Liping Wu, Tao Lv*
The People’s Hospital of Deyang, North Taishan Road, Deyang, Sichuan, China
As of now, there are increasing cases related to oculogyric crisis (OGC), mainly focusing on clinical manifestations. The pathogenesis of OGC is still uncertain, and there is no unified treatment protocol. This review aims to explore the treatment and management strategies for OGC based on existing cases, hoping to provide references for clinicians in identifying and treating OGC in practice.
DOI: 10.29245/2572.942X/2024/3.1304 View / Download PdfDOI: 10.29245/2572.942X/2024/2.1301 View / Download PdfAndressa Gonçalves Rodrigues-Fândhrs1, Bruna Kulmann-Leal1, José Artur Bogo Chies2*
1Postgraduate Program in Genetics and Molecular Biology (PPGBM), Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, Brazil
2Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Federal University of Rio Grande do Sul – UFRGS, Porto Alegre, Brazil
Huitong Ding1,2*, Sanskruti Madan1, Rhoda Au1,2,3,4,5,6, P. Murali Doraiswamy7, Chunyu Liu2,8
1Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
2The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
3Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
4Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
5Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
6Departments of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
7Neurocognitive Disorders Program, Departments of Psychiatry and Medicine, and the Duke Institute for Brain Sciences, Duke University School of Medicine, Durham, NC, USA
8Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
Accumulating evidence suggests that reproductive markers, such as age at menarche, are associated with cognitive function and the risk of developing Alzheimer's disease (AD). These reproductive markers offer promising potential for predicting the risk of AD, underscoring the necessity for sex-specific considerations in understanding and managing this neurodegenerative disorder. This review first discusses recent findings on reproductive markers in AD progression, and further points out the direction for future research to unravel the complex interplay between reproductive health and cognitive health. We advocate for the incorporation of sex heterogeneity into AD precision medicine to tailor sex-specific diagnostic and intervention approaches.
DOI: 10.29245/2572.942X/2024/2.1300 View / Download PdfHirotaka Nomiya1, Masami Yamada1,2*
1Department of Cell Biology and Biochemistry, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
2Life Science Innovation Center, University of Fukui, Bunkyo, Fukui-City, Fukui, Japan
The interactions between genetic and environmental factors (G x E interactions) play a crucial role in the pathogenesis of schizophrenia. The administration of phencyclidine, a psychotropic drug, to Kpna1-deficient mice induces behavioral abnormalities resembling schizophrenia. In the nucleus accumbens of these mice, the expressions of dopamine receptors, an RNA editing enzyme, and cytoplasmic dynein demonstrate gene-environment interaction-dependent alterations. Kpna1-deficient mice may be useful as a gene-environment interaction model for schizophrenia and provide insights into its pathogenesis. Further, changes in gene expression in the nucleus accumbens may be involved in the development of schizophrenia.
DOI: 10.29245/2572.942X/2024/2.1299 View / Download PdfDOI: 10.29245/2572.942X/2024/1.1298 View / Download PdfDr. Robert W Baumhefner
Neurology Service, Veterans Administration West, Los Angeles Healthcare Center, Los Angeles, CA, USA;
Sarah Kawtharani1, Elias Horanieh2, Bader Ali3, Mohammad Housheimy1, Houssein Darwish1*
1Department of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon
2Department of Surgery, University of Balamand, Beirut, Lebanon
3Medical Student, University of Balamand, Beirut, Lebanon
Background: Contrast Induced Encephalopathy is a known but rare complication of endovascular procedures. Patients show neurologic symptoms mimicking a stroke and include visual disturbances, motor or sensory deficits, headache, seizures, memory loss, confusion, aphasia, and coma. Irreversible neurological symptoms are rare and fatal encephalopathy is even more so.
Case Report: In this article we present a case of a 75-year-old female patient who showed neurological symptoms mimicking a stroke post cerebral Digital Subtraction Angiography that was done with Iohexol as a contrast agent, as a diagnostic work up to rule out a ruptured aneurysm. Further investigations showed no arterial spasms nor dissection. Symptoms reappeared after the second contrast administration but completely resolved after the administration of steroids and fluids.
