Combination of Vestibular Rehabilitation and Galvanic Vestibular Stimulation Improves Verbal and Visuospatial Memory: A Randomized Control Trial in Patients with Amnestic Mild Cognitive Impairment

Background and Aim: Considering the critical input of the vestibular system to the hippocampus as an area involved in cognition, and vestibular disorders reported in patients with amnestic Mild Cognitive Impairment (aMCI), we aimed to investigate the effects of Vestibular Rehabilitation (VR) with and without noisy Galvanic Vestibular Stimulation (nGVS) on cognitive function in patients with aMCI. Methods: In a randomized controlled trial, twenty-two patients with aMCI were randomly assigned to two groups receiving: 1) VR for four weeks (VR group); 2) VR for four weeks with nGVS for three sessions (GVS+VR group). Outcome measures were Rey's Auditory-Verbal Learning Test (RAVLT), Corsi blocks, Visual Search (VS), and match to sample tests. Results: Mean immediate and delayed recalls of RAVLT, all of the outcomes of Corsi blocks and VS tests, and the error rate of the match to sample tests improved significantly after intervention in VR and GVS+VR groups. Between-group differences were observed for learning and delayed recalls of RAVLT (p=0.001, d=0.444 and p<0.001, d=0.512 respectively), reaction times 1 and 2 in VS (p=0.007, d=0.325 and p=0.001, d=0.446 respectively), the total correct trial of Corsi blocks (p=0.026, d=0.235), and error rate of the match to sample (p=0.017, d=0.266) tests. Conclusion: The synergistic effect of VR and GVS suggested that simultaneous use of both stimulations improves verbal and visuospatial memory in aMCI patients. Study protocol location: https://irct.ir/trial/47249 Trial registration number: IRCT20160131026279N

Sensing of Alzheimer’s Disease and Multiple Sclerosis Using Nano-Bio Interfaces

It is well understood that patients with different diseases may have a variety of specific proteins (e.g., type, amount, and configuration) in their plasmas. When nanoparticles (NPs) are exposed to these plasmas, the resulting coronas may incorporate some of the disease-specific proteins. Using gold (Au) NPs with different surface properties and corona composition, we have developed a technology for the discrimination and detection of two neurodegenerative diseases, Alzheimer's disease (AD) and multiple sclerosis (MS). Applying a variety of techniques, including UV-visible spectra, colorimetric response analyses and liquid chromatography-tandem mass spectrometry, we found the corona-NP complexes, obtained from different human serums, had distinct protein composition, including some specific proteins that are known as AD and MS biomarkers. The colorimetric responses, analyzed by chemometrics and statistical methods, demonstrate promising capabilities of the technology to unambiguously identify and discriminate AD and MS. The developed colorimetric technology might enable a simple, inexpensive and rapid detection/discrimination of neurodegenerative diseases. KEYWORDS: Alzheimer’s disease; colorimetric technology; disease-specific protein corona; gold nanoparticles; multiple sclerosi

Role of Zinc Supplementation in the Treatment of Levetiracetam-Induced Hair Loss: A Case Series

Objective: Cosmetic side effects are of important causes for non-compliance in patients on anti-epileptics. TE is among the most encountered cosmetic adverse effects. Method: This report presents three patients with seizure disorder who developed levetiracetam- induced TE. Levetiracetam was considered the best therapeutic option for the treatment of the presented patients and therefore, was not changed to other anti-epileptics. To manage TE, it was decided to add Zinc sulfate to the therapeutic levetiracetam regimen. Results:  All three patients reported improvement in their hair condition while their seizure was controlled. Significance: Levetiracetam has favorable safety and efficacy profiles. However; the hair loss caused by this medication is a major drawback. Zinc supplementation is suggested to be safe and cost effective when considering management of levetiracetam-induced TE

Onset of Mania by Vitamin B12 Injection in a 52-Year Old Patient with Refractory and Resistant Depression

Vitamin B12 affects and modify the function of multiple organ systems. Its deficiency may cause psychiatric symptoms in addition to hematologic, gastrointestinal, and neurologic manifestations. The present case study aims to report  a patient with vitamin B12 deficiency who coexisted with resistant and persistent depression, and experienced mania phase after the replacement of vitamin B12. For a patient with refractory and resistant depression  and evidence or a risk factor for vitamin B12 deficiency, it is required to check plasma levels and monitor psychiatric symptoms during vitamin B12 supplementation. There are some manifestations of B12 deficiency including bipolar disorder, mood lability, irritability, and psychosis due to deficiency but  we  didn’t  find  case  report  about  induce  of  psychiatric  presentation follow   correction  of  vitamin B12  deficienc

