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Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which the brain can remodel the dysfunction consequent to a lesion. Ischemic brain lesions are the most frequent brain lesions often associated with visual function disability. Experimental and clinical studies established that visual function disability can impede the neurorehabilitation therapy efficiency. Neuro-optometric therapy has been proved to significantly improve the patient outcome after brain lesions. The pathophysiological mechanisms underlying this process are yet to be deciphered. Current knowledge regarding the pathophysiological mechanisms involved in ischemic lesions and neuroplasticity as a reparation process offers real support to a more efficient neurorehabilitation therapy that can contribute to the improvement of life quality in stroke patients. Keywords: neuroplasticity, neuro-optometric rehabilitation, ischemic stroke

Introduction. SARS-COV 2 infection causes damage of the peripheral nervous system: loss of smell loss of taste and demyelination or axonal injury in the spinal roots and motor and sensory nerves with acute polyradiculoneuritis. As many people are affected by COVID-19, the number of patients with secondary peripheral nervous system damage is increasing. Material and method. There are a significant number of Guillain Barre syndrome (GBS) cases reported in COVID-19 positive patients, leading to the recognition of GBS as one of the peripheral nervous system complications of SARS-COV 2 infection. We are trying to summarise the particularities of specific rehabilitation in post-COVID patients. Results and discussions. The rehabilitation of a COVID patients has particularities, first – because of infectious risk carried by the patient during the procedures, second by the patient’s pulmonary and physical impairments induced by the Coronavirus. Conclusions. There is scarce evidence for rehabilitation interventions, and many recommendations are based on methods developed in other viral infections or chronic pulmonary and neurologic conditions. There is a urgent need for studies regarding the efficacy of interventions in COVID rehabilitation, as the number of patients is constantly increasing. Keywords: therapeutic plasma exchange, plasmapheresis, neuroimmune disorders,rehabilitation

The neurological diagnosis, can be, in some situations, a challenging one. Clinical presentation for neurological disease, which has no imagistic diagnosis criteria, can develop during several month or years. Therefore, the first evaluation of the patient with neurological symptoms is not always conclusive. Pallidopyramidal syndrome and hereditary spastic paraplegia (HSP) can present common features and diagnostic approach has to be careful. genetic assessment is the gold diagnosis method in some cases. Therapeutic strategies, following a correct diagnosis has to be addressed to improvement the patient's quality of life by rehabilitation methods and medication targeting the pathophysiological processes involvement. The aim of this paper is to discuss the clinical evolution and the diagnosis strategies in hereditary spastic paraplegia.

Disability as a stroke consequence is reported by 3% males and 2% females in general population. Motor deficits are common in stroke patients, but their complete recovery is seen only in a minority of cases. Assessment of motor deficits uses clinical methods, especially standardized scales, but also electrophysiological and imagistic methods. The motor recovery is a continuous process, maximal in the first month after stroke, decreasing gradually over the first 6 months. Most powerful predictors for motor recovery are clinical parameters: severity of motor deficit, onset of first voluntary movements after stroke in the first 48-72 hours, a continuous improvement in motor function during the first 8 weeks, a good postural control during the first month, young age, male sex, left hemispheric stroke and absence of other neurological impairments are strong positive predictors. Presence of motor-evoked potentials in paretic muscles and imagistic parameters as location, stroke volume and motor pathways integrity are paraclinical predictors for recovery. There are no specific biomarker which is efficient in predicting recovery. In patients with poor chances for recovery according to actual predictors, the development of more precise algorithms to assess functional outcome is needed, in order to support the choice of appropriate methods and intensity of rehabilitation treatment. Key words: ischemic stroke rehabilitation, functional assessment, motor improvement, recovery predictors, prognostic factors

Hemorrhagic strokes (ICH) affects mainly young active people, with increasing incidence in developing countries. Mortality is high in acute phase, and patients are prone to complications related to stroke itself and to coexisting medical conditions. Patients with ICH are at high risk in developing deep venous thrombosis (DVT) with secondary pulmonary embolism (PE). Prevention of venous thrombotic events in hemorrhagic stroke patients requires intermittent pneumatic compression and preventive doses of low molecular weight heparins (LMWH) in high-risk patients. If DVT and /or PE occurs, the therapeutic management should balance the risk of recurrent cerebral bleeding and the life-threatening risk of PE, making the decision to start anticoagulation challenging. We present a case of a young patient with a large hypertensive capsulo-lenticular hemorrhage, who was diagnosed with pulmonary embolism 21 days after stroke onset. The decision was for anticoagulant treatment initial with LWMH, and switch to direct oral anticoagulants (DOAC) after 10 days; strict control of vascular risk factors of the patients (hypertension, diabetes and obesity) was achieved. Rehabilitation treatment, delayed until day 21, was recommended with progressive intensity. Evolution of the patient was favorable, with complete hematoma resorbtion under DOAC treatment at 10 weeks follow-up and important motor recovery. Rehabilitation program was intensive during this interval, and strongly contributive to neurologic improvement.

