Sensory Dysfunction Research Articles

Targeted Therapy of Spinal Cord Injury: Inhibition of Apoptosis Is a Promising Therapeutic Strategy.

Spinal cord injury (SCI) is a serious disabling central nervous system injury that can lead to motor, sensory, and autonomic dysfunction below the injury level. SCI can be divided into primary injury and secondary injury according to pathological process. Primary injury is mostly irreversible, while secondary injury is a dynamic regulatory process. Apoptosis is an important pathological event of secondary injury and has a significant effect on the recovery of nerve function after SCI. Nerve cell death can further aggravate the microenvironment of the injured site, leading to neurological dysfunction and thus affect the clinical outcome of patients. Therefore, apoptosis plays a crucial role in the pathological progression of secondary SCI, while inhibiting apoptosis may be a promising therapeutic strategy for SCI. This review will summarize and explore the factors that lead to cell death after SCI, the influence of cross talk between signaling pathways and pathways involved in apoptosis and discuss the influence of apoptosis on SCI, and the therapeutic significance of targeting apoptosis on SCI. This review helps us to understand the role of apoptosis in secondary SCI and provides a theoretical basis for the treatment of SCI based on apoptosis.

Acute spinal cord injury in Africa: exploring the long-term outcomes and future directions of acute spinal cord injury – short communication

Acute spinal cord injury (ASCI), a key factor behind serious sensory, motor, and autonomic dysfunctions, holds on as a fundamental cause of morbidity, psychological disturbances, and high socioeconomic burden. This study sheds light, particularly on the African countries where it is found that traumatic ASCI, mainly due to road traffic accidents, remains the leading cause, with 130 cases per million in this part of the world. Moreover, limited resources, with the lack of funds and equipment, as well as widespread poverty, restrict the availability of suitable diagnostic, management, and treatment options. The weight of the evidence suggests that there is an ultimate need for well-developed infrastructure embracing a multidisciplinary approach to rehabilitation in Africa. Furthermore, international collaborations, posing a significantly wide background for evidence-based information and resources, are indispensable for ASCI prospects and future studies among the African population. The purpose of this study is to fill a part of the persistent gap in the research era regarding the ASCI in Africa and direct future research toward investigating its different aspects as well as exploring its interventional needs.

Restoration of Over-Ground Walking via Non-Invasive Neuromodulation Therapy: A Single-Case Study

Spinal cord injuries (SCI) can result in sensory and motor dysfunctions, which were long considered permanent. Recent advancement in electrical neuromodulation has been proven to restore sensorimotor function in people with SCI. These stimulation protocols, however, were mostly invasive, expensive, and difficult to implement. In this study, transcutaneous electrical stimulation (tES) was used to restore over-ground walking of an individual with 21 years of chronic paralysis from a cervical SCI. After a total of 66 weeks of rehabilitation training with tES, which included standing, functional reaching, reclined sit-up, treadmill walking, and active biking, significant improvement in lower-limb volitional movements and overall light touch sensation were shown as measured by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) score. By the end of the study, the participant could walk in a 4-m walking test with the aid of a walking frame and ankle–foot orthoses. The successful sensorimotor recovery of our study participant sheds light on the future of non-invasive neuromodulation treatment for SCI paralysis.

Tauroursodeoxycholic Acid Inhibited Apoptosis and Oxidative Stress in H2O2-Induced BMSC Death via Modulating the Nrf-2 Signaling Pathway: the Therapeutic Implications in a Rat Model of Spinal Cord Injury

Spinal cord injury (SCI) is a prevalent and significant injury to the central nervous system, resulting in severe consequences. This injury is characterized by motor, sensory, and excretory dysfunctions below the affected spinal segment. Transplantation of bone marrow mesenchymal stem cells (BMSCs) has emerged as a potential treatment for SCI. However, the low survival as well as the differentiation rates of BMSCs within the spinal cord microenvironment significantly limit their therapeutic efficiency. Tauroursodeoxycholic acid (TUDCA), an active ingredient found in bear bile, has demonstrated its neuroprotective, antioxidant, and antiapoptotic effects on SCI. Thus, the present study was aimed to study the possible benefits of combining TUDCA with BMSC transplantation using an animal model of SCI. The results showed that TUDCA significantly enhanced BMSC viability and reduced apoptosis (assessed by Annexin V-FITC, TUNEL, Bax, Bcl-2, and Caspase-3) as well as oxidative stress (assessed by ROS, GSH, SOD, and MDA) both in vitro and in vivo. Additionally, TUDCA accelerated tissue regeneration (assessed by HE, Nissl, MAP2, MBP, TUJ1, and GFAP) and improved functional recovery (assessed by BBB score) following BMSC transplantation in SCI. These effects were mediated via the Nrf-2 signaling pathway, as evidenced by the upregulation of Nrf-2, NQO-1, and HO-1 expression levels. Overall, these results indicate that TUDCA could serve as a valuable adjunct to BMSC transplantation therapy for SCI, potentially enhancing its therapeutic efficacy.

