Archives of Neuroscience
Volume:9 Issue: 3, Jul 2022

Vascular dementia (VaD) is the second most common type of dementia after Alzheimer’s disease worldwide. Vascular dementia is a neurodegenerative disorder characterized by gradual cognitive impairment. Ischemic and hemorrhagic strokes result in VaD, markedly distributing cerebral blood flow and decreasing patients’ cognitive and memory performance. Due to their high energy demands, neurons are more sensitive to cellular architecture changes and exposed to mitochondrial stress than other cell types. Mitochondrial dysfunction and selective autophagy of mitochondria, known as mitophagy, are associated with VaD. This review aims to elucidate the association between mitophagy and VaD.

This review was conducted independently by at least two researchers dominant in various VaD studies. We searched databases including Elsevier, Google Scholar, and PubMed using the terms ‘vascular dementia’, ‘vascular cognitive impairment’, and ‘mitophagy’. We evaluated 70 articles on the relationship between VaD and mitophagy and interpreted the results. Adobe Photoshop 2022 was used for drawing figures by researchers.

The autophagy process plays a protective role in experimental VaD models via preserving vascular integrity and the structure of the blood-brain barrier, upregulating occludin and claudin protein expressions, reducing oxidative stress, and decreasing cognitive dysfunction. Some studies claim that autophagy could have adverse effects in a time-dependent manner against neuronal injury. Prolonged autophagy and overexpressed autophagic proteins induce ischemic injury and cause neuronal cells to undergo apoptotic cell death.

Although there are limited studies on the activation of mitophagy-related pathways in VaD, and the definitive role of mitophagy in neuronal healing is unclear, further research is needed to elucidate mitophagy pathways in neurons.

Tranexamic acid (TXA) belongs to the family of lysine-derived antifibrinolytics. TXA requires a simple molecular breakdown in the liver to be metabolized and has a high renal excretion.

This study aimed to determine the effect of TXA on subdural hematoma (SDH) treatment using the SR method.

Following a systematic review design, this study aimed to evaluate the effect of TXA on SDH treatment using studies published from 2000 to 2020. The search was performed by two researchers who were dominant in various types of SR studies and specialized discussion of neurosurgery. A checklist that contained the following items was used to collect the data: surname, year of study, year of publication, population, sample size, age, intervention, and outcomes. Data were also classified and reported using Word software.

Initially, 178 articles were identified, out of which 118 were removed due to the relevance of the title and method, 44 due to duplication, six due to following the SR method, and three due to having a case report design. Seven studies were found as eligible, as follows: the study by Wakabayashi et al. with a sample of 199 patients, Kageyama et al.’s study with 21 patients, Wan et al.’s study with 90 patients, Kutty et al.’ study with 27 patients, Tanweer et al.’s study with 14 patients, Yamada et al.’s study with 193 patients, and Lodewijkx et al.’s study with 7 patients. All articles showed that TXA could reduce SH.

Regarding the positive effect of TXA on reducing SDH, administration of this medicine is recommended in the treatment of patients with CSDH.

Thoracic disc herniation is a rare illness and is mainly asymptomatic. There are some surgical approaches to treat symptomatic patients, and none has absolute dominance over the others. For this reason, there is a debate between spine surgeons to decide which method could help these patients with better efficacy and safety.

To seek the potential differences between the two of these methods, the conventional anterior transthoracic and the more recent modified transfacet approaches, we conducted this study.

This is a retrospective case-series study comparing the anterior transthoracic and the modified transfacet method; each of these approaches was preferred and performed by one surgery team. Patients were divided into two groups based on the procedure and assessed using Frankel’s score, visual along scale (VAS) score, short-form health survey questionnaire (SF-36), and the spine functional index (SFI).

Eleven patients underwent a transthoracic approach, and eight patients had a posterior transfacet pedicle-sparing approach. The Frankel’s score improved at least one score in ten patients from the transthoracic group and seven patients from the transfacet pedicle-sparing group. No major difference was found between the two groups concerning SFI and SF-36 questionnaire.

This study exhibited satisfying efficacy and safety of the modified transfacet pedicle-sparing method compared to the transthoracic approach. Both improved Frankel’s scores, SFI, and patients’ quality of life. Despite encountering some limitations, especially a small number of subjects, our study suggests that these surgical methods could be used efficiently considering the patient’s comorbidities, location of the herniated disc and its calcification, and experience and skill of the surgeon.

Limited studies have attempted to identify the care needs of patients with spinal cord injury (SCI) and their professional caregivers at home and after discharge from the hospital. However, little information about these needs has led to increased physical and psychological complications and thus a reduced quality of life in SCI patients.

This study aimed to explain the experiences of patients and their caregivers regarding physical and psychological care needs at home.

