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1.
Phys Chem Chem Phys ; 26(8): 6655-6666, 2024 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-37975741

RESUMEN

5-(tert-Butyl)-2-hydroxy-1,3-isophthalaldehyde (5-tBHI) shows solvent dependent single or dual emission. The photophysics of 5-tBHI has been studied in a variety of solvents and the results were compared with that of the methyl derivative of the probe as well as the 5-tBHI anion. It has been found that the intramolecular H-bonded conformer of 5-tBHI predominantly exists in non-polar solvents, and undergoes facile excited state intramolecular proton transfer (ESIPT). On the other hand, a dynamic equilibrium can be found in polar, protic solvents, even in the ground state, except in water. NMR analyses confirm the loss of aromaticity of the probe in the ground state via anion formation, in equilibrium with the solvent mediated intermolecularly H-bonded state, in neat polar protic solvents like methanol. The proton transfer process, either intramolecularly or intermolecularly, was found to be of the order of 1 ps, and even faster than the instrumental resolution in the case of water. The current finding provides important insights on the photophysics of this small, substituted phenol.

2.
Am J Occup Ther ; 77(6)2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-38048262

RESUMEN

IMPORTANCE: Visual function is critical to support occupational performance for persons with Parkinson's disease (PwP), yet it can be adversely affected by the disease. OBJECTIVE: To evaluate the prevalence and general awareness of visual dysfunction and identify the association between visual dysfunction and occupational performance in PwP. DESIGN: Self-reported cross-sectional electronic survey. PARTICIPANTS: PwP, identified from a registered database at a neurological institute, were invited to complete the survey through emails and newsletters. OUTCOMES AND MEASURES: The survey contained items of self-reported visual difficulties, diagnosed eye conditions, and about general awareness about disease-related visual dysfunction. Ophthalmological symptoms and occupational performance were measured with the Visual Impairment Parkinson's disease Questionnaire and the Revised Self-Reported Functional Visual Performance Scale, respectively. RESULTS: Data from PwP (n = 92; Mage = 69 yr) were analyzed. Nearly half were unaware that their disease could affect vision. Awareness was not associated with disease duration. Individuals reporting awareness tended to report difficulties with vision. Functional activities requiring vision were mildly impaired, and the frequency of ophthalmologic symptoms (commonly related to ocular surface disorder) was low. Nevertheless, a higher frequency of ophthalmologic symptoms was positively associated with a higher degree of disability in activities of daily living (Spearman's ρ = .49, p < .01). CONCLUSIONS AND RELEVANCE: Visual dysfunction related to Parkinson's disease may affect occupational performance. Screening for changes in vision in these individuals may aid occupational therapists in addressing functional independence and activity engagement. What This Article Adds: People with Parkinson's disease may not have a general awareness that the disease can adversely affect visual function. Those individuals with awareness tend to notice changes in vision, and this disease-related visual dysfunction may limit engagement and participation in everyday activities. Active evaluation of visual function in people with Parkinson's disease is recommended. Occupational therapists could play a key role by screening for visual dysfunction and providing patient education in the clinic.


Asunto(s)
Actividades Cotidianas , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Estudios Transversales , Terapeutas Ocupacionales , Trastornos de la Visión/complicaciones
3.
Environ Monit Assess ; 195(3): 390, 2023 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-36781506

RESUMEN

Knowledge about glacier extent, dynamics, and characteristics are important for climate change attribution and prediction. Understanding on long-term dynamics and glacier inventory is crucial, particularly for the melt-dominated and latitudinally-diverse western Himalayan glacier basins. In this study, a temporal inventory is prepared for Warwan-sub basin (WSB), utilizing satellite imageries since the 1993 (Landsat TM: 1993; ETM+: 2001, 2008; OLI: 2020) and elevation model (SRTM DEM: 2000). The base inventory was generated for the year 2001 and systematically adjusted to the glacier situations in 1993, 2008, and 2020. Results indicate that in the year 2001, WSB in the western Himalaya included 84 glaciers (> 0.02 km2) covering an area of 187.9 ± 5.8 km2. The mapping (2001) further revealed a supraglacial debris cover of 15% of the glacierized area (28.2 ± 0.9 km2). Overall, the debris cover increased by 6% between 1993 and 2020. Temporal analyses clearly suggest a period of gain in the glacierized area (2001-2008) interspersed by the two phases of decline (1993-2001 and 2008-2020). Results specify a stronger decline in the glacierized area during 1993 to 2001 (197.03 ± 6.1 to 187.9 ± 5.8 km2) than between 2008 and 2020 (188.4 ± 5.9 to 182.8 ± 5.66 km2). Remarkably, the glacierized area increased from 187.9 ± 5.8 to 188.4 ± 5.8 km2 during 2001 to 2008. In view of widespread recession of regional glaciers, the gain in the area between 2001 and 2008 represents a peculiar characteristic of WSB that needs further detailed investigation. Further analyses suggest that low-altitude, east-facing, debris-free, steep-sloped, and small glaciers experienced greater loss in the area than large, debris-covered, north-facing, gently sloped, and high-altitude glaciers. Overall, the study at the sub-basin scale reveals inherent glacier dynamics with periodic increase and decrease in the glacierized area and a notable influence of non-climatic factors in regulating spatial heterogeneity and the rate of glacier changes.


