The Egyptian journal of neurology, psychiatry and neurosurgery最新文献

{"title":"Repercussions of microglial efferocytosis on neurodegeneration in Alzheimer’s Disease (AD): a double-edged sword and perplexing factor warranting scrutiny in AD research","authors":"SriHarsha Kanuri","doi":"10.1186/s41983-024-00853-5","DOIUrl":"https://doi.org/10.1186/s41983-024-00853-5","url":null,"abstract":"Alzheimer’s disease (AD) is a neurodegenerative disease characterized by the accumulation of amyloid beta (Aβ) and tau aggregates within the neuronal milieu. To prevent their neurotoxicity, these pathological aggregates will be cleared from the neuronal environment by extracellular, intracellular, and excretory mechanisms. As these compensatory mechanisms become overwhelmed, these left-behind aggregates will instigate neuronal loss via varied downstream signaling events. As a result, neurons undergo cell death through apoptosis and necrosis leading to the accumulation of cellular debris. Timely clearance of this cellular debris is critical, otherwise it can further potentiate neuronal loss by perpetuating pro-inflammatory environment. Microglial cells migrate and engulf these dead neurons by a process known as canonical efferocytosis. On the other hand, normal living neurons will be cleared by microglial cells through extracellular exposure of phosphatidyl serine (PS) under the pathological influence of Aβ and tau through non-canonical efferocytosis. Canonical efferocytosis should be predominant with the absence of the non-canonical efferocytosis during the physiological conditions. Upregulation of cytokines, and chemokines in AD creates a fertile ground for the amplification of non-canonical efferocytosis in parallel to canonical efferocytosis. The preponderance of the non-canonical over canonical pathways leads to exuberant clearance of stressed and normal living neurons along with dead neurons, thereby leading to exacerbated neuronal loss, brain tissue thinning and severe cognitive disturbances in AD. Research efforts should be directed to understanding the factors that fine-tune the balance between these clearance processes. Novel therapeutic strategies that reinforce canonical efferocytosis will be beneficial by improving tissue repair, healing, and regeneration in AD.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141550609","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":"Stem cell therapies in stroke rehabilitation: a narrative review of current strategies and future prospects","authors":"Nicholas Aderinto, Gbolahan Olatunji, Emmanuel Kokori, Adetola Emmanuel Babalola, Ismaila Ajayi Yusuf, Oluwatobiloba Oluwatomisin Apampa, Bonaventure Michael Ukoaka, John Ehi Aboje, Temiloluwa Adefusi, Abdulrahmon Moradeyo, Opabode Muntaqim Obasanjo, Ikponmwosa Jude Ogieuhi, Oluwatobi Omoworare, Doyin Olatunji","doi":"10.1186/s41983-024-00851-7","DOIUrl":"https://doi.org/10.1186/s41983-024-00851-7","url":null,"abstract":"This paper explores the potential of stem cell therapies in revolutionising stroke recovery, addressing the limitations of current treatments and emphasising regenerative medicine as a promising alternative. Stroke, a leading cause of disability and death worldwide, necessitates innovative approaches due to the temporal constraints and regenerative deficiencies in existing therapeutic modalities. The review explores the diverse mechanisms underlying stem cell-mediated recovery, encompassing neuroprotection, neurogenesis, angiogenesis, modulation of inflammatory responses, and induction of host brain plasticity. We searched prominent databases (PubMed, Scopus, Google Scholar, and Web of Science) from inception to January 2024 for studies on “stem cell therapy” or “regenerative medicine” combined with “stroke recovery” or “cerebrovascular accident”. Studies in humans and animals, published in peer-reviewed journals, and investigating the impact of stem cell therapy on stroke recovery were included. We excluded non-English publications and those lacking sufficient outcome data. Evidence from animal studies demonstrates the efficacy of various stem cell types, while human studies, though limited, contribute valuable insights into safety and potential efficacy. Safety considerations, crucial for successful clinical application, emphasise the need for rigorous preclinical and clinical studies, long-term follow-up data, and ethical standards. Challenges in the field, such as study design heterogeneity, optimising stem cell delivery methods, and identifying subpopulations likely to benefit, require concerted efforts to overcome. Standardising methodologies, refining delivery routes, and personalising interventions based on biomarkers are essential. This review positions stem cell therapies as promising for comprehensive neural tissue recovery following stroke.