Use of Twitter in Neurology: Boon or Bane?

Twitter is a free, open access social media platform that is widely used in medicine by physicians, scientists, and patients. It provides an opportunity for advocacy, education, and collaboration. However, it is likely not utilized to its full advantage by many disciplines in medicine, and pitfalls exist in its use.

Neuromodulation Options and Patient Selection for Parkinson's Disease.

Neuromodulation therapies, including deep brain stimulation (DBS) and pump therapies, are currently the standard of care for PD patients with advanced disease and motor complications that are difficult to control with medical management alone. The quest for alternate lesser invasive approaches led to the development of several novel therapies like intrajejunal levodopa infusions (IJLI), continuous subcutaneous apomorphine infusions (CSAI) and Magnetic Resonance guided Focused Ultrasound (MRgFUS) in recent years. To achieve good outcomes with any of these therapeutic modalities, careful patient selection, multidisciplinary evaluation and technical expertise are equally important.

Raman spectroscopy for the qualitative and quantitative analysis of solid dosage forms of Sitagliptin.

To demonstrate the potential of Raman spectroscopy for the qualitative and quantitative analysis of solid dosage pharmacological formulations, different concentrations of Sitagliptin, an Active Pharmaceutical Ingredient (API) currently prescribed as an anti-diabetic drug, are characterised. Increase of the API concentrations induces changes in the Raman spectral features specifically associated with the drug and excipients. Principal Component Analysis (PCA) and Partial Least Squares Regression (PLSR), were used for the qualitative and quantitative analysis of the spectral responses.

Global Survey on Telemedicine Utilization for Movement Disorders During the COVID-19 Pandemic.

Background: The COVID-19 pandemic restricted usual healthcare management for movement-disorders patients, with a consequent upsurge in telemedicine to bridge the gap.

Objective: To assess global telemedicine usage in the context of the pandemic.

Methods: The Movement Disorder Society (MDS) Telemedicine Study Group surveyed telemedicine experts from 40 countries across all continents in March-April 2020.

Quantitative analysis of solid dosage forms of cefixime using Raman spectroscopy.

Quantification of antibiotics is of significant importance because of their use in the prevention and treatment of different diseases. Cefixime (CEF) is a cephalosporin antibiotic that is used against bacterial infections. In the present study, Raman spectroscopy has been applied for the identification and quantification of Raman spectral features of cefixime with different concentrations of Active Pharmaceutical Ingredient (API) and excipients in solid dosage forms.

Parkinson's Disease in the Middle East, North Africa, and South Asia: Consensus from the International Parkinson and Movement Disorder Society Task Force for the Middle East.

Background: Understanding the regional needs and available healthcare resources to treat Parkinson's disease (PD) is essential to plan appropriate future priorities. The International Parkinson and Movement Disorder Society (MDS) Task Force for the Middle East was established to raise awareness and promote education across the region on PD and other movement disorders. Broadly, the task force encompasses the countries of the Middle East but has included North Africa and South Asia as well (MENASA).

Rationale and patient selection for interventional therapies in Parkinson's disease.

Parkinson's disease (PD) is increasing in prevalence due to a growing elderly population. Although there is no cure, there are exercise therapies and medications for mild to moderate disease. For more advanced disease, infusion or surgical interventions including deep brain stimulation surgery, levodopa carbidopa intestinal gel, and subcutaneous apomorphine infusion are considered.

Telemedicine Use for Movement Disorders: A Global Survey.

Background: Telemedicine is increasingly used to care for patients with movement disorders, but data regarding its global use are limited.

Introduction: To obtain baseline international data about telemedicine use among movement disorder clinicians.

Methods: An online survey was sent to all 6,056 Movement Disorder Society members in 2015.

Movement Disorders and Deep Brain Stimulation in the Middle East.

Background: Deep brain stimulation (DBS) is a well-established neuromodulation therapy for advanced Parkinson disease, essential tremor and dystonia. In as much as this therapy is being developed in the Middle East, a better understanding of the incidence and prevalence of movement disorders, health care, and social framework is required for the region.

Methods: We reviewed current literature on the incidence and prevalence of various movement disorders in the Middle East amenable to DBS surgery.

Cognitive Impact of Deep Brain Stimulation on Parkinson's Disease Patients.

