Search

Introduction Neurological sequelae following SARS-CoV-2 infection still represent a serious concern both for neurologists and neuroscientists. In our paper, we investigated pain, myalgia, and fatigue as symptoms in long-COVID patients with an electrophysiological approach, comprising the evaluation of sympathetic skin responses (SSRs) and quantitative electromyography (qEMG). Materials and methods Twelve patients were enrolled (mean age, 47.7 ± 11.6 years), referred to our attention because of myalgia, pain, or muscle cramps, which persisted about 6 months after the diagnosis of SARS-CoV-2 infection. They underwent conventional electroneurography (ENG), needle electromyography (EMG), and SSRs; moreover, qEMG was performed by sampling at least 20 motor unit potentials (20–30 MUPs) during weak voluntary contraction in deltoid and tibialis anterior muscles. The mean duration, amplitude, and percentage of polyphasic potentials were assessed and compared with healthy and age-matched volunteers. Results ENG did not disclose significant changes compared to healthy subjects; needle EMG did not reveal denervation activity. In addition, qEMG showed MUPs similar to those recorded in healthy volunteers in terms of polyphasia (deltoid: p = 0.24; TA: p = 0.35), MUP area (deltoid: p = 0.45; TA: p = 0.44), mean duration (deltoid: p = 0.06; TA: p = 0.45), and amplitude (deltoid: p = 0.27; TA: p = 0.63). SSRs were not recordable from lower limbs in seven patients (58%) and from the upper ones in three of them (25%). Conclusion Our data suggest an involvement of the autonomic system, with a focus on cholinergic efferent sympathetic activity, without any evidence of myopathic changes.

We study nested variational inequalities, which are variational inequalities whose feasible set is the solution set of another variational inequality. We present a projected averaging Tikhonov algorithm requiring the weakest conditions in the literature to guarantee the convergence to solutions of the nested variational inequality. Specifically, we only need monotonicity of the upper- and the lower-level variational inequalities. Also, we provide the first complexity analysis for nested variational inequalities considering optimality of both the upper- and lower-level.

Movement disorders as well as peripheral neuropathies are extremely frequent in the general population; therefore, it is not uncommon to encounter patients with both these conditions. Often, the coexistence is coincidental, due to the high incidence of common causes of peripheral neuropathy, such as diabetes and other age-related disorders, as well as of Parkinson disease (PD), which has a typical late onset. Nonetheless, there is broad evidence that PD patients may commonly develop a sensory and/or autonomic polyneuropathy, triggered by intrinsic and/or extrinsic mechanisms. Similarly, some peripheral neuropathies may develop some movement disorders in the long run, such as tremor, and rarely dystonia and myoclonus, suggesting that central mechanisms may ensue in the pathogenesis of these diseases. Although rare, several acquired or hereditary causes may be responsible for the combination of movement and peripheral nerve disorders as a unique entity, some of which are potentially treatable, including paraneoplastic, autoimmune and nutritional aetiologies. Finally, genetic causes should be pursued in case of positive family history, young onset or multisystemic involvement, and examined for neuroacanthocytosis, spinocerebellar ataxias, mitochondrial disorders and less common causes of adult-onset cerebellar ataxias and spastic paraparesis. Deep phenotyping in terms of neurological and general examination, as well as laboratory tests, neuroimaging, neurophysiology, and next-generation genetic analysis, may guide the clinician toward the correct diagnosis and management.

