Restorative Neurology and Neuroscience - Volume 37, issue 1

Authors: Qin, Aiping | Zhang, Qian | Wang, Jun | Sayeed, Iqbal | Stein, Donald G.

Article Type: Research Article

Abstract: Background: In this proof-of-concept paper, we investigated whether combination treatment with progesterone (P4) and chloroquine (CQ) would reduce ischemic injury more effectively than either agent alone in a transient middle cerebral artery occlusion (tMCAO) model in male rats. Methods: P4 (8 mg/kg) and CQ (25 mg/kg) were given alone or in combination beginning at different times during surgery and for 3 days post-occlusion. Locomotor activity and grip strength were evaluated as measures of impairment and recovery. Infarct size was assessed by TTC staining. Markers of autophagy (LC3 and SQSTM1/p62) and apoptosis (Bcl-2 and Bax) were evaluated with western blotting. …Results: At the doses we employed, the combination was not more effective than either drug given separately on measures of grip strength or locomotor activity. However, combination therapy substantially reduced infarct size, and significantly increased Bcl-2 protein levels and suppressed Bax expression. Progesterone decreased the expression of LC3-II 24 h and SQSTM1/p62 after ischemia. Conclusions: Our findings suggest that combination therapy with P4 and CQ is not detrimental and has a small-to-moderate additive neuroprotective effect on ischemic injury in rats without substantively affecting behavioral outcomes. CQ and P4 may help to regulate the expression of both autophagy-related and apoptosis-related proteins. Show more

Keywords: Apoptosis, autophagy, cerebral ischemia, chloroquine, progesterone

DOI: 10.3233/RNN-180837

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 1-10, 2019

Authors: Zhang, LingYu | Cao, Bei | Zou, Yutong | Wei, Qian-Qian | Ou, RuWei | Zhao, Bi | Yang, Jing | Wu, Ying | Shang, HuiFang

Article Type: Research Article

Abstract: Background: Cognitive impairment is an important and common symptom in patients with multiple system atrophy (MSA). Objective: The objective of the study was to explore the potential relationships among frontal lobe function, behavioral changes and quality of life (QoL) in patients with MSA. Methods: A total of 203 MSA patients were enrolled and evaluated using the Frontal Assessment Battery (FAB), the Frontal Behavioral Inventory (FBI) and the Parkinson’s disease Questionnaire-39 item version (PDQ-39). Seventy-eight age-, sex-, and education-matched healthy controls were recruited to complete the FAB. Results: Among MSA patients, those with frontal lobe …dysfunction were older (P  = 0.005), had older age of onset (P  = 0.002), lower educational level (P  <  0.001), higher scores in the PDQ-39 domains of mobility (P  = 0.042), ADL (P  = 0.020), cognition (P  <  0.001) and communication compared to those with normal frontal lobe function. The most common frontal behavioral changes were logopenia followed by apathy and inflexibility. The severity of frontal behavioral changes was associated with MSA subtype (P  = 0.015), disease severity (Unified Multiple System Atrophy Rating Scale-I (UMSARS-I), UMSARS-II, UMSARS-IV, and total UMSARS scores) (P  <  0.001), orthostatic hypotension (P  = 0.022), severity of depressive symptoms and total score on the PDQ-39 (P  <  0.001). Binary logistic regression showed that the determinants of poor QoL in patients with MSA were disease severity (UMSARS-I and total UMSARS scores) (P  <  0.05), depression (P  = 0.013) and total FBI score (P  = 0.003). Conclusions: Frontal behavioral changes were potential determinants of poor QoL in MSA, in addition to the disease severity and depressive symptoms. Early discovery and management of frontal behavioral changes in addition to motor and depressive symptoms will help to improve the QoL of MSA patients. Show more

Keywords: Multiple system atrophy, frontal assessment battery, frontal behavior inventory, quality of life

DOI: 10.3233/RNN-180862

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 11-19, 2019

Authors: Chen, Hailong | Zheng, Jiuqin | Ma, Junjie

Article Type: Research Article

Abstract: This article has been retracted, and the online PDF has been watermarked “RETRACTED”. A retraction notice is available at DOI: 10.3233/RNN-239001 .

