scholarly journals KCNA2 Autoimmunity in Progressive Cognitive Impairment: Case Series and Literature Review

2021 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Charles Timäus ◽  
Philipp von Gottberg ◽  
Sina Hirschel ◽  
Claudia Lange ◽  
Jens Wiltfang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Impairments ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Causal Link ◽  
Current Evidence ◽  
Progressive Dementia ◽  
Systematic Assessment

Autoimmune dementia is a novel and expanding field which subsumes neuropsychiatric disorders with predominant cognitive impairments due to an underlying autoimmune etiology. Progressive dementias with atypical clinical presentation should trigger a thorough diagnostic approach including testing for neural surface and intracellular antibodies to avoid a delay in accurate diagnosis and initiating appropriate therapy. Here, we present two emerging cases of progressive dementia with co-existing serum autoantibodies against the KCNA2 (potassium voltage-gated channel subfamily A member 2) subunit. We found various cognitive deficits with dominant impairments in the memory domain, particularly in delayed recall. One patient presented a subacute onset of then-persisting cognitive deficits, while the other patient’s cognitive impairments progressed more chronically and fluctuated. Cognitive impairments coincided with additional neuropsychiatric symptoms. Both had a potential paraneoplastic background according to their medical history and diagnostic results. We discuss the potential role of KCNA2 autoantibodies in these patients and in general by reviewing the literature. The pathogenetic role of KCNA2 antibodies in cognitive impairment is not well delineated; clinical presentations are heterogeneous, and thus a causal link between antibodies remains questionable. Current evidence indicates an intracellular rather than extracellular epitope. We strongly suggest additional prospective studies to explore KCNA2 antibodies in specifically-defined cohorts of cognitively impaired patients via a systematic assessment of clinical, neuropsychological, neuroimaging, as well as laboratory and CSF (cerebrospinal fluid) parameters, and antibody studies to (1) determine the epitope’s location (intracellular vs. extracellular), (2) the mode of action, and (3) seek co-existing, novel pathogenetic autoantibodies in sera and CSF.

scholarly journals The Role of High Triglycerides Level in Predicting Cognitive Impairment: A Review of Current Evidence

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2118
Author(s):  
Alina Mihaela Dimache ◽  
Delia Lidia Șalaru ◽  
Radu Sascău ◽  
Cristian Stătescu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Lifestyle Modification ◽  
Cognitive Disorders ◽  
Current Evidence ◽  
Barrier Dysfunction ◽  
Serum Triglycerides ◽  
Cerebral Amyloidosis ◽  
The Relationship

The burden of cognitive disorders is huge and still growing, however the etiology and the degree of cognitive impairment vary considerably. Neurodegenerative and vascular mechanisms were most frequently assessed in patients with dementia. Recent studies have shown the possible involvement of triglycerides levels in cognitive function through putative mechanisms such as brain blood barrier dysfunction or amyloid metabolism imbalance, but not all research in the field found this association. Several clinical studies evaluated the relationship between different forms of cognitive decline and levels of serum triglycerides, independent of other cardiovascular risk factors. This review focuses on the role of triglycerides in cognitive decline, cerebral amyloidosis and vascular impairment. Considering that the management of hypertriglyceridemia benefits from lifestyle modification, diet, and specific drug therapy, future studies are requested to appraise the triglycerides–cognitive impairment relationship.

scholarly journals A Comprehensive Review Evaluating the Impact of Protein Source (Vegetarian vs. Meat Based) in Hepatic Encephalopathy

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 370
Author(s):  
Umair Iqbal ◽  
Ravirajsinh N. Jadeja ◽  
Harshit S. Khara ◽  
Sandeep Khurana
Keyword(s):  
Hepatic Encephalopathy ◽  
Protein Intake ◽  
Alternative Therapy ◽  
Case Series ◽  
Current Evidence ◽  
Branch Chain Amino ◽  
The Impact ◽  
Protein Diets

