Related Neurological Disorders Research Articles

Spectrum of neurological manifestations, existence of diabetes mellitus, and 5-year mortality and cancer association outcomes in a cohort of Omani patients with positive anti- GAD autoimmunity

ABSTRACT Objectives There is scarce data in the literature concerning the anti-GAD65 antibodies (GAD-Abs) autoimmunity in the Omani population. Methods Retrospective cohort study included GAD-Abs positive patients (n = 444) presented to a tertiary referral center in Oman from January 2005 until January 2018, with a five-year follow-up to study the cancer association and mortality outcomes. Results Out of 444 patients, 27 patients (6.1%) showed GAD-Abs related neurological disorders. Adult age group was significantly associated with more GAD-Abs related neurological manifestations compared to pediatric and adolescents age group (P = 0.045). There was no association between the presence or absence of neurological manifestations with diabetes mellitus nor the titer level of GAD-Abs. Refractory status epilepticus and stiff person syndrome were the main causes of death in patients with neurological manifestations over five years and none of them found to have associated cancer. Conclusion The GAD-Abs autoimmunity represents a spectrum of neurological manifestations with variable severity and outcome among Omanis with positive GAD-Abs testing. The results of this study will serve as a platform for future studies to address the impact of GAD-Abs autoimmunity on the morbidity, mortality and treatment efficacy in the Omani population.

A novel phosphodiesterase 5 inhibitor, RF26, improves memory impairment and ameliorates tau aggregation and neuroinflammation in the P301S tauopathy mouse model of Alzheimer's disease

Phosphodiesterase-5 (PDE5) inhibitors are primarily used in the treatment of erectile dysfunction and pulmonary hypertension, but have also been reported to have a potential therapeutic effect for the treatment of Alzheimer's disease (AD). This is likely to be through stimulation of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling by elevating cGMP, a secondary messenger involved in processes of neuroplasticity. In the present study, we evaluated the efficacy of a novel PDE5 inhibitor, RF26, using P301S tauopathy mice model. A body of experimental evidence suggests that the development of tau inclusions leads to the neurodegeneration observed in tauopathies, including AD, Frontotemporal dementia (FTD), Supranuclear palsy and others. RF26 successfully targeted NO/cGMP signaling pathway and showed a significant improvement of spatial memory task performance of P301S mice using Morris Water Maze and T-maze. Furthermore, RF26 -treated mice showed a significant reduction of phosphorylated tau load, gliosis and downregulated pro-inflammatory cytokines. The presented data support the efficacy of RF26 as a potent PDE5 inhibitor and calls for further investigation as a potential therapeutic drug for Alzheimer's and other tauopathy related neurological disorders.

Exploring the Frontier: The Human Microbiome's Role in Rare Childhood Neurological Diseases and Epilepsy.

Emerging research into the human microbiome, an intricate ecosystem of microorganisms residing in and on our bodies, reveals that it plays a pivotal role in maintaining our health, highlighting the potential for microbiome-based interventions to prevent, diagnose, treat, and manage a myriad of diseases. The objective of this review is to highlight the importance of microbiome studies in enhancing our understanding of rare genetic epilepsy and related neurological disorders. Studies suggest that the gut microbiome, acting through the gut-brain axis, impacts the development and severity of epileptic conditions in children. Disruptions in microbial composition can affect neurotransmitter systems, inflammatory responses, and immune regulation, which are all critical factors in the pathogenesis of epilepsy. This growing body of evidence points to the potential of microbiome-targeted therapies, such as probiotics or dietary modifications, as innovative approaches to managing epilepsy. By harnessing the power of the microbiome, we stand to develop more effective and personalized treatment strategies for children affected by this disease and other rare neurological diseases.

Antioxidant Effect of Naringin Demonstrated Through a Bayes' Theorem Driven Multidisciplinary Approach Reveals its Prophylactic Potential as a Dietary Supplement for Ischemic Stroke.

