European Neurology最新文献

{"title":"Association of Pesticide Exposure with Cognitive Function in Farmers.","authors":"Ismail Setyopranoto, Abdul Gofir, Laxmiprita Pusparani Rahardjo, Andre Stefanus Panggabean, Ery Kus Dwianingsih, Indarwati Setyaningsih, Cempaka Thursina Srie Setyaningrum, Sri Sutarni, Rusdy Ghazali Malueka","doi":"10.1159/000530899","DOIUrl":"10.1159/000530899","url":null,"abstract":"<p><strong>Introduction: </strong>Organophosphate and carbamate are two types of pesticides that can induce cholinesterase suppression in humans. These lead to poisoning symptoms including muscle paralysis and respiratory depression in acute settings. In chronic settings, the mechanism of organophosphate and carbamate poisoning is still openly discussed. Accordingly, this study aimed to identify any correlations between erythrocyte cholinesterase and type of pesticides with cognitive performance of the subjects.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in two sampling periods (July 2017 and October 2018) in Ngablak Districts, Magelang Regency, Central Java, Indonesia. The study subjects were farmers with history of pesticide exposure. Cholinesterase levels (ChE) were analyzed from blood samples. Cognitive performance was assessed using the Mini Mental State Examination (MMSE) and Stroop Test.</p><p><strong>Results: </strong>In total, 151 subjects aged between 23 and 91 years old were included. The long-term organophosphate exposure group had significantly lower MMSE scores compared with other types of pesticides, but not in carbamate (p = 0.017). After comparing \"organophosphate only\" and \"carbamate only\" groups, there were significant differences in MMSE scores (p = 0.018) but not in blood ChE levels (p = 0.286). Detailed assessment in MMSE domains showed significantly lower scores for orientation, attention, and registration domains (p &lt; 0.05) in the organophosphate group. There were no significant associations between types of pesticides and blood ChE levels with the Stroop Test results (p &gt; 0.05).</p><p><strong>Conclusions: </strong>Long-term organophosphate exposure could produce lower cognitive function and the insignificant association between blood ChE levels to MMSE could lead to non-cholinergic pathways as its underlying pathology.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"305-314"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9688589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Acute Transverse Myelitis following COVID-19 Infection: A Review on the Potential Pathways.","authors":"Majid Reza Farrokhi,&nbsp;Farideh Iravanpour,&nbsp;Negar Nejabat","doi":"10.1159/000529927","DOIUrl":"https://doi.org/10.1159/000529927","url":null,"abstract":"<p><strong>Background: </strong>Acute transverse myelitis (ATM) is a rare neurological disorder in adults characterized by localized inflammation of gray and white matter in one or more contiguous spinal cord segments in the absence of a compressive injury. Several reports have connected the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to the pathophysiology of ATM.</p><p><strong>Summary: </strong>Direct invasion of the spinal cord, cytokine storm, or an autoimmune response are the possible pathways by which the SARS-CoV-2 virus can affect the spinal cord and lead to ATM. Direct invasion is facilitated by the presence of angiotensin-converting enzyme 2 (ACE2) receptors on the membranes of the spinal cord neurons. Cytokine storm syndrome could be derived from elevated levels of several immunological factors following severe involvement with coronavirus disease 2019 (COVID-19). Finally, autoimmune responses can cause post-infectious ATM through several hypothesized processes, including molecular mimicry, epitope spreading, bystander activation, and polyclonal B-cell activation.</p><p><strong>Key messages: </strong>COVID-19-induced ATM is mostly a longitudinally-extensive ATM (LEATM), in which more spinal cord segments are damaged, which results in a worse sequel compared to short-segment ATM. Therefore, it is suggested that COVID-19 patients, particularly severe cases, be followed up for a probable incidence of ATM, even long after recovery from the disease and elimination of the virus from the host, because an early diagnosis and effective therapy may stop the spread of inflammation to adjacent segments.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"209-216"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9788872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minor Salivary Gland Biopsy for the Diagnosis of Neurosarcoidosis.","authors":"Nicolas Fournier,&nbsp;Yvan Jamilloux,&nbsp;Mathieu Gerfaud-Valentin,&nbsp;Nathalie Streichenberger,&nbsp;Sandra Vukusic,&nbsp;Romain Marignier,&nbsp;Géraldine Androdias,&nbsp;Pascal Seve","doi":"10.1159/000529920","DOIUrl":"https://doi.org/10.1159/000529920","url":null,"abstract":"<p><strong>Introduction: </strong>The definite diagnosis of neurosarcoidosis is challenging since it requires a compatible histology of the nervous system. When neurosarcoidosis is suspected, other systemic manifestations are investigated to confirm the diagnosis. A minor salivary gland biopsy (MSGB) is often performed since it is minimally invasive. The objective of the present study was to assess its performance for the diagnosis of neurosarcoidosis.</p><p><strong>Methods: </strong>A retrospective single-center study included patients who underwent a MSGB in a tertiary neurological university hospital (Lyon, France) between 2015 and 2018. Clinical presentations unlikely to be compatible with neurosarcoidosis were excluded. Positive cases of neurosarcoidosis were defined as definite, probable, and possible cases, according to the latest international neurosarcoidosis diagnostic criteria from the Neurosarcoidosis Consortium Consensus Group.