The association between SARS-CoV-2 infection with increased risk for new-onset neurodegenerative diseases remains unclear. Therefore, this meta-analysis aims to elucidate whether new-onset neurodegenerative diseases are long-term sequelae of SARS-CoV-2 infection. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched for articles published up to January 10, 2023. A systematic review and meta-analysis were performed to calculate the pooled effect size, expressed as hazard ratios (HR) with corresponding 95% confidence interval (CI) of each outcome. Twelve studies involving 33 146 809 individuals (2 688 417 post-COVID-19 cases and 30 458 392 controls) were included in the present metaanalysis. The pooled analyses compared with control groups showed a significant association between SARS-CoV-2 infection and increased risk for new-onset

Background Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide. Gut dysbiosis is hypothesized to cause PD; therefore, whether probiotics can be used as adjuvants in the treatment of PD is being actively investigated. Aims We performed a systematic review and meta-analysis to evaluate the effectiveness of probiotic therapy in PD patients. Methods PUBMED/MEDLINE, EMBASE, Cochrane, Scopus, PsycINFO and Web of Science databases were searched till February 20, 2023. The meta-analysis used a random effects model and the effect size was calculated as mean difference or standardized mean difference. We assessed the quality of the evidence using the Grade of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Eleven studies involving 840 participants were included in the final analysis. This meta-analysis showed high-quality evidence of improvement in Unified PD Rating Scale Part III motor scale (standardized mean difference [95% confidence interval]) (− 0.65 [− 1.11 to − 0.19]), non-motor symptom (− 0.81 [− 1.12 to − 0.51]), and depression scale (− 0.70 [− 0.93 to -0.46]). Moderate to low quality evidence of significant improvement was observed in gastrointestinal motility (0.83 [0.45–1.10]), quality of life (− 1.02 [− 1.66 to − 0.37]), anxiety scale (− 0.72 [− 1.10 to − 0.35]), serum inflammatory markers (− 5.98 [− 9.20 to − 2.75]), and diabetes risk (− 3.46 [− 4.72 to − 2.20]). However, there were no significant improvements in Bristol Stool Scale scores, constipation, antioxidant capacity, and risk of dyslipidemia. In a subgroup analysis, probiotic capsules improved gastrointestinal motility compared to fermented milk. Conclusion Probiotic supplements may be suitable for improving the motor and non-motor symptoms of PD and reducing depression. Further research is warranted to determine the mechanism of action of probiotics and to determine the optimal treatment protocol.

Introduction: Coronavirus disease 2019 (COVID-19), a global pandemic, has infected approximately 10% of the world's population. This comprehensive review aims to determine the prevalence of various neurological disorders in COVID-19 without overlapping meta-analysis errors. Methods: We searched for meta-analyses on neurologic disorders following COVID-19 published up to March 14, 2023. We obtained 1,184 studies, of which 44 meta-analyses involving 9,228,588 COVID-19 patients were finally included. After confirming the forest plot of each study and removing overlapping individual studies, a re-meta-analysis was performed using the random effect model. Results: The summarized combined prevalence of each neurological disorder is as follows: stroke 3.39%(95% confidence interval, 1.50-5.27), dementia 6.41%(1.36-11.46), multiple sclerosis 4.00%(2.50-5.00), epilepsy 5.36%(-0.60-11.32), Parkinson's disease 0.67%(-1.11-2.45), encephalitis 0.66%(-0.44-1.77) and Guillain–Barré syndrome 3.83%(-0.13-7.80). In addition, the mortality risk of patients with co-morbidities of COVID-19 is as follows: stroke OR 1.63(1.23-2.03), epilepsy OR 1.71(1.00-2.42), dementia OR 1.90(1.31-2.48), Parkinson's disease OR 3.94(-2.12-10.01). Conclusion: Our results show that the prevalence and mortality risk may increase in some neurological diseases during the COVID-19 pandemic. Future studies should elucidate the precise mechanisms for the link between COVID-19 and neurological diseases, determine which patient characteristics predispose them to neurological diseases, and consider potential global patient management.

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory central nervous system disease that is driven by antibodies of the immunoglobulin G1 class. MOGAD has recently been recognized as an autoimmune disease; therefore, little is known about its rehabilitation. Here, we present a case of MOGAD that showed significant recovery after rehabilitation. A 58-year-old woman developed weakness in all extremities, dysarthria, and dysphagia. She visited the neurology department, and early brain and spine magnetic resonance imaging showed multifocal high intensity in the subcortical and periventricular white matter and the cervical cord. The patient's serum tested positive for anti-MOG antibodies. She was diagnosed with MOGAD and received intravenous steroid pulse therapy. After pharmacologic therapy, the patient was transferred to the rehabilitation department. Initially, her Functional Independence Measure (FIM) motor score was 26, allowing her to stand independently for only a few seconds. After 5 weeks of rehabilitation involving physical therapy, occupational therapy, and balance training, her FIM motor score improved to 60. However, 4 months after discharge, the disease relapsed with symptoms of motor weakness in all extremities, and steroid treatment was initiated. On the second admission, her FIM motor score was 42, but after continuous multidisciplinary rehabilitation, it improved to 76. Computerized cognitive therapy improved her cognitive function, from a Korean version of the Mini-Mental State Examination score of 23 on the first admission to 30 on final discharge. Since MOGAD is a relapsing disease, a favorable outcome can be achieved with continuous monitoring and multidisciplinary, symptom-specific rehabilitation.

ObjectiveIn this study, we aimed for the first time to evaluate the effectiveness of atomoxetine (Strattera) in the treatment of cognitive impairment and aphasia after stroke in a large sample.MethodsWe reviewed the data of 106 patients with poststroke aphasia and cognitive impairment (atomoxetine treatment group = 55 patients vs control group = 51 patients), including scores of the Korean version of the Mini-Mental State Examination (K-MMSE) and the Korean version of the Western Aphasia Battery. Wilcoxon signed-rank tests were used to compare the initial and follow-up K-MMSE and Korean version of the Western Aphasia Battery scores. Mann-Whitney U tests were used to compare the degree of improvement in K-MMSE and Aphasia Quotient (AQ) scores between the atomoxetine and control groups.ResultsBaseline characteristics including age, years of education, and scores of the initial Functional Independence Measure, Korean version of the Modified Barthel Index, Hamilton Depression Rating Scale, K-MMSE, and AQ did not differ significantly between the 2 groups. Follow-up K-MMSE and AQ scores were significantly better than the initial scores in both the treatment and control groups. However, improvements in K-MMSE scores were significantly greater in the treatment group than in the control group. In addition, the atomoxetine group had significantly higher AQ scores than the control group, especially for auditory verbal comprehension and naming.ConclusionsAtomoxetine has been shown to significantly improve cognitive function and language in patients with poststroke aphasia. It is also the first study to report improvement in auditory comprehension and naming by administration of atomoxetine.