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Cureus Jun 2022Introduction Thyroid hormones play a crucial role in the proper functioning of the nervous system. Both T3 and T4 hormones have many significant actions on the...
Introduction Thyroid hormones play a crucial role in the proper functioning of the nervous system. Both T3 and T4 hormones have many significant actions on the neuromuscular system and brain. In hypothyroid patients, various neurological signs and symptoms such as weakness, fatigue, paresthesias, arthralgias, etc. may be seen. Reaction time is a good indicator of the processing of the central nervous system. So, our study aims to observe the change in reaction time in hypothyroid patients as compared to the control group. And to understand, if some difference is observed, how does it change after treatment with thyroxin in a hypothyroid group. Materials and methods This study was conducted at the tertiary care teaching hospital in the Vidarbha region. In this study, 40 newly diagnosed primary hypothyroid patients (including males and females), in the age group of 20 to 45 years, and whose thyroid-stimulating hormone (TSH) levels were between 10 and 50 mIU/L and free T4 levels below the normal level were included. A suitable comparable control group of the same demographic parameter was selected. Reaction time was taken before the start of thyroxin treatment in both groups, and results were analyzed by using an unpaired t-test. The reaction time of the hypothyroid group was again measured after eight weeks of the start of thyroxin treatment, it was compared with the initial reaction time, and data were compared by using the paired t-test. Result In the hypothyroid group as compared to the control group both auditory and visual reaction times were significantly on the higher side (p<0.05). Also, there was a significant improvement in reaction time after the start of thyroxin treatment (p<0.05), which suggests improvement in CNS activity in hypothyroid patients after initiation of therapy. Conclusion Thyroid hormones play a crucial role in the proper functioning and processing of the central nervous system. Due to this reason, reaction time in hypothyroid patients was on the longer side, showing a slowing of the nervous system when reacting to a specific stimulus. After thyroxin treatment for a sufficient period, reaction times were of shorter duration as compared to before the start of thyroxin, which shows well-recovered nervous activity. Therefore, reaction time is not only used as a handy tool to identify early central nervous system manifestations of hypothyroidism but also used to monitor response to treatment.
PubMed: 35875293
DOI: 10.7759/cureus.26074 -
European Journal of Translational... Jul 2022The article presents the results of neuropsychological remote and face-to-face testing of 25 children aged 12 to 17 years in the nearest (during and 1-2 weeks after the...
The article presents the results of neuropsychological remote and face-to-face testing of 25 children aged 12 to 17 years in the nearest (during and 1-2 weeks after the treatment) and later period (2-12 months) after COVID-19 infection with predominant respiratory tract infection, organized in Ekaterinburg in the State Autonomous Institution "Children's Hospital № 8". Indication of family contact with patients with a new coronavirus infection was found in all patients, a positive nasopharyngeal swab for SARS-CoV-2 RNA by PCR was found in 58%, non-focal neurological complaints were found in 54% of children. The control group consisted of 25 pupils of Moscow comprehensive schools (14 girls and 11 boys) aged between 12 and 16 years who were examined before the pandemic. The methods included: investigation of the kinesthetic, spatial, dynamic, graphic praxis; auditory-motor coordination; visual, object-constructive gnosis; auditory-speech, visual memory; voluntary attention; thinking. Significant differences with the results of neuropsychological tests performed in children in the control group were found, allowing us to assert impairment of memory, attention, visual gnosis, visual-spatial function, kinesthetic and dynamic praxis, verbal and non-verbal component of thinking. According to A.R. Luria's theory, the topic of the disorders involves the temporo-parieto-occipital, mediobasal, frontotemporal parts of the brain, the reticular formation and limbic structures. This necessitates the development of corrective educational programs and an in-depth diagnostic algorithm that determines the morphological substrate of cognitive disorders in children, who have undergone COVID-19.
PubMed: 35838578
DOI: 10.4081/ejtm.2022.10685 -
Brain Communications 2022Disability in multiple sclerosis is generally classified by sensory and motor symptoms, yet cognitive impairment has been identified as a frequent manifestation already...
