Papers by Olubunmi Ogunrin
Frontiers in neurology, May 23, 2024
Frontiers in Human Neuroscience, Jun 27, 2023
Background: Parkinson's disease (PD) is a chronic neurodegenerative disorder complicated by cogni... more Background: Parkinson's disease (PD) is a chronic neurodegenerative disorder complicated by cognitive dysfunctions which are associated with increased caregiver burden, pressure on community health facilities, and mortality in affected patients. Most of the data concerning cognitive dysfunctions in PD are from studies conducted in Europe and North America, but there is paucity of data from Sub-Saharan Africa. Objective: The objective of this study is to determine the frequency, pattern and predictors of cognitive impairments amongst patients with Parkinson's disease. Materials and methods: This was a cross sectional case control study carried out at a tertiary health facility in South-south Nigeria. Participants with PD were consecutively recruited from the neurology outpatient clinics. Demographic and disease-specific data were obtained with the use of a pre-tested questionnaire. Cognitive performance of thirty patients with PD were compared with thirty demographically matched controls using the Community Screening Instrument for Dementia (CSID). CSID was already validated among Nigerians. Results: The frequency of cognitive impairment using the CSID was 50% for PD patients (3.3% for controls). Poor cognitive performance was observed across several cognitive domains including language, executive dysfunction, psychomotor speed, and constructional apraxia among PD patients. The independent predictors of the overall cognitive impairment in patients with PD determined by logistic regression analysis include recall deficiency (p = 0.007), impairment with naming (p = 0.044), apraxia (p = 0.003), Hoen&Yahr staging (p = 0.046), UPDRS score (p = 0.015) and age at presentation (p = 0.014).
Journal of the Neurological Sciences, 2017
Background: The occurrence of cerebral microbleeds (CMBs) needs to be fully evaluated in patients... more Background: The occurrence of cerebral microbleeds (CMBs) needs to be fully evaluated in patients with cerebral large artery disease (CLAD). Objective: The hypothesis of this study was that Vascular Endothelial Growth Factor (VEGF) might affect the occurrence of CMBs in those with CLAD. Patients and Methods/Material and Methods: We prospectively registered the patients with CLAD, who were hospitalized in our Neuro-center. Background, atherosclerotic risk factors, administration of antithrombotics before hospitalization and levels of cytokines and chemokines were evaluated. Susceptibility Weighted Imaging (SWI) or T2 Star Weighted MR Angiography (SWAN) were taken for the evaluation of CMBs. Brain Observer Micro Bleed Scale (BOMBS) was used for the assessment of the CBMs. We also examined of VEGF value of the participants. Since more than half of the patients showed VEGF below the sensitivity, patients were dichotomized between above and below the sensitivity of VEGF. Results: Sixty-six patients (71.1±8.9 years, 53 males and 13 females) were included in this study. Although patients' background and atherosclerotic risk factors were not correlated with VEGF value, those with VEGF of above the sensitivity tended to have CMBs more frequently (60.0% vs 32.6%, in the presence and absence of CMBs, P=0.056). With regard to the location of CMBs, those in the cortex and/or grey-white junction were observed more frequently in the patients with VEGF of above the sensitivity after multivariate analyses (Odds ratio: 3.80, 95% confidential interval: 1.07-13.5, P=0.039). Conclusion: In patients with CLAD, the elevation of VEGF might be associated with the presence of CMBs, especially located in the cortex and/or grey-white junction.
Journal of Clinical Research & Bioethics, 2016
Objective: The knowledge and application of ethical principles to the conduct of human subjects' ... more Objective: The knowledge and application of ethical principles to the conduct of human subjects' research is crucial to the integrity of the research industry. This study sought to assess the knowledge and practice of research ethics among biomedical researchers in research institutions in southern Nigeria. Methods: Four tertiary biomedical research institutions from the three geo-political zones situated in the southern part of Nigeria were selected using a stratified random sampling technique. Research participants were then selected by purposive sampling from these institutions. The knowledge and practice of research ethics among the study participants were assessed with a pre-tested structured questionnaire. Statistical analysis was done with Stata version 10SE. Results: A total of 102 biomedical researchers (66 males and 36 females) with a mean age of 39.8 (SD 7.0) years participated in the study. Forty-five percent knew that ethical review of research is for the protection of research participants from harm though sixty-four percent had attended at least one training seminar in research ethics. About fifteen percent knew of any international ethical guideline. Approximately eighty-five percent agreed that independent ethical review of protocol is important but only forty-eight percent received ethical approval for their research. Conclusion: The knowledge and practice of research ethics is inadequate among Nigerian biomedical researchers. Attendance at ethics seminar did not reflect knowledge and practice of research ethics. The knowledge and practice of research ethics need improvement. The independent review of research protocols must be obligatory.
