Vol 3-4 Mini Review

Simulation of Cellular Remodeling: from Cardiac Myofiber to Whole Heart

Ani Amar*

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel

Heart failure is characterized as any heart condition resulting from impairment of the heart’s ability to pump blood, with high prevalence in both aged and diseased hearts. Numerous population-based studies have shown that, in patients with impaired left ventricular systolic function, additional structural and functional cardiovascular abnormalities are often found, making it difficult to understand the underlying pathophysiological processes. Advances in experimental and modeling tools have led to the identification of many cellular mechanisms that contribute to cardiac failure. Still, the mechanism by which cardiac myofiber adaptation ultimately leads to failure remains unclear. Several human cell, tissue, and organ models are used to model heart failure. In this mini review, several available human models are summarized with a focus on the simulation of cellular remodeling: from membrane excitation at the level of the single cell to contraction of the ventricle.

DOI: 10.29245/2572.942X/2018/4.1186 View / Download Pdf
Vol 3-4 Mini Review

A Quantitative View on Naturally Occurring Autoantibodies in Neurodegenerative Diseases

Yannick Kronimus, Richard Dodel*, Sascha Neumann

Department of Geriatrics, University Duisburg-Essen, Germaniastrasse 1-3, 45356 Essen, Germany

Accumulation and aggregation of Beta-Amyloid (Aβ) and Alpha-Synuclein (α-Syn) are considered as central or even causative for the development of Alzheimer’s (AD) and Parkinson’s disease (PD). Therefore, the regulation of these proteins seems to be an essential aspect for prevention and is of central interest in current research aiming to find therapeutic approaches. The human immunological repertoire already contains such a regulatory system. Naturally occurring autoantibodies (nAbs) against the proteins Aβ (nAbs-Aβ) and α-Syn (nAbs-α-Syn) are part of the innate immune system and modulate the metabolism of their specific antigens including protein clearance and inhibition of aggregation. Thus, many researchers hypothesize that in the course of AD and PD, quantitative alterations of nAbs-Aβ and nAbs-α-Syn arise resulting in impaired proteastasis. Such alterations would represent promising, reliable biomarkers and indicate potential approaches for therapeutic strategies. Hence, it is not surprising that many studies dealing with nAbs-Aβ and nAbs-α-Syn titers in AD and PD patients in comparison to control participants are available in the literature. In this mini review, we summarize the current evidence. Furthermore, we critically discuss problems and future requirements for nAbs quantification when a clinical application is the overriding goal.

DOI: 10.29245/2572.942X/2018/4.1189 View / Download Pdf
Vol 3-4 Commentary

Commentary: Alpha-Synuclein Aggregates Cause Calcium Dysregulation by Activating Calcium Pump SERCA

Cristine Betzer1,2, Poul Henning Jensen1,2*

1Danish Research Institute of Translational Neuroscience - DANDRITE, Aarhus University, Denmark

2Department of Biomedicine, Aarhus University, Denmark

DOI: 10.29245/2572.942X/2018/4.1197 View / Download Pdf
Vol 3-4 Commentary

Commentary: "Promoting Myelin Repair through In vivo Neuroblast Reprogramming"

Bilal El Waly1, Myriam Cayre1, Pascale Durbec1*

1Aix Marseille University, CNRS, IBDM-UMR 7288, Case 907, Parc Scientifique de Luminy, campus de Luminy, 13288 Marseille, Cedex 09, France

DOI: 10.29245/2572.942X/2018/4.1196 View / Download Pdf
Vol 3-4 Mini Review

Kv1.3 In Microglia: Neuroinflammatory Determinant and Promising Pharmaceutical Target

Sara R. Roig1, Irene Estadella1, Sergi Cirera-Rocosa1, María Navarro-Pérez1, Antonio Felipe1*

1Molecular Physiology Laboratory, Dpt. de Bioquímica i Biomedicina Molecular, Institut de Biomedicina (IBUB), Universitat de Barcelona, Av. Diagonal 643, E-08028 Barcelona, Spain

