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Topic Review
Pelvic Floor Dysfunctions
Urinary, bowel, and sexual dysfunctions are the most frequent and disabling pelvic floor (PF) disorders in patients with multiple sclerosis (MS). PF dysfunction negatively impacts the performance of daily living activities, walking, and the physical dimension of quality of life (QoL) in people with MS. Patient-reported outcomes on sphincteric functioning could be useful to detect PF disorders and their impact on patients’ lives. PF rehabilitation proposed by Kegel is based on a series of regularly repeated exercises for “the functional restoration of the perineal muscles”. Over time, various therapeutic modalities have been added to PF muscles exercises, through the application of physical or instrumental techniques, such as intravaginal neuromuscular electrical stimulation, electromyographic biofeedback, transcutaneous tibial nerve stimulation. PF rehabilitation has been applied in MS treatment, with improvements of lower urinary tract symptoms severity, QoL, level of anxiety and depression, and sexual dysfunction. 
  • 649
  • 19 Apr 2022
Topic Review
Treatment Strategies of Epilepsy in Dravet Syndrome
Dravet Syndrome (DS) is a developmental epileptic encephalopathy characterized by drug-resistant seizures and other clinical features, including intellectual disability and behavioral, sleep, and gait problems. The pathogenesis is strongly connected to voltage-gated sodium channel dysfunction. The consensus of seizure management in DS consists of a combination of conventional and recently approved drugs such as stiripentol, cannabidiol, and fenfluramine. Despite promising results in randomized clinical trials and extension studies, the prognosis of the developmental outcomes of patients with DS remains unfavorable.
  • 648
  • 11 Apr 2023
Topic Review
Huntington’s Disease Drug Development
Huntington’s Disease (HD) is a severely debilitating neurodegenerative disorder in which sufferers exhibit different combinations of movement disorders, dementia, and behavioral or psychiatric abnormalities. The disorder is a result of a trinucleotide repeat expansion mutation that is inherited in an autosomal dominant manner. While there is still no treatment to alter the course of HD, there are medications that lessen abnormal movement and psychiatric symptoms.
  • 648
  • 31 Oct 2023
Topic Review
Diabetic Choroidopathy in the Pathogenesis of Diabetic Retinopathy
Diabetic microangiopathy is one of the main responsible factors of multiorgan complications in diabetes, including nephropathy, diabetic retinopathy (DR), cardiovascular disease, and neuropathy. The retinal vascular system, neurons, and glia constitute the neurovascular unit (NVU), where these structures present a close interdependency that promotes autoregulation, maintains the blood–retinal barrier (BRB), and provides structural support. Diabetes affects the NVU, leading to retinal dysfunction and microvascular damage. An early loss of neurovascular coupling, neurodegeneration, glial alteration, and neuroinflammation can occur even before the microvascular alterations become appreciable. Although the retinal microvasculopathy in DR is preponderant and has captured most of the attention in clinical studies, the choroidal vascular layer changes are not fully elucidated. The choroidal vascular bed nourishes the outer retinal layers; the foveola, in particular, relies solely on the choroid. 
  • 647
  • 29 Jun 2023
Topic Review
Neuromuscular Stimulation as an Facilitative Intervention Tool
Neuromodulators at the periphery, such as neuromuscular electrical stimulation (NMES), have been developed as add-on tools to regain upper extremity (UE) paresis after stroke, but this recovery has often been limited. To overcome these limits, novel strategies to enhance neural reorganization and functional recovery are needed. This review aims to discuss possible strategies for enhancing the benefits of NMES. To date, NMES studies have involved some therapeutic concerns that have been addressed under various conditions, such as the time of post-stroke and stroke severity and/or with heterogeneous stimulation parameters, such as target muscles, doses or durations of treatment and outcome measures.
  • 645
  • 29 Jan 2022
Topic Review
Macronutrients or Mineral Elements in Depression
Depression is a common mental disorder that seriously affects the quality of life and leads to an increasing global suicide rate. Macro, micro, and trace elements are the main components that maintain normal physiological functions of the brain. Depression is manifested in abnormal brain functions, which are considered to be tightly related to the imbalance of elements.
  • 643
  • 26 Apr 2023
Topic Review
The Local Neuropeptide System of Keratinocytes
The synthesis and activity of neuropeptides and their receptors in epithelial cells of the skin and mucous membranes. Note that the term "neuropeptide" was originally coined to indicate small protein molecules that are contained in neurons, however it is now known that the synthesis of this class of peptides is not restricted to neurons.
