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1.
Vaccine ; 42(7): 1777-1784, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38365482

RESUMO

This phase 3 observer-blind, randomized, controlled study was conducted in adults ≥18 years of age to assess the safety and immunogenicity of NVX-CoV2373 as a heterologous booster compared to BBIBP-CorV when utilized as a homologous booster. Approximately 1000 participants were randomly assigned in a 1:1 ratio to receive a single dose of NVX-CoV2373 or BBIBP-CorV after prior vaccination with 2 or 3 doses of BBIBP-CorV. Solicited adverse events (AEs) were collected for 7 days after vaccination. Unsolicited AEs were collected for 28 days following the booster dose and serious adverse and adverse events of special interest (AESI) were collected throughout the study. Anti-spike IgG and neutralizing antibodies against SARS-CoV-2 were measured at baseline, day 14, day 28, and day 180. The study achieved its primary non-inferiority endpoint and also demonstrated statistically higher neutralization responses when NVX-CoV2373 was utilized as a heterologous booster compared with BBIBP-CorV as a homologous booster. Both vaccines had an acceptably low reactogenicity profile, and no new safety concerns were found. Heterologous boosting with NVX-CoV2373 was a highly immunogenic and safe vaccine regimen in those previously vaccinated with BBIBP-CorV.


Assuntos
Vacinas contra COVID-19 , Vacinas de Produtos Inativados , Vacinas , Adulto , Humanos , Vacinas contra COVID-19/efeitos adversos , Vacinação , Anticorpos Neutralizantes , Imunogenicidade da Vacina , Anticorpos Antivirais
2.
Cell Mol Neurobiol ; 43(7): 3435-3447, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37561339

RESUMO

Stroke is a life-threatening medical condition and is a leading cause of disability. Cerebral ischemia is characterized by a distinct inflammatory response starting with the production of various cytokines and other inflammation-related agents. Progranulin (PGRN), a multifunctional protein, is critical in diverse physiological reactions, such as cell proliferation, inflammation, wound healing, and nervous system development. A mature PGRN is anti-inflammatory, while granulin, its derivative, conversely induces pro-inflammatory cytokine expression. PGRN is significantly involved in the brain tissue and its damage, for example, improving mood and cognitive disorders caused by cerebral ischemia. It may also have protective effects against nerve and spinal cord injuries by inhibiting neuroinflammatory response and apoptosis or it may be related to the proliferation, accumulation, differentiation, and activation of microglia. PGRN is a neurotrophic factor in the central nervous system. It may increase post-stroke neurogenesis of the subventricular zone (SVZ), which is particularly important in improving long-term brain function following cerebral ischemia. The neurogenesis enhanced via PGRN in the ischemic brain SVZ may be attributed to the induction of PI3K/AKT and MAPK/ERK signaling routes. PGRN can also promote the proliferation of neural stem/progenitor cells through PI3K/AKT signaling pathway. PGRN increases hippocampal neurogenesis, reducing anxiety and impaired spatial learning post-cerebral ischemia. PGRN alleviates cerebral ischemia/reperfusion injury by reducing endoplasmic reticulum stress and suppressing the NF-κB signaling pathway. PGRN can be introduced as a potent neuroprotective agent capable of improving post-ischemia neuronal actions, mainly by reducing and elevating the inflammatory and anti-inflammatory cytokines. Expression, storage, cleavage, and function of progranulin (PGRN) in the pathogenesis of ischemic stroke.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Progranulinas/metabolismo , Proteínas Proto-Oncogênicas c-akt , Fosfatidilinositol 3-Quinases , Isquemia Encefálica/metabolismo , Acidente Vascular Cerebral/complicações , Citocinas/metabolismo , Inflamação/metabolismo
3.
Mol Biol Rep ; 49(11): 10797-10809, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35851435