Microglial cells are responsible for brain immunosurveillance. These cells maintain brain homeostasis, phagocytose cellular debris, present antigens to T-lymphocytes and secrete cytokines and chemokines. Upon activation, microglia can polarize into two different phenotypes in particular environments: the classical M1 proinflammatory state and the alternative M2 anti-inflammatory state. Chronically activated M1 microglial cells are involved in neuroinflammation in various brain diseases. In multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and neuropathic pain, brain inflammation is involved in initiation and pathological progression, which is partially mediated by activated microglia. Molecular studies revealed that expression of the voltage-gated potassium channel Kv1.3 is a M1 phenotypic feature. Indeed, an increase in Kv1.3 expression and function was detected in chronically activated microglial cells in patients. Therefore, recent works evaluated Kv1.3-targeted therapies for neuroimmune diseases and showed encouraging results. Inhibition of Kv1.3 activity led to amelioration of some pathology-related features in brain diseases. This review summarizes the latest findings concerning microglial function in neuroinflammatory processes, focusing on the involvement of Kv1.3 and highlighting this channel as a promising therapeutic target.

DOI: 10.29245/2572.942X/2018/4.1191 View / Download Pdf
Vol 3-4 Research Article

Brain Function in Gulf War Illness (GWI) and Associated Mental Health Comorbidities

Brian E. Engdahl1-4, Lisa M. James1,2,4,5, Ryan D. Miller1, Arthur C. Leuthold1,2, Scott M. Lewis1,6, Adam F. Carpenter1,6, Apostolos P. Georgopoulos1,2,4-6*

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 Psychology, University of Minnesota, Minneapolis, Minnesota, USA

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

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

6Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA

GWI has affected a substantial number of Gulf War (GW) veterans. The disease involves several organ systems among which the brain is most prominent. Neurological, cognitive and mood-related (NCM) symptoms frequently dominate and are at the root of chronic ill-health and disability in veterans suffering from GWI. In addition, such symptoms frequently co-occur with diagnosable mental health disorders, predominantly posttraumatic stress disorder (PTSD). Here we investigated the possibility that increased GWI severity leads, above a threshold, to a diagnosable mental health disorder (excluding psychosis). For this purpose, we used, in separate analyses, symptom severity scores and resting-state brain functional connectivity patterns, as determined by magnetoencephalography (MEG). Two-hundred-thirty GW-era veterans participated in this study. They completed diagnostic interviews to establish the presence of GWI and assess mental health status. This distinguished 3 groups: healthy controls (N = 41), veterans with GWI and no mental illness (GWI group, N = 91), and veterans with both GWI and mental health disorder (GWI+MH, N = 98). For each veteran, symptom severity scores in the 6 GWI domains (fatigue, pain, NCM, skin, gastrointestinal, respiratory) were available as well as 9 summary measures of the distribution of Synchronous Neural Interactions (SNI) derived from the MEG recordings. We tested the hypothesis that, in the presence of GWI, the appearance of a diagnosable mental health disorder may depend on GWI symptom severity. For that purpose, we performed a logistic regression on the GWI population, where the presence (or absence) of the MH disorder was the dependent variable and the age- and gender-adjusted GWI severity in the 6-symptom domains were the predictors. The outcome was the probability that a participant will have MH disorder or not. Similarly, we tested the hypothesis that the presence of the MH disorder can be predicted by the SNI distribution patterns by performing a second logistic regression as above but with the 9 SNI measures as predictors. We found GWI symptom severity differed significantly across groups (GWI+MH > GWI > Control). SNI distributions of the GWI group also differed significantly from the other groups in a systematic hemispheric pattern, such that the presence of GWI involved predominantly the left hemisphere, and presence of mental health disorders involved, in addition, the right hemisphere. Both logistic regressions yielded highly significant outcomes, demonstrating that both GWI symptom severity and SNI distribution measures can predict the presence of MH disorder in GWI. Remarkably, the prediction probabilities for MH presence derived from the symptom-based and SNI-based logistic regressions were positively and highly statistically significantly correlated. Taken together, both objective (neural) and subjective (symptoms) indices suggest that GWI is distinct from healthy controls and varies in severity in a continuum that leads, at the higher end, to a diagnosable MH disorder. The positive correlation between the GWI symptom-based and brain-based predicted classifications provides a key link between GWI symptom severity and synchronous neural interactions in the context of mental illness.