Annals of Biomedical Sciences, 2009
Acute intermittent porphyria (AIP) is a rare autosomal dominant inherited disorder of heme biosyn... more Acute intermittent porphyria (AIP) is a rare autosomal dominant inherited disorder of heme biosynthesis which manifest with neurovisceral symptoms. Its manifestation in children before the age of puberty is said to be very rare and suggest homozygous state when it does occur before puberty. AIP mimics many other disorders and so may be easily missed leading to delay in appropriate management and poor prognosis. The authors report a case of AIP in a 5 year old boy from Nigeria. Key words : Acute, intermittent, porphyria, young, child, Nigeria.
The introduction of genomic research to, and emergence of biobanks in, sub-Saharan African countr... more The introduction of genomic research to, and emergence of biobanks in, sub-Saharan African countries raise ethical issues that require urgent attention. Firstly, there are concerns about whether individuals and communities would agree to participate in this type of research especially considering how communitarianism may affect their decision-making process. Secondly, there are controversies over whether the informed consent process as it is applied to other biomedical researches would be appropriate for genomic research in sub-Saharan Africa. And thirdly, the components of engagement of culturally distinct communities in genomic research are not yet clarified. Although community engagement during the recruitment stage have been described, there is dearth of information on effective strategies beyond this stage and which model is the most appropriate for sub-Saharan African settings. Therefore, my research explored the opinions of indigenous potential research participants on involv...
BACKGROUND: Post traumatic epilepsy is recurrent chronic seizures occurring after four weeks foll... more BACKGROUND: Post traumatic epilepsy is recurrent chronic seizures occurring after four weeks following brain injury. It commonly occurs after road traffic accidents thus making it a preventable cause of chronic seizures. The prevalence and pattern of this disorder is not known among Nigerian patients with epilepsy. OBJECTIVE: This study aimed at determining the prevalence of and predisposing type of head injury to developing post traumatic epilepsy. METHODS: We studied 244 consecutive patients with epilepsy attending the neurology clinic of a tertiary health facility in an urban Nigerian city by analyzing the details of their demographic and clinical data obtained with the aid of a structured questionnaire and from the Epilepsy Registry of a Neurology Unit between January and December 2006. RESULTS: Thirty-eight patients with a mean age of 38.6 ± 7.3 years (age range 15-75 years) had posttraumatic epilepsy comprising 15.57% of all cases of epilepsy. Thirty-three (86.8%) had closed head injury. Thirty-two (84.2%) of the patients had positive history of loss of consciousness. Twentytwo patients (57.9%) sustained head injury from motor vehicle accidents. Majority of the patients had secondarily generalized seizures (73.7% of the cases). Twenty-seven (71.4%) of the 38 patients had seizure onset in the first year after brain injury. Depressed skull fracture (19/38; 50%) was the most common abnormal CT finding. CONCLUSION: Post traumatic epilepsy contributes significantly to the number of patients with epilepsy presenting to our neurology services. There is need to educate people on the usefulness of seat-belts and helmets while driving. WAJM 2010; 29(3): 153-157.
West African journal of medicine, Jul 22, 2011
BACKGROUND: Post traumatic epilepsy is recurrent chronic seizures occurring after four weeks foll... more BACKGROUND: Post traumatic epilepsy is recurrent chronic seizures occurring after four weeks following brain injury. It commonly occurs after road traffic accidents thus making it a preventable cause of chronic seizures. The prevalence and pattern of this disorder is not known among Nigerian patients with epilepsy. OBJECTIVE: This study aimed at determining the prevalence of and predisposing type of head injury to developing post traumatic epilepsy. METHODS: We studied 244 consecutive patients with epilepsy attending the neurology clinic of a tertiary health facility in an urban Nigerian city by analyzing the details of their demographic and clinical data obtained with the aid of a structured questionnaire and from the Epilepsy Registry of a Neurology Unit between January and December 2006. RESULTS: Thirty-eight patients with a mean age of 38.6 ± 7.3 years (age range 15-75 years) had posttraumatic epilepsy comprising 15.57% of all cases of epilepsy. Thirty-three (86.8%) had closed head injury. Thirty-two (84.2%) of the patients had positive history of loss of consciousness. Twentytwo patients (57.9%) sustained head injury from motor vehicle accidents. Majority of the patients had secondarily generalized seizures (73.7% of the cases). Twenty-seven (71.4%) of the 38 patients had seizure onset in the first year after brain injury. Depressed skull fracture (19/38; 50%) was the most common abnormal CT finding. CONCLUSION: Post traumatic epilepsy contributes significantly to the number of patients with epilepsy presenting to our neurology services. There is need to educate people on the usefulness of seat-belts and helmets while driving. WAJM 2010; 29(3): 153-157.
