Cognitive Training and Stress Detection in MCI Frail Older People Through Wearable Sensors and Machine Learning

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Cerebellar Ataxia with Complete Clinical Recovery and Resolution of MRI Lesions Related to Central Pontine Myelinolysis: Case Report and Literature Review

There are several reports of central pontine myelinolysis (CPM) in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561–567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms

A System for Neuromotor Based Rehabilitation on a Passive Robotic Aid

In the aging world population, the occurrence of neuromotor deficits arising from stroke and other medical conditions is expected to grow, demanding the design of new and more effective approaches to rehabilitation. In this paper, we show how the combination of robotic technologies with progress in exergaming methodologies may lead to the creation of new rehabilitation protocols favoring motor re-learning. To this end, we introduce the Track-Hold system for neuromotor rehabilitation based on a passive robotic arm and integrated software. A special configuration of weights on the robotic arm fully balances the weight of the patients’ arm, allowing them to perform a purely neurological task, overcoming the muscular effort of similar free-hand exercises. A set of adaptive and configurable exercises are proposed to patients through a large display and a graphical user interface. Common everyday tasks are also proposed for patients to learn again the associated actions in a persistent way, thus improving life independence. A data analysis module was also designed to monitor progress and compute indices of post-stroke neurological damage and Parkinsonian-type disorders. The system was tested in the lab and in a pilot project involving five patients in the post-stroke chronic stage with partial paralysis of the right upper limb, showing encouraging preliminary results

A Case Study of Upper Limb Robotic-Assisted Therapy Using the Track-Hold Device

The Track-Hold System (THS) project, developed in a healthcare facility and therefore in a controlled and protected healthcare environment, contributes to the more general and broad context of Robotic-Assisted Therapy (RAT). RAT represents an advanced and innovative rehabilitation method, both motor and cognitive, and uses active, passive, and facilitating robotic devices. RAT devices can be equipped with sensors to detect and track voluntary and involuntary movements. They can work in synergy with multimedia protocols developed ad hoc to achieve the highest possible level of functional re-education. The THS is based on a passive robotic arm capable of recording and facilitating the movements of the upper limbs. An operational interface completes the device for its use in the clinical setting. In the form of a case study, the researchers conducted the experimentation in the former Tabarracci hospital (Viareggio, Italy). The case study develops a motor and cognitive rehabilitation protocol. The chosen subjects suffered from post-stroke outcomes affecting the right upper limb, including strength deficits, tremors, incoordination, and motor apraxia. During the first stage of the enrolment, the researchers worked with seven patients. The researchers completed the pilot with four patients because three of them got a stroke recurrence. The collaboration with four patients permitted the generation of an enlarged case report to collect preliminary data. The preliminary clinical results of the Track-Hold System Project demonstrated good compliance by patients with robotic-assisted rehabilitation; in particular, patients underwent a gradual path of functional recovery of the upper limb using the implemented interface

Effects of Global Warming on Patients with Dementia, Motor Neuron or Parkinson’s Diseases: A Comparison among Cortical and Subcortical Disorders

Exposure to global warming can be dangerous for health and can lead to an increase in the prevalence of neurological diseases worldwide. Such an effect is more evident in populations that are less prepared to cope with enhanced environmental temperatures. In this work, we extend our previous research on the link between climate change and Parkinson’s disease (PD) to also include Alzheimer’s Disease and other Dementias (AD/D) and Amyotrophic Lateral Sclerosis/Motor Neuron Diseases (ALS/MND). One hundred and eighty-four world countries were clustered into four groups according to their climate indices (warming and annual average temperature). Variations between 1990 and 2016 in the diseases’ indices (prevalence, deaths, and disability-adjusted life years) and climate indices for the four clusters were analyzed. Unlike our previous work on PD, we did not find any significant correlation between warming and epidemiological indices for AD/D and ALS/MND patients. A significantly lower increment in prevalence in countries with higher temperatures was found for ALS/MND patients. It can be argued that the discordant findings between AD/D or ALS/MND and PD might be related to the different features of the neuronal types involved and the pathophysiology of thermoregulation. The neurons of AD/D and ALS/MND patients are less vulnerable to heat-related degeneration effects than PD patients. PD patients’ substantia nigra pars compacta (SNpc), which are constitutively frailer due to their morphology and function, fall down under an overwhelming oxidative stress caused by climate warming

UN CASO DI SINDROME ATASSICA IN POLINEUROPATIA SENSITIVO-MOTORIA DI ORIGINE DISMETABOLICA TRATTATO EFFICACEMENTE CON AGOPUNTURA E CON INTERVENTI DI MINDFULNESS E DI IMAGERY

Nel dolore cronico di eziologia ignota nel soggetto avviene un distacco dalla propria esperienza consapevole del corpo che ostacola il processo di guarigione naturale. L’integrazione di diverse tecniche adatte a favorire l’autoguarigione sembra essere quindi l’approccio più adatto. L’agopuntura può rappresentare il trattamento di elezione che permette un graduale ripristino della normale attività metabolica. Allo stesso tempo, la meditazione di consapevolezza mindfulness favorisce l’esperienza e l’accettazione del corpo con un’attitudine di apertura e decentramento. È quindi possibile fare esperienza del dolore mediata dall’Imagery e proporre esercizi induttivi nella direzione dell’attenuazione del dolore

Exosomal content in patients with ALS compared to those with selective involvement of lower motor neuron

The aim of our work was to study the exosomal specific content in ALS/MND patients, by comparing the exosomal-bound and free-circulating blood amounts of miR-155 and neuronal damage-asso- ciated proteins, and correlating them to blood cytokine level

Blood Analytes as Biomarkers of Mechanisms Involved in Alzheimer’s Disease Progression

Alzheimer’s disease (AD) is the leading cause of dementia, but the pathogenetic factors are not yet well known, and the relationships between brain and systemic biochemical derangements and disease onset and progression are unclear. We aim to focus on blood biomarkers for an accurate prognosis of the disease. We used a dataset characterized by longitudinal findings collected over the past 10 years from 90 AD patients. The dataset included 277 observations (both clinical and biochemical ones, encompassing blood analytes encompassing routine profiles for different organs, together with immunoinflammatory and oxidative markers). Subjects were grouped into four severity classes according to the Clinical Dementia Rating (CDR) Scale: mild (CDR = 0.5 and CDR = 1), moderate (CDR = 2), severe (CDR = 3) and very severe (CDR = 4 and CDR = 5). Statistical models were used for the identification of potential blood markers of AD progression. Moreover, we employed the Pathfinder tool of the Reactome database to investigate the biological pathways in which the analytes of interest could be involved. Statistical results reveal an inverse significant relation between four analytes (high-density cholesterol, total cholesterol, iron and ferritin) with AD severity. In addition, the Reactome database suggests that such analytes could be involved in pathways that are altered in AD progression. Indeed, the identified blood markers include molecules that reflect the heterogeneous pathogenetic mechanisms of AD. The combination of such blood analytes might be an early indicator of AD progression and constitute useful therapeutic targets

Micro-RNA carrying exosomes in motor neuron disease patients

Overexpression of miR-206 and miR-29 could delay the muscle weakness observed in ALS/MND patients, thus providing a potential therapeutic target