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MNJ (Malang Neurology Journal)
Published by Universitas Brawijaya
ISSN : 24076724     EISSN : 24425001     DOI : -
Core Subject : Science,
Neuroscience
Malang Neurology Journal is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures of neurology disease, treatment, or other health issues related to neurology that is important also acceptable. Letters and commentaries of our published articles are welcome.
Arjuna Subject : -
Articles 299 Documents
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SUDDEN PROGRESSIVE LOWER LIMB WEAKNESS CAUSED BY TRANSVERSE MYELITIS, MENINGITIS, AND COMMUNICANS HYDROCEPHALUS DUE TO TUBERCULOSIS: A RARE CASE REPORT Simanjuntak, Arya Marganda; Candra, Riky; Gracia, Felicita; Maryanti, Yossi; Sucipto; Sukiandra, Riki; Juananda, Desby
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.17

Abstract

Background: This report presents a rare case of TB myelitis with concurrent TBM, emphasizing the importance of early detection and intervention due to its atypical symptoms and high risk of neurological disability. Objective: To report a rare case of tuberculous myelitis occurring concurrently with TBM and to highlight the importance of early recognition, appropriate imaging, and timely therapeutic intervention to improve neurological outcomes. Methods: A clinical case review was conducted involving a 32-year-old male presenting with progressive neurological deficits. Clinical evaluation, neuroimaging, cerebrospinal fluid (CSF) analysis, and treatment response were assessed. Management consisted of anti-tuberculosis therapy, corticosteroids, and intensive rehabilitation, with neurosurgical intervention deferred due to medical instability. Result: he patient initially developed chronic headache, fever, and cough, followed by worsening lower limb weakness, numbness, and urinary retention. Neurological examination revealed paraplegia with sensory level at T4. Imaging demonstrated hydrocephalus and pulmonary tuberculosis, while CSF analysis confirmed TBM. A diagnosis of TB myelitis with concurrent meningitis was established. Following initiation of anti-tuberculosis therapy (2RHZE/10RH), corticosteroids, and rehabilitation, the patient showed gradual neurological improvement despite the postponement of neurosurgical procedures. However, there are still few standardized protocols for diagnosing and treating TB myelitis, which calls for more research. Conclusion: Rapid diagnosis of TB myelitis, a treatable complication of CNS tuberculosis, can significantly improve patient outcomes, necessitating further research and development of new therapeutic approaches.
PARKINSON’S DISEASE DEMENTIA: A COMPREHENSIVE CASE REPORT Fitriasari, Elsye; Laksmidewi, Anak Agung Ayu Putri; Widyastuti, Ketut; Mahadewi, Ni Putu Ayu Putri
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.18

Abstract

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder affecting 1–2% of individuals over 60 years old. Beyond motor symptoms, PD is often associated with dementia, especially with advancing age and disease duration. The risk of Parkinson’s Disease Dementia (PDD) increases markedly in older patients, reaching up to 80–90% by age 90. Key risk factors include age, severity of parkinsonism, male gender, psychiatric symptoms, and mild cognitive impairment. PDD differs from Alzheimer’s disease, with more prominent deficits in attention, executive function, and visuospatial skills. Its pathogenesis involves dopaminergic neuronal loss, α-synuclein deposition, inflammation, and oxidative stress. Case Report: A 70-year-old man with a five-year history of worsening hand tremors, gait disturbance, and bradykinesia presented with additional cognitive decline, including forgetfulness and difficulty managing daily tasks. He had a known diagnosis of PD, hypertension, and hearing impairment. Physical exam showed classic PD features, and brain MRI revealed cortical atrophy and an absent swallow tail sign. He was diagnosed with PDD, Hoehn and Yahr stage 3, and treated with pharmacologic therapy and rehabilitation. Discussion: The diagnosis of PDD in this patient was based on the Movement Disorder Society (MDS) criteria, which require pre-existing PD, gradual onset of dementia, and significant cognitive decline affecting daily function, without other identifiable causes. Cognitive testing and MRI findings supported the diagnosis. PDD is associated with neurodegeneration involving dopaminergic and other neurotransmitter systems, particularly affecting executive function and memory. Management aims to address both motor and cognitive symptoms, with cholinesterase inhibitors like rivastigmine shown to improve cognitive outcomes. Conclusion: Patients with PD may experience progression to dementia, marked by both motor and non-motor symptoms. Compared to age-matched individuals without PD, those with PD are at a substantially higher risk of developing dementia.
ENHANCING NEUROPLASTICITY IN POST-STROKE MOTOR RECOVERY: A SYSTEMATIC REVIEW OF THE COMPARATIVE EFFICACY OF CIMT AND MIRROR THERAPY Ayulanda, Meiyin; Adzima, Vita Febrylia; Paramitha, Dewi Pradnya; Alya Satira; Hotma Lestari
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.16