Conclusion: Contrast Induced Encephalopathy should be further investigated with imaging to rule out other thromboembolic or hemorrhagic causes. Treatment via the administration of steroids and fluids have shown to be effective with complete remission of symptoms.
DOI: 10.29245/2572.942X/2024/1.1294 View / Download PdfDOI: 10.29245/2572.942X/2024/1.1295 View / Download PdfFumiaki Iwane1*, Brian Johnson2, Leonardo G Cohen1
1Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
2Department of Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
Itzhak Kurek*, Jean-Christophe Quillet, Michael Siani-Rose
Cannformatics, Inc., San Francisco, CA, USA
Autism spectrum disorder (ASD) is a group of lifelong heterogeneous neurodevelopmental conditions with a wide range of severity levels that affect social communication and social interaction. Diagnosis of ASD relies on subjective observation of these clinical phenotypes. The growing body of big data generated by subjective methods and more recently by objective high-throughput technologies such as omics for the detection of biomolecules, is being successfully applied to a rapidly-growing number of machine learning (ML) algorithms to inform research for diagnostics and interventions for patients with ASD. While most reviews in this area are focused on the ML approaches, we highlight the impact of the database on the expected outcomes in ML-based ASD research studies.
DOI: 10.29245/2572.942X/2023/3.1293 View / Download PdfMartina von der Bey1,2, Ebru Ercan-Herbst1*
1BioMed X Institute, Im Neuenheimer Feld, Heidelberg, Germany
2Molecular and Translational Neuroscience, Department of Neurology, Ulm University, Albert-Einstein-Allee, Ulm, Germany
One of the biggest challenges in the field of neurological disorders is the limited availability of freshly dissected human brain tissue. Therefore, the use of human induced pluripotent stem cells (hiPSCs) is important to develop human brain-like models to study the interaction of different brain cell types in health and disease. For physiologically relevant disease modeling, three-dimensional (3D) cell culture systems are of great importance because they provide a more representative in vivo-like micro-environment to the cells. The field of 3D cell culture systems using diverse hiPSC-derived cells is growing and gets steadily advanced. However, to this day, there is no cell culture model available that includes all brain cell types. Here, we review the latest improvements of 3D hiPSC-based cell culture systems in the field of neuroscience. We focus on innovations for the generation of neurons, astrocytes, oligodendrocytes, microglia as well as endothelial cells and pericytes.
DOI: 10.29245/2572.942X/2023/2.1290 View / Download PdfDOI: 10.29245/2572.942X/2023/2.1291 View / Download PdfRobert B. Slocum
Narrative Medicine Program Coordinator, University of Kentucky HealthCare, Lexington, Kentucky, USA
Neda Jafri1, Savanna Dasgupta1, James E. Siegler1,2*
1Cooper Neurological Institute, Cooper University Health Care, Camden, NJ, USA
2Cooper Medical School of Rowan University, Camden, NJ, USA
Endovascular thrombectomy (EVT) revolutionized the treatment for acute ischemic stroke due to large vessel occlusion (LVO). Current guidelines published by multiple academic societies recommend EVT for eligible patients who present within 24 hours of the time last seen well. However, more recent data suggests that extending this window past 24 hours produces more favorable outcomes in specific patients presenting with anterior circulation LVO. More specifically, recent observational data indicates a higher probability of functional independence, functional improvement, and long-term survival with EVT when compared to best medical management. Based on the available data, there is unclear equipoise in randomizing all patients with acute ischemic stroke due to LVO to EVT or medical management. However, for those patients with large established infarction, distal occlusions, or well beyond the 24-hour window, randomized clinical trials are called upon to determine whether there is benefit of EVT in these patient groups. In this narrative review, we will summarize the most recent data on EVT in the ultra extended window (>24 hours after time last seen normal) and discuss further considerations of this treatment.
