关键词： Neurological gait disorder   Fall risk   Gait analysis   Mobility assessment   Fall prediction  

摘要： Objective To evaluate the predictive validity of multimodal clinical assessment outcomes and quantitative measures of in- and off-laboratory mobility for fall-risk estimation in patients with different forms of neurological gait disorders. Methods The occurrence, severity, and consequences of falls were prospectively assessed for 6 months in 333 patients with early stage gait disorders due to vestibular, cerebellar, hypokinetic, vascular, functional, or other neurological diseases and 63 healthy controls. At inclusion, participants completed a comprehensive multimodal clinical and functional fall-risk assessment, an in-laboratory gait examination, and an inertial-sensor-based daily mobility monitoring for 14 days. Multivariate logistic regression analyses were performed to identify explanatory characteristics for predicting the (1) the fall status (non-faller vs. faller), (2) the fall frequency (occasional vs. frequent falls), and (3) the fall severity (benign vs. injurious fall) of patients. Results 40% of patients experienced one or frequent falls and 21% severe fall-related injuries during prospective fall assessment. Fall status and frequency could be reliably predicted (accuracy of 78 and 91%, respectively) primarily based on patients' retrospective fall status. Instrumented-based gait and mobility measures further improved prediction and provided independent, unique information for predicting the severity of fall-related consequences. Interpretation Falls- and fall-related injuries are a relevant health problem already in early stage neurological gait disorders. Multivariate regression analysis encourages a stepwise approach for fall assessment in these patients: fall history taking readily informs the clinician about patients' general fall risk. In patients at risk of falling, instrument-based measures of gait and mobility provide critical information on the likelihood of severe fall-related injuries.

关键词： Binaural beat   EEG power   Cognitive score   Reaction time   Memory   Imaginary coherence  

摘要： Binaural beat (BB) is a promising technique for memory improvement in elderly or people with neurological conditions. However, the related modulation of cortical networks followed by behavioral changes has not been investigated. The objective of this study is to establish a relationship between BB oscillatory brain activity evoked by stimulation and a behavioral response in a short term memory task. Three Groups A, B, and C of 20 participants each received alpha (10 Hz), beta (14 Hz), and gamma (30 Hz) BB, respectively, for 15 min. Their EEG was recorded in pre, during, and post BB states. Participants performed a digit span test before and after a BB session. A significant increase in the cognitive score was found only for Group A while a significant decrease in reaction time was noted for Groups A and C. Group A had a significant decrease of theta and increase of alpha power, and a significant increase of theta and decrease of gamma imaginary coherence (ICH) post BB. Group C had a significant increase in theta and gamma power accompanied by the increase of theta and gamma ICH post BB. The effectiveness of BB depends on the frequency of stimulation. A putative neural mechanism involves an increase in theta ICH in parieto-frontal and interhemispheric frontal networks.

关键词： Cerebral palsy   Ectopic pregnancy   Neurological morbidity   Pregnancy outcomes   Preterm birth   Subsequent pregnancy  

摘要： Purpose To evaluate perinatal outcomes and long-term neurological morbidity of offspring to mothers with a history of ectopic pregnancy. Methods In this retrospective study, perinatal outcomes and long-term neurological morbidity of offspring were assessed among mothers with a history of ectopic pregnancy, either medically or surgically treated. The study groups were followed until 18 years of age for neurological-related morbidity. For perinatal outcomes, generalized estimated equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence and Cox proportional hazards model was conducted to control for confounders. Results A total of 243,682 mothers were included;1424 mothers (0.58%) had a previous ectopic pregnancy, of which 25.6% (n = 365) were treated medically, and 74.3% (n = 1059) were treated surgically. Using GEE models, controlling for confounders, both surgically and medically treated ectopic pregnancies were noted as independent risk factors for preterm delivery in the subsequent pregnancies. Maternal history of surgically treated ectopic pregnancy was also independently associated with cesarean delivery. Offspring to mothers with previous ectopic pregnancy had comparable rates of long-term neurological morbidity. In the Cox proportional hazards model, controlling for confounders, being born to a mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring. Conclusions Maternal history of ectopic pregnancy is independently associated with preterm delivery. However, offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.

