Neurodevelopmental Status of Moderate to Late Preterm Infants at 6 Months Corrected Age

Background: Moderate Preterm (MP) and Late Preterm (LP) infants together comprise more than 80% of all prematurely born infants. Since last decade, there has been growing concern about Neurodevelopmental Abnormality (NDA) in these infants. This study was aimed to assess neurodevelopmental status of moderate to late preterm born neonates and to determine factors associated with adverse neurodevelopmental outcome in a tertiary hospital in Bangladesh. Materials and methods: In this prospective observational study 215 preterm (32 to <37 completed weeks gestation at birth) infants (107 MP and 108 LP) were enrolled from the Special Care Neonatal Unit (SCANU) Chittagong Medical College Hospital from June 2018 to May 2019. Neurodevelopmental assessment was done by Rapid Neurodevelopmental Assessment (RNDA) at 1, 3 and 6 months of Corrected Age (CA). Results: Of the 215 enrolled children, 63 (29.3%) attended all the 3 follow-up, 123 (57.2%) had incomplete follow-up or lost and 29 (13.5%) died. At final follow-up out of 63 infants 43 (68.3%) had no abnormality in all 8 domains of RNDA. Seven infants (11.1%) had abnormality in one domain and 13 (20.6%) had abnormality in more than one domain. Gross motor abnormality was most common abnormality (28.6%), followed by cognition (14.3%), vision (12.7%) and behavior (12.7%). Small for gestational age and lower birth weight were found to be independent predictive factors for NDA in moderate to late preterm infants. Conclusion: Study has shown that NDA persist till 6 months of CA in moderate to late preterm infants. It is important to closely monitor the neurodevelopmental status and provide early intervention in referred cases. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 50-54

Paratonia in Dementia: A Systematic Review

Background: Paratonia is a dementia-induced motor abnormality. Although paratonia affects virtually all people with dementia, it is not well known among clinicians and researchers. Objective: The aim of this study was to perform a systematic review of the literature on the definition, pathogenesis, diagnosis, and intervention of paratonia as well as to propose a research agenda for paratonia. Methods: In this systematic review, the Embase, PubMed, CINAHL, and Cochrane CENTRAL databases were searched for articles published prior to December 2019. Two independent reviewers performed data extraction and assessed the risk of bias of the studies. The following data were extracted: first author, year of publication, study design, study population, diagnosis, assessment, pathogenesis, therapy and interventions. Results: Thirty-five studies met the inclusion criteria and were included. Most studies included in the review mention clinical criteria for paratonia. Additionally, pathogenesis, method of assessment, diagnosis, and paratonia severity as are interventions to address paratonia are also discussed. Conclusion: This systematic review outlines what is currently known about paratonia, as well as discusses the preliminary research on the underlying mechanisms of paratonia. Although paratonia has obvious devastating impacts on health and quality of life, the amount of research to date has been limited. In the last decade, there appears to have been increased research on paratonia, which hopefully will increase the momentum to further advance the field.

017 Widespread extra-motor abnormality is a prominent MRI signature of ALS: a cross-cohort study

IntroductionAmyotrophic lateral sclerosis (ALS) is a heterogeneous neurodegenerative disease characterised by motor dysfunction, but now recognised as a complex multi-system disorder. Neuroimaging studies’ indicate an expanding, though inconsistent, list of extra-motor neural involvement. The objective of the current study was to examine pattern of grey matter change across two clinically well matched patient cohorts to identify core neural changes underlying ALS.MethodsIndependent ALS and age-matched healthy control cohorts were compared from Oxford (ALS: 45; Control: 34) and Sydney (ALS: 45; Control: 27). Whole-brain voxel-based morphometry and subcortical volumetric analyses were carried out.ResultsSubcortical volumetric reduction was consistently observed in the thalamus, caudate and hippocampus (all p < 0.05). Pattern of cortical grey matter atrophy showed variability across ALS cohorts, but consistently implicated crus I-II of the cerebellum and orbitofrontal cortices (p < 0.01, family-wise error corrected).ConclusionsThe core grey matter MRI signature of ALS comprises extensive extra-motor cortical and subcortical abnormality. Significant variability exists, which highlights the heterogeneous nature of ALS as defined by current diagnostic guidelines.

