... or head Electromyogram (EMG), nerve conduction velocities (NCV) MRI of the back, neck, or head Spinal tap Alternative Names Neurological deficits - focal Images Brain References Daroff RB, Jankovic ...
Mueller, Kathryn L.; Tomblin, J. Bruce
Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder often associated with other developmental disorders including speech, language, and reading disorders. Here, we review the principal features of ADHD and current diagnostic standards for the disorder. We outline the ADHD subtypes, which are based upon the dimensions…
Full Text Available Objective: To examine the intervertebral disc characteristic on magnetic resonance imaging (MRI in lumbar herniated disc (LHD patients with progressive neurological deficit. Methods: Patients were collected retrospectively from Dr. Hasan Sadikin General Hospital Database from 2011–2013 with LHD, had neurological deficit such as radiculopathy and cauda equine syndrome for less than four weeks with a positive sign confirmed by neurological examination and confirmatory with MRI examination. Results: A total of 14 patients with lumbar herniated disc disease (10 males, 4 females suffered from progressive neurological deficit with an average age of (52.07±10.9 years old. Early disc height was 9.38±0.5 mm and progressive neurological deficit state disc height was 4.03±0.53 mm, which were significantly different statisticaly (p<0.01. Symptoms of radiculopathy were seen in 11 patients and cauda equine syndrome in three patients. Modic changes grade 1 was found in five patients, grade 2 in eight patients,grade 3 in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three patients. Thecal sac compression 1/3 compression was seen in four patients and 2/3 compression in ten patients. Conclusions: Neurosurgeon should raise concerns on the characteristic changes of intervertebral disc in magnetic resonance imaging examination to avoid further neural injury in lumbar herniated disc patients.
Fiona A. Desland
Full Text Available Animal models of stroke have been crucial in advancing our understanding of the pathophysiology of cerebral ischemia. Currently, the standards for determining neurological deficit in rodents are the Bederson and Garcia scales, manual assessments scoring animals based on parameters ranked on a narrow scale of severity. Automated open field analysis of a live-video tracking system that analyzes animal behavior may provide a more sensitive test. Results obtained from the manual Bederson and Garcia scales did not show significant differences between pre- and post-stroke animals in a small cohort. When using the same cohort, however, post-stroke data obtained from automated open field analysis showed significant differences in several parameters. Furthermore, large cohort analysis also demonstrated increased sensitivity with automated open field analysis versus the Bederson and Garcia scales. These early data indicate use of automated open field analysis software may provide a more sensitive assessment when compared to traditional Bederson and Garcia scales.
Aldrete, J A
Of late, regional anesthesia has enjoyed unprecedented popularity; this increase in cases has brought a higher frequency of instances of neurological deficit and arachnoiditis that may appear as transient nerve root irritation, cauda equina, and conus medullaris syndromes, and later as radiculitis, clumped nerve roots, fibrosis, scarring dural sac deformities, pachymeningitis, pseudomeningocele, and syringomyelia, etc., all associated with arachnoiditis. Arachnoiditis may be caused by infections, myelograms (mostly from oil-based dyes), blood in the intrathecal space, neuroirritant, neurotoxic and/or neurolytic substances, surgical interventions in the spine, intrathecal corticosteroids, and trauma. Regarding regional anesthesia in the neuroaxis, arachnoiditis has resulted from epidural abscesses, traumatic punctures (blood), local anesthetics, detergents, antiseptics or other substances unintentionally injected into the spinal canal. Direct trauma to nerve roots or the spinal cord may be manifested as paraesthesia that has not been considered an injurious event; however, it usually implies dural penetration, as there are no nerve roots in the epidural space posteriorly. Sudden severe headache while or shortly after an epidural block using the loss of resistance to air approach usually suggests pneumocephalus from an intradural injection of air. Burning severe pain in the lower back and lower extremities, dysesthesia and numbness not following the usual dermatome distribution, along with bladder, bowel and/or sexual dysfunction, are the most common symptoms of direct trauma to the spinal cord. Such patients should be subjected to a neurological examination followed by an MRI of the effected area. Further spinal procedures are best avoided and the prompt administration of IV corticosteroids and NSAIDs need to be considered in the hope of preventing the inflammatory response from evolving into the proliferative phase of arachnoiditis.
Moon, Tae Yong; Jeong, Hee Seok; Jeong, Yeo Jin [Pusan National University and Research Institute for Convergence of Biomedical Science and Technology, Dept. of Radiology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of); Lee, In Sook [Dept. of Radiology, Pusan National University Hospital, Busan (Korea, Republic of)
To determine the computed tomography (CT) findings predictive of neurological deficits in thoracolumbar spine injuries. One hundred two patients with thoracolumbar spinal burst fractures, after excluding the patients with brain and cervical cord injuries and unconsciousness, who underwent consecutive spine 128-multidetector CT scan formed the study group. The neurological findings were clinically classified as no deficit (n = 58), complete deficit with paraplegia (n = 22), and incomplete deficit with either motor or sensory impairment (n = 22). The following four CT imaging parameters were analyzed: the level of the main burst fracture as the cord (n = 44) and the cauda equina (n = 58) levels; the extent of canal encroachment as central canal ratios (CCRs) below 0.5 (n = 43) and above 0.5 (n = 59); the degree of laminar fracture as no fracture (n = 33), linear fracture (n = 7), separated fracture (n = 27), and displaced fracture (n = 35); fractured vertebra counted as single (n = 53) and multiple (n = 49). Complete neurological deficit was associated with injuries at the cord level (p = 0.000) and displaced laminar fractures (p = 0.000); incomplete neurological deficit was associated with CCRs below 0.5 (p = 0.000) and multiple vertebral injuries (p = 0.002). CT scan can provide additional findings predictive of neurological deficits in thoracolumbar spinal burst fractures.
Ghobrial, George M; Williams, Kim A; Arnold, Paul; Fehlings, Michael; Harrop, James S
Iatrogenic neurologic deficits after lumbar spine surgery are rare complications, but important to recognize and manage. Complications such as radiculopathy, spinal cord compression, motor deficits (i.e. foot drop with L5 radiculopathy), and new onset radiculitis, while uncommon do occur. Attempts at mitigating these complications with the use of neuromonitoring have been successful. Guidance in the literature as to the true rate of iatrogenic neurologic deficit is limited to several case studies and retrospective designed studies describing the management, prevention and treatment of these deficits. The authors review the lumbar spinal surgery literature to examine the incidence of iatrogenic neurologic deficit in the lumbar spinal surgery literature. An advanced MEDLINE search conducted on May 14th, 2015 from January 1, 2004 through May 14, 2015, using the following MeSH search terms "postoperative complications," then subterms "lumbar vertebrae," treatment outcome," "spinal fusion," and "radiculopathy" were included together with "postoperative complications" in a single search. Postoperative complications including radiculopathy, weakness, and spinal cord compression were included. The definition of iatrogenic neurologic complication was limited to post-operative radiculopathy, motor weakness or new onset pain/radiculitis. An advanced MEDLINE search conducted on May 14th, 2015 using all of the above terms together yielded 21 results. After careful evaluation, 11 manuscripts were excluded and 10 were carefully reviewed. The most common indications for surgery were degenerative spondylolisthesis, spondylosis, scoliosis, and lumbar stenosis. In 2783 patients in 12 total studies, there were 56 patients who had reported a postoperative neurologic deficit for a rate of 5.7. The rates of deficits ranged from 0.46% to 17% in the studies used. The average rate of reported neurologic complications within these papers was 9% (range 0.46-24%). Thirty patients of a total of
World-famous Mexican painter Frida Kahlo is an impressive example of a professional artist whose artistic subject matter was extremely influenced by her chronic, severe illness. Many of her best-known works depict her physical and mental suffering. She was one of those very uncommon artists who dared to show their nude, sick body. This chapter describes and explains the biographical events and works of Frida Kahlo that are closely related to neurology: congenital anomaly (spina bifida), poliomyelitis, spine injury, and neuropathic pain. © 2013 Elsevier B.V. All rights reserved.
Kemp, S.; Allan, R. S.; Patanjali, N.; Barnett, M. H.; Jonker, B. P.
We report a unique case of neurological deficit from late onset multiple sclerosis (MS), in a 65-year-old woman, after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). At 3.5months post-SRS for TN, the patient developed ataxia and left leg paraesthesiae and brain MRI showed altered
Prechtl, HFR; Einspieler, C; Cioni, G; Bos, AF; Ferrari, F; Sontheimer, D
Background In normal awake infants, fidgety movements are seen from the age of 6 weeks to 20 weeks. The aim of the study was to test the predictive value of absent or abnormal spontaneous movements in young infants for the later development of neurological deficits. Methods In a collaborative study
Thomas A. Buckley
Full Text Available Concussion, or mild traumatic brain injury, incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom. The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control. The current acute evaluation for concussion utilizes the subjective balance error scoring system (BESS to assess postural control. While the sensitivity of the overall test battery is high, the sensitivity of the BESS is unacceptably low and, with repeat administration, is unable to accurately identify recovery. Sophisticated measures of postural control, utilizing traditional linear assessments, have identified impairments in postural control well beyond BESS recovery. Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion. Recently, the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy (ApEn. ApEn, most commonly in the medial-lateral plane, has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values; unfortunately these studies have not gone beyond the acute phase of recovery. One study has identified lingering deficits in postural control, utilizing Shannon and Renyi entropy metrics, which persist at least through clinical recovery and return to participation. Finally, limited evidence from two studies suggest that individuals with a previous history of a single concussion, even months or years prior, may display altered ApEn metrics. Overall, non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.
Boutrous, Mina L; Afifi, Rana O; Safi, Hazim J; Estrera, Anthony L
Delayed neurologic deficit (DND) is a devastating adverse event after thoracoabdominal aortic aneurysm repair. Multiple adjuncts have been devised to counteract the development of DND, most notably cerebrospinal fluid (CSF) drainage. We report a case of a 63-year-old woman in whom DND developed four times during the first 10 days after her thoracoabdominal aortic operation. This necessitated lumbar drain "weaning" to allow for a slowly rising CSF pressure and preservation of lower extremity motor function. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Skyhøj Olsen, T; Friberg, L; Lassen, N A
This study investigates whether the cerebral blood flow reduction occurring in attacks of classic migraine is sufficient to cause neurologic deficits. Regional cerebral blood flow measured with the xenon 133 intracarotid injection technique was analyzed in 11 patients in whom a low-flow area...... ischemia and neurologic deficits. Hence, this study suggests a vascular origin of the prodromal neurologic deficits that may accompany attacks of classic migraine....
Kelly, Michael P; Lenke, Lawrence G; Godzik, Jakub; Pellise, Ferran; Shaffrey, Christopher I; Smith, Justin S; Lewis, Stephen J; Ames, Christopher P; Carreon, Leah Y; Fehlings, Michael G; Schwab, Frank; Shimer, Adam L
OBJECTIVE The authors conducted a study to compare neurological deficit rates associated with complex adult spinal deformity (ASD) surgery when recorded in retrospective and prospective studies. Retrospective studies may underreport neurological deficits due to selection, detection, and recall biases. Prospective studies are expensive and more difficult to perform, but they likely provide more accurate estimates of new neurological deficit rates. METHODS New neurological deficits were recorded in a prospective study of complex ASD surgeries (pSR1) with a defined outcomes measure (decrement in American Spinal Injury Association lower-extremity motor score) for neurological deficits. Using identical inclusion criteria and a subset of participating surgeons, a retrospective study was created (rSR1) and neurological deficit rates were collected. Continuous variables were compared with the Student t-test, with correction for multiple comparisons. Neurological deficit rates were compared using the Mantel-Haenszel method for standardized risks. Statistical significance for the primary outcome measure was p spinal deformities, and exclusion criteria were identical. Sagittal Cobb measurements were higher in pSR1, although sagittal alignment was similar. Preoperative neurological deficit rates were similar in the groups. Three-column osteotomies were more common in pSR1, particularly vertebral column resection. New neurological deficits were more common in pSR1 (pSR1 17.3% [95% CI 12.6-22.2] and rSR1 9.0% [95% CI 5.0-13.0]; p = 0.01). The majority of deficits in both studies were at the nerve root level, and the distribution of level of injury was similar. CONCLUSIONS New neurological deficit rates were nearly twice as high in the prospective study than the retrospective study with identical inclusion criteria. These findings validate concerns regarding retrospective cohort studies and confirm the need for and value of carefully designed prospective, observational cohort
Stine, O C; Saratsiotis, J B; Mosser, R S
Five hundred seventy-five children from low-income urban neighborhoods who were between 10 and 12 years of age were examined by pediatricians for certain neurological signs. Classroom teachers ranked each child according to types of behavior. Data on neurological signs found in more than 15 children and on types of classroom behavior clinically expected to be related to central nervous system defects were studied statistically. Significant positive associations were found between nystagmus and hyperactivity, mixed dominance and hyperactivity, and mixed dominance and variable day-to-day performance. Errors in moving parts of the body on verbal command were associated with distractibility and underachievement. Head circumference greater than the 90th percentile for age was associated with unvarying behavior and clumsiness; tactile agnosia with unvarying behavior; asymmetry of the eyes with hyperactivity; and asymmetrical position of the child's head with underachievement. A negative association was found between nystagmus and musical ability.
Royakkers, A.A.; Willigers, H.; Ven, A.J.A.M. van der; Wilmink, J.T.; Durieux, M.; Kleef, M. van
Epidural abscess is a rare but serious complication of epidural anesthesia for peri- and postoperative analgesia. It is feared because of possible persistent neurological deficits. Epidural abscess presents mostly with a classic triad of symptoms: back pain, fever and variable neurological signs and
Liu, Hao; Sun, Xiaowei; Zou, Wei; Leng, Mengtong; Zhang, Beng; Kang, Xiaoyu; He, Tao; Wang, Hui
Hemorrhagic stroke accounts for approximately 15% of all stroke cases, and is associated with high morbidity and mortality. Limited human studies suggested that scalp acupuncture could facilitate functional recovery after cerebral hemorrhage. In the current study, we used an animal model of cerebral hemorrhage to examine the potential effects of scalp acupuncture. Adult male Sprague-Dawley rats received autologous blood (50μL) into the right caudate nucleus on the right side under pentobarbital anesthesia, and then received scalp acupuncture (DU20 through GB7 on the lesion side) or sham acupuncture (1cm to the right side of the acupoints) (n=10 per group). A group of rats receiving autologous blood into the caudate nucleus but no other intervention, as well as a group of rats receiving anesthesia but no blood injection to the brain (n=10 per group) were included as additional controls. Composite neuroscore, corner turn test, forelimb placing test, wire hang task and beam walking were used to evaluate the behavior of rats. Hematoxylin and Eosin (HE) staining was used to observe the histopathological changes. Western blot was used to detect the content of tumor necrosis factor alpha (TNF-α) and nuclear factor-KappaB (NFκB) protein expression. Scalp acupuncture attenuated neurological deficits (pvs. sham acupuncture using a variety of behavioral tests) at 1-7days after the treatment. The brain content of TNF-α and NFκB was decreased (pacupuncture could improve neurological deficits in a rat model of hemorrhagic stroke. Copyright © 2017 Elsevier Ltd. All rights reserved.
World-famous Mexican painter Frida Kahlo is an impressive example of an artist whose entire life and creativity were extremely influenced by chronic, severe illness. Many of her best-known works depict her physical and mental suffering. She was one of those very uncommon artists who dared to show their nude, sick body. This article describes biographical events and works of Frida Kahlo that are closely related to neurology: congenital anomaly (spina bifida), poliomyelitis, spine injury, neuropathic pain.
Smith, P M; Talbot, C E; Jeffery, N D
Recurrent seizuring is a common neurological problem in dogs and can present diagnostic difficulties for the attending clinician. Associated interictal neurological deficits strongly suggest brain disease but the frequency of structural abnormalities in patients without such deficits is unknown. In this study the prevalence of clinically significant magnetic resonance imaging (MRI) abnormalities was determined in two groups of interictally normal dogs, those younger than 6 years and those older than 6 years of age. In the former group, only 1/46 dogs (2.2%) had significant MRI abnormalities, whereas in the latter group, 8/30 (26.7%) were abnormal. None of the dogs had an identifiable metabolic cause for the seizures. These findings suggest that the diagnostic yield of advanced neuroimaging techniques in young seizuring dogs without interictal neurological deficits is low, but reaffirms their value in similar older individuals.
Full Text Available Our objective was to characterize the saccadic eye movements in patients with type 3 Gaucher disease (chronic neuronopathic in relationship to neurological and neurophysiological abnormalities. For approximately 4 years, we prospectively followed a cohort of 15 patients with Gaucher type 3, ages 8-28 years, by measuring saccadic eye movements using the scleral search coil method. We found that patients with type 3 Gaucher disease had a significantly higher regression slope of duration vs amplitude and peak duration vs amplitude compared to healthy controls for both horizontal and vertical saccades. Saccadic latency was significantly increased for horizontal saccades only. Downward saccades were more affected than upward saccades. Saccade abnormalities increased over time in some patients reflecting the slowly progressive nature of the disease. Phase plane plots showed individually characteristic patterns of abnormal saccade trajectories. Oculo-manual dexterity scores on the Purdue Pegboard test were low in virtually all patients, even in those with normal cognitive function. Vertical saccade peak duration vs amplitude slope significantly correlated with IQ and with the performance on the Purdue Pegboard but not with the brainstem and somatosensory evoked potentials. We conclude that, in patients with Gaucher disease type 3, saccadic eye movements and oculo-manual dexterity are representative neurological functions for longitudinal studies and can probably be used as endpoints for therapeutic clinical trials.ClinicalTrials.gov NCT00001289.
Honczarenko, K; Ostanek, L; Grzelec, H; Fabian, A; Fiedorowicz-Fabrycy, I; Fryze, C
27 patients (22 women, 5 men); age 17 to 56 yr. (mean age 37 yr.) were included in this study, 4 had primary antiphospholipid syndrome and 18 secondary antiphospholipid syndrome in the course of systemic connective tissue disease and in 5 cases increased levels of anticardiolipid antibodies were found which did not meet the criteria necessary for diagnosis of secondary antiphospholipid syndrome. The mean duration of the disease was 8 yrs. Among primary antiphospholipid syndrome patients two had ischaemic stroke, one migraine-like headache and seizures. 18 patients had lupus erythematosus, two mixed connective tissue disease, one rheumatoid arthritis, one Sjögren syndrome, one Behçet disease. In 55% of patients migraine-like headache, polyneuropathies, encephalophaties, stroke, seizures and vision disturbances were present. In 18.5% of patients EEG exam revealed focal lesions with tendency for generalisation. On brain stem auditory evoked potentials examination, in 11.1% of patients conductivity lesions in mesencephalon and pons were found, visual evoked potentials, in 11.1% of patients in visual tracts. In 37% of patients, neuropathy was found on EMG exam. Neurological symptoms are one of the most frequent disorders in systemic connective tissue disease associated with the presence of anicardiolipin antibodies.
Schmal, Hagen; Hauschild, Oliver; Culemann, Ulf
This multicenter register study was performed to define injury and fracture constellations that are at risk to develop pelvic associated neural lesions. Data of 3607 patients treated from 2004 to 2009 for pelvic fractures were evaluated for neurological deficits depending on Tile classification, ...
Renno, T; Taupin, V; Bourbonnière, L
The cytokine interferon-gamma (IFNgamma) is implicated in the induction of acute CNS inflammation, but it is less clear what role if any IFNgamma plays in progression to chronic demyelination and neurological deficit. To address this issue, we have expressed IFNgamma in myelinating oligodendrocyt...
Bryan, Laura K; Hamer, Sarah A; Shaw, Sarah; Curtis-Robles, Rachel; Auckland, Lisa D; Hodo, Carolyn L; Chaffin, Keith; Rech, Raquel R
A 10-year-old Quarter Horse gelding presented to the Texas A&M University Veterinary Teaching Hospital with a six month-history of ataxia and lameness in the hind limbs. The horse was treated presumptively for equine protozoal myeloencephalitis (EPM) based on clinical signs but was ultimately euthanized after its condition worsened. Gross lesions were limited to a small area of reddening in the gray matter of the thoracic spinal cord. Histologically, trypanosome amastigotes morphologically similar to Trypanosoma cruzi, the agent of Chagas disease in humans and dogs, were sporadically detected within segments of the thoracic spinal cord surrounded by mild lymphoplasmacytic inflammation. Ancillary testing for Sarcocystis neurona, Neospora spp., Toxoplasma gondii and Leishmania spp. was negative. Conventional and real time polymerase chain reaction (PCR) of affected paraffin embedded spinal cord were positive for T. cruzi, and sequencing of the amplified T. cruzi satellite DNA PCR fragment from the horse was homologous with various clones of T. cruzi in GenBank. While canine Chagas disease cases have been widely reported in southern Texas, this is the first report of clinical T. cruzi infection in an equid with demonstrable amastigotes in the spinal cord. In contrast to previous instances of Chagas disease in the central nervous system (CNS) of dogs and humans, no inflammation or T. cruzi amastigotes were detected in the heart of the horse. Based on clinical signs, there is a potential for misdiagnosis of Chagas disease with other infectious diseases that affect the equine CNS. T. cruzi should be considered as a differential diagnosis in horses with neurologic clinical signs and histologic evidence of meningomyelitis that originate in areas where Chagas disease is present. The prevalence of T. cruzi in horses and the role of equids in the parasite life cycle require further study. Copyright © 2015 Elsevier B.V. All rights reserved.
Schmal, Hagen; Hauschild, Oliver; Culemann, Ulf; Pohlemann, Tim; Stuby, Fabian; Krischak, Gert; Südkamp, Norbert P
This multicenter register study was performed to define injury and fracture constellations that are at risk to develop pelvic associated neural lesions. Data of 3607 patients treated from 2004 to 2009 for pelvic fractures were evaluated for neurological deficits depending on Tile classification, pelvic injury configuration, and treatment.In 223 patients (6.5%), neurological lesions were diagnosed on the day of discharge from the hospital. The degree of instability of the pelvic fracture correlated with occurrence of nerve lesions. Rate of neurological dysfunction increased from 1.5% in type A fractures to 14.4% in type C fractures (P<.001). As the most endangered anatomical regions in pelvic fractures, the roots L5 (18.3%) and S1 (15.6%) and isolated peripheral nerves (19.2%) were identified. Patients sustaining complex pelvic trauma (7.85%) suffered from significantly more neurological dysfunctions (33.5%) compared to patients without peripelvic organ or soft tissue injuries (P<.001). Whereas stable type A3 sacral fractures were not associated with a different risk to develop neurological deficits (3.8%), unstable sacral fractures with the need for operative fixation showed an increased rate of accompanying nerve lesions (15.4%; P<.001). Twenty-one (11.5%) operative sacral stabilizations were supplemented with nerve root decompression (mainly S1). Neurological complications in the course of treatment were seen in 69 cases (1.9%).A high degree of instability, complex pelvic trauma, and unstable sacral fractures predispose for additional neurological deficits in patients with pelvic fractures. Copyright 2010, SLACK Incorporated.
Hansen, Martin Rune Hassan; Jørs, Erik; Lander, Flemming
Pyrethroid pesticides have been suggested to be a cause of Parkinson disease and other neurodegenerative diseases. To investigate this, a cross-sectional study was conducted among 120 Bolivian public health vector program spray men, primarily exposed to pyrethroids. Pesticide exposure and central...... nervous system (CNS) symptoms were determined by a structured interview, whereas neuromotor and neurocognitive performance was assessed using the computerized Behavioral Assessment and Research System and CATSYS system. Individuals exposed to higher levels reported significantly more CNS symptoms...... quintile = -0.405 [-0.660 to -0.150]), and workers only exposed to pyrethroids performed worse than workers also exposed to other pesticides (adjusted β = -1.344 [-2.224 to -0.464]). Chronic pyrethroid exposure may cause deterioration in neurocognitive performance, and exposure control is recommended....
Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei
Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage. The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year. Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit. PMID:26512572
Tötterman, Anna; Hellund, Johan C; Glott, Thomas; Madsen, Jan Erik; Røise, Olav
Background and purpose Neurological deficits and pain are common after displaced sacral fractures. However, little is known about the association between the long-term clinical outcomes and radiological findings. We examined the long-term radiological findings and their correlations with lumbosacral pain and neurological deficits in the lower extremities after surgery for sacral fractures. Methods 28 consecutive patients with operatively treated displaced sacral fractures were followed for mean 11 (8–13) years. Sensorimotor impairments of the lower extremities were classified according to the American Spinal Injury Association (ASIA). Pain was assessed using a visual analog scale (VAS). All patients underwent conventional radiographic examination and CT, and the images were scrutinized for nonunion, residual displacement, narrowing of the sacral foramina, and post-foraminal encroachment of the L5 and S1 nerves. Results There was residual displacement of ≥ 10 mm in 16 of the 28 patients. 26 patients had narrowing of 1 or more neural root foramina in L5-S4. 8 patients reported having no pain, 11 had pain only in the lumbosacral area, and 9 had pain in combination with radiating leg pain. Statistically significant correlations were found between narrowing of the sacral foramina and neurological deficits in the corresponding dermatomes. Significant correlations were also found between post-foraminal encroachment of L5 nerves and both sensory and motor deficits. No correlations were found between pain and radiological findings. Interpretation Pathological radiological findings are common 11 years after operatively treated displaced sacral fractures. Sacral foraminal and L5 post-foraminal bony encroachments were common findings and correlated with neurological deficits. However, lumbosacral pain did not correlate with radiological sequelae after fracture healing. PMID:24694272
Full Text Available Abstract Background Intracerebral hemorrhage (ICH remains a serious clinical problem lacking effective treatment. Urocortin (UCN, a novel anti-inflammatory neuropeptide, protects injured cardiomyocytes and dopaminergic neurons. Our preliminary studies indicate UCN alleviates ICH-induced brain injury when administered intracerebroventricularly (ICV. The present study examines the therapeutic effect of UCN on ICH-induced neurological deficits and neuroinflammation when administered by the more convenient intraperitoneal (i.p. route. Methods ICH was induced in male Sprague-Dawley rats by intrastriatal infusion of bacterial collagenase VII-S or autologous blood. UCN (2.5 or 25 μg/kg was administered i.p. at 60 minutes post-ICH. Penetration of i.p. administered fluorescently labeled UCN into the striatum was examined by fluorescence microscopy. Neurological deficits were evaluated by modified neurological severity score (mNSS. Brain edema was assessed using the dry/wet method. Blood-brain barrier (BBB disruption was assessed using the Evans blue assay. Hemorrhagic volume and lesion volume were assessed by Drabkin's method and morphometric assay, respectively. Pro-inflammatory cytokine (TNF-α, IL-1β, and IL-6 expression was evaluated by enzyme-linked immunosorbent assay (ELISA. Microglial activation and neuronal loss were evaluated by immunohistochemistry. Results Administration of UCN reduced neurological deficits from 1 to 7 days post-ICH. Surprisingly, although a higher dose (25 μg/kg, i.p. also reduced the functional deficits associated with ICH, it is significantly less effective than the lower dose (2.5 μg/kg, i.p.. Beneficial results with the low dose of UCN included a reduction in neurological deficits from 1 to 7 days post-ICH, as well as a reduction in brain edema, BBB disruption, lesion volume, microglial activation and neuronal loss 3 days post-ICH, and suppression of TNF-α, IL-1β, and IL-6 production 1, 3 and 7 days post
Onu, David O; Hunn, Andrew W; Bohmer, Robert D
The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.
Qiao, Jun; Xiao, Liangyan; Zhu, Zezhang; Xu, Leilei; Qian, Bangping; Liu, Zhen; Sun, Xu; Qiu, Yong
To our knowledge, few studies have focused on delayed postoperative neurologic deficit (DPND) after spine deformity surgery. This study was intended to investigate the incidence, risk factors, treatments, and outcomes of DPND after corrective surgery for spinal deformity in a single spine center. The database of a single spine center was queried for dates from 2002 to 2014 to identify all spinal deformity cases. The variables extracted included patient age, diagnosis, procedure, whether neuromonitoring was used and if so which methods were used, whether neuromonitoring abnormalities were detected, whether new neurologic deficits occurred, whether implants were used, and the degree of recovery from new neurologic deficits (none, partial, complete). The patients were classified as pediatric (<21 years old) or adult (≥21 years old). The rates of DPND were tabulated and stratified on the basis of age, diagnosis, and surgical features. A total of 5377 cases were investigated from 2002 through 2014. Seven cases of DPND were reported (incidence, 0.13%). For adult patients, the overall incidence of DPND was 0.17%, and for pediatric patients, it was 0.10%. The incidence of DPND was 0.35% when osteotomies were performed and 0.05% without osteotomies. After the onset of neurologic deficits, loss of somatosensory evoked potentials occurred in 1 patient, and loss of motor evoked potentials occurred in all 7 patients. Revision surgery was performed for 3 patients. At the last follow-up visit, 1 patient experienced no recovery, 2 partial recovery, and 5 complete recovery. The incidence of DPND is low. Old age and osteotomies are risk factors for DPND. Most patients with DPND experience varying degrees of recovery. Copyright © 2017 Elsevier Inc. All rights reserved.
Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei
Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fract...
Full Text Available Attention deficit hyperactivity disorder (ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Soft neurological signs (SNS are minor neurological abnormalities in motor performance, and are used as one evaluation method for neurodevelopmental delays in children with ADHD. Our aim is to establish a quantitative evaluation system for children with ADHD. We focused on the arm movement called pronation and supination, which is one such soft neurological sign. Thirty three children with ADHD aged 7–11 years (27 males, six females and twenty five adults participants aged 21–29 years old (19 males, six females participated in our experiments. Our results suggested that the pronation and supination function in children with ADHD has a tendency to lag behind that of typically developing children by several years. From these results, our system has a possibility to objectively evaluate the neurodevelopmental delay of children with ADHD.
Ito, Manabu; Abumi, Kuniyoshi; Kotani, Yoshihisa; Takahata, Masahiko; Hojo, Yoshihiro; Minami, Akio
The number of reports describing osteoporotic vertebral fracture has increased as the number of elderly people has grown. Anterior decompression and fusion alone for the treatment of vertebral collapse is not easy for patients with comorbid medical problems and severe bone fragility. The purpose of the present study was to evaluate the efficacy of one-stage posterior instrumentation surgery for the treatment of osteoporotic vertebral collapse with neurological deficits. A consecutive series of 21 patients who sustained osteoporotic vertebral collapse with neurological deficits were managed with posterior decompression and short-segmental pedicle screw instrumentation augmented with ultra-high molecular weight polyethylene (UHMWP) cables with or without vertebroplasty using calcium phosphate cement. The mean follow-up was 42 months. All patients showed neurologic recovery. Segmental kyphotic angle at the instrumented level was significantly improved from an average preoperative kyphosis of 22.8–14.7 at a final follow-up. Spinal canal occupation was significantly reduced from an average before surgery of 40.4–19.1% at the final follow-up. Two patients experienced loosening of pedicle screws and three patients developed subsequent vertebral compression fractures within adjacent segments. However, these patients were effectively treated in a conservative fashion without any additional surgery. Our results indicated that one-stage posterior instrumentation surgery augmented with UHMWP cables could provide significant neurological improvement in the treatment of osteoporotic vertebral collapse. PMID:20157741
Qiu, Yong; Wang, Shoufeng; Wang, Bin; Yu, Yang; Zhu, Feng; Zhu, Zezhang
A retrospective study. To investigate the incidence of neurologic deficits after scoliosis correction at 1 institution and identify the risk factors for such deficits in scoliosis correction. Neurologic deficit is one of the risks of surgical correction of scoliosis. Reports of the incidence of the neurologic deficits involving a large number of cases at 1 institution are rare. Statistical analysis of the neurologic deficits was performed in 1373 scoliosis cases treated at 1 institution by etiologies in light of the patients' sex, age, sagittal profile, surgical approach, Cobb's angle, and the type of surgery. The total incidence of neurologic deficits was 1.89% and that of serious and mild ones was 0.51% and 1.38%, respectively. The total incidence of neurologic deficits were 1.06% in adolescent idiopathic scoliosis patients and 2.89% in congenital scoliosis (CS) patients, 3.32% in scoliosis patients with hyperkyphosis (>40 degrees ) and 1.38% in those without hyperkyphosis, 3.43% for combined procedures and 1.24% for single posterior procedures, 3.69% in patients with Cobb's angle more than 90 degrees and 1.45% in those with an angle less than 90 degrees , 1.68% with primary surgery and 5.97% with revision surgery, the difference between them was significant (P hyperkyphosis and 0.61% without hyperkyphosis, the difference between them was significant (P hyperkyphosis, scoliosis correction by combined procedures, scoliosis with a Cobb's angle more than 90 degrees , and a revision surgery.
Gonçalves, Daniel; Meireles, Joana; Rocha, Ruben; Sampaio, Mafalda; Leão, Miguel
The syndrome of transient headache and neurologic deficits associated with cerebrospinal fluid lymphocytosis (HaNDL) is characterized by 1 or more episodes of severe headache, transient neurologic deficits, and lymphocytic pleocytosis in the cerebrospinal fluid. It is a benign and self limited disorder seldom reported in pediatric age. We report the case of a 14-year-old girl who suffered from 2 episodes of headache with transient focal neurologic deficits and pleocytosis consistent with the syndrome of HaNDL. This entity should be taken into account as a differential diagnosis in otherwise healthy children presenting with recurrent headache and acute neurologic deficits. Repeated use of invasive and expensive laboratory and imaging investigations can be avoided when the diagnosis of the syndrome of HaNDL is correctly established.
Hoeger, Harald; Bubna-Littitz, Herrmann; Engelmann, Mario; Schwerdtner, Ingrid; Schmid, Diethard; Lahoda, Robert; Seidl, Rainer; Lubec, Gert; Lubec, Barbara
In a recent publication, we described neurodegeneration along with neurotransmitter deficits and impaired differentiation in the guinea pig 3 months following severe perinatal asphyxia (PA). We were therefore interested in the clinical features in terms of neurology, cognitive functions, and behavior. We tested the long-term effects of PA in an animal model, which in the rat are well documented and resemble the clinical situation. Examinations consisted of an observational battery for motor and reflex functions and the acoustic startle response setting. We tested cognitive functions in the multiple T-maze and evaluated behavior using the elevated plus maze and open field studies. No neurologic deficits were observed in the observational battery, including the acoustic startle response. Cognitive functions of memory and learning were not impaired in the multiple T-maze. In the open field and in the elevated plus maze, the system to test anxiety-related behavior, guinea pigs performed well. Our findings of patent neurology, cognitive functions, and behavior do not reflect the prominent morphologic findings of neurodegeneration. This is in agreement with corresponding studies on PA in the rat at the identical time point. We learned from this study that both test systems, although representing the standard in neuroscience, are either not sensitive enough or central nervous system lesions are clinically fully compensated.
Venna, S; Hurri, H; Alaranta, H
The purpose of the study was to examine how neurological deficits of the leg, i.e. sensory deficit, deficient reflexes and muscular weakness, correlate with reaction times of upper limbs in a group with chronic low-back pain. Thirty-two patients were studied. Three sets of measurements of simple reaction time and choice reaction time of upper limbs were conducted at one-week intervals. Neurological deficits of the leg were recorded by a physician and the subjects answered a questionnaire about the severity of their low-back symptoms (Oswestry's index). We also defined a neurological index which reflected the total sum of the three types of leg deficits experienced by each of the subjects. Sensory deficit of the leg and the neurological index correlated strongly with slower reaction times of upper limbs, while the other two neurological deficits did not reach a level of significance. Sensory deficits of the leg seem to be an indicator of much greater motor disability than has been thought so far. The motor disability not only appears distally from the lumbar radicular damage caused for example by an intervertebral herniation, it also seems to relate to psychomotor reaction more generally, even on upper limbs.
Spinal cord injury (SCI) is associated with worst outcomes and requires a prolonged rehabilitation. Ayurvedic indigenous methods of rehabilitation are often utilized to treat such conditions. A case of SCI was followed up for 3 months upon an Ayurvedic composite intervention and subsequently reported. The composite treatment plan involved Ayurvedic oral medications as well as a few selected external and internal pancha karma procedures. A substantial clinical and patient centered outcome improvement in existing neurological deficits and quality of life was observed after 3 months of the Ayurvedic treatment given to this case. PMID:24812477
Full Text Available Spinal cord injury (SCI is associated with worst outcomes and requires a prolonged rehabilitation. Ayurvedic indigenous methods of rehabilitation are often utilized to treat such conditions. A case of SCI was followed up for 3 months upon an Ayurvedic composite intervention and subsequently reported. The composite treatment plan involved Ayurvedic oral medications as well as a few selected external and internal pancha karma procedures. A substantial clinical and patient centered outcome improvement in existing neurological deficits and quality of life was observed after 3 months of the Ayurvedic treatment given to this case.
Jiang, Lei-Sheng; Shen, Lei; Wang, Wei; Wu, Hao; Dai, Li-Yang
Traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process is very rare, and only ten cases have been previously reported. The objective of this paper was to describe a case of traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process, and its management with atlantoaxial transarticular screw fixation and bony fusion through an anterior retropharyngeal approach, and to review the relevant literature. The patient's medical and radiographic history is reviewed as well as the relevant medical literature. Posterior atlantoaxial dislocation was confirmed in a 48-year-old male struck by an automobile through conventional radiography, computed tomography and magnetic resonance imaging. No related fracture of the odontoid process or neurological deficit was found in this patient. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach was performed after several unsuccessful attempts of closed reduction. At the latest follow-up, the lateral cervical spine radiography in flexion and extension demonstrated no instability of the atlantoaxial complex 21 months after the operation. In conclusion, patients with posterior atlantoaxial dislocation without fracture may survive with few or no-long term neurological deficit. Routine CT and MRI of the cervical spine should be carried out in patients with head or neck trauma to prevent missing of this rare clinical entity. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach is safe and useful in case the management of dislocation is unsuccessful under closed reduction.
Full Text Available Mammalian target of rapamycin (mTOR is a serine/threonine protein kinase and activation of its signal pathway plays an important role in regulating protein growth and synthesis as well as cell proliferation and survival. In the present study, we examined the contribution of mTOR and its downstream products to brain injuries and neurological deficiencies after cardiac arrest (CA induced-transient global ischemia. CA was induced by asphyxia followed by cardiopulmonary resuscitation (CPR in rats. Our results showed that expression of p-mTOR, mTOR-mediated phosphorylation of 4E-binding protein 4 (4E-BP1 and p70 ribosomal S6 protein kinase 1 (S6K1 pathways were amplified in CA rats compared to their controls. Blocking mTOR using rapamycin attenuated upregulation of pro-inflammatory cytokines (namely IL-1β, IL-6 and TNF-α, and Caspase-3, indicating cell apoptosis and also promoting the levels of vascular endothelial growth factor (VEGF and its subtype receptor VEGFR-2 in the hippocampus. Moreover, the effects of rapamycin were linked to improvement of neurological deficits and increased brain water content observed in CA rats. In conclusion, activation of mTOR signal is engaged in pathophysiological process during CA-induced transient global ischemia and blocking mTOR pathway plays a beneficial role in regulating injured neuronal tissues and neurological deficits via PIC, apoptotic Caspase-3 and VEGF mechanisms. Targeting one or more of these specific mTOR pathways and its downstream signaling molecules may present new opportunities for neural dysfunction and vulnerability related to transient global ischemia.
Shamji, Mohammed F; Roffey, Darren M; Young, Darryl K; Reindl, Rudy; Wai, Eugene K
Prospective, 2-center, observer-blinded, randomized controlled trial. Investigate clinical and radiologic outcomes of bracing versus no-bracing in the treatment of stable thoracolumbar burst fractures. Management of thoracolumbar burst fractures depends upon clinical presentation of neurological deficit and radiographic features of fracture severity. Neurologically intact patients with mild deformity and biomechanical stability may be treated with conservative therapy. Patients with stable (AO type A3), single level, thoracolumbar burst fractures between T12 and L2 with no neurological deficit were randomized to nonoperative treatment with a customized thoracolumbosacral orthosis (TLSO) or no-brace. Self-reported clinical outcomes of pain, disability, and health-related quality of life, and radiographic outcomes of kyphotic progression and loss of vertebral height, assessed by 2 independent reviewers blinded to treatment group, were measured at 6 months follow-up. Twenty-three consecutive eligible patients were included (TLSO: n=12; no-brace: n=11). There were no between-group differences regarding level of injury (P=0.75) and baseline spine geometry including fractional canal compromise (P=0.49), anterior loss of vertebral body height (P=0.28), and sagittal Cobb angle (P=0.13). In-hospital stay was significantly shorter in the no-brace group (mean: 2.8±3.0 d) compared with the TLSO group (mean: 6.3±2.1 d; P=0.004). At follow-up there were no differences in anterior loss of vertebral body height (TLSO: 12.5%±10.2% vs. no-brace: 11.9%±8.1%; P=0.88), kyphotic progression (TLSO: 5.3±4.4 degrees vs. no-brace 5.2±3.6 degrees; P=0.93), adverse events, or self-reported clinical outcomes. Neurologically intact patients with stable thoracolumbar burst fractures treated with or without bracing had similar radiographic and clinical outcomes at 6 months follow-up. The no-brace group had shorter in-hospital lengths of stay. Conservative therapy involving early
Mark Joseph M. Desamero; Mikaela Angelica Villablanca; Jussiaea V. Bariuan; Therese Marie A. Collantes; Delia T. Ang Gobonseng; Mary Jasmin C. Ang; Alejandro C. Fajardo Jr; Cleofas R. Cervancia; Maria Amelita C. Estacio
Summary. The effect of honey and propolis on the neurologic deficit and neural damage in extracranial internal carotid artery occlusion ischemic stroke was investigated using male Sprague-Dawley rats which were randomly allocated into distilled water, propolis and honey treated groups. Neurologic motor assessment was performed daily during the 7-day treatment period and brain samples were processed and analyzed by histopathological approach. Oral administration of honey and propolis from the ...
Wang, Ligang; Wang, Libo; Dai, Zhibo; Wu, Pei; Shi, Huaizhang; Zhao, Shiguang
Oxidative stress has been strongly implicated in the pathogenesis of traumatic brain injury (TBI). Mitochondrial ferritin (Ftmt) is reported to be closely related to oxidative stress. However, whether Ftmt is involved in TBI-induced oxidative stress and neurological deficits remains unknown. In the present study, the controlled cortical impact model was established in wild-type and Ftmt knockout mice as a TBI model. The Ftmt expression, oxidative stress, neurological deficits, and brain injury were measured. We found that Ftmt expression was gradually decreased from 3 to 14 days post-TBI, while oxidative stress was gradually increased, as evidenced by reduced GSH and superoxide dismutase levels and elevated malondialdehyde and nitric oxide levels. Interestingly, the extent of reduced Ftmt expression in the brain was linearly correlated with oxidative stress. Knockout of Ftmt significantly exacerbated TBI-induced oxidative stress, intracerebral hemorrhage, brain infarction, edema, neurological severity score, memory impairment, and neurological deficits. However, all these effects in Ftmt knockout mice were markedly mitigated by pharmacological inhibition of oxidative stress using an antioxidant, N-acetylcysteine. Taken together, these results reveal an important correlation between Ftmt and oxidative stress after TBI. Ftmt deficiency aggravates TBI-induced brain injuries and neurological deficits, which at least partially through increasing oxidative stress levels. Our data suggest that Ftmt may be a promising molecular target for the treatment of TBI. © 2017 The Author(s).
Yilmaz, A; Kaleagasi, H; Dogu, O; Kara, E; Ozge, A
A 27-year-old woman was admitted to the Emergency Department with right upper-extremity numbness and mild weakness followed by a bifrontal throbbing headache for 30 min, which was similar to a headache lasting for 12 h that had occurred 3 days ago. Laboratory tests were unremarkable except for cerebrospinal fluid (CSF) lymphocytic pleocytosis. On the following day, a headache episode with left hemiparesis and hemihypoaesthesia, left hemifield visio-spatial inattention, anosagnosia and confusion recurred. The headache was diagnosed as headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) syndrome according to the criteria of the second edition of the International Classification of Headache Disorders. Simultaneously performed magnetic resonance imaging (MRI) revealed swelling of the grey matter, CSF enhancement in the sulci of the right temporal and occipital regions and hypoperfusion of the same brain regions. During the following 10 days two more similar episodes recurred and during the ensuing 12 months the patient remained headache free. Neuroimaging findings of the HaNDL syndrome are always thought as virtually normal. MRI abnormalities in our patient have not been reported in HaNDL syndrome previously, although they have been reported in hemiplegic migraine patients before. The findings in our case suggest that hemiplegic migraine and HaNDL syndrome may share a common pathophysiological pathway resulting in similar imaging findings and neurological symptoms.
Fama, Rosemary; Le Berre, Anne-Pascale; Hardcastle, Cheshire; Sassoon, Stephanie A; Pfefferbaum, Adolf; Sullivan, Edith V; Zahr, Natalie M
Variations in pattern and extent of cognitive and motor impairment occur in alcoholism (ALC). Causes of such heterogeneity are elusive and inconsistently accounted for by demographic or alcohol consumption differences. We examined neurological and nutritional factors as possible contributors to heterogeneity in impairment. Participants with ALC (n = 96) and a normal comparison group (n = 41) were examined on six cognitive and motor domains. Signs of historically determined subclinical Wernicke's encephalopathy were detected using the Caine et al. criteria, which were based on postmortem examination and chart review of antemortem data of alcoholic cases with postmortem evidence for Wernicke's encephalopathy. Herein, four Caine criteria provided quantification of dietary deficiency, cerebellar dysfunction, low general cognitive functioning and oculomotor abnormalities in 86 of the 96 ALC participants. Subgroups based on Caine criteria yielded a graded effect, where those meeting more criteria exhibited greater impairment than those meeting no to fewer criteria. These results could not be accounted for by history of drug dependence. Multiple regression indicated that compromised performance on ataxia, indicative of cerebellar dysfunction, predicted non-mnemonic and upper motor deficits, whereas low whole blood thiamine level, consistent with limbic circuit dysfunction, predicted mnemonic deficits. This double dissociation indicates biological markers that contribute to heterogeneity in expression of functional impairment in ALC. That non-mnemonic and mnemonic deficits are subserved by the dissociable neural systems of frontocerebellar and limbic circuitry, both commonly disrupted in ALC, suggests neural mechanisms that can differentially affect selective functions, thereby contributing to heterogeneity in pattern and extent of dysfunction in ALC. © 2017 Society for the Study of Addiction.
Clark, Aaron J.; Safaee, Michael; Chou, Dean; Weinstein, Philip R.; Molinaro, Annette M.; Clark, John P.; Mummaneni, Praveen V.
Study Design ?Retrospective review. Objective ?Intraoperative motor evoked potential (MEP) monitoring in spine surgery may assist surgeons in taking corrective measures to prevent neurologic deficits. The efficacy of monitoring MEPs intraoperatively in patients with myelopathy from nondegenerative causes has not been quantified. We compared the sensitivity and specificity of intraoperative MEP monitoring in patients with myelopathy caused by nondegenerative processes to patients with degenera...
Lee, Jung Bin [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Dong Hun; Oh, Jae Hee [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Seo, Hye Sun [Dept. of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul (Korea, Republic of)
A patent foramen ovale (PFO) is a persisting fetal circulation structural abnormality that can cause neurologic deficits such as migraine and cryptogenic stroke. Here we report a case of PFO diagnosed by cardiac multidetector row CT in an adolescent male with chronic migraine and stroke.
G.M. van Woerden (Geeske); K.D. Harris; M.R. Hojjati (Mohammed Reza); R.M. Gustin; S. Qiu; R. de Avila Freire (Rogerio); Y. Jiang; Y. Elgersma (Ype); E.J. Weeber
textabstractAngelman Syndrome (AS) is a severe neurological disorder characterized by mental retardation, motor dysfunction and epilepsy. We now show that the molecular and cellular deficits of an AS mouse model can be rescued by introducing an additional mutation at the inhibitory phosphorylation
Holland, C T
To describe basic epidemiological features, clinical characteristics and outcomes of asymmetrical focal neurological deficits identified in dogs and cats with naturally occurring tick paralysis (Ixodes holocyclus). A retrospective study. Computer records were reviewed for all dogs and cats treated for tick paralysis between July 1999 and June 2006 at a suburban veterinary hospital in Newcastle, New South Wales. Neurological deficits were identified in 17/197 dogs and 10/89 cats and included unilateral facial paralysis (14 dogs; 2 cats), anisocoria (4 dogs; 7 cats), unilateral loss of the cutaneous trunci reflex (1 dog; 1 cat) and Horner's syndrome in 2 cats with anisocoria. Occurrence of deficits was not linked to season, severity of tick paralysis, breed, age, sex or body weight. With facial paralysis and anisocoria, the site of tick attachment was invariably on the head or neck and always ipsilateral to the facial paralysis. By contrast, with anisocoria alone, no consistent relationship was noted between any one pupillary dimension and the side of tick attachment. With cutaneous trunci deficits the site of tick attachment was the ipsilateral caudal axilla. Compared with recovery times from generalised signs of tick paralysis, those for facial paralysis were significantly longer (days to weeks; P neurological deficits are a consistent finding in a proportion of dogs and cats with naturally occurring tick paralysis due to I. holocylcus.
Schiemanck, S.K.; Kwakkel, G.; Post, M.W.; Prevo, A.J.
OBJECTIVE: Ischemic lesion volume is assumed to be an important predictor of poststroke neurological deficits and functional outcome. This critical review examines the methodological quality of MRI studies and the predictive value of hemispheric infarct volume for neurological deficits (at body
Zukor, Katherine; Wang, Hong; Hurst, Brett L; Siddharthan, Venkatraman; Van Wettere, Arnaud; Pilowsky, Paul M; Morrey, John D
Neurological respiratory deficits are serious outcomes of West Nile virus (WNV) disease. WNV patients requiring intubation have a poor prognosis. We previously reported that WNV-infected rodents also appear to have respiratory deficits when assessed by whole-body plethysmography and diaphragmatic electromyography. The purpose of this study was to determine if the nature of the respiratory deficits in WNV-infected rodents is neurological and if deficits are due to a disorder of brainstem respiratory centers, cervical spinal cord (CSC) phrenic motor neuron (PMN) circuitry, or both. We recorded phrenic nerve (PN) activity and found that in WNV-infected mice, PN amplitude is reduced, corroborating a neurological basis for respiratory deficits. These results were associated with a reduction in CSC motor neuron number. We found no dramatic deficits, however, in brainstem-mediated breathing rhythm generation or responses to hypercapnia. PN frequency and pattern parameters were normal, and all PN parameters changed appropriately upon a CO 2 challenge. Histological analysis revealed generalized microglia activation, astrocyte reactivity, T cell and neutrophil infiltration, and mild histopathologic lesions in both the brainstem and CSC, but none of these were tightly correlated with PN function. Similar results in PN activity, brainstem function, motor neuron number, and histopathology were seen in WNV-infected hamsters, except that histopathologic lesions were more severe. Taken together, the results suggest that respiratory deficits in acute WNV infection are primarily due to a lower motor neuron disorder affecting PMNs and the PN rather than a brainstem disorder. Future efforts should focus on markers of neuronal dysfunction, axonal degeneration, and myelination.
Yao, D L; Masonic, K; Petullo, D; Li, L Y; Lincoln, C; Wibberley, L; Alderson, R F; Antonaccio, M
Fibroblast growth factor-13 (FGF-13), novel member of FGF family has recently been molecularly cloned as a result of high throughput sequencing of a ovarian cancer cell, hippocampal, and kidney cDNA libraries. The human gene encodes for a protein with a molecular weight of 22 kDa that is most homologous to FGF-8 (70% similarity). In the current study, we tested the effects of intravenously administered FGF-13 in a model of permanent focal cerebral ischemia in Sprague-Dawley rats. FGF-13 or the vehicle was administered systematically via the tail vein 30 min prior, and 30 min and 24 h after the occlusion of the left middle cerebral artery (MCAo). Animals were weighed and evaluated behaviorally prior to and at 24 and 48 h after MCAo. The volume of cerebral infarct and swelling were determined using an image analysis system (BioQuant) and cresyl violet stained sequential sections from the forebrain region. Histopathology was evaluated to compare the therapeutic effects. We found a 63% reduction in infarct volume in FGF-13- vs. vehicle-treated animals (infarct volume was 21.9+/-3.8% in vehicle- and 8.1+/-1.6% in FGF-13-treated rats, p=0.0016) and a moderate inhibition of brain swelling by FGF-13. The reduction in infarct volume and brain swelling were associated with improvement of clinical deficits in FGF-13 treated animals (p<0.001). Histopathological examination determined that nervous tissue was better preserved in FGF-13 treated rats than those of controls. These data show that pretreatment with intravenous FGF-13 reduces infarct size and ameliorates neurological deficits following permanent focal cerebral ischemia in rats. Copyright 1999 Elsevier Science B.V.
Beraldi, Rosanna; Chan, Chun-Hung; Rogers, Christopher S; Kovács, Attila D; Meyerholz, David K; Trantzas, Constantin; Lambertz, Allyn M; Darbro, Benjamin W; Weber, Krystal L; White, Katherine A M; Rheeden, Richard V; Kruer, Michael C; Dacken, Brian A; Wang, Xiao-Jun; Davis, Bryan T; Rohret, Judy A; Struzynski, Jason T; Rohret, Frank A; Weimer, Jill M; Pearce, David A
Ataxia telangiectasia (AT) is a progressive multisystem disorder caused by mutations in the AT-mutated (ATM) gene. AT is a neurodegenerative disease primarily characterized by cerebellar degeneration in children leading to motor impairment. The disease progresses with other clinical manifestations including oculocutaneous telangiectasia, immune disorders, increased susceptibly to cancer and respiratory infections. Although genetic investigations and physiological models have established the linkage of ATM with AT onset, the mechanisms linking ATM to neurodegeneration remain undetermined, hindering therapeutic development. Several murine models of AT have been successfully generated showing some of the clinical manifestations of the disease, however they do not fully recapitulate the hallmark neurological phenotype, thus highlighting the need for a more suitable animal model. We engineered a novel porcine model of AT to better phenocopy the disease and bridge the gap between human and current animal models. The initial characterization of AT pigs revealed early cerebellar lesions including loss of Purkinje cells (PCs) and altered cytoarchitecture suggesting a developmental etiology for AT and could advocate for early therapies for AT patients. In addition, similar to patients, AT pigs show growth retardation and develop motor deficit phenotypes. By using the porcine system to model human AT, we established the first animal model showing PC loss and motor features of the human disease. The novel AT pig provides new opportunities to unmask functions and roles of ATM in AT disease and in physiological conditions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Uchino, Haruto; Nakayama, Naoki; Kazumata, Ken; Kuroda, Satoshi; Houkin, Kiyohiro
Postoperative hyperperfusion-related transient neurological deficits (TNDs) are frequently observed in adult patients with moyamoya disease who undergo direct bypass procedures. The present study evaluated the effect of the free radical scavenger edaravone on postoperative hyperperfusion in adult moyamoya disease. This study included 92 hemispheres in 72 adult patients who underwent direct bypass for moyamoya disease. Serial measurements of cerebral blood flow were conducted immediately after surgery and on postoperative days 2 and 7. In 40 hemispheres for 36 patients, edaravone (60 mg/d) was administered from the day of surgery to postsurgical day 7. The incidence of postoperative hyperperfusion and associated TNDs were compared with a control group that included 52 hemispheres in 36 patients. Radiological hyperperfusion was observed in 28 of 40 (70.0%) and 39 of 52 (75.0%) hemispheres in the edaravone and control groups, respectively (P=0.30). Hyperperfusion-related TND incidences were significantly lower in the edaravone group compared with the control group (12.5% versus 32.7%; P=0.024). Multivariate analysis demonstrated that edaravone administration (P=0.009) and left-sided surgery (P=0.037) were significantly correlated with hyperperfusion-related TNDs (odds ratios, 0.3 and 4.2, respectively). Perioperative administration of edaravone reduced the incidence of hyperperfusion-related TNDs after direct bypass procedures in adult patients with moyamoya disease. © 2016 American Heart Association, Inc.
Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei
Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury.We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage.The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year.Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit.
Romeo, Stefano; Chiandetti, Alessio; Siracusano, Alberto; Troisi, Alfonso
Indirect evidence suggests partially common pathogenetic mechanisms for Neurological Soft Signs (NSS), neurocognition, and social cognition in schizophrenia. However, the possible association between NSS and mentalizing impairments has not yet been examined. In the present study, we assessed the ability to attribute mental states to others in patients with schizophrenia and predicted that the presence of theory of mind deficits would be significantly related to NSS. Participants were 90 clinically stable patients with a DSM-IV diagnosis of schizophrenia. NSS were assessed using the Neurological Evaluation Scale (NES). Theory of mind deficits were assessed using short verbal stories designed to measure false belief understanding. The findings of the study confirmed our hypothesis. Impaired sequencing of complex motor acts was the only neurological abnormality correlated with theory of mind deficits. By contrast, sensory integration, motor coordination and the NES Others subscale had no association with patients׳ ability to pass first- or second-order false belief tasks. If confirmed by future studies, the current findings provide the first preliminary evidence for the claim that specific NSS and theory of mind deficits may reflect overlapping neural substrates. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Neurotoxicity from iodinated contrast agents is a known but rare complication of angiography and neurovascular intervention. Neurotoxicity results from contrast penetrating the blood-brain barrier with resultant cerebral oedema and altered neuronal excitability. Clinical effects include encephalopathy, seizures, cortical blindness and focal neurological deficits. Contrast induced encephalopathy is extensively reported as a transient and reversible phenomenon. We describe a patient with a persistent motor deficit due to an encephalopathy from iodinated contrast media administered during cerebral aneurysm coiling. This observation and a review of the literature highlights that contrast-induced encephalopathy may not always have a benign outcome and can cause permanent deficits. This potential harmful effect should be recognised by the angiographer and the interventionalist.
Derouesne, C.; Salamon, R.
Ways in which teaching neurology can be simplified for the nonspecialist practitioner are addressed in this assessment of the state-of-the-art in France. The hypothesis implies simplifying both the diagnoses and symptomatology. (LBH)
Huang, Eagle Yi-Kung; Tsui, Pi-Fen; Kuo, Tung-Tai; Tsai, Jing-Jr.; Chou, Yu-Ching; Ma, Hsin-I; Chiang, Yung-Hsiao; Chen, Yuan-Hao
Aims To investigate the role of dopamine in cognitive and motor learning skill deficits after a traumatic brain injury (TBI), we investigated dopamine release and behavioral changes at a series of time points after fluid percussion injury, and explored the potential of amantadine hydrochloride as a chronic treatment to provide behavioral recovery. Materials and Methods In this study, we sequentially investigated dopamine release at the striatum and behavioral changes at 1, 2, 4, 6, and 8 weeks after fluid percussion injury. Rats subjected to 6-Pa cerebral cortical fluid percussion injury were treated by using subcutaneous infusion pumps filled with either saline (sham group) or amantadine hydrochloride, with a releasing rate of 3.6mg/kg/hour for 8 weeks. The dopamine-releasing conditions and metabolism were analyzed sequentially by fast scan cyclic voltammetry (FSCV) and high-pressure liquid chromatography (HPLC). Novel object recognition (NOR) and fixed-speed rotarod (FSRR) behavioral tests were used to determine treatment effects on cognitive and motor deficits after injury. Results Sequential dopamine-release deficits were revealed in 6-Pa-fluid-percussion cerebral cortical injured animals. The reuptake rate (tau value) of dopamine in injured animals was prolonged, but the tau value became close to the value for the control group after amantadine therapy. Cognitive and motor learning impairments were shown evidenced by the NOR and FSRR behavioral tests after injury. Chronic amantadine therapy reversed dopamine-release deficits, and behavioral impairment after fluid percussion injuries were ameliorated in the rats treated by using amantadine-pumping infusion. Conclusion Chronic treatment with amantadine hydrochloride can ameliorate dopamine-release deficits as well as cognitive and motor deficits caused by cerebral fluid-percussion injury. PMID:24497943
Eagle Yi-Kung Huang
Full Text Available AIMS: To investigate the role of dopamine in cognitive and motor learning skill deficits after a traumatic brain injury (TBI, we investigated dopamine release and behavioral changes at a series of time points after fluid percussion injury, and explored the potential of amantadine hydrochloride as a chronic treatment to provide behavioral recovery. MATERIALS AND METHODS: In this study, we sequentially investigated dopamine release at the striatum and behavioral changes at 1, 2, 4, 6, and 8 weeks after fluid percussion injury. Rats subjected to 6-Pa cerebral cortical fluid percussion injury were treated by using subcutaneous infusion pumps filled with either saline (sham group or amantadine hydrochloride, with a releasing rate of 3.6 mg/kg/hour for 8 weeks. The dopamine-releasing conditions and metabolism were analyzed sequentially by fast scan cyclic voltammetry (FSCV and high-pressure liquid chromatography (HPLC. Novel object recognition (NOR and fixed-speed rotarod (FSRR behavioral tests were used to determine treatment effects on cognitive and motor deficits after injury. RESULTS: Sequential dopamine-release deficits were revealed in 6-Pa-fluid-percussion cerebral cortical injured animals. The reuptake rate (tau value of dopamine in injured animals was prolonged, but the tau value became close to the value for the control group after amantadine therapy. Cognitive and motor learning impairments were shown evidenced by the NOR and FSRR behavioral tests after injury. Chronic amantadine therapy reversed dopamine-release deficits, and behavioral impairment after fluid percussion injuries were ameliorated in the rats treated by using amantadine-pumping infusion. CONCLUSION: Chronic treatment with amantadine hydrochloride can ameliorate dopamine-release deficits as well as cognitive and motor deficits caused by cerebral fluid-percussion injury.
