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Neurological and metabolic disorders
Research Guide
What is Neurological and metabolic disorders?
Neurological and metabolic disorders refer to conditions linking hyperglycemia, basal ganglia lesions, and movement disorders such as chorea, hemichorea-hemiballismus, and seizures in patients with diabetes or uremia.
This field examines clinical manifestations, neuroimaging findings, differential diagnosis, and management of hyperglycemic chorea and related disorders. The cluster includes 42,387 papers focused on associations between hyperglycemia and basal ganglia abnormalities. Growth rate over the past 5 years is not available.
Topic Hierarchy
Research Sub-Topics
Hyperglycemic Hemichorea-Hemiballismus
Researchers investigate the acute onset of unilateral involuntary movements associated with non-ketotic hyperglycemia and striatal hyperintensities on neuroimaging. Studies focus on pathophysiological mechanisms involving basal ganglia T1-hyperintensity and clinical outcomes post-glycemic control.
Neuroimaging in Hyperglycemic Chorea
This area examines characteristic MRI findings such as T1-hyperintense basal ganglia lesions in hyperglycemic states, correlating imaging patterns with clinical chorea severity. Research explores sequential imaging evolution and diffusion-weighted abnormalities for diagnostic specificity.
Pathophysiology of Hyperglycemia-Induced Basal Ganglia Lesions
Studies elucidate mechanisms including excitotoxicity, osmotic demyelination, and petechial hemorrhage linking chronic hyperglycemia to chorea-inducing striatal damage. Experimental models investigate metabolic stress effects on dopaminergic pathways.
Management of Hyperglycemic Movement Disorders
Research evaluates glycemic correction efficacy versus symptomatic therapies like dopamine blockers in resolving chorea and hemiballismus. Long-term follow-up studies assess recurrence risks and persistent deficits post-resolution.
Uremic Chorea in Dialysis Patients
This sub-topic covers choreiform movements in end-stage renal disease, focusing on electrolyte imbalances and neuroimaging parallels to hyperglycemic chorea. Clinical series analyze dialysis adequacy's role in symptom amelioration.
Why It Matters
Hyperglycemia worsens stroke prognosis in both diabetic and nondiabetic patients, as Capes et al. (2001) demonstrated through a meta-analysis showing increased mortality and poor recovery with elevated poststroke glucose levels. Microalbuminuria in type II diabetes predicts clinical proteinuria and early mortality, with Mogensen (1984) reporting that patients aged 50-75 with 30-140 micrograms of albumin per milliliter in urine progressed to overt proteinuria. Lesions in the subthalamic nucleus reverse experimental parkinsonism, per Bergman, Wichmann, and DeLong (1990), offering insights into basal ganglia-targeted therapies for movement disorders linked to metabolic disturbances.
Reading Guide
Where to Start
"Diagnosis and management of dementia with Lewy bodies" by McKeith et al. (2005) provides an accessible entry with revised clinical criteria and core features like REM sleep behavior disorder, foundational for understanding basal ganglia-related disorders.
Key Papers Explained
DeLong (1990) "Primate models of movement disorders of basal ganglia origin" establishes basal ganglia mechanisms, which Bergman, Wichmann, and DeLong (1990) "Reversal of Experimental Parkinsonism by Lesions of the Subthalamic Nucleus" extend by showing lesion reversals. McKeith et al. (2005) "Diagnosis and management of dementia with Lewy bodies" builds diagnostic frameworks linking to movement issues. Armstrong et al. (2013) "Criteria for the diagnosis of corticobasal degeneration" refines criteria informed by prior basal ganglia work.
Paper Timeline
Most-cited paper highlighted in red. Papers ordered chronologically.
Advanced Directions
Field centers on basal ganglia lesions in hyperglycemia without recent preprints or news. Frontiers involve neuroimaging-MRI correlations in chorea from diabetes or uremia, per cluster description.