Background: The continue efforts for long term reducing of intraocular pressure (IOP) in patients with open angle glaucoma, focused the attention on those patients who received different therapies, other that topical drugs for IOP reduction, that can influence this parameter.. The aim of this study was to evaluate the IOP, total oxidative stress and anti-oxidant capacity of plasma before and after nicergoline therapy in patients with ischemic stroke and associated open angle glaucoma. Material and method: a group of 35 patients with ischemic stroke and chronic open angle glaucoma (under topical beta-blockers therapy) was studied regarding the values of IOP, total oxidative stress (TOS) and total antioxidant capacity (TAC) before (T1) and after 6 month (T2) of nicergoline therapy. Results: IOP values for both eyes were significantly reduced when the values of T1 examination were compared with those of T2 assessment. The total oxidative stress parameter was also significantly reduced after nicergoline therapy together with increasing of total antioxidant capacity of plasma. Conclusions: besides its positive effects on neuronal metabolism for ischemic stroke patients, nicergoline is able to influence the IOP in patients with open angle glaucoma and to improve the plasmatic oxidative stress/antioxidant balance. By this mechanism nicergoiline can contribute to a neuroprotection and better visual function preservation for these patients, improving their chances to neuro-motor rehabilitation and their quality of life.

BACKGROUND Curcumin is an antioxidant that reduces inflammation and pain. This study aimed to assess the effect of pretreatment with naproxen and liposomal curcumin compared with naproxen and curcumin solution on oxidative stress parameters and pain in a rat model of migraine. MATERIAL AND METHODS Sixty-three male Wistar rats included a control group (n=9) and a rat model of migraine (n=54) induced by intraperitoneal injection of nitroglycerin (1 mg/0.1 kg). The rat model group was divided into an untreated control group (n=9), a group pretreated with naproxen alone (2.8 mg/kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with curcumin solution (1 mg/0.1 kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with curcumin solution (2 mg/0.1 kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with liposomal curcumin solution (1 mg/0.1 kg) (n=9) a group pretreated with naproxen (2.8 mg/kg) combined with liposomal curcumin solution (2 mg/0.1 kg) (n=9). Spectroscopy measured biomarkers of total oxidative status and nociception was tested using an injection of 1% of formalin into the rat paw. RESULTS Expression of biomarkers of oxidative stress and enhanced nociception were significantly increased following pretreatment with combined naproxen and liposomal curcumin compared with curcumin solution or naproxen alone (P

Introduction & objectives: Starting from the well-known functional hemispheric asymmetry and concomitantly, from the clinical findings of practitioners involved in the post-stroke rehabilitation process, the aim of this study was to evaluate whether ischemic stroke in the dominant hemisphere results in more severe initial motor deficit and if its motor recovery is decreased compared to that of the non-dominant hemisphere. Material and method: This was a retrospective study, comprising 39 patients with ischemic stroke in the middle cerebral artery territory, divided into two groups depending on the hemispheric location of the lesion (left/right). They were evaluated for their segmental muscle strength using the Medical Research Council Muscle Strength Grading Scale, both in terms of initial value and evolution between two successive admissions. Results and conclusions: No significant difference was found for motor deficit evaluated on the occasion of the first admission between patients with left-side stroke and those with right-side stroke. Motor recovery was more obvious proximally in the paretic limbs, but without statistical significance. Key words: hemispheric dominance, functional laterality, stroke, motor rehabilitation

