ObjectiveTo assess the diagnostic utility of biomarkers that could differentiate Chronic Traumatic Encephalopathy (CTE) from Alzheimer disease (AD).BackgroundCTE is a neurodegenerative disease associated with multiple head trauma. The diagnosis depends on neuropathologic findings postmortem, and patients can present cognitive and behavioral changes. These symptoms can usually be mistaken for other dementias, such as AD, leading to an underestimated frequency of CTE. Therefore, specific biomarkers can be useful for comprehending disease development, diagnosis and prognosis.Design/MethodsWe systematically searched the MEDLINE, Embase and Cochrane databases. We also searched the trial registries and reference lists of articles. We included studies that were relevant to the PICO question posed and analysed different biomarkers. We screened titles and abstracts and if they were pertinent, we assessed the full text and reported results narratively.ResultsTwenty-two studies were identified through database searching. One study was excluded due to duplicity among the databases. Twenty-one articles were assessed for eligibility and 6 were included in the qualitative synthesis. P-Tau and T-tau proteins were indicated as biomarkers of neurodegenerative diseases such as CTE and AD, but not from other tauopathies. Exosomal tau levels are higher in CTE patients than in AD patients, and it might be useful since it is very stable, crosses the blood–brain barrier and reflects their cellular origin. Pathophysiologic differences between CTE and AD are pointed out as a way to find specific biomarkers for CTE. The biomarkers associated with neuroaxonal damage (NFL), glial response with astroglial scarring (GFAP and sTREM2), and microvascular damage with disruption of the blood–brain barrier (cerebrospinal fluid/serum albumin ratio) are promising in that way.ConclusionsBiomarkers that arise from pathophysiologic processes distinct from the 2 diseases, appear to be promising. However, further well-designed studies are needed to assess the real utility of the biomarkers in differential diagnosis between CTE and AD.
The natural history of arachnoid cysts is still a topic of debate in the medical literature and important to the neurosurgeon who intends to manage these cases. This article consists of a review of the literature available in the main digital libraries with wide access. This search resulted in six studies in which the developmental aspects of patients with this condition were specifically investigated. The analysis of those articles allowed us to conclude that the main and possibly only proven risk factor for cyst enlargement is age below five years, while among patients above this age group we can expect a benign evolution.
Background: Ischemic strokes (IS) patients usually present cognitive deficits and psychiatric disorders. Studies describe this coexistence in the chronic phase, although alterations may relate with acute damage to emotion and cognition circuits Objectives: Assess cognitive and psychiatric symptoms during the subacute phase of IS. Design and setting: A prospective study, screening patients admitted in the Stroke Unit of Hospital Municipal Odilon Behrens, in Belo Horizonte, Minas Gerais, Brazil. Methods: Adults with acute IS and healthy controls were submitted to neuropsychological tests between 30 and 60 days after the event. Incidental, immediate and working memory, learning, late recall, recognition, phonemic verbal fluency, attention and facial emotion recognition were evaluated. Results: Eighteen patients were evaluated in the subacute phase, and twenty-one participants composed the control group, showing no socioeconomic differences between them. There was significant difference in immediate memory (p <0,01), late recall (p<0,05) and recognition (p<0,03) tests from the Brief Cognitive Screening Battery, and in the depression subscale from Hospital Anxiety and Depression Scale (p <0,04). Although there was no significant difference in Facial Emotion Recognition Test (p=0,745), the expression of sadness positively correlated with levels of anxiety (rho=0,587, p<0,05) and depression (rho=0,598, p<0,01), while the expression of fear negatively correlated with depressive symptoms (rho=0,481, p<0,05). Conclusion: Cognitive deficits and psychiatric symptoms in the subacute phase of IS are probably associated with memory impairments. Furthermore, depression and anxiety symptoms may influence the emotion recognition.
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