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Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 11275

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Dr. Lilla Bonanno

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IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy
Interests: neuroimaging; neurophysiology; neurorehabilitation
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Dear Colleagues,

In recent decades researchers have been trying to enhance the development of reliable biomarkers for neurodegenerative diseases, while medical practice has been moving toward precision medicine. However, there is still an urgent need to identify disease-specific biomarkers to improve the early diagnostic workup, favor clinical classification and prognostic models, and facilitate the development of effective disease-modifying therapies. Most neurodegenerative disorders, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and amyotrophic lateral sclerosis, are late onset, meaning there is some factor that changes as a person ages for each disease. One constant factor is that in each disease, neurons gradually lose function as the disease progresses with age. About 20–40% of healthy people between 60 and 78 years old experience discernable decrements in cognitive performance in several domains, including working, spatial, episodic memory, and processing speed.

This Special Issue aims to highlight the current knowledge regarding neurodegeneration pathogenic mechanisms and underline possible current practices and future perspectives in neurodegenerative diseases.

In this Special Issue, original articles and reviews are welcome. We look forward to receiving your contributions.

Dr. Lilla Bonanno
Guest Editor

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Keywords

neurodegenerative diseases
amyotrophic lateral sclerosis
multiple sclerosis
Parkinson's disease
Alzheimer's disease
Huntington's disease
multiple system atrophy
prion diseases

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Published Papers (9 papers)

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Research

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28 pages, 7016 KiB

Open AccessArticle

Efficiency of Lidocaine Intramuscular and Intraosseous Trigger Point Injections in the Treatment of Residual Chronic Pain after Degenerative Lumbar Spinal Stenosis Decompression Surgery

by Mustafa Al-Zamil, Natalia G. Kulikova, Natalia A. Shnayder, Natalia B. Korchazhkina, Marina M. Petrova, Tatyana I. Mansur, Vasilissa V. Blinova, Zarina M. Babochkina, Ekaterina S. Vasilyeva and Ivan V. Zhhelambekov

J. Clin. Med. 2024, 13(18), 5437; https://doi.org/10.3390/jcm13185437 - 13 Sep 2024

Viewed by 655

Abstract

Introduction: Despite the long-term use of intramuscular and intraosseous lidocaine trigger point injections (LTPI) in the treatment of patients with low back pain, there have been no studies examining their efficiency in treatment of residual pain after degenerative lumbar spinal stenosis (DLSS) decompression surgery. The purpose of our research is to examine the LTPI efficiency in the treatment of residual lumbar pain after DLSS decompression surgery and to compare the analgesic and recovery effects of intramuscular and intraosseous LTPI administered in the L4–S1 region and in the posterior superior iliac spine (PSIS) after treatment and during four months of follow-up. Materials and Methods: We observed 99 patients (F:50, M:49) aged 42 to 59 years with residual neurological disorders after DLSS decompression surgery. In all patients, the pain syndrome exceeded 6 points on the VAS and averaged 7.2 ± 0.11 points. The control group (n = 21) underwent only pharmacotherapy. In addition to pharmacotherapy, the LTPI group underwent intramuscular LTPI in L4–S1 (n = 20), intramuscular LTPI in the PSIS (n = 19), intraosseous LTPI in L5, S1 (n = 20), and intraosseous LTPI in the PSIS (n = 19). A neurological examination was carried out before treatment, 7 days after completion of treatment, and at the end of the second and fourth months of the follow-up period. Results: In the control group, intramuscular LTPI in L4–S1 subgroup, intramuscular LTPI in PSIS subgroup, intraosseous LTPI in L5, S1 subgroup, and intraosseous LTPI in PSIS subgroup, the severity of pain decreased after treatment by 27.1% (p ≤ 0.05), 41.7% (p ≤ 0.01), 50.7% (p ≤ 0.01), 69% (p ≤ 0.01), and 84.7% (p ≤ 0.01), respectively, and at the end of the second month of follow-up, by 14.3% (p > 1), 29.2% (p ≤ 0.05), 38% (p ≤ 0.01), 53.5% (p ≤ 0.01), and 72.2% (p ≤ 0.01), respectively. Reduction of neurogenic claudication, regression of sensory deficit, increase of daily step activity, and improvement of quality of life after treatment were noted in intramuscular LTPI subgroups by 19.6% (p ≤ 0.05), 36.4 (p ≤ 0.05), 40.3% (p ≤ 0.01), and 21.0% (p ≤ 0.05), respectively, and in interosseous LTPI subgroups by 48.6% (p ≤ 0.01), 67.4% (p ≤ 0.01), 68.3% (p ≤ 0.01), and 46% (p ≤ 0.01), respectively. Conclusions: LTPI is highly effective in the treatment of patients with residual pain after DLSS decompression surgery. High analgesic effect, significant regression of sensory deficits and gait disorders, and remarkable improvement of daily step activity and quality of life are noted not only after the end of LTPI treatment but also continue for at least 2 months after treatment. Intraosseous LTPI is more effective than intramuscular LTPI by 92%, and LTPI in PSIS is more effective than LTPI in L4–S1 by 28.6%. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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11 pages, 273 KiB