  • 642
  • 04 Jan 2022
Topic Review
The Basics of Neuroimmunology
Neuroimmunology is an interdisciplinary field that brings together knowledge from biology, immunology, chemistry, neurology, pathology, psychiatry, and virology to examine the intricate interrelations between the central nervous system (CNS) and immune system (IS), its interactions during various developmental stages, as well as maintaining homeostasis or responding to injuries. 
  • 642
  • 14 Sep 2023
Topic Review
HMGB1 and Post-Aneurysmal Subarachnoid Hemorrhage
Aneurysmal subarachnoid hemorrhage (aSAH) is characterized by a robust sterile inflammatory response immediately after the subarachnoidal bleed. Several damage-associated molecular pattern molecules (DAMPs) are liberated upon injury of the brain cells from different intracellular compartments and have the capability to activate immune cells through the ligation of their cognizant receptors (pattern recognition receptors (PRRs)). Among them, high mobility group box-1 (HMGB1), which acts normally as a transcription factor, when released extracellularly upregulates inflammation due to its interaction with TLR-2, TLR-4 and RAGE during early brain injury after aSAH. However, recent investigations show that different isoforms of HMGB1 exist and may dominate during different phases of the brain injury with different consequences. Surprisingly, the oxidized isoform of HMGB1 plays an anti-inflammatory and pro-resovling role contrary to well accepted pro-inflammatory role of HMGB1 after aSAH.
  • 641
  • 17 Oct 2022
Topic Review
Clozapine for Treating Treatment-Resistant Schizophrenia
Clozapine is listed as one of the most effective antipsychotics and has been approved for treating treatment-resistant schizophrenia (TRS); however, several type A and B adverse reactions, including weight gain, metabolic complications, cardiotoxicity, convulsions, and discontinuation syndromes, exist. The critical mechanisms of clinical efficacy for schizophrenia, TRS, and adverse reactions of clozapine have not been elucidated. The GABA isomer L-β-aminoisobutyric acid (L-BAIBA), a protective myokine in the peripheral organs, was identified as a candidate novel transmission modulator in the central nervous system (CNS). L-BAIBA activates adenosine monophosphate-activated protein kinase (AMPK) signalling in both the peripheral organs and CNS. Activated AMPK signalling in peripheral organs is an established major target for treating insulin-resistant diabetes, whereas activated AMPK signalling in the hypothalamus contributes to the pathophysiology of weight gain and metabolic disturbances. Clozapine increases L-BAIBA synthesis in the hypothalamus. In addition, the various functions of L-BAIBA in the CNS have been elucidated, including as an activator of GABA-B and group-III metabotropic glutamate (III-mGlu) receptors. Considering the expressions of GABA-B and III-mGlu receptors (localised in the presynaptic regions), the activation of GABA-B and III-mGlu receptors can explain the distinct therapeutic advantages of clozapine in schizophrenia or TRS associated with N-methyl-D-aspartate (NMDA) receptor disturbance compared with other atypical antipsychotics via the inhibition of the persistent tonic hyperactivation of thalamocortical glutamatergic transmission in the prefrontal cortex. L-BAIBA has also been identified as a gliotransmitter, and a detailed exploration of the function of L-BAIBA in tripartite synaptic transmission can further elucidate the pathophysiology of effectiveness for treating TRS and/or specific adverse reactions of clozapine.
  • 641
  • 20 Sep 2023
Topic Review
3D Bioprinting of Human Brain Organoids
Brain organoids are invaluable tools for pathophysiological studies or drug screening, but there are still challenges to overcome in making them more reproducible and relevant. Recent advances in three-dimensional (3D) bioprinting of human neural organoids is an emerging approach that may overcome the limitations of self-organized organoids. It requires the development of optimal hydrogels, and a wealth of research has improved the knowledge about biomaterials both in terms of their intrinsic properties and their relevance on 3D culture of brain cells and tissue.
  • 640
  • 01 Feb 2023
Topic Review
Neuropsychiatric and Neurocognitive Sequelae Following Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) is a medical emergency that requires immediate intervention. The etiology varies between cases; however, rupture of an intracranial aneurysm accounts for 80% of medical emergencies. Early intervention and treatment are essential to prevent long-term complications. Treatment of SAH has drastically improved, which is responsible for the rapid rise in SAH survivors. Post-SAH, a significant number of patients exhibit impairments in memory and executive function and report high rates of depression and anxiety that ultimately affect daily living, return to work, and quality of life.