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509202","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":"Spontaneous posterior fossa hemorrhage: profile and functional outcome in patients attending Tanta stroke unit","authors":"Mahmoud Hamed Nassar, Basem Hamdy Fouda, Ahmed Safwat Abd ElMohsen Elsaid, Wafik Said Bahnasy, Ehab Ahmed Shawky El-Seidy, Ahmed Mustafa Kishk","doi":"10.1186/s41983-024-00850-8","DOIUrl":"https://doi.org/10.1186/s41983-024-00850-8","url":null,"abstract":"The most dangerous and least curable type of stroke is spontaneous intracerebral hemorrhage (ICH), and prognosis is highly correlated with location and size in the posterior fossa. The objective of this work was to estimate the frequency of posterior fossa hemorrhage (PFH) in Tanta University Hospitals, as well as identify functional outcomes and mortality in PFH. This study was performed on 33 posterior fossa hemorrhagic patients and 119 posterior ischemic stroke patients (PCIS) submitted to the CT brain and the MRI brain, using the following scales: GCS and NIHSS, and the intracerebral hemorrhage scale (ICH score). Posterior fossa hemorrhage (PFH) represents 16.83% of total hemorrhagic stroke in the ER. Vertigo and DCL are more common in PFH (60.6%, 48.4%) than in PCIS. 82% of PFH patients had hypertension (HTN) hemorrhage. The cerebellum is the most common site for PFH (48%), pontine (24%), thalamic (18%), and midbrain (9%). PFH had unfavorable outcomes in 55% of the studied patients; the MRS mean was 4; and 39% died in the follow-up. Posterior fossa hemorrhage is a potentially serious neurovascular emergency associated with complex symptomatology. PFH demonstrates diverse prognoses depending on the location of the intracerebral hemorrhage and the size of the hematoma.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509203","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":"Modified frontal horn index: a novel risk predictor for sunken flap syndrome in the patients undergoing shunt procedures for post-decompressive craniectomy hydrocephalus","authors":"Vikrant Yadav, Anurag Sahu, Ravi Shankar Prasad, Nityanand Pandey, Manish Kumar Mishra, Ravi Shekhar Pradhan","doi":"10.1186/s41983-024-00854-4","DOIUrl":"https://doi.org/10.1186/s41983-024-00854-4","url":null,"abstract":"Decompressive craniectomy (DC) is a neurosurgical procedure, frequently used in lowering the refractory intracranial pressure (ICP) following traumatic brain injuries. Post-traumatic hydrocephalus (PTH), a debilitating complication in the patients with traumatic brain injuries, occurs in 11.9–36% patients undergoing DCs. Sunken flap syndrome (SFS) is a rare entity, following DCs or cerebrospinal fluid (CSF) diversion procedures for PTH after DCs and leads to neurological deterioration of the patients. Literature regarding risk factors associated with SFS in the patients undergoing ventriculoperitoneal shunt procedures for hydrocephalus following DCs is scarce. The aim of this study is to determine the incidence of SFS and to establish a relationship between several clinico-radiological features and SFS in patients undergoing shunt procedures for PTH. This retrospective study was conducted in a tertiary care trauma centre upon 60 patients who underwent shunt procedures for PTH. Intraventricular haemorrhage (P < 0.0001), communicating-type hydrocephalus (P = 0.0006), and modified frontal horn index (P < 0.0001) were significantly associated with development of SFS. MFHI > 43 was a significant risk factor in development of SFS. SFS is the common complication following shunt procedures for PTH after DCs. MFHI is significant risk predictor for SFS. MFHI > 43 is associated with higher chances of developing SFS following shunt insertion in PTH. Early cranioplasty following DCs might prevent development of SFS.