Chronic neurological diseases and COVID-19: Associations and considerations

The 2019 novel coronavirus pandemic, severe acute respiratory syndrome CoV-2 (COVID-19), has been a worldwide urgent public health threat, resulting in six-hundred seventy thousand deaths to date. The COVID-19 pandemic has led to a series of public health challenges. One such challenge is the management of diseases such as chronic neurological diseases during an epidemic event. COVID-19 affects all kinds of people, including older people with chronic underlying diseases, who are particularly at risk of severe infection or even death. Chronic neurological diseases such as epilepsy, dementia, Parkinson’s disease (PD), and multiple sclerosis (MS) are frequently associated with comorbidities; thus, these patients are in the high-risk category. Therefore, in this article, we review associations and challenges the people with epilepsy, dementia, PD, and MS faces during the COVID-19 pandemic and suggest approaches to provide consensus recommendations on how to provide the best possible care

Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis

Abstract Background and aims The nonmotor symptoms (NMS) of Parkinson's disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and NMS of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension. Methods A total of 93 PD patients with depression and 67 PD patients without depression were included in the study, and NMS were compared between the two groups. Furthermore, the possible associations between depression severity measured by Beck Depression Inventory (BDI) and NMS were investigated using linear regression or binary logistic regression models controlled for possible confounders. Eventually, we performed a subgroup analysis in each mild, moderate, and severe depression group. Results Orthostatic hypotension, constipation, and hyposexuality showed a significant difference between PD patients with and without depression (p < 0.001, p = 0.029, and p < 0.001, respectively). The BDI score was significantly associated with hyposexuality, Montreal cognitive assessment (MoCA), and Pittsburgh Sleep Quality (p = 0.016, p = 0.010, and p = 0.011, respectively); however, after adjustments for possible confounders, the associations of the BDI score with the MoCA score and hyposexuality remained significant (p = 0.015 and p = 0.019, respectively). Considering subgroup analysis, a similar pattern of significant results was observed particularly in the severe group. Conclusions This study suggests a possible association between depression in PD patients and some NMS observed in the course of PD. These findings could be beneficial for early diagnosis of the disease, which eventually could make a considerable difference in the management of PD patients. Additional interventional longitudinal studies are warranted to explore how controlling depression could impact the NMS of patients with PD

Evaluating Executive Functions in Patients with Juvenile Myoclonic Epilepsy Using Frontal Assessment Battery

Objective. In this study, we aimed to evaluate the executive profile of juvenile myoclonic epilepsy (JME) patients using the Frontal Assessment Battery (FAB) as a bedside screening tool and investigate its association with seizure proximity, family history of epilepsy, and polytherapy/monotherapy with antiepileptic drugs (AEDs). Background. JME patients have deficits in various aspects of executive functions. FAB has proved to be a useful tool for evaluating executive functions in clinical settings. Methods. Thirty-one JME patients and 110 healthy controls (HCs) were enrolled in this study. The participants were assessed using six subsets of FAB, including conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control, and environmental autonomy. Results. Compared to HCs, JME patients showed lower scores in conceptualization, mental flexibility, programming, sensitivity to interference, and total FAB. The number of AEDs (polytherapy versus monotherapy) and duration of time since the last seizure had no significant effect on FAB scores in JME patients. We found significant associations between disease duration and conceptualization, mental flexibility, inhibitory control, and total FAB score only in JME patients with recent seizure. Finally, receiver operating characteristic (ROC) analysis showed area under the curve (AUC) of 0.971 (95% confidence interval (CI): 0.947–0.994) for FAB total score, 0.933 for conceptualization (95% CI: 0.973-894), and 0.836 for mental flexibility (95% CI: 0.921-751). Conclusions. In summary, JME patients had deficits in different aspects of executive functions. FAB is a useful clinical tool for evaluation of executive functions in JME patients

A systematic review of resting-state and task-based fmri in juvenile myoclonic epilepsy

Functional neuroimaging modalities have enhanced our understanding of juvenile myoclonic epilepsy (JME) underlying neural mechanisms. Due to its non-invasive, sensitive and analytical nature, functional magnetic resonance imaging (fMRI) provides valuable insights into relevant functional brain networks and their segregation and integration properties. We systematically reviewed the contribution of resting-state and task-based fMRI to the current understanding of the pathophysiology and the patterns of seizure propagation in JME Altogether, despite some discrepancies, functional findings suggest that corticothalamo-striato-cerebellar network along with default-mode network and salience network are the most affected networks in patients with JME. However, further studies are required to investigate the association between JME\u27s main deficiencies, e.g., motor and cognitive deficiencies and fMRI findings. Moreover, simultaneous electroencephalography-fMRI (EEG-fMRI) studies indicate that alterations of these networks play a role in seizure modulation but fall short of identifying a causal relationship between altered functional properties and seizure propagation. This review highlights the complex pathophysiology of JME, which necessitates the design of more personalized diagnostic and therapeutic strategies in this group