DOI: 10.3233/RNN-180879

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 21-29, 2019

Authors: Terelak-Borys, Barbara | Grabska-Liberek, Iwona | Schoetzau, Andreas | Konieczka, Katarzyna

Article Type: Research Article

Abstract: Background: It is still debatable whether visual field defects in glaucoma have a reversible component and to what extent a temporary loss can be provoked. Objective: To investigate the response of the visual function to a cold provocation in glaucoma patients, particularly to test whether subjects with Flammer syndrome (FS) behaved differently from subjects without FS. Methods: Ten (10) primary open-angle glaucoma (POAG) patients with FS, 7 POAG patients without FS, and 11 healthy controls were tested with program G2 on the Octopus 101 perimeter before and after putting one hand in cold water (4°C) for …2 min. The mean sensitivity (MS) of each visual field was included in the statistical analysis. Results: In glaucoma patients with FS, the mean MS significantly decreased after cold provocation (delta MS = –0.91 dB, CI = –1.43 to –0.39, p  = 0.0014). In contrast, the mean MS in glaucoma patients without FS did not change significantly (delta MS = 0.17 dB, CI = –0.43 to 0.78, p  = 0.56). Likewise, the mean MS did not change significantly in the healthy controls (delta MS = 0.23 dB, CI = –0.27 to 0.72, p  = 0.36). Conclusions: Cold provocation induced a transient visual field deterioration in the glaucoma patients with FS but not in the glaucoma patients without FS or in the healthy controls. We assume this effect to be the result of a transient reduction of ocular blood flow. Show more

Keywords: Primary open angle glaucoma, Flammer syndrome, visual field, cold provocation, transient visual field impairment, ocular blood flow

DOI: 10.3233/RNN-180866

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 31-39, 2019

Authors: Gautam, Surabhi | Tolahunase, Madhuri | Kumar, Uma | Dada, Rima

Article Type: Research Article

Abstract: Background: Recovery of patients with rheumatoid arthritis (RA) depends on several physical and psychological factors, besides pharmacological treatment. Co-morbid depression adversely affects the outcome in RA. Usual medical therapies have a limited scope and fail to cure the psychological component of the disease. With advanced therapeutic options, achieving a state of remission has become the treatment goal, yoga based mind body intervention (MBI) may provide a holistic approach in its treatment dimension. Hence, MBIs are the need of hour as majority of diseases have a psychosomatic component. Objective: To explore the effect of Yoga based MBI on disease …specific inflammatory markers and depression severity in active RA patients on routine disease modifying anti-rheumatic drugs (DMARDs) therapy. Methods: A total of 72 RA patients were randomized into 2 groups: yoga group (yoga with DMARDs) and control group (DMARDs only). Blood samples were collected pre and post intervention for primary outcome measurements of systemic biomarkers. Disease activity score 28, erythrocyte sedimentation rate (DAS28ESR) and health assessment questionnaire disability index (HAQ-DI) were used to assess disease activity and functional status respectively at pre and post intervention time-points. Secondary outcome, depression severity, was assessed by Beck Depression Inventory II scale (BDI-II) at 2 weekly intervals during 8 weeks of the study interventional plan. Results: After 8 weeks of yoga based MBI, there was significant decrease in the severity of RA as seen by reduction in levels of various systemic inflammatory markers as well as in DAS28ESR (p -value <0.0001; effect size = 0.210) and HAQ-DI (p -value 0.001; effect size = 0.159). Also, yoga group experienced a statistically significant time dependent step-wise decline in depression symptoms over the period of 8 weeks as compared to control group (p -value <0.0001; effect size = 0.5). Regression analysis showed greater reduction in the scores of BDI-II with DAS28ESR (R2  = 0.426; p  <  0.0001) and HAQ-DI (R2  = 0.236; p  = 0.003) in yoga group. Conclusions: Yoga, a mind body intervention re-established immunological tolerance by aiding remission at molecular and cellular level along with significant reduction in depression. Thus in this severe autoimmune inflammatory arthritis with a major psychosomatic component, yoga can be used as a complementary/adjunct therapy. Show more