Hepatic encephalopathy (HE) is a common neurological consequence in patients with cirrhosis and has a healthcare burden of USD 5370 to 50,120 per patient annually. HE significantly hampers the quality of life and is a major cause of morbidity and mortality. Patients with cirrhosis are at a high risk for protein-calorie malnutrition due to altered metabolism. Current evidence has changed the old belief of protein restriction in patients with cirrhosis and now 1.2 to 1.5 g/kg/day protein intake is recommended. Case series and studies with small numbers of participants showed that a vegetarian protein diet decreases the symptoms of HE when compared to a meat-based diet, but the evidence is limited and requires further larger randomized controlled trials. However, vegetable or milk-based protein diets are good substitutes for patients averse to meat intake. Branch chain amino acids (BCAA) (leucine, isoleucine and valine) have also been shown to be effective in alleviating symptoms of HE and are recommended as an alternative therapy in patients with cirrhosis for the treatment of HE. In this review, we provide an overview of current literature evaluating the role of protein intake in the management of HE in cirrhosis.

scholarly journals Differences in Assessment of Everyday Preferences Between People With Cognitive Impairment and Their Care Partners: The Role of Neuropsychiatric Symptoms

2020 ◽  
Vol 28 (10) ◽  
pp. 1070-1078
Author(s):  
James M. Wilkins ◽  
Joseph J. Locascio ◽  
Jeanette M. Gunther ◽  
Liang Yap ◽  
Bradley T. Hyman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Care Partners

Cognitive Impairment in Children with Arachnoid Cyst of Sylvian Fissure: Does it Justify the Neurosurgical Treatment?

2020 ◽  
Vol 81 (04) ◽  
pp. 362-367 ◽  
Author(s):  
Karolina Kwiatkowska ◽  
Magdalena Dębicka ◽  
Agnieszka Maryniak ◽  
Stanisław Kwiatkowski
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Intracranial Hypertension ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Clinical Symptoms ◽  
Cognitive Impairments ◽  
Neurological Deficits ◽  
Neurosurgical Treatment ◽  
The Relationship

AbstractThis report discusses the relationship between arachnoid cysts (ACs) and cognitive deficits, and we ask if cognitive impairments could justify neurosurgical treatment. In clinical practice, only AC patients with symptoms of intracranial hypertension or focal neurological deficits are referred to surgery. Occasionally, one might assume that nonspecific problems such as impairment of learning, speech, or cognitive functions are caused by an AC and can be improved by surgery. We describe three patients, in which surgery was indicated on the basis of clinical symptoms such as headaches and the size of the cysts. A neuropsychological examination before AC surgery revealed reduced cognitive potential, and the same examination repeated after surgery showed improvement. We have not found any other reason for this change, except for the decompression of the AC.

scholarly journals Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1244
Author(s):  
Michele Fabrazzo ◽  
Antonio Russo ◽  
Alessio Camerlengo ◽  
Claudia Tucci ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Potential Effect ◽  
Acute Onset ◽  
Predisposing Factors ◽  
Narrative Review ◽  
Predisposing Factor ◽  
Altered Level

SARS-CoV-2 neuroinvasive and neurotropic abilities may underlie delirium onset and neuropsychiatric outcomes. Only a limited number of studies have addressed the potential effect of SARS-CoV-2 infection on mental health so far. Most studies mainly reported the acute onset of mixed neuropsychiatric conditions in patients infected with SARS-CoV-2, characterized by agitated behavior, altered level of consciousness, and disorganized thinking, regardless of psychological or socioeconomic triggering factors. The present narrative review aims to analyze and discuss the mechanisms underlying the neuroinvasive/neurotropic properties of SARS-CoV-2 and the subsequent mental complications. Delirium appeared as a clinical manifestation of SARS-CoV-2 brain infection in some patients, without systemic or multiple organ failure symptoms. A small number of studies demonstrated that neuropsychiatric symptoms associated with COVID-19, initially presenting as a confused state, may subsequently evolve in a way that is consistent with the patients’ neuropsychiatric history. A literature analysis on this topic prevalently showed case reports and case series of patients presenting delirium or delirium-like symptoms as the main outburst of COVID-19, plus a cognitive impairment, from mild to severe, which pre-existed or was demonstrated during the acute phase or after infection. Dementia appeared as one of the most frequent predisposing factors to SARS-CoV-2 infection complicated with delirium. Instead, contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a neuropsychiatric history. Therefore, clinicians should contemplate the possibility that COVID-19 appears as delirium followed by a psychiatric exacerbation, even without other systemic symptoms. In addition, cognitive impairment might act as a predisposing factor for COVID-19 in patients with delirium.