RESUMO

Omega-3 fatty acids constitute a group of fatty acids with anti-inflammatory and preventive effects against various diseases. Studies in animal models have demonstrated the preventive and therapeutic effects of omega-3 fatty acids after spinal cord injury (SCI) in reducing inflammatory reactions and promoting neuroregeneration. However, studies on the efficacy of omega-3 fatty acids in treatment and prevention after SCI seem to be questionable. This study evaluates potential reasons for omega-3 fatty acid therapy oversight in populations after SCI. Therefore, some of the reasons could cover heterogeneous patient groups in size, level of injury, quality of life assessment, time since injury, no single standardised dose, various follow-up durations and metabolic changes, often insufficient to record. Due to the difficulty of collecting cases for the study, especially in the acute phase after SCI, multicenter, coordinated studies are needed to establish the effects of omega-3 fatty acids on treatment, recovery, and disease prevention in patients after SCI. Although the present results of such studies are still inconclusive, the failure to exploit the potential properties of omega-3 fatty acids in the treatment of patients with SCI solely due to methodological difficulties should be considered a potential waste.


Assuntos
Ácidos Graxos Ômega-3 , Traumatismos da Medula Espinal , Animais , Qualidade de Vida , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/metabolismo , Ácidos Graxos Ômega-3/uso terapêutico , Inflamação/tratamento farmacológico , Anti-Inflamatórios/uso terapêutico , Estudos Multicêntricos como Assunto
4.
Neurology ; 98(6): e573-e588, 2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-34906974

RESUMO

BACKGROUND AND OBJECTIVES: There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide. METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression. RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36). DISCUSSION: Ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve health care facilities in LMICs.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Adolescente , Adulto , Humanos , Incidência , AVC Isquêmico/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Adulto Jovem
5.
Eur J Drug Metab Pharmacokinet ; 47(2): 165-176, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34893967

RESUMO

Desmoteplase is a bat (Desmodus rotundus) saliva-derived fibrinolytic enzyme resembling a urokinase and tissue plasminogen activator. It is highly dependent on fibrin and has some neuroprotective attributes. Intravenous administration of desmoteplase is safe and well tolerated in healthy subjects. Plasma fibrinolytic activity is linearly related to its blood concentration, its terminal elimination half-life ranges from 3.8 to 4.92 h (50 vs. 90 µg/kg dose). Administration of desmoteplase leads to transitory derangement of fibrinogen, D-dimer, alpha2-antiplasmin, and plasmin and antiplasmin complex which normalize within 4-12 h. It does not alter a prothrombin test, international normalized ratio, activated partial thromboplastin time, and prothrombin fragment 1.2. Desmoteplase was tested in myocardial infarction and pulmonary embolism and showed promising results versus alteplase. In ischemic stroke trials, desmoteplase was linked to increased rates of symptomatic intracranial hemorrhages and case fatality. However, data from "The desmoteplase in Acute Ischemic Stroke" Trials, DIAS-3 and DIAS-J, suggest that the drug is well tolerated and its safety profile is comparable to placebo. Desmoteplase is theoretically a superior thrombolytic because of high fibrin specificity, no activation of beta-amyloid, and lack of neurotoxicity. It was associated with better outcomes in patients with significant stenosis or occlusion of a proximal precerebral vessels. However, DIAS-4 was stopped as it might have not reached its primary endpoint. Due to its promising properties, desmoteplase may be added into treatment of ischemic stroke with extension of the time window and special emphasis on patients presenting outside the 4.5-h thrombolysis window, with wake-up strokes and strokes of unknown onset.


Assuntos
AVC Isquêmico , Ativadores de Plasminogênio , Fibrinolíticos/efeitos adversos , Fibrinolíticos/farmacocinética , Fibrinolíticos/farmacologia , Humanos , AVC Isquêmico/tratamento farmacológico , Ativadores de Plasminogênio/efeitos adversos , Ativadores de Plasminogênio/farmacocinética , Ativadores de Plasminogênio/farmacologia
6.
Ann Pharmacother ; 55(1): 52-58, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32618479