Huang, Eagle Yi-Kung; Tsui, Pi-Fen; Kuo, Tung-Tai; Tsai, Jing-Jr; Chou, Yu-Ching; Ma, Hsin-I; Chiang, Yung-Hsiao; Chen, Yuan-Hao
To investigate the role of dopamine in cognitive and motor learning skill deficits after a traumatic brain injury (TBI), we investigated dopamine release and behavioral changes at a series of time points after fluid percussion injury, and explored the potential of amantadine hydrochloride as a chronic treatment to provide behavioral recovery. In this study, we sequentially investigated dopamine release at the striatum and behavioral changes at 1, 2, 4, 6, and 8 weeks after fluid percussion injury. Rats subjected to 6-Pa cerebral cortical fluid percussion injury were treated by using subcutaneous infusion pumps filled with either saline (sham group) or amantadine hydrochloride, with a releasing rate of 3.6 mg/kg/hour for 8 weeks. The dopamine-releasing conditions and metabolism were analyzed sequentially by fast scan cyclic voltammetry (FSCV) and high-pressure liquid chromatography (HPLC). Novel object recognition (NOR) and fixed-speed rotarod (FSRR) behavioral tests were used to determine treatment effects on cognitive and motor deficits after injury. Sequential dopamine-release deficits were revealed in 6-Pa-fluid-percussion cerebral cortical injured animals. The reuptake rate (tau value) of dopamine in injured animals was prolonged, but the tau value became close to the value for the control group after amantadine therapy. Cognitive and motor learning impairments were shown evidenced by the NOR and FSRR behavioral tests after injury. Chronic amantadine therapy reversed dopamine-release deficits, and behavioral impairment after fluid percussion injuries were ameliorated in the rats treated by using amantadine-pumping infusion. Chronic treatment with amantadine hydrochloride can ameliorate dopamine-release deficits as well as cognitive and motor deficits caused by cerebral fluid-percussion injury.
Chio, Chung-Ching; Lin, Hung-Jung; Tian, Yu-Feng; Chen, Yu-Chieh; Lin, Mao-Tsun; Lin, Cheng-Hsien; Chang, Ching-Ping; Hsu, Chien-Chin
Despite previous evidence for a potent inflammatory response after a traumatic brain injury (TBI), it is unknown whether exercise preconditioning (EP) improves outcomes after a TBI by modulating inflammatory responses. We performed quantitative real-time PCR (qPCR) to quantify the genes encoding 84 cytokines and chemokines in the peripheral blood and used ELISA to determine both the cerebral and blood levels of interleukin-6 (IL-6). We also performed the chromatin immunoprecipitation (ChIP) assay to evaluate the extent of nuclear factor kappa-B (NF-κB) binding to the DNA elements in the IL-6 promoter regions. Also, we adopted the Western blotting assay to measure the cerebral levels of heat shock protein (HSP) 70, synapsin I, and β-actin. Finally, we performed both histoimmunological and behavioral assessment to measure brain injury and neurological deficits, respectively. We first demonstrated that TBI upregulated nine pro-inflammatory and/or neurodegenerative messenger RNAs (mRNAs) in the peripheral blood such as CXCL10, IL-18, IL-16, Cd-70, Mif, Ppbp, Ltd, Tnfrsf 11b, and Faslg. In addition to causing neurological injuries, TBI also upregulated the following 14 anti-inflammatory and/or neuroregenerative mRNAs in the peripheral blood such as Ccl19, Ccl3, Cxcl19, IL-10, IL-22, IL-6, Bmp6, Ccl22, IL-7, Bmp7, Ccl2, Ccl17, IL-1rn, and Gpi. Second, we observed that EP inhibited both neurological injuries and six pro-inflammatory and/or neurodegenerative genes (Cxcl10, IL-18, IL-16, Cd70, Mif, and Faslg) but potentiated four anti-inflammatory and/or neuroregenerative genes (Bmp6, IL-10, IL-22, and IL-6). Prior depletion of cerebral HSP70 with gene silence significantly reversed the beneficial effects of EP in reducing neurological injuries and altered gene profiles after a TBI. A positive Pearson correlation exists between IL-6 and HSP70 in the peripheral blood or in the cerebral levels. In addition, gene silence of cerebral HSP70 significantly reduced the
For patients with Parkinson disease, falls are generally attributed to postural instability. However, closer examination often shows that parkinsonian patients tend to keep falling at the same spot in their home on performing the same actions such as standing up from a chair, starting to walk, or turning at the corner and hitting the same part of the head. Each time the patients fall, their treating physicians explain the reasons for falling and tell them how to avoid falls in daily life. In spite of the repeated advice given by physicians, these patients fall in the same manner and location. When physicians question them regarding the reason for repeating the same risky actions that they had been asked to avoid, the patients answer that they clearly remembered their physician's advice but had thought that they would be able to successfully accomplish the risky actions at that time. Thus, it seems that this type of fall is partly caused by decision-making deficit. Negative-reward motor learning is known to be defective in parkinsonian patients who are being treated with dopamine agonists and are liable to indulge in risky behavior and tend to be involved in pathological gambling. The behavioral abnormalities that are caused by defective decision making and are common to pathological gambling and repeated falling in parkinsonian patients could be termed as "Korinai syndrome, " which means "syndrome involving the inability to learn by experience." In contrast, patients with dementia often show loss of fear reaction, which may result in the life-threatening inability to perceive crises. The present author performed a series of studies just after the Great East Japan Earthquake in March 2011; these studies were based on the behavior of patients with dementia during this large earthquake. The results showed that both intellectually normal elderly people and patients with mild dementia had shown evident fear reactions and could remember their own fearful experience
Mulroy, Eoin; Yap, Joel; Danesh-Meyer, Helen; Anderson, Neil
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure. Short-to-medium term management with CSF drainage and acetazolamide may be necessary to prevent visual loss. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Meng, Hao; Gao, Yuan; Li, Mo; Luo, Zhuojing; Du, Junjie
Traumatic posterior atlantoaxial dislocation associated with odontoid fracture is extremely rare, with only eight cases reported thus far in the English literature. This report concerns a 47-year-old female who presented with considerable pain and stiffness in the neck without a neurologic deficit after injury due to a fall. Radiographs, computed tomography, and magnetic resonance imaging demonstrated a posterior dislocation of the atlas with respect to the axis with an odontoid fracture. No cord compression or intramedullary cord signal abnormalities were detected at the level of the atlantoaxial dislocation. A pedicle screw fixation/fusion was performed via a posterior approach following successful closed reduction.
Takakura, Tomokazu; Muragaki, Yoshihiro; Tamura, Manabu; Maruyama, Takashi; Nitta, Masayuki; Niki, Chiharu; Kawamata, Takakazu
OBJECTIVE The aim of the present study was to evaluate the usefulness of navigated transcranial magnetic stimulation (nTMS) as a prognostic predictor for upper-extremity motor functional recovery from postsurgical neurological deficits. METHODS Preoperative and postoperative nTMS studies were prospectively applied in 14 patients (mean age 39 ± 12 years) who had intraparenchymal brain neoplasms located within or adjacent to the motor eloquent area in the cerebral hemisphere. Mapping by nTMS was done 3 times, i.e., before surgery, and 1 week and 3 weeks after surgery. To assess the response induced by nTMS, motor evoked potential (nTMS-MEP) was recorded using a surface electromyography electrode attached to the abductor pollicis brevis (APB). The cortical locations that elicited the largest electromyography response by nTMS were defined as hotspots. Hotspots for APB were confirmed as positive responsive sites by direct electrical stimulation (DES) during awake craniotomy. The distances between hotspots and lesions (DHS-L) were measured. Postoperative neurological deficits were assessed by manual muscle test and dynamometer. To validate the prognostic value of nTMS in recovery from upper-extremity paresis, the following were investigated: 1) the correlation between DHS-L and the serial grip strength change, and 2) the correlation between positive nTMS-MEP at 1 week after surgery and the serial grip strength change. RESULTS From the presurgical nTMS study, MEPs from targeted muscles were identified in 13 cases from affected hemispheres. In one case, MEP was not evoked due to a huge tumor. Among 9 cases from which intraoperative DES mapping for hand motor area was available, hotspots for APB identified by nTMS were concordant with DES-positive sites. Compared with the adjacent group (DHS-L motor recovery at 1 week, 3 weeks, and 3 months after surgery (r = 0.87, 0.88, and 0.77, respectively). CONCLUSIONS Navigated TMS is a useful tool for identifying motor eloquent
Li, Yongxin; Wu, Ping; Liang, Fanrong; Huang, Wenhua
Human neuroimaging studies and animal models have suggested that white matter damage from ischemic stroke leads to the functional and structural reorganization of perilesional and remote brain regions. However, the quantitative relationship between the transcallosal tract integrity and clinical motor performance score after stroke remains unexplored. The current study employed a tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) to investigate the relationship between white matter diffusivity changes and the clinical scores in stroke patients. Probabilistic fiber tracking was also used to identify structural connectivity patterns in the patients. Thirteen ischemic stroke patients and fifteen healthy control subjects participated in this study. TBSS analyses showed that the corpus callosum (CC) and bilateral corticospinal tracts (CST) in the stroke patients exhibited significantly decreased fractional anisotropy and increased axial and radial diffusivity compared with those of the controls. Correlation analyses revealed that the motor and neurological deficit scores in the stroke patients were associated with the value of diffusivity indices in the CC. Compared with the healthy control group, probabilistic fiber tracking analyses revealed that significant changes in the inter-hemispheric fiber connections between the left and right motor cortex in the stroke patients were primarily located in the genu and body of the CC, left anterior thalamic radiation and inferior fronto-occipital fasciculus, bilateral CST, anterior/superior corona radiate, cingulum and superior longitudinal fasciculus, strongly suggesting that ischemic induces inter-hemispheric network disturbances and disrupts the white matter fibers connecting motor regions. In conclusion, the results of the present study show that DTI-derived measures in the CC can be used to predict the severity of motor skill and neurological deficit in stroke patients. Changes in structural
Bourke, M G
The incidence of spinal tuberculosis is increasing in developed nations. In Ireland, half of all cases seen in the most recent decade for which figures are available were diagnosed in 2005-2007, the three most recent years for which there is complete data. We discuss a patient who presented with neurological complications due to destructive spinal tuberculous disease affecting the sixth cervical vertebra.
Kim, Kang Wook; Lee, Hyuk Jin; Rhee, Seung Hwan; Baek, Goo Hyun
Previous studies of minimal medial epicondylectomy for cubital tunnel syndrome included patients with mild disease, making it difficult to determine how much this procedure improved sensory and motor impairments in patients with moderate to severe disease. We asked if minimal epicondylectomy improved sensory and motor impairments in patients with moderate to severe cubital tunnel syndrome. We retrospectively reviewed 25 patients treated with minimal medial epicondylectomy for advanced cubital tunnel syndrome involving motor weakness between January 2003 and February 2009. Preoperatively, five patients had Medical Research Council (MRC) Grade 4 motor strength without atrophy (McGowan Grade IIA), nine had MRC Grade 3 motor strength with detectable atrophy (McGowan Grade IIB), and 11 had MRC Grade 3 or less motor strength with severe atrophy (McGowan Grade III). Postoperatively we obtained DASH scores and evaluated improvement of sensory impairment and motor impairment: excellent with minimal sensory deficit and motor deficit, good with mild deficits, fair with improved but persistent deficit(s), and poor with no improvement. The minimum followup was 13 months (mean, 46 months; range, 13-86 months). The mean DASH score was 14 points (range, 2-47 points). Of the 25 patients, sensory improvement and motor improvement were excellent in 16 patients, good in five, fair in two, and poor in two. Twenty-three of the 25 patients improved at least one McGowan grade. There were no complications, such as medial elbow instability. Minimal medial epicondylectomy can improve sensory and motor impairments for patients with moderate to severe cubital tunnel syndrome. Level IV, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.
Koenraads, Yvonne; Braun, Kees P J; Van Der Linden, Denise C P; Imhof, Saskia M.; Porro, Giorgio L.
IMPORTANCE: Visual field examination in young or neurologically impaired children is a challenge. As a result, the Behavioral Visual Field (BEFIE) Screening Test was developed in 1995. OBJECTIVES: To evaluate the applicability of the BEFIE test in a large population of young or neurologically
Tony J.H. Chan
Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD affects 5%–8% of children in the U.S. (10% of males and 4% of females. The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 6.1 ± 5.7 µg/g, 22.7 ± 24.1 µg/g, 0.9 ± 1.4 µg/g, and 6.0 × 105 ± 1.6 × 105 µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles.
King, Marcie L; Manzel, Kenneth; Bruss, Joel; Tranel, Daniel
Research on changes in personality and behavior following brain damage has focused largely on negative outcomes, such as increased irritability, moodiness, and social inappropriateness. However, clinical observations suggest that some patients may actually show positive personality and behavioral changes following a neurological event. In the current work, we investigated neuroanatomical correlates of positive personality and behavioral changes following a discrete neurological event (e.g., stroke, benign tumor resection). Patients (N = 97) were rated by a well-known family member or friend on five domains of personality and behavior: social behavior, irascibility, hypo-emotionality, distress, and executive functioning. Ratings were acquired during the chronic epoch of recovery, when psychological status was stabilized. We identified patients who showed positive changes in personality and behavior in one or more domains of functioning. Lesion analyses indicated that positive changes in personality and behavior were most consistently related to damage to the bilateral frontal polar regions and the right anterior dorsolateral prefrontal region. These findings support the conclusion that improvements in personality and behavior can occur after a neurological event, and that such changes have systematic neuroanatomical correlates. Patients who showed positive changes in personality and behavior following a neurological event were rated as having more disturbed functioning prior to the event. Our study may be taken as preliminary evidence that improvements in personality and behavior following a neurological event may involve dampening of (premorbidly) more extreme expressions of emotion. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Background and Aim: Stroke is one of the most important factors of mortality and disability in the world. Free radicals are produced following ischemic stroke and they play a central role in breaking the blood-brain barrier and causing brain edema formation. The aim of the current study was to evaluate the effect of hydro- alcoholic extract of Origanum vulgare on brain edema and neurologic deficit in a rat stroke model. Materials and Methods: In thisexperimental study, 35 male Wistar rats were randomly divided into 5 equal groups. The first two groups (control and Sham received distilled water, while three treatment groups received oral Origanum vulgare extract for 30days (50,75and 100 mg/kgdaily, respectively. Two hours after the last dose of Origanum vulgare extract,each main group underwent a 60 min middle cerebral artery occlusion. Then, the assessment of blood brain edema, and neurologic deficits analysis were done . Brain edema (brain water content was analyzed by One-Way ANOVA using LSD method and neurologic deficits analysis by means of Mann-Whitney U, and P<0.05 was taken as the significant level. Results: Origanum vulgare extract reduced brain edema in the experimental groups of 50 (82.49±0.47, 75 (80.89±0.63 and 100 mg/kg/day (80.80±0.66 compared to the control group (84.46±0.67. The neurologic deficit scores in the experimental groups of 75and 100mg/kg/day, compared with control group, but neurologic deficit scores did not affect the group receiving the dose 50 mg/kg. Conclusion: The obtained data indicate that Origanum vulgar extract via reduction of brain edema and neurologic deficits scorescan have a protective effect on the stroke model.
Yang, Li; Bai, Harrison X; Zhao, Xin; Xiao, Yanqiao; Tan, Liming
Postpartum cerebral angiopathy (PCA) is a cerebrovascular disease that occurs during the postpartum period. It is characterized by reversible multifocal vasoconstriction of the cerebral arteries. We report a patient with PCA proven by cerebral angiography that revealed multifocal, segmental narrowing of the cerebral arteries and non-aneurysmal subarachnoid hemorrhage. The patient suddenly deteriorated with focal neurological deficits on the 5 th day of hospitalization. She was treated with calcium-channel blockers and monitored with daily transcranial Doppler ultrasound. Her symptoms gradually improved and she was discharged on the 11 th day of hospitalization. At 1-month follow-up, patient was completely symptom-free with no neurological deficits.
Rummo, J.H.; Routh, D.K.; Rummo, N.J.; Brown, J.F.
Forty-five children 4 to 8 y of age who had been exposed to environmental lead were studied, consisting of an acute encephalopathy group and groups with short- and long-term exposure but without encephalopathy. Control children were matched for age, sex, race, and socioeconomic status with lead-exposed subjects, but lived in post-1945 housing and had negative neurological history and blood tests. The encephalopathy group had a significantly higher incidence of neurological deficits, retarded mental development, and higher hyperactivity than control subjects. Children with short- and long-term exposure short of encephalopathy were somewhat inferior to matched control subjects, but not to a statistically significant extent.
Dimitrijević, Mirjana; Kotur-Stevuljević, Jelena; Stojić-Vukanić, Zorica; Vujnović, Ivana; Pilipović, Ivan; Nacka-Aleksić, Mirjana; Leposavić, Gordana
The study examined (a) whether there is sex difference in spinal cord and plasma oxidative stress profiles in Dark Agouti rats immunised for experimental autoimmune encephalomyelitis (EAE), the principal experimental model of multiple sclerosis, and (b) whether there is correlation between the oxidative stress in spinal cord and neurological deficit. Regardless of rat sex, with the disease development xanthine oxidase (XO) activity and inducible nitric oxide synthase (iNOS) mRNA expression increased in spinal cord, whereas glutathione levels decreased. This was accompanied by the rise in spinal cord malondialdehyde level. On the other hand, with EAE development superoxide dismutase (SOD) activity decreased, while O2(-) concentration increased only in spinal cord of male rats. Consequently, SOD activity was lower, whereas O2(-) concentration was higher in spinal cord of male rats with clinically manifested EAE. XO activity and iNOS mRNA expression were also elevated in their spinal cord. Consistently, in the effector phase of EAE the concentration of advanced oxidation protein product (AOPP) was higher in spinal cord of male rats, which exhibit more severe neurological deficit than their female counterparts. In as much as data obtained in the experimental models could be translated to humans, the findings may be relevant for designing sex-specific antioxidant therapeutic strategies. Furthermore, the study indicated that the increased pro-oxidant-antioxidant balance in plasma may be an early indicator of EAE development. Moreover, it showed that plasma AOPP level may indicate not only actual activity of the disease, but also serve to predict severity of its course.
Age-related cognitive deficits are observed in both humans and animals. Yet, the molecular mechanisms underlying these deficits are not yet fully elucidated. In aged animals, a decrease in intrinsic excitability of pyramidal neurons from the CA1 sub-region of hippocampus is believed to contribute to age-related cognitive impairments, but the molecular mechanism(s) that modulate both these factors has yet to be identified. Increasing activity of the transcription factor cAMP response element-binding protein (CREB) in young adult rodents has been shown to facilitate cognition, and increase intrinsic excitability of their neurons. However, how CREB changes with age, and how that impacts cognition in aged animals, is not clear. Therefore, we first systematically characterized age- and training-related changes in CREB levels in dorsal hippocampus. At a remote time point after undergoing behavioral training, levels of total CREB and activated CREB (phosphorylated at S133, pCREB) were measured in both young and aged rats. We found that pCREB, but not total CREB was significantly reduced in dorsal CA1 of aged rats. Importantly, levels of pCREB were found to be positively correlated with short-term spatial memory in both young and aged rats i.e. higher pCREB in dorsal CA1 was associated with better spatial memory. These findings indicate that an age-related deficit in CREB activity may contribute to the development of age-related cognitive deficits. However, it was still unclear if increasing CREB activity would be sufficient to ameliorate age-related cognitive, and biophysical deficits. To address this question, we virally overexpressed CREB in CA1, where we found the age-related deficit. Young and aged rats received control or CREB virus, and underwent water maze training. While control aged animals exhibited deficits in long-term spatial memory, aged animals with CREB overexpression performed at levels comparable to young animals. Concurrently, aged neurons
Sudhir Kumar Srivastava
Full Text Available Vanishing bone disease is an extremely rare disorder of unknown etiology characterized by idiopathic osteolysis of bone. We describe a case of vanishing bone disease of chest wall and spine with kyphoscoliosis and neurological deficit. A 17-year-old male presented with gradually progressive deformity of back and dorsal compressive myelopathy with nonambulatory power in lower limbs. Radiographs revealed absent 4 th-7 th ribs on the right side with dorsal kyphoscoliosis and severe canal narrowing at the apex. The patient was given localized radiotherapy and started on a monthly infusion of 4 mg zoledronic acid. Posterior instrumented fusion with anterior reconstruction via posterolateral approach was performed. The patient had a complete neurological recovery at 5 weeks following surgery. At 1 year, anterior nonunion was noted for which transthoracic tricortical bone grafting was done. Bone graft from the patient′s mother was used both times. At 7 months following anterior grafting, the alignment was maintained and the patient was asymptomatic; however, fusion at graft-host interface was not achieved. Bisphosphonates and radiotherapy were successful in halting the progress of osteolysis.
Schaffer, Yael; Geva, Ronny
Given the primary role of memory in children's learning and well-being, the aim of this review was to examine the outcomes of memory remediation interventions in children with neurological deficits as a function of the affected memory system and intervention method. Fifty-seven studies that evaluated the outcome of memory interventions in children were identified. Thirty-four studies met the inclusion criteria, and were included in a systematic review. Diverse rehabilitation methods for improving explicit and implicit memory in children were reviewed. The analysis indicates that teaching restoration strategies may improve, and result in the generalisation of, semantic memory and working memory performance in children older than 7 years with mild to moderate memory deficits. Factors such as longer protocols, emotional support, and personal feedback contribute to intervention efficacy. In addition, the use of compensation aids seems to be highly effective in prospective memory tasks. Finally, the review unveiled a lack of studies with young children and the absence of group interventions. These findings point to the importance of future evidence-based intervention protocols in these areas.
Full Text Available Paying attention to visual stimuli is typically accompanied by event-related desynchronizations (ERD of ongoing alpha (7-14 Hz activity in visual cortex. The present study used time-frequency based analyses to investigate the role of impaired alpha ERD in visual processing deficits in schizophrenia (Sz. Subjects viewed sinusoidal gratings of high (HSF and low (LSF spatial frequency designed to test functioning of the parvo- versus magnocellular pathways, respectively. Patients with Sz and healthy controls paid attention selectively to either the LSF or HSF gratings which were presented in random order. Event-related brain potentials (ERPs were recorded to all stimuli. As in our previous study, it was found that Sz patients were selectively impaired at detecting LSF target stimuli and that ERP amplitudes to LSF stimuli were diminished, both for the early sensory-evoked components and for the attend minus unattend difference component (the Selection Negativity, which is generally regarded as a specific index of feature-selective attention. In the time-frequency domain, the differential ERP deficits to LSF stimuli were echoed in a virtually absent theta-band phase locked response to both unattended and attended LSF stimuli (along with relatively intact theta-band activity for HSF stimuli. In contrast to the theta-band evoked responses which were tightly stimulus locked, stimulus-induced desynchronizations of ongoing alpha activity were not tightly stimulus locked and were apparent only in induced power analyses. Sz patients were significantly impaired in the attention-related modulation of ongoing alpha activity for both HSF and LSF stimuli. These deficits correlated with patients’ behavioral deficits in visual information processing as well as with visually based neurocognitive deficits. These findings suggest an additional, pathway-independent, mechanism by which deficits in early visual processing contribute to overall cognitive impairment in
Venkitaraman, R; Sohaib, S A; Barbachano, Y; Parker, C C; Huddart, R A; Horwich, A; Dearnaley, D
Neurological deficit from malignant spinal cord compression (SCC) is a major complication of metastatic castration-resistant prostate cancer (CRPC). The aims of the present study were to determine the incidence of neurological deficit in metastatic prostate cancer patients and to determine the optimal frequency of screening magnetic resonance imaging (MRI) spine required to detect clinically occult radiological SCC (rSCC). A retrospective analysis of the clinical data of 130 consecutive patients with CRPC, with no functional neurological deficit, who had screening MRI spine from January 2001 to May 2005, was undertaken. Patients found to have rSCC received radiotherapy. All patients were followed-up to document the incidence of neurological deficit. Thirty-seven (28.4%) patients had rSCC on MRI. The proportion of patients free from neurological deficit at 3, 6, 12, 18 and 24 months was 94, 80, 59 and 43%, respectively, in patients who had rSCC on initial MRI and 97.5, 89, 75 and 63%, respectively, in patients who had no rSCC. A high prostate-specific antigen (PSA) level at initial MRI (P = 0.035) and a short PSA doubling time neurological deficit on univariate analysis, whereas back pain (P = 0.059), although an important predictive factor, did not attain statistical significance. On multivariate analysis, only rapid PSA doubling time (neurological deficit (P = 0.042). MRI spine can be used to detect asymptomatic rSCC in patients with CRPC and serial estimations are required to maintain a low incidence of clinical SCC. If serial screening MRI spine is used to detect rSCC in 90% of patients before the development of neurological signs, the optimum frequency depends on the subset of patients studied. The results of our study suggest that the optimum frequency would be every 4-6 months for patients with previous SCC, rapid or high PSA or back pain and annually for asymptomatic patients. 2009 The Royal College of Radiologists. Published by Elsevier Ltd. All rights
Getty, Laura A.; Summy, Sarah E.
A limited body of research on language deficits in children with emotional and behavioral disorders (EBD) exists. However, initial studies have found a direct relationship between language deficits and EBD. Reading, writing, and math deficits have been found to co-occur in children with EBD and language deficits. Additionally, antisocial behaviors…
Park, Eunjeong; Chang, Hyuk-Jae; Nam, Hyo Suk
The pronator drift test (PDT), a neurological examination, is widely used in clinics to measure motor weakness of stroke patients. The aim of this study was to develop a PDT tool with machine learning classifiers to detect stroke symptoms based on quantification of proximal arm weakness using inertial sensors and signal processing. We extracted features of drift and pronation from accelerometer signals of wearable devices on the inner wrists of 16 stroke patients and 10 healthy controls. Signal processing and feature selection approach were applied to discriminate PDT features used to classify stroke patients. A series of machine learning techniques, namely support vector machine (SVM), radial basis function network (RBFN), and random forest (RF), were implemented to discriminate stroke patients from controls with leave-one-out cross-validation. Signal processing by the PDT tool extracted a total of 12 PDT features from sensors. Feature selection abstracted the major attributes from the 12 PDT features to elucidate the dominant characteristics of proximal weakness of stroke patients using machine learning classification. Our proposed PDT classifiers had an area under the receiver operating characteristic curve (AUC) of .806 (SVM), .769 (RBFN), and .900 (RF) without feature selection, and feature selection improves the AUCs to .913 (SVM), .956 (RBFN), and .975 (RF), representing an average performance enhancement of 15.3%. Sensors and machine learning methods can reliably detect stroke signs and quantify proximal arm weakness. Our proposed solution will facilitate pervasive monitoring of stroke patients.
Anoop C Dhamangaonkar
Full Text Available INTRODUCTION: Traumatic spine injuries are on the rise. The literature is sparse regarding epidemiology of patients with traumatic spine injuries from this part of the world. OBJECTIVES: To analyse the following in patients with traumatic spine injuries with neurological deficits: demographic and social profile, common modes of injury, pre-hospitalisation practices, region of spine affected, severity of neurological deficit and the lay individuals’ awareness about traumatic spine injuries. METHODS: The study sample comprised 52 adult patients with traumatic spine injuries with neurological deficits. We collected data on demographic and social characteristics, mode of injury, pre-hospitalisation treatment, interval between injury and presentation, spine region affected and severity of neurological deficits and patient's knowledge about such injuries. RESULTS: The average patient age was 31.32y. The male: female ratio was 2.25:1, and the most common modes of injury were fall from height, followed by traffic accident. More than half of the patients suffered cervical spine injuries, followed by dorsolumbar spine injuries. Only 9.61% of patients received pre-hospitalisation treatment. All patients understood there could be complete functional recovery after treatment for traumatic spine injuries. CONCLUSION: There is a growing need to improve railway and roadway safety equipment and to make it accessible and affordable to the susceptible economically weaker population. Attempts should be made to increase awareness regarding traumatic spine injuries.
Ha Son Nguyen
Full Text Available Traumatic high-grade spondylolisthesis in subaxial cervical spine is frequently associated with acute spinal cord injury and quadriparesis. There have been rare cases where such pathology demonstrates minimal to no neurological deficits. Assessment of the underlying biomechanics may provide insight into the mechanism of injury and associated neurological preservation. Patient 1 is a 63-year-old female presenting after a motor vehicle collision with significant right arm pain without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, associated with a locked facet on the left at C6/7 and a locked facet on the right at C7/T1, with a fracture of the left C7 pedicle and right C7 lamina. Patient 2 is a 60-year-old male presenting after a bicycle collision with transient bilateral upper extremity paresthesias without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, with fractures of bilateral C7 pedicles, C7/T1 facets, and C7 lamina. Patient 3 is a 36-year-old male presenting after a motor vehicle collision with diffuse tingling sensation throughout all extremities. His neurological examination was nonfocal. Imaging demonstrated a grade 4 spondylolithesis at C7/T1, associated with bilateral C7/T1 locked facets. From literature, most cases were noted to be dislocations resulting from fractures of the posterior elements. A minority of cases has been found to involve facet dislocations without fractures. Further biomechanical studies are needed to understand the underlying mechanisms.
Xie, Jing-Ming; Zhang, Ying; Wang, Ying-Song; Bi, Ni; Zhao, Zhi; Li, Tao; Yang, Hua
To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery. A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and July 2011 were included in our study. Of the 76 patients, 37 were male and 39 female, with an average age of 17.5 years (range 10-48 years). There were 52 adolescent patients (with an age hyperkyphosis (X 5), level of vertebral column resected (X 6), number of segmental vessels ligated (X 7), preexisting neurologic dysfunction (X 8), and associated with intraspinal and brain stem anomalies (X 9). The multi-factor unconditional logistic regression analysis revealed that X 8 (OR = 49.322), X 9 (OR = 18.423), X 5 (OR = 11.883), and X 6 (OR = 8.769) were independent and positively correlated with the neurologic deficit. Preexisting neurologic dysfunction, associated with intraspinal and brain stem anomalies, scoliosis associated with thoracic hyperkyphosis and level of vertebral column resected are independent risk factors for neurologic deficits during PVCR procedure.
Brumback, R A; Weinberg, W A
The high incidence of poor social adjustment in long-term follow-up studies of depressed children seems to relate to the inadequacy of the pharmacotherapy necessary to sustain long-lasting remission or possibly to repetitive inappropriate stresses. Insufficient antidepressant therapy with resultant intermittent depression-induced dysfunction of the socialization functions performed by the right cerebral hemisphere would not permit the child to develop appropriate interpersonal skills (causing failure in most social situations), and associated cognitive difficulties would complicate academic performance. Repeated school failure and chronic social ineptitude preclude development of the skills necessary for successful independent living in society. Thus, if symptoms of depression are found, it is imperative that the learning-disabled or behaviorally disturbed child or adolescent receive adequate antidepressant therapy to ensure complete long-term remission of the depression. In addition, learning-disabled individuals, even without apparent diagnosable depressive illness, must be offered appropriate methods for learning and communication which reduce stress. When such appropriate educational strategies are offered and poor performance still ensues (or continues), a trial of antidepressant therapy should be considered. Recognition of the depressive nature of symptoms may not be possible until treatment-induced improvement has occurred and depression-associated learning disability has resolved. Improvement in academic performance associated with improved cognitive function after treatment-induced remission of a depressive episode can be dramatic, with resolution of apparent learning disability. Poor educational achievement associated with chronic learning difficulties ultimately affects adult social functioning, and untreated or improperly treated chronic depression may result in the development of later personality disturbances. Therefore, before attributing school
Liu, Rong; Xu, Nenggui; Yi, Wei; Huang, Kangbai; Su, Minzhi
Electroacupuncture effect on neurological behavior and the expression of tyrosine kinase Janus kinase 2 (JAK 2) of ischemic cortex in rats with the focal cerebral ischemia were investigated in this study. The model of focal cerebral ischemia was established by the heat-coagulation induced the occlusion of the middle cerebral artery. The electro-acupuncture was applied on Baihui (GV 20) and Dazhui (GV 14), and AG490 was applied by intracerebroventricular infusion. The expressions of JAK2 mRNA and phospharylated JAK2 (p-JAK2) in the ischemic cortex were observed by in situ hybridization and western blotting. The expressions of JAK2 mRNA and p-JAK2 were rarely found in sham surgery group. In model group, the expression of JAK2 mRNA and JAK2 phosphorylation had increased. After 1 day of cerebral ischemia, the expression had reached its peak. After cerebral ischemia, the expressions of JAK2 mRNA and p-JAK2 were consistent with the neurological deficit score. Electroacupuncture treatment and AG490 intervention were able to improve the neurological deficit score after cerebral ischemia, and down-regulate the expressions of JAK2 mRNA and JAK2 phosphorylation. After cerebral ischemia, the excessive expressions of JAK2 and the JAK2 phosphorylation would be one of mechanisms by which the brain injury got worse. The therapy of electro-acupuncture could reduce the expression of JAK2, and inhibit JAK2 phosphorylated activation, so as to block the abnormal activation of signal transduction pathway which was induced by JAK2.
The purpose of this study was to evaluate the effectiveness of the Neurological Impress Method as an intervention to improve reading skills in elementary school children with emotional disabilities. When educators work with children with emotional disabilities, the focus is often on modifying behaviors. This focus on behavior rather than academics…
Ashok K Shetty
Full Text Available Mild traumatic brain injury (mTBI resulting from exposure to blast shock waves (BSWs is one of the most predominant causes of illnesses among veterans who served in the recent Iraq and Afghanistan wars. Such mTBI can also happen to civilians if exposed to shock waves of bomb attacks by terrorists. While cognitive problems, memory dysfunction, depression, anxiety and diffuse white matter injury have been observed at both early and/or delayed time-points, an initial brain pathology resulting from exposure to BSWs appears to be the dysfunction or disruption of the blood-brain barrier (BBB. Studies in animal models suggest that exposure to relatively milder BSWs (123 kPa initially induces free radical generating enzymes in and around brain capillaries, which enhances oxidative stress resulting in loss of tight junction proteins, edema formation, and leakiness of BBB with disruption or loss of its components pericytes and astrocyte end-feet. On the other hand, exposure to more intense BSWs (145-323 kPa causes acute disruption of the BBB with vascular lesions in the brain. Both of these scenarios lead to apoptosis of endothelial and neural cells and neuroinflammation in and around capillaries, which may progress into chronic traumatic encephalopathy and/or a variety of neurological impairments, depending on brain regions that are afflicted with such lesions. This review discusses studies that examined alterations in the brain milieu causing dysfunction or disruption of the BBB and neuroinflammation following exposure to different intensities of BSWs. Furthermore, potential of early intervention strategies capable of easing oxidative stress, repairing the BBB or blocking inflammation for minimizing delayed neurological deficits resulting from exposure to BSWs is conferred.
Shetty, Ashok K; Mishra, Vikas; Kodali, Maheedhar; Hattiangady, Bharathi
Mild traumatic brain injury (mTBI) resulting from exposure to blast shock waves (BSWs) is one of the most predominant causes of illnesses among veterans who served in the recent Iraq and Afghanistan wars. Such mTBI can also happen to civilians if exposed to shock waves of bomb attacks by terrorists. While cognitive problems, memory dysfunction, depression, anxiety and diffuse white matter injury have been observed at both early and/or delayed time-points, an initial brain pathology resulting from exposure to BSWs appears to be the dysfunction or disruption of the blood-brain barrier (BBB). Studies in animal models suggest that exposure to relatively milder BSWs (123 kPa) initially induces free radical generating enzymes in and around brain capillaries, which enhances oxidative stress resulting in loss of tight junction (TJ) proteins, edema formation, and leakiness of BBB with disruption or loss of its components pericytes and astrocyte end-feet. On the other hand, exposure to more intense BSWs (145-323 kPa) causes acute disruption of the BBB with vascular lesions in the brain. Both of these scenarios lead to apoptosis of endothelial and neural cells and neuroinflammation in and around capillaries, which may progress into chronic traumatic encephalopathy (CTE) and/or a variety of neurological impairments, depending on brain regions that are afflicted with such lesions. This review discusses studies that examined alterations in the brain milieu causing dysfunction or disruption of the BBB and neuroinflammation following exposure to different intensities of BSWs. Furthermore, potential of early intervention strategies capable of easing oxidative stress, repairing the BBB or blocking inflammation for minimizing delayed neurological deficits resulting from exposure to BSWs is conferred.
Peters, Lieke H. J.; Maathuis, Carel G. B.; Hadders-Algra, Mijna
Background: Some evidence suggests that children with specific behavioral problems are at risk for motor problems. It is unclear whether neurological condition plays a role in the propensity of children with behavioral problems to develop Motor problems. Aims: To examine the relation between
Martin-Balbuena, S; Arpa-Gutierrez, F J
The pseudomigraine syndrome with cerebrospinal fluid (CSF) and pleocytosis (PMP) or headache with neurologic deficits and CSF lymphocytosis (HaNDL) is an entity that they have been realized multiple contributions to their etiophysiopathology in the 25 years of their discovery. The PMP is described in 1980 by Swanson, Bartleson and Whisnant, and parallelly for Marti-Masso, and from then on there have been contributions of new cases, ones some atypical for mild headache, prolonged recurrence, symptomatic intracranial hypertension or infections for citomegalovirus that simulates PMP. They have carried out several approaches diagnoses along the years being established at the moment in the year 2004 by the International Classification of Headache Disorders. They have carried out contributions to their knowledge thanks to the realization of electroencephalograms, single photon emission computed tomography brain imaging, transcranial Doppler, evoked potentials, brain magnetic resonance imaging diffusion... giving place to the existence of numerous theories like the infectious-autoimmune, dysfunction of the blood brain barrier, spread cortical depression, trigeminous-vascular activation. The PMP or HaNDL is a benign entity with even unknown etiophysiopathology and where it is important the differential diagnosis with other entities potentially more dangerous.
Kovari, Viktor Zsolt
To detail the management, complications and results of a crossbow arrow injury, where the broadhead went through the mouth, tongue, soft palate, C2 vertebra, spinal canal, dural sack, exiting the neck posteriorly and the arrow shaft lodged in the spine causing mild spinal cord injury. Case presentation. A penetrating axial cervical spine crossbow injury was treated successfully in spite of the following interdisciplinary complications: meningitis, cerebrospinal fluid leakage, re-bleeding, and cardiac arrest. The shaft was removed from the neck, and C1-3 dorsal stabilization was performed. Controlled Computed Tomography (CT) showed adequate implant position. After 4 months the patient's fine motor skills improved, and he became able to button his shirt on his own, and to eat and drink without any help. Additionally, he was able to walk without any support. At the time of control at the outpatient clinic his behavior was adequate: he cooperated with the examining doctor and answered with short sentences although his psychomotor skills were slightly slower. Although bow and crossbow spine injuries are rare nowadays they still occur. The removal of a penetrating missile resulting in such a spinal injury required a unique solution. General considerations, such as securing the airway, leaving the penetrating arrow in the neck and immobilizing both the arrow and neck for transport, thorough diagnostic imaging, preventing cerebrospinal fluid leakage, administering prophylactic antibiotics with broad coverage and stabilizing the spine if required, are advised.
... four domains of neurological and behavioral functioning (cognitive, emotional, motor and sensory) for..., with 66% English-speaking and 34% Spanish-speaking. Frequency of Response: Once to the screener, and... Respondents: 52,800 for the screener and 5,660 for the Toolbox measures; Estimated Number of Responses per...
... sensory) for use in large longitudinal or epidemiological studies where functioning is monitored over time... Neurological and Behavioral Function. Type of Information Collection Request: New. Need and Use of Information...' age, gender, race/ethnicity, education and primary language. The targeted population will be non...
Sun, Xiang-Yao; Zhang, Xi-Nuo; Hai, Yong
This study evaluated differences in outcome variables between percutaneous, traditional, and paraspinal posterior open approaches for traumatic thoracolumbar fractures without neurologic deficit. A systematic review of PubMed, Cochrane, and Embase was performed. In this meta-analysis, we conducted online searches of PubMed, Cochrane, Embase using the search terms "thoracolumbar fractures", "lumbar fractures", ''percutaneous'', "minimally invasive", ''open", "traditional", "posterior", "conventional", "pedicle screw", "sextant", and "clinical trial". The analysis was performed on individual patient data from all the studies that met the selection criteria. Clinical outcomes were expressed as risk difference for dichotomous outcomes and mean difference for continuous outcomes with 95 % confidence interval. Heterogeneity was assessed using the χ 2 test and I 2 statistics. There were 4 randomized controlled trials and 14 observational articles included in this analysis. Percutaneous approach was associated with better ODI score, less Cobb angle correction, less Cobb angle correction loss, less postoperative VBA correction, and lower infection rate compared with open approach. Percutaneous approach was also associated with shorter operative duration, longer intraoperative fluoroscopy, less postoperative VAS, and postoperative VBH% in comparison with traditional open approach. No significant difference was found in Cobb angle correction, postoperative VBA, VBA correction loss, Postoperative VBH%, VBH correction loss, and pedicle screw misplacement between percutaneous approach and open approach. There was no significant difference in operative duration, intraoperative fluoroscopy, postoperative VAS, and postoperative VBH% between percutaneous approach and paraspianl approach. The functional and the radiological outcome of percutaneous approach would be better than open approach in the long term. Although trans-muscular spatium approach belonged to open fixation methods
Santin, L.J.; Bilbao, A.; Pedraza, C.; Matas-Rico, E.; López-Barroso, D.; Castilla-Ortega, E.; Sánchez-López, J.; Riquelme, R.; Varela-Nieto, I.; de la Villa, P.; Suardíaz, M.; Chun, J.; De Fonseca, F. Rodriguez; Estivill-Torrús, G.
Lysophosphatidic acid (LPA) has emerged as a new regulatory molecule in the brain. Recently, some studies have demonstrated a role for this molecule and its LPA1 receptor in the regulation of plasticity and neurogenesis in the adult brain. However, no systematic studies have been conducted to investigate whether the LPA1 receptor is involved in behavior. Here we studied the phenotype of maLPA1–null mice, which bear a targeted deletion at the lpa1 locus, in a battery of tests examining neurologic performance, habituation in exploratory behavior in response to low and mild anxiety environments and spatial memory. MaLPA1-null mutants showed deficits in both olfaction and somesthesis, but not in retinal or auditory functions. Sensorimotor coordination was impaired only in the equilibrium and grasping reflexes. The mice also showed impairments in neuromuscular strength and analgesic response. No additional differences were observed in the rest of the tests used to study sensoriomotor orientation, limb reflexes, and coordinated limb use. At behavioral level, maLPA1-null mice showed an impaired exploration in the open field and increased anxiety-like response when exposed to the elevated plus maze. Furthermore, the mice exhibit impaired spatial memory retention and reduced use of spatial strategies in the Morris water maze. We propose that the LPA1 receptor may play a major role in both spatial memory and response to anxiety-like conditions. PMID:19689455
UCL's former provost, Sir Derek Roberts, has been drafted in for a year to run the college. UCL is expected to have a 6 million pounds deficit this year and up to a 10 million pounds deficit next year. Sir Christopher Llewellyn-Smith took over at UCL nearly 4 years ago and decided then that the finanical situation was serious enough to warrant a reduction in the vast expansion policy undertaken by his predecessor (1 page).
Ryan, R; Gutierrez-Quintana, R; Ter Haar, G; De Decker, Steven
Congenital vertebral malformations are common incidental findings in small breed dogs. This retrospective observational study evaluated the type and prevalence of thoracic vertebral malformations in 171 neurologically normal and 10 neurologically abnormal screw-tailed brachycephalic dogs. Neurologically normal dogs underwent CT for reasons unrelated to spinal disease, while affected dogs underwent MRI. Imaging studies were reviewed and vertebral malformations including hemivertebrae, block vertebrae, transitional vertebrae, and spina bifida were documented. The group of clinically normal dogs consisted of 62 French bulldogs, 68 Pugs and 41 English bulldogs. The group of affected dogs consisted of one French bulldog and nine Pugs. Overall, 80.7% of neurologically normal animals were affected by at least one vertebral malformation. There was a significant influence of breed, with thoracic vertebral malformations occurring more often in neurologically normal French bulldogs (P neurologically normal French bulldogs (93.5%; P neurologically normal Pugs (17.6%; P = 0.004 vs. English bulldogs). Neurologically normal Pugs were more often diagnosed with transitional vertebrae and spina bifida compared to other breeds (P neurologically normal screw-tailed brachycephalic dogs. While hemivertebrae are often interpreted as incidental diagnostic findings, they appear to be of greater clinical importance in Pugs compared to other screw-tailed brachycephalic breeds. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lee, Pei-chin; Niew, Wern-ing; Yang, Hao-jan; Chen, Vincent Chin-hung; Lin, Keh-chung
This meta-analysis examined the effect of behavioral parent training on child and parental outcomes for children with attention deficit hyperactivity disorder. Meta-analytic procedures were used to estimate the effect of behavioral parent training on children with attention deficit hyperactivity disorder. Variables moderating the intervention…
Ramieri, Alessandro; Domenicucci, Maurizio; Cellocco, Paolo; Lenzi, Jacopo; Dugoni, Demo Eugenio; Costanzo, Giuseppe
Cervical subaxial malalignment due to complete or partial post-traumatic dislocation is generally associated to neurological impairment of ranging severity. Literature lacks reporting this entity in patients with no neurological issues. Cervical traction is not widely accepted in treating this kind of injury, due to its potential for neurological damage, although surgery seems to represent the gold standard. We studied in detail 18 cervical subaxial severe dislocations and ptosis, especially analyzing 2 personal cases plus 5 from the literature without neurological impairment. We discuss the role of pre-operative cervical traction and its influence on the overall surgical planning and outcome. Sixteen cases of anterior complete luxation were described in detail by literature. Five patients were reported having no associated neurological impairment and three were treated by pre-operative traction. Our two cases of cervical subaxial dislocation due to bi-pedicular fractures without neurological deficits were treated by traction and surgical fixation. Subaxial bi-pedicular fracture is a highly unstable condition of the cervical spine. Complete or incomplete dislocation requires instrumented fixation. An intact neurological status is very rare. Pathological canal enlargement seems to be able to protect the spinal cord, during trauma and/or traction. For these findings, cervical traction could be applied with no excessive worrying. We prefer a progressive traction up to 20 lb, administered in 7-10 days with no intubation and close neuro-vascular status monitoring. Good pre-operative realignment can be properly achieved in the majority of cervical dislocations, thus avoiding three-stage surgery and somatectomy.
Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I
To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.
The article describes and analyzes the behavioral and neurological aspects that bring together discussions on attention deficit disorder and hyperactivity and outlines some historical conceptual antecedents...
Full Text Available Abstract Background Animal models of Parkinson's disease have been widely used for investigating the mechanisms of neurodegenerative process and for discovering alternative strategies for treating the disease. Following 10 injections with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 25 mg/kg and probenecid (250 mg/kg over 5 weeks in mice, we have established and characterized a chronic mouse model of Parkinson's disease (MPD, which displays severe long-term neurological and pathological defects resembling that of the human Parkinson's disease in the advanced stage. The behavioral manifestations in this chronic mouse model of Parkinson's syndrome remain uninvestigated. The health benefit of exercise in aging and in neurodegenerative disorders including the Parkinson's disease has been implicated; however, clinical and laboratory studies in this area are limited. In this research with the chronic MPD, we first conducted a series of behavioral tests and then investigated the impact of endurance exercise on the identified Parkinsonian behavioral deficits. Results We report here that the severe chronic MPD mice showed significant deficits in their gait pattern consistency and in learning the cued version of the Morris water maze. Their performances on the challenging beam and walking grid were considerably attenuated suggesting the lack of balance and motor coordination. Furthermore, their spontaneous and amphetamine-stimulated locomotor activities in the open field were significantly suppressed. The behavioral deficits in the chronic MPD lasted for at least 8 weeks after MPTP/probenecid treatment. When the chronic MPD mice were exercise-trained on a motorized treadmill 1 week before, 5 weeks during, and 8–12 weeks after MPTP/probenecid treatment, the behavioral deficits in gait pattern, spontaneous ambulatory movement, and balance performance were reversed; whereas neuronal loss and impairment in cognitive skill, motor coordination, and
Nicholls, Russell E; Alarcon, Juan Marcos; Malleret, Gaël; Carroll, Reed C; Grody, Michael; Vronskaya, Svetlana; Kandel, Eric R
.... This physiological phenotype was associated with deficits in behavioral flexibility in both the Morris water maze and a delayed nonmatch to place T-maze task, suggesting that NMDAR-dependent LTD...
Full Text Available Posterior reversible encephalopathy syndrome presents with a variety of neurologic features, which, although devastating at some point, are potentially reversible on prompt recognition and institution of appropriated treatment. We report the management of three cases occurring in the last 4 years in our tertiary university hospital.
Full Text Available Abstract Background Previous studies suggest that the cyclooxygenase-2 (COX-2 inhibitor nimesulide has a remarkable protective effect against different types of brain injury including ischemia. Since there are no reports on the effects of nimesulide on permanent ischemic stroke and because most cases of human stroke are caused by permanent occlusion of cerebral arteries, the present study was conducted to assess the neuroprotective efficacy of nimesulide on the cerebral infarction and neurological deficits induced by permanent middle cerebral artery occlusion (pMCAO in the rat. Methods Ischemia was induced by permanent occlusion of the middle cerebral artery in rats, via surgical insertion of a nylon filament into the internal carotid artery. Infarct volumes (cortical, subcortical and total and functional recovery, assessed by neurological score evaluation and rotarod performance test, were performed 24 h after pMCAO. In initial experiments, different doses of nimesulide (3, 6 and 12 mg/kg; i.p or vehicle were administered 30 min before pMCAO and again at 6, 12 and 18 h after stroke. In later experiments we investigated the therapeutic time window of protection of nimesulide by delaying its first administration 0.5–4 h after the ischemic insult. Results Repeated treatments with nimesulide dose-dependently reduced cortical, subcortical and total infarct volumes as well as the neurological deficits and motor impairment resulting from permanent ischemic stroke, but only the administration of the highest dose (12 mg/kg was able to significantly (P Conclusions These data show that nimesulide protects against permanent focal cerebral ischemia, even with a 2 h post-treatment delay. These findings have important implications for the therapeutic potential of using COX-2 inhibitors in the treatment of stroke.
Acute, transient hemorrhagic hypotension does not aggravate structural damage or neurologic motor deficits but delays the long-term cognitive recovery following mild to moderate traumatic brain injury
Schütz, Christian; Stover, John F.; Thompson, Hilaire J.; Hoover, Rachel C.; Morales, Diego M.; Schouten, Joost W.; McMillan, Asenia; Soltesz, Kristie; Motta, Melissa; Spangler, Zachery; Neugebauer, Edmund; McIntosh, Tracy K.
Objectives Posttraumatic hypotension is believed to increase morbidity and mortality in traumatically brain-injured patients. Using a clinically relevant model of combined traumatic brain injury with superimposed hemorrhagic hypotension in rats, the present study evaluated whether a reduction in mean arterial blood pressure aggravates regional brain edema formation, regional cell death, and neurologic motor/cognitive deficits associated with traumatic brain injury. Design Experimental prospective, randomized study in rodents. Setting Experimental laboratory at a university hospital. Subjects One hundred nineteen male Sprague-Dawley rats weighing 350-385 g. Interventions Experimental traumatic brain injury of mild to moderate severity was induced using the lateral fluid percussion brain injury model in anesthetized rats (n = 89). Following traumatic brain injury, in surviving animals one group of animals was subjected to pressure-controlled hemorrhagic hypotension, maintaining the mean arterial blood pressure at 50-60 mm Hg for 30 mins (n = 47). The animals were subsequently either resuscitated with lactated Ringer’s solution (three times shed blood volume, n = 18) or left uncompensated (n = 29). Other groups of animals included those with isolated traumatic brain injury (n = 34), those with isolated hemorrhagic hypotension (n = 8), and sham-injured control animals receiving anesthesia and surgery alone (n = 22). Measurements and Main Results The withdrawal of 6-7 mL of arterial blood significantly reduced mean arterial blood pressure by 50% without decreasing arterial oxygen saturation or Pao2. Brain injury induced significant cerebral edema (p hypotension. Brain injury-induced neurologic deficits persisted up to 20 wks after injury and were also not aggravated by the hemorrhagic hypotension. Cognitive dysfunction persisted for up to 16 wks postinjury. The superimposition of hemorrhagic hypotension significantly delayed the time course of cognitive recovery
Hayakawa, T; Waltz, A G
Acute occlusion of the left middle cerebral artery (MCA) was accomplished without anesthesia and inside an intact cranium containing cerebrospinal fluid (CSF) in ten cats five to nine days after implantation of an occlusive device through the orbit. Immediate neurological deficits included forced ambuxlation, circling, and tonic deviation of the head and neck toward the side of the occluded artery; weakness of the opposite limbs; and an apathetic or akinetic state. Two cats died within 24 hours. The other eight cats improved but secondary deficits developed in two, causing death. In two of the remaining six cats no deficits were apparent seven days later. The cerbral infarcts regularly involved the basal ganglia, internal capsule, and cortical regions, and were larger and less variable than those produced by MCA occlusion through and open optic foramen or craniectomy with cranial decompression by drainage of CSF. This model of acute focal cerebral ischemia may be of value for studies of physiological and biochemical factors uninfluenced by sedatives, anesthesia, or recent surgical procedures.
Nwaneri, Damia Uchechukwu; Ibadin, Michael Okoeguale; Ofovwe, Gabriel Egberue; Sadoh, Ayebo Evawere
Behavioral aberrations such as nail biting, finger sucking, and pica have been postulated as risk factors that enhance helminths ova transmission. These aberrations may present commonly in children with chronic neurological disorders and predispose them to heavy intensity of intestinal helminthiasis. This comparative cross-sectional study was to determine the prevalence, intensity, and behavioral risk factors for intestinal helminthiasis in children with chronic neurological disorders and apparently healthy controls. Fresh stool samples from 155 children (2-17 years) with chronic neurological disorders seen at the child neurology clinic and 155 age and sex matched controls from nursery and primary schools in Benin City were analyzed using the Kato-Katz technique for detection of ova of helminths from November 2008 to April 2009. The prevalence of intestinal helminthiasis (31.0%) was significantly higher in children with chronic neurological disorders compared with the controls (19.4%) (P=0.03). The intensity of infections in both groups was light ranging 24-144 eggs per gram. Ascaris lumbricoides, Trichuris trichiura and hookworm were the intestinal helminths isolated in both groups. Behavioral aberrations were significantly more represented in the subjects than in the controls (Pworming exercise were practices significantly associated with decreased prevalence of intestinal helminthiasis in the subjects and controls. Behavioral modification in children with chronic neurological disorders should be an integral part of the control program for intestinal helminthiasis.
Bagher Ghobari Bonab
Full Text Available Beneficial effects of stimulants on core symptoms of Attention Deficit Hyperactivity Disorder (ADHD have been reported in several studies. Behavioral interventions have also been proposed as empirically supported interventions for ADHD. Although cognitive-behavioral therapies (CBT have been criticized for the lack of evidence-based data, some studies have indicated the positive effects of CBT techniques on children with attention deficit hyperactivity disorder (ADHD. This article reports the effects of self-monitoring technique, as a CBT technique, on inattentive behaviors of children with ADHD.
Full Text Available Background: Back pain caused by lumbar region pathologies is a condition that leads to loss of productivity and physical disability, with high costs of diagnosis and treatment. This study was planned to investigate the effect of taping and soft orthosis application on the pain and functional disability in the pathology of lumbar region without neurological deficit. Methods: This study is randomized controlled trial. Sixty-three volunteer patients were randomly divided into three groups of 21 people. Group I, soft orthotics and stabilization exercise program; Group II, Kinesio taping and stabilization exercise program; Group III, stabilization exercise program was applied. After obtaining demographic data of the participants; patients were evaluated in terms of range of motion and muscle strength. We used visual analog scale for pain level assessment, sit and reach test for flexibility assessment, timed up and go test (TUG for functional ambulation and balance, modified Schober test for lumbar spine flexibility, Oswestry Disability Index in the assessment of functional disability. They were assessed at the pretreatment, third (post treatment and six week (home programs and follow-up. Results: The results showed that significant differences (p<0.05 occurred over time in the study parameters such as functional ambulation, flexibility, lumbar flexibility, functional disability, pain, strength, range of motion in all groups. In comparisons between groups, there was a difference mainly in favor of Group II (p<0.05. Conclusions: We have concluded that in lumbar region pathologies without neurological deficits, stabilization exercises combined with orthotics and Kinesio taping applications reduces pain and functional disability.
Feng, H-L; Leng, Y; Ma, C-H; Zhang, J; Ren, M; Chuang, D-M
Lithium and valproic acid (VPA) are two primary drugs used to treat bipolar disorder, and have been shown to have neuroprotective properties in vivo and in vitro. A recent study demonstrated that combined treatment with lithium and VPA elicits synergistic neuroprotective effects against glutamate excitotoxicity in cultured brain neurons, and the synergy involves potentiated inhibition of glycogen synthase kinase-3 (GSK-3) activity through enhanced GSK-3 serine phosphorylation [Leng Y, Liang MH, Ren M, Marinova Z, Leeds P, Chuang DM (2008) Synergistic neuroprotective effects of lithium and valproic acid or other histone deacetylase inhibitors in neurons: roles of glycogen synthase kinase-3 inhibition. J Neurosci 28:2576-2588]. We therefore investigated the effects of lithium and VPA cotreatment on the disease symptom onset, survival time and neurological deficits in cooper zinc superoxide dismutase (SOD1) G93A mutant mice, a commonly used mouse model of amyotrophic lateral sclerosis (ALS). The G93A ALS mice received twice daily i.p. injections with LiCl (60 mg/kg), VPA (300 mg/kg) or lithium plus VPA, starting from the 30(th) day after birth and continuing until death. We found that combined treatment with lithium and VPA produced a greater and more consistent effect in delaying the onset of disease symptoms, prolonging the lifespan and decreasing the neurological deficit scores, compared with the results of monotreatment with lithium or VPA. Moreover, lithium in conjunction with VPA was more effective than lithium or VPA alone in enhancing the immunostaining of phospho-GSK-3beta(Ser9) in brain and lumbar spinal cord sections. To our knowledge, this is the first demonstration of enhanced neuroprotection by a combinatorial approach using mood stabilizers in a mouse ALS model. Our results suggest that clinical trials using lithium and VPA in combination for ALS patients are a rational strategy.