DOI: 10.29245/2572.942X/2023/2.1289 View / Download PdfChristopher Nardone1,2, Xin Gu3, Stephen J. Elledge1,2*
1Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women’s Hospital, Boston, MA, USA
2Department of Genetics, Harvard Medical School, Boston, MA, USA
3Department of Neurobiology, Harvard Medical School, Boston, MA, USA
The MiT/TFE proteins (MITF, TFE3, TFEB, and TFEC) constitute a family of transcription factors that maintain cellular homeostasis by controlling the transcription of genes involved in lysosomal biogenesis, autophagy, oxidative metabolism, and pigmentation. While significant effort has been placed in understanding the downstream function of this family, the upstream regulation has only recently become clearer. It was appreciated that the nutrient-sensing Rag GTPases-mTORC1 pathway attenuates the activity of this family, but how this occurs mechanistically remained unclear. The physiological role of the MiT/TFE family is underscored by the fact that numerous human diseases are caused by their misregulation. The goal of this minireview is to provide a summary of recent findings that have elucidated how this family is regulated upstream and, hence, the molecular basis of a rare kidney cancer and neurodevelopmental syndrome caused by mutations in TFE3. The information presented here may serve as a framework for future studies.
DOI: 10.29245/2572.942X/2023/1.1287 View / Download PdfSai Krishna Vallamchetla
All India Institute of Medical Sciences, Bhopal, India
The ketogenic diet (KD) has emerged as a promising therapeutic strategy for a variety of neurological disorders, including epilepsy, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and autism spectrum disorder. The potential benefits of the KD are attributed to its capacity to modulate neurotransmission, reduce inflammation, improve mitochondrial function, and enhance synaptic plasticity. Despite the growing body of evidence supporting the KD's therapeutic potential, there remain challenges in its implementation, such as potential side effects, nutrient deficiencies, and the need for careful monitoring by healthcare professionals. Factors affecting the success of the KD include patient adherence, individual metabolic response, and appropriate diet customization. This review summarizes the current evidence supporting the KD's role in the management of neurological disorders, discusses the underlying mechanisms of action, highlights the challenges and considerations associated with its use, and addresses the factors that can influence treatment success. Further research is needed to optimize the KD for different patient populations, elucidate the specific therapeutic mechanisms, and identify potential biomarkers to predict treatment response, ultimately enhancing the quality of life and overall well-being of individuals affected by neurological disorders.
DOI: 10.29245/2572.942X/2023/1.1286 View / Download PdfConnor Farrell, Keeley J Brookes*
Biosciences, Nottingham Trent University, Clifton Campus, Nottingham, NG8 11NS, UK
The APOE gene and particularly the ε4 allele have been a long-established risk factor for Alzheimer’s disease (AD), demonstrating the largest genetic effect size in this complex disease. In light of the odds ratios observed for the risk allele, many studies disregard neighbouring association signals as merely “tagging” this effect. Polygenic risk score (PRS) analyses in this field regularly use low linkage disequilibrium parameters (r2≥0.1) when selecting SNPs for analysis across the genome and remove kilobases of data surrounding the APOE locus, preventing confounding factors influencing their results. This study investigated a 500kb region surrounding the APOE locus, utilising PRS analysis to explore whether additional SNPs in this region could be providing contributory effects to AD predictability. The data presented here suggest that the “sphere of influence” of the APOE isoform SNPs covers a region of around 92kb; SNPs in Linkage Disequilibrium (LD) at r2<0.4 with rs429358 potentially contribute independently to the PRS predictability for AD, and that there are additional independent SNPs in this region that have increased effects in an APOE ε4 negative sample. This study concludes that further consideration is required when selecting LD parameters for PRS analysis and that additional investigation into the region surrounding APOE may yield polymorphisms that may play a pivotal role in the development of AD.