Asunto(s)
Monitoreo del Ambiente , Cubierta de Hielo , Monitoreo del Ambiente/métodos , Cambio Climático , Imágenes Satelitales , Altitud
4.
Mov Disord ; 37(10): 1996-2007, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36103156

RESUMEN

Poststroke movement disorders (PSMDs) are a common cause of secondary movement disorders. Although prior studies have highlighted the clinical spectrum and phenomenology of PSMDs, there are many knowledge gaps worth addressing. Some of the most important include lack of clinical definitions, variable stroke symptom latencies, and lack of biomarkers for vulnerability for or resilience against developing PSMDs. Collectively, the association between stroke localization and phenomenology is less than 30%, and the long-term clinical prognosis and treatment responses are highly variable. After summarizing the accumulated evidence regarding the phenomenology, pathophysiology, neuroimaging, and treatment of PSMDs, highlighting the many gaps and controversies including diagnostic challenges, we propose a roadmap for future research to fill these gaps and resolve the related controversies. More research is warranted concerning the phenomenology, classification, diagnostic criteria, and pathophysiology of PSMDs. Further, there is an urgent need for treatment guidelines for the management of PSMDs. © 2022 International Parkinson and Movement Disorder Society.


Asunto(s)
Trastornos del Movimiento , Accidente Cerebrovascular , Humanos , Trastornos del Movimiento/complicaciones , Trastornos del Movimiento/terapia , Neuroimagen , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia
5.
Mov Disord ; 37(2): 325-333, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34724257

RESUMEN

BACKGROUND: Rasagiline has received attention as a potential disease-modifying therapy for Parkinson's disease (PD). Whether rasagiline is disease modifying remains in question. OBJECTIVE: The main objective of this study was to determine whether rasagiline has disease-modifying effects in PD over 1 year. Secondarily we evaluated two diffusion magnetic resonance imaging pulse sequences to determine the best sequence to measure disease progression. METHODS: This prospective, randomized, double-blind, placebo-controlled trial assessed the effects of rasagiline administered at 1 mg/day over 12 months in early-stage PD. The primary outcome was 1-year change in free-water accumulation in posterior substantia nigra (pSN) measured using two diffusion magnetic resonance imaging pulse sequences, one with a repetition time (TR) of 2500 ms (short TR; n = 90) and one with a TR of 6400 ms (long TR; n = 75). Secondary clinical outcomes also were assessed. RESULTS: Absolute change in pSN free-water accumulation was not significantly different between groups (short TR: P = 0.346; long TR: P = 0.228). No significant differences were found in any secondary clinical outcomes between groups. Long TR, but not short TR, data show pSN free-water increased significantly over 1 year (P = 0.025). Movement Disorder Society Unified Parkinson's Disease Rating Scale testing of motor function, Part III increased significantly over 1 year (P = 0.009), and baseline free-water in the pSN correlated with the 1-year change in Movement Disorder Society Unified Parkinson's Disease Rating Scale testing of motor function, Part III (P = 0.004) and 1-year change in bradykinesia score (P = 0.044). CONCLUSIONS: We found no evidence that 1 mg/day rasagiline has a disease-modifying effect in PD over 1 year. We found pSN free-water increased over 1 year, and baseline free-water relates to clinical motor progression, demonstrating the importance of diffusion imaging parameters for detecting and predicting PD progression. © 2021 International Parkinson and Movement Disorder Society.


Asunto(s)
Enfermedad de Parkinson , Imagen de Difusión por Resonancia Magnética , Progresión de la Enfermedad , Método Doble Ciego , Humanos , Indanos/farmacología , Indanos/uso terapéutico , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/tratamiento farmacológico , Estudios Prospectivos
6.
Brain ; 144(6): 1774-1786, 2021 07 28.
Artículo en Inglés | MEDLINE | ID: mdl-33889943