Open AccessArticle

Supplementing Best Care with Specialized Rehabilitation Treatment in Parkinson’s Disease: A Retrospective Study by Different Expert Centers

by Maria Felice Ghilardi, Angelo Quartarone, Alessandro Di Rocco, Rocco Salvatore Calabrò, Sheng Luo, Hongliang Liu, Monica Norcini, Margherita Canesi, Veronica Cian, Marianna Zarucchi, Paola Ortelli, Daniele Volpe, Leila Bakdounes, Davide Castelli, Alessio Di Fonzo, Giulia Franco, Emanuele Frattini, Laura Avanzino, Elisa Pelosin, Carla Ogliastro, Roberto Ceravolo, Giovanni Palermo, Luca Tommasini, Daniela Frosini, Lucilla Parnetti, Nicola Tambasco, Pasquale Nigro, Simone Simoni and Peter Schmidt Show full author list Hide full author list

J. Clin. Med. 2024, 13(10), 2999; https://doi.org/10.3390/jcm13102999 - 20 May 2024

Cited by 1 | Viewed by 1103

Abstract

Background: This is a retrospective longitudinal study comparing 374 patients with Parkinson’s disease (PD) who were treated in centers offering a specialized program of enhanced rehabilitation therapy in addition to expert outpatient care to 387 patients with PD, who only received expert outpatient care at movement disorders centers in Italy. Methods: The data are from subjects recruited in the Parkinson’s Outcome Project (POP) at six Italian centers that are part of a multicenter collaboration for care quality improvement (the Fresco Network). The effects were measured with a baseline and a follow-up clinical evaluation of the Timed-Up-and-Go test (TUG), Parkinson’s Disease Questionnaire (PDQ-39), and Multidimensional Caregiver Strain Index (MCSI), the number of falls and hospitalizations for any cause. We used a generalized linear mixed model with the dependent variables being the response variable, which included the covariates demographics, evaluation, and treatment variables. Results: We found that the subjects who underwent specialized enhanced rehabilitation had a better motor outcome over time than those who were managed by expert neurologists but had participated in community programs for exercise and other allied health interventions. The greatest effects were seen in patients in the early stages of the disease with a high amount of vigorous exercise per week in the last six months. Similar effects were seen for PDQ39, MCSI, the number of falls, and hospitalization. Conclusions: Long-term benefits to motor function and the quality of life in patients with PD and burden reduction in their caregivers can be achieved through a systematic program of specialized enhanced rehabilitation interventions. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

12 pages, 1084 KiB

Open AccessArticle

The Effects of Home Automation on Personal and Social Autonomies in Spinal Cord Injury Patients: A Pilot Study

by Giuseppa Maresca, Desirèe Latella, Caterina Formica, Isabella Veneziani, Augusto Ielo, Angelo Quartarone, Rocco Salvatore Calabrò and Maria Cristina De Cola