RESUMO

BACKGROUND: The approved dosing of ertapenem in patients with chronic kidney disease stage 5 utilizing dialysis (CKD-5D) is 0.5 g intravenous daily. Several reports associated this dosing strategy with neurotoxicity. OBJECTIVE: The purpose of this study is to identify the incidence of neurotoxicity in this population and the risk factors associated with this toxicity. The secondary objective was to review the literature and discuss a safer/cost-effective dosing strategy based on available data. METHODS: A retrospective study was conducted screening all patients who received ertapenem and hemodialysis at our quaternary hospital between May 2015 and March 2019. Patients' demographics, comorbidities, concomitant drugs (known to induce neurotoxicity), and seizure history were collected. RESULTS: A total of 99 eligible patients were identified; 10 of them (10%) developed neurotoxicity. The patients who developed neurotoxicity were all male; mean age was 74 ± 9 years as compared with 68.9 ± 13 years in the sample. Bivariate relationships between all predictors and the seizures (dichotomously coded) were estimated to investigate the risk factors. The following were the significant predictors of seizures: male sex (17%; P = 0.014), dementia (27%; P = 0.012), and concomitant use of ß-lactams, aminoglycosides, or fluoroquinolones (19.6%; P = 0.042). CONCLUSION AND RELEVANCE: The currently approved ertapenem dose imposes a risk of developing neurotoxicity in patients with CKD-5D. Utilizing the published data in this population, alternative post-dialysis dosing strategies administered through dialysis access such as 1 g loading dose, followed by either 0.5 g (for the 48 hours interdialytic time) or 1 g (for the 72 hours interdialytic time) might warrant further investigation for efficacy and safety.


Assuntos
Antibacterianos/administração & dosagem , Ertapenem/administração & dosagem , Síndromes Neurotóxicas , Diálise Renal , Insuficiência Renal Crônica/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Ertapenem/efeitos adversos , Ertapenem/uso terapêutico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Síndromes Neurotóxicas/epidemiologia , Síndromes Neurotóxicas/etiologia , Insuficiência Renal Crônica/terapia , Estudos Retrospectivos , Convulsões/epidemiologia , Convulsões/etiologia
7.
Clin Neurol Neurosurg ; 199: 106227, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33011516

RESUMO

OBJECTIVE: To compare ischemic and hemorrhagic stroke patients with COVID-19 to non-COVID-19 controls, and to describe changes in stroke admission patterns during the pandemic. METHODS: This is a single center, retrospective, observational study. All consecutive patients admitted with primary diagnosis of ischemic/ hemorrhagic stroke between March1st -May10th 2020 were included and compared with the same time period in 2019. RESULTS: There was a 41.9% increase in stroke admissions in 2020 (148 vs 210,P = .001). When comparing all ischemic strokes, higher rate of large vessel occlusion (LVO) (18.3% vs 33.8%,P = .008) and significant delay in initiation of mechanical thrombectomy after hospital arrival (67.75 vs 104.30 minutes,P = .001) was observed in 2020. When comparing all hemorrhagic strokes, there were no differences between the two years. Among 591 COVID-19 admissions, 31 (5.24%) patients with stroke including 19 with ischemic (3.21%) and 12 with hemorrhagic stroke (2.03%) were identified. Patients with COVID-19 and ischemic stroke were significantly younger (58.74 vs 48.11 years,P = .002), predominantly male (68.18% vs 94.74%,P = .016), had lesser vascular risk factors, had more severe clinical presentation (NIHSS 7.01 vs 17.05,P < .001), and higher rate of LVO (23.6% vs. 63.1%,P = .006). There was no difference in the rate of endovascular thrombectomy, but time to groin puncture was significantly longer in COVID-19 patients (83.41 vs 129.50 minutes,P = .003). For hemorrhagic stroke, COVID-19 patients did not differ from non-COVID-19 patients. CONCLUSIONS: Stroke continues to occur during this pandemic and stroke pathways have been affected by the pandemic. Stroke occurs in approximately 5% of patients with COVID-19. COVID-19 associated ischemic stroke occurs in predominantly male patients who are younger, with fewer vascular risk factors, can be more severe, and have higher rates of LVO. Despite an increase in LVO during the pandemic, treatment with mechanical thrombectomy has not increased. COVID-19 associated hemorrhagic stroke does not differ from non-COVID-19 hemorrhagic stroke patients.


