immune-sorbent assay (ELISA) kit. Results: Of the 158 patients who had TDM, 75.31% were taking sodium valproate, 15.18% were on phenytoin, and 9.49% were on carbamazepine monotherapy. In our study, we found that 12 patients (7.59%) had TSH levels between 4 to 10 mIU/l, indicating subclinical hypothyroidism (SCH). The plasma drug levels of all 12 patients who had SCH were found to be below the therapeutic range. Conclusions: This study has established a significant association between ASMs, particularly sodium valproate, and thyroid dysfunction, specifically SCH, in patients with epilepsy. Our findings suggest that prolonged ASM therapy can lead to thyroid disturbances, warranting careful monitoring of thyroid function in these patients.

Evaluation of TRPM2 Channel-Mediated Autophagic Signaling Pathway in Hippocampus and Cortex Tissues of Rat Offspring Following Prenatal Exposure to Elevated Alcohol Levels.

Fetal alcohol syndrome (FAS) can occur because of high amount of alcohol intake during pregnancy and is characterized by both physical and neurological problems. Children diagnosed with FAS have difficulties in learning, memory, and coordination. Hippocampus has a major role in memory and learning. We aimed to determine whether alcohol exposure during pregnancy had any effect on offspring by evaluating learning ability as well as oxidative stress and autophagy in the hippocampus and cortex tissues of litters. Attention was also paid to sex differences. To do so, TRPM2, Beclin1, p62, LC3B, IBA1, parvalbumin, GAD65, and mGluR5 expression levels were evaluated by immunohistochemistry. Lactate dehydrogenase (LDH), and malondialdehyde (MDA) levels, as well as total oxidant (TOS) and total antioxidant (TAS) status were determined by ELISA. Learning experiments were evaluated by the Morris water maze (MWM) test. Our findings demonstrated that IBA1, LC3B, GAD65, and mGluR5 expression levels were higher in female rats of the chronic alcohol exposure (CAE) model. Our IHC results revealed that TRPM2 expression levels were significantly increased in both males and females in the CAE group. Likewise, TAS was lower, and TOS was higher in CAE animals. Moreover, MWM outcomes supported a learning deficiency in CAE litters compared to controls and indicated that female offspring outperformed males in learning experiments. Therefore, our results revealed the detrimental effects of alcohol exposure during pregnancy on autophagy signaling in the hippocampus and cortex tissue of litters, which could affect the learning ability of animals.

The Neuroprotective Action of Resveratrol Against Cognitive Impairments Induced by Lorazepam in Male Rats.

The study examines how chronic resveratrol administration affects behavioral and neurochemical changes caused by Lorazepam (LZP), a classical anti-anxiety medicine associated with neurodegenerative and neurological problems. Forty male rats were placed into four groups: a control group receiving 1% Tween 80, the LZP group receiving 2 mg/kg/day, the Resveratrol group receiving 50 mg/kg/day, and the LZP plus resveratrol group receiving the same doses of LZP and Resveratrol. Oral therapy was given daily for 6 weeks. The animals were euthanized after open field and Y maze behavioral tests. In specific brain regions, neurochemical analyses were performed on GABA, glutamic acid, monoamines (norepinephrine, dopamine, and serotonin) and their metabolites, DNA fragmentation (8-hydroxy-2-deoxyguanosine or 8-HdG), brain-derived neurotrophic factor (BDNF), and Ca-ATPase. Resveratrol therapy improved GABA, glutamic acid, monoamines, and their metabolites in the cerebral cortex, hippocampus, and striatum. Additionally, it reduced DNA fragmentation (8- HdG) and counteracted LZP-induced Ca-ATPase downregulation at a significant level (p < 0.05). Resveratrol also reversed LZP-induced behavioral changes in the Y maze and open field tests. Resveratrol has anxiolytic-like actions like benzodiazepines and neuroprotective capabilities against LZP-induced adverse effects.

Gut bacteria: an etiological agent in human pathological conditions.