Disability in multiple sclerosis is generally classified by sensory and motor symptoms, yet cognitive impairment has been identified as a frequent manifestation already in the early disease stages. Imaging- and more recently blood-based biomarkers have become increasingly important for understanding cognitive decline associated with multiple sclerosis. Thus, we sought to determine the prognostic utility of serum neurofilament light chain levels alone and in combination with MRI markers by examining their ability to predict cognitive impairment in early multiple sclerosis. A comprehensive and detailed assessment of 152 early multiple sclerosis patients (Expanded Disability Status Scale: 1.3 ± 1.2, mean age: 33.0 ± 10.0 years) was performed, which included serum neurofilament light chain measurement, MRI markers (i.e. T-hyperintense lesion volume and grey matter volume) acquisition and completion of a set of cognitive tests (Symbol Digits Modalities Test, Paced Auditory Serial Addition Test, Verbal Learning and Memory Test) and mood questionnaires (Hospital Anxiety and Depression scale, Fatigue Scale for Motor and Cognitive Functions). Support vector regression, a branch of unsupervised machine learning, was applied to test serum neurofilament light chain and combination models of biomarkers for the prediction of neuropsychological test performance. The support vector regression results were validated in a replication cohort of 101 early multiple sclerosis patients (Expanded Disability Status Scale: 1.1 ± 1.2, mean age: 34.4 ± 10.6 years). Higher serum neurofilament light chain levels were associated with worse Symbol Digits Modalities Test scores after adjusting for age, sex Expanded Disability Status Scale, disease duration and disease-modifying therapy (B = -0.561; SE = 0.192; = 0.004; 95% CI = -0.940 to -0.182). Besides this association, serum neurofilament light chain levels were not linked to any other cognitive or mood measures (all -values > 0.05). The tripartite combination of serum neurofilament light chain levels, lesion volume and grey matter volume showed a cross-validated accuracy of 88.7% (90.8% in the replication cohort) in predicting Symbol Digits Modalities Test performance in the support vector regression approach, and outperformed each single biomarker (accuracy range: 68.6-75.6% and 68.9-77.8% in the replication cohort), as well as the dual biomarker combinations (accuracy range: 71.8-82.3% and 72.6-85.6% in the replication cohort). Taken together, early neuro-axonal loss reflects worse information processing speed, the key deficit underlying cognitive dysfunction in multiple sclerosis. Our findings demonstrate that combining blood and imaging measures improves the accuracy of predicting cognitive impairment, highlighting the clinical utility of cross-modal biomarkers in multiple sclerosis.
PubMed: 35813883
DOI: 10.1093/braincomms/fcac153 -
Journal of Clinical Medicine Jul 2022Auditory steady-state response (ASSR) is a translational biomarker for several neurological and psychiatric disorders, such as hearing loss, schizophrenia, bipolar...
The Full Informational Spectral Analysis for Auditory Steady-State Responses in Human Brain Using the Combination of Canonical Correlation Analysis and Holo-Hilbert Spectral Analysis.
Auditory steady-state response (ASSR) is a translational biomarker for several neurological and psychiatric disorders, such as hearing loss, schizophrenia, bipolar disorder, autism, etc. The ASSR is sinusoidal electroencephalography (EEG)/magnetoencephalography (MEG) responses induced by periodically presented auditory stimuli. Traditional frequency analysis assumes ASSR is a stationary response, which can be analyzed using linear analysis approaches, such as Fourier analysis or Wavelet. However, recent studies have reported that the human steady-state responses are dynamic and can be modulated by the subject's attention, wakefulness state, mental load, and mental fatigue. The amplitude modulations on the measured oscillatory responses can result in the spectral broadening or frequency splitting on the Fourier spectrum, owing to the trigonometric product-to-sum formula. Accordingly, in this study, we analyzed the human ASSR by the combination of canonical correlation analysis (CCA) and Holo-Hilbert spectral analysis (HHSA). The CCA was used to extract ASSR-related signal features, and the HHSA was used to decompose the extracted ASSR responses into amplitude modulation (AM) components and frequency modulation (FM) components, in which the FM frequency represents the fast-changing intra-mode frequency and the AM frequency represents the slow-changing inter-mode frequency. In this paper, we aimed to study the AM and FM spectra of ASSR responses in a 37 Hz steady-state auditory stimulation. Twenty-five healthy subjects were recruited for this study, and each subject was requested to participate in two auditory stimulation sessions, including one right-ear and one left-ear monaural steady-state auditory stimulation. With the HHSA, both the 37 Hz (fundamental frequency) and the 74 Hz (first harmonic frequency) auditory responses were successfully extracted. Examining the AM spectra, the 37 Hz and the 74 Hz auditory responses were modulated by distinct AM spectra, each with at least three composite frequencies. In contrast to the results of traditional Fourier spectra, frequency splitting was seen at 37 Hz, and a spectral peak was obscured at 74 Hz in Fourier spectra. The proposed method effectively corrects the frequency splitting problem resulting from time-varying amplitude changes. Our results have validated the HHSA as a useful tool for steady-state response (SSR) studies so that the misleading or wrong interpretation caused by amplitude modulation in the traditional Fourier spectrum can be avoided.
