JNS-cover.jpgJournal of Neurological Sciences

Vol 358 | No. 1-2 | 15 November 2015 | Pages 1-540


Thalamus and MS: Role of thalamic atrophy in daily living and employment activities of MS patients

Jeanie McGee, Alireza Minagar

The two thalamic nuclei, which are considered as part of deep gray matter substance of brain, play significant roles in human central nervous system (CNS). They are involved in activation of cortex, processing and relaying sensory data to the superior cortical centers, and are crucial for normal cognition. The thalamic structures are among the heavily-affected areas of the CNS and the measurable atrophy of these deep-seated nuclei translates into significant cognitive decline which manifest in patients with multiple sclerosis (MS).



Venous thromboembolism prevention during the acute phase of intracerebral hemorrhage

Zhou Zeng, Zhiping Hu, Jie Zhang

Although knowledge of intracerebral hemorrhage (ICH) continues to evolve, it is still a major cause of morbidity and mortality worldwide. Venous thromboembolism (VTE) events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), are common and preventable complications of ICH. On the basis of the current systematic review and guidelines, the optimal prophylactic treatment remains unclear.

Scales for hyperkinetic disorders: A systematic review

Sara Pietracupa, Elisa Bruno, Andrea E. Cavanna, Marika Falla, Mario Zappia, Carlo Colosimo

Hyperkinetic movement disorders represent a heterogeneous group of disorders in which involuntary movements are the prevalent clinical symptoms. The five main categories of hyperkinetic disorders are tremor, dystonia, tics, myoclonus and drug-induced dyskinesia. The severity of hyperkinetic disorders is assessed by all clinicians when they examine a patient; quantifying the severity also provides a means of studying the natural history of a given disorder and the possible effect of new therapeutic interventions.

Emerging immunopharmacological targets in multiple sclerosis

Mojtaba Farjam, Guang-Xian Zhang, Bogoljub Ciric, Abdolmohamad Rostami

Inflammatory demyelination of the central nervous system (CNS) is the hallmark of multiple sclerosis (MS), a chronic debilitating disease that affects more than 2.5 million individuals worldwide. It has been widely accepted, although not proven, that the major pathogenic mechanism of MS involves myelin-reactive T cell activation in the periphery and migration into the CNS, which subsequently triggers an inflammatory cascade that leads to demyelination and axonal damage. Virtually all MS medications now in use target the immune system and prevent tissue damage by modulating neuroinflammatory processes.

Effects of long-term whole-body vibration training on mobility in patients with multiple sclerosis: A meta-analysis of randomized controlled trials

Sini Kantele, Saija Karinkanta, Harri Sievänen

This meta-analysis evaluated feasibility and efficacy of long-term whole-body vibration (WBV) training in improving mobility of multiple sclerosis (MS) patients.

Zeroing in on zoster: A tale of many disorders produced by one virus

Kristin M. Galetta, Don Gilden

While herpes zoster infection has been recognized since antiquity, chickenpox (varicella) was confused with smallpox until the 1800s, when both illnesses became better understood. In the 20th century, varicella zoster virus (VZV) was shown to cause varicella upon primary (first-time) infection and herpes zoster (shingles) after reactivation of latent VZV. Scientific progress over the past 50 years has rapidly advanced the understanding and prevention of disease produced by VZV. Combined imaging and virological studies continue to reveal the protean neurological, ocular and visceral disorders produced by VZV.


Original Articles

Polyphenon E, non-futile at neuroprotection in multiple sclerosis but unpredictably hepatotoxic: Phase I single group and phase II randomized placebo-controlled studies

Jesus Lovera, Alexander Ramos, Deidre Devier, Virginia Garrison, Blake Kovner, Tara Reza, Dennis Koop, William Rooney, Anne Foundas, Dennis Bourdette

Phase I (PhI): assess the safety of Polyphenon E in people with multiple sclerosis (MS) and determine the futility of Polyphenon E as a neuroprotective agent. Correlate plasma levels of EGCG with neuroprotective effects. Phase II (PhII): Further assess safety and confirm the neuroprotective effects of Polyphenon E.

