Resolving Issues of the Central Nervous System and Other Body Parts

Hans Liljenström^*
*Correspondence: Hans Liljenström, Department of Biometry and Analysis Technology, Swedish University, Uppsala, Sweden, Email:

Keywords

Neuroscience • Artificial intelligence • Human Brain Project • Consciousness • Free Will

Introduction

The estimated number of people with PN in the United States varies widely, from 16 million to 30 million indicating that there is a lack of agreement regarding diagnostic criteria and treatment recommendations. The majority of PN diagnoses are linked to chronic conditions like diabetes, cardiovascular disease, autoimmune disease, infection, or cancer, while a small percentage of PN diagnoses are linked to genetic disorders. Symptoms can be alleviated by addressing the underlying causes of PN and halting its progression. However, PN is idiopathic for many people and has no known cause. Treatment proposals exist

For diabetes related PN or chemotherapy related PN. However, the management of day-to-day PN symptoms is typically the primary focus of healthcare providers for patients with idiopathic PN or PN with less common causes. The absence of agreement concerning might be connected with an absence of information on the side effects and encounters of those living with PN.

Literature Review

Due to the absence of clear biomarkers that can measure damage to the peripheral nervous system, the diagnosis of PN is more challenging than that of chronic diseases like diabetes or high blood pressure. Electromyography and nerve conduction velocity tests have been around for a long time, but we do not yet have a definitive biomarker for PN. Despite the fact that peripheral nerve channels are anatomically distinct from affected body parts, PN diagnosis and treatment are frequently dependent on the primary source of the disease. PN is categorized as idiopathic when primary conditions and genetic causes are eliminated. Selfmanagement plays a significant role in the course of illness and quality of life of people with PN, just as it does for people with other chronic conditions like diabetes and high blood pressure. Self-management programs for people with PN have been the subject of a few studies, but the majority of them have been part of larger studies on primary conditions in which people with idiopathic PN were included. To identify the main signs and symptoms of PN by etiology and to investigate the connections between PN and both social determinants of health and psychophysiological factors related to selfmanagement, we present a systematic investigation of people with PN in a national sample. Future interventions, such as a contextually relevant self-care support program for PN patients and their families, will be informed by our findings [1].

Discussion

We were unable to directly contact participants to verify their eligibility, so we were unable to conduct a national random sample. Online surveys commonly encounter this issue. We employed strategies for community engagement, including collaboration with reputable online PN support groups, to recruit a national sample. To begin, a Community Advisory Board (CAB) comprised of the study's principal investigator, co-investigators, patients and their families, leaders of PN support groups, and a local neurologist was established to oversee recruitment and guide study procedures. The CAB provided feedback after reviewing questionnaires and recruitment materials (such as pamphlets and program webpages).

Direct recruitment involved creating and disseminating targeted recruitment materials to well-established neuropathy support networks like the Western Neuropathy Association and the Foundation for Peripheral Neuropathy. A brief study description and a link to our website and survey were sent to ten leaders of support groups by the research team. The pioneers sent the overview connect to their gathering individuals and energized them also, their companions with PN to take an interest. Posting materials with the permission of online group moderators in neuropathy-specific Facebook groups was an example of indirect recruitment. The FPN online newsletter had approximately 30,000 subscribers at the time of the study's announcement, as did the Facebook group "Peripheral Neuropathy Success Stories!" had around 20 thousand followers [2].

Measures We gathered demographic data such as zip codes, age, gender, race, ethnicity, language, income, marital status, housing type, employment, living arrangement, and the kind of healthcare provider (such as a doctor, nurse practitioner, chiropractor, acupuncturist, or another). Height and weight were among the physiological data. Additionally, we gathered information regarding the year that PN symptoms began and the underlying cause. We also gathered a lot of information about the participants' current experiences with PN symptoms. The presence, frequency, timing, and location of muscle weakness, numbness, and tingling were all inquired about. The body heat map, which showed the (x, y) coordinates of each body part, including the upper and lower arms, legs, and chest and abdomen, was used by participants to report these symptoms.

The following were other measures: The Neuropathy Pain Scale (NPS) was used to measure neuropathic pain. The NPS is a 11-item scale for pain intensity (including, among other things, sharpness, sensitivity, and itchiness), with 0 representing less severe symptoms and 10 representing the most severe [3].