Through complex interactions with the host's immune and physiological systems, gut bacteria play a critical role as etiological agents in a variety of human diseases, having an impact that extends beyond their mere presence and affects the onset, progression, and severity of the disease. Gaining a comprehensive understanding of these microbial interactions is crucial to improving our understanding of disease pathogenesis and creating tailored treatment methods. Correcting microbial imbalances may open new avenues for disease prevention and treatment approaches, according to preliminary data. The gut microbiota exerts an integral part in the pathogenesis of numerous health conditions, including metabolic, neurological, renal, cardiovascular, and gastrointestinal problems as well as COVID-19, according to recent studies. The crucial significance of the microbiome in disease pathogenesis is highlighted by this role, which is comparable to that of hereditary variables. This review investigates the etiological contributions of the gut microbiome to human diseases, its interactions with the host, and the development of prospective therapeutic approaches. To fully harness the benefits of gut microbiome dynamics for improving human health, future research should address existing methodological challenges and deepen our knowledge of microbial interactions.

Restorative Effect of Consuming Red Wine Against Adverse Changes in the Brain of Rodents Exposed to Beer

Objective: There is a surge in the availability of alcoholic products accompanied by a high rate of consumption despite increasing neurological problems. Aim of this study is to determine whether regular intake of brewed beer and red wine affects the microanatomy of the cerebral cortex, hippocampus and brain weight. Materials and Methods: 20 male albino Wistar rats were assigned to four groups of five animals each. Group A, the control was given distilled water; Group B was administered 5 mL/kg body weight of beer; Group C received 5 ml/kg of red wine; and Group D was dosed with 5 ml/kg of beer and followed with 5 ml/kg of red wine. Daily treatments by gavage lasted 15 days, and animal subjects were euthanized via cervical dislocation on day 16. Individual brains were collected and weighed using an electronic scale (SF-400) and afterwards dissected to obtain tissue samples from the cerebral cortex and hippocampus, immediately fixed in 10% formalin for micro-anatomic studies. The paraffin embedding method was used for histological preparation while sections were cut at 5 µm and stained with hematoxylin and eosin. Brain weight was analyzed using the Statistical Product and Service Solutions (SPSS) software via one-way analysis of variance. Results: Histopathological changes including intracerebral haemorrhage and loss of pyramidal neurons observed in group B (beer) samples were not visible in Group D (beer plus red wine), while no microstructural changes occurred in group C (red wine) sections when compared with the control. The output of statistical analysis showed a non-significant reduction in brain weight of group B, whereas a significant increase was noticed in group C while group D showed a non-significant increase. Conclusion: These findings indicate that red wine counteracts beer-induced changes in brain morphology, hypothesising the neuroprotective effect of the wine.

7238 A rare cause of primary ovarian failure in an adolescent due to a genetic mutation in mitochondrial poly-A-polymerase (mTPAP) mRNA