Convergent validation of EQ-5D-5L in patients with Parkinson's disease

Alonso Alvarado-Bolaños, Amin Cervantes-Arriaga, Mayela Rodríguez-Violante, Rodrigo Llorens-Arenas, Humberto Calderón-Fajardo, Roxanna Millán-Cepeda, Roberto Leal-Ortega, Ingrid Estrada-Bellmann, Carlos Zuñiga-Ramírez

The European Quality of Life Questionnaire 5 level version (EQ-5D-5L) is a recently updated instrument to assess Health-Related Quality of Life (HRQoL) that has not been validated extensively. The main objective of this study was to evaluate the internal consistency and convergent validation of the EQ-5D-5L in a large sample of subjects with Parkinson's disease (PD).

Cognitive outcome in acute simvastatin treatment for aneurysmal subarachnoid hemorrhage: A propensity matched analysis

George K.C. Wong, Adrian Wong, Beny C.Y. Zee, Wai S. Poon, Matthew T.V. Chan, Tony Gin, Deyond Y.W. Siu, Vincent C.T. Mok

Experimental evidence has indicated the benefit of simvastatin in the treatment of subarachnoid hemorrhage (SAH). Recently, acute simvastatin treatment was not shown to be beneficial in neurological outcome using modified Rankin Scale. Cognitive function is another important dimension of outcome assessment and yet had not been investigated in statin studies for aneurysmal subarachnoid hemorrhage. We therefore explored whether acute simvastatin treatment would improve cognitive outcomes.

Predictive score for early diagnosis of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD)

Hiroko Tada, Jun-ichi Takanashi, Hideo Okuno, Masaya Kubota, Takanori Yamagata, Gou Kawano, Takashi Shiihara, Shin-ichiro Hamano, Shinichi Hirose, Takuya Hayashi, Hitoshi Osaka, Masashi Mizuguchi

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) at onset manifests an early seizure (ES) usually lasting more than 30 min. Following ES, some patients exhibit almost clear consciousness with no neurological symptoms, and no MRI abnormality for a few days, which may lead to an initial misdiagnosis of prolonged febrile seizures (PFS). To allow an early diagnosis of AESD, we retrospectively analyzed clinical manifestations, laboratory data, and radiologic and EEG findings in patients with AESD (n = 62) having ES of over 30 min, and ones with PFS (n = 54), using logistic regression analyses.   

No relation between sympathetic outflow to muscles and respiratory function in amyotrophic lateral sclerosis

Kazumasa Shindo, Mai Tsuchiya, Yuta Ichinose, Akiko Onohara, Megumi Fukumoto, Kishin Koh, Ryusuke Takaki, Nobuo Yamashiro, Fumikazu Kobayashi, Takamura Nagasaka, Yoshihisa Takiyama

In amyotrophic lateral sclerosis (ALS), not only impairment of motor neurons but also impairment of the autonomic nervous system has been demonstrated by previous physiological studies. Several investigators have reported a correlation between autonomic dysfunction and respiratory dysfunction in ALS. This study analyzed the relation between parameters of respiratory function and muscle sympathetic nerve activity (MSNA) in a large number of ALS patients.

Planning future clinical trials in Machado Joseph disease: Lessons from a phase 2 trial

Jonas Alex Morales Saute, Carlos R.M. Rieder, Raphael Machado Castilhos, Thais Lampert Monte, Artur Francisco Schumacher-Schuh, Karina Carvalho Donis, Rui D'Ávila, Gabriele Nunes Souza, Aline Dutra Russo, Gabriel Vasata Furtado, Tailise Conte Gheno, Diogo Onofre Gomes Souza, Maria Luiza Saraiva-Pereira, Luis Valmor Cruz Portela, Suzi Camey, Vanessa Bielefeld Leotti Torman, Laura Bannach Jardim

In a recent phase 2 clinical trial in spinocerebellar ataxia type 3/Machado Joseph disease (SCA3/MJD), a neurogenetic disorder without specific therapy, benefits of lithium carbonate were found only on secondary efficacy outcomes, all related to ataxic features. In order to help designing future studies, we further analyzed the trial data searching for treatment response modifiers and metric properties of spinocerebellar ataxia (SCA) scales.