Abstract

Background: Upper limb motor impairment is a common and often persistent consequence of stroke, significantly affecting patients' functional independence. Constraint-Induced Movement Therapy (CIMT) and Mirror Therapy (MT) have been widely utilized in post-stroke rehabilitation, yet their comparative effectiveness and neuroplastic mechanisms remains underexplored. Objective: This systematic review aimed to evaluate and compare the efficacy of CIMT, MT, and their combination in improving upper limb motor function among post-stroke patients, with a particular focus on their role in promoting neuroplasticity and neurorestoration Methods: A systematic review based on PRISMA recommendations was conducted on PubMed, ResearchGate, ScienceDirect, and ProQuest, resulting in nine eligible studies. Quality and risk of bias were assessed using the Joanna-Briggs Institute checklist. Results: A total of 248 stroke survivors participated in the reviewed studies. Outcome measures included the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), Manual Function Test (MFT), and Motor Activity Log (MAL). All three interventions—CIMT, MT, and their combination—resulted in significant improvements in upper limb function compared to conventional therapy. CIMT and its variants (modified-CMIT) consistently  showed superior outcomes, particularly in patients with residual voluntary movement. Notably, combined CIMT and MT interventions demonstrated synergistic benefits in several trials. Conclusion: Both CIMT and MT are effective neurorestorative interventions for upper limb recovery after stroke, with CIMT generally producing greater improvements. CIMT primarily promotes cortical reorganization through intensive, task-specific training, whereas MT engages visuomotor and mirror neuron systems to enhance motor network activation. Their integration may provide synergistic neuroplastic benefits.
SYSTEMATIC REVIEW AND META-ANALYSIS ON THE RELATIONSHIP BETWEEN NEURODEGENERATIVE BIOMARKERS AND NEUROBEHAVIORAL CHANGES Ristinawati, Ira; Ilhamsyah, Rudi; Yang, Han; Pradana, Muhammad Yusuf Brilliant; Putra, Mohammad Sandhia Mahardhika
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.15

Abstract

Background: Neurodegenerative diseases represent a growing global health challenge, with early detection remaining elusive in clinical settings. Recent advances in fluid biomarkers have enabled the identification of molecular changes preceding clinical symptoms, thus offering promising avenues for early diagnosis and personalized management. This review synthesizes current findings on biomarker utility alongside neuroimaging in neurodegenerative disease detection and prognosis Objective: To evaluate the diagnostic accuracy and prognostic value of fluid biomarkers and neuroimaging in the early detection of neurodegenerative diseases, with a focus on Alzheimer’s disease. Methods: This systematic review and meta-analysis, registered in PROSPERO (CRD420251142436), followed PRISMA guidelines. Comprehensive searches across PubMed and Scopus identified peer-reviewed studies from 1985–2025 on neurodegenerative biomarkers and neurobehavioral changes. Standardized mean differences (SMD) along with 95% confidence intervals (CI) were calculated using a random-effects model to address study variability. The degree of heterogeneity was quantified by the I² statistic, while publication bias was assessed qualitatively due to the limited number of included studies. Results: This Meta-analysis reveals heterogeneity in biomarker-MRI correlations, biomarkers demonstrate remarkable accuracy in detecting Alzheimer’s at its earliest stages. This early detection capability for early intervention. No consistent overall effect emerged, underscoring standardization protocols remains a major challenge. Conclusion: Biomarker represent a promising approach for early detection and precise intervention in Alzheimer’s disease. Integrating fluid biomarkers, advanced neuroimaging, and standardized cerebrospinal fluid analysis enhances diagnostic accuracy and enables timely therapy during the prodromal stage. Future research should explore synergies between fluid biomarkers and digital cognitive tools to develop scalable, cost-effective screening protocols.
TECHNETIUM-99M TRODAT-1 NEUROMOLECULAR IMAGING FOR PARKINSONIAN SYNDROME: FIRST EXPERIENCE IN INDONESIAN PUBLIC HOSPITAL Aliwarga, Randy; Kusumahstuti, Kharisma Perdani; Nugrahadi, Trias; Kartamihardja, Achmad Hussein Sundawa
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.19

