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Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach
Conclusion Robotic therapy has matured and represents an embodiment of a paradigm shift in neurorehabilitation following a stroke: instead of focusing on compensation, it affords focus in ameliorating the impaired limb in line with concepts of neuroplasticity. This technology-based treatment provides intensity, interactivity, flexibility, and adaptiveness to patient's performance and needs. Furthermore, it increases the productivity of rehabilitation care. Of course, efficiency must be discussed within a local perspective. For example, following the cost containment shown in the VA ROBOTICS study (46), the UK Nati...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

A Novel Variant in Non-coding Region of GJB1 Is Associated With X-Linked Charcot-Marie-Tooth Disease Type 1 and Transient CNS Symptoms
Conclusion A novel GJB1 variant of c.-170T>G in non-coding region was found in this big Chinese CMTX1 pedigree. This is the first report of variant in non-coding DNA sequence associated with transient CNS symptoms. Thyroid malfunction may contribute to the CNS symptoms in this case. Ethics Statement This study has been reviewed and approved by the Ethics Committee of the China-Japan Union Hospital of Jilin University. Each member of the family provided written informed consent to the participation in the study, the genetic test, and authorized to publish the study including the photos in accordance with the Decl...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Beta Amyloid Deposition Is Not Associated With Cognitive Impairment in Parkinson's Disease
In this study, we used a well-validated visual assessment to clinically rate scans as being amyloid positive or negative (38). As there is not an accepted threshold based on standardized centiloid reference regions, we defined an amyloid positivity centiloid cut-off threshold in our sample. Our cut-off (CL = 31.3, SUVR = 1.21) corresponds well to the estimated value proposed by Rowe and colleagues (34) in the context of AD (CL = 25–30), however our estimated threshold may be biased by the low number of Aβ positive patients. Our results suggest a lower prevalence of amyloid-positive PDD individuals than in ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

A Chinese Family With Adult-Onset Leigh-Like Syndrome Caused by the Heteroplasmic m.10191T > C Mutation in the Mitochondrial MTND3 Gene
Conclusion The m.10191T>C mutation in the mtDNA of the complex I (CI) subunit of MTND3 results in the substitution of a highly conserved amino acid (p.Ser45Pro) within the ND3 protein, leading to CI dysfunction through impaired enzyme catalysis rather than impaired stability or assembly, causing a broad clinical spectrum of disorders (26). Patients with the m.10191T>C mutation are rare. In the present study, we report on a family of patients with the extremely rare adult-onset Leigh-like syndrome with the m.10191T>C mutation. Including the two patients from our reported family, the m.10191T...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Motor Abilities in Adolescents Born Preterm Are Associated With Microstructure of the Corpus Callosum
Conclusions: Impairments in motor abilities are present in preterm born adolescents without major neuromotor impairment and in the absence of focal brain injury. Altered microstructure of the corpus callosum microstructure appears a crucial factor, in particular for movement quality. Introduction Very preterm birth (birth <32 weeks of gestation) is associated with high risk of impaired neurodevelopment. Rates of severe neuromotor impairment, i.e., Cerebral Palsy (CP), are decreasing, in particular in those preterm children born with moderately low and very low birth weight (1). However, in a substantial propo...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