The burden of distress and related coping processes in family caregivers of patients with Alzheimer's disease living in the community

Alberto Raggi, Domenica Tasca, Simonetta Panerai, Walter Neri, Raffaele Ferri

Many patients with dementia live in the community and depend on a family member for assistance. Taking care of non-self-sufficient people such as those with dementia causes distress. This study concerns factors contributing to feelings of burden and consequent coping strategies adopted by family caregivers of patients with Alzheimer's disease living in the community.

Association of functional genetic variants in PPARδ encoding peroxisome proliferator-activated receptor delta with ischemic stroke in Chinese Uyghur population

Yeqing Tong, Faxian Zhan, Li Cai, ShengHong Han, Xuhuan Guan, Liangqiang Lin, Xiaoxia Li, Shuangyi Hou, Qing Lu, Jiafa Liu

PPARδ belongs to a receptor family of ligand-activated transcription factors involved in the regulation of inflammation, cellular glucose uptake, protection against atherosclerosis and endothelial cell function. Through these effects, they might be involved with the ischemic stroke (IS). We recruited 200 subjects (100 IS patients diagnosed by CTs or/and magnetic resonance imaging (MRI) and 100 normal healthy controls from Chinese Uyghur population) to assess the nature of the functional polymorphisms of PPARδ +294T/C and any links with IS in this unique population.

Bulbar impairment score predicts noninvasive volume-cycled ventilation failure during an acute lower respiratory tract infection in ALS

Emilio Servera, Jesús Sancho, Pilar Bañuls, Julio Marín

Amyotrophic lateral sclerosis (ALS) patients can suffer episodes of lower respiratory tract infections (LRTI) leading to an acute respiratory failure (ARF) requiring noninvasive ventilation (NIV).

The "butterfly diagram": A gait marker for neurological and cerebellar impairment in people with multiple sclerosis

Alon Kalron, Lior Frid

People with multiple sclerosis (PwMS) frequently experience walking and balance impairments. In our previous report, we demonstrated that spatio-temporal gait parameters, collected by the Zebris FDM-T instrumented treadmill (Zebris Medical GmbH, Germany), serve as valid markers of neurological impairment in the MS population. In the current study, we focused on a unique outcome statistic of the instrumented treadmill, the "butterfly" diagram which reflects the variability of the center of pressure trajectory during walking.        

Two-year outcome of thymectomy with or without immunosuppressive treatment in nonthymomatous myasthenia gravis and its effect on regulatory T cells

Michala Jakubíková, Jiří Piťha, Helena Marečková, Michaela Týblová, Iveta Nováková, Jan Schutzner

Myasthenia gravis (MG) is the autoimmune disorder in which the thymus is considered the pathogenic organ. Thymectomy (TE) is a therapeutic option for MG and often ameliorates clinical symptoms.

Kinematic analysis of the gait of adult sheep during treadmill locomotion: Parameter values, allowable total error, and potential for use in evaluating spinal cord injury

Sina Safayi, Nick D. Jeffery, Sara K. Shivapour, Mahdi Zamanighomi, Tyler J. Zylstra, Joshua Bratsch-Prince, Saul Wilson, Chandan G. Reddy, Douglas C. Fredericks, George T. Gillies, Matthew A. Howard III

We are developing a novel intradural spinal cord (SC) stimulator designed to improve the treatment of intractable pain and the sequelae of SC injury. In-vivo ovine models of neuropathic pain and moderate SC injury are being implemented for pre-clinical evaluations of this device, to be carried out via gait analysis before and after induction of the relevant condition. We extend previous studies on other quadrupeds to extract the three-dimensional kinematics of the limbs over the gait cycle of sheep walking on a treadmill.

Stroke mortality and its determinants in a resource-limited setting: A prospective cohort study in Yaounde, Cameroon

Clovis Nkoke, Alain Lekoubou, Eric Balti, Andre Pascal Kengne

About three quarters of stroke deaths occur in developing countries including those in sub-Saharan African. Short and long-term stroke fatality data are needed for health service and policy formulation.

Tumefactive demyelinating lesions as a first clinical event: Clinical, imaging, and follow-up observations

In Hye Jeong, Su-Hyun Kim, Jae-Won Hyun, AeRan Joung, Hyo-Jin Cho, Ho Jin Kim

Tumefactive demyelinating lesions (TDLs) are associated with a variety of demyelinating diseases in the central nervous system (CNS). However, there are no current guidelines describing how to classify and treat patients with this rare phenotype. Thus, the present study aimed to determine the long-term evolution and disease course of patients initially presenting with TDLs and to describe their clinical and radiographic characteristics.