PubMed: 35807153
DOI: 10.3390/jcm11133868 -
Journal of Sleep Research Dec 2022Recent studies have shown that slow oscillations (SOs) can be driven by rhythmic auditory stimulation, which deepens slow-wave sleep (SWS) and improves memory and the...
Recent studies have shown that slow oscillations (SOs) can be driven by rhythmic auditory stimulation, which deepens slow-wave sleep (SWS) and improves memory and the immune-supportive hormonal milieu related to this sleep stage. While different attempts have been made to optimise the driving of the SOs by changing the number of click stimulations, no study has yet investigated the impact of applying more than five clicks in a row. Likewise, the importance of the type of sounds in eliciting brain responses is presently unclear. In a study of 12 healthy young participants (10 females; aged 18-26 years), we applied an established closed-loop stimulation method, which delivered sequences of 10 pink noises, 10 pure sounds (B note of 247 Hz), 10 pronounced "a" vowels, 10 sham, 10 variable sounds, and 10 "oddball" sounds on the up phase of the endogenous SOs. By analysing area under the curve, amplitude, and event related potentials, we explored whether the nature of the sound had a differential effect on driving SOs. We showed that every stimulus in a 10-click sequence, induces a SO response. Interestingly, all three types of sounds that we tested triggered SOs. However, pink noise elicited a more pronounced response compared to the other sounds, which was explained by a broader topographical recruitment of brain areas. Our data further suggest that varying the sounds may partially counteract habituation.
Topics: Female; Humans; Acoustic Stimulation; Electroencephalography; Sleep; Sleep, Slow-Wave; Sound
PubMed: 35762085
DOI: 10.1111/jsr.13676 -
Cureus Jun 2022Coronavirus disease 2019 (COVID-19) pneumonia is an infection of the lungs that causes severe inflammation in the lungs' alveoli. It causes alveoli to fill with fluid,...
Coronavirus disease 2019 (COVID-19) pneumonia is an infection of the lungs that causes severe inflammation in the lungs' alveoli. It causes alveoli to fill with fluid, blood clots, and sometimes even pus. Patients who are infected with COVID-19 pneumonia experience severe cough, shortness of breath, fever, fatigue, chest pain, night sweats, chills, loss of appetite, etc. During the initial phase of the COVID-19 pneumonia pandemic, it was thought that ivermectin might be helpful in patients infected with COVID-19 pneumonia, but this was later proven to be false due to its severe risks/side effects. Infectious Disease Society of America (IDSA) suggests against the use of ivermectin for COVID-19 pneumonia. However, some providers continue to use ivermectin as one of the treatments for patients infected with COVID-19 infection. In this case report, we will discuss ivermectin causing acute psychosis in healthy 45- and 51-year-old patients with no known history of any mental health illness.
PubMed: 35747110
DOI: 10.7759/cureus.26141 -
International Journal of Environmental... Jun 2022Online courses are prevalent around the world, especially during the COVID-19 pandemic. Long hours of highly demanding online learning can lead to mental fatigue and... (Randomized Controlled Trial)
Randomized Controlled Trial
Online courses are prevalent around the world, especially during the COVID-19 pandemic. Long hours of highly demanding online learning can lead to mental fatigue and cognitive depletion. According to Attention Restoration Theory, 'being away' or a mental shift could be an important strategy to allow a person to recover from the cognitive overload. The present study aimed to test the interleaving strategy as a mental shift method to help sustain students' online learning attention and to improve learning outcomes. A total of 81 seventh-grade Chinese students were randomly assigned to four learning conditions: blocked (by subject matter) micro-lectures with auditory textual information (B-A condition), blocked (by subject matter) micro-lectures with visual textual information (B-V condition), interleaved (by subject matter) micro-lectures with auditory textual information (I-A condition), and interleaved micro-lectures by both perceptual modality and subject matter (I-all condition). We collected self-reported data on subjective cognitive load (SCL) and attention level, EEG data during the 40 min of online learning, and test results to assess learning outcomes. The results showed that the I-all condition showed the best overall outcomes (best performance, low SCL, and high attention). This study suggests that interleaving by both subject matter and perceptual modality should be preferred in scheduling and planning online classes.
Topics: COVID-19; Cognition; Humans; Learning; Pandemics; Students
PubMed: 35742754
DOI: 10.3390/ijerph19127505 -
Journal of Speech, Language, and... Jun 2022Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive,...
PURPOSE
Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds).
