关键词： Neurite orientation dispersion and density imaging   Cervical spondylotic myelopathy   Diffusion tensor imaging   Fractional anisotropy   Intracellular volume fraction   Neurological recovery  

摘要： BACKGROUND CONTEXT: Predicting postoperative prognosis with preoperative diagnostic imaging has clinical importance. Recent studies have indicated the utility of diffusion tensor imaging (DTI) to quantify the severity of cervical spondylotic myelopathy (CSM) and assess the prognosis of surgical outcomes. However, how to apply DTI to evaluate CSM in a clinical setting is not fully elucidated. Neurite orientation dispersion and density imaging (NODDI) is a model-based practical diffusion-weighted magnetic resonance imaging analysis for estimating specific microstructural features related directly to neuronal morphology. In a prior study, we indicated preoperative NODDI parameters are a promising tool with which to predict neuronal recovery after decompression surgery in patients with CSM with 2 years follow-up. However, the correlation between NODDI parameters and postoperative long-term outcomes and change of parameters over time postoperatively has remained largely unknown. STUDY DESIGN: Retrospective cohort study. PURPOSE: To determine the change of parameters of NODDI and conventional DTI over time, and the relationship between parameters and neurological recovery 2 years after surgery. PATIENT SAMPLE: We included 28 consecutive patients with nontraumatic cervical lesions from CSM who underwent laminoplasty and were followed up for > 2 years. Patients underwent magnetic resonance imaging before and approximately 2 weeks, 6 months, and 1 year after surgery. OUTCOME MEASURES: In addition to conventional DTI metrics, we evaluated intracellular volume fraction (ICVF) and orientation dispersion index, which are metrics derived from NODDI. The Japanese Orthopedic Association (JOA) scoring system was used before and 2 years after surgery to assess neurological outcome (JOA recovery rate). METHODS: NODDI and conventional DTI values were measured at the C2-C3 intervertebral level (control value) and the most compressed levels (C3-C7 intervertebral levels) were measured by

摘要： Neurological disorders are the largest contributor to the global burden of disease in terms of morbidity, as measured with disability-adjusted life years, and the second largest contributor to mortality.1 If neurological disorders are included that have so far not been accounted for in the Global Burden of Diseases, Injuries, and Risk Factors (GBD) study, such as cerebral malaria, then the proportion of people with neurological diseases becomes even larger, especially in low-income and middle-income countries (LMICs).2 The Policy View in The Lancet Neurology by Feigin and colleagues,3 which sets out priorities and recommendations to tackle the growing burden of neurological disorders using GBD data, is therefore a welcome and timely call for action. Environmental risk factors such as climate change and air pollution, which is especially pronounced in the megalopolises of LMICs, must also be understood and addressed to reduce disease burden; a relationship has been shown between air pollution and cardiovascular disease, including stroke.6 Creating and maintaining healthy environments is key to curbing the epidemic of communicable and non-communicable neurological disorders in LMICs and is part of the One Health approach, which deals with the interconnectedness of human, animal, and environmental health. A One Health approach also involves collaboration across multiple sectors, including communities (eg, patients, their families, care deliverers, faith organisations), the public sector (eg, governments, public health institutions, academia, education), the private sector, and non-governmental organisations.

关键词： adverse childhood experiences   childhood sexual abuse   conversion disorder   functional neurological disorder   predictive factors   treatment outcome  

摘要： Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM-IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient-related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, beta = 0.608 p < .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, beta = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, beta = 0.435, p = .008) outcome. Conclusion Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed.

关键词： HINT1   Psychiatric   Neurodevelopmental   ARAN-NM  

关键词： Epilepsy   Depression   Adolescent   Mental health screening  

摘要： Purpose: Depression is one of the most prevalent psychiatric comorbidities in epilepsy. This quality improvement project compared a standardized rating scale, the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y), with physician opinion to see if it improved sensitivity to depressive symptoms. Results: A convenience sample of thirty adolescents with epilepsy ages 12-17 (mean [M] = 15.02, standard deviation [SD] = 1.81;53% female) participated in the screening. Thirteen percent of the sample scored in the Elevated range on the NDDI-E-Y (exceeded cutoff). Seven percent of the sample were rated by the physician as definitely showing signs of depression. There were two false negatives when the NDDI-E-Y score exceeded the established cutoff, but physician rating was negative for depressive symptoms. Conclusion: This pilot project shows that the NDDI-E-Y is a convenient clinical tool with the potential to improve sensitivity in the detection of depressive symptoms in adolescents with epilepsy. (C) 2020 Elsevier Inc. All rights reserved.

