Annals of Indian Academy of Neurology
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   2022| September  | Volume 25 | Issue 7  
    Online since September 7, 2022

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Air pollution and headache disorders
Divyani Garg, Man Mohan Mehndiratta, Mohammad Wasay, Vasundhara Aggarwal
September 2022, 25(7):35-40
Air pollution, the most prevalent form of pollution worldwide, is associated with a wide range of neurological disorders, including neurodegenerative conditions, stroke, autism, depression, and developmental delay. There is accumulating evidence on the association between air pollution and headache disorders, especially migraine. Many classical and non-classical air pollutants have been associated with headache, including particulate matter, nitrogen dioxide, sulfur dioxide, ozone, carbon monoxide, as well as polycyclic aromatic hydrocarbons and volatile organic compounds. There has also been research on the impact of biomass fuels on health-related symptoms, including headache, which form an important source of air pollution in our country. The exact mechanisms underlying headache pathophysiology vis-à-vis air pollution are not precisely defined but include triggering of neuroinflammation and activation of the transient receptor potential ankyrin 1 (TRPA1)-associated pathways. Evidence from different regions of the world indicates a significant association between headache incidence and prevalence, and occurrence of air pollution. Despite growing data, research on adverse effects of air pollution on headache disorders remains limited, and appropriate outcome measures are not holistically defined in these studies. Due to the rapid advancement of the scourge of air pollution, there is a pressing need to expand the arena of research, specifically focused on pathological mechanisms, impact on health and quality-of-life parameters, as well as broader global ramifications.
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Environmental toxins and brain: Life on earth is in danger
Vasundhara Aggarwal, Man M Mehndiratta, Mohammad Wasay, Divyani Garg
September 2022, 25(7):15-21
Man and environment have a strong connection with each other for their functioning. Environmental toxins which can be natural or manmade result in the loss of this balance by causing systemic inflammatory response within the human body, with the brain being the most affected target end-organ. These problems are more prominent in Third World countries, where environmental regulations laws are either relaxed or non-existent. These neurotoxins play a very important aetiological role in the manifestation of various neurodegenerative diseases, neurodevelopmental disorders and psychiatric disorders. Environmental neurotoxicity results from inhibition of mitochondrial activity, excess oxidative stress leading to neuroinflammation, and promoting apoptosis and neuronal cell death. Having the know-how of these neurotoxins will provide insight into the process of neurodegeneration and will result in further designing of studies to delve into processes and mechanisms of neuronal regeneration and axonal sprouting. This review highlights the various central nervous system disorders associated with exposure to environmental neurotoxins and discusses the way forward to prevent or halt the process of neurodegeneration.
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Air pollution and ischaemic stroke
Jamie S Y. Ho, Eric Jou, Benjamin Y Q. Tan, Vijay K Sharma
September 2022, 25(7):26-34
Air pollution is a significant contributor of cardiovascular diseases, including ischaemic stroke (IS), with substantial mortality and morbidity. However, associations between air pollution and IS remain unclear. Limited data are available on the relationship between IS and individual air pollutants. In this systematic review, we present an overview of the current literature about various individual ambient air pollutants that are believed to contribute towards incidence of hospitalization and mortality related to IS.
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Current evidence for the association between air pollution and Parkinson's disease
Yuji Saitoh, Hidehiro Mizusawa
September 2022, 25(7):41-46
Parkinson's disease (PD) is a progressive neurodegenerative disorder, and its global incidence is on the rise. There is increasing interest in understanding the role of air pollution in the development of human disease. Although the precise mechanisms are not understood, several epidemiological studies have reported a positive association between air pollution and the risk of PD. However, the various pollutants studied, endpoints measured, and differences in study design yield conflicting results. This review summarizes recent evidence regarding the relationship between particulate matter, ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide and PD. Limitations and challenges are also discussed, with suggestions for future work to understand the true effects of air pollution on PD.