Abstract

Background: Parkinsonian syndromes are characterized by progressive motor impairment resulting from nigrostriatal dopaminergic degeneration. Although diagnosis is primarily clinical, early disease stages often overlap with non-parkinsonian disorders, leading to misclassification. Dopamine transporter (DaT) imaging provides an objective biomarker for confirming presynaptic dopaminergic loss. However, the only internationally approved tracer, Iodine-123 ioflupane (DaTscan™), remains unavailable in Indonesia due to the absence of high-power cyclotron facilities and logistical constraints. Technetium-99m TRODAT-1, a generator-based alternative, offers a practical solution for countries with limited nuclear infrastructure. Objective: Two patients with confirmed Parkinson’s disease (A, B) underwent brain SPECT/CT imaging using 99mTc-TRODAT-1. Radiotracer preparation followed standard reconstitution and autoclaving procedures, achieving >95% radiochemical purity. Images acquired four hours post-injection were evaluated visually using the Fabiani scale to assess DaT binding patterns. Results: Patient A demonstrated asymmetric uptake loss in the posterior putamen consistent with mid-stage PD, while Patient B exhibited near-complete absence of striatal binding with increased extra-striatal activity, typical of advanced PD with cognitive decline. Both cases confirm that TRODAT-1 provides reliable visualization of nigrostriatal degeneration and remains technically feasible for local production and distribution. Conclusion: 99mTc-TRODAT-1 represents a viable and diagnostically robust DaT imaging option for Indonesia, offering both clinical accuracy and logistical practicality. Broader implementation could substantially improve diagnostic precision and disease staging in parkinsonian syndromes nationwide.
EARLY FLUID THERAPY IN NEUROCRITICAL CARE: DIAGNOSIS-SPECIFIC MORTALITY PATTERNS FROM AN OPEN DATASET ANALYSIS Firdaus, Indy Zahrotul; Sitepu, Imanuel Suranta Pemerana; Putri, Syarellia Syafira; Ferdian, Farrel Rafif; Ernanda, Shelby Amrus; Rakhmatiar, Rodhiyan
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.01.13

Abstract

Background: Neurocritical conditions such as traumatic brain injury, stroke, and brain tumor contribute significantly to mortality. Fluid balance is a key determinant of outcome, as overload can exacerbate brain edema and intracranial hypertension. However, diagnosis-specific evidence remains limited. Objective: To investigate the association between early fluid balance and in-hospital mortality across major neurocritical diagnoses through secondary analysis of a large critical care dataset. Methods: We conducted a secondary analysis using a publicly available dataset from Harvard Dataverse. Adult patients with neurocritical diagnoses were identified, and cumulative fluid balance within the first 72 hours was calculated. Patients were stratified by diagnosis and categorized into positive (>0 mL) or negative fluid balance groups. The primary outcome was in-hospital mortality. Results: A positive early fluid balance was likely correlated with higher mortality across the cohort even without having significant correlation (OR 0.205, 95% CI 0.031–1.301, p=0.093). The effect was strongest for SAH (OR 5.35, 95% CI 0.84–34.12, p=0.036) and for SAH, TBI, ICH, and brain tumor, the interaction terms all approached statistical significance (p=0.036-0.051), suggesting that more positive fluid balance might be associated with an increased risk of death. In contrast, infarct showed no such pattern (p = 0.256). Fluid type could not be distinguished in this dataset, but prior studies suggest composition may further modify outcomes. Conclusion: Early fluid balance shows diagnosis-specific prognostic value in neurocritical care, with fluid overload strongly linked to mortality in SAH, TBI, ICH and Brain tumor. Future studies should integrate fluid type alongside balance to refine individualized strategies.
CLINICAL CHARACTERISTICS, MOTOR AND NON-MOTOR COMPLICATIONS, AND QUALITY OF LIFE OF PARKINSON’S DISEASE PATIENTS Maryanti, Yossi; Sukiandra, Riki; Juananda, Desby; Lestari, Enny; Octaria, Allysa; Andrilla, Faiza; Zahira, Mifta; Putri, Reta Amelia
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.01.14