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"191 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509205","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":"Disease-modifying therapies as positive predictors of quality of life for Sudanese patients with multiple sclerosis: a cross-sectional study","authors":"Eman Saleh Omar, Hayat M. Suliman, Bashier Osman, Safa A. Abdalla, Iman Hassan Abdoon","doi":"10.1186/s41983-024-00855-3","DOIUrl":"https://doi.org/10.1186/s41983-024-00855-3","url":null,"abstract":"Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease with devastating, disabling, and negative impacts on the patients’ quality of life (QoL). Although MS was not known in Sudan, it seems to be rising in recent years. This is a cross-sectional, hospital-based study aimed at assessing the impact of MS medications on patients’ QoL in neurology clinics in Khartoum City. Sixty-four patients diagnosed with MS were recruited. SF-36 questionnaire was used to assess the patients’ QoL. Data were collected from patients’ records in addition to the hand-delivered questionnaire. Data were analyzed using ANOVA test and logistic regression; p ≤ 0.05 was considered statistically significant. The majority of patients were females from north Sudan (92.2%). The mean age was 28.2 ± 6.5. Relapsing–remitting was the most diagnosed MS type (65.6%). Fatigue and urinary incontinence were the most observed symptoms. All patients had vitamin D deficiency (5–20 ng/ml). Disease-modifying therapies (DMTs) were prescribed to 37.5% of patients. The overall mean QoL was 53.9 ± 14.7 with fair physical and mental health (51.8 ± 19.2 and 57.0 ± 10.9, respectively). Patients on DMTs showed a significantly good QoL compared to azathioprine (p ≤ 0.01), corticosteroids (p ≤ 0.01.), and no medications (p ≤ 001). Azathioprine (OR = 0.12; p ≤ 0.05), corticosteroids (OR = 0.14; p ≤ 0.05) and no treatment (OR = 0.01; p ≤ 0.001) negatively affected MS patients’ QoL when compared to DMTs. Vitamin D supplementation was significantly (p ≤ 0.01) associated with good QoL. MS was prominent in young females’ descendants of Sudanese northern tribes. DMTs improve the devastating effect of MS on patients’ QoL, and vitamin D supplementation was significantly associated with good QoL of MS patients.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"173 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509204","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":"The role of neurotransmitter receptors in antipsychotic medication efficacy for Alzheimer’s-related psychosis","authors":"Bhawana Sharma, Saumya Das, Avijit Mazumder, Deepraj Singh Rautela, Pankaj Kumar Tyagi, Navneet Khurana","doi":"10.1186/s41983-024-00848-2","DOIUrl":"https://doi.org/10.1186/s41983-024-00848-2","url":null,"abstract":"Alzheimer's disease (AD) is marked by cognitive decline along with the presence of mental symptoms, most notably psychosis. Although antipsychotic drugs are commonly recommended to treat these symptoms, there is ongoing discussion on the safety and effectiveness of these drugs in AD patients. The therapeutic management of Alzheimer’s disease-related psychosis (ARP) is hampered by its limited therapy options, determining the precise brain regions in Alzheimer’s patients with understanding of the neurological substrates implicated in ARP. While new therapies including brexpiprazole and atypical antipsychotics present promising therapeutic choices, practical implementation and potential upcoming therapies approaches is discussed along with mechanism-based understanding of different neurotransmitters with pharmaceutical therapies. Our objective is to contribute to more efficient and individualized treatment approaches by offering a thorough resource for medical professionals and researchers working in the field of managing and researching psychosis associated with AD. The examination containing new data supporting newer therapeutic approaches that target receptors and providing better safety and effectiveness characteristics. This study point out gaps in our existing understanding and make recommendations for future research, emphasizing the necessity of clinical trials created especially for psychotic Alzheimer’s patients. Secondly, the neurochemical and neuropathological bases of ARP, with a focus on changes in the dopamine, serotonin, and glutamate systems of neurotransmitters are also described in detail. Different pharmacodynamics antipsychotic medications are covered in later sections of this