RESUMEN

The pathophysiology of dystonic tremor and essential tremor remains partially understood. In patients with medication-refractory dystonic tremor or essential tremor, deep brain stimulation (DBS) targeting the thalamus or posterior subthalamic area has evolved into a promising treatment option. However, the optimal DBS targets for these disorders remains unknown. This retrospective study explored the optimal targets for DBS in essential tremor and dystonic tremor using a combination of volumes of tissue activated estimation and functional and structural connectivity analyses. We included 20 patients with dystonic tremor who underwent unilateral thalamic DBS, along with a matched cohort of 20 patients with essential tremor DBS. Tremor severity was assessed preoperatively and approximately 6 months after DBS implantation using the Fahn-Tolosa-Marin Tremor Rating Scale. The tremor-suppressing effects of DBS were estimated using the percentage improvement in the unilateral tremor-rating scale score contralateral to the side of implantation. The optimal stimulation region, based on the cluster centre of gravity for peak contralateral motor score improvement, for essential tremor was located in the ventral intermediate nucleus region and for dystonic tremor in the ventralis oralis posterior nucleus region along the ventral intermediate nucleus/ventralis oralis posterior nucleus border (4 mm anterior and 3 mm superior to that for essential tremor). Both disorders showed similar functional connectivity patterns: a positive correlation between tremor improvement and involvement of the primary sensorimotor, secondary motor and associative prefrontal regions. Tremor improvement, however, was tightly correlated with the primary sensorimotor regions in essential tremor, whereas in dystonic tremor, the correlation was tighter with the premotor and prefrontal regions. The dentato-rubro-thalamic tract, comprising the decussating and non-decussating fibres, significantly correlated with tremor improvement in both dystonic and essential tremor. In contrast, the pallidothalamic tracts, which primarily project to the ventralis oralis posterior nucleus region, significantly correlated with tremor improvement only in dystonic tremor. Our findings support the hypothesis that the pathophysiology underpinning dystonic tremor involves both the cerebello-thalamo-cortical network and the basal ganglia-thalamo-cortical network. Further our data suggest that the pathophysiology of essential tremor is primarily attributable to the abnormalities within the cerebello-thalamo-cortical network. We conclude that the ventral intermediate nucleus/ventralis oralis posterior nucleus border and ventral intermediate nucleus region may be a reasonable DBS target for patients with medication-refractory dystonic tremor and essential tremor, respectively. Uncovering the pathophysiology of these disorders may in the future aid in further improving DBS outcomes.


Asunto(s)
Estimulación Encefálica Profunda/métodos , Temblor Esencial/fisiopatología , Temblor Esencial/cirugía , Temblor/fisiopatología , Temblor/cirugía , Adulto , Trastornos Distónicos/complicaciones , Trastornos Distónicos/fisiopatología , Trastornos Distónicos/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/fisiopatología , Núcleos Talámicos Posteriores/fisiopatología , Núcleos Talámicos Posteriores/cirugía , Estudios Retrospectivos , Tálamo/fisiopatología , Tálamo/cirugía , Temblor/etiología
7.
Neuromodulation ; 25(6): 796-803, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32578304

RESUMEN

OBJECTIVE: We aimed to formulate a practical clinical treatment algorithm for Holmes tremor (HT) by reviewing currently published clinical data. MATERIALS AND METHODS: We performed a systematic review of articles discussing the management of HT published between January 1990 and December 2018. We examined data from 89 patients published across 58 studies detailing the effects of pharmacological or surgical interventions on HT severity. Clinical outcomes were measured by a continuous 1-10 ranked scale. The majority of studies addressing treatment response were case series or case reports. No randomized control studies were identified. RESULTS: Our review included 24 studies focusing on pharmacologic treatments of 25 HT patients and 34 studies focusing on the effect of deep brain stimulation (DBS) in 64 patients. In the medical intervention group, the most commonly used drugs were levetiracetam, trihexyphenidyl, and levodopa. In the surgically treated group, the thalamic ventralis intermedius nucleus (VIM) and globus pallidus internus (GPi) were the most common brain targets for neuromodulation. The two targets accounted for 57.8% and 32.8% of total cases, respectively. Overall, compared to the medically treated group, DBS provided greater tremor suppression (p = 0.025) and was more effective for the management of postural tremor in HT. Moreover, GPi DBS displayed greater benefit in the resting tremor component (p = 0.042) and overall tremor reduction (p = 0.022). CONCLUSIONS: There is a highly variable response to different medical treatments in HT without randomized clinical trials available to dictate treatment decisions. A variety of medical and surgical treatment options can be considered for the management of HT. Collaborative research between different institutions and researchers are warranted and needed to improve our understanding of the pathophysiology and management of this condition. In this review, we propose a practical treatment algorithm for HT based on currently available evidence.


Asunto(s)
Estimulación Encefálica Profunda , Temblor , Estimulación Encefálica Profunda/efectos adversos , Globo Pálido , Humanos , Levodopa , Núcleos Talámicos , Temblor/etiología
8.
Environ Monit Assess ; 194(2): 84, 2022 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-35015159