Abstract Disclosure: J. Epstein: None. S. Veera: None. J. Pappas: None. B.C. Shah: None. Primary ovarian insufficiency (POI) is a dysfunction or loss of ovarian follicles with associated amenorrhea. While most causes are idiopathic, approximately 15% of POI cases are due to single gene or chromosomal abnormalities, such as X chromosome abnormalities. Many of these nuclear genes encode for proteins that function within the mitochondria. Mitochondrial disorders affect tissues with high energy demand, such as the neurological, skeletal, cardiac, and endocrine systems. Furthermore, mature ovaries have a relatively higher concentration of mitochondria, which play a role in cellular respiration along with steroidogenesis. Mutations that disrupt these pathways can therefore lead to ovarian dysfunction. We present a case of a 17-year-old female with concern for primary amenorrhea. She underwent pubarche at age 12 years and thelarche at 14 years, with slowed progression. Height Z score was -1.61 and weight Z score was -0.41. Lab work at presentation was significant for LH 18.6 IU/L (N 2.4-12.6 IU/L), FSH 43.9 IU/L (N 1.1-9.6 IU/L), low estradiol &amp;lt;2.5 pg/mL (N 30-100 pg/mL), low total testosterone 8.3 ng/dL (N 15-31 ng/dL), unremarkable HbA1C, cortisol, thyroid levels, and a 46 XX karyotype. Pelvic ultrasound showed small ovarian volumes with a 1.9 cc right ovary, 1.5 cc left ovary consistent with lack of hormonal stimulation, and uterus length of 4.9 cm (N &amp;gt; 4 cm) consistent with early hormonal stimulation. She was started on transdermal estrogen replacement. Past medical history included stable pericardial effusion, episodes of supraventricular tachycardia, pre-cataracts, speech delays, mild learning disabilities, spastic diplegia, progressive gait abnormalities, ligamentous laxity, and recurrent patellar dislocations requiring multiple orthopedic limb surgeries. Family history was significant for parental consanguinity as first cousins. As the etiology of the POI remained unknown, genetic testing was completed. Whole exome sequencing (WES) revealed a homozygous pathogenic variant in the MTPAP gene: p.(Leu495Arg) (CTG&amp;gt;CGG): c.1484 T&amp;gt;G in exon 9 on chromosome 10p11.23. MTPAP, also known as SPAX4, TENT6, or PAPD1, is a nuclear-encoded polymerase involved in synthesizing the 3’ poly(A) tail of mitochondrial transcripts as well as in mRNA degradation. She was diagnosed with autosomal recessive MTPAP-related neurodevelopmental and movement disorder. Monogenic disorders affecting mitochondrial function are rare causes of POI. A high index of suspicion should be raised when a constellation of neurological, musculoskeletal, and cardiac problems co-exist. WES can be a very useful tool for uncovering rare genetic disorders. Further studies are needed to clarify details of organ specific mitochondrial dysfunction and possible therapeutics in individuals affected with MTPAP-related neurodevelopmental and movement disorders. Presentation: 6/1/2024

A-102 Clinical Evaluation of Novel Markers in Brain Injury

Abstract Background Traumatic brain injury (TBI) is a significant health concern affecting individuals of all ages, demanding precise diagnostic methodologies to guide effective clinical management. According to the 2010 definition, a TBI results from an external force causing an alteration in brain function or other evidence of brain pathology. Current diagnostic tools, i.e. CT scans and the Glasgow Coma Scale (GCS), are inefficient because they are time and labor intensive. The need for rapid diagnostic tools is underscored by the drawbacks of existing methods, such as CT scans, which are expensive, expose patients to large amounts of radiation, and lead to delayed treatment. Recent advances in TBI diagnosis involve novel biomarkers, such as Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-Terminal Hydrolase L1 (UCH-L1), which have shown promise in revolutionizing the assessment of head traumas. GFAP, a glial-specific protein, is elevated in circulation after a TBI, distinguishing it from multi-trauma patients without brain injuries. UCH-L1, found in neurons, is significantly elevated in TBI patients compared to uninjured controls. A 2021 study further supports the clinical effectiveness of these biomarkers, demonstrating their capacity to exclude CT-positive injury in acute TBI cases. The primary aim of this study is to explore the clinical utility of the Abbott Alinity TBI assay, specifically biomarkers GFAP and UCH-L1, in emergency department patients with a history of head trauma. Methods A retrospective study involving 238 emergency department patients with a history of head trauma and noncontrast CT scans was conducted using the Abbott Alinity TBI assay. Serum samples were collected, and biomarker values were established and compared to CT scan results. The study was comprised of 94 females and 144 males spanning various age groups. The GFAP and UCH-L1 cutoffs used were FDA approved, at 35.0 ng/L and 400.0 ng/L, respectively. If either marker was above the cutoff the patient ruled at risk for TBI. Results Results demonstrated the assay correctly identified all CT-positive cases (100% sensitivity), placing them in the rule-in group, while identifying 44 patients with a 0 chance of TBI. The negative predictive value for the TBI overall was 100% (95% CI: 91.96%-100%). The GFAP assay alone identified 30/31 positive CT scans, reporting a 98.77% (95% CI: 92.03%-99.82%) negative predictive value. The UCH-L1 assay reported 26/31 positive CT scans with a negative predictive value of 94.68% (95% CI: 88.71-97.58%). Analyzing the data revealed the TBI assay would have reduced CT scans by 18.5%. Conclusions The results of this study did show a potential reduction in the number of patients sent to CT making it a valuable tool for triaging patients presenting with head trauma; however, the complexity of neurological problems may lead to increased false positives, reducing assay specificity. Despite this limitation, this study concludes that the GFAP and UCH-L1 markers could be used to triage patients into CT rule-out and rule-in groups, thereby streamlining clinical management. In conclusion, this assay, incorporating GFAP and UCH-L1 biomarkers, presents as a promising diagnostic tool for emergency departments.

