Neurological Research and Therapy

Astrocytes are glial cells that play a crucial role in providing a supportive environment for neurons, mainly by cell. cell interactions mediating numerous physiological and biochemical functions in the central nervous system (CNS). Astrocytes are also critical for intercellular signaling in the neurovascular unit. Although numerous reports have detailed the complex effects of astrocytes upon neurons in neurodegenerative disease, whether or not astrocytes act as initiators or contributors in the pathogenesis of Amyotrophic Lateral Sclerosis (ALS) remains unclear. A broad overview of astrocytes’ link to motor neuron degeneration in ALS, as well as specific functions of astrocytes within the neurovascular unit is presented. This review summarizes current knowledge of the astrocyte’s role in disease pathogenesis and discusses the potential of the astrocyte as a target for future ALS therapies. 

Amyotrophic Lateral Sclerosis (ALS) is a debilitating neurodegenerative and neurovascular disorder with multi-factorial molecular mechanisms of pathology. At the very core of B-CNS B alterations associated with ALS are the keys to barrier immunopenetration by inflammatory cells into the CNS parenchyma, the Matrix Metallo Proteinases (MMPs). MMPs are a vastly diverse family of endo peptidases that possess a multitude of CNS functions, substrates and regulatory mechanisms. This review will examine the accumulated evidence describing MMPs and TIMPs (Tissue Inhibitors of Metallo Proteinases) and discuss the various CNS processes in the neurodegenerative environment that MMPs are implicated in including neuro and systemic inflammation, cell damage and apoptosis, as well as interactions with vascular growth factors. In conclusion, opposing MMP functions and their contribution to B-CNS-B disruption in ALS will be addressed with perspective into potential future studies.   

Eyelid Myoclonia with Absences (EMA) can often be clinically mistaken for a tic disorder. This case report describes a 4-year-old female who presented with eye fluttering and blinking accompanied by a hand gesture described as a “brow wipe” that was exacerbated by sunlight, warm temperatures, anxiety, and excitement. She was diagnosed with a transient tic disorder, and aripiprazole and clonazepam treatment partially decreased symptom intensity. She was stable for months, after which symptoms worsened with constant tics while in the sun and seeking light stimuli to induce an episode. Video electroencephalogram confirmed self-induced photosensitive seizures with generalized epileptiform discharges consistent with generalized seizures. The EMA diagnosis was confirmed by these characteristic eye closure-related discharges, and the patient was successfully treated with valproate. We also present a brief review of the literature that underscores the clinical similarities between EMA and tics, as well as the importance of timely implementation of appropriate treatment in EMA.

Approved pharmacological preparations for the treatment of Attention Deficit Hyperactive Disorder (ADHD) are not readily available in most low and middle-income countries. There is a growing body of alternative non-pharmacological interventions based on neuroplasticity that may address this treatment gap.  Balance Auditory Vision Integration Exercises (Bal-A-Vis-X) are based on a series of gradually complex but modifiable rhythmic movements using sand bags and racquetballs. Sustained attention is demanded for the smooth execution of the exercises. The outcome of using Bal-A-Vis-X in children with a Diagnostic Statistical Manual (DSMV) diagnosis of ADHD is described. 

Methods: Parents of 18 children with a clinical diagnosis of ADHD referred to a psychiatrist were offered Bal-A-Vis-X, methylphenidate or both, over a 6-week period. Eleven opted for Bal-A-Vis-X, 4 decided on oral methylphenidate, and 3 requested both methylphenidate and Bal-A-Vis-X. Our primary outcome measure was duration of sustained attention after the 6-week period. Secondary outcome measures included a theta to beta ratio as measured by an Electroencephalogram (EEG).  

Results: After 6 weeks of Bal-A-Vis-X, sustained attention increased by more than 15 minutes in 9 of 11 children who  received the Bal-A-Vis-X. Duration of sustained rhythmic movements measured in minutes during Bal-A Vis-X appeared to predict global improvement in schoolwork. 

Conclusion: Bal-A-Vis-X has the potential of reaching out and making a difference to thousands of children in Africa who have no access to medication for ADHD. There is need for adequately powered double-blinded randomized controlled trials aimed at establishing the efficacy and cost effectiveness of this promising technique.