Assuntos
COVID-19/complicações , Hospitalização , SARS-CoV-2 , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/terapia , COVID-19/mortalidade , COVID-19/terapia , Procedimentos Endovasculares , Feminino , Humanos , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/mortalidade , Taxa de Sobrevida , Trombectomia , Emirados Árabes Unidos
8.
AJNR Am J Neuroradiol ; 41(12): 2263-2268, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32855182

RESUMO

The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To provide baseline institutional stroke data within and outside the COVID-19 pandemic, all consecutive ischemic stroke and TIA admissions (COVID and non-COVID) to the hospital during a 10-week period from March 1 to May 10, 2020, were collected and compared with data from the same time period in 2019. Among 20 patients with COVID-19 and acute ischemic stroke, 15 (75%) had large-vessel occlusion. These patients were young (mean age, 46.5 years), male (93%), without major burden of traditional cardiovascular risk factors, and had a severe stroke presentation. Large-vessel occlusions were observed in multiple vessels (40%), uncommonly affected vessels, and atypical locations with a large thrombus burden. Systemic thrombosis separate from large-vessel occlusion was not uncommon (26%). At short-term follow-up, stroke etiology remained undetermined in 46% of patients and functional outcome was poor. The above findings raise the possibility of stroke related to mechanisms induced by the COVID-19 infection itself, including a hypercoagulable state and/or endothelial damage. In addition, they document the severe presentation and poor outcomes of large-vessel occlusion in COVID-19 ischemic stroke.


Assuntos
COVID-19/complicações , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/patologia , AVC Isquêmico/patologia , Transtornos Cerebrovasculares/virologia , Feminino , Humanos , AVC Isquêmico/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2
9.
J Cerebrovasc Endovasc Neurosurg ; 22(1): 8-14, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32596138

RESUMO

Objective: Mechanical thrombectomy (MT) is now an established treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO) within 6 hours. Since 2018, MT is also recommended from 6-24 hours after selecting with additional multimodal imaging including perfusion imaging. We sought to investigate patients with significant discrepancy in core infarct between computed tomography (CT) and CT perfusion (CTP). Methods: In this retrospective study, patients with AIS who were evaluated for MT using the RAPID software (IschemaView, Redwood City, CA, USA) from February 2018 to March 2019 were included. Cases with discrepancy between infarct volume on non-contrast CT and core volume (cerebral blood flow <30%) as analyzed by RAPID on CTP were analyzed. Results: In the study period, 635 patients were evaluated for acute stroke symptoms. Non-contrast head CT was performed in 635 patients, and CTP with RAPID software post processing was performed in 134 patients. Among the 134 patients, 8 (5.9%) patients had gross discrepancy in core infarct between CT and CTP, with underestimation of infarct by CTP. Evaluation of these cases shows that the likely reason for this discrepancy is recanalization of a LVO, which then leads to erroneously normal or gross underestimate of the core infarct volume determined from CTP post processing analysis. Conclusions: Recanalization of a LVO can lead to erroneously normal or gross underestimation of the core infarct as determined by post processing software analysis of CTP data. The whole composite of hyperacute CT imaging should be examined while making decisions. This caveat of perfusion imaging interpretation has not been reported previously.

