Recovery Of Neurological Disorders Research Articles

Towards Transforming Neurorehabilitation: The Impact of Artificial Intelligence on Diagnosis and Treatment of Neurological Disorders.

Background and Objectives: Neurological disorders like stroke, spinal cord injury (SCI), and Parkinson's disease (PD) significantly affect global health, requiring accurate diagnosis and long-term neurorehabilitation. Artificial intelligence (AI), such as machine learning (ML), may enhance early diagnosis, personalize treatment, and optimize rehabilitation through predictive analytics, robotic systems, and brain-computer interfaces, improving outcomes for patients. This systematic review examines how AI and ML systems influence diagnosis and treatment in neurorehabilitation among neurological disorders. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, and Scopus databases with a search time range from 2014 to 2024. This review has been registered on Open OSF (n) EH9PT. Results: Recent advancements in AI and ML are revolutionizing motor rehabilitation and diagnosis for conditions like stroke, SCI, and PD, offering new opportunities for personalized care and improved outcomes. These technologies enhance clinical assessments, therapy personalization, and remote monitoring, providing more precise interventions and better long-term management. Conclusions: AI is revolutionizing neurorehabilitation, offering personalized, data-driven treatments that enhance recovery in neurological disorders. Future efforts should focus on large-scale validation, ethical considerations, and expanding access to advanced, home-based care.

Therapeutic Potential of Low-Intensity Magnetic Field Stimulation in 6-Hydroxydopamine Rat Model of Parkinson's Disease: From Inflammation to Motor Function.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that mainly affects the aged population. Transcranial magnetic field (MF) stimulation has shown to provide temporary motor recovery in neurological disorders. The aim of this study was to understand the cellular and molecular mechanism of low-intensity MF stimulation (17.96 µT; 50Hz; 2 h/day, four weeks) in a rat model of severe PD. A clinically relevant, bilateral striatal 6-hydroxydopamine (6-OHDA) lesioned rat model of severe PD was employed to test the efficacy of low-intensity MF stimulation in the management of motor symptoms. The mechanism of action of MF was dissected by assessing the microglial activation, tissue ultrastructure, and cerebrospinal fluid (CSF) metabolomics using microdialysis. We observed a significant improvement in the postural balance and gait after MF exposure with a significant reduction in the number of activated microglia. There was an improvement in striatal dopaminergic innervation and glutamate levels but it did not reach a level of statistical significance. MF stimulation helped ameliorate the motor deficits and reduced inflammation but was unable to provide a significant change in terms of dopaminergic innervation and metabolic profile in the severe 6-OHDA PD rat model.

Acute spinal cord compression due to spinal subdural hematoma after spinal anaesthesia in-patient under anticoagulant drug

BackgroundSubdural spinal cord hematomas are very rare condition. They most often occur in patients with primary or secondary blood haemostasis disorders and following lumbar punctures. Early diagnosis and management preserve functional prognosis.Case descriptionWe report the case of a female 69-year-old patient on oral anticoagulant, Acenocoumarol 4 mg (SINTROM) for previous aortic prosthesis. The patient had undergone surgery for appendicitis under spinal anaesthesia 2 days before her admission in neurosurgery department. She was admitted in emergency for 1/5 central flaccid paraplegia with sensitive umbilical level. A spinal MRI performed showed a collection intradural in intermediate signal in T1 and hyposignal in T2 with echo gradient of 8 mm thickness extended from D8 to L2 compressing the marrow with anomalies of intramedullary signal extended from D8 to the conus medullaris. We retained indication to operate the patient early in emergency because of acute spinal cord compression. We performed T12-L2 laminectomy, durotomy and evacuated hematoma. Postoperative marked by an immediate recovery of sensitivity and an onset of motor recovery from 1/5 to 2/5 and 4/5 follow up at on year with physiotherapy.ConclusionSpinal cord compression due to subdural spinal hematomas not often described especially in patients with haemostasis blood disorders due to anticoagulants drugs. In addition, we should pay attention with lumbar puncture in these patients. Emergency surgery allows a good prognosis about recovery of neurological disorders.