Introduction Clinical neurophysiology deals with nervous system functions assessed with electrophysiological and ultrasound-based imaging techniques. Even though the need for highly specialized neurophysiologists has increased, residency training rarely takes today’s requirements into account. This study aimed to snapshot the neurophysiological training provided by Italian specialization schools in neurology. Methods A single-page web-based survey comprising 13 multiple-choice categorical and interval scale questions was sent via e-mail to neurology specialization school directors. The survey addressed the programs’ structural neurophysiology organization, time dedicated to each clinical neurophysiology subspecialty, and descriptors assessing the discipline’s importance (e.g., residents who attempted residential courses, gained certifications, or awards gained). Results The most studied neurophysiological techniques were electroencephalography (EEG) and electromyography (EMG). Most specialization schools devoted less than 3 months each to multimodal evoked potentials (EPs), ultrasound sonography (US), and intra-operative monitoring. Of the 35 specialization schools surveyed, 77.1% reported that four students, or fewer, participated in the Italian Society of Clinical Neurophysiology Examination in Neurophysiology. Of the 35 specialization centers surveyed, 11.4% declared that the final evaluation required students to discuss a neurophysiological test. Discussion Our survey underlined the poorly standardized technical requirements in postgraduate neurology specialization schools, wide variability among training programs, and limited training on multi-modal evoked potentials, intraoperative monitoring, and sonography. These findings underline the need to reappraise and improve educational and training standards for clinical neurophysiology during postgraduate specialization schools in neurology with an international perspective.

Introduction Neurological complications of SARS-CoV-2 disease have received growing attention, but only few studies have described to date clinical and neurophysiological findings in COVID patients during their stay in intensive care units (ICUs). Here, we neurophysiologically assessed the presence of either critical illness neuropathy (CIP) or myopathy (CIM) in ICU patients. Materials and Methods Patients underwent a neurophysiological assessment, including bilateral examination of the median, ulnar, deep peroneal and tibial motor nerves and of the median, ulnar, radial and sural sensory nerves. Needle electromyography (EMG) was performed for both distal and proximal muscles of the lower and upper limbs. In order to differentiate CIP from CIM, Direct Muscle Stimulation (DMS) was applied either to the deltoid or tibialis anterior muscles. Peak to peak amplitudes and onset latencies of the responses evoked by DMS (DMSamp, DMSlat) or by motor nerve stimulation (MNSamp, MNSlat) were compared. The ratio MNSamp to DMSamp (NMR) and the MNSlat to DMSlat difference (NMD: MNSlat − DMSlat) were also evaluated. Results Nerve conduction studies showed a sensory-motor polyneuropathy with axonal neurogenic pattern, as confirmed by needle EMG. Both MNSamp and NMR were significantly reduced when compared to controls (p

To assess the relationship between resilience and several diseases and individual features in primary Sjӧgren's Syndrome (SS) patients. Resilience was assessed using the Resilience Scale (RS-14). Disease activity, damage, and reported symptoms were assessed by means of ESSDAI (EULAR Sjogren's syndrome disease activity index), SSDDI (Sjӧgren's Syndrome Disease Damage Index) and ESSPRI (EULAR Sjӧgren's Syndrome Patient Reported Index). EuroQol, HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assessment Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue), and IPAQ (International Physical Activity Questionnaire) questionnaires were submitted to evaluate physical and mental well-being of the recruited patients. Data about the autoimmune profile, systemic manifestations, and current therapy were collected. Educational qualifications and work activities were also considered. Descriptive, correlational, and linear regression analysis were performed. 74 consecutive women with primary SS and 74 sex and age-matched healthy subjects as a control group were recruited. SS patients displayed a moderate value of resilience (median 78.5) with no significant difference compared to controls (p = 0.38). An inverse relationship was found between resilience and mood disorders such as anxiety (p = 0.038) and depression (p

Introduction SARS-CoV-2 might spread through the nervous system, reaching respiratory centers in the brainstem. Because we recently reported neurophysiological brainstem reflex abnormalities in COVID-19 patients, we here neuropathologically assessed structural brainstem damage in two COVID-19 patients. Materials and methods We assessed neuropathological features in two patients who died of COVID-19 and in two COVID-19 negative patients as controls. Neuronal damage and corpora amylacea (CA) numbers /mm2 were histopathologically assessed. Other features studied were the immunohistochemical expression of the SARS-CoV-2 nucleoprotein (NP) and the Iba-1 antigen for glial activation. Results Autopsies showed normal gross brainstem anatomy. Histopathological examination demonstrated increased neuronal and CA damage in Covid-19 patients’ medulla oblongata. Immunohistochemistry disclosed SARS-CoV-2 NP in brainstem neurons and glial cells, and in cranial nerves. Glial elements also exhibited a widespread increase in Iba-1 expression. Sars-Co-V2 was immunohistochemically detected in the vagus nerve fibers. Discussion Neuropathologic evidence showing SARS-CoV-2 in the brainstem and medullary damage in the area of respiratory centers strongly suggests that the pathophysiology of COVID-19-related respiratory failure includes a neurogenic component. Sars-Co-V2 detection in the vagus nerve, argues for viral trafficking between brainstem and lung.