Internal carotid artery occlusion accounts for 15-20% of ischemic strokes, caused by atherosclerosis or dissection. Clinical symptoms are variable, from asymptomatic cases to minor or severe strokes. Diagnosis in internal carotid artery (ICA) occlusion is based on imaging techniques. Prognosis after ICA occlusion depends on many factors: severity of neurologic deficit, spontaneous recanalization of the artery, and the occurrence of recurrent strokes. Patients with spontaneous recanalization of the occluded ICA tend to have a retained functional ability and favorable clinical outcomes. Medical treatment, recanalization techniques and intensive rehabilitation program are essential in improving functional outcome of patients with stroke produced by ICA occlusion. We present the case of a young patient diagnosed with ischemic stroke produced by internal carotid artery occlusion, with consecutive severe neurologic deficit, and an unfavorable functional outcome, as evaluated with the Modified Rankin Scale. Spontaneous recanalization of the occluded ICA was observed after 6 weeks, suggesting a carotid dissection. The patient was included in an intensive rehabilitation program, associated with best medical therapy, showing improvement of its functional status at 3 months follow up. Key words: ischemic stroke, carotid artery occlusion, carotid dissection, spontaneous recanalization, functional outcome

Visual rehabilitation therapy is one of the most problematic issue in stroke rehabilitation. The difficulties consist in specific assessment of visual deficit and poor results reports by the authors of the clinical studies. Opposite, experimental studies reports encouraging results that give hopes in this specific rehabilitation therapy. There are still difficult to analyze different aquisitions concerning various visual residual deficits after stroke, the main rehabilitation targgets being motor rehabilitation in order to ensure at least a partial autonomy in day by day life. All the studies that proved there are chances for a better quality of life if there is an improvement of visual abilities together with motor and cognitive skills with a better rehabilitation prognosis. The aim of this paper is to make a brief report regarding two of the most important visual deficits after stroke as are homonymous hemianopsia and neglect. Starting with differential diagnosis, neuroplasticity and specific rehabilitation available method, the main issues are discussed. a better understanding of phenomena that are associated with spontaneous rehabilitation, or enhancing the progress of recuperation by various method, could be able to bring a new light and hopefully better results in rehabilitation for these patients Key words: stroke, visual impairment, visual rehabilitation, neuroplasticity, homonymous hemianopsia

Stroke is an acute hypoperfusion of cerebral parenchyma that most often leads to outstanding motor deficits that can last for the rest of the patient’s life. The purpose of the neurorehabilitation process is to limit, as far is possible for the motor deficits and to bring the patient to an independent life. A modern method consists in robotic neurorehabilitation which is more and more used, associated with functional electrical stimulation (FES). At the lower limb, the use of robotic rehabilitation associated with FES is already considered a success due to relatively stereotypical movements of the lower limb. In opposition, the upper limb is more difficult to rehabilitate due to its more complex movements. Therefore, eye-hand coordination (EHC) constitutes an important factor that is conditioning the rehabilitation progress. The eye-hand coordination can be brutally disturbed by stroke with critical consequences on motor-executive component. The EHC development depends on the interaction between a feedback complex and the prediction of the upper limb motility in the space, and requires the association between visual system, oculomotor system and hand motor system. We analyzed the stroke impact on this sensorial-motor functional integration and looked for a possible solution for the interruption of coordination between eyes and the movements of the superior limb. We consider that our study can contribute to a better understanding and to a faster rehabilitation of the motor deficit in the upper limb after stroke. Key words: stroke, rehabilitation, eye-hand coordination, robotic neurorehabilitation

Background: Our study aimed to assess the efficiency of Curcumin nanoformulation (LCC) on experimental nephrotoxicity induced by Gentamicin in rats. Methods: Six groups of seven rats were used: C—(control group) received saline solution i.p. (i.p. = intraperitoneal), G—gentamicin (G, 80 mg/kg body weight (b.w.)), GCC1 and GCC2—with G and CC solution (single dose of 10 mg/kg b.w.-CC1, or 20 mg/kg b.w.-CC2), GLCC1 (10 mg/kg b.w.) and GLCC2 (20 mg/kg b.w.) with G and LCC administration. Oxidative stress parameters (NOx = nitric oxide, MDA = malondialdehyde, TOS = total oxidative stress), antioxidant parameters (CAT = catalase, TAC = total antioxidant capacity), matrix metalloproteinases (MMP-2 and MMP-9), and renal function parameters (creatinine, blood urea nitrogen, and urea) were measured. Kidneys histopathologic examination was made for each group. Results: Pretreatment with CC and LCC in both doses had significantly alleviating effects on assessed parameters (NOx, MDA, TOS, CAT, TAC, MMP-2, and -9) as compared with the untreated group (p &lt, 0.006). Histopathological aspect and renal function were significantly improved in CC and LCC groups. Liposomal formulation (LCC) showed higher efficiency on all examined parameters compared to CC (p &lt, 0.006). Conclusions: Our results demonstrated improving renal function and kidney cytoarchitecture, oxidative stress/antioxidant/balance, and MMPs plasma concentrations with better dose-related efficacity of LCC than CC.

