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Topic Review
Post-Acute COVID-19 Neurological Syndrome
The emergency caused by SARS-CoV-2 had, and still has, devastating socio-economic aspects. Assessing the impact of COVID-19 on vulnerable groups of people is crucial for the adaptation of governments’ responses. Growing scientific evidence suggests that it is essential to keep the attention on people after acute SARS-CoV-2 infection; indeed, some clinical manifestations are frequently present even after recovery. There is consensus on the need to define which symptoms persist after the infection and which disabilities may arise after COVID-19. Recent reviews, case reports, and original contributions suggest that various organs may be affected, and neurological symptoms are present in about one third of patients with COVID-19. Neurological complications after severe COVID-19 infection might include delirium, brain inflammation, stroke, and nerve damage. In the recent pandemic, neurologists and neurobiologists have a chance to study key features of infection neurology. 
  • 593
  • 18 May 2021
Topic Review
Neurofibromatosis Type 2 (NF2)
Patients diagnosed with neurofibromatosis type 2 (NF2) are extremely likely to develop meningiomas, in addition to vestibular schwannomas. Meningiomas are a common primary brain tumor; many NF2 patients suffer from multiple meningiomas. In NF2, patients have mutations in the NF2 gene, specifically with loss of function in a tumor-suppressor protein that has a number of synonymous names, including: Merlin, Neurofibromin 2, and schwannomin. Merlin is a 70 kDa protein that has 10 different isoforms. The Hippo Tumor Suppressor pathway is regulated upstream by Merlin. This pathway is critical in regulating cell proliferation and apoptosis, characteristics that are important for tumor progression. Mutations of the NF2 gene are strongly associated with NF2 diagnosis, leading to benign proliferative conditions such as vestibular schwannomas and meningiomas. Unfortunately, even though these tumors are benign, they are associated with significant morbidity and the potential for early mortality. In this review, we aim to encompass meningiomas and vestibular schwannomas as they pertain to NF2 by assessing molecular genetics, common tumor types, and tumor pathogenesis.
  • 593
  • 22 Feb 2021
Topic Review
Movement Disorders Induced by SARS-CoV-2 Infection
Infections are a significant cause of movement disorders. The clinical manifestations of SARS-CoV-2 infection are variable, with up to one-third of patients developing neurologic complications, including movement disorders. 
  • 591
  • 23 Feb 2022
Topic Review
The Role of Polysaccharide in Treating Neurodegenerative Disorders
The prevalence of neurodegenerative pathologies increases significantly with growing life expectancy. Neurodegenerative diseases including common diseases such as Alzheimer’s disease (AD) and Parkinson’s disease (PD) impose a global public health burden. In this context, natural products could play a leading role in the search for new drugs for the treatment of neurodegeneration. Of note, more than 80 percent of drugs are of natural origin. Natural polysaccharides (general formula of Cx(H2O)y; where x is number 200_2500) occurs naturally in living matter (on the contrary to polysaccharides combined artificially in the process of organic synthesis) and principally play structural and storage functions. Natural polysaccharides can be classified according to their origin, namely plants (e.g., starch, cellulose), algae (e.g., agar, alginates), animals (e.g., chitin, hyaluronic acid), bacteria (e.g., dextran, polylactosamine), and fungal (e.g., chitosan, elsinan). As one of the most widely distributed biomolecules in nature, natural polysaccharides have received considerable attention because of their diverse pharmacological activity as inhibitors of cellular processes, with their antioxidant, anticoagulant, antithrombotic and anticancer effects.
  • 589
  • 09 Feb 2022
Topic Review
Stress, Anxiety and Depression
Stress, anxiety and depressive disorders are often characterized by the activation of the stress axis, which results in similar symptoms at some point in these disorders. These disorders are closely related to each other—they occur simultaneously or follow one another. The diagnosis of stress, anxiety and depression is not a perfect procedure currently—it is based on patient observation and an interview with the patient and their family. There are no laboratory tests that would dispel the doubts of the doctor making the diagnosis and allow the appropriate treatment to be implemented as soon as possible. Therefore, this study will review the components of saliva that could be helpful in the quick diagnosis of stress, anxiety and/or depression. Such potential salivary biomarkers could also be useful in monitoring the effectiveness of pharmacological treatment prescribed by a psychiatrist. The following are promising salivary biomarkers of stress, anxiety or depression: cortisol, immunoglobulin A (sIgA), lysozyme, melatonin, α-amylase (sAA), chromogranin A (CgA) and fibroblast growth factor 2 (FGF-2). 
  • 585
  • 16 Apr 2021
Topic Review
Cerebral Metabolic Dysfunction after SAH
Cerebral metabolic dysfunction has been shown to extensively mediate the pathophysiology of brain injury after subarachnoid hemorrhage (SAH). 
