Mild cognitive impairment (MCI) is a condition in which people have more memory or thinking problems than other people their age. The symptoms of MCI are not as severe as those of Alzheimer’s disease or a related dementia. People with MCI can usually take care of themselves and carry out their normal daily activities.
People with MCI are at a greater risk of developing Alzheimer’s disease or a related dementia. Estimates vary as to how many people who have MCI will develop dementia. Roughly one to two out of 10 people age 65 or older with MCI are estimated to develop dementia over a one-year period. However, in many cases, the symptoms of MCI stay the same or even improve.
Guillain-Barré syndrome is an autoimmune disease that affects the nerves outside the brain and spinal cord (the peripheral nerves) and develops over several days to weeks. GBS can cause severe muscle weakness, and death occurs in about 5% of patients. The most common subtypes are acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Approximately 90% of people with GBS in North America and Europe have AIDP.
Signs and Symptoms of GBS
Patients with the AIDP subtype of GBS typically have weakness that starts in the legs and spreads to the arms, as well as decreased or absent reflexes. In more than 50% of these patients, nerves that originate in the brain stem (cranial nerves) are affected, which may cause facial weakness, difficulty swallowing, and eye muscle weakness or paralysis. Approximately 25% to 30% of patients develop severe weakness or paralysis of the muscles used to breathe. GBS commonly causes symptoms of low back pain and limb numbness and tingling, and fluctuations in blood pressure or an irregular heart rhythm can also occur.
Risk Factors and Conditions Associated With GBS
GBS affects people worldwide, and the lifetime risk of GBS is estimated at 1 in 1000. Although individuals of any age can develop GBS, the incidence increases with age, and males are slightly more likely to develop GBS than females.
Approximately two-thirds of patients have a diarrheal or respiratory illness within 4 to 6 weeks prior to the onset of GBS symptoms. Other, less common events or conditions that may trigger GBS include recent surgery, pregnancy, and immunosuppression. Although rare sporadic cases of GBS have been reported after vaccinations, the risk of developing postvaccination GBS is much lower than the risk of developing GBS after an infection.
Diagnosis and Treatment of GBS
Diagnosis of GBS is made based on symptoms and physical examination findings. Neurological testing often includes electromyography and nerve conduction studies to assess nerve and muscle function. Results of a spinal tap (lumbar puncture) may support the diagnosis of GBS and can rule out other neurological diseases.
Individuals with suspected GBS should be admitted to the hospital. All patients with GBS need close monitoring of their breathing, heart rate, and blood pressure. Individuals who develop severe respiratory muscle weakness or paralysis are supported with mechanical ventilation. Patients who have difficulty swallowing may receive nutrition through a feeding tube.
Current recommended treatments for GBS are intravenous immune globulin (IVIG), an infusion of antibodies, or plasma exchange, which involves removal and replacement of the liquid component of blood. About 40% to 50% of patients with GBS do not improve within 4 weeks after IVIG or plasma exchange and need prolonged supportive care. Physical, occupational, and speech therapy are important to help patients regain strength and function.
What Is the Prognosis of GBS?
Most patients with GBS gradually improve and can have a complete recovery over 6 to 12 months. However, some patients have residual symptoms, including fatigue, pain, numbness, tingling, and muscle weakness. Some factors associated with a higher risk of death due to GBS include older age, more severe disease, and need for mechanical ventilation.
Recently, low-field MRI scanners have become available that are portable, are cryogen-free, are easy to use, provide rapid patient loading and unloading, have minimal power requirements, and have relatively low purchase prices and maintenance costs. For some indications, including ischemic stroke, these MRI scanners are a welcomed addition to the clinical armamentarium, as they have the potential to improve some aspects of clinical care over the current standard of care.
For one, they offer rapid “point-of-care” imaging diagnosis. Owing to their reduced cost and portability, these scanners could be deployed in a myriad of new settings, such as at-large public gatherings (e.g., sporting events or rock concerts), rural health care centers, emergency rooms, and assisted living facilities. Future innovations in motion correction, noise remediation, and image data upload capabilities suggest the eventual use of these scanners in ambulances or even on the battlefield.
Take an animated look inside the neuron, and learn how scientists are addressing brain disease. With approximately 86 billion neurons in the brain, humans contain the most complex communications network imaginable. To address diseases of brain development and degeneration, neuroscientists are investigating how and why this network breaks down, and what can be done to repair it.
One area of study is dendrites, which are the tree-like structures of neurons, that receive electrical impulses. Researchers are carefully mapping out brain circuits and uncovering how connectivity changes can result in defects of the visual system or behavioral problems. The core section of the neuron is the cell body. Genetic engineering tools are revealing how mutations impact brain development and contribute to autism spectrum disorder or rare, inherited forms of neurological disease.