Background: Migraine is one of the most common disorders and its pathophysiological mechanisms are still under research, oxidative stress being emphasized as an important contributor. This study aimed to analyze the retinal nerve fiber layer (RNFL) thickness and oxidative/anti-oxidant balance in migraine patients. Methods: Two groups of subjects were evaluated: a group of patients with migraine and a control group of healthy volunteers. RNFL thickness was assessed for all subjects by the ocular coherence tomography spectral domain (OCT-SD). The oxidative stress parameter, namely nitric oxide (NOx), malondialdehyde (MDA), and total oxidative stress (TOS) were assessed. The antioxidant capacity of plasma was evaluated by assessing the level of catalase, and total anti-oxidative (TOS) capacity. Migraine severity was graded using the Migraine Disability Assessment Score (MIDAS) questionnaire. Results: All the oxidative stress parameters (NOx, MDA, and TOS) were significantly increased, and both parameters for anti-oxidative status were significantly decreased in the migraine group compared with the control group (p &lt, 0.0001). Significant correlations with all the quadrants and different oxidative stress parameters were found, most involved being temporal quadrant. A significant positive correlation between catalase and macular RNFL thickness (inner ring, temporal quadrant) in migraine patients, for both eyes, was observed (p = 0.014 for the right eye and p = 0.12 for the left eye). Conclusion: The assessment of the oxidative stress/anti-oxidative balance together with RFLN thickness can constitute a promising method to evaluate the progression of the diseases. It can also contribute to the estimation of the efficiency of various therapies targeting oxidative stress and associated inflammation.

Visual rehabilitation therapy (VRT) is one of the most important and difficult post stroke rehabilitation component that can considerably improve the quality of patient's life. There are also evidences that VRT contribute to a better motor recuperation, by offering a support for spatial and temporal orientation due to process of motor activity recuperation. Visual rehabilitation methods can be classified into the following groups: Visual Substitution Therapy, Visual Scanning Training (VST), Audio-Visual Scanning Training (AViST) and Vision Restoration Training (VRT). Even the evaluation of the results of training methods have an important subjective component, being assessed by various questionnaires, there are continues improving of these methods designed to achieve better results in post stroke rehabilitation therapy. Understanding the anatomical support and psysiological background of the visual process in brain networks, and also, the pathophysiology of visual function impairment after stroke, could be a good support for an personalized rehabilitation therapy adapted to each patient. This paper is aimed to emphasise the main methods of vision rehabilitation therapy in order to offer to the post stroke rehabilitation team an instrument for their day by day activities designed to improve the quality of life for stroke surviving patients.

Traumatic vertebral artery (VA) dissection is a severe consequence of a cervical injury, which usually involves the vertebrae and spinal cord. Traumatic VA dissection has been frequently underdiagnosed or misdiagnosed, mainly because many patients remain asymptomatic. The consequence of VA dissection is ischemia in the territory supplied by the affected artery. The VA dissection presents most often as a vertebrobasilary transient ischemic attack or ischemic stroke, usually preceded by local symptoms such as neck pain or headache. Headache is a common symptom in patients with cervical artery dissection, but its characters are not specific. Diagnosis of VA dissection usually requires a CT-angiography. Delayed onset of symptoms with a variable asymptomatic interval, ranging from several days to 3 months, has been reported. The risk of stroke remains high, especially in the first weeks after the confirmation of VA dissection. Treatment of traumatic VA dissections include anticoagulation or antiplatelet therapy and revascularization techniques. We present the case of a patient with spinal cord injury and operated C5 fracture, who was diagnosed with unilateral VA dissection 6 months after the traumatic event, during the rehabilitation program.

