Peka Christova1,2, Lisa M. James1,2,3, Adam F. Carpenter1,4, Scott M. Lewis1,4, Rachel A. Johnson1, Brian E. Engdahl1,2,5, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA

4Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

5Department of Psychology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Independent lines of research have documented elevated peripheral inflammation and brain white matter alterations in Gulf War Illness (GWI). We recently documented an association of C-reactive protein (CRP), a marker of inflammation, and decreased fornix white matter integrity in GWI. The aim of the present study was to extend those findings to evaluate the association between CRP and white matter anisotropy and diffusion throughout the brain in GWI. Sixty-three veterans with GWI provided blood samples for evaluation of CRP and underwent a 3T magnetic resonance imaging scan from which fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were obtained. An additional index characterizing the shape of the diffusion ellipsoid, Ca, which reflects deviation from sphericity (or isotropy) was obtained. Results demonstrated that CRP was significantly associated with decreased FA and Ca and with increased RD and MD, but not AD. These findings documenting a highly significant association between peripheral inflammation and specific white matter alterations in GWI are discussed in terms of GWI-related exposures that may promote systemic inflammation and deleterious neural effects downstream.

DOI: 10.29245/2572.942X/2020/3.1276 View / Download Pdf

Lisa M. James1,2,3, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA

4Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Dementia and Parkinson’s disease are the two most common age-related neurodegenerative conditions. Recent studies have identified Human Leukocyte Antigen (HLA) Class II DRB1 alleles that are protective or neutral with respect to dementia. Here we extend those findings to evaluate the association of the population frequency of HLA DRB1 alleles with the prevalence of dementia and Parkinson’s disease in14 Continental Western European countries. Nine HLA DRB1 alleles were identified including four that are protective against dementia (DRB1*01:01, DRB1*04:01, DRB1*13:02, DRB1*15:01), three that are neutral (DRB1*03:01, DRB1*07:01, DRB1*08:01), and two susceptibility alleles (DRB1*11:01, DRB1*04:05). Results demonstrated that the population prevalence’s of dementia and Parkinson’s disease are highly correlated and that the association between the nine DRB1 alleles above and the population prevalence of dementia is highly overlapping with that of Parkinson’s disease. These findings suggest a common HLA Class II DRB1 profile. Given the diverse role of HLA Class II alleles in protection from foreign antigens, autoimmunity, and, possibly, neuroprotection, the shared HLA profile between dementia and Parkinson’s disease indicates that common immunogenetic mechanisms underlie the pathogenesis and manifestation of these diseases.

DOI: 10.29245/2572.942X/2020/3.1275 View / Download Pdf

Caroline Figueiredo da Silva1*, Gustavo Figueiredo da Silva1, Washigton Luiz Gomes de Medeiros Junior1, Marcus Vinícius Magno Gonçalves2

1Medical student - Department of Medicine, University of the Region of Joinville (UNIVILLE), Brazil

2Medical Doctor, PhD and Professor of Neurology, University of the Region of Joinville (UNIVILLE), Brazil

The objective of this review is to provide an overview of the current knowledge of Anti-IgLON5 syndrome. The IgLON proteins are a family of cell adhesion molecules and the presence of antibodies against IgLON5 is crucial for the Anti-IgLON5 Syndrome diagnosis. This syndrome has an expanded clinical spectrum that involves prominent sleep disorder, progressive bulbar dysfunction, gait instability with abnormal eye movements reminiscent, and cognitive deterioration sometimes associated with chorea. The main neuropathological finding is the neuronal loss with hyperphosphorylated tau (p-Tau) protein accumulation at the hypothalamus, brainstem tegmentum, hippocampus, periaqueductal gray matter, medulla oblongata, and upper cervical cord. The exact pathogenesis is still unclear and involves a neurodegenerative process and autoimmune response. Early diagnosis is important to avoid unnecessary tests and prevent complications. Important resources for diagnosis are the antibody testing of serum and CSF for IgLON5-IgG. The Anti-IgLON5 syndrome mortality is high and new studies published described a good response to immune therapy. However, the response to immune therapy depends on some clinical and analytical characteristics. In addition, future studies are needed to thoroughly analyze the aspects of pathogenesis and treatment of this important pathological syndrome.

