Dear Colleagues:

Welcome to the October–December 2020 edition of Innovations in Clinical Neuroscience (ICNS). For 2020’s fourth and final quarterly issue of ICNS, we start with a letter to the editor from Josef Finsterer, MD, PhD. Here, Dr. Finsterer addresses the potential shortcomings of a case report by Diaz-Abad et al, which was previously published in the November–December 2019 issue of ICNS, titled, “Use of Noninvasive Ventilation with Volume-assured Pressure Support for Treatment-refractory Myasthenia Gravis.” Unproven diagnoses, retaining essential myasthenia gravis symptom information, and intolerability of certain treatments are some of the sectors Dr. Finsterer presents in “Nonresponsive Myasthenia Is Suspicious for Congenital Myasthenic Syndrome or Myopathy.” 

Following this is original research by Benmakhlouf et al. In “Intellectual Disability in Morocco: A Pilot Study,” the authors thoroughly report the demographic and clinical characteristic of 186 patients with intellectual disability, defined as a collection of disorders pertaining to congenital qualification in intellectual functioning and adaptive behavior, residing in Fez City, Morocco, and its regions from October 2014 to July 2019. Throughout their study, Benmakhlouf et al discuss their findings, which are based on gathered data and evaluated by IBM SPSS (version 24). The authors also highlight the relationship between intellectual disability and genetic causation and heightened consanguinity rate. 

Next, in their commentary, “Who Will Pay for Robotic Rehabilitation? The Growing Need for a Cost-effectiveness Analysis,” Calabrò et al review the basis of robot-assisted rehabilitation and how it has been advancing in the rehabilitation field, exhibiting efficacy and safety in patients with various neurological disorders, as well as analyze the primary economic considerations surrounding this type of technology. The authors describe how a cost-effective evaluation is needed for this method to be integrated into neurorehabilitation healthcare systems. 

Then, Dahal et al discuss their takeaways from conducting a national mental health survey managed in three Nepal districts to test the efficacy of largescale surveys in “Pilot Mental Health Survey, Nepal: Lessons Learned for Survey Design and Instrumentation.” The takeaways were primarily related to instrumentation, procedures, and survey methods after observing 1,647 individuals over the age of 13 years and older.  Additionally, Dahal et al were able to identify the portions of survey techniques and tools that need refining. 

Following the pilot study, Edmund G. Howe, III, MD, JD, and Falicia Elenberg, BS, examine the potential of Big Data, data sets that can be utilized when divulging trends and connections, in “Ethical Challenges Posed by Big Data.” Using their original research, Dr. Howe and Ms. Elenberg also analyze how Big Data can hinder medicine and public health fields, as it could plausibly breach patient privacy and bring about other ethical concerns, including patients’ autonomy via provision of adequate consent and equity. With these concerns at play, the authors purpose the need for solutions to control and prevent the above ethical challenges. 

Following this is “Multiple Cellular Therapies Along with Neurorehabilitation in Spastic Diplegic Cerebral Palsy: A Case Report” by Mullangi et al. Here, the authors describe the case of a 4-year-old individual with spastic diplegic cerebral palsy, a childhood condition that impairs motor and cognitive function, who was treated with autologous bone marrow mononuclear cells transplantation. Given that cerebral palsy management does not cure the condition’s pathology, the authors believe early intervention, such as the above autologous bone marrow mononuclear cells transplantation, might alter cerebral palsy’s pathology. Throughout their article, Mullangi et al share their follow-up data, testing implications, and improvements of the 4-year-old patient. 

Next is another case report by Trigoboff et al. In “Neuroleptic Malignant Syndrome: Can Be an Unrecognized Chronic Fatal Disease,” the authors review the fatal outcome of neuroleptic malignant syndrome’s (a potential side effect of antipsychotics) chronic elements, and those who are most at risk. Through the case of a 45-year-old patient, Trigoboff et al aim to encourage physicians to maintain a heightened level of consciousness when administrating traditional antipsychotic medications to patients who have an increased chance of developing neuroleptic malignant syndrome.  

Finally, we wrap up the issue with the Risk Management column, where Donna Vanderpool, MBA, JD, provides clinicians with a guideline, resources, and a Telepsychiatry Checklist that can be addressed and examined in preparation for the uncertainty of the post-COVID-19 world.

As always, we hope you enjoy this issue of ICNS, and we look forward to receiving your feedback. 


Amir Kalali, MD

Editor, Innovations in Clinical Neuroscience [/protected]