Annals of Clinical and Experimental Neurology

Introduction. Functional tremor (FT) is the most common phenotype of functional movement disorders. Electrophysiological assessment is included in the diagnostic criteria for tremor; however, there is currently no consensus criteria for the differential diagnosis of FT.

The objective of this study was to evaluate the utility of tremor frequency characteristics derived from accelerometry for the differential diagnosis between FT and organic tremor (OT).

Materials and methods. Nineteen patients with FT, 20 patients with essential tremor, and 20 patients with Parkinson's disease were enrolled in the study and underwent electrophysiological examination with a two-channel accelerometer and subsequent data processing.

Results. The study results revealed the differences in the frequency peak widths in patients with FT and OT, predominantly while performing a cognitive load task. This criterion showed a high sensitivity (100%) and a high specificity (97.5%) for the diagnosis of FT in the study population.

Conclusion. Tremor characteristics recorded during accelerometry combined with cognitive load task can serve as an additional testing aid for differential diagnosis between functional and organic tremor.

Introduction. Frailty and mild cognitive impairment (MCI) are common geriatric syndromes. Peripheral serum cholinesterase (pChE) is a laboratory indicator that may reflect dysfunction of cholinergic processes in the central nervous system. Published data demonstrate the potential utility of pChE as a marker for a range of neurodegenerative disorders.

Aim. This study aimed to identify and investigate the relationship between serum pChE levels in patients and various screening scores of cognitive status, frailty, and metabolic parameters.

Materials and methods. The study included 50 women aged over 60 years. Screening clinical examinations were conducted, including Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Age Is Not a Hindrance questionnaire, and Charlson Comorbidity Index. A blood chemistry analysis was performed, including a kinetic colorimetric assay of serum pChE.

Results. The Age Is Not a Hindrance score and pChE activity exhibited a moderate inverse correlation with a Spearman coefficient (rS) of –0.31; 95% confidence interval (CI) –0.5 to –0.03; p < 0.05. The MoCA scores and pChE levels also showed a moderate inverse correlation with rS of –0.32; 95% CI: –0.55 to –0.05, p < 0.05. A high risk of MCI is defined by a pChE activity threshold point of 9978 U/L, with a sensitivity of 47% and a specificity of 97%. The association between pChE activity and the prevalence of cognitive impairment remained significant even when different socio-demographic and metabolic parameters were included in the regression model, odds ratio (OR) 1.0005; 95% CI: 1.0001–1.009; p = 0.01).

Conclusion. Women over 60 years of age in an outpatient setting exhibited an inverse correlation between the Age Is Not a Hindrance questionnaire score and the pChE activity. A pChE activity of 9978 U/L or higher was associated with an elevated risk of concomitant mild cognitive impairment. However, it is important to consider the high probability of false negatives in this context. This association persisted across a variety of clinical and metabolic factors.

Introduction. With the number of patients with Parkinson's disease steadily growing, the need for novel treatment approaches is increasing. Combining transplantation of neuronal progenitors derived from induced pluripotent stem cells and transcranial direct current stimulation (tDCS) is among the promising methods.

Aim: to examine the effect of tDCS on the cell graft condition and motor symptoms of Parkinson's syndrome in rats.

Materials and methods. Parkinson's syndrome was modeled in Wistar rats by the unilateral intranigral injection of 6-hydroxydopamine (6-OHDA; 12 μg in 3 μL) The model rats underwent neurotransplantation (3 × 105 cells in 10 μL) into the caudate nuclei on the affected side. The animals underwent tDCS for 14 days. Behavioral changes were analyzed by open field and beam-walking tests. Development and morphological characteristics of the graft were assessed by the morphochemical study.

Results. Neurotransplantation had no significant effect on the behavior of rats with parkinsonism; however, combined with tDCS, it increased motor activity during the open field tests compared with the group of model rats (р = 0.0014) and mitigated their anxiety-related behaviors (р = 0.048) in tests at 3 weeks after the transplantation. These effects were not observed in tests at 3 months. The morphochemical study revealed larger graft sizes in the animals that underwent tDCS compared with the controls and cell shift to the marginal zone of the graft. Stimulation was also shown to induce division of a part of cells at early stages of differentiation and promote active synaptogenesis.

Conclusion. Combining neurotransplantation and tDCS in the 6-OHDA-induced model of parkinsonism demonstrated its potential to manage both motor and non-motor symptoms. Optimizing protocols of transplantation and tDCS and evaluating their long-term efficacy and safety are required to successfully implement this method into clinical practice.