Stroke is a leading cause of serious long-term disability: about one third of patients developing spasticity of the affected limbs. Spasticity is characterized by a velocity-dependent increase in resistance to passive movement, and is one of the “positive signs” of upper motor neuron syndrome. Spasticity induces pain, ankylosis, tendon retraction, increasing motor deficit, which may limit the efficacy of rehabilitation methods . Spasticity is also correlated with activity limitations, and reduces quality of life of patients and caregivers. Assessment of post-stroke spasticity requires first clinical examination; scales as Ashworth Modifyed scale and Tardieu Modifyed scale are useful quantitative tools. Treatment of spasticity is often challenging for the rehabilitation team, requiring a multidisciplinary approach. Therapeutic interventions include physical therapy, occupational therapy, use of assistive devices, pharmacological treatment and injectable treatment. Botulinum toxin injections in spastic upper and lower limb muscles have significant effect in reducing muscle tone and improving passive function in affected limbs, and should also be considered for improvement of active function.

Over the past 10 years great progress has been made in the diagnosis and treatment of neurological pathology such is stroke. Primary intracerebral hemorrhage (PICH) is a devastating subtype of stroke, caused by acute and spontaneously of the blood in the cerebral parenchyma. Its many causes offer a substantial heterogeneity in terms of clinical appearance, evolution, prognosis and therapeutically resources. Despite of high importance in neurology, the pathophisiological mechanisms of PICH is not complete understand. The aim of this paper is to emphasize the importance of etiological factors and pathophysiological mechanisms in the clinical evolution, prognosis and patient's rehabilitation in PICH

Background: Although there are previous studies regarding the migraine pathophysiology, the clinical entity of migraine with aura can have an different pathophysiological mechanism compared with migraine without aura. One of the most important mechanism in migraine is represented by increasing of oxidative stress. The aim of this study was to study the levels of two oxidative stress molecules: nitric oxide (NO) and malondialdehyde (MDA) in migraine with visual aura compared with migraine without aura. Material and Method: a Control group (healthy volunteers) of 37 patients and 58 patient with migraine divided in Group 1 (migraine with visual aura) and Group 2 (migraine without aura) were taken in the study. All the patient were assessed regarding the age, body mass index, blood pressure, basal glycaemia, smoking/non-smoking status, C reactive protein and fibrinogen. Visual aura was assessed regarding transitive negative visual symptoms or positive visual symptoms. Oxidative status was assessed by measurements of the plasma levels of NO and MDA. Results; C reactive protein was significantly increased in both group 1 and 2 compared with control group, but with no statistical difference between group 1 and 2. Oxidative stress (NO and MDA) was significantly increased in both group 1 and 2 compared with control group. There was also found a statistical difference regarding NO and MDA levels between group 1 and 2. Conclusions; patients with visual aura have more intense oxidative stress that can contribute to cortical spreading depression mechanism involved in migraine pathophysiology. This difference between oxidative status in migraine with aura compared with migraine without aura can influence different clinical presentation of these patients. consequently, this difference can be a guide for further individualized therapies for migraine patients.

Hemorrhagic transformation (HT) may occur as a part of the natural history of acute ischemic stroke, with incidence between 13-43% in computer-tomography (CT) studies. Detection of HT in a patient with ischemic stroke is important in establishing treatment in the acute phase in assessing prognosis and in taking therapeutical decisions for secondary stroke prevention. There were controversies regarding optimal treatment in acute ischemic stroke with HT, especially if the patient needs further anticoagulant or antiplatelet treatment. Rehabilitation treatment needs to be continued for post-stroke patients who developed HT, because HT does not decrease rehabilitation outcome. We present rehabilitation treatment and prognosis in a case of hemorrhagic transformation after an embolic ischemic stroke treated with anticoagulants, which required reinitiation of anticoagulant treatment.