DOI: 10.29245/2572.942X/2018/4.1198 View / Download Pdf
Vol 3-4 Commentary

Commentary: Auricular Neuromodulation: The Emerging Concept Beyond the Stimulation of Vagus and Trigeminal Nerves

Claire-Marie Rangon*

Head of Scientific Auriculotherapy Diploma, Faculty of Medicine, University of Paris-Saclay, 94276 Le Kremlin-Bicêtre, France

The ears are a potential gateway to the brain, mainly through their innervation. Transcutaneous stimulation of the vagus (tVNS) and trigeminal (TNS) nerves at the auricles is gaining ground in the field of non-invasive brain therapeutics.

The concept of Auricular Neuromodulation (AN), described in the article « Auricular Neuromodulation: The emerging concept beyond the stimulation of vagus and trigeminal nerves”1 is particularly interesting for neurologists, and might even help researchers to unravel fundamental mechanisms of brain functioning.

DOI: 10.29245/2572.942X/2018/4.1200 View / Download Pdf
Vol 3-4 Review Article

Choroid Plexus Blood-CSF Barrier: Major Player in Brain Disease Modeling and Neuromedicine

Conrad E. Johanson1*, Nancy L. Johanson2

1Department of Neurosurgery, Alpert Medical School at Brown University, Providence, RI, 02903 USA

2408 Autumn Trail, Georgetown, TX 78626, USA

The choroid plexus (CP) of the blood-cerebrospinal fluid barrier (BCSFB) impacts CSF homeostasis, brain diseases, and neuromedical translation. CP executes neuroendocrine, excretory, and neuroimmune actions. BCSFB diversely manages brain-spinal cord fluid environments, giving rise to a wide pathophysiology spectrum. Newly-discovered choroidal phenomena include integration of circadian clock signals, immune interaction with gut microbiotica, and expression of receptors to taste CSF composition. BCSFB tight junctions and transcellular mechanisms differ from blood-brain barrier (BBB) counterparts, variably regulating pathogen and leukocyte access to the CSF-brain nexus. This review highlights microbial agents, substrates and autoantigens using CP epithelial membranes to penetrate CSF and periventricular regions. Lipopolysaccharide (LPS) is analyzed as a barrier-damaging agent and neuroinflammation promoter. Transducing LPS- and toll-like receptor activity produce CP-CSF cytokines in sickness behavior and virulent sepsis-associated encephalopathy. Agents/systems that counter oxidative activity such as matrix metalloproteinase 8 inhibitors and Nrf2 activators (bile acids and isothiocyanates) show promise as neural and CP protectants. One review theme emphasizes CP’s preponderant role in initiating central diseases, and their remediation. In view of BCSFB permeability alterations and epithelial transformation, we discuss systemic lupus erythematosus, N-methyl D-aspartate-associated autoencephalitis, helicobacter disruption of BCSFB, toll-like receptor 2 stimulation in CP (neuroinflammation), the CP gateway for trypanosomes, and APOE-linked cholesterol transport into CSF. Another section treats concurrent involvement of BCSFB-BBB alterations in helminthic meningitis, forebrain ischemia, acute hyperthermia, leptin resistance/obesity, diabetes mellitus, and Alzheimer-type neurodegeneration. Barrier impairment is analyzed by injury type, time course, therapeutic strategies, and translational neuromedicine principles. The restorative power of BCSFB-transported growth factors, hormones and medicinal agents is emphasized for strengthening CP-CSF homeostatic mechanisms in seizures, stroke and Parkinsonism. A worthy therapeutic aim is to attenuate CNS disorders triggered by BCSFB malfunction, using CSF-delivered therapeutic agents for promoting neural viability.

