1,721,008 research outputs found

    COVID-19 and neurological disorders: are neurodegenerative or neuroimmunological diseases more vulnerable?

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    Neurological disorders and coronavirus 2019 (COVID-19) pandemic are two conditions with a recent well-documented association. Intriguing evidences showed that COVID-19 infection can modify clinical spectrum of manifested neurological disorders but also it plays a crucial role in the development of future diseases as long-tem consequences. In this viewpoint review, we aimed to assess the vulnerability to SARS-CoV-2 infection and development of COVID-19 among neurological disorders. With this in mind, we tested the hypothesis that age rather than neuropathology itself could be decisive in neurodegenerative diseases such as Parkinson’s disease, whereas neuropathology rather than age may be critical in neuroimmunological diseases such as Multiple Sclerosis. Highlighting the role of potential susceptibility or protection factors from this disastrous infection, we also stratify the risk for future neurodegeneration

    Clinical trial: imaging techniques in sleep studies

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    Sleep is a global phenomenon affecting the whole brain and in which the brain activity dynamically changes across the stages. Sophisticated imaging techniques have been developed to investigate the intriguing interaction: sleep-brain. This chapter critically reviews the main applications of imaging studies in the field of sleep research. The neural correlates of sleep stages, in particular nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep as well as the phasic activity characterizing these stages will be discussed with magnifying glass focus on neuroimaging. Functional neuroimaging studies disrupted the basic neurophysiological notions on sleep, demonstrating that brain activity is increased during NREM sleep in synchrony to specific phasic NREM oscillations. As well as REM sleep may be characterized by cortical deactivation/quiescence especially the prefrontal cortex. The clinical relevance of this evidence consists for improving the knowledge on mechanisms and neural networks underlying the physiology of the human sleep

    Therapy for Insomnia and Circadian Rhythm Disorder in Alzheimer Disease

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    Purpose of the review: There is strong evidence for a bidirectional association between sleep disorders and Alzheimer’s disease (AD). In particular, insomnia may be a potentially modifiable risk factor for AD. The present review summarizes recent advances in treatment of sleep disorders in AD. Recent findings: Some studies investigated the efficacy and safety of hypnotic agents as ramelteon and mirtazapine to treat sleep disorders in AD but no significant therapeutic effects have been observed. Benzodiazepines are the most frequently used medication for treatment of insomnia but they may cause significant side effects in old subjects. Suvorexant, an orexin receptor antagonist, showed a positive effect on AD insomnia. Recent report suggests an association between trazodone use and delayed cognitive decline in AD. With respect to circadian rhythm disorders, non-pharmacological treatments, especially bright light therapy, could be useful and safe options for treatment in AD. Summary: Some pharmacological and non-pharmacological treatments might have benefits in AD patients with sleep disturbances, but further well-designed controlled trials are needed

    Comparison between Electrocardiographic and Earlobe Pulse Photoplethysmographic Detection for Evaluating Heart Rate Variability in Healthy Subjects in Short- and Long-Term Recordings

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    Heart rate variability (HRV) is commonly used to assess autonomic functions and responses to environmental stimuli. It is usually derived from electrocardiographic signals; however, in the last few years, photoplethysmography has been successfully used to evaluate beat-to-beat time intervals and to assess changes in the human heart rate under several conditions. The present work describes a simple design of a photoplethysmograph, using a wearable earlobe sensor. Beat-to-beat time intervals were evaluated as the time between subsequent pulses, thus generating a signal representative of heart rate variability, which was compared to RR intervals from classic electrocardiography. Twenty-minute pulse photoplethysmography and ECG recordings were taken simultaneously from 10 healthy individuals. Ten additional subjects were recorded for 24 h. Comparisons were made of raw signals and on time-domain and frequency-domain HRV parameters. There were small differences between the inter-beat intervals evaluated with the two techniques. The current findings suggest that our wearable earlobe pulse photoplethysmograph may be suitable for short and long-term home measuring and monitoring of HRV parameters

    Sleep disorders and Parkinson’s disease: is there a right direction?

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    In the last years, the hypothesis of a close relationship between sleep disorders (SDs) and Parkinson's disease (PD) has significantly strengthened. Whether this association is causal has been also highlighted by recent evidence demonstrating a neurobiological link between SDs and PD. Thus, the question is not whether these two chronic conditions are mutually connected, but rather how and when this relationship is expressed. Supporting this, not all SDs manifest with the same temporal sequence in PD patients. Indeed, SDs can precede or occur concomitantly with the onset of the clinical manifestation of PD. This review discusses the existing literature, putting under a magnifying glass the timing of occurrence of SDs in PD-neurodegeneration. Based on this, here, we propose two possible directions for studying the SDs-PD relationship: the first direction, from SDs to PD, considers SDs as potential biomarker/precursor of future PD-neurodegeneration; the second direction, from PD to SDs, considers SDs as concomitant symptoms in manifest PD, mainly related to primary PD-neuropathology and/or parkinsonian drugs. Furthermore, for each direction, we questioned SDs-PD relationship in terms of risk factors, neuronal circuits/mechanisms, and impact on the clinical phenotype and disease progression. Future research is needed to investigate whether targeting sleep may be the winning strategy to treat PD, in the context of a personalized precision medicine

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Magnetic Resonance Parkinsonism Index and midbrain to pons ratio: Which index better distinguishes Progressive Supranuclear Palsy patients with a low degree of diagnostic certainty from patients with Parkinson Disease?

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    Introduction: Differentiating clinically progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) may be challenging, especially in the absence of vertical supranuclear gaze palsy (VSGP). The Magnetic Resonance Parkinsonism Index (MRPI) has been reported to accurately distinguish between PSP and PD, yet few data exist on the usefulness of this biomarker for the differentiation of PSP-P from PD. Methods: Thirty-four patients with PSP-P, 46 with PSP-Richardson's syndrome (PSP-RS), 53 with PD, and 53 controls were enrolled. New consensus criteria for the clinical diagnosis of PSP were used as the reference standard. The MRPI, and a new index termed MRPI 2.0 including the measurement of the third ventricle width (MRPI multiplied by third ventricle width/frontal horns width ratio), were calculated on T1-weighted MR images. Results: The MRPI differentiated patients with PSP-P from those with PD with sensitivity and specificity of 73.5% and 98.1%, respectively, while the MRPI 2.0 showed higher sensitivity (100%) and similar specificity (94.3%) in differentiating between these two groups. Both biomarkers showed excellent performance in differentiating PSP-P patients with VSGP from those with PD, but the MRPI 2.0 was much more accurate (95.8%) than MRPI in differentiating PSP-P patients with slowness of vertical saccades from PD patients. Conclusion: The MRPI 2.0 accurately differentiated PSP-P patients from those with PD. This new index was more powerful than MRPI in differentiating PSP patients in the early stage of the disease with slowness of vertical saccades from patients with PD, thus helping clinicians to consolidate the diagnosis based on clinical features, in vivo
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