Journal of the Neurological Sciences, Feb 1, 2012
ObjectiveThis study assessed the effects of highly active antiretroviral therapy on the cognitive... more ObjectiveThis study assessed the effects of highly active antiretroviral therapy on the cognitive performances of HIV seropositive patients with severe immune depression.
Acta Scientific Neurology, Aug 1, 2023
Chronic Medical Condition is a condition that last longer than one year or more, requires ongoing... more Chronic Medical Condition is a condition that last longer than one year or more, requires ongoing medical attention and limit activities of daily living. Among these conditions in sub-Saharan Africa (SSA) are epilepsy, diabetes mellitus, Human Immunodeficiency Virus infections bronchial asthma, chronic liver disease and others. Cognitive decline could be present in about 60% of patients with chronic medical conditions especially older adults and those with multiple comorbidities. These chronic medical conditions could have heterogenous patterns of presentation and may have different underlying pathophysiological mechanisms. Various instruments used for neuropsychological assessment of cognition in these conditions and treatment is basically through pharmacologic and nonpharmacologic therapies including cognitive behavioural therapy. This review is an attempt to describe the specific patterns of presentations of cognitive dysfunctions in patients living with common chronic medical conditions in sub-Saharan Africa such as memory, information processing, attention/concentration, learning, visual spatial skills and other executive functions. We also highlighted recent advances of possible pathophysiological mechanism and management of this conditions. Furthermore, well conducted large scale trials to explore the peculiar pathophysiological mechanisms of cognitive decline in patients with chronic medical conditions in sub-Saharan Africa in the near future. Introduction According to the National Centre for Chronic Disease Prevention and Health Promotion-NCCDPHP (www.cdc.gov), chronic medical condition refers to a condition that last 1 year or more and require ongoing medical attention and limit activities of the daily living or both (National Centre for Chronic Disease Prevention and Health Promotion-(NCCDPHP). Many of these chronic diseases may be inherited such as Diabetes mellitus, hypertension, asthma or acquired such as HIV/AIDS. Researchers from the developed countries have shown that patients with chronic medical disorders have impaired quality of life and deleterious effects on vocations [1,2]. Recent publications from Centre for Diseases Control (CDC) indicated that chronic diseases are the leading cause of morbidity, disability and death in the United States of America (USA). They also affirmed that chronic diseases are the leading drivers of $ 4.1 trillion is annual health care cost [1]. In sub-Saharan Africa, the commonly encountered chronic diseases include cancers, diabetes mellitus, liver diseases, asthma, hypertension among others. Observational studies showed that most patients in sub-Saharan Africa have issue with academic and vocational achievements when they developed chronic medical conditions [3] and this has led some researchers in Africa to conduct some studies on cognitive performances among sufferers of chronic medical conditions. Most of these studies also aimed at determining the specific patterns of cognitive impairment peculiar to this medical conditions.
The Nigerian postgraduate medical journal, 2004
This is an analysis of the effects of prognosticating factors on the outcome of patients with tet... more This is an analysis of the effects of prognosticating factors on the outcome of patients with tetanus who were seen in our hospital between 1990 and 2000. Tetanus remains a major public health hazard associated with high mortality. A total of 66 cases were analysed with a slight female preponderance. The mortality rate was 26.2% with an age-adjusted fatality rate of 16.2% for those under 40 years of age. This increased to 75% for those patients above 70 years of age. The most common portal of entry was lower limb, specifically the foot, and this was the case in 56%. The socio-economic status of the patients, the immunisation status, the incubation period, the age of the patient, the severity of the spasms, the duration of hospital stay, the type of treatment received and the onset time were found to affect the outcome of the patients. We recommend that health care providers should take every opportunity to review the vaccination status of their parents and provide tetanus vaccine when indicated, and recall when treating injured patients that many middle-aged and older adults are not adequately immunised against tetanus.