CNS - Central Nervous System

CSF - Cerebrospinal Fluid

IgG - Immunoglobulin G

MRI – Magnetic Resonance Imaging

PSP-like - Progressive Supranuclear Palsy

p-Tau - Hyperphosphorylated Tau Protein

REM - Rapid Eye Movement

DOI: 10.29245/2572.942X/2020/3.1269 View / Download Pdf

Keshav Mishra1, Devendra Purohit1*, Somnath Sharma1

1Department of Neurosurgery, SMS Medical College, Jaipur, India

Cognitive impairment is a major cause of morbidity and impaired quality of life in traumatic brain Injury (TBI) patients. Assessment of cognitive function using classically designed scales is time and resource intensive undertaking which also requires expert neuropsychiatrist referral. Montreal cognitive assessment Score (MoCA) is a brief screening tool designed to assess various cognitive domains which has been found to be more sensitive than Mini Mental State Examination (MMSE) score both in Alzheimer disease and subsequently in TBI population. Applied on TBI population, it reliably detects cognitive impairment in mild TBI, compared to normal controls and also differentiates cognitive disturbances between mild and severe TBI but its ability to differentiate cognitive function between mild and moderate TBI is equivocal.

DOI: 10.29245/2572.942X/2020/3.1238 View / Download Pdf

Don R. Thorpe1,2, Brian E. Engdahl1-4, Arthur Leuthold2,3, Apostolos P. Georgopoulos1,2,3,5,6*

1Graduate Program in Cognitive Science, University of Minnesota, Minneapolis, Minnesota, USA

2Brain Sciences Center, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA

3Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota, USA

4Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA

5Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA

6Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA

Mild traumatic brain injury (mTBI) affects 22% of U.S. service members returning from Afghanistan and Iraq. Its diagnosis is challenging due to the heterogeneous structural and functional alterations inflicted by diverse injury mechanisms. mTBI is diagnosed mainly based on history (trauma) and clinical evaluation, since conventional neuroimaging methods, such as magnetic resonance imaging (MRI) and computerized tomography (CT) of the brain, typically do not reveal clear abnormalities. Similarly, the assessment of recovery following mTBI relies exclusively on clinical evaluation, based on several criteria. With respect to brain function, we hypothesized that mTBI reflects disturbed dynamic interactions among neuronal populations, a disturbance not detectable by the aforementioned techniques. In a quest for an objective tool to detect the presence of mTBI and assess recovery from it, here we used magnetoencephalography (MEG), a modality highly suited to assess the dynamic functional status of the brain. Specifically, we used the Synchronous Neural Interactions (SNI) test to evaluate functional brain status of 257 healthy (“control”) veterans, 19 veterans with a clinical diagnosis of active mTBI (“a-mTBI”), and 18 veterans who suffered from mTBI and, at the time of testing, were deemed to have recovered from it (“r-mTBI”). A stepwise linear discriminant analysis (LDA) yielded 37 SNI predictors that classified 100% correctly of all 257 control and 19 a-mTBI brains. We then used these predictors to classify the 18 r-mTBI brains to control or a-mTBI groups: 9 brains (50%) were classified as control, whereas the other 10 (50%) were classified as a-mTBI. These findings (a) document the power of SNI MEG to correctly detect a-mTBI, and (b) raise concerns regarding the validity of clinical assessment tools to pronounce recovery from mTBI. On the positive side, our results provide an objective brain-based continuum along which the status of a mTBI brain can be assessed. This measure, together with clinical evaluation, should appreciably reduce the uncertainty and considerably improve the quantification of recovery from mTBI, guiding further treatment.

