qEEG Analysis in the Diagnosis of Alzheimers Disease; a Comparison of Functional Connectivity and Spectral Analysis

Alzheimers disease (AD) is a brain disorder that is mainly characterized by a progressive degeneration of neurons in the brain, causing a decline in cognitive abilities and difficulties in engaging in day-to-day activities. This study compares an FFT-based spectral analysis against a functional connectivity analysis based on phase synchronization, for finding known differences between AD patients and Healthy Control (HC) subjects. Both of these quantitative analysis methods were applied on a dataset comprising bipolar EEG montages values from 20 diagnosed AD patients and 20 age-matched HC subjects. Additionally, an attempt was made to localize the identified AD-induced brain activity effects in AD patients. The obtained results showed the advantage of the functional connectivity analysis method compared to a simple spectral analysis. Specifically, while spectral analysis could not find any significant differences between the AD and HC groups, the functional connectivity analysis showed statistically higher synchronization levels in the AD group in the lower frequency bands (delta and theta), suggesting that the AD patients brains are in a phase-locked state. Further comparison of functional connectivity between the homotopic regions confirmed that the traits of AD were localized in the centro-parietal and centro-temporal areas in the theta frequency band (4-8 Hz). The contribution of this study is that it applies a neural metric for Alzheimers detection from a data science perspective rather than from a neuroscience one. The study shows that the combination of bipolar derivations with phase synchronization yields similar results to comparable studies employing alternative analysis methods.

More than Just a Brain Disorder: A Five-Point Manifesto for Psychological Care for People with Huntington’s Disease

Huntington’s disease (HD) is a rare and complex condition where affected individuals, family members, caregivers, and clinicians face a number of both long-term and fluctuating challenges. The predominant biomedical framework adopted in HD to date has traditionally viewed it as a brain disorder first and foremost. As a consequence, one of the most challenging aspects of the condition—psychological difficulties and their care—is often not given the emphasis it deserves in everyday clinical practice. Here, we propose a manifesto outlining five points to address the quality, effectiveness, availability, and accessibility of psychological care in HD. These include (1) Listening to People with HD, (2) Reformulating Difficulties Psychologically, (3) Exploring New Interventions, (4) Increasing Psychological Provision, and (5) Learning from Other Conditions. As the search for a cure continues, we hope that this manifesto will create a new impetus towards refining the current approach to psychological difficulties in HD and ultimately improve the quality of life of the tens of thousands of families affected by HD worldwide.

Migraine

Migraine is the most common disabling brain disorder. Chronic migraine, a condition characterized by the experience of migrainous headache on at least 15 days per month, is highly disabling. Patients with chronic migraine present to primary care, are often referred for management to secondary care, and make up a large proportion of patients in specialist headache clinics. Many patients with chronic migraine also have medication overuse, defined as using a compound analgesic, opioid, triptan or ergot derivative on at least 10 days per month. All doctors will encounter patients with chronic headaches. A basic working knowledge of the common primary headaches, and a rational manner of approaching the patient with these conditions, allows a specific diagnosis of chronic migraine to be made quickly and safely, and by making this diagnosis one opens up a substantial number of acute and preventive treatment options. This article discusses the current state of management of chronic migraine.

Korelasi Tingkat Kepatuhan Konsumsi Obat Antiepilepsi Menggunakan Kuesioner MGLS (Morisky, Green, Levine Adherence Scale) dengan Frekwensi Kejang Pasien Epilepsi

Epilepsy is a chronic non-communicable brain disorder that can affect people of all ages. AED (antiepileptic drug) is the main therapy for most epilepsy patients with the overall goal being to prevent seizures without causing side effects. One measure of management of drug therapy in epilepsy is the decrease / loss of seizures, so that the frequency of seizures is one of the measures to achieve end-outcome. This study was an observational cross sectional study conducted on outpatients in Airlangga University Hospital, which aims to look at the relationship between the level of adherence using antiepileptic drugs with the incidence of seizures in epilepsy patients. The level of adherence with AED consumption in this study used the MGLS questionnaire (Morisky, Green, Levine Adherence Scale). The level of adherence based on the MGLS questionnaire was divided into 3 levels including low, medium or medium obedient and high compliant. The seizure events in epilepsy patients observed were the presence or absence of seizures during the past month, the data of which were obtained from patient or family interviews and from diary seizures. The results of the study of 40 respondents found that there was a moderate positive correlation between the level of adherence measured using the MGLS questionnaire whose majority level of adherence was moderate with the occurrence of seizures in epilepsy patients (r = 0.423 with p = 0.006 <0.05.