J. Clin. Med. 2024, 13(5), 1275; https://doi.org/10.3390/jcm13051275 - 23 Feb 2024

Viewed by 965

Abstract

Background: Spinal cord injury (SCI) is a severe and progressive neurological condition caused by trauma to the nervous system, resulting in lifelong disability and severe comorbidities. This condition imposes serious limitations on everyday life, interfering with patients’ social lives and compromising their quality of life, psychological well-being, and daily living activities. Rehabilitation is essential to helping SCI patients gain more independence in their daily routines. Home automation (HA) systems provide personalized support to users, allowing them to manage various aspects of their living environment, promoting independence and well-being. This study aims to demonstrate the efficacy of an HA system in enhancing personal and social autonomies in SCI patients, resulting in improved cognitive function and reduced anxiety–depressive symptoms compared to traditional training. Methods: We enrolled 50 SCI patients undergoing neurorehabilitation at IRCCS Centro Neurolesi (Messina, Italy). These patients were randomly assigned to one of two groups: a control group (CG) and an experimental group (EG). The CG received traditional training, while the EG underwent HA training. We evaluated the patients before (T0) and after (T1) rehabilitation using various scales, including the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HRS-A), the 12-Item Short-Form Survey (SF-12), the Functional Independence Measure (FIM), Activities of Daily Living (ADL), Instrumental Activities of Daily Living Scale (IADL), and the EQ-5D-5L. Results: The effect of the experimental treatment showed an improvement in all patients test scores in the EG, especially regarding cognitive functions, mood disorders, activities of daily living, and quality of life. Conclusion: Our findings suggest that HA may be effective in improving daily autonomy and, in turn, alleviating mood disorders and enhancing psychological well-being. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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19 pages, 1108 KiB

Open AccessArticle

Unlocking the Protective Potential of Upper Respiratory Infection Treatment Histories against Alzheimer’s Disease: A Korean Adult Population Study

by Ho Suk Kang, Ji Hee Kim, Joo-Hee Kim, Woo Jin Bang, Hyo Geun Choi, Nan Young Kim, Ha Young Park and Mi Jung Kwon

J. Clin. Med. 2024, 13(1), 260; https://doi.org/10.3390/jcm13010260 - 2 Jan 2024

Cited by 2 | Viewed by 1281

Abstract

With increasing interest in the inflammation-pathogen infection hypothesis and its potential links to Alzheimer’s disease (AD) development, there is growing consideration of using upper respiratory infection (URI) treatments as interventions for AD. This nested case–control study explored the potential association between prior URI histories and AD development in a Korean adult population using the national health screening cohort data (2002–2019). The study included 26,920 AD patients and 107,680 matched control individuals, focusing on those seeking respiratory treatment. Logistic regression analyses assessed the impact of URI histories and treatment on AD risk while adjusting for covariates. Our results revealed that over a 1-year period, individuals with URI histories (≥1, ≥2, or ≥3 instances) exhibited decreasing probabilities of developing AD, with risk reductions of 19%, 15%, and 12%, respectively. Expanding our investigation to a 2-year period consistently showed a 17% reduction in AD risk. This effect remained robust across diverse demographic groups and after adjusting for covariates, encompassing comorbidities, hypertension, hyperlipidemia, blood glucose levels, and lifestyle factors. Subgroup analyses further substantiated this association. In conclusion, our findings cautiously suggest a potential protective role of prior URI treatment histories in mitigating the risk of AD development. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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Review