DOI: 10.29245/2572.942X/2018/4.1194 View / Download Pdf
Vol 3-4 Mini Review

Regulation of Adult Neurogenesis in the Cerebral Cortex

Koji Ohira*

Laboratory of Nutritional Brain Science, Department of Food Science and Nutrition, Mukogawa Women’s University, Nishinomiya, Japan

It is widely accepted that new neurons are generated throughout life, which is called adult neurogenesis, in limited regions of the adult mammalian brain, such as the hippocampal dentate gyrus and subventricular zone. In these regions, neural stem cells (NSCs) and neural progenitor cells (NPCs) have been reported to proliferate and produce postmitotic neurons. Adult neurogenesis in these regions is influenced by various factors. For examples, antidepressant treatments, learning and memory, and environmental enrichment prompt to increase generation and survival of new neurons. Moreover, pathological processes, such as neuroinflammation, stroke or epilepsy, are able to induce proliferation and differentiation of NSCs and NPCs. In contrast, down-regulation of adult neurogenesis is associated with alcohol abuse, high stress level, some drugs, such as cytostatics, COX-2 inhibitors, and opioides. Recently, adult neurogenesis in the cerebral cortex is becoming clear gradually, and cortical NSCs and NPCs are identified in a few mammals. However, it remains largely unknown what factors can regulate adult neurogenesis in the cerebral cortex. This review focuses on the effects of regulating factors on cortical adult neurogenesis, such as brain damages, aging and certain drugs, and we discuss implications of cortical adult neurogenesis for brain diseases and damages.

DOI: 10.29245/2572.942X/2018/4.1192 View / Download Pdf
Vol 3-4 Mini Review

The Mas Receptor as a Future Perspective in Parkinson's Disease

Mostafa A. Rabie, Mai A. Abd El Fattah, Noha N. Nassar, Dalaal M. Abdallah, Hanan S. El-Abhar*

Department of Pharmacology and Toxicology Faculty of Pharmacy, Cairo University, Cairo, Egypt

The current review sheds light on the importance of the cerebral renin angiotensin system (RAS) in Parkinson’s disease (PD), as a neurodegenerative disorder. Local RAS has been identified in the nigrostriatal pathway and plays a pivotal role in the progression of PD via binding to the upregulated angiotensin II type-1 receptor (AT-1R). Activation of AT-1R induces an oxidative stress neuroinflammatory status that results in further deterioration of dopaminergic neurons. Mas receptor (MasR) together with AT-2R, are considered major components of RAS protective arm, which mediates actions opposing AT-1R activation. Accordingly, angiotensin converting enzyme-2 (ACE-2)/Angiotensin 1-7 (Ang 1-7)/MasR axis has been emerged as a novel therapeutic target to ameliorate the devastating effects of Ang II/AT-1R cue in a 6-hydroxydopamine (OHDA) lesioned PD model. Stimulation of MasR via its physiological ligand Ang 1-7 attenuated 6-OHDA induced neurotoxicity as evidenced by the improved motor performance and coordination along with the preservation of the dopaminergic neurons. Via enhanced MasR/PI3K/Akt/ CREB/BDNF/TrKB neurogenesis cascade, besides both antioxidants and anti-inflammation mechanisms, Ang 1-7 proved its therapeutic benefits in PD, partly through MasR, to open up a new avenue for treatment.

DOI: 10.29245/2572.942X/2018/4.1208 View / Download Pdf
Vol 3-4 Mini Review

New Insights on Neuronal Functions of Ghrelin Receptor GHS-R in Obesity

Jong Han Lee1,2, Sahar Eshghjoo3, Jon Davis4, Robert C. Alaniz3, Yuxiang Sun2,5*

1College of Pharmacy, Gachon University, Incheon, Gyeonggi, Korea

2Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

3Department of Microbial Pathogenesis and Immunology, Texas A&M University, Health Science Center, College Station, TX, USA

4Integrative Physiology and Neuroscience, Washington State University, Pullman WA, USA

5Department of Nutrition and Food Science, Texas A&M University, College Station, TX, USA