Adriana E Bulboacă,1 Sorana D Bolboacă,2 Ioana C Stănescu,3 Carmen A Sfrângeu,1 Alina Porfire,4 Lucia Tefas,4 Angelo C Bulboacă3 1Department of Pathophysiology, Iuliu HaÅ£ieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania; 2Department of Medical Informatics and Biostatistics, Iuliu HaÅ£ieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania; 3Department of Neurology and Pediatric Neurology, Iuliu HaÅ£ieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania; 4Department of Pharmaceutical Technology and Biopharmaceutics, Iuliu-HaÅ£ieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania Background: Curcumin has antioxidative properties that could be useful in various diseases due to its ability to act on multiple targets of various cellular pathways. We aimed to assess the efficacy of liposomal curcumin compared with curcumin solution, when in addition to sumatriptan (ST) treatment, in an experimental migraine model induced with nitroglycerin (NTG) in rats. Methods: Seven groups of 9 rats each were investigated: control group without migraine (1 mL saline solution intraperitoneal injection [ip]), control group with induced migraine, NTG+ST group (ST), NTG+ST+curcumin1 (CC1) group – 1 mg/100 g body weight (bw), NTG+ST+CC2 – 2 mg/100 g bw, NTG+ST+liposomal curcumin1 (lCC1) group – 1 mg/100 g bw, and NTG+ST+lCC2 (lCC2) group – 2 mg/100 g bw. NTG and ST were administered as 1 mL ip NTG | 1 mg/100 g bw and 1 mL ip ST | 1 mg/100 g bw, respectively. Plasma total oxidative stress (TOS), malondialdehyde (MDA), nitric oxide (NOx), thiol levels, as well as total antioxidative capacity (TAC) were assessed. The nociception process was assessed by counting the number of flinches and shakes after the formalin test. Results: The plasma TOS, MDA, and NOx levels, as oxidative stress parameters, were significantly decreased in the curcumin-treated groups, especially where curcumin was in liposomal form. The thiol and TAC were also improved by the curcumin treatment, with the best results obtained for the liposomal curcumin. The closest number of flinches and shakes to the control group was obtained for the group treated with liposomal curcumin at a dose of 2 mg/100 g bw. Conclusion: Liposomal curcumin in a dose of 2 mg/100 g bw when in addition to ST treatment could be an optimum therapeutic strategy for migraine attacks and could represent a base for future clinical research and application. Keywords: rats, migraine disorder, liposomal curcumin, serotonin, oxidative stress, nociception

Spondylodiscitis is an infection of the intervertebral disc space, involves the vertebrae, causing vertebral osteomyelitis and spread to adjacent epidural space, causing dural, radicular or spinal cord compression. Appears mainly in adult and immunocompromised patients, mainly by haematogenous inoculation from systemic infections with bacteriemia. Patients with hepatic cirrhosis have frequent bacteriemias, produced by increased gut permeability, immune dysfunction and frequent need for invasive procedures. Despite high frequency of blood stream infections, discitis and vestebral osteomyelitis are rarely reported. We present the case of a 53 years old woman, diagnosed with class B Child Pugh cirrhosis, which presents with intense back pain and cauda equina syndrome, without clinical signs of infection. Diagnosis was confirmed by spinal MRI, but very soon after treatment onset, the patient suffered a septic shock with haemodynamic instability, which leads to patient’s death. This case illustrates how an unusual complication of cirrhosis – bacteriemia - could precipitate the unfavorable evolution of the patient by producing a remote septic complication. Persistent back pain in a cirrhotic patient should also raise the hypothesis of an infectious cause, in which early management is essential. Early diagnosis in essential for successful treatment, and good prognosis after long-term antibiotic treatment can be achieved in the majority of patients.

The investigation of the mechanisms that leads to neuronal apoptosis is under investigation all over the world. The enhancement of oxidative stress in brain neurons is one of the most important pathophysiological mechanism associated with neurodegeneration. The antioxidant effect of flavonoids can be one important mechanism for modulation of neuronal apoptosis in neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. In addition to their influence on the cerebral blood flow, flavonoids interact with signalization cascades that lead to the inhibition of neuronal death by oxidative stress apoptosis and thus promote neuronal survival and synaptic plasticity. Acting on the intracellular antioxidant mechanisms the flavonoids can become a balance regulator for production of reactive oxygen species (ROS) and reactive nitrogen species (RNS). Addition of antioxidant effect of flavonoids to dietary components can constitute an adjuvant therapy for delaying the neurodegenerative processes. The aim of this paper was to review the antioxidant effects of flavonoids in Alzheimer’s and Parkinson’s diseases.

