International Journal of Neurorehabilitation

The exact causes of Parkinson's disease (PD) are currently unknown, but studies have shown that the environment and genetics are the two factors that play the biggest role in Parkinson's disease. DJ-1 gene (belong to the PARK genes) is known as the main cause of Parkinson's disease in populations. In Vietnam, the evaluation of DJ-1 gene mutation frequency in patients is necessary to clarify the pathogenesis and genetic mechanisms of this disease. In this research, we identified the frequency mutations of the DJ-1 gene in Vietnamese PD patients. The results showed that we detected some DJ-1 mutations at exon 5 and exon 7. Interestingly, Ala86Gly and Gln95Leu mutations of exon 5 and His138Pro of exon 7 are found, which leads to a change in amino acid sequence and possibly a change in a functional protein. In addition, out of more than 20 heterozygous or homozygous mutations occurring in the intron regions 4 and 5, we found that 3 homozygous mutations occurred frequently in both patient and control. The data of mutation analysis has shown the ambiguous and unforeseeable meanings; however, they possibly associated with the mutation of PD. Therefore, the study of our next will focus on the relationship between these mutations with some clinical symptoms in patients.

Background: The purpose of the study was to investigate the effect of high frequency rTMS with constraint induced movement therapy (CIMT) on Upper extremity motor function. Clinical Stroke Assessment Scales and fMRI was used to assess the response of CIMT with rTMS on blood oxygenation-level dependent (BOLD) sequence component. Methodology: RCT was conducted at All India Institute of Medical Sciences, New Delhi, on chronic stroke patients (N=60) between 12 to 36 months of index event with atleast 10° of wrist extension, 10° of thumb abduction, Brunnstorm stage 2-4; NIHSS 4–20. Patients were randomized to CIMT alone (Group A n=30) & rTMS with CIMT (Group B n=30). rTMS (10 Hz, 750 pulses with 110%RMT) was administered for 3 weeks (5days/week). Radiological Assessment of the patients was done with fMRI (BOLD) along with assessment of Fugl Meyer (FM), Barthel Index, and modified Rankin Scales (MRS) at baseline, 3 weeks (Post intervention) & 3 month (follow up) Results: FM showed statistically significant improvement in group B as compared to group A at 3 weeks (95%CI: -12.4 to -9.3, p=0.003) and 3months (95%CI: 7.4 to 4.2, p=0.01). Repeated measure ANOVA showed that the mean groups were different at all-time points indicating some degree of improvement in all the subjects (F=3.4, p=0.01; F=5.4, p=0.002). The BOLD cluster activation was compared between two groups; there was increase in the number of clusters found in Group B. Conclusion: Both the groups showed improvement, increased cluster count showing alterations in cortical activations (fMRI-BOLD) after CIMT with rTMS in patients with chronic stroke indicated more degree of clinical improvement in upper extremity function.

Aim: To study disability burden due to common prevalent neurological disorders.

Material and Methods: Study from a tertiary care neuropsychiatry hospital from North India. Cases had been collected with all detailed demographic and relevant findings from the year 2009 to 2018; almost 10 years of data were collected and recorded. The detailed analyses of the cases were done. All the cases which lead to permanent disability leading to Locomotors, cognitive and other deficits from the Neurological disorder were included and recorded. Cases leading to temporary disability were excluded from the study.

Results: Total numbers of patients around ten tears were 1203 in number, Out of which 1001 were males and 202 were females. Stroke accounted for the largest proportion of disability among all neurological disorders analysed. Cerebral palsy, post enchephalitis sequalae and mental Retardation with Epilepsy were the second, third, and fourth largest contributors of permanent physical or cognitive disability. The proportional contributions of the other neurological disorders analysed were less substantial and varied from 0.4% for Multiple sclerosis to round 5% for tuberculosis of Brain.

Among the largest number Stroke Cerebrovascular accident is the largest group comprises of round 44 % of the permanent disability followed by Cerebral palsy, (22.8%) Post encephalitis, sequalae (11.8%) and mental Retardation with Epilepsy (9.2%). Other groups comprises of Tuberculosis of brain (5.2%), Motor Neuron diseases (3.5%) and small number of cases of myelopathy, dementia and Multiple sclerosis and related disorders.

Stroke the number of male patients are more as compared to females.

The age pattern varied between the various neurological disorders for disability .The age group range for CVA varies grom 30 to 80, mostly in elderly, whereas cerebral palsy, post encephalitis sequale, mental retardation and Epilepsy prevailed in younger age group.

Conclusion: The burden due to Neurological disorders is increasing in India and leading to further disability. In developing countries were most of the population belongs to middle or low socio-economic status against increase the burden as the sole family member get disabled and the whole family is dependent on their livelihood.