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18 pages, 968 KiB

Open AccessReview

Asymmetry in Atypical Parkinsonian Syndromes—A Review

by Patryk Chunowski, Natalia Madetko-Alster and Piotr Alster

J. Clin. Med. 2024, 13(19), 5798; https://doi.org/10.3390/jcm13195798 - 28 Sep 2024

Viewed by 408

Abstract

Background/Objectives: Atypical parkinsonian syndromes (APSs) are a group of neurodegenerative disorders that differ from idiopathic Parkinson’s disease (IPD) in their clinical presentation, underlying pathology, and response to treatment. APSs include conditions such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and dementia with Lewy bodies (DLB). These disorders are characterized by a combination of parkinsonian features and additional symptoms, such as autonomic dysfunction, supranuclear gaze palsy, and asymmetric motor symptoms. Many hypotheses attempt to explain the causes of neurodegeneration in APSs, including interactions between environmental toxins, tau or α-synuclein pathology, oxidative stress, microglial activation, and vascular factors. While extensive research has been conducted on APSs, there is a limited understanding of the symmetry in these diseases, particularly in MSA. Neuroimaging studies have revealed metabolic, structural, and functional abnormalities that contribute to the asymmetry in APSs. The asymmetry in CBS is possibly caused by a variable reduction in striatal D2 receptor binding, as demonstrated in single-photon emission computed tomography (SPECT) examinations, which may explain the disease’s asymmetric manifestation and poor response to dopaminergic therapy. In PSP, clinical dysfunction correlates with white matter tract degeneration in the superior cerebellar peduncles and corpus callosum. MSA often involves atrophy in the pons, putamen, and cerebellum, with clinical symmetry potentially depending on the symmetry of the atrophy. The aim of this review is to present the study findings on potential symmetry as a tool for determining potential neuropsychological disturbances and properly diagnosing APSs to lessen the misdiagnosis rate. Methods: A comprehensive review of the academic literature was conducted using the medical literature available in PubMed. Appropriate studies were evaluated and examined based on patient characteristics and clinical and imaging examination outcomes in the context of potential asymmetry. Results: Among over 1000 patients whose data were collected, PSP-RS was symmetrical in approximately 84% ± 3% of cases, with S-CBD showing similar results. PSP-P was symmetrical in about 53–55% of cases, while PSP-CBS was symmetrical in fewer than half of the cases. MSA-C was symmetrical in around 40% of cases. It appears that MSA-P exhibits symmetry in about 15–35% of cases. CBS, according to the criteria, is a disease with an asymmetrical clinical presentation in 90–99% of cases. Similar results were obtained via imaging methods, but transcranial sonography produced different results. Conclusions: Determining neurodegeneration symmetry may help identify functional deficits and improve diagnostic accuracy. Patients with significant asymmetry in neurodegeneration may exhibit different neuropsychological symptoms based on their individual brain lateralization, impacting their cognitive functioning and quality of life. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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13 pages, 227 KiB

Open AccessReview

Prognostic Evaluation of Disorders of Consciousness by Using Resting-State fMRI: A Systematic Review

by Maria Le Cause, Lilla Bonanno, Antonella Alagna, Carmen Bonanno, Jolanda De Caro, Anna Lisa Logiudice, Patrizia Pollicino, Francesco Corallo, Simona De Salvo, Carmela Rifici, Angelo Quartarone and Silvia Marino

J. Clin. Med. 2024, 13(19), 5704; https://doi.org/10.3390/jcm13195704 - 25 Sep 2024

Viewed by 671

Abstract

Background: This review focuses on the prognostic role of resting-state functional magnetic resonance imaging (fMRI) in disorders of consciousness (DOCs). Several studies were conducted to determine the diagnostic accuracy in DOC patients to identify prognostic markers and to understand the neural correlates of consciousness. A correct diagnosis of consciousness in unresponsive or minimally responsive patients is important for prognostic and therapeutic management. Functional connectivity is considered as an important tool for the formulation of cerebral networks; it takes into account the primary sensorimotor, language, visual and central executive areas, where fMRI studies show damage in brain connectivity in the areas of frontoparietal networks in DOC patients. Methods: The integration of neuroimaging or neurophysiological methods could improve our knowledge of the neural correlates of clinical response after an acquired brain injury. The use of MRI is widely reported in the literature in different neurological diseases. In particular, fMRI is the most widely used brain-imaging technique to investigate the neural mechanisms underlying cognition and motor function. We carried out a detailed literature search following the relevant guidelines (PRISMA), where we collected data and results on patients with disorders of consciousness from the studies performed. Results: In this review, 12 studies were selected, which showed the importance of the prognostic role of fMRI for DOCs. Conclusions: Currently there are still few studies on this topic. Future studies using fMRI are to be considered an added value for the prognosis and management of DOCs. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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20 pages, 674 KiB

Open AccessReview

Metabolic and Immune System Dysregulation: Unraveling the Connections between Alzheimer’s Disease, Diabetes, Inflammatory Bowel Diseases, and Rheumatoid Arthritis

