关键词： COVID-19   neurological symptoms   long-term effects   novel therapies   biomarkers  

摘要： Despite the increasing large population of COVID-19(+)infected patients, knowledge of the disease remains limited. Understanding the effects and long-term implications of COVID-19 will be paramount to implementing the right public health measures and developing future preventive and effective treatments. In this article, we discuss currently available information with COVID-19-related neurological complications, possible routes of virus infection into the central nervous system, and hypothesis about virus-induced cytokine storm syndrome, long-term outcomes, as well as ongoing clinical studies of novel therapies and biomarkers for COVID-19. Understanding the effects of COVID-19 on neurological systems is crucial for properly diagnosing and caring for the disease. We need to be prepared that COVID-19 could cause long-lasting debilitations after the infection has cleared. Investigating long-term effects of the disease will yield insight for providing comprehensive care to the survivors. Understanding these risks will also lead to better treatments as well as inform policies to create a system capable of caring for those affected by COVID-19 long after the pandemic has subsided.

关键词： at-risk neonates   Hammersmith Neonatal Neurological Examination   neurodevelopmental disability  

摘要： Background and Objectives: Hammersmith Neonatal Neurologic Examination (HNNE) is used to identify term and preterm infants at risk of neurodevelopmental disability. The test is recommended at corrected term age in preterm;and around 2 weeks postnatal age in term neonates. As the current trend is to discharge based on physiological stability, it may not be feasible to perform HNNE at recommended age. The authors investigated whether predictive ability of the test for neurodevelopmental disability remained unchanged if performed early (before discharge). Methods: The authors enrolled preterm and at-risk term neonates. HNNE PE was performed before discharge in all infants. The test was repeated in preterm infants at 40 weeks postmenstrual age and in term neonates at 2 weeks of age (HNNE RA). Neurodevelopmental disability was assessed at 1 year of age. Results: HNNE PE was done in 125 neonates (103 preterm, 22 term neonates). HNNE RA was done in 58% infants. Neurodevelopmental disability was assessed in 84 (67%) of infants. Neurodevelopmental disability was noted in 14/84 (16.6%) babies. The receiver operating characteristic curve of raw scores showed that area under the curve for HNNE PE (0.71) and HNNE RA (0.66) were similar. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for both the tests were similar for a cutoff optimality score of 32.5. HNNE PE could be performed up to 4 weeks earlier than HNNE RA with the same predictive ability for neurodevelopmental disability. Conclusions: HNNE PE was as reliable as HNNE RA in predicting neurodevelopmental disability at 1 year of age. Completion of the test is assured and provides several weeks lead time for early intervention.

关键词： discharge disposition   neurological condition   outcomes  

摘要： Objective To study characteristics and outcomes of patients with stroke, traumatic brain injury (TBI), and epilepsy with discharge against medical advice (DAMA). Data Sources/Study Setting Retrospective analysis of the 2013 Nationwide Readmissions Database, a nationally representative inpatient administrative dataset. Study Design Associations between predictors and DAMA at index admission were analyzed using adjusted logistic models. We examined 30-day all-cause readmissions. Data Collection Methods Patients aged >= 18 years at index admission for International Classification of Diseases-9 diagnosis code of epilepsy, TBI, or stroke were included. Principal Findings Discharge against medical advice occurred in 1998/58278 patients (3.43 percent) in the epilepsy group, 1762/211 213 (0.83 percent) in the stroke group, and 1289/74 652 (1.73 percent) in the TBI group. Factors consistently associated with increased likelihood of DAMA included lower age, male sex, non-Medicare and nonprivate insurance, lower socioeconomic status, and behavioral risk factors (smoking history, alcohol history, and drug use). The crude 30-day all-cause readmission rate for those with DAMA from their index admission was 16.4 percent for the stroke cohort, 13.9 percent for epilepsy, and 13.4 percent for TBI. DAMA at index admission was significantly associated with increased risk of 30-day all-cause readmission among all groups (adjusted odds ratio 1.79, 95% CI: 1.65-1.94,P < .0001). Conclusions Age, sex, insurance status, socioeconomic status, and behavioral factors were associated with DAMA in neurological patients. Further research is needed to develop interventions to reduce DAMA in high-risk groups.

关键词： checklist   consent form   drugs   neurosciences   patient information sheet   quality   research ethics committee  

摘要： Background and purpose Clinical trials (CTs) aimed at vulnerable groups, such as patients with mental disorders, create ethical complexity. The patient information sheet (PIS) should provide all of the information about the CT that is relevant to the subject's decision to participate. After being informed, the subject will decide freely whether to take part in the CT and will read and sign the informed consent form (ICF). The objective was to assess the quality of PISs/ICFs from a hospital neurology service. The assessment was made using validated and reliable checklists of the information included in the PISs/ICFs of CTs with medicinal products. Methods The study comprised analyses of compliance with the checklists of 21 PISs and ICFs reviewed/approved during 2016-2017 by a medicinal research ethics committee. Results All PISs/ICFs were from multicenter CTs sponsored by pharmaceutical companies in different therapeutic areas, mainly Parkinson's (52.4%) and Alzheimer's (38.1%) diseases. The PISs from the neurology service demonstrated good compliance (>= 80%) with the checklist, whereas ICFs should be improved. Sponsors omitted some relevant information, such as the study title or that the participant be informed of any information arising from the research that may be relevant to the subject's health, although this information may be in the PIS. Conclusions The PISs/ICFs of CTs of medicinal products that are currently used need improvement. PISs and ICFs should be separate documents for each CT. In particular, the PISs/ICFs should consider the criteria related to the decision of participants, protect their rights and ensure that the information received is complete.

