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  1. Article ; Online: Acute akinetic-rigid syndrome in COVID-19 encephalitis.

    Maramattom, Boby Varkey / Kishore, Asha

    Acta neurologica Belgica

    2022  Volume 122, Issue 3, Page(s) 847–849

    MeSH term(s) COVID-19/complications ; Encephalitis ; Humans ; Parkinson Disease ; Parkinsonian Disorders ; Tremor
    Language English
    Publishing date 2022-02-22
    Publishing country Italy
    Document type Letter
    ZDB-ID 127315-2
    ISSN 2240-2993 ; 0300-9009
    ISSN (online) 2240-2993
    ISSN 0300-9009
    DOI 10.1007/s13760-022-01892-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Treatable cerebellar ataxias.

    K P, Divya / Kishore, Asha

    Clinical parkinsonism & related disorders

    2020  Volume 3, Page(s) 100053

    Abstract: Cerebellar ataxic syndrome is a heterogenous class of disorders which can result from a miscellany of causes- genetic or acquired. There are a few metabolic, immune mediated, inflammatory and hereditary causes of ataxia which can be diagnosed from the ... ...

    Abstract Cerebellar ataxic syndrome is a heterogenous class of disorders which can result from a miscellany of causes- genetic or acquired. There are a few metabolic, immune mediated, inflammatory and hereditary causes of ataxia which can be diagnosed from the gamut of possibilities, offering great relief to the ailing patient, their family and the treating physician. A pragmatic algorithm for diagnosing treatable causes of ataxia includes a thorough clinical history, meticulous examination for associated signs and an investigative mind to clinch the diagnosis. With novel diagnostic techniques and targeted therapies, early diagnosis and treatment can lead to favourable outcomes. In this review, diseases presenting predominantly as cerebellar ataxia and are treatable by targeted therapies are discussed.
    Language English
    Publishing date 2020-04-04
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2590-1125
    ISSN (online) 2590-1125
    DOI 10.1016/j.prdoa.2020.100053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Review on Implantable Neuroelectrodes.

    Krishnan, Jithin / Joseph, Roy / Vayalappil, Muraleedharan Chirathodiyil / Krishnan, Syam / Kishore, Asha

    Critical reviews in biomedical engineering

    2023  Volume 52, Issue 1, Page(s) 21–39

    Abstract: The efficacy of every neuromodulation modality depends upon the characteristics of the electrodes used to stimulate the chosen target. The geometrical, chemical, mechanical and physical configuration of electrodes used in neurostimulation affects several ...

    Abstract The efficacy of every neuromodulation modality depends upon the characteristics of the electrodes used to stimulate the chosen target. The geometrical, chemical, mechanical and physical configuration of electrodes used in neurostimulation affects several performance attributes like stimulation efficiency, selectivity, tissue response, etc. The efficiency of stimulation in relation to electrode impedance is influenced by the electrode material and/or its geometry. The nature of the electrode material determines the charge transfer across the electrode-tissue interface, which also relates to neuronal tissue damage. Electrode morphology or configuration pattern can facilitate the modulation of extracellular electric field (field shaping). This enables selective activation of neurons and minimizes side effects. Biocompatibility and biostability of the electrode materials or electrode coating have a role in glial formation and tissue damage. Mechanical and electrochemical stability (corrosion resistance) determines the long-term efficacy of any neuromodulation technique. Here, a review of electrodes typically used for implantable neuromodulation is discussed. Factors affecting the performance of electrodes like stimulation efficiency, selectivity and tissue responses to the electrode-tissue interface are discussed. Technological advancements to improve electrode characteristics are also included.
    MeSH term(s) Humans ; Electric Impedance ; Electrodes ; Prostheses and Implants
    Language English
    Publishing date 2023-11-08
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1411103-2
    ISSN 1943-619X ; 0278-940X
    ISSN (online) 1943-619X
    ISSN 0278-940X
    DOI 10.1615/CritRevBiomedEng.2023049282
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  4. Article ; Online: Head Drop and Trunk Flexion as an Early Manifestation of Anti-IgLON5 Disease.

    Soman Pillai, Kanchana / Maramattom, Boby Varkey / Gopalannair Santhamma, Shagos / Kishore, Asha

    Movement disorders clinical practice

    2022  Volume 10, Issue 1, Page(s) 135–137

    Language English
    Publishing date 2022-10-18
    Publishing country United States
    Document type Case Reports
    ISSN 2330-1619
    ISSN (online) 2330-1619
    DOI 10.1002/mdc3.13575
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  5. Article ; Online: Depotentiation of associative plasticity is intact in Parkinson's disease with mild dyskinesia.