Introduction Cortical atrophy is known to be a valuable sign of cognitive decline. The purpose of this study was to assess the association between low thyroid-stimulating hormone (TSH), posterior cortical atrophy (Koedam score – KS) and nitro-oxidative stress in elderly patients. Material and methods A study (SG) and a control group (CG), each subdivided by gender, were investigated. Subjects older than 59 years with low serum TSH level and with mild cognitive impairment were included in the SG. The CG was formed by subjects free of significant cortical atrophy and free or thyroid dysfunction. Demographic and clinical characteristics of the patients (Mini Mental State Examination, MMSE), Koedam score on cranial magnetic resonance imaging, and blood parameters (TSH, FT4, and nitric oxide – NOx) were assessed. Results Subjects in the study group had fewer years of education above the 8th grade compared with the control group (p < 0.0001). A significantly higher percentage of subjects in the study group had a Koedam score of 2 or 3 compared with controls, who had in the majority of cases a Koedam score of zero (p < 0.02). Significantly higher NOx levels were observed when study groups of both genders were compared with corresponding controls (p < 0.001). No significant differences were observed with regard to FT4 (p > 0.70). Nitric oxide was found to be significantly associated with TSH (p < 0.03) and KS (p < 0.002) when the whole study group was considered as well as when just the non-smoker study group was investigated. Conclusions Our study revealed an association between subclinical thyroid hypofunction, nitro-oxidative stress, and posterior cortical atrophy as an early stage of global atrophy.

Objective. Our study aimed to investigate the analgesic and antioxidative stress effects of Curcumin (CC) in experimental migraine induced by Nitroglycerin (NTG) on rats, compared with Indomethacin (ID) and Propranolol (PP) treatments. Material and Methods. Five groups of 10 rats treated i.p. were investigated: control group (healthy rats) injected with saline solution (0.9%), NTG-control group injected with NTG (1 mg/100 gbw, bw = body weight), and three groups with pretreatment applied 30 min previous to the formalin test (NTG + CC group: Curcumin (10 mg/100 gbw), NTG + PP group: Propranolol (100 μg/100 gbw), and NTG + ID group: Indomethacin (0.5 mg/100 gbw)). Formalin test was performed and number of flinches and shakes were counted. Several oxidative stress parameters were also assessed. Results. The smallest values of malondialdehyde (MDA), nitric oxide (NOx), and total oxidative status (TOS) were observed on NTG + CC with significant differences as compared with the control group (p<0.0001). The group pretreated with Curcumin proved significantly smaller number of flinches and shakes compared with both NTG + PP and NTG + ID. Conclusion. Our study demonstrates a superior activity of Curcumin not only versus control, but also versus Propranolol and Indomethacin.

Introduction. Hemodynamic changes of the cerebral arteries in ophthalmic migraine may be an important pathophysiological mechanism of the disease. The nitric oxide (NO) synthesis plays a significant role in hemodynamic changes due to vasodilatation effect. The purpose of this study is to evaluate the possible hemodynamic changes by Doppler measurements and their correlation with NO synthesis in ophthalmic migraine. Method. 37 ophthalmic migraine patients were compared with 35 healthy volunteers. Other cerebral and ophthalmic diseases were excluded by ophthalmological, neurological, and cranial MRI examinations. The migraine assessment scale (MIDAS) was used for clinical evaluation. Transcranial Doppler ultrasonography (TCD) was performed using 2 and 4 MHz frequencies transducers. The flow velocities of the internal carotid artery, middle cerebral artery, posterior cerebral artery, and NO plasma concentration were assessed 2 hours after migraine attacks. Results. The NO synthesis was significantly increased compared to the control group. The flow velocities decreased in internal carotid artery, middle cerebral artery, and posterior cerebral artery. The correlation between decreased flow velocities and NO plasma concentration was significant. Conclusions. Autonomic nervous system dysfunction in ophthalmic migraine is an important pathophysiological mechanism. The flow velocity status may reflect the vasomotor response and endothelial reactivity induced by NO synthesis. Further studies on the vasomotor response are necessary for the evaluation of this pathophysiological mechanism implication in ophthalmic migraine.

Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to determine if gender differences exist regarding periodontal status and several plasma biomarkers in patients with a recent large artery atherosclerosis ischemic stroke (IS). Material and methods: Patients with their first IS within less than six weeks who were able to undergo periodontal examinations were evaluated. Demographic data, periodontal status, oxidative stress parameters/plasma antioxidant capacity, and C-reactive protein in patients who suffered a recent large artery atherosclerosis ischemic stroke were reccorded. Results: 93 patients were included in the study. More men were smokers (12/57 vs. 3/36) and consumed alcohol (17/57 vs. 3/36), and more women had higher glycemic values (p = 0.023), total cholesterol (p &lt, 0.001), LDL (low-density lipoprotein)-cholesterol (p = 0.010), and HDL (high-density lipoprotein)-cholesterol (p = 0.005) levels. Significantly more men than women had moderate plus severe periodontal disease (p = 0.018), significantly higher levels of nitric oxide (p = 0.034), and significantly lower levels of total antioxidant capacity (p = 0.028). Conclusions: In this pilot study, men seem to be more prone to oxidative stress and to develop more severe forms of periodontitis among patients with stroke, but the results need validation on a larger sample.