10.
Heliyon ; 6(1): e03219, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32042969

RESUMO

INTRODUCTION: The aim of the study was to determine the outcome, prescribed therapy, and localization of non-traumatic intracerebral haemorrhage in patients with atrial fibrillation. PATIENTS AND METHODS: This retrospective study enrolled patients with atrial fibrillation hospitalised for non-traumatic intracerebral haemorrhage from 2004 to 2013. We compared the patients according to previous antithrombotic therapy, demographics, previous CHADS2 score, comorbidities, the international normalised ration, localisation of intracerebral hamorrhage, stroke severity, prescribed antithrombotic therapy and outcome. RESULTS: A total of 85 patients were enrolled and assigned to an AT+ group (n = 49; 14 on aspirin, 35 on warfarin) and an AT- group (n = 36; without antithrombotic therapy prior to hospitalisation). The latter had a lower proportion of known atrial fibrillation (90% vs 47%, P < 0.001). The mean INR was 2.6 ± 1.5. The in-hospital mortality rates in both groups were high: 43% in AT+ group and 47% in AT- group. There were no significant differences in any of the predefined comparisons. CONCLUSION: Treating patients with intracerebral haemorrhage and atrial fibrillation is challenging due to higher mortality rates and issues regarding the use of antithrombotic treatment in stroke prevention. Based on our data, prior antithrombotic therapy was not associated with increased in-hospital mortality rates or poorer functional outcome at hospital discharge in comparison with no prior antithrombotic therapy.

11.
BMJ Open ; 9(11): e031144, 2019 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727655

RESUMO

INTRODUCTION: Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients. METHODS AND ANALYSIS: The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence. ETHICS AND DISSEMINATION: Ethical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.


Assuntos
Isquemia Encefálica/epidemiologia , Hemorragia Cerebral/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adolescente , Adulto , Isquemia Encefálica/mortalidade , Isquemia Encefálica/fisiopatologia , Hemorragia Cerebral/mortalidade , Hemorragia Cerebral/fisiopatologia , Clima , Etnicidade , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Prevenção Secundária , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/fisiopatologia , Adulto Jovem
12.
Eur J Med Res ; 24(1): 25, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349792

RESUMO

BACKGROUND: Cardioembolism in paroxysmal atrial fibrillation (PAF) is a preventable cause of transient ischaemic attack (TIA) or ischaemic stroke; however, due to its transient nature, a short-duration Holter monitor may miss a significant proportion of events. METHODS: We conducted an open-label randomised controlled trial of cardiac monitoring after a TIA or ischaemic stroke comparing a 14-day ECG monitoring patch (Zio® Patch, iRhythm Technologies) with short-duration Holter monitoring for the detection of PAF. The primary outcome was the detection of one or more episodes of ECG-documented PAF lasting at least 30 s within 90 days in each of the study arms. A budget impact analysis from the healthcare perspective was performed. RESULTS: From February 2016 through February 2017, 43 (76.8%) of the 56 patients assigned to the patch-based monitoring group and 47 (78.3%) of the 60 patients assigned to short-duration Holter monitoring group had successful monitor placement with 90 days of follow-up. Of the 26 protocol failures between the two groups, 23 (88.5%) were due to patient refusal for outpatient short-duration ECG monitor placement, whilst only 1 (3.8%) was due unsuccessful ZioPatch placement. The rate of detection of PAF at 90 days was 16.3% in the patch-based monitoring group (seven patients) compared to 2.1% in the short-duration Holter monitoring group (1 patient), with an odds ratio of 8.9 (95% CI 1.1-76.0; P = 0.026). An economic model demonstrated that implementation of the Zio Patch service would result in 10.8 more strokes avoided per year compared to current practice with Holter monitoring with an associated yearly saving in direct medical costs of £113,630, increasing to £162,491 over 5 years. CONCLUSIONS: Early, prolonged, patch-based monitoring after an index stroke or TIA is superior to short-duration Holter monitoring in the detection of PAF and likely cost-effective for preventing recurrent strokes. Trial registration http://www.isrctn.com. Unique identifier: ISRCTN 50253271. Registered 21 January 2016.


Assuntos
Eletrocardiografia Ambulatorial , Coração/fisiopatologia , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Fibrilação Atrial/diagnóstico , Determinação de Ponto Final , Feminino , Humanos , Masculino
13.
Front Neurol Neurosci ; 44: 89-99, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220845