  780 71 -
Air pollution and intracranial hemorrhage
Mervyn Lim Jun Rui, Jaclyn Tan, Benjamin Yong-Qiang Tan, Tseng Tsai Yeo, Vijay K Sharma
September 2022, 25(7):22-25
Air pollution is a significant contributor to cardiovascular and cerebrovascular diseases. including intracranial hemorrhage (ICH). However, associations between air pollution, various pollutants, and ICH are complex and remain poorly understood. Limited data are available on the relationship between ICH and individual air pollutants. In this review, we present an overview of the current literature about ambient air pollutants that are believed to contribute towards ICH as well as possible underlying mechanisms.
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Evaluation of the effect of air pollution on cognitive functions, cognitive decline, and dementia
Fettah Eren, Serefnur Ozturk
September 2022, 25(7):9-14
The incidence of dementia increases with aging. It is known that the disease brings with it many problems for patients and caregivers. Studies on the development of various treatment modalities for the disease continue. However, the main step in the management of this process is the identification of dementia risk factors. The prevalence of dementia is higher in those living in urban areas where exposure to air pollution and chemical effects is higher. This situation supports the relationship of air pollution, which has increased especially in the last decade, with the increase in cognitive decline and dementia frequency. Exposure to air pollution is one of the well-known causes of neurological diseases. This condition was associated with significant disability and early mortality. Although the close relationship between cerebrovascular diseases and air pollution is known, current studies also reveal the relationship between neuropsychiatric diseases and air pollution. It has been shown that microparticles inhaled through the respiratory system are responsible for this situation. Although individual sensitivity is prominent in the disease, the etiopathogenetic process remains relatively uncertain. Researchers have detected that the relationship between dementia and air pollution is because of the effects of increased proinflammatory mediators and reactive oxygen radicals. Evaluation of air pollution, which plays a role in the etiopathogenesis of dementia, in the light of current literature and revealing this relationship will provide important contributions in taking the necessary measures to prevent the disease.
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Air pollution and cerebrovascular disorders with special reference to Asia: An overview
Bushra Taimuri, Sohail Lakhani, Maryam Javed, Divyani Garg, Vasundhara Aggarwal, Man Mohan Mehndiratta, Mohammad Wasay
September 2022, 25(7):3-8
Background: Among the primary environmental issues affecting global health, air pollution is considered the leading cause of concern. Globally, around 800,000 deaths were attributed to air pollution according to WHO. Evidence suggests that there has been a strong association of air pollution with stroke. Approximately, 25% of stroke mortality was due to air pollution according to a study in 2013. Objective: The aim of this review was to analyze the association between stroke, intracerebral hemorrhage, and subarachnoid hemorrhage and air pollution and its burden globally with a special focus on South Asia along with its association with the COVID-19 pandemic. Results: There is growing research data linking air pollution to cardiovascular disorders including stroke. Short-term and long-term air pollution exposures have been shown to increase stroke incidence in epidemiological data. Air pollution, both gaseous and particle, show a strong and tight temporal relationship with stroke hospitalizations and death. The link between ICH and SAH to air pollution is less strong and less well studied as compared to ischemic stroke. Stroke and air pollution both are highly prevalent in South Asia. It is possible that the high prevalence of stroke in south Asia may be linked to the high frequency of air pollution in addition to other conventional risk factors. Decreased stroke admissions and mortality and reduced cardiovascular mortality reported during coronavirus disease 2019 (COVID) lockdown may be attributable to decreased levels of air pollution. Conclusion: Even though air pollution poses a significant threat to human health, a great number of countries still fail to achieve internationally agreed air quality standards. Air pollution should be recognized among the most significant controllable risk factors for cardiovascular and cerebrovascular disease prevention and treatment.
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Save the mind-air pollution and brain health
Man Mohan Mehndiratta, Vasundhara Aggarwal, Divyani Garg
September 2022, 25(7):1-2
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