DOI: 10.29245/2572.942X/2020/3.1274 View / Download Pdf

Peka Christova1,2, Lisa M. James1,2,3, Adam F. Carpenter1,4, Scott M. Lewis1,4, Brian E. Engdahl1,5, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA

4Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

5Department of Psychology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Independent lines of research have demonstrated that GWI is associated with elevated inflammatory markers, metabolic disruptions, and alterations in brain morphometry. Possessing specific Class II human leukocyte antigen (HLA) alleles, on the other hand, has been shown to protect against GWI and to be inversely associated with symptom severity in a dose-dependent manner. The aim of the present study was to evaluate the association between C-reactive protein (CRP), a marker of inflammation, body mass index (BMI), and brain morphometry in GWI veterans with and without a protective HLA allele. Sixty-three veterans with GWI provided blood samples for evaluation of CRP and HLA, height and weight for calculating BMI, and underwent a 3T magnetic resonance imaging scan from which the volume, surface area, and cortical thickness of 68 cortical regions of interest (ROI) were determined. Results demonstrated that the CRP was highly significantly associated with BMI and cortical thinning in veterans lacking protective HLA alleles but not in those possessing a protective HLA allele. Given the role of HLA in antibody production against foreign antigens, the findings suggest that persistent foreign antigens stemming from lack of immunogenetic protection against them contribute to inflammation, metabolic disruption, and cortical thinning in GWI. The findings are discussed in terms of GW-related exposures that are known to result in inflammation.

DOI: 10.29245/2572.942X/2020/3.1273 View / Download Pdf

Peka Christova1,2, Lisa M. James1,2,3, Adam F. Carpenter1,4, Scott M. Lewis1,4, Rachel A. Johnson1, Brian E. Engdahl1,2,5, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, US

4Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

5Department of Psychology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Memory and mood impairments are among the most commonly reported symptoms in veterans with Gulf War Illness (GWI), suggesting hippocampal involvement. Several studies have also documented evidence of inflammation in GWI. The aim of the present study was to evaluate the association between C-reactive protein (CRP), a marker of inflammation, and hippocampal volume and microstructural alterations of its major output, the fornix. Sixty-three veterans with GWI provided blood samples for evaluation of CRP and underwent a 3T magnetic resonance imaging scan from which hippocampal volume and fornix fractional anisotropy (FA) were obtained. Results demonstrated that CRP was significantly and negatively associated with hippocampal volume and fornix FA in GWI. Given the known closely interwoven associations between inflammation and neurodegeneration, it is possible that the effects we observed could be due to neurodegeneration, secondary to chronic neuroinflammation. Finally, given the known association of hippocampus to memory and mood disorders, our findings provide new insights into memory and mood alterations associated with GWI.

DOI: 10.29245/2572.942X/2020/3.1272 View / Download Pdf

Maria del Rocio Cantero, Horacio F. Cantiello

Laboratorio de Canales Iónicos, Instituto Multidisciplinario de Salud, Tecnología y Desarrollo (IMSaTeD, CONICET-UNSE) Santiago del Estero, Argentina

Microtubules (MTs) are long cylindrical structures of the cytoskeleton that control cell division, vesicular transport, and the shape of cells. MTs are highly charged and behave as nonlinear electrical transmission lines. However, comparatively little is known about the role(s) these nonlinear electrical properties of MTs play in cell function. MTs form bundles, which are particularly prominent in neurons, where they help developmentally define axons and dendrites. The present review summarizes recent work from our laboratory which demonstrated that 1) bundles of rat brain MTs spontaneously generate electrical oscillations and bursts of electrical activity similar to action potentials; 2) actin filaments control electrostatically the oscillatory response of brain MTs; and 3) neurites of cultured mouse hippocampal neurons generate and propagate electrical oscillations thus, providing a cellular correlate to the isolated MT oscillations. Electrical oscillations are an intrinsic property of brain MT bundles, which may have important implications in the control of various neuronal functions, including a contribution to the intrinsic oscillatory modes of neurons, and thus to higher brain functions, including the formation of memory and the onset of consciousness.