    Kishore, Asha / James, Praveen / Rajeswari, Parvathy / Sarma, Gangadhara / Krishnan, Syam / Meunier, Sabine / Popa, Traian

    Parkinsonism & related disorders

    2022  Volume 99, Page(s) 16–22

    Abstract: Objective: Depotentiation of homosynaptic plasticity of the primary motor cortex (M1) is impaired in patients with Parkinson's disease (PD) who have developed dyskinesias. In this exploratory study, we tested whether this holds true for heterosynaptic ... ...

    Abstract Objective: Depotentiation of homosynaptic plasticity of the primary motor cortex (M1) is impaired in patients with Parkinson's disease (PD) who have developed dyskinesias. In this exploratory study, we tested whether this holds true for heterosynaptic plasticity induced by paired associative stimulation (PAS).
    Methods: Dyskinetic (n=11) and Non-dyskinetic (n=11), levodopa-treated PD patients were tested in M1 with PAS
    Results: PAS
    Conclusions: Cerebellar stimulation enhances heterosynaptic plasticity in PD irrespective of dyskinesias. Depotentiation mechanisms of heterosynaptic plasticity are preserved in PD patients, including those with dyskinesias. The lack of depotentiation of LTP-like plasticity as a hallmark of dyskinesia in PD patients is not absolute. The ability to depotentiate LTP-like plasticity may potentially depend on the type of plasticity induced (homosynaptic or heterosynaptic), the circuits involved in these responses and the adequacy of dopaminergic stimulation.
    MeSH term(s) Antiparkinson Agents/adverse effects ; Dyskinesia, Drug-Induced/etiology ; Evoked Potentials, Motor/physiology ; Humans ; Long-Term Synaptic Depression/physiology ; Motor Cortex ; Neuronal Plasticity ; Parkinson Disease/complications ; Transcranial Magnetic Stimulation/methods
    Chemical Substances Antiparkinson Agents
    Language English
    Publishing date 2022-05-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2022.04.019
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  6. Article: Cerebellar and basal ganglia structural connections in humans: Effect of aging and relation with memory and learning.

    Radhakrishnan, Vineeth / Gallea, Cecile / Valabregue, Romain / Krishnan, Syam / Kesavadas, Chandrasekharan / Thomas, Bejoy / James, Praveen / Menon, Ramshekhar / Kishore, Asha

    Frontiers in aging neuroscience

    2023  Volume 15, Page(s) 1019239

    Abstract: Introduction: The cerebellum and basal ganglia were initially considered anatomically distinct regions, each connected : Methods: In this study, we validated and expanded the previous findings of the structural connectivity within the cerebellum- ... ...

    Abstract Introduction: The cerebellum and basal ganglia were initially considered anatomically distinct regions, each connected
    Methods: In this study, we validated and expanded the previous findings of the structural connectivity within the cerebellum-basal ganglia subcortical network, in a larger dataset of 64 subjects, across different age ranges. Tractography and fixel-based analysis were performed on the 3 T diffusion-weighted dataset using Mrtrix3 software, considering fiber density and cross-section as indicators of axonal integrity. Tractography of the well-established cerebello-thalamo-cortical tract was conducted as a control. We tested the relationship between the structural white matter integrity of these connections with aging and with the performance in different domains of Addenbrooke's Cognitive Examination.
    Results: Tractography analysis isolated connections from the dentate nucleus to the contralateral putamen
    Conclusion: We validated the structural connectivity within the cerebellum-basal ganglia reciprocal network, in a larger dataset of human subjects, across wider age range. The structural features of the subcortical cerebello-basal ganglia tracts in human subjects display age-related neurodegeneration. Individual morphological variability of cerebellar tracts to the striatum and prefrontal cortex was associated with different cognitive functions, suggesting a functional contribution of cerebellar tracts to cognitive decline with aging. This study offers new perspectives to consider the functional role of these pathways in motor learning and the pathophysiology of movement disorders involving the cerebellum and striatum.
    Language English
    Publishing date 2023-01-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2558898-9
    ISSN 1663-4365
    ISSN 1663-4365
    DOI 10.3389/fnagi.2023.1019239
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  7. Article ; Online: Quantifying abnormal writing kinematics in writer's cramp using a novel software platform.

