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Paulus Sugianto
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Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya
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AKSONA
Published by Universitas Airlangga
ISSN : -     EISSN : 28077970     DOI : https://doi.org/10.20473/aksona.v2i1.170
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience
AKSONA is a scientific journal published by the Department of Neurology, Faculty of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital. AKSONA focuses on original research, case reports, and review articles on all aspects of neuroscience: Neurosurgery, Neuropsychology, Movement Disorder, Sleep Disorder, Pain and pain intervention, Neuro infection, etc. This journal is a peer-reviewed journal established to improve understanding of all things in neurology and neurosciences.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 83 Documents
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Factor Associated with Orthostatic Hypotension in Parkinson’s Disease Marisdina, Selly; Nindela, Rini; Haddani, Muhammad Hasnawi; Minda Nur'aini; Ratnasari, Nurlia Puspita
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

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Abstract

Highlight: Neurogenic orthostatic hypotension is commonly found in Parkinson’s disease (PD) and unnoticed by both patients and clinicians. Underweight has been associated to orthostatic hypotension in Parkinson’s disease, among other factors.   ABSTRACT Introduction: Orthostatic hypotension (OH) affect approximately 30% of patients with Parkinson's disease (PD). This condition not only reduces quality of life  but is also associated with increased mortality. OH has been shown to double the risk of falls in the elderly, worsens motor function, and  accelerate cognitive decline. There has been limited study into the prevalence and contributing factors of OH in Parkinson’s disease patients in Indonesia. Objective: This study aimed to determine factors associated with OH in patients with Parkinson’s disease. The variables analyzed included age, sex, duration of PD, disease stage based on the Hoehn and Yahr scale, levodopa equivalent dose (LED), the length of antiparkinsonian agents use, MoCA Ina (Montreal Cognitive Assessment Indonesian version) score, comorbid conditions, use of antihypertensive agents, and body mass index (BMI). Methods: This is a descriptive-analytic study with a cross-sectional design. The study population consisted of all Parkinson’s disease patients who visited the neurology polyclinics at  two hospitals in Palembang. Patients were selected based on specific inclusion and exclusion criteria. To discover associations, bivariate and multivariate analyses were performed. Results: The study involved 41 patients with PD at Mohammad Hoesin Hospital and Pusri Medika Hospital in Palembang, from June to December 2024. OH, was found in 43.9% of PD patients, most of whom reported symptoms. Bivariate and multivariate analyses revealed no significant associations between OH and factors such as comorbidities, the length of antiparkinsonian medication use, total LED, age, sex, duration of PD, disease stage (Hoehn and Yahr scale), and of the use of antihypertensive agents. However, underweight BMI was significantly associated with OH in PD patients (p = 0.002, OR = 34.571, 95% CI: 3.77–317.28). Conclusion:Underweight was identified as a significant associated factor for OH in PD patients.  
Factor Affecting Insomnia in Ischemic Stroke Patients Fajarini, Agustina; Mukhlisa, Mukhlisa; Handayani, Sri; Ramadhoni, Pinto Desti; Irfannuddin, Irfannuddin
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

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Abstract

Highlight: Insomnia is prevalent in ischemic stroke patients and can hinder the recovery process. Stroke patients have a higher prevalence of insomnia and related symptoms than the general population.  This study found a complex relationship between physical, psychological, and social risk factors for insomnia following ischemic stroke.   ABSTRACT Introduction: Insomnia is common in ischemic stroke patients and can negatively impact on the post-stroke recovery process by interfering with the body's natural healing process, reducing the effectiveness of rehabilitation therapy, and affecting the recovery of cognitive function. Effective management and early intervention in  insomnia are needed to enhance health services for stroke patients, promote optimal recovery, and improve their quality of life. Objective: This study aimed to identify and analyze the various factors associated with the occurrence of insomnia among patients with ischemic stroke. Methods: This is a cross-sectional study that used secondary data from medical records and primary data gathered through questionnaire-based interviews. The subjects were 105 ischemic stroke patients at the Neurology Clinic of Dr. Mohammad Hoesin Hospital, Palembang, between May to July 2024. The data acquired for further analysis included social and demographic details, comorbid conditions, depression, anxiety, pain, insomnia, medication use, sleep hygiene, and stroke clinical features. The data was then analyzed using IBM SPSS Statistics 24 and assessed through bivariate and multivariate analyses to evaluate the relationships between variables. Results: The prevalence of insomnia in this study was 42.9%, with mild insomnia observed in 26.7%, moderate insomnia in 13.3%, and severe insomnia in 2.9% of the subjects. Obstructive sleep apnea (OSA) (OR: 22.718), sleep hygiene index (OR: 6.490), and education level (OR: 3.453) were identified as determinants related to insomnia in ischemic stroke patients. Indirect factors associated with insomnia in ischemic stroke patients include depression, the number of comorbid diseases, pain, diabetes, a history of insomnia, anxiety, and stroke onset. Conclusion: There is a complex relationship between various physical, psychological, and social factors and the incidence of insomnia after ischemic stroke.  
Cerebellar Purkinje Cells and GABA Neurotransmission in the Diabetic Rodent Models: A Systematic Review Kalanjati, Viskasari P; Mahdi, Rayhan B; Aditya, Dwi Martha Nur
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.70359

Abstract

Highlight: Reduced cerebellar Purkinje cell numbers and altered dendritic trees due to cell deaths were reported in hyperglycemia.  In hyperglycemia, altered GABAergic neurotransmissions are due to lower GABA synthesis and its receptors expression levels in cerebellum. Impaired motor and cognitive functions were observed related to cerebellar Purkinje cell damage in a diabetic rat model.   ABSTRACT Introduction: Hyperglycemia-induced neurotoxicity has been linked to the cerebellum, specifically the impairment of Purkinje cells; its relation to GABA neurotransmission has yet to be cleared. Objective: We conducted an updated review on the mechanism of hyperglycemia-induced impairment of cerebellar Purkinje cells in a rodent diabetic model. Methods: A modified ScR-PRISMA flow diagram was applied as the screening tool. All English-language research articles published between 2014 and 2024 that containing the purposed topics and were indexed in PubMed and Medline were included. These articles were then critically appraised using the JBI checklist to minimize  potential bias. The final inclusion of 8 articles was included for analysis and discussion, together with additional retrieved articles. Results: Hyperglycemic-induced subjects demonstrated a marked reduction in Purkinje and granular cell populations, accompanied by several morphological impairments. Alterations were observed in GABAergic inhibitory neurotransmission, including receptors and GABA synthesis, compared to controls. These findings are consistent with observed deficits in motor coordination and cerebellar function. Conclusion: Hyperglycemia produces adverse effects on the function and survival of Purkinje cells in the cerebellum. Impaired GABAergic neurotransmission might result as parts of oxidative stress and inflammation induced by hyperglycemia in the cerebellar cells. Taken altogether, these results in motor impairment and cognitive dysfunction.

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