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   Table of Contents - Current issue
Coverpage
July-September 2022
Volume 1 | Issue 3
Page Nos. 122-147

Online since Thursday, September 29, 2022

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Biomaterials as regenerative therapies for traumatic brain injury: a narrative review p. 122
Wang Hui, Su Zhi, Ling Ziao
DOI:10.4103/2773-2398.356521  
Over recent years, the events associated with traumatic brain injury (TBI) have become critical health problems. TBI involves various functional deficits that are caused by neuronal loss and is a common feature in various neuropathologies. Patients with TBI have a very high degree of disability and impairment at both the physical and psychological levels, thus creating a significant burden on the quality of life. Although stem cell therapy has achieved some success in the reconstruction of neural circuits for TBI therapies, there are several limitations that need to be overcome, such as the stem cell transplantation pathways and time to transplantation are challenges for clinical application. Recently, bioactive materials from the tissue engineering field have become promising candidates for TBI therapies. Herein, we briefly summarize and discuss the advantages and disadvantages of TBI-related biomaterials (such as hydrogels, nanofibers, and nanomaterials) for the regeneration of neural tissue and functional recovery at the lesion sites of TBI. Finally, we describe the desirable characteristics of bioactive materials for neural repair in TBI. Because the development of therapeutic strategies with biomaterials is still in its infancy, biomaterials deserve high priority and further development as a treatment for TBI.
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RESEARCH ARTICLE Top

Estimating high-order brain functional network via signed random walk for mild cognitive impairment identification p. 128
Li-Mei Zhang, Xiao Wu, Hui Su, Ting-Ting Guo, Ming-Xia Liu
DOI:10.4103/2773-2398.356522  
Brain functional network (BFN) has become an increasingly important tool to discover informative biomarkers for diagnosing neurodegenerative diseases, such as Alzheimer’s disease and its prodrome stage, namely mild cognitive impairment. Currently, the most popular BFN estimation methods include Pearson’s correlation and sparse representation. Despite their empirical success in some scenarios, such estimated BFNs only capture the low-order relationship (i.e., the direct connectivity strength between brain regions), ignoring the high-order information in the brain (e.g., the global network structure). Therefore, in this study, we proposed a novel method based on the signed random walk (SRW) to estimate high-order BFNs. Not only can SRW measure the global network structure, but it can also naturally deal with negative brain functional connectivity through the structural balance theory. To the best of our knowledge, this study was the first to use SRW in BFN estimation. Furthermore, considering the complex interaction among different brain regions, we developed a parameterized variant of SRW for improving the flexibility of the high-order BFN estimation model. To illustrate the effectiveness of the proposed method, we identified patients with mild cognitive impairment from normal controls based on the estimated high-order BFNs. Our experimental findings showed that the proposed scheme tended to achieve higher classification performance than baseline methods.
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CASE REPORTS Top

Possible replacement of augmenting medication in treatment-resistant depression by transcranial magnetic stimulation: a case report p. 136
Anita Vaishampayan, Bassem Saad, Daniel Amarasinghe, Brin Carly, Richard Balon, Mischel Nicholas
DOI:10.4103/2773-2398.356523  
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. As the left prefrontal cortex activity is linked to depression, rTMS induces blood flow in the left dorsolateral prefrontal cortex. We used rTMS in a middle-aged male patient with depression who had discontinued psychostimulant medication over a 12-month period. He had been consistently taking dextroamphetamine-amphetamine extended release 30 mg once daily prior to the onset of rTMS treatment. The patient achieved depression remission through 39 sessions of high-frequency left dorsolateral prefrontal cortex rTMS treatments. We assessed disease progression using the Quick Inventory of Depressive Symptomatology, and we measured blood pressure before each session of rTMS. After tapering the dextroamphetamine-amphetamine extended release from 30 mg to 10 mg, the patient’s score on the Quick Inventory of Depressive Symptomatology increased slightly to 7 and then dropped to 0. The results indicate that interval rTMS can lower blood pressure and may be an alternative to adjunctive psychostimulants.
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Paroxysmal sympathetic hyperexcitation syndrome caused by ventriculoperitoneal shunt pressure-regulation in post-traumatic hydrocephalus: a case report p. 139
Li-Jun Yang, Xin-Wei Tang, Hai-Qing Li, Wang-Huan Dun, Wen-Ke Fan, Hong-Yu Xie, Nian-Hong Wang, Jun-Fa Wu, Yi Wu
DOI:10.4103/2773-2398.356524  
Paroxysmal sympathetic hyperactivity (PSH) is a rare symptom, but is difficult to manage. Here, we report a case of post-trauma PSH in a young male patient. The main reason for the occurrence of PSH in trauma patients may be nonnoxious or noxious stimuli. In this case, the detection of positive sympathetic parameters and heart rate variability after pressure regulation provided strong evidence for the PSH attack, thus enhancing the accuracy and reliability of early diagnosis. Clinicians should be alert to the possibility of PSH caused by rapid decline of ventricular pressure. Moreover, the appropriate regulation of ventricular pressure combined with pharmacologic interventions, rehabilitation and nutritional support may reduce and control this symptom.
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A case report describing accidental swallowing of an intermittent oro-esophageal tube p. 143
Han Xu, Lin Yan, Yin Lei, Qin Shen, Li Ding, Lin Gu
DOI:10.4103/2773-2398.356525  
A 74-year-old man with dementia was undergoing rehabilitation following a recent cerebrovascular accident. A nasogastric tube was inserted owing to swallowing dysfunction. However, the patient often dislodged the tube. We decided to apply intermittent feeding via an oro-esophageal tube. One day, he accidentally swallowed the tube into his stomach. The intermittent oro-esophageal tube was successfully removed by gastroscopy. This case herein highlights the need to be aware of dysphagia in patients with dementia when inserting an intermittent oro-esophageal tube.
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LETTER TO THE EDITOR Top

Treatment-resistant obsessive-compulsive disorder and multimodal augmentation: a case study p. 146
Shreya Verma, Shubhajeet Roy, Vaibhav Singh, Amit Singh, Sujita Kumar Kar
DOI:10.4103/2773-2398.356526  
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