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Patricia Wulandari
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Sriwijaya Journal of Neurology
Published by Phlox Institute: Indonesian Medical Research Organization
ISSN : 29871425     EISSN : 29871425     DOI : https://doi.org/10.59345/sjn
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience
Focus Sriwijaya Journal of Neurology (SJN) focused on the development of medical sciences especially neurology for human well-being. Scope Sriwijaya Journal of Neurology (SJN) publishes articles which encompass all aspects of basic research/clinical studies related to the field of neurology and allied science fields, especially all type of original articles, case report, review articles, narrative review, meta-analysis, systematic review, mini-reviews and book review.
Arjuna Subject : Ilmu Syaraf - Neorologi
Articles 26 Documents
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Beyond Amyloid: Investigating the Role of Tau Oligomers in Alzheimer's Disease Progression in Medan, Indonesia Sony Sanjaya; Brenda Jaleel; Cindy Susanti; Yi-Fen Huang; Husin Sastranagara; Agnes Mariska
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.26

Abstract

Introduction: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cognitive decline and memory impairment. While amyloid plaques have been a central focus of AD research, increasing evidence suggests that tau oligomers play a crucial role in disease progression. This study aimed to investigate the relationship between tau oligomers, cognitive function, and disease severity in AD patients in Medan, Indonesia. Methods: An observasional case series study was conducted involving 50 AD patients diagnosed according to the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria. Cerebrospinal fluid (CSF) samples were collected and analyzed for tau oligomers using an enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR) scale. Correlation analyses were performed to examine the relationship between tau oligomer levels, cognitive performance, and disease severity. Results: The mean tau oligomer level in AD patients was 120.5 ± 35.2 pg/mL. A significant negative correlation was observed between tau oligomer levels and MMSE scores (r = -0.65, p < 0.001), indicating that higher tau oligomer levels were associated with poorer cognitive performance. Furthermore, tau oligomer levels were positively correlated with CDR scores (r = 0.58, p < 0.001), suggesting a link between tau oligomers and disease severity. Conclusion: This study provides evidence for the involvement of tau oligomers in AD progression in the Indonesian population. Elevated CSF tau oligomer levels are associated with cognitive decline and disease severity in AD patients. These findings highlight the potential of tau oligomers as a therapeutic target and emphasize the need for further research to develop effective interventions.
Gut-Brain Axis Dysfunction in Parkinson's Disease: Early Biomarkers and Therapeutic Potential in Jakarta, Indonesia Zahra Amir; Wisnu Wardhana Putra; Linda Purnama; Saurie Hernandez; Adolfo Rawlings; Immanuel Simbolon
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.27

Abstract

Introduction: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Increasing evidence suggests a crucial role of gut-brain axis dysfunction in PD pathogenesis. This study aimed to investigate the gut microbiome composition, identify potential early biomarkers, and explore the therapeutic potential of targeting the gut-brain axis in PD patients in Jakarta, Indonesia. Methods: This cross-sectional study involved 50 PD patients and 50 age-matched healthy controls from Jakarta. Stool and blood samples were collected for 16S rRNA gene sequencing to analyze gut microbiome composition, and serum inflammatory markers (TNF-α, IL-6, and CRP) were measured using ELISA. Clinical data, including disease duration, severity, and non-motor symptoms, were assessed using standardized scales. Results: PD patients exhibited significant alterations in gut microbiome composition compared to controls, with a decrease in beneficial bacteria (e.g., Faecalibacterium prausnitzii) and an increase in pro-inflammatory bacteria (e.g., Enterobacteriaceae). Elevated levels of serum inflammatory markers were also observed in PD patients. Correlation analysis revealed associations between specific gut microbiota, inflammatory markers, and disease severity. Conclusion: This study provides evidence of gut-brain axis dysfunction in PD patients in Jakarta, Indonesia. Alterations in gut microbiome composition and increased systemic inflammation may serve as potential early biomarkers and therapeutic targets for PD. Further research is needed to explore the causal relationship and develop targeted interventions.
Artificial Intelligence for Early Detection of Motor Neuron Disease Using Gait Analysis and Speech Patterns in Pekanbaru, Indonesia Sari Sulistyoningsih; Louisa Istarini; Dedi Sucipto; Serena Jackson; Agnes Mariska; Linda Purnama; Imanuel Simbolon
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.28