Aim of the present study was to evaluate the relationship between sensory sensitivity and autistic eating behaviours or Eating Disorders (EDs) symptomatology, in a group of 75 adults with Autism Spectrum Disorders (ASDs) without intellectual disabilities, through a series of self-report questionnaires. We found that, controlling for demographic and clinical features: (i) hypersensitivity in the vision domain predicted higher levels of both EDs symptoms and autistic eating behaviours; (ii) hyposensitivity in the taste domain predicted higher levels of EDs symptoms. This gives preliminary evidence that not only in children diagnosed with ASDs, but even in adult individuals, the threshold of sensory sensitivity is associated with dysfunctional eating behaviours.

Vegetable oils present great economic importance as they can be used and marketed by different industries based on their properties. Currently, several techniques can be employed to extract oils from seeds. However, novel techniques are not easily applicable in any environment. Thus, this study aimed to evaluate the efficiency of simple techniques; Bligh and Dyer, Soxhlet, and acid hydrolysis, in extracting oil from canola, flaxseed, soybean, and sunflower seeds. The sum of fatty acids found in extracted oils indicated Bligh and Dyer as the most efficient method among those assessed. Furthermore, the lower content of polyunsaturated fatty acids quantified in oils obtained by Soxhlet or acid hydrolysis may result from oxidation triggered using high temperatures required by both methods. Different lipid extraction methodologies were compared for the determination of fatty acid content in seeds.

Purpose It has been widely shown that dissociative features might play a fundamental role in producing body image distortions in patients affected by eating disorders. Here, we hypothesize that the Mirror Gazing Test (MGT), a task consisting in mirror exposure in a condition of sensory deprivation, would elicit dissociative symptoms in a group of patients with anorexia nervosa (AN). Methods Fourteen patients with AN and fourteen healthy controls (HC) underwent a 10 min MGT and completed the Strange Face Questionnaire and a short version of the Clinician-Administered Dissociative States Scale, along with a psychological assessment for eating disorders psychopathology, anxiety and depression. Results AN patients reported a higher number of strange-face apparitions and dissociative sensations than HC during the MGT. Dissociative identity (compartmentalization of two or more identities) and depersonalization (detachment of bodily-self) were much higher in patients with AN than in HC. These findings were correlated with body dissatisfaction and disruption in interoceptive awareness. Conclusion Dissociation and body image dysfunction are strongly connected in the pathophysiology of anorexia nervosa. Future research should investigate the same aspects in other psychiatric conditions characterized by body image distortions, such as Body Dysmorphic Disorder. Level of evidence I, Experimental studies.

International audience; In this paper, we investigated the age distribution and dynamics of polyps in the slow-growing and long-lived gorgonian Corallium rubrum (the Mediterranean red coral), applying an a posteriori demographic approach by considering each colony as a population of polyps. In the Mediterranean red coral, new polyps emerge from the coenenchyme in different regions of the colony and their budding rate depends on the age of branches. The age of polyps, branches and colonies were estimated using the organic-matter-staining dating method on thin sections of the colony skeleton. The median age and maximum life span of polyps were 4 and 12 years suggesting the presence of senescence processes: thus a colony renews several times its polyps during life cycle. Polyps were divided into annual age classes, and their mortality rates calculated. The polyp age distribution was then used to construct a mortality table and an algebraic transition matrix based on the age at death of 234 polyps. Finally, the polyp budding rate of a young, unbranched colony was calculated, and polyp temporal dynamics simulated. These findings represent the first steps for developing demographic models able to describe polyp dynamics of old and highly branched colonies.

