Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Parkinson’s disease (PD) is a neurological disorder characterized by heterogeneous symptomatology, in which the classical motor features of Parkinsonism are associated with clinically significant non-motor symptoms. Olfactory alteration, as a manifestation of PD’s premotor or prodromal phase, is well known. These impairments can lead to malnutrition, decreased appetite, and depression, thereby worsening patients’ quality of life. However, only a few studies clarify the mechanisms, characteristics, and clinical diagnostic and therapeutic implications of impaired taste perception. Moreover, unlike most motor features of PD, non-motor symptoms often have limited treatment options or responses. The purpose of this review is to collate and describe all relevant studies on taste and smell alterations in patients with PD and how these alterations could affect nutritional status. Our search aimed to identify English-language research articles and reviews published in peer-reviewed journals over the past two decades (2004–2024), while also including older foundational studies when relevant. Several studies show that hyposmia in PD worsens over time, potentially linked to structural changes in the brain’s basal ganglia and piriform cortex. Severe hyposmia is also associated with a higher risk of dementia in PD patients and can negatively influence quality of life, affecting social interactions and nutrition. Regarding taste perception, recent studies have suggested that hypogeusia may occur even in the prodromal stage of PD, such as in patients with REM sleep disorder, although the exact mechanisms remain unclear. Additionally, research has explored the role of bitter taste receptors and their possible involvement in inflammation and α-synuclein misfolding, suggesting a link between taste dysfunction and immune system changes in PD. Attention was then focused on the gut microbiota’s link to the central nervous system and its contribution to gustatory dysfunctions, as well as how the nasal microbiome influences PD progression by altering the olfactory system. Nowadays, the primary role of a correct diet in the overall treatment of PD patients is becoming increasingly important for practitioners. Diet should be included among the available aids to counteract some aspects of the pathology itself. For all these reasons, it is also crucial to determine whether these chemosensory impairments could serve as disease markers, helping to better understand the underlying mechanisms of the disease....
Background Seizures are a common but often overlooked manifestation of MELAS. This study aimed to describe the characteristics of seizures in MELAS and to analyze the clinical, electroencephalographic, imaging, and biochemical factors associated with drug-resistant epilepsy. Methods A single-center retrospective study was conducted to investigate the clinical characteristics of seizures in MELAS patients. The study collected data on clinical features, muscle biopsy results, genetic testing, seizure symptoms, electroencephalography (EEG), neuroimaging findings, cerebrospinal fluid and blood biochemistry, and the modified Rankin Scale (mRS). We also investigated the correlation between seizure frequency and mRS scores. In addition, we analyzed the risk factors for drug-resistant epilepsy in MELAS. Results A total of 37 patients with confirmed MELAS (24 males and 13 females) were included in the study. All patients experienced seizures, with an onset age ranging from 14 to 53 years and a mean of 32 years. These MELAS patients experienced a variety of seizure types, with generalized seizures being the most common. EEG findings revealed background rhythm abnormalities in all patients, and epileptiform discharges were observed in 37.8% of patients during the interictal phase. Status epilepticus (OR 16.499; 95% CI, 1.615–168.557; P = 0.018) and elevated resting serum lactate levels (OR 8.594; 95% CI, 1.342–59.733; P = 0.024) were identified as independent risk factors for drug-resistant epilepsy. In addition, changes in the seizure frequency at the last follow-up compared to baseline were positively correlated with the mRS score. (r = 0.533, p < 0.001). Conclusion Status epilepticus and elevated resting serum lactate levels were predictive of the development of drug-resistant epilepsy in MELAS. Poor seizure control was significantly associated with increased clinical disability. Early identification of high-risk patients for drug-resistant epilepsy could facilitate the development of more effective treatment plans....