Abstract

Introduction: Motor neuron disease (MND) is a devastating neurodegenerative disorder characterized by progressive muscle weakness, atrophy, and ultimately, paralysis. This study investigated the potential of artificial intelligence (AI) to detect MND in its early stages using gait analysis and speech pattern recognition in a population in Pekanbaru, Indonesia. Methods: A cross-sectional study was conducted at the Neurology Department of a tertiary referral hospital in Pekanbaru, Indonesia. A total of 150 participants aged 40-75 years were recruited and categorized into three groups. Gait analysis was performed using wearable sensors to collect data on stride length, cadence, swing time, stance time, and gait variability. Machine learning algorithms, including support vector machines (SVM), random forest (RF), and deep learning models like convolutional neural networks (CNN), were trained on the combined gait and speech data to classify participants into the three groups. Results: Significant differences were observed in gait parameters between the MND group and the other two groups. Individuals with MND exhibited shorter stride length (p<0.001), slower cadence (p<0.001), increased swing time variability (p=0.002), and reduced stance time (p=0.003). Speech analysis revealed distinct patterns in the MND group, including reduced speech rate (p<0.001), increased pause duration (p=0.004), and decreased vocal intensity (p=0.001). The AI models, particularly the CNN model, demonstrated high accuracy in differentiating individuals with MND from healthy controls and those with other neurological conditions. The CNN model achieved an accuracy of 94.7%, sensitivity of 92%, specificity of 96%, and an area under the receiver operating characteristic curve (AUC) of 0.98. Conclusion: AI-powered gait analysis and speech pattern recognition show promise as a non-invasive and cost-effective tool for the early detection of MND in Pekanbaru, Indonesia. This technology has the potential to improve diagnostic accuracy and facilitate timely intervention, ultimately enhancing the quality of life for individuals with MND.
The Impact of Early Intervention on Motor Outcomes in Infants with Cerebral Palsy: A Longitudinal Study with Advanced Neuroimaging Correlates in Surabaya, Indonesia Habiburrahman Said; Novalika Kurnia; Fatimah Mursyid; Sophia Lucille Rodriguez; Theresia Putri Sinaga; Aline Hafidzah
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.29

Abstract

Introduction: Cerebral palsy (CP) is a prevalent neurodevelopmental disorder affecting motor function in children. Early intervention (EI) has been shown to improve motor outcomes in infants with CP, but the underlying neural mechanisms remain poorly understood. This longitudinal study investigated the impact of EI on motor outcomes and its association with neuroimaging correlates in infants with CP in Surabaya, Indonesia. Methods: We recruited 60 infants diagnosed with CP aged 6-18 months in Surabaya, Indonesia. Participants were randomly assigned to either an EI group receiving 6 months of individualized, home-based intervention or a control group receiving standard care. Motor function was assessed using the Gross Motor Function Measure (GMFM-88) at baseline, 6 months, and 12 months. Advanced neuroimaging techniques, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), were used to assess brain structure and function at baseline and 12 months. Results: Infants in the EI group demonstrated significantly greater improvements in GMFM-88 scores compared to the control group at 6 and 12 months (p < 0.05). DTI revealed increased fractional anisotropy (FA) in the corticospinal tract and corpus callosum in the EI group at 12 months, indicating improved white matter integrity. fMRI showed increased functional connectivity in motor networks in the EI group compared to the control group at 12 months. Conclusion: Early intervention significantly improved motor outcomes in infants with CP in Surabaya, Indonesia. These improvements were associated with enhanced white matter integrity and functional connectivity in motor-related brain regions. Our findings highlight the importance of early intervention in promoting neuroplasticity and improving motor function in infants with CP.
Genetic and Environmental Influences on Autism Spectrum Disorder: A Multi-Center Study Exploring Gene-Environment Interactions and Biomarkers in Indonesia Vita Amanda; Rashidah Unaib Al-Zayid; Winata Putri; Sonya Syarifah; Tiffany Gabriele; Leonardo Simanjuntak; Cinthya Callathea
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.30

