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Byline: Abhishek. Bhoyar, Rohan. Mahale, Nitish. Kamble, Vikram. Holla, Pramod. Pal, Ravi. Yadav Introduction: Movement disorders can present in emergency services in an acute severe form which can be life [...]

Byline: Srikanth. Boini, Rohan. Mahale, Seshagiri. Donaparthi, Nitish. Kamble, Vikram. Holla, Pramod. Pal, Bindu. Kutty, Ravi. Yadav Background: Sleep disturbances have been reported to occur in progressive supranuclear palsy (PSP). [...]

Byline: Vaishali. Bagrodia, Vikram. Holla, Nitish. Kamble, Pramod. Pal, Ravi. Yadav Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder. In India, an accurate number of PD patients remains [...]

Byline: Koti. Neeraja, Bharath. Surisetti, Nisha. Mol, Shweta. Prasad, Vikram. Holla, Nitish. Kamble, Rohan. Mahale, Pramod. Pal, Ravi. Yadav Dear Editor, The COVID-19 pandemic has brought about unprecedented changes to [...]

BACKGROUND: Anti-glutamate decarboxylase 65 antibody-associated cerebellar ataxia (anti-GAD65Ab-associated CA) is the most widely studied immune-mediated CA. There are few case series evaluating the clinical, radiological, treatment profile, and outcome of anti-GAD65Ab-associated CA. OBJECTIVE: To study the clinical, radiological profile, associated neoplasm, treatment outcome, and prognosis in patients diagnosed with anti-GAD65Ab-associated CA. METHODS: A retrospective descriptive analysis of a cohort of patients diagnosed with anti-GAD65Abassociated CA was performed and analyzed. RESULTS: Thirteen patients were selected for the analysis with female predominance (70%). The mean age at presentation was 47.5 ± 11.1 years (range, 29-65 years), and the median duration of the symptoms was 4 months. All 13 patients (100%) had gait ataxia. Ten patients had limb ataxia along with gait ataxia (75%). Seven patients had cerebellar dysarthria (54%). Four patients (31%) had gazeevoked jerky nystagmus. Five patients (39%) were diagnosed with type 2 diabetes mellitus, and one patient had hypothyroidism in addition to type 2 diabetes mellitus. Brain magnetic resonance imaging was normal in seven (54%) patients, and pure cerebellar atrophy was observed in six patients. One patient was detected with a colon neoplasm. All 13 patients received intravenous methylprednisolone, followed by oral steroids over 3 months. Six patients (50%) received plasma exchange along with intravenous methylprednisolone. Favorable outcomes (modified Rankin scale score =2) were observed in five patients and poor outcomes in two; six patients were lost to follow-up after the first admission. CONCLUSION: Anti-GAD65Ab-associated CA presents as subacute to chronic progressive CA with a favorable outcome with immunotherapy. Anti-GAD antibodies should be assessed in serum or cerebrospinal fluid in patients presenting subacute to chronic sporadic CA. The occurrence of a systemic neoplasm is rare in anti-GAD65Ab-associated CA. [ABSTRACT FROM AUTHOR]

Byline: Vidya. Menon, Shantala. Hegde, P. Pratyusha, Nitish. Kamble, Ravi. Yadav, Amitabh. Bhattacharya, Pramod. Pal Background: Parkinson's disease (PD) is characterized by bradykinesia, tremor, rigidity, postural instability and cognitive deficits [...]

Background:Dementia with Lewy body is a neurodegenerative disorder and is the second most common cause of dementia after Alzheimer's disease. We aimed to study the demographic, clinical, neuropsychological, and imaging characteristics of these patients. Methods: The current study is a retrospective chart review of 37 patients who met the diagnostic criteria of probable dementia with Lewy body. The relevant demographic data and clinical details including detailed history, examination, clinical scales (unified Parkinson's disease rating scale scores in OFF and ON states), mini mental status examination scores, and neuropsychological and imaging findings were retrieved from the medical records. Results: There were 33 men in the study. The mean age was 67.08 ± 9.27 years, mean age of disease onset was 63.76 ± 8.67 years, and mean duration of illness was 3.32 ± 2.2 years. In most of the patients, rapid eye movement sleep behavior disorder preceded the illness by 5.5 ± 6.88 years. The patients had good response to levodopa with significant improvement in the unified Parkinson's disease rating scale part III score (P = 0.0018). The mean mini mental status examination score was 16.97 ± 5.96. Brain magnetic resonance imaging showed diffuse cerebral atrophy (42.4%) as the most common finding. Fluorodeoxyglucose-positron emission tomography (n = 8) showed hypometabolism in the occipital lobes with sparing of the posterior cingulate gyrus. Neuropsychological assessment showed impairment in mental speed, focused and sustained attention, verbal fluency, working memory, planning, set shifting, response inhibition, verbal learning and memory, and visuospatial construction. Conclusions: There was early cognitive impairment with multiple domains affected. In most of the patients, brain magnetic resonance imaging showed atrophy and occipital lobe hypometabolism on fluorodeoxyglucose-positron emission tomography. [ABSTRACT FROM AUTHOR]

Byline: Shweta. Prasad, Vikram. Holla, Koti. Neeraja, Bharath. Surisetti, Nitish. Kamble, Ravi. Yadav, Pramod. Pal Background: The COVID-19 pandemic has compelled countries to impose lockdowns to curb the spread. As [...]

Owing to the presence of multiple enzymatic domains, LRRK2 has been associated with a diverse set of cellular functions and signaling pathways. It also has several pathological mutant-variants, and their incidences show ethnicity biases and drug-response differences with expression in dopaminergic-neurons and astrocytes. Here, we aimed to assess the cell-intrinsic effect of the LRRK2-I1371V mutant variant, prevalent in East Asian populations, on astrocyte yield and biology, involving Nrf2-mediated glutathione machinery, glutamate uptake and metabolism, and ATP generation in astrocytes derived from LRRK2-I1371V PD patient iPSCs and independently confirmed in LRRK2-I1371V-overexpressed U87 cells. Astrocyte yield (GFAP-immunopositive) was comparable between LRRK2-I1371V and healthy control (HC) populations; however, the astrocytic capability to mitigate oxidative stress in terms of glutathione content was significantly reduced in the mutant astrocytes, along with a reduction in the gene expression of the enzymes involved in glutathione machinery and nuclear factor erythroid 2-related factor 2 (Nrf2) expression. Simultaneously, a significant decrease in glutamate uptake was observed in LRRK2-I1371V astrocytes, with lower gene expression of glutamate transporters SLC1A2 and SLC1A3. The reduction in the protein expression of SLC1A2 was also directly confirmed. Enzymes catalyzing the generation of γ glutamyl cysteine (precursor of glutathione) from glutamate and the metabolism of glutamate to enter the Krebs cycle (α-ketoglutaric acid) were impaired, with significantly lower ATP generation in LRRK2-I1371V astrocytes. De novo glutamine synthesis via the conversion of glutamate to glutamine was also affected, indicating glutamate metabolism disorder. Our data demonstrate for the first time that the mutation in the LRRK2-I1371V allele causes significant astrocytic dysfunction with respect to Nrf2-mediated antioxidant machinery, AT -generation, and glutamate metabolism, even with comparable astrocyte yields. [ABSTRACT FROM AUTHOR]