Crucial Role of Central Nervous System as a Viral Anatomical Compartment for HIV-1 Infection

The chronic infection established by the human immunodeficiency virus 1 (HIV-1) produces serious CD4+ T cell immunodeficiency despite the decrease in HIV-1 ribonucleic acid (RNA) levels and the raised life expectancy of people living with HIV-1 (PLWH) through treatment with combined antiretroviral therapies (cART). HIV-1 enters the central nervous system (CNS), where perivascular macrophages and microglia are infected. Serious neurodegenerative symptoms related to HIV-associated neurocognitive disorders (HAND) are produced by infection of the CNS. Despite advances in the treatment of this infection, HAND significantly contribute to morbidity and mortality globally. The pathogenesis and the role of inflammation in HAND are still incompletely understood. Principally, growing evidence shows that the CNS is an anatomical reservoir for viral infection and replication, and that its compartmentalization can trigger the evolution of neurological damage and thus make virus eradication more difficult. In this review, important concepts for understanding HAND and neuropathogenesis as well as the viral proteins involved in the CNS as an anatomical reservoir for HIV infection are discussed. In addition, an overview of the recent advancements towards therapeutic strategies for the treatment of HAND is presented. Further neurological research is needed to address neurodegenerative difficulties in people living with HIV, specifically regarding CNS viral reservoirs and their effects on eradication.

Acute musculoskeletal neck and back pain

Back and neck pain is widespread in the population. Preferably, patients of working age are sick, which leads to serious economic losses. The transition of pain from acute to chronic increases financial costs, so effective treatment of back pain is an important medical, social and economic problem. Musculoskeletal pain (MSP) prevails among all types of back pain. The source of the MSP can be various structures of the musculoskeletal system: bones, joints, muscles, fascia, tendons, ligaments, intervertebral discs. The provoking factors for the development of the MSP are static and dynamic overloads arising from physical work, long stay in a fixed posture, unprepared movements, hypothermia, vibrations. The leading diagnostic method for the MSP is a physical research of a patient which includes a detailed collection of complaints and anamnesis, inspection in statics and dynamics, carrying out global and special tests, neuroorthopedic and neurological research. In most cases, the analysis of the results obtained allows you to set a clinical diagnosis without appointing additional research methods. Two cases of acute MSP with different localization, clinical manifestations and flow are offered to the discussion. In the first case, the process was localized in the muscles of the law back. In the second patient, the muscular tonic syndrome developed in the muscles of the neck and shoulder belt and was supported by functional blockades of the vertebral motor segments. For the treatment of both patients, NSAID, muscle relaxant, glucocorticoid, as well as non-drug therapy methods were used. For local injection therapy, a drug group of glucocorticoids was used, having a sodium phosphate and betamethazone dipropionate as part of the sodium betamethasone. The combination of two betamethazone salts provides both the rapid and prolonged effect of the drug, which makes it reasonable to use it with acute musculoskeletal pain.

Applying Propensity Score Methods in Clinical Research in Neurology

Propensity score-based analysis is increasingly being used in observational studies to estimate the effects of treatments, interventions, and exposures. We introduce the concept of the propensity score and how it can be used in observational research. We describe four different ways of using the propensity score: matching on the propensity score, inverse probability of treatment weighting using the propensity score, stratification on the propensity score, and covariate adjustment on the propensity score (with a focus on the first two). We provide recommendations for the use and reporting of propensity score methods for the conduct of observational studies in neurological research.

Tualang Honey: A Decade of Neurological Research

Tualang honey has been shown to protect against neurodegeneration, leading to improved memory/learning as well as mood. In addition, studies have also demonstrated its anti-inflammatory and antioxidant properties. However, a substantial part of this research lacks systematization, and there seems to be a tendency to start anew with every study. This review presents a decade of research on Tualang honey with a particular interest in the underlying mechanisms related to its effects on the central nervous system. A total of 28 original articles published between 2011 and 2020 addressing the central nervous system (CNS) effects of Tualang honey were analysed. We identified five main categories, namely nootropic, antinociceptive, stress-relieving, antidepressant, and anxiolytic effects of Tualang honey, and proposed the underlying mechanisms. The findings from this review may potentially be beneficial towards developing new therapeutic roles for Tualang honey and help in determining how best to benefit from this brain supplement.

Multiverse to inform neurological research: an example using recovery outcome of neglect

Objective Multiverse analysis provides an ideal tool for understanding how inherent, yet ultimately arbitrary methodological choices impact the conclusions of individual studies. With this investigation, we aimed to demonstrate the utility of multiverse analysis for evaluating generalisability and identifying potential sources of bias within studies employing neurological populations. Methods Multiverse analysis was used to evaluate the robustness of the relationship between post-stroke visuospatial neglect and poor long-term recovery outcome within a sample of 1113 (age = 72.5, 45.1% female) stroke survivors. A total of 25,600 t-test comparisons were run across 400 different patient groups defined using various combinations of valid inclusion criteria based on lesion location, stroke type, assessment time, neglect impairment definition, and scoring criteria across 16 standardised outcome measures. Results Overall, 33.9% of conducted comparisons yielded significant results. 99.9% of these significant results fell below the null specification curve, indicating a highly robust relationship between neglect and poor recovery outcome. However, the strength of this effect was not constant across all comparison groups. Comparisons which included < 100 participants, pre-selected patients based on lesion type, or failed to account for allocentric neglect impairment were found to yield average effect sizes which differed substantially. Similarly, average effect sizes differed across various outcome measures with the strongest average effect in comparisons involving an activities of daily living measure and the weakest in comparisons employing a depression subscale. Conclusions This investigation demonstrates the utility of multiverse analysis techniques for evaluating effect robustness and identifying potential sources of bias within neurological research.

Multiverse to inform neurological research: an example using recovery outcome of neglect

ObjectiveMultiverse analysis provides an ideal tool for understanding how inherent, yet ultimately arbitrary methodological choices impact the conclusions of individual studies. With this investigation we aimed to demonstrate the utility of multiverse analysis for evaluating generalisability and identifying potential sources of bias within studies employing neurological populations.MethodMultiverse analysis was used to evaluate the robustness of the relationship between post-stroke visuospatial neglect and poor long term recovery outcome within a sample of 1113 (age =72.5, 45.1% female) stroke survivors. A total of 25,600 t-test comparisons were run across 400 different patient groups defined using various combinations of valid inclusion criteria based on lesion location, stroke type, assessment time, neglect impairment definition, and scoring criteria across 16 standardised outcome measures.ResultsOverall, 33.9% of conducted comparisons yielded significant results. 99.9% of these significant results fell below the null specification curve, indicating a highly robust relationship between neglect and poor recovery outcome. However, the strength of this effect was not constant across all comparison groups. Comparisons which included <100 participants, pre-selected patients based on lesion type, or failed to account for allocentric neglect impairment were found to yield average effect sizes which differed substantially. Similarly, average effect sizes differed across various outcome measures with the strongest average effect in comparisons involving an activities of daily living measure and the weakest in comparisons employing a depression subscale.ConclusionsThis investigation demonstrates the utility of multiverse analysis techniques for evaluating effect robustness and identifying potential sources of bias within neurological research.