Archives of Neuroscience
Volume:8 Issue: 3, Jul 2021

 Approach to lower-thoracic spine for discectomy remains controversial. In this study, we compare primary and secondary outcomes of transpedicular (TP) and transthoracic (TT) approach for discectomy at lower thoracic levels in patients with neurological manifestations.

 In this retrospective study, 12 patients with TP or TT approach for lower thoracic discectomy with neurological manifestation, mainly foot drop, were included. During TP approach, cord manipulation was kept at minimum. Posterior fusion was performed in all patients. TT approach was performed by intended level thoracotomy, anterio-lateral fusion was achieved in this group. The postoperative primary and secondary outcomes of the approach were compared in these patients. SPSS software version 20 was used for analysis, and a P-value < 0.005 was considered significant.

 Twelve patients with neurological manifestation were operated using either of the approaches. Six patients in TP group and four in TT group attained complete neurological recovery after 10.2 and 7.6 weeks, respectively. The mean operative time was 50% more in TT approach. Blood loss in TP approach was less than half, and patients were mobilized earlier with decreased hospital stay. All patients with TT approach needed postoperative intensive care unit (ICU) admission, two of them developed pulmonary complications and postsurgical intercostal neuralgia, and one had cerebrospinal fluid (CSF) leak and readmission within 30 days of discharge.

 Although TT approach offers excellent exposure for discs in lower thoracic levels, it is associated with increased morbidity and higher complication rates. On the other hand, TP approach offers ample exposure with reduced operative time and blood loss, as well as early mobilization and discharge.

Aging is the main factor for onset of disease. Nonetheless, chronological age does not necessarily correspond to biological age. The regulation of aging, circadian rhythms, and temperature involves the same brain structure: the hypothalamus. We previously showed that the analysis of the circadian rhythm of temperature may predict neurologic signs with 24 hours of antecedence. Our hypothesis is that the circadian rhythm of temperature changes gradually with aging and correlates with biological age. This study aims to assess whether the circadian rhythm of temperature correlates with the chronological age of healthy individuals aged between 18 and 72 years and changes more intensely in individuals with obesity, which is a disease associated with unhealthy aging. To achieve the study goals, 60 individuals will be enrolled and separated into four groups according to age (< or ≥ 45 years) and health status (healthy or obese). The participants will wear a wristband with vital sign sensors and an accelerometer for three days to detect movement during wake period and lack of movement during sleep period. The ratio between the mean skin temperature during the sleep and preceding wake period will be the main parameter to be analyzed in the study. The possible result is that this ratio is higher in healthy young individuals, as well as healthy age-matched individuals. This could imply the discovery of a simple and non-invasive method related to the biological age that could guide the prevention and treatment of aging-related diseases.

 Peripheral nerve injuries remain a great challenge for microsurgery, Despite the significant progress in recent decades. The current gold standard is autogenous nerve grafting with a success rate as low as 50% in long gaps. Current studies have focused on finding alternative methods for bridging nerve defects. Previous data have demonstrated human amniotic membrane role in stimulating neural regeneration. On the other hand, Adipose-derived mesenchymal stem cells can differentiate into all three germ layers and could support nerve repair. The purpose of this study was to compare the role of the human amniotic membrane with and without adipose tissue stem cells in sciatic nerve injury with gap in rats.

 we aimed to compare the role of the human amniotic membrane with and without adipose tissue stem cells in sciatic nerve injury with gap in rats.

Twenty-four male Wistar rats were randomized into four groups. In the first group, the nerve gap was repaired using the inverse resected nerve segment (control group), the second group was repaired with a human amniotic membrane (AM group), the third group repair was done with an amnion sheet with seeded Adipose-derived mesenchymal stem cells (AM/ADMSCs group). The last group wasn't repaired and both stumps were sutured to muscles.

 All the animals underwent the procedures and survived without complication. The sciatic function index and hot plate test result were significantly improved in the AM and AM/ADMSCs group that was comparable to the control group (as a gold standard of care) (P > 0.05). There is no significant difference between experimental groups in latency 12 weeks after surgery. Based on histopathology findings, regenerative nerve fibers were seen in the implanted area of both AM and AM/ADMSCs group; however, the nerve fibers were surrounded with significant fibrosis (scar formation) in AM/ADMSCs group. The axon counts in the control groups were significantly higher than in the other groups (P < 0.01).

Our study showed the role of amniotic membrane in the promotion of nerve regeneration in the sciatic nerve injury with a gap, but adding Adipose-derived mesenchymal stem cells has no extra benefit as well as caused more tissue scar.

 Several studies have investigated the association of heavy metals such as lead and cadmium with neurodegenerative diseases such as Parkinson's disease.

