Dear Colleagues:

Welcome to the January–February 2019 issue of Innovations in Clinical Neuroscience (ICNS). We start this issue with a review article by Yeo et al titled, “Virtual Reality Neurorehabilitation for Mobility in Spinal Cord Injury: A Structured Review.” Here, investigators conducted a literature review and reported that VR therapy has resulted in significant improvements in Functional Reach Test (FRT), Berg Balance Scale (BBS), gait speed, muscle strength, Spinal Cord Independence measure (SCIM-III), and Walking Index for Spinal Cord Injury II (WISCI II) measures, as well as voluntary muscle control, in patients with SCI, but no significant differences were observed in fine hand motor movement. The authors concluded that VR therapy has potential as a useful tool in SCI rehabilitation, but larger, multicenter trials are needed to fully determine the usefulness of VR therapy in this patient group.

Next, in a case series by Baroud et al titled “Brain Imaging in New Onset Psychiatric Presentations,” the authors report two cases of college-aged patients who presented with psychiatric symptoms and were found to have brain changes on magnetic resonance imaging (MRI). The authors describe the characteristics of each case, and discuss diagnosis, including differentials, and treatment. The authors use the cases to illustrate the benefit of neuroimaging when evaluating patients with new onset or atypical psychiatric presentations

Despite the lack of scientific evidence, reports reveal that many medical personnel, in addition to the general population, believe that astronomical phenomena can influence the emergence of psychiatric symptoms in patients with mental health disorders. To investigate whether there is any truth behind this belief, Demler et al evaluated the potential psychiatric impact of the phases of the moon on patients in a state psychiatric hospital. In their article, “Exploring the Potential Psychiatric Implications of Astronomical Phenomena,” the authors noted the number of restraints or seclusions (R&S) and code green psychiatric emergencies (CG) recorded 14 days before and 14 days after a full moon to measure differences in patient behavior between the dates of September 2013 and July 2018. This time frame of the analysis included the August 21, 2017, solar eclipse; thus the authors also highlighted the correlation between a partial solar eclipse and the number of CG events. The authors reported that, after analysis, the data failed to reveal any significant association between lunar and solar behavior and the actions of patients with psychiatric disorders.

Next, in a brief report titled, “Synthetic Cannabinoids—”Spice” Can Induce a Psychosis: A Brief Review,” by Yeruva et al, the authors describe a current trend in illicit drug use, synthetic marijuana, and review prevalence data, demographic characteristics of users, common adverse effects, and signs and symptoms of its use.

Following this, in the latest installment of “Hot Topics in Neuroscience,” Mohanty and Lippmann review the evidence supporting the possible benefits of marijuana for treatment of Parkinson’s disease symptoms in their article, “Marijuana for Parkinson’s Disease?” Their brief review of the literature revealed that other than some animal studies, human research on marijuana therapy in Parkinson’s disease is primarily restricted to patient surveys and anecdotal or case reports. While this limited human research suggests that marijuana might be useful in mitigating some motor and non-motor, mood, and/or cognitive symptoms of Parkinson’s, no substantial human studies on marijuana in this patient population have been conducted. Thus, the authors conclude that the safety and efficacy of cannabis products as a treatment option for symptoms of Parkinson’s disease remain unclear, and clinicians should maintain caution before recommending marijuana to this patient population.   

Next, in the latest installment of our “Research to Practice” column, Targum and Nemeroff update us on discoveries regarding the relationship between early life abuse and adult mental health disorders. In the interview titled, “The Effect of Early Life Stress on Adult Psychiatric Disorders,” Targum and Nemeroff discuss the latest neurobiological and epigenetic studies exploring the significant impact that early childhood maltreatment has on adult health. According to Nemeroff, early life stress has been associated with social, emotional, and cognitive impairment; adult medical and psychiatric disorders; disability; and even earlier death. Nemeroff describes a new research institute he helped to establish that will be conducting research for the development of therapies that address the special psychiatric needs of abused children and adults who were abused as children.

Finally, Vanderpool provides the latest “Risk Management” installment titled, “HIPAA Compliance: A Common Sense Approach.” Here, the author reviews the Security Rule and the differences in security compliance requirements of large entities versus solo practices. The author also discusses five key actions physicians can take to stay HIPAA compliant, including a HIPAA compliance checklist.

We hope you enjoy this issue of ICNS. As always, we welcome your submissions and feedback.


Amir Kalali, MD

Editor, Innovations in Clinical Neuroscience