Reduced facial expressiveness in Parkinson's disease: A pure motor disorder?

Lucia Ricciardi, Matteo Bologna, Francesca Morgante, Diego Ricciardi, Bruno Morabito, Daniele Volpe, Davide Martino, Alessandro Tessitore, Massimiliano Pomponi, Anna Rita Bentivoglio, Roberto Bernabei, Alfonso Fasano

Impaired emotional facial expressiveness is an important feature in Parkinson's disease (PD). Although there is evidence of a possible relationship between reduced facial expressiveness and altered emotion recognition or imagery in PD, it is unknown whether other aspects of the emotional processing, such as subjective emotional experience (alexithymia), might influence hypomimia in this condition. In this study wee aimed to investigate possible relationship between reduced facial expressiveness and altered emotion processing (including facial recognition and alexithymia) in patients with PD.

Hydroxychloroquine reduces microglial activity and attenuates experimental autoimmune encephalomyelitis

Marcus W. Koch, Rana Zabad, Fabrizio Giuliani, Walter Hader Jr., Ray Lewkonia, Luanne Metz, V. Wee Yong

Microglial activation is thought to be a key pathophysiological mechanism underlying disease activity in all forms of MS. Hydroxychloroquine (HCQ) is an antimalarial drug with immunomodulatory properties that is widely used in the treatment of rheumatological diseases. In this series of experiments, we explore the effect of HCQ on human microglial activation in vitro and on the development of experimental autoimmune encephalitis (EAE) in vivo.

Age-related changes of inactivating BK channels in rat dorsal root ganglion neurons

Weiwei Yu, Xianguang Lin, Shangbang Gao, Chenhong Li

The large-conductance, voltage- and Ca2+-activated K+ channels (termed BK) are associated with age-related dysfunctions or diseases. Previously, with our colleagues, we reported that the rβ2-associated inactivating BK (BKi) channels play an essential role in rat dorsal root ganglion (DRG) neurons. However, the age-dependent changes in BKi channels are still elusive. Here, we identify three types of BK channels in small DRG neurons, the single exponential BKi, the double exponential BKi and the non-inactivating BK.

Exploring the effect of electrical muscle stimulation as a novel treatment of intractable tremor in Parkinson's disease

Onanong Jitkritsadakul, Chusak Thanawattano, Chanawat Anan, Roongroj Bhidayasiri

As the pathophysiology of tremor in Parkinson disease (PD) involves a complex interaction between central and peripheral mechanisms, we propose that modulation of peripheral reflex mechanism by electrical muscle stimulation (EMS) may improve tremor temporarily.

A cohort study of Han Chinese MFN2-related Charcot–Marie–Tooth 2A

He Lv, Lu Wang, Wei Zhang, Zhaoxia Wang, Yuehuan Zuo, Jing Liu, Yun Yuan

Charcot–Marie–Tooth 2A (CMT2A) is caused by mutations in mitochondrial fusion protein mitofusin 2 (MFN2). CMT2A had a large variety of clinical symptoms and several cohort studies were published recently. This study is to summarized the clinical, electrophysiological, pathological and genetic features in Han Chinese CMT2A.

Proteomic analysis of the hippocampus in naïve and ischemic-preconditioned rat

Takayuki Nakajima, Ryusuke Hata, Tomohiro Kondo, Shigeo Takenaka

The hippocampus exhibits regional differences in vulnerability to ischemia, wherein pyramidal cells in the CA1 region are vulnerable to ischemia while pyramidal cells in the CA3 region and granule cells in the dentate gyrus (DG) region are relatively ischemia resistant. However, pyramidal cells in the CA1 region reportedly exhibit ischemic tolerance following exposure to a brief non-lethal period of ischemia known as ischemic preconditioning. In this study, we used proteomic analysis to examine the difference in protein expression between naïve rat CA1 and CA3/DG regions, as well as the altered protein expression in the CA1 region after 3 min of ischemic preconditioning. 