Cognitive profile of patients with Chiari 1 malformation

2020 ◽  
Vol 18 (5) ◽  
pp. 21-24
Author(s):  
E. G. MENDELEVICH ◽  
◽  
R. G. KOKURKINA ◽  
Keyword(s):  
Prefrontal Cortex ◽  
Literature Review ◽  
Executive Functioning ◽  
Emotional Disorders ◽  
Cognitive Deficits ◽  
Cognitive Impairments ◽  
Cognitive Profile ◽  
Cerebellar Dysfunction ◽  
Chiari 1 Malformation

This paper presents literature review on cognitive impairments in patients with CM1, data on which began to be formed in the recent years. Data on the predominant deficit in the structure of executive functioning in patients with CM1 are presented. The genesis of cognitive deficits in patients with CM1 is most often considered in the context of cerebellar dysfunction and damage to the connections of the cerebellum with the prefrontal cortex, which leads to dysmetria of thinking and emotions. Data from other studies are presented that consider the role of additional factors of cognitive dysfunction in CM1, such as pain and emotional disorders.

scholarly journals Antipsychotics in Alzheimer's disease: A critical analysis

2011 ◽  
Vol 5 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Eduardo Marques da Silva ◽  
Rafaela de Castro Oliveira Pereira Braga ◽  
Thiago Junqueira Avelino-Silva ◽  
Luiz Antonio Gil Junior
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Critical Analysis ◽  
Scientific Literature ◽  
Neuropsychiatric Symptoms ◽  
Current Evidence ◽  
Psychotic Symptoms ◽  
Review Of Literature ◽  
Thematic Review

Abstract The estimated worldwide prevalence of dementia among adults older than 60 years of age was 3.9% in 2005. About 90% of demented patients will develop neuropsychiatric symptoms (NS) such as delirium, delusion, aggressiveness and agitation. The treatment of NS involves non-pharmacologic strategies (with varying degrees of success according to the scientific literature) and pharmacologic treatment (PT). The present review of literature examined the current role of AP in the management of NS in dementia. Methods: A thematic review of medical literature was carried out. Results: 313 articles were found, 39 of which were selected for critical analysis. Until 2005, the best evidence for PT had supported the use of selective serotonin re-uptake inhibitors (SSRIs), anticholinesterases, memantine and antipsychotics (AP). In 2005, the U.S. Food and Drug Administration (FDA) disapproved the use of atypical APs to treat neuropsychiatric symptoms in individuals with dementia (the same occurred with the typical APs in 2008). After this, at least two important randomized placebo-controlled multicenter trials were published examining the effectiveness of atypical APs in Alzheimer's disease (CATIE-AD) and the effects of interrupting AP treatment (DART-AD). Conclusions: Based on the current evidence available, APs still have a place in treatment of the more serious psychotic symptoms, after the failure of non-pharmacological treatment and of an initial approach with selective inhibitors of serotonin uptake, anticholinesterases and memantine.

scholarly journals Targeting Aggrephagy for the Treatment of Alzheimer’s Disease

Cells ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 311 ◽  
Author(s):  
Sandeep Malampati ◽  
Ju-Xian Song ◽  
Benjamin Chun-Kit Tong ◽  
Anusha Nalluri ◽  
Chuan-Bin Yang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurodegenerative Diseases ◽  
Small Molecules ◽  
Neuropsychiatric Symptoms ◽  
Misfolded Protein ◽  
Older Individuals ◽  
Progressive Dementia ◽  
The Brain

Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases in older individuals with specific neuropsychiatric symptoms. It is a proteinopathy, pathologically characterized by the presence of misfolded protein (Aβ and Tau) aggregates in the brain, causing progressive dementia. Increasing studies have provided evidence that the defect in protein-degrading systems, especially the autophagy-lysosome pathway (ALP), plays an important role in the pathogenesis of AD. Recent studies have demonstrated that AD-associated protein aggregates can be selectively recognized by some receptors and then be degraded by ALP, a process termed aggrephagy. In this study, we reviewed the role of aggrephagy in AD development and discussed the strategy of promoting aggrephagy using small molecules for the treatment of AD.

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