Nystagmus in Laurence-Moon-Biedl Syndrome

Introduction. Laurence-Moon-Biedl (LMB) syndrome is a rare autosomal-recessive ciliopathy with manifold symptomatology. The cardinal clinical features include retinitis pigmentosa, obesity, intellectual delay, polydactyly/syndactyly, and hypogenitalism. In this paper, the authors report on three siblings with Laurence-Moon-Biedl syndrome associated with a probable pseudocycloid form of congenital nystagmus.Methods. This was a case study conducted at King Khaled Hospital.Results. The authors assert that the nystagmus in Laurence-Moon-Biedl syndrome is essentially similar to idiopathic motor-defect nystagmus and the nystagmus seen in optic nerve hypoplasia, ocular albinism, and bilateral opacities of the ocular media.Conclusion. The data support the previous hypothesis that there is a common brain stem motor abnormality in sensory-defect and motor-defect nystagmus.

Borneol, a Bicyclic Monoterpene Alcohol, Reduces Nociceptive Behavior and Inflammatory Response in Mice

Borneol, a bicyclic monoterpene, has been evaluated for antinociceptive and anti-inflammatory activities. Antinociceptive and anti-inflammatory activities were studied by measuring nociception by acetic acid, formalin, hot plate, and grip strength tests, while inflammation was prompted by carrageenan-induced peritonitis. The rotarod test was used to evaluate motor coordination. Borneol produced a significant (P<0.01) reduction of the nociceptive behavior at the early and late phases of paw licking and reduced the writhing reflex in mice (formalin and writhing tests, resp.). When the hot plate test was conducted, borneol (in higher dose) produced an inhibition (P<0.05) of the nociceptive behavior. Such results were unlikely to be provoked by motor abnormality. Additionally, borneol-treated mice reduced the carrageenan-induced leukocytes migration to the peritoneal cavity. Together, our results suggest that borneol possess significant central and peripheral antinociceptive activity; it has also anti-inflammatory activity. In addition, borneol did not impair motor coordination.

Magnesium Sulfate: Fetal Neuroprotective Role in Reducing the Risk of Cerebral Palsy

ABSTRACT Advances in perinatal and neonatal medicine have significantly improved survival rates of preterm infants. This improvement has been associated with substantial risk of neurodevelopmental impairments and with increased number of infants with special health care needs. Cerebral palsy is the most well known and potentially most disabling motor abnormality associated with prematurity. There has been limited progress in understanding the causes of cerebral palsy and in developing primary prevention strategies. Several studies have summarized the experimental evidence that supports possible neuroprotective effects of magnesium. Five randomized controlled trials of antenatal magnesium sulfate found a trend of reduced risk of cerebral palsy in preterm infants. Three meta-analyses using the data from these five trials found that magnesium sulfate given to women at risk of premature birth significantly reduced the risk of cerebral palsy without increasing the risk of perinatal or infant death. How to cite this article Constantinescu S, Denes M, Chilianu A, Vladareanu R. Magnesium Sulfate: Fetal Neuroprotective Role in Reducing the Risk of Cerebral Palsy. Donald School J Ultrasound Obstet Gynecol 2013;7(1):98-104.

Clinicopathologic analysis of progressive non-fluent aphasia and corticobasal degeneration:Case report and review

Objective: To investigate progressive non-fluent aphasia and histopathologically-proven corticobasal degeneration. Methods: We evaluated symptoms, signs, neuropsychological deficits, and radiology data longitudinally, in a patient with autopsy-proven corticobasal degeneration and correlated these observations directly to the neuroanatomic distribution of the disease. Results: At presentation, a specific pattern of cognitive impairment was evident with an extreme extrapyramidal motor abnormality. Follow-up examination revealed persistent impairment of praxis and executive functioning, progressive worsening of language performance, and moderately preserved memory. The motor disorder manifested and worsened as the condition progressed. Many of the residual nerve cells were ballooned and achromatic with eccentric nuclei. Tau-immunoreactive pathology was significantly more prominent in neurons in the frontal and parietal cortices and dentate nuclei than in temporal neocortex, hippocampi and brainstem. Conclusion: The clinical diagnosis of progressive non-fluent aphasia secondary to corticobasal degeneration hinged on a specific pattern of impaired cognition as well as an extrapyramidal motor disorder, reflecting the neuroanatomic distribution of the disease in frontal and anterior temporal cortices and the dentate nuclei.