DOI: 10.29245/2572.942X/2020/3.1267 View / Download Pdf

Steven Yale1*, Halil Tekiner2, Eileen S Yale3

1University of Central Florida College of Medicine, Department of Internal Medicine, Orlando, USA

2Department of the History of Medicine and Ethics, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey

3University of Florida, Division of General Internal Medicine, Gainesville, USA

DOI: 10.29245/2572.942X/2020/2.1266 View / Download Pdf

Yu-Lung Lin1, Yi-Wei Li1, Li-Na Wei1*

Department of Pharmacology, University of Minnesota, Minneapolis, USA

Receptor interacting protein 140 (RIP140), gene named Nuclear receptor interacting protein 1 (Nrip1), is a transcription co-regulator of numerous nuclear receptors and transcription factors that are important for various biological processes. RIP140 is highly expressed in various cell types of the brain, especially cortex and hippocampus. Increasingly, studies have begun to reveal its multiple functional roles in maintaining brain health. In particularly, there appears to be an intimate relationship between RIP140 and neurodegenerative diseases, such as reduced RIP140 expression in Alzheimer’s Disease (AD) postmortem brain and impaired cognitive functions in RIP140 knockout mice. The different functional roles of RIP140, mediated by distinct mechanisms, coordinately contribute to the execution of stress response of the brain to Endoplasmic Reticulum (ER) stress, heat shock (HS) stress, oxidative stress and psychological/behavioral stress. In this review, we describe the roles of RIP140 in three brain cell types (neurons, microglia, and astrocytes) stressed by pharmacological agents or behavioral manipulation. These results demonstrate physiological integration of various functional roles of RIP140 in different brain cells to facilitate survival and recovery from stress. The results also suggest a potential, preventive and/or therapeutic strategy by targeting RIP140 in managing neurodegenerative diseases.

DOI: 10.29245/2572.942X/2020/2.1265 View / Download Pdf

Mohamed ElSayed Abdelhady1*, Nida Fatima2*, Yaman Al Kailani1, Ahmed Own1, Surjith Vattoth1

1Department of Neuro radiology, Hamad General Hospital, Doha, Qatar

2Department of Neurosurgery, Hamad General Hospital, Doha, Qatar

DOI: 10.29245/2572.942X/2020/1.1259 View / Download Pdf

Loris A Chahl

School of Biomedical Sciences and Pharmacy University of Newcastle NSW 2308 Australia

It has been shown previously that rats treated as neonates with capsaicin exhibited hyperactivity in a novel environment and had brain changes, including reduced brain weight, reduced hippocampal area, reduced cortical thickness and increased neuronal density in several cortical areas. These brain changes resembled those found in subjects with schizophrenia. This mini review discusses recent findings on the effects of capsaicin on hippocampal neurons and the role of TRPV1 channels in the central nervous system, which provide a possible explanation for the effects of capsaicin on the developing rat brain. Future studies on the role of TRPV1 channels in the brain hold great promise for further understanding of neuropsychiatric disorders.

DOI: 10.29245/2572.942X/2020/1.1264 View / Download Pdf

Isabelle Pastor Bandeira1*, Washigton Luiz Gomes de Medeiros Junior1, André Eduardo de Almeida Franzoi1, Laura Fiuza Parolin2, Paulo Roberto Wille3, Marcus Vinícius Magno Gonçalves4

1Department of Medicine, University of the Region of Joinville (UNIVILLE), Brazil

2University of the Region of Joinville (UNIVILLE), Brazil

3University of the Region of Joinville (UNIVILLE), Brazil

4University of the Region of Joinville (UNIVILLE), Brazil

Pseudoathetosis is a movement disorder caused by loss of proprioception. The disorder is characterized by involuntary, slow, and writhing movements. Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). The disease is characterized by multiple lesions of the brain and spinal cord. These lesions are disseminated in time and space. The onset of the neuroinflammation is characterized by episodes of neurological dysfunction that usually recover. Reports of MS with pseudoathetosis are extremely rare. The association of these two disorders is uncommon. This article shows a 29-year-old woman who presented pseudoathetosis as the initial symptom of MS. Therefore, this case report is very relevant for medical knowledge due to the rare form presentation of MS.

DOI: 10.29245/2572.942X/2020/1.1258 View / Download Pdf

Lisa M. James1,2,3, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, USA

4Department of Neurology, University of Minnesota Medical School, Minneapolis, USA

Dementia is a leading cause of death worldwide, representing a significant global burden. In addition to genetic and lifestyle factors that have been widely linked to dementia, pathogens are increasingly recognized as contributing to the development of dementia. Here we discuss the role of human leukocyte antigens (HLA) in maintaining brain health by facilitating the elimination of pathogens and highlight evidence suggesting that the inability to eliminate pathogens contributes to dementia. Finally, we briefly review common forms of dementia including Alzheimer’s disease, vascular dementia, frontotemporal dementia, Lewy body dementia, and prion dementia in an effort to contextualize the role of persistent pathogens across the various dementia phenotypes.