The Lower Extremity Function scale, a component of the Neuro-QOL, was used to measure mobility (mobility; 8 items) on the Upper Extremity Function scale and the Lower Extremity Mobility (LEM) scale, respectively (fine motor, activities of daily living; 15 items) for mobility in the upper extremities (UEM). Using a modified version of the High Blood Pressure Self Care Profile (HBP-SCP), self-management behaviors were evaluated. This scale asks about mindfulness and spirituality as well as the frequency with which people engage in healthy behaviors like staying active, eating well, getting enough sleep, and not drinking alcohol. Although more females than males reported being "disabled," more males reported suffering from PN symptoms, our analysis revealed that there were minimal gender differences in symptoms. On the other hand, demographic characteristics differed significantly between the known and unknown causes of PN in the analysis. Compared to people with known PN etiologies, the idiopathic group was predominantly White, had a higher socioeconomic status, and was older [4].

However, due to the limitations imposed by the characteristics of our sample, these findings must be interpreted with caution. The majority of the sample was White, and online data were collected. Our analysis of three cycles of the National Health and Nutrition Examination Survey (NHANES) from revealed that racial minorities were more likely to have PN using the monofilament test. Black had the highest proportion of PN prevalence followed by other racial groups Mexican Americans. Whites made up 67.8 percent of PN cases, which was less than the 77.3 percent of the national population. Compared to the national sample above, our sample had a higher proportion of women. The outcomes might be different if diverse racial/ethnic minority groups, gender, and socioeconomic status were taken into account (social determinants of health, or SDH). The SDH may be discouraged by the prevalence of PN. Nevertheless, our findings indicate that PN episodes and pain severity are significantly more correlated with perceived differences in the PN etiology than with gender differences.

For instance, the idiopathic group reported more sensory alterations in the feet and lower extremities than the known etiology group, whereas the known etiology group reported muscle weakness and numbness in areas other than the extremities. Because sensory changes in the lower extremities frequently signal serious disease progression and subsequent mobility impairment, these symptoms require serious attention. Self-management guidelines ought to include strategies for preserving LEM because LEM is closely related to quality of life for all PN groups, regardless of etiology. Sleep disturbances, depressive symptoms, patient activation, and self-care behaviors are additional significant quality of life predictors for people with PN. In addition, basic research ought to investigate various physiological pathways and the role of precision medicine in addressing these deficits because of the heterogeneity of symptom manifestations and differences in perceived quality of life between individuals with known and unknown causes of PN [5].

There is no effective pharmacological treatment for PN symptoms, even for those with a well-known etiology, as indicated by the state of the clinical science of PN. Active treatment of hyperglycemia in diabetics may offer some prevention or delay in diabetes-related PN. Although pancreatic transplantation may provide some diabetes-related PN stability, even more aggressive treatment does not improve PN. Evidence-based self-management support is essential because of the chronic nature of PN-related conditions; some rigorous studies highlight the potential for enhanced peripheral nerve regeneration, and lifestylebased strategies like improving diet, increasing physical activity, and reducing weight consistently show positive results. For instance, the landmark Diabetes Prevention Program (DPP) trial conducted by the National Institute of Diabetes and Digestive and Kidney Diseases randomized participants with prediabetes to either metformin, placebo, or a diet and exercise-based behavioral modification program [6].

In the DPP, the risk of developing diabetes decreased by 58% in the lifestyle behavior modification group compared to the placebo group and by 31% in the metformin group over an average of 2.8 years. In addition, the Impeded Glucose Resistance Neuropathy patients with diabetes related neuropathy. According to the DPP guidelines, all 32 participants received dietary counseling (targeted weight loss of 7%) and increased weekly exercise of at least 150 minutes for a year. Intra-Epidermal Nerve Fiber Density (IENFD), an objective outcome measure, and subjective measures (visual analog pain scales) demonstrated a link between metabolic improvement and slight nerve fiber improvement. Skin biopsy revealed a significant improvement in IENFD after a year of this lifestyle intervention. There was a strong correlation between neuropathic pain relief and an improvement in IENFD. Our study participants expressed their dissatisfaction with the "lack of clear diagnosis and treatment guidelines" and inadequate "sensible selfmanagement support" for their conditions in qualitative data.

Conclusion

According to the data, our healthcare system is unable to provide many people with PN with clinical management or self-management support that is precise and meaningful. Future research and treatment plans should include more patient-engaged efforts because this population is growing and experiences significant mental health stressors that affect quality of life. Our research suggests novel strategies for successfully collaborating with the PN community to collect patient outcome data, despite the notion that the PN population is difficult to reach. Project HEALING, for instance, was developed in collaboration with a number of patient advocacy organizations using the operational framework of community-based participatory research. A successful method for recruiting patients was to collaborate with reputable community organizations as study ambassadors to reach the intended audience. Our study's recruitment materials were enthusiastically shared by leaders of several online PN support groups, demonstrating the importance of recognizing this debilitating disease and providing high-quality information and resources on disease management for PN sufferers. As a result, a descriptive assessment of an understudied population can be successfully implemented through community-based participatory research.

Acknowledgement

None.

Conflict of Interest

None.

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