Papers at a Glance
| # | Paper | Year | Venue | Citations | Open Access |
|---|---|---|---|---|---|
| 1 | Diagnosis and management of dementia with Lewy bodies | 2005 | Neurology | 5.0K | ✕ |
| 2 | Primate models of movement disorders of basal ganglia origin | 1990 | Trends in Neurosciences | 3.8K | ✕ |
| 3 | A Rating Scale for Drug-Induced Akathisia | 1989 | The British Journal of... | 2.2K | ✕ |
| 4 | Assessment of Alcohol Withdrawal: the revised clinical institu... | 1989 | British Journal of Add... | 1.9K | ✕ |
| 5 | Microalbuminuria Predicts Clinical Proteinuria and Early Morta... | 1984 | New England Journal of... | 1.9K | ✕ |
| 6 | Reversal of Experimental Parkinsonism by Lesions of the Subtha... | 1990 | Science | 1.9K | ✕ |
| 7 | Microvascular and Macrovascular Complications of Diabetes | 2008 | Clinical Diabetes | 1.9K | ✕ |
| 8 | Stress Hyperglycemia and Prognosis of Stroke in Nondiabetic an... | 2001 | Stroke | 1.8K | ✕ |
| 9 | Criteria for the diagnosis of corticobasal degeneration | 2013 | Neurology | 1.8K | ✓ |
| 10 | The role of iron in brain ageing and neurodegenerative disorders | 2014 | The Lancet Neurology | 1.7K | ✓ |
Frequently Asked Questions
What are the core clinical features of dementia with Lewy bodies?
The DLB Consortium revised criteria for dementia with Lewy bodies incorporate core clinical features including REM sleep behavior disorder and severe neuroleptic sensitivity. McKeith et al. (2005) suggest improved assessment methods for these features. Pathologic diagnosis aligns with clinical indicators in the updated framework.
How does microalbuminuria relate to outcomes in type II diabetes?
Microalbuminuria of 30 to 140 micrograms of albumin per milliliter predicts clinical proteinuria and early mortality in type II diabetics aged 50 to 75. Mogensen (1984) tracked patients from 1973 whose disease onset was after age 40. This marker identifies high-risk individuals for progression.
What is stress hyperglycemia's impact on stroke patients?
Stress hyperglycemia associates with increased mortality and poor recovery after stroke in diabetic and nondiabetic patients. Capes et al. (2001) conducted a systematic review and meta-analysis of acute poststroke glucose levels. Elevated glucose worsens prognosis regardless of baseline diabetes status.
How do basal ganglia lesions contribute to movement disorders?
Primate models show basal ganglia alterations underlie movement disorders like parkinsonism. DeLong (1990) detailed these models in Trends in Neurosciences. Subthalamic nucleus hyperactivity drives deficits reversible by lesions, as Bergman, Wichmann, and DeLong (1990) found.
What criteria diagnose corticobasal degeneration?
Updated criteria for corticobasal degeneration reflect expanded clinicopathologic understanding. Armstrong et al. (2013) from an international consortium revised diagnostics for behavioral neurology and movement disorders. These address limitations in prior standards.
What role does iron play in neurodegenerative disorders?
Iron contributes to brain ageing and neurodegenerative disorders through specific mechanisms. Ward et al. (2014) reviewed this in The Lancet Neurology. The paper links iron accumulation to pathology in conditions overlapping with metabolic influences.
Open Research Questions
- ? How do specific basal ganglia lesions from hyperglycemia induce chorea versus hemichorea-hemiballismus?
- ? What neuroimaging patterns distinguish hyperglycemic chorea from stroke-related movement disorders?
- ? Can subthalamic nucleus interventions mitigate metabolic-induced parkinsonism in diabetic patients?
- ? Does iron dysregulation exacerbate basal ganglia damage in uremic or hyperglycemic states?
- ? What management strategies reverse neuroleptic sensitivity in dementia with Lewy bodies comorbid with diabetes?
Recent Trends
The cluster holds 42,387 works on hyperglycemia-basal ganglia links to chorea and seizures, with no 5-year growth rate available.
No recent preprints or news coverage reported in the last 6-12 months.
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