</p><p><strong>Results: </strong>A total of 529 patients underwent a MSGB for clinical manifestations compatible with neurosarcoidosis. Among the 13 who fulfilled the criteria for neurosarcoidosis, only one had a positive MSGB. The sensitivity of MSGB was 7.7% (95% CI [0.2-36.0%]) and the specificity was 100.0% (95% CI [99.3-100%]).</p><p><strong>Conclusion: </strong>Considering the low sensitivity of MSGB for the diagnosis of NS, MSGB should be performed in selected indications, including a suspicion of spinal cord sarcoidosis, or when there is a strong clinical, laboratory, and radiological suspicion of NS. MSGB should rather not be performed when the chest CT-scan does not show signs of pulmonary or lymph node sarcoidosis.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"171-177"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9790800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Berlin Bowel Bothers: Might Adolf Hitler's Gut Problems Have Been Parkinson-Related?","authors":"Milan Beckers, Peter J Koehler, Geert J A Wanten, Bastiaan R Bloem","doi":"10.1159/000530166","DOIUrl":"10.1159/000530166","url":null,"abstract":"<p><p>It has been argued that Adolf Hitler (1889-1945) had Parkinson's disease. He also experienced several gastrointestinal symptoms, for which various explanations have been sought, both contemporaneously and by later authors. In this Historical Note, a possible relationship between Hitler's Parkinson's disease and his gastrointestinal symptoms is explored. Specifically, we posit the hypothesis that Hitler may have suffered from small-intestinal bacterial overgrowth (SIBO), thus providing an early example of SIBO occurring as a prodromal Parkinson's disease symptom.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"222-227"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Respiratory Function and Motor Function in Different Stages of Parkinson's Disease.","authors":"Chong Xi,&nbsp;Xiao-Chen Bai,&nbsp;Ce Li,&nbsp;Wei-Ning Wang,&nbsp;Shan Tian,&nbsp;Yi-Lin Tang,&nbsp;Bo Shen,&nbsp;Jian Wang,&nbsp;Yi-Min Sun,&nbsp;Yu-Lian Zhu","doi":"10.1159/000530390","DOIUrl":"https://doi.org/10.1159/000530390","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory dysfunction in patients with Parkinson's disease (PD) could present in the early stage and worsen in the late stages. These changes could be a factor affecting the ability of daily living and quality of life of patients with PD. The primary objective of this study was to assess the respiratory function and its association with motor function in patients with different stages of PD.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted at the Huashan Hospital of Fudan University in Shanghai, China. The study included 65 patients diagnosed with PD (the Hoehn and Yahr scale between 1 and 4) and 20 healthy individuals of similar age, gender, weight, and height. The ventilatory function was assessed using the spirometry. Motor function was evaluated using subscale III of the United Parkinson's disease rating scale (UPDRS-III). After confirming the normality of data distribution, we performed one-way ANOVA with a Tukey's post hoc test.</p><p><strong>Results: </strong>Compared with the healthy individuals, there was no statistical significance in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) in the H&amp;Y 1 group and H&amp;Y 2 group (p &gt; 0.05) but reduced peak expiratory flow (PEF) in the H&amp;Y 2 group (p = 0.002). Reduced FVC, FEV1, and PEF was seen in the H&amp;Y 3 group (p = 0.002, p = 0.001, and p = 0.0001, respectively). Reduced FVC, FEV1, PEF, and FEF25-75% was seen in the H&amp;Y 4 group (p = 0.001, p = 0.0001, p = 0.0001, and p = 0.025, respectively). The correlation analysis revealed that there was a significant negative correlation between FVC and UPDRS-III scores (r = -0.248, p = 0.046), disease duration (r = -0.276, p = 0.026), H&amp;Y scale (r = -0.415, p = 0.001). FEV1 was negatively correlated with UPDRS-III scores (r = -0.277, p = 0.025), disease duration (r = -0.291, p = 0.019), H&amp;Y scale (r = -0.434, p = 0.0001). FEF25-75% was negatively correlated with disease duration (r = -0.247, p = 0.047), H&amp;Y scale (r = -0.278, p = 0.025).</p><p><strong>Conclusion: </strong>Our findings revealed that respiratory impairment is present in moderate and advanced PD patients, and directly related to the severity of the disease. It is important to conduct respiratory function test in the clinical practice.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"242-249"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Initiation of Exoskeletal Robotic Gait Training Improves Functional Outcomes in the Patients with Stroke: A Retrospective Observational Study.","authors":"Akira Degami,&nbsp;Shingo Taki,&nbsp;Takeshi Imura,&nbsp;Yuji Iwamoto,&nbsp;Naoki Imada,&nbsp;Ryo Tanaka,&nbsp;Susumu Urakawa,&nbsp;Tetsuji Inagawa,&nbsp;Hayato Araki,&nbsp;Osamu Araki","doi":"10.1159/000527710","DOIUrl":"https://doi.org/10.1159/000527710","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of early initiation of gait training using hybrid assistive limb (HAL) remains unclear. This observational study aimed to investigate whether early initiation of gait training using HAL improves functional outcomes in patients with stroke.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with acute stroke admitted to our facility. HAL was used for exoskeletal robotic gait training. Study participants were median split into an early group and a late group based on the days from stroke onset to initiation of gait training using HAL. The functional outcomes, defined by the Brunnstrom recovery stage (BRS), modified Rankin Scale (mRS), and Functional Independence Measure (FIM) at discharge, were compared using propensity score-matched analysis.