Subthalamic nucleus (STN) or globus pallidus interna (GPi) deep brain stimulation (DBS) is considered a robust therapeutic tool in the treatment of Parkinson's disease (PD) patients, although it has been reported to potentially cause cognitive decline in some cases. We here provide an in-depth and critical review of the current literature regarding cognition after DBS in PD, summarizing the available data on the impact of STN and GPi DBS as monotherapies and also comparative data across these two therapies on 7 cognitive domains. We provide evidence that, in appropriately screened PD patients, worsening of one or more cognitive functions is rare and subtle after DBS, without negative impact on quality of life, and that there is very little data supporting that STN DBS has a worse cognitive outcome than GPi DBS.

DBS Programming: An Evolving Approach for Patients with Parkinson's Disease.

Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process.

The Association Between Physical Activity With Cognitive Function and Brain-Derived Neurotrophic Factor in People With Parkinson's Disease: A Pilot Study.

The objective of this study was to examine the effect of physical capacity on the relationship of brain-derived neurotrophic factor (BDNF) with cognitive function in people with PD. For this study, serum BDNF levels were measured in 29 PD participants and 30 healthy controls. Cognitive function was assessed using the Montreal Cognitive Assessment (MOCA) scale.

Relationship of circulatory BDNF with cognitive deficits in people with Parkinson's disease.

Background: Brain-derived neurotrophic factor (BDNF) and cognitive function are diminished in people with Parkinson's disease (PD). The relationship of cognitive function and serum level of BDNF, however is yet to be examined. The aim of this study was to examine serum BDNF levels in PD.

Asian perspectives on the recognition and management of levodopa 'wearing-off' in Parkinson's disease.

Most Parkinson's disease patients will receive levodopa therapy, and of these, the majority will develop some levodopa-induced complications. For many patients, the first complication to develop is the decline in the duration of therapeutic benefit of each levodopa dose, a phenomenon commonly termed 'wearing-off'. There is already extensive literature documenting the epidemiology and management of wearing-off in Parkinson's disease patients of western descent.

Computational modeling of an endovascular approach to deep brain stimulation.

Objective: Deep brain stimulation (DBS) therapy currently relies on a transcranial neurosurgical technique to implant one or more electrode leads into the brain parenchyma. In this study, we used computational modeling to investigate the feasibility of using an endovascular approach to target DBS therapy.

Approach: Image-based anatomical reconstructions of the human brain and vasculature were used to identify 17 established and hypothesized anatomical targets of DBS, of which five were found adjacent to a vein or artery with intraluminal diameter ≥1 mm.

Improved spatial targeting with directionally segmented deep brain stimulation leads for treating essential tremor.

Deep brain stimulation (DBS) in the ventral intermediate nucleus of thalamus (Vim) is known to exert a therapeutic effect on postural and kinetic tremor in patients with essential tremor (ET). For DBS leads implanted near the caudal border of Vim, however, there is an increased likelihood that one will also induce paresthesia side-effects by stimulating neurons within the sensory pathway of the ventral caudal (Vc) nucleus of thalamus. The aim of this computational study was to (1) investigate the neuronal pathways modulated by therapeutic, sub-therapeutic and paresthesia-inducing DBS settings in three patients with ET and (2) determine how much better an outcome could have been achieved had these patients been implanted with a DBS lead containing directionally segmented electrodes (dDBS).

Fatal reperfusion injury after thrombolysis for phlegmasia cerulea dolens.

Reperfusion injury after venous thrombolysis for phlegmasia cerulea dolens (PCD), despite its potentially rapid, fatal course, has not been well described in the literature. Two cases of fatal reperfusion injury after venous thrombolysis are reported, and the clinical manifestations and treatment strategies of PCD and the aspects of reperfusion injury relevant to the interventionalist are reviewed.

Cortical magnetoencephalography of deep brain stimulation for the treatment of postural tremor.

The effects of deep brain stimulation (DBS) on motor cortex circuitry in Essential tremor (ET) and Parkinson's disease (PD) patients are not well understood, in part, because most imaging modalities have difficulty capturing and localizing motor cortex dynamics on the same temporal scale as motor symptom expression. Here, we report on the use of magnetoencephalography (MEG) to characterize sources of postural tremor activity within the brain of an ET/PD patient and the effects of bilateral subthalamic nucleus DBS on these sources. Recordings were performed during unilateral and bilateral DBS at stimulation amplitudes of 0 V, 1 V, and 3 V corresponding to no therapy, subtherapeutic, and therapeutic configurations, respectively.