Brian E Emmert, Stephanie Gandelman, David Do, Kevin Donovan, Dennis L Kolson, Matthew K Schindler
{"title":"A Characterization of Neurology Consults for Inpatients with SARS-CoV-2 Infection Compared to Other Respiratory Viruses.","authors":"Brian E Emmert, Stephanie Gandelman, David Do, Kevin Donovan, Dennis L Kolson, Matthew K Schindler","doi":"10.3390/neurolint15040089","DOIUrl":"10.3390/neurolint15040089","url":null,"abstract":"<p><p><b>Introduction:</b> Neurological consultation for patients infected with SARS-CoV-2 is common; it is currently unknown whether the neurologist's approach to inpatient consultation of patients with SARS-CoV-2 should differ from the paradigm used to evaluate hospitalized patients with similar respiratory viruses. The goal of the present study is to determine if the preponderance of new neurologic diagnoses differs between inpatients with SARS-CoV-2 and similar non-SARS-CoV-2 respiratory viruses for whom neurology is consulted. <b>Methods:</b> We performed a retrospective chart analysis of inpatient neurologic consultations at three major Philadelphia-based hospitals. We compared the final neurologic diagnosis of 152 patients infected with SARS-CoV-2 to 54 patients with a similar ubiquitous non-SARS-CoV-2 respiratory virus (influenza A, influenza B, respiratory syncytial virus, rhinovirus, or adenovirus, the most commonly tested respiratory viruses at our institution). Secondary metrics included age, sex, level of care, prior neurologic diagnoses, and mortality. A multinomial logistic regression model was utilized to evaluate the relative difference between diagnostic category groups on all metrics. <b>Results:</b> The proportion of patients with seizure who were infected with SARS-CoV-2 admitted to an intensive care unit (ICU) was significantly higher than those who were admitted to a medical-surgical floor. SARS-CoV-2 was also associated with increased risk for ICU admission compared to other common respiratory viruses. SARS-CoV-2 inpatients requiring neurologic consultation were also more likely to be older and female as compared to the non-SARS-CoV-2 cohort. In other domains, the proportion of neurologic diagnoses between SAR-CoV-2 and non-SARS-CoV-2 respiratory viruses showed no significant difference. <b>Conclusion:</b> Patients requiring inpatient neurologic consultation with a diagnosis of SARS-CoV-2 infection or another respiratory virus were found to be remarkably similar in terms of their ultimate neurologic diagnosis, with the exception of a larger preponderance of seizure in critical-care-level patients with SARS-CoV-2 infection. Our study suggests that the neurological approach to patients hospitalized with SARS-CoV-2 should be similar to that for patients with similar common respiratory infections, noting that seizure was seen more frequently in critically ill patients infected with SARS-CoV-2.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"15 4","pages":"1393-1402"},"PeriodicalIF":3.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10745801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characterizing the Impact of Compression Duration and Deformation-Related Loss of Closure Force on Clip-Induced Spinal Cord Injury in Rats","authors":"Po-Hsuan Lee, Heng-Juei Hsu, Chih-Hao Tien, Chi-Chen Huang, Chih-Yuan Huang, Hui-Fang Chen, Ming-Long Yeh, Jung-Shun Lee","doi":"10.3390/neurolint15040088","DOIUrl":"https://doi.org/10.3390/neurolint15040088","url":null,"abstract":"The clip-induced spinal cord injury (SCI) rat model is pivotal in preclinical SCI research. However, the literature exhibits variability in compression duration and limited attention to clip deformation-related loss of closure force. We aimed to investigate the impact of compression duration on SCI severity and the influence of clip deformation on closure force. Rats received T10-level clip-induced SCI with durations of 1, 5, 10, 20, and 30 s, and a separate group underwent T10 transection. Outcomes included functional, histological, electrophysiological assessments, and inflammatory cytokine analysis. A tactile pressure mapping system quantified clip closure force after open–close cycles. Our results showed a positive correlation between compression duration and the severity of functional, histological, and electrophysiological deficits. Remarkably, even a brief 1-s compression caused significant deficits comparable to moderate-to-severe SCI. SSEP waveforms were abolished with durations over 20 s. Decreased clip closure force appeared after five open–close cycles. This study offers critical insights into regulating SCI severity in rat models, aiding researchers. Understanding compression duration and clip fatigue is essential for experiment design and interpretation using the clip-induced SCI model.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"121 20","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136351604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ilaria Pozzato, Mohit Arora, Candice McBain, Nirupama Wijesuriya, Yvonne Tran, James W. Middleton, Ashley R. Craig