Comparing Guidelines to Daily Practice When Screening Older Patients for the Risk of Functional Decline in Hospitals: Outcomes of a Functional Resonance Analysis Method (FRAM) Study.

Dutch hospitals are required to screen older patients for functional decline using 4 indicators: malnutrition, delirium, physical impairment, and falls, to recognize frail older patients promptly. The Functional Resonance Analysis Method was employed to deepen the understanding of work according to the protocols (work-as-imagined [WAI]) in contrast to the realities of daily practice (work-as-done [WAD]). Data have been collected from 3 hospitals (2 tertiary and 1 general) and 4 different wards: an internal medicine ward, surgical ward, neurology ward, and a trauma geriatric ward. WAI models were based on national guidelines and hospital protocols. Data on WAD were collected through semistructured interviews with involved nurses (n = 30). Hospital protocols were more extensive than national guidelines for all screening indicators. Additional activities mainly comprised specific preventive interventions or follow-up assessments after adequate measurements. Key barriers identified to work according to protocols included time constraints, ambiguity regarding task ownership, nurses' perceived limitations in applying their clinical expertise due to time constraints, insufficient understanding of freedom-restricted interventions, and the inadequacy of the Delirium Observation Scale Score in patients with neurological and cognitive problems. Performance variability stemmed from timing issues, frequently attributable to time constraints. The most common reasons for deviating from the protocol are related to time constraints, lack of knowledge, and/or patient-related factors. Also, collaboration among relevant disciplines appears important to ensure good health outcomes. Future research endeavors could shed a light on the follow-up procedures of the screening process and roles of other disciplines, such as physiotherapists.

Functional movement disorder similar to Parkinson’s disease: a case report

IntroductionFunctional neurological disorder challenges conventional medical understanding, presenting neurological symptoms without organic explanations. This report delves into the intricate interplay between psychological and physical manifestations, emphasizing the importance of timely diagnosis and intervention and its impact on a patient’s mental health and quality of life.Case presentationA 40-year-old single Iranian man was admitted for the third time owing to exacerbation of mood symptoms, including depression, irritability, aggression, suicidal ideation, and movement and sensory problems. The patient’s symptoms began with psychological stressors and family conflict, leading to muscle weakness and tremors in the left hand. Over a year, muscle weakness escalated, leading to slow movement, motor impairment in the lower limbs, and reliance on a cane for walking. The patient still exhibited symptoms, such as a mask-like face, stooped walking posture, and a relative improvement of symptoms periodically. At first, the patient was suspected of Parkinson’s disease and was placed on levodopa and amantadine. However, the medication was discontinued owing to an unsatisfactory response and the lack of strong evidence in favor of neurological problems on frequent examinations and reviews. Despite multiple hospitalizations, the patient’s symptoms remained unresolved. Finally, after years of investigations, based on specialists’ recommendations, he was admitted to the psychosomatic ward for diagnostic evaluationele, and he was diagnosed with functional neurological disorder (psychogenic parkinsonism). He underwent pharmacotherapy, electroconvulsive therapy, and psychotherapy. He was discharged with partial improvement of symptoms, but showed periods of relapse and remission during the following years.ConclusionThis case study illuminates functional neurological disorder complexities, emphasizing the need for a holistic diagnostic approach. Timely interventions, including psychological support, can alleviate symptoms, reduce healthcare costs, and improve the overall prognosis. The report contributes to evolving functional neurological disorder understanding in psychiatry and neurology. The report underscores early recognition, advocating for comprehensive interventions involving psychiatric support, cognitive-behavioral therapy, and patient psychoeducation.