by Julia Doroszkiewicz, Jan Mroczko, Izabela Winkel and Barbara Mroczko

J. Clin. Med. 2024, 13(17), 5057; https://doi.org/10.3390/jcm13175057 - 26 Aug 2024

Viewed by 1397

Abstract

Alzheimer’s disease (AD), diabetes mellitus (DM), inflammatory bowel diseases (IBD), and rheumatoid arthritis (RA) are chronic conditions affecting millions globally. Despite differing clinical symptoms, these diseases share pathophysiological mechanisms involving metabolic and immune system dysregulation. This paper examines the intricate connections between these disorders, focusing on shared pathways such as insulin resistance, lipid metabolism dysregulation, oxidative stress, and chronic inflammation. An important aspect is the role of amyloid-beta plaques and tau protein tangles, which are hallmark features of AD. These protein aggregates are influenced by metabolic dysfunction and inflammatory processes similar to those seen in DM, RA, and IBD. This manuscript explores how amyloid and tau pathologies may be exacerbated by shared metabolic and immune dysfunction. Additionally, this work discusses the gut–brain axis and the influence of gut microbiota in mediating disease interactions. Understanding these commonalities opens new avenues for multi-targeted therapeutic approaches that address the root causes rather than merely the symptoms of these conditions. This integrative perspective could lead to more effective interventions and improved patient outcomes, emphasizing the importance of a unified approach in managing these interconnected diseases. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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23 pages, 1614 KiB

Open AccessReview

Trace Elements in Alzheimer’s Disease and Dementia: The Current State of Knowledge

by Magdalena Tyczyńska, Marta Gędek, Adam Brachet, Wojciech Stręk, Jolanta Flieger, Grzegorz Teresiński and Jacek Baj

J. Clin. Med. 2024, 13(8), 2381; https://doi.org/10.3390/jcm13082381 - 19 Apr 2024

Cited by 6 | Viewed by 2099

Abstract

Changes in trace element concentrations are being wildly considered when it comes to neurodegenerative disorders, such as Alzheimer’s disease and Parkinson’s disease. This study aims to present the role that trace elements play in the central nervous system. Moreover, we reviewed the mechanisms involved in their neurotoxicity. Low zinc concentrations, as well as high levels of copper, manganese, and iron, activate the signalling pathways of the inflammatory, oxidative and nitrosative stress response. Neurodegeneration occurs due to the association between metals and proteins, which is then followed by aggregate formation, mitochondrial disorder, and, ultimately, cell death. In Alzheimer’s disease, low Zn levels suppress the neurotoxicity induced by β-amyloid through the selective precipitation of aggregation intermediates. High concentrations of copper, iron and manganese cause the aggregation of intracellular α-synuclein, which results in synaptic dysfunction and axonal transport disruption. Parkinson’s disease is caused by the accumulation of Fe in the midbrain dopaminergic nucleus, and the pathogenesis of multiple sclerosis derives from Zn deficiency, leading to an imbalance between T cell functions. Aluminium disturbs the homeostasis of other metals through a rise in the production of oxygen reactive forms, which then leads to cellular death. Selenium, in association with iron, plays a distinct role in the process of ferroptosis. Outlining the influence that metals have on oxidoreduction processes is crucial to recognising the pathophysiology of neurodegenerative diseases and may provide possible new methods for both their avoidance and therapy. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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Other

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11 pages, 487 KiB

Open AccessSystematic Review

REM Sleep Behavior Disorder and Cognitive Functions in Parkinson’s Patients: A Systematic Review

by Giulia Marafioti, Francesco Corallo, Davide Cardile, Giuseppe Di Lorenzo, Angelo Quartarone and Viviana Lo Buono

J. Clin. Med. 2023, 12(23), 7397; https://doi.org/10.3390/jcm12237397 - 29 Nov 2023

Cited by 2 | Viewed by 2025

Abstract

Sleep disorders, such as REM sleep behavior disorder (RBD) and excessive daytime sleepiness, are among the most common non-motor symptoms in subjects with Parkinson’s disease (PD). Sleep disorders have a major negative impact on the quality of life of patients and their caregivers. In addition, REM sleep behavior disorder is an important risk factor for cognitive impairment in PD. This systematic review was conducted on studies investigating the influence of RBD on cognitive performance in PD subjects. We searched the PubMed and Scopus databases, screened the references of the studies included, and reviewed articles for additional citations. From the first 244 publications, we included only 11 studies that met the search criteria. The results showed that sleep disorders in PD were associated with impaired executive functions, visual-constructive abilities, reduced attention, and episodic verbal memory, and could predict the possible risk of developing dementia. Full article

(This article belongs to the Special Issue Current Practice and Future Perspectives of Neurological Conditions Caused by Neurodegeneration)

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