{"title":"Cognitive Failure in Adults with Spinal Cord Injury: A Valuable Adjunct Measure for Enhancing Cognitive Assessment and Rehabilitation Outcomes","authors":"Ilaria Pozzato, Mohit Arora, Candice McBain, Nirupama Wijesuriya, Yvonne Tran, James W. Middleton, Ashley R. Craig","doi":"10.3390/neurolint15040087","DOIUrl":"https://doi.org/10.3390/neurolint15040087","url":null,"abstract":"Cognitive impairment is common in persons with spinal cord injury (SCI), impacting their daily functioning and rehabilitation. This study assesses the extent of self-reported cognitive failures in everyday life in persons with SCI and its relationships with objective neurocognitive measures and psychosocial factors, including depressive mood, anxiety, perceived control, and fatigue. The differences between forty-one adults with a chronic SCI and forty-one able-bodied controls were examined. The participants completed the Cognitive Failures Questionnaire (CFQ) to assess cognitive failure and neurocognitive tests assessing attention and executive functions, as well as a psychosocial assessment. The SCI group reported higher cognitive failure rates than the able-bodied group (31.7% versus 19%, p > 0.05). Objective neurocognitive tests did not significantly correlate with the CFQ scores in either group. However, the CFQ scores were positively associated with most psychosocial factors, even after controlling for covariates. The CFQ scores were significantly associated with depressive mood in persons with SCI. These findings highlight the importance of incorporating self-reported cognitive measures into neurocognitive assessments and rehabilitation planning for adults with SCI. Self-reports capture everyday cognitive challenges that objective tests may miss. Additionally, this study highlights the strong connections between cognitive failures and psychosocial issues, particularly mood disorders, emphasizing the need for comprehensive rehabilitation and psychosocial support post-SCI, addressing both cognitive and emotional wellbeing.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"49 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135430511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niko Dunkić, Marija Nazlić, Valerija Dunkić, Ivica Bilić
{"title":"Analysis of Post-COVID-19 Guillain–Barré Syndrome over a Period of One Year in the University Hospital of Split (Croatia)","authors":"Niko Dunkić, Marija Nazlić, Valerija Dunkić, Ivica Bilić","doi":"10.3390/neurolint15040086","DOIUrl":"https://doi.org/10.3390/neurolint15040086","url":null,"abstract":"The virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is capable of attacking the nervous system in several ways and leading to neurological diseases such as GBS (Guillain–Barré syndrome) through the resulting neurotropism and immune response. The aim of this study is to show the relationship between Coronavirus disease (COVID-19) and GBS and to better understand the clinical symptoms to prevent poor outcomes. Data from 15 patients were extracted from the Department of Neurology, University Hospital of Split, Croatia, for the year 2021. The age of the patients ranged from 26 to 89 years, of whom 27% were women. Sixty seven percent of all GBS patients recovered from COVID-19 infection, whereas post-vaccinal polyradiculoneuritis was detected in 6%. Forty four percent of the patients who developed GBS had a severe form of COVID-19 infection. Forty percent of patients were treated with intravenous immunoglobulins (IVIG), followed by therapeutic plasma exchange (PLEX) in 27%. After the therapy, improvement was observed in 13 patients, while two patients died. The results suggest that SARS-CoV-2 triggers GBS because it follows a similar pattern of infection as the other viral and bacterial agents that contribute to the onset of GBS. There is no evidence that prior infection with COVID-19 worsens the clinical presentation of GBS.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Series of Four Patients with Artery of Percheron Occlusion over a Three-Month Period","authors":"Matej Perovnik, Janja Pretnar Oblak, Senta Frol","doi":"10.3390/neurolint15040085","DOIUrl":"https://doi.org/10.3390/neurolint15040085","url":null,"abstract":"Here, we present a case series of four patients diagnosed with acute ischaemic stroke due to occlusion of the artery of Percheron (AOP), a rare stroke variant, observed in a single emergency centre within a three-month period. AOP occlusion is characterized by bilateral thalamic infarction with or without involvement of the mesencephalon. The presenting symptoms are diverse and not specific, but commonly include disturbance of consciousness, memory impairment, and vertical gaze palsy. In addition, due to the location of the infarction, imaging recognition is challenging and AOP occlusion often remains undiagnosed. This paper emphasizes the necessity of early recognition and appropriate management of AOP occlusion to significantly impact patient outcomes. Moreover, we argue that the condition might be more common than previously thought and that misdiagnosis or delay in diagnosis may lead to inappropriate treatment and potential failure to apply thrombolysis within the required timeframe.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"61 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Pelizzari, Elena Antoniono, Donatella Giraudo, Gianluca Ciardi, Gianfranco Lamberti