    Vysakha, Kavadisseril Vivekanandan / Radhakrishnan, Vineeth / James, Praveen / Kumar, B Suresh / Susvirkar, Ashish Anand / Sarma, Gangadhara / Cherian, Ajith / Divya, K P / Nair, Syam Krishnan / Kishore, Asha

    Acta neurologica Belgica

    2024  

    Abstract: Background: Writer's cramp is a task-specific focal hand dystonia, which is diagnosed clinically. Quantification of defect in WC is done using clinical scales, while digitized platforms are lacking.: Objective: To design and test a platform that can ... ...

    Abstract Background: Writer's cramp is a task-specific focal hand dystonia, which is diagnosed clinically. Quantification of defect in WC is done using clinical scales, while digitized platforms are lacking.
    Objective: To design and test a platform that can differentiate and quantify the abnormal kinematics of writing using a software interface and to validate it in adult-onset isolated writer's cramp (WC).
    Methods: A native platform was designed using Java and Wacom Intuos pro tablet and the data analyzed using a MATLAB-based platform called Large Data-Based Evaluation of Kinematics in Handwriting (LEKH). We standardized this new platform by comparing the handwriting between patients with WC and age, and gender and education-matched healthy controls, using standard tasks to assess the kinematics.
    Results: Comparison of the writing of right-handed WC patients (N = 21) and 39 healthy controls (N = 39) showed that patients differed from controls in the frequency of strokes (P < 0.001), number of inversions of velocity (P < 0.001), number of breaks (P = 0.02), air time and paper time (P < 0.001).
    Conclusions: Using the LEKH platform, the kinematic profile of patients with WC could be differentiated from healthy controls. Studies in larger samples will be needed to derive statistical models that can differentiate the flexion and extension types of WC which can help in muscle selection and to quantify the effects of treatment.
    Language English
    Publishing date 2024-04-04
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 127315-2
    ISSN 2240-2993 ; 0300-9009
    ISSN (online) 2240-2993
    ISSN 0300-9009
    DOI 10.1007/s13760-024-02532-x
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  8. Article: Subtypes of PSP and Prognosis: A Retrospective Analysis.

    Mahale, Rohan R / Krishnan, Syam / Divya, K P / Jisha, V T / Kishore, Asha

    Annals of Indian Academy of Neurology

    2021  Volume 24, Issue 1, Page(s) 56–62

    Abstract: Background: Progressive supranuclear palsy (PSP) is a clinically heterogeneous disease characterized by supranuclear gaze palsy and varying combinations of Parkinsonism, gait disturbances, postural instability, and fronto-limbic cognitive dysfunction. A ...

    Abstract Background: Progressive supranuclear palsy (PSP) is a clinically heterogeneous disease characterized by supranuclear gaze palsy and varying combinations of Parkinsonism, gait disturbances, postural instability, and fronto-limbic cognitive dysfunction. A major challenge in clinical diagnosis is the existence of subtypes whose clinical features overlap with those of other Parkinsonian disorders.
    Objectives: To categorize patients of PSP into its using the recently proposed movement disorder society criteria (2017) and to determine the prognosis of the PSP subtypes.
    Methods: Demographic and clinical data of patients diagnosed with PSP over a 21 year period were collected by review of medical records and categorized into its subtypes. Subtype prognosis was assessed from the interval between disease onset and attainment of the first of 5 clinical disability milestones namely wheelchair dependency, unintelligible speech, severe dysphagia, severe cognitive impairment, and urinary catheterization.
    Results: When categorized into subtypes, out of the 334 patients with PSP, PSP-RS predominated (72%), followed by PSP-parkinsonism (PSP-P) (13.5%), PSP-corticobasal syndrome (PSP-CBS) (5.1%), PSP-frontal (PSP-F) (4.2%), PSP-progressive gait freezing (PSP-PGF) (4.2%), PSP-postural instability (PSP-PI) (0.6%), and PSP-speech/language (PSP-SL) (0.3%). PSP-P reaches the milestones of wheelchair dependency, unintelligible speech, and dysphagia later than other subtypes.
    Conclusion: PSP-RS was the commonest and PSP-OM the rarest PSP subtype in our retrospective PSP cohort analysis. PSP-P had a better prognosis than all other subtypes of PSP. A large proportion of these cases would remain unclassified using NINDS-SPSP (1996) criteria.
    Language English
    Publishing date 2021-01-19
    Publishing country India
    Document type Journal Article
    ZDB-ID 2240174-X
    ISSN 1998-3549 ; 0972-2327
    ISSN (online) 1998-3549
    ISSN 0972-2327
    DOI 10.4103/aian.AIAN_611_20
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  9. Article: Myoclonus- A Review.

