摘要： Highlights from the article: This study aim to present epidemiologic profile and clinical evolution of 185 patients followed by a multidisciplinary team in a Brazilian rehabilitation hospital whose symptoms meet DSM5 criterias for FND. Patients who participated in rehabilitation were five times more likely to be cured than patients who did not. History of fainting, altered sensitivity, symptoms onset over a year, bladder complaints and use of locomotion aid have worse prognosis.

关键词： Lumbar   Sacral   Radiculopathy   Diagnosis   Correlation  

摘要： Background: Lumbo-sacral radiculopathy (LSR) is a common musculoskeletal disorder for which patients seek medical care and referrals for advanced imaging. However, accurate diagnosis remains challenging. Neuropathic pain screening questionnaires, clinical neurological examination and magnetic resonance imaging (MRI) are used in the initial diagnosis. The utility of these tools in diagnosing LSR varies and their correlation has not been reported. Methods: A cross-sectional, multicentre, blinded design was used in six physiotherapy departments in Kenya. Each participant was blindly examined by three independent clinicians using the Self-Reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) score, clinical neurological examination (CNE) and MRI. Spearman's rank coefficient (r) was used to examine the correlation between the three tests. Linear regression and odds ratios were used to establish correlations between socio-demographic, clinical and diagnostic parameters. The diagnostic accuracy of individual or combined sets of CNE tests in diagnosing LSR, with reference to MRI, was determined using Receiver Operating Characteristics (ROC) curves. Results: We enrolled 102 participants (44 males, 58 females;mean age: 44.7years). Results indicated a significant positive correlation (r=0.36, P=0.01) between S-LANSS, CNE and MRI among patients with low back and radiating leg symptoms. Positive agreement existed between combined neuro-conduction tests (sensory, motor and reflex) and neuro-dynamic tests (NDT).The NDT component of CNE (Straight Leg Raise Test [SLRT] and Femoral Nerve Stretch Test [FNST]) was significantly associated (P=0.05) with MRI: patients who had positive NDT results had higher odds (8.3) for positive nerve root compromise on MRI versus those who had negative NDT results. Conclusion: This was the first study to investigate the correlation between S-LANSS, CNE and MRI in patients presenting with low back and radiating leg symptoms. Results ind

关键词： Community rehabilitation   experience   goal-setting   neurological long-term conditions   phenomenology   qualitative methods   self-management support  

摘要： Purpose: There is increasing interest in tailoring self-management support, but little detail is available on the relevance and impact of such approaches for people with progressive neurological conditions. The aim of this study was to draw on individuals' experiences to inform the practice of self-management support for these groups. Method: Community rehabilitation service users were purposively recruited and took part in in-depth qualitative interviews. Interviews were audio-recorded and transcribed. Data analysis was iterative and interpretative, taking a phenomenological approach. Strategies to enhance rigor were auditability, peer review, and researcher reflexivity. Results: The sample consisted of 10 adults (age 20-79 years) who were living with a range of progressive neurological conditions. Individuals demonstrated resourcefulness in developing practice-based self-management strategies. Beyond practical strategies, interviewees' experiences were signified by reflecting on and upholding a sense of identity and a desire for purpose against the background of losses and gains over time. Linking with this overarching theme of "Sense of self" were aspects of "My body and mind", "Time", "Space", "Relationships", and "What I do". Conclusions: Self-management approaches for individuals with progressive neurological conditions will benefit from incorporating ways of recognizing, articulating, and supporting the person's sense of identity and purpose.

关键词： Neurology   Postgraduates   Burnout   Career choice regret   China  

摘要： Background: In China, the shortage of doctors leads to stressful clinical work and increasing turnover. Medical students undergoing postgraduate specialty training will be the country's medical workforce in the coming decades, but are also subject to high workloads and academic pressure. This may have significant implications for burnout and career choice regret. Despite the importance of burnout and career choice regret, the status and relationship of these aspects in Chinese neurology postgraduates are largely unexplored, and associated factors remain unknown. Methods: This study investigated the prevalence of and factors influencing burnout and career choice regret among neurology postgraduates in China. We conducted a national cross-sectional study of Chinese neurology postgraduates. Data were collected using a self-administered questionnaire that covered demographic information, the Maslach Burnout Inventory, and additional item to assess career choice regret. Results: Of 4902 neurology postgraduates, 2008 returned completed questionnaires (response rate 41%). After excluding incomplete questionnaires, data for 1814 participants were analyzed. In total, 83.6% of participants had experienced symptoms of burnout, and 46.6% reported career choice regret. Binary logistic regression analysis showed postgraduate entrance examination scores, marital status, and having children were associated with burnout (all P < 0.05). Career choice regret was the strongest risk factor for burnout (odds ratio [OR] = 3.17, 95% confidence interval [CI] 2.33-4.32). Multiple logistic regression showed postgraduates with shorter work or study hours per week (OR = 0.64, 95% CI 0.47-0.88) had a low risk for career choice regret, whereas married participants (OR = 1.54, 95% CI 1.07-2.20) had a high risk for career choice regret. No symptoms of burnout (OR = 0.33, 95% CI 0.24-0.45) was also associated with a low risk for career choice regret. Conclusions: Burnout symptoms and career choice r

关键词： Spinal cord injury   Bone marrow-derived mesenchymal stem cells   IGF-1   Gene and cell therapy  