{"title":"Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation?","authors":"Laura Pelizzari, Elena Antoniono, Donatella Giraudo, Gianluca Ciardi, Gianfranco Lamberti","doi":"10.3390/neurolint15040084","DOIUrl":"https://doi.org/10.3390/neurolint15040084","url":null,"abstract":"Background: In this study, we aimed to investigate the incidence of fecal incontinence (FI) after severe acquired brain injuries (sABIs) and to determine whether this symptom can lead to an inability to return home after rehabilitation. Methods: This was a retrospective observational cohort study. In total, 521 acute sABI inpatients were enrolled from the Department of Neurorehabilitation at an academic tertiary care hospital. Patients were divided into two groups, with and without FI, at the end of the rehabilitation phase. The primary and secondary endpoints were the incidence of persistent FI and any difference in the discharge destination. Results: Upon admission, new-onset FI was found in 443 (85%) patients, of which 38% had traumatic sABI. Moreover, 62.7% of all patients had FI upon admission. At discharge, 53.3% (264/495) of patients still had FI. Of these, 75.4% (199/264) had a Rancho Level of Cognitive Functioning Scale (LCFS) ≥3. A statistically significant correlation between FI at discharge and the presence of frontal lesions, autonomic crises, and increased LCFS scores was noted. Among the patients discharged to their homes, the proportion with persistent FI was lower (34% vs. 53.3). Conclusions: FI was significantly persistent after sABI, even after recovery from unconsciousness, and must be considered as a consequence of, rather than an independent risk factor for, unfavorable outcomes.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"74 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Viktoria Milkova, Neli Vilhelmova-Ilieva, Anna Gyurova, Kamelia Kamburova, Ivaylo Dimitrov, Elina Tsvetanova, Almira Georgieva, Milka Mileva
{"title":"Remdesivir-Loaded Nanoliposomes Stabilized by Chitosan/Hyaluronic Acid Film with a Potential Application in the Treatment of Coronavirus Infection","authors":"Viktoria Milkova, Neli Vilhelmova-Ilieva, Anna Gyurova, Kamelia Kamburova, Ivaylo Dimitrov, Elina Tsvetanova, Almira Georgieva, Milka Mileva","doi":"10.3390/neurolint15040083","DOIUrl":"https://doi.org/10.3390/neurolint15040083","url":null,"abstract":"An object of the present study was the development of liposomes loaded with the medicine Veklury® (remdesivir) stabilized by electrostatic adsorption of polysaccharide film formed from chitosans with different physicochemical characteristics and hyaluronic acid. The functionalization of the structures was achieved through the inclusion of an aptamer (oligonucleotide sequence) with specific affinity to the spike protein of the human coronavirus HCoV-OC43. The hydrodynamic size, electrokinetic potential and stability of the structures were evaluated at each step in the procedure. The encapsulation efficiency and loaded amount of remdesivir (99% and 299 µg/mL) were estimated by UV–vis spectroscopy. Our investigations showed manifestation of promising tendencies for prolonged periods of the drug release and increased effectiveness of its antiviral action. Among all studied versions of the delivery system, the most distinguished and suitable in a model coronavirus therapy are the liposomes formed from chitosan oligosaccharides. The cytotoxicity of the liposomes was determined against the HCT-8 cell line. A cytopathic effect inhibition test was used for the assessment of the antiviral activity of the compounds. The virucidal activity and the effect on the viral adsorption of the samples were reported by the end-point dilution method, and the alteration in viral titer was determined as Δlgs compared to untreated controls. The redox-modulating properties of the nanoparticles were studied in vitro in certain/several/a few chemical model systems. Our investigations showed a manifestation of promising tendencies for a prolonged effect of the drug release and increased effectiveness of its antiviral action.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"1985 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136102455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Raquel Pereira, Mobina Alemi, Mariana Cerqueira-Nunes, Clara Monteiro, Vasco Galhardo, Helder Cardoso-Cruz