RESUMEN

The existing knowledge on long-term climate trends over glaciated parts of Indian Himalayan Region (IHR) is limited. The present study aims at assessing the long-term (1901-2016) as well as the recent (1990-2016) temperature and precipitation trends over the glaciated parts of western (WH), central (CH) and eastern Himalaya (EH) within the IHR using Climate Research Unit Time Series version 4.01 (CRU TS4.01) data. Mann-Kendall and Sen's slope estimator tests were employed to determine the monotonic trend direction and magnitude of change over time on annual and seasonal basis. The temperature and precipitation trends were quantitatively assessed here in terms of percent change over mean as well as in absolute terms. Results show that annual average temperature remains > 0 °C in WH (2.26 °C) and CH (3.24 °C) but < 0 °C in EH (-0.97 °C). Long-term analysis (1901-2016) reveals the maximum warming in EH (74.67% or 0.93 °C) followed by WH (52.56% or 0.64 °C) and minimum in CH (44.31% or 0.73 °C). The winter warming is notably higher (WH: 1.11 °C, CH: 1.19 °C and EH: 1.41 °C) than the summer (WH: 0.31 °C, CH: 0.26 °C and EH: 0.54 °C). Annual precipitation gradually increases from WH (535.57 mm) to CH (749.91 mm) to EH (1249.49 mm), of which 68%, 76%, and 90% respectively, are summer-induced. Nevertheless, precipitation showed no clear trend in WH (slight increase of 4.53%) and EH (slight decrease of -5.30%), but a clear reduction in CH (-19.25%). Seasonally, precipitation decreased in winter (-4.53%) but increased in summer (10.65%) in WH, clearly decreased in both winter (-24.69%) and summer (-17.01%) in CH, and slightly increased in winter (2.21%) but decreased in summer (-6.80%) in EH. In recent decades (1990-2016), warming trend further accelerated in WH (0.95 °C) and CH (1.01 °C) but decreased in EH (0.60 °C). The overall precipitation trends also changed during 1990-2016 as WH experienced an overall reduction (-5%), CH maintained a declining trend (-13.10%), and EH showed slight increase (1.01%). The study concludes that the climate of glaciated parts has changed significantly, but the trend and magnitude is highly heterogeneous over different regions which likely influenced the glaciated environment.


Asunto(s)
Cambio Climático , Monitoreo del Ambiente , Clima , Estaciones del Año , Temperatura
9.
Ann Neurol ; 88(2): 375-387, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32418250

RESUMEN

OBJECTIVE: This study addresses an important problem in neurology, distinguishing tremor and ataxia using quantitative methods. Specifically, we aimed to quantitatively separate dysmetria, a cardinal sign of ataxia, from tremor in essential tremor (ET). METHODS: In Experiment 1, we compared 19 participants diagnosed with ET undergoing thalamic deep brain stimulation (DBS; ETDBS ) to 19 healthy controls (HC). We quantified tremor during postural tasks using accelerometry and dysmetria with fast, reverse-at-target goal-directed movements. To ensure that endpoint accuracy was unaffected by tremor, we quantified dysmetria in selected trials manifesting a smooth trajectory to the endpoint. Finally, we manipulated tremor amplitude by switching DBS ON and OFF to examine its effect on dysmetria. In Experiment 2, we compared 10 ET participants with 10 HC to determine whether we could identify and distinguish dysmetria from tremor in non-DBS ET. RESULTS: Three findings suggest that we can quantify dysmetria independently of tremor in ET. First, ETDBS and ET exhibited greater dysmetria than HC and dysmetria did not correlate with tremor (R2 < 0.01). Second, even for trials with tremor-free trajectories to the target, ET exhibited greater dysmetria than HC (p < 0.01). Third, activating DBS reduced tremor (p < 0.01) but had no effect on dysmetria (p > 0.2). INTERPRETATION: We demonstrate that dysmetria can be quantified independently of tremor using fast, reverse-at-target goal-directed movements. These results have important implications for the understanding of ET and other cerebellar and tremor disorders. Future research should examine the neurophysiological mechanisms underlying each symptom and characterize their independent contribution to disability. ANN NEUROL 2020;88:375-387.


Asunto(s)
Ataxia Cerebelosa/diagnóstico , Ataxia Cerebelosa/fisiopatología , Temblor Esencial/diagnóstico , Temblor Esencial/fisiopatología , Temblor/diagnóstico , Temblor/fisiopatología , Anciano , Ataxia Cerebelosa/terapia , Estimulación Encefálica Profunda/métodos , Diagnóstico Diferencial , Temblor Esencial/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Postura/fisiología , Temblor/terapia
10.
Artículo en Inglés | MEDLINE | ID: mdl-33563813

RESUMEN

OBJECTIVE: To evaluate the relationship between health-related quality of life (HR-QoL) and both physical and psychiatric factors in a large, international, multicentre cohort of patients with isolated dystonia, the Dystonia Coalition. METHODS: Natural history data from 603 patients with isolated dystonia (median age 57 years (IQR: 48 to 64 years), 67.0% women) were prospectively acquired and analysed. HR-QoL (RAND 36-Item Health Survey), severity of depressive symptoms, generalised anxiety (Hospital Anxiety and Depression Scale) and social anxiety (Liebowitz Social Anxiety Scale) were assessed. Dystonia severity (Burke-Fahn-Marsden Dystonia Rating Scale) and dystonic tremor were examined. Statistical predictors of HR-QoL were calculated using saturated path analysis. RESULTS: Reduced HR-QoL was strongly associated with the degree of depressive symptoms and generalised and social anxiety (8/8 RAND 36 subscales, p≤0.001). Increased dystonia severity was associated with worse physical functioning, physical and emotional role functioning and social functioning (all p≤0.001). The presence of tremor correlated with worse physical functioning and pain (all p≤0.006). Younger age was associated with reduced emotional well-being and vitality (all p≤0.006). There were no HR-QoL differences between sexes. CONCLUSION: HR-QoL in isolated dystonia is strongly associated with psychiatric and physical features. While current standard of care focus on motor aspects of dystonia, comprehensive care should address both physical and mental aspects of health.