Spinal Cord Injury Repair Using Flash Graphene Based Treatments: A Literature Review

Introduction: Spinal cord injury is a prominent neurological complication and is characterized by motor, sensory and autonomic dysfunction. It can cause paralysis depending on the area that is affected within the spinal cord. There have been many attempts to mitigate this condition and regeneration of neurons is one of the leading cures. Graphene is a carbon compound that is made from graphite. This unique one-atom layer is a versatile substance with potential uses in electronics due to its flexibility, conductance properties, and transparency. In the past, the creation of graphene was very expensive but now with the new technology of flash graphene, a method where carbon compounds are zapped into graphene flakes through flash heating, graphene is an accessible material for scaffolds to renew neurogenesis within spinal cord injury patients. Methods: A literature search was conducted using predetermined inclusion criteria and resulted in multiple primary research papers that presented research on graphene as a potential scaffolding agent for spinal cord injury. Results: Graphene based interfaces used within spinal cord injury have shown an increase in cell viability and neuron regeneration. These graphene interfaces do not create a disturbance in the electrical conductances that occur within the neuronal network. Graphene woven technology can also detect subtle muscle, which allows for quantifiable regeneration data. Discussion: With the creation of graphene, the carbon becomes fixed in a solid state and can be used as a conductor within electronics. Graphene usage within the body is not considered toxic as long as it is used within measured concentrations. This technology can be used to significantly impact how patients with spinal cord injury recover, potentially regaining use of their previously paralyzed limbs through neuron regeneration on graphene interfaces such as scaffolds or nanoplatelets.

Characteristics of Sensory Neuron Dysfunction in Amyotrophic Lateral Sclerosis (ALS): Potential for ALS Therapy.

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder characterised by the progressive degeneration of motor neurons, resulting in muscle weakness, paralysis, and, ultimately, death. Presently, no effective treatment for ALS has been established. Although motor neuron dysfunction is a hallmark of ALS, emerging evidence suggests that sensory neurons are also involved in the disease. In clinical research, 30% of patients with ALS had sensory symptoms and abnormal sensory nerve conduction studies in the lower extremities. Peroneal nerve biopsies show histological abnormalities in 90% of the patients. Preclinical research has reported several genetic abnormalities in the sensory neurons of animal models of ALS, as well as in motor neurons. Furthermore, the aggregation of misfolded proteins like TAR DNA-binding protein 43 has been reported in sensory neurons. This review aims to provide a comprehensive description of ALS-related sensory neuron dysfunction, focusing on its clinical changes and underlying mechanisms. Sensory neuron abnormalities in ALS are not limited to somatosensory issues; proprioceptive sensory neurons, such as MesV and DRG neurons, have been reported to form networks with motor neurons and may be involved in motor control. Despite receiving limited attention, sensory neuron abnormalities in ALS hold potential for new therapies targeting proprioceptive sensory neurons.

Sensory Integration Approaches for Children and Youth in Occupational Therapy Practice.

This AOTA Position Statement describes the role of occupational therapy practitioners in providing services to children and youth with a variety of sensory processing patterns and sensory integrative dysfunction. It also serves as a resource for policymakers, funding and reimbursement sources, and caregivers.

Clinical reading-related oculomotor assessment in visual snow syndrome

PurposeVisual snow syndrome (VSS) is a complex neurological condition presenting with an array of sensory, motor, and perceptual dysfunctions and related visual and non-visual symptoms. Recent laboratory studies have found subtle, basic, saccadic-based abnormalities in this population. The objective of the present investigation was to determine if saccadic-related problems could be confirmed and extended using three common clinical reading-related eye movement tests having well-developed protocols and normative databases. MethodsThis was a retrospective analysis of 32 patients (ages 16–56 years) diagnosed with VSS in the first author's optometric practice. There was a battery of three reading-related tests: the Visagraph Reading Eye Movement Test, the Developmental Eye Movement (DEM) Test, and the RightEye Dynamic Vision Assessment Test, all performed using their standard documented protocols and large normative databases. ResultsA high frequency of oculomotor deficits was found with all three tests. The greatest percentage was revealed with the Visagraph (56%) and the least with the RightEye (23%). A total of 77% of patients failed at least one of the three tests. ConclusionThe present findings confirm and extend earlier investigations revealing a high frequency of saccadic-based oculomotor problems in the VSS population, now including reading-related tasks. This is consistent with the more general oculomotor/motor problems found in these individuals.