paper, with an emphasis on how these medications' interactions with certain neurotransmitter receptors may affect their therapeutic efficacy and side-effects profile. The review article summarizes the most recent findings regarding the contribution of neurotransmitter receptors to the effectiveness of antipsychotic drugs in the management of ADP. We provide a thorough overview of second-generation (atypical) antipsychotics, emphasizing how their unique affinity for neurotransmitter receptors influences their clinical application in psychosis associated with AD. The difficulties of treating Alzheimer’s with antipsychotics are also covered in this study, including the potential for cognitive impairment to worsen, the emergence of extrapyramidal symptoms, and other unfavorable effects. New approaches to studying and treating ARP including neuroinflammation-targeting medicines, transcranial magnetic stimulation (TMS), cerebrospinal fluid (CSF) biomarkers, and muscarinic acetylcholine receptor (mAChR) agonists like xanomeline. Reducing psychosis through treatment options could be improved by knowledge of N-methyl-D-aspartate glutamate receptors (NMDAR) hypofunction processes in gamma-aminobutyric acid (GABAergic) neurons.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509206","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":"The hidden threat: subdural empyema strikes a healthy teen","authors":"Ahmed Dahshan, Ahmed Hamdy Youssef, Abdallah Al Subhi, Wael Salah Darweesh, Zakaria Al Fahdi, Mahmood Al Yahyaai","doi":"10.1186/s41983-024-00849-1","DOIUrl":"https://doi.org/10.1186/s41983-024-00849-1","url":null,"abstract":"The incidence estimates for intracranial subdural empyema are 0.1 per 100,000 individuals, making it a rare clinical condition. It is a highly morbid and fatal illness that is most commonly the result of a primary infection somewhere else. The authors present a young male patient 15 years presented with 1 week history of headache, fever, confusion and seizure attack with initial negative CT head and nearly negative CSF analysis. With few days he developed left sided weakness. MRI brain showed right temporoparietal subdural fluid collection with midline shift. Urgent neurosurgical evacuation was made and revealed subdural empyema. The boy received combination therapy of vancomycin, ceftriaxone, and metronidazole. The culture of the pus was negative but 16S rRNA gene sequencing (bacterial) revealed streptococcus intermedius. He made a good recovery with no recollection or neurological deficit on follow up. This case highlights the possibility of occurrence of this rare infection in otherwise healthy individuals without obvious precipitating factor. It also indicates the superiority of MRI brain over CT head in detection of subdural collection. The rapid diagnosis and intervention improve the outcome of the patient.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141524060","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":"Investigating the association between blood oxidative stress markers and dementia in Egyptian elderly women","authors":"Lamyaa Kamel Ebrahim, Sherihan Adel, Sarah A. Hamza, M. Alsadany, Suzan Mounir Ali","doi":"10.1186/s41983-024-00847-3","DOIUrl":"https://doi.org/10.1186/s41983-024-00847-3","url":null,"abstract":"","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"29 5","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141342573","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":"Unraveling Alzheimer’s: the promise of aducanumab, lecanemab, and donanemab","authors":"Taha Ameen, Syeda Naveera Kashif, Syed Muhammad Iraj Abbas, Kulsoom Babar, Syed Muhammad Sinaan Ali, Abdul Raheem","doi":"10.1186/s41983-024-00845-5","DOIUrl":"https://doi.org/10.1186/s41983-024-00845-5","url":null,"abstract":"","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"29 14","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340295","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":"Customized treatment for Parkinson’s disease: extending lifespan and improving symptoms","authors":"R. Indu, S. Dimri","doi":"10.1186/s41983-024-00844-6","DOIUrl":"https://doi.org/10.1186/s41983-024-00844-6","url":null,"abstract":"","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"16 2","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349887","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}