11.
Eur J Neurol ; 28(12): 3999-4009, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34296504

RESUMEN

BACKGROUND AND PURPOSE: Several clinical and demographic factors relate to anatomic spread of adult-onset isolated dystonia, but a predictive model is still lacking. The aims of this study were: (i) to develop and validate a predictive model of anatomic spread of adult-onset isolated dystonia; and (ii) to evaluate whether presence of tremor associated with dystonia influences model predictions of spread. METHODS: Adult-onset isolated dystonia participants with focal onset from the Dystonia Coalition Natural History Project database were included. We developed two prediction models, one with dystonia as sole disease manifestation ("dystonia-only") and one accepting dystonia OR tremor in any body part as disease manifestations ("dystonia OR tremor"). Demographic and clinical predictors were selected based on previous evidence, clinical plausibility of association with spread, or both. We used logistic regressions and evaluated model discrimination and calibration. Internal validation was carried out based on bootstrapping. RESULTS: Both predictive models showed an area under the curve of 0.65 (95% confidence intervals 0.62-0.70 and 0.62-0.69, respectively) and good calibration after internal validation. In both models, onset of dystonia in body regions other than the neck, older age, depression and history of neck trauma were predictors of spread. CONCLUSIONS: This predictive modeling of spread in adult-onset isolated dystonia based on accessible predictors (demographic and clinical) can be easily implemented to inform individuals' risk of spread. Because tremor did not influence prediction of spread, our results support the argument that tremor is a part of the dystonia syndrome, and not an independent or coincidental disorder.


Asunto(s)
Distonía , Trastornos Distónicos , Adulto , Bases de Datos Factuales , Distonía/epidemiología , Trastornos Distónicos/complicaciones , Trastornos Distónicos/epidemiología , Humanos , Temblor/epidemiología , Temblor/etiología
12.
Bioorg Chem ; 108: 104655, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33548732

RESUMEN

The elusive targets and the multifactorial etiology of Parkinson's disease (PD) have hampered the discovery of a potent drug for PD. Furthermore, the presently available medications provide only symptomatic relief and have failed to mitigate the pathogenesis associated with PD. Therefore, the current study was aimed to evaluate the prospective of swertiamarin (SW), a secoiridoid glycoside isolated from a traditional medicinal plant, Enicostemma littorale Blume to ameliorate the characteristic features of PD in Caenorhabditis elegans. SW (25 µM) administration decreased the α-synuclein (α-syn) deposition, inhibited apoptosis and increased dopamine level mediated through upregulating the expression of genes linked to ceramide synthesis, mitochondrial morphology and function regulation, fatty acid desaturase genes along with stress responsive MAPK (mitogen-activated protein kinase) pathway genes. The neuroprotective effect of SW was evident from the robust reduction of 6-hydroxydopamine (6-OHDA) induced dopaminergic neurodegeneration independent of dopamine transporter (dat-1). SW mediated translational regulation of MAPK pathway genes was observed through increase expression of SKN-1 and GST-4. Further, in-silico molecular docking analysis of SW with C. elegans MEK-1 showed a promising binding affinity affirming the in-vivo results. Overall, these novel finding supports that SW is a possible lead for drug development against the multi- factorial PD pathologies.


Asunto(s)
Proteínas de Caenorhabditis elegans/metabolismo , Proteínas de Unión al ADN/metabolismo , Gentianaceae/química , Glucósidos Iridoides/farmacología , Fármacos Neuroprotectores/farmacología , Enfermedad de Parkinson/tratamiento farmacológico , Pironas/farmacología , Factores de Transcripción/metabolismo , alfa-Sinucleína/antagonistas & inhibidores , Animales , Apoptosis/efectos de los fármacos , Caenorhabditis elegans/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Humanos , Glucósidos Iridoides/química , Glucósidos Iridoides/aislamiento & purificación , Estructura Molecular , Fármacos Neuroprotectores/química , Fármacos Neuroprotectores/aislamiento & purificación , Enfermedad de Parkinson/metabolismo , Pironas/química , Pironas/aislamiento & purificación , Transducción de Señal/efectos de los fármacos , Relación Estructura-Actividad , alfa-Sinucleína/genética , alfa-Sinucleína/metabolismo
13.
Mov Disord ; 35(10): 1796-1801, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32562441