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关键词： Electroencephalography   History of neurology   Kluver-Bucy syndrome   Mu rhythm  

摘要： This article provides a biographic and scientific profile of prof. Hrayr Terzian (Addis Abeba 1925-Verona 1988). In 1966, Terzian was appointed professor of the clinic of nervous and mental diseases in Cagliari, and in 1970 moved to Verona, where until his death he led the Neurology Clinic serving as the first rector of the local university. As a close friend of the psychiatrist Franco Basaglia (1924-1980), Terzian contributed to the reform of the Italian mental health system. His interests and scientific contributions were extremely broad. He was the first to describe the electroencephalographic changes induced by the antipsychotic chlorpromazine and, together with Henri Gastaut (1915-1995) and his wife Yvette, to describe the rolandic arched ("mu") rhythm. He contributed to elucidate the inhibitory mechanisms of the cerebellum on the antigravity postural tone and provided the first description of Kluver-Bucy syndrome in humans. Always attentive to the social and political aspects of medical practice, prof. Terzian achieved outstanding results both in experimental neurophysiology and in clinical neurology. Besides offering a tribute to Hrayr Terzian, this article provides a brief historical overview of the different clinical pictures caused by bilateral temporal lesions: from the first animal observations by Sanger Brown (1852-1928) and sir Edward Albert Sharpey-Schafer (1850-1935), later confirmed and expanded upon by Heinrich Kluver (1897-1979) and Paul C. Bucy (1904-1992), to the first cases of bitemporal lesions in humans, including that of the famous patient H.M. (Henry Gustav Molaison, 1926-2008).

关键词： multidisciplinary collaboration   neurological deficits   ovarian cystadenoma   sciatic schwannomas  

摘要： Sciatic schwannomas (SSs) are extremely rare, and most are benign. Herein, we report a case of giant SSs in a woman who presented with abdominal pain. Because of the pain pattern and auxiliary examination findings, the patient was initially diagnosed with an ovarian cystadenoma. Magnetic resonance imaging (MRI) revealed an intrapelvic tumor. Histopathological examination confirmed that the mass was a benign intrapelvic schwannoma. Two days after complete tumor resection, the patients experience impaired mobility of the right lower limb. The tumor was 7 x 5.5 x 5 cm(3) in size and in contact with the sacrum. The patient was followed up for up to 2 years. No evidence of recurrence was observed in the MRI scan. Severe damages to the sciatic nerve during surgery resulted in permanent neurological deficits. Hence, we also discuss the diagnostic tools and treatments for intrapelvic SSs, as well as the importance of careful radiological examination and multidisciplinary collaboration.

摘要： In our study, we evaluated 52 consecutive patients with an established diagnosis of suspected iNPH with a screening magnetic resonance image (MRI) of the cervical *** we acknowledge the limitation of our small sample size and single surgeon, single institution study design, we believe that the co-incidence of myelopathy in this relatively small group of patients with iNPH is novel and of possible clinical significance and therefore deserves validation in larger sample sizes and at other institutions.[...]while this manuscript served as an initial report on the association between iNPH and cervical myelopathy, we completely agree that it would be optimal to perform objective gait testing following both surgeries, and hope to provide this information in a future manuscript.

关键词： COVID-19   Alpha-synuclein   Myoclonus   Parkinsonism   Virus   SARS-CoV-2  

摘要： SARS-CoV-2 infection can associate diverse neurological manifestations. Several studies have provided proof to support the theory of neurotropic involvement of SARS-CoV-2. Alpha-synuclein has been described as a native antiviral factor within neurons, and upregulation of this protein can be seen in animals that suffered other neuroinvasive infections. To assess if increased expression of this protein takes place in COVID-19 patients with neurological symptoms, we analyzed serum total alpha-synuclein levels in three groups: seven COVID-19 patients with myoclonus, Parkinsonism and/or encephalopathy;thirteen age- and sex-matched COVID-19 patients without neurological involvement and eight age- and sex-matched healthy controls. We did not find differences among them. In a subset of four patients, the change in serum alpha-synuclein before and after the onset of neurological symptoms was not significant either. Cerebrospinal fluid alpha-synuclein levels were also similar between neurological COVID-19 and healthy controls. Overall, these results cannot support the hypothesis of alpha-synuclein upregulation in humans with neurological symptoms in COVID-19. Further research taking into account a larger group of COVID-19 patients including the whole spectrum of neurological manifestations and disease severity is needed.