90. The Clinical and Neurochemical Effect of Transcranial Magnetic Stimulation on the Unusual Symptoms of Multiple Sclerosis

Research Abstract
Background/Objective(s)
A plethora of debilitating symptoms can be caused by multiple sclerosis (MS) such as sensory and motor dysfunction, cognitive impairment, mood disorder, and fatigue. Such complaints can drastically impact a patient's quality of life, are mostly assessed in a clinical manner or with the help of scales, questionnaires, or test batteries, and cannot be completely or partially relieved using pharmaco the rapeutics. Moreover, their underlying mechanisms are not fully elucidated. Therefore, probing corticospinal excitability as a surrogate of the neuronal network function by using transcranial magnetic stimulation (TMS) could help in further understanding the underlying mechanisms of MS.
Applying TMS could help in identifying biomarkers of the disease itself. In addition, an inflammation-mediated synaptopathy seems to underlie a hyperexcitability state which could appear, using TMS, as an …
Research Authors
Amal Tohamy, Ghaydaa Shehata, Mahmoud Yosry
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Multiple Sclerosis and Related Disorders
Research Member
Ghaydaa Ahmed Shehata Abo Zeid
Amal Mohamed Aly Tohamy
Research Pages
106051
Research Publisher
Elsevier
Research Vol
92
Research Website
https://www.sciencedirect.com/science/article/pii/S2211034824006278
Research Year
2024

Impact of Parkinsonism comorbid depression on cognitive functions

Research Abstract
Background
Parkinson's disease (PD) is a chronic progressive neurodegenerative disabling disease and involves about 1–3% of the worldwide population over the age of 60. A significant prevalence of psychopathological symptoms has been recorded as most patients with PD developed over their disease course neuropsychiatric symptoms such as depression, anxiety, sleep disorders, psychosis, and cognitive and behavioral abnormalities. These non-motor symptoms, which could appear decades before motor ones, become disturbing symptoms during the later phases of the disease. Hence, the current research aims to study depressive symptoms in Parkinson's disease patients. Thirty-six patients with Parkinson’s disease aged from 40 to 65 years (20 males and 16 females) and 36 age and sex-matched controls (19 males and 17 females) were included in the study. Unified Parkinson’s Disease Rating Scale …
Research Authors
Ghaydaa A Shehata, Hassan M Farweez, Anwar M Ali, Huda S Hassan, Amal M Tohamy, Mohamed Mostafa, Mostafa A Ibrahim, Khaled Tarek, Asmaa Ahmed Elrashedy, Ramy Abdelnaby, Mohamed Elsayed, Dina Elsayed Gaber
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Research Member
Ghaydaa Ahmed Shehata Abo Zeid
Hasan Mohamed Mohamed Mohamed Ferwez
Anwar Mohamed Ali Kobeisy
Amal Mohamed Aly Tohamy
Mohamed Mustafa Ahmed Mohamed
Research Pages
Pages 37
Research Publisher
Springer Berlin Heidelberg
Research Vol
Volume 60 Issue 1
Research Website
https://scholar.google.com.eg/scholar?oi=bibs&cluster=7996670340842538608&btnI=1&hl=en
Research Year
2024

Prevalence and determinants of post-stroke psychosis in Aswan: a prospective study

Research Abstract

Background

Post-stroke psychosis (PSP) is a rare but serious neuropsychiatric condition characterized by delusions and/or hallucinations following a stroke. Despite its impact on prognosis and quality of life, PSP remains underdiagnosed and undertreated, with limited data on its prevalence and risk factors. The purpose of this study is to assess the prevalence and determinants of post-stroke psychosis (PSP), as well as to compare PSP and non-PSP patients in terms of improvement and daily living outcomes. This nested case–control study included 2,624 acute stroke patients from a university hospital between May 2017 and April 2022. Patients who developed PSP within 6 months post-stroke were identified as cases (n = 108), and 119 patients without PSP were randomly selected as controls. Comprehensive assessments included clinical, laboratory, and imaging evaluations at baseline. After 6 months, follow-up evaluations were conducted, including neurological examinations, psychiatric assessments, and stroke severity assessments using the Barthel index (BI). The psychiatric assessments included the Hamilton Depression Rating Scale for depression and the Mini-Mental State Examination for cognitive status.

Results

The prevalence of PSP was 5.4%. risk factors significantly associated with PSP included older age, male patients, lower education level (≤ 5 years), hemiplegia, sphincter affection, cortical lesion, brain atrophy, small vessel disease, ischemic stroke, post-stroke dementia, and seizures. Non-specified psychosis and delusional disorder were the most common psychosis subtypes. There was a significantly higher percentage of excellent patients in the non-PSP group compared to those who had PSP regarding the observed improvement in the patient's condition. Also, there is a higher percentage of deteriorated patients in the PSP group (46.6%) compared to another group (18.9%) regarding BI.