RESUMO

Tracing the history of neglect is intriguing, as diverse terminologies have been used to characterize a multi-factorial disorder with rather startling manifestations. In part, heterogeneous terms may have hinted at distinct subtypes. Thus, different variants of hemi-inattention and neglect relate conceptually, but may be functionally dissociable. Patients with neglect, acting as if the world-space they perceive is full, do not phenomenally experience the omissions or absences so patently obvious to an observer. From the late 19th century, hemi-inattention was described according to its prominent manifestations, visual, bodily or spatial. Since then, diverse terms including imperception, inattention, unilateral visual inattention, unilateral spatial agnosia, and neglect, among others, reflected proposed underlying mechanisms. Major theories presented to account for this curious, even astonishing, neurological disorder, included disruption of body-scheme, perceptual rivalry and extinction, forgetting or amnesia for half the body, and highly nuanced models of distribution of directed spatial attention, and of disrupted perceptual processes. Unlike neurological counterparts, already designated as hemi-syndromes by the first part of the 20th century, not until about 1970 did neglect become so broadly recognized as a syndrome. Earlier, commonalities were identified, features conceptually clustered, and then subtypes were distinguished. Neglect was designated as an overarching term for a class of disorder with distinct subtypes, including visual, motor, extrapersonal, bodily or personal, other somatosensory, and representational. Specificity for modality, chronology, material, and symptom severity was noted. Remarkable clinical, neuropsychological, and behavioral manifestations of hemi-inattention and neglect may involve varying proposed mechanisms of higher cognitive functions, all within a spectrum of clinical disorder. Concepts of connectivity and interaction, neural networks, and functional integration enhance understanding of dysfunction, recovery, and compensation in neglect and inattention. Focus on distinct manifestations clustered under the umbrella of neglect offers a vantage point for examining historical trends in approach to the phenomenon.


Assuntos
Agnosia/história , Alestesia/história , Atenção/fisiologia , Transtornos da Percepção/história , Agnosia/diagnóstico , Alestesia/diagnóstico , História do Século XX , Humanos , Transtornos da Percepção/fisiopatologia , Pesquisadores/história , Terminologia como Assunto
14.
Front Neurol Neurosci ; 43: 164-176, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30336460

RESUMO

The studies on the relation between artistic production, especially visual art, and brain function gave a basis to the development of neuroesthetics. Most of the information on brain artistic creativity comes from studies on brain disease in well-established visual artists. Brain disease may cause change, dissolution, or emergence of artistic creativity. The visual artistic production may become impaired in individuals with a variety of brain diseases, including focal and generalised disorders of sudden and slowly progressive onset. In addition to that, neurological disorders may add content into visual art production, even becoming the artistic theme. Here, we discuss the particular case of abstract expressionist Willem de Kooning and the evolution of his artistic production in the context of his neurodegenerative illness. The change of de Kooning's artistic style has been the subject of many reviews, and the main focus of this paper is on artistic style across his prolific artistic career in the context of his progressive neurological condition, which he developed in his late years, and his long history of alcohol addiction. There are conflicting data from the literature on the effect of his neurological condition and clear cognitive decline on his artistic output, with preservation of recognition and the quality of his art. Hence, two pertinent questions relate to how he was able to maintain his output despite his cognitive decline, and how his condition could have affected his work.


Assuntos
Encefalopatias/fisiopatologia , Encéfalo/fisiopatologia , Criatividade , Demência/fisiopatologia , Pinturas/história , Alcoolismo , Encefalopatias/história , Demência/diagnóstico , História do Século XX , Humanos
15.
Front Neurol Neurosci ; 43: 8-22, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30336485

RESUMO

Visual art is one of the means of non-verbal communication that bypasses cultural, societal, language and, more importantly, time differences. It allows for establishing a multilevel connection between the artist and art receiver. Production of visual art is a form of expression of emotions. Art reception involves the initiation of a cascade of emotions and thoughts based on visual input. One of the ways to express artistic content is through abstraction. Abstract visual art is based on portraying elements that do not represent any real, objective shapes, with the means of lines, colours, tones and texture. Abstract expressionism is a form of abstract art infused with strong emotional and expressive content. The combination of expression of emotions in abstraction requires almost direct translation between neuronal function and artistic output without using formal shapes or references as means of communication. That is why it is very interesting to look at the artistic output in abstract expressionists with neurological disorders affecting the brain. Here, we review several key abstract expressionists, including James Brooks, Agnes Martin and Willem de Kooning, and their artistic production in the context of brain disease.


