Progression of Nigrostriatal Denervation in Cerebellar Multiple System Atrophy: A Prospective Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013172
Author(s):  
Thomas Wirth ◽  
Izzie Jacques NAMER ◽  
Ben Monga ◽  
Caroline BUND ◽  
Andra Valentina Iosif ◽  
...  
Keyword(s):  
Multiple System Atrophy ◽  
Prospective Study ◽  
Diagnostic Criteria ◽  
Cerebellar Ataxia ◽  
Late Onset ◽  
Final Diagnosis ◽  
Binding Ratio ◽  
A Prospective Study ◽  
Principal Criterion

Background and Objectives:Nigro-striatal dopaminergic denervation (NSDD) remains poorly characterized in cerebellar multiple system atrophy (MSA-C). We aimed to study NSDD progression in MSA-C and evaluate the capacity for [123I]-FP-CIT-SPECT and parkinsonism to differentiate MSA-C from idiopathic late-onset cerebellar ataxia (ILOCA).Material and methods:We included 85 patients successively referred for sporadic late-onset cerebellar ataxia (SLOCA). Every six months, SARA, UPDRS-III and SDFS scores were measured, and MSA-C diagnostic criteria were searched for. Striatal/occipital dopaminergic binding ratio was evaluated every year with [123I]-FP-CIT-scintigraphy.Results:After a mean follow-up of 33.8 months, 33 patients had probable MSA-C, 8 possible MSA-C and 44 ILOCA. SARA and UPDRS-III scores worsened faster in the probable MSA-C group (p<0.01) compared to the ILOCA group. Baseline striatal/occipital ratio was lower (2.3 vs 2.97; p<0.01) and more decreasing among probable MSA-C patients (p<0.01). Weighting dysautonomia and parkinsonism and/or NSDD as additional and principal criterion, respectively, in the possible MSA-C diagnostic criteria slightly improved their specificity (81.6% vs 76.9%) and sensitivity (77.8% vs 72.2%) to predict a final diagnosis of probable MSA-C.Conclusions:Rapid symptoms worsening and NSDD existence and progression predict MSA-C among SLOCA patients. Parkinsonism, NSDD and dysautonomia should be considered equivalent for possible MSA-C diagnosis.

scholarly journals Outcome of SARS-COV-2-Related Thyrotoxicosis in Survivors of COVID-19: A Prospective Study

2021 ◽  
Author(s):  
Alessandro Pizzocaro ◽  
Paolo Colombo ◽  
Walter Vena ◽  
Salvatore Ariano ◽  
Paola Magnoni ◽  
...  
Keyword(s):  
Prospective Study ◽  
Thyroid Function ◽  
Late Onset ◽  
Overt Hypothyroidism ◽  
Ultrasound Evaluation ◽  
Median Period ◽  
A Prospective Study ◽  
Receptor Antibodies ◽  
Serum Tsh

Abstract PurposeTo evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis. MethodsThis was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At the follow-up, patients were evaluated for serum thyrotropic (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.ResultsAfter recovery of COVID-19, serum TSH values significantly increased (P<0.001) and FT4 values significantly decreased (P=0.001), without significant change in serum FT3 (P=0.572). At the follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) with a prevalence that was significantly higher in cases with serum TSH > 3.0 mU/l as compared to those with TSH values below 1.0 mU/L (P=0.039). All subjects resulted to be negative for TgAb, TPOAb and TRAb. ConclusionIn a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.

Follow-up of neurophysiological tests and CT in late-onset cerebellar ataxia and multiple system atrophy

1993 ◽  
Vol 240 (3) ◽  
pp. 168-176 ◽  
Author(s):  
Karl Wessekl ◽  
Georg-Peter Huss ◽  
Hartmut Br�ckmann ◽  
Detlef K�mpf
Keyword(s):  
Multiple System Atrophy ◽  
Cerebellar Ataxia ◽  
Late Onset ◽  
Neurophysiological Tests

scholarly journals Quantitative muscle MRI to follow up late onset Pompe patients: a prospective study

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Sebastian Figueroa-Bonaparte ◽  
◽  
Jaume Llauger ◽  
Sonia Segovia ◽  
Izaskun Belmonte ◽  
...  
Keyword(s):  
Prospective Study ◽  
Late Onset ◽  
Muscle Mri ◽  
A Prospective Study

scholarly journals A Prospective Study of Posterior (Transpedicular) Approach versus Anterior (Transthoracic/Thoracoabdominal) Approach for Posttraumatic Compression Fracture of Thoracolumbar Vertebra in a Tertiary Care Center: Comparison of Clinical and Radiological Outcomes

2020 ◽  
Author(s):  
Rahul Varshney ◽  
Parthasarathi Datta ◽  
Pulak Deb ◽  
Santanu Ghosh
Keyword(s):  
Prospective Study ◽  
Posterior Approach ◽  
Spinal Injuries ◽  
Anterolateral Approach ◽  
Kyphotic Angle ◽  
Posterior Group ◽  
Thoracoabdominal Approach ◽  
A Prospective Study ◽  
Anterior Group

Abstract Objective The aim of this article was to analyze the clinical and radiological outcomes of transpedicular decompression (posterior approach) and anterolateral approach in patients with traumatic thoracolumbar spinal injuries. Methods  It was a prospective study of patients with fractures of dorsolumbar spine from December 2011 to December 2013. A total of 60 patients with traumatic spinal injuries were admitted during the study period (December 2011–2013), of which 51 cases were finally selected and taken for operations while 3 were eventually lost in follow-up. Twenty patients were operated by anterolateral approach, titanium mesh cage, and fixation with bicortical screws. Twenty-eight patients were treated with posterior approach and transpedicular screw fixation. Clinical and radiographic evaluations were performed on all 48 patients before and after surgery. Results There were 48 patients of thoracolumbar burst fractures with 40 male and 8 female patients. Range of follow-up was from 1 month to 20 months, with a mean of 7.4. Preoperatively in anterior group, 65% of the patients were bed ridden, 20% patients were able to walk with support, and 15% of the patients were able to walk without support. In posterior group, 78.57% patients were bed ridden, 10.71% were able to walk with support, and 10.71% patients were able to walk without support. Kyphotic angle changes were seen in 16 patients out of 18 in anterior group and 20 patients in posterior group out of 25. Out of 18 patients in anterior group, 14 showed reduction in kyphotic angle of 10 to 100 (improvement), with mean improvement of 4.070. In posterior group, 7 patients showed improvement of 10 to 80 (reduction in kyphotic angle) whereas 13 patients showed deterioration of 1 to 120. The mean improvement was 2.140 in 7 patients and mean deterioration was 4.920. No statistical difference was found (p > 0.05) regarding improvement in urinary incontinence during the follow-up period. Conclusion There are significant differences in anterior and posterior approaches in terms of clinical improvement. Compared with posterior approach, the anterolateral approach can reduce fusion segment and well maintain the kyphosis correction. The selection of treatment should be based on clinical and radiological findings, including neurological deficit.

Pulmonary hypertension in late onset neonatal sepsis using functional echocardiography: a prospective study

2021 ◽  
Author(s):  
Sujata Deshpande ◽  
Pradeep Suryawanshi ◽  
Shrikant Holkar ◽  
Yogen Singh ◽  
Rameshwor Yengkhom ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Prospective Study ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
A Prospective Study

Customised gold weight eyelid implantation in paralytic lagophthalmos

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Study Design ◽  
Study Group ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Gold Weight ◽  
One Year ◽  
A Prospective Study

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

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