Abstract

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex etiology involving genetic and environmental factors. This multi-center study investigated gene-environment interactions and potential biomarkers associated with ASD in the Indonesian population. Methods: Children diagnosed with ASD (n=500) and age-matched typically developing controls (n=500) were recruited across five major Indonesian cities. Whole-exome sequencing targeted genotyping, and environmental risk factor assessments were conducted. Biomarker analyses included cytokine levels, oxidative stress markers, and neurotransmitters. Results: Genetic analysis revealed both rare and common variants associated with ASD risk, including variants in CHD8, SCN2A, NRXN1, and novel genes. Prenatal exposures (maternal medication use, infections), perinatal complications (preterm birth, low birth weight), and postnatal factors (pesticide exposure, air pollution) were associated with increased ASD risk. Children with ASD exhibited elevated inflammatory markers (TNF-α, IL-6, IL-1β), increased oxidative stress (higher MDA, lower GSH), and altered neurotransmitter levels (lower serotonin and dopamine) compared to controls. Conclusion: This study provides insights into the interplay of genetic and environmental factors contributing to ASD risk in Indonesia. The identified genetic variants, environmental risk factors, and potential biomarkers may contribute to our understanding of ASD etiology and inform the development of targeted interventions and early detection strategies.
Cerebral Infarction Due to Polycythemia Vera: A Case Report Oktasari, Nur Aida; Nurotus Saniyah
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.42

Abstract

Introduction: Changes in blood viscosity can cause thrombosis in the brain, causing a stroke. Polycythemia vera is one of the causes of blood hyperviscosity. This study aimed to present cases of cerebral infarction related to polycythemia vera. Case presentation: A 55-year-old woman came to the emergency room with complaints of sudden weakness in the left limbs. One week before admission, the patient complained of headaches accompanied by spinning dizziness. Her left limbs often tingled and became weaker. There was an asymmetric facial deviation to the right, and the patient had difficulty communicating with unclear articulation. Specific examination of neurology shows dysarthria, left-sided motor type facial paralysis, examination of motor strength of the upper and lower extremities on the left 2 and 5 on the right, and the left upper limb often feels tingling. On the left limb, normal physiological biceps reflex was found, positive Chaddock pathological reflex. Morphological examination of peripheral blood showed normocytic normochromic with erythrosis and thrombocytosis and found giant platelets. This patient was diagnosed with an ischemic stroke caused by cerebral infarction, with polycythemia vera etiology, and accompanied by comorbid diseases of diabetes mellitus and uncontrolled hypertension. Conclusion: In patients with high-risk criteria for thrombosis, the management of phlebotomy, administration of low-dose aspirin, and cytoreduction in the form of hydroxyurea aims to achieve a hematocrit <45% so as to prevent worsening and recurrence of stroke.
Prenatal Exposure to Maternal Stress and Neurodevelopmental Outcomes in Children: A Longitudinal Study with Epigenetic Analysis in Jakarta, Indonesia Fatimah Mursyid; Akmal Hasan; Tomiola Owkwulu; Maximillian Wilson; Yi-Fen Huang; Husin Sastranagara
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.81

Abstract

Introduction: Prenatal exposure to maternal stress has been identified as a potential risk factor for adverse neurodevelopmental outcomes in children. This study aimed to investigate the association between prenatal maternal stress and neurodevelopmental outcomes in children in Jakarta, Indonesia, and to explore the potential mediating role of epigenetic modifications. Methods: A longitudinal cohort study was conducted involving 300 pregnant women recruited from antenatal clinics in Jakarta. Maternal stress was assessed during the second trimester of pregnancy using the Perceived Stress Scale (PSS). Neurodevelopmental outcomes in children were evaluated at 12 and 24 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Epigenetic analysis of cord blood DNA methylation was performed using the Illumina Infinium MethylationEPIC BeadChip. Results: Higher maternal stress scores during pregnancy were significantly associated with lower cognitive, language, and motor scores in children at 12 and 24 months of age. Epigenetic analysis revealed differential methylation patterns in genes related to neurodevelopment in children exposed to high prenatal maternal stress. Mediation analysis indicated that DNA methylation partially mediated the association between prenatal maternal stress and neurodevelopmental outcomes. Conclusion: Prenatal exposure to maternal stress is associated with adverse neurodevelopmental outcomes in children, and epigenetic modifications may play a mediating role in this relationship. These findings highlight the importance of addressing maternal stress during pregnancy to promote optimal child neurodevelopment.
The Role of the Vestibular System in Balance Disorders and Falls in the Elderly: A Prospective Cohort Study with Posturography Assessment in Surabaya, Indonesia Venny Melinda; Johan Wirahadi Putro; Mariana Alifah; Michelle Birne; Abhimanyu Putra
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.82