Naringin (NAR), a flavanone glycoside, occurs widely in citrus fruits, vegetables, and alcoholic beverages. Despite evidence of the neuroprotective effects of NAR on animal models of ischemic stroke, brain cell-type-specific data about the antioxidant efficacy of NAR and possible protein targets of such beneficial effects are limited. Here, we demonstrate the brain cell type-specific prophylactic role of NAR, an FDA-listed food additive, in an in vitro oxygen-glucose deprivation (OGD) model of cerebral ischemia using MTT and DCFDA assays. Using Bayes' theorem-based predictive model, we first ranked the top-10 protein targets (ALDH2, ACAT1, CTSB, FASN, LDHA, PTGS1, CTSD, LGALS1, TARDBP, and CDK1) from a curated list of 289 NAR-interacting proteins in neurons that might be mediating its antioxidant effect in the OGD model. When preincubated with NAR for 2days, N2a and CTX-TNA2 cells could withstand up to 8h of OGD without a noticeable decrease in cell viability. This cerebroprotective effect is partly mediated by reducing intracellular ROS production in the above two brain cell types. The antioxidant effect of NAR was comparable with the equimolar (50µM) concentration of clinically used ROS-scavenger and neuroprotective edaravone. Molecular docking of NAR with the top-10 protein targets from Bayes' analysis showed the lowest binding energy for CDK1 (- 8.8kcal/M). Molecular dynamics simulation analysis showed that NAR acts by inhibiting CDK1 by stably occupying its ATP-binding cavity. Considering diet has been listed as a risk factor for stroke, NAR may be explored as a component of functional food for stroke or related neurological disorders.

Natural Flavonoids as an Intervention for Hepatic Encephalopathy: Preclinical Evidence-based Review

Abstract: Hepatic encephalopathy (HE) is a serious neuropsychiatric disorder caused in patients with both; acute and chronic liver diseases, which consists of various complications ranging from cognitive impairment, disorientation, confusion, and coma. The available therapies mainly focus on decreasing ammonia levels either through increasing its elimination or decreasing its production, some medications may subside the duration and limit the consequences of HE, but there is no complete available treatment for HE-like manifestation. Thus, there is a need to explore new pharmacotherapy for the treatment and management of HE. Flavonoids are polyphenolic compounds easily found in vegetables, fruits, flowers, beverages, and plants based foods. In modern research, flavonoids have gained attention due to their broad pharmacological properties, like anti-oxidant, antiviral, anti-inflammatory, cardioprotective, cytoprotective, and neuroprotective activity. Several preclinical studies suggest that various flavonoids have a potential therapeutic role in a variety of metabolic- related neurological disorders, including HE. This review focuses on all pre-clinical reports that highlight the neuroprotective potential of natural flavonoids for the management of HE. Based on numerous pre-clinical studies and taking into account the therapeutic effects of natural flavonoids, the present study illustrates the cellular and molecular mechanisms responsible for the potential role of natural flavonoids as pharmacotherapy for the management and treatment of HE.

A synonymous mutation of rs1137070 cause the mice Maoa gene transcription and translation to decrease.

The Monoamine Oxidase-A (MAOA) EcoRV polymorphism (rs1137070) is a unique synonymous mutation (c.1409 T > C) within the MAOA gene, which plays a crucial role in Maoa gene expression and function. This study aimed to explore the relationship between the mouse Maoa rs1137070 genotype and differences in MAOA gene expression. Mice carrying the CC genotype of rs1137070 exhibited a significantly lower Maoa expression level, with an odds ratio of 2.44 compared to the T carriers. Moreover, the wild-type TT genotype of MAOA demonstrated elevated mRNA expression and a longer half-life. We also delved into the significant expression and structural disparities among genotypes. Furthermore, it was evident that different aspartic acid synonymous codons within Maoa influenced both MAOA expression and enzyme activity, highlighting the association between rs1137070 and MAOA. To substantiate these findings, a dual-luciferase reporter assay confirmed that GAC was more efficient than GAT binding. Conversely, the synonymous mutation altered Maoa gene expression in individual mice. An RNA pull-down assay suggested that this alteration could impact the interaction with RNA-binding proteins. In summary, our results illustrate that synonymous mutations can indeed regulate the downregulation of gene expression, leading to changes in MAOA function and their potential association with neurological-related diseases.

Dual effects of ARX poly-alanine mutations in human cortical and interneuron development.

