Clinical and translational neuroscience

This very readable and erudite book on neurology and religion, edited and co-authored by well-known and very knowledgeable experts in theology and philosophy as well as in neuroscience and medicine. They take on the difficult task to try to explain religious experience and behaviour in neuroscientific terms to study correlations of neural phenomena with subjective experiences of spirituality and hypotheses to explain such phenomena. There probably is a neurological and evolutionary basis for subjective experiences traditionally categorized as spiritual or religious.

The purpose of the present study was to conduct a systematic review of the literature, adhering to PRISMA guidelines, regarding evidence of neuroplasticity in children and adolescents in response to cognitive or sensory-motor interventions. Twenty-eight studies employing seven different types of neuroimaging techniques were included in the review. Findings revealed that significant variability existed across the 28 studies with regard to the clinical populations examined, type of interventions employed, neuroimaging methods, and the type of neuroimaging data included in the studies. Overall, results supported that experience-dependent interventions were associated with neuroplastic changes among children and adolescents in both neurotypical and clinical populations. However, it remains unclear whether these molecular neuroplastic changes, including the degree and direction of those differences, were the direct result of the intervention. Although the findings are encouraging, method...

The Swiss Archives of Neurology and Psychiatry was founded in 1917 by Constantin von Monakow (1853–1930), the first professor of neurology at the University of Zurich and founder of the Swiss Neurological Society. The carefully bound booklets of these Archives are to be found completely in the scientific library of the Psychiatric University Hospital Burghölzli in Zürich. It is hoped that this treasure trove of knowledge will be preserved for all those interested in the history of neurology and psychiatry in its integrity. Today’s work in and on this archives allows time and again to bring out older works and to present them in the light of more modern concepts. Of medical–historical interest is also the category of obituaries, occurring in almost all issues, virtually a “Who’s Who” of neurologists and psychiatrists who have laid the foundations for our subjects.

Background: Transcranial Doppler (TCD) is a well-established tool for cerebrovascular assessment. Estimating the flow velocity across the intracranial arteries helps to identify children with sickle cell anaemia who are at risk for stroke. Objective: Our aim is to correlate TCD findings with clinical condition in children with sickle cell disease (SCD) to determine the value of TCD assessment as a predictive tool for stroke in SCD and to identify any association of TCD findings with disease severity, transfusion therapy and treatment administered. Methods: Eighty-five paediatric SCD patients aged from 3 years to 18 years of both genders who were followed up at the Hematology Clinic of New Children’s Hospital at Cairo University were included in this cross-sectional observational study. All our participants underwent routine laboratory investigations and TCD assessments. Results: Oof the 85 patients, two patients (2.3%) died before completing the TCD study and eventually 83 patients ...

Background and methods: Acquired demyelinating syndromes (ADS) encompass distinct entities and occur in approximately 1/100,000 children. While the use of high dose intravenous corticosteroids is well-established, agreement on steroid taper and type of second line therapy is lacking. A comprehensive, unified and standardized treatment approach is crucial in the management of patients with rare diseases. Therefore, this study performed from July 2018 to June 2020 aimed at developing a national consensus on the management of ADS in the pediatric population using the Delphi approach. Consensus was defined as agreement in >75%. Designated Neuropediatricians with an expertise in the management of pediatric neuroinflammatory diseases in all university and cantonal hospitals of Switzerland were included. The response rate was 100%. Results: High-dose i.v. methylprednisolone (20–30 mg/kg/die for 5 days) is the first line treatment irrespective of the distinct entity of the ADS. An oral s...

Acute stroke treatment has advanced substantially over the last years. Important milestones constitute intravenous thrombolysis, endovascular therapy (EVT), and treatment of stroke patients in dedicated units (stroke units). At present in Switzerland there are 13 certified stroke units and 10 certified EVT-capable stroke centers. Emerging challenges for the prehospital pathways are that (i) acute stroke treatment remains very time sensitive, (ii) the time window for acute stroke treatment has opened up to 24 h in selected cases, and (iii) EVT is only available in stroke centers. The goal of the current guideline is to standardize the prehospital phase of patients with acute stroke for them to receive the optimal treatment without unnecessary delays. Different prehospital models exist. For patients with large vessel occlusion (LVO), the Drip and Ship model is the most commonly used in Switzerland. This model is challenged by the Mothership model where stroke patients with suspected L...

Stroke has become an absolute emergency that is treated by additional endovascular means or by replacing pharmacological options. Modern neuroradiological techniques such as computed tomography (CT) allow us to examine multiple parameters of the diseased brain. These focused on the parenchyma and hemodynamics for pretherapeutic decisions. However, it has become evident that the clot is the current target for interventional measures. Clot length is established as a marker for recanalization. The dense artery sign is known as an acute CT sign of stroke that is readily visible on acute nonenhanced CT. The rationale behind our study was to study if clot density might represent clot vulnerability or resistance to treatment. We conducted a prospective study of all consecutive stroke patients admitted to our hospital over 1 year, who presented with signs of acute middle cerebral artery stroke within the therapeutic window, and who underwent either intravenous or combined intravenous and in...

Objective: The aim of this study is to evaluate how anxiety influences the burden of disease of cluster headache. Methods: Participants completed a modified version of the EUROLIGHT questionnaire. Anxiety was measured with the anxiety subscale of the Hospital Anxiety and Depression scale. An elevated level of anxiety was assumed when eight or more points were scored. Results: The data of 1089 participants were taken for analysis. The score of the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) correlated weakly with the number of attacks in the last 30 days ( r = 0.17). A score of eight and above in the HADS-A was associated with hurting oneself during an attack (odds ratio (OR) = 2.63), worrying about future attacks (OR = 2.95) and reporting of both failed relationships (OR = 2.81) and career problems (OR = 2.65). The odds of feeling understood by family and friends as well as colleagues and employers were lower in anxious persons (OR = 0.35 and 0.40, respect...

Neurology is focused on a model where patients receive their care through repeated visits to clinics and doctor’s offices. Diagnostic tests often require expensive and specialized equipment that are only available in clinics. However, this current model has significant drawbacks. First, diagnostic tests, such as daytime EEG and sleep studies, occur under artificial conditions in the clinic, which may mask or wrongly emphasize clinically important features. Second, early detection and high-quality management of chronic neurological disorders require repeat measurements to accurately capture the dynamics of the disease process, which is impractical to execute in the clinic for economical and logistical reasons. Third, clinic visits remain inaccessible to many patients due to geographical and economical circumstances. Fourth, global disruptions to daily life, such as the one caused by COVID-19, can seriously harm patients if access to in-person clinical visits for diagnostic and treatm...

Neurology is focused on a model where patients receive their care through repeated visits to clinics and doctor’s offices. Diagnostic tests often require expensive and specialized equipment that are only available in clinics. However, this current model has significant drawbacks. First, diagnostic tests, such as daytime EEG and sleep studies, occur under artificial conditions in the clinic, which may mask or wrongly emphasize clinically important features. Second, early detection and high-quality management of chronic neurological disorders require repeat measurements to accurately capture the dynamics of the disease process, which is impractical to execute in the clinic for economical and logistical reasons. Third, clinic visits remain inaccessible to many patients due to geographical and economical circumstances. Fourth, global disruptions to daily life, such as the one caused by COVID-19, can seriously harm patients if access to in-person clinical visits for diagnostic and treatm...