Conclusion

PSP is a prevalent post-stroke complication associated with distinct risk factors and poor functional outcomes. Early screening and identification of high-risk patients, along with multidisciplinary management strategies, are crucial for optimizing recovery and quality of life in stroke survivors.

Research Authors
Bastawy M Al Fawal, Gellan K Ahmed, Ahmed K Ibrahim, Mohamed A Abdelhamed, Nourelhoda A Haridy
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Publisher
Springer Berlin Heidelberg
Research Vol
Volume 60
Research Website
https://link.springer.com/article/10.1186/s41983-024-00852-6
Research Year
2024

Case Report: Avoidant/restrictive food intake disorder after tonsillectomy

Research Abstract
Background
Avoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery.
Case presentation
A female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis.
Conclusions
To our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy.
Research Authors
Gellan Ahmed, Ahmed A Karim, Eman M Khedr, Khaled Elbeh, Amira Moheb, Marwa Abokresha, Nourelhoda Haridy
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Frontiers in Psychiatry
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Pages
1351056
Research Publisher
Frontiers
Research Vol
Volume 15
Research Website
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1351056/full
Research Year
2024

Short-Term Therapeutic Effect of Repetitive Transcranial Magnetic Stimulations of Sleep Disorders in Parkinson’s Disease: A Randomized Clinical Trial (Pilot Study)

Research Abstract

This study aimed to evaluate the efficacy of rTMS in treating sleep disorders in PD. It included 24 patients with PD who had sleep disorders. Group allocations (active or sham with a ratio of 2:1) were placed in serially numbered closed envelopes. Each patient was evaluated with the following: MDS-UPDRS, Parkinson’s Disease Sleep Scale (PDSS), Beck Depression Inventory (BDI), and polysomnography (PSG) before and 10 days after the treatment sessions. Each session consisted of 10 trains, 20 Hz, 10 sec for each, over the parietal cortex (bilaterally). Scores of UPDRS, BDI, and PDSS improved significantly in the active group but not in the sham group. The PSG data showed that sleep onset and rapid eye movement (REM) latencies (min), REM duration, and time spent awake (both as %TST) were improved after rTMS in the active group compared with the sham group. The number of awakenings, the wake-after-sleep onset index, the arousal index, and periodic leg movements (PLMs) were all significantly reduced in the active group but not in the sham group. Ten sessions of 20 Hz rTMS over parietal cortexes improved sleep quality and PLMs in patients with PD. The improvement in PSG and PDSS were correlated with improvements in UPDRS and BDI scores.

Research Authors
Eman M Khedr, Gellan K Ahmed, Mohammad Ahmad Korayem, Sara Ahmed Salah Hussain Elamary, Maha M El-Kholy, Nourelhoda A Haridy
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Brain Sciences
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Pages
556
Research Publisher
MDPI
Research Vol
Volume 14
Research Website
https://www.mdpi.com/2076-3425/14/6/556
Research Year
2024

Determining Optimal Cut-Off Value For Ultrasound-Measured Median Nerve Cross-Sectional Area For Diagnosis Of Carpal Tunnel Syndrome In A Sample Of Egyptian Population

Research Abstract
Background
Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. Different populations have different cross-sectional area (CSA) cut-offs for carpal tunnel syndrome. This study aimed to evaluate median nerve ultrasound in Egyptian CTS patients and matched controls, correlate ultrasound with nerve conduction studies, and determine optimal CSA cut-off at the inlet for CTS screening.
Methods
This study included 35 patients with CTS and 35 age and sex-matched healthy control. The median nerve conduction studies (NCS) and the median nerve CSA using ultrasound (US) at different locations, including the carpal tunnel inlet, were measured in all participants. The receiver operator characteristic (ROC) curve analysis was performed to detect the sensitivity and specificity of nerve US-measured CSA for diagnosis of CTS.
Results
There was a significant difference in the median nerve CSA at the inlet and outlet between the CTS and control group. A significant correlation was found between the inlet and outlet CSA and the cMAP of the median nerve. The optimal cut-off CSA of the median nerve for anticipation of compression is≥ 8.8 mm2 at the inlet and ≥ 8.4 mm2 at the outlet.
Conclusion
Ultrasound can be used as a screening tool for diagnosing CTS by measuring the median nerve CSA. This study proposed cut-off values for median nerve CSA at the inlet and outlet cut-off values of ≥8.8 mm2 and ≥8.4 mm2, respectively. Further research with larger sample sizes and a unified US protocol is warranted to confirm the current findings.
Research Authors
Shahera Sayed Ahmed Abd El Maged, Khalid O Mohamed, Hassan M Farweez, Nourelhoda A Haridy
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Journal of Current Medical Research and Practice
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Pages
9-18
Research Publisher
Assiut University, Faculty of Medicine
Research Vol
Volume 9
Research Website
https://journals.ekb.eg/article_356664.html
Research Year
2024

