Resumo em Inglês:

Abstract: Background Nerolidol, a natural sesquiterpene alcohol found in essential oils, has demonstrated antioxidant, anti-inflammatory, and neuroprotective properties. However, its effects on pentylenetetrazole (PTZ)-induced seizure and associated oxidative brain damage remain unclear. Objective To evaluate the anticonvulsant effects of nerolidol on PTZ-induced seizures in mice and to investigate its impact on oxidative and nitrosative stress markers in the hippocampus and cortex. Methods Male mice were divided into 5 groups: control, PTZ, and PTZ pretreated with nerolidol (25, 50, or 100 mg/kg, orally) 30 minutes before PTZ administration. Seizure activity was assessed by measuring latencies to minimal clonic seizures (MCSs) and generalized tonic-clonic seizures (GTCSs). After a behavioral evaluation, hippocampal and cortical tissues were analyzed for malondialdehyde (MDA), nitric oxide (NO) metabolites, superoxide dismutase (SOD), catalase (CT), and total thiol content. Results Nerolidol significantly increased MCS and GTCS latencies compared with the PTZ group. In the hippocampus, all doses reduced MDA levels, while in the cortex this effect was observed at 50 and 100 mg/kg. Nitric oxide metabolites were decreased by the two higher doses in both brain regions. The PTZ-induced reductions in SOD and CT activities were reversed by nerolidol at all doses, and total thiol levels were restored at 50 and 100 mg/kg. Conclusion Nerolidol exhibits anticonvulsant and neuroprotective effects on PTZ-induced seizures, likely mediated by reduced oxidative and nitrosative stress and enhancement of endogenous antioxidant defenses.

Resumo em Inglês:

Abstract: Background Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by both motor and non-motor symptoms, with autonomic dysfunction significantly impacting patients' quality of life. Despite its recognized importance, comprehensive evaluation of autonomic dysfunction in PD remains limited. Objective To assess cardiovascular autonomic dysfunction in PD, explore its association with disease severity, and examine the modulatory effects of dopaminergic therapy. Methods A cross-sectional study was conducted involving 60 PD patients and 30 age- and sex-matched healthy controls. Autonomic function was evaluated using standardized cardiovascular tests, including deep breathing, the Valsalva maneuver, and head-up tilt. Heart rate variability, baroreflex sensitivity, and orthostatic blood pressure responses were measured. Parkinson's disease patients were evaluated in both dopaminergic medication ON and OFF states. Correlations between autonomic parameters and disease severity were analyzed. Results Parkinson's disease patients demonstrated significant autonomic impairment compared to controls (p < 0.001). Standard deviation of NN intervals (SDNN) (21.3 ± 8.7 vs. 32.5 ± 10.2 ms), baroreflex sensitivity (4.2 ± 1.8 vs. 7.1 ± 2.3 ms/mmHg), and heart rate response to deep breathing (8.3 ± 3.2 vs. 13.7 ± 4.1 bpm) were reduced, while systolic blood pressure drop on tilt increased (22.5 ± 12.8 vs. 8.3 ± 5.7 mmHg). Autonomic impairment correlated with disease severity. Dopaminergic medication showed modest but significant improvements in heart rate variability (p = 0.032), baroreflex sensitivity (p = 0.041), and orthostatic response (p = 0.025). Conclusion Parkinson's disease patients exhibit marked cardiovascular autonomic dysfunction correlating with disease severity. The modest modulatory effects of dopaminergic medication on autonomic parameters suggest complex dopaminergic-autonomic interactions and supports autonomic parameters as potential markers of disease progression.

Resumo em Inglês:

Abstract: Background Transcranial Doppler (TCD) is a diagnostic tool to detect real-time spontaneous microembolic signals (MESs) in intracranial circulation. Critically-ill coronavirus disease 2019 (COVID-19) patients may present an increased likelihood of MESs due to systemic inflammation and hypercoagulability. Objective To assess the presence of MESs and other TCD parameters, including cerebral blood flow velocity (CBFV), pulsatility, and resistance indices, and to calculate the estimated cerebral perfusion pressure (eCPP) in patients with and without COVID-19. Methods The TCD monitoring was performed for 1 hour in both middle cerebral arteries (MCAs) of adult patients in the Intensive Care Unit (ICU) with confirmed COVID-19 infection. The eCPP was calculated by multiplying the mean arterial pressure (MAP) by the ratio of end-diastolic velocity to mean CBFV, then adding 14 mmHg. Results We evaluated 31 subjects: 11 intubated COVID-19 patients, 10 non-intubated COVID-19 patients, and 10 intubated non-COVID-19 patients. Patient ages ranged from 29 to 84 (median: 62; interquartile range [IQR]: 50–70) years, with 64.5% being male individuals. A total of 17 (54.8%) subjects died during hospitalization, and 2 patients (6.45%) lacked an ultrasonographic signal via the transtemporal window. No MESs were detected. A positive correlation was found between the resistance index of MCAs (p = 0.390) and D-dimer (p = 0.049). In contrast, direct bilirubin (p = −0.494), C-reactive protein (CRP; p = −0.540), activated partial thromboplastin time (aPTT; p = −0.495), and D-dimer (p = −0.439) were negatively correlated with eCPP. Conclusion No spontaneous cerebral microemboli were observed in this cohort, but patients with higher direct bilirubin, CRP, aPTT, and D-dimer presented lower eCPP.

Resumo em Inglês:

Abstract: Predicting future advances in science is practically impossible because unexpected discoveries can radically change the march of ongoing processes. Predicting the nearest future may have a slightly greater chance of success. First, the diagnosis of risk factors for Alzheimer's disease (AD), based on the preponderant role of genetics, will be made very early. Diagnosis will be made with biomarkers prior to clinical manifestations. Furthermore, the prevention of AD and of dementia due to AD will be possible with better control of the many risk factors for dementia, healthier lifestyles, multi-target drugs, and genetic therapy. The relationship between AD and aging will be better understood, opening possibilities for intervention in aging itself. As the pathophysiology of AD is not unique, treatment will be individualized, according to the stage and characteristics of the disease. Most clinical trials will have surrogate markers as primary outcomes. Treatments to decrease the velocity or arrest the evolution of mild cognitive impairment (MCI) and mild dementia caused by AD will be available. Additionally, artificial intelligence (AI) will aid in the diagnosis and selection of the best treatments. Access to the new methods for diagnosing and treating AD is currently limited to a small parcel of the population, especially in low- and middle-income countries, because of their high costs. Due to the high prevalence of AD, it is possible these will become less expensive in the future. The possibility of reversing dementia once it has set in will probably have to wait for longer.

Resumo em Inglês:

Abstract: The amygdala is a central structure of the limbic system. For several decades, volumetric asymmetries of the amygdala have been described, initially associated with psychiatric disorders. In epilepsy, a growing literature highlights the distinctive features of amygdala enlargement (AE), considering that since its original description, diagnosis has been primarily radiological. The objective of the present work is to demonstrate, through reviews of existing academic publications and through our experience, that its function goes beyond imaging, contemplating a defined clinical, electrographic, and histopathological pattern that responds to both medical and surgical treatment. Therefore, it would be an entity that extends beyond a reactive phenomenon. In conclusion, AE would be a specific syndrome defined with particular characteristics that extends beyond a reactive mechanism secondary to adjacent epileptogenic networks.

Resumo em Inglês:

Abstract Myasthenia gravis is an antibody-mediated disorder of the neuromuscular junction. Fatigability and fluctuations are hallmarks of the disease, posing a challenge: evaluation through a single physical examination may not reflect disease control. A shift towards patient-reported Outcomes is a new paradigm in the current practice, and these outcomes are usually assessed through validated scales. In the present paper, we discuss some of the most used scales in the clinical practice, such as the Myasthenia Gravis Foundation of America (MGFA) scale, the Myasthenia Gravis Activities of Daily Living (MG-ADL) scale, and the 15-Item Myasthenia Gravis Quality of Life (MG-QOL15) scale. Definitions of remission, minimal manifestation, high-burden disease, highly-active disease, and others are reviewed, and correlations involving these definitions and the scales are presented. Guidance on how to assess disease severity, therapeutic response, and a rationale for treatment escalation are explored.

Resumo em Inglês:

Abstract: The present article aims to understand Ovide Decroly1s intervention in the pedagogical field considering his medical-neurological training. Thus, it shows that, in 1901, Decroly founded an institute of special education and, 6 years later, created the Hermitage School, for disabled and so-called normal children respectively. In these educational endeavors, Decroly used the mental tests of the Binet-Simon scale, but indicating their limits; and in the light of the experience of American psychology, in the 1920s, he developed, with Raymond Buyse, the Decroly-Buyse tests.