Obesity is defined as excessive fat accumulation caused by the imbalance of energy intake versus expenditure. Low-grade chronic inflammation is a hallmark of obesity, and it is closely linked to insulin resistance. Obesity-induced inflammation and its associated metabolic dysfunctions underlay pathological processes of many chronic diseases such as insulin resistance, diabetes, sarcopenia and cardiovascular disease. Ghrelin is the only known circulating orexigenic hormone; it stimulates growth hormone release, and increases adiposity and insulin resistance. Ghrelin’s functions are mediated through its receptor, growth hormone secretagogue receptor (GHS-R). The brain plays a critical role in energy homeostasis and energy metabolism. GHS-R is primarily expressed in the brain; the brain is a key ghrelin targeting site. The current review discusses the insights we have gained from global GHS-R knockout mice and neural conditional GHS-R knockout mice, specifically involving the roles of GHS-R in food intake, feeding adaptation, thermogenesis, meta-inflammation, and physical activity.

DOI: 10.29245/2572.942X/2018/4.1180 View / Download Pdf
Vol 3-4 Mini Review

Relevance of Catalytic Autoantibodies to Myelin Basic Protein (MBP) in Autoimmune Disorders

Mario Gonzalez-Gronow1, 2*, Salvatore V. Pizzo2

1Department of Biological Sciences, Laboratory of Environmental Neurotoxicology, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile

2Department of Pathology, Duke University Medical Center, Durham, NC, USA

Catalytic autoantibodies with proteinase enzymatic activity against myelin basic protein (MBP) are a distinctive feature of several autoimmune disorders. These autoantibodies, named abzymes (Abz), have both antibody and proteinase activity in a single molecule. Abz targeting MBP (MBP Abz) are commonly found in sera from multiple sclerosis (MS) and systemic lupus erythematosus (SLE) patients, and only recently have been identified in sera from autism spectrum disorder (ASD) patients. Their activities and specificity are similar in MS and SLE; however, although they recognize the same substrate, MBP, the catalytic activity of the Abz from autism spectrum disorder patients is controlled by different proteinase inhibitors. MBP Abz are generated as part of a process started by loss of compaction of myelin due to changes in charge after deamination of arginyl residues in MBP by the enzyme peptidylarginine deiminase. This exposes a normally hidden surface of MBP to T-cells initiating the autoimmune response. A large body of evidence suggests that MBP Abz play an important role in the pathogenesis not only of MS and SLE, but also of ASD. Many autoantibodies found in MS and SLE are also observed in healthy individuals at ranges usually considered pathological; however, clinical signs of the disease are not manifested, suggesting that expression of single autoantibodies may be inconsequential to develop the disease. However, it is the expression of hundreds of different autoantibodies, in addition to MBP Abz, that collectively lead to the clinical development of MS and SLE.

DOI: 10.29245/2572.942X/2018/4.1199 View / Download Pdf
Vol 3-4 Mini Review

Usefulness of Optical Coherence Tomography Measures as Biomarkers in Schizophrenia

Roberto Rodriguez-Jimenez1,2,3*, Eugenio Blázquez4, Antonio Lobo2,5, José Luis Santos2,6

1Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain

2CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain

3CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, Spain

4Department of Oftalmology, Hospital Universitario 12 de Octubre, Madrid, Spain

5Department of Psychiatry, Universidad Zaragoza, Instituto de Investigación Sanitaria Aragón

6Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain

Optical coherence tomography (OCT) is a non-invasive imaging technique recently used to investigate neurodegenerative disorders, such as Alzheimer’s disease, Parkinson’s disease or multiple sclerosis. Over the last years it has been used in schizophrenia research due to the potential utility of its measurements as biomarkers of the disease. From the first publication by Ascaso et al. (Eur J Psychiat. 2010) until now, a number of papers have been published regarding this topic. Although the majority of them have found a reduction in the thickness or the volume of some retinal and optic nerve structures, there have also been some results with contradictory data. These could be due on the one hand to methodological factors such as the use of different OCT devices or the inclusion/exclusion criteria. On the other hand, there could be an important limitation due to the fact that the different stages of the disorder and their different neurobiological correlates and biomarkers were not taken into consideration. Future longitudinal studies, that begin the assessments in the first psychotic episode (or even before, in ultra-high risk population) are needed in order to clarify the potential role of some OCT measures as biomarkers in schizophrenia.