Keywords: Rheumatoid arthritis, yoga, immunomodulation, depression, inflammation, meditation, remission, oxidative stress

DOI: 10.3233/RNN-180875

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 41-59, 2019

Authors: Song, Chiang-Soon | Lee, Oan-Na | Woo, Hee-Soon

Article Type: Research Article

Abstract: Background: Cognitive orientation to daily occupational performance (CO-OP) is a task-specific training applied using a cognitive behavioral approach to improve performance in daily activities and to enable the patient to overcome limitations related to them. Objectives: The purpose of this study was to investigate the effects of the CO-OP approach in comparison with task-specific upper extremity training (TUET) on performance related to daily and functional activities in individuals with chronic hemiparetic stroke. Methods: Forty-nine participants diagnosed with stroke for the first time underwent 30 minutes of either the CO-OP approach or TUET 5 days a week …for 4 weeks. We evaluated their performance on the box-and-block test (BBT), Canadian occupational performance measure (COPM), and community integration questionnaire (CIQ) and Wolf motor function test-functional score (WMFT-F) before and after the training. Results: Our results show a significantly improvement in the WMFT-F, COPM-P, COPM-S, BBT, and CIQ scores after training in the CO-OP group, but only COPM-S score was significantly improvement after training in TUET group (p  <  0.05). This study also found higher increases in the mean WMFT-F, COPM-P, COPM-S and BBT scores in the CO-OP group than in the TUET group, but CIQ score did not have a significantly higher increase between-group after training. Conclusions: The results of this study suggest that the CO-OP approach resulted in a positive therapeutic effect on self-selected occupational performance and daily and functional activities in individuals with chronic hemiparetic stroke. Show more

Keywords: Activities of daily living, cognition, communities, stroke

DOI: 10.3233/RNN-180853

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 61-70, 2019

Authors: Lawton, Teri | Huang, Ming-Xiong

Article Type: Research Article

Abstract: Background: In the U.S. 3.8 million people have a Traumatic Brain Injury (TBI) each year. Rapid brain training exercises to improve cognitive function after a mild TBI are needed. Objective: This study determines whether cognitive remediation by discriminating the direction a test pattern moves relative to a stationary background (movement figure-ground discrimination) improves the vision and cognitive deficits that result from a TBI, providing a paradigm shift in treatment methods. Methods: Movement-discrimination neurotraining was used to remediate low-level visual timing deficits in the dorsal stream to determine whether it improved high-level cognitive functions, such as processing …speed, reading fluency, and the executive control functions of attention and working memory in four men with a TBI between the ages of 15–68. Standardized tests, as well as Magnetoencephalography (MEG) brain imaging, were administered at the beginning and end of 8–16 weeks of intervention training to evaluate improvements in cognitive skills. Results: Movement-discrimination cognitive neurotraining remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency, processing speed, and working memory for all TBI patients we studied. MEG brain imaging, using the Fast-VESTAL procedure, showed that this movement-discrimination training improved time-locked activity in the dorsal stream, attention, and executive control networks. Conclusions: Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement discrimination training in improving high-level cognitive functions such as focusing and switching attention, working memory, processing speed, and reading. This study found that movement-discrimination training was very rapid and effective in remediating cognitive deficits, providing a new approach that is very beneficial for treating a mild TBI. Show more

Keywords: Traumatic brain injuries, cortical plasticity, perceptual learning, reading, processing speed, attention, working memory, dorsal stream, visual timing, brain exercise, neurorehabilitation, MEG

DOI: 10.3233/RNN-180856

Citation: Restorative Neurology and Neuroscience, vol. 37, no. 1, pp. 71-86, 2019