Compare canal transportation and dentin removal using micro computed tomography (micro-CT) and measure instrumentation time in the root canal preparation of primary molars using K-files, ProDesign Logic and Reciproc files. A representative sample of 81 root canals of primary molars was randomised into three groups: K-files (#15-40), ProDesign Logic (#25) and Reciproc (R25). A single-trained operator prepared all root canals. A standardised micro-CT evaluation was performed before and after instrumentation using the CTan® program. Instrumentation time was also recorded. Statistical analysis involved one-way ANOVA, Tukey’s post hoc test, Kruskal–Wallis test and Dunn’s test, considering a 5% level of significance. Reciproc led to more canal transportation than K-files and ProDesign Logic (p

The diagnostic workflow of patients with cognitive decline needs an extensive clinical evaluation. The use of FDG-PET can be helpful because the finding of a rather specific pattern of hypometabolism could point to specific neurodegenerative disorders. In patients with memory impairment and visuo-spatial deficits, FDG-PET may reveal a pattern of temporo-parietal hypometabolism that is associated with Alzheimer’s disease or a more extended area of hypometabolism that spreads to the occipital cortex, as in posterior cortical atrophy indicating signs of neurodegeneration in the associative visual cortex. In the spectrum of fronto-temporal lobe degeneration, FDG-PET is used to support the diagnosis by excluding AD and to identify areas of hypometabolism that are associated with the behavioural variant of FTD or with progressive primary aphasia. When cognitive impairment develops along with parkinsonism, FDG-PET can be used to differentiate among the different forms of disorders, such as dementia with Lewy bodies, progressive supranuclear palsy and cortico-basal degeneration, occurring with different specific pattern of altered metabolism. In this pictorial essay, we present a series of clinical cases in which the use of FDG-PET contributed to the final diagnosis.

In this work, we investigated the activity of Keggin heteropolyacid catalysts (i.e., H3PW12O40, H3PMo12O40 and H4SiW12O40) in β-pinene reactions with alkyl alcohols (i.e. methyl, ethyl, propyl, sec-propyl, butyl and sec-butyl alcohols), and exploring the different aspects that drive the selectivity of this process. We have found that carbon skeletal rearrangements and isomerization providing intermediate carbocations that controlling the reaction selectivity. β-pinene was preferentially converted to α-terpinyl ion which undergoes a nucleophilic attack of alcohol providing alkyl alcohol. Bornyl ion was converted to bornyl and fenchyl ethers. The other secondary products were β-pinene isomers obtained from bornyl and α-terpinyl carbocations. Phosphotungstic acid (i.e., H3PW12O40) was the most active catalyst and selective toward the main product (α-terpinyl alkyl ether); the highest conversion (ca. 96%) and ether selectivity (ca. 61%) was achieved in the reactions with β-pinene. Although having also been alkoxylate, α-pinene was less reactive (ca. 40%), while camphene and limonene remained unreactive under reaction conditions studied. An increase of temperature resulted in an improvement on conversion of β-pinene and selectivity toward α-terpinyl methyl ether. Similarly, the H3PW12O40 concentration played a crucial role on reaction selectivity. This work presents positive features such as a short reaction time, high atom economy, mild reaction conditions (i.e., low temperature and room pressure). Even though soluble the catalyst was easily recovered by liquid -liquid extraction and efficiently reused.

Brain stimulation techniques, such as transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS) are used to treat psychiatric and neurological diseases. It elicits physical, cognitive, and mood benefits by promoting neuroplasticity. However, at the same time, several studies showed that these techniques could also alter moral judgment and social behaviour, leading to aggressive and prosocial behaviour; thus, there arises an ethical consideration about their effects and usability. Morality has been debated over centuries as the social behaviour regulator in our society. It is required for cognitive executive functions, problem solving, consequence anticipation, conflict management, and emotional evaluation. From an anatomical point of view, in addition to its philosophical and psychological complexity, we know that morality involves different brain areas and neural circuits both cortical and subcortical. In this mini-review, we report a number of recent results related to the use of brain stimulation techniques for modulating moral and social behaviour in human beings.