Search

AbstractMotor Neuron Diseases (MNDs), familial and sporadic, are progressive neurodegenerative disorders that, for an extended period in the past, were considered purely motor disorders. During the course of the disease, however, some patients exhibit concomitant non-motor signs; thus, MNDs are currently perceived as multisystem disorders. Assessment of non-motor symptoms is usually performed clinically, although laboratory tests can also be routinely used to objectively evaluate these symptoms. Sympathetic Skin Response (SSR) is an example of a neurophysiological test that has been used in cases of Amyotrophic Lateral Sclerosis, Spinal Muscular Atrophy, and Monomelic Atrophy, mostly to assess Autonomic Nervous System (ANS) disorders. Dysautonomia affects quality of life and life expectancy, as it is involved in cardiovascular events and incidents of sudden death. SSR abnormalities are present even in subclinical involvement of the ANS in MNDs. In this review, we present published research examining SSR findings in various MNDs, and discuss the correlation of SSR findings with clinical symptoms and disease severity, as well as the potential sources of abnormal findings. The aim of this study is to raise clinician awareness of autonomic dysfunction in MNDs and present the benefits of SSR examination in patient care. [ABSTRACT FROM AUTHOR]

Background: Microembolic signals (MES) can be detected using transcranial Doppler (TCD) ultrasound in several clinical scenarios, including acute ischemic stroke (AIS). This narrative review aims to provide insights into their role in AIS patient management and outcomes., Methods: The present narrative review consolidates current observational and randomized evidence on the prevalence and clinical relevance of MES in different AIS subtypes and settings., Results: MES prevalence is higher in AIS patients with large artery atherosclerosis, indicating unstable or vulnerable plaques, and lower in those with small vessel disease. Detecting MES can significantly aid in managing AIS patients, particularly when the cause is unclear, as MES detected in different cerebral arteries can indicate conditions like covert cardioembolism, aortic arch atherosclerosis, or coagulation disorders, including cancer-related stroke. MES are associated with higher risk of stroke recurrence, independently of the underlying stroke mechanism. The detection of MES during and after acute systemic or endovascular reperfusion procedures in large-vessel occlusion patients appears to be predictive of adverse clinical outcomes and recurrent stroke. Finally, a reduction in MES detection may serve as surrogate marker and intermediate endpoint evaluating secondary stroke prevention treatments in the settings of randomized-controlled clinical trials., Conclusion: MES detection on TCD in AIS remains a useful diagnostic tool as it helps the clinicians to approach the stroke underlying mechanism by detecting and quantifying ongoing cerebral embolization and localizing an embolic source in real time. In addition, it allows monitoring and treatment individualization in stroke patients, while further determining recurrent stroke risk., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)