DOI: 10.29245/2572.942X/2022/2.1284 View / Download PdfEffie-Photini C. Tsilibary1,2, Danielle Carlson1,2, Apostolos P. Georgopoulos1,2*
1Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota, USA
Gulf War Illness (GWI) afflicted many veterans of the 1990-91 Gulf War with multiple symptoms worsening with time. The reasons for GWI have not been elucidated but may include toxicity due to inflammatory factors induced by vaccines administered to deployed and nondeployed veterans. In particular, the anthrax vaccine may have harmful effects in veterans lacking specific protective HLA alleles, as we reported previously, using a murine neuroblastoma N2A cell culture system. Lack of these protective alleles could allow several vaccine antigens to circulate chronically, resulting in protracted low-grade inflammation accompanying the disease. When N2A cells were exposed to GWI serum or the antigen of the anthrax vaccine, the cells underwent apoptosis due to compromised cell membrane, mitochondrial and cytoskeletal function. Elucidation of mechanisms of GWI should provide clues for therapy. Since antigen-induced inflammation accompanies GWI and stem cells were reported to have antimicrobial activity, we examined the effect of murine stem cells co-cultured with N2A cells before exposure to GWI serum and also Protective Antigen PA63, the main component of the anthrax vaccine. The presence of stem cells completely prevented GWI serum toxicity, since it resulted in inhibition of apoptosis. Moreover, cultures of stem cells exposed to PA63 resulted in the degradation of this antigen. We conclude that stem cells can protect against vaccine-induced toxic components of the GWI serum in N2A cells, prompting further studies on the possible beneficial effects of these cells in GWI.
DOI: 10.29245/2572.942X/2021/1.1281 View / Download PdfDavis B. Rippee1, Gabriella E. Glassman2, Sara C. Chaker3, Patrick E. Assi4, Jennifer Black, Alonda C. Pollins4, Jun Yao4, Wesley P. Thayer4,6*
1University of Mississippi School of Medicine, Jackson, MS, USA
2Florida State University College of Medicine, Tallahassee, FL, USA
3Vanderbilt University, Nashville, TN, USA
4Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
5Meharry Medical College, Nashville, TN, USA
6*Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
Introduction: Peripheral nerve injuries commonly result from trauma and can lead to devastating loss of sensory and motor function. A novel strategy to improve peripheral nerve regeneration is a chemical fusogen known as polyethylene glycol (PEG). Several animal studies have illustrated PEG’s potential to help prevent axon loss after peripheral nerve injury. However, the relative rate of success and potential complications of these studies have not been definitively shown in the literature. The purpose of this systematic review is to evaluate the literature regarding the success of PEG adjunct treatment after peripheral nerve injury in preclinical models.
Materials and Methods: The MEDLINE database was queried using the PubMed search engine with the following keywords and phrases: “polyethylene glycol” OR “PEG” AND “nerve” AND “fusion”. All resulting articles were screened by two reviewers. Animal type, nerve type, injury type, type(s) of analyses, and overall superiority of outcomes were assessed.
Results: One-hundred and seventy-nine articles were identified, and thirteen studies remained after the application of inclusion and exclusion criteria. Twelve of the thirteen studies utilized rats as the preclinical model, while one utilized a guinea pig. Superiority of peripheral nerve repair outcomes with adjunct PEG treatment compared to a control group was reported in eleven of thirteen studies.
Conclusions: The majority of studies reported positive outcomes when using PEG; this indicates that PEG treatment has the potential to enhance peripheral nerve regeneration after injury. However, the results of some of these studies indicated several uncertainties that need to be addressed in future studies. These preclinical models may help guide clinicians regarding the use of PEG treatment in peripheral nerve repair.