The effect of tremor onset on middle cerebellar peduncle of Parkinson's disease

Wataru Sako, Nagahisa Murakami, Yoshimichi Miyazaki, Takashi Abe, Masafumi Harada, Yuishin Izumi, Ryuji Kaji

The majority of studies of Parkinson's disease (PD) focused on basal ganglia initially; however, accumulating evidence suggests cerebellar involvement in pathophysiology. We aimed to investigate the effects of tremor onset on middle cerebellar peduncle (MCP) width of PD patients and of disease duration on differential diagnosis. We measured MCP width of 81 PD, 34 multiple system atrophy (MSA) and 16 normal controls, using MRI. A meta-analysis was performed including two previous and the present studies.

Quantitative muscle ultrasound measures rapid declines over time in children with SMA type 1

Kay W. Ng, Anne M. Connolly, Craig M. Zaidman

Muscles are small in spinal muscular atrophy (SMA). It is not known if muscle size changes over time in SMA type 1. We quantified changes over time in muscle size and echointensity during two repeated ultrasound examinations of unilateral proximal (biceps brachii/brachialis and quadriceps) and distal (anterior forearm flexors and tibialis anterior) muscles in three children with SMA type 1. We compared muscle thickness (MT) to body weight-dependent normal reference values. Children were 1, 6, and 11 months old at baseline and had 2, 2 and 4 months between ultrasound examinations, respectively.

Canalith repositioning in apogeotropic horizontal canal benign paroxysmal positional vertigo: Do we need faster maneuvering?

Minho Hwang, Sang-Hoon Kim, Kyung-Wook Kang, Dasom Lee, Sae-Young Lee, Myeong-Kyu Kim, Seung-Han Lee

A correct diagnosis and a proper treatment may yield a rapid and simple cure for benign paroxysmal positional vertigo (BPPV). Although the Gufoni maneuver is widely used to treat apogeotropic horizontal-canal BPPV (HC-BPPV), few studies have clarified the relationship between the speed and intensity of maneuver execution and successful canalith reposition. To evaluate the effect of accelerated execution of the Gufoni maneuver, a prospective randomized controlled study was conducted with HC-BPPV patients in a single dizziness clinic.    

The effectiveness of the correction of cognitive impairment using computer-based stimulation programs for patients with coronary heart disease after coronary bypass surgery

Oksana Vasilyevna Eryomina, Marina Mikhaylovna Petrova, Semyon Vladimirovich Prokopenko, Elena Yuryevna Mozheyko, Darya Sergeevna Kaskaeva, Oksana Alexandrovna Gavrilyuk

We evaluated effectiveness of using copyrighted computer-based stimulation programs in the correction of cognitive function in patients with coronary heart disease after coronary bypass surgery. A total of 74 patients were examined, all the patients underwent a course of drug therapy, 37 patients underwent a course of rehabilitation in addition to medical therapy using computer-based stimulation programs (1 time per day for 20 min within 10 days). A course of rehabilitation using computer-based stimulation programs in patients with coronary heart disease after coronary bypass surgery was proved to be an effective way of correcting cognitive function.

Cerebral vasospasm and corticospinal tract injury induced by a modified rat model of subarachnoid hemorrhage

Yang Qin, Jian-wen Gu, Gai-li Li, Xian-hua Xu, Ke Yu, Fa-bao Gao

Double-hemorrhage rat models of subarachnoid hemorrhages (SAH) are most effective at simulating delayed cerebral vasospasms (CVS). The present study modified the models to minimize additional trauma and investigated injury of the corticospinal tract (CST) using diffusion tensor imaging (DTI).

Reduced cerebrospinal fluid concentrations of oxysterols in response to natalizumab treatment of relapsing remitting multiple sclerosis

Lenka Novakova, Markus Axelsson, Clas Malmeström, Henrik Zetterberg, Ingemar Björkhem, Virginija Danylaité Karrenbauer, Jan Lycke

Natalizumab therapy reduces inflammation and degeneration of the CNS in relapsing-remitting multiple sclerosis (RRMS). In cerebrospinal fluid (CSF) the concentration of 24S-hydroxycholesterol (24OHC) reflect neurodegeneration, whereas 27-hydroxycholesterol (27OHC) is dependent on the integrity of the blood-brain barrier (BBB).

