Abnormal resting-state brain activity and connectivity of brain-bladder control network in overactive bladder syndrome

Background Neuroimaging studies have shown that the brain is involved in the mechanism of overactive bladder disease (OAB). Purpose To explorer spatial patterns of spontaneous neural activities and functional integration in patients with OAB. Material and Methods In total, 28 patients with OAB and 28 matched healthy controls (HC) underwent resting-state functional magnetic resonance imaging and completed questionnaires to assess clinical symptoms. The amplitude of low-frequency fluctuation (ALFF) and ROI-based functional connectivity (FC) within the brain-bladder control network (BBCN) were calculated and compared between the two groups using a two-sample t-test. Pearson correlation analysis was performed to investigate the relationship between ALFF and the clinical score of patients with OAB. Results Compared with HCs, patients with OAB exhibited significantly decreased ALFF in the left superior medial middle gyrus (SFGmed) and superior dorsal frontal gyrus (SFGdor), and increased ALFF in the right hippocampus. Furthermore, ALFF values in the left SFGmed were negatively correlated with OABSS scores. FC in patients with OAB was significantly increased between the bilateral caudate nucleus (CAU) and bilateral SFGdor, the bilateral CAU and bilateral supplementary motor area (SMA), the bilateral thalamus and SMA; the left CAU and bilateral SFGmed, the left CAU and bilateral anterior cingulate gyrus, and the left CAU and left insula. Additionally, decreased FC was found between the bilateral amygdala and bilateral SFGmed and the left SMA and left insula. Conclusion These abnormal activities and connectivities of BBCN may indicate impaired cortical control of micturition in OAB, suggesting a possible neural mechanism of OAB.

Bioelectric Medicine: Magicall Tools for Treatment of Many Diseases

Bioelectronic medicine is a relatively new area that focuses on developing methods for treating diseases that do not need medications. Bioelectronic medicine treatments are now possible thanks to a small embedded system that produces and delivers frequent digital doses to nerve bundles, resulting in a disease-fighting effect that can last hours or days and is based on mechanisms similar to drug therapies. Although this may sound like science fiction, electronic brain and nerve stimulators are now presence applicable to treat so many of ailments, including epilepsy, Parkinson's disease, and bladder control. Progress in treating such disorders has opened up possibilities for boosting memory, improving eyesight, strengthening a shaky gait, and even improving a golfer's swing. Those self-improvement dreams may be a long way off, but bioelectronic medicine is gaining traction as a new way to treat difficult diseases. What distinguishes bioelectronic medicine is its biological effect on the body, which goes beyond symptom management to treat the underlying condition by using the body's own mechanisms. With promising early results in many trials and further trials ongoing, bioelectronic therapies are likely to be accepted for clinical use within the next few years. To make this advancement possible, forward-thinking scientists, engineers, doctors, and innovators with specialised talents combined old and new discoveries in ways no one had before.

Guillain-Barré Syndrome: A Rare Case Report

Introduction: Guillain-Barré syndrome (GBS) is a rare neurodegenerative condition in which the immune system of the body mistakenly damages a portion of the peripheral nerve system. The initial signs are general weakness and numbness in the limbs. Initial symptoms occur within a few days or weeks of infection. These symptoms can spread fast, ultimately paralyzing the entire body. The peripheral system consists of the brain and spinal cord. The nerve network is found outside of the brain and spinal cord. GBS can range from a minor case with short weakness to a completely fatal paralysis that renders the individual unable to breathe on their own. Fortunately, even the most severe instances of GBS may be recovered from. Some people will remain feeble even after they have recovered. The majority of patients reach the peak of their weakness within the first two weeks of symptoms appearing; by the third week, 90 percent of those affected are at their weakest. Symptoms of muscle weakness include difficulty with muscles of the eyes and vision, swallowing difficulties, difficulty in speaking, or chewing, pricking or pins and needles sensations in the hands and feet, pain that can be severe, especially at night, coordination problems, and unsteadiness, abnormal heartbeat/rate or blood pressure, problems with digestion and/or bladder control, and problems with digestion and/or bladder control. Background: Guillain-Barré syndrome can affect anyone. It can attack at any age (though it is more common in adults and the elderly), and both sexes are equally susceptible to the condition. GBS is predicted to afflict one in every 100,000 people each year. GBS affects between 3,000 and 6,000 persons in the United States each year. Case Presentation: A 53 years old male patient came to the hospital with the chief complaint of weakness in all four limbs for 6 days. A patient was apparently alright 6 days back later he was experience weakness in the left side of the body following covid vaccination on 4th June, weakness was gradually progressive in nature and progress to the right side of the body after 2 days. Later on, 8th of June patient got admitted to GMC yavatmal where the routine investigation was done including a CT scan brain which normal and doctors ask for an MRI brain for which the patient and his relative had taken a DAMA discharge and brought the patient to AVBR Hospital. All investigation has been done after that the physician diagnosed the patient having Guillain barre syndrome. The patient weakness has been worse and the treatment start according to the disease condition. Medical treatment including physical therapy also been started to reducing physical weakness and the patient condition is improved day by day. Intervention: The intervention was given to the patient such as injection ceftriaxone 1 gm BD, Inj pan 40 mg OD, Inj Emset 4 mg TDS, Inj optinurone 1 Amp in 100 ml normal saline.