  • 583
  • 11 Jan 2021
Topic Review
Clinical Neurophysiology and Genetics of Dystonia Diagnosis
Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. Neurophysiology played a role in untangling dystonia pathophysiology, demonstrating characteristic reduction in inhibition of central motor circuits and alterations in the somatosensory system. The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). Other parameters need further confirmations and more solid evidence to be considered as support for the dystonia diagnosis. Genetic testing should be guided by characteristics such as age at onset, body distribution, associated features, and coexistence of other movement disorders (parkinsonism, myoclonus, and other hyperkinesia). 
  • 582
  • 06 Sep 2022
Topic Review
Synaptic Disruption by Soluble Oligomers in Neurodegenerative Diseases
Neurodegenerative diseases are the result of progressive dysfunction of the neuronal activity and subsequent neuronal death. Currently, the most prevalent neurodegenerative diseases are by far Alzheimer’s (AD) and Parkinson’s (PD) disease, affecting millions of people worldwide. Although amyloid plaques and neurofibrillary tangles are the neuropathological hallmarks for AD and Lewy bodies (LB) are the hallmark for PD, current evidence strongly suggests that oligomers seeding the neuropathological hallmarks are more toxic and disease-relevant in both pathologies. The presence of small soluble oligomers is the common bond between AD and PD: amyloid β oligomers (AβOs) and Tau oligomers (TauOs) in AD and α-synuclein oligomers (αSynOs) in PD. Such oligomers appear to be particularly increased during the early pathological stages, targeting synapses at vulnerable brain regions leading to synaptic plasticity disruption, synapse loss, inflammation, excitation to inhibition imbalance and cognitive impairment. Absence of TauOs at synapses in individuals with strong AD disease pathology but preserved cognition suggests that mechanisms of resilience may be dependent on the interactions between soluble oligomers and their synaptic targets.
  • 580
  • 31 Aug 2022
Topic Review
Developmental Coordination Disorder
As described in the American Psychiatric Association’s (Washington, DC, USA) latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the child with Developmental Coordination Disorder （DCD) has motor coordination below expectations for his or her chronologic age and therefore may have been described as “clumsy” and may have had delays in early motor milestones, such as walking and crawling. Difficulties with coordination of either gross or fine motor movements, or both, could interfere with academic achievement or activities of daily living. Coordination difficulties do not relate to a medical condition or disease (e.g., cerebral palsy, muscular dystrophy, visual impairment, or intellectual disability).
  • 579
  • 06 May 2021
Topic Review
Endothelial Progenitor Cells in Neurovascular Disorders
Endothelial progenitor cells (EPCs) are a population of cells that circulate in the blood looking for areas of endothelial or vascular injury in order to repair them. Endothelial dysfunction is an important component of disorders with neurovascular involvement. EPCs have a capacity to repair or replace the damaged endothelium through a differentiation into mature endothelial cells, which are able to embed into the new vessels. Moreover, through a secretion of various growth factors, including stromal cell-derived factor-1α (SDF-1α), vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF-1), they promote angiogenesis or vasculogenesis and recruit more EPCs. EPCs express various cell markers on their surface, which include both markers characteristic for hematopoietic stem cells (CD34 and CD133) and markers characteristic for endothelial cells, such as VEGFR-2 (vascular endothelial growth factor receptor-2), vWF (von Willebrand factor), VE-cadherin (vascular endothelial cadherin) or CD144, Tie-2, CD62E (e-selectin) and c-kit/CD117.
  • 575
  • 01 Nov 2022
Topic Review
Noninvasive Brain Stimulation for Neurorehabilitation in Post-Stroke Patients
Noninvasive brain stimulation (NIBS) is a popular neuromodulatory technology of rehabilitation focusing on the local cerebral cortex, which can improve clinical functions by regulating the excitability of corresponding neurons. Increasing evidence has been obtained from the clinical application of NIBS in post-stroke patients, especially repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). With advances in neuronavigation technologies, functional near-infrared spectroscopy, and functional MRI, specific brain regions can be precisely located for stimulation, which also presents the possibility that neuromodulation in post-stroke rehabilitation evolving from a single target to multiple targets, circuits and even networks. It is essential to review the findings of current research, discuss future directions of NIBS application, and finally promote the use of NIBS in post-stroke rehabilitation.
  • 571
  • 06 Apr 2023
Topic Review
Ischemic Stroke Genetics
The etiology of ischemic stroke is multifactorial. Although receiving less emphasis, genetic causes make a significant contribution to ischemic stroke genesis, especially in early-onset stroke. Several stroke classification systems based on genetic information corresponding to various stroke phenotypes were proposed. Twin and family history studies, as well as candidate gene approach, are common methods to discover genetic causes of stroke, however, both have their own limitations. Genome-wide association studies and next generation sequencing are more efficient, promising and increasingly used for daily diagnostics. Some monogenic disorders, despite covering only about 7% of stroke etiology, may cause well-known clinical manifestations that include stroke. Polygenic disorders are more frequent, causing about 38% of all ischemic strokes, and their identification is a rapidly developing field of modern stroke genetics. Current advances in human genetics provide opportunity for personalized prevention of stroke and novel treatment possibilities. Genetic risk scores (GRS) and extended polygenic risk scores (PRS) estimate cumulative contribution of known genetic factors to a specific outcome of stroke. Combining those scores with clinical information and risk factor profiles might result in better primary stroke prevention. Some authors encourage the use of stroke gene panels for stroke risk evaluation and further stroke research. Moreover, new biomarkers for stroke genetic causes and novel targets for gene therapy are on the horizon.