This qualitative descriptive study was conducted on 24 SCI patients and their professional caregivers using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Purposeful sampling was continued until data saturation was reached. The conventional content analysis approach proposed by Graneheim and Lundman (continuous comparison) was used to analyze the data.

The age range of the participants was 29 - 48 years, with an average age of 37.8 years. Seven of the participants had paraplegia, and three of them had tetraplegia. The results of data analysis led to the extraction of two main categories, including physical and psychological care needs.

By identifying the real needs of patients after discharge from the hospital, we emphasize the need to remove barriers to home health care services and provide more financial support to meet patients' needs. Therefore, policymakers are encouraged to use the results of this study to plan at-home patient care services.

One of the most important objectives in the deformity correction surgery of spine is to achieve appropriate sagittal alignment, to improve patient outcome and reduce the risk of junctional failure. Intra-operative rod bending is crucial to achieve desired alignment.

Assessment of accuracy of rod bending by spine surgeons with or with-out template and/or correction.

Spine surgeons were asked to bend two rods; one in-situ on three-dimensional (3D) printed moulage, designed based on schematic representation of a patient with Kyphoscoliosis, the other rod was asked to bend with correction angles. The differences were measured and correlated with experience and specialty.

21 fellowship trained spine surgeons participated in this study, for in-situ rod, mean thoracic and lumbar bend were 65.2 (P = 0.033) and 49.3 (P = 0.077) degrees, respectively and for the correction rod, mean bend in thoracic and lumbar were 53.8 (P = 0.001) and 51.8 (P = 0.004) degrees, respectively, with significant difference from cut-off point. Each curve was over-bend and it was more pronounce in thoracic, both on in-situ and correction rods, 61.9 and 71.1 %, respectively. Level of experience showed positive correlation with degree of rod bending more than five years in thoracic in-situ bend (P = 0.003) and thoracic bend with correction (P = 0.004). Field of specialty showed positive correlation as well; with orthopedic in-situ bend (P = 0.002) and with correction (P = 0.003).

Spine surgeons tend to over-bend rods, when given target angles and when correction is needed. However, when provided with template, a 3D printed moulage in our study, accuracy of rod bending improved significantly.

Parkinson’s disease (PD) remains a significant health concern in Morocco. Multivariate analysis was not used in any study to evaluate the role of various factors that contributed to the onset of the disease.

This study investigates the role of family, environmental, and professional factors in PD development.

The present study is an age-matched case-control study with risk estimation based on odds ratios (OR) with a 95% confidence interval (CI). In total, 180 cases were matched with 360 controls.

The average age of participants was 68.3 ± 11.2 years. Adjusted logistic regression analysis showed that the family history of PD (ORa = 7.19, CI 95% 3.41 - 15.13), male sex (ORa = 1.92, CI 95% 1.16 - 3.16), spring water consumption (ORa = 3.31, CI 95% 2.05 - 5.34), drug use (ORa = 2.12, CI 95% 1.33 - 3.38), a history of head injury (ORa = 3.38, CI 95% 1.16 - 9.83) and non - consumption of coffee (ORa = 3.04, CI 95%1.56 - 5.90) were significantly associated with the onset of the disease. In a univariate analysis, well water consumption was observed as a significant risk factor but could not be shown to be significant in a multivariate analysis. Previous work on a farm (ORa = 0.30, CI 95% 0.16 - 0.54) and history of general anesthesia (ORa = 0.47, CI 95% 0.27 - 0.83) were inversely associated with PD risk. No statistical significance was observed in the data on occupational exposure and disease risk, although there was a 30% decrease in risk for the service occupations (ORa = 0.05, CI 95% 0.01 - 0.18).

As a result, further research is needed to determine additional risk factors.

Diffuse axonal injury (DAI) is an injury that occurs after the onset of traumatic brain injury (TBI), leading to many problems for patients and imposing high costs on the treatment system.

This study was conducted to investigate the status of laboratory variables in patients with DAI.

This cross-sectional study included 140 patients. Data collection tools were a demographic profile form and magnetic resonance imaging (MRI). Laboratory tests, including glucose, LDL-C, HDL-C, total cholesterol, triglycerides, Hb, HCT, PT, PTT, INR, BUN, creatinine, and CRP were evaluated. Also, specialized devices were used to study the laboratory and radiology variables.

Most (61.5%) of the patients were male, 47.1% had a non-governmental occupation, and 55.7% were less than 30 years old. Also, in 87.9% of cases, traffic accidents were the cause of DAI and in 65% of patients, the Glasgow Coma Scale (GCS) was less than 7. In all the laboratory variables differences were observed between the experimental and the control groups.

The laboratory variables in patients with DAI had a statistically significant difference compared to the case group, which indicates the negative effect of DAI on laboratory variables. Further studies are required to confirm our results.