The latest medical research on Neurology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about neurology gathered by our medical AI research bot.

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Long-term deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression.

Journal Neurol Neurosurg Psychiatry

Deep brain stimulation (DBS) reduces depressive symptoms in approximately 40%-60% of patients with treatment-resistant depression (TRD), but data on long-term efficacy and safety are scarce. Our objective was to assess the efficacy and safety of DBS targeted at the ventral anterior limb of the internal capsule (vALIC) in 25 patients with TRD during a 1-year, open-label, maintenance period, which followed a 1-year optimisation period.

Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HAM-D-17), Montgomery-Asberg Depression Rating Scale (MADRS) and self-reported Inventory of Depressive Symptomatology (IDS-SR). Primary outcomes were response rate (≥50% HAM-D-17 score reduction) after the maintenance phase, approximately 2 years after DBS surgery, and changes in depression scores and occurrence of adverse events during the maintenance phase.

Of 25 operated patients, 21 entered and 18 completed the maintenance phase. After the maintenance phase, eight patients were classified as responder (observed response rate: 44.4%; intention-to-treat: 32.0%). During the maintenance phase, HAM-D-17 and MADRS scores did not change, but the mean IDS-SR score decreased from 38.8 (95% CI 31.2 to 46.5) to 35.0 (95% CI 26.1 to 43.8) (p=0.008). Non-responders after optimisation did not improve during the maintenance phase. Four non-DBS-related serious adverse events occurred, including one suicide attempt.

vALIC DBS for TRD showed continued efficacy 2 years after surgery, with symptoms remaining stable after optimisation as rated by clinicians and with patient ratings improving. This supports DBS as a viable treatment option for patients with TRD.

NTR2118.

Migraine with brainstem aura: defining the core syndrome.

Brain

Migraine with brainstem aura is a rare subtype of migraine with aura. Although this entity has been known for many years, its diagnosis and even it...

Peripherally derived angiotensin converting enzyme-enhanced macrophages alleviate Alzheimer-related disease.

Brain

Targeted overexpression of angiotensin-converting enzyme (ACE), an amyloid-β protein degrading enzyme, to brain resident microglia and peripheral m...

Deficiencies in vesicular transport mediated by TRAPPC4 are associated with severe syndromic intellectual disability.

Brain

The conserved transport protein particle (TRAPP) complexes regulate key trafficking events and are required for autophagy. TRAPPC4, like its yeast ...

Adult loss of Cacna1a in mice recapitulates childhood absence epilepsy by distinct thalamic bursting mechanisms.

Brain

Inborn errors of CACNA1A-encoded P/Q-type calcium channels impair synaptic transmission, producing early and lifelong neurological deficits, includ...

Clinical and neuroimaging phenotypes of genetic parkinsonism from infancy to adolescence.

Brain

Genetic early-onset parkinsonism presenting from infancy to adolescence (≤21 years old) is a clinically diverse syndrome often combined with other ...

Postoperative delirium is associated with increased plasma neurofilament light.

Brain

While delirium is associated with cognitive decline and dementia, there is limited evidence to support causality for this relationship. Clarificati...

Ampelopsin improves cognitive impairment in Alzheimer's disease and involvement of neuroinflammation and oxidative stress in the hippocampus.

Current Alzheimer Research

Neuroinflammation and oxidative stress have important effects on cognitive functions in the pathophysiological process of Alzheimer's disease (AD). In the current study, we determined the effects of Ampelopsin (AMP) on the levels of proinflammatory cytokines (PICs, IL-1β, IL-6 and TNF-α), and products of oxidative stress 8-isoprostaglandin F2α (8-iso PGF2α, a product of oxidative stress); and 8-hydroxy-2'-deoxyguanosine (8-OHdG, a key biomarker of protein oxidation) in the hippocampus using a rat model of AD.

ELISA was used to examine PICs and products of oxidative stress; and western blot analysis was used to examine protein expression of NADPH oxidase (NOXs). The Spatial working memory tests and Morris water maze were used to assess cognitive functions.

We observed amplification of IL-1β, IL-6 and TNF-α as well as 8-iso PGF2α and 8-OHdG in the hippocampus of AD rats. Systemic administration of AMP attenuated upregulation of PICs and products of oxidative stress. AMP also inhibited NOX4 in the hippocampus of AD rats. Notably, AMP largely recovered the impaired learning performance in AD rat and this was linked to signal pathways of PIC and oxidative stress.

We showed the significant role of AMP in improving the memory impairment in AD rats likely via inhibition of signal pathways of neuroinflammation and oxidative stress suggesting that AMP may present prospects in preventing and/or alleviating development of the impaired cognitive functions in AD as a complementary alternative intervention.

Dual inhibition of DPP-4 and cholinesterase enzymes by phytoconstituents of an ethanolic extract of Prosopis cineraria pods: Therapeutic implications for the treatment of diabetes-associated neurological impairments.