Impact of COVID-19 Pandemic on Patients with Tension-Type Headache

Research Abstract
Background
Headaches were overlooked in treatment during the coronavirus "COVID-19" pandemic. This study aimed to assess the impact of COVID-19 on patients with tension headache (TH) and identify predictors of headache worsening.
Methods
This cross-sectional study compared TH patients (PwTH) (n=157) to controls without TH (PwoTH) (n=151) during the pandemic. Sociodemographic, clinical, COVID-19-related, depression, and anxiety data were contrasted between groups pre-pandemic and during-pandemic. PwTH was categorized into worsening (WPwTH) and non-worsening (NWPwTH) groups to identify worsening predictors.
Results
66.2% of PwTH were females versus 49.7% of PwoTH (p=0.004). Both groups exhibited significantly increased depression and anxiety levels during versus pre-pandemic, with no intergroup differences. Of 157 PwTH, 125 (79.6%) had WPwTH versus 32 (20.4%) had NWPwTH during pandemic. WPWTH had significantly increased headache frequency versus NWPwTH during the pandemic (P=0.001). Both subgroups had increased anxiety and depression, but WPWTH had significantly higher increase in anxiety (P=0.03). Regression analysis revealed that family COVID-19 exposure, healthcare visits, and increased anxiety significantly predicted TTH worsening.
Conclusions
This study revealed that a substantial percentage of TTH patients worsened during the COVID-19 pandemic. Family COVID-19 exposure, healthcare visits, and increased anxiety predicted worsening TTH. Managing these factors during stress may avoid TTH worsening.
Research Authors
Bastawy M Al Fawal, Eman M Khedr, Nourelhoda A Haridy, Abdelrahman S Elsoghier, Mohamed Nemr Othman, Ahmed Abdelwarith
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Aswan University Medical Journal
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Pages
125-136
Research Publisher
Aswan University, Faculty of Medicine
Research Vol
Volume 4
Research Website
https://aumj.journals.ekb.eg/article_345371.html
Research Year
2024

The role of infections and inflammation in schizophrenia: review of the evidence

Research Abstract

Background

Schizophrenia is a severe mental illness affecting approximately 1% of the population worldwide. While its exact causes remain unknown, emerging evidence suggests that infections and inflammation may contribute to disease development in a subset of individuals. This review comprehensively summarizes the evidence linking infections, immune system dysfunction, and schizophrenia risk.

Main body

Several population-based studies have linked serious prenatal or childhood infections requiring hospitalization to increased risk of later schizophrenia diagnosis, especially in individuals with genetic predisposition. Both central nervous system infections and systemic infections appear to confer risk. Specific pathogens including Toxoplasma gondii, herpesviruses, Chlamydophila, and more have been implicated. Autoimmune diseases are also associated with increased schizophrenia susceptibility, possibly due to blood-brain barrier disruption allowing brain-reactive antibodies access. The recent Coronavirus disease 2019 (COVID-19) pandemic raises questions about SARS-CoV-2 as a risk factor for new-onset psychosis. The mechanisms underlying the infection-schizophrenia link likely involve inflammation, cytokines, microglial activation, and tryptophan/kynurenine pathway modulation. Treatments targeting inflammation showed some efficacy in schizophrenia, further supporting an inflammation hypothesis. While the epidemiological and mechanistic evidence is substantial, further research is needed to conclusively determine the exact mechanisms linking immune dysfunction to schizophrenia requires further study.

Conclusion

The evidence suggests immune system abnormalities likely play a role, perhaps by interacting with genetic and environmental factors, in instigating schizophrenia pathophysiology in a subset of patients. More research is needed to understand these connections more clearly which may aid future prevention and personalized treatment approaches tailored to specific illness subtypes.

Research Authors
Gellan K Ahmed, Haidi Karam-Allah Ramadan, Khaled Elbeh, Nourelhoda A Haridy
Research Date
Research Department
Department of Neurology and Psychiatry
Research Journal
Middle East Current Psychiatry
Research Member
Nourelhoda Ahmed Ahmed Haridy
Research Publisher
Springer Berlin Heidelberg
Research Vol
Volume 31
Research Website
https://link.springer.com/article/10.1186/s43045-024-00397-7
Research Year
2024
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