METHOD
Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses (EFAs). Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds.
RESULTS
The VFS-Peds is appropriate for use with children aged 6-17 years and consists of child self-report (VFS-C), parent proxy-report (VFS-P), and teacher proxy-report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable measure of fatigue regardless of the child's gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity.
CONCLUSIONS
This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue, and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.19836154.
Topics: Adolescent; Auditory Perception; Child; Hearing Loss; Humans; Mental Fatigue; Parents; Proxy; Psychometrics; Reproducibility of Results; School Teachers; Surveys and Questionnaires
PubMed: 35623338
DOI: 10.1044/2022_JSLHR-22-00051 -
Frontiers in Surgery 2022Metastasis of ovarian carcinoma to the central nervous system occurs in <2% of cases and classically localizes within the brain parenchyma. Moreover, leptomeningeal...
Metastasis of ovarian carcinoma to the central nervous system occurs in <2% of cases and classically localizes within the brain parenchyma. Moreover, leptomeningeal spread of these tumors is an exceedingly rare phenomenon. Here, we conduct a systematic review of the current literature on the natural history, treatment options, and proposed pathogenic mechanisms of leptomeningeal carcinomatosis in ovarian carcinoma. We also report a case of a 67-year-old female with stage IV metastatic ovarian serous carcinoma initially confined to the peritoneal cavity with a stable disease burden over the course of three years. Follow-up imaging demonstrated an intracranial lesion, which was resected via craniotomy, and pathology was consistent with the original diagnosis. Three months after surgery, she developed rapidly progressive dizziness, generalized weakness, fatigue, and ataxia. Repeat MRI demonstrated interval development of extensive and diffusely enhancing dural nodularity, numerous avidly enhancing supratentorial and infratentorial lesions, enhancement of the bilateral trigeminal nerves, internal auditory canals, and exit wound from the surgical site into the posterior aspect of the right-sided neck musculature consistent with diffuse leptomeningeal dissemination. The present case highlights that leptomeningeal dissemination of ovarian carcinoma is a potential yet rare consequence following surgical resection of an ovarian parenchymal metastasis. Progressive clinical symptomatology that develops postoperatively in this patient population should prompt urgent workup to rule out leptomeningeal disease and an expedited radiation oncology consultation if identified.
PubMed: 35548192
DOI: 10.3389/fsurg.2022.850050 -
Frontiers in Cellular and Infection... 2022Entacapone, one of the most common drugs distributed among patients with Parkinson's disease, is a peripherally acting catechol-O-methyltransferase (COMT) inhibitor that...
BACKGROUND AND AIMS
Entacapone, one of the most common drugs distributed among patients with Parkinson's disease, is a peripherally acting catechol-O-methyltransferase (COMT) inhibitor that is used in addition to levodopa to control symptoms. However, there have been negative effects reported against entacapone, namely, gastrointestinal (GI) problems and drowsiness. In this pilot study, we aim to examine the hypothesis that the discomfort induced by entacapone might be originated from the shift of microbial composition by adjusting the effect of levodopa.
METHODS
The population in this pilot study consisted of 13 PD patients treated with levodopa only and 11 with both levodopa and entacapone. The 16S rRNA gene sequence data were processed, aligned, and categorized using the DADA2. Alpha diversity indices for Observed, Chao1, Shannon, and Simpson metrics were calculated with Phyloseq 1.32.0. Dissimilarities were calculated using unweighted unique fraction metrics (Unifrac), weighted Unifrac, and Canberra distance. Functional differences were calculated by PICRUSt2 based on the KEGG database.
RESULTS
Results of 16S rRNA sequencing analysis showed that while entacapone did not influence the species richness, the composition of the microbial community shifted considerably. Relative abundances of bacteria related to constipation and other GI disorders also altered significantly. Functional enrichment analysis revealed changes in the metabolic activity of alanine, aspartate, and glutamate. These amino acids are related to common side effects of entacapone such as auditory hallucinations, fatigue, and nightmare.
CONCLUSION
Our findings provide testable hypothesis on the cause of unpleasant side effects of entacapone, which in the long run could possibly be reduced through gut microbiota manipulation.
Topics: Adenosine Deaminase; Antiparkinson Agents; Catechol O-Methyltransferase; Catechol O-Methyltransferase Inhibitors; Catechols; Gastrointestinal Microbiome; Humans; Intercellular Signaling Peptides and Proteins; Levodopa; Nitriles; Parkinson Disease; Pilot Projects; RNA, Ribosomal, 16S
PubMed: 35463646
DOI: 10.3389/fcimb.2022.837019