Ubhi, Kiren; Inglis, Chandra; Mante, Michael; Patrick, Christina; Adame, Anthony; Spencer, Brian; Rockenstein, Edward; May, Verena; Winkler, Juergen; Masliah, Eliezer
The term α-synucleinopathies refers to a group of age-related neurological disorders including Parkinson’s disease (PD), Dementia with Lewy Bodies (DLB) and Multiple System Atrophy (MSA) that display an abnormal accumulation of alpha-synuclein (α-syn). In contrast to the neuronal α-syn accumulation observed in PD and DLB, MSA is characterized by a widespread oligodendrocytic α-syn accumulation. Transgenic mice expressing human α-syn under the oligodendrocyte-specific myelin basic protein promoter (MBP1-hαsyn tg mice) model many of the behavioral and neuropathological alterations observed in MSA. Fluoxetine, a selective serotonin reuptake inhibitor, has been shown to be protective in toxin-induced models of PD, however its effects in an in vivo transgenic model of α-synucleinopathy remain unclear. In this context, this study examined the effect of fluoxetine in the MBP1-hαsyn tg mice, a model of MSA. Fluoxetine adminstration ameliorated motor deficits in the MBP1-hαsyn tg mice, with a concomitant decrease in neurodegenerative pathology in the basal ganglia, neocortex and hippocampus. Fluoxetine adminstration also increased levels of the neurotrophic factors, GDNF (glial-derived neurotrophic factor) and BDNF (brain-derived neurotrophic factor) in the MBP1-hαsyn tg mice compared to vehicle-treated tg mice. This fluoxetine-induced increase in GDNF and BDNF protein levels was accompanied by activation of the ERK signaling pathway. The effects of fluoxetine adminstration on myelin and serotonin markers were also examined. Collectively these results indicate that fluoxetine may represent a novel therapeutic intervention for MSA and other neurodegenerative disorders. PMID:22281106
Perez-Robles, Ruth; Doval, Eduardo; Jane, Ma Claustre; da Silva, Pedro Caldeira; Papoila, Ana Luisa; Virella, Daniel
To contribute to the validation of the sensory and behavioral criteria for Regulation Disorders of Sensory Processing (RDSP) (DC:0-3R, 2005), this study examined a sample of toddlers in a clinical setting to analyze: (1) the severity of sensory modulation deficits and the behavioral symptoms of RDSP; (2) the associations between sensory and…
DuPaul, George J.; Ervin, Ruth A.; Hook, Christine L.; McGoey, Kara E.
A study investigated effects of classwide peer tutoring (CWPT) on classroom behavior and academic performance of 18 students with attention deficit hyperactivity disorder (ADHD). CWPT led to improvements in performance in math or spelling for 50% of students with ADHD, along with reductions in off-task behavior for most participants. (Author/CR)
Hollo, Alexandra; Wehby, Joseph H.; Oliver, Regina M.
Low language proficiency and problem behavior often co-occur, yet language deficits are likely to be overlooked in children with emotional and behavioral disorders (EBD). Random effects meta-analyses were conducted to determine prevalence and severity of the problem. Across 22 studies, participants included 1,171 children ages 5-13 with formally…
Toriumi, Kazuya; Oki, Mika; Muto, Eriko; Tanaka, Junko; Mouri, Akihiro; Mamiya, Takayoshi; Kim, Hyoung-Chun; Nabeshima, Toshitaka
We previously reported that prenatal treatment with phencyclidine (PCP) induces glutamatergic dysfunction in the prefrontal cortex (PFC), leading to schizophrenia-like behavioral deficits in adult mice. However, little is known about the prenatal effect of PCP treatment on other types of neurons. We focused on γ-aminobutyric acid (GABA)-ergic interneurons and evaluated the effect of prenatal PCP exposure on the neurodevelopment of GABAergic interneurons in the PFC. PCP was administered at the dose of 10 mg/kg/day to pregnant dams from embryonic day 6.5 to 18.5. After the pups were reared to adult, we analyzed their GABAergic system in the PFC using immunohistological, biochemical, and behavioral analyses in adulthood. The prenatal PCP treatment decreased the density of parvalbumin-positive cells and reduced the expression level of glutamic acid decarboxylase 67 (GAD67) and GABA content of the PFC in adults. Additionally, prenatal PCP treatment induced behavioral deficits in adult mice, such as hypersensitivity to PCP and prepulse inhibition (PPI) deficits. These behavioral deficits were ameliorated by pretreatment with the GABAB receptor agonist baclofen. Furthermore, the density of c-Fos-positive cells was decreased after the PPI test in the PFC of mice treated with PCP prenatally, and this effect was ameliorated by pretreatment with baclofen. These findings suggest that prenatal treatment with PCP induced GABAergic dysfunction in the PFC, which caused behavioral deficits.
Alfieri, Alessio; Srivastava, Salil; Siow, Richard C M; Cash, Diana; Modo, Michel; Duchen, Michael R; Fraser, Paul A; Williams, Steven C R; Mann, Giovanni E
Disruption of the blood-brain barrier (BBB) and cerebral edema are the major pathogenic mechanisms leading to neurological dysfunction and death after ischemic stroke. The brain protects itself against infarction via activation of endogenous antioxidant defense mechanisms, and we here report the first evidence that sulforaphane-mediated preactivation of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream target heme oxygenase-1 (HO-1) in the cerebral vasculature protects the brain against stroke. To induce ischemic stroke, Sprague-Dawley rats were subjected to 70 min middle cerebral artery occlusion (MCAo) followed by 4, 24, or 72 h reperfusion. Nrf2 and HO-1 protein expression was upregulated in cerebral microvessels of peri-infarct regions after 4-72 h, with HO-1 preferentially associated with perivascular astrocytes rather than the cerebrovascular endothelium. In naïve rats, treatment with sulforaphane increased Nrf2 expression in cerebral microvessels after 24h. Upregulation of Nrf2 by sulforaphane treatment prior to transient MCAo (1h) was associated with increased HO-1 expression in perivascular astrocytes in peri-infarct regions and cerebral endothelium in the infarct core. BBB disruption, lesion progression, as analyzed by MRI, and neurological deficits were reduced by sulforaphane pretreatment. As sulforaphane pretreatment led to a moderate increase in peroxynitrite generation, we suggest that hormetic preconditioning underlies sulforaphane-mediated protection against stroke. In conclusion, we propose that pharmacological or dietary interventions aimed to precondition the brain via activation of the Nrf2 defense pathway in the cerebral microvasculature provide a novel therapeutic approach for preventing BBB breakdown and neurological dysfunction in stroke. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.
Nasser Sobhi Gharamaleki
Full Text Available Background Attention deficit/hyperactivity disorder is a kind of disorder that may lead to interpersonal, emotional, educational and domestic problems. Moreover, it may lead to high-risk behaviors among teenagers and this area of research is now a focus of attention for many researchers in order to find solution for its treatment and prevention. Objectives The aim of present study was to determine the effectiveness of dialectical behavior therapy on the decrease of high risk behaviors among students suffering from attention deficit/hyperactivity disorder. Methods This research was done experimentally and through designing pre-test and post-test and using control group. Research population included all male third-grade high school students suffering from attention deficit/hyperactivity disorder (case study: Ardabil city, 2015. Research sample included 40 male students suffering from attention deficit/hyperactivity disorder who were selected through multi-step cluster sampling and classified into two groups: experimental group (n = 20 subjects and control group (n = 20 subjects. For data collection we used Iranian teenage risk-taking scale, Conner’s Adult ADHD Rating Scale- Self report form and Subscale and diagnostic interview based on DSM-5. The data were analyzed by univariate analysis of covariance (ANCOVA model in the SPSS software version 22. Results The results of univariate analysis of covariance showed that dialectical behavior therapy had been effective in decreasing high-risk behaviors (P < 0/001. The data analysis had showed that there was a significant difference between high-risk behaviors of control and experiment groups in the post-test. Conclusions According to the findings training dialectical behavior is effective in controlling emotional behavior and in regulation of emotions; therefore, along with other therapeutic methods we can use this approach as an effective way to decrease psychological and behavioral problems mainly
Fehlings, D L; Roberts, W; Humphries, T; Dawe, G
This study evaluates the effectiveness of cognitive behavioral therapy (CBT) in improving the home behavior of children with attention deficit hyperactivity disorder (ADHD). Twenty-five boys (age 7 to 13) with a diagnosis of ADHD were randomized to a CBT or supportive therapy control group. Outcome measures included parent and teacher ratings of the child on the Behavior Problem Checklist-Attention Problem Subscale (BPC-AP), and the Self-Control Rating Scale (SCRS), parent ratings on the Modified Werry Weiss Activity Scale, and child ratings on the Piers Harris Self-Concept Scale and Matching Familiar Figures Task. Data were analyzed using a two-way analysis of variance for main effects. A significant improvement favoring CBT was found on the Werry Weiss Scale, which measures the parent's perception of the child's hyperactivity in the home, and the child's rating of his/her self-esteem on the Piers Harris Self-Concept Scale. Other outcome measures did not demonstrate statistical differences. This research provides support for the use of CBT in children with ADHD. CBT was found to improve the parent's perception of the child's hyperactivity in the home as well as the child's self-esteem.
Ravizza, Susan M; Solomon, Marjorie; Ivry, Richard B; Carter, Cameron S
Restricted and repetitive behaviors (RRBs) are hallmark symptoms of autism spectrum disorders (ASDs); however, it has proven difficult to understand the mechanisms underlying these behaviors. One hypothesis suggests that RRBs are the result of a core deficit in attention. Alternatively, abnormalities of the motor system may constitute the central mechanism underlying RRBs, given motor deficits observed in ASDs. In this experiment, we investigated the etiology of RRBs and the relationship between attention and motor deficits. Movement impairments (a) may be indirectly related to attention deficits, (b) may result from a shared compromised process, or (c) may be independent. Twenty-two adolescents with ASD and 20 typically developing participants performed a spatial attention task. Movement impairments were assessed with a rhythmic tapping task. Attentional orienting and motor control were found to be related and supported the hypothesis that these impairments in ASD arise from a shared process. In contrast, measures of attention switching and motor control were found to be independent. Stereotyped behaviors, as assessed by parental ratings, were related more to the degree of motor impairment than to deficits of attention. These results suggest that both attentional orienting deficits and stereotyped RRBs are related to a compromised motor system.
Hermes, Gretchen; Ajioka, James W; Kelly, Krystyna A; Mui, Ernest; Roberts, Fiona; Kasza, Kristen; Mayr, Thomas; Kirisits, Michael J; Wollmann, Robert; Ferguson, David J P; Roberts, Craig W; Hwang, Jong-Hee; Trendler, Toria; Kennan, Richard P; Suzuki, Yasuhiro; Reardon, Catherine; Hickey, William F; Chen, Lieping; McLeod, Rima
Worldwide, approximately two billion people are chronically infected with Toxoplasma gondii with largely unknown consequences. To better understand long-term effects and pathogenesis of this common, persistent brain infection, mice were infected at a time in human years equivalent to early to mid adulthood and studied 5-12 months later. Appearance, behavior, neurologic function and brain MRIs were studied. Additional analyses of pathogenesis included: correlation of brain weight and neurologic findings; histopathology focusing on brain regions; full genome microarrays; immunohistochemistry characterizing inflammatory cells; determination of presence of tachyzoites and bradyzoites; electron microscopy; and study of markers of inflammation in serum. Histopathology in genetically resistant mice and cytokine and NRAMP knockout mice, effects of inoculation of isolated parasites, and treatment with sulfadiazine or alphaPD1 ligand were studied. Twelve months after infection, a time equivalent to middle to early elderly ages, mice had behavioral and neurological deficits, and brain MRIs showed mild to moderate ventricular dilatation. Lower brain weight correlated with greater magnitude of neurologic abnormalities and inflammation. Full genome microarrays of brains reflected inflammation causing neuronal damage (Gfap), effects on host cell protein processing (ubiquitin ligase), synapse remodeling (Complement 1q), and also increased expression of PD-1L (a ligand that allows persistent LCMV brain infection) and CD 36 (a fatty acid translocase and oxidized LDL receptor that mediates innate immune response to beta amyloid which is associated with pro-inflammation in Alzheimer's disease). Immunostaining detected no inflammation around intra-neuronal cysts, practically no free tachyzoites, and only rare bradyzoites. Nonetheless, there were perivascular, leptomeningeal inflammatory cells, particularly contiguous to the aqueduct of Sylvius and hippocampus, CD4+ and CD8+ T cells
Full Text Available Abstract Background Worldwide, approximately two billion people are chronically infected with Toxoplasma gondii with largely unknown consequences. Methods To better understand long-term effects and pathogenesis of this common, persistent brain infection, mice were infected at a time in human years equivalent to early to mid adulthood and studied 5–12 months later. Appearance, behavior, neurologic function and brain MRIs were studied. Additional analyses of pathogenesis included: correlation of brain weight and neurologic findings; histopathology focusing on brain regions; full genome microarrays; immunohistochemistry characterizing inflammatory cells; determination of presence of tachyzoites and bradyzoites; electron microscopy; and study of markers of inflammation in serum. Histopathology in genetically resistant mice and cytokine and NRAMP knockout mice, effects of inoculation of isolated parasites, and treatment with sulfadiazine or αPD1 ligand were studied. Results Twelve months after infection, a time equivalent to middle to early elderly ages, mice had behavioral and neurological deficits, and brain MRIs showed mild to moderate ventricular dilatation. Lower brain weight correlated with greater magnitude of neurologic abnormalities and inflammation. Full genome microarrays of brains reflected inflammation causing neuronal damage (Gfap, effects on host cell protein processing (ubiquitin ligase, synapse remodeling (Complement 1q, and also increased expression of PD-1L (a ligand that allows persistent LCMV brain infection and CD 36 (a fatty acid translocase and oxidized LDL receptor that mediates innate immune response to beta amyloid which is associated with pro-inflammation in Alzheimer's disease. Immunostaining detected no inflammation around intra-neuronal cysts, practically no free tachyzoites, and only rare bradyzoites. Nonetheless, there were perivascular, leptomeningeal inflammatory cells, particularly contiguous to the aqueduct of
Full Text Available This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF. The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation. The mean operation time was 93 min (range: 62–110 min and the mean intraoperative blood loss was 452 mL in all cases. The average canal encroachment was 50.04% and 10.92% prior to the surgery and at last followup, respectively (P<0.01. The preoperative kyphotic angle was 17.2 degree (±6.87 degrees, whereas it decreased to 8.42 degree (±4.99 degrees at last followup (P<0.01. Besides, the mean vertebral body height increased from 40.15% (±9.40% before surgery to 72.34% (±12.32% at last followup (P<0.01. 45 patients showed 1-2 grades improvement in Frankel’s scale at last followup. This technique allows for satisfactory canal clearance and restoration of vertebral body height and kyphotic angle, and it may promote the recovery of neurological function. However, further research is still necessary to confirm the efficacy of this treatment.
Pan, Dao; Sciascia, Anthony; Vorhees, Charles V; Williams, Michael T
Mucopolysaccharidosis type I (MPS I) is one of the most common lysosomal storage diseases with progressive neurological dysfunction. To characterize the chronological behavioral profiles and identify the onset of functional deficits in a MPS I mouse model (IDUA(-/-)), we evaluated anxiety, locomotor behavior, startle, spatial learning and memory with mice at 2, 4, 6 and 8 months of age. In automated open-field test, IDUA(-/-) mice showed hypoactivity as early as 2 months of age and altered anxiety starting from 6 months of age during the initial exploratory phase, even though normal habituation was observed at all ages. In the marble-burying task, the anxiety-like compulsive behavior was normal in IDUA(-/-) mice at almost all tested ages, but significantly reduced in 8-month old male IDUA(-/-) mice which coincided with the rapid death of IDUA(-/-) males starting from 7 months of age. In the Morris water maze, IDUA(-/-) mice exhibited impaired proficient learning only at 4 months of age during the acquisition phase. Spatial memory deficits were observed in IDUA(-/-) mice during both 1 and 7 days probe trials at 4 and 8 months of age. The IDUA(-/-) mice performed normally in a novel object recognition task at younger ages until 8 months old when reduced visual cognitive memory retention was noted in the IDUA(-/-) mice. In addition, 8-month-old IDUA(-/-) mice failed to habituate to repeated open-field exposure, suggesting deficits in non-aversive and non-associative memory. In acoustic startle assessment, significantly more non-responders were found in IDUA(-/-) mice, but normal performance was seen in those that did show a response. These results presented a temporal evaluation of phenotypic behavioral dysfunctions in IDUA(-/-) mice from adolescence to maturity, indicating the impairments, with different ages of onset, in locomotor and anxiety-like compulsive behaviors, spatial learning and memory, visual recognition and short-term non-associative memory retention
Kirshenbaum, Greer S; Idris, Nagi F; Dachtler, James; Roder, John C; Clapcote, Steven J
Social behavioral deficits have been observed in patients diagnosed with alternating hemiplegia of childhood (AHC), rapid-onset dystonia-parkinsonism and CAPOS syndrome, in which specific missense mutations in ATP1A3, encoding the Na(+), K(+)-ATPase α3 subunit, have been identified. To test the hypothesis that social behavioral deficits represent part of the phenotype of Na(+), K(+)-ATPase α3 mutations, we assessed the social behavior of the Myshkin mouse model of AHC, which has an I810N mutation identical to that found in an AHC patient with co-morbid autism. Myshkin mice displayed deficits in three tests of social behavior: nest building, pup retrieval and the three-chamber social approach test. Chronic treatment with the mood stabilizer lithium enhanced nest building in wild-type but not Myshkin mice. In light of previous studies revealing a broad profile of neurobehavioral deficits in the Myshkin model - consistent with the complex clinical profile of AHC - our results suggest that Na(+), K(+)-ATPase α3 dysfunction has a deleterious, but nonspecific, effect on social behavior. By better defining the behavioral profile of Myshkin mice, we identify additional ATP1A3-related symptoms for which the Myshkin model could be used as a tool to advance understanding of the underlying neural mechanisms and develop novel therapeutic strategies.
Kirshenbaum, Greer S.; Idris, Nagi F.; Dachtler, James; Roder, John C.; Clapcote, Steven J.
Abstract Social behavioral deficits have been observed in patients diagnosed with alternating hemiplegia of childhood (AHC), rapid-onset dystonia-parkinsonism and CAPOS syndrome, in which specific missense mutations in ATP1A3, encoding the Na+, K+-ATPase α3 subunit, have been identified. To test the hypothesis that social behavioral deficits represent part of the phenotype of Na+, K+-ATPase α3 mutations, we assessed the social behavior of the Myshkin mouse model of AHC, which has an I810N mutation identical to that found in an AHC patient with co-morbid autism. Myshkin mice displayed deficits in three tests of social behavior: nest building, pup retrieval and the three-chamber social approach test. Chronic treatment with the mood stabilizer lithium enhanced nest building in wild-type but not Myshkin mice. In light of previous studies revealing a broad profile of neurobehavioral deficits in the Myshkin model – consistent with the complex clinical profile of AHC – our results suggest that Na+, K+-ATPase α3 dysfunction has a deleterious, but nonspecific, effect on social behavior. By better defining the behavioral profile of Myshkin mice, we identify additional ATP1A3-related symptoms for which the Myshkin model could be used as a tool to advance understanding of the underlying neural mechanisms and develop novel therapeutic strategies. PMID:27276195
Koenraads, Yvonne; Braun, Kees P J; van der Linden, Denise C P; Imhof, Saskia M; Porro, Giorgio L
Visual field examination in young or neurologically impaired children is a challenge. As a result, the Behavioral Visual Field (BEFIE) Screening Test was developed in 1995. To evaluate the applicability of the BEFIE test in a large population of young or neurologically impaired children, its reliability and consistency of findings across time, and its potential diagnostic value compared with standard conventional perimetry. The BEFIE tests were performed at an academic tertiary center and measured the peripheral visual field extension in degrees by observing an individual's response to a stimulus on a graded arc that moved from the periphery to the center of the visual field along different meridians. Patient files from all children who underwent this test were retrospectively analyzed. In total, 1788 BEFIE tests were performed in 835 children (median age, 3.4 years). Reliability and results of all tests were longitudinally evaluated. The diagnostic value of the BEFIE test was assessed by comparing monocular BEFIE test results with those of standard conventional perimetry in children who underwent both. Of 1788 tests, 74% (95% CI, 72%-76%) were considered reliable from the age of 4 months and older, with increasing success with higher ages; 56% reliable in children younger than 1 year; 71% reliable in children between 1 and 2 years; and more than 75% reliable in children 2 years and older (Spearman r = 0.506; P = .11). Peripheral visual field defects were found in 28% (95% CI, 25%-31%) of all first reliable tests. In 75% of children who underwent serial testing, results were consistent and there were good explanations in the case of discrepancies. Comparison of monocular BEFIE tests with standard conventional perimetry results in 147 eyes yielded a positive predictive value of 98% (95% CI, 94%-100%), negative predictive value of 66% (95% CI, 56%-75%), specificity of 98% (95% CI, 95%-100%), sensitivity of 60% (95% CI, 50%-71%), and superior sensitivity of 80
Bravo J, Paulina; Ibarra C, Judith; Paredes M, Marcela
Vitamin B12 deficiency is extremely common in strict vegetarians and their variants. Infants of vegetarian mothers have a higher risk of deficiency and are more prone to its effects. To report a case in order to warn people about the importance of suspected vitamin B12 deficiency in children of vegetarian mothers. A 12-month old infant, daughter of a longtime vegetarian woman, who presented neurological and hematological compromise due to vitamin B12 deficiency, is discussed. After a short period of parenteral administration of cyanocobalamin and enteral nutrition, the patient evolved with clinical and laboratory improvement, although she still had residual development delay. Vitamin B12 deficiency is often not suspected by the pediatrician in healthy infants. Clinical manifestations can be nonspecific, such as apathy, food refusal and progressive impairment of psychomotor development. A nutritional anamnesis performed on the mother (with great emphasis on those strict vegetarians) to estimate her reserves in the period prior to, during and after delivery can be critical to detect the risk of this vitamin deficiency in young children.
Full Text Available Introduction. Strokes and stroke-mimics have been extensively studied in the emergency department setting. Although in-hospital strokes are less studied in comparison to strokes in the emergency department, they are a source of significant direct and indirect costs. Differentiating in-hospital strokes from stroke-mimics is important. Thus, our study aimed to identify variables that can differentiate in-hospital strokes from stroke-mimics. Methods. We present here a retrospective analysis of 93 patients over a one-year period (2009 to 2010, who were evaluated for a concern of in-hospital strokes. Results. About two-thirds (57 of these patients were determined to have a stroke, and the remaining (36 were stroke-mimics. Patients with in-hospital strokes were more likely to be obese (p=0.03, have been admitted to the cardiology service (p=0.01, have atrial fibrillation (p=0.03, have a weak hand or hemiparesis (p=0.03, and have a prior history of stroke (p=0.05, whereas, when the consults were called for “altered mental status” but no other deficits (p<0.0001, it is likely a stroke-mimic. Conclusion. This study demonstrates that in-hospital strokes are a common occurrence, and knowing the variables can aid in their timely diagnosis and treatment.
Sarver, Dustin E; Rapport, Mark D; Kofler, Michael J; Raiker, Joseph S; Friedman, Lauren M
Excess gross motor activity (hyperactivity) is considered a core diagnostic feature of childhood ADHD that impedes learning. This view has been challenged, however, by recent models that conceptualize excess motor activity as a compensatory mechanism that facilitates neurocognitive functioning in children with ADHD. The current study investigated competing model predictions regarding activity level's relation with working memory (WM) performance and attention in boys aged 8-12 years (M = 9.64, SD = 1.26) with ADHD (n = 29) and typically developing children (TD; n = 23). Children's phonological WM and attentive behavior were objectively assessed during four counterbalanced WM tasks administered across four separate sessions. These data were then sequenced hierarchically based on behavioral observations of each child's gross motor activity during each task. Analysis of the relations among intra-individual changes in observed activity level, attention, and performance revealed that higher rates of activity level predicted significantly better, but not normalized WM performance for children with ADHD. Conversely, higher rates of activity level predicted somewhat lower WM performance for TD children. Variations in movement did not predict changes in attention for either group. At the individual level, children with ADHD and TD children were more likely to be classified as reliably Improved and Deteriorated, respectively, when comparing their WM performance at their highest versus lowest observed activity level. These findings appear most consistent with models ascribing a functional role to hyperactivity in ADHD, with implications for selecting behavioral treatment targets to avoid overcorrecting gross motor activity during academic tasks that rely on phonological WM.
Yang, Liu; Liu, Zhijia; Ren, Honglei; Zhang, Lei; Gao, Siman; Ren, Li; Chai, Zhi; Meza-Romero, Roberto; Benedek, Gil; Vandenbark, Arthur A; Offner, Halina; Li, Minshu
Traumatic brain injury (TBI) results in severe neurological impairments without effective treatments. Inflammation appears to be an important contributor to key pathogenic events such as secondary brain injury following TBI and therefore serves as a promising target for novel therapies. We have recently demonstrated the ability of a molecular construct comprised of the human leukocyte antigen (HLA)-DRα1 domain linked covalently to mouse (m)MOG-35-55 peptide (DRα1-MOG-35-55 construct) to reduce CNS inflammation and tissue injury in animal models of multiple sclerosis and ischemic stroke. The aim of the current study was to determine if DRα1-MOG-35-55 treatment of a fluid percussion injury (FPI) mouse model of TBI could reduce the lesion size and improve disease outcome measures. Neurodeficits, lesion size, and immune responses were determined to evaluate the therapeutic potential and mechanisms of neuroprotection induced by DRα1-MOG-35-55 treatment. The results demonstrated that daily injections of DRα1-MOG-35-55 given after FPI significantly reduced numbers of infiltrating CD74(+) and CD86(+) macrophages and increased numbers of CD206(+) microglia in the brain concomitant with smaller lesion sizes and improvement in neurodeficits. Conversely, DRα1-MOG-35-55 treatment of TBI increased numbers of circulating CD11b(+) monocytes and their expression of CD74 but had no detectable effect on cell numbers or marker expression in the spleen. These results demonstrate that DRα1-MOG-35-55 therapy can reduce CNS inflammation and significantly improve histological and clinical outcomes after TBI. Future studies will further examine the potential of DRα1-MOG-35-55 for treatment of TBI.
Dickerson, F B; Ringel, N B; Boronow, J J
Thirty-nine hospitalized chronic schizophrenics were administered the Luria-Nebraska Neuropsychological Battery (LNNB) and the Weschler Adult Intelligence Scale-Revised when they were clinically stable. Test variables were related to Brief Psychiatric Rating Scale ratings and two behavioral measures of ward functioning, points and activities. Spearman correlations of test variables with the symptom and behavioral measures were entered into a series of median polish analyses. There was an overall significant relationship between the two sets of variables. Neuropsychological test variables that were most highly correlated with symptom/behavioral measures were LNNB Left Frontal, Memory, and Intellectual Processes scales. The positive symptoms of thought disorder and hallucinations were most consistently related to neuropsychological variables. In contrast with other findings in the literature, negative symptoms were not significantly correlated with neuropsychological performance.
Full Text Available The aim of our investigation was to characterize the role of group I mGluRs and NMDA receptors in pathomechanisms of experimental autoimmune encephalomyelitis (EAE, the rodent model of MS. We tested the effects of LY 367385 (S-2-methyl-4-carboxyphenylglycine, a competitive antagonist of mGluR1, MPEP (2-methyl-6-(phenylethynyl-pyridine, an antagonist of mGluR5, and the uncompetitive NMDA receptor antagonists amantadine and memantine on modulation of neurological deficits observed in rats with EAE. The neurological symptoms of EAE started at 10-11 days post-injection (d.p.i. and peaked after 12-13 d.p.i. The protein levels of mGluRs and NMDA did not increase in early phases of EAE (4 d.p.i., but starting from 8 d.p.i. to 25 d.p.i., we observed a significant elevation of mGluR1 and mGluR5 protein expression by about 20% and NMDA protein expression by about 10% over the control at 25 d.p.i. The changes in protein levels were accompanied by changes in mRNA expression of group I mGluRs and NMDARs. During the late disease phase (20–25 d.p.i., the mRNA expression levels reached 300% of control values. In contrast, treatment with individual receptor antagonists resulted in a reduction of mRNA levels relative to untreated animals.
Jones, Nicole Tuomi; McGill, Amanda C; Vogler, Jason E; Oxley, Stephen
The primary goals of compulsory, inpatient, psychiatric treatment are to decrease dangerous behaviors and help improve functioning so that a safe discharge to a less restrictive environment can be obtained. This study examined the aggression rates, levels of functioning, and treatment adherence for persons treated for schizophrenia (N = 506) compared with persons treated for borderline personality disorder (BPD) (N = 98) in an inpatient psychiatric facility. Over half of persons engaged in at least one incident of aggressive behavior during hospitalization. Differences in the types of aggression and functional deficits between these two clinical sub-groups were found. In addition, overall impairment increased the likelihood of aggressive behavior for persons diagnosed with schizophrenia, whereas irritability and social dependence increased the risk of aggression for persons diagnosed with BPD. Treatment interventions that target the improvement of these deficits may help reduce the intensity and severity of aggressive behaviors and help improve functioning and discharge readiness.
Chronis, Andrea M.; Gamble, Stephanie A.; Roberts, John E.; Pelham, William E., Jr.
An adaptation of the Coping With Depression Course (CWDC) was evaluated in mothers of children with attention-deficit/hyperactivity disorder (ADHD), a population at risk for depression. Mothers were randomly assigned to receive the CWDC either immediately following an intensive summer treatment program targeting their child's behavior or after a…
Martin, Allan R; De Leener, Benjamin; Cohen-Adad, Julien; Aleksanderek, Izabela; Cadotte, David W; Kalsi-Ryan, Sukhvinder; Tetreault, Lindsay; Crawley, Adrian; Ginsberg, Howard J; Fehlings, Michael G
Diffusion tensor imaging (DTI), magnetization transfer (MT), and T2*-weighted imaging measure aspects of spinal cord microstructure. This study investigates if these techniques can quantify injury to individual white matter (WM) tracts and correlate with focal neurological impairments in degenerative cervical myelopathy (DCM). Fifty-seven DCM patients (age 56.7; 61% male; 32 mild, 16 moderate, 9 severe) underwent comprehensive clinical assessments and multimodal MRI (3T GE). Analysis with Spinal Cord Toolbox extracted fractional anisotropy (FA), MT ratio (MTR), and T2* WM/gray matter (GM) ratio (representing gray-white contrast) from regions of interest including: total WM, lateral corticospinal tracts (LCSTs), dorsal columns (DCs), and spinothalamic tracts (STTs) at C1-C2. Spearman correlations were calculated between total WM and global disability (mJOA), and between metrics in unilateral/bilateral WM tracts and measures of focal neurological impairment: mJOA upper/lower extremity (UE/LE) motor scores, UE strength, JAMAR grip force, and UE sensation. DCM subjects showed reduced FA (P < .001), decreased MTR (P < .001), and increased T2*-WM/GM ratio (P < .001) vs 32 healthy subjects (MANOVA P < .001). FA of the WM correlated well with mJOA (r = 0.69, P < .01), whereas the other metrics showed weaker relationships (T2*-WM/GM: r = 0.46, P = .01; MTR: r = 0.39, P = .02). FA provided the strongest correlations with focal neurological deficits (all P < .05): FA of bilateral LCSTs correlated with mJOA motor scores (r = 0.65); FA of ipsilateral LCST predicted arm power (left: r = 0.64, right: r = 0.62) and grip strength (left: r = 0.55, right: r = 0.54); FA of the DCs correlated well with ipsilateral hand sensation (left: r = 0.61, right: r = 0.66), while contralateral STTs showed a weaker association (left: r = 0.38, right: r = 0.36). Microstructural MRI successfully measures WM injury rostral to cord compression in DCM, reflecting global and focal impairment. The DTI
DuPaul, G J; Ervin, R A; Hook, C L; McGoey, K E
We investigated the effects of classwide peer tutoring (CWPT) on the classroom behavior and academic performance of students with attention deficit hyperactivity disorder (ADHD). Typical instructional activities were contrasted with CWPT for 18 children with ADHD and 10 peer comparison students attending first- through fifth-grade general education classes. CWPT led to increases in active engagement in academic tasks along with reductions in off-task behavior for most participants. Of student...
such as schizophrenia or depression wherein impaired social behavior is prominent. Among inbred mouse strains, it appears as though there are...disorders: a systematic review. Keio J. Med. 57, 15e36. Alabdali, A., Al-Ayadhi, L., El-Ansary, A., 2014. Association of social and cognitive impairment and...Award Number: W81XWH-12-1-0506 TITLE: Novel Therapeutic Targets To Treat Social Behavior Deficits in Autism and Related Disorders PRINCIPAL
To date, various psychiatric disorders such as disruptive behavior, attention-deficit/hyperactivity and autism spectrum disorders have been associated with deficits in empathy in school-aged children and adolescents. In this dissertation, behavioral and physiological measures were used to study
With increasing aging population, cognitive deteriorations due to neuro- degenerative diseases or stroke are so commonly observed that it is thought to be inevitable with aging. For dementia and stroke, a communication disorder due to language deterioration is one of the main problems. Behavioral neurology aims to clarify the relationship between brain function and behavior; language deterioration is one of the main targets, and its clinical applications are really useful for making better understanding of patients. Language is sequences of sound or characters that carry meanings for communication. From the evolutionary perspective, "language" can be thought about by considering birds and dogs: the basal ganglia and anterior cingulate, and the thalamus and cerebral cortex are thought to provide the neurobiological background, respectively. Humans can use language. The language area is a newly developed brain area in evolution and is mainly localized in the left cerebral hemisphere. Semantic memory has also developed in humans. There are two routes, the superficial and deep routes, with the latter associated with meaning, and three brain areas are involved: the peri-Sylvian area, per-peri-Sylvian area, and right hemisphere. Using these principles, language symptoms of dementia with progressive non-fluent aphasia (PA), semantic dementia (SD), Alzheimer's disease (AD), and vascular dementia (VaD) can be understood. Namely, the symptoms of PA is understood by the dysfunction of peri-Sylvian language area, those of SD and AD by that of peri-peri-Sylvian language area, and those of some VaD cases and AD cases by that of right hemisphere.
Allsop, Stephen A.; Vander Weele, Caitlin M.; Wichmann, Romy; Tye, Kay M.
Many psychiatric illnesses are characterized by deficits in the social domain. For example, there is a high rate of co-morbidity between autism spectrum disorders and anxiety disorders. However, the common neural circuit mechanisms by which social deficits and other psychiatric disease states, such as anxiety, are co-expressed remains unclear. Here, we review optogenetic investigations of neural circuits in animal models of anxiety-related behaviors and social behaviors and discuss the important role of the amygdala in mediating aspects of these behaviors. In particular, we focus on recent evidence that projections from the basolateral amygdala (BLA) to the ventral hippocampus (vHPC) modulate anxiety-related behaviors and also alter social interaction. Understanding how this circuit influences both social behavior and anxiety may provide a mechanistic explanation for the pathogenesis of social anxiety disorder, as well as the prevalence of patients co-diagnosed with autism spectrum disorders and anxiety disorders. Furthermore, elucidating how circuits that modulate social behavior also mediate other complex emotional states will lead to a better understanding of the underlying mechanisms by which social deficits are expressed in psychiatric disease. PMID:25076878
Aniruddha Thekkatte Jagannatha
Full Text Available Study design: Retrospective review of the case file. Objective: The primary objective was to report this rare case and discuss the mechanism of dislocation and technique of manual closed reduction of C1-C2 vertebrae in such scenarios. Summary of background data: Posterior atlantoaxial dislocation (AAD is extremely rare and a few cases have been reported in English literature. This young man sustained a high speed car accident and survived an extreme hyperextension injury to the craniovertebral junction (CVJ without any neurological deficits. On evaluation for neck pain he was noted with a dislocated odontoid lying in front of Atlas. There was C1-C2 facet diastases. No bony injury was noted at CVJ. Transverse axial ligament (TAL was intact. He underwent a successful awake reduction of the dislocation. The joint had to be manually distracted, realigned, and released under the guidance of fluoroscopy. This was followed by single stage C1-C2 Goel′s fusion with awake prone positioning. This patient was able to go back to work at the end of 3 months (GOS 5. Conclusions: This condition is extremely rare, can be carefully reduced manually under adequate neuromonitoring, and requires C1-C2 fusion in the same sitting.
Faregh, Neda; Derevensky, Jeff
Impulsivity is inherent to both problem gambling and ADHD. The purpose of this study is to examine ADHD key symptoms, and gambling behaviors and problem severity among adolescents. Additionally, internalizing and externalizing behaviors exhibited among these individuals and the role of these symptoms in gambling are examined. We used a cross-sectional study design and survey 1,130 adolescents aged 12-19. Results indicated that adolescents who screened positive for ADHD were significantly more likely than non-ADHD adolescents to engage in gambling and significantly more likely to develop gambling problems. Those who screened positive as predominantly inattentive and those who screened positive for ADHD Combined (Inattention and Hyperactivity-Impulsivity) were equally likely to gamble, but the latter were twice as likely to have gambling problems. However, we found no significant interaction between the key ADHD symptoms and gambling as the severity of hyperactivity-impulsivity or inattention did not significantly differ with respect to gambling pathology. Emotional problems and depressive affect were the only variables that could significantly differentiate the ADHD types and gambling severity. Our Results highlight the clinical importance of considering the subtype of ADHD among gamblers and the greater association of depressive affect and emotional problems with gambling among adolescents.
Marques, D M; O'Connell, R J; Benimoff, N; Macrides, F
This study compared the effects of transection of the lateral olfactory tracts (LOT) and the accessory olfactory tracts (AOT) in male hamsters on nest building, food piling, and sexual behavior. Autoradiographic tracing of amino acids injected into the olfactory bulbs allowed accurate determination of the location and extent of the transections. Animals with complete bilateral transection of the projections to the amygdaloid targets of the accessory olfactory bulbs and to the main olfactory targets posterior to the olfactory tubercle showed no sexual behavior postoperatively; they did not exhibit extensive genital investigation and did not mount females. In contrast, most of the animals with partial sparing of accessory olfactory bulb efferents to the amygdala did exhibit investigatory and copulatory behaviors postoperatively, although half of the animals with this partial sparing developed delayed deficits in these sexual behaviors. Almost all animals without detectable main olfactory bulb efferents to posterior targets showed delayed deficits in nest building and food piling. This was true whether or not there was partial sparing of accessory olfactory bulb efferents to the amygdala. The animals with LOT transections typically built nests and piled food during the first postoperative week, but stopped building nests and piling food by the fourth postoperative week. Cold stress enhanced these two behaviors in control animals but did not obviate the deficits in experimental animals. Caudally placed transections, which spared a larger portion of the main olfactory projections than rostally placed transections, did not spare more behavior. In fact, the caudally placed transections produced shorter delays in the appearance of deficits in nest building and food piling. These results indicate that the accessory olfactory bulb efferents to the amygdala are more important for sexual behavior than for nest building and food piling in male hamsters. Nest building and food
Fisher, Caroline A; Sewell, Katherine; Baker, Amy
Behcet's disease is a vasculitis and multisystem inflammatory syndrome. Neurological abnormalities occur in a subset of patients. This report presents a case of neuro-Behcet's disease characterized by an initial onset of behavior changes prior to diagnosis, which evolved into a chronic behavioral syndrome. Neuroimaging investigations revealed progressive periventricular white matter and brainstem atrophy and lesions in the basal ganglia and deep white matter tracts, while neuropsychological investigations revealed reductions in information processing, executive functioning, and memory. The case indicates that behavior changes may be the first symptoms to emerge in Behcet's, before other defining features of the disease.
Lucas, Marjolein J; Brouwer, Matthijs C; van de Beek, Diederik
We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy. Adults with pneumococcal meningitis have the highest risk of developing focal neurological deficits, which are most commonly caused by cerebral infarction, but can also be due to cerebritis, subdural empyema, cerebral abscess or intracerebral bleeding. Focal deficits may improve during clinical course and even after discharge, but a proportion of patients will have persisting focal neurological deficits that often interfere in patient's daily life. Hearing loss occurs in a high proportion of patients with pneumococcal meningitis and has been associated with co-existing otitis. Children and adults recovering from bacterial meningitis without apparent neurological deficits are at risk for long-term cognitive deficits. Early identification of neurological sequelae is important for children to prevent additional developmental delay, and for adults to achieve successful return in society after the disease. Neurological sequelae occur in a substantial amount of patients following bacterial meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Casabella Abril, B; Pérez Sánchez, J
1) To find the opinion of general practitioners working in primary care (GP in PC) regarding how they deal with neurological patients. 2) To find the effect on this question of intern training in family and community medicine (FCM). A survey filled out by a representative sample of GP in PC working at PC public clinics in 1991 in a health region in Catalonia. 56 GP in PC. A self-administered selection questionnaire (multiple choice and scale of 5 points). MEASUREMENTS, MAIN RESULTS AND CONCLUSIONS: Less confidence handling neurological patients than patients with other common medical conditions. Greater need for recycling in neurology than in other basic areas of medicine. Positive impact of FCM intern training on doctors' approach to the examination of neurological patients and application of basic exploratory techniques (ophthalmoscope, reflex hammer, diapason and phonendoscope). The GP intern-trained in FCM lacks confidence in present out-patient specialised support (the area neuropsychiatrist).
SOORANILUNSING, RJ; HADDERSALGRA, M; OLINGA, AA; HUISJES, HJ; TOUWEN, BCL
Behavioural and cognitive development at 12 years were studied in 172 children with and 174 children without minor neurological dysfunction (MND). MND could be differentiated into fine manipulative disability, co-ordination problems, hypotonia and choreiform dyskinesia. Fine manipulative disability
Tabatabaei, Seyed Reza Fatemi; Ghaderi, Shahab; Bahrami-Tapehebur, Mohammad; Farbood, Yaghoob; Rashno, Masome
Oxidative stress has a major role in progression of diabetes-related behavioral deficits. It has been suggested that Aloe vera has anti-diabetic, antioxidative, and neuroprotective effects. The present study was designed to determine the effects of Aloe vera gel on behavioral functions, oxidative status, and neuronal viability in the hippocampus of streptozotocin (STZ)-induced diabetic rats. Fifty five adult male Wistar rats were randomly divided into five groups, including: control (normal saline 8ml/kg/day; P.O.), diabetic (normal saline 8ml/kg/day; P.O.), Aloe vera gel (100mg/kg/day; P.O.), diabetic+Aloe vera gel (100mg/kg/day; P.O.) and diabetic+NPH insulin (10 IU/kg/day; S.C.). All treatments were started immediately following confirmation of diabetes in diabetic groups and were continued for eight weeks. Behavioral functions were evaluated by employing standard behavioral paradigms. Additionally, oxidative status and neuronal viability were assessed in the hippocampus. The results of behavioral tests showed that diabetes enhanced anxiety/depression-like behaviors, reduced exploratory and locomotor activities, decreased memory performance, and increased stress related behaviors. These changes in diabetic rats were accompanied by increasing oxidative stress and neuronal loss in the hippocampus. Interestingly, eight weeks of treatment with Aloe vera gel not only alleviated all the mentioned deficits related to diabetes, but in some aspects, it was even more effective than insulin. In conclusion, the results suggest that both interrelated hypoglycemic and antioxidative properties of Aloe vera gel are possible mechanisms that improve behavioral deficits and protect hippocampal neurons in diabetic animals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Sauer, Aisha V.; Hernandez, Raisa Jofra; Fumagalli, Francesca; Bianchi, Veronica; Poliani, Pietro L.; Dallatomasina, Chiara; Riboni, Elisa; Politi, Letterio S.; Tabucchi, Antonella; Carlucci, Filippo; Casiraghi, Miriam; Carriglio, Nicola; Cominelli, Manuela; Forcellini, Carlo Alberto; Barzaghi, Federica; Ferrua, Francesca; Minicucci, Fabio; Medaglini, Stefania; Leocani, Letizia; la Marca, Giancarlo; Notarangelo, Lucia D.; Azzari, Chiara; Comi, Giancarlo; Baldoli, Cristina; Canale, Sabrina; Sessa, Maria; D’Adamo, Patrizia; Aiuti, Alessandro
Adenosine Deaminase (ADA) deficiency is an autosomal recessive variant of severe combined immunodeficiency (SCID) caused by systemic accumulation of ADA substrates. Neurological and behavioral abnormalities observed in ADA-SCID patients surviving after stem cell transplantation or gene therapy represent an unresolved enigma in the field. We found significant neurological and cognitive alterations in untreated ADA-SCID patients as well as in two groups of patients after short- and long-term enzyme replacement therapy with PEG-ADA. These included motor dysfunction, EEG alterations, sensorineural hypoacusia, white matter and ventricular alterations in MRI as well as a low mental development index or IQ. Ada-deficient mice were significantly less active and showed anxiety-like behavior. Molecular and metabolic analyses showed that this phenotype coincides with metabolic alterations and aberrant adenosine receptor signaling. PEG-ADA treatment corrected metabolic adenosine-based alterations, but not cellular and signaling defects, indicating an intrinsic nature of the neurological and behavioral phenotype in ADA deficiency. PMID:28074903
Sorgi, Paul J; Hallowell, Edward M; Hutchins, Heather L; Sears, Barry
Attention deficit hyperactivity disorder (ADHD) is the most common neurological condition in children. This pilot study evaluated the effects of high-dose eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the isolated plasma phospholipids and behavior in children with ADHD (primarily inattentive subtype and combined subtype). Nine children were initially supplemented with 16.2 g EPA/DHA concentrates per day. The dosage was adjusted dependent on the ratio of arachidonic acid (AA) to EPA in the isolated plasma phospholipids at four weeks to reach a level normally found in the Japanese population. At the end of the eight-week study, supplementation resulted in significant increases in EPA and DHA, as well as a significant reduction in the AA:EPA ratio (20.78 +/- 5.26 to 5.95 +/- 7.35, p DHA concentrates may improve behavior in children with ADHD.
Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A
The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.
Neuronopathic Gaucher disease in the mouse: viable combined selective saposin C deficiency and mutant glucocerebrosidase (V394L) mice with glucosylsphingosine and glucosylceramide accumulation and progressive neurological deficits.
Sun, Ying; Liou, Benjamin; Ran, Huimin; Skelton, Matthew R; Williams, Michael T; Vorhees, Charles V; Kitatani, Kazuyuki; Hannun, Yusuf A; Witte, David P; Xu, You-Hai; Grabowski, Gregory A
Gaucher disease is caused by defective acid beta-glucosidase (GCase) function. Saposin C is a lysosomal protein needed for optimal GCase activity. To test the in vivo effects of saposin C on GCase, saposin C deficient mice (C-/-) were backcrossed to point mutated GCase (V394L/V394L) mice. The resultant mice (4L;C*) began to exhibit CNS abnormalities approximately 30 days: first as hindlimb paresis, then progressive tremor and ataxia. Death occurred approximately 48 days due to neurological deficits. Axonal degeneration was evident in brain stem, spinal cord and white matter of cerebellum accompanied by increasing infiltration of the brain stem, cortex and thalamus by CD68 positive microglial cells and activation of astrocytes. Electron microscopy showed inclusion bodies in neuronal processes and degenerating cells. Accumulation of p62 and Lamp2 were prominent in the brain suggesting the impairment of autophagosome/lysosome function. This phenotype was different from either V394L/V394L or C-/- alone. Relative to V394L/V394L mice, 4L;C* mice had diminished GCase protein and activity. Marked increases (20- to 30-fold) of glucosylsphingosine (GS) and moderate elevation (1.5- to 3-fold) of glucosylceramide (GC) were in 4L;C* brains. Visceral tissues had increases of GS and GC, but no storage cells were found. Neuronal cells in thick hippocampal slices from 4L;C* mice had significantly attenuated long-term potentiation, presumably resulting from substrate accumulation. The 4L;C* mouse mimics the CNS phenotype and biochemistry of some type 3 (neuronopathic) variants of Gaucher disease and is a unique model suitable for testing pharmacological chaperone and substrate reduction therapies, and investigating the mechanisms of neuronopathic Gaucher disease.
Lee, Young Sik; Kim, Se Hee; You, Ji Hee; Baek, Hyung Tae; Na, Chul; Kim, Bung Nyun; Han, Doug Hyun
Objective Previous studies have reported comorbidity of attention deficit and hyperactivity disorder (ADHD) and allergic diseases. The current study investigated ADHD like behavioral symptoms and parenting stress in pediatric allergic rhinitis. Methods Eighty-seven children (6-13 years old) with allergic rhinitis and 73 age- and sex-matched children of control group were recruited. Diagnosis and severity assessments of allergic rhinitis were determined by a pediatric allergist. The Parenting ...
Knouse, Laura E.; Safren, Steven A.
Attention-deficit / hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated with chronic functional impairment and increased rates of comorbidity. Cognitive-behavioral therapy (CBT) approaches for this disorder have emerged relatively recently, and available evidence from open and randomized controlled trials suggests that these approaches are promising in producing significant symptom reduction. A con...
Lin, Chao; Chao, Honglu; Li, Zheng; Xu, Xiupeng; Liu, Yinlong; Bao, Zhongyuan; Hou, Lijun; Liu, Yan; Wang, Xiaoming; You, Yongping; Liu, Ning; Ji, Jing
Omega-3 fatty acids (ω-3 FAs) attenuate inflammation and improve neurological outcome in response to traumatic brain injury (TBI), but the specific anti-inflammatory mechanisms remain to be elucidated. Here we found that NLRP3 inflammasome and subsequent pro-inflammatory cytokines were activated in human brains after TBI. Rats treated with ω-3 FAs had significantly less TBI-induced caspase-1 cleavage and IL-1β secretion than those with vehicle. G protein-coupled receptor 40 (GPR40) was observed to be involved in this anti-inflammation. GW1100, a GPR40 inhibitor, eliminated the anti-inflammatory effect of ω-3 FAs after TBI. β-Arrestin-2 (ARRB2), a downstream scaffold protein of GPR40, was activated to inhibit inflammation via directly binding with NLRP3 in the ω-3 FAs treatment group. Interestingly, we also observed that ω-3 FAs prevented NLRP3 mitochondrial localization, which was reversed by GW1100. Furthermore, ω-3 FAs markedly ameliorated neuronal death and behavioral deficits after TBI, while GW1100 significantly suppressed this effect. Collectively, these data indicate that the GPR40-mediated pathway is involved in the inhibitory effects of ω-3 FAs on TBI-induced inflammation and ARRB2 is activated to interact with NLRP3. Copyright © 2017. Published by Elsevier Inc.
Engstrom, Anna K; Snyder, Jessica M; Maeda, Nobuyo; Xia, Zhengui
Alzheimer's disease (AD) is characterized by progressive cognitive decline and memory loss. Environmental factors and gene-environment interactions (GXE) may increase AD risk, accelerate cognitive decline, and impair learning and memory. However, there is currently little direct evidence supporting this hypothesis. In this study, we assessed for a GXE between lead and ApoE4 on cognitive behavior using transgenic knock-in (KI) mice that express the human Apolipoprotein E4 allele (ApoE4-KI) or Apolipoprotein E3 allele (ApoE3-KI). We exposed 8-week-old male and female ApoE3-KI and ApoE4-KI mice to 0.2% lead acetate via drinking water for 12 weeks and assessed for cognitive behavior deficits during and after the lead exposure. In addition, we exposed a second (cellular) cohort of animals to lead and assessed for changes in adult hippocampal neurogenesis as a potential underlying mechanism for lead-induced learning and memory deficits. In the behavior cohort, we found that lead reduced contextual fear memory in all animals; however, this decrease was greatest and statistically significant only in lead-treated ApoE4-KI females. Similarly, only lead-treated ApoE4-KI females exhibited a significant decrease in spontaneous alternation in the T-maze. Furthermore, all lead-treated animals developed persistent spatial working memory deficits in the novel object location test, and this deficit manifested earlier in ApoE4-KI mice, with female ApoE4-KI mice exhibiting the earliest deficit onset. In the cellular cohort, we observed that the maturation, differentiation, and dendritic development of adult-born neurons in the hippocampus was selectively impaired in lead-treated female ApoE4-KI mice. These data suggest that GXE between ApoE4 and lead exposure may contribute to cognitive impairment and that impaired adult hippocampal neurogenesis may contribute to these deficits in cognitive behavior. Together, these data suggest a role for GXE and sex differences in AD risk.
Heinz, G.H.; Hoffman, D.; Klimstra, J.; Stebbins, K.
We review wildlife/mercury literature and our own research findings that demonstrate the relevance of wildlife toxicity data in protecting human health. Methylmercury affects wildlife through reduced adult survival and reproduction, aberrant behavior, immune system effects, and teratogenic effects. Methylmercury can readily cross the blood-brain barrier, is excreted into eggs in birds, and is transferred to young mammals across the placenta and in milk. Its principal effect on wildlife is on neurological functions. Wild mink (Mustela vison) and otter (Lutra canadensis) have died from methylmercury poisoning, with signs of poisoning including anorexia, loss of weight, incoordination, tremors, and convulsions, which are symptoms similar to those experienced by mercury-poisoned humans. Mammals also may experience tonic and clonic convulsions and an increase in fetal anomalies, again paralleling toxic problems in people. Antibody-producing cells can be suppressed by methylmercury. Microscopically, the most notable lesions are in the cerebrum. Extensive vacuolation of hepatocytes in the liver and necrosis and other changes in the appearance of the proximal convoluted tubules of the kidneys are often noted. When harp seals (Pagophilus groenlandicus) were dosed with methylmercury chloride the number of circulating erythrocytes decreased and white blood cell counts greatly increased. The poisoned seals also suffered from uremia, hyperproteinemia, hypercholesterolemia, hyperbilirubinemia, and elevations in lactic dehydrogenase and alkaline phosphatase. In birds, signs of methylmercury poisoning included emaciation and weakness in the extremities, which progressed until the birds died. Mercury poisoning in birds and mammals can be diagnosed from a combination of the signs of poisoning if the animal is still alive, the pathological effects seen in a gross necropsy, the histopathological effects seen with a microscope, and the concentrations of mercury in various tissues. Our
The predominant neurologic morbidities included: cerebral palsy (42.4%), epilepsy (27.8%), febrile seizure (6.5%), mental retardation(6.2%), microcephaly (5.6%), behavioral problems (5.6%), poliomyelitis (4.5%), hydrocephalus (4.2%), visual impairment (2.8%), down syndrome (1.7%), and attention deficit hyperactivity ...
Coelho, Luzia Flavia; Barbosa, Deise Lima Fernandes; Rizzutti, Sueli; Muszkat, Mauro; Bueno, Orlando Francisco Amodeo; Miranda, Monica Carolina
Medication has proved highly efficacious as a means of alleviating general symptoms of attention-deficit hyperactivity disorder (ADHD). However, many patients remain functionally impaired by inappropriate behavior. The present study analyzed the use of cognitive behavioral therapy (CBT) with the Token-Economy (TE) technique to alleviate problem behavior for 25 participants with ADHD, all children (19 boys, mean age 10.11) on long-term methylphenidate medication, who were given 20 CBT sessions with 10 weeks of TE introduced as of session 5. Their ten most acute problem behaviors were selected and written records kept. On weekdays, parents recorded each inappropriate behavior and provided a suitable model for their actions. At weekly sessions, problem behaviors were counted and incident-free participants rewarded with a token. To analyze improvement (less frequent problem behavior), a list of 11 behavioral categories was rated: inattention, impulsivity, hyperactivity, disorganization, disobeying rules and routines, poor self-care, verbal/physical aggression, low frustration tolerance, compulsive behavior, antisocial behavior, lacking in initiative and distraction. Two CBT specialists categorized behaviors and an ADHD specialist ruled on discrepancies. Statistical analyses used were Generalized Estimating Equations with Poisson distribution and autoregressive order correlation structure. In the course of the sessions, problematic behaviors decreased significantly in seven categories: impulsiveness, hyperactivity, disorganization, disobeying rules and routine, poor self-care, low frustration tolerance, compulsive behaviors, and antisocial behaviors. Caregiver attitudes to children's inappropriate behavior were discussed and reshaped. As functional improvement was observed on applying TE for 10 weeks, this type of intervention may be useful as an auxiliary strategy combined with medication.
Luzia Flavia Coelho
Full Text Available Medication has proved highly efficacious as a means of alleviating general symptoms of attention-deficit hyperactivity disorder (ADHD. However many patients remain functionally impaired by inappropriate behavior. The present study analyzed the use of cognitive behavioral therapy (CBT with the Token Economy (TE technique to alleviate problem behavior for 25 participants with ADHD, all children (19 boys, mean age 10.11 on long-term methylphenidate medication, who were given 20 CBT sessions with 10 weeks of TE introduced as of session 5. Their ten most acute problem behaviors were selected and written records kept. On weekdays, parents recorded each inappropriate behavior and provided a suitable model for their actions. At weekly sessions, problem behaviors were counted and incident-free participants rewarded with a token. To analyze improvement (less frequent problem behavior, a list of 11 behavioral categories was rated: inattention, impulsivity, hyperactivity, disorganization, disobeying rules and routines, poor self-care, verbal/physical aggression, low frustration tolerance, compulsive behavior, antisocial behavior, lacking in initiative and distraction. Two CBT specialists categorized behaviors and an ADHD specialist ruled on discrepancies. Statistical analyses used were Generalized Estimating Equations with Poisson distribution and autoregressive order correlation structure. In the course of the sessions, problematic behaviors decreased significantly in 7 categories: impulsiveness, hyperactivity, disorganization, disobeying rules and routine, poor self-care, low frustration tolerance, compulsive behaviors, and antisocial behaviors. Caregiver attitudes to children's inappropriate behavior were discussed and reshaped. As functional improvement was observed on applying TE for 10 weeks, this type of intervention may be useful as an auxiliary strategy combined with medication.
Greeson, Megan R; Kennedy, Angie C; Bybee, Deborah I; Beeble, Marisa; Adams, Adrienne E; Sullivan, Cris
Exposure to intimate partner violence (IPV) has negative consequences for children's well-being and behavior. Much of the research on parenting in the context of IPV has focused on whether and how IPV victimization may negatively shape maternal parenting, and how parenting may in turn negatively influence child behavior, resulting in a deficit model of mothering in the context of IPV. However, extant research has yet to untangle the interrelationships among the constructs and test whether the negative effects of IPV on child behavior are indeed attributable to IPV affecting mothers' parenting. The current study employed path analysis to examine the relationships among IPV, mothers' parenting practices, and their children's externalizing behaviors over three waves of data collection among a sample of 160 women with physically abusive partners. Findings indicate that women who reported higher levels of IPV also reported higher levels of behavior problems in their children at the next time point. When parenting practices were examined individually as mediators of the relationship between IPV and child behavior over time, one type of parenting was significant, such that higher IPV led to higher authoritative parenting and lower child behavior problems [corrected]. On the other hand, there was no evidence that higher levels of IPV contributed to more child behavior problems due to maternal parenting. Instead, IPV had a significant cumulative indirect effect on child behavior via the stability of both IPV and behavior over time. Implications for promoting women's and children's well-being in the context of IPV are discussed.
Ward, Ryan D; Simpson, Eleanor H; Kandel, Eric R; Balsam, Peter D
In recent years it has become possible to develop animal models of psychiatric disease in genetically modified mice. While great strides have been made in the development of genetic and neurobiological tools with which to model psychiatric disease, elucidation of neural and molecular mechanisms thought to underlie behavioral phenotypes has been hindered by an inadequate analysis of behavior. This is unfortunate given the fact that the experimental analysis of behavior has created powerful methods for isolating and describing the functional properties of behavioral mechanisms that are capable of providing deep understanding of behavioral phenotypes. A better understanding of the biological basis of normal behavior and its disturbance in psychiatric disease will require the application of these rigorous behavior analytic tools to animal models. In this review we provide an example of a merging of genetic and behavioral methods and illustrate its utility in the analysis of a mouse model of the motivational deficits in schizophrenia. The synergy between basic behavior analysis, neuroscience, and animal models of psychiatric disease has great potential for achieving a deeper understanding of behavior and its neurobiological mechanisms as well as for leading to improvements in diagnosis and treatment in clinical settings. Copyright © 2011 Elsevier B.V. All rights reserved.