RESUMEN

BACKGROUND: Limited tools are available for the assessment of orthostatic tremor severity and disability. OBJECTIVES: To develop and validate a self-administered orthostatic tremor scale. METHODS: After expert consensus and literature review generating a list of 42 items, the scale was developed and modified for validation after a patient focus group, multiple rounds of Delphi panels, and cognitive interviews. Clinimetric evaluations included assessing content validity, internal consistency, measurement error and reliability, construct validity, and concurrent validity anchored on the examiner's Clinical Global Impression score. RESULTS: Eleven items ranked on a Likert scale from 0 (no disability/severity) to 5 (maximal disability/severity) were evaluated in 54 orthostatic tremor patients (16 men and 38 women; mean age: 69.17 ± 9.64 years; disease duration: 13.83 ± 11.24 years) to probe severity and disability over the preceding 1-week period. The 11-item scale showed good internal consistency (Cronbach's alpha = 0.863) and acceptable (>0.40) item-to-total correlation. However, one item was removed at the final Delphi panel because of significant floor effect, poor item-to-total correlation, and poor factor-loading, leaving the scale with 10 items (10-item Orthostatic Tremor Severity and Disability Scale). Test-retest reliability at 2 weeks was excellent (two-way random intraclass correlation coefficient > 0.90), and the individual item test-retest reliability showed good agreement, with a threshold weighted kappa >0.60 for all items. Exploratory factor analyses revealed a parsimonious two-factor construct accounting for 57.7% of the scale's variance. The 10-item Orthostatic Tremor Severity and Disability Scale scores correlated with the CGI. CONCLUSIONS: The self-administered 10-item Orthostatic Tremor Severity and Disability Scale scale is valid and reliable for capturing orthostatic tremor-related severity and disability. © 2020 International Parkinson and Movement Disorder Society.


Asunto(s)
Evaluación de la Discapacidad , Temblor , Anciano , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Temblor/diagnóstico
14.
Brain ; 142(6): 1644-1659, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-30957839

RESUMEN

Dystonia is a movement disorder characterized by involuntary muscle co-contractions that give rise to disabling movements and postures. A recent expert consensus labelled the incidence of tremor as a core feature of dystonia that can affect body regions both symptomatic and asymptomatic to dystonic features. We are only beginning to understand the neural network-level signatures that relate to clinical features of dystonic tremor. At the same time, clinical features of dystonic tremor can resemble that of essential tremor and present a diagnostic confound for clinicians. Here, we examined network-level functional activation and connectivity in patients with dystonic tremor and essential tremor. The dystonic tremor group included primarily cervical dystonia patients with dystonic head tremor and the majority had additional upper-limb tremor. The experimental paradigm included a precision grip-force task wherein online visual feedback related to force was manipulated across high and low spatial feedback levels. Prior work using this paradigm in essential tremor patients produced exacerbation of grip-force tremor and associated changes in functional activation. As such, we directly compared the effect of visual feedback on grip-force tremor and associated functional network-level activation and connectivity between dystonic tremor and essential tremor patient cohorts to better understand disease-specific mechanisms. Increased visual feedback similarly exacerbated force tremor during the grip-force task in dystonic tremor and essential tremor cohorts. Patients with dystonic tremor and essential tremor were characterized by distinct functional activation abnormalities in cortical regions but not in the cerebellum. We examined seed-based functional connectivity from the sensorimotor cortex, globus pallidus internus, ventral intermediate thalamic nucleus, and dentate nucleus, and observed abnormal functional connectivity networks in dystonic tremor and essential tremor groups relative to controls. However, the effects were far more widespread in the dystonic tremor group as changes in functional connectivity were revealed across cortical, subcortical, and cerebellar regions independent of the seed location. A unique pattern for dystonic tremor included widespread reductions in functional connectivity compared to essential tremor within higher-level cortical, basal ganglia, and cerebellar regions. Importantly, a receiver operating characteristic determined that functional connectivity z-scores were able to classify dystonic tremor and essential tremor with 89% area under the curve, whereas combining functional connectivity with force tremor yielded 94%. These findings point to network-level connectivity as an important feature that differs substantially between dystonic tremor and essential tremor and should be further explored in implementing appropriate diagnostic and therapeutic strategies.


Asunto(s)
Distonía/congénito , Trastornos Distónicos/fisiopatología , Temblor Esencial/fisiopatología , Vías Nerviosas/fisiopatología , Temblor/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Cerebelo/fisiopatología , Distonía/fisiopatología , Globo Pálido/fisiopatología , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Persona de Mediana Edad , Corteza Motora/fisiopatología
15.
Bioorg Chem ; 99: 103784, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32361184

RESUMEN

As a part of our drug discovery program for anti-tubercular agents, a total of seventeen 2, 3-diaryl benzofuran hybrids were designed, synthesized and screened for their anti-tubercular potential against Mycobacterium tuberculosis H37Ra avirulent strain. Out of seventeen, four derivatives showed significant activity against M. tuberculosis H37Ra avirulent strain (ATCC 25177) with MIC value ranging from 12.5 to 50 µg/mL but out of four, one derivative (9E) was significantly active (MIC 12.5 µg/mL), which was further supported by the molecular docking energy (-8.4 kcal/mol) with respect to the first line anti-tubercular drug, isoniazid (-6.2 kcal/mol) on the target Polyketide Synthase-13. All the derivatives were also evaluated for their cytotoxicity against the normal lung cell line L-132 by the MTT assay and no toxicity was observed up to 27.4 µg/mL concentration. This report on the antitubercular potential of benzofuran derivatives may be of great help in anti-tubercular drug development.


