Clinical Neuroscience

[Movement analyzing devices for analyzing the actual state of patients with movement disorders]

JOBBÁGY Ákos, HARCOS Péter, FAZEKAS Gábor, VALÁLIK István

MARCH 24, 2010

Clinical Neuroscience - 2010;63(03-04)

[Movement analysis gives valuable information on the actual state of patients. Based on it, the early diagnosis and objective assessment of the progress of several diseases can be helped. Our research work has been focused on developing clinically applicable movement analyzing devices.]

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Clinical Neuroscience

[Comment of the invited editor]

FOLYOVICH András

[Comment of the invited editor 2010;63(03-04)]

Clinical Neuroscience

[Differential diagnosis of atypical Parkinsonian syndromes]

CSÓTI Ilona, FORNÁDI Ferenc

[Atypical Parkinson syndromes are distinguished from idiopathic Parkinson disease by insufficient or missing response to dopaminergic replacement therapy and therefore they have significantly unfavorable prognoses. Early differential diagnosis is very important for the patient. It enables the therapist to give suitable consults, to avoid unnecessary or inappropriate therapy, which are not free of medication side effects and furthermore facilitates the selection of adapted symptomatically medical and physical measures of treatment. In case of future development of neuroprotective or causally therapy strategies correct diagnosis will allow an early start of therapy. The differential diagnosis separation of the three clinical pictures from the idiopathic Parkinson disease with clinical criteria might be difficult in the early stage of disease. Additional neuroimaging and nuclear medical investigations may support the clinical probable diagnosis.]

Clinical Neuroscience

[Frontotemporal dementia or frontotemporal lobar degeneration - Overview of a group of proteinopathies]

CATHERINE Haberland

[Frontotemporal dementia is the second most common early onset dementia after Alzheimer disease. Frontotemporal dementias are a complex group of dementias. The clinical diagnosis can be perplexing because of concurring psychiatric and neurologic syndromes. Frontotemporal lobar degeneration, the underlying pathology, represents an emerging group of proteinopathies. Genetic factors play an important part in the etiologies of dementias. This article overviews current defining characteristics of frontotemporal dementias known also as frontotemporal lobar degenerations]

Clinical Neuroscience

[Numbers, counting and calculating problems in view of cognitive neurology]

MÁRKUS Attila

[The ability to count and calculate is a human-specific skill comprised of understanding numeric values and categories and performing numerical operations; it is an acoustic-verbal symbolic activity that may be expressed in writing and understood by reading. The neuronal bases and precursors of cognitive systems have been supplied to mankind by the process of evolution. Abilities to create symbols (speech, visual letter and number symbols) must have played a decisive role in the emergence of man from the world of primates. Although counting and calculating problems are classified into numerous types, two main forms of dyscalculia have practical importance: the acquired one (the loss of learned knowledge) and the developmental one (the disturbance of the acquisition of arythmetical knowledge).]

Clinical Neuroscience

[Vertigo - comorbidity with psychiatric disorders]

FAZEKAS András

[Vertigo is one of the most common symptom and complaint in the clinical practice. The differential diagnosis can only be attained by a careful interdisciplinary way of thinking and activity, given the fact that the vestibular, neurological and psychiatric disorders - considered as pathogenic factors - are being present simultaneously in triggering the symptoms, and there can be overlaps between the certain pathological processes. The author deals with the co-morbidity of the vertigo and the psychiatric symptoms - anxiety, panic-disorder -, pointing out the common neurobiological and neurophysiological factors in the background of the symptoms, emphasizing the importance of the SSRI-s in the restoration of the serotonerg dysfunction.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

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Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

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Clinical Neuroscience

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