 In this study, we investigated the relationship between the serum levels of lead and cadmium in Parkinson's disease.

 In this case-control study, the serum levels of lead and cadmium in 100 patients with Parkinson's disease referred to our university hospital, and 30 healthy individuals were investigated. Basic information such as age and gender and other demographic and clinical data were registered in the checklist. The levels of lead and cadmium were measured using atomic absorption spectrophotometry (AAS). Data was analyzed by SPSS software version 23, and a P < 0.05 was considered as significant.

 The mean cadmium level in patient and control groups was 14.91 ± 8.72 and 4.71 ± 2.72 ppb, respectively (P < 0.001). The mean lead level was 158.35 ± 157.64 and 35.35 ± 16.25 ppb in patients and controls, respectively (P < 0.001). At ages above 65 years, there was a significant difference between the level of cadmium (P < 0.001) and lead (P < 0.001) in patients and healthy subjects. In addition, there was a significant difference in the level of cadmium (P = 0.003) between patients and healthy subjects at ages below 65 years. This was true for both males (P < 0.05) and females (P < 0.05). There was no significant difference in the level of lead and cadmium in various severity rates of the disease, as well as in different symptoms of the patients.

 Based on the findings, the levels of serum lead and cadmium were higher in the patients, indicating a probable relationship between the Parkinson's disease and the levels of these metals.

 The SARS-CoV-2 may cause vasculitis and thromboembolic events. We report on an unusual case of spontaneous intracerebral hemorrhage and delayed cerebral vasospasms in a patient with COVID-19.

 A 65-year-old male was transferred to the emergency department due to a short period of unconsciousness. Twenty-two hours prior to presentation, the patient had a 39.5°C fever with breathing difficulties. Initial COVID-19 PCR was positive. While conscious and without any neurological impairment, a large right frontal intracerebral hemorrhage (ICH) was detected. A preoperative angiogram showed no pathological blood vessels or vasospasm. The patients had a generalized tonic-clonic seizure due to ICH progression, which led to an immediate microsurgical ICH removal. Thirteen days thereafter, the patient became unconscious again. Angiography revealed severe cerebral vasospasm (CV) that required repetitive percutaneous transluminal angioplasty (PTA) and intra-arterial nimodipine treatment.

 We present the first case of ICH and delayed vasospasm associated with COVID-19. In these patients, combined maximum surgical and endovascular therapy is needed.

Atorvastatin exerts neuroprotective effects on the treatment of central nervous system disorders. Morphine analgesic tolerance and dependence remain as major concerns in medicine. Nitric oxide (NO) pathway mediates the development of opioid analgesic tolerance and dependence, as well as atorvastatin neuroprotection.

The present study aimed to assess the possible involvement of the NO/cGMP pathway in the process of the effects of atorvastatin on morphine physical dependence.

Dependence was induced by repetitive injection of morphine sulfate. Naloxone was injected at the dose of 4 mg/kg on the last day of the experiment to assess withdrawal signs. Animals received atorvastatin (1, 5, 10, and 20 mg/kg, orally). Nitric oxide synthase (NOS) inhibitors and ODQ were injected before protective dose of atorvastatin. The gene expression of NOS isoforms was evaluated by real-time PCR. Thereafter, the hippocampal levels of cGMP and nitrite were measured.

Treatment with atorvastatin 10 mg/kg significantly attenuated naloxone-induced withdrawal behaviours. The administration of L-NAME, aminoguanidine, and ODQ before atorvastatin enhanced its effects. The treatment with atorvastatin significantly decreased the nitrite and cGMP levels as well as NOS gene expression in the hippocampus of dependent animals.

It can be concluded that atorvastatin, possibly, through inducible NOS, could alleviate morphine dependence and withdrawal signs.

 Dementia affects mental health and psychological capital indicators, which disappear with gradual deterioration in mental and cognitive functions. Gradual loss of ability to function independently can cause negative emotional symptoms and even further reduce cognitive and functional impairment.

 The current study aimed to investigate the effectiveness of cognitive rehabilitation on psychological capital in the elderly with dementia.

 The current quasi-experimental research was performed following a pre and -post test design with a control group. The effect of cognitive rehabilitation on psychological capital of patients aged 60 - 74 years who were admitted to the private Tehran clinics during 2020 was assessed. The convenience sampling method was used to select the participants. So that among eligible patients who had inclusion criteria, 11 were selected and then randomly divided into two groups. Lutans Psychological Capital Questionnaire was used to collect data. After the treatment, a post-test was carried out for all study groups. Data analysis was performed by analysis of covariance.

 The results of the analysis of covariance indicated the effectiveness cognitive rehabilitation on psychological capital in the elderly with dementia (P < 0.05).