  • 568
  • 14 Jan 2022
Topic Review
Neuroprotective Natural Products for AD
Neuroprotective natural products, for exmaple, the cholinesterase inhibitor galantamine, have effects on neurovegetative diseases. Rivastigmine is also a semi-synthetic derivative of a natural product called physostigmine. Mixtures or extracts of natural products might have advantages compared to individual natural compounds, as they have multiple simultaneous target approaches, which could be a novel treatment option for Alzheimer’s disease (AD), considering the complexity of its pathophysiology. Mounting evidence has suggested that herbs or herbal formulations, together with mixtures obtained from other natural sources, may provide cognitive benefits to AD patients. Consequently, various natural sources and their extracts are extensively employed in animal models and AD patients.
  • 567
  • 09 Jun 2021
Topic Review
New Strategies for Neurodegenerative Diseases
The complex network of malfunctioning pathways occurring in the pathogenesis of neurodegenerative diseases (NDDs) represents a huge hurdle in the development of new effective drugs to be used in therapy. In this context, redox reactions act as crucial regulators in the maintenance of neuronal microenvironment homeostasis. Particularly, their imbalance results in the severe compromising of organism’s natural defense systems and subsequently, in the instauration of deleterious OS, that plays a fundamental role in the insurgence and progress of NDDs.
  • 563
  • 08 Apr 2021
Topic Review
Corpus Callosotomy for Controlling Epileptic Spasms
Epileptic spasms (ESs) are a type of epileptic seizure characterized as brief muscle contractions with ictal polyphasic slow waves on an electroencephalogram and a main feature of West syndrome. Resection surgeries, including frontal/posterior disconnections and hemispherotomy, have been established for the treatment of medically intractable ES in patients with unilaterally localized epileptogenic regions. Corpus callosotomy (CC) has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. However, CC has also been adopted for ES treatment. 
  • 559
  • 18 Jan 2022
Topic Review
Mediterranean Diet and Cognitive Functions
Mediterranean Diet (MedDiet) consists of a large number of vegetables, fruits, beans, legumes, whole grains, olive oil, seeds, herbs and spices, as well as fish, seafood, eggs, cheese and poultry and disrecommends unusual red meats and sweets. In particular, a high intake of fish and low intake of alcohol contributes to the delay of cognitive decline.
  • 558
  • 08 Jul 2021
Topic Review
Ketogenic Diets in the Management of Lennox-Gastaut Syndrome
Epilepsy is an important medical problem with approximately 50 million patients globally. No more than 70% of epileptic patients will achieve seizure control after antiepileptic drugs, and several epileptic syndromes, including Lennox-Gastaut syndrome (LGS), are predisposed to more frequent pharmacoresistance. Ketogenic dietary therapies (KDTs) are a form of non-pharmacological treatments used in attempts to provide seizure control for LGS patients who experience pharmacoresistance. In general, KDTs are diets rich in fat and low in carbohydrates that put the organism into the state of ketosis. A classic ketogenic diet (cKD) is the best-evaluated KDT, while alternative KDTs, such as the medium-chain triglyceride diet (MCT), modified Atkins diet (MAD), and low glycemic index treatment (LGIT) present several advantages due to their better tolerability and easier administration. The literature reports regarding LGS suggest that KDTs can provide ≥50% seizure reduction and seizure-free status in a considerable percentage of the patients.
  • 558
  • 01 Dec 2022
Topic Review
Degenerative Cervical Myelopathy
Degenerative cervical myelopathy (DCM), earlier referred to as cervical spondylotic myelopathy (CSM), is the most common and serious neurological disorder in the elderly population caused by chronic progressive compression or irritation of the spinal cord in the neck. The clinical features of DCM include localised neck pain and functional impairment of motor function in the arms, fingers and hands. If left untreated, this can lead to significant and permanent nerve damage including paralysis and death.
  • 556
  • 11 May 2021
Topic Review
Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis
Cerebral venous thrombosis (CVT) is a relatively rare disorder in the general population and is frequently misdiagnosed upon initial examination. The knowledge of wide clinical aspects and imaging signs will be essential in providing a timely diagnosis. 
  • 556
  • 18 May 2022
Topic Review
Syncope
Syncope is a common yet complex presenting symptom and requires thoughtful and efficient evaluation to determine its etiology. Estimates indicate that one-half of all Americans will experience loss of consciousness during their lives, with recurrence rates as high as 13.5%. The incidence of syncope is roughly bimodal, with a peak in late adolescence to early adulthood, typically vasovagal in origin, and a second peak in older age, with a sharp rise after age 70 years.
  • 555
  • 15 Jun 2021
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