摘要： BackgroundSurvival and therapeutic actions of bone marrow-derived mesenchymal stem cells (BMMSCs) can be limited by the hostile microenvironment present during acute spinal cord injury (SCI). Here, we investigated whether BMMSCs overexpressing insulin-like growth factor 1 (IGF-1), a cytokine involved in neural development and injury repair, improved the therapeutic effects of BMMSCs in *** a SCI contusion model in C57Bl/6 mice, we transplanted IGF-1 overexpressing or wild-type BMMSCs into the lesion site following SCI and evaluated cell survival, proliferation, immunomodulation, oxidative stress, myelination, and functional ***-IGF1 transplantation was associated with increased cell survival and recruitment of endogenous neural progenitor cells compared to BMMSC- or saline-treated controls. Modulation of gene expression of pro- and anti-inflammatory mediators was observed after BMMSC-IGF1 and compared to saline- and BMMSC-treated mice. Treatment with BMMSC-IGF1 restored spinal cord redox homeostasis by upregulating antioxidant defense genes. BMMSC-IGF1 protected against SCI-induced myelin loss, showing more compact myelin 28days after SCI. Functional analyses demonstrated significant gains in BMS score and gait analysis in BMMSC-IGF1, compared to BMMSC or saline *** of IGF-1 in BMMSC resulted in increased cell survival, immunomodulation, myelination, and functional improvements, suggesting that IGF-1 facilitates the regenerative actions of BMMSC in acute SCI.

关键词： CD8+ T cells   HSAN-I   SPTLC2   neurological diseases   ER stress  

摘要： Patients with the neurological disorder HSAN-I suffer frequent infections, attributed to a lack of pain sensation and failure to seek care for minor injuries. Whether protective CD8(+) T cells are affected in HSAN-I patients remains unknown. Here, we report that HSAN-I-associated mutations in serine palmitoyltransferase subunit SPTLC2 dampened human T cell responses. Antigen stimulation and inflammation induced SPTLC2 expression, and murine T-cell-specific ablation of Sptlc2 impaired antiviralT-cell expansion and effector function. Sptlc2 deficiency reduced sphingolipid biosynthetic flux and led to prolonged activation of the mechanistic target of rapamycin complex 1 (mTORC1), endoplasmic reticulum (ER) stress, and CD8(+) T cell death. Protective CD8(+) T cell responses in HSAN-I patient PBMCs and Sptlc2-deficient mice were restored by supplementing with sphingolipids and pharmacologically inhibiting ER stress-induced cell death. Therefore, SPTLC2 underpins protective immunity by translating extracellular stimuli into intracellular anabolic signals and antagonizes ER stress to promote T cell metabolic fitness.

关键词： Neurofilaments   Protein aggregation   Protein degradation   Neurodegeneration   Giant axonal neuropathy (GAN)   Charcot-Marie-tooth (CMT) disease  

摘要： Many neurodegenerative disorders, including Parkinson's, Alzheimer's, and amyotrophic lateral sclerosis, are well known to involve the accumulation of disease-specific proteins. Less well known are the accumulations of another set of proteins, neuronal intermediate filaments (NFs), which have been observed in these diseases for decades. NFs belong to the family of cytoskeletal intermediate filament proteins (IFs) that give cells their shape;they determine axonal caliber, which controls signal conduction;and they regulate the transport of synaptic vesicles and modulate synaptic plasticity by binding to neurotransmitter receptors. In the last two decades, a number of rare disorders caused by mutations in genes that encode NFs or regulate their metabolism have been discovered. These less prevalent disorders are providing novel insights into the role of NF aggregation in the more common neurological disorders.

关键词： Paraneoplastic motor neuron disease   Anti-Hu antibodies   Limbic encephalitis   Small cell lung cancer  

摘要： Highlights • Paraneoplastic motor neuron disease (PMND) may present as a second delayed syndrome in patients with anti-Hu antibodies. • Linkage between cancer and motor neuron disease is discussed, PMND has been reported in patients with anti-Ma2 antibodies. • PMND is a rare, but potentially treatable condition. [ABSTRACT FROM AUTHOR]

关键词： Neuromyelitis optica spectrum disorders   Aquaporin-4   Folicular helper T cell   Cytokines  

摘要： Due to their function in assisting B cells, T-FH cells may be involved in the production of pathogenic IgG in neuromyelitis optica spectrum disorder (NMOSD). In the present study, the proportion of IL-6(+) and IL-17(+) T-FH cell subsets was higher in NMOSD patients than healthy individuals. The frequency of both T-FH cell subsets were directly associated with disease activity. By contrast, NMOSD patients with a higher proportion of IL-10(+) T-FH cell subsets showed a lower neurological disabilities score. In summary, all findings suggest that expansion of peripheral IL-6(+) and IL-17(+) T-FH cells may be involved in the severity of NMOSD.

关键词： Hemorrhagic stroke   Nuclear receptor   Microglia   Astrocyte   Motor dysfunction  

摘要： Inflammatory responses are considered to play pivotal roles in the pathogenesis of intracerebral hemorrhage (ICH). Here we show that a nuclear receptor Nurr1 (NR4A2) was expressed prominently in microglia/macrophages and astrocytes in the perihematomal region in the striatum of mice after ICH. Daily administration of a Nurr1 agonist amodiaquine (40 mg/kg, i.p.) from 3 h after ICH induction diminished perihematomal activation of microglia/macrophages and astrocytes. Amodiaquine also suppressed ICH-induced mRNA expression of IL-1 beta, CCL2 and CXCL2, and ameliorated motor dysfunction of mice. These results suggest that Nurrl serves a novel target for ICH therapy.