 Spinal cord injuries (SCI) are a variety of chronic diseases that various causes such as trauma may contribute to its onset. One of the problems in these patients is the problem of physical activity and, consequently, daily activities.

 This study aimed to assess daily living of patients with SCI.

 In this descriptive cross-sectional study in 2019, 120 patients with SCI in Kermanshah were included in the study using purposive sampling. The instruments used in this study fell into two parts. One part included the demographic characteristics of the SCI patients, and the other part was a questionnaire of the rate of the Impact on Participation and Autonomy questionnaire (IPA-P). Data were analyzed by SPSS software version 16 using descriptive tests such as mean and standard deviation.

 The result showed there was a significant relationship between demographic characteristics such as education (P < 0.007), time of spinal cord injury (P < 0.01), and income (P = 0.000). Also, the results showed there was a relationship between Autonomy and Participation, and the age of patients and their autonomy and participation decreased with age (P = 0.000, R = 0.72). Most of the patients had severe problems with daily activities. Also, most patients had very poor scores in relation to daily living activities.

 Considering the low rate of participation and autonomy in patients with SCI, it is suggested to conduct studies aimed at improving their self-care and social participation.

To compare the pharmacological effects of steroids in comparison to steroids with antiviral drugs for the treatment of Bell’s Palsy.

A total 60 patients were enrolled and segregated equally into two groups, where patients on prednisolone were labeled as group A (Control group), whereas patients on prednisolone + acyclovir were labeled as group B (study group). All patients had House Brackmann score. The control group started oral prednisolone 1 mg/kg for 10 days, whereas the study group started acyclovir 400 mg 4 times a day for 10 days along with prednisolone tablets. Patients were regularly observed till the study was completed. Primary outcome measure was facial nerve recovery. Health-related quality of life and facial appearance were considered secondary outcomes.

The primary outcomes assessed as complete recovery from Bell’s Palsy by Brackmann score at week 4 were found in 17/30 (57%) patients and 23/30 (77%) patients at week 8 in the control group. Complete recovery from Bell’s Palsy was also shown in the experimental group (Prednisolone + acyclovir) where 25/30 (83%) patients completed recovery at week 4, while 27/30 (90%) patients at week 8. Comparison of the two groups showed a significant improvement in the study group (prednisolone + acyclovir) (P = 0.047) at week 4 and (P = 0.02) at week 8. The secondary outcomes were assessed as improvement in the quality of life and facial appearance from Bell’s Palsy. Health utility score was 0.84 ± 0.01 in the control group (On prednisolone) with facial appearance score of (Derriford appearance scale 59) 61 ± 28. At week 4, the study group (on prednisolone+ acyclovir) showed 0.88 ± 0.12 score on Health utility index scale-3 and 46 ± 26 score on Derriford appearance scale. Comparison of the quality of life (Health quality index scale-3) and facial appearance among both control and study groups showed a significant improvement in the study group (P = 0.001 and P = 0.005, respectively). Moreover, when health utility score and Derriford appearance were compared among both groups, it showed a significant improvement in the study group (P = 0.001 and 0.016, respectively).

The combination of prednisolone with acyclovir is found superior to prednisolone alone, and this combination treatment results in improvement in both recovery and quality of life.

Both epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) are often associated with some degree of cognitive impairment. Video electroencephalography (EEG) monitoring is the gold standard for diagnosing PNES. This diagnostic procedure is costly and available in specific tertiary centers. Neuropsychological assessment can provide clues for the differential diagnosis of PNES and ES and help clarify the nature and etiology of these two disorders.

Therefore, this study aimed to compare the neuropsychological profiles of PNES and ES patients.

In this analytical cross-sectional study, 30 patients with ES and 31 patients with PNES were compared by neuropsychiatric tests, such as the Wechsler Adult Intelligence scale (WAIS), Addenbrooke’s Cognitive examination (ACE), and California Verbal Learning test (CVLT).

There was a female predominance in the PNES group (female-to-male ratio = 4.16/1, P = 0.003). In the PNES group, 77.4% of the patients had a psychiatric disorder versus 66.7% of the patients in the ES group; however, the difference was not statistically significant (P = 0.34). The mean score of total intelligence was higher in the PNES group (84.77 ± 16.94), compared to the ES group (83.63 ± 10.04); however, the difference was not significant (P = 0.75). Based on the mean subscale scores, the digit symbol score (WAIS-IV subscale) and memory score (ACE subscale) were significantly higher in the PNES group compared to the ES group (P = 0.037 and 0.032, respectively).

This study showed that neuropsychological assessments might not differentiate ES from non-epileptic seizures.