Full Text Available Objective: This study was designed to examine the effect of environmental enrichment during methamphetamine (METH dependency and withdrawal on methamphetamine-induced spatial learning and memory deficits and obsessive-compulsive behavior.Method: Adult male Wistar rats (200 ± 10 g chronically received bi-daily doses of METH (2 mg/kg, sc, with 12 hours intervals for 14 days. Rats reared in standard (SE or enriched environment (EE during the development of dependence on METH and withdrawal. Then, they were tested for spatial learning and memory (the water maze, and obsessive-compulsive behavior as grooming behavior in METH-withdrawn rats.Results: The results revealed that the Sal/EE and METH/EE rats reared in EE spent more time in the target zone on the water maze and displayed significantly increased proximity to the platform compared to their control groups. METH withdrawn rats reared in EE displayed less grooming behavior than METH/SE group.Conclusion: Our findings revealed EE ameliorates METH-induced spatial memory deficits and obsessive-compulsive behavior in rats.
OLTHOF, E; DEVRIES, TW; TOUWEN, BCL; SMRKOVSKY, M; GEVENBOERE, LM; HEIJMANS, HSA; VANDERVEER, E
Neurological, cognitive and behavioural development were assessed in a group of 21, 8- to 10-year old children whose mothers took coumarins during pregnancy. Findings were compared with those in a group of 17 control children. The study was performed to test whether it is feasible to carry out a
Shaywitz, B A; Sullivan, C M; Anderson, G M; Gillespie, S M; Sullivan, B; Shaywitz, S E
To determine the effects of large doses of aspartame on behavior, cognition, and monoamine metabolism in children with attention deficit disorder. A randomized, double-blind, placebo-controlled crossover study of unmedicated children meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed) criteria for attention deficit disorder. Behavioral assessments were performed in the child's home by their parents and in the classroom by a teacher. Cognitive tests were administered and blood drawing was performed during a 2-day inpatient admission to our Children's Study Center. Administration of aspartame (single morning dose, 34 mg/kg) or placebo for alternate 2-week periods. Behavioral and cognitive tests included the Matching Familiar Figures Test (MFFT), Children's Checking Task (CCT), the Airplane Test, the Wisconsin Card Sorting Test (WCST), the Subjects Treatment Emergent Symptom Scale (STESS), the Multigrade Inventory for Teachers (MIT), and the Conners Behavior Rating Scale. Blood was drawn for complete blood cell count and liver function tests, as well as amino acid, methanol, formate, serotonin, and monoamine metabolite analyses, and urine was collected for measurement of catecholamine and monoamine metabolite excretion. No clinically significant differences between aspartame and placebo were found for the STESS, MIT, or Conners ratings, or for the MFFT, CCT, WCST, or Airplane cognition tests. Also, no differences were noted for any of the biochemical measures, except for the expected increase in plasma phenylalanine and tyrosine following aspartame. The findings indicate that aspartame at greater than 10 times usual consumption has no effect on the cognitive and behavioral status of children with attention deficit disorder. In addition, aspartame does not appear to affect urinary excretion rates of monoamines and metabolites.
Couch, Brian A; Kerrisk, Meghan E; Kaufman, Adam C; Nygaard, Haakon B; Strittmatter, Stephen M; Koleske, Anthony J
Alzheimer's disease (AD) is a progressive neurodegenerative dementia characterized by amyloid plaque accumulation, synapse/dendrite loss, and cognitive impairment. Transgenic mice expressing mutant forms of amyloid-β precursor protein (AβPP) and presenilin-1 (PS1) recapitulate several aspects of this disease and provide a useful model system for studying elements of AD progression. AβPP/PS1 mice have been previously shown to exhibit behavioral deficits and amyloid plaque deposition between 4-9 months of age. We crossed AβPP/PS1 animals with mice of a mixed genetic background (C57BL/6 × 129/SvJ) and investigated the development of AD-like features in the resulting outcrossed mice. The onset of memory-based behavioral impairment is delayed considerably in outcrossed AβPP/PS1 mice relative to inbred mice on a C57BL/6 background. While inbred AβPP/PS1 mice develop deficits in radial-arm water maze performance and novel object recognition as early as 8 months, outcrossed AβPP/PS1 mice do not display defects until 18 months. Within the forebrain, we find that inbred AβPP/PS1 mice have significantly higher amyloid plaque burden at 12 months than outcrossed AβPP/PS1 mice of the same age. Surprisingly, inbred AβPP/PS1 mice at 8 months have low plaque burden, suggesting that plaque burden alone cannot explain the accompanying behavioral deficits. Analysis of AβPP processing revealed that elevated levels of soluble Aβ correlate with the degree of behavioral impairment in both strains. Taken together, these findings suggest that animal behavior, amyloid plaque deposition, and AβPP processing are sensitive to genetic differences between mouse strains. Copyright © 2012 Wiley Periodicals, Inc.
Carr, Joshua L; Agnihotri, Sabrina; Keightley, Michelle
Prenatal alcohol exposure can have detrimental effects on a child's development of adaptive behaviors necessary for success in the areas of academic achievement, socialization, and self-care. Sensory processing abilities have been found to affect a child's ability to successfully perform adaptive behaviors. The current study explored whether significant differences in sensory processing abilities, adaptive behavior, and neurocognitive functioning are observed between children diagnosed with partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), or children who were prenatally exposed to alcohol (PEA), but did not meet criteria for an FASD diagnosis. The influence of IQ on adaptive behavior as well as further exploration of the relationship between sensory processing and adaptive behavior deficits among these children was also examined. A secondary analysis was conducted on some of the Short Sensory Profile (SSP) scores, Adaptive Behavior Assessment System--Second Edition (ABAS-II) scores, and Wechsler Intelligence Scale--Fourth Edition/Wechsler Preschool and Primary Scale of Intelligence--Third Edition (WISC- IV/WPPSI-III) scores of 46 children between 3 and 14 years of age with pFAS, ARND, or who were PEA. Greater sensory processing deficits were found in children with a diagnosis of pFAS and ARND compared to those in the PEA group. Children with an ARND diagnosis scored significantly worse on measures of adaptive behavior than the PEA group. Children with pFAS scored significantly lower than children with ARND or PEA on perceptual/performance IQ. No correlation was found between IQ scores and adaptive behaviors across the FASD diagnostic categories. A significant positive correlation was found between SSP and ABAS-II scores. Regardless of the diagnosis received under the FASD umbrella, functional difficulties that could not be observed using traditional measures of intelligence were found, supporting guidelines that a broad
Mannix, Rebekah; Berglass, Jacqueline; Berkner, Justin; Moleus, Philippe; Qiu, Jianhua; Andrews, Nick; Gunner, Georgia; Berglass, Laura; Jantzie, Lauren L; Robinson, Shenandoah; Meehan, William P
With the recent increasing interest in outcomes after repetitive mild traumatic brain injury (rmTBI; e.g., sports concussions), several models of rmTBI have been established. Characterizing these models in terms of behavioral and histopathological outcomes is vital to assess their clinical translatability. The purpose of this study is to provide an in-depth behavioral and histopathological phenotype of a clinically relevant model of rmTBI. The authors used a previously published weight-drop model of rmTBI (7 injuries in 9 days) in 2- to 3-month-old mice that produces cognitive deficits without persistent loss of consciousness, seizures, gross structural imaging findings, or microscopic evidence of structural brain damage. Injured and sham-injured (anesthesia only) mice were subjected to a battery of behavioral testing, including tests of balance (rotarod), spatial memory (Morris water maze), anxiety (open field plus maze), and exploratory behavior (hole-board test). After behavioral testing, brains were assessed for histopathological outcomes, including brain volume and microglial and astrocyte immunolabeling. Compared with sham-injured mice, mice subjected to rmTBI showed increased exploratory behavior and had impaired balance and worse spatial memory that persisted up to 3 months after injury. Long-term behavioral deficits were associated with chronic increased astrocytosis and microgliosis but no volume changes. The authors demonstrate that their rmTBI model results in a characteristic behavioral phenotype that correlates with the clinical syndrome of concussion and repetitive concussion. This model offers a platform from which to study therapeutic interventions for rmTBI.
Zhao, Yuanfang; Li, Jingguang; Liu, Xiqin; Song, Yiying; Wang, Ruosi; Yang, Zetian; Liu, Jia
Individuals with developmental prosopagnosia (DP) exhibit severe difficulties in recognizing faces and to a lesser extent, also exhibit difficulties in recognizing non-face objects. We used fMRI to investigate whether these behavioral deficits could be accounted for by altered spontaneous neural activity. Two aspects of spontaneous neural activity were measured: the intensity of neural activity in a voxel indexed by the fractional amplitude of spontaneous low-frequency fluctuations (fALFF), and the connectivity of a voxel to neighboring voxels indexed by regional homogeneity (ReHo). Compared with normal adults, both the fALFF and ReHo values within the right occipital face area (rOFA) were significantly reduced in DP subjects. Follow-up studies on the normal adults revealed that these two measures indicated further functional division of labor within the rOFA. The fALFF in the rOFA was positively correlated with behavioral performance in recognition of non-face objects, whereas ReHo in the rOFA was positively correlated with processing of faces. When considered together, the altered fALFF and ReHo within the same region (rOFA) may account for the comorbid deficits in both face and object recognition in DPs, whereas the functional division of labor in these two measures helps to explain the relative independency of deficits in face recognition and object recognition in DP. Copyright © 2016 Elsevier Ltd. All rights reserved.
Riechers, Ronald George; Wang, Xiao-Feng; Piero, Traci; Ruff, Suzanne Smith
Background Mild traumatic brain injury (mTBI) is a common injury among military personnel serving in Iraq or Afghanistan. The impact of repeated episodes of combat mTBI is unknown. Objective To evaluate relationships among mTBI, post-traumatic stress disorder (PTSD) and neurological deficits (NDs) in US veterans who served in Iraq or Afghanistan. Methods This was a case–control study. From 2091 veterans screened for traumatic brain injury, the authors studied 126 who sustained mTBI with one or more episodes of loss of consciousness (LOC) in combat. Comparison groups: 21 combat veterans who had definite or possible episodes of mTBI without LOC and 21 veterans who sustained mTBI with LOC as civilians. Results Among combat veterans with mTBI, 52% had NDs, 66% had PTSD and 50% had PTSD and an ND. Impaired olfaction was the most common ND, found in 65 veterans. The prevalence of an ND or PTSD correlated with the number of mTBI exposures with LOC. The prevalence of an ND or PTSD was >90% for more than five episodes of LOC. Severity of PTSD and impairment of olfaction increased with number of LOC episodes. The prevalence of an ND for the 34 combat veterans with one episode of LOC (4/34=11.8%) was similar to that of the 21 veterans of similar age and educational background who sustained civilian mTBI with one episode of LOC (2/21=9.5%, p-NS). Conclusions Impaired olfaction was the most frequently recognised ND. Repeated episodes of combat mTBI were associated with increased likelihood of PTSD and an ND. Combat setting may not increase the likelihood of an ND. Two possible connections between mTBI and PTSD are (1) that circumstances leading to combat mTBI likely involve severe psychological trauma and (2) that altered cerebral functioning following mTBI may increase the likelihood that a traumatic event results in PTSD. PMID:22431700
Roy, Arunima; Oldehinkel, Albertine J; Verhulst, Frank C; Ormel, Johan; Hartman, Catharina A
The progression to depression in children with attention-deficit/hyperactivity disorder (ADHD) is not clearly understood. To clarify this relationship, we tested the following hypotheses in a population-based study: (1) children with ADHD have a higher risk of developing depression than children without ADHD; (2) the pathway from ADHD to depression is mediated (partly) through anxiety and disruptive behavior disorders; and (3) mediation through anxiety is more prevalent in girls, and mediation through disruptive behavior disorders is more prevalent in boys. From October 2008 to September 2010, the Composite International Diagnostic Interview was used to assess ADHD, major depressive episodes, anxiety disorders, and disruptive behavior disorders in 1,584 participants from the TRacking Adolescents' Individual Lives Survey (TRAILS) cohort. Cox regression was used to model the effects of ADHD, anxiety, and disruptive behaviors on depression. Risk of and pathways to depression were studied in both children with ADHD and children with subthreshold ADHD. Comorbid depression was present in 36% of children with a diagnosis of ADHD, 24% of children with subthreshold ADHD, and 14% of children with no ADHD. Anxiety and disruptive behaviors mediated 32% of depression in ADHD. Pathways through anxiety and disruptive behavior disorders were independent of gender. Disruptive behavior disorder was a stronger mediator than anxiety for both genders (all P disruptive behavior disorders are present in a child with ADHD. © Copyright 2014 Physicians Postgraduate Press, Inc.
Karacay, Bahri; Bonthius, Nancy E; Plume, Jeffrey; Bonthius, Daniel J
Alcohol abuse during pregnancy often induces neuropsychological problems in the offspring, including learning disorders, attention deficits, and behavior problems, all of which are prominent components of fetal alcohol spectrum disorders (FASD). However, not all children who were exposed to alcohol in utero are equally affected by it. While some children have major deficits, others are spared. This unequal vulnerability is likely due largely to differences in fetal genetics. Some fetuses appear to have certain genotypes that make them much more prone to FASD. However, to date, no gene has been identified that worsens alcohol-induced brain dysfunction. Nitric oxide (NO) is a gaseous molecule that can protect developing neurons against alcohol-induced death. In the brain, NO is produced by neuronal nitric oxide synthase (nNOS). In this study, we examined whether homozygous mutation of the nNOS gene in mice worsens the behavioral deficits of developmental alcohol exposure. Wild-type and nNOS(-/-) mice received alcohol (0.0, 2.2, or 4.4 mg/g) daily over postnatal days (PDs) 4 to 9. Beginning on PD 85, the mice underwent a series of behavioral tests, including open field activity, the Morris water maze, and paired pulse inhibition. For the wild-type mice, alcohol impaired performance only in the water maze. In contrast, for the nNOS(-/-) mice, alcohol impaired performance on all 3 tasks. Furthermore, the nNOS(-/-) mice were substantially more impaired than wild-type mice in their performance on all 3 of the behavioral tests and at both the low (2.2) and high (4.4) doses of alcohol. Targeted disruption of the nNOS gene worsens the behavioral impact of developmental alcohol exposure and allows alcohol-induced learning problems to emerge that are not seen in wild type. This is the first demonstration that a specific genotype can interact with alcohol to worsen functional brain deficits in an animal model of FASD. Copyright © 2015 by the Research Society on Alcoholism.
DuPaul, G J; Ervin, R A; Hook, C L; McGoey, K E
We investigated the effects of classwide peer tutoring (CWPT) on the classroom behavior and academic performance of students with attention deficit hyperactivity disorder (ADHD). Typical instructional activities were contrasted with CWPT for 18 children with ADHD and 10 peer comparison students attending first- through fifth-grade general education classes. CWPT led to increases in active engagement in academic tasks along with reductions in off-task behavior for most participants. Of students with ADHD, 50% exhibited improvements in academic performance in math or spelling during CWPT conditions, as measured by a treatment success index. Participating teachers and students reported a high level of satisfaction with intervention procedures. Our results suggest that peer tutoring appears to be an effective strategy for addressing the academic and behavioral difficulties associated with ADHD in general education settings.
Syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) in a patient with confusional symptoms, diffuse EEG abnormalities, and bilateral vasospasm in transcranial Doppler ultrasound: A case report and literature review.
Hidalgo de la Cruz, M; Domínguez Rubio, R; Luque Buzo, E; Díaz Otero, F; Vázquez Alén, P; Orcajo Rincón, J; Prieto Montalvo, J; Contreras Chicote, A; Grandas Pérez, F
HaNDL syndrome (transient headache and neurological deficits with cerebrospinal fluid lymphocytosis) is characterised by one or more episodes of headache and transient neurological deficits associated with cerebrospinal fluid lymphocytosis. To date, few cases of HaNDL manifesting with confusional symptoms have been described. Likewise, very few patients with HaNDL and confusional symptoms have been evaluated with transcranial Doppler ultrasound (TCD). TCD data from patients with focal involvement reveal changes consistent with vasomotor alterations. We present the case of a 42-year-old man who experienced headache and confusional symptoms and displayed pleocytosis, diffuse slow activity on EEG, increased blood flow velocity in both middle cerebral arteries on TCD, and single-photon emission computed tomography (SPECT) findings suggestive of diffuse involvement, especially in the left hemisphere. To our knowledge, this is the first description of a patient with HaNDL, confusional symptoms, diffuse slow activity on EEG, and increased blood flow velocity in TCD. Our findings suggest a relationship between cerebral vasomotor changes and the pathophysiology of HaNDL. TCD may be a useful tool for early diagnosis of HaNDL. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Solanki, Naimesh; Atrooz, Fatin; Asghar, Saman; Salim, Samina
Earlier, we reported that elevated anxiety-like behavior and high aggression in aged retired breeder Long-Evans (L-E) rats was associated with increased plasma corticosterone and elevated oxidative stress levels. In the present study, we examined how this aged aggressive and anxious rat strain responds to acute sleep deprivation (24h) and whether their behaviors can be modulated via antioxidant tempol treatment. Four groups of L-E rats were utilized: naïve control (NC), tempol treated control (T+NC), sleep deprived (SD), tempol treated and sleep deprived (T+SD). Thus, two groups were treated with tempol (1mM in drinking water for 2 weeks) while the other two were not. Two groups were subjected to acute sleep deprivation (24h) using the columns-in-water model while the other two were not. Sleep deprivation induced anxiety-like behavior, led to significant depression-like behavior and short-term memory impairment in SD rats. And, decision-making behavior also was compromised in SD rats. These behavioral and cognitive impairments were prevented with tempol treatment in T+SD rats. Tempol treatment also reduced SD-induced increase in corticosterone and oxidative stress levels in T+SD rats. These results suggest potential involvement of oxidative stress mechanisms in regulation of sleep deprivation induced behavioral and cognitive deficits in male aged-aggressive rats. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Deschamps, P. K. H.; Schutter, D. J. L. G.; Kenemans, J. L.; Matthys, W.
Empathy has been associated with decreased antisocial and increased prosocial behavior. This study examined empathy and prosocial behavior in response to sadness and distress in disruptive behavior disorder (DBD) and attention-deficit hyperactivity disorder (ADHD). Six- and 7-year-old children with
Conidi, Francis X.; Drogan, Oksana; Giza, Christopher C.; Kutcher, Jeffery S.; Alessi, Anthony G.; Crutchfield, Kevin E.
Summary We sought to assess neurologists' interest in sports neurology and learn about their experience in treating sports-related neurologic conditions. A survey was sent to a random sample of American Academy of Neurology members. A majority of members (77%) see at least some patients with sports-related neurologic issues. Concussion is the most common sports-related condition neurologists treat. More than half of survey participants (63%) did not receive any formal or informal training in sports neurology. At least two-thirds of respondents think it is very important to address the following issues: developing evidence-based return-to-play guidelines, identifying risk factors for long-term cognitive-behavioral sequelae, and developing objective diagnostic criteria for concussion. Our findings provide an up-to-date view of the subspecialty of sports neurology and identify areas for future research. PMID:24790800
Stringer, Megan; Abeysekera, Irushi; Thomas, Jared; LaCombe, Jonathan; Stancombe, Kailey; Stewart, Robert J; Dria, Karl J; Wallace, Joseph M; Goodlett, Charles R; Roper, Randall J
Down syndrome (DS) is caused by three copies of human chromosome 21 (Hsa21) and results in phenotypes including intellectual disability and skeletal deficits. Ts65Dn mice have three copies of ~50% of the genes homologous to Hsa21 and display phenotypes associated with DS, including cognitive deficits and skeletal abnormalities. DYRK1A is found in three copies in humans with Trisomy 21 and in Ts65Dn mice, and is involved in a number of critical pathways including neurological development and osteoclastogenesis. Epigallocatechin-3-gallate (EGCG), the main polyphenol in green tea, inhibits Dyrk1a activity. We have previously shown that EGCG treatment (~10mg/kg/day) improves skeletal abnormalities in Ts65Dn mice, yet the same dose, as well as ~20mg/kg/day did not rescue deficits in the Morris water maze spatial learning task (MWM), novel object recognition (NOR) or balance beam task (BB). In contrast, a recent study reported that an EGCG-containing supplement with a dose of 2-3mg per day (~40-60mg/kg/day) improved hippocampal-dependent task deficits in Ts65Dn mice. The current study investigated if an EGCG dosage similar to that study would yield similar improvements in either cognitive or skeletal deficits. Ts65Dn mice and euploid littermates were given EGCG [0.4mg/mL] or a water control, with treatments yielding average daily intakes of ~50mg/kg/day EGCG, and tested on the multivariate concentric square field (MCSF)-which assesses activity, exploratory behavior, risk assessment, risk taking, and shelter seeking-and NOR, BB, and MWM. EGCG treatment failed to improve cognitive deficits; EGCG also produced several detrimental effects on skeleton in both genotypes. In a refined HPLC-based assay, its first application in Ts65Dn mice, EGCG treatment significantly reduced kinase activity in femora but not in the cerebral cortex, cerebellum, or hippocampus. Counter to expectation, 9-week-old Ts65Dn mice exhibited a decrease in Dyrk1a protein levels in Western blot analysis
Guha, Suman K; Tillu, Rucha; Sood, Ankit; Patgaonkar, Mandar; Nanavaty, Ishira N; Sengupta, Arjun; Sharma, Shobhona; Vaidya, Vidita A; Pathak, Sulabha
Cerebral malaria is associated with cerebrovascular damage and neurological sequelae. However, the neurological consequences of uncomplicated malaria, the most prevalent form of the disease, remain uninvestigated. Here, using a mild malaria model, we show that a single Plasmodium chabaudi adami infection in adult mice induces neuroinflammation, neurogenic, and behavioral changes in the absence of a blood-brain barrier breach. Using cytokine arrays we show that the infection induces differential serum and brain cytokine profiles, both at peak parasitemia and 15days post-parasite clearance. At the peak of infection, along with the serum, the brain also exhibited a definitive pro-inflammatory cytokine profile, and gene expression analysis revealed that pro-inflammatory cytokines were also produced locally in the hippocampus, an adult neurogenic niche. Hippocampal microglia numbers were enhanced, and we noted a shift to an activated profile at this time point, accompanied by a striking redistribution of the microglia to the subgranular zone adjacent to hippocampal neuronal progenitors. In the hippocampus, a distinct decline in progenitor turnover and survival was observed at peak parasitemia, accompanied by a shift from neuronal to glial fate specification. Studies in transgenic Nestin-GFP reporter mice demonstrated a decline in the Nestin-GFP(+)/GFAP(+) quiescent neural stem cell pool at peak parasitemia. Although these cellular changes reverted to normal 15days post-parasite clearance, specific brain cytokines continued to exhibit dysregulation. Behavioral analysis revealed selective deficits in social and anxiety-like behaviors, with no change observed in locomotor, cognitive, and depression-like behaviors, with a return to baseline at recovery. Collectively, these findings indicate that even a single episode of mild malaria results in alterations of the brain cytokine profile, causes specific behavioral dysfunction, is accompanied by hippocampal microglial
Rygula, Rafal; Abumaria, Nashat; Domenici, Enrico; Hiemke, Christoph; Fuchs, Eberhard
Recently, we described an advanced model of chronic social stress in male rats based on the resident intruder paradigm. In this model, rats subjected to daily social stress for 5 weeks showed behavioral changes resembling anhedonia and motivational deficits in humans. In the present study, male Wistar rats were subjected to 5 weeks of daily social defeat by an aggressive conspecific and concomitant treatment with the antidepressant drug fluoxetine (10 mg/kg) after the first week of stress. Compared with controls, rats exposed to chronic stress had significantly reduced locomotor and exploratory activity (rearing and sniffing) and diminished preference for sucrose solution. These effects were paralleled by decreased body weight gain, increased adrenal weights and decreased plasma levels of testosterone measured post mortem. The stress-induced effects on locomotor activity and rearing behavior were counteracted by fluoxetine treatment.
Knouse, Laura E; Safren, Steven A
Attention-deficit/hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated with chronic functional impairment and increased rates of comorbidity. Cognitive behavioral therapy (CBT) approaches for this disorder have emerged recently, and available evidence from open and randomized controlled trials suggests that these approaches are promising in producing significant symptom reduction. A conceptual model of how CBT may work for ADHD is reviewed along with existing efficacy studies. A preliminary comparison of effect sizes across intervention packages suggests that targeted learning and practice of specific behavioral compensatory strategies may be a critical active ingredient in CBT for adult ADHD. The article concludes with a discussion of future directions and critical questions that must be addressed in this area of clinical research. Copyright 2010 Elsevier Inc. All rights reserved.
Miller, Drew J; Derefinko, Karen J; Lynam, Donald R; Milich, Richard; Fillmore, Mark T
This study examined the classification accuracy of the UPPS Impulsive Behavior Scale (UPPS) in discriminating several attention deficit/hyperactivity disorder (ADHD) subtypes, including predominantly inattentive type (ADHD/I), combined type (ADHD/C), and combined type with behavioral problems (ADHD/ODD), between each other and a non-ADHD control group using logistic regression analyses. The sample consisted of 88 children ranging in age from 9.0 years to 12.8 years, with a mean of 10.9 years. Children were predominantly male (74%) and Caucasian (86%) and in grades 3-7. Results indicated that the UPPS performed well in classifying ADHD subtypes relative to traditional diagnostic measures. In addition, analyses indicated that differences in symptoms between subtypes can be explained by specific pathways to impulsivity. Implications for the assessment of ADHD and conceptual issues are discussed.
Cirelli, Christe A.; Sidener, Tina M.; Reeve, Kenneth F.; Reeve, Sharon A.
The effects of activity schedules on on-task and on-schedule behavior were assessed with two boys at risk for attention-deficit/hyperactivity disorder (ADHD) and referred by their public school teachers as having difficulty during independent work time. On-task behavior increased for both participants after two training sessions. Teachers, peers,…
Shillingford, Margaret Ann; Lambie, Glenn W.; Walter, Sara Meghan
Attention deficit hyperactive disorder (ADHD) is a prevalent diagnostic disorder for many students, which correlates with negative academic, social, and personal consequences. This article presents an integrative, cognitive-behavioral, systemic approach that offers behaviorally based interventions for professional school counselors to support…
Optimizing the phenotyping of rodent ASD models: enrichment analysis of mouse and human neurobiological phenotypes associated with high-risk autism genes identifies morphological, electrophysiological, neurological, and behavioral features
Buxbaum Joseph D
Full Text Available Abstract Background There is interest in defining mouse neurobiological phenotypes useful for studying autism spectrum disorders (ASD in both forward and reverse genetic approaches. A recurrent focus has been on high-order behavioral analyses, including learning and memory paradigms and social paradigms. However, well-studied mouse models, including for example Fmr1 knockout mice, do not show dramatic deficits in such high-order phenotypes, raising a question as to what constitutes useful phenotypes in ASD models. Methods To address this, we made use of a list of 112 disease genes etiologically involved in ASD to survey, on a large scale and with unbiased methods as well as expert review, phenotypes associated with a targeted disruption of these genes in mice, using the Mammalian Phenotype Ontology database. In addition, we compared the results with similar analyses for human phenotypes. Findings We observed four classes of neurobiological phenotypes associated with disruption of a large proportion of ASD genes, including: (1 Changes in brain and neuronal morphology; (2 electrophysiological changes; (3 neurological changes; and (4 higher-order behavioral changes. Alterations in brain and neuronal morphology represent quantitative measures that can be more widely adopted in models of ASD to understand cellular and network changes. Interestingly, the electrophysiological changes differed across different genes, indicating that excitation/inhibition imbalance hypotheses for ASD would either have to be so non-specific as to be not falsifiable, or, if specific, would not be supported by the data. Finally, it was significant that in analyses of both mouse and human databases, many of the behavioral alterations were neurological changes, encompassing sensory alterations, motor abnormalities, and seizures, as opposed to higher-order behavioral changes in learning and memory and social behavior paradigms. Conclusions The results indicated that mutations
Full Text Available Research suggests that self-injurious behavior (SIB is related to social deficits and cooccurring problem behaviors in children and adolescents with autism spectrum disorder. A sample of 95 participants with ASD was assessed on presence and frequency of SIB (Behavior Problems Inventory, social deficits (the Matson Evaluation of Social Skills with Youngsters-II and cooccurring problem behaviors (ASD-Comorbidity-Child version. A model was created and tested to explain the relationship between these variables. Results showed that the model was acceptable in presenting the relationships between these variables. This information could be used to help predict which individuals are at risk of developing further cooccurring behavioral problems and determine risk markers for the development of social deficits.
Full Text Available This study investigated the relationship between Child Behavior Checklist (CBCL symptoms and attention-deficit hyperactivity disorder (ADHD subtypes [inattentive (ADHD-I and combined (ADHD-C] with or without comorbidities. Overall, 116 ADHD children were interviewed using the Mini-International Neuropsychiatric Interview to assess ADHD subtypes and comorbidities, and were then divided into four groups according to their subtypes and comorbidities. The CBCL was completed by the parents of the ADHD children. The association between behavioral symptom severity and groups was examined by comparing the CBCL scales of the four groups. The scores for the Aggressive Behavior (p = 0.014 and Anxiety/Depression scales (p = 0.033 were higher in patients with ADHD-I with comorbidities than with ADHD-I without comorbidities. In addition, the score for the Aggressive Behavior scale was higher in patients with ADHD-C without comorbidities than in patients with ADHD-I without comorbidities (p = 0.011. The scores for the six CBCL scales were all higher in patients with ADHD-C with comorbidities than in patients with ADHD-I without comorbidities. Our findings suggest a synergistic effect of the co-occurrence of comorbidities and the ADHD-C subtype on behavioral symptom severity. Physicians could use the CBCL scales to distinguish patients with more severe symptoms from patients with less severe symptoms.
Bertalan, Abigail; Kent, Marc; Glass, Eric
Hypothyroidism is a common endocrine disease in dogs. A variety of clinicopathologic abnormalities may be present; however, neurologic deficits are rare. In some instances, neurologic deficits may be the sole manifestation of hypothyroidism. Consequent ly, the diagnosis and management of the neurologic disorders associated with hypothyroidism can be challenging. This article describes several neurologic manifestations of primary hypothyroidism in dogs; discusses the pathophysiology of hypothyroidism-induced neurologic disorders affecting the peripheral and central nervous systems; and reviews the evidence for the neurologic effects of hypothyroidism.
Full Text Available Animals prenatally exposed to valproic acid (VPA, an antiepileptic agent, have been used as a model for autism spectrum disorders (ASDs. Previous studies have identified enhanced NMDA receptor (NMDAR function in the brain of VPA rats, and demonstrated that pharmacological suppression of NMDAR function normalizes social deficits in these animals. However, whether repetitive behavior, another key feature of ASDs, can be rescued by NMDAR inhibition remains unknown. We report here that memantine, an NMDAR antagonist, administered to VPA mice rescues both social deficits and repetitive behaviors such as self-grooming and jumping. These results suggest that suppression of elevated NMDAR function in VPA animals normalizes repetitive behaviors in addition to social deficits.
Geiszler, Philippine Camilla; Barron, Matthew Richard; Pardon, Marie-Christine
htau mice are deficient of murine tau but express all six human tau isoforms, leading to gradual tau misprocessing and aggregation in brain areas relevant to Alzheimer's disease. While histopathological changes in htau mice have been researched in the past, we focused here on functional consequences of human tau accumulation. htau mice and their background controls - murine tau knock-out (mtau(-/-)) and C57Bl/6J mice - underwent a comprehensive trial battery to investigate species-specific behavior, locomotor activity, emotional responses, exploratory traits, spatial and recognition memory as well as acquisition, retention and extinction of contextual fear at two, four, six, nine and twelve months of age. In htau mice, tau pathology was already present at two months of age, whereas deficits in food burrowing and spatial working memory were first noted at four months of age. At later stages the presence of human tau on a mtau(-/-) background appeared to guard cognitive performance; as mtau(-/-) but not htau mice differed from C57Bl/6J mice in the food burrowing, spontaneous alternation and object discrimination tasks. Aging mtau(-/-) mice also exhibited increased body mass and locomotor activity. These data highlight that reduced food-burrowing performance was the most robust aspect of the htau phenotype with aging. htau and mtau(-/-) deficits in food burrowing pointed at the necessity of intact tau systems for daily life activities. While some htau and mtau(-/-) deficits overlap, age differences between the two genotypes may reflect distinct functional effects and compared to C57Bl/6J mice, the htau phenotype appeared stronger than the mtau(-/-) phenotype at young ages but milder with aging. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Safavi, Parvin; Hasanpour-Dehkordi, Ali; AmirAhmadi, Maryam
.... To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD...
Yerys, Benjamin E; Wallace, Gregory L; Sokoloff, Jennifer L; Shook, Devon A; James, Joette D; Kenworthy, Lauren
Recent estimates suggest that 31% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 24% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co-morbid ADHD symptoms (ASD+ADHD; n = 21), children with ASD without ADHD (ASD; n = 28), and a typically developing control group (n = 21) were included in the study; all groups were matched on age, gender-ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control (EC), autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in EC and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone.
Broeders, Mark; Geurts, Hilde; Jennekens-Schinkel, Aag
Background: Various psychiatric and neurological disorders including epilepsy have been associated with language deficits. Pragmatic language deficits, however, have seldom been the focus of earlier studies in children with epilepsy. Moreover, it is unknown whether these pragmatic deficits are
Walton, E. V.; Brzozowski, Walter T.
The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological…
Ellis, Terry; Motl, Robert W
Persons with chronic progressive neurologic diseases such as Parkinson disease (PD) and multiple sclerosis (MS) face significant declines in mobility and activities of daily living, resulting in a loss of independence and compromised health-related quality of life over the course of the disease. Such undesirable outcomes can be attenuated through participation in exercise and physical activity, yet there is profound and prevalent physical inactivity in persons with PD and MS that may initiate a cycle of deconditioning and worsening of disease consequences, independent of latent disease processes. This Special Interest article highlights the accruing evidence revealing the largely sedentary behaviors common among persons living with physically disabling conditions and summarizes the evidence on the benefits of physical activity in persons with PD and MS. We then examine the social cognitive theory as an approach to identifying the primary active ingredients for behavioral change and, hence, the targets of interventions for increasing physical activity levels. The design and efficacies of interventions based on the social cognitive theory for increasing physical activity in persons with PD and MS are discussed. Finally, a rationale for adopting a secondary prevention approach to delivering physical therapy services is presented, with an emphasis on the integration of physical activity behavior change interventions into the care of persons with chronic, progressive disabilities over the course of the disease.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A42) for more insights from the authors.
Alsop, Brent; Furukawa, Emi; Sowerby, Paula; Jensen, Stephanie; Moffat, Cara; Tripp, Gail
Altered sensitivity to positive reinforcement has been hypothesized to contribute to the symptoms of attention-deficit hyperactivity disorder (ADHD). In this study, we evaluated the ability of children with and without ADHD to adapt their behavior to changing reinforcer availability. Of one hundred sixty-seven children, 97 diagnosed with ADHD completed a signal-detection task in which correct discriminations between two stimuli were associated with different frequencies of reinforcement. The response alternative associated with the higher rate of reinforcement switched twice during the task without warning. For a subset of participants, this was followed by trials for which no reinforcement was delivered, irrespective of performance. Children in both groups developed an initial bias toward the more frequently reinforced response alternative. When the response alternative associated with the higher rate of reinforcement switched, the children's response allocation (bias) followed suit, but this effect was significantly smaller for children with ADHD. When reinforcement was discontinued, only children in the control group modified their response pattern. Children with ADHD adjust their behavioral responses to changing reinforcer availability less than typically developing children, when reinforcement is intermittent and the association between an action and its consequences is uncertain. This may explain the difficulty children with ADHD have adapting their behavior to new situations, with different reinforcement contingencies, in daily life. © 2016 Association for Child and Adolescent Mental Health.
Ahmed, Mohammad Ejaz; Tucker, Donovan; Dong, Yan; Lu, Yujiao; Zhao, Ningjun; Wang, Ruimin; Zhang, Quanguang
Ischemic stroke in rodents stimulates neurogenesis in the adult brain and the proliferation of newborn neurons that migrate into the penumbra zone. The present study investigated the effect of Methylene Blue (MB) on neurogenesis and functional recovery in a photothrombotic (PT) model of ischemic stroke in rats. PT stroke model was induced by photo-activation of Rose Bengal dye in cerebral blood flow by cold fiber light. Rats received intraperitoneal injection of either MB (0.5mg/kg/day) from day 1 to day 5 after stroke or an equal volume of saline solution as a control. Cell proliferative marker 5-bromodeoxyuridine (BrdU) was injected twice daily (50mg/kg) from day 2 to day 8 and animals were sacrificed on day 12 after PT induction. We report that MB significantly enhanced cell proliferation and neurogenesis, as evidenced by the increased co-localizations of BrdU/NeuN, BrdU/DCX, BrdU/MAP2 and BrdU/Ki67 in the peri-infarct zone compared with vehicle controls. MB thus effectively limited infarct volume and improved neurological deficits compared to PT control animals. The effects of MB were accompanied with an attenuated level of reactive gliosis and release of pro-inflammatory cytokines, as well as elevated levels of cytochrome c oxidase activity and ATP production in peri-infarct regions. Our study provides important information that MB has the ability to promote neurogenesis and enhance the newborn-neurons' survival in ischemic brain repair by inhibiting microenvironmental inflammation and increasing mitochondrial function. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.
Tohda, Chihiro; Nakanishi, Ruiko; Kadowaki, Makoto
We previously reported that knockout mice lacking the p85alpha regulatory subunit of phosphoinositide-3 kinase (PI3K) (p85alpha(-/-) mice) significantly showed spatial learning-deficits, restlessness and motivation-deficit in water maze tests. It was also shown in the report that decline of PI3K activity in several brain areas related to losses of synapses and myelinated axons. However, any other behavioral patterns have not been elucidated, the aim of the present study was to observe behavioral natures of in p85alpha(-/-) mice using several behavioral tests. In order to examine behaviors, a novel object recognition test, an open field test, an object exploring test, a hole-board test and an elevated plus maze test were carried out in p85alpha(-/-) mice. The p85alpha(-/-) mice significantly showed a deficit in object recognition memory, less exploring novel objects, and anxiety. Hyperactivity was observed in p85alpha(-/-) mice in male-specific manner. The present results suggest that deficiencies in PI3K activity result in hyperactivity, memory deficit and an increase in anxiety. Therefore, these behavioral phenotypes can be analyzed in a relationship with losses of synapses and myelinated axons in the brain, which resulted from deficiencies in PI3K activity.
Ware, Ashley L.; O’Brien, Jessica W.; Crocker, Nicole; Deweese, Benjamin N.; Roesch, Scott C.; Coles, Claire D.; Kable, Julie A.; May, Philip A.; Kalberg, Wendy O.; Sowell, Elizabeth R.; Jones, Kenneth Lyons; Riley, Edward P.; Mattson, Sarah N.
Background The present study examined prevalence of psychiatric disorders and behavioral problems in children with and without prenatal alcohol exposure (AE) and attention-deficit/hyperactivity disorder (ADHD). Methods Primary caregivers of 344 children (8–16y, M=12.28) completed the Computerized Diagnostic Interview Schedule for Children-IV (C-DISC-4.0) and the Child Behavior Checklist (CBCL). Subjects comprised 4 groups: AE with ADHD (AE+, n=85) and without ADHD (AE−, n=52), and non-exposed with ADHD (ADHD, n=74) and without ADHD (CON, n=133). The frequency of specific psychiatric disorders, number of psychiatric disorders (comorbidity), and CBCL behavioral scores were examined using chi-square and ANCOVA techniques. Results Clinical groups had greater frequency of all psychiatric disorders, except for anxiety, where the AE− and CON groups did not differ. There was a synergistic effect of AE and ADHD on conduct disorder. For Comorbidity, children with ADHD had increased psychiatric disorders regardless of AE, which did not have an independent effect on comorbidity. For CBCL scores, there were significant main effects of AE and ADHD on all scores and significant AE X ADHD interactions for Withdrawn/Depressed, Somatic Complaints, Attention, and all Summary scores. There was a synergistic effect of AE and ADHD on Externalizing, Total Problems, and Attention Problems. Conclusion Findings indicate that ADHD diagnosis elevates children’s risk of psychiatric diagnoses, regardless of AE, but suggest a synergistic relation between AE and ADHD on conduct disorder and externalizing behavioral problems in children. Findings affirm a poorer behavioral prognosis for alcohol-exposed children with ADHD and suggest that more than one neurobehavioral profile may exist for individuals with AE. PMID:22974279
Ware, Ashley L; O'Brien, Jessica W; Crocker, Nicole; Deweese, Benjamin N; Roesch, Scott C; Coles, Claire D; Kable, Julie A; May, Philip A; Kalberg, Wendy O; Sowell, Elizabeth R; Jones, Kenneth Lyons; Riley, Edward P; Mattson, Sarah N
This study examined prevalence of psychiatric disorders and behavioral problems in children with and without prenatal alcohol exposure (AE) and attention-deficit/hyperactivity disorder (ADHD). Primary caregivers of 344 children (8 to 16 years, M = 12.28) completed the Computerized Diagnostic Interview Schedule for Children-IV (C-DISC-4.0) and the Child Behavior Checklist (CBCL). Subjects comprised 4 groups: AE with ADHD (AE+, n = 85) and without ADHD (AE-, n = 52), and nonexposed with ADHD (ADHD, n = 74) and without ADHD (CON, n = 133). The frequency of specific psychiatric disorders, number of psychiatric disorders (comorbidity), and CBCL behavioral scores were examined using chi-square and analysis of covariance techniques. Clinical groups had greater frequency of all psychiatric disorders, except for anxiety, where the AE- and CON groups did not differ. There was a combined effect of AE and ADHD on conduct disorder. For comorbidity, children with ADHD had increased psychiatric disorders regardless of AE, which did not have an independent effect on comorbidity. For CBCL scores, there were significant main effects of AE and ADHD on all scores and significant AE × ADHD interactions for Withdrawn/Depressed, Somatic Complaints, Attention, and all Summary scores. There was a combined effect of AE and ADHD on Externalizing, Total Problems, and Attention Problems. Findings indicate that ADHD diagnosis elevates children's risk of psychiatric diagnoses, regardless of AE, but suggest an exacerbated relation between AE and ADHD on conduct disorder and externalizing behavioral problems in children. Findings affirm a poorer behavioral prognosis for alcohol-exposed children with ADHD and suggest that more than 1 neurobehavioral profile may exist for individuals with AE. Copyright © 2012 by the Research Society on Alcoholism.
Andrew C Etchell
Full Text Available The fluent production of speech requires accurately timed movements. In this article, we propose that a deficit in brain timing networks is the core neurophysiological deficit in stuttering. We first discuss the experimental evidence supporting the involvement of the basal ganglia and supplementary motor area in stuttering and the involvement of the cerebellum as a mechanism for compensating for the neural deficits that underlie stuttering. Next, we outline the involvement of the right inferior frontal gyrus as another putative compensatory locus in stuttering and suggest a role for this structure in an expanded core timing-network. Subsequently, we review behavioral studies of timing in people who stutter and examine their behavioral performance as compared to people who do not stutter. Finally, we highlight challenges to existing research and provide avenues for future research with specific hypotheses.
Daley, D.; van der Oord, S.; Ferrin, M.; Danckaerts, M.; Doepfner, M.; Cortese, S.; Sonuga-Barke, E.J.S.
OBJECTIVE: Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of
Hämäläinen, Jarmo A.; Salminen, Hanne K.; Leppänen, Paavo H. T.
A review of research that uses behavioral, electroencephalographic, and/or magnetoencephalographic methods to investigate auditory processing deficits in individuals with dyslexia is presented. Findings show that measures of frequency, rise time, and duration discrimination as well as amplitude modulation and frequency modulation detection were…
Thaler, Verena; Urton, Karolina; Heine, Angela; Hawelka, Stefan; Engl, Verena; Jacobs, Arthur M.
Comorbidity of learning disabilities is a very common phenomenon which is intensively studied in genetics, neuropsychology, prevalence studies and causal deficit research. In studies on the behavioral manifestation of learning disabilities, however, comorbidity is often neglected. In the present study, we systematically examined the reading…
McGoey, Kara E.; DuPaul, George J.
Compares the effects of a token reinforcement and a response cost intervention in reducing the disruptive behavior of four preschool children with attention-deficit/hyperactivity disorder. Results show that both interventions were effective; teachers rated both highly acceptable with a preference for response cost. Implications for future research…
Mullane, Jennifer; Corkum, Penny
Objective: The authors conducted a preliminary evaluation of a behavioral sleep intervention for children with attention-deficit/hyperactivity disorder (ADHD) and dyssomnia delivered via distance treatment. Method: Three children (1 male, 2 females; aged 6-10 years) with ADHD and dyssomnia participated in a 5-week manualized intervention. Using a…
Brown, Renee B.
This study reviews pertinent research, then uses a single-subject experimental design and methodology to assess the impact of both positive and negative interventions to reduce the incidence of inappropriate classroom behavior in a 12.2 year-old male student with Attention Deficit Hyperactivity Disorder (ADHD). In the context of this study,…
Dai, Mei; Liou, Benjamin; Swope, Brittany; Wang, Xiaohong; Zhang, Wujuan; Inskeep, Venette; Grabowski, Gregory A; Sun, Ying; Pan, Dao
To study the neuronal deficits in neuronopathic Gaucher Disease (nGD), the chronological behavioral profiles and the age of onset of brain abnormalities were characterized in a chronic nGD mouse model (9V/null). Progressive accumulation of glucosylceramide (GC) and glucosylsphingosine (GS) in the brain of 9V/null mice were observed at as early as 6 and 3 months of age for GC and GS, respectively. Abnormal accumulation of α-synuclein was present in the 9V/null brain as detected by immunofluorescence and Western blot analysis. In a repeated open-field test, the 9V/null mice (9 months and older) displayed significantly less environmental habituation and spent more time exploring the open-field than age-matched WT group, indicating the onset of short-term spatial memory deficits. In the marble burying test, the 9V/null group had a shorter latency to initiate burying activity at 3 months of age, whereas the latency increased significantly at ≥12 months of age; 9V/null females buried significantly more marbles to completion than the WT group, suggesting an abnormal response to the instinctive behavior and an abnormal activity in non-associative anxiety-like behavior. In the conditional fear test, only the 9V/null males exhibited a significant decrease in response to contextual fear, but both genders showed less response to auditory-cued fear compared to age- and gender-matched WT at 12 months of age. These results indicate hippocampus-related emotional memory defects. Abnormal gait emerged in 9V/null mice with wider front-paw and hind-paw widths, as well as longer stride in a gender-dependent manner with different ages of onset. Significantly higher liver- and spleen-to-body weight ratios were detected in 9V/null mice with different ages of onsets. These data provide temporal evaluation of neurobehavioral dysfunctions and brain pathology in 9V/null mice that can be used for experimental designs to evaluate novel therapies for nGD.
Davies, McKenzie; Jacobs, Addison; Brody, David L; Friess, Stuart H
Hypoxemia during initial stabilization of patients with severe traumatic brain injury (TBI) has been associated with poorer outcomes. However, the effects of delayed hypoxemia occurring during intensive care post-TBI on outcome is unclear. Pre-clinical models of TBI have rarely shown cognitive or behavioral deficits beyond 6 weeks post-injury and commonly have not included modeling of secondary insults. We have previously developed a murine model of TBI followed by delayed hypoxemia to model the secondary insult of hypoxemia and brain hypoxia occurring in the intensive care setting. Understanding long-term effects of delayed hypoxemia post-TBI in our murine model is critical for future testing of candidate therapeutics targeting secondary brain hypoxia. For this study, forty 5-week-old male mice were randomized to controlled cortical impact (CCI; N = 24) or sham surgery (N = 16). One day later, awake animals were randomized to 60 min of hypoxemia or normoxemia. Six months after initial injury, animals underwent behavior testing (Morris water maze, social interaction, and tail suspension) before euthanasia for immunohistochemistry (IHC) assessments. At 6 months post-injury, mice experiencing CCI and hypoxemia (CCI+H) had longer swim distances to the hidden platform (51 cm) compared to CCI alone (26 cm) or sham animals (22 cm). During social interaction assessments, CCI + H mice spent less time interacting with novel stimulus mice (79 sec) than CCI alone (101 sec) or sham animals (139 sec). CCI + H had larger lesion volumes compared to CCI alone (14.0% vs. 9.9%; p < 0.003). Glial fibrillary acidic protein IHC at 6 months post-injury demonstrated increased astrogliosis in the ipsilateral white matter of CCI + H compared to CCI alone. To summarize, this clinically relevant model of delayed hypoxia post-TBI resulted in long-term behavioral deficits and evidence of exacerbated structural injury.
Full Text Available To study the neuronal deficits in neuronopathic Gaucher Disease (nGD, the chronological behavioral profiles and the age of onset of brain abnormalities were characterized in a chronic nGD mouse model (9V/null. Progressive accumulation of glucosylceramide (GC and glucosylsphingosine (GS in the brain of 9V/null mice were observed at as early as 6 and 3 months of age for GC and GS, respectively. Abnormal accumulation of α-synuclein was present in the 9V/null brain as detected by immunofluorescence and Western blot analysis. In a repeated open-field test, the 9V/null mice (9 months and older displayed significantly less environmental habituation and spent more time exploring the open-field than age-matched WT group, indicating the onset of short-term spatial memory deficits. In the marble burying test, the 9V/null group had a shorter latency to initiate burying activity at 3 months of age, whereas the latency increased significantly at ≥12 months of age; 9V/null females buried significantly more marbles to completion than the WT group, suggesting an abnormal response to the instinctive behavior and an abnormal activity in non-associative anxiety-like behavior. In the conditional fear test, only the 9V/null males exhibited a significant decrease in response to contextual fear, but both genders showed less response to auditory-cued fear compared to age- and gender-matched WT at 12 months of age. These results indicate hippocampus-related emotional memory defects. Abnormal gait emerged in 9V/null mice with wider front-paw and hind-paw widths, as well as longer stride in a gender-dependent manner with different ages of onset. Significantly higher liver- and spleen-to-body weight ratios were detected in 9V/null mice with different ages of onsets. These data provide temporal evaluation of neurobehavioral dysfunctions and brain pathology in 9V/null mice that can be used for experimental designs to evaluate novel therapies for nGD.
Lee, Young Sik; Kim, Se Hee; You, Ji Hee; Baek, Hyung Tae; Na, Chul; Kim, Bung Nyun; Han, Doug Hyun
Previous studies have reported comorbidity of attention deficit and hyperactivity disorder (ADHD) and allergic diseases. The current study investigated ADHD like behavioral symptoms and parenting stress in pediatric allergic rhinitis. Eighty-seven children (6-13 years old) with allergic rhinitis and 73 age- and sex-matched children of control group were recruited. Diagnosis and severity assessments of allergic rhinitis were determined by a pediatric allergist. The Parenting Stress Index-Short Form (PSI-SF), ADHD Rating Scale (ARS), and Child Behavior Checklist (CBCL) were completed by their mothers. In the allergic rhinitis group, the total PSI-SF score (pallergic rhinitis, those of children with comorbid ADHD demonstrated significantly higher parenting stress than those without comorbid ADHD (pallergic symptoms and the ARS total score (beta=0.50, pallergic symptom severity and the ARS total score (B=8.4, SD=2.5, t=3.3, pallergic rhinitis, and this factor increased parenting stress and disrupted the parent-child relationship. Routine evaluation and early management of ADHD symptoms in pediatric allergic rhinitis may benefit families of children with allergic rhinitis.
Full Text Available Attention-deficit/hyperactivity disorder (ADHD has been associated with obesity in children. Lifestyle-related behaviors (external eating, screen time and physical inactivity are well known to be associated with increased risk of obesity, but their associations with ADHD are unclear. The objectives of this study were to clarify the associations between ADHD symptoms in children and their associated lifestyle. A cross sectional study was carried out with a total of 785 primary students aged 9 to 13 years old and their parents were recruited by stratified random sampling from primary schools of China. The Cochran-Mantel-Haenszel (CMH test was used to examine the relationships between ADHD symptoms and health related behaviors. We found that children with ADHD symptoms were likely to spend more time using a computer during school days; they were also more likely to eat while using a computer. These children were also more likely to eat while seated in a car, using a smart phone, using a computer at bedtime, and snacking before going to sleep than children without ADHD symptoms. An increased risk of obesity in children with ADHD symptoms was associated with the overuse of electronic devices, eating while using electronic devices, and delaying bedtimes to snack and use electronic devices.
Hutchins Heather L
Full Text Available Abstract Background Attention deficit hyperactivity disorder (ADHD is the most common neurological condition in children. This pilot study evaluated the effects of high-dose eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA supplementation on the isolated plasma phospholipids and behavior in children with ADHD (primarily inattentive subtype and combined subtype. Methods Nine children were initially supplemented with 16.2 g EPA/DHA concentrates per day. The dosage was adjusted dependent on the ratio of arachidonic acid (AA to EPA in the isolated plasma phospholipids at four weeks to reach a level normally found in the Japanese population. Results At the end of the eight-week study, supplementation resulted in significant increases in EPA and DHA, as well as a significant reduction in the AA:EPA ratio (20.78 ± 5.26 to 5.95 ± 7.35, p Conclusion The findings of this small pilot study suggest supplementation with high-dose EPA/DHA concentrates may improve behavior in children with ADHD.
Gard, David E; Sanchez, Amy H; Starr, Jessica; Cooper, Shanna; Fisher, Melissa; Rowlands, Abby; Vinogradov, Sophia
Self-determination theory (SDT) provides a model for understanding motivation deficits in schizophrenia, and recent research has focused on problems with intrinsic motivation. However, SDT emphasizes that motivated behavior results from three different factors: intrinsic motivators (facilitated by needs for autonomy, competency, and relatedness), extrinsic motivators (towards reward or away from punishment), or when intrinsic and extrinsic motivators are absent or thwarted a disconnect-disengagement occurs resulting in behavior driven by boredom or 'passing time'. Using a novel approach to Ecological Momentary Assessment, we assessed the degree to which people with schizophrenia were motivated by these factors relative to healthy control participants. Forty-seven people with and 41 people without schizophrenia were provided with cell phones and were called four times a day for one week. On each call participants were asked about their goals, and about the most important reason motivating each goal. All responses were coded by independent raters (blind to group and hypotheses) on all SDT motivating factors, and ratings were correlated to patient functioning and symptoms. We found that, relative to healthy participants, people with schizophrenia reported goals that were: (1) less motivated by filling autonomy and competency needs, but equivalently motivated by relatedness; (2) less extrinsically rewarding, but equivalently motivated by punishment; (3) more disconnected-disengaged. Higher disconnected-disengaged goals were significantly associated with higher negative symptoms and lower functioning. These findings indicate several important leverage points for behavioral treatments and suggest the need for vigorous psychosocial intervention focusing on autonomy, competence, and reward early in the course of illness. Copyright © 2014 Elsevier B.V. All rights reserved.
Full Text Available Radek Ptacek,1,2 George B Stefano,1,3 Simon Weissenberger,1 Devang Akotia,1 Jiri Raboch,1 Hana Papezova,1 Lucie Domkarova,1 Tereza Stepankova,1 Michal Goetz4 1Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; 2Department of Psychology, University of New York in Prague, Prague, Czech Republic; 3MitoGenetics Research Institute, MitoGenetics, LLC, Farmingdale, NY, USA; 4Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Attention deficit hyperactivity disorder (ADHD is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity–impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs. In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1 impulsive behavior in ADHD patients leads to disordered eating behavior; 2 other psychologic comorbidities present in ADHD patients account for eating behavior; 3 poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4 other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from
Arendt, Robert E.; Minnes, Sonnia; Singer, Lynn T.
SUMMARY Research on animal models demonstrates that fetal cocaine exposure results in neurologic deficits in memory and learning. Although drug effects on human infants are difficult to separate from other environmental influences of a drug-using lifestyle, studies suggest that infants exposed to cocaine in utero have reduced growth, delays in sensory-motor development, attentional deficits, and depressed responsivity to social stimulation. Standard interventions to promote behavioral state regulation in affected infants may be helpful when parents are capable of participating. PMID:25688173
Robinson, K M; Grossman, M
This article proposes to use information processing models of cognition to guide behaviorally based treatments of language deficits, specifically, single-word object naming. Our approach is illustrated with a clinical case of a transcortical sensory aphasic. Clinical neuropsychological and functional imaging data demonstrate that the components comprising the information processing network that underpins naming can be mapped onto a cerebral neural network in the neurologically intact and that reorganization of function seen in transcortical sensory aphasia can demonstrate plasticity in this neural network. The observed balance of impaired and preserved clinical and physiological components in reorganizing neural networks such as this can be used to design treatment strategies to alleviate naming deficits.
Sean M. Molnar
Full Text Available Heavy episodic drinking is prevalent among young adults and is a public issue of increasing importance. Its initiation and maintenance are associated with deficits in the capacity to inhibit automatic processing in favor of non-habitual responses. This study used functional magnetic resonance imaging (fMRI to examine behavioral and brain activity indices of cognitive control during the Stroop task as a function of binge drinking. Heavy episodic drinkers (HED reported consuming 5+/6+ drinks in two hours at least five times in the past six months and were compared to light drinkers (LED who reported two or fewer binge episodes but were matched on demographics, intelligence and family history of alcoholism. Greater conflict-induced activity in the ventrolateral prefrontal cortex (VLPFC and thalamus was observed in HED participants and it was positively correlated with alcohol intake and alcohol-related harmful consequences. HEDs maintained intact accuracy but at a cost of prolonged reaction times to high-conflict trials and increased ratings of task difficulty. Greater activation of the areas implicated in cognitive control is consistent with compensatory network expansion to meet higher cognitive demands. These results provide further insight into degradation of cognitive control in HEDs which may benefit development of detection and prevention strategies.
Xu, Tiantian; Zhang, Manke; Hu, Jiani; Li, Zihan; Wu, Taipu; Bao, Jianing; Wu, Siyu; Lei, Lili; He, Defu
Rare earth elements (REEs) are widely used in industry, agriculture, medicine and daily life in recent years. However, environmental and health risks of REEs are still poorly understood. In this study, neurotoxicity of trichloride neodymium, praseodymium and scandium were evaluated using nematode Caenorhabditis elegans as the assay system. Median lethal concentrations (48 h) were 99.9, 157.2 and 106.4 mg/L for NdCl3, PrCl3 and ScCl3, respectively. Sublethal dose (10-30 mg/L) of these trichloride salts significantly inhibited body length of nematodes. Three REEs resulted in significant declines in locomotor frequency of body bending, head thrashing and pharyngeal pumping. In addition, mean speed and wavelength of crawling movement were significantly reduced after chronic exposure. Using transgenic nematodes, we found NdCl3, PrCl3 and ScCl3 resulted in loss of dendrite and soma of neurons, and induced down-expression of dat-1::GFP and unc-47::GFP. It indicates that REEs can lead to damage of dopaminergic and GABAergic neurons. Our data suggest that exposure to REEs may cause neurotoxicity of inducing behavioral deficits and neural damage. These findings provide useful information for understanding health risk of REE materials. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background Although increasing evidence has indicated that brain insulin dysfunction is a risk factor for Alzheimer disease (AD, the underlying mechanisms by which insulin deficiency may impact the development of AD are still obscure. Using a streptozotocin (STZ-induced insulin deficient diabetic AD transgenic mouse model, we evaluated the effect of insulin deficiency on AD-like behavior and neuropathology. Results Our data showed that administration of STZ increased the level of blood glucose and reduced the level of serum insulin, and further decreased the phosphorylation levels of insulin receptors, and increased the activities of glycogen synthase kinase-3α/β and c-Jun N-terminal kinase in the APP/PS1 mouse brain. We further showed that STZ treatment promoted the processing of amyloid-β (Aβ precursor protein resulting in increased Aβ generation, neuritic plaque formation, and spatial memory deficits in transgenic mice. Conclusions Our present data indicate that there is a close link between insulin deficient diabetes and cerebral amyloidosis in the pathogenesis of AD.