Objective. This narrative review aimed to explore the multifaceted nature of ischemic stroke (IS) and its underlying genetic factors, emphasize the role of genetics in early detection and prevention, and acknowledge the complex influences on stroke prevalence across various countries.

Methods. An extensive overview of the causes, mechanisms, and genetics of IS was conducted by reviewing several studies and recent findings. The role of specific genes in monogenic stroke disorders, implications of polygenic influences, recent advances in genetic evaluation, and methods for early IS detection were synthesized and discussed.

Results. IS was influenced by genetics, underlying medical conditions, and lifestyle. Specific genes, including NOTCH3, HTRA1, COL3A1, and mtDNA, are involved in monogenic stroke syndromes and predominantly affect younger populations. Polygenic disorders, studied using genome-wide association study and sequencing techniques, play a prominent role in susceptibility to IS. Genetic evaluation has become instrumental in risk prediction, influencing clinical practices and potential therapeutic interventions. Early detection methods, such as enhanced imaging techniques and blood biomarkers, are crucial for managing IS outcomes.

Conclusion. Ischemic stroke is a complex disorder with a significant global impact. Understanding its genetic basis promises to improve early detection and effectively establish preventative measures. Although genetic evaluation and innovative detection techniques offer promise, focusing on lifestyle modifications and managing underlying health conditions remains paramount for reducing the incidence and severity of IS. Continuous research and technological advancements are essential for developing personalized medical approaches and improving global healthcare strategies.

Disability due to Parkinson’s disease (PD) is increasing faster than for any other neurodegenerative disorder. A multidisciplinary approach to rehabilitation of patients with PD is recommended including various types of physical training. Because of its general beneficial effect, aerobic endurance training is necessary for all people to maintain their health. Aerobic exercise in PD is also used for rehabilitation of motor and non-motor symptoms. This article justifies the choice of aerobic exercise intensity, shows challenges in selecting intensity based on maximum oxygen consumption due to the influence of clinical and behavioral factors, difficulties in assessing the effectiveness of therapy due to the wide range of training intensity and amount in the studies. The article summarizes types of exercises used in rehabilitation of patients with PD (walking, Nordic walking, training with a bicycle ergometer and treadmill, aquatic exercises) and their benefits for patients with different courses of the disease. For patients with freezing of gait, bicycle ergometer is a piece of equipment of choice for aerobic stationary training, and Nordic walking is a preferred type of outdoor training. The author shows the role of aerobic training in the treatment of non-motor symptoms such as depression, cognitive changes, and sleep disorders. A question about the use of aerobic training in patients with Hoehn–Yahr grade 4–5 of PD remains open. Further studies are needed to evaluate training protocols, assess rehabilitation effectiveness and evaluate physical training in the advanced PD.

Transcranial magnetic stimulation (TMS) is a non-invasive method for targeted modulation of the electrical activity of brain neurons with a magnetic field. Although TMS efficacy was demonstrated in the treatment of several neurological and mental disorders, changes in nervous tissue at the cellular and molecular levels with different duration and intensity of stimulation have been relatively understudied by cellular neurobiology methods. Aim. The aim of this review was to evaluate and summarize new experimental data on the fundamental mechanisms underlying the action of TMS and its potential in modulating structural and functional changes in nervous tissue. This article summarizes recent data on the effects of different TMS protocols on the mechanisms underlying synaptic plasticity, neurogenesis, and neuronal differentiation. Separate sections summarize the neuroprotective effects of this method and glial microenvironment response. Studies to investigate the mechanisms of TMS will contribute to the development of more effective and reliable treatment protocols.

A syndrome of mild encephalopathy with reversible splenial lesion (MERS) was described in a post-COVID-19 male patient. The clinical manifestations included neuropsychiatric and visual abnormalities; when focusing separately on an object (one eye closed), the left eye perceived it as normal, but the right eye perceived it as multiple images moving diagonally into the distance. T2, FLAIR, and ADC magnetic resonance imaging (MRI) showed a splenial lesion that resolved rapidly without using corticosteroids. The patient was diagnosed with cerebral polyopia because he saw images arranged in ordered rows after focusing on an object. Differential diagnoses included astigmatism, palinopsia, and polyopic visual hallucinations. Monocular polyopia is explained by anomia associated with the patient's partial split-brain syndrome (the splenial lesion, neuropsychiatric abnormalities); involvement of the pathways from the frontal eye fields to the brainstem structures responsible for initiating extraocular eye movements. The association of neurological complications with prior COVID-19, rapid resolution of symptoms, and MRI lesions without initiating immunosuppressive therapy suggested endotheliopathy as the cause of COVID-19 complications.