DOI: 10.29245/2572.942X/2019/1.1260 View / Download Pdf

Tao Tao*, Jie Sun, Min-Sheng Zhu

Model Animal Research Center, State Key Laboratory of Pharmaceutical Biotechnology and Department of Neurology of the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing University, China

DOI: 10.29245/2572.942X/2019/1.1263 View / Download Pdf

Ashutosh Gupta

Consultant Neurologist, Department of Neurology, Shree Aggarsain International Hospital, Rohini, Delhi, India

The venom toxins of honeybee cause anaphylactic allergic reactions and/or any type of stroke. Hemorrhagic strokes are more severe than the ischemic strokes. Diverse pathophysiological mechanisms have been postulated for occurrence of these strokes. We discuss here mechanism of acute fatal hemorrhagic and ischemic stroke in a middle age woman, stung by the honeybee on her right arm and who clinically manifested loss of consciousness and tonic clonic seizure, within 3-4 hours followed by hemiparesis. The MRI revealed brain lesions of multiple infarctions with hemorrhagic transformation, subdural (SDH) and subarachnoid (SAH) hemorrhages. This appears to be the first report, wherein a patient had entire spectrum of stroke (infarcts, subarachnoid and subdural hemorrhages), after a single inciting event of bee sting.

DOI: 10.29245/2572.942X/2019/1.1262 View / Download Pdf

Lisa M. James1,2,3, Apostolos P. Georgopoulos1,2,3,4*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, USA

4Center for Cognitive Sciences, University of Minnesota, Minneapolis, USA

5Department of Neurology, University of Minnesota Medical School, Minneapolis, USA

Human Leukocyte Antigen (HLA) Class II DRB1*13:02 has recently been found to protect against dementia in Continental Western Europe. Here we extend those findings by evaluating the association between the population frequency of two additional Class II HLA alleles – DRB1*01:01 and DRB1*15:01 – alone and in combination with DRB1*13:02, on dementia prevalence in Continental Western Europe. Results indicated that the prevalence of dementia in 14 Continental Western European (CWE) countries significantly decreased exponentially with increasing frequency of any of the three alleles alone and in combination (P’s < 0.001). When combined, the population frequency of the three alleles accounted for 67% of the variance in dementia prevalence. The combined frequency of DRB1*01:01, DRB1*13:02, and DRB1*15:01 was also significantly associated with dementia prevalence in those aged 65 years and older (P = 0.004) and with a change in dementia prevalence between 1990 and 2016 (P = 0.006). These findings, which document the protective effects of three common Class II HLA alleles on dementia prevalence in CWE, are discussed in terms of the role of HLA class II genes in pathogen elimination. More specifically, we hypothesize that dementia prevalence is higher for countries in which the population frequency of these protective alleles is low, prohibiting the successful elimination of pathogens that may play a causal role in dementia.

DOI: 10.29245/2572.942X/2019/1.1261 View / Download Pdf

Effie-Photini C. Tsilibary1,2, Eric P. Souto1, Marian Kratzke1,2, Lisa M. James1,2,3, Brian E. Engdahl1,2,4, Apostolos P. Georgopoulos1,2,3,5*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA

4Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA

5Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA

Gulf War Illness (GWI) is a multisystem disorder of unknown etiology that has afflicted many veterans of the 1990-91 Gulf War who have sustained progressively worsening health since the war1. Recent studies have demonstrated the presence of active inflammation in GWI2,3 and, in addition, a positive association of the levels of C-reactive protein (CRP), an inflammatory marker, with GWI symptom severity3. Moreover, we have shown that GWI serum contains substances that are harmful to neural cultures4`, a detrimental effect that can be prevented by serum of healthy GW veterans4 and partially so by pooled human immunoglobulin G (IgG)5. Although possible exposure to environmental toxins in war theater has been traditionally blamed for GWI6, the evidence above3-5 and the fact that the disease also afflicted nondeployed veterans7, point to other causes, including the vaccines administered to GW veterans4,5,7, such as the vaccine against anthrax. Here we present, for the first time, evidence indicating the presence of the harmful anthrax protective antigen PA63 in the serum of 15 veterans suffering from GWI, as follows. First, we confirmed that the addition of GWI serum to the culture had a detrimental effect, including decreased cell spreading and increased cell apoptosis, as reported previously4. And second, we found that the concomitant addition of specific polyclonal or monoclonal antibodies against PA63 had a remarkable protective effect on N2A cultures, significantly ameliorating cell spreading and reducing cell apoptosis. These results document that the adverse effects of GWI serum on neural cultures are due, in part, to persistent pathogens derived from the anthrax vaccine. We hypothesize that these anthrax pathogens persisted in the blood of the GWI veterans tested because of inability of those veterans to make antibodies against them, probably due to lack of Human Leukocyte Antigen (HLA) protection8. Finally, our findings point to a possible successful intervention in GWI consisting in neutralizing (by administering specific antibodies) and/or removing (by plasmapheresis) those harmful anthrax antigens.

DOI: 10.29245/2572.942X/2019/6.1255 View / Download Pdf

José Berciano1*, Antonio García2, Jon Infante1

1Service of Neurology, University Hospital “Marqués de Valdecilla (IDIVAL)”, University of Cantabria, and “Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)”, Santander, Spain

2Service of Clinical Neurophysiology, University Hospital “Marqués de Valdecilla (IDIVAL)”, and “Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)”, Santander, Spain

Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is a form of ataxia characterized by the combination of bilateral vestibular, cerebellar and somatosensory impairment. In this commentary we summarized our report of five CANVAS cases presenting with spasmodic cough, which antedated the appearance of imbalance in several decades. Furthermore, in the hallmark of a severe sensory ataxia, tendon jerks and T-reflex recordings were almost completely preserved; sparing of muscle spindle afferents (fibres Ia) is probably the pathophysiological basis of normoreflexia.

DOI: 10.29245/2572.942X/2019/5.1257 View / Download Pdf

Pascal J.D. Grolaux

Department of Osteopathy, Kinesis Health Associates, 2d floor, 155 Ochterloney Street, Dartmouth, B2Y1C9, Nova Scotia, Canada

Background: Generalized anxiety disorder (GAD), chronic pain (CP) and irritable bowel syndrome (IBS) are debilitating inflammatory disorders that are frequently seen in primary care facilities but not sufficiently addressed by classical medical treatments. Transcutaneous vagus nerve stimulation (tVNS) is a promising therapeutic tool for a wide range of conditions that showed already encouraging clinical results. However, the effects of tVNS, on GAD, IBS and CP, were not yet explored in the context of an investigation conducted in a private healthcare center.

Objective: In an uncontrolled, open label, small investigation scale study, we investigated the feasibility, safety and the effects of tVNS for patients suffering from GAD, CP and IBS in a multidisciplinary healthcare center.

Methods: The effects of tVNS on GAD, CP and IBS in 10 participants (anxiety, 40%; chronic pain, 30%; IBS, 30%) were investigated during a 4-week period and a 2-month follow-up. GAD, CP and IBS were assessed using the Generalized Anxiety Disorder GAD-7, the Brief Pain Inventory Short Form questionnaire and the Irritable Bowel Syndrome Severity Scoring System. Transcutaneous vagus nerve stimulation was performed using a transcutaneous electrical nerve stimulation device and ear clip electrodes plugged in the concha area of the ear. All participants, received a bi-weekly 30-minute stimulation for 4 weeks. The tVNS parameters, (GAD: 20Hz-80µs), (CP: 5Hz-200 µs), (IBS: 3Hz-250µs), were set for each group to target different physiological effects meditated by the vagus nerve.

Results: The anxiety and the IBS group showed a non-statistically significant improvement but an improved clinical status (mean score from “severe” to “moderate”) both at the end of the stimulation period (4 weeks) and at 2-month follow-up. The CP group didn’t show any significant clinical improvement (mean score from “moderate” to “moderate”). Furthermore, tVNS was demonstrated to be likely safe and was well tolerated.