Rohde, Palle Duun; Madsen, Lisbeth Strøm; Arvidson, Sandra Marie Neumann
Fruit flies are important model organisms for functional testing of candidate genes in multiple disciplines, including the study of human diseases. Here we use a high-throughput locomotor activity assay to test the response on activity behavior of gene disruption in Drosophila melanogaster. The aim...... was to investigate the impact of disruption of 14 candidate genes for human attention-deficit/hyperactivity disorder (ADHD) on fly behavior. By obtaining a range of correlated measures describing the space of variables for behavioral activity we show, that some mutants display similar phenotypic responses...... in fruit flies. Results provide additional support for the investigated genes being risk candidate genes for ADHD in humans....
Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John
Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522
Adalio, Christopher J; Owens, Elizabeth B; McBurnett, Keith; Hinshaw, Stephen P; Pfiffner, Linda J
Neuropsychological functioning underlies behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Children with all forms of ADHD are vulnerable to working memory deficits and children presenting with the inattentive form of ADHD (ADHD-I) appear particularly vulnerable to processing speed deficits. As ADHD-I is the most common form of ADHD presented by children in community settings, it is important to consider how treatment interventions for children with ADHD-I may be affected by deficits in processing speed and working memory. We utilize data collected from 199 children with ADHD-I, aged 7 to 11 years, who participated in a randomized clinical trial of a psychosocial-behavioral intervention. Our aims are first to determine whether processing speed or working memory predict treatment outcomes in ADHD-I symptom severity, and second whether they moderate treatment effects on ADHD-I symptom severity. Results of linear regression analyses reveal that baseline processing speed significantly predicts posttreatment ADHD-I symptom severity when controlling for baseline ADHD-I symptom severity, such that better processing speed is associated with greater symptom improvement. However, predictive effects of working memory and moderation effects of both working memory and processing speed are not supported in the present study. We discuss study limitations and implications of the relation between processing speed and treatment benefits from psychosocial treatments for children with ADHD-I.
Full Text Available Homayoun Sadeghi-Bazargani,1,2 Leili Abedi,3 Minoo Mahini,4 Shahrokh Amiri,5 Davoud Khorasani-Zavareh6 1Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2World Health Organization Collaborating Center on Safe Community Promotion, Stockholm, Sweden; 3Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, 4Department of Counseling, Aras International Campus, University of Tehran, Jolfa, 5Research Center of Psychiatry and Behavioral Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, 6Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran Background: The aim of this study was to assess the association of motorcycle traffic injuries with motorcycle riding behavior and subtypes of attention-deficit hyperactivity disorder (ADHD while controlling for individual correlates of motorcycle traffic injuries.Methods: A case-control study was carried out in 298 patients with motorcycle trauma along with 151 control patients admitted to the Shohada and Imam Reza university hospitals as the two referral specialty centers in the East Azarbyjan Province of Iran in 2013. The Persian version of the Motorcycle Riding Behavior Questionnaire and the Persian version of Conner’s Adult ADHD Rating Scales (the self-report short version were used to assess riding behavior and screen for adult ADHD, respectively. The scale has four subscales, comprising subscale A (inattention, subscale B (hyperactivity, impulsivity, subscale C (A + C, and subscale D (ADHD index. The statistical analysis was done using Stata version 11.Results: All subjects were male and aged 13–79 years. Approximately 54% of the participants were married and 13% had academic education. Approximately 18% of the motorcycle riders stated that their motorcycle riding was only for fun purposes. More than two thirds of the participants did not
Wallace, Claire; Ievers-Landis, Carolyn E; Scherer, Catherine; Roizen, Nancy; Augustyn, Marilyn
Tony is a 6-year-old multiracial boy diagnosed as having attention-deficit/hyperactivity disorder-combined type who is followed in your primary care practice and has started on a stimulant medication. Tony continues to have difficulty with emotion regulation and impulse control both at home and at school. He was asked to leave his private school soon after beginning first grade because of physical fighting, emotional outbursts, and arguing with teachers.His mother made the decision to enroll Tony in online virtual schooling for the remainder of the academic year, with the plan to transition back to traditional school for the next academic year. They have enrolled in a program that offers lessons online and sends materials to the home for the child to use to complete certain types of assignments (e.g., science experiments). Virtual schools are different from traditional home schooling because children receive their instruction from teachers online with parental assistance as opposed to parents being responsible for teaching all material. Tony's mother comes to your practice requesting assistance with setting up an appropriate school environment for her son at home, where she can monitor and support his academic progress.Tony is a bright child, with an Intelligence Quotient in the superior range. He has advanced academic skills, but he becomes dysregulated if he is told he is wrong or that he has answered a question incorrectly. For example, if he answered a question incorrectly in class, he would become verbally abusive toward his teacher and often have temper tantrums. This challenging behavior occurred daily at school and was one of the factors leading to his expulsion. The behavior had predated the introduction of stimulant medication and had remained consistent after he began medication.Tony's parents are highly educated, and both parents hold professional jobs with steady income. His parents have good command of typical behavior management strategies such as
Eckert, Auston; Huang, Lei; Gonzalez, Rodolfo; Kim, Hye-Sun; Hamblin, Milton H; Lee, Jean-Pyo
: Present therapies for stroke rest with tissue plasminogen activator (tPA), the sole licensed antithrombotic on the market; however, tPA's effectiveness is limited in that the drug not only must be administered less than 3-5 hours after stroke but often exacerbates blood-brain barrier (BBB) leakage and increases hemorrhagic incidence. A potentially promising therapy for stroke is transplantation of human induced pluripotent stem cell-derived neural stem cells (hiPSC-NSCs). To date, the effects of iPSCs on injuries that take place during early stage ischemic stroke have not been well studied. Consequently, we engrafted iPSC-NSCs into the ipsilesional hippocampus, a natural niche of NSCs, at 24 hours after stroke (prior to secondary BBB opening and when inflammatory signature is abundant). At 48 hours after stroke (24 hours after transplant), hiPSC-NSCs had migrated to the stroke lesion and quickly improved neurological function. Transplanted mice showed reduced expression of proinflammatory factors (tumor necrosis factor-α, interleukin 6 [IL-6], IL-1β, monocyte chemotactic protein 1, macrophage inflammatory protein 1α), microglial activation, and adhesion molecules (intercellular adhesion molecule 1, vascular cell adhesion molecule 1) and attenuated BBB damage. We are the first to report that engrafted hiPSC-NSCs rapidly improved neurological function (less than 24 hours after transplant). Rapid hiPSC-NSC therapeutic activity is mainly due to a bystander effect that elicits reduced inflammation and BBB damage. Clinically, cerebral vessel occlusion is rarely permanent because of spontaneous or thrombolytic therapy-mediated reperfusion. These results have clinical implications indicating a much extended therapeutic window for transplantation of human induced pluripotent stem cell-derived neural stem cells (hiPSC-NSCs; 24 hours after stroke as opposed to the 5-hour window with tissue plasminogen activator [tPA]). In addition, there is potential for a synergistic
Flores, Jerry J; Klebe, Damon; Rolland, William B; Lekic, Tim; Krafft, Paul R; Zhang, John H
Germinal matrix hemorrhage remains the leading cause of morbidity and mortality in preterm infants in the United States with little progress made in its clinical management. Survivors are often afflicted with long-term neurological sequelae, including cerebral palsy, mental retardation, hydrocephalus, and psychiatric disorders. Blood clots disrupting normal cerebrospinal fluid circulation and absorption after germinal matrix hemorrhage are thought to be important contributors towards post-hemorrhagic hydrocephalus development. We evaluated if upregulating CD36 scavenger receptor expression in microglia and macrophages through PPARγ stimulation, which was effective in experimental adult cerebral hemorrhage models and is being evaluated clinically, will enhance hematoma resolution and ameliorate long-term brain sequelae using a neonatal rat germinal matrix hemorrhage model. PPARγ stimulation (15d-PGJ2) increased short-term PPARγ and CD36 expression levels as well as enhanced hematoma resolution, which was reversed by a PPARγ antagonist (GW9662) and CD36 siRNA. PPARγ stimulation (15d-PGJ2) also reduced long-term white matter loss and post-hemorrhagic ventricular dilation as well as improved neurofunctional outcomes, which were reversed by a PPARγ antagonist (GW9662). PPARγ-induced upregulation of CD36 in macrophages and microglia is, therefore, critical for enhancing hematoma resolution and ameliorating long-term brain sequelae. Copyright © 2015 Elsevier Inc. All rights reserved.
Capone, George T; Brecher, Liza; Bay, Mihee
The purpose of this study was to characterize children with Down syndrome and attention-deficit hyperactivity disorder (ADHD) with disruptive behaviors using the Aberrant Behavior Checklist (ABC), and to measure the treatment effects of guanfacine on maladaptive behaviors. Subjects were enrolled from a group of outpatients who visited our clinic between 2002 and 2007. Subjects (N = 23) were children with Down syndrome ages 4 to 12 years (mean 7.4 ± 4.1), who met criteria for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition The Aberrant Behavior Checklist Irritability and Hyperactivity subscales each showed a significant decrease (P behaviors were reduced. Medication was generally well tolerated and the incidence of treatment emergent side effects remained low. © The Author(s) 2016.
Haider, Saida; Sadir, Sadia; Naqvi, Fizza; Batool, Zehra; Tabassum, Saiqa; Khaliq, Saima; Anis, Lubna; Sajid, Irfan; Haleem, Darakhshan J
Magnesium (Mg) is the fourth most abundant biological mineral essential for good health. Neuroprotective, anxiolytic and antidepressant effects of magnesium following stress and brain injuries are well established. In present study, we analyzed the protective effects of magnesium in rats exposed to sub-chronic noise stress. Magnesium Chloride (MgCl2, 100 mg/kg) was administered intraperitoneally once daily for 15 days prior exposure to noise stress. Rats were exposed to noise stress for 4 h after administration of magnesium for 15 days. At the end of treatment behavioral alterations were assessed. Animals were decapitated following behavioral testing and the brains were dissected out for neurochemical estimations by HPLC-EC. Improvement in noise-induced memory deficits as assessed by novel object recognition (NOR) test and elevated plus maze (EPM) test was found in magnesium treated rats. This improvement in noise-induced behavioral deficits following treatment with magnesium may be attributed to a significant decrease (p < 0.01) in dopamine (DA) and serotonin (5-hydroxytryptamine; 5-HT) turnover as compared to control rats observed in present work. These results suggest that treatment with magnesium can attenuate the noise-induced deficits and may be used as a therapy against noise-induced neurodegeneration. Moreover an adequate amount of magnesium in daily diet may help to develop the ability to resist against or cope up with stressful conditions encountered in daily life.
Lycett, Kate; Sciberras, Emma; Mensah, Fiona K; Hiscock, Harriet
Behavioral sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), as are internalizing and externalizing comorbidities. The prevalence of these difficulties and the extent to which they co-exist in children with ADHD could inform clinical practice, but remains unclear. Therefore, we examined the association between sleep problems and internalizing and externalizing comorbidities in children with ADHD. Children aged 5-13 years were recruited from 21 pediatric practices across Victoria, Australia (N = 392). Internalizing and externalizing comorbidities (none, internalizing, externalizing, co-occurring) were assessed by the telephone-administered Anxiety Disorders Interview Schedule for Children IV/Parent version. Sleep problem severity was assessed by primary caregiver report (no, mild, moderate or severe problem). Moderate/severe sleep problems were confirmed using International Classification of Sleep Disorders. Seven specific sleep problem domains (bedtime resistance, sleep anxiety, sleep onset delay, sleep duration, night waking, parasomnias and daytime sleepiness) were assessed using the Children's Sleep Habits Questionnaire. Data were analyzed using adjusted logistic and linear regression models. Compared to children without comorbidities, children with co-occurring internalizing and externalizing comorbidities were more likely to have moderate/severe sleep problems (adjusted OR 2.4, 95 % CI 1.2; 4.5, p = 0.009) and problematic sleep across six of seven sleep domains. Children with either comorbidity alone were not at risk of moderate/severe sleep problems, but at the sleep domain level, children with internalizing alone had more sleep anxiety, and those with externalizing alone had less night waking. In conclusion, children with ADHD experiencing co-occurring internalizing and externalizing comorbidities are at an increased risk of sleep problems.
Mengucci Julie F
Full Text Available Abstract Background Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, is a common, complex, predominately genetic but highly treatable disorder, which in its more severe form has such a profound effect on brain function that every aspect of the life of an affected individual may be permanently compromised. Despite the broad base of scientific investigation over the past 50 years supporting this statement, there are still many misconceptions about ADHD. These include believing the disorder does not exist, that all children have symptoms of ADHD, that if it does exist it is grossly over-diagnosed and over-treated, and that the treatment is dangerous and leads to a propensity to drug addiction. Since most misconceptions contain elements of truth, where does the reality lie? Results We have reviewed the literature to evaluate some of the claims and counter-claims. The evidence suggests that ADHD is primarily a polygenic disorder involving at least 50 genes, including those encoding enzymes of neurotransmitter metabolism, neurotransmitter transporters and receptors. Because of its polygenic nature, ADHD is often accompanied by other behavioral abnormalities. It is present in adults as well as children, but in itself it does not necessarily impair function in adult life; associated disorders, however, may do so. A range of treatment options is reviewed and the mechanisms responsible for the efficacy of standard drug treatments are considered. Conclusion The genes so far implicated in ADHD account for only part of the total picture. Identification of the remaining genes and characterization of their interactions is likely to establish ADHD firmly as a biological disorder and to lead to better methods of diagnosis and treatment.
Full Text Available Abstract Vascular dementia (VaD is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia using an evidence-based approach. The material was retrieved and selected from searches of databases (Medline, Scielo, Lilacs, preferentially from the last 15 years, to propose a systematic way to assess cognition, function and behavior, and disease severity staging, with instruments adapted for our milieu, and diagnosis disclosure. The present proposal contributes to the definition of standard diagnostic criteria for VaD based on various levels of evidence. It is noteworthy that only around half of the population of patients with vascular cognitive impairment present with dementia, which calls for future proposals defining diagnostic criteria and procedures for this condition.
White, Susan W.; Albano, Anne Marie; Johnson, Cynthia R.; Kasari, Connie; Ollendick, Thomas; Klin, Ami; Oswald, Donald; Scahill, Lawrence
Anxiety is a common co-occurring problem among young people with autism spectrum disorders (ASD). Characterized by deficits in social interaction, communication problems, and stereotyped behavior and restricted interests, this group of disorders is more prevalent than previously realized. When present, anxiety may compound the social deficits of…
Khaliq, Saima; Haider, Saida; Naqvi, Faizan; Perveen, Tahira; Saleem, Sadia; Haleem, Darakhshan Jabeen
Caffeine administration has been shown to enhance performance and memory in rodents and humans while its withdrawal on the other hand produces neurobehavioral deficits which are thought to be mediated...
Lang, Min; Wither, Robert G.; Colic, Sinisa; Wu, Chiping; Monnier, Philippe P.; Bardakjian, Berj L.; Zhang, Liang; Eubanks, James H.
Mutations of the X-linked gene encoding methyl CpG binding protein type 2 (MECP2) are the predominant cause of Rett syndrome, a severe neurodevelopmental condition that affects primarily females. Previous studies have shown that major phenotypic deficits arising from MeCP2-deficiency may be reversible, as the delayed reactivation of the Mecp2 gene in Mecp2-deficient mice improved aspects of their Rett-like phenotype. While encouraging for prospective gene replacement treatments, it remains unclear whether additional Rett syndrome co-morbidities recapitulated in Mecp2-deficient mice will be similarly responsive to the delayed reintroduction of functional Mecp2. Here, we show that the delayed reactivation of Mecp2 in both male and female Mecp2-deficient mice rescues established deficits in motor and anxiety-like behavior, epileptiform activity, cortical and hippocampal electroencephalogram patterning and thermoregulation. These findings indicate that neural circuitry deficits arising from the deficiency in Mecp2 are not engrained, and provide further evidence that delayed restoration of Mecp2 function can improve a wide spectrum of the Rett-like deficits recapitulated by Mecp2-deficient mice. PMID:24009314
Full Text Available Dementia with Lewy bodies (DLB and Parkinson's Disease (PD are common causes of motor and cognitive deficits and are associated with the abnormal accumulation of alpha-synuclein (α-syn. This study investigated whether passive immunization with a novel monoclonal α-syn antibody (9E4 against the C-terminus (CT of α-syn was able to cross into the CNS and ameliorate the deficits associated with α-syn accumulation. In this study we demonstrate that 9E4 was effective at reducing behavioral deficits in the water maze, moreover, immunization with 9E4 reduced the accumulation of calpain-cleaved α-syn in axons and synapses and the associated neurodegenerative deficits. In vivo studies demonstrated that 9E4 traffics into the CNS, binds to cells that display α-syn accumulation and promotes α-syn clearance via the lysosomal pathway. These results suggest that passive immunization with monoclonal antibodies against the CT of α-syn may be of therapeutic relevance in patients with PD and DLB.
Jeffrey M Sequeira
Full Text Available The central nervous system continues to develop during gestation and after birth, and folate is an essential nutrient in this process. Folate deficiency and folate receptor alpha autoantibodies (FRα-AuAb have been associated with pregnancy-related complications and neurodevelopmental disorders. In this pilot study, we investigated the effect of exposure to FRα antibodies (Ab during gestation (GST, the pre-weaning (PRW, and the post weaning (POW periods on learning and behavior in adulthood in a rat model. In the open field test and novel object recognition task, which examine locomotor activity and anxiety-like behavior, deficits in rats exposed to Ab during gestation and pre-weaning (GST+PRW included more time spent in the periphery or corner areas, less time in the central area, frequent self-grooming akin to stereotypy, and longer time to explore a novel object compared to a control group; these are all indicative of increased levels of anxiety. In the place avoidance tasks that assess learning and spatial memory formation, only 30% of GST+PRW rats were able to learn the passive place avoidance task. None of these rats learned the active place avoidance task indicating severe learning deficits and cognitive impairment. Similar but less severe deficits were observed in rats exposed to Ab during GST alone or only during the PRW period, suggesting the extreme sensitivity of the fetal as well as the neonatal rat brain to the deleterious effects of exposure to Ab during this period. Behavioral deficits were not seen in rats exposed to antibody post weaning. These observations have implications in the pathology of FRα-AuAb associated with neural tube defect pregnancy, preterm birth and neurodevelopmental disorders including autism.
Ryan, Bryce C; Young, Nancy B; Crawley, Jacqueline N; Bodfish, James W; Moy, Sheryl S
Mouse lines with behavioral phenotypes relevant to symptoms in neurodevelopmental disorders may provide models to test hypotheses about disease etiology and to evaluate potential treatments. The present studies were designed to confirm and expand earlier work on the intriguing behavioral profile of the C58/J inbred strain, including low social approach and aberrant repetitive movements. Additional tests were selected to reflect aspects of autism, a severe neurodevelopmental disorder characterized by emergence of symptoms early in life, higher prevalence in males, social deficits and abnormal repetitive behavior. Mice from the C57BL/6J inbred strain, which has a similar genetic lineage and physical appearance to C58/J, served as a comparison group. Our results revealed that C58/J mice display elevated activity levels by postnatal day 6, which persist into adulthood. Despite normal olfactory ability, young adult male C58/J mice showed deficits in social approach in the three-chambered choice assay and failed to demonstrate social transmission of food preference. In contrast, female C58/J mice performed similarly to female C57BL/6J mice in both social tests. C58/J mice of both sexes demonstrated abnormal repetitive behaviors, displaying excessive jumping and back flipping in both social and non-social situations. These stereotypies were clearly evident in C58/J pups by postnatal days 20-21, and were also observed in C58/J dams during a test for maternal behavior. Overall, the strain profile for C58/J, including spontaneously developing motor stereotypies emerging early in the developmental trajectory, and social deficits primarily in males, models multiple components of the autism phenotype. Copyright 2009 Elsevier B.V. All rights reserved.
Zimmermann, Fernanda Francine; Gaspary, Karina Vidarte; Leite, Carlos Eduardo; De Paula Cognato, Giana; Bonan, Carla Denise
Changes in social behavior are associated with brain disorders, including mood disorders, stress, schizophrenia, Alzheimer's disease, and autism spectrum disorders (ASD). Autism is a complex neurodevelopmental disorder characterized by deficits in social interaction, impaired communication, anxiety, hyperactivity, and the presence of restricted interests. Zebrafish is one of the most social vertebrates used as a model in biomedical research, contributing to an understanding of the mechanisms that underlie social behavior. Valproic acid (VPA) is used as an anti-epileptic drug and mood stabilizer; however, prenatal VPA exposure in humans has been associated with an increased incidence of autism and it can also affect fetal brain development. Therefore, we conducted a behavioral screening at different periods of zebrafish development at 6, 30, 70, and 120dpf (days postfertilization) after VPA exposure in the early development stage to investigate social behavior, locomotion, aggression, and anxiety. VPA (48μM) exposure during the first 48hpf (hours postfertilization) did not promote changes on survival, morphology, and hatching rate at 24hpf, 48hpf, and 72hpf. The behavioral patterns suggest that VPA exposure induces changes in locomotor activity and anxiety at different developmental periods in zebrafish. Furthermore, a social interaction deficit is present at 70dpf and 120dpf. VPA exposure did not affect aggression in the adult stage at 70dpf and 120dpf. This is the first study that demonstrated zebrafish exposed to VPA during the first 48h of development exhibit deficits in social interaction, anxiety, and hyperactivity at different developmental periods. Copyright © 2015 Elsevier Inc. All rights reserved.
Green, Chloe T; Long, Debra L; Green, David; Iosif, Ana-Maria; Dixon, J Faye; Miller, Meghan R; Fassbender, Catherine; Schweitzer, Julie B
Computerized working memory and executive function training programs designed to target specific impairments in executive functioning are becoming increasingly available, yet how well these programs generalize to improve functional deficits in disorders, such as attention-deficit/hyperactivity disorder (ADHD), beyond the training context is not well-established. The aim of this study was to examine the extent to which working memory (WM) training in children with ADHD would diminish a core dysfunctional behavior associated with the disorder, "off-task" behavior during academic task performance. The effect of computerized WM training (adaptive) was compared to a placebo condition (nonadaptive) in a randomized, double-blind, placebo-controlled design in 26 children (18 males; age, 7 to 14 years old) diagnosed with ADHD. Participants completed the training in approximately 25 sessions. The Restricted Academic Situations Task (RAST) observational system was used to assess aspects of off-task behavior during the completion of an academic task. Traditional measures of ADHD symptoms (Conners' Parent Rating Scale) and WM ability (standardized WM tests) were also collected. WM training led to significant reductions in off-task ADHD-associated behavior on the RAST system and improvement on WM tests. There were no significant differences between groups in improvement on parent rating scales. Findings lend insight into the generalizability of the effects of WM training and the relation between deficits in WM and off-task behavioral components of ADHD. These preliminary data suggest WM training may provide a mechanism for indirectly altering academic performance in children with ADHD.
The present study sought to investigate the relationship between challenging behavior, comorbid psychopathology, and Attention-Deficit\\/Hyperactivity Disorder (AD\\/HD) in Fragile X Syndrome (FRAX). Additionally, this study sought to examine how such disorders are predicted by gender, presence of autism spectrum disorder (ASD), and presence of intellectual disability (ID). A total of 47 children and adolescents with FRAX were assessed. Results revealed high levels of challenging behavior and AD\\/HD symptoms within the sample, with some participants exhibiting symptoms of comorbid psychopathology. Further analysis revealed that challenging behavior and comorbid psychopathology were positively correlated, with stereotypy correlating most strongly with comorbid psychopathology. In addition, ASD was found to predict challenging behavior, and gender was found to predict AD\\/HD symptoms. The implications of these findings are discussed.
van den Hoofdakker, Barbara J; Hoekstra, Pieter J; van der Veen-Mulders, Lianne; Sytema, Sjoerd; Emmelkamp, Paul M G; Minderaa, Ruud B; Nauta, Maaike H
This study aims to explore the influence of paternal variables on outcome of behavioral parent training (BPT) in children with attention-deficit/hyperactivity disorder (ADHD). 83 referred, school-aged children with ADHD were randomly assigned to BPT plus ongoing routine clinical care (RCC) or RCC alone. Treatment outcome was based on parent-reported ADHD symptoms and behavioral problems. Moderator variables included paternal ADHD symptoms, depressive symptoms, and parenting self-efficacy. We conducted repeated measures analyses of variance (ANOVA) for all variables, and then analyzed the direction of interaction effects by repeated measures ANOVA in high and low scoring subgroups. Paternal ADHD symptoms and parenting self-efficacy played a moderating role in decreasing behavioral problems, but not in decreasing ADHD symptoms. Paternal depressive symptoms did not moderate either treatment outcome. BPT is most beneficial in reducing children's behavioral problems when their fathers have high levels of ADHD symptoms or high-parenting self-efficacy.
Newman, Isabel; Leader, Geraldine; Chen, June L; Mannion, Arlene
The present study sought to investigate the relationship between challenging behavior, comorbid psychopathology, and Attention-Deficit/Hyperactivity Disorder (AD/HD) in Fragile X Syndrome (FRAX). Additionally, this study sought to examine how such disorders are predicted by gender, presence of autism spectrum disorder (ASD), and presence of intellectual disability (ID). A total of 47 children and adolescents with FRAX were assessed. Results revealed high levels of challenging behavior and AD/HD symptoms within the sample, with some participants exhibiting symptoms of comorbid psychopathology. Further analysis revealed that challenging behavior and comorbid psychopathology were positively correlated, with stereotypy correlating most strongly with comorbid psychopathology. In addition, ASD was found to predict challenging behavior, and gender was found to predict AD/HD symptoms. The implications of these findings are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Trujillo-Orrego, N; Pineda, D A; Arango, C P; Puerta, I C; Lopera, F; Aguirre-Acevedo, D C; Hincapie-Henao, L; Pineda-Alvarez, D E; Arcos-Burgos, M; Muenke, M
The Wender-Utah Rating Scale (WURS) has been used for retrospective screening of attention deficit hyperactivity disorders (ADHD) symptoms and its comorbidities. To establish the ADHD behavioral phenotype dimensions of adults from 140 Antioquian families with genetic segregation for ADHD diagnosis, using the WURS -Spanish version. 392 adults from both genders, belonging to nuclear and multigenerational families with one or more ADHD affected members were selected. The Composite International Diagnostic Interview (CIDI) for mental disorder was administered to establish the gold standard diagnosis of ADHD through the long life. All participants fulfill the WURS. Exploratory and confirmatory factor analyses were done to determine the behavioral dimensions of the ADHD phenotype. A factor structure of four dimensions was derived, measuring behavioral decontrol, hyperactivity, inattention and anxiety, and which explained the 60% of the total variance. The behavioral adult ADHD phenotype in the Antioquian families was conformed by four dimensions, which could be used in heritability and linkage future studies.
Ljung, Therese; Chen, Qi; Lichtenstein, Paul; Larsson, Henrik
The prevention of suicidal behavior is one of the most important tasks for mental health clinicians. Although a few studies have indicated an increased risk of suicidal behavior among individuals with attention-deficit/hyperactivity disorder, the development of more effective ways of identifying and modifying the risk is hampered by our limited understanding of the underlying mechanisms for this association. To explore whether attention-deficit/hyperactivity disorder and suicidal behavior share genetic and environmental risk factors. Matched cohort design across different levels of family relatedness recorded from January 1, 1987, to December 31, 2009. We identified 51 707 patients with attention-deficit/hyperactivity disorder (through patient and prescribed drug registers) in Sweden and their relatives by linking longitudinal population-based registers. Control participants were matched 1:5 on sex and birth year. Any record of suicide attempt or completed suicide defined by discharge diagnoses of the International Classification of Diseases. Individuals with attention-deficit/hyperactivity disorder (probands) had increased risks of attempted and completed suicide, even after adjusting for comorbid psychiatric disorders (odds ratio [OR] = 3.62 [95% CI, 3.29-3.98] and 5.91 [95% CI, 2.45-14.27], respectively). The highest familial risk was observed among first-degree relatives (attempted suicide: OR = 2.42 [95% CI, 2.36-2.49] among parents of probands with ADHD and OR = 2.28 [95% CI, 2.17-2.40] among full siblings of probands with ADHD; completed suicide: OR = 2.24 [95% CI, 2.06-2.43] and OR = 2.23 [1.83-2.73], respectively), whereas the risk was considerably lower among more genetically distant relatives (attempted suicide: OR = 1.59 [95% CI, 1.47-1.73] among maternal half siblings, OR = 1.57 [95% CI, 1.45-1.70] among paternal half siblings, and OR = 1.39 [95% CI, 1.35-1.43] among cousins; completed suicide: OR = 1.51 [95% CI, 1
Gaastra, Geraldina F; Groen, Yvonne; Tucha, Lara; Tucha, Oliver
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies...
The article describes and analyzes the behavioral and neurological aspects that bring together discussions on attention deficit disorder and hyperactivity and outlines some historical conceptual antecedents. Descriptive statements focusing on the behavior of those diagnosed predominate in the behavioral dimension. Etiological explanations, principally on brain function in the neurological dimension are included. The analysis was based on documentary materials such as historical studies, interviews with health professionals in Buenos Aires between 2008 and 2011, specialized publications, psychometric instruments and psychiatric manuals.
Hochberg, Uri; Degu, Asfaw; Cramer, Grant R; Rachmilevitch, Shimon; Fait, Aaron
Deficit irrigation techniques are widely used in commercial vineyards. Nevertheless, varieties respond differently to water availability, prompting the need to elucidate the physiological and molecular mechanisms involved in the interactions between genotypes and their environment. In the present study, the variability in berry metabolism under deficit irrigation was investigated in the field on Shiraz and Cabernet Sauvignon (CS), known for their hydraulic variability. Berry skin metabolite profiling of the two cultivars was performed by parallel GC-MS and LC-MS at four development stages. Under similar irrigation, the cultivars differed in stomata regulation. In response to water deficit, CS exhibited lessened loss in berry weight and milder metabolic alteration of berry-skin primary metabolites, as compared with Shiraz. The metabolic stress responses were shown to depend on berry phenology. Characteristic metabolic changes included a decrease in amino acids and TCA cycle intermediates from veraison onward. In contrast, water deficit induced the accumulation of stress-related metabolites such as: proline, beta-alanine, raffinose, nicotinate and ascorbate, to a greater extent in Shiraz. Polyphenol metabolism in response to water stress also underwent significant changes, unique to each cultivar. Results suggest a link between the vine hydraulics and water-deficit driven changes in the berry skin metabolism, with significant consequences on the metabolic composition of the fruit. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Liu, Yuxin; Qin, Liya; Wilson, Belinda; Wu, Xuefei; Qian, Li; Granholm, Ann-Charlotte; Crews, Fulton T; Hong, Jau-Shyong
We have previously reported that a single injection of endotoxin, lipopolysaccharide (LPS, 5mg/kg, i.p.), causes a delayed and progressive loss of TH-IR neurons in the substantia nigra (SN) in C57BL/six male mice. In this study, we determined sex differences and behavioral deficits accompanying the loss of TH-IR neurons in response to peripheral LPS injection. A single injection of LPS (5mg/kg, i.p.) failed to produce any loss of TH-IR neurons in the SN of female mice over a 12-month period. To determine if multiple-injections were required, female mice received five injections of LPS (5mg/kg, i.p.) at either weekly or monthly intervals. Behavioral motor ability and TH-IR neuronal loss were determined after the first injection of LPS. We found significant differences in both behavioral activities and neuronal loss between these two injection paradigms. Between 7 and 20 months after the first injection of LPS, progressive behavioral changes, measured by rotor-rod and open-field activities, and neuronal loss in SN were observed in monthly injected, but not in weekly injected mice. In addition, reduced rotor-rod ability in monthly injected mice were restored following treatment of l-dopa/carbidopa (30 mg/3mg/kg), i.p.). Approximately 40 and 50% loss of TH-IR neurons at 9 and 20 months, respectively, was observed after exposure to LPS, suggesting that the behavioral deficit is related to loss of dopamine function in the nigra-striatal pathway. More intense immuno-staining of alpha-synuclein and inflammatory markers were detected in brain sections exposed to LPS. In conclusion, these results show that multi-LPS monthly injections can induce a delayed and progressive loss of TH-IR neurons and motor deficits which resemble the progressive nature of Parkinson's disease. Further, the present study reveals a clear sex difference: female mice are more resistant to LPS than male mice. Repeated monthly LPS injections are required to cause both motor behavioral deficits and DA
Full Text Available Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic MCI could be useful in determining progression of amnestic MCI. The purpose of this study was to investigate the features of emotional face processing in amnestic MCI by using event-related potentials (ERPs. Patients with amnestic MCI and healthy controls performed a face recognition task, giving old/new responses to previously studied and novel faces with different emotional messages as the stimulus material. Using the learning-recognition paradigm, the experiments were divided into two steps, ie, a learning phase and a test phase. ERPs were analyzed on electroencephalographic recordings. The behavior data indicated high emotion classification accuracy for patients with amnestic MCI and for healthy controls. The mean percentage of correct classifications was 81.19% for patients with amnestic MCI and 96.46% for controls. Our ERP data suggest that patients with amnestic MCI were still be able to undertake personalizing processing for negative faces, but not for neutral or positive faces, in the early frontal processing stage. In the early time window, no differences in frontal old/new effect were found between patients with amnestic MCI and normal controls. However, in the late time window, the three types of stimuli did not elicit any old/new parietal effects in patients with amnestic MCI, suggesting their recollection was impaired. This impairment may be closely associated with amnestic MCI disease. We conclude from our data that face recognition processing and emotional memory is
Silverman, J L; Pride, M C; Hayes, J E; Puhger, K R; Butler-Struben, H M; Baker, S; Crawley, J N
Autism spectrum disorder (ASD) is diagnosed by two core behavioral criteria, unusual reciprocal social interactions and communication, and stereotyped, repetitive behaviors with restricted interests. Excitatory/inhibitory imbalance is a prominent hypothesis for the etiology of autism. The selective GABAB receptor agonist R-baclofen previously reversed social deficits and reduced repetitive behaviors in a mouse model of Fragile X syndrome, and Arbaclofen improved some clinical symptoms in some Fragile X and ASD patients. To evaluate R-baclofen in a broader range of mouse models of ASD, we tested both the R-baclofen enantiomer and the less potent S-baclofen enantiomer in two inbred strains of mice that display low sociability and/or high repetitive or stereotyped behaviors. R-baclofen treatment reversed social approach deficits in BTBR T+ Itpr3tf/J (BTBR), reduced repetitive self-grooming and high marble burying scores in BTBR, and reduced stereotyped jumping in C58/J (C58), at nonsedating doses. S-baclofen produced minimal effects at the same doses. These findings encourage investigations of R-baclofen in other preclinical model systems. Additional clinical studies may be warranted to further evaluate the hypothesis that the GABAB receptor represents a promising pharmacological target for treating appropriately stratified subsets of individuals with ASD.
, of the neurological deficits complicating chronic myeloid leukaemia. Method: Using patients\\' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July ...
Raineki, Charlis; Cortés, Millie Rincón; Belnoue, Laure; Sullivan, Regina M.
Abuse during early life, especially from the caregiver, increases vulnerability to develop later life psychopathologies such as depression. Although signs of depression are typically not expressed until later life, signs of dysfunctional social behavior have been found earlier. How infant abuse alters the trajectory of brain development to produce pathways to pathology is not completely understood. Here we address this question using two different but complementary rat models of early-life abuse from postnatal days (PN) 8–12: a naturalistic paradigm, where the mother is provided with insufficient bedding for nest building and a more controlled paradigm, where infants undergo olfactory classical conditioning. Amygdala neural assessment (c-Fos), as well as social behavior and forced swim tests were performed at preweaning (PN20) and adolescence (PN45). Our results show that both models of early life abuse induce deficits in social behavior, even during the preweaning period; however, depressive-like behaviors were observed only during adolescence. Adolescent depressive-like behavior corresponds with an increase in amygdala neural activity in response to forced swim test. A causal relationship between the amygdala and depressive-like behavior was suggested through amygdala temporary deactivation (muscimol infusions), which rescued the depressive-like behavior in the forced swim test. Our results indicate that social behavior deficits in infancy could serve as an early marker for later psychopathology. Moreover, the implication of the amygdala in the ontogeny of depressive-like behaviors in infant abused animals is an important step toward understanding the underlying mechanisms of later life mental disease associated with early-life abuse. PMID:22649253
Crocker, Nicole; Vaurio, Linnea; Riley, Edward P; Mattson, Sarah N
Adaptive behavior, the ability to respond successfully to everyday demands, may be especially sensitive to the effects of heavy prenatal alcohol exposure. Similar adaptive dysfunction is common in other developmental disorders including attention-deficit/hyperactivity disorder (ADHD). ADHD is frequently present in alcohol-exposed children and this overlap in clinical presentation makes identification of alcohol-exposed children difficult. Direct comparison of children with prenatal alcohol exposure and ADHD may yield distinct patterns of cognitive and behavioral performance and add to growing knowledge of the neuropsychological and behavioral profile of prenatal alcohol exposure. Therefore, the aim of the current study was to compare adaptive behavior in children with histories of heavy prenatal alcohol exposure (ALC), nonexposed children with ADHD (ADHD), and typically developing controls (CON). Sixty-five children (ALC = 22, ADHD = 23, CON = 20) were selected from a larger ongoing study of the behavioral teratogenicity of alcohol. Alcohol-exposed and control participants were selected to match the ADHD subjects on age, sex, socioeconomic status, and race/ethnicity. Caregivers were administered the Vineland Adaptive Behavior Scales, a semi-structured interview, and were asked to rate their child's behavior on 3 domains of adaptive function. Data were analyzed using regression techniques. Relative to controls, children in both the ALC and ADHD groups showed adaptive behavior deficits on all 3 domains and children in the ALC group were significantly more impaired than the ADHD group on the daily living skills domain. Within the ALC group, socialization standard scores were lower at older ages. This negative relationship between age and standard scores in the ALC group was also observed on the communication domain, a finding not previously reported. This study suggests that both children with prenatal alcohol exposure and children with ADHD show impairments in
McNamara Laurie K
Full Text Available Abstract Background An accumulating body of evidence is consistent with the hypothesis that excessive or prolonged increases in proinflammatory cytokine production by activated glia is a contributor to the progression of pathophysiology that is causally linked to synaptic dysfunction and hippocampal behavior deficits in neurodegenerative diseases such as Alzheimer's disease (AD. This raises the opportunity for the development of new classes of potentially disease-modifying therapeutics. A logical candidate CNS target is p38α MAPK, a well-established drug discovery molecular target for altering proinflammatory cytokine cascades in peripheral tissue disorders. Activated p38 MAPK is seen in human AD brain tissue and in AD-relevant animal models, and cell culture studies strongly implicate p38 MAPK in the increased production of proinflammatory cytokines by glia activated with human amyloid-beta (Aβ and other disease-relevant stressors. However, the vast majority of small molecule drugs do not have sufficient penetrance of the blood-brain barrier to allow their use as in vivo research tools or as therapeutics for neurodegenerative disorders. The goal of this study was to test the hypothesis that brain p38α MAPK is a potential in vivo target for orally bioavailable, small molecules capable of suppressing excessive cytokine production by activated glia back towards homeostasis, allowing an improvement in neurologic outcomes. Methods A novel synthetic small molecule based on a molecular scaffold used previously was designed, synthesized, and subjected to analyses to demonstrate its potential in vivo bioavailability, metabolic stability, safety and brain uptake. Testing for in vivo efficacy used an AD-relevant mouse model. Results A novel, CNS-penetrant, non-toxic, orally bioavailable, small molecule inhibitor of p38α MAPK (MW01-2-069A-SRM was developed. Oral administration of the compound at a low dose (2.5 mg/kg resulted in attenuation of
Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko
To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system.
Roy, Arunima; Oldehinkel, Albertine J; Verhulst, Frank C; Ormel, Johan; Hartman, Catharina A
Objective: The progression to depression in children with attention-deficit/hyperactivity disorder (ADHD) is not clearly understood. To clarify this relationship, we tested the following hypotheses in a population-based study: (1) children with ADHD have a higher risk of developing depression than
A. Roy (Arunima); A.J. Oldehinkel (Albertine); F.C. Verhulst (Frank); J. Ormel (Johan); C.A. Hartman (Catharina)
textabstractObjective: The progression to depression in children with attention-deficit/hyperactivity disorder (ADHD) is not clearly understood. To clarify this relationship, we tested the following hypotheses in a population-based study: (1) children with ADHD have a higher risk of developing
Miller, Lucy Jane; Nielsen, Darci M.; Schoen, Sarah A.
Children with attention deficit hyperactivity disorder (ADHD) are impulsive, inattentive and hyperactive, while children with sensory modulation disorder (SMD), one subtype of Sensory Processing Disorder, have difficulty responding adaptively to daily sensory experiences. ADHD and SMD are often difficult to distinguish. To differentiate these…
Han, Yvonne M. Y.; Leung, Winnie Wing-man; Wong, Chun Kwok; Lam, Joseph M. K.; Cheung, Mei-Chun; Chan, Agnes S.
Increasing evidence suggests that immunological factors are involved in the pathogenesis of autism spectrum disorders (ASD). The present study examined whether immunological abnormalities are associated with cognitive deficits in children with ASD. Eighteen high-functioning (HFA) and 19 low-functioning (LFA) children with ASD, aged 8-17 years,…
Briscoe-Smith, Allison M.; Hinshaw, Stephen P.
Objective: The objectives of this study were to examine whether girls with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of having histories of abuse and to assess whether the presence of an abuse history may constitute a distinct subgroup of youth with ADHD. Method: We examined rates and correlates of child abuse in an…
Danforth, Jeffrey S
Behavioral parent training is an evidence-based treatment for problem behavior described as attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. However, adherence to treatment fidelity and parent performance of the management skills remains an obstacle to optimum outcome. One variable that may limit the effectiveness of the parent training is that demanding behavior management procedures can be deceptively complicated and difficult to perform. Based on outcome research for families of children with co-occurring ADHD and conduct problem behavior, an example of a visual behavior management flow chart is presented. The flow chart may be used to help teach specific behavior management skills to parents. The flow chart depicts a chain of behavior management strategies taught with explanation, modeling, and role-play with parents. The chained steps in the flow chart are elements common to well-known evidence-based behavior management strategies, and perhaps, this depiction well serve as a setting event for other behavior analysts to create flow charts for their own parent training, Details of the flow chart steps, as well as examples of specific applications and program modifications conclude.
Ding, Yu-qiang; Liu, Yong; Zhang, Xianghui; Wu, Renrong; Guo, Xiaofeng; Zhao, Jingping
Background Various signs of activation of microglia have been reported in schizophrenia, and it is hypothesized that microglia activation is closely associated with the neuropathology of schizophrenia. Methods Neonatal intrahippocampal injection of lipopolysaccharide (LPS), an activator of microglia, was performed in rats at postnatal day 7 (P7), and they were separately given saline, risperidone (0.5 mg/kg), minocycline (40 mg/kg) or a combination of both of them at P42 for consecutive 14 days. Behavioral changes (locomotion activity, social interaction, novel object recognition and prepulse inhibition) were examined and the number of microglia was assessed by using immunohistochemistry in adulthood. Results The adult rats in LPS-injected group showed obvious behavioral alteration (e. g. deficits in social interaction, novel object recognition and prepulse inhibition) and a dramatic increase of number of activated microglial cells in the hippocampus and other brain regions such as cerebral cortex and thalamus compared to those in saline-injected group. Interestingly, application of either minocycline, risperidone or both of them significantly rescued behavioral deficits and attenuated microglia activation. Conclusion Our results suggest that inhibition of microglia activation may be one of mechanisms underlying the antipsychotic effect of minocycline and risperidone. PMID:24705495
Ware, Ashley L.; Crocker, Nicole; O’Brien, Jessica W.; Deweese, Benjamin N.; Roesch, Scott C.; Coles, Claire D.; Kable, Julie A.; May, Philip A.; Kalberg, Wendy O.; Sowell, Elizabeth R.; Jones, Kenneth Lyons; Riley, Edward P.; Mattson, Sarah N.
Purpose of Study Prenatal exposure to alcohol often results in disruption to discrete cognitive and behavioral domains, including executive function (EF) and adaptive functioning. In the current study, the relation between these two domains was examined in children with histories of heavy prenatal alcohol exposure, non-exposed children with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), and typically developing controls. Methods As part of a multisite study, three groups of children (8-18y, M = 12.10) were tested: children with histories of heavy prenatal alcohol exposure (ALC, N=142), non-exposed children with ADHD (ADHD, N=82), and typically developing controls (CON, N=133) who did not have ADHD or a history of prenatal alcohol exposure. Children completed subtests of the Delis-Kaplan Executive Function System (D-KEFS) and their primary caregivers completed the Vineland Adaptive Behavior Scales-II (VABS). Data were analyzed using regression analyses. Results Analyses showed that EF measures were predictive of adaptive abilities and significant interactions between D-KEFS measures and group were present. For the ADHD group, the relation between adaptive abilities and EF was more general, with three of the four EF measures showing a significant relation with adaptive score. In contrast, for the ALC group, this relation was specific to the nonverbal EF measures. In the CON group, performance on EF tasks did not predict adaptive scores over the influence of age. Conclusion These results support prior research in ADHD suggesting that EF deficits are predictive of poorer adaptive behavior and extend this finding to include children with heavy prenatal exposure to alcohol. However, the relation between EF and adaptive ability differed by group, suggesting unique patterns of abilities in these children. These results provide enhanced understanding of adaptive deficits in these populations, as well as demonstrate the ecological validity of laboratory
Ware, Ashley L; Crocker, Nicole; O'Brien, Jessica W; Deweese, Benjamin N; Roesch, Scott C; Coles, Claire D; Kable, Julie A; May, Philip A; Kalberg, Wendy O; Sowell, Elizabeth R; Jones, Kenneth Lyons; Riley, Edward P; Mattson, Sarah N
Prenatal exposure to alcohol often results in disruption to discrete cognitive and behavioral domains, including executive function (EF) and adaptive functioning. In the current study, the relation between these 2 domains was examined in children with histories of heavy prenatal alcohol exposure, nonexposed children with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), and typically developing controls. As part of a multisite study, 3 groups of children (8 to 18 years, M = 12.10) were tested: children with histories of heavy prenatal alcohol exposure (ALC, n = 142), nonexposed children with ADHD (ADHD, n = 82), and typically developing controls (CON, n = 133) who did not have ADHD or a history of prenatal alcohol exposure. Children completed subtests of the Delis-Kaplan Executive Function System (D-KEFS), and their primary caregivers completed the Vineland Adaptive Behavior Scales-II. Data were analyzed using regression analyses. Analyses showed that EF measures were predictive of adaptive abilities, and significant interactions between D-KEFS measures and group were present. For the ADHD group, the relation between adaptive abilities and EF was more general, with 3 of the 4 EF measures showing a significant relation with adaptive score. In contrast, for the ALC group, this relation was specific to the nonverbal EF measures. In the CON group, performance on EF tasks did not predict adaptive scores over the influence of age. These results support prior research in ADHD, suggesting that EF deficits are predictive of poorer adaptive behavior and extend this finding to include children with heavy prenatal exposure to alcohol. However, the relation between EF and adaptive ability differed by group, suggesting unique patterns of abilities in these children. These results provide enhanced understanding of adaptive deficits in these populations, as well as demonstrate the ecological validity of laboratory measures of EF. Copyright © 2012 by the Research
Schor, Nina F
As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.
Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M
Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.
Bertoux, Maxime; de Souza, Leonardo Cruz; O'Callaghan, Claire; Greve, Andrea; Sarazin, Marie; Dubois, Bruno; Hornberger, Michael
Relative sparing of episodic memory is a diagnostic criterion of behavioral variant frontotemporal dementia (bvFTD). However, increasing evidence suggests that bvFTD patients can show episodic memory deficits at a similar level as Alzheimer's disease (AD). Social cognition tasks have been proposed to distinguish bvFTD, but no study to date has explored the utility of such tasks for the diagnosis of amnestic bvFTD. Here, we contrasted social cognition performance of amnestic and non-amnestic bvFTD from AD, with a subgroup having confirmed in vivo pathology markers. Ninety-six participants (38 bvFTD and 28 AD patients as well as 30 controls) performed the short Social-cognition and Emotional Assessment (mini-SEA). BvFTD patients were divided into amnestic versus non-amnestic presentation using the validated Free and Cued Selective Reminding Test (FCSRT) assessing episodic memory. As expected, the accuracy of the FCSRT to distinguish the overall bvFTD group from AD was low (69.7% ) with ∼50% of bvFTD patients being amnestic. By contrast, the diagnostic accuracy of the mini-SEA was high (87.9% ). When bvFTD patients were split on the level of amnesia, mini-SEA diagnostic accuracy remained high (85.1% ) for amnestic bvFTD versus AD and increased to very high (93.9% ) for non-amnestic bvFTD versus AD. Social cognition deficits can distinguish bvFTD and AD regardless of amnesia to a high degree and provide a simple way to distinguish both diseases at presentation. These findings have clear implications for the diagnostic criteria of bvFTD. They suggest that the emphasis should be on social cognition deficits with episodic memory deficits not being a helpful diagnostic criterion in bvFTD.
Khaliq, Saima; Haider, Saida; Naqvi, Faizan; Perveen, Tahira; Saleem, Sadia; Haleem, Darakhshan Jabeen
Caffeine administration has been shown to enhance performance and memory in rodents and humans while its withdrawal on the other hand produces neurobehavioral deficits which are thought to be mediated by alterations in monoamines neurotransmission. A role of decreased brain 5-HT (5-hydroxytryptamine, serotonin) levels has been implicated in impaired cognitive performance and depression. Memory functions of rats were assessed by Water Maze (WM) and immobility time by Forced Swim Test (FST). The results of this study showed that repeated caffeine administration for 6 days at 30 mg/kg dose significantly increases brain 5-HT (pcaffeine. Withdrawal of caffeine however produced memory deficits and significantly increases the immobility time of rats in FST. The results of this study are linked with caffeine induced alterations in serotonergic neurotransmission and its role in memory and depression.
Full Text Available Celiac disease (CD is an immune-mediated disease characterized by permanent gastrointestinal tract sensitivity to gluten in genetically predisposed individuals. It has varied clinical manifestations, ranging from gastrointestinal to extraintestinal, including neurological, skin, reproductive and psychiatric symptoms, which makes its diagnosis difficult and challenging. Known neurological manifestations of CD include epilepsy with or without occipital calcification, attention deficit hyperactivity disorder and ataxia, headache, neuropathies and behavior disorders. We present the case of a 14-year-old female with headaches and blurred vision for 1 year; she was noted to have papilledema on ophthalmic examination with increased cerebrospinal fluid opening pressure on lumber puncture and was diagnosed as a case of pseudotumor cerebri (PTC. Meanwhile her workup for chronic constipation revealed elevated tissue transglutaminase IgA and antiendomysial IgA antibodies. Upper gastrointestinal endoscopy with duodenal biopsy confirmed the diagnosis of CD. The patient was started on a gluten-free diet, leading to resolution of not only gastrointestinal symptoms but also to almost complete resolution of symptoms of PTC. This report describes the correlation of CD and PTC as its neurological manifestation.
Blader, Joseph C; Pliszka, Steven R; Kafantaris, Vivian; Sauder, Colin; Posner, Jonathan; Foley, Carmel A; Carlson, Gabrielle A; Crowell, Judith A; Margulies, David M
Diagnostic criteria for disruptive mood dysregulation disorder (DMDD) require 1) periodic rageful outbursts and 2) disturbed mood (anger or irritability) that persists most of the time in between outbursts. Stimulant monotherapy, methodically titrated, often culminates in remission of severe aggressive behavior, but it is unclear whether those with persistent mood symptoms benefit less.This study examined the association between the presence of persistent mood disturbances and treatment outcomes among children with attention-deficit/hyperactivity disorder (ADHD) and periodic aggressive, rageful outbursts. Within a cohort of children with ADHD and aggressive behavior (n = 156), the prevalence of persistent mood symptoms was evaluated at baseline and after completion of a treatment protocol that provided stimulant monotherapy and family-based behavioral treatment (duration mean [SD] = 70.04 [37.83] days). The relationship of persistent mood symptoms on posttreatment aggressive behavior was assessed, as well as changes in mood symptoms. Aggressive behavior and periodic rageful outbursts remitted among 51% of the participants. Persistent mood symptoms at baseline did not affect the odds that aggressive behavior would remit during treatment. Reductions in symptoms of sustained mood disturbance accompanied reductions in periodic outbursts. Children who at baseline had high irritability but low depression ratings showed elevated aggression scores at baseline and after treatment; however, they still displayed large reductions in aggression. Among aggressive children with ADHD, aggressive behaviors are just as likely to decrease following stimulant monotherapy and behavioral treatment among those with sustained mood symptoms and those without. Improvements in mood problems are evident as well. Therefore, the abnormalities in persistent mood described by DMDD's criteria do not contraindicate stimulant therapy as initial treatment among those with comorbid ADHD
Køster, Brian; Søndergaard, Jens; Nielsen, Jesper Bo
The objective of this study was to develop new scales measuring knowledge and attitude about UVR and sun related behavior, and to examine their association to sun related behavior objectively measured by personal dosimetry. During May-August 2013, 664 Danes wore a personal electronic UV...... 12 and 15' were both associated with increased risk of sunburn. Attitude towards tan was associated to both outdoor time and exposure as well as use of protection, but not to sunburn. The results regarding Knowledge deficit of UV and risk of melanoma associated to UVR exposure and Perceived barrier...... and important were positively correlated with protective behavior. Knowledge deficit of UV and risk of melanoma, perceived benefits and importance of protection behavior was also correlated with use of protection. 'Knowledge deficit of UV and risk of melanoma and Perceived barrier towards sun avoidance between...
Bock, J; Breuer, S; Poeggel, G; Braun, K
In a novel animal model Octodon degus we tested the hypothesis that, in addition to genetic predisposition, early life stress (ELS) contributes to the etiology of attention-deficit hyperactivity disorder-like behavioral symptoms and the associated brain functional deficits. Since previous neurochemical observations revealed that early life stress impairs dopaminergic functions, we predicted that these symptoms can be normalized by treatment with methylphenidate. In line with our hypothesis, the behavioral analysis revealed that repeated ELS induced locomotor hyperactivity and reduced attention towards an emotionally relevant acoustic stimulus. Functional imaging using ( 14 C)-2-fluoro-deoxyglucose-autoradiography revealed that the behavioral symptoms are paralleled by metabolic hypoactivity of prefrontal, mesolimbic and subcortical brain areas. Finally, the pharmacological intervention provided further evidence that the behavioral and metabolic dysfunctions are due to impaired dopaminergic neurotransmission. Elevating dopamine in ELS animals by methylphenidate normalized locomotor hyperactivity and attention-deficit and ameliorated brain metabolic hypoactivity in a dose-dependent manner.
He, Qing; Koprich, James B; Wang, Ying; Yu, Wen-bo; Xiao, Bao-guo; Brotchie, Jonathan M; Wang, Jian
The accumulation of misfolded α-synuclein in dopamine (DA) neurons is believed to be of major importance in the pathogenesis of Parkinson's disease (PD). Animal models of PD, based on viral-vector-mediated over-expression of α-synuclein, have been developed and show evidence of dopaminergic toxicity, providing us a good tool to investigate potential therapies to interfere with α-synuclein-mediated pathology. An efficient disease-modifying therapeutic molecule should be able to interfere with the neurotoxicity of α-synuclein aggregation. Our study highlighted the ability of an autophagy enhancer, trehalose (at concentrations of 5 and 2% in drinking water), to protect against A53T α-synuclein-mediated DA degeneration in an adeno-associated virus serotype 1/2 (AAV1/2)-based rat model of PD. Behavioral tests and neurochemical analysis demonstrated a significant attenuation in α-synuclein-mediated deficits in motor asymmetry and DA neurodegeneration including impaired DA neuronal survival and DA turnover, as well as α-synuclein accumulation and aggregation in the nigrostriatal system by commencing 5 and 2% trehalose at the same time as delivery of AAV. Trehalose (0.5%) was ineffective on the above behavioral and neurochemical deficits. Further investigation showed that trehalose enhanced autophagy in the striatum by increasing formation of LC3-II. This study supports the concept of using trehalose as a novel therapeutic strategy that might prevent/reverse α-synuclein aggregation for the treatment of PD.
Der-Avakian, Andre; Barnes, Samuel A.
Deficits in reward and motivation are common symptoms characterizing several psychiatric and neurological disorders. Such deficits may include anhedonia, defined as loss of pleasure, as well as impairments in anticipatory pleasure, reward valuation, motivation/effort, and reward learning. This chapter describes recent advances in the development of behavioral tasks used to assess different aspects of reward processing in both humans and non-human animals. While earlier tasks were generally developed independently with limited cross-species correspondence, a newer generation of translational tasks has emerged that are theoretically and procedurally analogous across species and allow parallel testing, data analyses, and interpretation between human and rodent behaviors. Such enhanced conformity between cross-species tasks will facilitate investigation of the neurobiological mechanisms underlying discrete reward and motivated behaviors and is expected to improve our understanding and treatment of neuropsychiatric disorders characterized by reward and motivation deficits. PMID:26873017
J Gordon Millichap
Utilization behavior was investigated in an adult with an acute behavioral disturbance, memory deficits, and a localized inferior medial bifrontal lesion at the Psychology Department, National Hospital, Queen Square, London; the MRC Applied Psychology Unit, Cambridge; and Department of Neurology, Atkinson Morley's Hospital, Wimbledon; and St. Andrews Hospital, Northampton, UK.
Suchert, Vivien; Pedersen, Anya; Hanewinkel, Reiner; Isensee, Barbara
Existing studies reveal that high levels of sedentary behavior are associated with more inattention and hyperactivity problems. Since most previous studies used screen time as an indicator of sedentary behavior and assessed symptoms of attention-deficit/hyperactivity disorder (ADHD) by short screening measures which do not allow to distinguish between subtypes of ADHD, the current study aimed to investigate association between different types of sedentary behavior and symptoms and subtypes of ADHD. The current cross-sectional study analyzed data of 913 students (46.1% girls) aged 13-17 years (M = 15.0, SD = 0.6). Using a self-administered questionnaire, screen-based and non-screen-based sedentary behavior and ADHD symptoms were assessed. Linear and logistic regression analyses were conducted. All analyses were adjusted for age, gender, moderate to vigorous physical activity and body mass index. Screen time was related to the total ADHD score (p ADHD. As far as ADHD symptoms are considered as a correlate of sedentary behavior, the type of activity which is pursued sedentarily seems to matter: screen time, but not other non-screen-based sedentary activities should be considered as being a risk factor for ADHD.
Patros, Connor H G; Hudec, Kristen L; Alderson, R Matt; Kasper, Lisa J; Davidson, Collin; Wingate, LaRicka R
College students with attention-deficit/hyperactivity disorder-related hyperactive/impulsive (HI) and/or inattentive (IA) symptoms may be at greater risk for suicidal behavior due to core and secondary symptoms that increase their potential to engage in behaviors that put them at risk for suicidal behavior. Consequently, the current study examined the moderating effect of combined HI/IA symptoms, in addition to independent HI and IA symptoms on the relationship between depressed mood and suicidal thoughts and behavior. A sample of 1,056 undergraduate students (61.5% female, 96.4% aged 18-24 years) provided self-report ratings of mood, suicidal behavior (thoughts, self-harm, attempts, and need for medical attention), and current HI/IA symptoms. Significant moderation effects were detected, such that greater HI/IA symptoms were associated with a stronger relationship between depressed mood and suicidal ideation and attempts, but not self-harm. Current HI and IA symptoms significantly moderated the relationship between depressed mood and suicidal thoughts and suicide attempts, but did not moderate the relationship between depressed mood and self-harm and need for medical attention. The current findings suggest that the presence of combined HI/IA symptoms conveys increased suicide risk for depressed college students. Additionally, results suggest a complex relationship between independent HI and IA symptoms and severe suicidal outcomes. © 2013 Wiley Periodicals, Inc.