Penerapan Latihan Rom Aktif Terhadap Kekuatan Otot Ekstremitas Bawah Pada Lansia Pasca Stroke

Stroke is a brain disorder that occurs due to damage to part of the brain caused by blocked blood vessels so that the flow of oxygen is not met properly. Stroke can cause death, paralysis, impaired speech, and decreased consciousness. The purpose of this case study was to increase lower extremity muscle strength by using ROM exercises. The method used was a case study by providing nursing care to two elderly post-stroke using Active Rom exercises. The results of this case study before doing active ROM on client I experienced a decrease in muscle strength with a percentage of 25 degrees 2 and client II experienced a decrease in muscle strength with a percentage of 25 degrees 2. After doing active ROM there was an increase in muscle strength in client I with a percentage of 75 degrees 4 and on client II with a percentage of 50 degrees 3. This case study can be said that the application of active range of motion (ROM) exercises can increase lower extremity muscle strength in the elderly after stroke. This case study is a consideration for nurses and other health workers to apply active ROM exercises in post-stroke patients.Key words : Gerontic Nursing Care, Elderly Post-Stroke, Active ROM. AbstrakStroke adalah gangguan pada otak yang terjadi karena adanya gangguan kerusakan pada sebagian otak disebabkan karena pembuluh darah yang tersumbat sehingga aliran oksigen tidak terpenuhi dengan baik. Penyakit stroke dapat menyebabkan kematian, kelumpuhan, gangguan berbicara, dan menurunkan kesadaran. Tujuan dari studi kasus ini adalah untuk meningkatkan kekuatan otot ekstremitas bawah dengan menggunakan latihan ROM. Metode yang digunakan adalah studi kasus dengan memberikan asuhan keperawatan pada dua lansia pasca stroke dengan menggunakan latihan Rom Aktif. Hasil studi kasus ini sebelum dilakukan ROM aktif pada klien I mengalami penurunan kekuatan otot dengan presentase 25 derajat 2 dan klien II mengalami penurunan kekuatan otot dengan presentase 25 derajat 2. Setelah dilakukan ROM aktif terjadi peningkatan kekuatan otot pada klien I dengan presentase 75 derajat 4 dan pada klien II dengan presentase 50 derajat 3. Kesimpulan studi kasus ini dapat disimpulkan bahwa penerapan latihan range of motion (ROM) aktif dapat meningkatkan kekuatan otot ekstremitas bawah pada lansia pasca stroke. Studi kasus ini sebagai pertimbangan bagi perawat dan tenaga kesehatan lain untuk menerapkan latihan ROM aktif pada pasien pasca strokeKata kunci: Asuhan Keperawatan Gerontik, Lansia Pasca Stroke, ROM aktif.

Principal Components Analysis of EEG Signals for Epileptic Patient Identification

According to the behavior of its neuronal connections, it is possible to determine if the brain suffers from abnormalities such as epilepsy. This disease produces seizures and alters the patient’s behavior and lifestyle. Neurologists employ the electroencephalogram (EEG) to diagnose the disease through brain signals. Neurologists visually analyze these signals, recognizing patterns, to identify some indication of brain disorder that allows for the epilepsy diagnosis. This article proposes a study, based on the Fourier analysis, through fast Fourier transformation and principal component analysis, to quantitatively identify patterns to diagnose and differentiate between healthy patients and those with the disease. Subsequently, principal component analysis can be used to classify patients, employing frequency bands as the signal features. Besides, it is made a classification comparison before and after using principal component analysis. The classification is performed via logistic regression, with a reduction from 5 to 4 dimensions, as well as from 8 to 7, achieving an improvement when there are 7 dimensions in the precision, recall, and F1 score metrics. The best results obtained, without PCA are: precision 0.560, recall 0.690, and F1 score 0.620; meanwhile, the best values obtained using PCA are: precision 0.734, recall 0.787, and F1 score 0.776.

Genotoxic Damage During Brain Development Presages Prototypical Neurodegenerative Disease