Infantile spasms, with an incidence of 1.6 to 4.5 per 10,000 live births, are a relentless and devastating childhood epilepsy marked by severe seizures but also leads to lifelong intellectual disability. Alarmingly, up to 5% of males with this condition carry a mutation in the Aristaless-related homeobox ( ARX ) gene. Our current lack of human-specific models for developmental epilepsy, coupled with discrepancies between animal studies and human data, underscores the gap in knowledge and urgent need for innovative human models, organoids being one of the best available. Here, we used human neural organoid models, cortical organoids (CO) and ganglionic eminences organoids (GEO) which mimic cortical and interneuron development respectively, to study the consequences of PAE mutations, one of the most prevalent mutation in ARX . ARX PAE produces a decrease expression of ARX in GEOs, and an enhancement in interneuron migration. That accelerated migration is cell autonomously driven, and it can be rescued by inhibiting CXCR4. We also found that PAE mutations result in an early increase in radial glia cells and intermediate progenitor cells, followed by a subsequent loss of cortical neurons at later timepoints. Moreover, ARX expression is upregulated in COs derived from patients at 30 DIV and is associated with alterations in the expression of CDKN1C . Furthermore, ARX PAE assembloids had hyperactivity which were evident at early stages of development. With effective treatments for infantile spasms and developmental epilepsies still elusive, delving into the role of ARX PAE mutations in human brain organoids represents a pivotal step toward uncovering groundbreaking therapeutic strategies.

Nervonic acid protects against oligodendrocytes injury following chronic cerebral hypoperfusion in mice

Chronic cerebral hypoperfusion (CCH) has been acknowledged as a potential contributor to cognitive dysfunction and brain injury, causing progressive demyelination of white matter, oligodendrocytes apoptosis and microglia activation. Nervonic acid (NA), a naturally occurring fatty acid with various pharmacological effects, has been found to alleviate neurodegeneration. Nonetheless, evidence is still lacking on whether NA can protect against neurological dysfunction resulting from CCH. To induce CCH in mice, we employed the right unilateral common carotid artery occlusion (rUCCAO) method, followed by oral administration of NA daily for 28 days after the onset of hypoperfusion. We found that NA ameliorated cognitive function, as evidenced by improved performance of NA-treated mice in both novel object recognition test and Morris water maze test. Moreover, NA mitigated demyelination and loss of oligodendrocytes in the corpus callosum and hippocampus of rUCCAO-treated mice, and prevented oligodendrocyte apoptosis. Furthermore, NA protected primary cultured murine oligodendrocytes against oxygen-glucose deprivation (OGD)-induced cell death in a concentration-dependent manner. These findings indicated that NA promotes oligodendrocyte maturation both in vivo and in vitro. Our findings suggest that NA offers protective effects against cerebral hypoperfusion, highlighting its potential as a promising treatment for CCH and related neurological disorders.

Out of Sight, Out of Mind: reflections from the Covid era on social knowledge and medical thinking in Adolf Lukas Vischer’s ‘barbed wire disease’

ABSTRACT This article explores the relationship between wartime captivity and the production of medical knowledge through the phenomenon of ‘barbed wire disease’. This was a term used by First World War POWs and internees themselves to describe symptoms of depression and related neurological disorders. The Swiss surgeon Adolf Lukas Vischer borrowed it for the title of a book he wrote in 1918 suggesting that the spatial and temporal peculiarities of camp life made prolonged captivity in such an environment inhumane and a threat to future societal stability. The article argues that Vischer’s findings should be seen through the lens of historical time. His observations led him to draw attention to the contemporaneous plight of previously highly mobile and self-reliant migrants across the world now living for an unknown duration within the confines of the barbed wire. Yet equally, the article makes the case for thinking in a transhistorical way about the (often under-appreciated) mutual inter-dependence of social knowledge and medical thinking, especially in times of large-scale displacement. The shadow of the past, it will be suggested, continues to shape approaches to the mental health problems faced by people living in atypical temporal and spatial settings today, including those experiencing the symptoms of Long Covid and those held in immigration detention.