关键词： Lymphoma   Diagnosis   Sarcoidosis   Neurology   Burkitt lymphoma   Angiotensin Converting Enzyme   Vasculitis  

摘要： The title "great imitator" refers to conditions which can cause varied manifestations and mimic many diseases. Lymphoma is worthy of this title. We describe three cases of lymphoma in which lymphoma mimicked other diseases causing neurological dysfunction, specifically sarcoidosis, vasculitis and infection respectively. Case 1 was a 66-year-old man with subacute progressive diplopia and gait disturbance and investigations revealing a supratentorial para-falcine soft tissue lesion, mid-thoracic cord enhancement and right axillary mass and an elevated serum ACE. Right axillary mass core biopsy was diagnostic of Burkitt lymphoma. Case 2 was a 50-year-old man with several weeks of constitutional symptoms and development of lower limb weakness and numbness, urinary retention and confusion while in hospital. MRI brain demonstrated multi-territory cerebral infarcts. Intravascular lymphoma was diagnosed on random skin biopsy. Case 3 was a 65-year-old man with several weeks of headache and diplopia on a background of previously treated Burkitt lymphoma. CSF analysis showed a lymphocytic pleocytosis and markedly low glucose with cytologic analysis negative for malignancy. Investigations for an infective cause were negative. FDG-PET demonstrated marked, disseminated spinal and cranial leptomeningeal disease and a multi-focal, intra-dural relapse of Burkitt lymphoma was diagnosed. The varied manifestations in our cases demonstrate the ability for lymphoma to mimic infective, inflammatory, granulomatous (including sarcoidosis) and neoplastic aetiologies. An elevated serum ACE appears insufficiently diagnostic to confirm sarcoidosis and tissue for histological examination should be sought whenever possible. When the diagnosis is uncertain, the possibility of this great imitator should be considered, especially for multi-focal disease. (C) 2020 Elsevier Ltd. All rights reserved.

关键词： Pediatric neurology physiotherapy   Walking problem   Cerebral palsy  

摘要： Introduction: Cerebral palsy is one of the conditions that usually cause disability in children. One of its symptoms is the walking problem. The purpose of this study is to examine the effectivity of Pediatric Physiotherapy Run Technique (PPRT) in improving walking ability of children with cerebral palsy. Methods: This is a pre-experimental study with time-series design. Twenty participants were included in this study. The outcome measure used was motor gross function measure (MGFM) walking dimension, which measured at baseline and after three times and nine times of PPRT session. Data were analyzed using repeated measure ANOVA. Results: The results of this study showed that there is a significantly different (p< 0.05) between pre, three times and nine times. The nine times is significantly higher than the baseline. Conclusion: Children with cerebral palsy may benefit from the PPRT program to improve their walking capacity. (C) 2019 Elsevier Espana, S.L.U. All rights reserved.

关键词： Bariatric surgery   Weight loss   Drop foot   Neurological complications  

摘要： Background The relationship between rapid weight loss and peroneal nerve entrapment neuropathy (PNEN) was shown in various series following bariatric surgery. Thus, we aimed to determine the occurrence of PNEN in our patients who underwent laparoscopic sleeve gastrectomy (LSG) and to reveal the factors contributing to this complication. Methods We evaluated our series of 635 patients in terms of neurological symptoms following laparoscopic sleeve gastrectomy, retrospectively. We recorded the preoperative data, laboratory vitamin and nutrient levels, weight loss, electromyography (EMG) findings, and treatment modalities of these patients. Results Seven out of 635 patients developed foot drop as a result of PNEN after bariatric surgery. The mean total weight loss for these patients was 50.6 kg in 6 months, and 63 kg in 12 months. In the laboratory analyses, we did not detect any signs of vitamin deficiency. EMG findings confirmed the diagnosis. Conclusion We demonstrate that rapid weight loss is correlated with the risk of foot drop incidence as a result of PNEN.