PubMed, Aug 1, 2006
Background: HIV infection causes a range of cognitive and behavioral symptoms that become more fr... more Background: HIV infection causes a range of cognitive and behavioral symptoms that become more frequent and severe as the immune system deteriorates and symptomatic illness ensues. Objective: To determine the impact of disease progression on cognitive abilities of Nigerian Africans who present in the HIV/AIDS clinic of the University Teaching Hospital, Benin City, Nigeria, using the CD4 levels as the measure of disease progression. Methods: A total of 288 subjects comprising 96 randomly selected symptomatic AIDS patients, 96 randomly selected asymptomatic HIV-positive patients and 96 HIV-negative controls participated in the study. Enzyme-linked immunosorbent assay (ELISA) method was used to detect HIV infection, and CD4 levels were obtained for all subjects. The Community Screening Interview for Dementia (CSI 'D') was used to assess cognitive performance of subjects. Subjects were matched for age, sex and level of education. Results: Each category of subjects comprised 48 males and 48 females. The mean ages were 32.94 +/- 8.0 years, 31.47 +/- 6.7 years and 33.56 +/- 7.1 years for the controls, asymptomoatic HIV-positive and symptomatic AIDS subjects respectively (p = 0.127). The mean CD4 levels were 684 +/- 44/microL (controls), 284 +/- 62/microL (asymptomatic HIV positive) and 142 +/- 36/microL (symptomatic AIDS). The mean CS1 'D' scores were 66.46 +/- 1.90 (controls), 66.31 +/- 2.14 (asymptomatic HIV positive) and 56.62 +/- 4.23 (symptomatic AIDS). Conclusion: Cognitive abilities of HIV/AIDS patients decline as the disease progresses. This is reflected in the cognitive performances of the symptomatic AIDS patients. The lower the CD4 levels, the worse the cognitive deficits. There was, however, no significant difference in the performance of asymptomatic HIV-positive patients and the controls.
Journal of the Neurological Sciences, Oct 1, 2013
eNeurologicalSci, Jun 1, 2016
Cognitive dysfunction is common among patients with human immunodeficiency virus (HIV) infection ... more Cognitive dysfunction is common among patients with human immunodeficiency virus (HIV) infection however there are few reports from sub-Saharan Africa. Methods: We studied fifty seropositive patients with human immunodeficiency virus (HIV) infection along with fifty matched seronegative control. Medical history taking and general physical and neurological examinations were done for all study participants. Laboratory evaluations and chest X-ray were done for all the patients. The cognitive function was done with the aid of 'Fepsy' automated test battery for all the study participants. The data was analyzed with statistical package for social sciences software version 21.0 (SPSS Chicago IL). Result: About 70% of the HIV patients were in advanced disease stage. The auditory and visual reaction times, binary choice reaction times, and computerized visual scanning task time were more prolonged in the HIV group (p b 0.05). There were also increased memory accuracy and binary choice task accuracy in the HIV group (p b 0.05). However the vigilance task performance was similar between the two groups (p N 0.05). Among the patients with HIV infection, the presence of anemia and central nervous system toxoplasmosis infection was associated with prolonged auditory and visual reaction times. Conclusion: There was a high rate of cognitive dysfunction in patients with HIV infection in this study.
Annals of African Medicine, 2015
Chronic kidney disease (CKD) has become a public health concern and may be complicated by cogniti... more Chronic kidney disease (CKD) has become a public health concern and may be complicated by cognitive impairment (CI) contributing significantly to morbidity and poor prognosis. This hospital-based study aimed at determining the prevalence and the determinants of CI among CKD patients in Nigeria. A total of 190 CKD patients and a 100 healthy control subjects completed this cross-sectional study. Sociodemographic data and history of common clinical features of CKD were obtained with the use of interviewer administered semi-structured questionnaires. The six-item cognitive impairment test was used for assessment of cognitive function of patients and controls. The prevalence of CI in Stages 3, 4, and 5 CKD patients were 24.0%, 41.6%, and 46.2%, respectively with overall prevalence of 35.3% while only 6.0% of controls had CI (P = 0.03). The most potent determinants of CI were low hematocrit (odds ratio [OR] =3.50), low serum bicarbonate levels (OR = 2.20), and high serum urea (OR = 2.11). CKD is associated with significant CI in Nigerian patients especially with progressive deterioration in renal function. There is a need for regular evaluation of CKD patients for cognitive deficits.
