Impact of Depression on Cognitive Function and Disease Severity in Idiopathic Cervical Dystonia Patients : One-Center Data in Cross-Sectional Study

Funding Information: The APC was funded by Latvian Society of Neurologists (Reg. Nr. 40008017147; 13 Pilsonu Str, Riga, LV 1002, Latvia; Ph.: (+371) 67069420; Email: [email protected]). Publisher Copyright: © 2022 by the authors.Background: Cervical dystonia is a highly disabling hyperkinetic movement disorder with a lot of nonmotor symptoms. One symptom with a high prevalence is depression, which may negatively affect dystonia patients. The aim of the study was to investigate the impact of depression on disease severity and cognitive functions in cervical dystonia patients. Methods: Patients with cervical dystonia were interviewed and divided into two groups, based on the Patient Health Questionnaire-9: those with no depression or mild depressive features and those with moderate, moderately severe, and severe depression. The severity of dystonia and cognitive functions were assessed and compared in both groups. Results: A total of 52 patients were investigated. Self-assessment of the disease was more negative in clinically significant depressive signs group ( p = 0.004), with a tendency for patients with clinically significant depressive features to have a slightly higher score on objective dystonia scales (TSUI and TWSTRS), but without statistically significant differences ( p = 0.387 and p = 0.244, respectively). Although not statistically significant, a slightly higher MoCA scale score was registered in cervical dystonia patients with clinically insignificant depressive signs. There was a tendency for worse results in the abstraction category in patients with clinically significant depression ( p = 0.056). Conclusions: Patients with clinically significant depression have a more negative self-assessment of the disease and perform worse in abstraction tasks.publishersversionPeer reviewe

Ischemic Stroke Due to Middle Cerebral Artery M1 Segment Occlusion : Latvian Stroke Register Data

Publisher Copyright: © 2015 by Elina Pucite.The occlusion of middle cerebral artery (MCA) is the most common cause of ischemic stroke. A retrospective single centre analysis of ischemic stroke was conducted using data from the Latvian Stroke Register in the period from January 2013 till December 2014. The study included 478 patients who had confirmed MCA occlusion using computed tomography angiography (CTA). Half of the patients were males-237 (49.6%), average age 69.51, average age of females was 74.58 years. Cardioembolic stroke was the most common cause of MCA M1 segment occlusion in 294 (61.5%) cases. Small cerebral artery occlusion was not a cause of M1 MCA occlusion. The reperfusion therapy group consisted of 209 patients and the conservative therapy group of 269 patients. Both groups presented similar neurological status when they were admitted to hospital. However, the reperfusion therapy group had better neurological status (NIHSS 6.82) than in the conservative therapy group (NIHSS 8.2) at the time period when patients were discharged from hospital (p < 0.05). There were more cases of good functional outcome (39.2%) and less of poor (34.5%) in the reperfusion group, as well as less mortality-7.6%. Middle cerebral artery (MCA) is the most common site of stroke and the most common cause of its occlusion is cardioembolism. There is high incidence of recurrence of stroke due to M1 MCA occlusion. Both groups presented a similar neurological status on admission, but more improvement was seen in the reperfusion therapy group after discharge of patients from hospital. The functional outcome was also better in the reperfusion therapy group.publishersversionPeer reviewe

Neurosyphilis Mimicking Herpes Simplex Encephalitis on Magnetic Resonance Imaging : A Case Report

Publisher Copyright: © Am J Case Rep.Objective: Rare disease Background: Neurosyphilis is a central nervous system infection caused by Treponema pallidum, that can develop at any time after the initial infection. The clinical signs of neurosyphilis are very variable, as well as its radiological features, and it is a diagnostic challenge. Knowledge of clinical symptoms and correct laboratory diagnostics, combined with routine radiological examination and additional diagnostic tools, such as high-resolution, threedimensional FLAIR sequence, T2-weighted, and T1-weighted contrast-enhanced magnetic resonance imaging (MRI) are key to making an accurate diagnosis of neurosyphilis. Case Report: We present the clinical case of a patient who presented a 1-year history of vague clinical symptoms and was misdiagnosed with herpes simplex virus (HSV) encephalitis. Initial head MRI revealed extensive cerebral white matter lesions with cortical contrast enhancement, mainly of anterior and medial parts of the left temporal lobe, as typically seen in HSV encephalitis. Empirical therapy with acyclovir was started until a diagnosis of syphilis was confirmed with laboratory findings. Later, the therapy was changed to penicillin G. The patient’s condition improved after receiving targeted treatment. A control MRI scan was performed, and previously detected changes in the brain had decreased significantly. Conclusions: MRI is the imaging of choice to support the diagnosis of neurosyphilis. Our findings suggest that neuroimaging can play an important role in indicating suspicion of syphilitic encephalitis. Enhancement of the anterior and medial parts of the temporal lobe is an atypical imaging finding, and it can simulate an infection with HSV. Early treatment is critical to a positive outcome.publishersversionPeer reviewe

Acute Ischemic Stroke Endovascular Treatment of Patients with Large Vessel Occlusions