Застосування поглинача вільних кисневих радикалів едаравону у хворих на субарахноїдальний крововилив (аналітичний огляд)

Актуальність. Поглинач вільних кисневих радикалів ксаврон (едаравон) сприяє зменшенню зони ішемічного ушкодження й істотному поліпшенню віддалених наслідків інсульту, а тому широко використовується в лікуванні ішемічного інсульту. Проте роль едаравону в лікуванні хворих на субарахноїдальний крововилив досі не з’ясована. Мета: дослідити можливість та ефективність застосування поглинача вільних кисневих радикалів ксаврону (едаравону) в комплексі терапії у хворих на субарахноїдальний крововилив. Матеріали та методи. Було проведено пошук досліджень та систематичних оглядів за ключовими словами: «гострий інсульт»; «субарахноїдальний крововилив», «геморагічна трансформація», «едаравон» у базі даних Google Scholar, опублікованих за період з 2003 по 2021 рік. Результати. Застосування едаравону у хворих на субарахноїдальний крововилив супроводжувалося активацією протизапальних і зниженням прозапальних пептидів, активацією антиапоптозних механізмів, зниженням перекисного окислення ліпідів і зменшенням окислювальної травми, зменшенням проникності гематоенцефалічного бар’єра та вираженості набряку головного мозку. Висновки. Основні ефекти едаравону (ксаврону) сприяли зменшенню неврологічного дефіциту, прискоренню швидкості відновлення неврологічних порушень та покращенню функціональних результатів лікування. Таким чином, введення едаравону у хворих на субарахноїдальний крововилив є вірогідно ефективним та безпечним.

Application of a free radical scavenger edaravone in patients with hemorrhagic stroke

BACKGROUND. The free radical scavenger edaravone helps to reduce the area of ischemic injury and improve the longterm effects of stroke, and is therefore widely used in the treatment of ischemic stroke. However, the role of edaravone in the treatment of hemorrhagic stroke patients has not yet been clarified.
 OBJECTIVE. To investigate the feasibility and effectiveness of the use of the free radical scavenger edaravone in the treatment of patients with acute hemorrhagic stroke.
 MATERIALS AND METHODS. A search was conducted for studies and systematic reviews for the keywords “acute stroke”, “intracerebral hemorrhage”, “subarachnoid hemorrhage”, “hemorrhagic transformation”, “edaravone” in the Google Scholar database published between 2003 and 2020.
 RESULTS. The use of edaravone in patients with intracerebral hemorrhage was accompanied by activation of anti-inflammatory and reduction of pro-inflammatory peptides, activation of anti-apoptotic mechanisms, reduction of lipid peroxidation and oxidative trauma, reduction of permeability of the hematocenosis.
 CONCLUSIONS. The main effects of edaravone have been to reduce neurological deficits, accelerate the rate of recovery of neurological disorders, and improve functional outcomes. Thus, the introduction of edaravone in patients with hemorrhagic stroke has proven to be reliably effective and safe.

Analysis of the influence of various factors on the course of neurological disorders in children with spinal cord injury

Background. The study of the influence of various factors on the course of recovery of neurological disorders in children with spinal cord injuries is an important and relevant problem. The main causes of thoracic and lumbar injuries of the spine in children are road accidents and catatraumas. Anatomical and physiological features of the spine and spinal cord in children have a significant influence on the nature of spinal cord injury, clinical manifestations of the injury, and method of treatment. The degree of spinal canal deformity at the level of the damaged segment is directly proportional to the severity of the neurological disorder. The time between injury to when surgery is performed will strongly influence the nature and course of recovery of motor functions. Aim. To assess the influence of different factors in pediatric patients with complicated injuries of the spine at the thoracic and thoracolumbar levels on the recovery of neurological disorders. Materials and methods. The analysis of results of the surgical treatment of 36 children (24 boys and 12 girls) aged 3-17 years with damage to the spine and spinal cord in the thoracic spine and thoracolumbar junction, accompanied with neurological deficit in the form of central or peripheral paresis and paralysis, was performed. All patients underwent surgical intervention depending on the type and extent of damage. Clinical methods (i.e., detailed neurological examination) as well as X-ray, CT, and MRI were used as diagnostic methods. Results. The study revealed that the most severe damage concerning neurological disorders in children with spinal cord injury occurs in the thoracic spine. The extent of neurological changes depends not only on the level of damage to the spinal column but also on the magnitude of spinal canal stenosis. Surgery performed in the first hours of the injury leads to a more rapid and full recovery of the neurological deficit. Conclusion. Therefore, this study found that several factors influence the recovery of neurological disorders in children with spinal cord injury: timing of surgery, localization of the injury, spinal stenosis, the nature of lesions of the spinal cord, and the elements involved.