Abstract

Background: Parkinson’s disease is a chronic and progressive neurodegenerative disorder characterized by both motor and non-motor symptoms that worsen over time, ultimately reducing patients’ quality of life. Objective: This study aimed to describe the clinical characteristics, motor and non-motor complications, and quality of life of Parkinson’s disease patients treated at Arifin Achmad Regional General Hospital, Riau. Methods: This study was a descriptive cross-sectional study conducted at the Neurology Polyclinic of Arifin Achmad Regional General Hospital, Riau, from January to August 2025. Samples were obtained using a total sampling technique. Results: A total of 31 Parkinson’s patients were included. More than half (54.8%) were aged ≥ 60 years, and 51.6% were males. Most had a high school education (32.3%), were unemployed (90.3%), and were not engaged in social activities (61.3%). The majority had no family history of Parkinson’s disease (83.9%) but presented with comorbidities (54.8%). Tremor was the predominant symptom (96.8%), while 67.7% had no motor complications. Cognitive impairment was found in 45.2%, mainly affecting the memory domain (96.8%). Poor sleep quality was common (61.3%), with nocturia as the most frequent disturbance (90.3%). Regarding quality of life, 32.3% of patients were within the acceptable range, with the mobility domain being the most affected (48.4%). Conclusion: Most Parkinson’s patients were elderly males with moderate disease progression. Comprehensive management addressing both motor and non-motor symptoms is essential to improve patients’ overall quality of life.
COMMENT ON: RADIOLOGICAL EVALUATION OF SINONASAL, INTRAORBITAL AND INTRACRANIAL EXTENSION OF MUCORMYCOSIS IN POST-COVID PATIENTS Alizai, Hassam Nasir Khan; Pasha, Aainah
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.20

Abstract

This letter critiques the article by Kalekar et al. that evaluates the radiological features and extent of mucormycosis, a rare and serious fungal infection, in post-COVID patients using computed tomography (CT) and magnetic resonance imaging (MRI). The letter points out some major flaws and weaknesses in the article, such as the lack of a clear research question and hypothesis, the weak literature review and theoretical framework, the poor study design and methodology, and the superficial discussion and conclusion. The letter suggests some ways to improve the article, such as formulating a specific research question and hypothesis, conducting a comprehensive and critical literature review, describing and justifying the study design and methodology in detail, and discussing the implications and limitations of the study. The letter hopes that the critique will help the authors revise their article and make it more suitable for publication.
HIGH RISK OF OBSTRUCTIVE SLEEP APNEA, OBESITY, MELATONIN LEVELS, AND C-REACTIVE PROTEIN IN INDIVIDUALS WITH AND WITHOUT DIABETES MELLITUS: A COMPARATIVE STUDY Indrasari Utami, Desak Ketut; Saraswati, Made Ratna; Ariyanti Putri, Putu Dian; Yustiantara, Putu Sanna; Pikatan, Orlando
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July (ARTICLE IN PRESS)
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.1

Abstract

Background: Sleep is a fundamental pillar for maintaining metabolic, endocrine, and cardiovascular stability. However, individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) are disproportionately susceptible to sleep-related disorders, particularly Obstructive Sleep Apnea (OSA). This relationship is often bidirectional, where sleep disturbances can exacerbate insulin resistance and negatively impact the overall prognosis of the disease. Objective: The primary goal of this study was to conduct a comparative analysis between diabetic and non-diabetic individuals regarding sleep quality, OSA risk, and obesity prevalence. Additionally, the research aimed to investigate whether these clinical factors correlated with differences in specific biomarkers, specifically melatonin and C-reactive protein (CRP) levels. Methods: A cross-sectional study was conducted at Ngoerah General Hospital involving 52 participants that fulfilled the eligibility criteria (26 with T2DM and 26 without). Sleep assessment was using the PSQI, Epworth Sleepiness Scale, and STOP-BANG questionnaire. Anthropometric measurements were taken, and blood samples were analysed for melatonin and CRP levels using ELISA. Results: In a cohort of 52 participants (divided evenly into 26 with T2DM and 26 without), significant clinical disparities were observed. The diabetic group demonstrated a much higher prevalence of poor sleep quality (61.5%) compared to the non-diabetic group (26.9%, p=0.012). Similarly, the risk of high-grade OSA was substantially more common among diabetic patients (42.3%) than in the control group (7.7%, p=0.004), with obesity present exclusively in the diabetic cohort (19.2%). Despite these findings, there were no statistically significant differences between the two groups regarding daytime sleepiness, CRP levels (p=0.634), or melatonin concentrations (p=0.194). Conclusion: Patients with T2DM exhibit a significantly higher burden of sleep dysfunction, obesity, and OSA risk compared to individuals without diabetes. However, these physical manifestations did not translate into distinct variations in CRP or melatonin levels in this study. These results highlight the necessity for a holistic approach to diabetes management that actively integrates sleep and circadian health, while suggesting that further longitudinal research is needed to clarify the behavior of these biomarkers over time.

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