Peripheral neuropathy: A neglected cause of disability in COPD - A narrative review.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory syndrome with systemic involvement leading to various cardiovascular, metabolic, and neurological comorbidities. It is well known that conditions associated with oxygen deprivation and metabolic disturbance are associated with polyneuropathy, but current data regarding the relationship between COPD and peripheral nervous system pathology is limited. This review summarizes the available data on the association between COPD and polyneuropathy, including possible pathophysiological mechanisms such as the role of hypoxia, proinflammatory state, and smoking in nerve damage; the role of cardiovascular and metabolic comorbidities, as well as the diagnostic methods and screening tools for identifying polyneuropathy. Furthermore, it outlines the available options for managing and preventing polyneuropathy in COPD patients. Overall, current data suggest that optimal screening strategies to diagnose polyneuropathy early should be implemented in COPD patients due to their relatively common association and the additional burden of polyneuropathy on quality of life.

Short- and long-term outcome and predictors in an international cohort of patients with neuro-COVID-19.

BACKGROUND AND PURPOSE: Despite the increasing number of reports on the spectrum of neurological manifestations of COVID-19 (neuro-COVID), few studies have assessed short- and long-term outcome of the disease. METHODS: This is a cohort study enrolling adult patients with neuro-COVID seen in neurological consultation. Data were collected prospectively or retrospectively in the European Academy of Neurology NEuro-covid ReGistrY ((ENERGY). The outcome at discharge was measured using the modified Rankin Scale and defined as 'stable/improved' if the modified Rankin Scale score was equal to or lower than the pre-morbid score, 'worse' if the score was higher than the pre-morbid score. Status at 6 months was also recorded. Demographic and clinical variables were assessed as predictors of outcome at discharge and 6 months. RESULTS: From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized. 432 (53.3%) were discharged with worse functional status. Older age, stupor/coma, stroke and intensive care unit (ICU) admission were predictors of worse outcome at discharge. 132 (16.3%) died in hospital. Older age, cancer, cardiovascular complications, refractory shock, stupor/coma and ICU admission were associated with death. 262 were followed for 6 months. Acute stroke or ataxia, ICU admission and degree of functional impairment at discharge were predictors of worse outcome. 65/221 hospitalized patients (29.4%) and 10/32 non-hospitalized patients (24.4%) experienced persisting neurological symptoms/signs. 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow-up. CONCLUSIONS: Neuro-COVID is a severe disease associated with worse functional status at discharge, particularly in older subjects and those with comorbidities and acute complications of infection.

Characteristic Personality Traits of Multiple Sclerosis Patients-An Unicentric Prospective Observational Cohort Study.

BACKGROUND AND OBJECTIVES: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. METHODS AND MATERIALS: Patients with relapsing-remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. RESULTS: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. CONCLUSIONS: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions.

Patients with Parkinson's Disease and Myasthenia Gravis-A Report of Three New Cases and Review of the Literature.

Neurodegenerative diseases such as Parkinson's disease (PD)have increasing incidence, due to lifespan expansion. The association between PD and Myasthenia Gravis (MG) is uncommon, and so far, since 1987, 26 cases have been reported. We report here a series of three new cases, two men and one woman with this peculiar combination of conditions, identified in the Neurology Department of Colentina Clinical Hospital. In this article, the pathogenesis of MG in patients with PD is discussed, along with a literature review regarding the co-occurrence of these two neurological diseases.