Assuntos
Encefalopatias/fisiopatologia , Encéfalo/fisiopatologia , Cognição/fisiologia , Doenças Neurodegenerativas/fisiopatologia , Arte , Encéfalo/fisiologia , Pessoas Famosas , Humanos
16.
Front Neurol Neurosci ; 42: 51-58, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29151091

RESUMO

The custom of Couvade and Couvade syndrome is a phenomenon observed since ancient times. Whether it constitutes a disease entity or it should be considered a ritual or custom remains a matter of debate. Historical transcripts shed light into the distinct origins and inclinations of couvade behaviors, some of them having religious inclinations. Currently, there are several views on this phenomenon including medical, psychoanalytic, and psychological. Some explain this syndrome as part of men's preparation and participation in pregnancy and post-partum period. Others see it as men rivalling with women for procreative ability or ability to carry an unborn child in the womb. There are a set of criteria that can be used in diagnosing Couvade syndrome, which may be helpful in standardizing clinical detection and management of patients. It is important to embed this syndrome in contemporary society to understand the complexity of male involvement in pregnancy and fatherhood, which at the end may not be a disease. In this review, the authors will guide the reader through history, possible etiologies, and clinical aspects of Couvade syndrome.


Assuntos
Transtornos Somatoformes/etiologia , Feminino , Humanos , Masculino , Gravidez , Transtornos Somatoformes/etnologia , Transtornos Somatoformes/metabolismo , Transtornos Somatoformes/fisiopatologia
18.
Behav Sci (Basel) ; 7(2)2017 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-28475130

RESUMO

Art is defined as expression or application of human creative skill and imagination producing works to be appreciated primarily for their aesthetic value or emotional power. This definition encompasses two very important elements-the creation and reception of art-and by doing so it establishes a link, a dialogue between the artist and spectator. From the evolutionary biological perspective, activities need to have an immediate or remote effect on the population through improving survival, gene selection, and environmental adjustment, and this includes art. It may serve as a universal means of communication bypassing time, cultural, ethnic, and social differences. The neurological mechanisms of both art production and appreciation are researched by neuroscientists and discussed both in terms of healthy brain biology and complex neuronal networking perspectives. In this paper, we describe folk art and the issue of symbolic archetypes in psychoanalytic thought as well as offer neuronal mechanisms for art by emphasizing mirror/neurons and the role they play in it.

19.
Front Neurol Neurosci ; 35: 56-64, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25273489

RESUMO

The theme of hysteria and hypnotism has been attracting the attention of medics, psychologists, writers, and the broad lay public. The role of hypnotism in the context of societal functioning, especially in crime, was a subject of research and significant debates between different neurology and psychology schools. One of these debates was between the Nancy and Salpêtrière schools of neurology at the end of the 19th century, and it was focused around a few cases of crime committed allegedly under hypnosis. In order to understand this particular quarrel, this chapter examines the history of mesmerism, hysteria, hypnosis, and fin-de-siècle neurology represented by both the Nancy and Salpêtrière schools.


Assuntos
Prova Pericial , Hipnose/história , Neurologia/história , Crime/história , Crime/psicologia , França , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Ilustração Médica/história
20.
Prog Brain Res ; 203: 255-75, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24041285

RESUMO

Visual art production involves multiple processes including basic motor skills, such as coordination of movements, visual-spatial processing, emotional output, sociocultural context, and creativity. Thus, the relationship between artistic output and brain diseases is particularly complex, and brain disorders may lead to impairment of artistic production in multiple domains. Neurological conditions may also occasionally modify artistic style and lead to surprisingly innovative features in people with an initial loss of creativity. This chapter focuses on anecdotal reports of various neurological disorders and their potential consequences on works produced by famous or well-established artists, including Carl Frederik Reutersward, Giorgio de Chirico, Krystyna Habura, Leo Schnug, Ignatius Brennan, and many others.


Assuntos
Arte/história , Encefalopatias/história , Pessoas Famosas , História do Século XIX , História do Século XX
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