The putative acceleration of optic neuritis when combined with chronic hepatitis B

Shuo Zhao, Tingjun Chen, Chunxia Peng, Huanfen Zhou, Hongyang Li, Dehui Huang, Quangang Xu, Shihui Wei

To review the clinical features of optic neuritis (ON) combined with chronic hepatitis B (CHB) retrospectively.

Coexistence of Charcot Marie Tooth disease type 1A and diabetes in Taiwan: A clinicopathological study

Hua-Chuan Chao, Cheng-Ta Chou, Yi-Chung Lee, Kon-Ping Lin

Charcot Marie Tooth disease type 1A (CMT1A) is the most commonly inherited demyelinating polyneuropathy with variable phenotypes, affected by several comorbidities, especially diabetes mellitus (DM). Previous studies showed that DM exacerbates the clinical manifestations of CMT1A.

Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits

Shadi Yaghi, Charlotte Herber, Joshua Z. Willey, Howard F. Andrews, Amelia K. Boehme, Randolph S. Marshall, Ronald M. Lazar, Bernadette Boden-Albala

While imaging is useful in confirming the diagnosis of ischemic stroke, negative diffusion weighted imaging (DWI) is reported in up to 25% of patients. Our aim was to identify predictors of MRI-positive stroke from the itemized NIHSS.

Effects of low doses of Tat-PIM2 protein against hippocampal neuronal cell survival

Su Jung Woo, Min Jea Shin, Dae Won Kim, Hyo Sang Jo, Ji In Yong, Eun Ji Ryu, Hyun Ju Cha, Sang Jin Kim, Hyeon Ji Yeo, Su Bin Cho, Jung Hwan Park, Chi Hern Lee, Eun Ji Yeo, Yeon Joo Choi, Sungyeon Park, Seung Kwon Im, Duk-Soo Kim, Oh-Shin Kwon, Jinseu Park, Won Sik Eum, Soo Young Choi
  • DOI: http://dx.doi.org/10.1016/j.jns.2015.08.1549
  • p226–235
  • Published online: September 1 2015
  • Abstract
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Oxidative stress is considered a major factor in various neuronal diseases including ischemia-reperfusion injury. Proviral Integration Moloney 2 (PIM2) proteins, one of the families of PIM kinases, play crucial roles in cell survival. However, the functions of PIM2 protein against ischemia are not understood. Therefore, the protective effects of PIM2 against oxidative stress-induced hippocampal HT22 cell death and brain ischemic injury were evaluated using Tat-PIM2, a cell permeable fusion protein.

Thalamic atrophy predicts cognitive impairment in relapsing remitting multiple sclerosis. Effect on instrumental activities of daily living and employment status

Athanasios Papathanasiou, Lambros Messinis, Petros Zampakis, Georgios Panagiotakis, Philippos Gourzis, Vasileios Georgiou, Panagiotis Papathanasopoulos

Cognitive impairment is an important predictor of quality of life at all stages of MS. Magnetic Resonance Imaging (MRI) markers have been used to associate tissue damage with cognitive dysfunction.

Does astroglial protein S100B contribute to West Nile neuro-invasive syndrome?

R.B. Kuwar, D.S. Stokic, A.A. Leis, F. Bai, A.M. Paul, J.D. Fratkin, P.J.S. Vig

The clinical spectrum of West Nile Virus (WNV) infection ranges from a flu-like febrile condition to a more severe neuro-invasive disease that can cause death. The exact mechanism of neurodegeneration in neuro-invasive form of WNV infection has not been elucidated; however, a destructive role played by glial cells in promoting WNV mediated neurotoxicity has widely been speculated. The clinical studies revealed that the astroglial protein S100B is significantly elevated in the blood and CSF of patients with WNV infection, even in the absence of neuro-invasive disease.

Quantitative evaluation of gait ataxia by accelerometers

Shinichi Shirai, Ichiro Yabe, Masaaki Matsushima, Yoichi M. Ito, Mitsuru Yoneyama, Hidenao Sasaki

An appropriate biomarker for spinocerebellar degeneration (SCD) has not been identified. Here, we performed gait analysis on patients with pure cerebellar type SCD and assessed whether the obtained data could be used as a neurophysiological biomarker for cerebellar ataxia. We analyzed 25 SCD patients, 25 patients with Parkinson's disease as a disease control, and 25 healthy control individuals. Acceleration signals during 6 min of walking and 1 min of standing were measured by two sets of triaxial accelerometers that were secured with a fixation vest to the middle of the lower and upper back of each subject.

Usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment

Tatsuya Nakama, Satoshi Yamashita, Tomoo Hirahara, Sadahisa Okamoto, Shoji Honda, Masaki Watanabe, En Kimura, Makoto Uchino, Shigetoshi Yano, Jun-ichi Kuratsu, Yukio Ando

Cryptococcal meningitis is a severe infection among immunosuppressed individuals, with a high mortality rate. Although amphotericin B is the first-choice drug for treatment, its use is restricted when adverse effects are clinically problematic. The usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment has been unconfirmed. We evaluated the efficacy of intraventricular infusion of amphotericin B through Ommaya reservoirs.

A global health delivery framework approach to epilepsy care in resource-limited settings

Maggie F. Cochran, Aaron L. Berkowitz

The Global Health Delivery (GHD) framework (Farmer, Kim, and Porter, Lancet 2013;382:1060–69) allows for the analysis of health care delivery systems along four axes: a care delivery value chain that incorporates prevention, diagnosis, and treatment of a medical condition; shared delivery infrastructure that integrates care within existing healthcare delivery systems; alignment of care delivery with local context; and generation of economic growth and social development through the health care delivery system.

Hyperthermic preconditioning severely accelerates neuronal damage in the gerbil ischemic hippocampal dentate gyrus via decreasing SODs expressions

Dong Won Kim, Jeong-Hwi Cho, Geum-Sil Cho, In Hye Kim, Joon Ha Park, Ji Hyeon Ahn, Bai Hui Chen, Bich-Na Shin, Hyun-Jin Tae, Seongkweon Hong, Jun Hwi Cho, Young-Myeong Kim, Moo-Ho Won, Jae-Chul Lee

It is well known that neurons in the dentate gyrus (DG) of the hippocampus are resistant to short period of ischemia. Hyperthermia is a proven risk factor for cerebral ischemia and can produce more extensive brain damage related with mortality rates. The aim of this study was to examine the effect of hyperthermic conditioning (H) on neuronal death, gliosis and expressions of SODs as anti-oxidative enzymes in the gerbil DG following 5 min-transient cerebral ischemia. The animals were randomly assigned to 4 groups: 1) (N + sham)-group was given sham-operation with normothermia (N); 2) (N + ischemia)-group was given 5 min-transient ischemia with N; 3) (H + sham)-group was given sham-operation with H; and 4) (H + ischemia)-group was given 5 min-transient cerebral ischemia with H.                    

Burden among Parkinson's disease care givers for a community based study from India

Jaya Sanyal, Soumi Das, Epsita Ghosh, T.K. Banerjee, L.V.K.S. Bhaskar, Vadlamudi Raghavendra Rao

Aim was to analyze predictors of burden among primary caregivers (CGs) of Indian Parkinson's disease (PD) patients. 150 PD patients were administered using Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale (H&Y), Montgomery Asberg Depression Rating Score (MADRS) and Mini Mental State Examination (MMSE) in this cross-sectional evaluation study. CG burden was assessed by Caregiver's Burden Scale (CBS), Hospital Anxiety and Depression Scale (HADS), SF-36 and 20-item Burden Assessment Schedule (BAS).                       

Plasma cortisol level in amyotrophic lateral sclerosis

Rossella Spataro, Paolo Volanti, Francesco Vitale, Francesco Meli, Tiziana Colletti, Antonino Di Natale, Vincenzo La Bella

Background. Amyotrophic Lateral sclerosis (ALS) is associated with a significant distress, being linked to changes in hypothalamic–pituitary–adrenal axis activity. A loss of cortisol circadian rhythmicity in ALS patients was suggested, while more recently an increased plasma cortisol level in the disease has been reported.Objective. To assay the circadian plasma cortisol level in ALS and to study its relationship with the clinical phenotype and the rate of disease progression.Patients and methods.          