Investigating Diabetic Foot Pathophysiology and Amputation Prevention Strategies through Behavioral Modification

Diabetic foot complications stem from intricate interactions between macrovascular and microvascular changes, neuropathy, inflammation, immune responses, hyperglycemia, oxidative stress, and infection susceptibility. Macrovascular factors like atherosclerosis lead to tissue ischemia, while microvascular dysfunction worsens perfusion deficits. Neuropathy contributes significantly to such complications, causing sensory loss, motor problems, and autonomic dysfunction. This results in unnoticed injuries, muscle atrophy, deformities, and dry skin, elevating the risk of non-healing wounds and infections. Inflammation and immune responses amplify tissue damage and hinder healing. Chronic hyperglycemia generates advanced glycation end products, stiffening tissues, while oxidative stress exacerbates damage. Mitochondrial dysfunction further compromises cellular energy production, worsening tissue repair challenges. These multifaceted factors collectively contribute to diabetic foot complications. The impact of modifiable behavior factors such as smoking, heavy alcohol consumption, and exercise on the risk of lower extremity amputation (LEA) in diabetic patients is also not to be ignored. Substantial data had identified increased LEA risk from smoking and heavy alcohol intake and reduced risk from regular exercise. The cumulative impact of these behaviors underscores the significance of behavior modification in preventing LEA and enhancing the well-being of diabetic patients. Understanding these mechanisms is vital for developing effective preventive strategies, diagnostics, and treatments, addressing the impact of diabetic foot complications on individuals and healthcare systems.

Sensory Processing Differences in Individuals With Autism Spectrum Disorder: A Narrative Review of Underlying Mechanisms and Sensory-Based Interventions.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with social interaction and restricted, repetitive patterns of behavior. Altered sensory processing and perception are consideredcharacteristics of ASD. Sensory processing differences (SPDs) are commonly observed in individuals with ASD, leading to atypical responses to sensory stimuli.SPDs refer to the way in which individuals receive, process, and respond to sensory information from the environment. People with SPDs may be hypersensitive (over-reactive) or hyposensitive (under-reactive) to sensory input, or they may experience fragmented or distorted perceptions. These differences can make it difficult for individuals with SPDs to filter out irrelevant sensory information, and to integrate sensory information from different sources. This study intends to investigate the underlying mechanisms contributing to SPDs in individuals with autism and determine the effectiveness of sensory-based therapies in addressing these challenges. The literature suggests that altered neural pathways, sensory gating dysfunction, and atypical sensory modulation contribute to SPDs in individuals with ASD. Assistive technology, environmental changes, and sensory-based interventions like sensory integration therapy (SIT) have all shown promise in improving sensory functioning and reducing associated behavioral issues. However, further research is needed to improve our understanding of sensory processing in autism and to optimize interventions for individuals with ASD.

The causes, diagnostics, and treatment of psychogenic blindness – a systematic review

Introduction: Conversion disorders are characterized by the presence of motor or sensory dysfunction, resulting in significant discomfort or disability, the occurrence of which is not justified by any somatic disease. Psychogenic blindness, a specific manifestation of conversion disorders, refers to the loss or impairment of vision that cannot be attributed to any organic abnormalities in the eyes or visual system. The exact mechanisms underlying psychogenic blindness are not fully understood, but it is believed to involve complex interactions between the brain, visual pathways, and psychological processes. This systematic review aims to summarize reported cases of blindness in conversion disorders. Material and methods: A comprehensive search of the MEDLINE and Embase databases identified 13 relevant articles reporting a total of 17 patients with psychogenic blindness. Results: The risk and triggering factors for psychogenic blindness included acute stress (for example acute physical injury), chronic stressful situations (such as chronic health problems, disruptions in family relationships), and multiple factors including coexisting psychiatric conditions (like anxiety or other conversion disorders). The course of blindness varied among patients, with duration ranging from hours to years. Diagnostic methods involved thorough ophthalmic and neurological examinations, brain imaging, and psychiatric evaluations. Conclusions: This review provides valuable insights into managing patients with psychogenic blindness. The findings highlight the need for a multidisciplinary approach involving ophthalmologists, neurologists, and mental health specialists. Further research is required to elucidate the underlying mechanisms and develop effective treatment strategies for individuals with psychogenic blindness. Keywords: psychogenic blindness, conversion disorders, causes

A sensory signature of unaffected biological parents predicts the risk of autism in their offspring.