  • 640
  • 25 May 2023
Topic Review
Connections between Intestinal Flora and Kynurenine Pathway
The intestinal flora has been the focus of numerous investigations recently, with inquiries not just into the gastrointestinal aspects but also the pathomechanism of other diseases such as nervous system disorders and mitochondrial diseases. Mitochondrial disorders are the most common type of inheritable metabolic illness caused by mutations of mitochondrial and nuclear DNA. Metabolites of the kynurenine pathway are linked to many disorders, such as depression, schizophrenia, migraine, and also diseases associated with impaired mitochondrial function. The kynurenine pathway includes many substances, for instance kynurenic acid and quinolinic acid. 
  • 640
  • 05 Mar 2024
Topic Review
Gene-Environment Interactions in Schizophrenia
Schizophrenia is a devastating mental illness with a strong genetic component that is the subject of extensive research. Despite the high heritability, it is well recognized that non-genetic factors such as certain infections, cannabis use, psychosocial stress, childhood adversity, urban environment, and immigrant status also play a role. Whenever genetic and non-genetic factors co-exist, interaction between the two is likely. This means that certain exposures would only be of consequence given a specific genetic makeup.
  • 639
  • 06 Dec 2021
Topic Review
Subependymal Giant Cell Astrocytomas in Tuberous Sclerosis Complex
Tuberous sclerosis complex (TSC) is an autosomal-dominant disorder caused by mutations inactivating TSC1 or TSC2 genes and characterized by the presence of tumors involving many organs, including the brain, heart, kidneys, and skin. Subependymal giant cell astrocytoma (SEGA) is a slow-growing brain tumor almost exclusively associated with TSC.
  • 639
  • 03 Jul 2023
Topic Review
Role of Autophagy in Postischemic Brain Neurodegeneration
After cerebral ischemia, autophagy was found to be activated in neuronal, glial and vascular cells. Some studies have shown the protective properties of autophagy in postischemic brain, while other studies have shown completely opposite properties. Thus, autophagy is now presented as a double-edged sword with possible therapeutic potential in brain ischemia. 
  • 638
  • 12 Sep 2023
Topic Review
Use of AI to Monitor Antiplatelet Therapy
Platelets play a critical role in blood clotting and the development of arterial blockages. Antiplatelet therapy is vital for preventing recurring events in conditions like coronary artery disease and strokes. However, there is a lack of comprehensive guidelines for using antiplatelet agents in elective neurosurgery. Continuing therapy during surgery poses a bleeding risk, while discontinuing it before surgery increases the risk of thrombosis. Discontinuation is recommended in neurosurgical settings but carries an elevated risk of ischemic events. Conversely, maintaining antithrombotic therapy may increase bleeding and the need for transfusions, leading to a poor prognosis. Artificial intelligence (AI) holds promise in making difficult decisions regarding antiplatelet therapy. 
  • 635
  • 13 Oct 2023
Topic Review
Mapping the Glymphatic Pathway Using Imaging
The glymphatic system is a recently discovered waste clearance system that has been associated with many diseases including Alzheimer’s disease, hemorrhage, and neurotrauma. Thus, it opens an array of research opportunities to improve and understand their prognoses. Currently, ex vivo fluorescence microscopy of brain slices, MRI, and macroscopic cortical imaging are the most common ways of determining glymphatic system function.
  • 634
  • 28 Aug 2023
Topic Review
The Basics of Brain to Understand Music
Music is a complex phenomenon with multiple brain areas and neural connections being implicated. Music is a universal phenomenon that utilizes a myriad of brain resources. Engaging with music is among the most cognitively demanding tasks a human can undergo, and it is identified across all cultures; therefore, it underscores its fundamental human nature. Fundamental to understanding music are the concepts of pitch perception, rhythm perception, and tonality perception.
  • 634
  • 09 Oct 2023
Topic Review
Biomarkers in Alzheimer’s Disease
Alzheimer’s disease (AD), as the main cause of dementia, affects millions of people around the world, whose diagnosis is based mainly on clinical criteria. Unfortunately, the diagnosis is obtained very late, when the neurodegenerative damage is significant for most patients. Therefore, the exhaustive study of biomarkers is indispensable for diagnostic, prognostic, and even follow-up support. 
  • 631
  • 11 Jan 2024
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