NAD+ supplement relieved chronic sleep restriction (CSR)-induced microglial proinflammation in vivo and in vitro

Sleep insufficiency is a significant health problem worldwide and can induce multiple neurodevelopmental disorders in the central nervous system (CNS). Sleep deprivation (SD), especially chronic SD, leads to cognition and memory loss and worsens neurodegenerative disease liability. Microglia are the main inflammation-dominant glia and play a crucial role in SD-induced neurological impairments. Nicotinamide adenine dinucleotide (NAD+) is a redox reaction coenzyme that exerts anti-inflammatory and mitochondria-protective effects in microglia. Whether NAD+ mitigated SD-induced neurological disorders by regulating microglial functions is still unknown. In the current study, we designed an in vivo and in vitro model to evaluate the neuroprotective effect of NAD+ on chronic sleep restriction (CSR) and further investigate the underlying mechanisms. Behavioral tests and immunofluorescence staining were applied to investigate the cognition impairments and microglial activation. Biochemical experiments were tested to analyze the oxidative status and possible mechanism. In vitro data were used to verify the in vivo data. Our results displayed that NAD+ supplement mitigated CSR-induced cognitive decline and microglial activation response by suppressing the expression of pro-inflammatory cytokines in vivo. NAD+ administration also decreased oxidative stress and mitochondrial impairments in microglia. In vitro results showed that NAD+ treatment inhibited ROS production and prompted M1 conversion to M2 phenotype. cGAS-STING/NF-κB pathways were significantly activated but down-regulated by NAD+ administration. H151, a STING antagonist, was applied to validate that NAD+ treatment alleviates neuroinflammation partially by regulating cGAS-STING pathways in microglia. Our findings suggest that NAD+ supplement is a promising therapy for sleep disorders-induced neurological problems, and cGAS-STING pathway may act as a critical regulator in microglial proinflammation.

Influenza Infection During Pregnancy and Risk of Seizures in Offspring

Seizure is a common neurological problem among infants and children up to age 6 years. Prenatal exposure to maternal influenza infection has been reported to be associated with childhood seizures. To evaluate the association between maternal influenza infection and risk of childhood seizures. This cohort study identified mother-offspring pairs from January 1, 2004, to December 31, 2013, using records in Taiwan's Maternal and Child Health Database. Mothers who had influenza infection during pregnancy and their first offspring were identified and assigned to the influenza group. Mothers in the control group were those without influenza during pregnancy and were matched 1:4 with mothers in the influenza group by maternal age, offspring sex, and date of delivery. Offspring were followed up until December 31, 2020. Data were analyzed between March 2023 and July 2024. Diagnosis of influenza infection during pregnancy defined using International Classification of Diseases, Ninth Revision, Clinical Modification codes 487.0, 487.1, and 487.8, or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes J09, J10, and J11. The primary outcome was the association between maternal influenza infection during pregnancy and risk of any type of seizures during childhood, including both epilepsy and febrile seizures. Adjusted hazard ratios (AHRs) and 95% CIs were estimated using Cox proportional hazards regression models. Pregnancy-related complications were collected as covariates. A total of 1 316 107 mother-offspring pairs were enrolled, of whom 75 835 mothers (predominant maternal age, 25-29 years; 39 324 male offspring [51.9%]) were assigned to the influenza group and 1 240 272 were matched and assigned to the control group (n = 303 340; predominant maternal age, 30-34 years; 157 296 male offspring [51.9%]). In the influenza group, there was a slightly higher prevalence of placenta previa or abruption compared with the control group (1.6% [1241] vs 1.4% [4350]; P < .001). The cumulative risk of seizures was higher among offspring whose mothers had influenza infection. After controlling for potential confounders, the AHRs were 1.09 (95% CI, 1.05-1.14) for seizures, 1.11 (95% CI, 1.06-1.17) for febrile convulsions, and 1.04 (95% CI, 0.97-1.13) for epilepsy. In the subgroup analysis, no statistically significant differences were observed between the trimesters regarding the timing of influenza infection. Results of this cohort study suggest that maternal influenza infection during pregnancy was associated with an increased risk of childhood seizures, especially febrile seizures, but not epilepsy. Further studies are needed to elucidate the mechanisms underlying childhood neurological development.