DOI: 10.29245/2572.942X/2021/1.1280 View / Download PdfLisa M. James1,2,3,4, Brian E. Enghdal1,2,4,5,, Arthur C. Leuthold1,2, Apostolos P. Georgopoulos1,2,3,4,6*
1The PTSD Research Group, Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN, USA
2Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA
3Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
4Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN, USA
5Department of Psychology, University of Minnesota, Minneapolis, MN, USA
6Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA
Previous research has demonstrated highly accurate classification of veterans with posttraumatic stress disorder (PTSD) and controls based on synchronous neural interactions (SNI), highlighting the utility of SNI as a biomarker of PTSD. Here we extend that research to classify additional trauma-related outcomes including subthreshold PTSD, partial recovery, and full recovery according to SNI. A total of 219 U.S. veterans completed diagnostic interviews and underwent a magnetoencephalography (MEG) scan from which SNI was computed. Linear discriminant analysis was used to classify the PTSD and control brains, achieving 100% accuracy. That discriminant function was then used to classify each brain in the subthreshold PTSD, partial recovery, and full recovery diagnostic groups as PTSD or Control. All of the subthreshold PTSD diagnostic group were classified as PTSD, as were three-quarters of the partial recovery group. Findings regarding the full recovery group were mixed, documenting variability in the functional brain status of PTSD recovery. The results of the present study add to the literature supporting the discriminatory power of MEG SNI and demonstrate the utility of SNI as a biomarker of various PTSD-related trajectories.
DOI: 10.29245/2572.942X/2021/1.1279 View / Download PdfShervin Assari1,2*
1Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
2Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
Background: While clinical studies have documented sex differences in emotional, behavioral, and cognitive function of children with Attention Deficit and Hyperactive Disorder (ADHD), it is unknown if these sex differences are due to differences in referral and diagnosis or if they can be also seen when we screen a community sample for ADHD. If these sex differences exist in populations with a diagnosis history but cannot be seen in screening, then they are unfair, preventable, and due to gender (social processes in referral and diagnosis) rather than sex.
Aim:Using the data from a community sample of 9-10-year-old healthy developing children, we explored sex differences in the associations between cognitive, emotional, behavioral, and health status with positive screening vs. history of diagnosed ADHD.
Methods: The Adolescent Brain Cognitive Development (ABCD) study included a national sample of 10,171 American children between ages 9 and 10 years old. This sample included 1,488 children with a history of psychiatric diagnosis and 8,683 children without a diagnosis. The two independent variables were screening and history of ADHD. The following variables were outcomes: symptom severity, cognitive function, body mass index (BMI), internalizing, externalizing, and total behavioral disorders. Sex was the moderator, and age, race, ethnicity, education, household income, and family structure were covariates. Mixed-effects regression models were used to adjust for the nested nature of the data.
Results: Positive screening for ADHD and a history of diagnosis were both associated with worse cognitive function, higher internalizing, externalizing, total problem behaviors, higher inattention (ADHD symptoms), and lower BMI. Sex altered the association between history of diagnosis but not positive screening for ADHD with externalizing, and total behavioral problems as well as cognitive function. Sex did not affect the associations between positive screening for ADHD or a history of diagnosis with BMI or ADHD symptoms. Both history of diagnosis and positive screening for ADHD were associated with higher internalizing for boys than girls.
Conclusion: History of diagnosis, but not positive screening for ADHD, is differently associated with behavioral and cognitive performance of males and females. As sex differences are seen in correlates of history of diagnosis but not positive screening, some of the observed sex differences are due to differential referral and diagnosis rather than differential presentation of ADHD in the community. This finding suggests that some of the so-called “sex differences” that are believed to be due to biology and heritable may be “gender differences” and modifiable. This is important because while gender differences are preventable and modifiable, sex differences are not.
DOI: 10.29245/2572.942X/2021/1.1278 View / Download PdfDOI: 10.29245/2572.942X/2020/4.1277 View / Download PdfDavid J Wang1*, Manas Sharma2
1Department of Medical Imaging, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, Canada
2Department of Medical Imaging, University Hospital, London Health Sciences Centre, 339 Windermere Road, London, Canada
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 PdfLisa 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 PdfDon 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 PdfCaroline 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.
Abbreviations
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 PdfPeka 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 PdfPeka 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