Conclusions: Due to low sample size, this study failed to demonstrate significant clinical effects of tVNS on GAD, IBS and CP. However, trend analysis may carefully suggest tVNS to be a noteworthy clinical alternative to be used in private healthcare center in the treatment of chronic inflammation disorders like GAD and IBS. Acute tVNS was well-tolerated and is likely safe. Powerful, double-blind controlled studies are needed to support the use of tVNS on these disorders.

Clinical Trial Registration: http:/www.clinicaltrials.gov. Unique identifier: NCT03440255.

Abbreviations: α7nAChR, alpha7 nicotinic acetylcholine receptor; ABVN, auricular branch of the vagus nerve; CAN, central autonomic network; CAP, cholinergic anti-inflammatory pathway; CP, chronic pain; DMVN, dorsal motor nucleus of the vagus; GABA, γ-aminobutyric acid; GAD, general anxiety disorder; HR, heart rate; HPA, hypothalamic pituitary adrenal; HRV, heart rate variability; IBS, irritable bowel syndrome; IL, Interleukin; fMRI, functional magnetic resonance imagery; NF-κB, nuclear factor kappa B; NTS, nucleus tractus solitarius; pNN50, percentage of successive R-R intervals that differ by more than 50ms from the preceding one; PW, pulse width; RMSSD, root mean square of successive R-R interval differences; RR, respiratory rate; RSA, respiratory sinus arrhythmia; SD1, standard deviation of the distance of each point from the y = x axis in a Poincaré plot; TENS, transcutaneous electrical nerve stimulation; TNF, tumor necrosis factor; VN, vagus nerve; nVNS, non-invasive vagus nerve stimulation; tVNS, transcutaneous vagus nerve stimulation.

DOI: 10.29245/2572.942X/2019/5.1251 View / Download Pdf

Lisa M. James1,2,3,4, Apostolos P. Georgopoulos1,2,3,4,5*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA

4Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN 55455, USA

5Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Human Leukocyte Antigen (HLA) Class II DRB1*13 alleles have recently been found to protect against age-related brain deterioration, even in the presence of apolipoprotein E4 (apoE4),1,2 suggesting a possible protection against dementia. Here we evaluated the association between the population frequency of common DRB1*13 alleles and the prevalence of dementia in Continental Western Europe. Prevalence of dementia in Continental Western Europe was derived from published reports on dementia frequency from the Global Burden of Disease Study 2016 and population totals obtained from the Population Reference Bureau. DRB1*13:01 and DRB1*13:02 allele frequencies were obtained from a publicly available database (allelefrequency.net) and apolipoprotein E was obtained from published reports on the world distribution of apoE4. The prevalence of dementia in 14 Continental Western European (CWE) countries, where life expectancy is practically identical, significantly decreases exponentially with increasing frequency of DRB1*13:02 (R2 = 0.452, P = 0.008), even when adjusted for the prevalence of apolipoprotein E4 allele, a known risk factor for Alzheimer’s disease. This finding documents the protective effect of DRB1*13:02 on dementia prevalence in CWE. Since the function of HLA class II genes is to aid in the elimination of pathogens by enabling the production of antibodies against their antigens in specific immunity, the protective effect of DRB1*13:02 points to the presence of persistent harmful antigens as causal factors in development of dementia, antigens specific to DRB1*13:02 that could not be eliminated in its absence.