Curcumin (CC) is known to have anti-inflammatory and anti-oxidative properties and has already been tested for its efficiency in different diseases including diabetes mellitus (DM). New formulations and route administration were designed to obtain products with higher bioavailability. Our study aimed to test the effect of intraperitoneal (i.p.) administration of liposomal curcumin (lCC) as pre-treatment in streptozotocin(STZ)-induced DM in rats on oxidative stress, liver, and pancreatic functional parameters. Forty-two Wistar-Bratislava rats were randomly divided into six groups (seven animals/group): control (no diabetes), control-STZ (STZ-induced DM &mdash, 60 mg/100g body weight a single dose intraperitoneal administration, and no CC pre-treatment), two groups with DM and CC pre-treatment (1mg/100g bw&mdash, STZ + CC1, 2 mg/100g bw&mdash, STZ + CC2), and two groups with DM and lCC pre-treatment (1 mg/100g bw&mdash, STZ + lCC1, 2 mg/100g bw&mdash, STZ + lCC1). Intraperitoneal administration of Curcumin in diabetic rats showed a significant reduction of nitric oxide, malondialdehyde, total oxidative stress, and catalase for both evaluated formulations (CC and lCC) compared to control group (p &lt, 0.005), with higher efficacy of lCC formulation compared to CC solution (p &lt, 0.002, excepting catalase for STZ + CC2vs. STZ + lCC1when p = 0.0845). The CC and lCC showed hepatoprotective and hypoglycemic effects, a decrease in oxidative stress and improvement in anti-oxidative capacity status against STZ-induced DM in rats (p &lt, 0.002). The lCC also proved better efficacy on MMP-2, and -9 plasma levels as compared to CC (p &lt, 0.003, excepting STZ + CC2 vs. STZ + lCC1 comparison with p = 0.0553). The lCC demonstrated significantly better efficacy as compared to curcumin solution on all serum levels of the investigated markers, sustaining its possible use as adjuvant therapy in DM.

Introduction. Migraine is an important cause of disability that affects the quality of life producing a substantial social impairment. Objectives. The aim of this study was to evaluate the correlation between migraine severity and comorbidities in patients with episodic migraine. Methods. 2 groups of patients were included in the study: group 1 – control group (healthy subjects, n = 50), and group 2 – study group (patients with episodic migraine attacks, n = 65). Both groups were assessed for nonmodifiable risk factors (age), and modifiable risk factors: BMI (body mass index), lipids profiles (LDL-cholesterol, HDL-cholesterol, triglycerides), inflammatory parameters (C reactive protein and fibrinogen), and endothelial dysfunction (nitric oxide synthesis expressed as NOx). The migraine was diagnosed according to ICHD-2 (International Classification of Headache Disorders) and the severity was evaluated by MIDAS (Migraine Disability Assessment Scale). The study group was compared with control group. The parameters that showed statistic significance were correlated with MIDAS scale. Results. There was a significant correlation between the severity and frequency of migraine attacks (evaluated by MIDAS scale) and BMI. The subgroup with higher inflammatory parameters and decreased NOx had an increased MIDAS score. Conclusions. The connection between obesity, inflammatory parameters and migraine may be useful for new prophylaxis potent therapies. The individual personalized therapies according with particular risk factors of each patient may be a chance for better results. Identification and control of risk factors in migraine patients may be particularly important.

The health care system needs to face new and advanced medical technologies that can improve the patients' quality of life by replacing lost or decreased functions. In stroke patients, the disabilities that follow cerebral lesions may impair the mandatory daily activities of an independent life. These activities are dependent mostly on the patient's upper limb function so that they can carry out most of the common activities associated with a normal life. Therefore, an upper limb exoskeleton device for stroke patients can contribute a real improvement of quality of their life. The ethical problems that need to be considered are linked to the correct adjustment of the upper limb skills in order to satisfy the patient's expectations, but within physiological limits. The debate regarding the medical devices dedicated to neurorehabilitation is focused on their ability to be beneficial to the patient's life, keeping away damages, injustice, and risks.