Lateral Preoptic Area Neurons Activated by Angiotensin-(1–7) Increase Intravesical Pressure: A Novel Feature in Central Micturition Control

Central micturition control and urine storage involve a multisynaptic neuronal circuit for the efferent control of the urinary bladder. Electrical stimulation of the lateral preoptic area (LPA) at the level of the decussation of the anterior commissure in cats evokes relaxation of the bladder, whereas ventral stimulation of LPA evokes vigorous contraction. Endogenous Angiotensin-(1–7) [(Ang-(1–7)] synthesis depends on ACE-2, and its actions on binding to Mas receptors, which were found in LPA neurons. We aimed to investigate the Ang-(1–7) actions into the LPA on intravesical pressure (IP) and cardiovascular parameters. The gene and protein expressions of Mas receptors and ACE-2 were also evaluated in the LPA. Angiotensin-(1–7) (5 nmol/μL) or A-779 (Mas receptor antagonist, 50 nmol/μL) was injected into the LPA in anesthetized female Wistar rats; and the IP, mean arterial pressure (MAP), heart rate (HR), and renal conductance (RC) were recorded for 30 min. Unilateral injection of Ang-(1–7) into the LPA increased IP (187.46 ± 37.23%) with peak response at ∼23–25-min post-injection and yielded no changes in MAP, HR, and RC. Unilateral or bilateral injections of A-779 into the LPA decreased IP (−15.88 ± 2.76 and −27.30 ± 3.40%, respectively) and elicited no changes in MAP, HR, and RC. The genes and the protein expression of Mas receptors and ACE-2 were found in the LPA. Therefore, the LPA is an important part of the circuit involved in the urinary bladder control, in which the Ang-(1–7) synthetized into the LPA activates Mas receptors for increasing the IP independent on changes in RC and cardiovascular parameters.

AI and Robotics to Rehabilitate Lower Body Paralysis

Spinal cord injuries have unpredictable outcomes. While some recover full movement, most of them suffer permanent paralysis, ranging from partial to full-body. Alongside paralysis often comes the loss of bladder control, sexual dysfunction, bedsores, and psychological state issues, among other challenges. The solution for this is the Exoskeleton and the AI technology that offers opportunities to expand virtual and physical access for individuals with disabilities. We will disclose some machines that have an excellent impact on the lives of the elderly and other people with disabilities. However, a very important part of bringing these opportunities to success is guaranteeing that approaching AI technology works well for individuals with a large variety of skills. This paper shows how a wearable exoskeleton suit helps paralyzed people regain their ability to walk, how it works, and how this technology can be improved.

A Novel deep learning approach for the automated diagnosis of normal pressure hydrocephalus

Normal Pressure Hydrocephalus (NPH), an Atypical Parkinsonian syndrome, is a neurological syndrome that mainly affects elderly people. This syndrome shows the symptoms of Parkinson’s disease (PD), such as walking impairment, dementia, impaired bladder control, and mental impairment. The Magnetic Resonance Imaging (MRI) is the aptest modality for the detection of the abnormal build-up of cerebrospinal fluid in the brain’s cavities or ventricles, which is the major cause of NPH. This work aims to develop an automated biomarker for NPH segmentation and classification (NPH-SC) that efficiently detect hydrocephalus using a deep learning-based approach. Removal of non-cerebral tissues (skull, scalp, and dura) and noise from brain images by skull stripping, unsharp-mask based edge sharpening, segmentation by marker-based watershed algorithm, and labelling are performed to improve the accuracy of the CNN based classification system. The brain ventricles are extracted using the external and internal markers and then fed into the convolutional neural networks (CNN) for classification. This automated NPH-SC model achieved a sensitivity of 96%, a specificity of 100%, and a validation accuracy of 97%. The prediction system, with the help of a CNN classifier, is used for the calculation of test accuracy of the system and obtained promising 98% accuracy.

Patient-Reported Outcomes of Bladder and Bowel Control in Children with Spina Bifida

Background: The primary aim was to describe patient-reported morbidity from neurogenic bladder and bowel dysfunction in a cohort of children with spina bifida. The secondary aim was to describe the overall surgical burden in these children. Methods: Children with meningocele or myelomeningocele, born between 2000–2016, and followed by a tertiary spina bifida center were evaluated in a cross-sectional cohort study using data from charts and a prospective national follow-up program. Results: In the group of 62 patients, clean intermittent catheterization (CIC) was used by 47 (76%) of the patients, and anticholinergic treatment was used by 36 (58%). More than one third of the patients reported inadequate results with daily urinary leakage. Laxatives and enema were used regularly by 45 (73%) and 39 (63%) patients, respectively. Inadequate results were reported by seven (11%) patients. One or more urogenital or gastrointestinal operations had been performed in 26 (42%) patients, with a total of 109 procedures overall. Conclusions: Despite substantial bowel and bladder management, a significant portion of children suffered from inadequate results concerning bladder and bowel control. Many surgeries were performed in a defined group of the children. Prospective, long-term studies can evaluate if more aggressive medical and/or surgical management could increase bowel and bladder control.