Gait disturbance is the most common symptom in idiopathic normal-pressure hydrocephalus (iNPH). However, its pathophysiology in iNPH has not been clarified. Some researchers have hypothesized that the mesencephalic locomotor region, which is a functionally defined area in the brainstem playing an important role in locomotion, is involved in the development of gait disturbance in iNPH. The purpose of the study was to investigate whether the midbrain is involved in the manifestation of gait disturbance in iNPH. Twenty-one iNPH patients who showed clinical improvements after shunt surgery were studied. Brain magnetic resonance imaging (MRI) was performed and clinical symptoms were assessed before and 1 year after surgery. Gait disturbance was assessed by the Timed Up and Go test and gait subcategory of the iNPH Grading Scale, a validated assessment tool for iNPH symptoms. Anteroposterior, left-to-right diameter and cross-sectional areas of the midbrain were measured at the inferior collicular level of axial images in MRI. The diameters and cross-sectional area of the midbrain at baseline did not show significant correlation with gait assessments at baseline (Spearman's correlation). The midbrain measurement did not show significant difference between the baseline and postoperative values (paired t test), and its change rates did not show significant correlation with the change (rates) of the gait assessments. In this study there were no findings to suggest involvement of the midbrain in the manifestation of gait disturbance in iNPH. The hypothesis that the mesencephalic locomotor region is involved in the manifestation of gait disturbance in iNPH needs to be reconsidered.
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http://dx.doi.org/10.1007/s00415-010-5847-2 | DOI Listing |
Cureus
November 2024
Research Institute of Health and Welfare, Kibi International University, Takahashi, JPN.
Proliferative diabetic retinopathy (PDR) and peripheral arterial disease (PAD) of the lower extremities are serious complications of type 2 diabetes mellitus (T2DM). Aerobic exercise has been shown to be primarily effective for glycemic control and gait disturbance owing to PAD. However, the safety and efficacy of exercise therapy in patients with PDR remain unclear.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic.
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive disease characterized by disproportionate ventricular enlargement at brain imaging with gait disturbance and an increased risk of falling. Gait assessment is a key feature in the diagnosis of iNPH and characterization of post-surgical outcomes.
Research Question: How do gait parameters change 24 h after CSF tap test (CSFTT) and after ventriculoperitoneal shunt surgery?
Methods: The PRISMA guidelines were used to perform the systematic review.
Zh Nevrol Psikhiatr Im S S Korsakova
December 2024
Siberian State Medical University, Tomsk, Russia.
In a number of causes of Parkinson's disease (PD), occupation is periodically mentioned as a possible risk factor. However, a look at the complex impact of external factors on people of certain professions and the expansion of the area of risk factors in a rapidly changing world leads to the emergence of new studies. There is an assumption that the risk of developing PD is increased in doctors due to long-term exposure to stress.
View Article and Find Full Text PDFEur J Neurol
January 2025
School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.
Background: The regulatory role of the apolipoprotein E (APOE) ε4 allele in the clinical manifestations of spinocerebellar ataxia type 3 (SCA3) remains unclear. This study aimed to evaluate the impact of the APOE ε4 allele on cognitive and motor functions in SCA3 patients.
Methods: This study included 281 unrelated SCA3 patients and 182 controls.
BMC Geriatr
December 2024
Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3- 20, Koto-ku, Tokyo, 136-0075, Japan.
Background: Dizziness and unstable gait with resultant falls are common symptoms among the older adults. Most of studies have focused on statistical analysis regarding single factor related to dizziness and unstable gait. On the other hand, there are very few comprehensive studies using a large number of patients except several review papers.
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