The transmission of nerve impulses occurs along the axon, which is insulated, much like an electrical wire, by a fatty layer called the myelin sheath. Scientists have invented a medicine to stop the immune system from mistakenly attacking this layer, which occurs during multiple sclerosis. Other molecules currently in development instruct the body to regenerate the sheath and repair damage. The axon also transports valuable cellular cargo, such as neurotransmitters, along tracks from one end of the neuron to the other.
Researchers are testing drug candidates for their ability to remove molecular traffic jams when this transport system fails, as often occurs in Parkinson’s and Alzheimer’s disease. The axon terminals make connections called synapses with other cells, using neurotransmitters as signals. Some scientists are evaluating how finely tuning the receptors for these chemicals could ease depression and anxiety.
Others are finding ways to promote the regrowth of lost synapses, which could halt neurodegeneration. From genetics to behavior, neuroscience is accelerating new interventions for the most challenging disorders of the nervous system.
Sitting too much can boost #stroke risk. But adding more movement—even low-effort activity such as doing household chores—may help lower that risk. #HarvardHealthhttps://t.co/y8qviVinxG
The study involved 7,607 adults who wore a hip-mounted accelerometer (a device that records how fast you move) for a week. Their average age was 63. During a follow-up period averaging 7.4 years, 246 of the participants experienced a stroke.
People who sat for 13 or more hours per day during the initial week of motion tracking were 44% more likely to have a stroke compared with those who’d spent less than 11 hours per day sitting still. In addition, longer bouts of sitting (more than 17 minutes at a time) were linked to a higher risk than shorter bouts (less than eight minutes).
Deep brain stimulation is a surgical procedure that involves implanting electrodes in the brain, which deliver electrical impulses that block or change the abnormal activity that cause symptoms. (Courtesy: Cleveland Clinic)
“He had limited use of his hand. It really wasn’t functioning,” explains Andre Machado, MD, PhD, who is Chairman of the Cleveland Clinic Neurological Institute. “He couldn’t do as much manual work, with both hands, and that was a limitation for his quality of life.”
For the study, Joe first underwent two surgical procedures — one to insert the DBS device under the skin of his chest, just below the collarbone, and the other, to implant the DBS electrode in a part of the cerebellum called the dentate nucleus. Once activated, the device, called an implantable pulse generator, serves as a specially-calibrated pacemaker for the brain, stimulating it to try and enhance motor rehabilitation.
COMMENTARY:
Many times in science, application precedes understanding. Deep brain stimulation, either by electrical or magnetic pulses is a good example.
It is not at all understood how the brain really works, much less how electrical and magnetic stimulation in the brain works. It may stimulate or slow down neural impulses, or interrupt the incoming signals or the outgoing messages. Are there any other possibilities?
At least it does work, Apparently.
One thing for certain is that deep brain stimulation is preferable to previous treatments, which produced small, destructive, irreversible lesions in the brain. At least these stimulations can be stopped if they don’t work.
I enjoyed this posting, since it reignited my interest in the cerebellum. This amazing Organ has more neurons than the rest of the brain combined, represented by innumerable small granule cells. I wasn’t even aware of the dentate nucleus, which is an island of cerebral cortex-like neurons in the white matter of the cerebellum. Apparently the action of the cerebellum is orchestrated through this and a couple of other islands of neurons. All of the coordination, movement, and thought processing accomplished in the cerebellum takes place through these nuclei.
It was also fascinating to learn of a patient who has complete lack of a cerebellum, and suffers only some mild incoordination and speech problems. Apparently, absent the cerebellum, the rest of the brain is largely capable of taking over the function of the missing cerebellum. Once the brain is formed, However, and dependent upon the cerebellum, damage to this organ causes a great deal of coordination, movement, and balance problems.
I’ll put another plug-in for sleep, diet and exercise, as well as being careful with your body. Prevention is far better than treatment.
Robert D. Brown Jr., M.D., M.P.H., E. Paul Lindell, M.D.,Giuseppe Lanzino, M.D., and Harry Cloft, M.D., Ph.D., explain what a brain aneurysm is and the different treatment options there are at Mayo Clinic for a patient with a brain aneurysm.
Mayo Clinic neurovascular experts care for 17,000 people each year with aneurysms, strokes, and other blood vessel and cerebrovascular conditions. Each brain aneurysm is unique. Your doctor will use state-of-the-art arterial imaging to evaluate, diagnose and assess the aneurysm’s risk of rupture.
Every patient has team of doctors working together to create an individualized path of care. Some aneurysms do not require surgery and are closely monitored instead.
Find out about the care you can receive for brain aneurysms at Mayo Clinic at https://mayocl.in/370ZldS
In @usnews, @JennOligoMyelin detailed the range of early #MultipleSclerosis symptoms, explained why patients should talk to their doctor if they suspect they’re experiencing symptoms, & highlighted why early treatment is crucial to managing MS. https://t.co/xeHC7Dautp
MS symptoms vary depending on the brain or spinal cord area that’s affected. According to the National Multiple Sclerosis Society, more common symptoms include:
Fatigue so extreme it interferes with ability to function at home and work.
Doctors Without Waiting Rooms 