Western Pacific Amyotrophic Lateral Sclerosis and Parkinsonism-Dementia Complex (ALS/PDC) is a disappearing prototypical neurodegenerative disorder (tau-dominated polyproteinopathy) linked with prior exposure to phytogenotoxins in cycad seed used for medicine and/or food. The principal cycad genotoxin, methylazoxymethanol (MAM), forms reactive carbon-centered ions that alkylate nucleic acids in fetal rodent brain and, depending on the timing of systemic administration, induces persistent developmental abnormalities of the cortex, hippocampus, cerebellum, and retina. Whereas administration of MAM prenatally or postnatally can produce animal models of epilepsy, schizophrenia or ataxia, administration to adult animals produces little effect on brain structure or function. The neurotoxic effects of MAM administered to rats during cortical brain development (specifically, gestation day 17) are used to model the histological, neurophysiological and behavioral deficits of human schizophrenia, a condition that may precede or follow clinical onset of motor neuron disease in subjects with sporadic ALS and ALS/PDC. While studies of migrants to and from communities impacted by ALS/PDC indicate the degenerative brain disorder may be acquired in juvenile and adult life, a proportion of indigenous cases shows neurodevelopmental aberrations in the cerebellum and retina consistent with MAM exposure in utero. MAM induces specific patterns of DNA damage and repair that associate with increased tau expression in primary rat neuronal cultures and with brain transcriptional changes that parallel those associated with human ALS and Alzheimer’s disease. We examine MAM in relation to neurodevelopment, epigenetic modification, DNA damage/replicative stress, genomic instability, somatic mutation, cell-cycle reentry and cellular senescence. Since the majority of neurodegenerative disease lacks a solely inherited genetic basis, research is needed to explore the hypothesis that early-life exposure to genotoxic agents may trigger or promote molecular events that culminate in neurodegeneration.

Treating Depression and other Serotonin Deficiency Brain Disorders with Tryptophan

: Deficits of brain serotonin (5-hydroxytryptamine; 5-HT) are implicated in a number of psychiatric illnesses including depression. Treatment efficacy of this highly prevalent brain disorder is not adequate largely because serotonin stores are depleted. Tryptophan an essential amino acid is the sole precursor of serotonin; its systemic or oral administration increases serotonin synthesis because tryptophan hydroxylase, the rate limiting enzyme of 5-HT biosynthesis, is physiologically unsaturated with its substrate. The present article targets importance of tryptophan supplementation in treating serotonin deficiency and improving therapeutic intervention in depression and other serotonin deficiency brain disorders.

On the outside looking in: a phenomenological study of the lived experience of Australian adults with a disorder of the corpus callosum

Background While classified as a rare condition, a congenital disorder of the corpus callosum (DCC) is one of the most commonly identified brain anomalies in newborns, occurring in 1:4000 live births. Advances in imaging techniques have improved early diagnosis for children, yet adults with a DCC—who may present with extreme heterogeneity in cause and impact—often experience challenges in receiving a definitive diagnosis and accessing appropriate services and supports. To date, the dearth of evidence documenting the lived experiences of adults with DCC has made it difficult to determine adequate policy and service responses. This exploratory research aims to address this gap by presenting the first qualitative examination of the experiences and impact of complete or partial agenesis of the corpus callosum among adults. Results Eight face-to-face interviews were conducted with Australian adults, aged 23–72 years, to explore their lived experience. Data was collected in four Australian states from June to August 2017. Thematic and interpretive analyses were employed to analyse data. Three emergent themes described difficulties related to: (1) reactions to the diagnosis; (2) access to supports and key life domains, and (3) identifying as an adult. Interview analysis described lived experiences typically outlining a lifetime of exclusion and misunderstanding from family, educators and disability and health support services. Conclusions This paper contributes to filling the knowledge gap around a rare congenital brain disorder affecting the lives of adults. Findings confirm a considerable lack of information and support for adults living with corpus callosum disorders. Greater professional and societal understanding is needed to improve access to the key life domains of education, employment and social inclusion for adults with a DCC. To instigate truly effective change, social research must tackle the issues of applicability and impact to alter the dominance of uninformed practices, hindered by prevailing myths. This research paves the way for further phenomenological studies in which participant narrative is vital. Further research will elicit stronger policy and service responses for all current and emerging adults with a DCC.

Nutritional Ketosis as a Potential Treatment for Alcohol Use Disorder

Alcohol use disorder (AUD) is a chronic, relapsing brain disorder, characterized by compulsive alcohol seeking and disrupted brain function. In individuals with AUD, abstinence from alcohol often precipitates withdrawal symptoms than can be life threatening. Here, we review evidence for nutritional ketosis as a potential means to reduce withdrawal and alcohol craving. We also review the underlying mechanisms of action of ketosis. Several findings suggest that during alcohol intoxication there is a shift from glucose to acetate metabolism that is enhanced in individuals with AUD. During withdrawal, there is a decline in acetate levels that can result in an energy deficit and could contribute to neurotoxicity. A ketogenic diet or ingestion of a ketone ester elevates ketone bodies (acetoacetate, β-hydroxybutyrate and acetone) in plasma and brain, resulting in nutritional ketosis. These effects have been shown to reduce alcohol withdrawal symptoms, alcohol craving, and alcohol consumption in both preclinical and clinical studies. Thus, nutritional ketosis may represent a unique treatment option for AUD: namely, a nutritional intervention that could be used alone or to augment the effects of medications.