关键词： COVID-19   Corona virus   Pandemic   Stroke   Neurological disorders  

摘要： Corona virus disease 2019 (COVID-19) pandemic has become a globally challenging issue after its emergence in December 2019 from Wuhan, China. Despite its common presentation as respiratory distress, patients with COVID-19 have also shown neurological manifestation especially stroke. Therefore, the authors sought to determine the etiology, underlying risk factors, and outcomes among patients with COVID-19 presenting with stroke. We conducted a systematic review of the electronic database (PubMed, Google Scholar, Scopus, Medline, EMBASE, and Cochrane library) using different MeSH terms from November 2019 to June 2020. A total of 39 patients with stroke from 6 studies were included. The mean age of our included patients was 61.4 +/- 14.2 years. Majority of the patients (n= 36, 92.3%) with COVID-19 had ischemic stroke, 5.1% (n= 2) had hemorrhagic stroke, and 2.6% (n= 1) had cerebral venous thrombosis at the time of initial clinical presentation. Almost all of the patients presented had underlying risk factors predisposing to stroke which included diabetes mellitus, hyperlipidemia, hypertension, and previous history of cerebrovascular disease. 51.2% (n= 20) of the included patients infected with COVID-19 with stroke died, while remaining patients were either discharged home or transferred to a rehabilitation unit. Exploring the neurological manifestation in terms of stroke among patients with COVID-19 is a step towards better understanding of the virus, preventing further spread, and treating the patients affected by this pandemic.

关键词： Epilepsy   Depression   NDDI-E   Taiwanese  

摘要： Introduction: Depression is the most commonly seen psychiatric co-morbidity of epilepsy. Depression in patients with epilepsy (PWE) is underrecognized. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a useful tool to screen for major depressive episodes (MDEs) in PWE. This study validated the Taiwanese version of the NDDI-E using data from adult PWE in our hospital. Method: PWE were recruited from the Taipei Veterans General Hospital from April 2017 to December 2019. The Chinese version of the NDDI-E for the Taiwanese population and the Beck Depression Inventory-II (BDI-II) were completed as part of the self-rated psychiatric assessments. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was completed as part of the psychiatric assessment before the self-rated assessment. Internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were used to assess the utility of the Taiwanese version of the NDDI-E. Results: We recruited 109 patients during the 33-month study period. The mean age was 33.1 +/- 8.94 years old. The mean NDDI-E score was 12.32 +/- 4.96. The mean BDI-II score was 13.26 +/- 12.77. All NDDI-E items were significantly positively associated with the corrected overall NDDI-E score (Cronbach's alpha = 0.902, r = 0.825, p < 0.0001). The cut-off point for the NDDI-E determined with receiver operating characteristic (ROC) curve analysis is 15 (sensitivity = 85.0%, specificity = 87.64%). Conclusion: The Chinese version of the NDDI-E adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for detecting MDE in Taiwanese PWE.

关键词： Category-specific semantic impairments   Classifier languages   Semantic deficits   Brain's semantic system   Semantic universals  

摘要： We compared two non-overlapping data sets: (a) the semantic categories in representative samples of nominal classification languages (N = 334);and in a non-overlapping population (b) semantic category-specific impairments of European neurological patients (N = 121). Each of these appears to organize world objects in natural kinds (e.g., animal, body part, plant, fruit and vegetable, liquid) or manmade kinds (e.g., food, clothing, tool, vehicle, furniture). We show that whenever a specific semantic category is found as a cognitive impairment, this category also exists in some language as a semantic classifier. Since all of the existing semantic impairments reports are with speakers whose languages lack semantic nominal classification systems, the present regularities between grammar and cognitive deficit suggests the idea that cognitive universals may constrain how the neural substrate of knowledge is organized and can break apart but also how they can become expressed in different grammars. (C) 2020 The Authors. Published by Elsevier B.V.

关键词： COVID-19   SARS-CoV-2   Neurological damage   Gene prioritization   Gene enrichment  

摘要： The recent pandemic outbreak of coronavirus is pathogenic and a highly transmittable viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). In this time of ongoing pandemic, many emerging reports suggested that the SARS-CoV-2 has inimical effects on neurological functions, and even causes serious neurological damage. The neurological symptoms associated with COVID-19 include headache, dizziness, depression, anosmia, encephalitis, stroke, epileptic seizures, and Guillain-Barre syndrome along with many others. The involvement of the CNS may be related with poor prognosis and disease worsening. Here, we review the evidence of nervous system involvement and currently known neurological manifestations in COVID-19 infections caused by SARS-CoV-2. We prioritize the 332 human targets of SARS-CoV-2 according to their association with brain-related disease and identified 73 candidate genes. We prioritize these 73 genes according to their spatio-temporal expression in the different regions of brain and also through evolutionary intolerance analysis. The prioritized genes could be considered potential indicators of COVID-19-associated neurological symptoms and thus act as a possible therapeutic target for the prevention and treatment of CNS manifestations associated with COVID-19 patients.