{"title":"Dynamics of Lateral Habenula–Ventral Tegmental Area Microcircuit on Pain-Related Cognitive Dysfunctions","authors":"Ana Raquel Pereira, Mobina Alemi, Mariana Cerqueira-Nunes, Clara Monteiro, Vasco Galhardo, Helder Cardoso-Cruz","doi":"10.3390/neurolint15040082","DOIUrl":"https://doi.org/10.3390/neurolint15040082","url":null,"abstract":"Chronic pain is a health problem that affects the ability to work and perform other activities, and it generally worsens over time. Understanding the complex pain interaction with brain circuits could help predict which patients are at risk of developing central dysfunctions. Increasing evidence from preclinical and clinical studies suggests that aberrant activity of the lateral habenula (LHb) is associated with depressive symptoms characterized by excessive negative focus, leading to high-level cognitive dysfunctions. The primary output region of the LHb is the ventral tegmental area (VTA), through a bidirectional connection. Recently, there has been growing interest in the complex interactions between the LHb and VTA, particularly regarding their crucial roles in behavior regulation and their potential involvement in the pathological impact of chronic pain on cognitive functions. In this review, we briefly discuss the structural and functional roles of the LHb–VTA microcircuit and their impact on cognition and mood disorders in order to support future studies addressing brain plasticity during chronic pain conditions.","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"14 1-2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136263650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Visual-Motor Illusion via Image Videos Showing Increased Exercise Intensity on the Tibial Anterior during Sit-to-Stand Movement: A Study of Healthy Participants.","authors":"Junpei Tanabe, Kazu Amimoto, Katsuya Sakai, Motoyoshi Morishita","doi":"10.3390/neurolint15040081","DOIUrl":"10.3390/neurolint15040081","url":null,"abstract":"<p><p>Visual-motor illusion (VMI) elicits kinesthetic sensation from visual stimulation. We have previously performed ankle motion VMI with resistance applied to the ankle joint on the paralyzed side (power-VMI (P-VMI)) and ankle motion VMI without resistance (standard-VMI (S-VMI)) to activate the tibialis anterior (TA) muscle in stroke-paralyzed patients and compared sit-to-stand (STS) durations, but these studies did not measure TA activity during the STS movement. The purpose of this study was to evaluate the effects of different intensities of visual stimuli presented during VMI on TA and STS movement. Healthy right-footed adults (<i>n</i> = 18) observed two different VMI videos of ankle dorsiflexion, including S-VMI and P-VMI, with an observation time of 2 min each. STS movement was evaluated before and after watching each video. Each participant performed both S-VMI and P-VMI interventions on the same day. Only P-VMI enhanced the integrated electromyogram of the TA, increased the angular velocities of the trunk forward inclination and the ankle dorsiflexion, and shortened the STS duration. Our results indicate that P-VMI facilitates the activation of TA during STS, and we believe that we have clarified the intervention mechanism of VMI.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"15 4","pages":"1290-1302"},"PeriodicalIF":3.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute Presentation and Long-Term Rehabilitation Follow-Up of Ischemic Myelopathy Due to Clinically Suspected Fibrocartilaginous Embolism in an Adolescent Male: A Case Report and Review.","authors":"Einat Berla, Oleg Kerzhner, Tomm Caspi, Sharon Shaklai, Dianne Michaeli","doi":"10.3390/neurolint15040080","DOIUrl":"10.3390/neurolint15040080","url":null,"abstract":"<p><p>Ischemic myelopathy is uncommon in the pediatric population, with fibrocartilaginous embolism (FCE) being one of its rarest causes. We present the case of an otherwise healthy 17-year-old student who experienced sudden onset of severe low-back pain amidst intensive physical training, which rapidly deteriorated to complete sensory-motor paralysis of his lower limbs. He was treated with IV Methylprednisolone and anticoagulation after the initial work-up suggested spinal cord infarction. After eight days, sufficient clinical-radiological correlation was achieved to support FCE diagnosis as the most likely cause of infarction. He subsequently received inpatient rehabilitation treatment for four months, after which he was followed as an outpatient for a total period of 16 months. While significant neurological and functional gains were achieved during this period, he also experienced some worsening. This case highlights the importance both of performing a thorough assessment and being familiar with FCE as a possible differential diagnosis of spinal cord infarction in children, to facilitate its timely identification and proper acute and long-term management. This case report was prepared following CARE guidelines after obtaining the patient's written informed consent.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"15 4","pages":"1273-1289"},"PeriodicalIF":3.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}