PET provides a noninvasive means to evaluate the functional integrity of the presynaptic monoaminergic system in the living human brain. Methods: In this study, a novel 18 F-labeled tetrabenazine derivative, 18 F-(1)fluoropropyldihydrotetrabenazine ( 18 F-AV-133), was used for the noninvasive assessment of the vesicular monoamine transporters type 2 (VMAT2) in 17 Parkinson disease (PD) patients and 6 healthy controls. The binding potential (BP) of 18 F-AV-133 was calculated using Logan graphical analysis. Voxel-based and volume-of-interest-based analyses of BP images were performed to examine brain regional reductions in VMAT2 density in PD. Results: VMAT2 BP was decreased by 81% in the posterior putamen, 70% in the anterior putamen, and 48% in the caudate nucleus of PD patients. Voxelbased analysis demonstrated VMAT2 reductions in the striatum and mid brain of PD patients. Furthermore, VMAT2 BPs in the caudate nuclei significantly correlated with the clinical severity of PD. Conclusion: These findings indicate that the novel 18 Flabeled ligand 18 F-AV-133 can sensitively detect monoaminergic terminal reductions in PD patients. Studies with 18 F-AV-133 may allow the presymptomatic identification of individuals with disorders characterized by degeneration of dopaminergic nigrostriatal afferents.

No abstract

No abstract

Objective The aim of the study is to visually rate major forms of dementia using global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and Fazeka’s scales and Koedam’s score using magnetic resonance imaging (MRI). The purpose is to correlate the visual rating scales (VRS) with severity of dementia. Materials and Methods Thirty patients fulfilling DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for Alzheimer’s dementia (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) underwent MRI brain. Cortical atrophy, medial temporal, and parietal lobe atrophy were assessed using GCA and MTA scales and Koedam’s score, respectively. White matter hyperintensities were assessed using Fazeka’s scale. Correlation between VRS and mini-mental state exam (MMSE) scores was done using Pearson correlation coefficient. Results 70% of patients had Grade 2 GCA. More patients with AD had higher MTA scores as compared with others with 57% of AD patients showing abnormal for age MTA scores. Fazeka’s scale was abnormal for age in 58.33% of VaD and 57% AD patients. Majority (75%) showing severe parietal atrophy (Grade 3 Koedam’s score) were AD patients. Disproportionate frontal lobe atrophy was seen in all four (100%) FTD patients. Significant negative correlation was seen between MMSE and GCA scores of all patients (p-value = 0.003) as well as between MTA and MMSE scores in AD patients (p-value = 0.00095). Conclusion Visual rating of MTA is a reliable method for detecting AD and correlates strongly with memory scores. Atrophy of specific regions is seen more commonly in some conditions, for instance, where MTA and parietal atrophy are specific for AD while asymmetric frontal lobe and temporal pole atrophy favor FTD.

No abstract

Background & Objective: Social determinants of evolving covid--19 pandemic have not been well studied. To determine trends in transition of this epidemic in India we performed a study in states at various levels of human development index (HDI). Methods:We used publicly available data sources to track progress of covid--19 epidemic in India in different states and territories where it was reported in significant numbers. The states (n=20) were classified into tertiles of HDI and weekly trends in cases and deaths plotted from 15 March to 2 May 2020. To assess association of HDI with state--level covid--19 burden we performed Pearson's correlation. Logarithmic trends were evaluated for calculation of projections. A microlevel study was performed in select urban agglomerations for identification of socioeconomic status (SES) differentials.Results: There is wide regional variation in covid--19 cases and deaths in India from mid--March to early--May 2020. High absolute numbers have been reported from states of Maharashtra, Gujarat, Delhi, Madhya Pradesh, Rajasthan and Tamilnadu. Growth rate in cases and deaths is slow in high HDI states while it has increased rapidly in middle and lower HDI states. In mid--March 2020 there was a strong positive correlation of state--level HDI with weekly covid--19 cases (r= 0.37, 0.40) as well as deaths (r= 0.31, 0.42). This declined by early--May for cases (r= 0.04, 0.06) as well as deaths (r= --0.005, 0.001) with significant negative logarithmic trend (cases R squared= 0.92; deaths R squared= 0.84). These trends indicate increasing cases and deaths in low HDI states. Projection reveals that this . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

No abstract

Chikungunya (CHIK) has re-emerged as a potential neurotropic virus, with outbreaks recently being reported from many parts of India. The present study was conducted to study the spectrum and outcome of neurological complications in patients of CHIK during the 2016 outbreak in Delhi. A total of 42 cases seropositive for IgM CHIK antibodies by MAC-ELISA and developing neurological complications were enrolled. The male:female ratio was 1:2 (age range ¼ 18-90 years). The neurological manifestations observed were encephalitis (n ¼ 12), bulbar palsy (n ¼ 3), acute disseminated encephalomyelitis (n ¼ 1), cerebellitis (n ¼ 1), myelopathy (n ¼ 1), radiculoneuropathy (n ¼ 3), carpal tunnel syndrome (n ¼ 9) and tremors (n ¼ 1). Ten patients reported worsening of pre-existing neuropathic symptoms of diabetic peripheral neuropathy (n ¼ 4) and carpal tunnel syndrome (n ¼ 6). One patient had aggravation of myasthenia gravis leading to respiratory failure. The majority of patients (n ¼ 32) showed a good outcome; ten had a poor prognosis, out of which four died, all from the encephalitis group, particularly the elderly with co-morbidities.