Journal of the National Medical Association, Sep 1, 2008
Vascular disease remains the prime contributor to the pathogenesis of stroke, but dyslipidemia ha... more Vascular disease remains the prime contributor to the pathogenesis of stroke, but dyslipidemia has not been clearly established as a risk factor for stroke the same way it has been for coronary artery disease. There is no casecontrolled study on the contribution of serum lipids to stroke in Nigerians. This study aimed at assessing the possibility of serum lipids as risk factor for stroke in Nigerian patients. Method: The demography, blood pressure, fasting plasma glucose and fasting serum lipids of 87 consecutive patients with first-ever stroke managed at the University of Benin teaching hospital between January and December 2005 were analyzed and compared with those of age-and sexmatched controls. Results: Eighty-seven stroke patients (55 males and 32 females; mean age 61.25 ± 14.77 years) were compared with age-and sex-matched controls. Ischemic stroke constituted 64.37%, while the rest had hemorrhagic stroke. There were no significant differences in the serum cholesterol, HDL-C and LDL-C levels of stroke patients and controls (p>0.05), but the serum triglyceride level was higher among the stroke patients (p<0.001) with a significant relative risk (RR=1.77; p<0.01). Conclusion: In this cross-sectional case-control study, there is no significant difference in the serum lipids of Nigerian patients with stroke with the exception of serum triglyceride, which seems to confer significant stroke risk.
Canadian Journal of Neurological Sciences, May 1, 2007
Neuropsychological impairments in HIV/AIDS have been extensively researched and reported in devel... more Neuropsychological impairments in HIV/AIDS have been extensively researched and reported in developed countries, usually reflecting the prominence of initial sub-cortical involvement and characterized by memory loss (usually impaired retrieval), general slowing of psychomotor speed and thought processes and impaired manipulation of acquired knowledge. 1,2 Memory impairment, both verbal and non-verbal, is characteristic of HIV-associated dementia. 3 During the early years of the HIV epidemic, cognitive symptoms were thought to be common even during the initial ABSTRACT: Background: Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts. Methods: A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery-the Iron Psychology 'FePsy' were used for cognitive assessments. Results: The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p>0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p<0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p<0.05). The HIVpositive subjects with CD4+ counts <200/µl and between 200 and 499/µl had significant memory impairment (p<0.001 and p<0.001 respectively) but there was no significant impairment among those with count ≥500/µl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p<0.001). Conclusions: We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS. RÉSUMÉ: Étude prospective cas-témoin du fonctionnement mnésique chez les patients atteints du VIH/SIDA. Contexte : Une atteinte de la mémoire, habituellement de la récupération de l'information, a été décrite chez les patients atteints du VIH/SIDA, spécialement chez ceux dont la maladie est sévère. Les perturbations neuro-cognitives dans le VIH/SIDA ont été associées à une faible qualité de vie et de fidélité à la médication. Cette étude prospective cas-témoin a été conçue dans le but d'évaluer la mémoire verbale et non verbale ainsi que l'attention chez des Africains Nigériens atteints du VIH/SIDA et d'évaluer s'il existe une corrélation avec le décompte des lymphocytes T CD4+ (CD4+). Méthodes : 288 sujets choisis au hasard, soit 96 patients VIH-positifs symptomatiques, 96 patients VIH-positifs asymptomatiques et 96 témoins VIH-négatifs ont participé à l'étude. Les sujets ont été appariés pour l'âge, le sexe et le niveau de scolarité. L'évaluation cognitive a été effectuée au moyen du Recognition Memory Test (RMT) et du Choice Reaction Time Tasks, qui font partie d'une batterie de tests neuropsychologiques informatisés, le Iron Psychology « FePsy ». Résultats : Les scores mnésiques moyens des sujets asymptomatiques VIH-positifs n'étaient pas significativement différents de ceux des témoins (p > 0,05). Cependant, les scores des sujets VIH-positifs symptomatiques étaient significativement plus bas que ceux des témoins (p < 0,05). Les deux groupes de patients VIH-positifs avaient un ralentissement psychomoteur et un déficit d'attention (p < 0,05). Les sujets VIH-positifs dont le décompte CD4+ était inférieur à 200/Ìl et entre 200 et 499/Ìl avaient une atteinte mnésique significative (p < 0,001 et p < 0,001 respectivement). Il n'existait pas d'atteinte significative chez ceux dont le décompte était ? 500/Ìl. Cependant, ils avaient un déficit de l'attention soutenue par rapport aux témoins (p < 0,001), quel que soit leur décompte CD4+. Conclusions : Il n'y a pas de perturbation significative de la mémoire chez les sujets VIH-positifs asymptomatiques, malgré la présence d'un déficit de l'attention et d'un ralentissement psychomoteur. La sévérité de la suppression immunitaire (basée sur le décompte des lymphocytes T CD4+) est un déterminant puissant du déclin cognitif chez les sujets atteints du VIH/SIDA.
Uploads
Papers by Olubunmi Ogunrin