    Chandarana, Mitesh / Saraf, Udit / Divya, K P / Krishnan, Syam / Kishore, Asha

    Annals of Indian Academy of Neurology

    2021  Volume 24, Issue 3, Page(s) 327–338

    Abstract: Myoclonus is a hyperkinetic movement disorder characterized by a sudden, brief, involuntary jerk. Positive myoclonus is caused by abrupt muscle contractions, while negative myoclonus by sudden cessation of ongoing muscular contractions. Myoclonus can be ... ...

    Abstract Myoclonus is a hyperkinetic movement disorder characterized by a sudden, brief, involuntary jerk. Positive myoclonus is caused by abrupt muscle contractions, while negative myoclonus by sudden cessation of ongoing muscular contractions. Myoclonus can be classified in various ways according to body distribution, relation to activity, neurophysiology, and etiology. The neurophysiological classification of myoclonus by means of electrophysiological tests is helpful in guiding the best therapeutic strategy. Given the diverse etiologies of myoclonus, a thorough history and detailed physical examination are key to the evaluation of myoclonus. These along with basic laboratory testing and neurophysiological studies help in narrowing down the clinical possibilities. Though symptomatic treatment is required in the majority of cases, treatment of the underlying etiology should be the primary aim whenever possible. Symptomatic treatment is often not satisfactory, and a combination of different drugs is often required to control the myoclonus. This review addresses the etiology, classification, clinical approach, and management of myoclonus.
    Language English
    Publishing date 2021-05-21
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2240174-X
    ISSN 1998-3549 ; 0972-2327
    ISSN (online) 1998-3549
    ISSN 0972-2327
    DOI 10.4103/aian.AIAN_1180_20
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  10. Article ; Online: Interleaved Stimulation for Freezing of Gait in Advanced Parkinson's Disease.

    Zafar, Syed M / Rajan, Roopa / Krishnan, Syam / Kesavapisharady, Krishnakumar / Kishore, Asha

    Neurology India

    2021  Volume 69, Issue 2, Page(s) 457–460

    Abstract: Background: Freezing of gait (FOG) is a disabling and refractory symptom of advanced Parkinson's disease (PD). Interleaved stimulation (ILS) is a novel paradigm which may benefit axial symptoms of PD.: Objectives: To assess the effect of ILS on FOG ... ...

    Abstract Background: Freezing of gait (FOG) is a disabling and refractory symptom of advanced Parkinson's disease (PD). Interleaved stimulation (ILS) is a novel paradigm which may benefit axial symptoms of PD.
    Objectives: To assess the effect of ILS on FOG in patients unresponsive to conventional subthalamic nucleus (STN) stimulation.
    Methods: 19 PD patients receiving subthalamic stimulation and experiencing FOG at both conventional (130-150Hz) and low frequency (60Hz) stimulation were given ILS.The primary outcome measure was the UPDRS part III gait score (item 29) at 3 months after ILS. A subset of patients was tested with the stand-walk-sit (SWS) test, 30 min after ILS.
    Results: The mean UPDRS part III gait score (baseline: 1.8 ± 0.6) improved at 30 min (1.1 ± 0.8, P = 0.017) and remained improved at 3 months (1.2 ± 0.8, P = 0.048). FOG episodes reduced during SWS test (P = 0.041).
    Conclusions: ILS of STN through two adjacent contacts provided significant short-term beneficial effects on FOG.
    MeSH term(s) Deep Brain Stimulation ; Gait ; Gait Disorders, Neurologic/etiology ; Gait Disorders, Neurologic/therapy ; Humans ; Parkinson Disease/complications ; Parkinson Disease/therapy ; Subthalamic Nucleus ; Treatment Outcome
    Language English
    Publishing date 2021-04-27
    Publishing country India
    Document type Journal Article
    ZDB-ID 415522-1
    ISSN 1998-4022 ; 0028-3886
    ISSN (online) 1998-4022
    ISSN 0028-3886
    DOI 10.4103/0028-3886.314570
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