Publisher Copyright: © 2015 by Arturs Balodis.Mechanical thrombectomy as an active treatment method has recently been chosen for patients with large artery occlusions and thrombolysis beyond a time window. The aim of our study was to evaluate the results of endovascular treatment in patients with proximal vessel occlusion, compare this group with the intravenous thrombolysis group, and to identify possible criteria of active treatment. The prospective study included 81 patients hospitalised in the Pauls Stradiņš Clinical University Hospital due to acute ischemic stroke; 48 of them received mechanical thrombectomy and 33-intravenous thrombolysis. Thrombectomy (TE) was performed using Solitaire FR stent retrievers. The NIHSS score was used for evaluation of early therapy results and mRS (modified Rankin Scale) was used for late therapy results. ASPECTS was used to define the lesion size using imaging on admission and after treatment. Median NIHSS on admission was higher in the TE group-16 (range 12 to 19) than in the TL group-12 (range 8 to 15) (p 0.05). Frequency of symptomatic intracerebral haemorrhages was similar in the groups. Mechanical thrombectomy can achieve better late functional outcome than thrombolysis in a selected patients group.publishersversionPeer reviewe

Lack of Accredited Clinical Training in Movement Disorders in Europe, Egypt, and Tunisia

Background: Little information is available on the official postgraduate and subspecialty training programs in movement disorders (MD) in Europe and North Africa. Objective: To survey the accessible MD clinical training in these regions. Methods: We designed a survey on clinical training in MD in different medical fields, at postgraduate and specialized levels. We assessed the characteristics of the participants and the facilities for MD care in their respective countries. We examined whether there are structured, or even accredited postgraduate, or subspecialty MD training programs in neurology, neurosurgery, internal medicine, geriatrics, neuroradiology, neuropediatrics, and general practice. Participants also shared their suggestions and needs. Results: The survey was completed in 31/49 countries. Structured postgraduate MD programs in neurology exist in 20 countries; structured neurology subspecialty training exists in 14 countries and is being developed in two additional countries. Certified neurology subspecialty training was reported to exist in 7 countries. Recommended reading lists, printed books, and other materials are the most popular educational tools, while courses, lectures, webinars, and case presentations are the most popular learning formats. Mandatory activities and skills to be certified were not defined in 15/31 countries. Most participants expressed their need for a mandatory postgraduate MD program and for certified MD sub-specialization programs in neurology. Conclusion: Certified postgraduate and subspecialty training exists only in a minority of European countries and was not found in the surveyed Egypt and Tunisia. MD training should be improved in many countries.Peer reviewe

Impact of the COVID-19 Pandemic on the Mortality Rate and Clinical Outcome of Patients Admitted to Pauls Stradiņš Clinical University Hospital with Spontaneous Intracerebral Haemorrhage

Publisher Copyright: © 2023 Inese Blimhena-Pastare et al., published by Sciendo.Spontaneous intracerebral haemorrhage (SICH) remains the most devastating type of stroke with the highest morbidity and mortality. Since the start of the COVID-19 pandemic, serious modifications have been made in health care systems, affecting patients with all kinds of disease, including SICH. This study compared mortality rates, and clinical and functional outcomes of patients diagnosed with SICH in the pre-COVID-19 and COVID-19 time periods. Retrospective analysis was performed using patient data from Pauls Stradiņš Clinical University Hospital from 2018 to 2021, dividing it into two subgroups based on the beginning of the COVID-19 pandemic. In this study, 329 patients in total were analysed. No statistically significant differences were found in mortality rate (p = 0.389) and neurological status at hospital admission (p = 0.309) between the time periods prior to COVID-19 and during the COVID-19 period. A statistically significant difference was found in the clinical status of patients (p = 0.016) measured using the Glasgow Coma Scale, indicating a worse level of consciousness of patients diagnosed with SICH at the time of admission to the hospital in the COVID-19 period. No statistically significant differences were found in the clinical outcome (p = 0.204) and functional outcome (p = 0.556) of the patients at discharge from the hospital. In the COVID-19 period, admission of patients with SICH fell by 25%. For patients with SICH, the COVID-19 pandemic was associated with a reduced admission rate and a worse level of consciousness at the time of admission, calling for further research to identify what caused it and how to avoid delayed medical help in the case of the development of acute neurological symptoms during the COVID-19 outbreak.Peer reviewe

Systemic pro-inflammatory molecule response to acute submaximal exercise in moderately and highly trained athletes

Abstract The effect of training status on acute exercise-induced release of pro-inflammatory biomarkers in circulatory system was studied in 10 moderately trained and seven highly trained athletes. The subjects performed an hour of submaximal bicycle exercise at workload equal to ~70% of heart rate reserve. Venous blood samples were collected 15 min before and immediately after the exercise. Intereukin-6, tumor necrosis factor-α, and monocyte chemotactic protein-1 response to exercise was similar in moderately trained and highly trained athletes (2.5 ± 2.4 vs. 1.0 ± 1.0 pg mL , respectively), suggesting that training status had no impact on cytokine and monocyte chemotactic protein-1 post-exercise concentrations with this experimental model