Non-linear dynamics of human locomotion: effects of rhythmic auditory cueing on local dynamic stability

It has been observed that times series of gait parameters [stride length (SL), stride time (ST), and stride speed (SS)], exhibit long-term persistence and fractal-like properties. Synchronizing steps with rhythmic auditory stimuli modifies the persistent fluctuation pattern to anti-persistence. Another non-linear method estimates the degree of resilience of gait control to small perturbations, i.e., the local dynamic stability (LDS). The method makes use of the maximal Lyapunov exponent, which estimates how fast a non-linear system embedded in a reconstructed state space (attractor) diverges after an infinitesimal perturbation. We propose to use an instrumented treadmill to simultaneously measure basic gait parameters (time series of SL, ST, and SS from which the statistical persistence among consecutive strides can be assessed), and the trajectory of the center of pressure (from which the LDS can be estimated). In 20 healthy participants, the response to rhythmic auditory cueing (RAC) of LDS and of statistical persistence [assessed with detrended fluctuation analysis (DFA)] was compared. By analyzing the divergence curves, we observed that long-term LDS (computed as the reverse of the average logarithmic rate of divergence between the 4th and the 10th strides downstream from nearest neighbors in the reconstructed attractor) was strongly enhanced (relative change +73%). That is likely the indication of a more dampened dynamics. The change in short-term LDS (divergence over one step) was smaller (+3%). DFA results (scaling exponents) confirmed an anti-persistent pattern in ST, SL, and SS. Long-term LDS (but not short-term LDS) and scaling exponents exhibited a significant correlation between them (r = 0.7). Both phenomena probably result from the more conscious/voluntary gait control that is required by RAC. We suggest that LDS and statistical persistence should be used to evaluate the efficiency of cueing therapy in patients with neurological gait disorders.

Mapping transplanted stem cell migration after a stroke: a serial, in vivo magnetic resonance imaging study

Preferential migration of stem cells toward the site of a lesion is a highly desirable property of stem cells that allows flexibility in the site of graft implantation in the damaged brain. In rats with unilateral stroke damage, neural stem cells transplanted into the contralateral hemisphere migrate across to the lesioned hemisphere and populate the area around the ischaemic infarct. To date, the migration of neural stem cells in the damaged brain has been mainly inferred from snapshot histological images. In this study, we demonstrate that by pre-labelling neural stem cells with the bimodal contrast agent Gadolinium- Rhodam Ine Dextran [GRID, detectable by both magnetic resonance imaging (MRI) and fluorescent microscopy], the transhemispheric migration of transplanted neural stem cells contralateral to a stroke lesion can be followed in vivo by serial MRI and corroborated by subsequent histological analyses. Our results indicate that neural stem cells migrated from the injection tract mainly along the corpus callosum within 7 days of transplantation and extensively re-populated the peri-lesion area by 14 days following implantation. In contrast, neural stem cells transplanted into sham controls did not show any substantial migration outside of the injection tract, suggesting that the transcallosal migration observed in the stroke-lesioned animals is due to neural stem cells being attracted by the lesion site. In vivo tracking of the migration of neural stem cells responding to damage will greatly enhance our understanding of optimal transplantation strategies as well as how neural stem cells promote functional and anatomical recovery in neurological disorders.