Abstract

Introduction: Falls in the elderly represent a significant public health concern, often leading to injury, disability, and reduced quality of life. The vestibular system plays a crucial role in maintaining balance, and its decline with age is a major contributor to falls. This study aimed to investigate the relationship between vestibular function, assessed through posturography, and the incidence of falls in elderly individuals in Surabaya, Indonesia. Methods: A prospective cohort study was conducted involving 150 participants aged 60 years and above residing in Surabaya. Baseline assessments included a comprehensive geriatric assessment, vestibular function tests using computerized dynamic posturography (CDP), and questionnaires on falls history. Participants were followed up for 12 months to record the occurrence of falls. Data analysis included descriptive statistics, correlation analysis, and logistic regression to identify predictors of falls. Results: The incidence of falls during the 12-month follow-up period was 32%. CDP revealed significant age-related decline in vestibular function, particularly in measures of sensory organization and balance strategy. Poor performance on CDP, especially in conditions with altered visual and proprioceptive inputs, was significantly associated with an increased risk of falls. History of previous falls, presence of comorbidities, and use of polypharmacy were also identified as significant predictors of falls. Conclusion: Vestibular dysfunction, as assessed by CDP, is a significant risk factor for falls in the elderly. Incorporating posturography assessment into routine geriatric evaluations may help identify individuals at high risk of falls, allowing for targeted interventions to prevent falls and associated complications.
Transcranial Magnetic Stimulation for the Treatment of Chronic Dizziness: A Randomized Controlled Trial in Bandung, Indonesia Zahra Amir; Nabila Saraswati; Made Swastika; Zainal Abidin Hasan; Aisyah Andina Rasyid; Hasrita Soleiman; Bernadette Wilson
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.90

Abstract

Introduction: Chronic dizziness is a debilitating condition with limited treatment options. Transcranial magnetic stimulation (TMS) has shown promise in treating various neurological conditions. This randomized controlled trial investigated the efficacy and safety of TMS in treating chronic dizziness in Bandung, Indonesia. Methods: Participants with chronic dizziness (≥ 3 months) were randomly assigned to receive either active TMS or sham TMS for 10 sessions over two weeks. The active TMS group received 1 Hz stimulation over the right dorsolateral prefrontal cortex (DLPFC), while the sham group received placebo stimulation. The primary outcome was the change in Dizziness Handicap Inventory (DHI) score from baseline to four weeks post-intervention. Secondary outcomes included changes in Vertigo Symptom Scale (VSS) scores, Hospital Anxiety and Depression Scale (HADS) scores, and quality of life measures. Safety was assessed through monitoring of adverse events. Results: A total of 60 participants completed the study (30 in each group). The active TMS group showed a significantly greater improvement in DHI scores compared to the sham group (p < 0.001). Significant improvements were also observed in VSS, HADS, and quality of life measures in the active TMS group. No serious adverse events were reported. Conclusion: This study provides evidence for the efficacy and safety of TMS in treating chronic dizziness in the Indonesian population. TMS may be a valuable therapeutic option for patients with chronic dizziness who have not responded to conventional therapies.
The Impact of Gestational Diabetes on Long-Term Cognitive Function: A Prospective Cohort Study with Neuroimaging Correlates in Bandung, Indonesia Miranda Aisah; Lestini Wulansari; Vania Delma; Reza Andrianto; Zahra Amir; Dedi Sucipto; Agnes Mariska; Saurie Hernandez
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.91

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a growing public health concern with potential long-term consequences for both mother and child. Emerging evidence suggests that GDM may impact maternal cognitive function, but the underlying mechanisms remain unclear. This prospective cohort study investigates the association between GDM and long-term cognitive function in mothers, exploring potential neuroimaging correlates. Methods: Pregnant women were recruited from antenatal clinics in Bandung, Indonesia, between 2018 and 2020. GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cognitive function was assessed at 6 months, 1 year, and 3 years postpartum using a comprehensive neuropsychological battery. A subset of participants underwent structural and functional magnetic resonance imaging (MRI) at 3 years postpartum. Results: Women with GDM exhibited lower scores on tests of executive function, processing speed, and memory compared to women without GDM at all follow-up assessments. MRI analysis revealed alterations in brain structure and function inwomen with a history of GDM, including reduced gray matter volume in the prefrontal cortex and hippocampus, and altered functional connectivity within the default mode network. Conclusion: GDM is associated with long-term cognitive impairment in mothers, possibly mediated by structural and functional brain changes. These findings highlight the importance of early identification and management of GDM to mitigate potential long-term cognitive consequences.

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