Sagiv, Sharon K; Thurston, Sally W; Bellinger, David C; Amarasiriwardena, Chitra; Korrick, Susan A
To investigate the association of prenatal mercury exposure and fish intake with attention-deficit/hyperactivity disorder (ADHD)-related behavior. For a population-based prospective birth cohort recruited in New Bedford, Massachusetts (1993-1998), we analyzed data for children examined at age 8 years with peripartum maternal hair mercury measures (n = 421) or maternal report of fish consumption during pregnancy (n = 515). Inattentive and impulsive/hyperactive behaviors were assessed using a teacher rating scale and neuropsychological testing. The median maternal hair mercury level was 0.45 μg/g (range, 0.03-5.14 μg/g), and 52% of mothers consumed more than 2 fish servings weekly. In multivariable regression models, mercury exposure was associated with inattention and impulsivity/hyperactivity; some outcomes had an apparent threshold with associations at 1 μg/g or greater of mercury. For example, at 1 μg/g or greater, the adjusted risk ratios for mild/markedly atypical inattentive and impulsive/hyperactive behaviors were 1.4 (95% CI, 1.0-1.8) and 1.7 (95% CI, 1.2-2.4), respectively, for an interquartile range (0.5 μg/g) mercury increase; there was no confounding by fish consumption. For neuropsychological assessments, mercury and behavior associations were detected primarily for boys. There was a protective association for fish consumption (>2 servings per week) with ADHD-related behaviors, particularly impulsive/hyperactive behaviors (relative risk = 0.4; 95% CI, 0.2-0.6). Low-level prenatal mercury exposure is associated with a greater risk of ADHD-related behaviors, and fish consumption during pregnancy is protective of these behaviors. These findings underscore the difficulties of balancing the benefits of fish intake with the detriments of low-level mercury exposure in developing dietary recommendations in pregnancy.
Full Text Available Abstract Background Apathy is frequently observed in numerous neurological disorders, including Alzheimer's and Parkinson's, as well as neuropsychiatric disorders including schizophrenia. Apathy is defined as a lack of motivation characterized by diminished goal-oriented behavior and self-initiated activity. This study evaluated a chronic restraint stress (CRS protocol in modeling apathetic behavior, and determined whether administration of an anticholinesterase had utility in attenuating CRS-induced phenotypes. Methods We assessed behavior as well as regional neuronal activity patterns using FosB immunohistochemistry after exposure to CRS for 6 h/d for a minimum of 21 d. Based on our FosB findings and recent clinical trials, we administered an anticholinesterase to evaluate attenuation of CRS-induced phenotypes. Results CRS resulted in behaviors that reflect motivational loss and diminished emotional responsiveness. CRS-exposed mice showed differences in FosB accumulation, including changes in the cholinergic basal forebrain system. Facilitating cholinergic signaling ameliorated CRS-induced deficits in initiation and motivational drive and rescued immediate early gene activation in the medial septum and nucleus accumbens. Conclusions Some CRS protocols may be useful for studying deficits in motivation and apathetic behavior. Amelioration of CRS-induced behaviors with an anticholinesterase supports a role for the cholinergic system in remediation of deficits in motivational drive.
Neurological sleep disorders are common in the general population and may have a strong impact on quality of life. General practitioners play a key role in recognizing and managing sleep disorders in the general population. They should therefore be familiar with the most important neurological sleep disorders. This review provides a comprehensive overview of the most prevalent and important neurological sleep disorders, including Restless legs syndrome (with and without periodic limb movements in sleep), narcolepsy, NREM- and REM-sleep parasomnias and the complex relationship between sleep and epilepsies. Although narcolepsy is considered as a rare disease, recent discoveries in narcolepsy research provided insight in the function of brain circuitries involved in sleep wake regulation. REM sleep behavioral parasomnia (RBD) is increasingly recognized to represent an early manifestation of neurodegenerative disorders, in particular evolving synucleinopathies. Early diagnosis may thus open new perspectives for developing novel treatment options by targeting neuroprotective substances.
Arciniegas, David B.; Anderson, C. Alan
The risk of attempted or completed suicide is increased in patients with migraine with aura, epilepsy, stroke, multiple sclerosis, traumatic brain injury, and Huntington's disease. Contrary to the general perception that the risk of suicide among patients with Alzheimer's disease and other dementing conditions is low, several reports suggest that the risk of suicide in these patients increases relative to the general population. Some patients at risk for neurologic disorders are also at increased risk for suicide; in particular, the risk of suicide is increased among persons at risk for Huntington's disease, independent of the presence or absence of the Huntington's gene mutation. The risk of attempted or completed suicide in neurologic illness is strongly associated with depression, feelings of hopelessness or helplessness, and social isolation. Additional suicide risk factors in persons with neurologic illness include cognitive impairment, relatively younger age (under 60 years), moderate physical disability, recent onset or change in illness, a lack of future plans or perceived meaning in life, recent losses (personal, occupational, or financial), and prior history of psychiatric illness or suicidal behavior. Substance dependence, psychotic disorders, anxiety disorders, and some personality disorders (eg, borderline personality disorder) may also contribute to increased risk of suicide among persons with neurologic illnesses. Identification and aggressive treatment of psychiatric problems, especially depression, as well as reduction of modifiable suicide risk factors among patients with neurologic illness is needed to reduce the risk of attempted and completed suicide in this population.
Corbetta, Maurizio; Ramsey, Lenny; Callejas, Alicia; Baldassarre, Antonello; Hacker, Carl D.; Siegel, Joshua S.; Astafiev, Serguei V.; Rengachary, Jennifer; Zinn, Kristina; Lang, Catherine E.; Connor, Lisa Tabor; Fucetola, Robert; Strube, Michael; Carter, Alex R.; Shulman, Gordon L.
SUMMARY A long-held view is that stroke causes many distinct neurological syndromes due to damage of specialized cortical and subcortical centers. However, it is unknown if a syndrome-based description is helpful in characterizing behavioral deficits across a large number of patients. We studied a large prospective sample of first-time stroke patients with heterogeneous lesions at 1–2 weeks post-stroke. We measured behavior over multiple domains and lesion anatomy with structural MRI and a probabilistic atlas of white matter pathways. Multivariate methods estimated the percentage of behavioral variance explained by structural damage. A few clusters of behavioral deficits spanning multiple functions explained neurological impairment. Stroke topography was predominantly subcortical, and disconnection of white matter tracts critically contributed to behavioral deficits and their correlation. The locus of damage explained more variance for motor and language than memory or attention deficits. Our findings highlight the need for better models of white matter damage on cognition. PMID:25741721
Ward, Ryan D.; Simpson, Eleanor H.; Kandel, Eric R.; Balsam, Peter D
In recent years it has become possible to develop animal models of psychiatric disease in genetically modified mice. While great strides have been made in the development of genetic and neurobiological tools with which to model psychiatric disease, elucidation of neural and molecular mechanisms thought to underlie behavioral phenotypes has been hindered by an inadequate analysis of behavior. This is unfortunate given the fact that the experimental analysis of behavior has created powerful met...
Choudhary, Kailash M; Mishra, Awanish; Poroikov, Vladimir V; Goel, Rajesh Kumar
Epilepsy is a chronic neurological disorder and generally associated with certain psychiatric comorbidities. Among several comorbidities depressive behavior and cognitive impairment has been reported to be most debilitating comorbidity associated with epilepsy. This study was envisaged to evaluate the ameliorative effect of Curcumin on depression like behavior and cognitive impairment observed in pentylenetetrazole kindled animals. Male Swiss Albino mice were kindled with subconvulsive dose of pentylenetetrazole (35 mg/kg, i.p.). Successfully kindled animals were used in the study to observe the effect of different treatments. Treatment groups received phenytoin (30 mg/kg) and Curcumin (50, 100 and 200mg/kg) for 15 days. The animals were challenged with pentylenetetrazole (35 mg/kg, i.p.) on day 5, 10 and 15 and seizure severity score, immobility period, number of mistakes and step down latency were recorded. On 15th day, all the animals were sacrificed after behavioral evaluations and their brain was isolated and homogenized to estimate brain norepinephrine, serotonin, total nitrite level and acetylcholinesterase activity. Phenytoin treatment significantly improved the depressive like behavior along with its anticonvulsant effect, however was unable to improve memory impairment. Curcumin significantly attenuated seizure severity, depression like behavior and memory impairment in kindled animals, in dose dependent manner. These results were supported by the biochemical modulation of brain monoamine, nitrosative stress level and acetylcholinesterase activity. Thus present study concluded that Curcumin has the ameliorative effect on seizure severity, depression like behavior and memory impairment in pentylenetetrazole kindled mice, possibly via central monoaminergic modulation and inhibitory effect on nitrosative stress and acetylcholinesterase activity. Copyright © 2013 Elsevier B.V. All rights reserved.
N. N. Zavadenko
Full Text Available Treatment of developmental disorders, correction of learning disabilities and behavioral problems in children should be prompt, complex and include pharmacotherapy with nootropic agents. The results of recent studies shown in this review proved effectiveness of pharmacotherapy with pyritinol in children with perinatal injury of central nervous system and its consequences, psychomotor and speech development delay, dyslexia, attention deficit/hyperactivity disorder, cognitive disorders and learning disabilities (including manifestations of epilepsy, chronic tic disorders and Tourette syndrome. Due to its ability to optimize metabolic processes in central nervous system, pyritinol is used in treatment of vegetative dysfunction in children and adolescents, especially associated with asthenical manifestations, as well as in complex therapy of exertion headache and migraine. The drug is effective in treatment of cognitive disorders in children and adolescents with epilepsy, pyritinol was administered without changing of the basic anticonvulsive therapy and no deterioration (increase of severity of seizures or intensity of epileptiform activity on electroencephalogramms was observed. Significant nootropic effect of pyritinol, including neurometabolic, neuroprotective, neurodynamic and other mechanisms, in association with safety and rare side effects of this drug determines its wide usage in pediatric neurology.
Becker, Stephen P; Langberg, Joshua M; Evans, Steven W
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) experience high rates of sleep problems and are also at increased risk for experiencing comorbid mental health problems. This study provides an initial examination of the 1-year prospective association between sleep problems and comorbid symptoms in youth diagnosed with ADHD. Participants were 81 young adolescents (75 % male) carefully diagnosed with ADHD and their parents. Parents completed measures of their child's sleep problems and ADHD symptoms, oppositional defiant disorder (ODD) symptoms, and general externalizing behavior problems at baseline (M age = 12.2) and externalizing behaviors were assessed again 1 year later. Adolescents completed measures of anxiety and depression at both time-points. Medication use was not associated with sleep problems or comorbid psychopathology symptoms. Regression analyses indicated that, above and beyond demographic characteristics, ADHD symptom severity, and initial levels of comorbidity, sleep problems significantly predicted greater ODD symptoms, general externalizing behavior problems, and depressive symptoms 1 year later. Sleep problems were not concurrently or prospectively associated with anxiety. Although this study precludes making causal inferences, it does nonetheless provide initial evidence of sleep problems predicting later comorbid externalizing behaviors and depression symptoms in youth with ADHD. Additional research is needed with larger samples and multiple time-points to further examine the interrelations of sleep problems and comorbidity.
Mauricio Schüler Nin
Full Text Available The pharmacological action of SSRI antidepressants may include a normalization of the decreased brain levels of neurosteroids such as that of the progesterone metabolite allopregnanolone and that of the brain-derived neurotrophic factor (BDNF, which are decreased in patients with depression and PTSD. Allopregnanolone and BDNF decrease in these patients is associated with behavioral symptom severity. Antidepressant treatment upregulates both allopregnanolone levels and the expression of BDNF in a manner that significantly correlates with improved symptomatology, which suggests that neurosteroid biosynthesis and BDNF expression may be interrelated. Preclinical studies using the socially isolated mouse as an animal model of behavioral deficits that resemble some of the symptoms observed in PTSD patients have shown that fluoxetine and derivatives improve anxiety-like behavior, fear responses, and aggressive behavior by elevating the corticolimbic levels of allopregnanolone and BDNF mRNA expression. These actions appeared to be independent and more selective from the action of these drugs on 5-HT reuptake inhibition.Hence, this review addresses the hypothesis that in PTSD or depressed patients brain allopregnanolone levels and BDNF expression upregulation may be part of the mechanisms involved in the beneficial actions of antidepressants or other selective brain steroidogenic stimulant (SBSS molecules.
Fond, Guillaume; Loundou, Anderson; Guillaume, Sébastien; Quantin, Xavier; Macgregor, Alexandra; Lopez, Régis; Courtet, Philippe; Bernard, Paquito; Bailly, Daniel; Abbar, Mocrane; Leboyer, Marion; Boyer, Laurent
International audience; It is unclear whether adult smokers with childhood attention-deficit/hyperactivity disorder history (CH) have more severe smoking behavior than non-CH smokers, while it is clearly suggested that CH adolescents have more severe smoking behavior than CH adolescents. The aim of the present comprehensive meta-analysis is to determine whether CH smokers have more severe smoking behavior characteristics than those without and the effect of age on the association between CH a...
Departments of 1Anatomy and 2Neurological Surgery, College of Medicine, University of Ibadan, Nigeria. Summary: Hydrocephalus is usually associated with functional deficits which can be assessed by neurobehavioral tests. This study characterizes the neurobehavioral deficits occurring with increasing duration and ...
Banks, Sarah; Weintraub, Sandra
Lack of insight is a core diagnostic criterion for behavioral variant frontotemporal dementia (bvFTD), and is believed to be intact in the early stages of primary progressive aphasia (PPA). In other neurological conditions, symptom-specific insight has been noted, with behavioral symptoms appearing especially vulnerable to reduced insight. Different components of insight, self-awareness and self-monitoring, are also often considered separate phenomena. The current study compared insight in patients with PPA, bvFTD, and probable Alzheimer’s disease (PrAD) and a group of cognitively intact control subjects. Additionally, differences in insight for the domains primarily affected by the three types of dementia, namely, Behavior, Naming, and Memory, were assessed, and self-awareness and self-monitoring were compared. A total of 55 participants were enrolled. Participants were asked to complete self-estimate scales demonstrating their perceived ability immediately prior to, and immediately following a test in each domain of interest. Results indicated that PPA and normal control groups performed very similarly on control (Weight and Eyesight) and cognitive domains, whereas bvFTD and PrAD patients were unable to accurately assess Memory. All three diagnostic groups failed to accurately assess their behavioral symptoms, suggesting that this domain is vulnerable to loss of insight across diagnoses. Naming ability, in contrast, was either accurately assessed or underestimated in all groups. Finally, there were no notable differences between self-awareness and self-monitoring, potential explanations for this are examined. PMID:18194832
Datta Gupta, Nabanita; Deding, Mette; Lausten, Mette
A number of studies have documented negative long term effects of low birth weight. Yet, not much is known about the dynamics of the process leading to adverse health and educational outcomes in the long-run. While some studies find effects of the same size at both school age and young adulthood......, others find a diminishing negative effect over time due to a catching-up process. The purpose of this paper is to try to resolve this puzzle by analyzing the medium term consequences of low birth weight measured as various child outcomes at ages 6 months, 3, 7 and 11, using data from the Danish...... Longitudinal Survey of Children. Observing the same children at different points in time allows us to chart the evolution of health and behavioral deficits among children born with low birth weight and helps inform the nature and timing of interventions....
Mohammad Reza Mohammadi
Full Text Available Attention deficit hyperactivity disorder (ADHD is one of the most common psychological disorders of childhood. Methylphenidate is highly effective in the treatment of ADHD. This study aimed to determine the effectiveness of combined Parent behavioral management training (PBMT and medication treatment (Methylphenidate in reducing ADHD symptoms in 6-12-year-old children, using randomized sampling. A total of 50 children with ADHD were assigned into two groups: an experimental group of PBMT and a control group of medication treatment (Methylphenidate without other interventions. Conners’ Parent Rating Scale (CPRS-48 was employed before and after interventions to determine the effects. Descriptive Statistics method (consisting of Mean and Standard deviation and Statistical inference method, (including t-test and Levene's Test were used for data analysis. Findings revealed that the combined behavioral intervention of PBMT and methylphenidate treatment is more effective in reduction of ADHD in children. The difference of means between pre-test and post-test of CPRS in the experimental group was equal to 10.77, and it was equal to 1.88 in the control group. In addition, PBMT was more effective in the case of younger parents (P<0.025. However, parents’ education level did not affect the behavioral intervention (P<0.025.The findings suggest that combined intervention of PBMT and methylphenidate is effective in reducing the symptoms of ADHD in children.
Elmore, Jessica L; Bruhn, Ann M; Bobzien, Jonna L
Autism Spectrum Disorder (ASD) can greatly inhibit a child's communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications. Copyright © 2016 The American Dental Hygienists’ Association.
Tian, Yu-Hua; Hwan Kim, Seung; Lee, Seok-Yong; Jang, Choon-Gon
The central nervous system is affected by polychlorinated biphenyls (PCBs). Previous studies have indicated that developmental exposure to PCBs impairs behavioral performance and alters cognitive abilities. This study assessed the effects of lactational and postnatal exposure to a commercial PCBs mixture, Aroclor 1254 (A1254), on mice performing several neurobehavioral tasks including the open field test, novel object test, elevated plus maze test, Y-maze test, and tail suspension test. In the open field test, PCBs treatment (6 and 18 mg/kg/day) was associated with increased movement, time duration, and frequency in the central zone in female but not male mice. PCBs-treated female mice (6 and 18 mg/kg/day) also showed decreased novel object recognition, indicating impairment in recognition memory. Finally, we performed autoradiographic receptor binding assays for dopamine (DA) D₁ and D₂ receptors, dopamine transporter (DAT), and the N-methyl-D-aspartic acid (NMDA) receptor after behavioral tests to examine whether alterations occurred in the dopaminergic and NMDAergic systems of the brain. Our results showed that PCBs treatment did not change D₁ and D₂ receptors or DAT binding in the dorsal striatum of female mice. However, PCBs treatment significantly decreased NMDA receptor binding in the dorsal striatum, frontal cortex, cingulate cortex, and motor cortex, and CA3 and dentate gyrus (DG) of the hippocampus in female mice. Collectively, our results suggest that long-term PCBs exposure can induce anxiolytic behavior, cognitive deficits, and changes of NMDA receptors. Copyright © 2011 Wiley-Liss, Inc.
Not only the sugar, early infarct sign, hyperDense middle cerebral artery, age, neurologic deficit score but also atrial fibrillation is predictive for symptomatic intracranial hemorrhage after intravenous recombinant tissue plasminogen activator
Full Text Available Background: Symptomatic intracranial hemorrhage (sICH is the most unwanted adverse event in patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (i.v. rt-PA. Many tool scores are available to predict the probability of sICH. Among those scores, the Sugar, Early infarct sign, hyperDense middle cerebral artery, Age, Neurologic deficit (SEDAN gives the highest area under the curve-receiver operating characteristic value. Objective: We aimed to examine any factors other than the SEDAN score to predict the probability of sICH. Methods: Patients with acute ischemic stroke treated with i.v. rt-PA within 4.5 h time window from January 2010 to July 2012 were evaluated. Compiling demographic data, risk factors, and comorbidity (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation (AF, ischemic heart disease, valvular heart disease, previous stroke, gout, smoking cigarette, drinking alcoholic beverage, family history of stroke, and family history of ischemic heart disease, computed tomography scan of patients prior to treatment with rt-PA, and assessing the National Institutes of Health Stroke Scale (NIHSS score for the purpose of calculating SEDAN score were analyzed. Results: Of 314 patients treated with i.v. rt-PA, there were 46 ICH cases (14.6% with 14 sICH (4.4% and 32 asymptomatic intracranial hemorrhage cases (10.2%. The rate of sICH occurrence was increased in accordance with the increase in the SEDAN score and AF. Age over 75 years, early infarction, hyperdense cerebral artery, baseline blood sugar more than 12 mmol/l, NIHSS as 10 or more, and AF were the risk factors to develop sICH after treated with rt-PA at 1.535, 2.501, 1.093, 1.276, 1.253, and 2.492 times, respectively. Conclusions: Rather than the SEDAN score, AF should be a predictor of sICH in patients with acute ischemic stroke after i.v. rt-PA treatment in Thai population.
Singh, Navdeep; Bansal, Yashika; Bhandari, Ranjana; Marwaha, Lovish; Singh, Raghunath; Chopra, Kanwaljit; Kuhad, Anurag
Indeed, intracerebral hemorrhage (ICH) account for only 15% of all strokes but it is one of the most devastating subtype of stroke associated with behavioral, cognitive and neurological deficits. The primary cause of neurological deficits in ICH is the hematoma growth, generation of free radicals, inflammatory cytokines and exhausting endogenous anti-oxidant machinery. It has been found that neuroinflammation following ICH leads to exaggeration of hallmarks of ICH. With this background, the study was aimed to evaluate the protective effect of resveratrol (RSV) in intracerebroventricular (ICV) collagenase (COL) induced neurological deficits in rats. The present study was designed to explore the protective effects of resveratrol (5, 10, 20 mg/kg) against ICV-COL induced ICH. Animals were subjected to a battery of behavioral tests to access behavioral changes, including neurological scoring tests (cylinder test, spontaneous motility, righting reflex, horizontal bar test, forelimb flexion), actophotometer, rotarod, Randall Sellito and von Frey. Post stroke depression was estimated using forced swim test (FST). Memory deficit was monitored using Morris water maze (MWM). Chronic treatment with RSV (20 mg/kg) for 21 days restored various behavioral changes, including neurological scoring tests (cylinder test, spontaneous motility, righting reflex, horizontal bar test, forelimb flexion), actophotometer, rotarod, Randall Sellito and Von Frey. RSV also restores increase in immobility time forced swim test used to evaluate post stroke depression and impaired memory deficit in Morris water maze. RSV administration also attenuated increased nitro-oxidative stress and TNF-α level. RSV being a potent antioxidant also restores changes in endogenous anti-oxidant levels. In conclusion, our research demonstrates that RSV has a protective effect against ICH by virtue of its anti-inflammatory property and antioxidant and nitrosative stress restoring property.
Scott, Luisa L; Davis, Scott J; Yen, Rachel C; Ordemann, Greg J; Nordquist, Sarah K; Bannai, Deepthi; Pierce, Jonathan T
Symptoms of withdrawal from chronic alcohol use are a driving force for relapse in alcohol dependence. Thus, uncovering molecular targets to lessen their severity is key to breaking the cycle of dependence. Using the nematode Caenorhabditis elegans, we tested whether one highly conserved ethanol target, the large-conductance, calcium-activated potassium channel (known as the BK channel or Slo1), modulates ethanol withdrawal. Consistent with a previous report, we found that C. elegans displays withdrawal-related behavioral impairments after cessation of chronic ethanol exposure. We found that the degree of impairment is exacerbated in worms lacking the worm BK channel, SLO-1, and is reduced by selective rescue of this channel in the nervous system. Enhanced SLO-1 function, via gain-of-function mutation or overexpression, also dramatically reduced behavioral impairment during withdrawal. Consistent with these results, we found that chronic ethanol exposure decreased SLO-1 expression in a subset of neurons. In addition, we found that the function of a distinct, conserved Slo family channel, SLO-2, showed an inverse relationship to withdrawal behavior, and this influence depended on SLO-1 function. Together, our findings show that modulation of either Slo family ion channel bidirectionally regulates withdrawal behaviors in worm, supporting further exploration of the Slo family as targets for normalizing behaviors during alcohol withdrawal. Copyright © 2017 by the Genetics Society of America.
Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.
Biederman, Joseph; Petty, Carter R; Day, Helen; Goldin, Rachel L; Spencer, Thomas; Faraone, Stephen V; Surman, Craig B H; Wozniak, Janet
We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD). Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children. Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.
Allan, Andrea M; Liang, Xiaomin; Luo, Yuping; Pak, ChangHui; Li, Xuekun; Szulwach, Keith E; Chen, Dahua; Jin, Peng; Zhao, Xinyu
... −/−) mice exhibit several core deficits frequently associated with autism, including reduced social interaction, learning deficits, anxiety, defective sensory motor gating, depression and abnormal brain serotonin activity...
Glass, Leila; Ware, Ashley L; Mattson, Sarah N
Alcohol consumption during pregnancy can have deleterious consequences for the fetus, including changes in central nervous system development leading to permanent neurologic alterations and cognitive and behavioral deficits. Individuals affected by prenatal alcohol exposure, including those with and without fetal alcohol syndrome, are identified under the umbrella of fetal alcohol spectrum disorders (FASD). While studies of humans and animal models confirm that even low to moderate levels of exposure can have detrimental effects, critical doses of such exposure have yet to be specified and the most clinically significant and consistent consequences occur following heavy exposure. These consequences are pervasive, devastating, and can result in long-term dysfunction. This chapter summarizes the neurobehavioral, neurologic, and neuroimaging characteristics of FASD, focusing primarily on clinical research of individuals with histories of heavy prenatal alcohol exposure, although studies of lower levels of exposure, particularly prospective, longitudinal studies, will be discussed where relevant. © 2014 Elsevier B.V. All rights reserved.
Køster, Brian; Søndergaard, Jens; Nielsen, Jesper Bo
-dosimeter for one week that measured their UVR exposure. Afterwards, they answered a questionnaire on sun-related items. We applied descriptive analysis, linear and logistic regression analysis to evaluate the associations between the questionnaire scales and objective UVR measures. Perceiving protection as routine...... and important were positively correlated with protective behavior. Knowledge deficit of UV and risk of melanoma, perceived benefits and importance of protection behavior was also correlated with use of protection. 'Knowledge deficit of UV and risk of melanoma and Perceived barrier towards sun avoidance between...... 12 and 15' were both associated with increased risk of sunburn. Attitude towards tan was associated to both outdoor time and exposure as well as use of protection, but not to sunburn. The results regarding Knowledge deficit of UV and risk of melanoma associated to UVR exposure and Perceived barrier...
Miller, Haylie L.; Ragozzino, Michael E.; Cook, Edwin H.; Sweeney, John A.; Mosconi, Matthew W.
The neurocognitive impairments associated with restricted and repetitive behaviors (RRBs) in autism spectrum disorder (ASD) are not yet clear. Prior studies indicate that individuals with ASD show reduced cognitive flexibility, which could reflect difficulty shifting from a previously learned response pattern or a failure to maintain a new…
Martinez, Sarah; Davalos, Deana
Objective: Executive dysfunction in college students who have had an acute traumatic brain injury (TBI) was investigated. The cognitive, behavioral, and metacognitive effects on college students who endorsed experiencing a brain injury were specifically explored. Participants: Participants were 121 college students who endorsed a mild TBI, and 121…
Wu, Jiangbo; de Theije, Caroline G M; Lopes da Silva, Sofia; Abbring, Suzanne; van der Horst, Hilma; Broersen, Laus M; Willemsen, Linette; Kas, Martien J; Garssen, Johan; Kraneveld, Aletta D
Enhanced mammalian target of rapamycin (mTOR) signaling in the brain has been implicated in the pathogenesis of autism spectrum disorder (ASD). Inhibition of the mTOR pathway improves behavior and neuropathology in mouse models of ASD containing mTOR-associated single gene mutations. The current
Wu, Jiangbo; de Theije, Caroline G M; da Silva, Sofia Lopes; Abbring, Suzanne; van der Horst, Hilma; Broersen, Laus M; Willemsen, Linette; Kas, Martien; Garssen, Johan; Kraneveld, Aletta D
Enhanced mammalian target of rapamycin (mTOR) signaling in the brain has been implicated in the pathogenesis of autism spectrum disorder (ASD). Inhibition of the mTOR pathway improves behavior and neuropathology in mouse models of ASD containing mTOR-associated single gene mutations. The current
DuPaul, George J.; Kern, Lee; Caskie, Grace I. L.; Volpe, Robert J.
We examined the degree to which child, family, and treatment variables predicted treatment outcomes for reading and math achievement and oppositional behavior in a sample of 135 young children (105 boys and 30 girls). All of the participants met "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision"…
McCormick, Cheryl M; Green, Matthew R; Cameron, Nicole M; Nixon, Feather; Levy, Marisa J; Clark, Rachel A
There is increasing evidence that exposure to stressors in adolescence has long-lasting effects on emotional and cognitive behavior, but little is known as to whether reproductive functions are affected. We investigated appetitive and consummatory aspects of sexual behavior in male rats that were exposed to chronic social instability stress (SS, n=24) for 16 days in mid-adolescence compared to control rats (CTL, n=24). Over five sexual behavior test sessions with a receptive female, SS rats made fewer ejaculations (p=0.02) and had longer latencies to ejaculation (p=0.03). When only data from rats that ejaculated in the fifth session were analyzed, SS rats (n=18) had reduced copulatory efficiency (more mounts and intromissions before ejaculation) compared to CTL rats (n=19) (p=0.004), and CTL rats were twice as likely as SS rats to make more than one ejaculation in the fifth session (p=0.05). Further, more CTL (14/24) than SS (5/25) rats ejaculated in four or more sessions (p=0.05). SS rats had lower plasma testosterone concentrations than CTL rats (p=0.05), but did not differ in androgen receptor, estrogen receptor alpha, or Fos immunoreactive cell counts in the medial preoptic area. The groups did not differ in a partner preference test administered between the fourth and fifth sexual behavior session. The results suggest that developmental history contributes to individual differences in reproductive behavior, and that stress exposures in adolescence may be a factor in sexual sluggishness. Copyright © 2012 Elsevier Inc. All rights reserved.
Full Text Available Mood disorders affect the lives and functioning of millions each year. Epidemiological studies indicate that childhood trauma is predominantly associated with higher rates of both mood and anxiety disorders. Exposure of rats to stress during juvenility (JS (27-29 days of age has comparable effects and was suggested as a model of induced predisposition for these disorders. The importance of the environment in the regulation of brain, behavior and physiology has long been recognized in biological, social and medical sciences. Here, we studied the effects of JS on emotional and cognitive aspects of depressive-like behavior in adulthood, on Hypothalamic-Pituitary-Adrenal (HPA axis reactivity and on the expression of cell adhesion molecule L1 (L1-CAM. Furthermore, we combined it with the examination of potential reversibility by enriched environment (EE of JS - induced disturbances of emotional and cognitive aspects of behavior in adulthood. Three groups were tested: Juvenile Stress -subjected to Juvenile stress; Enriched Environment--subjected to Juvenile stress and then, from day 30 on to EE; and Naïves. In adulthood, coping and stress responses were examined using the elevated plus-maze, open field, novel setting exploration and two way shuttle avoidance learning. We found that, JS rats showed anxiety- and depressive-like behaviors in adulthood, altered HPA axis activity and altered L1-CAM expression. Increased expression of L1-CAM was evident among JS rats in the basolateral amygdala (BLA and Thalamus (TL. Furthermore, we found that EE could reverse most of the effects of Juvenile stress, both at the behavioral, endocrine and at the biochemical levels. The interaction between JS and EE resulted in an increased expression of L1-CAM in dorsal cornu ammonis (CA area 1 (dCA1.
Broeders, Mark; Geurts, Hilde; Jennekens-Schinkel, Aag
Background: Various psychiatric and neurological disorders including epilepsy have been associated with language deficits. Pragmatic language deficits, however, have seldom been the focus of earlier studies in children with epilepsy. Moreover, it is unknown whether these pragmatic deficits are related to general intellectual functioning. Both…
Hormes, Julia M; Kearns, Brianna; Timko, C Alix
To assess disordered online social networking use via modified diagnostic criteria for substance dependence, and to examine its association with difficulties with emotion regulation and substance use. Cross-sectional survey study targeting undergraduate students. Associations between disordered online social networking use, internet addiction, deficits in emotion regulation and alcohol use problems were examined using univariate and multivariate analyses of covariance. A large University in the Northeastern United States. Undergraduate students (n = 253, 62.8% female, 60.9% white, age mean = 19.68, standard deviation = 2.85), largely representative of the target population. The response rate was 100%. Disordered online social networking use, determined via modified measures of alcohol abuse and dependence, including DSM-IV-TR diagnostic criteria for alcohol dependence, the Penn Alcohol Craving Scale and the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) screen, along with the Young Internet Addiction Test, Alcohol Use Disorders Identification Test, Acceptance and Action Questionnaire-II, White Bear Suppression Inventory and Difficulties in Emotion Regulation Scale. Disordered online social networking use was present in 9.7% [n = 23; 95% confidence interval (5.9, 13.4)] of the sample surveyed, and significantly and positively associated with scores on the Young Internet Addiction Test (P social networking sites is potentially addictive. Modified measures of substance abuse and dependence are suitable in assessing disordered online social networking use. Disordered online social networking use seems to arise as part of a cluster of symptoms of poor emotion regulation skills and heightened susceptibility to both substance and non-substance addiction. © 2014 Society for the Study of Addiction.
Matton, Seth; Romeo, Gerardo P
Routine dental care for people with autism spectrum disorders can be complex. There is little published on postoperative behavioral changes associated with use of general anesthetics in this population. The authors describe postoperative behavioral changes in 2 patients with autism spectrum disorder and attention deficit hyperactivity disorder that the patients' caretakers described as regression. In both cases, behaviors representative of autism spectrum disorder and attention deficit hyperactivity disorder worsened after uncomplicated oral surgery after receipt of a general anesthetic in the operating room. In both cases, behavioral changes caused great difficulties for the patients and caretakers and were difficult to address. With little in the scientific literature, these 2 cases have a great importance for the dental care practitioner. Awareness must be raised so that further investigation can occur regarding this phenomenon. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.
Gaastra, Geraldina F; Groen, Yvonne; Tucha, Lara; Tucha, Oliver
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of
Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan
The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N = 22), Conduct Disorder (CD; N = 17), Learning Disabilities (LD; N = 24) and Autistic Spectrum Disorders (ASD; N = 20).…
Fichten, Catherine S.; Heiman, Tali; Jorgensen, Mary; Nguyen, Mai Nhu; Havel, Alice; King, Laura; Budd, Jillian; Amsel, Rhonda
We tested the ability of Ajzen's Theory of Planned Behavior (TPB) model to predict intention to graduate among Canadian and Israeli students with and without a learning disability/attention deficit hyperactivity disorder (LD/ADHD). Results based on 1486 postsecondary students show that the model's predictors (i.e., attitude, subjective norms,…
Fabiano, Gregory A.; Pelham, William E., Jr.; Gnagy, Elizabeth M.; Burrows-MacLean, Lisa; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Arnold, Fran; Garefino, Allison; Keenan, Jenna K.; Onyango, Adia N.; Hoffman, Martin T.; Massetti, Greta M.; Robb, Jessica A.
Currently behavior modification, stimulant medication, and combined treatments are supported as evidence-based interventions for attention deficit hyperactivity disorder in classroom settings. However, there has been little study of the relative effects of these two modalities and their combination in classrooms. Using a within-subject design, the…
Tourette Syndrome: Overview and Classroom Interventions. A Complex Neurobehavioral Disorder Which May Involve Learning Problems, Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Symptoms, and Stereotypical Behaviors.
Fisher, Ramona A.; Collins, Edward C.
Tourette Syndrome is conceptualized as a neurobehavioral disorder, with behavioral aspects that are sometimes difficult for teachers to understand and deal with. The disorder has five layers of complexity: (1) observable multiple motor, vocal, and cognitive tics and sensory involvement; (2) Attention Deficit Hyperactivity Disorder; (3)…
Slattery, Lindsey; Crosland, Kimberly; Iovannone, Rose
"Attention-deficit/hyperactivity disorder" (ADHD) is one of the most prevalent disorders in school-age children. Children with ADHD often have difficulty at school and at home. Medication is a common treatment for children with ADHD; however, it has been shown to be more effective when combined with behavioral interventions.…
The present study evaluated the effectiveness of the First Step to Success (FSS) early intervention program with Turkish children identified with attention-deficit/hyperactivity disorder (ADHD). Intervention effectiveness on target children's academic engagement behaviors was studied. Participants were four 7-year-old first-grade students in…
Riggs, Paula D.; Winhusen, Theresa; Davies, Robert D.; Leimberger, Jeffrey D.; Mikulich-Gilbertson, Susan; Klein, Constance; Macdonald, Marilyn; Lohman, Michelle; Bailey, Genie L.; Haynes, Louise; Jaffee, William B.; Haminton, Nancy; Hodgkins, Candace; Whitmore, Elizabeth; Trello-Rishel, Kathlene; Tamm, Leanne; Acosta, Michelle C.; Royer-Malvestuto, Charlotte; Subramaniam, Geetha; Fishman, Marc; Holmes, Beverly W.; Kaye, Mary Elyse; Vargo, Mark A.; Woody, George E.; Nunes, Edward V.; Liu, David
Objective: To evaluate the efficacy and safety of osmotic-release methylphenidate (OROS-MPH) compared with placebo for attention-deficit/hyperactivity disorder (ADHD), and the impact on substance treatment outcomes in adolescents concurrently receiving cognitive-behavioral therapy (CBT) for substance use disorders (SUD). Method: This was a…
van den Hoofdakker, Barbara J.; Nauta, Maaike H.; van der Veen-Mulders, Lianne; Sytema, Sjoerd; Emmelkamp, Paul M. G.; Minderaa, Ruud B.; Hoekstra, Pieter J.
Objective To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone. Methods We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC
Hoekstra, PJ; Steenhuis, MP; Troost, PW; Korf, J; Kallenberg, CGM; Minderaa, RB
The aim of this study was to investigate social and behavioral problems related to attention-deficit hyperactivity disorder (ADHD), obsessions and compulsions, and tic severity in children with a tic disorder. Parents of 58 children with a tic disorder with and without different forms of ADHD
Jonsdottir, S; Bouma, A; Sergeant, JA; Scherder, EJA; Bouma, J.M.
Objective. The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). Methods. Twenty-two children diagnosed with
Jonsdottir, S.; Bouma, A.; Sergeant, J.A.; Scherder, E.J.A.
Objective. The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). Methods. Twenty-two children diagnosed with
Gilger, Jeffrey W.; Olulade, Olumide A.
Observable behavior, such as test scores, is the gold standard by which we make judgments about levels of function, grade placements, and the presence/absence of pathology. Individual differences in test performance have long intrigued researchers and clinicians, and some have noted how people can come up with essentially the same answers using…
Lee, Minkyung; Ryu, Young Hoon; Cho, Won Gil; Kang, Yeo Wool; Lee, Soo Jin; Jeon, Tae Joo; Lyoo, Chul Hyoung; Kim, Chul Hoon; Kim, Dong Goo; Lee, Kyochul; Choi, Tae Hyun; Choi, Jae Yong
Depression frequently accompanies in Parkinson's disease (PD). Previous research suggested that dopamine (DA) and serotonin systems are closely linked with depression in PD. However, comprehensive studies about the relationship between these two neurotransmitter systems are limited. Therefore, the purpose of this study is to evaluate the effect of dopaminergic destruction on the serotonin system. The interconnection between motor and depression was also examined. Two PET scans were performed in the 6-hydroxydopamine (6-OHDA) lesioned and sham operated rats: [(18) F]FP-CIT for DA transporters and [(18) F]Mefway for serotonin 1A (5-HT(1A)) receptors. Here, 6-OHDA is a neurotoxin for dopaminergic neurons. Behavioral tests were used to evaluate the severity of symptoms: rotational number for motor impairment and immobility time, acquired from the forced swim test for depression. Region-of-interests were drawn in the striatum and cerebellum for the DA system and hippocampus and cerebellum for the 5-HT system. The cerebellum was chosen as a reference region. Nondisplaceable binding potential in the striatum and hippocampus were compared between 6-OHDA and sham groups. As a result, the degree of DA depletion was negatively correlated with rotational behavior (R(2) = 0.79, P = 0.003). In 6-OHDA lesioned rats, binding values for 5-HT(1A) receptors was 22% lower than the sham operated group. This decrement of 5-HT(1A) receptor binding was also correlated with the severity of depression (R(2) = 0.81, P = 0.006). Taken together, this research demonstrated that the destruction of dopaminergic system causes the reduction of the serotonergic system resulting in the expression of depressive behavior. The degree of dopaminergic dysfunction was positively correlated with the impairment of the serotonin system. Severity of motor symptoms was also closely related to depressive behavior. © 2015 Wiley Periodicals, Inc.
Pollak, Yehuda; Shalit, Reut; Aran, Adi
Adults with attention deficit/hyperactivity disorder (ADHD) are prone to suboptimal decision making and risk taking. The aim of this study was to test performance on a theoretically-based probabilistic decision making task in well-characterized adults with and without ADHD, and examine the relation between experimental risk taking and history of real-life risk-taking behavior, defined as cigarette, alcohol, and street drug use. University students with and without ADHD completed a modified version of the Cambridge Gambling Test, in which they had to choose between alternatives varied by level of risk, and reported their history of substance use. Both groups showed similar patterns of risk taking on the experimental decision making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD. These finding question the validity of experimental probabilistic decision making task as a valid model for ADHD-related risk-taking behavior. Copyright © 2017 Elsevier B.V. All rights reserved.
Zarrabi, Mojgan; Shahrivar, Zahra; Tehrani Doost, Mehdi; Khademi, Mojgan; Zargari Nejad, Ghazale
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in which impairment of executive functions plays an important role. The main objective of this study was to assess the validity of the Behavior Rating Inventory of Executive Function (BRIEF) in children with ADHD. Thirty children, aged 7-12 years, attending the child and adolescent clinic of Roozbeh hospital and diagnosed with ADHD according to interview with a child and adolescent psychiatrist, formed our ADHD group. In contrast, thirty participants of the control group were selected from 7 to 12 year-old students according to Conners' Teacher/Parent Rating Scale and did not have ADHD. The kiddie schedule for affective disorders and schizophrenia-present and lifetime version-Persian version was also completed for all children to rule out other psychiatric disorders. After oral consent, parents of 60 children (ADHD = 30, control = 30), completed three questionnaires of ADHD-Rating Scale-IV, Conners' Parent Rating Scale-Revised: Short Version and BRIEF. Children in ADHD group got higher scores than those in the control group in all subscales and indices of BRIEF (P behavioral aspects of executive functions, especially to discriminate children with ADHD and normal ones.
Balboni, Giulia; Incognito, Oriana; Belacchi, Carmen; Bonichini, Sabrina; Cubelli, Roberto
The evaluation of adaptive behavior is informative in children with attention-deficit/hyperactivity disorder (ADHD) or specific learning disorders (SLD). However, the few investigations available have focused only on the gross level of domains of adaptive behavior. To investigate which item subsets of the Vineland-II can discriminate children with ADHD or SLD from peers with typical development. Student's t-tests, ROC analysis, logistic regression, and linear discriminant function analysis were used to compare 24 children with ADHD, 61 elementary students with SLD, and controls matched on age, sex, school level attended, and both parents' education level. Several item subsets that address not only ADHD core symptoms, but also understanding in social context and development of interpersonal relationships, allowed discrimination of children with ADHD from controls. The combination of four item subsets (Listening and attending, Expressing complex ideas, Social communication, and Following instructions) classified children with ADHD with both sensitivity and specificity of 87.5%. Only Reading skills, Writing skills, and Time and dates discriminated children with SLD from controls. Evaluation of Vineland-II scores at the level of item content categories is a useful procedure for an efficient clinical description. Copyright © 2016 Elsevier Ltd. All rights reserved.
Majewska, M D
Clinical and preclinical studies provide convincing evidence for persistent neurological/psychiatric impairments and possible neuronal degeneration associated with chronic cocaine/stimulant abuse. These impairments include multifocal and global cerebral ischemia, cerebral hemorrhages, infarctions, optic neuropathy, cerebral atrophy, cognitive impairments, and mood and movement disorders. These findings may encourage the placement of stimulant addiction into the category of organic brain disorders. Functional and microanatomical anomalies in the frontal and temporal cortex as well as other brain regions may be responsible for certain aspects of phenomenology and neuropsychopathology that are characteristic of stimulant polydrug addictions. These may include broad spectrum of deficits in cognition, motivation, and insight; behavioral disinhibition; attention deficits; emotional instability; impulsiveness; aggressiveness; depression; anhedonia; and persistent movement disorders. Although it is still debated whether the hypofrontality and other brain anomalies observed in stimulant abusers are a consequence or an antecedent of drug abuse, this debate seems purely academic and irrelevant with respect to the importance of compensating for these deficits in the development of treatment strategies. The neuropsychiatric impairments accompanying stimulant abuse may contribute to the very high rate of relapse in addicts that can take place after long periods (years) of abstinence. It is possible that the neurological deficits present in stimulant addicts, whether they are primary or secondary to stimulant abuse, are responsible for perpetual drug abuse which may be a form of self-medication (Weiss et al. 1991, 1992). In this context, addiction to stimulants, once fully developed, may represent a true biological dependency on drugs that temporarily compensate for existing neurological deficits. The concept of self-medication by drug addicts is supported by major theories of
Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.
Gard, David E.; Sanchez, Amy H.; Starr, Jessica; Cooper, Shanna; Fisher, Melissa; Rowlands, Abby; Vinogradov, Sophia
Self-Determination Theory (SDT) provides a model for understanding motivation deficits in schizophrenia, and recent research has focused on problems with intrinsic motivation. However, SDT emphasizes that motivated behavior results from three different factors: intrinsic motivators (facilitated by needs for autonomy, competency, and relatedness), extrinsic motivators (towards reward or away from punishment), or when intrinsic and extrinsic motivators are absent or thwarted a disconnect/disengagement occurs resulting in behavior driven by boredom or ‘passing time’. Using a novel approach to Ecological Momentary Assessment, we assessed the degree to which people with schizophrenia were motivated by these factors relative to healthy control participants. Forty-seven people with and 41 people without schizophrenia were provided with cell phones and were called four times a day for one week. On each call participants were asked about their goals, and about the most important reason motivating each goal. All responses were coded by independent raters (blind to group and hypotheses) on all SDT motivating factors, and ratings were correlated to patient functioning and symptoms. We found that, relative to healthy participants, people with schizophrenia reported goals that were: 1) less motivated by filling autonomy and competency needs, but equivalently motivated by relatedness; 2) less extrinsically rewarding, but equivalently motivated by punishment; 3) more disconnected/disengaged. Higher disconnected/disengaged goals were significantly associated with higher negative symptoms and lower functioning. These findings indicate several important leverage points for behavioral treatments and suggest the need for vigorous psychosocial intervention focusing on autonomy, competence, and reward early in the course of illness. PMID:24853060
Eckerle, Judith K; Hill, Lindsay Knauf; Iverson, Sandra; Hellerstedt, Wendy; Gunnar, Megan; Johnson, Dana E
To determine the occurrence of vision and hearing deficits in international adoptees and their associations with emotional, behavioral and cognitive problems. The Minnesota International Adoption Project (MnIAP) was a 556-item survey that was mailed to 2,969 parents who finalized an international adoption in Minnesota (MN) between January 1990 and December 1998 and whose children were between 4 and 18 years-old at the time of the survey. Families returned surveys for 1,906 children (64%); 1,005 had complete data for analyses. The survey included questions about the child's pre-adoption experiences and post-placement medical diagnoses, and the Child Behavior Checklist (CBCL). Multivariate logistic regression assessed associations between hearing and vision problems and problems identified by the CBCL. Information on hearing and vision screening and specific vision and hearing problems was also collected via a telephone survey (HVS) from 96/184 children (52%) seen between June 1999 and December 2000 at the University of Minnesota International Adoption Clinic. In both cohorts, 61% of children had been screened for vision problems and 59% for hearing problems. Among those children screened, vision (MnIAP = 25%, HVS = 31%) and hearing (MnIAP = 12%, HVS = 13%) problems were common. For MnIAP children, such problems were significant independent predictors for T scores >67 for the CBCL social problems and attention subscales and parent-reported, practitioner-diagnosed developmental delay, learning and speech/language problems, and cognitive impairment. Hearing and vision problems are common in international adoptees and screening and correction are available in the immediate post-arrival period. The importance of identifying vision and hearing problems cannot be overstated as they are risk factors for development and behavior problems.
Delgado-Rico, Elena; Río-Valle, Jacqueline S; Albein-Urios, Natalia; Caracuel, Alfonso; González-Jiménez, Emilio; Piqueras, María J; Brandi, Pilar; Ruiz-López, Isabel M; García-Rodríguez, Inmaculada; Martín-Matillas, Miguel; Delgado-Fernández, Manuel; Campoy, Cristina; Verdejo-García, Antonio
The aim of this study was to explore the effects of a multidisciplinary behavioral intervention including cognitive behavioral therapy, structured physical activity, and dietary counseling on impulsive personality and cognitive skills and subsequent BMI loss in excess weight adolescents. Forty-two adolescents with excess weight (14 males and 28 females, range 12-17 years), as defined by the International Obesity Task Force Criteria, participated in our study. We used a longitudinal observational design with two assessments: before and after treatment. We collected baseline measures of impulsive personality (UPPS-P scale), cognitive performance (letter number sequencing, Stroop and Iowa gambling task), and biometric parameters. After 12 weeks of intervention, parallel measures were used to determine whether treatment-induced changes in impulsivity and cognition predicted changes in BMI. BMI showed a statistically significant reduction after treatment [from mean (SD) 29.36 (4.51) to 27.31 (4.41), Cohen's d=0.5]. Greater reductions in negative urgency (negative-emotion-driven impulsivity) and greater improvement in cognitive inhibitory control skills were associated with greater reductions in BMI. Because the design was correlational and lacked a control group, future studies should clarify whether these associations reflect a causal effect or just overlapping improvements associated with a third variable (e.g. increases in attention procurement or motivation).
Full Text Available Alterations of the normal redox state can be found in all stages of schizophrenia, suggesting a key role for oxidative stress in the etiology and maintenance of the disease. Pharmacological blockade of N-methyl-D-aspartic acid (NMDA receptors can disrupt natural antioxidant defense systems and induce schizophrenia-like behaviors in animals and healthy human subjects. Perinatal administration of the NMDA receptor (NMDAR antagonist ketamine produces persistent behavioral deficits in adult mice which mimic a range of positive, negative, and cognitive symptoms that characterize schizophrenia. Here we tested whether antioxidant treatment with the glutathione (GSH precursor N-acetyl-cysteine (NAC can prevent the development of these behavioral deficits. On postnatal days (PND 7, 9 and 11, we treated mice with subanesthetic doses (30 mg/kg of ketamine or saline. Two groups (either ketamine or saline treated also received NAC throughout development. In adult animals (PND 70–120 we then assessed behavioral alterations in a battery of cognitive and psychomotor tasks. Ketamine-treated animals showed deficits in a task of cognitive flexibility, abnormal patterns of spontaneous alternation, deficits in novel-object recognition, as well as social interaction. Developmental ketamine treatment also induced behavioral stereotypy in response to an acute amphetamine challenge, and it impaired sensorimotor gating, measured as reduced prepulse inhibition (PPI of the startle response. All of these behavioral abnormalities were either prevented or strongly ameliorated by NAC co-treatment. These results suggest that oxidative stress is a major factor for the development of the ketamine-induced behavioral dysfunctions, and that restoring oxidative balance during the prodromal stage of schizophrenia might be able to ameliorate the development of several major symptoms of the disease.
This study aimed to investigate perception and processing of musical features in prelingually deaf adolescent CI-users and examine whether this is influenced by music training. Eleven adolescent CI-users received intensive music training for two weeks. Before and after training they completed...... responses for timbre, intensity and rhythm but not for pitch. No effect of training was found in the MMN responses. The findings indicate that despite congenital deafness and late implantation, young CI users are able to discriminate details in music. Furthermore, the behavioral advances suggest that......, in a wider perspective, music training may serve as a supplementary measure of rehabilitation....
Katrina L Paumier
Full Text Available Parkinson's disease (PD pathology is characterized by the formation of intra-neuronal inclusions called Lewy bodies, which are comprised of alpha-synuclein (α-syn. Duplication, triplication or genetic mutations in α-syn (A53T, A30P and E46K are linked to autosomal dominant PD; thus implicating its role in the pathogenesis of PD. In both PD patients and mouse models, there is increasing evidence that neuronal dysfunction occurs before the accumulation of protein aggregates (i.e., α-syn and neurodegeneration. Characterization of the timing and nature of symptomatic dysfunction is important for understanding the impact of α-syn on disease progression. Furthermore, this knowledge is essential for identifying pathways and molecular targets for therapeutic intervention. To this end, we examined various functional and morphological endpoints in the transgenic mouse model expressing the human A53T α-syn variant directed by the mouse prion promoter at specific ages relating to disease progression (2, 6 and 12 months of age. Our findings indicate A53T mice develop fine, sensorimotor, and synaptic deficits before the onset of age-related gross motor and cognitive dysfunction. Results from open field and rotarod tests show A53T mice develop age-dependent changes in locomotor activity and reduced anxiety-like behavior. Additionally, digigait analysis shows these mice develop an abnormal gait by 12 months of age. A53T mice also exhibit spatial memory deficits at 6 and 12 months, as demonstrated by Y-maze performance. In contrast to gross motor and cognitive changes, A53T mice display significant impairments in fine- and sensorimotor tasks such as grooming, nest building and acoustic startle as early as 1-2 months of age. These mice also show significant abnormalities in basal synaptic transmission, paired-pulse facilitation and long-term depression (LTD. Combined, these data indicate the A53T model exhibits early- and late-onset behavioral and synaptic
Paumier, Katrina L; Sukoff Rizzo, Stacey J; Berger, Zdenek; Chen, Yi; Gonzales, Cathleen; Kaftan, Edward; Li, Li; Lotarski, Susan; Monaghan, Michael; Shen, Wei; Stolyar, Polina; Vasilyev, Dmytro; Zaleska, Margaret; D Hirst, Warren; Dunlop, John
Parkinson's disease (PD) pathology is characterized by the formation of intra-neuronal inclusions called Lewy bodies, which are comprised of alpha-synuclein (α-syn). Duplication, triplication or genetic mutations in α-syn (A53T, A30P and E46K) are linked to autosomal dominant PD; thus implicating its role in the pathogenesis of PD. In both PD patients and mouse models, there is increasing evidence that neuronal dysfunction occurs before the accumulation of protein aggregates (i.e., α-syn) and neurodegeneration. Characterization of the timing and nature of symptomatic dysfunction is important for understanding the impact of α-syn on disease progression. Furthermore, this knowledge is essential for identifying pathways and molecular targets for therapeutic intervention. To this end, we examined various functional and morphological endpoints in the transgenic mouse model expressing the human A53T α-syn variant directed by the mouse prion promoter at specific ages relating to disease progression (2, 6 and 12 months of age). Our findings indicate A53T mice develop fine, sensorimotor, and synaptic deficits before the onset of age-related gross motor and cognitive dysfunction. Results from open field and rotarod tests show A53T mice develop age-dependent changes in locomotor activity and reduced anxiety-like behavior. Additionally, digigait analysis shows these mice develop an abnormal gait by 12 months of age. A53T mice also exhibit spatial memory deficits at 6 and 12 months, as demonstrated by Y-maze performance. In contrast to gross motor and cognitive changes, A53T mice display significant impairments in fine- and sensorimotor tasks such as grooming, nest building and acoustic startle as early as 1-2 months of age. These mice also show significant abnormalities in basal synaptic transmission, paired-pulse facilitation and long-term depression (LTD). Combined, these data indicate the A53T model exhibits early- and late-onset behavioral and synaptic impairments
Paumier, Katrina L.; Sukoff Rizzo, Stacey J.; Berger, Zdenek; Chen, Yi; Gonzales, Cathleen; Kaftan, Edward; Li, Li; Lotarski, Susan; Monaghan, Michael; Shen, Wei; Stolyar, Polina; Vasilyev, Dmytro; Zaleska, Margaret; D. Hirst, Warren; Dunlop, John
Parkinson's disease (PD) pathology is characterized by the formation of intra-neuronal inclusions called Lewy bodies, which are comprised of alpha-synuclein (α-syn). Duplication, triplication or genetic mutations in α-syn (A53T, A30P and E46K) are linked to autosomal dominant PD; thus implicating its role in the pathogenesis of PD. In both PD patients and mouse models, there is increasing evidence that neuronal dysfunction occurs before the accumulation of protein aggregates (i.e., α-syn) and neurodegeneration. Characterization of the timing and nature of symptomatic dysfunction is important for understanding the impact of α-syn on disease progression. Furthermore, this knowledge is essential for identifying pathways and molecular targets for therapeutic intervention. To this end, we examined various functional and morphological endpoints in the transgenic mouse model expressing the human A53T α-syn variant directed by the mouse prion promoter at specific ages relating to disease progression (2, 6 and 12 months of age). Our findings indicate A53T mice develop fine, sensorimotor, and synaptic deficits before the onset of age-related gross motor and cognitive dysfunction. Results from open field and rotarod tests show A53T mice develop age-dependent changes in locomotor activity and reduced anxiety-like behavior. Additionally, digigait analysis shows these mice develop an abnormal gait by 12 months of age. A53T mice also exhibit spatial memory deficits at 6 and 12 months, as demonstrated by Y-maze performance. In contrast to gross motor and cognitive changes, A53T mice display significant impairments in fine- and sensorimotor tasks such as grooming, nest building and acoustic startle as early as 1–2 months of age. These mice also show significant abnormalities in basal synaptic transmission, paired-pulse facilitation and long-term depression (LTD). Combined, these data indicate the A53T model exhibits early- and late-onset behavioral and synaptic impairments
Hibbeln, Joseph. R.; Gow, Rachel V.
Synopsis Nutritional insufficiencies of omega-3 highly unsaturated fatty acids (HUFAs) may have adverse effects on brain development and neurodevelopmental outcomes. A recent meta-analysis of ten randomized controlled trials of omega-3 HUFAs reported a small to modest effect size for the efficacy of omega-3 for treating symptoms of ADHD in youth. Several controlled trials of omega-3 HUFAs combined with micronutrients (vitamins, minerals) show sizeable reductions in aggressive, antisocial, and violent behavior in youth and in young adult prisoners. Meta-analyses report efficacy for depressive symptoms in adults, and preliminary findings suggest anti-suicidal properties in adults, but studies in youth are insufficient to draw any conclusions regarding mood. Dietary adjustments to increase omega-3 and reduce omega-6 HUFA consumption are sensible recommendations for youth and adults based on general health considerations, while the evidence base for omega-3 HUFAs as potential psychiatric treatments develops. PMID:24975625
Anton, John J.
This abstract describes a research effort to apply technological advances in virtual reality simulation and computer-based games to create behavioral modification programs for individuals with Autism Spectrum Disorder (ASD). The research investigates virtual social skills training within a 3D game environment to diminish the impact of ASD social impairments and to increase learning capacity for optimal intellectual capability. Individuals with autism will encounter prototypical social contexts via computer interface and will interact with 3D avatars with predefined roles within a game-like environment. Incremental learning objectives will combine to form a collaborative social environment. A secondary goal of the effort is to begin the research and development of virtual reality exercises aimed at triggering the release of neurotransmitters to promote critical aspects of synaptic maturation at an early age to change the course of the disease.
Michael J Yetman
Full Text Available Alzheimer's disease (AD researchers have struggled for decades to draw a causal link between extracellular Aβ aggregation and intraneuronal accumulation of microtubule-associated protein tau. The amyloid cascade hypothesis posits that Aβ deposition promotes tau hyperphosphorylation, tangle formation, cell loss, vascular damage, and dementia. While the genetics of familial AD and the pathological staging of sporadic disease support this sequence of events, attempts to examine the molecular mechanism in transgenic animal models have largely relied on models of other inherited tauopathies as the basis for testing the interaction with Aβ. In an effort to more accurately model the relationship between Aβ and wild-type tau in AD, we intercrossed mice that overproduce human Aβ with a tau substitution model in which all 6 isoforms of the human protein are expressed in animals lacking murine tau. We selected an amyloid model in which pathology was biased towards the entorhinal region so that we could further examine whether the anticipated changes in tau phosphorylation occurred at the site of Aβ deposition or in synaptically connected regions. We found that Aβ and tau had independent effects on locomotion, learning, and memory, but found no behavioral evidence for an interaction between the two transgenes. Moreover, we saw no indication of amyloid-induced changes in the phosphorylation or aggregation of human tau either within the entorhinal area or elsewhere. These findings suggest that robust amyloid pathology within the medial temporal lobe has little effect on the metabolism of wild type human tau in this model.
