Because the function and mechanisms of sleep are partially clear, here we applied a meta-analysis to address the issue whether sleep function includes antioxidative properties in mice and rats. Given the expansion of the knowledge in the sleep field, it is indeed ambitious to describe all mammals, or other animals, in which sleep shows an antioxidant function. However, in this paper we reviewed the current understanding from basic studies in two species to drive the hypothesis that sleep is a dynamic-resting state with antioxidative properties. We performed a systematic review of articles cited in Medline, Scopus, and Web of Science until March 2015 using the following search terms: Sleep or sleep deprivation and oxidative stress, lipid peroxidation, glutathione, nitric oxide, catalase or superoxide dismutase. We found a total of 266 studies. After inclusion and exclusion criteria, 44 articles were included, which are presented and discussed in this study. The complex relationship between sleep duration and oxidative stress is discussed. Further studies should consider molecular and genetic approaches to determine whether disrupted sleep promotes oxidative stress.

Introduction We designed a follow‐up study of frontline health workers at COVID‐19 patient care, within the same working conditions, to assess the influence of their general characteristics and pre‐existing anxiety/depression/dissociative symptoms and resilience on the development of symptoms of post‐traumatic stress disorder (PTSD), while monitoring their quality of sleep, depersonalization/derealization symptoms, acute stress, state anxiety, and burnout. Methods In a Hospital reconfigured to address the surge of patients with COVID‐19, 204 frontline health workers accepted to participate. They completed validated questionnaires to assess mental health: before, during, and after the peak of inpatient admissions. After each evaluation, a psychiatrist reviewed the questionnaires, using the accepted criteria for each instrument. Correlations were assessed using multivariable and multivariate analyses, with a significance level of .05. Results Compared to men, women reporting pre‐existing anxiety were more prone to acute stress; and younger age was related to both pre‐existent common psychological symptoms and less resilience. Overall the evaluations, sleep quality was bad on the majority of participants, with an increase during the epidemic crisis, while persistent burnout had influence on state anxiety, acute stress, and symptoms of depersonalization/derealization. PTSD symptoms were related to pre‐existent anxiety/depression and dissociative symptoms, as well as to acute stress and acute anxiety, and negatively related to resilience. Conclusions Pre‐existent anxiety/depression, dissociative symptoms, and coexisting acute anxiety and acute stress contribute to PTSD symptoms. During an infectious outbreak, psychological screening could provide valuable information to prevent or mitigate against adverse psychological reactions by frontline healthcare workers caring for patients.

BackgroundVascular parkinsonism (VP) is defined as the presence of parkinsonian syndrome, evidence of cerebrovascular disease, and an established relationship between the two disorders. However, the diagnosis of VP is problematic, particularly for the clinician confronted with moving from diagnosis to treatment. Given the different criteria used in the diagnosis of VP, the effectiveness of available therapeutic interventions for this disease are currently unknown.MethodsTo assess the clinical response of all published therapeutic interventions for VP that have been reported in the literature, we conducted a systematic review looking for VP subjects treated with any therapeutic intervention. To clarify the prevalence of responsiveness to levodopa among VP subjects, we conducted a meta-analysis of 17 observational studies retrieved with the search criteria of our review. Also, four studies were included in a second analysis to explore if nigrostriatal lesion affected the prevalence of levodopa response in VP subjects. Relevant articles were identified from MEDLINE, Scopus, and Web of Science published until June 2017.Results436 non-duplicate citations were identified for screening, 107 articles were assessed for eligibility, and only 23 observational studies were included in this review. No randomized clinical trials were found. Four different therapies were found in the literature; among them, levodopa was the only one repetitively reported. The calculated event rate of levodopa response in VP subjects was of 0.304 [95% confidence interval (CI) of 0.230–0.388]. The overall odds ratio for good response to levodopa in VP with lesion in the nigrostriatal pathway vs. no lesion in the nigrostriatal pathway was 15.15 (95% CI: 5.2–44.17).ConclusionDespite the lack of randomized controlled trials, results of this systematic review and meta-analysis show that VP subjects, as operationally defined here, have a low response rate to levodopa; nigrostriatal lesion could be used as a proxy predictor of levodopa response in VP subjects. Other therapies seem to be co-adjuvant. Randomized controlled trials with a clear definition of VP are necessary to be able to assign positive or negative predictive values to available treatments and to recommend any of the therapeutic interventions for these subjects.

Brain-Computer Interfaces (BCI) coupled to robotic assistive devices have shown promise for the rehabilitation of stroke patients. However, little has been reported that compares the clinical and physiological effects of a BCI intervention for upper limb stroke rehabilitation with those of conventional therapy. This study assesses the feasibility of an intervention with a BCI based on electroencephalography (EEG) coupled to a robotic hand orthosis for upper limb stroke rehabilitation and compares its outcomes to conventional therapy. Seven subacute and three chronic stroke patients (M = 59.9 ± 12.8) with severe upper limb impairment were recruited in a crossover feasibility study to receive 1 month of BCI therapy and 1 month of conventional therapy in random order. The outcome measures were comprised of: Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), motor evoked potentials elicited by transcranial magnetic stimulation (TMS), hand dynamometry, and EEG. Additionally, BCI performance and user experience were measured. All measurements were acquired before and after each intervention. FMA-UE and ARAT after BCI (23.1 ± 16; 8.4 ± 10) and after conventional therapy (21.9 ± 15; 8.7 ± 11) were significantly higher (p < 0.017) compared to baseline (17.5 ± 15; 4.3 ± 6) but were similar between therapies (p > 0.017). Via TMS, corticospinal tract integrity could be assessed in the affected hemisphere of three patients at baseline, in five after BCI, and four after conventional therapy. While no significant difference (p > 0.05) was found in patients’ affected hand strength, it was higher after the BCI therapy. EEG cortical activations were significantly higher over motor and non-motor regions after both therapies (p < 0.017). System performance increased across BCI sessions, from 54 (50, 70%) to 72% (56, 83%). Patients reported moderate mental workloads and excellent usability with the BCI. Outcome measurements implied that a BCI intervention using a robotic hand orthosis as feedback has the potential to elicit neuroplasticity-related mechanisms, similar to those observed during conventional therapy, even in a group of severely impaired stroke patients. Therefore, the proposed BCI system could be a suitable therapy option and will be further assessed in clinical trials.

Parkinson’s disease (PD) is not a single entity but rather a heterogeneous neurodegenerative disorder. The present study aims to conduct a critical systematic review of the literature to describe the main pharmacological strategies to treat cognitive dysfunction and major depressive disorder in PD patients. We performed a search of articles cited in PubMed from 2004 to 2014 using the following MeSH terms (Medical subject headings) “Parkinson disease”; “Delirium,” “Dementia,” “Amnestic,” “Cognitive disorders,” and “Parkinson disease”; “depression,” “major depressive disorder,” “drug therapy.” We found a total of 71 studies related to pharmacological treatment in cognitive dysfunction and 279 studies for pharmacological treatment in major depressive disorder. After fulfillment of all the inclusion and exclusion criteria, 13 articles remained for cognitive dysfunction and 11 for major depressive disorder, which are presented and discussed in this study. Further research into non-motor symptoms of PD may provide insights into mechanisms of neurodegeneration, and provide better quality of life by using rational drugs.