DOI: 10.29245/2572.942X/2018/4.1205 View / Download Pdf
Vol 3-4 Commentary

Commentary: Live Imaging Followed by Single Cell Tracking to Monitor the Cell Biology and Lineage Progression of Multiple Neural Populations

Felipe Ortega1,2,3*

1Biochemistry and Molecular Biology Department, Faculty of Veterinary medicine, Complutense University, Madrid, Spain

2Institute of Neurochemistry (IUIN), Madrid, Spain

3Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Spain

Live imaging and single cell tracking enables researchers to monitor crucial aspects of the biology of neural populations. In this commentary, we highlight the requirements, applications, and limitations of a protocol recently published by our research group. This protocol involves adapting the culture of several types of neural cells to time-lapse video microscopy, and the post-processing of the data to track distinct cell populations.

DOI: 10.29245/2572.942X/2018/4.1201 View / Download Pdf
Vol 3-4 Mini Review

Detrusor Myoplasty for Acontractile/Hypocontractile Bladder in Spinal Cord Injury Patients

Pawan Agarwal1*, Dhananjaya Sharma2

Plastic Surgery Unit, Department of Surgery, NSCB Government Medical College, Jabalpur, MP, India

Acontractile bladder is very common after spinal cord injury which may lead to morbidity and even renal failure. The standard treatment options to facilitate bladder emptying include clean intermittent catheterization (CIC) or indwelling catheter (IC), which is also not free of complications. The purpose of this article is to review the treatment options for acontractile bladder; especially feasibility and effectiveness of muscle wrap around urinary bladder to improve voluntary voiding. We performed Rectus Abdominis Detrusor Myoplasty (RADM) in 5 patients of acontractile bladder following spinal cord injury. Postoperatively, all 5 patients could void urine immediately after removal of per-urethral catheter after 3 weeks. After RADM, Post Void Residual Volume, Bladder Contractility Index, Detrusor Pressure and urine flow rate (V-max) improved significantly (p < 0.05) in all patients. Rectus Abdominis Detrusor Myoplasty is a promising surgical option in a patient having hypocontractile or acontractile urinary bladder. In this mini review RADM and other treatment options for acontractile bladder have been reviewed.

DOI: 10.29245/2572.942X/2018/4.1182 View / Download Pdf
Vol 3-4 Mini Review

A Novel Role of Chloride Channels in Cerebellar Ataxia

Friederike Auer*

1Department of Animal Physiology, Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany

Cerebellar ataxias are characterized by a disturbance of motor coordination and learning. To understand the molecular mechanisms underlying especially hereditary cerebellar ataxias, many mouse models, often with altered Purkinje cell firing, have been studied in the past decades. Of particular interest were mouse lines with mutations in ion channels or their ligands. In this context, a recently described ANO2-/- mouse line has been reported to show a variety of ataxic symptoms, ranging from gait abnormalities and problems in motor coordination to severely impaired motor learning. These mice lack the calcium-gated chloride channel Anoctamin 2 (ANO2). First studies, focusing on the molecular mechanisms underlying the ataxic phenotype of ANO2-/- mice, indicate an involvement of ANO2 in two different processes in the neuronal network of the cerebellar cortex. Both mechanisms are thought to modulate the firing pattern of cerebellar Purkinje cells and could, therefore, explain the ataxic phenotype of ANO2-/- mice. This review summarizes the so far obtained data regarding the role of ANO2 in the coordination and learning of movements.

DOI: 10.29245/2572.942X/2018/4.1206 View / Download Pdf
Vol 3-4 Review Article

"Treatment of Charcot Neuroarthropathy and Osteomyelitis of the Same Foot: A Retrospective Cohort Study."- A Brief Review

Martin Berli*, Lazaros Vlachopoulos, Sabra Leupi, Thomas Boeni, Charlotte Vlachopoulos-Baltin

Department of Orthopedicsn University Hospital Balgrist Zurich, Switzerland

A brief review of the above-mentioned article: forty patients with 43 affected feet and 60 cases of osteomyelitis were included in this study. They were split into two groups, one with osteomyelitis outside and another one with osteomyelitis within the active Charcot region. The results showed that the amputation rate did not differ between the two groups, although in group 1 – osteomyelitis outside the active Charcot region.