Introduction: Pituitary apoplexy is a rare condition caused by hemorrhage or infarction of the pituitary gland, often in the context of a pituitary adenoma. This study aimed to examine the epidemiological, clinical, paraclinical, therapeutic, and progressive characteristics of pituitary apoplexy caused by pituitary adenoma. Patients and Method: We conducted a retrospective descriptive study, analyzing 16 medical files of patients hospitalized for pituitary apoplexy out of 160 cases of pituitary adenomas in the Neurosurgery Department of the National University Hospital Center of Fann over a 6-year period, from January 1, 2014, to December 31, 2020. Results: We collected 16 cases of pituitary apoplexy over 6 years. The average age of our patients was 42.5 years, ranging from 17 to 79 years. Males were most represented, accounting for 80% of cases, with a sex ratio of M/F = 4. The clinical presentation included tumor syndrome (headache and neurological signs), endocrine signs, and general signs. In this study, 93.75% of patients underwent surgery via a transsphenoidal approach under endoscopy, with one case of incomplete excision (6.25%). Complications were mainly diabetes insipidus and nasal obstruction, occurring in 31.25% and 18.75% of cases, respectively. Conclusion: Pituitary apoplexy is a rare but serious complication of pituitary adenomas. It requires prompt diagnosis, confirmed by medical imaging. Hormone replacement therapy and tumor excision provide satisfactory results....
The COVID-19 pandemic and increased demands for neurologists have inspired the creation of remote, digitalized tests of neurological functions. This study investigates two tests from the Neurological Functional Tests Suite (NeuFun-TS) smartphone application, the “Postural Sway” and “Pronator Drift” tests. These tests capture different domains of postural control and motoric dysfunction in healthy volunteers (n = 13) and people with neurological disorders (n = 68 relapsing–remitting multiple sclerosis [MS]; n = 21 secondary progressive MS; n = 23 primary progressive MS; n = 13 other inflammatory neurological diseases; n = 21 non-inflammatory neurological diseases; n = 4 clinically isolated syndrome; n = 1 radiologically isolated syndrome). Smartphone accelerometer data was transformed into digital biomarkers, which were filtered in the training cohort (~ 80% of subjects) for test–retest reproducibility and correlations with subdomains of neurological examinations and validated imaging biomarkers. The independent validation cohort (~ 20%) determined whether biomarker models outperformed the best single digital biomarkers. Postural sway acceleration magnitude in the eyes closed and feet together stance demonstrated the highest reliability (ICC = 0.706), strongest correlations with age (Pearson r <= 0.82) and clinical and imaging outcomes (r <= 0.65, p < 0.001) and stronger predictive value for sway-relevant neurological disability outcomes than models that aggregated multiple biomarkers (coefficient of determination R2 = 0.46 vs 0.38). The pronator drift test only captured cerebellar dysfunction, had less reproducible biomarkers, but provided additive value when combined with postural sway biomarkers into models predicting global scales of neurological disability. In conclusion, a simple 1-min postural sway test accurately measures body oscillations that increase with natural aging and differentiates them from abnormally increased body oscillations in people with neurological disabilities....
Background/Objectives: Forensic psychiatric expertise significantly contributes to clinical criminology. Interdisciplinary investigations, evaluation tactics, and the use of criminology indices are essential for psychosocial prognostic assessments of conflict, aggression, adaptability, and recovery. Methods: This study aims to assess the impact of the COVID-19 pandemic on forensic psychiatric expertise by analyzing demographic variables such as age, gender, background, and other relevant data including criminal records, forensic antecedents, personal pathological antecedents, diagnosis, and discernment. Our study included 186 patients categorized into pandemic and post-pandemic periods. Results: Most participants were male, with no significant rural–urban distribution differences. During the COVID period, common criminal acts included aggression and child pornography, followed by attempted murder. A significant association was found between discernment and psychiatric disorders (p < 0.0011), with 67.6% of the patients lacking discernment having mental illnesses. Legal outcomes varied with discernment; 60.3% of patients without discernment required mandatory hospitalization (p < 0.0011). Conclusions: Medico-legal antecedents were more frequent during the pandemic, and safety measures were more commonly applied to those lacking discernment....
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