The role of physical activity against chemotherapy-induced peripheral neuropathy: a narrative review

Several studies investigated the side effect of adjuvant cancer treatments, and different types of preventive techniques or treatments have been assessed. Chemotherapy-induced peripheral neuropathy (CIPN) is the most common neurological side effect. Exercise training has been widely studied as an adjuvant therapy to prevent CIPN and improve post-chemotherapy functional outcome and quality of life (QoL). This narrative review aims to summarize the data obtained from the latest studies about physical activity (PA) for the prevention and treatment of CIPN and associated QoL measures. Literature research was conducted to obtain studies including PA interventions for patients with CIPN. Ten studies met inclusion criteria and were therefore summarized and discussed, focusing on exercise type and functional outcome. It seems clear that, regardless of the type of exercise, PA plays a positive role in the treatment of CIPN, providing a significant symptom improvement. There has been no standardization of type, quantity, and intensity of PA administered to the subjects in the various studies probably due to a physiological difference between samples, grade of neuropathy, and difference among therapies

Correlati corticali della paratonia in pazienti con malattia di Alzheimer

La paratonia è caratterizzata dall’incapacità di mantenere la muscolatura degli arti rilassata durante la mobilizzazione passiva. Sono stati descritti due tipi di paratonia: facilitatoria, quando il soggetto assiste, e oppositiva, quando il soggetto si oppone involontariamente al movimento imposto dall’esaminatore. Tipicamente correlata a decadimento cognitivo, e valutata mediante scale cliniche, recenti studi hanno dimostrato la possibilità di valutare quantitativamente la paratonia mediante elettromografia di superficie. La sensibilità della metodica ha permesso di dimostrare la presenza di paratonia anche in soggetti sani e giovani o comunque in soggetti in cui la valutazione clinica non è in grado di evidenziarla. La prevalenza e l’entità della paratonia aumenta con l’età ed è maggiore in soggetti con decadimento cognitivo, in particolare quando sono coinvolte le aree frontali, tuttavia i meccanismi fisiopatologici alla base della paratonia non sono ancora stati chiariti. L’obiettivo di questo studio è verificare se in pazienti con malattia di Alzheimer sia presente una correlazione inversa tra paratonia e funzione delle aree premotorie, che potrebbero esercitare un controllo inibitorio sul circuito sensori-motorio corticale, ipoteticamente alla base della paratonia. Un gruppo di pazienti con malattia di Alzheimer dimostrato dall’accumulo di beta-amiloide all’esame PET è stato valutato mediante elettromiografia di superficie a livello dei muscoli bicipite e tricipite dell’arto superiore non dominante durante l’esecuzione di movimenti passivi di flesso-estensione. L’attività paratonica registrata è stata correlata alla funzione delle aree premotorie sfruttando le sequenze di perfusione effettuate all’inizio della valutazione PET-amiloide. I risultati mostrano una significativa correlazione inversa tra il livello di paratonia ed il metabolismo cerebrale nelle aree premotorie, in particolare nelle aree di Brodmann 6, 8 e 9 (p < 0.006). In pazienti con malattia di Alzheimer, una ridotta funzione delle aree premotorie corrisponde a più alti livelli di paratonia, confermando quindi l’ipotesi alla base dello studio. Bassi livelli di paratonia sono verosimilmente fisiologici e dovuti all’attivazione delle aree motorie primarie ad opera delle afferenze sensitive ad origine fusoriale attivate dal movimento passivo. L’aumento dell’attività paratonia sarebbe quindi spiegabile da una disfunzione delle aree premotorie e quindi dal ridursi dell’attività inibitoria sull’area motoria primaria. Questo studio è il primo a chiarire i meccanismi fisiopatologici della paratonia e a valorizzarne l’utilità come biomarcatore di funzione corticale premotoria.Paratonia is a form of hypertonia that occurs during the passive movement of a limb by an operator. Two types of paratonia can be recognized (facilitatory and oppositional), and it can be elicited in subjects of all ages with a higher incidence in elderly subjects and those with a form of dementia, especially with frontal lobe degeneration. Previous electromyography-based studies have allowed the evaluation of paratonia with quantitative data. The aim of this study is to verify a possible inverse correlation between paratonic activity and premotor area function in subjects with Alzheimer's disease by cross-referencing electromyographic data with PET amyloid data. The results obtained show a significant inverse correlation between the level of paratonia and cerebral metabolism in premotor areas, particularly in Brodmann areas 6, 8, and 9 (p < 0.006). Considering that the separate analysis of the two types of paratonia does not reach significance, we can hypothesize that oppositional and facilitatory paratonia are the different manifestations of a frontal lobe dysfunction that results in an inability to relax the muscles. We can also hypothesize that there is a cortical control circuit that premotor areas play on the primary motor area