Establishment of Vietnamese human induced pluripotent stem cell-derived Orexin-A neurons

Narcolepsy type 1 is a neurological disorder that severely affects sleep control due to a decrease in orexin neurons. Although research on neurological diseases, including narcolepsy, is vital for advancing science and improving human life, progress is hindered by the challenge of obtaining human brain samples as well as the difficulty in culturing neuronal cell lines. To overcome this obstacle, we generated Orexin-A neurons from human induced pluripotent stem cells (hiPSCs) by utilising a differentiation medium supplemented with N-acetyl-D-mannosamine (ManNAc) and Bone morphogenetic protein 4 (BMP4). The cells obtained from our study were characterised using immunofluorescence staining, real-time PCR, and competitive ELISA technique. The results show that our research successfully generated a hiPSC line with pluripotent stem cell characteristics. Furthermore, Orexin-A neurons derived from hiPSCs showed positive results for NCAM1 and TUBB3 markers, an increase in HCRT gene expression, and the capacity to secrete Orexin-A. These promising findings suggest that our hiPSC-derived Orexin-A neurons could serve as a foundation for cell-based disease modelling and further investigations into the underlying mechanisms of related neurological disorders.

System Design and Development of a Novel, Unique Neuro Physical Medical Treatment Method for Spinal Muscular Atrophy and Similar Neurological Muscle Diseases.

The project is entirely original to the author. It proposes the theory of a method under development aimed at treating SMA and other related neurological muscle disorders The study will utilize a 14-channel EEG device to analyze brain data. The brain signals recorded by this device will be transmitted to the patient's muscles, potentially restoring functions lost in SMA patients. These functions include coughing, swallowing, breathing, chewing, walking, and movements of the hands, arms, and other muscles. By using this EEG device, brain signals can be visualized as waves, and its specialized software allows users to manipulate objects on a computer screen with thought alone. The system also simulates facial movements and expressions on-screen

Evaluation on the therapeutic effect of AKT inhibitors in hemin-induced cortical neuron injury

Objective: This study aims to evaluate the therapeutic effect of Threonine Kinase 1 (AKT) inhibitors in haemorrhage-induced cortical neuron damage. Methods: Cultured cortical neurons were exposed to bleeding administration in vitro and AKT inhibitors was used, also. Subsequently, evaluation of the therapeutic effect was conducted using cell viability assays, apoptosis analysis, and all data were performed statistic analysis. Results: AKT inhibitors significantly alleviated haemorrhage-induced cortical neuron damage, indicated by increased cell survival and reduced cell apoptosis, confirming the positive effect of AKT inhibitors in neuronal protection. Conclusion: AKT inhibitors have a significant therapeutic effect on cortical neuron protection with blood stimulation, which may serve as a potential treatment strategy for related neurological disorders, under the haemorrhage condition.

Exploring the anti-amyloid potential of salvianolic acid A against the ALS-associated mutant SOD1: insights from molecular docking and molecular dynamic simulations

ABSTRACT A central feature of a variety of related neurological disorders, including amyotrophic lateral sclerosis (ALS), is the deposition of misfolded protein aggregates in key regions of the human brain. Hence, targeting aggregation-prone SOD1 with small molecules can be used to design strategies to inhibit its aggregation. Based on molecular docking and molecular dynamics (MD) simulation, this study suggested that plant flavonoids can act as a potent anti-amyloidogenic polyphenol against SOD1 aggregation. Initial screening of flavonoids against protein aggregates identified Rosmarinic acid and Salvianolic acid A as promising drug leads that can effectively inhibit pathogenic behaviour. Our results showed that Salvianolic acid A reduces the β-sheet content and increases the structural stability, hydrophobicity, flexibility, and significantly the lost hydrogen bonds of the mutant compared to other compounds. Besides, we revealed changes in the free energy landscape (FEL) of WT-SOD1 and mutant states (unbound/bound) to differentiate aggregation. We deduced that the above-mentioned flavonoids can deviation the pathogenic behaviour of the D124 V mutant. Among them, Salvianolic acid A showed the greatest therapeutic potential against the D124 V mutant. Hence, Salvianolic acid A could serve as a drug candidate for the design of highly efficient inhibitors in reducing fatal and irreversible ALS.