amputations were exclusively performed at the forefoot and in group 2 – with osteomyelitis within the active Charcot region – exclusively in the mid- and hindfoot. Amputations in group 2 were, therefore, more high level. The duration of immobilization and antibiotic treatment was significantly longer in group 2. We conclude, that patients treated for osteomyelitis in an active Charcot foot should be considered and treated as separate entities, depending on whether the osteomyelitis is located within or outside the active Charcot region. If osteomyelitis occurs outside the active Charcot region, primary amputation may be preferred to internal resection.

DOI: 10.29245/2572.942X/2018/4.1176 View / Download Pdf
Vol 3-4 Mini Review

Oral Galactose Provides a Different Approach to Incretin-Based Therapy of Alzheimer's Disease

Melita Salkovic-Petrisic*

Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia

Incretin-based drugs originally developed for the treatment of type 2 diabetes mellitus are currently under investigation for their therapeutic potential in sporadic Alzheimer’s disease (AD). Two major incretin hormones are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), which both additionally have neuroprotective, neurotrophic and neurogenesis-promoting effects upon the stimulation of GLP-1 and GIP receptors in the brain. This review points out another approach to the incretin-related sAD therapy based on the therapeutic potential of oral galactose in a streptozotocin-induced rat model of sporadic AD (STZ-icv model). Chronic oral galactose treatment prevents the development and ameliorates already developed cognitive deficits in the early stage of sAD-like pathology in STZ-icv rat model. The underlying mechanism(s) of these beneficial effects might be related to stimulation of endogenous GLP-1-mediated central effects and normalization of cerebral glucose hypometabolism as well as other oral galactose-induced effects along the oro-gastro-intestinal tract. The beneficial effects on cognitive impairment seem to depend on galactose exposure, presence and stage of sAD-like pathology. Further research is needed to clarify therapeutic potential and safety profile of oral galactose treatment as well as its possible advantages over or synergistic activity with the GLP-1 analogues and inhibitors of dipeptidyl peptidase-4.

DOI: 10.29245/2572.942X/2018/4.1204 View / Download Pdf
Vol 3-4 Mini Review


Cuneyt Tetikkurt*

Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey

Neurosarcoidosis is a multisystemic disease that involves the the brain, spinal cord, meninges, cranial, or the peripheral nerves. As sarcoidosis is a multiorgan granulomatosis, neurological features may represent the systemic effects of sarcoidosis in other organs or neurosarcoidosis. For the diagnosis of neurosarcoidosis, consistent histological changes in neurologic tissues should occur with systemic involvement in other organs, essentially in the lungs, lymph nodes, skin, or eyes. The prevalance of neurosarcoidosis is difficult to establish because most patients are either asymptomatic, have minor undiagnosed neurologic symptoms, incidence of neurosarcoidosis is variable, and different clinical criteria are used for the identification of neurologic involvement. Neurosarcoidosis occurs in approximately 5 percent of the sarcoidosis patients while postmortem studies reveal that 10 percent of the sarcoidosis cases have neurologic disease. Furthermore, less than 1 percent of sarcoidosis patients may present with isolated neurosarcoidosis. Because of diverse clinical appearence, lack of specific laboratory or radiogic findings, and difficulty to obtain neural tissue biopsy the diagnosis of neurosarcoidosis poses a challenge for the clinician. The prognosis of neurologic involvement is another difficult aspect to predict. Identification of neurosarcoidosis constitutes one of the most crucial aspects of sarcoidosis as the delayed diagnosis may lead to an unfavorable prognostic outcome for the patient.

DOI: 10.29245/2572.942X/2018/4.1190 View / Download Pdf
Vol 3-4 Commentary

Commentary: Autopsy Validation of 123I-FP-CIT Dopaminergic Neuroimaging for the Diagnosis of DLB

Curtis Osborne*, John Paul Taylor, Alan J. Thomas

Institute of Neuroscience, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK

DOI: 10.29245/2572.942X/2018/4.1213 View / Download Pdf