Despite the emphasis on sensory dysfunction phenotypes in the revised diagnostic criteria for autism spectrum disorder (ASD), there has been limited research, particularly in the field of neurobiology, investigating the concordance in sensory features between individuals with ASD and their genetic relatives. Therefore, our objective was to examine whether neurobehavioral sensory patterns could serve as endophenotypic markers for ASD. We combined questionnaire- and lab-based sensory evaluations with sensory fMRI measures to examine the patterns of sensory responsivity in 30 clinically diagnosed with ASD, 26 matched controls (CON), and 48 biological parents for both groups (27 parents of individuals with ASD [P-ASD] and 21 for individuals with CON [P-CON]). The ASD and P-ASD groups had higher sensory responsivity and rated sensory stimuli as more unpleasant than the CON and P-CON groups, respectively. They also exhibited greater hemodynamic responses within the sensory cortices. Overlapping activations were observed within these sensory cortices in the ASD and P-ASD groups. Using a machine learning approach with robust prediction models across cohorts, we demonstrated that the sensory profile of biological parents accurately predicted the likelihood of their offspring having ASD, achieving a prediction accuracy of 71.4%. These findings provide support for the hereditary basis of sensory alterations in ASD and suggest a potential avenue to improve ASD diagnosis by utilizing the sensory signature of biological parents, especially in families with a high risk of ASD. This approach holds promising prospects for early detection, even before the birth of the offspring.

Resveratrol can improve spinal cord injury by activating Nrf2/HO-1 signaling pathway

Spinal cord injury (SCI) often induces severe sensory and motor dysfunction. Oxidative stress is an important pathophysiological process of secondary SCI, and its inhibition could facilitate the alleviation of the injury. Resveratrol is a natural plant polyphenol compound that has significant antioxidant and anti-inflammatory effects. It can inhibit oxidative stress by activating the Nrf2/HO-1 signal pathway. In this report, we analyze the antioxidant effect of resveratrol in SCI, clarify the specific mechanism of action and provide a theoretical basis for the clinical employment of resveratrol for SCI.

7 T MRI of the Cervical Neuroforamen: Assessment of Nerve Root Compression and Dorsal Root Ganglia in Patients With Radiculopathy.

The aim of this study was to assess the diagnostic value of 3-dimensional dual-echo steady-state (DESS) magnetic resonance imaging (MRI) of the cervical spine at 7 T compared with 3 T in patients with cervical radiculopathy. Patients diagnosed with cervical radiculopathy were prospectively recruited between March 2020 and January 2023 before undergoing surgical decompression and received 3-dimensional DESS imaging at 3 T and 7 T MRI. Cervical nerve root compression and the dimensions of the dorsal root ganglia were assessed by 2 radiologists independently. Signal intensity, visibility of nerve anatomy, diagnostic confidence, and image artifacts were evaluated with Likert scales. The degree of neuroforaminal stenosis was assessed on standard clinical 3 T scans. Statistics included the analysis of the diagnostic accuracy and interreader reliability. The Wilcoxon signed rank test was used to assess differences between the groups. Forty-eight patients (mean age, 57 ± 12 years; 22 women) were included in the study with the highest prevalence of severe neuroforaminal stenosis observed at C6 (n = 68) followed by C7 (n = 43). Direct evaluation of nerve root compression showed significantly higher diagnostic confidence and visibility of cervical nerve rootlets, roots, and dorsal root ganglia on 7 T DESS than on 3 T DESS (diagnostic confidence: P = 0.01, visibility: P < 0.01). Assessment of nerve root compression using 7 T DESS allowed more sensitive grading than standard clinical MRI ( P < 0.01) and improved the performance in predicting sensory or motor dysfunction (area under the curve combined: 0.87). 7 T DESS imaging allows direct assessment of cervical nerve root compression in patients with radiculopathy, with a better prediction of sensory or motor dysfunction than standard clinical MRI. Diagnostic confidence and image quality of 7 T DESS were superior to 3 T DESS.