The Effects of Intelectin-1 on Antioxidant and Angiogenesis in HUVECs Exposed to Oxygen Glucose Deprivation
Conclusion: These results suggest intelectin-1 promotes angiogenesis, inhibits oxidative stress and reduces apoptosis by stimulating the Akt-eNOS signaling pathway in response to ischemia in vitro. Introduction Stroke is a main reason of human neurological disability, ischemic stroke (IS) accounts for almost 80–90% of all strokes. IS occurs after a cerebral blood flow disruption, leading to cellular death and tissue damage by restricting glucose and oxygen supplies (1). Ischemic vascular diseases cause substantial vascular valve and vascular endothelial cell injuries, eventually damaging the surrounding tis...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Age Is a Greater Influence on Small Saccades Than Target Size in Normal Subjects on the Horizontal Video Head Impulse Test
Conclusion: While this study suggests that target size may have a statistically significant impact on the vHIT saccade profile of normal subjects, age has a greater influence on the incidence and size of small vHIT saccades. Introduction The video head impulse test (vHIT) is a quantitative adaptation of the clinical head impulse test (1), and enables functional assessment of the high-frequency angular vestibulo-ocular reflex (VOR) in all three planes of head rotation (2, 3). Lightweight goggles worn by the subject detect head movement using an accelerometer and gyroscope, and a high frame rate video camera tracks eye...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Decompressive Craniectomy for Traumatic Brain Injury: Postoperative Cerebral Hemodynamic Evaluation
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment
Conclusion In this study, reduced CBF and FA and increased MD in the inner NAWM layers for both PVWMH and DWMH suggested extensive WM alterations beyond the visible WM lesions commonly observed on clinical MRI of svMCI subjects. CBF penumbras cover more extensive WM at risk than DTI penumbras, suggesting the likelihood that compromised CBF precedes white matter integrity changes, and CBF penumbras may be a potential target for the prevention of further microstructural white matter damage. The imaging parameters investigated, however, did not correlate to cognition. Author Contributions YZ, QX, and XG conceived and desig...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

The Young Male Syndrome —An Analysis of Sex, Age, Risk Taking and Mortality in Patients With Severe Traumatic Brain Injuries
Conclusion The willingness of young males to engage in dangerous situations might be adaptive in terms of fitness maximization. Nonetheless, for some individuals this intense sexual competition can be detrimental to health. The correspondence between the age distribution of the reproductively most active population and those suffering sTBI only partially supports the evolutionary hypothesis about risk-taking behavior. The prevalence of higher external mortality rates of young males, on the other hand, was not present in our data at all, nor did we find any support for the assumption that sTBI acquired from riskier behavio...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Decompressive Craniectomy for Traumatic Brain Injury: Postoperative TCD Cerebral Hemodynamic Evaluation
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Cell-Based Therapies for Stroke: Promising Solution or Dead End? Mesenchymal Stem Cells and Comorbidities in Preclinical Stroke Research
Conclusion The high prevalence of comorbidities in patients with stroke indicates the need for therapies in preclinical studies that take into account these comorbidities in order to avoid failures in translation to the patient. Preclinical studies are beginning to evaluate the efficacy of MSC treatment in stroke associated with comorbidities, especially hypertension, for ischemic and hemorrhagic stroke. Regarding aging and diabetes, only ischemic stroke studies have been performed. For the moment, few studies have been performed and contradictory results are being reported. These contradictory results may be due to the u...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study
Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551. Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality worldwide. In 2013 ~2.8 million TBI cases were recorded an...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Thrombolysis in Ischemic Stroke Patients with Isolate Pulmonary Arteriovenous Malformations
Pulmonary arteriovenous malformations are rare cause for ischemic stroke. British Thoracic Society Clinical Statement considered insufficient evidence of safety or clinical benefit to recommend thrombolysis for stroke with pulmonary arteriovenous malformations. For pulmonary arteriovenous malformations with hereditary hemorrhagic telangiectasia, bleeding risk after thrombolysis is high, while for isolate pulmonary arteriovenous malformations, bleeding risk is much lower. We here present 2 cases of ischemic stroke with isolate pulmonary arteriovenous malformations treated with thrombolysis.
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2019 Category: Neurology Authors: Gaoping Lin, Peng Jiang, Min Lou Tags: Case Report Source Type: research

Incidence and prevalence of dementia associated with transient ischaemic attack and stroke: analysis of the population-based Oxford Vascular Study
Publication date: March 2019Source: The Lancet Neurology, Volume 18, Issue 3Author(s): Sarah T Pendlebury, Peter M Rothwell, Oxford Vascular StudySummaryBackgroundRisk of dementia after stroke is a major concern for patients and carers. Reliable data for risk of dementia, particularly after transient ischaemic attack or minor stroke, are scarce. We studied the risks of, and risk factors for, dementia before and after transient ischaemic attack and stroke.MethodsThe Oxford Vascular Study is a prospective incidence study of all vascular events in a population of 92 728 people residing in Oxfordshire, UK. Patients with tran...
Source: The Lancet Neurology - February 14, 2019 Category: Neurology Source Type: research

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