Lapchak, Paul A; Schubert, David R; Maher, Pamela A
Acute ischemic stroke is a major risk for morbidity and mortality in our aging population. Currently only one drug, the thrombolytic tissue plasminogen activator, is approved by the US Food and Drug Administration to treat stroke. Therefore, there is a need to develop new drugs that promote neuronal survival following stroke. We have synthesized a novel neuroprotective molecule called CNB-001 (a pyrazole derivative of curcumin) that has neurotrophic activity, enhances memory, and blocks cell death in multiple toxicity assays related to ischemic stroke. In this study, we tested the efficacy of CNB-001 in a rigorous rabbit ischemic stroke model and determined the molecular basis of its in vivo activity. CNB-001 has substantial beneficial properties in an in vitro ischemia assay and improves the behavioral outcome of rabbit ischemic stroke even when administered 1 h after the insult, a therapeutic window in this model comparable to tissue plasminogen activator. In addition, we elucidated the protein kinase pathways involved in neuroprotection. CNB-001 maintains the calcium-calmodulin-dependent kinase signaling pathways associated with neurotrophic growth factors that are critical for the maintenance of neuronal function. On the basis of its in vivo efficacy and novel mode of action, we conclude that CNB-001 has a great potential for the treatment of ischemic stroke as well as other CNS pathologies.
Furukawa, Emi; Alsop, Brent; Sowerby, Paula; Jensen, Stephanie; Tripp, Gail
The behavioral sensitivity of children with ADHD to punishment has received limited theoretical and experimental attention. This study evaluated the effects of punishment on the response allocation of children with ADHD and typically developing children. Two hundred and ten children, 145 diagnosed with ADHD, completed an operant task in which they chose between playing two simultaneously available games. Reward was arranged symmetrically across the games under concurrent variable interval schedules. Asymmetric punishment schedules were superimposed; responses on one game were punished four times as often as responses on the other. Both groups allocated more of their responses to the less frequently punished alternative. Response bias increased significantly in the ADHD group during later trials, resulting in missed reward trials and reduced earnings. Punishment exerted greater control over the response allocation of children with ADHD with increased time on task. Children with ADHD appear more sensitive to the cumulative effects of punishment than typically developing children. © 2016 Association for Child and Adolescent Mental Health.
Fatseas, Melina; Alexandre, Jean-Marc; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Guilleux, Alice; Groupe Jeu; Challet-Bouju, Gaëlle; Grall-Bronnec, Marie
Previous studies showed that Pathological Gambling and Attention Deficit/Hyperactivity Disorder (ADHD) often co-occur. The aim of this study was to examine whether ADHD is associated with specific severity patterns in terms of gambling behavior, psychopathology and personality traits. 599 problem and non-problem-gamblers were recruited in addiction clinics and gambling places in France. Subjects were assessed with the Wender-Utah Rating Scale-Child, the Adult ADHD Self-Report Scale, the Mini International Neuropsychiatric Interview, the Temperament and Character Inventory, the South Oaks Gambling Screen and questionnaires assessing gambling related cognitive distortions and gambling habits. 20.7% (n=124) of gamblers were screened positive for lifetime or current ADHD. Results from the multivariate analysis showed that ADHD was associated with a higher severity of gambling-related problems and with more psychiatric comorbidity. Among problem gamblers, subjects with history of ADHD were also at higher risk for unemployment, psychiatric comorbidity and specific dysfunctional personality traits. This study supports the link between gambling related problems and ADHD in a large sample of problem and non-problem gamblers, including problem-gamblers not seeking treatment. This points out the necessity to consider this disorder in the prevention and in the treatment of pathological gambling. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Geladé, Katleen; Janssen, Tieme W P; Bink, Marleen; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap
The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, is still an intensely debated subject. The current randomized controlled trial compared neurofeedback to (1) optimally titrated methylphenidate and (2) a semi-active control intervention, physical activity, to account for nonspecific effects. A multicenter 3-way parallel-group study with balanced randomization was conducted. Children with a DSM-IV-TR diagnosis of ADHD, aged 7-13 years, were randomly allocated to receive neurofeedback (n = 39), methylphenidate (n = 36), or physical activity (n = 37) over a period of 10-12 weeks. Neurofeedback comprised theta/beta training on the vertex (Cz). Physical activity consisted of moderate to vigorous intensity exercises. Neurofeedback and physical activity were balanced in terms of number (~30) and duration of sessions. A double-blind pseudorandomized placebo-controlled crossover titration procedure was used to determine an optimal dose in the methylphenidate intervention. Parent and teacher ratings on the Strengths and Difficulties Questionnaire (SDQ) and Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) were used to assess intervention outcomes. Data collection took place between September 2010 and March 2014. Intention-to-treat analyses revealed an improvement in parent-reported behavior on the SDQ and the SWAN Hyperactivity/Impulsivity scale, irrespective of received intervention (ηp² = 0.21-0.22, P ≤ .001), whereas the SWAN Inattention scale revealed more improvement in children who received methylphenidate than neurofeedback and physical activity (ηp² = 0.13, P ≤ .001). Teachers reported a decrease of ADHD symptoms on all measures for methylphenidate, but not for neurofeedback or physical activity (range of ηp² = 0.14-0.29, P neurofeedback and physical activity in decreasing ADHD symptoms in children with ADHD
Wigal, Sharon B; Wigal, Tim; Schuck, Sabrina; Brams, Matthew; Williamson, David; Armstrong, Robert B; Starr, H Lynn
To assess the effect of Osmotic-Release Oral System (OROS) methylphenidate (MPH) on a variety of measures evaluating academic performance, cognition, and social behavior in children with attention-deficit/hyperactivity disorder (ADHD). This double-blind, randomized, placebo-controlled, crossover laboratory school study enrolled 78 children aged 9-12 years with ADHD who responded to OROS MPH. After determining individualized OROS MPH dosing (18-54 mg/day), 71 subjects received blinded treatment (OROS MPH or placebo then vice versa) on each of 2 laboratory school days, separated by 1 week. Primary efficacy was measured by Permanent Product Measure of Performance at 4 hours after study drug administration. Treatment with OROS MPH resulted in statistically significant improvement in Permanent Product Measure of Performance and Swanson, Kotkin, Agler, M-Flynn, and Pelham scores, measures of response time, and of working memory compared to placebo. Other measures did not meet all pre-established criteria for significance (maintenance of the overall type I error rate at 5%). Adverse events were consistent with previous reports of stimulant medications used in the management of ADHD. There were no discontinuations due to adverse events, and no serious adverse events or deaths. OROS MPH dosed to reduce core symptoms of ADHD to within the normal range also improved performance on a variety of academic tasks in school-aged children compared to placebo. Adverse effects reported were consistent with prior studies. CLINICAL TRIAL REGISTRY INFORMATION: Double-Blind, Randomized, Placebo-Controlled, Crossover Study Evaluating the Academic, Behavioral and Cognitive Effects of Concerta on Older Children with ADHD, URL: http://clinicaltrials.gov/ct2/show/NCT00799409, unique identifier: NCT00799409.
Uran, Pınar; Kılıç, Birim Günay
We aimed to investigate the similarities and differences in neuropsychological test performance, demographic features and behavioral patterns of children and adolescents with the attention deficit hyperactivity disorder combined type (ADHD-C), and the severe mood dysregulation (SMD). Study includes 112 children: 67 with ADHD-C, 24 with SMD and 21 healthy controls. These groups were identified by using the schedule for affective disorders, and schizophrenia for the school-age children-present and lifetime version (KSADS-PL) and the K-SADS-PL-SMD Module. Conners' Parent and Teacher Rating Scale-revised long form (CPRS-R:L and CTRS-R:L) and neuropsychological tests were administered to the research groups. ADHD-C group's performances in Wisconsin Card Sorting Test, Trail Making Test, Stroop Test TBAG form and Controlled Oral Word Association Test were significantly poorer than the control group's performances (p Performance of the SMD group was only descriptively intermediate between performances of the ADHD-C and control group. In the "Oppositional", "Hyperactivity", "Social Problems", "Impulsive", "Emotional Lability" and "Conners' Global Index" subscales of CPRS-R:L, the average scores of the SMD group were significantly higher than the ADHD-C and control group's average scores (p < 0.05). ADHD-C group (but not SMD) could be significantly differentiated from healthy controls with the neuropsychological tests used. SMD group could be differentiated from the ADHD-C and healthy control groups with CPRS-R:L; i.e., ADHD-C versus SMD could be differentiated at the behavioral level only.
Full Text Available Etiology of aberrant social behavior consistently points to a strong polygenetic component involved in fundamental developmental pathways, with the potential of being enhanced by defects in bioenergetics. To this end, the occurrence of social deficits and mitochondrial outcomes were evaluated in conditional Pten (Phosphatase and tensin homolog haplo-insufficient mice, in which only one allele was selectively knocked-out in neural tissues. Pten mutations have been linked to Alzheimer's disease and syndromic autism spectrum disorders, among others. By 4-6 weeks of age, Pten insufficiency resulted in the increase of several mitochondrial Complex activities (II-III, IV and V not accompanied by increases in mitochondrial mass, consistent with an activation of the PI3K/Akt pathway, of which Pten is a negative modulator. At 8-13 weeks of age, Pten haplo-insufficient mice did not show significant behavioral abnormalities or changes in mitochondrial outcomes, but by 20-29 weeks, they displayed aberrant social behavior (social avoidance, failure to recognize familiar mouse, and repetitive self-grooming, macrocephaly, increased oxidative stress, decreased cytochrome c oxidase (CCO activity (50% and increased mtDNA deletions in cerebellum and hippocampus. Mitochondrial dysfunction was the result of a downregulation of p53-signaling pathway evaluated by lower protein expression of p21 (65% of controls and the CCO chaperone SCO2 (47% of controls, two p53-downstream targets. This mechanism was confirmed in Pten-deficient striatal neurons and, HCT 116 cells with different p53 gene dosage. These results suggest a unique pathogenic mechanism of the Pten-p53 axis in mice with aberrant social behavior: loss of Pten (via p53 impairs mitochondrial function elicited by an early defective assembly of CCO and later enhanced by the accumulation of mtDNA deletions. Consistent with our results, (i SCO2 deficiency and/or CCO activity defects have been reported in patients
Liang, Jing; Shen, Yi; Shao, Xuesi M; Scott, Michael B; Ly, Eddie; Wong, Stephanie; Nguyen, Albert; Tan, Kevin; Kwon, Bill; Olsen, Richard W; Spigelman, Igor
FAE offspring. DHM administration alone in pregnant rats had no adverse effect on litter size, progeny weight, anxiety level, PTZ seizure threshold, or DGC GABAAR function. Our results indicate that FAE induces long-lasting alterations in physiology, behavior, and hippocampal GABAAR function and that these deficits are prevented by DHM co-treatment of EtOH-exposed dams. The absence of adverse side effects and the ability of DHM to prevent FAE consequences suggest that DHM is an attractive candidate for development as a treatment for prevention of fetal alcohol spectrum disorders.
Full Text Available Attention-Deficit Hyperactivity Disorder (ADHD and Tourette Syndrome (TS present as distinct conditions clinically; however, comorbidity and inhibitory control deficits have been proposed for both. Whilst such deficits have been studied widely within clinical populations, findings are mixed – partly due to comorbidity and/or medication effects - and studies have rarely distinguished between subtypes of the disorders. Studies in the general population are sparse. Using a continuity approach, the present study examined (i the relationships between inattentive and hyperactive/impulsive aspects of ADHD and TS-like behaviors in the general population, and (ii their unique associations with automatic and executive inhibitory control, as well as (iii yawning (a proposed behavioral model of TS. One hundred and thirty-eight participants completed self-report measures for ADHD and TS-like behaviors as well as yawning, and a conditioned inhibition task to assess automatic inhibition. A sub-sample of fifty-four participants completed three executive inhibition tasks. An exploratory factor analysis of the TS behavior checklist supported a distinction between phonic and motor like pure TS behaviors. Whilst hyperactive/impulsive aspects of ADHD were associated with increased pure and compulsive TS-like behaviors, inattention in isolation was related to reduced obsessive-compulsive TS-like behaviors. TS-like behaviors were associated with yawning during situations of inactivity, and specifically motor TS was related to yawning during stress. Phonic TS and inattention aspects of ADHD were associated with yawning during concentration/activity. Whilst executive interference control deficits were linked to hyperactive/impulsive ADHD-like behaviors, this was not the case for inattentive ADHD or TS-like behaviors, which instead related to increased performance on some measures. No associations were observed for automatic conditioned inhibition.
Bonthius, Daniel J; Winters, Zachary; Karacay, Bahri; Bousquet, Samantha Larimer; Bonthius, Daniel J
The cerebellum is a major target of alcohol-induced damage in the developing brain. However, the cerebella of some children are much more seriously affected than others by prenatal alcohol exposure. As a consequence of in utero alcohol exposure, some children have substantial reductions in cerebellar volume and corresponding neurodevelopmental problems, including microencephaly, ataxia, and balance deficits, while other children who were exposed to similar alcohol quantities are spared. One factor that likely plays a key role in determining the impact of alcohol on the fetal cerebellum is genetics. However, no specific gene variant has yet been identified that worsens cerebellar function as a consequence of developmental alcohol exposure. Previous studies have revealed that mice carrying a homozygous mutation of the gene for neuronal nitric oxide synthase (nNOS-/- mice) have more severe acute alcohol-induced neuronal losses from the cerebellum than wild type mice. Therefore, the goals of this study were to determine whether alcohol induces more severe cerebellum-based behavioral deficits in nNOS-/- mice than in wild type mice and to determine whether these worsened behavior deficits are associated with worsened cerebellar neuronal losses. nNOS-/- mice and their wild type controls received alcohol (0.0, 2.2, or 4.4mg/g) daily over postnatal days 4-9. In adulthood, the mice underwent behavioral testing, followed by neuronal quantification. Alcohol caused dose-related deficits in rotarod and balance beam performance in both nNOS-/- and wild type mice. However, the alcohol-induced behavioral deficits were substantially worse in the nNOS-/- mice than in wild type. Likewise, alcohol exposure led to losses of Purkinje cells and cerebellar granule cells in mice of both genotypes, but the cell losses were more severe in the nNOS-/- mice than in wild type. Behavioral performances were correlated with neuronal number in the nNOS-/- mice, but not in wild type. Thus, homozygous
Full Text Available Persistent neurobehavioral deficits and brain changes need validation for brain restoration. Two hours middle cerebral artery occlusion (tMCAO or sham surgery was performed in male Sprague-Dawley rats. Neurobehavioral and cognitive deficits were measured over 10 weeks included: (1 sensory, motor, beam balance, reflex/abnormal responses, hindlimb placement, forepaw foot fault and cylinder placement tests, and (2 complex active place avoidance learning (APA and simple passive avoidance retention (PA. Electroretinogram (ERG, hemispheric loss (infarction, hippocampus CA1 neuronal loss and myelin (Luxol Fast Blue staining in several fiber tracts were also measured. In comparison to Sham surgery, tMCAO surgery produced significant deficits in all behavioral tests except reflex/abnormal responses. Acute, short lived deficits following tMCAO were observed for forelimb foot fault and forelimb cylinder placement. Persistent, sustained deficits for the whole 10 weeks were exhibited for motor (p<0.001, sensory (p<0.001, beam balance performance (p<0.01 and hindlimb placement behavior (p<0.01. tMCAO produced much greater and prolonged cognitive deficits in APA learning (maximum on last trial of 604±83% change, p<0.05 but only a small, comparative effect on PA retention. Hemispheric loss/atrophy was measured 10 weeks after tMCAO and cross-validated by two methods (e.g., almost identical % ischemic hemispheric loss of 33.4±3.5% for H&E and of 34.2±3.5% for TTC staining. No visual dysfunction by ERG and no hippocampus neuronal loss were detected after tMCAO. Fiber tract damage measured by Luxol Fast Blue myelin staining intensity was significant (p<0.01 in the external capsule and striatum but not in corpus callosum and anterior commissure. In summary, persistent neurobehavioral deficits were validated as important endpoints for stroke restorative research in the future. Fiber myelin loss appears to contribute to these long term behavioral dysfunctions and
Rao, Patricia A.; Landa, Rebecca J.
Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines ("Diagnostic and Statistical Manual of the American Psychiatric Association," 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity…
Full Text Available Manganese-enhanced magnetic resonance imaging (MEMRI has been suggested to be a useful tool to visualize and map behavior-relevant neural populations at large scale in freely behaving rodents. A primary concern in MEMRI applications is Mn 2+ toxicity. Although a few studies have specifically examined toxicity on gross motor behavior, Mn 2+ toxicity on skilled motor behavior was not explored. Thus, the objective of this study was to combine manganese as a functional contrast agent with comprehensive behavior evaluation. We evaluated Mn 2+ effect on skilled reach-to-eat action, locomotion, and balance using a single pellet reaching task, activity cage, and cylinder test, respectively. The tests used are sensitive to the pathophysiology of many neurological and neurodegenerative disorders of the motor system. The behavioral testing was done in combination with a moderate dose of manganese. Behavior was studied before and after a single, intravenous infusion of MnCl 2 (48 mg/kg. The rats were imaged at 1, 3, 5, 7, and 14 days following infusion. The results show that MnCl 2 infusion resulted in detectable abnormalities in skilled reaching, locomotion, and balance that recovered within 3 days compared with the infusion of saline. Because some tests and behavioral measures could not detect motor abnormalities of skilled movements, comprehensive evaluation of motor behavior is critical in assessing the effects of MnCl 2 . The relaxation mapping results suggest that the transport of Mn 2+ into the brain is through the choroid plexus-cerebrospinal fluid system with the primary entry point and highest relaxation rates found in the pituitary gland. Relaxation rates in the pituitary gland correlated with measures of motor skill, suggesting that altered motor ability is related to the level of Mn circulating in the brain. Thus, combined MEMRI and behavioral studies that both achieve adequate image enhancement and are also free of motor skills deficits are
...), launched the Neurological Alliance of Ireland, a nationwide coalition of patient advocacy groups and physicians and authored Standards of Care, the "blueprint" for the development of neurological...
Li, Yan; Xu, Xijin; Wu, Kusheng; Chen, Gangjian; Liu, Junxiao; Chen, Songjian; Gu, Chengwu; Zhang, Bao; Zheng, Liangkai; Zheng, Minghao; Huo, Xia
Guiyu is the major electronic waste (e-waste) recycling town in China. The primary purpose of this study was to measure the lead levels in neonates and examine the correlation between lead levels and neurobehavioral development. One hundred full-term neonates from Guiyu and fifty-two neonates from neighboring towns (control group) in the late summer of 2006 were selected for study. The lead levels in the umbilical cord blood (CBPb) and lead levels in meconium (MPb) of neonates were determined with atomic absorption spectrophotometry. The neonatal behavioral neurological assessment (NBNA) was conducted on all neonates. A questionnaire related to the exposure to lead of pregnant women was used as a survey of the neonates' mothers. Compared with the control group, neonates in Guiyu had significantly higher levels of lead (P e-waste recycling. Neonates with high levels of lead load have lower NBNA scores (P e-waste recycling activities related to lead contamination. This study suggests that environmental lead contamination due to e-waste recycling have an impact on neurobehavioral development of neonates in Guiyu.
Redmond, Sean M.; Ash, Andrea C.
Cross-etiology comparisons provide important information that can help practitioners establish criteria for differential diagnosis and tailor interventions towards the source of children’s difficulties. This study examined the extent to which parent rating scales of socioemotional behavioral difficulties differentiate cases of attention-deficit/hyperactivity disorder (ADHD) from cases of specific language impairment (SLI), and typical development (TD). Parents of 60 children (7–8 years) compl...
Sturm, Joshua J; Zhang-Hooks, Ying-Xin; Roos, Hannah; Nguyen, Tuan; Kandler, Karl
Hearing loss leads to a host of cellular and synaptic changes in auditory brain areas that are thought to give rise to auditory perception deficits such as temporal processing impairments, hyperacusis, and tinnitus. However, little is known about possible changes in synaptic circuit connectivity that may underlie these hearing deficits. Here, we show that mild hearing loss as a result of brief noise exposure leads to a pronounced reorganization of local excitatory and inhibitory circuits in the mouse inferior colliculus. The exact nature of these reorganizations correlated with the presence or absence of the animals' impairments in detecting brief sound gaps, a commonly used behavioral sign for tinnitus in animal models. Mice with gap detection deficits (GDDs) showed a shift in the balance of synaptic excitation and inhibition that was present in both glutamatergic and GABAergic neurons, whereas mice without GDDs showed stable excitation-inhibition balances. Acoustic enrichment (AE) with moderate intensity, pulsed white noise immediately after noise trauma prevented both circuit reorganization and GDDs, raising the possibility of using AE immediately after cochlear damage to prevent or alleviate the emergence of central auditory processing deficits. SIGNIFICANCE STATEMENT Noise overexposure is a major cause of central auditory processing disorders, including tinnitus, yet the changes in synaptic connectivity underlying these disorders remain poorly understood. Here, we find that brief noise overexposure leads to distinct reorganizations of excitatory and inhibitory synaptic inputs onto glutamatergic and GABAergic neurons and that the nature of these reorganizations correlates with animals' impairments in detecting brief sound gaps, which is often considered a sign of tinnitus. Acoustic enrichment immediately after noise trauma prevents circuit reorganizations and gap detection deficits, highlighting the potential for using sound therapy soon after cochlear damage
Dey, Nicholas D; Bombard, Matthew C; Roland, Bartholomew P; Davidson, Stacy; Lu, Ming; Rossignol, Julien; Sandstrom, Michael I; Skeel, Reid L; Lescaudron, Laurent; Dunbar, Gary L
The purpose of this study was to evaluate the therapeutic effects of the transplantation of bone-marrow mesenchymal stem cells (MSCs), genetically engineered to over-express brain-derived neurotrophic factor (BDNF) or nerve growth factor (NGF) on motor deficits and neurodegeneration in YAC 128 transgenic mice. MSCs, harvested from mouse femurs, were genetically engineered to over-express BDNF and/or NGF and these cells, or the vehicle solution, were injected into the striata of four-month old YAC 128 transgenic and wild-type mice. Assessments of motor ability on the rotarod and the severity of clasping were made one day prior to transplantation and once monthly, thereafter, to determine the effects of the transplanted cells on motor function. The mice were sacrificed at 13-months of age for immunohistological examination. All YAC 128 mice receiving transplants had reduced clasping, relative to vehicle-treated YAC 128 mice, while YAC 128 mice that were transplanted with MSCs which were genetically engineered to over-express BDNF, had the longest latencies on the rotarod and the least amount of neuronal loss within the striatum of the YAC 128 mice. These results indicate that intrastriatal transplantation of MSCs that over-express BDNF may create an environment within the striatum that slows neurodegenerative processes and provides behavioral sparing in the YAC 128 mouse model of HD. Further research on the long-term safety and efficacy of this approach is needed before its potential clinical utility can be comprehensively assessed. Copyright (c) 2010 Elsevier B.V. All rights reserved.
This case is an example of a high congenital spinal lesion with very minimal or negligible neurological deficits, with no other congenital malformations. Key Words: Thoracic spine, Myelocystomeningocele, Intact nervous system. Résumé Rapporter un cas peu commun et un cas rare d'une anomalie congenitale vertébrale ...
Kofler, Michael J; Larsen, Ross; Sarver, Dustin E; Tolan, Patrick H
Middle school is a critical yet understudied period of social behavioral risks and opportunities that may be particularly difficult for emerging adolescents with attention-deficit/hyperactivity disorder (ADHD) given their childhood social difficulties. Relatively few ADHD studies have examined social behavior and social-cognitive problem solving beyond the elementary years, or examined aspects of positive (prosocial) behavior. The current study examined how middle school students with clinically elevated ADHD symptoms differ from their non-ADHD peers on baseline (6th grade) and age-related changes in prosocial and aggressive behavior, and the extent to which social-cognitive problem solving strategies mediate these relations. Emerging adolescents with (n = 178) and without (n = 3,806) clinically elevated, teacher-reported ADHD-combined symptoms were compared longitudinally across 6th through 8th grades using parallel process latent growth curve modeling, accounting for student demographic characteristics, oppositional-defiant disorder (ODD) symptoms, deviant peer association, school climate, and parental monitoring. Sixth graders with elevated ADHD symptoms engaged in somewhat fewer prosocial behaviors (d = -0.44) and more aggressive behavior (d = 0.20) relative to their peers. These small social behavioral deficits decreased but were not normalized across the middle school years. Contrary to hypotheses, social-cognitive problem solving was not impaired in the ADHD group after accounting for co-occurring ODD symptoms and did not mediate the association between ADHD and social behavior during the middle school years. ADHD and social-cognitive problem solving contributed independently to social behavior, both in 6th grade and across the middle school years; the influence of social-cognitive problem solving on social behavior was highly similar for the ADHD and non-ADHD groups. (c) 2015 APA, all rights reserved).
Gelade, K.; Janssen, T.W.P.; Bink, M.; van Mourik, R.; Maras, A.; Oosterlaan, J.
Objective: The efficacy of neurofeedback as treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, are still intensely debated subjects. The current randomised controlled trial compared neurofeedback to (1) optimally
Geladé, Katleen; Janssen, Tieme W. P.; Bink, Marleen; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap
The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, is still an intensely debated subject. The current randomized controlled trial compared neurofeedback to (1) optimally
Strine, Tara W; Lesesne, Catherine A; Okoro, Catherine A; McGuire, Lisa C; Chapman, Daniel P; Balluz, Lina S; Mokdad, Ali H
Attention-deficit/hyperactivity disorder (ADHD) affects 3% to 7% of school-aged children and has been associated with a variety of comorbid mental illnesses and functional impairments, largely in clinical samples...
Rao, Patricia A; Landa, Rebecca J
Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity disorder is sometimes comorbid with autism spectrum disorder. In the current study, we examined rates of parent-reported clinically significant symptoms of attention ...
Lavely, James A
The neurologic examination in the puppy or kitten can be a challenging experience. Understanding the development of behavior reflexes and movement in puppies and kittens enables us to overcome some of these challenges and to recognize the neurologically abnormal patient. Subsequently,we can identify the neuroanatomic localization and generate a differential diagnosis list. This article first reviews the pediatric neurologic examination and then discusses diseases unique to these individuals.
Nowinski, W. L.; Chua, B.C.
Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. ...
highly trained radiologists, neurology, neurosurgery and physiotherapy units. Study period: During a six months period from 1st July 2010 to 30th January 2011, 167 patients who presented to Mulago hospital's accident and emergency unit with neurologic deficits suggestive of acute stroke (29) were screened.
Methods: This is a prospective study describing persisting neurological impairments post discharge among children treated for cerebral malaria. ... The persisting neurologic deficits among survivors at follow up were: memory impairment (1.5%), seizure disorders (0.8%), visual impairment (0.8%), speech impairment (0.8%), ...
Those with symptomatic epilepsy were more likely to have neurologic deficit, simple partial seizure, secondarily generalized seizure, focal epileptiform discharges and focal slow waves. Conclusion. The most common abnormalities in LOE were cerebral infarct and brain tumor. A careful history, neurological examination and ...
Semenova, Svetlana; Contet, Candice; Roberts, Amanda J.
Rationale: The role of β4-containing nicotinic acetylcholine receptors (nAChRs) in cognition, anxiety, depression, and analgesia in the absence of nicotine is unclear. Methods: Wild-type (β4+/+) and knockout (β4−/−) mice for the nAChR β4 subunit were tested in behavioral tests assessing cognitive function, affective behaviors, and nociception. Results: There were no learning and memory deficits in β4−/− mice compared with β4+/+ mice during the acquisition of the Barnes maze, contextual fear conditioning, and Y maze tasks. In the Barnes maze memory retention test, male β4−/− mice showed reduced use of the spatial search strategy, indicating small spatial memory deficits compared with β4+/+ mice. In the cue-induced fear conditioning memory retention test, β4−/− mice exhibited reduced freezing time compared with β4+/+ mice. Compared with β4+/+ mice, β4−/− mice exhibited decreased anxiety-like behavior in the light–dark box. Depression-like behavior in β4−/− mice was decreased in the tail suspension test and increased in the forced swim test compared with β4+/+ mice. β4−/− mice did not differ from β4+/+ mice in basal nociception but were less sensitive to the antinociceptive effect of nicotine in 2 tests of acute thermal pain. Conclusions: Lack of β4-containing nAChRs resulted in small deficits in hippocampus- and amygdala-dependent memory retention functions. β4-containing nAChRs are involved in anxiety- and depression-like behaviors and contribute to the analgesic effects of nicotine. PMID:22573727
Full Text Available BackgroundSeveral neurological disorders have also been widely described in celiac disease patients.ObjectiveThe aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature.MethodsThis prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed.ResultsIn neurological evaluation, totally 40 (13. 5% of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations.ConclusionIt is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.
Bogdan, Yelena; Tornetta, Paul; Jones, Clifford; Gilde, Alex K; Schemitsch, Emil; Vicente, Milena; Horwitz, Daniel; Sanders, David; Firoozabadi, Reza; Leighton, Ross; de Dios Robinson, Juan; Marcantonio, Andrew; Hamilton, Benjamin
The purpose of this study is to evaluate a series of operatively treated acetabular fractures with neurologic injury and to track sensory and motor recovery. Operatively treated acetabular fractures with neurologic injury from 8 trauma centers were reviewed. Patients were followed for at least 6 months or to neurologic recovery. Functional outcome was documented at 3 months, 6 months, and final follow-up. Outcomes included motor and sensory recovery, brace use, development of chronic regional pain syndrome, and return to work. One hundred thirty-seven patients (101 males and 36 females), average age 42 (17-87) years, met the criteria. Mechanism of injury included MVC (67%), fall (11%), and other (22%). The most common fracture types were transverse + posterior wall (33%), posterior wall (23%), and both-column (23%). Deficits were identified as preoperative in 57%, iatrogenic in 19% (immediately after surgery), and those that developed postoperatively in 24%. A total of 187 nerve deficits associated with the following root levels were identified: 7 in L2-3, 18 in L4, 114 in L5, and 48 in S1. Full recovery occurred in 54 (29%), partial recovery in 69 (37%), and 64 (34%) had no recovery. Forty-three percent of S1 deficits and 29% of L5 deficits had no recovery. Fifty-five percent of iatrogenic injuries did not recover. Forty-eight patients wore a brace at the final follow-up, all for an L5 root level deficit. Although 60% (42/70) returned to work, chronic regional pain syndrome was seen to develop in 19% (18/94). Peripheral neurologic injury in operatively treated acetabular fractures occurs most commonly in the sciatic nerve distribution, with L5 root level deficits having only a 26% chance of full recovery. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Shi, Fu-Dong; Jia, Jian-Ping
In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.
Machado, Daniele G; Cunha, Mauricio P; Neis, Vivian B; Balen, Grasiela O; Colla, André R; Grando, Jaine; Brocardo, Patricia S; Bettio, Luis E B; Dalmarco, Juliana B; Rial, Daniel; Prediger, Rui D; Pizzolatti, Moacir G; Rodrigues, Ana Lúcia S
Rosemary, Rosmarinus ofﬁcinalis L., has several therapeutic applications in folk medicine for the treatment of a wide range of diseases, including depression. To evaluate the ability of Rosmarinus ofﬁcinalis hydroalcoholic extract (ROHE), as compared to the positive control fluoxetine, to reverse behavioral (hyperactivity, anhedonic behavior and learning deficit in water maze) and biochemical alterations (serum glucose level and acetylcholinesterase, AChE, activity) induced by an animal model of depression, the olfactory bulbectomy (OB) in mice. Locomotor and exploratory behavior was assessed in the open-field, novel object and novel cage tests, anhedonic behavior was assessed in the splash test; cognitive deficits were evaluated in the water maze task. For the first set of experiments, ROHE (10-300 mg/kg) or fluoxetine (10mg/kg) was administered once daily (p.o.) for 14 days after OB and the behavioral tests were performed. For the second set of experiments, serum glucose and hippocampal and cerebrocortical AChE activity were determined in OB and SHAM-operated mice treated orally with ROHE (10mg/kg), fluoxetine (10mg/kg) or vehicle. ROHE (10-300 mg/kg), similar to fluoxetine, reversed OB-induced hyperactivity, increased exploratory and anhedonic behavior. OB needed significantly more trials in the training session to acquire the spatial information, but they displayed a similar profile to that of SHAM mice in the test session (24h later), demonstrating a selective deficit in spatial learning, which was not reversed by ROHE or fluoxetine. A reduced serum glucose level and an increased hippocampal AChE activity were observed in bulbectomized mice; only the latter effect was reversed by fluoxetine, while both effects were reversed by ROHE. ROHE exerted an antidepressant-like effect in bulbectomized mice and was able to abolish AchE alterations and hypoglycemia, but not spatial learning deficit induced by OB. Overall, results suggest the potential of Rosmarinus
Mikhail Guryevich Poluektov
Full Text Available Sleep disorders are closely associated with both nervous system diseases and mental disorders; however, such patients prefer to seek just neurological advice. Insomnia is the most common complaint in routine clinical practice. It is characterized by different impairments in sleep and daytime awakening. Obstructive sleep apnea syndrome is less common, but more clinically important because of its negative impact on the cardiovascular and nervous systems. The common neurological disorders are restless legs syndrome and REM sleep behavior disorder, as well as narcolepsy, the major manifestations of which are impaired nocturnal sleep and daytime awakening.
Full Text Available Post-traumatic stress disorder (PTSD is a debilitating anxiety disorder that may develop after an individual has experienced or witnessed a severe traumatic event. It has been shown that the 18 kDa translocator protein (TSPO may be correlated with PTSD and that the TSPO ligand improved the behavioral deficits in a mouse model of PTSD. Midazolam, a ligand for TSPO and central benzodiazepine receptor (CBR, induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether midazolam ameliorates PTSD behavior in rats as assessed by the single prolonged stress (SPS model. The SPS rats received daily Sertraline (Ser (15 mg/kg, i.p. [corrected] and midazolam (0.125, 0.25, 0.5, and 1 mg/kg, i.p. [corrected] during the exposure to SPS and behavioral assessments, which included the open field (OF test, the contextual fear paradigm (CFP, and the elevated plus-maze (EPM. The results showed that, like Ser (15 mg/kg, i.p. [corrected], midazolam (0.25 and 0.5 mg/kg, i.p. [corrected] significantly reversed the behavioral deficiencies of the SPS rats, including PTSD-associated freezing and anxiety-like behavior but not the effects on spontaneous locomotor activity. In addition, the anti-PTSD effects of midazolam (0.5 mg/kg, i.p. [corrected] were antagonized by the TSPO antagonist PK11195 (3 mg/kg, i.p., the CBR antagonist flumazenil (15 mg/kg, i.p. [corrected] and the inhibitor of steroidogenic enzymes finasteride (30 mg/kg, i.p. [corrected], which by themselves had no effect on PTSD-associated freezing and anxiety-like behavior. In summary, this study demonstrated that midazolam improves the behavioral deficits in the SPS model through dual TSPO and CBR and neurosteroidogenesis.
J Gordon Millichap
Computerized power spectral analysis (PSA), permitting topographic representation and statistical analysis of EEG, of 25 right-handed males, 9-12 years of age with attention deficit hyperactivity disorder was used in studies from the Departments of Psychology, Pediatrics (Neurology) and Computing Center, University of Tennessee and East Tennessee Children’s Hospital, Knoxville, TN.
Full Text Available Sleep problems are frequently addressed as a primary or secondary concern during the visit to the pediatric neurology clinic. Sleep disorders can mimic other neurologic diseases (e.g., epilepsy and movement disorders, and this adds challenges to the diagnostic process. Sleep disorders can significantly affect the quality of life and functionality of children in general and those with comorbid neurological diseases in particular. Understanding the pathophysiology of sleep disorders, recognizing the implications of sleep disorder in children with neurologic diseases and behavioral difficulties, and early intervention continue to evolve resulting in better neurocognitive outcomes.
Maynor, M L
This case report illustrates neurological deficits as an unusual presentation of acute myelogenous leukemia. Neurological deficits are rare early in this disease. Our patient presented with anorexia, malaise, headache, and multiple cranial nerve palsies. A high WBC count and abnormal peripheral smear led to the diagnosis of leukemia. This report demonstrates that, although rare, CNS symptoms may be the initial manifestation of leukemia. Blood dyscrasias should not be overlooked in patients with the acute onset of neurological symptoms. A complete blood count and differential should be obtained under those circumstances.
Athanasios K. Petridis
Full Text Available Atlantoaxial dislocation in children is a very rare condition. We present the case of a dislocation happened during a break-dance maneuver. The purpose of this report is describing dangers of break-dancing and discussing the treatment we chose. The patient was followed up until 12 months after surgery. Magnetic resonance imaging and computed tomography of the cervical spine were evaluated. Translaminar fixation of C1/C2 had been performed after manual reposition under X-ray illumination. After a 12-month follow-up, the patient shows a stable condition without neurological dysfunction. He is not allowed to perform any extreme sports.
Full Text Available Attention Deficit Hyperactivity Disorder is one of the most common developmental disorders of childhood with a reported world-wide prevalence of 8 to 12 %. In studies conducted in our country the prevalence rates in community were reported to vary between 8.6 to 8.1 % while clinical prevalence rates were reported to vary between 8.6 to 29.44 %. Fifty to eighty percent of cases were reported to continue into adolescence while thirty to fifty percent may continue into adulthood. Attention deficit hyperactivity disorder is known to accompany subtle physical anomalies, allergic and neurologic disorders, obesity and eating disorders, traumatic injuries, risky sexual behavior, sleep disorders, substance and alcohol use, axis I and II disorders, occupational, legal and academic problems and increased treatment expenditures. Though the effects of this disorder continue throughout life, create burdens to the society along with its treatment as well as disabling the affected patients through their lives, and receive increasing attention in recent years, reviews focusing on problems associated with it are lacking. Therefore, this study aimed to summarize the results of previous studies conducted about medical comorbidities in attention deficit hyperactivity disorder.
Balconi, Michela; Tirelli, Simone; Frezza, Alessandra
Recent research evidences supported the significant role of multimethodological neuroscientific approach for the diagnosis and the rehabilitative intervention in schizophrenia. Indeed both electrophysiological and neuroimaging measures in integration each other appear able to furnish a deep overview of the cognitive and affective behavior in schizophrenia patients (SPs). The aim of the present review is focused on the emotional dysfunctional response taking into account the multimeasures for emotional behavior, i.e., the event-related potentials (ERPs) and the hemodynamic profile functional near-infrared spectroscopy (fNIRS). These measures may be considered as predictive measures of the SPs’ deficits in emotional behavior. The integration between ERP and fNIRS may support both the prefrontal cortical localization anomaly and the attentional bias toward some specific emotional conditions (mainly negative). PMID:26579058
Balconi, Michela; Tirelli, Simone; Frezza, Alessandra
Recent research evidences supported the significant role of multimethodological neuroscientific approach for the diagnosis and the rehabilitative intervention in schizophrenia. Indeed both electrophysiological and neuroimaging measures in integration each other appear able to furnish a deep overview of the cognitive and affective behavior in schizophrenia patients (SPs). The aim of the present review is focused on the emotional dysfunctional response taking into account the multimeasures for emotional behavior, i.e., the event-related potentials (ERPs) and the hemodynamic profile functional near-infrared spectroscopy (fNIRS). These measures may be considered as predictive measures of the SPs' deficits in emotional behavior. The integration between ERP and fNIRS may support both the prefrontal cortical localization anomaly and the attentional bias toward some specific emotional conditions (mainly negative).
Berking, Matthias; Margraf, Matthias; Ebert, David; Wupperman, Peggilee; Hofmann, Stefan G.; Junghanns, Klaus
Objective: As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, our aim in the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD). Method: A prospective study investigated whether emotion-regulation skills were associated with AD and whether these…
Banks, Tracy; Ninowski, Jerilyn E.; Mash, Eric J.; Semple, Deborah L.
Although attention-deficit/hyperactivity disorder (ADHD) in adults has recently emerged as an important area of research, little attention has been given to the family functioning of women with ADHD, particularly in their role as mothers. We examined parenting self-esteem, locus of control, and disciplinary styles in a community sample of mothers…
Martinho Pimenta, A J; Castelo Branco, N A
Mood and behavioral abnormalities are the most common early findings related to vibroacoustic disease (VAD). Other signs and symptoms have been observed in VAD patients. Brain MRI discloses small multifocal lesions in about 50% of subjects with more than 10 yr of occupational exposure to large pressure amplitude (> or = 90 dB SPL) and low frequency (< or = 500 Hz) (LPALF) noise. However, to date, there have been no studies globally integrating all the neurological, imaging and neurophysiological data of VAD patients. This is the main goal of this study. The 60 male Caucasians diagnosed with VAD were neurologically evaluated in extreme detail in order to systematically identify the most common and significant neurological disturbances in VAD. This population demonstrates cognitive changes (identified through psychological and neurophysiological studies (ERP P300)), vertigo and auditory changes, visual impairment, epilepsy, and cerebrovascular diseases. Neurological examination reveals pathological signs and reflexes, most commonly the palmo-mental reflex. A vascular pattern underlying the multifocal hyperintensities in T2 MR imaging, with predominant involvement of the small arteries of the white matter, is probably the visible organic substratum of the neurological picture. However, other pathophyisological mechanisms are involved in epileptic symptomatology.
Full Text Available Moderate traumatic brain injury (TBI in children often happen when there's a sudden blow to the frontal bone, end with long unconscious which can last for hours and progressive cognitive deficits. However, with regard to the influences of moderate TBI during children adulthood, injury-induced alterations of locomotive ability, long-term memory performance, and hippocampal electrophysiological firing changes have not yet been fully identified. In this study, lateral fluid percussion (LFP method was used to fabricate moderate TBI in motor and somatosensory cortex of the 6-weeks-old mice. The motor function, learning and memory function, extracellular CA1 neural spikes were assessed during acute and subacute phase. Moreover, histopathology was performed on day post injury (DPI 16 to evaluate the effect of TBI on tissue and cell morphological changes in cortical and hippocampal CA1 subregions. After moderate LFP injury, the 6-weeks-old mice showed severe motor deficits at the early stage in acute phase but gradually recovered later during adulthood. At the time points in acute and subacute phase after TBI, novel object recognition (NOR ability and spatial memory functions were consistently impaired in TBI mice; hippocampal firing frequency and burst probability were hampered. Analysis of the altered burst firing shows a clear hippocampal theta rhythm drop. These electrophysiological impacts were associated with substantially lowered NOR preference as compared to the sham group during adulthood. These results suggest that moderate TBI introduced at motorsenory cortex in 6-weeks-old mice causes obvious motor and cognitive deficits during their adulthood. While the locomotive ability progressively recovers, the cognitive deficits persisted while the mice mature as adult mice. The cognitive deficits may be attributed to the general suppressing of whole neural network, which could be labeled by marked reduction of excitability in hippocampal CA1
Full Text Available Anatabine is a minor tobacco alkaloid, which is also found in plants of the Solanaceae family and displays a chemical structure similarity with nicotine. We have shown previously that anatabine displays some anti-inflammatory properties and reduces microgliosis and tau phosphorylation in a pure mouse model of tauopathy. We therefore investigated the effects of a chronic oral treatment with anatabine in a transgenic mouse model (Tg PS1/APPswe of Alzheimer's disease (AD which displays pathological Aβ deposits, neuroinflammation and behavioral deficits. In the elevated plus maze, Tg PS1/APPswe mice exhibited hyperactivity and disinhibition compared to wild-type mice. Six and a half months of chronic oral anatabine treatment, suppressed hyperactivity and disinhibition in Tg PS1/APPswe mice compared to Tg PS1/APPswe receiving regular drinking water. Tg PS1/APPswe mice also elicited profound social interaction and social memory deficits, which were both alleviated by the anatabine treatment. We found that anatabine reduces the activation of STAT3 and NFκB in the vicinity of Aβ deposits in Tg PS1/APPswe mice resulting in a reduction of the expression of some of their target genes including Bace1, iNOS and Cox-2. In addition, a significant reduction in microgliosis and pathological deposition of Aβ was observed in the brain of Tg PS1/APPswe mice treated with anatabine. This is the first study to investigate the impact of chronic anatabine treatment on AD-like pathology and behavior in a transgenic mouse model of AD. Overall, our data show that anatabine reduces β-amyloidosis, neuroinflammation and alleviates some behavioral deficits in Tg PS1/APPswe, supporting further exploration of anatabine as a possible disease modifying agent for the treatment of AD.
Roche-Martínez, A; Póo, P; Maristany-Cucurella, M; Jiménez-Llort, A; Camacho, J A; Campistol, J
Haemolytic-uraemic syndrome (HUS) is characterized by microangiopathic hemolytic anaemia, thrombopenia and multiorganic aggression, specially renal, gastrointestinal and central nervous system disturbances. Sporadic in Spain (2/1,500,000 inhabitants), its clinical onset includes acute renal failure, hypertension and central nervous system symptoms (irritability, drowsiness, convulsions, cortical blindness, hemiparesia or coma), due to metabolic distress, hypertension or central nervous system microangiopathy. Few long-term outcome studies have been published. A retrospective analysis of a series of 58 patients with HUS between 1981 and 2006, is reported. Clinical onset, laboratory, electrophysiology, neuroimaging tests, and prognosis factors are reviewed, together with long-term clinical outcome. 22 children presented neurologic symptoms, seven had some neurological test; one patient died; in five some neurological sequelae persisted (hemiparesia, cognitive deficit, visual-perception deficit), the other 16 remaining asymptomatic. Neurological morbility is high in HUS (27% of the children with neurological symptoms), with a 1.7% mortality. Seizure at onset was not a poor prognosis factor in our group. No positive correlation can be established between neuroimaging and long-term outcome.
Fernández-Jaén, Alberto; Fernández-Mayoralas, Daniel M; López-Arribas, Sonia; García-Savaté, Carolina; Muñiz-Borrega, Blanca; Pardos-Véglia, Alexandra; Prados-Parra, Baldomero; Calleja-Pérez, Beatriz; Muñoz-Jareño, Nuria
Numerous studies have documented that children with attention deficit hyperactivity disorder (ADHD) show a low social competence. To compare the symptomatic severity of ADHD, as well as associations to different subtypes, sex and comorbidities, with social functioning ("ability" and "leadership") estimated through a Behavior Assessment System for Children (BASC) for parents and teachers. We have retrospectively analyzed 170 patients with ADHD, diagnosed between 2007 and 2010. Social "ability," "leadership," "hyperactivity" and "attention deficit" sections of BASC and cardinal symptoms of ADHD measured through a Spanish scale for de evaluation of DHD (E-DHD) were registered. Results of these variables are analyzed according to the normative data by age and sex, and processed in Z values. The ratings for social skills were significantly lower in patients with conduct disorder or oppositional defiant disorder as informed by parents (pleadership" as parents and teachers. Intensity of attention deficit was the only variable that showed a significant relation with the social skills and leadership according to the BASC scores, independently of the informer.
Urbán, Edina; Szél, István; Fáy, Veronika; Dénes, Zoltán; Lippai, Zoltán; Fazekas, Gábor
We have read several publications of great authority on the neurological profession in the last two years in which were expressed assessments of the current situation combined with opinions about neurology and the necessity to reorganize neurological patient care. These articles took up the question of neurorehabilitation too. The authors, who on a daily basis, deal with the rehabilitation of people with disabilities as a consequence of neurological conditions, summarize some important definitions of rehabilitation medicine and the present system of neurological rehabilitation, as it is defined by the rehabilitation profession.
Kondziella, Daniel; Waldemar, Gunhild
This updated and expanded new edition takes neurology trainees by the hand and guides them through the whole patient encounter - from an efficient neurological history and bedside examination through to differential diagnosis, diagnostic procedures and treatment. At each step the expert authors......, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training....... Medical students, general practitioners and others with an interest in neurology will also find invaluable information here....
Consideration of underlying neurological and psychological deficits suggests that the autistic syndrome results from the coexistence of at least two distinct constellations of functional impairments: deficits in mechanical language skills, as in the developmental dysphasias; and deficits in social relatedness, play, and nonverbal communication, as…
Oorschot, Dorothy E; Voss, Logan; Covey, Matthew V; Goddard, Liping; Huang, William; Birchall, Penny; Bilkey, David K; Kohe, Sarah E
Brain injury in the premature infant is associated with a high risk of neurodevelopmental disability. Previous small-animal models of brain injury attributable to extreme prematurity typically fail to generate a spectrum of pathology and behavior that closely resembles that observed in humans, although they provide initial answers to numerous cellular, molecular, and therapeutic questions. We tested the hypothesis that exposure of rats to repeated hypoxia from postnatal day 1 (P1) to P3 models the characteristic white matter neuropathological injury, gray matter volume loss, and memory deficits seen in children born extremely prematurely. Male Sprague Dawley rats were exposed to repeated hypoxia or repeated normoxia from P1 to P3. The absolute number of pre-oligodendrocytes and mature oligodendrocytes, the surface area and g-ratio of myelin, the absolute volume of cerebral white and gray matter, and the absolute number of cerebral neurons were quantified stereologically. Spatial memory was investigated on a radial arm maze. Rats exposed to repeated hypoxia had a significant loss of (1) pre-oligodendrocytes at P4, (2) cerebral white matter volume and myelin at P14, (3) cerebral cortical and striatal gray matter volume without neuronal loss at P14, and (4) cerebral myelin and memory deficits in adulthood. Decreased myelin was correlated with increased attention deficit hyperactivity disorder-like hyperactivity. This new small-animal model of extreme prematurity generates a spectrum of short- and long-term pathology and behavior that closely resembles that observed in humans. This new rat model provides a clinically relevant tool to investigate numerous cellular, molecular, and therapeutic questions on brain injury attributable to extreme prematurity.
Alderson, R Matt; Rapport, Mark D; Kasper, Lisa J; Sarver, Dustin E; Kofler, Michael J
Contemporary models of ADHD hypothesize that hyperactivity reflects a byproduct of inhibition deficits. The current study investigated the relationship between children's motor activity and behavioral inhibition by experimentally manipulating demands placed on the limited-resource inhibition system. Twenty-two boys (ADHD = 11, TD = 11) between the ages of 8 and 12 years completed a conventional stop-signal task, two choice-task variants (no-tone, ignore-tone), and control tasks while their motor activity was measured objectively by actigraphs placed on their nondominant wrist and ankles. All children exhibited significantly higher activity rates under all three experimental tasks relative to control conditions, and children with ADHD moved significantly more than typically developing children across conditions. No differences in activity level were observed between the inhibition and noninhibition experimental tasks for either group, indicating that activity level was primarily associated with basic attentional rather than behavioral inhibition processes.
Freemon, Frank R
The great formative event in the history of North America, the Civil War of 1861 to 1865, was the stimulus for the development of clinical neurology and the neurosciences. The first neurological research center on the continent was the US Army hospital at Turner's Lane, Philadelphia, PA. Silas Weir Mitchell and his colleagues described causalgia (reflex sympathetic dystrophy), phantom limb sensation, and Horner's syndrome (before Horner). The medical leader of the Northern army was William Hammond. After the conclusion of hostilities, he began a huge clinical practice in New York City. In the United States, clinical neurology began in private practice, unlike Europe, where neurology began in institutions. Hammond's textbook, which first used the term athetosis, was used by a generation of physicians who encountered patients with neurological signs and symptoms. Early in the 20th century, neurological institutions were formed around universities; probably the most famous was the Montreal Neurological Institute founded by Wilder Penfield. The US federal government sponsored extensive research into the function and dysfunction of the nervous system through the Neurological Institute of Neurological Diseases and Blindness, later called the National Institute of Neurological Diseases and Stroke. The government officially classified the final 10 years of the 20th century as the Decade of the Brain and provided an even greater level of research funding.
Jangra, Ashok; Sriram, Chandra Shaker; Dwivedi, Shubham; Gurjar, Satendra Singh; Hussain, Md Iftikar; Borah, Probodh; Lahkar, Mangala
Chronic stress exposure can produce deleterious effects on the hippocampus (HC) which eventually leads to cognitive impairment and depression. Endoplasmic reticulum (ER) stress has been reported as one of the major culprits in the development of stress-induced cognitive impairment and depression. We investigated the neuroprotective efficacy of sodium phenylbutyrate (SPB), an ER stress inhibitor, and edaravone, a free radical scavenger, against chronic restraint stress (CRS)-induced cognitive deficits and anxiety- and depressive-like behavior in mice. Adult male Swiss albino mice were restrained for 6 h/day for 28 days and injected (i.p.) with SPB (40 and 120 mg/kg) or edaravone (3 and 10 mg/kg) for the last seven days. After stress cessation, the anxiety- and depressive-like behavior along with spatial learning and memory were examined. Furthermore, oxido-nitrosative stress, proinflammatory cytokines, and gene expression level of ER stress-related genes were assessed in HC and prefrontal cortex (PFC). CRS-exposed mice showed anxiety- and depressive-like behavior, which was significantly improved by SPB and edaravone treatment. In addition, SPB and edaravone treatment significantly alleviated CRS-induced spatial learning and memory impairment. Furthermore, CRS-evoked oxido-nitrosative stress, neuroinflammation, and depletion of Brain-derived neurotrophic factor were significantly ameliorated by SPB and edaravone treatment. We found significant up-regulation of ER stress-related genes in both HC and PFC regions, which were suppressed by SPB and edaravone treatment in CRS mice. Our study provides evidence that SPB and edaravone exerted neuroprotective effects on CRS-induced cognitive deficits and anxiety- and depressive-like behavior, which is possibly coupled with inhibition of oxido-nitrosative stress, neuroinflammation, and ER stress cascade.
Gaastra, Geraldina F.; Groen, Yvonne; Tucha, Lara; Tucha, Oliver
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of several types of classroom interventions (antecedent-based, consequence-based, self-regulation, combined) that can be applied by teachers in order to decrease off-task and disruptive classroom behavior in children with symptoms of ADHD. A second aim was to identify potential moderators (classroom setting, type of measure, students’ age, gender, intelligence, and medication use). Finally, it was qualitatively explored whether the identified classroom interventions also directly or indirectly affected behavioral and academic outcomes of classmates. Separate meta-analyses were performed on standardized mean differences (SMDs) for 24 within-subjects design (WSD) and 76 single-subject design (SSD) studies. Results showed that classroom interventions reduce off-task and disruptive classroom behavior in children with symptoms of ADHD (WSDs: MSMD = 0.92; SSDs: MSMD = 3.08), with largest effects for consequence-based (WSDs: MSMD = 1.82) and self-regulation interventions (SSDs: MSMD = 3.61). Larger effects were obtained in general education classrooms than in other classroom settings. No reliable conclusions could be formulated about moderating effects of type of measure and students’ age, gender, intelligence, and medication use, mainly because of power problems. Finally, classroom interventions appeared to also benefit classmates’ behavioral and academic outcomes. PMID:26886218
Gaastra, Geraldina F; Groen, Yvonne; Tucha, Lara; Tucha, Oliver
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of several types of classroom interventions (antecedent-based, consequence-based, self-regulation, combined) that can be applied by teachers in order to decrease off-task and disruptive classroom behavior in children with symptoms of ADHD. A second aim was to identify potential moderators (classroom setting, type of measure, students' age, gender, intelligence, and medication use). Finally, it was qualitatively explored whether the identified classroom interventions also directly or indirectly affected behavioral and academic outcomes of classmates. Separate meta-analyses were performed on standardized mean differences (SMDs) for 24 within-subjects design (WSD) and 76 single-subject design (SSD) studies. Results showed that classroom interventions reduce off-task and disruptive classroom behavior in children with symptoms of ADHD (WSDs: MSMD = 0.92; SSDs: MSMD = 3.08), with largest effects for consequence-based (WSDs: MSMD = 1.82) and self-regulation interventions (SSDs: MSMD = 3.61). Larger effects were obtained in general education classrooms than in other classroom settings. No reliable conclusions could be formulated about moderating effects of type of measure and students' age, gender, intelligence, and medication use, mainly because of power problems. Finally, classroom interventions appeared to also benefit classmates' behavioral and academic outcomes.
Full Text Available Introduction: The aim of the present research is to determine the effectiveness of parents’ behavioral training in compare to medication on the rate of the signs of attention deficit hyperactivity disorder (ADHD. Materials & Methods: Our population in this research was all boys in the elementary school (third, fourth and fifth grades and finally a sample of 630 subjects were included. We used a questionnaire of children’s morbid signs (CSI-4 which was completed by parents. For determination of acceptable scores in this scale, all subjects who obtained score 6 and more were selected and out of these subjects by use of random method as many as 45 subjects were chosen and 15 subjects were considered as the behavioral experimental group (under special care of a psychiatrist and the other 15 subjects were randomly put as the control group. The parents participated in seven sessions of behavioral training program, while for control group no kinds of training and medication intervention were carried out. Results: The results showed that both parent’s behavioral training program and medication have been effective meaningfully on ADHD (P=0.0005, also considering the averages differences, medication with Ritalin has caused more reduction of the signs of ADHD than parent’s behavioral training. Conclusion: At present, for children afflicted with ADHD, multi interventions are recommended that contains medication and parents training.
Solanto, M V; Wender, E H; Bartell, S S
Psychostimulants and behavior therapy have been postulated to be effective in treating attention-deficit hyperactivity disorder (ADHD) by compensating for a pathologically elevated reward threshold, but no studies have compared reinforcement to psychostimulants in maintaining task performance. The separate and combined effects of methylphenidate (MPH, 0.6 mg/kg) and a behavioral intervention (reward plus response cost) were assessed on a continuous performance test (CPT, a measure of sustained attention) modified to deliver auditory feedback contingent upon the subject's responses. Each of 22 children (6-10 years old) with ADHD were tested under four treatment conditions: placebo + feedback, placebo + behavioral contingencies, MPH + feedback, and MPH + contingencies. CPT performance, indexed by d' (ability to discriminate between target and false targets), was significantly better with MPH than with placebo, showing reduced deterioration over time. Contingency treatment improved mean d' compared to placebo + feedback but, in contrast, had no effect on the slope of performance deterioration. Addition of contingencies to MPH did not yield further improvement. The results indicate that MPH improved sustained attention on a laboratory task (and reduced task-irrelevant and other disinhibited behaviors), whereas behavioral contingencies did not. These findings suggest that, although both interventions improved stimulus discrimination processes, only MPH enhanced processes that mediate the regulation of effort over time. In addition, the disjunction between the effects of reward and of MPH provides evidence that psychostimulant effects on attention are only partially explained by the stimulation of brain centers associated with reward.
Full Text Available Many protein-coding genes identified by genome sequencing remain without functional annotation or biological context. Here we define a novel protein-coding gene, Nmf9, based on a forward genetic screen for neurological function. ENU-induced and genome-edited null mutations in mice produce deficits in vestibular function, fear learning and circadian behavior, which correlated with Nmf9 expression in inner ear, amygdala, and suprachiasmatic nuclei. Homologous genes from unicellular organisms and invertebrate animals predict interactions with small GTPases, but the corresponding domains are absent in mammalian Nmf9. Intriguingly, homozygotes for null mutations in the Drosophila homolog, CG45058, show profound locomotor defects and premature death, while heterozygotes show striking effects on sleep and activity phenotypes. These results link a novel gene orthology group to discrete neurological functions, and show conserved requirement across wide phylogenetic distance and domain level structural changes.