Asunto(s)
Antituberculosos/farmacología , Benzofuranos/farmacología , Diseño de Fármacos , Mycobacterium tuberculosis/efectos de los fármacos , Antituberculosos/síntesis química , Antituberculosos/química , Benzofuranos/síntesis química , Benzofuranos/química , Línea Celular , Relación Dosis-Respuesta a Droga , Humanos , Pruebas de Sensibilidad Microbiana , Estructura Molecular , Relación Estructura-Actividad
16.
J Neurol Neurosurg Psychiatry ; 90(8): 913-919, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-30846538

RESUMEN

OBJECTIVE: To investigate the effects of unilateral thalamic deep brain stimulation (DBS) on walking in persons with medication-refractory essential tremor (ET). METHODS: We performed laboratory-based gait analyses on 24 persons with medication-refractory ET before and after unilateral thalamic DBS implantation. Normal and tandem walking parameters were analysed across sessions (PRE-DBS/DBS OFF/DBS ON) by repeated measures analyses of variance. Pearson's correlations assessed whether changes in walking after DBS were global (ie, related across gait parameters). Baseline characteristics, lead locations and stimulation parameters were analysed as possible contributors to gait effects. RESULTS: DBS minimally affected gait at the cohort level. However, 25% of participants experienced clinically meaningful gait worsening. Walking speed decreased by >30% in two participants and by >10% in four others. Decreased walking speed correlated with increased gait variability, indicating global gait worsening in affected participants. The worsening persisted even after the stimulation was turned off. Participants with worse baseline tandem walking performance may be more likely to experience post-DBS gait worsening; the percentage of tandem missteps at baseline was nearly three times higher and tandem walking speeds were approximately 30% slower in participants who experienced gait worsening. However, these differences in tandem walking in persons with gait worsening as compared with those without worsening were not statistically significant. Lead locations and stimulation parameters were similar in participants with and without gait worsening. CONCLUSION: Global gait worsening occurred in 25% of participants with unilateral DBS for medication-refractory ET. The effect was present on and off stimulation, likely indicating a microlesion effect.


Asunto(s)
Encéfalo/patología , Estimulación Encefálica Profunda/efectos adversos , Temblor Esencial/terapia , Trastornos Neurológicos de la Marcha/etiología , Anciano , Temblor Esencial/patología , Temblor Esencial/fisiopatología , Femenino , Marcha , Trastornos Neurológicos de la Marcha/patología , Humanos , Masculino
17.
Mov Disord ; 34(1): 95-104, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30345712

RESUMEN

BACKGROUND: Evidence from functional imaging in essential tremor suggests that activity within parietal and motor cortices may be associated with worsening of tremor at increased visual feedback. OBJECTIVES: Examine how cortical oscillations within these regions and the connectivity between these regions is associated with worsening of tremor in essential tremor in response to high visual feedback. METHOD: The study included 24 essential tremor participants and 17 controls. We measured cortical activity and tremor magnitude at low and high feedback conditions. Cortical activity was measured using high-density electroencephalogram and isolated using source localization. RESULTS: Changes in power across feedback in the 4-12 Hz and 12-30 Hz bands were reduced within the contralateral motor cortex of essential tremor patients compared to controls. The 12-30 Hz bidirectional connectivity between the parietal and contralateral motor cortex was decreased in essential tremor patients. Worsening of tremor from low to high visual feedback was associated with 4-12 Hz activity in contralateral motor cortex. The greatest separation between groups was found when using the difference of the contralateral motor cortex activity at high and low feedback, rather than either feedback condition alone. CONCLUSION: Our findings provide new evidence that tremor in essential tremor is associated with reduced power across feedback in the motor cortex and reduced connectivity between the parietal and motor cortices. Combined with previous work on the cerebellar-thalamo-cortical motor circuit, our findings suggest that the network level disturbances associated with essential tremor extend to the cortico-cortical pathway between the parietal cortex and motor cortex. © 2018 International Parkinson and Movement Disorder Society.


Asunto(s)
Temblor Esencial/fisiopatología , Retroalimentación Sensorial/fisiología , Corteza Motora/fisiopatología , Temblor/fisiopatología , Anciano , Mapeo Encefálico , Cerebelo/fisiopatología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad
18.
Langmuir ; 35(38): 12285-12305, 2019 09 24.
Artículo en Inglés | MEDLINE | ID: mdl-31125238

RESUMEN

This feature article provides an overview of different kinds of futuristic biomaterials which have the potential to be used for fluorescent imaging and drug delivery, often simultaneously. The synthesis route or preparation process, fluorescence property, release profile, biocompatibility, bioimaging, and mechanistic approaches are vividly discussed. These include bioimaging with fluorescently doped quantum dots, mesoporous silica, noble metals, metal clusters, hydrophilic/hydrophobic polymers, semiconducting polymer dots, carbon/graphene dots, dendrimers, fluorescent proteins, and other nanobiomaterials. Another section discusses the controlled and targeted drug, gene, or biologically active material delivery using various vehicles such as micelles, 2D nanomaterials, organic nanoparticles, polymeric nanohybrids, and chemically modified polymers. In the last section, we discuss biomaterials, which can deliver biologically active molecules, and imaging the cell/tissue.