DOI: 10.29245/2572.942X/2019/5.1253 View / Download Pdf

Spyros Charonis1,2, Lisa M. James1,2, Apostolos P. Georgopoulos1,2*

1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, 5541, USA

2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Gulf War Illness (GWI) is a chronic, multi-symptom disorder of unknown etiology affecting veterans of the 1990-91 Gulf War. We identified previously1 a set of 6 Human Leukocyte Antigen (HLA) class II alleles that are protective for GWI, namely DPB1*01:01, DPB1*06:01, DQB1*02:02, DRB1*01:01, DRB1*08:11, and DRB1*13:02. Since the function of HLA class II molecules is to connect with matching extracellular antigens of various pathogens (mostly viruses), as an initial step in the sequence of events leading to the development of antibodies against the matched antigen and its subsequent elimination, we hypothesized that GWI may be due, in part, to the persistence of offending antigens which could not be eliminated2,3. We further hypothesized4,5 that such antigens were contained in the 16 vaccines administered to GW veterans against adenovirus, anthrax, botulinum, cholera, diphtheria, hepatitis B, influenza A, Japanese encephalitis, measles, meningococcus, poliomyelitis, rabies, smallpox, tetanus, typhoid, yellow fever6. This hypothesis predicts that antigens present in those vaccines should have a high affinity for matching with the 6 HLA class II protective alleles above. Here we tested this prediction by using the Immune Epitope DataBase (IEDB7) to determine the ranked affinity of each one of the 6 GWI protective alleles to the 10 most frequently assayed epitopes of each pathogen for which a vaccine was administered. We found that our 6 GWI protective alleles above collectively covered all vaccine antigens except for rubella for which all alleles above showed low binding affinity. Affinity strength varied among antigen-allele pairs, with DRB1*01:01 and DRB1*13:02 showing overall higher affinities. These two alleles also had the highest binding affinities for the anthrax antigen contained in the anthrax vaccine administered to GW veterans. These findings document a good match between the 6 GWI HLA protective alleles above and the antigens contained in the GW vaccines, and support the fundamental assumption that the HLA protection for GWI is mediated through the successful elimination of potentially harmful persistent antigens contained in those vaccines.

DOI: 10.29245/2572.942X/2019/5.1254 View / Download Pdf

Uwe Ernsberger

Institute for Clinical Neuroanatomy, Johann-Wolfgang-Goethe University, Frankfurt/Main, Germany

The molecular characterization of postganglionic sympathetic neurons by RNA sequencing has allowed the full assessment of gene expression in individual cells and classification of neurons into subpopulations defined by their gene expression profile and developmental history. The identification of growth factor receptor subunits specifically expressed by select neuron subpopulations enabled the demonstration of GDNF family ligands and the respective receptor subunits as instrumental in the innervation of certain targets. These are first critical steps in the attempt to characterize the molecular processes leading to the establishment and maintenance of target-specific sympathetic efferent pathways.

DOI: 10.29245/2572.942X/2019/4.1252 View / Download Pdf

Rémy Cohan2,8, Karolina A. Bearss1,2,4,6, Joseph F.X. DeSouza1-8

1Centre for Vision Research, York University, Canada

2Department of Psychology, York University, Canada

3Department of Biology, York University, Canada

4Neuroscience Graduate Diploma Program, York University, Canada

5Interdisciplinary Graduate Studies, York University, Canada

6Canadian Action and Perception Network (CAPnet), York University, Canada

7Vision: Science to Applications (VISTA) Program, York University, Canada

8Multisensory Neuroscience Laboratory, York University, Canada

Despite advancement in neuroimaging, the link between motor and cognitive processes, and the role of oscillations in motor behaviour remain unclear. Current research in neurodegenerative disorders (e.g., Parkinson’s and Alzheimer’s disease) indicates that changes in oscillatory brain rhythms (OBRs) observed from electroencephalographic (EEG) studies could be utilized to quantify and understand the neural network changes in the presence of pathology. Research suggests, that rhythmicity is a common feature amongst biological entities, and cyclic fluctuations in neurological systems in response to incoming stimuli from the environment, grant a great degree of flexibility to such systems in order to interact with their surroundings at an optimal level. This reciprocity between exogenous stimuli and endogenous mechanisms in the brain creates a two-way pathway that awards a bi-directional relationship between the environment, and the brain. Here, in this mini review we explore the role of OBRs, and review the current literature supporting the putative role of frequency-specific OBRs as potential biomarkers in neurodegenerative disorders, mainly Parkinson’s disease (PD), which in turn, may allow clinicians to identify effective therapies based on these biomarkers, expanding the armamentarium for delaying the rate of disease progression and symptom management.

DOI: 10.29245/2572.942X/2019/3.1207 View / Download Pdf