Vincristine‑induced peripheral neuropathy in children with acute lymphoblastic leukemia: Clinical and instrumental characteristics, search for new solutions

Objective. To evaluate clinical and electroneuromyographic characteristics of vincristine polyneuropathy in children with acute lymphoblastic leukemia.Materials and methods. A single-centre prospective cohort study involved 106 children with acute lymphoblastic leukemia, aged 3 to 17 years, with vincristine polyneuropathy; clinical and electroneuromyographic data were analyzed.Results. In the majority of cases, 84.9 % (n = 90) of patients, vincristine polyneuropathy debuted during the induction phase of chemotherapy. The clinical picture was dominated by combined neurological disorders in 67.9 % (n = 72) cases, with sensory and motor disorders dominating. Sensory dysfunction was manifested predominantly by pain in the lower extremities, changes in the motor sphere were characterized by the development of distal paresis of the lower extremities. In 66.0 % (n = 70) of patients, neurological disorders corresponded to the 2nd degree of severity according to the toxicity scale (NCI-STAE). According to the ENMG study, all children had motor axonal neuropathy of the peroneal nerves.Conclusions. The results of the study showed that the clinical picture of vincristine polyneuropathy is accompanied by sensory and motor symptoms. Currently, a complex of clinical and instrumental methods is used to verify the neurotoxic complication. The main objective method of diagnosis is an electroneuromyographic study. However, its capabilities are limited for determining the clinical manifestations associated with sensory disorders.

A retrospective study of cerebellopontine angle tumours: A single instituitional study

: Cerebellopontine angle (CPA) tumors are rare intracranial neoplasms that arise in the region between the cerebellum and the pons. These tumors can be challenging to treat due to their complex anatomy and proximity to critical neurovascular structures. Surgical intervention is often necessary to achieve a favorable outcome. The primary objectives of this retrospective study are to analyze the clinical and radiological characteristics of cerebellopontine angle tumors, identify pathological types, assess surgical resectability, and evaluate postoperative outcomes.: The study enrolled 14 patients who underwent surgical intervention for cerebellopontine angle tumors at Armed forces medical college, Pune. A retrospective analysis was performed, considering demographic data, clinical presentations, imaging characteristics and surgical outcomes.: Vestibular schwannoma was the predominant tumor type with majority of tumors manifesting between third to fifth decades. Clinical manifestation included SNHL, cerebellar dysfunction, headache and sensory trigeminal dysfunction. A substantial proportion (86%) presented with no useful hearing preoperatively. Surgical outcomes indicated varying degrees of success, with total resection achieved in a subset of cases. Notably, anatomical preservation of the facial nerve was accomplished in a significant proportion of patients. Postoperative assessments, using the House Brackmann system, revealed positive facial nerve function outcomes in a substantial percentage. Complications included cerebrospinal fluid leak (14%), meningitis(7%) and lower cranial nerve paresis (7%). : In conclusion, surgical intervention plays a crucial role in the management of cerebellopontine tumors. The choice of surgical approach should be individualized based on tumor characteristics and patient factors, with the goal of achieving maximum tumor resection while minimizing complications. Further research and advancements in surgical techniques are needed to optimize outcomes for patients with cerebellopontine tumors.

A Mitochondrial Nanoguard Modulates Redox Homeostasis and Bioenergy Metabolism in Diabetic Peripheral Neuropathy.

As a major late complication of diabetes, diabetic peripheral neuropathy (DPN) is the primary reason for amputation. Nevertheless, there are no wonder drugs available. Regulating dysfunctional mitochondria is a key therapeutic target for DPN. Resveratrol (RSV) is widely proven to guard mitochondria, yet the unsatisfactory bioavailability restricts its clinical application. Tetrahedral framework nucleic acids (tFNAs) are promising carriers due to their excellent cell entrance efficiency, biological safety, and structure editability. Here, RSV was intercalated into tFNAs to form the tFNAs-RSV complexes. tFNAs-RSV achieved enhanced stability, bioavailability, and biocompatibility compared with tFNAs and RSV alone. With its treatment, reactive oxygen species (ROS) production was minimized and reductases were activated in an in vitro model of DPN. Besides, respiratory function and adenosine triphosphate (ATP) production were enhanced. tFNAs-RSV also exhibited favorable therapeutic effects on sensory dysfunction, neurovascular deterioration, demyelination, and neuroapoptosis in DPN mice. Metabolomics analysis revealed that redox regulation and energy metabolism were two principal mechanisms that were impacted during the process. Comprehensive inspections indicated that tFNAs-RSV inhibited nitrosation and oxidation and activated reductase and respiratory chain. In sum, tFNAs-RSV served as a mitochondrial nanoguard (mito-guard), representing a viable drilling target for clinical drug development of DPN.