Absence of the Posterior Element of C1 and C2 Along With Mild Wedge Shape in Body of C3: Case Report

Due to the wide variety of cervical vertebral congenital anomalies, knowledge of their types and related clinical conditions can prove to be helpful for physicians and surgeons in the diagnosis and treatment of patients. The aim of this study is to report on a rare case of unstable cervical vertebral congenital anomaly in which the patient had a defect in the body of the C3 vertebra in addition to defects in the posterior arch of C1 and posterior element of C2. This type of anomaly has not been reported so far in the literature. To reduce the patient’s related neurological disorders, our treatment choice for this patient was occipitocervical fusion (OCF) surgery. At the 3-year postoperative follow-up, all sensory and motor problems related to this anomaly affecting the patient's upper and lower limbs and causing shoulder and neck pain were eliminated. In this rare type of anomaly, OCF surgery seems to be an effective choice in relieving the patient's neurological symptoms.

The influence of the prolactin/vasoinhibin axis on post-stroke lesion volume, astrogliosis, and survival.

Ischemic stroke is a significant global health issue, ranking fifth among all causes of death and a leading cause of serious long-term disability. Ischemic stroke leads to severe outcomes, including permanent brain damage and neuronal dysfunction. Therefore, decreasing and preventing neuronal injuries caused by stroke has been the focus of therapeutic research. In recent years, many studies have shown that fluctuations in hormonal levels influence the prognosis of ischemic stroke. Thus, it is relevant to understand the role of hormones in the pathophysiological mechanisms of ischemic stroke for preventing and treating this health issue. Here, we investigate the contribution of the prolactin/vasoinhibin axis, an endocrine system regulating blood vessel growth, immune processes, and neuronal survival, to the pathophysiology of ischemic stroke. Male mice with brain overexpression of prolactin or vasoinhibin by adeno-associated virus (AAV) intracerebroventricular injection or lacking the prolactin receptor (Prlr-/-) were exposed to transient middle cerebral artery occlusion (tMCAO) for 45 min followed by 48 h of reperfusion. Overexpression of vasoinhibin or the absence of the prolactin receptor led to an increased lesion volume and decreased survival rates in mice following tMCAO, whereas overexpression of prolactin had no effect. In addition, astrocytic distribution in the penumbra was altered, glial fibrillary acidic protein and S100b mRNA expressions were reduced, and interleukin-6 mRNA expression increased in the ischemic hemisphere of mice overexpressing vasoinhibin. Of note, prolactin receptor-null mice (Prlr-/-) showed a marked increase in serum vasoinhibin levels. Furthermore, vasoinhibin decreased astrocyte numbers in mixed hippocampal neuron-glia cultures. These observations suggest that increased vasoinhibin levels may hinder astrocytes' protective reactivity. Overall, this study suggests the involvement of the prolactin/vasoinhibin axis in the pathophysiology of ischemic stroke-induced brain injury and provides insights into the impact of its dysregulation on astrocyte reactivity and lesion size. Understanding these mechanisms could help develop therapeutic interventions in ischemic stroke and other related neurological disorders.

Focal brain cooling suppresses spreading depolarization and reduces endothelial nitric oxide synthase expression in rats

This study aimed to investigate the effects of focal brain cooling (FBC) on spreading depolarization (SD), which is associated with several neurological disorders. Although it has been studied from various aspects, no medication has been developed that can effectively control SD. As FBC can reduce neuronal damage and promote functional recovery in pathological conditions such as epilepsy, cerebral ischemia, and traumatic brain injury, it may also potentially suppress the onset and progression of SD. We created an experimental rat model of SD by administering 1 M potassium chloride (KCl) to the cortical surface. Changes in neuronal and vascular modalities were evaluated using multimodal recording, which simultaneously recorded brain temperature (BrT), wide range electrocorticogram, and two-dimensional cerebral blood flow. The rats were divided into two groups (cooling [CL] and non-cooling [NC]). Warm or cold saline was perfused on the surface of one hemisphere to maintain BrT at 37°C or 15°C in the NC and CL groups, respectively. Western blot analysis was performed to determine the effects of FBC on endothelial nitric oxide synthase (eNOS) expression. In the NC group, KCl administration triggered repetitive SDs (mean frequency = 11.57/h). In the CL group, FBC increased the duration of all KCl-induced events and gradually reduced their frequency. Additionally, eNOS expression decreased in the cooled brain regions compared to the non-cooled contralateral hemisphere. The results obtained by multimodal recording suggest that FBC suppresses SD and decreases eNOS expression. This study may contribute to developing new treatments for SD and related neurological disorders.