Asunto(s)
Materiales Biocompatibles , Portadores de Fármacos , Imagen Molecular/métodos , Animales , Materiales Biocompatibles/síntesis química , Materiales Biocompatibles/química , Materiales Biocompatibles/toxicidad , Portadores de Fármacos/síntesis química , Portadores de Fármacos/química , Portadores de Fármacos/toxicidad , Humanos , Hidrogeles/química
19.
Brain ; 141(2): 472-485, 2018 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-29293948

RESUMEN

Essential tremor is a neurological syndrome of heterogeneous pathology and aetiology that is characterized by tremor primarily in the upper extremities. This tremor is commonly hypothesized to be driven by a single or multiple neural oscillator(s) within the cerebello-thalamo-cortical pathway. Several studies have found an association of blood-oxygen level-dependent (BOLD) signal in the cerebello-thalamo-cortical pathway with essential tremor, but there is behavioural evidence that also points to the possibility that the severity of tremor could be influenced by visual feedback. Here, we directly manipulated visual feedback during a functional MRI grip force task in patients with essential tremor and control participants, and hypothesized that an increase in visual feedback would exacerbate tremor in the 4-12 Hz range in essential tremor patients. Further, we hypothesized that this exacerbation of tremor would be associated with dysfunctional changes in BOLD signal and entropy within, and beyond, the cerebello-thalamo-cortical pathway. We found that increases in visual feedback increased tremor in the 4-12 Hz range in essential tremor patients, and this increase in tremor was associated with abnormal changes in BOLD amplitude and entropy in regions within the cerebello-thalamo-motor cortical pathway, and extended to visual and parietal areas. To determine if the tremor severity was associated with single or multiple brain region(s), we conducted a birectional stepwise multiple regression analysis, and found that a widespread functional network extending beyond the cerebello-thalamo-motor cortical pathway was associated with changes in tremor severity measured during the imaging protocol. Further, this same network was associated with clinical tremor severity measured with the Fahn, Tolosa, Marin Tremor Rating Scale, suggesting this network is clinically relevant. Since increased visual feedback also reduced force error, this network was evaluated in relation to force error but the model was not significant, indicating it is associated with force tremor but not force error. This study therefore provides new evidence that a widespread functional network is associated with the severity of tremor in patients with essential tremor measured simultaneously at the hand during functional imaging, and is also associated with the clinical severity of tremor. These findings support the idea that the severity of tremor is exacerbated by increased visual feedback, suggesting that designers of new computing technologies should consider using lower visual feedback levels to reduce tremor in essential tremor.


Asunto(s)
Mapeo Encefálico , Temblor Esencial/complicaciones , Temblor Esencial/patología , Retroalimentación Sensorial/fisiología , Vías Nerviosas/fisiopatología , Visión Ocular/fisiología , Adulto , Anciano , Cerebelo/diagnóstico por imagen , Conectoma , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Corteza Motora/diagnóstico por imagen , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/patología , Oxígeno/sangre , Desempeño Psicomotor/fisiología , Análisis de Regresión , Tálamo/diagnóstico por imagen
20.
J Neurol Neurosurg Psychiatry ; 89(12): 1296-1300, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-29326293

RESUMEN

BACKGROUND: Subthalamic nucleus deep brain stimulation (STN DBS) surgery is clinically effective for treatment of cervical dystonia; however, the underlying physiology has not been examined. We used transcranial magnetic stimulation (TMS) to examine the effects of STN DBS on sensorimotor integration, sensorimotor plasticity and motor cortex excitability, which are identified as the key pathophysiological features underlying dystonia. METHODS: TMS paradigms of short latency afferent inhibition (SAI) and long latency afferent inhibition (LAI) were used to examine the sensorimotor integration. Sensorimotor plasticity was measured with paired associative stimulation paradigm, and motor cortex excitability was examined with short interval intracortical inhibition and intracortical facilitation. DBS was turned off and on to record these measures. RESULTS: STN DBS modulated SAI and LAI, which correlated well with the acute clinical improvement. While there were no changes seen in the motor cortex excitability, DBS was found to normalise the sensorimotor plasticity; however, there was no clinical correlation. CONCLUSION: Modulation of sensorimotor integration is a key contributor to clinical improvement with acute stimulation of STN. Since the motor cortex excitability did not change and the change in sensorimotor plasticity did not correlate with clinical improvement, STN DBS demonstrates restricted effects on the underlying physiology. CLINICAL TRIAL REGISTRATION: NCT01671527.


Asunto(s)
Estimulación Encefálica Profunda , Corteza Motora/fisiopatología , Núcleo Subtalámico/fisiología , Tortícolis/fisiopatología , Estimulación Magnética Transcraneal , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
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