Metaphoric language in the differential diagnosis of epilepsy and psychogenic non-epileptic seizures: Time to move forward

Conversation analysis (CA) to identify metaphoric language (ML) has been proposed as a tool for the differential diagnosis of epileptic (ES) and psychogenic nonepileptic seizures (PNES). However, the clinical relevance of metaphoric conceptualizations is not clearly defined. The current study aims to investigate the ML utilized by individuals with ES and PNES in a pulled multi-country sample. Two blinded researchers examined the transcripts and videos of 54 interviews of individuals (n = 29, Italy; n = 11, USA; n = 14, Russia) with ES and PNES, identifying the patient-seizure relationship representative of the patient's internal experience. The diagnoses were based on video-EEG. Metaphors were classified as “Space/place”, “External force”, “Voluntary action”, and “Other”. A total of 175 metaphors were identified. No differences between individuals with ES and PNES were found in metaphoric occurrence (χ2 (1, N = 54) = 0.07; p = 0.74). No differences were identified when comparing the types of metaphors utilized by participants with ES and those with PNES. Patients with PNES and ES did not demonstrate differences in terms of occurrence and categories in ML. Therefore, researchers and clinicians should carefully consider the use of metaphor conceptualizations for diagnostic purposes

Surface Electromyography Spectral Parameters for the Study of Muscle Fatigue in Swimming

The purpose of this study was to assess validity, stability and sensitivity, of 4 spectral parameters\u2013median frequency (Fmed), mean frequency (Fmean), Dimitrov index (DI), and mean instant frequency (Fmi)\u2013in measuring localized muscle fatigue in swimming and to investigate their correlation with the variations of kinematic data and mechanical fatigue. Electrophysiological measures of muscle fatigue were obtained in real-time during a 100 m front crawl test at maximum speed in 15 experienced swimmers, using surface electromyography in six muscles employed in front crawl, while kinematic data of swimming was measured from video analysis. Mechanical fatigue was measured as the difference between muscle strength prior to and immediately after the 100 m front crawl in a dry-land multi-stage isometric contraction test. Statistically significant fatigue (p < 0.0001) was found for all spectral parameters in all muscles. Fmed and Fmean varied between 10 and 25%, DI between 50 and 150%, and Fmi between 5 and 10%. Strong correlation (Pearson r 65 0.5) with mechanical fatigue was found for all spectral parameters except for Fmi and it was strongest for Fmed and Fmean. From our study, it turns out that Fmed and Fmean are more valid and stable parameters to measure fatigue in swimming, while DI is more sensitive

Characterization of a Lineage C.36 SARS-CoV-2 Isolate with Reduced Susceptibility to Neutralization Circulating in Lombardy, Italy

SARS-CoV-2 spike is evolving to maximize transmissibility and evade the humoral response. The massive genomic sequencing of SARS-CoV-2 isolates has led to the identification of single-point mutations and deletions, often having the recurrence of hotspots, associated with advantageous phenotypes. We report the isolation and molecular characterization of a SARS-CoV-2 strain, belonging to a lineage (C.36) not previously associated with concerning traits, which shows decreased susceptibility to vaccine sera neutralization