Color Vision as a Biological and Prognostic Marker in Ophthalmology, Along with Related Neurological Disorders

Color Vision resulted to be a useful biological marker asserting the course and developing the most part of neurological disorders. The analysis of the impairment pathway of color vision from V1, brain primary visive area, to V4, brain color vision area allows us to better understand the impar brain pathways implied in different neurological disorders.

Review of Phenotypic Heterogeneity of Neuronal Intranuclear Inclusion Disease and NOTCH2NLC-Related GGC Repeat Expansion Disorders.

Neuronal intranuclear inclusion disease (NIID) is an underdiagnosed neurodegenerative disorder caused by pathogenic GGC expansions in NOTCH2NLC. However, an increasing number of reports of NOTCH2NLC GGC expansions in patients with Alzheimer disease, essential tremor, Parkinson disease, amyotrophic lateral sclerosis, and oculopharyngodistal myopathy have led to the proposal of a new concept known as NOTCH2NLC-related GGC repeat expansion disorders (NREDs). The majority of studies have mainly focused on screening for NOTCH2NLC GGC repeat variation in populations previously diagnosed with the associated disease, subsequently presenting it as a novel causative gene for the condition. These studies appear to be clinically relevant but do have their limitations because they may incorrectly regard the lack of MRI abnormalities as an exclusion criterion for NIID or overlook concomitant clinical presentations not typically observed in the associated diseases. Besides, in many instances within these reports, patients lack pathologic evidence or undergo long-term follow-up to conclusively rule out NIID. In this review, we will systematically review the research on NOTCH2NLC 5' untranslated region GGC repeat expansions and their association with related neurologic disorders, explaining the limitations of the relevant reports. Furthermore, we will integrate subsequent studies to further demonstrate that these patients actually experienced distinct clinical phenotypes of NIID.

Identifying eleven new ferroptosis inhibitors as neuroprotective agents from FDA-approved drugs

With increasing evidence that ferroptosis is associated with diverse neurological disorders, targeting ferroptosis offers a promising avenue for developing effective pharmaceutical agents for neuroprotection. In this study, we identified ferroptosis inhibitors as neuroprotective agents from US Food and Drug Administration (FDA)-approved drugs. 1176 drugs have been screened against erastin-induced ferroptosis in HT22 cells, resulting in 89 ferroptosis inhibitors. Among them, 26 drugs showed significant activity with EC50 below10 μM. The most active ferroptosis inhibitor is lumateperone tosylate at nanomolar level. 11 drugs as ferroptosis inhibitors were not reported previously. Further mechanistic studies revealed that their mechanisms of actions involve free radical scavenging, Fe2+ chelation, and 15-lipoxygenase inhibition. Notably, the active properties of some drugs were firstly revealed here. These ferroptosis inhibitors increase the chemical diversity of ferroptosis inhibitors, and offer new therapeutic possibilities for the treatments of related neurological diseases.

Quantum mayfly optimization based feature subset selection with hybrid CNN for biomedical Parkinson’s disease diagnosis

Parkinson's disease (PD) arises from brain cell damage and necessitates early detection for effective treatment and symptom management. While various methods such as voice, speech, and written exams have been explored, utilizing automated tools is crucial to enhance accuracy. Recent advancements in artificial intelligence (AI) and deep learning (DL) provide an opportunity for precise early-stage PD identification. This study introduces a novel approach known as Quantum Mayfly Optimization-based feature subset selection with hybrid convolutional neural network (QMFOFS-HCNN) to improve PD detection and classification. QMFOFS-HCNN is designed to identify optimal feature subsets and overcome the dimensionality challenge. It combines a quantum mayfly optimization approach for feature selection with a convolutional neural network with attention-based long short-term memory for PD detection and classification. Additionally, hyperparameter selection is optimized using the Nadam optimizer. Experimental validation using benchmark datasets yielded compelling results. The QMFOFS-HCNN technique achieved accuracy rates: 96.35% for HandPD Spiral, 96.7% for HandPD Meander, 98.5% for Speech PD, and a perfect 100% for Voice PD datasets. These quantitative findings underscore the potential of AI and DL to enhance early PD detection accuracy significantly. These results offer promising prospects for improving healthcare outcomes in managing PD and related neurological disorders.