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Luib E, Demleitner AF, Cordts I, Westenberg E, Rau P, Pürner D, Haller B, Lingor P. Reduced tear fluid production in neurological diseases: a cohort study in 708 patients. J Neurol 2024; 271:1824-1836. [PMID: 38063868 PMCID: PMC10973005 DOI: 10.1007/s00415-023-12104-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND Tear fluid (TF) production is an important component of normal ocular function. It is regulated by parasympathetic and sympathetic innervation. Because parasympathetic nerve fibers originate in the brainstem, pathology in this brain region may affect TF production. For example, a reduction in TF production has been described in patients with Parkinson's disease (PD). METHODS TF was collected at one center from 772 individuals, 708 of which were patients with different neurological diseases, and 64 healthy controls. Wetting lengths (WL) were recorded using Schirmer test strips with a collection time of 10 min. RESULTS WL correlated negatively with age and was significantly reduced in subgroups of patients with neurodegenerative diseases (NDDs) (PD, Amyotrophic lateral sclerosis (ALS), other motor neuron diseases (MNDs)), as well as inflammatory/autoimmune/infectious central nervous system (CNS) diseases and vascular CNS diseases (VCDs), even if corrected for age or sex. While temperature had a significant negative effect on TF production, other environmental factors, such as hours of sunlight and humidity, did not. CONCLUSION WL was altered in many neurological diseases compared to healthy controls. Most importantly, we observed a reduction of WL in NDDs, independent of age or sex. This study highlights the potential of WL as an easily obtainable parameter and suggests functional alterations in the autonomic innervation in various neurological disorders.
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Affiliation(s)
- Elena Luib
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Antonia F Demleitner
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Isabell Cordts
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Erica Westenberg
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Petra Rau
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Dominik Pürner
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Paul Lingor
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
- DZNE, German Center for Neurodegenerative Diseases, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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Wang J. EFFECTIVENESS OF PHYSICAL EXERCISE ON THE RECOVERY OF LIMB FUNCTION IN STROKE PATIENTS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127032021_0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction Patients with cerebrovascular accident and hemiplegia need to perform physical exercise and aerobic training, but physical dysfunction restricts the performance of these activities. Objective The article aims to develop physical strength sports for stroke patients with hemiplegia to explore the efficacy of sports to regain limb function in these patients. Methods We randomly selected 30 patients with stroke sequelae and divided them into control and exercise groups. While undergoing rehab, the exercise group performed a certain amount of aerobic exercise. During this period, we compared the relevant physiological indicators of the patients, and, at the same time, we used the Fugle-Meyer motor function scoring method to assess limb function. Results The two groups of patients are significantly different regarding the recovery of physical function and the capacity for daily life. Physiological indicators of patients are also different. Conclusion Low-intensity aerobic exercise can help stroke and hemiplegia patients regain their basic ability to live and exercise. Level of evidence II; Therapeutic studies: investigation of treatment results.