</p><p><strong>Results: </strong>We performed a propensity score-matched analysis in 63 patients with stroke (31 from the early group and 32 from the late group), and 17 pairs were matched. There were no significant differences in discharge in the BRS of the upper limb and finger in the post-matched cohort. On the other hand, the BRS of the lower limb in the early group was significantly higher than that in the late group. In addition, the mRS, but not FIM scores, was significantly better in the early group than that in the late group.</p><p><strong>Conclusions: </strong>In conclusion, early initiation of gait training using HAL might improve the motor function of the paralyzed lower limb and disability in patients with stroke.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"121-127"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1159/000527760","DOIUrl":"https://doi.org/10.1159/000527760","url":null,"abstract":"<br />Eur Neurol 2022;85:494","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contents Vol. 85, 2022","authors":"","doi":"10.1159/000527761","DOIUrl":"https://doi.org/10.1159/000527761","url":null,"abstract":"<br />Eur Neurol 2022;85:I–VI","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"51 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138533633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of MRI in the Treatment of Drug-Resistant Focal Epilepsy","authors":"A. Bernasconi, N. Bernasconi","doi":"10.1159/000525262","DOIUrl":"https://doi.org/10.1159/000525262","url":null,"abstract":"Background: Epilepsy is a prevalent chronic condition affecting about 50 million people worldwide. A third of patients with focal epilepsy suffer from seizures unresponsive to medication. Uncontrolled seizures damage the brain, are associated with cognitive decline, and have negative impact on well-being. For these patients, the surgical resection of the brain region that gives rise to seizures is the most effective treatment. Summary: Magnetic resonance imaging (MRI) plays a central role in detecting epileptogenic brain lesions. In this review, we critically discuss advances in neuroimaging acquisition, analytical post-acquisition techniques, and machine leaning methods for the detection of epileptogenic lesions, prediction of clinical outcomes, and identification of disease subtypes. Key Message: MRI is a mandatory investigation for diagnosis and treatment of epilepsy, particularly when surgery is being considered. Continuous progress in imaging techniques, combined with machine learning, will continue to push the boundaries of lesion visibility and provide increasingly precise predictors of clinical outcomes. Current efforts aiming at strengthening the competences of epileptologists in neuroimaging will ultimately reduce the need for invasive diagnostics.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"333 - 341"},"PeriodicalIF":2.4,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47109963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antioxidants for Treatment of Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis","authors":"S. Ren, Chunmei Yao, Ya-ling Liu, G. Feng, Xiaohuan Dong, B. Gao, S. Qian","doi":"10.1159/000525045","DOIUrl":"https://doi.org/10.1159/000525045","url":null,"abstract":"Introduction: Increasing evidence has shown that oxidative stress is involved in the pathogenesis of Duchenne muscular dystrophy (DMD). Oxidative stress impairs muscle function, reduces regenerative capacity, and leads to atrophy and muscle weakness. The present study aimed to evaluate the effectiveness and safety of antioxidants in treatment of DMD patients. Methods: Medline, Embase, EBSCOhost, and Cochrane Library databases were searched using relevant keywords regarding DMD and antioxidants. The risk of bias for all included studies was assessed using the Cochrane risk of bias tool. The effectiveness of antioxidants in improving pulmonary function and muscle strength in DMD patients and their rate of adverse events was evaluated by meta-analysis. Results: A total of nine eligible studies were identified. Among these, two studies involving 85 patients compared idebenone with placebo. Pooled data showed a significant improvement in pulmonary function after idebenone treatment. Flavonoids- and omega 3-based compounds (FLAVOMEGA) significantly improved muscle strength. Two studies evaluated coenzyme Q10 (CoQ10) and reported clinical improvement in physical activity. The remaining four studies evaluated pentoxifylline, superoxide dismutase, vitamin E combination with penicillamine and penicillamine alone, respectively, and found no significant differences between the intervention and placebo groups, measured by pulmonary function, muscle strength, movement function, or quality of life. Most adverse events were mild, while the rates of dropout and serious adverse events were low with respect to antioxidants. Conclusions: Idebenone appeared to be safe and effective in improving pulmonary function in DMD patients, while pentoxifylline, superoxide dismutase, penicillamine, or a combination of vitamin E with penicillamine did not show a significant therapeutic effect. CoQ10 and FLAVOMEGA might be beneficial in improving muscle strength or physical activity in DMD patients. However, additional trials with more participants are warranted in the future.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"377 - 388"},"PeriodicalIF":2.4,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}