The Effects of Non-Invasive Brain Stimulation on Quantitative EEG in Patients With Parkinson's Disease: A Systematic Scoping Review.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, aside from alterations in the electroencephalogram (EEG) already registered. Non-invasive brain stimulation (NIBS) techniques have been suggested as an alternative rehabilitative therapy, but the neurophysiological changes associated with these techniques are still unclear. We aimed to identify the nature and extent of research evidence on the effects of NIBS techniques in the cortical activity measured by EEG in patients with PD. A systematic scoping review was configured by gathering evidence on the following bases: PubMed (MEDLINE), PsycINFO, ScienceDirect, Web of Science, and cumulative index to nursing & allied health (CINAHL). We included clinical trials with patients with PD treated with NIBS and evaluated by EEG pre-intervention and post-intervention. We used the criteria of Downs and Black to evaluate the quality of the studies. Repetitive transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), electrical vestibular stimulation, and binaural beats (BBs) are non-invasive stimulation techniques used to treat cognitive and motor impairment in PD. This systematic scoping review found that the current evidence suggests that NIBS could change quantitative EEG in patients with PD. However, considering that the quality of the studies varied from poor to excellent, the low number of studies, variability in NIBS intervention, and quantitative EEG measures, we are not yet able to use the EEG outcomes to predict the cognitive and motor treatment response after brain stimulation. Based on our findings, we recommend additional research efforts to validate EEG as a biomarker in non-invasive brain stimulation trials in PD.

Severe episodic memory impairment after strategic infarct: A case report / Grave comprometimento de memória episódica após infarto estratégico: um estudo de caso

ABSTRACT. Brain infarcts located in strategic regions often result in cognitive impairment. Based on a case study, this paper describes unusual and specific clinical and neuropsychological features of a strategic ischemic lesion in the left medial temporal lobe (MTL) structures. Taken together with the literature data, the case illustrates that a unilateral strategic infarct in MTL structures may result in severe impairment of episodic memory (EM), which refers to the ability to encode and retrieve personal experiences, including information about the time and place of an event and detailed description of the event itself. The preservation of other cognitive functions, the severe functional impairment, and the type of visual-verbal deficit in a left-sided lesion were identified as singular features of the case. The current case supports the critical role of the MTL structures in EM formation.

RESUMO. Infartos cerebrais localizados em regiões estratégicas comumente resultam em comprometimento cognitivo. Baseado em um estudo de caso, este artigo descreve características clínicas e neuropsicológicas incomuns e específicas de uma lesão isquêmica estratégica nas estruturas mediais do lobo temporal esquerdo. Tomado em conjunto com os dados da literatura, este caso ilustra que uma lesão isquêmica estratégica unilateral em estruturas do lobo temporal medial resulta no comprometimento da memória episódica, a qual se refere à habilidade de armazenar e recuperar experiências pessoais, o que inclui informações sobre o tempo e o local do evento e a descrição detalhada do próprio evento. A preservação de outras funções cognitivas, o grave comprometimento funcional e a modalidade de déficit visual-verbal em uma lesão à esquerda foram apontados como características singulares do caso. Este estudo de caso corrobora o papel crítico das estruturas do lobo temporal medial na formação da memória episódica.

Severe episodic memory impairment after strategic infarct: A case report.

Brain infarcts located in strategic regions often result in cognitive impairment. Based on a case study, this paper describes unusual and specific clinical and neuropsychological features of a strategic ischemic lesion in the left medial temporal lobe (MTL) structures. Taken together with the literature data, the case illustrates that a unilateral strategic infarct in MTL structures may result in severe impairment of episodic memory (EM), which refers to the ability to encode and retrieve personal experiences, including information about the time and place of an event and detailed description of the event itself. The preservation of other cognitive functions, the severe functional impairment, and the type of visual-verbal deficit in a left-sided lesion were identified as singular features of the case. The current case supports the critical role of the MTL structures in EM formation.

Infartos cerebrais localizados em regiões estratégicas comumente resultam em comprometimento cognitivo. Baseado em um estudo de caso, este artigo descreve características clínicas e neuropsicológicas incomuns e específicas de uma lesão isquêmica estratégica nas estruturas mediais do lobo temporal esquerdo. Tomado em conjunto com os dados da literatura, este caso ilustra que uma lesão isquêmica estratégica unilateral em estruturas do lobo temporal medial resulta no comprometimento da memória episódica, a qual se refere à habilidade de armazenar e recuperar experiências pessoais, o que inclui informações sobre o tempo e o local do evento e a descrição detalhada do próprio evento. A preservação de outras funções cognitivas, o grave comprometimento funcional e a modalidade de déficit visual-verbal em uma lesão à esquerda foram apontados como características singulares do caso. Este estudo de caso corrobora o papel crítico das estruturas do lobo temporal medial na formação da memória episódica.

Síndrome de opsoclonia-mioclonia-ataxia em paciente com AIDS / Opsoclonus-myoclonus-ataxia syndrome in an AIDS patient

É relatado aqui o caso de uma mulher de 38 anos com AIDS que desenvolveu a síndrome de opsoclonia-mioclonia-ataxia em um período diferente dos outros casos já relatados na literatura. A síndrome de opsoclonia-mioclonia-ataxia já tinha sido relatada como manifestação inicial de AIDS, assim como no momento da soroconversão de HIV e na síndrome de reconstituição imune. Este caso é único, uma vez que a paciente tinha contagem elevada de CD4 e carga viral negativa no momento em que a síndrome de opsoclonia-mioclonia-ataxia ocorreu.

We report the case of a 38-year-old woman with AIDS who developed opsoclonus-myoclonus-ataxia syndrome during a period different from other cases reported in literature. Opsoclonus-myoclonus-ataxia syndrome had already been reported as the initial neurological presentation of AIDS, as well as at the time of HIV-seroconversion and immune reconstitution syndrome. Our case is unique since the patient had an elevated CD4 count and negative viral load in the period when the opsoclonus-myoclonus-ataxia syndrome occurred.

Opsoclonus-myoclonus-ataxia syndrome in an AIDS patient.

We report the case of a 38-year-old woman with AIDS who developed opsoclonus-myoclonus-ataxia syndrome during a period different from other cases reported in literature. Opsoclonus-myoclonus-ataxia syndrome had already been reported as the initial neurological presentation of AIDS, as well as at the time of HIV-seroconversion and immune reconstitution syndrome. Our case is unique since the patient had an elevated CD4 count and negative viral load in the period when the opsoclonus-myoclonus-ataxia syndrome occurred.

Granulomatous amoebic meningoencephalitis in an immunocompetent patient.

OBJECTIVE: To report a case of granulomatous amoebic encephalitis caused by Balamuthia mandrillaris. DESIGN: Case report. SETTING: University hospital. PATIENTS: An adult female patient without any apparent suppressor immune system factor had central nervous system infection caused by B mandrillaris. MAIN OUTCOME MEASURES: Clinical, neuroimaging, and pathology findings. RESULTS: This study shows the diagnosis of B mandrillaris encephalitis suspected from a cerebral biopsy specimen and confirmed by immunohistochemical and polymerase chain reaction studies. CONCLUSIONS: This study demonstrates that the diagnosis of amoebic encephalitis represents a clinical challenge and confirming diagnoses are made, in most cases, after death. High suspicion, histopathologic examination, and indirect immunofluorescence, polymerase chain reaction, and cytokine studies from tissue and cerebrospinal fluid are the main devices to reach the diagnosis.