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Affiliation(s)
- Jisheng Wang
- ZhengZhou Vocational University of information and Technology, China
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Tao Z, Rao G, Wu S, Lin Y, Wang J, Chen Z. Rehabilitation Evaluation of Hemiplegic Patients with Anterior Circulation Cerebral Infarction Based on Cranial Magnetic Stimulation. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7868419. [PMID: 34367539 PMCID: PMC8346300 DOI: 10.1155/2021/7868419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/13/2021] [Accepted: 07/21/2021] [Indexed: 01/20/2023]
Abstract
Cerebral infarction is a common cerebrovascular disease in clinical medicine. Cerebral infarction in the anterior circulation accounts for about 90% of cerebral infarction. Its treatment and rehabilitation has always been a research hotspot in the medical field. Functional retraining can enhance the afferent impulses received by receptors, make the plasticity development of cerebral cortex function, and improve the loss of function. Based on the patient's individual condition, exercise therapy carries out the corresponding comprehensive functional training plan, which also includes the training of patients' daily living ability, turning over, bridge exercise, trunk rotation, etc., in order to improve the motor function of patients. The other is psychotherapy, which can cause emotional fluctuations, depression, anxiety, and other negative emotions due to the occurrence of diseases. In the rehabilitation treatment, relevant personnel can conduct psychological counseling for patients through timely and effective communication, so as to better establish patients' confidence in rehabilitation and improve the effect of rehabilitation treatment. The third is acupuncture treatment. Acupuncture is a traditional rehabilitation treatment in China. The rehabilitation effect of stroke has been proved by a large number of clinical practice. Acupuncture at Hegu, Quchi, Zusanli, and Taichong points can dredge channels and improve blood circulation. This paper mainly studies and analyzes the effect of behavior rehabilitation of hemiplegic patients with cerebral anterior circulation infarction treated by cranial magnetic stimulation. The rehabilitation treatment status of hemiplegic patients with anterior circulation cerebral infarction in a hospital was selected, and 100 cases were studied. Among them, 50 cases were treated with conventional rehabilitation therapy, and the other 50 cases were treated with cranial magnetic stimulation. The motor function, activities of daily living, and language expression ability of the two groups were compared for statistical analysis. After transcranial magnetic stimulation treatment, the abilities of the study group were better than those of the control group, P < 0.05, with statistical significance. Based on the reliable experimental data, we can draw a conclusion that the treatment of cranial magnetic stimulation has a significant effect on the rehabilitation of hemiplegic patients with cerebral anterior circulation infarction, which is higher than the conventional treatment and rehabilitation methods, and can be popularized in clinical application.
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Affiliation(s)
- Zhengde Tao
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
| | - Gaofeng Rao
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
| | - Shasha Wu
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
| | - Yongqiang Lin
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
| | - Jinqiao Wang
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
| | - Zhirui Chen
- Rehabilitation Department, The First People's Hospital of Wenling, Wenling 317500, Zhejiang, China
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Shimizu E, Yazu H, Aketa N, Yokoiwa R, Sato S, Katayama T, Hanyuda A, Sato Y, Ogawa Y, Tsubota K. Smart Eye Camera: A Validation Study for Evaluating the Tear Film Breakup Time in Human Subjects. Transl Vis Sci Technol 2021; 10:28. [PMID: 34004005 PMCID: PMC8083120 DOI: 10.1167/tvst.10.4.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/13/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aimed to demonstrate the efficacy of a "Smart Eye Camera (SEC)" in comparison with the efficacy of the conventional slit-lamp microscope by evaluating their diagnostic functionality for dry eye disease (DED) in clinical cases. Methods This retrospective study included 106 eyes from 53 adult Japanese patients who visited the Ophthalmology outpatient clinics in Keio University Hospital from June 2019 to March 2020. Tear film breakup time (TFBUT) and corneal fluorescence score (CFS) measurements for the diagnosis of DED were compared between the conventional slit-lamp microscope and SEC. Results The objective findings of DED showed that there was a strong correlation between the conventional slit-lamp microscope and SEC with respect to TFBUT and CFS results (Spearman's r = 0.887, 95% confidence interval [CI] = 0.838-0.922, and r = 0.920, 95% CI = 0.884-0.945, respectively). The interobserver reliability between the conventional slit-lamp microscope and SEC showed a moderate agreement (weighted Kappa κ = 0.527, 95% CI = 0.517-0.537 and κ = 0.550, 95% CI = 0.539-0.561 for TFBUT and CFS, respectively). The diagnostic performance of the SEC for Asia Dry Eye Society diagnostic criteria showed a sensitivity of 0.957 (95% CI = 0.841-0.992), specificity of 0.900 (95% CI = 0.811-0.927), positive predictive value of 0.880 (95% CI = 0.774-0.912), and negative predictive value of 0.964 (95% CI = 0.869-0.993). Moreover, the area under the receiver operating characteristic curve was 0.928 (95% CI = 0.849-1.000). Conclusions Compared with the conventional slit-lamp microscope, SEC has sufficient validity and reliability for diagnosing DED in the clinical setting. Translational Relevance The SEC can portably evaluate TFBUT in both basic research and clinical care.
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Affiliation(s)
- Eisuke Shimizu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
| | - Hiroyuki Yazu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
| | - Naohiko Aketa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
| | | | - Shinri Sato
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Taiichiro Katayama
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Yoko Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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