Different levels of physical activity and postural balance in women with multiple sclerosis

BACKGROUND:Multiple Sclerosis (MS) presents some clinical manifestations that may indicate motor, sensory and cognitive dysfunctions. Motor dysfunctions in MS are related to balance impairment, muscle weakness, gait, and fatigue and can lead to a significant decrease in quality of life. Postural balance is crucial for daily life activities and can be assessed by posturography. AIM:The primary objective was to evaluate the influence of different levels of habitual physical activity (PA) on postural balance in women with MS. Additionally, we included an evaluation of walking, mobility, fatigue, and quality of life. METHOD:This is a cross-sectional study with 25 women with MS. Habitual PA was measured using the Baecke-Questionnaire, separated into low-level (LL) and high-level (HL) PA. Posturography was used to evaluate postural balance and obtain displacement of the center of pressure (CoP-speed, CoP-area). We evaluated gait spatiotemporal-parameters (GAITRite), walking performance (6MWT), functional mobility (TUG), fatigue (FSS, MFIS), and quality-of-life (FAMS). RESULTS:The difference in CoP-speed and CoP-area was significant (p&lt;0.05) with LL group presented greater values than the HL group. We found a medium effect size CoP-speed (Cohen’s d=0.6) and higher CoP-area (Cohen’s d=1.1). No significant differences with the other variables were found. CONCLUSION:The results showed that the group with a LL PA presented worse postural balance compared to the group HL. Although level of PA and balance seem to be related, the results of this cross-sectional study could not confirm a causal inference. It is important to develop different strategies to increase PA levels and posture balance in women with MS.

Psychometric Properties of the Italian Version of the Toileting Habit Profile Questionnaire-Revised (THPQ-R) in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) often seem not to feel the need to go to the bathroom in whatever context they are in and may suffer from hypo-responsiveness. Recent studies show a correlation between sensory problems, constipation, and fecal incontinence in children. This requires an assessment tool to identify evacuation issues in children with sensory dysfunction. Therefore, the purpose of this study is to validate the Italian version of The Toileting Habit Profile Questionnaire-Revised (THPQ-R) in children with ASD. The inclusion criteria were a confirmed diagnosis of ASD and an age between 3 and 8 years old. The Toileting Habit Profile Questionnaire Revised (THPQ-R) was recently validated in the Italian language on a healthy population. The Italian version has 17 items with two alternative response options, frequently/always or never/rarely, based on how often the behavior occurs. The THPQ-R questionnaire is easy to administer, interpret, and manage. For concurrent validity, we used the Italian version of the Sensory Processing Measure and Sensory Processing Measure-Preschool. For the THPQ-R validation, 43 participants were recruited. The internal consistency, reporting an α value of 0.763, showed that the THPQ-R was a very reliable scale. The THPQ-R appears to be correlated only with the domains "Social Participation T-point", "Hearing T-point", and "Planning and Ideas T-point". However, these correlations are not statistically significant. Conclusion: The THPQ-R highlights positive results regarding validity and reliability and shows a positive correlation between defecation disorders and social participation.

Unraveling Functional Dysphagia: A Game-Changing Automated Machine-Learning Diagnostic Approach

(1) Background: Dysphagia affects around 16% of the US population. Diagnostic tests like X-ray barium swallow and endoscopy are used initially to diagnose the cause of dysphagia, followed by high-resolution esophageal manometry (HRM). If the above tests are normal, the patient is classified as functional dysphagia (FD), suggesting esophageal sensory dysfunction. HRM records only the contraction phase of peristalsis, not the distension phase. We investigated the utilization of esophageal distension–contraction patterns for the automatic classification of FD, using artificial intelligent shallow learners. (2) Methods: Studies were performed in 30 healthy subjects and 30 patients with FD. Custom-built software (Dplots 1.0) was used to extract relevant esophageal distension–contraction features. Next, we used multiple shallow learners, namely support vector machines, random forest, K-nearest neighbors, and logistic regression, to determine which had the best performance in terms of accuracy, precision, and recall. (3) Results: In the proximal segment, LR produced the best results, with accuracy of 91.7% and precision of 92.86%, using only distension features. In the distal segment, random forest produced accuracy of 90.5% and precision of 91.1% using both pressure and distension features. (4) Conclusions: Findings emphasize the crucial role of abnormality in the distension phase of peristalsis in FD patients.