Browsing by Author "Janki Makani"

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A comprehensive and critical narrative review on movement disorders linked through dengue virus based infection
(Springer-Verlag Italia s.r.l., 2025) Niraj Kumar Srivastava; Nikhil Pandey; Janki Makani; Ibrahim Hussain; Neetu Rani Dhiman; Anand Kumar; Deepika Srivastava Joshi
Background: Dengue virus (DENV) has emerged as a significant cause of neurological complications, including movement disorders, which fall under the broader category of neurological manifestations associated with DENV infection. These disorders can have serious implications for patient’s quality of life, especially in tropical and subtropical regions where dengue is endemic. The neurological complications of DENV, while less commonly recognized when compared to its classical features (like fever, haemorrhagic manifestations, or shock), are increasingly being reported thus warranting an exhaustive exploration. Methods: We undertook a comprehensive and critical review to investigate the emerging link between movement disorders and DENV infections. An in depth and broad range search was performed across leading scientific databases (PubMed, Scopus, Embase and Google Scholar). We collected and analyzed a wide spectrum of relevant studies and case reports. This detailed methodology ensured a systematic and authoritative exploration of the neurological consequences associated with DENV, creating the foundation for deeper clinical insight and future research. Results: The analysis encompassed 80 studies on movement disorders linked to DENV infections. These studies were thoroughly reviewed and critically evaluated, with the findings presented in an inclusive and investigative manner. Conclusion: This narrative review provides a comprehensive analysis of movement disorders linked to DENV infections, enveloping their epidemiology, clinical features, neuropathogenesis, current therapeutic strategies, and outlining extensive directions for future research. © Fondazione Società Italiana di Neurologia 2025.
Clozapine for Parkinson’s disease psychosis in a septuagenarian: a nightmare turned into bliss
(Springer-Verlag Italia s.r.l., 2025) Janki Makani; Anand Kumar; Ibrahim Hussain; N. Suresh Kumar; Deepika Srivastava Joshi
Parkinson’s disease psychosis, characterized by confusion, visual hallucinations, and delusions is a nightmare for the patients and caregivers. Classic neuroleptics aggravate the motor symptoms, hence the need for an effective atypical antipsychotic. Currently Pimavanserin is the only approved drug for Parkinson’s disease psychosis (PDP), however it is not readily available. Clozapine with its excellent anti psychotic profile, without worsening of motor features, cost effectiveness and easy availability transcends all boundaries in improving the Quality of life in PD patients with psychosis. We describe an elderly patient with PDP with an excellent response to low dose clozapine. © Fondazione Società Italiana di Neurologia 2024.
Clozapine for Parkinson’s disease psychosis in a septuagenarian: a nightmare turned into bliss
(Springer-Verlag Italia s.r.l., 2024) Janki Makani; Anand Kumar; Ibrahim Hussain; Niraj Kumar; Deepika Joshi
Parkinson’s disease psychosis, characterized by confusion, visual hallucinations, and delusions is a nightmare for the patients and caregivers. Classic neuroleptics aggravate the motor symptoms, hence the need for an effective atypical antipsychotic. Currently Pimavanserin is the only approved drug for Parkinson’s disease psychosis (PDP), however it is not readily available. Clozapine with its excellent anti psychotic profile, without worsening of motor features, cost effectiveness and easy availability transcends all boundaries in improving the Quality of life in PD patients with psychosis. We describe an elderly patient with PDP with an excellent response to low dose clozapine. © Fondazione Società Italiana di Neurologia 2024.
Unveiling the role of trace elements in modulating inflammatory and oxidative pathways in CAG repeat–driven spinocerebellar ataxia
(Academic Press, 2025) Surbhi Singh; Deepika Srivastava Joshi; Abhay Kumar Yadav; Shani Vishwakarma; Janki Makani; Janhavi Yadav; Anil Kumar Maurya; Gulabi Yadav; Chandmayee Mohanty; Anand Kumar; Royana Singh
Spinocerebellar ataxias are genetically inherited neurodegenerative disorders, primarily caused by CAG trinucleotide repeat expansions in genes. While these genetic mutations initiate disease onset, increasing evidence suggests that systemic factors, particularly trace element imbalance, oxidative stress, and immune dysregulation, play critical roles in disease progression. In this study, peripheral blood samples from genetically confirmed SCA patients (n = 15) and age- and sex-matched healthy controls (n = 18) were analyzed. Atomic Absorption Spectroscopy revealed significant alterations in plasma concentrations of both essential and toxic trace elements, suggesting their involvement in neurotoxicity, redox imbalance, and inflammation. To explore these links, oxidative stress markers, including malondialdehyde, superoxide dismutase, and glutathione peroxidase, as well as cytokines such as interleukin-6, interleukin-4, and interleukin-10, were quantified using ELISA. Receiver operating characteristic analysis demonstrated high diagnostic accuracy of these markers, particularly GPx and IL-10. A strong interconnection was observed among trace element dysregulation, oxidative stress, and inflammatory responses, indicating a synergistic role in exacerbating neurodegeneration. Molecular docking revealed that abnormal trace element levels may impair antioxidant enzyme function by disrupting metal-binding interactions, offering mechanistic insight into enzymatic dysfunction. Bioinformatics analyses, including functional enrichment and protein–protein interaction mapping, identified significant associations with mitochondrial dysfunction, reactive oxygen species metabolism, and cytokine signaling pathways. These findings suggest that SCA pathogenesis is not driven by genetic mutation alone. The combined effects of trace element imbalance, oxidative stress, and inflammation contribute to a complex pathogenic network, reinforcing the importance of targeting both genetic and systemic factors in therapeutic strategies. © 2025 Elsevier Ltd