Current Alzheimer Research

Insulin resistance causes decreased uptake of glucose which promotes susceptibility of type 2 associated neurological impairments.

The study was aimed to evaluate inhibition potential of an ethanolic extract of Prosopis cineraria (EPC) pods against DPP-4 and cholinesterase enzymes by in-vitro, in-vivo and in-silico assessments. The present study consists of in vivo studies on diabetes induced rat model by HOMA (Homeostasis of model Assessment) and related parameters, in vitro studies through DPP-4 enzyme assay, cholinesterase assays using Ellman's reaction. The in-silico studies were conducted by molecular docking of Cinerin C with targeted enzymes. The phytochemical characterization of the extract was demonstrated through LCMS studies. The antioxidant studies of extract were performed by FRAP and TEAC assays.

The extract showed 64.8% maximum inhibition of DPP-4, 34.91% inhibition of AChE and 74.35% inhibition of BuChE. Antioxidant capacity by an extract showed 847.81±16.25µM Fe2+ equivalent in case of FRAP assay and 0.40 ± 0.08 mmol/l of Trolox equivalent in TEAC assay. In vivo study shown competent glycaemic control against significant HOMA IR (1.5), HOMA % β (26.5) and HOMA % S (68.8) as well as pancreatic cell mass proliferation. The in-silico analysis also revealed positive pharmacophores interactions of Cinerin C with targeted enzymes (DPP4 and cholinesterase).

It can be concluded that phytoconstituents of Prosopis cineraria pod extract may be significantly consider in neuropharmacology to resolve insulin resistance induced neurological complications as shown inhibition against DPP-4, AChE and BuChE targets enzymes.

Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial.

Journal Alzheimers Research Therapy

Australian New Zealand Clinical Trials Registry, ACTRN 12616001635459. Registered on 25 November 2016.

A four-arm, rater-blinded randomized controlled trial. Participants (N = 59) were randomized to either a functional task exercise group, a cognitive training group, an exercise training group, or a waitlist control group for 8 weeks. All outcome measures were undertaken at baseline and post-intervention using Neurobehavioral Cognitive Status Examination, Trail Making Test A and B, Chinese Version Verbal Learning Test, Lawton Instrumental Activities of Daily Living Scale, and Zarit Burden Interview.

Results of the Kruskal-Wallis one-way ANOVA showed higher improvement in the functional task exercise group with significant between-group differences in memory (p = 0.009) compared to the exercise group and cognitive training group, functional status (p = 0.005) compared to the cognitive training group and waitlist control group, and caregiver burden (p = 0.037) compared to the exercise group and cognitive training group.

This pilot study showed that functional tasks exercise using simulated functional tasks as a means of combined cognitive and exercise program is feasible and beneficial in improving the memory and functional status of older adults with mild cognitive impairment as well as reducing the care-related burdens of their caregivers. The present findings warrant further well-designed longitudinal studies to examine the sustainability of effects and draw more definitive conclusions.

Secernin-1 is a novel phosphorylated tau binding protein that accumulates in Alzheimer's disease and not in other tauopathies.

Cerebral Palsy

We recently identified Secernin-1 (SCRN1) as a novel amyloid plaque associated protein using localized proteomics. Immunohistochemistry studies con...

Prospective validation of a machine learning model that uses provider notes to identify candidates for resective epilepsy surgery.

Epilepsia

Delay to resective epilepsy surgery results in avoidable disease burden and increased risk of mortality. The objective was to prospectively validate a natural language processing (NLP) application that uses provider notes to assign epilepsy surgery candidacy scores.

The application was trained on notes from (1) patients with a diagnosis of epilepsy and a history of resective epilepsy surgery and (2) patients who were seizure-free without surgery. The testing set included all patients with unknown surgical candidacy status and an upcoming neurology visit. Training and testing sets were updated weekly for 1 year. One- to three-word phrases contained in patients' notes were used as features. Patients prospectively identified by the application as candidates for surgery were manually reviewed by two epileptologists. Performance metrics were defined by comparing NLP-derived surgical candidacy scores with surgical candidacy status from expert chart review.

The training set was updated weekly and included notes from a mean of 519 ± 67 patients. The area under the receiver operating characteristic curve (AUC) from 10-fold cross-validation was 0.90 ± 0.04 (range = 0.83-0.96) and improved by 0.002 per week (P < .001) as new patients were added to the training set. Of the 6395 patients who visited the neurology clinic, 4211 (67%) were evaluated by the model. The prospective AUC on this test set was 0.79 (95% confidence interval [CI] = 0.62-0.96). Using the optimal surgical candidacy score threshold, sensitivity was 0.80 (95% CI = 0.29-0.99), specificity was 0.77 (95% CI = 0.64-0.88), positive predictive value was 0.25 (95% CI = 0.07-0.52), and negative predictive value was 0.98 (95% CI = 0.87-1.00). The number needed to screen was 5.6.

An electronic health record-integrated NLP application can accurately assign surgical candidacy scores to patients in a clinical setting.