Role of Mandukparni (Centella asiatica Linn Urban) in neurological disorders: Evidence from ethnopharmacology and clinical studies to network enrichment analysis

Centella asiatica Linn Urban (C. asiatica), aka Mandukparni, is one of the flagship herbs used in traditional medicines to effectively manage neurological problems. Although this plant has a wealth of comprehensive preclinical pharmacological profiles, further clinical research and execution of its molecular mode of action are still required. We searched electronic databases (Google Scholar, SciFinder, MEDLINE, Scopus, EMBASE, Science Direct, and PubMed) using relevant key words to retrieve information pertaining to C. asiatica till June 2023 and performed network pharmacology to understand the mechanism related to their neurobiological roles. This study extensively analyses its pharmacological properties, nutritional profile, ethnomedical uses, safety, and mechanistic role in treating neurological and neurodegenerative disorders. Additionally, a network pharmacology study was performed which suggests that its phytomolecules are involved in different neuroactive ligand-receptor pathways, glial cell differentiation, gliogenesis, and astrocyte differentiation. Hopefully, this report will lead to a paradigm shift in medical practice, research, and the creation of phytopharmaceuticals derived from C. asiatica that target the central nervous system.

B - 32 Neurological Problems in Boxers during the 20th Century: a Review and Synthesis

Abstract Objective There are no validated clinical diagnostic criteria for chronic traumatic encephalopathy or traumatic encephalopathy syndrome (TES). To understand the historical clinical condition, its applicability to modern day athletes, and the pathogenesis of clinical problems, we examined the literature in boxers from the 20th century, with specific attention to neurological findings and characteristics of clinical disease progression. Data Selection Data were extracted for 243 boxers included in 45 articles published between 1928 and 1999, including cases from articles originally published in German. The presence or absence of 22 neurological signs and features were extracted. Data Synthesis The most common neurological problems were slurring dysarthria (49%), gait disturbances (44%), and memory loss (36%), with several other problems that were less frequent, including hyperreflexia (25%), ataxia (22%), increased tone (19%), and extensor Babinski sign (16%). Frank dementia appeared in some cases (17%). There were significantly fewer neurological deficits reported in boxers who fought in the latter part of the 20th century compared to boxers who fought earlier in the century. For most cases, there were no comments about whether the neurological problems were progressive (145, 60%). A progressive condition was described in 71 cases (29%) and a stationary or improving condition was described in 27 cases (11%). Canonical neurodegenerative disease-like progression was described in 15 cases (6%). Conclusions Neurological problems associated with boxing-related neurotrauma during the 20th century are the foundation for present day TES. However, the clinical signs and features in the 20th century differ in most ways from the modern criteria for TES.

Neurological Complications Following Cardiac Surgery: Management and Future Directions

Neurological complications related to cardiac surgery present physicians with challenges. These complications severely impact patients’ outcomes, the quality of their lives, and affect the resources available at healthcare centers. The treatment of neurological complications requires a multidisciplinary approach, where evidenced-based interventions work to identify the patient profiles and risk factors. In addition, ongoing investigations on alternative treatment methods like cerebral oximetry and personalized risk stratification may likely improve management and outcomes of such high-risk patients. Based on the significance that neurological problems play after cardiac surgery, this paper intends to offer the practitioners and scientists vital insights to help them provide the most suitable healthcare to the affected patients and to guide future studies.

The complete genomic sequencing of a Klebsiella pneumoniae isolate derived from the blood of a patient suffering from severe neurological problems in Zhengzhou, China.

This study presents the comprehensive analysis of the genomic sequence of Klebsiella pneumoniae strain FAHZZU7042hy, having a 5,690,191 bp chromosome size. This strain was obtained from a blood sample of a patient suffering from severe neurological problems in Zhengzhou, China, 2023.