Persistent otolith dysfunction even after successful repositioning in benign paroxysmal positional vertigo

Eui-Joong Kim, Sun-Young Oh, Ji Soo Kim, Tae-Ho Yang, Si-Young Yang

To evaluate utricular and saccular function during the acute and resolved phases of BPPV, ocular and cervical vestibular evoked myogenic potentials (VEMPs) were studied in 112 patients with BPPV and 50 normal controls in a referral-based University Hospital. Ocular (oVEMPs) and cervical VEMPs (cVEMPs) were induced using air-conducted sound (1000 Hz tone burst, 100 dB normal hearing level) at the time of initial diagnosis and 2 months after successful repositioning in patients with BPPV, and the results were compared with those of the controls.          

Cervical and ocular vestibular evoked potentials in Machado–Joseph disease: Functional involvement of otolith pathways

Rodrigo Souza Ribeiro, Melissa Marques Pereira, José Luiz Pedroso, Pedro Braga-Neto, Orlando Graziani Povoas Barsottini, Gilberto Mastrocola Manzano

Machado–Joseph disease is defined as an autosomal dominant ataxic disorder caused by degeneration of the cerebellum and its connections and is associated with a broad range of clinical symptoms. The involvement of the vestibular system is responsible for several symptoms and signs observed in the individuals affected by the disease. We measured cervical and ocular vestibular evoked myogenic potentials in a sample of Machado–Joseph disease patients in order to assess functional pathways involved.

The characteristics of camptocormia in patients with Parkinson's disease: A large cross-sectional multicenter study in Japan

Shunya Nakane, Masaru Yoshioka, Nobuhito Oda, Takashi Tani, Keiji Chida, Mikiya Suzuki, Itaru Funakawa, Akira Inukai, Kazuko Hasegawa, Kenji Kuroda, Kouichi Mizoguchi, Keiichi Shioya, Yoshito Sonoda, Hidenori Matsuo

The goal of the present study was to clarify the clinical characteristics and laboratory results of parkinsonian symptoms among patients with and without camptocormia.

Olfactory bulb and olfactory sulcus depths are associated with disease duration and attack frequency in multiple sclerosis patients

Nermin Tanik, Halil Ibrahim Serin, Asuman Celikbilek, Levent Ertugrul Inan, Fatma Gundogdu

Background and purpose: Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative disease that progresses to axonal loss and demyelinization. Olfactory dysfunction in patients with MS has been reported frequently. We were interested in the associations of olfactory bulb (OB) and olfactory sulcus depth (OSD) with disease duration and attack frequency. Methods: We included 25 patients with MS and 30 age- and sex-matched controls in this study. The Expanded Disability Status Scale, Beck Depression Inventory, and Mini Mental State Examination were applied.                      

Cerebrospinal fluid Aβ40 is similarly reduced in patients with Frontotemporal Lobar Degeneration and Alzheimer's Disease

Inês Baldeiras, Isabel Santana, Maria João Leitão, Maria Helena Ribeiro, Rui Pascoal, Diana Duro, Raquel Lemos, Beatriz Santiago, Maria Rosário Almeida, Catarina Resende Oliveira

Cerebrospinal fluid (CSF) biomarkers have been increasingly studied for dementia diagnosis, however the accuracy to distinguish between different forms of dementia is still unsatisfactory. In this study, the added value of another CSF Aβ-peptide (Aβ40), along with the core CSF markers t-Tau, p-Tau, and Aβ42, in the discrimination between two large dementia groups of Frontotemporal Lobar Degeneration (FTLD; n = 107), Alzheimer's Disease (AD; n = 107) and non-demented subjects (n = 33) was evaluated. In FTLD, t-Tau and p-Tau were significantly increased in relation to controls, but lower than in AD, while Aβ42 was similar in FTLD and controls, but higher than in AD.

Sexual dysfunction in multiple sclerosis: A 6-year follow-up study

Kisic-Tepavcevic Darija, Pekmezovic Tatjana, Trajkovic Goran, Stojsavljevic Nebojsa, Dujmovic Irena, Mesaros Sarlota, Drulovic Jelena

Sexual dysfunction (SD) is a common but often overlooked and undertreated symptom in multiple sclerosis (MS). The purpose of our longitudinal study was to explore the changes in the level of sexual functioning in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the predictors of changes in SD during the period of observation.