Echoleah S Rufer
Full Text Available Fetal alcohol spectrum disorders (FASD are the leading non-genetic cause of neurodevelopmental disability in children. Although alcohol is clearly teratogenic, environmental factors such as gravidity and socioeconomic status significantly modify individual FASD risk despite equivalent alcohol intake. An explanation for this variability could inform FASD prevention. Here we show that the most common nutritional deficiency of pregnancy, iron deficiency without anemia (ID, is a potent and synergistic modifier of FASD risk. Using an established rat model of third trimester-equivalent binge drinking, we show that ID significantly interacts with alcohol to impair postnatal somatic growth, associative learning, and white matter formation, as compared with either insult separately. For the associative learning and myelination deficits, the ID-alcohol interaction was synergistic and the deficits persisted even after the offsprings' iron status had normalized. Importantly, the observed deficits in the ID-alcohol animals comprise key diagnostic criteria of FASD. Other neurobehaviors were normal, showing the ID-alcohol interaction was selective and did not reflect a generalized malnutrition. Importantly ID worsened FASD outcome even though the mothers lacked overt anemia; thus diagnostics that emphasize hematological markers will not identify pregnancies at-risk. This is the first direct demonstration that, as suggested by clinical studies, maternal iron status has a unique influence upon FASD outcome. While alcohol is unquestionably teratogenic, this ID-alcohol interaction likely represents a significant portion of FASD diagnoses because ID is more common in alcohol-abusing pregnancies than generally appreciated. Iron status may also underlie the associations between FASD and parity or socioeconomic status. We propose that increased attention to normalizing maternal iron status will substantially improve FASD outcome, even if maternal alcohol abuse
Rufer, Echoleah S; Tran, Tuan D; Attridge, Megan M; Andrzejewski, Matthew E; Flentke, George R; Smith, Susan M
Fetal alcohol spectrum disorders (FASD) are the leading non-genetic cause of neurodevelopmental disability in children. Although alcohol is clearly teratogenic, environmental factors such as gravidity and socioeconomic status significantly modify individual FASD risk despite equivalent alcohol intake. An explanation for this variability could inform FASD prevention. Here we show that the most common nutritional deficiency of pregnancy, iron deficiency without anemia (ID), is a potent and synergistic modifier of FASD risk. Using an established rat model of third trimester-equivalent binge drinking, we show that ID significantly interacts with alcohol to impair postnatal somatic growth, associative learning, and white matter formation, as compared with either insult separately. For the associative learning and myelination deficits, the ID-alcohol interaction was synergistic and the deficits persisted even after the offsprings' iron status had normalized. Importantly, the observed deficits in the ID-alcohol animals comprise key diagnostic criteria of FASD. Other neurobehaviors were normal, showing the ID-alcohol interaction was selective and did not reflect a generalized malnutrition. Importantly ID worsened FASD outcome even though the mothers lacked overt anemia; thus diagnostics that emphasize hematological markers will not identify pregnancies at-risk. This is the first direct demonstration that, as suggested by clinical studies, maternal iron status has a unique influence upon FASD outcome. While alcohol is unquestionably teratogenic, this ID-alcohol interaction likely represents a significant portion of FASD diagnoses because ID is more common in alcohol-abusing pregnancies than generally appreciated. Iron status may also underlie the associations between FASD and parity or socioeconomic status. We propose that increased attention to normalizing maternal iron status will substantially improve FASD outcome, even if maternal alcohol abuse continues. These findings
Full Text Available Jana Konicarova,1 Petr Bob,1,2 Jiri Raboch11Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; 2Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech RepublicBackground and objectives: Functional disturbances developed early in life include balance deficits which are linked to dysfunctions of higher levels of cognitive and motor integration. According to our knowledge, there are only a few studies suggesting that balance deficits are related to behavioral disturbances in attention-deficit/hyperactivity disorder (ADHD.Methods: We tested the extent to which balance deficits were related to ADHD symptoms in 35 medication-naïve boys of school age (8–11 years and compared the results with a control group of 30 boys of the same age.Results: ADHD symptoms in medication-naïve boys had specific relationships to disturbances of postural and gait balance.Conclusion: To our knowledge, this study provides the first evidence in the medical literature for a direct relationship between ADHD symptoms and balance deficits, that cannot be attributed to medication and the presence of any neurological disease.Keywords: ADHD, balance deficits, conduct problems, developmental disorders, inhibitory deficits, impulsivity
Faghihi, Mohammad Ali; Mottagui-Tabar, Salim; Wahlestedt, Claes
Neurological diseases are defined as an inappropriate function of the peripheral or central nervous system due to impaired electrical impulses throughout the brain and/or nervous system that may present with heterogeneous symptoms according to the parts of the system involved in these pathologic processes. Growing evidence on genetic components of neurological disease have been collected during recent years. Genetic studies have opened the way for understanding the underlying pathology of many neurological disorders. The outcome of current intense research into the genetics of neurological disorders will hopefully be the introduction of new diagnostic tools and the discovery of potential targets for new and more effective medications and preventive measures.
Li, Wendi; Zhang, Wei; Xiao, Lin; Nie, Jia
The aims of this study were to test the associations of the Internet addiction symptoms with impulsiveness, loneliness, novelty seeking and behavioral inhibition systems among adults with attention-deficit/hyperactivity disorder (ADHD) and adults with non-ADHD. A total of 146 adults aged between 19 and 33 years involved in this study. Participants were assessed with the Chinese version of the adult ADHD Self-report scale (ASRS), the Revised Chen Internet Addiction Scale (CIAS-R), the Barratt Impulsiveness Scale 11 (BIS-11), the Tridimensional Personality Questionnaire (TPQ), the UCLA loneliness scale, and the Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS Scale). The results of hierarchical regression analysis indicated that impulsiveness, loneliness, and behavioral inhibition system were significant predictors of Internet addition among adults with ADHD. Higher loneliness was significantly associated with more severe Internet addition symptoms among the non-ADHD group. Adults with high impulsiveness, loneliness, and BIS should be treated with caution for preventing Internet addiction. In addition, adults with and without ADHD should be provided with different preventative strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Effects of extended release methylphenidate treatment on ratings of attention-deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms.
Pearson, Deborah A; Santos, Cynthia W; Aman, Michael G; Arnold, L Eugene; Casat, Charles D; Mansour, Rosleen; Lane, David M; Loveland, Katherine A; Bukstein, Oscar G; Jerger, Susan W; Factor, Perry; Vanwoerden, Salome; Perez, Evelyn; Cleveland, Lynne A
The purpose of this study was to examine the behavioral effects of four doses of psychostimulant medication, combining extended-release methylphenidate (MPH) in the morning with immediate-release MPH in the afternoon. The sample comprised 24 children (19 boys; 5 girls) who met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV-TR) criteria for an autism spectrum disorder (ASD) on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS), and had significant symptoms of attention-deficit/hyperactivity disorder (ADHD). This sample consisted of elementary school-age, community-based children (mean chronological age=8.8 years, SD=1.7; mean intelligence quotient [IQ]=85; SD=16.8). Effects of four dose levels of MPH on parent and teacher behavioral ratings were investigated using a within-subject, crossover, placebo-controlled design. MPH treatment was associated with significant declines in hyperactive and impulsive behavior at both home and school. Parents noted significant declines in inattentive and oppositional behavior, and improvements in social skills. No exacerbation of stereotypies was noted, and side effects were similar to those seen in typically developing children with ADHD. Dose response was primarily linear in the dose range studied. The results of this study suggest that MPH formulations are efficacious and well-tolerated for children with ASD and significant ADHD symptoms.
Tobin, W Oliver; Pittock, Sean J
This article reviews the rapidly evolving spectrum of autoimmune neurologic disorders with a focus on those that involve the central nervous system, providing an understanding of how to approach the diagnostic workup of patients presenting with central nervous system symptoms or signs that could be immune mediated, either paraneoplastic or idiopathic, to guide therapeutic decision making. The past decade has seen a dramatic increase in the discovery of novel neural antibodies and their targets. Many commercial laboratories can now test for these antibodies, which serve as diagnostic markers of diverse neurologic disorders that occur on an autoimmune basis. Some are highly specific for certain cancer types, and the neural antibody profiles may help direct the physician's cancer search. The diagnosis of an autoimmune neurologic disorder is aided by the detection of an objective neurologic deficit (usually subacute in onset with a fluctuating course), the presence of a neural autoantibody, and improvement in the neurologic status after a course of immunotherapy. Neural autoantibodies should raise concern for a paraneoplastic etiology and may inform a targeted oncologic evaluation (eg, N-methyl-D-aspartate [NMDA] receptor antibodies are associated with teratoma, antineuronal nuclear antibody type 1 [ANNA-1, or anti-Hu] are associated with small cell lung cancer). MRI, EEG, functional imaging, videotaped evaluations, and neuropsychological evaluations provide objective evidence of neurologic dysfunction by which the success of immunotherapy may be measured. Most treatment information emanates from retrospective case series and expert opinion. Nonetheless, early intervention may allow reversal of deficits in many patients and prevention of future disability.
Background Attention-Deficit/Hyperactivity Disorder (ADHD) is a behavioral disorder affecting 3-5% of children. Although ADHD is highly heritable, environmental factors like exposure during early development to various toxic substances like polychlorinated biphenyls (PCBs) may contribute to the prevalence. PCBs are a group of chemical industrial compounds with adverse effects on neurobiological and cognitive functioning, and may produce behavioral impairments that share significant similarities with ADHD. The present study examined the relation between exposure to PCB 153 and changes in ADHD-like behavior in an animal model of ADHD, the spontaneously hypertensive rats (SHR/NCrl), and in Wistar Kyoto (WKY/NHsd) controls. Methods SHR/NCrl and WKY/NHsd, males and females, were orally given PCB 153 dissolved in corn oil at around postnatal day (PND) 8, 14, and 20 at a dosage of 1, 3 or 6 mg/kg bodyweight at each exposure. The control groups were orally administered corn oil only. The animals were behaviorally tested for exposure effects from PND 37 to 64 using an operant procedure. Results Exposure to PCB 153 was associated with pronounced and long-lasting behavioral changes in SHR/NCrl. Exposure effects in the SHR/NCrl depended on dose, where 1 mg/kg tended to reduce ADHD-like behaviors and produce opposite behavioral effects compared to 3 mg/kg and 6 mg/kg, especially in the females. In the WKY/NHsd controls and for the three doses tested, PCB 153 exposure produced a few specific behavioral changes only in males. The data suggest that PCB 153 exposure interacts with strain and sex, and also indicate a non-linear dose–response relation for the behaviors observed. Conclusions Exposure to PCB 153 seems to interact with several variables including strain, sex, dose, and time of testing. To the extent that the present findings can be generalized to humans, exposure effects of PCB 153 on ADHD behavior depends on amount of exposure, where high doses may aggravate ADHD
Pugliese, Cara E.; Anthony, Laura; Strang, John F.; Dudley, Katerina; Wallace, Gregory L.; Kenworthy, Lauren
Almost half of all children with autism spectrum disorder have average cognitive abilities, yet outcome remains poor. Because outcome in HFASD is more related to adaptive behavior skills than cognitive level it is important to identify predictors of adaptive behavior. This study examines cognitive and demographic factors related to adaptive…
Pineda, David A; Aguirre, Daniel C; Garcia, Mauricio A; Lopera, Francisco J; Palacio, Luis G; Kamphaus, Randy W
This study assesses the validity of the Behavioral Assessment System for Children-parent and teacher questionnaires for attention-deficit hyperactivity disorder diagnosis in a randomized sample of 344 Colombian children (145 cases, 199 controls), males and females, ages 6 to 11, with an estimated Wechsler Full Scale Intelligence Quotient over 70. The assessment protocol for both groups included psychiatric, neurologic, and psychological interviews, parent and teacher rating forms, and an Attention-Deficit Hyperactivity Disorder Checklist. All Behavioral Assessment System for Children-parent and teacher dimensions, except withdrawal and somatization, significantly differentiated cases and controls. Parents and teachers rated attention-deficit hyperactivity disorder combined type children as significantly more aggressive. Both questionnaires had good discriminant accuracy for detecting cases and control children, but accuracy for discriminating between attention-deficit hyperactivity disorder subtypes was poor. The Behavioral Assessment System for Children-parent and teacher questionnaires for 6- to 11-year-olds may be useful tools for diagnosing the presence of attention-deficit hyperactivity disorder. Additional assessment methods will be needed to discriminate between the subtypes.
Gohil, Kishorchandra; Godzdanker, Roy; O'Roark, Erin; Schock, Bettina C; Kaini, Ramesh R; Packer, Lester; Cross, Carroll E; Traber, Maret G
Functions of alpha-tocopherol (alpha-T) in vivo, other than those for fertility in females, are intensely debated. The discovery of alpha-T deficiency in patients with ataxia (AVED) followed by the identification of mutations in the gene encoding alpha-tocopherol transfer protein (TTP) in AVED patients demonstrates an essential role of alpha-T and TTP for normal neurological function. alpha-T molecular targets that account for alpha-T-sensitive neurological dysfunction remain to be discovered. We have used high-density oligonucleotide arrays to search for putative alpha-T-sensitive genes in the CNS and other tissues in an in vivo model of alpha-T deficiency imposed at birth by the deletion of the TTP gene in mice. Repression of genes affecting synaptic function and myelination and induction of genes for neurodegeneration in the motor cortex of alpha-T-deficient mice were identified. The expression of retinoic acid-related orphan receptor alpha (ROR-alpha) was repressed in the cortex and adrenal glands of TTP-deficient mice. Deficiency of ROR-alpha causes ataxia in mice and may account for ataxia in AVED patients. These observations suggest that some of the actions of alpha-T are mediated by the transcription factor ROR-alpha. The behavior of young TTP-null mice was essentially normal, but older mice showed inactivity, ataxia, and memory dysfunction. mRNA profiles of old alpha-T-deficient cerebral cortices are compatible with repressed activity of oligodendrocytes and astrocytes. In conclusion, gene-expression profiling studies have identified novel alpha-T-modulated genes and cells in the CNS that may be causatively linked with delayed neurodegeneration and age-related decline in behavioral repertoires.
Functional neurological disorders, also known as conversion disorder, are unexplained neurological symptoms. These symptoms are common and can be associated with significant consequences. This review covers the neuroimaging literature focusing on functional motor symptoms including motor functioning and upstream influences including self-monitoring and internal representations, voluntariness and arousal and trauma. Copyright © 2014. Published by Elsevier SAS.
... the National Library of Medicine’s MedlinePlus Living with HIV/AIDS × What research is being done? The National Institute of Neurological ... the National Library of Medicine’s MedlinePlus Living with HIV/AIDS See More About Research The National Institute of Neurological Disorders and Stroke ( ...
Full Text Available Xijin Wang,1 Qiang Guan,2 Meihua Wang,1 Liu Yang,1 Jie Bai,1 Zhiqiang Yan,3 Yuhong Zhang,4 Zhenguo Liu11Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 2Department of Neurology, Tongji Hospital, Tongji University, 3Shanghai Laboratory Animal Center, Chinese Academy of Sciences, 4Department of Neurology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, People’s Republic of ChinaAbstract: Aging is one of the strongest risk factors for Parkinson’s disease (PD. SIRT2 has been implicated in the aging process. It is pertinent to investigate the role of SIRT2 in aging-related dopaminergic neurotoxicity and to develop effective therapeutic strategies for PD through the use of aging animals. In this study, we observed that rotenone induced significant behavior abnormality and striatal dopamine depletion in aging rats, while it did not do so in young rats. No significant change in striatal serotonin level was observed in the aging rats after rotenone administration. There was also aging-related rotenone-induced increase in substantia nigra (SN SIRT2 expression in the rats. In addition, there was aging-related rotenone-induced SN malondialdehyde (MDA increase and glutathione (GSH decrease in the rats. No significant changes in cerebellar SIRT2, MDA, or GSH levels were observed in the aging rats after rotenone administration. Striatal dopamine content was significantly inversely correlated with SN SIRT2 expression in the rats. AK-7 significantly diminished striatal dopamine depletion and improved behavior abnormality in the rotenone-treated aging rats. Furthermore, AK-7 significantly decreased MDA content and increased GSH content in the SN of rotenone-treated aging rats. Finally, the effect of AK-7 on dopaminergic neurons and redox imbalance was supported by the results from primary mesencephalic cultures. Our study helps to elucidate the mechanism for the participation of aging
Babinski, Dara E; Waxmonsky, James G; Pelham, William E
This multiple baseline study evaluated the efficacy of behavioral parent training (BPT) for 12 parents (M age = 39.17 years; 91% mothers) and their children (ages 6-12; 83% boys) both with Attention-Deficit/Hyperactivity Disorder (ADHD), and also explored the acute effect of stimulant medication for parents before and after BPT. Parents rated their own and their children's symptoms and impairment and were stabilized on optimally dosed medication. Then, parents discontinued medication and were randomly assigned to a 3, 4, or 5 week baseline (BL), during which they provided twice-weekly ratings of their impairment, parenting, and their child's behavior. Following BL, parents and their children completed two laboratory tasks, once on their optimally dosed medication and once on a placebo to assess observable effects of medication on parent-child behavior, and they completed additional assessments of family functioning. Parents then completed eight BPT sessions, during which they were unmedicated. Twice-weekly ratings of parent and child behavior were collected during BPT and additional ratings were collected upon completing BPT. Two more parent-child tasks with and without parent medication were conducted upon BPT completion to assess the observable effects of BPT and BPT plus medication. Ten (83.33%) parents completed the trial. Improvements in parent and child behavior were observed, and parents reported improved child behavior with BPT. Few benefits of BPT emerged through parent reports of parent functioning, with the exception of inconsistent discipline, and no medication or interaction effects emerged. These results, although preliminary, suggest that some parents with ADHD benefit from BPT. While pharmacological treatment is the most common intervention for adults with ADHD, further examination of psychosocial treatments for adults is needed.
Waite, Roberta; Tran, Mary
The authors present findings from a qualitative descriptive study that explored how a diverse ethnic group of postsecondary students diagnosed with attention-deficit/hyperactivity disorder (ADHD) conceptualized their condition and how this conceptualization shaped their efforts to seek help. Kleinman's explanatory model, the organizing framework, called for participants to describe the etiology, symptom onset, pathophysiology, course, and treatment of ADHD. Twenty-seven participants from four academic institutions took part in the study. A common explanatory model of ADHD was not shared; however, gender and age differences were apparent. These finding have implications for nurses when providing culturally appropriate care to individuals with ADHD in their practice settings. 2010 Elsevier Inc. All rights reserved.
The importance of measurement precision and behavioral homologies in evaluating the behavioral consequences of fetal-ethanol exposure: commentary on Williams and colleagues ("Sensory-motor deficits in children with fetal alcohol spectrum disorder assessed using a robotic virtual reality platform").
Hamilton, Derek A
The recent study by Willams and colleagues utilized a novel robotic virtual reality measurement system to measure sensory-motor processing deficits in children with fetal alcohol spectrum disorders (FASDs). This system and the precise quantitation of distinct constituent behavioral processes may hold considerable utility and importance for the study of FASD-related motor deficits, their neural bases, and translational research efforts using homologous behavioral approaches in animal and human studies.. Copyright © 2013 by the Research Society on Alcoholism.
Maria Cristina Triguero Veloz Teixeira
Full Text Available Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI and Child Behavior Checklist for ages 6–18 (CBCL/6–18. Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.
Lee, Steve S; Hinshaw, Stephen P
This study evaluated predictors of adolescent delinquency severity (11 to 17 years of age) among a diverse group of preadolescent boys with attention deficit hyperactivity disorder (ADHD; n=100) and age-matched comparison boys (n=75). During childhood, baseline assessments yielded diagnostic information, and naturalistic summer programs provided multimethod measures of overt aggression, covert antisocial behavior (ASB), and peer status. Five years later, multi-informant measures of ASB and delinquency were gathered and independently rated. Baseline ADHD, overt aggression, and peer status were not significantly related to adolescent delinquency severity. Observed noncompliance and an objective measure of covert ASB each independently predicted delinquency. Covert ASB predicted delinquency severity more strongly for comparison boys than for probands.
Murray, Desiree W; Childress, Ann; Giblin, John; Williamson, David; Armstrong, Robert; Starr, H Lynn
To assess effects of OROS methylphenidate on cognitive and academic tasks in 9 to 12 year olds with attention-deficit/hyperactivity disorder (ADHD). A double-blind, within-subject, crossover design was used to compare OROS methylphenidate with placebo in a laboratory classroom setting on several cognitive and academic tasks for 68 children who met randomization criteria. Performance on the following measures was significantly better when children received individually optimized OROS methylphenidate than placebo: math fluency and accuracy measured by the Permanent Product Math Test, ADHD symptoms observed in the laboratory setting, computerized indices of attention and impulsivity as measured by the Test of Variables of Attention (TOVA), and visual-spatial working memory (Finger Windows Backwards). Study medication was well tolerated; adverse events were generally consistent with previous reports. OROS methylphenidate improves performance on measures of attention and vigilance, behavior, and working memory in a laboratory school setting in 9 to 12 year olds with ADHD.
Sneddon, Penny L.
This study evaluated the relationship between noise and academic performance and behavior of children with ADHD (n = 15) and without ADHD (n = 18). Children completed math sheets under four noise conditions: no noise, standard classroom noise, classroom noise with verbalizations, and classroom noise with classical music. There were no differences in math performance between the two groups. Children with ADHD exhibited more problem behaviors than children without ADHD. Group-by-condition inter...
Özgür, Erdoğan; Aksu, Hatice; Gürbüz-Özgür, Börte; Başak, Hatice Sema; Eskiizmir, Görkem
The aim of this study was to investigate the frequency of attention deficit hyperactivity disorder (ADHD) and other disruptive behavior disorders in children with recurrent epistaxis (RE). Children aged between 6-11 years were enrolled according to presence (n=34) and absence (n=103) of RE. Turgay DSM-IV-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale was applied to parents. Moreover, Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version was performed. Oppositional defiant disorder (ODD) and ADHD were determined in 17.6% and 32.4% of patients, respectively. When psychiatric diagnoses between both groups were compared, statistically significant differences were found in terms of ADHD and ODD (p=0.028 and p=0.003). In children with RE, the frequency of ADHD and ODD are higher than children without RE. A referral to a child psychiatrist should be considered, if a child with RE also has symptoms of increased activity, inattention and/or body-injurious behaviors.
Howard, Andrea L; Pritchard, Tyler R
This study examined rates of heavy drinking and alcohol problems in relation to drinking motives and protective behavioral strategies in university students with a documented current diagnosis of attention-deficit/hyperactivity disorder (ADHD; n = 31) compared with students with no history of ADHD (n = 146). Participants completed a Web-based questionnaire, and logistic regression models tested interactions between ADHD/comparison group membership and motives and protective strategies. Group differences in rates of heavy drinking and alcohol problems were not statistically significant, but medium-sized risk ratios showed that students without ADHD reported heavy drinking at a rate 1.44 times higher than students with ADHD and met screening criteria for problematic alcohol use at a rate of 1.54 times higher than students with ADHD. Other key findings were, first, that drinking to enhance positive affect (e.g., drinking because it is exciting), but not to cope with negative affect (e.g., drinking to forget your worries), predicted both heavy drinking and alcohol problems. Second, only protective behavioral strategies that emphasize alcohol avoidance predicted both heavy drinking and alcohol problems. Contrary to expectations, we found no ADHD-related moderation of effects of motives or protective strategies on our alcohol outcomes. Results of this study are limited by the small sample of students with ADHD but highlight tentative similarities and differences in effects of motives and strategies on drinking behaviors and alcohol problems reported by students with and without ADHD. PMID:28814878
van den Hoofdakker, Barbara J; Nauta, Maaike H; van der Veen-Mulders, Lianne; Sytema, Sjoerd; Emmelkamp, Paul M G; Minderaa, Ruud B; Hoekstra, Pieter J
To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone. We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC or RCC alone. Outcome was based on parent-reported behavioral problems and ADHD symptoms. Predictor/moderator variables included children's IQ, age, and comorbidity profile, and maternal ADHD, depression, and parenting self-efficacy. Superior BPT treatment effects on behavioral problems and ADHD symptoms were present in children with no or single-type comorbidity-anxiety/depression or oppositional defiant disorder (ODD)/conduct disorder (CD)-and when mothers had high parenting self-efficacy, but absent in children with broad comorbidity (anxiety/depression and ODD/CD) and when mothers had low parenting self-efficacy. In older children ADHD symptoms tended to decrease more through BPT than in younger children. Adjunctive BPT is most useful when mothers have high parenting self-efficacy and in children with no or single-type comorbidity.
Günther, Thomas; Herpertz-Dahlmann, Beate; Jolles, Jellemer; Konrad, Kerstin
This study aims to examine the influence of risperidone on various attentional functions, including intensity and selectivity aspects of attention plus inhibitory control in children with attention deficit/hyperactivity disorder (ADHD) with co-morbid Disruptive Behavior Disorders (DBD) and normal IQ. Children with ADHD and DBD, aged 8-15 years, were treated with risperidone (mean daily dose: 1.5 mg; n = 23) and examined with three attentional paradigms before and after a 4-week treatment period. Age- and IQ-matched normal controls (n = 23) were also tested without medication on the same two occasions. No influence of the medication could be detected for any neuropsychological variable, neither as a positive enhancement nor as adverse side effects. However, clinical symptoms of ADHD and DBD assessed on the IOWA Conners Scale significantly improved after the 4-week treatment period. Divergent behavioral and cognitive effects of risperidone on ADHD symptoms were observed, with a significant reduction in behavioral symptoms, whereas no positive treatment effects were found on laboratory tasks of impulsivity. Thus, the cognitive effects of risperidone seem to differ from the cognitive effects of stimulant treatments in children with ADHD + DBD. However, no negative impact of risperidone was observed on attentional functions either, i.e., there was no slowing of cognitive speed.
Andrea L Howard
Full Text Available This study examined rates of heavy drinking and alcohol problems in relation to drinking motives and protective behavioral strategies in university students with a documented current diagnosis of attention-deficit/hyperactivity disorder (ADHD; n = 31 compared with students with no history of ADHD (n = 146. Participants completed a Web-based questionnaire, and logistic regression models tested interactions between ADHD/comparison group membership and motives and protective strategies. Group differences in rates of heavy drinking and alcohol problems were not statistically significant, but medium-sized risk ratios showed that students without ADHD reported heavy drinking at a rate 1.44 times higher than students with ADHD and met screening criteria for problematic alcohol use at a rate of 1.54 times higher than students with ADHD. Other key findings were, first, that drinking to enhance positive affect (e.g., drinking because it is exciting, but not to cope with negative affect (e.g., drinking to forget your worries, predicted both heavy drinking and alcohol problems. Second, only protective behavioral strategies that emphasize alcohol avoidance predicted both heavy drinking and alcohol problems. Contrary to expectations, we found no ADHD-related moderation of effects of motives or protective strategies on our alcohol outcomes. Results of this study are limited by the small sample of students with ADHD but highlight tentative similarities and differences in effects of motives and strategies on drinking behaviors and alcohol problems reported by students with and without ADHD.
Morris, D M
Patients with neurological disorders present therapists with complex challenges for treatment, including weakness, hypertonicity, voluntary movement deficit, limited range of motion, sensory loss, incoordination, and postural instability. The presence of one or more of these impairments negatively influences these patients by contributing to problems in walking, transferring, and reaching. Aquatic rehabilitation offers a unique, versatile approach to the treatment of these disabilities. This article examines the problems encountered by patients with neurological disorders, general principles guiding neurotreatment, and aquatic neurorehabilitation approaches.
Jensen, K M; Nielsen, K.K.; Kristensen, E S
of neurological deficits underwent a complete diagnostic program including intravenous urography, voiding cystography and cystoscopy as well as spontaneous uroflowmetry, cystometry-emg and pressure-flow-emg study. The incidence of dyssynergia was 22%. However, neither the flow curve pattern nor single flow...... variables were able to identify children with dyssynergia. Consequently uroflowmetry seems inefficient in the screening for dyssynergia in neurological normal children with voiding disorders in the absence of anatomical bladder outlet obstruction....
Geraldina F Gaastra
Full Text Available Children with attention-deficit/hyperactivity disorder (ADHD often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of several types of classroom interventions (antecedent-based, consequence-based, self-regulation, combined that can be applied by teachers in order to decrease off-task and disruptive classroom behavior in children with symptoms of ADHD. A second aim was to identify potential moderators (classroom setting, type of measure, students' age, gender, intelligence, and medication use. Finally, it was qualitatively explored whether the identified classroom interventions also directly or indirectly affected behavioral and academic outcomes of classmates. Separate meta-analyses were performed on standardized mean differences (SMDs for 24 within-subjects design (WSD and 76 single-subject design (SSD studies. Results showed that classroom interventions reduce off-task and disruptive classroom behavior in children with symptoms of ADHD (WSDs: MSMD = 0.92; SSDs: MSMD = 3.08, with largest effects for consequence-based (WSDs: MSMD = 1.82 and self-regulation interventions (SSDs: MSMD = 3.61. Larger effects were obtained in general education classrooms than in other classroom settings. No reliable conclusions could be formulated about moderating effects of type of measure and students' age, gender, intelligence, and medication use, mainly because of power problems. Finally, classroom interventions appeared to also benefit classmates' behavioral and academic outcomes.
Miravalle, Augusto A; Schreiner, Teri
This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.
Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim
According to the American Heart Association, cardiomyopathies are classified as primary (solely or predominantly confined to heart muscle), secondary (those showing pathological myocardial involvement as part of a neuromuscular disorder) and those in which cardiomyopathy is the first/predominant manifestation of a neuromuscular disorder. Cardiomyopathies may be further classified as hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or unclassified cardiomyopathy (noncompaction, Takotsubo-cardiomyopathy). This review focuses on secondary cardiomyopathies and those in which cardiomyopathy is the predominant manifestation of a myopathy. Any of them may cause neurological disease, and any of them may be a manifestation of a neurological disorder. Neurological disease most frequently caused by cardiomyopathies is ischemic stroke, followed by transitory ischemic attack, syncope, or vertigo. Neurological disease, which most frequently manifests with cardiomyopathies are the neuromuscular disorders. Most commonly associated with cardiomyopathies are muscular dystrophies, myofibrillar myopathies, congenital myopathies and metabolic myopathies. Management of neurological disease caused by cardiomyopathies is not at variance from the same neurological disorders due to other causes. Management of secondary cardiomyopathies is not different from that of cardiomyopathies due to other causes either. Patients with neuromuscular disorders require early cardiologic investigations and close follow-ups, patients with cardiomyopathies require neurological investigation and avoidance of muscle toxic medication if a neuromuscular disorder is diagnosed. Which patients with cardiomyopathy profit most from primary stroke prevention is unsolved and requires further investigations. Copyright © 2013 Elsevier Inc. All rights reserved.
Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.
Merrill, Jean E; Hanak, Susan; Pu, Su-Fen; Liang, Jinjun; Dang, Chelsea; Iglesias-Bregna, Deborah; Harvey, Brian; Zhu, Bin; McMonagle-Strucko, Kathleen
Teriflunomide is an orally available anti-inflammatory drug that prevents T and B cell proliferation and function by inhibition of dihydroorotate dehydrogenase. It is currently being developed for the treatment of multiple sclerosis (MS). We report here for the first time the anti-inflammatory effects of teriflunomide in the Dark Agouti rat model of experimental autoimmune encephalomyelitis (EAE). Neurological evaluation demonstrated that prophylactic dosing of teriflunomide at 3 and 10 mg/kg delayed disease onset and reduced maximal and cumulative scores. Therapeutic administration of teriflunomide at doses of 3 or 10 mg/kg at disease onset significantly reduced maximal and cumulative disease scores as compared to vehicle treated rats. Dosing teriflunomide at disease remission, at 3 and 10 mg/kg, reduced the cumulative scores for the remaining course of the disease. Teriflunomide at 10 mg/kg significantly reduced inflammation, demyelination, and axonal loss when dosed prophylactically or therapeutically. In electrophysiological somatosensory evoked potential studies, therapeutic administration of teriflunomide, at the onset of disease, prevented both a decrease in waveform amplitude and an increase in the latency to waveform initiation in EAE animals compared to vehicle. Therapeutic dosing with teriflunomide at disease remission prevented a decrease in evoked potential amplitude, prevented an increase in latency, and enhanced recovery time within the CNS.
Kentrop, Jiska; van der Tas, Liza; Loi, Manila; van IJzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Joëls, Marian; van der Veen, Rixt
Early life adversity has a profound impact on brain development and later life health. Animal models have provided insight how early life stress programs stress responsiveness and might contribute to the development of psychiatric disorders. In the present study, the long-term effects of maternal deprivation (MD) on behavioral inhibition and attention were examined in adult male Wistar rats. To this end animals were tested in the 5-choice serial reaction time task (5-choice SRTT). We also explored the potential of a 3-day treatment with the glucocorticoid receptor (GR) antagonist mifepristone during early adolescence to normalize putative behavioral effects of early life stress. Deprivation of the mother for 24 h on postnatal day (PND) 3 led to a modest but significant increase in premature responses in the 5-choice SRTT, but did not affect measures of attention. Body weight was lower in deprived animals from weaning until the start of testing. Early adolescent mifepristone treatment (PND 26-28) did not influence performance on the 5-choice SRTT and did not mitigate the deprivation-related impairment in behavioral inhibition. Our results indicate that MD leads to impaired behavioral inhibition, and that mifepristone treatment during early adolescence does not normalize the behavioral changes caused by early life stress.
Mateen, Farrah J
A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.
Harrop, Clare; Gulsrud, Amanda; Kasari, Connie
Due to the uneven gender ratio of autism spectrum disorders (ASD), girls are rarely studied independently from boys. Research focusing on restricted and repetitive behaviors (RRBs) indicates that above the age of six girls have fewer and/or different RRBs than boys with ASD. In this study we investigated whether girls and boys with ASD…
Gandolfi, M.; Geroin, C.; Ferrari, F.; Marchina, L.A.; Varalta, V.; Fonte, C.; Picelli, A.; Dimitrova, E.; Munari, D.; Vale, N.; Waldner, A.; Smania, N.
BACKGROUND: Pusher behavior (PB) is a little-known postural control disorder characterized by alterations in the perception of body orientation in the coronal (roll) plane. Poststroke PB poses many short- and long-term concerns in clinical practice leading to the longer length of hospital stay and
Li, James J.; Lee, Steve S.
Emerging evidence suggests that some individuals may be simultaneously more responsive to the effects from environmental adversity "and" enrichment (i.e., differential susceptibility). Given that parenting behavior and a variable number tandem repeat polymorphism in the 3'untranslated region of the dopamine transporter (DAT1) gene are…
Mikami, Amori Yee; Jack, Allison; Emeh, Christina C.; Stephens, Haley F.
We examined associations between children's peer relationships and (a) their parents' social competence as well as (b) their parents' behaviors during the children's peer interactions. Participants were families of 124 children ages 6-10 (68% male), 62 with ADHD and 62 age- and sex-matched comparison youth. Children's peer relationships were…
Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje
To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...
Bøttger, Pernille; Doganli, Canan; Lykke-Hartmann, Karin
The two autosomal dominantly inherited neurological diseases: familial hemiplegic migraine type 2 (FHM2) and familial rapid-onset of dystonia-parkinsonism (Familial RDP) are caused by in vivo mutations of specific alpha subunits of the sodium–potassium pump (Na+/K+-ATPase). Intriguingly, patients...... patient symptoms and manifestations. Thus, it is interesting that mouse models targeting a specific -isoform cause different, although still comparable, phenotypes consistent with classical symptoms and other manifestations observed in FHM2 and RDP patients. This review highlights that use of mouse models...... with classical FHM2 and RDP symptoms additionally suffer from other manifestations, such as epilepsy/seizures and developmental disabilities. Recent studies of FHM2 and RDP mouse models provide valuable tools for dissecting the vital roles of the Na+/K+-ATPases, and we discuss their relevance to the complex...
Chronic pain is a frequent component of many neurological disorders, affecting 20–40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequentl...
Seth William Hurley
Full Text Available The hypothalamus has been recognized for its involvement in both maintaining homeostasis and mediating motivated behavior. The present article discusses a region of the hypothalamus known as the lateral hypothalamic area (LHA. It is proposed that brain nuclei within the LHA including the dorsal region of the lateral hypothalamus (LHAd and perifornical area (PeF provide a link between neural systems that regulates homeostasis and those that mediate appetitive motivated behaviors. Functional and immunohistochemical data indicate that the LHA promotes many motivated behaviors including food intake, water intake, salt intake, and sexual behavior. Anatomical tracing experiments demonstrate that the LHA is positioned to receive inputs from brain areas involved in regulating body fluid and energy homeostasis. Regions within the LHA send dense projections to the ventral tegmental area (VTA, providing a pathway for the LHA to influence dopaminergic systems generally recognized to be involved in motivated behaviors and their reinforcement. Furthermore, the LHA contains neurons that synthesize orexin/hypocretin, a neuropeptide that promotes many appetitive motivated behaviors. The LHA also receives inputs from brain areas involved in reward-related learning and orexin neuron activation can become conditioned to environmental stimuli that are associated with rewards. Therefore, it is hypothesized that the LHA integrates signaling from areas that regulate body fluid and energy balance and reward-related learning. In turn, this information is fed into mesolimbic circuitry to influence the performance of motivated behaviors. This hypothesis may foster experiments that will result in an improved understanding of LHA function. An improved understanding of LHA function may aid in treating disorders that are associated with an excess or impairment in the expression of ingestive behavior including obesity, anorexia, impairments in thirst, salt gluttony and salt
Li, Yan; Eskelund, Amanda; Zhou, H
Neuropsychiatric symptoms of systemic lupus erythematosus (NP-SLE) have been understudied compared to end-organ failure and peripheral pathology. Neuropsychiatric symptoms, particularly affective and cognitive indications, may be among the earliest manifestations of SLE. Among the potential...... pathophysiological mechanisms responsible for NP-SLE are increased peripheral pro-inflammatory cytokines, subsequent induction of indoleamine-2,3-dioxygenase (IDO) and activation of the kynurenine pathway. In the MRL/MpJ-Faslpr (MRL/lpr) murine model of lupus, depression-like behavior and cognitive dysfunction...... is evident before significant levels of autoantibody titers and nephritis are present. We examined the behavioral profile of MRL/lpr mice and their congenic controls, a comprehensive plasma cytokine and chemokine profile, and brain levels of serotonin and kynurenine pathway metabolites. Consistent...
Full Text Available Abstract Background Expressed Emotions (EE are associated with oppositional behavior (OPB in children with Attention Deficit/Hyperactivity Disorder (ADHD. EE has been linked to altered stress responses in some disorders, but ADHD has not been studied. We test the hypothesis that OPB in ADHD is mediated by altered stress-related cortisol reactivity to EE. Methods Two groups of children (with/without ADHD and their respective parents were randomly assigned to two different conditions with/without negative emotion and participated in an emotion provocation task. Parents' EE, their ratings of their children's OPB and their children's salivary cortisol levels were measured. Results Low parental warmth was associated with OPB in ADHD. High levels of parental EE elicited a larger cortisol response. Stress-related cortisol reactivity mediated the EE-OPB link for all children. This highlights the general importance of parent-child interactions on externalizing behavior problems. Conclusion High EE is a salient stressor for ADHD children that leads to increased levels of cortisol and OPB. The development of OPB might be mediated by the stress-response to high EE.
Qiu, Zhi-Kun; Liu, Chun-Hui; Gao, Zhuo-Wei; He, Jia-Li; Liu, Xu; Wei, Qing-Lan; Chen, Ji-Sheng
Post-traumatic stress disorder (PTSD) is a severe psychiatric condition. The allopregnanolone biosynthesis has been implicated as one of the possible contributors to PTSD. Inulin-type oligosaccharides of morinda officinalis (IOMO) had been shown to be effective in the therapy of depression. However, few studies concern the anti-PTSD-like effects of IOMO. To evaluate this, the single prolonged stress (SPS) model was used in the present study. It had been shown that the behavioral deficits of SPS-treated rats were reversed by IOMO (25.0 and 50.0 mg/kg, i.p.), which reversed the increased freezing time in contextual fear paradigm (CFP) and the decreased time and entries in open arms in the elevated plus maze (EPM) test without affecting the locomotor activity in the open field (OF) test. In addition, the decreased allopregnanolone in the prefrontal cortex, hippocampus, and amygdala was reversed by IOMO (25.0 and 50.0 mg/kg, i.p.), respectively. In summary, the present study indicated that the IOMO exert anti-PTSD-like behaviors, which maybe associated with the brain allopregnanolone biosynthesis.
Grizzell, J Alex; Iarkov, Alexandre; Holmes, Rosalee; Mori, Takahashi; Echeverria, Valentina
Chronic stress underlies and/or exacerbates many psychiatric conditions and often results in memory impairment as well as depressive symptoms. Such afflicted individuals use tobacco more than the general population and this has been suggested as a form of self-medication. Cotinine, the predominant metabolite of nicotine, may underlie such behavior as it has been shown to ameliorate anxiety and memory loss in animal models. In this study, we sought to investigate the effects of cotinine on working memory and depressive-like behavior in mice subjected to prolonged restraint. Cotinine-treated mice displayed better performance than vehicle-treated cohorts on the working memory task, the radial arm water maze test. In addition, with or without chronic stress exposure, cotinine-treated mice engaged in fewer depressive-like behaviors as assessed using the tail suspension and Porsolt's forced swim tests. These antidepressant and nootropic effects of cotinine were associated with an increase in the synaptophysin expression, a commonly used marker of synaptic density, in the hippocampus as well as the prefrontal and entorhinal cortices of restrained mice. The beneficial effects of cotinine in preventing various consequences of chronic stress were underscored by the inhibition of the glycogen synthase kinase 3 β in the hippocampus and prefrontal cortex. Taken together, our results show for the first time that cotinine reduces the negative effects of stress on mood, memory, and the synapse. Published by Elsevier B.V.
Jack, Allison; Emeh, Christina C.; Stephens, Haley F.
We examined associations between children's peer relationships and (a) their parents' social competence as well as (b) their parents' behaviors during the children's peer interactions. Participants were families of 124 children ages 6–10 (68% male), 62 with ADHD and 62 age- and sex-matched comparison youth. Children's peer relationships were assessed via parent and teacher report, and sociometric nominations in a lab-based playgroup. Parental characteristics were assessed via parent self-report and observations of behavior during their child's playgroup. After statistical control of relevant covariates, parents of children with ADHD reported poorer social skills of their own, arranged fewer playdates for their children, and displayed more criticism during their child's peer interaction than did parents of comparison youth. Parents' socialization with other parents and facilitation of the child's peer interactions predicted their children having good peer relationships as reported by teachers and peers, whereas parental corrective feedback to the child and praise predicted poor peer relationships. Parents' ratings of their child's social skills were positively associated with ratings of their own social skills, but negatively associated with criticism and facilitation of the child's peer interactions. Relationships between parental behaviors and peer relationships were stronger for youth with ADHD than for comparison youth. The relevance of findings to interventions is discussed. PMID:20339912
Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.
Sel, Çiğdem Genç; Aksoy, Erhan; Aksoy, Ayşe; Yüksel, Deniz; Özbay, Ferda
Various typical and atypical neurological manifestations can be seen as the initial symptoms of celiac disease (CD). We suggest that gluten toxicity is the most suspicious triggering risk factor for probable pathophysiological pathways of neurological involvement in atypical CD. The medical charts of 117 patients diagnosed with atypical CD were retrieved from a tertiary center in Ankara, Turkey. Eight patients reported as having neurologic manifestations as initiating symptoms were evaluated in detail. The initial neurological manifestations of CD in our study included atypical absence, which was reported first in this study, generalized tonic-clonic seizures, complex partial seizures, severe axial hypotonia and down phenotype, multifocal leukoencephalopathy, mild optic neuritis, attention deficit hyperactivity disorder, and short duration headaches. Seizures mostly emphasizing atypical absence could be the initial presentation manifestation of CD, first described in this literature. Gluten toxicity could be one of the most powerful triggering factors for developing epilepsy in CD. Learning disorders such as attention deficit hyperactivity disorder, short duration headaches, mild optic neuritis, encephalopathy, and DS could also be the initial neurological manifestations of atypical CD. A gluten-restricted diet may improve neurological complaints, epileptic discharges, and neuropsychiatric symptoms. All we found may be a small part of the full range of neurological disorders of unknown origin related to CD. Clinical suspicion should be the rule for accurate diagnosis of the disease.
Full Text Available Neuropsychiatric symptoms of systemic lupus erythematosus (NP-SLE have been understudied compared to end-organ failure and peripheral pathology. Neuropsychiatric symptoms, particularly affective and cognitive indications, may be among the earliest manifestations of SLE. Among the potential pathophysiological mechanisms responsible for NP-SLE are increased peripheral pro-inflammatory cytokines, subsequent induction of indoleamine-2,3-dioxygenase (IDO and activation of the kynurenine pathway. In the MRL/MpJ-Faslpr (MRL/lpr murine model of lupus, depression-like behavior and cognitive dysfunction is evident before significant levels of autoantibody titers and nephritis are present. We examined the behavioral profile of MRL/lpr mice and their congenic controls, a comprehensive plasma cytokine and chemokine profile, and brain levels of serotonin and kynurenine pathway metabolites. Consistent with previous studies, MRL/lpr mice had increased depression-like behavior and visuospatial memory impairment. Plasma levels of different inflammatory molecules (Haptoglobin, interleukin 10 (IL-10, interferon γ-inducible protein 10 (IP-10/CXCL10, lymphotactin, macrophage inhibitory protein 3β (MIP-3β/CCL19, monocyte chemotactic protein 1, 3 and 5 (MCP-1/CCL2, MCP-3/CCL7, MCP-5/CCL12, vascular cell adhesion molecule 1 (VCAM-1, lymphotactin and interferon γ (IFN-γ were increased in MRL/lpr mice. In cortex and hippocampus, MRL/lpr mice had increased levels of kynurenine pathway metabolites (kynurenine, 3-hydroxykynurenine, 3-hydroxynthranilic acid and quinolinic acid. Therefore, our study suggests that increased cytokine expression may be critical in the regulation subtle aspects of brain function in NP-SLE via induction of IDO and tryptophan/kynurenine metabolism.
Kikkert, Hedwig K; de Jong, Corina; Hadders-Algra, Mijna
BACKGROUND: In children with developmental disorders, motor problems often co-occur with cognitive difficulties. Associations between specific cognitive deficits underlying learning problems and minor neurological dysfunction (MND) are still unknown. AIMS: To assess associations between specific
Wang, Liang-Jen; Chen, Chih-Ken; Huang, Yu-Shu
This study investigated the gender differences in behavioral symptoms, as rated by various informants, and in neuropsychological performance, among patients with attention-deficit/hyperactivity disorder (ADHD) treated with methylphenidate during 24 months in a clinical setting. Study participants comprised 128 boys (mean age: 13.2±2.4 years) and 26 girls (mean age: 12.8±1.0 years) with ADHD. All patients were prescribed short-acting oral methylphenidate, taken two or three times daily; each dose ranged between 0.3 and 1.0 mg/kg. At the baseline and 6, 12, 18, and 24 months later, behavioral symptoms were evaluated using the parent and teacher forms of the Swanson, Nolan, and Pelham Version IV (SNAP-IV) scale for ADHD and the ADHD Rating Scale (completed by a child psychiatrist). In addition, neuropsychological function was assessed using the Test of Variables of Attention (TOVA) at each interval. Although both the boys and girls exhibited a significant decrease in the ADHD symptoms observed by parents and clinicians, the girls improved more than the boys did. Based on the teacher reports, neither the boys nor the girls exhibited significant decreases in ADHD symptoms. The symptoms rated by teachers were more severe in the boys than in the girls throughout the first 12 months; however, the gender difference lessened after 12 months. Based on the TOVA assessment, a composite score (containing response time, response time variability, and ADHD score obtained using the TOVA) did not indicate differences between genders. However, another composite score (containing omission errors, commission errors, and response sensitivity) suggested significant improvement only in the boys. The results suggested that according to a longitudinal follow-up, behavioral and neuropsychological changes among patients with ADHD might differ between genders. Gathering multidimensional information from patients with ADHD is essential in determining how gender modifies the functional
Manuel Tobias Munz
Full Text Available Background: Behavioral inhibition, which is a later-developing executive function (EF and anatomically located in prefrontal areas, is impaired in attention-deficit and hyperactivity disorder (ADHD. While optimal EFs have been shown to depend on efficient sleep in healthy subjects, the impact of sleep problems, frequently reported in ADHD, remains elusive. Findings of macroscopic sleep changes in ADHD are inconsistent, but there is emerging evidence for distinct microscopic changes with a focus on prefrontal cortical regions and non-rapid eye movement (non-REM slow-wave sleep. Recently, slow oscillations (SO during non-REM sleep were found to be less functional and, as such, may be involved in sleep-dependent memory impairments in ADHD. Objective: By augmenting slow-wave power through bilateral, slow oscillating transcranial direct current stimulation (so-tDCS, frequency = 0.75 Hz during non-REM sleep, we aimed to improve daytime behavioral inhibition in children with ADHD. Methods: 14 boys (10-14 yrs diagnosed with ADHD were included. In a randomized, double-blind, cross-over design, patients received so-tDCS either in the first or in the second experimental sleep night. Inhibition control was assessed with a visuomotor go/no-go task. Intrinsic alertness was assessed with a simple stimulus response task. To control for visuomotor performance, motor memory was assessed with a finger sequence tapping task. Results: SO-power was enhanced during early non-REM sleep, accompanied by slowed reaction times and decreased standard deviations of reaction times, in the go/no-go task after so-tDCS. In contrast, intrinsic alertness and motor memory performance were not improved by so-tDCS. Conclusion: Since behavioral inhibition but not intrinsic alertness or motor memory was improved by so-tDCS, our results suggest that lateral prefrontal slow oscillations during sleep might play a specific role for executive functioning in ADHD.
Gass, J T; McGonigal, J T; Chandler, L J
Alcoholism is a chronic relapsing disorder characterized by periods of heavy alcohol consumption and unsuccessful attempts at abstinence. Relapse is one of the most problematic aspects in the treatment of alcoholism and is triggered by ethanol-associated cues. Extinction-based cue exposure therapies have proven ineffective in the treatment of alcoholism. However, positive allosteric modulation of mGlu5 with CDPPB enhances the extinction learning of alcohol-seeking behavior. The current study investigated the impact of chronic alcohol exposure on the extinction of ethanol-seeking behavior. Adult Wistar rats were trained to self-administer alcohol with a light/tone stimulus serving as the alcohol cue. After training, one group of rats was exposed to chronic intermittent ethanol (CIE) daily for a period of 2 weeks to induce ethanol dependence. Control rats were exposed to air for the same period of time. Both groups were then retrained to self-administer ethanol and subsequently tested for changes in extinction learning. CIE exposed rats consumed more ethanol compared to their pre-CIE levels and to control rats. During extinction training, CIE rats responded significantly more on the previously active lever and required more sessions to reach extinction criteria compared to control rats. Treatment with CDPPB facilitated extinction in control rats and attenuated the increased resistance to extinction in CIE-exposed rats. These results demonstrate that chronic ethanol exposure not only alters ethanol intake, but also the extinction of ethanol-seeking behaviors. The ability to attenuate deficits through modulation of mGlu5 provides a potential target for pharmacological manipulation that could ultimately reduce relapse in alcoholics. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Vicidomini, C; Ponzoni, L; Lim, D; Schmeisser, M J; Reim, D; Morello, N; Orellana, D; Tozzi, A; Durante, V; Scalmani, P; Mantegazza, M; Genazzani, A A; Giustetto, M; Sala, M; Calabresi, P; Boeckers, T M; Sala, C; Verpelli, C
SHANK3 (also called PROSAP2) genetic haploinsufficiency is thought to be the major cause of neuropsychiatric symptoms in Phelan-McDermid syndrome (PMS). PMS is a rare genetic disorder that causes a severe form of intellectual disability (ID), expressive language delays and other autistic features. Furthermore, a significant number of SHANK3 mutations have been identified in patients with autism spectrum disorders (ASD), and SHANK3 truncating mutations are associated with moderate to profound ID. The Shank3 protein is a scaffold protein that is located in the postsynaptic density (PSD) of excitatory synapses and is crucial for synapse development and plasticity. In this study, we investigated the molecular mechanisms associated with the ASD-like behaviors observed in Shank3Δ11-/- mice, in which exon 11 has been deleted. Our results indicate that Shank3 is essential to mediating metabotropic glutamate receptor 5 (mGlu5)-receptor signaling by recruiting Homer1b/c to the PSD, specifically in the striatum and cortex. Moreover, augmenting mGlu5-receptor activity by administering 3-Cyano-N-(1,3-diphenyl-1H-pyrazol-5-yl)benzamide ameliorated the functional and behavioral defects that were observed in Shank3Δ11-/- mice, suggesting that pharmaceutical treatments that increase mGlu5 activity may represent a new approach for treating patients that are affected by PMS and SHANK3 mutations.
Literature complements medical literature in the academic and clinical development of neurologists. The present article explores the contributions of writers of fiction on neurology. Literary works of fiction with particular reference to neurology. A symbiosis between writers of fiction and doctors has been well recognised. From Shakespeare to Cervantes by way of Dickens and Cela to writer - physicians such as Anton Chekhov or António Lobo Antunes have contributed through their medically informed literature to the better understanding of neurology. Some writers like Dostoevsky, Machado de Assis and Margiad Evans have written about their own experiences with disease thus bringing new insights to medicine. Furthermore, some neurological disorders have been largely based on literary descriptions. For instance, Dostoevsky's epilepsy has been retrospectively analysed by famous neurologists including Freud, Alajouanine or Gastaut, whilst his writings and biography have prompted others like Waxman and Geschwind to describe typical behavioural changes in temporal lobe epilepsy, finding their source of inspiration in Dostoevsky. Likewise, Cirignotta et al have named an unusual type of seizure after the Russian novelist. Inspired by Lewis Carroll, Todd introduced the term Alice in Wonderland Syndrome to refer to visual distortions generally associated with migraine. Writers of fiction offer a humanised perception of disease by contributing new insights into the clinical history, informing about the subjective experience of the illness and helping to eradicate the stigma associated to neurological disorders.
Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J
Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. © 2014 Elsevier B.V. All rights reserved.
Full Text Available ADHD is a complex neurodevelopmental disorder that implies several-step process and there is no single test to diagnose both ADHD and associated comorbidities such as oppositional defiant disorder, anxiety disorder, depression and certain types of learning disabilities. The purpose of the present study was to examine correlations between behavioral and clinical symptoms by administering an extensive neuropsychological battery to a sample of children and adolescents from a developing country. The sample was divided into three groups: non-ADHD; ADHD-non-comorbid; and ADHD+comorbidity. A full neuropsychological battery and clinical assessment found that 105 children met DSM-5 criteria, of whom 46.6% had the predominantly inattentive presentation, 37.3% had combined presentation and 16% were predominantly hyperactive/impulsive presentation. The internal correlation between neuropsychological tests did not reach statistical significance in the comparison between ADHD and non-ADHD cases (p<0.17. Clinical ADHD cases, including both +comorbidity and non-comorbid groups, performed substantially worse on CPT, working memory. Comparing ADHD-non-comorbid and ADHD+comorbidity groups, the latter did significantly worse on inhibitory control, time processing and the level of perseveration response on CPT indexes, as well as on working memory performance and CBCL tests particularly the CBCL-DESR (deficient emotional self-regulation test in the ADHD+comorbidity group. Children diagnosed as oppositional-defiant (ODD or with conduct disorder (CD showed close correlations between clinical CBCL profiles and externalized symptoms. Our findings suggest that ADHD+comorbidity and ADHD non-comorbid cases may be differentiated by a number of neuropsychological measures, such as processing speed, inhibitory control and working memory, that may reflect different levels of involvement of the hot and cool executive domains, which are more impaired in cases of severe
Full Text Available Antonio Carlos Farias,1–4 Mara L Cordeiro,1,2,5 Erico PG Felden,6 Tiago S Bara,1,2 Cássia R Benko,1,2 Daniele Coutinho,1,2 Leandra F Martins,2 Rosilda TC Ferreira,1,2 James T McCracken5 1Faculdades Pequeno Príncipe, 2Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba, 3Department of Neuropediatrics, Children’s Hospital, Pequeno Príncipe, 4School of Medicine, University Positivo, Curitiba, Brazil; 5Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, US; 6Center for Health Science Research, Santa Catarina State University, Florianópolis, Brazil Background: Recent studies have suggested that children with attention-deficit hyperactivity disorder (ADHD may benefit from computerized cognitive training. Therapy implementation is especially complicated when ADHD is associated with learning disorders (LDs. This study tested the efficacy of a computer-based cognitive training program, namely, computerized cognitive training (CCT, in children with ADHD comorbid with an LD (ADHD-LD, with or without psychostimulant medication. Materials and methods: After diagnostic evaluations, 27 children with ADHD-LD (8 unmedicated and 19 medicated participated in CCT, which is intended to improve attention, memory, reasoning, visual processing, and executive functioning. The participants completed 24 1-hour sessions over 3 months. Neuropsychometric and standardized academic test results before and after training were compared to assess treatment efficacy. Shapiro–Wilk normality tests were applied, and subsequent Wilcoxon tests were used to identify significant differences in pre- versus post-training performance. Results: After CAT, children diagnosed with ADHD-LD showed 1 improvements in trained skills, measured directly within the software and indirectly by external psychometric tests; 2 improvements in
Nicholas T Van Dam
Full Text Available Although amnestic mild cognitive impairment (aMCI; often considered a prodromal phase of Alzheimer's disease, AD is most recognized by its implications for decline in memory function, research suggests that deficits in attention are present early in aMCI and may be predictive of progression to AD. The present study used functional magnetic resonance imaging to examine differences in the brain during the attention network test between 8 individuals with aMCI and 8 neurologically healthy, demographically matched controls. While there were no significant behavioral differences between groups for the alerting and orienting functions, patients with aMCI showed more activity in neural regions typically associated with the networks subserving these functions (e.g., temporoparietal junction and posterior parietal regions, respectively. More importantly, there were both behavioral (i.e., greater conflict effect and corresponding neural deficits in executive control (e.g., less activation in the prefrontal and anterior cingulate cortices. Although based on a small number of patients, our findings suggest that deficits of attention, especially the executive control of attention, may significantly contribute to the behavioral and cognitive deficits of aMCI.
Gonçalves, R; Penderis, J; Chang, Y P; Zoia, A; Mosley, J; Anderson, T J
To characterise the clinical presentation and neurological abnormalities in dogs affected by aortic thromboembolism. The medical records of 13 dogs diagnosed with aortic thromboembolism as the cause of the clinical signs, and where a complete neurological examination was performed, were reviewed retrospectively. The onset was acute in only four dogs, chronic in five dogs (with all of these presenting as exercise intolerance) or chronic with acute deterioration in four dogs. Dogs with an acute onset of clinical signs were more severely affected exhibiting neurological deficits, while dogs with a chronic onset of disease predominantly presented with the exercise intolerance and minimal deficits. The locomotor deficits included exercise intolerance with pelvic limb weakness (five of 13), pelvic limb ataxia (one of 13), monoparesis (two of 13), paraparesis (two of 13), non-ambulatory paraparesis (two of 13) and paraplegia (one of 13). There was an apparent male predisposition and the cavalier King charles spaniel was overrepresented. The rate of onset of clinical signs appears to segregate dogs affected by aortic thromboembolism into two groups, with different clinical characteristics and outcomes. Dogs with an acute onset of the clinical signs tend to be more severely affected, while dogs with a chronic onset predominantly present with exercise intolerance. It is therefore important to consider aortic thromboembolism as a differential diagnosis in dogs with an acute onset of pelvic limb neurological deficits and in dogs with longer standing exercise intolerance.
Jensen, Mark; Cox, Alexander P; Chaudhry, Naveed; Ng, Marcus; Sule, Donat; Duncan, William; Ray, Patrick; Weinstock-Guttman, Bianca; Smith, Barry; Ruttenberg, Alan; Szigeti, Kinga; Diehl, Alexander D
We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer's disease, multiple sclerosis, and stroke. ND is implemented in OWL 2 and currently has more than 450 terms that refer to and describe various aspects of neurological diseases. ND directly imports the development version of OGMS, which uses BFO 2. Term development in ND has primarily extended the OGMS terms 'disease', 'diagnosis', 'disease course', and 'disorder'. We have imported and utilize over 700 classes from related ontology efforts including the Foundational Model of Anatomy, Ontology for Biomedical Investigations, and Protein Ontology. ND terms are annotated with ontology metadata such as a label (term name), term editors, textual definition, definition source, curation status, and alternative terms (synonyms). Many terms have logical definitions in addition to these annotations. Current development has focused on the establishment of the upper-level structure of the ND hierarchy, as well as on the representation of Alzheimer's disease, multiple sclerosis, and stroke. The ontology is available as a version-controlled file at http://code.google.com/p/neurological-disease-ontology along with a discussion list and an issue tracker. ND seeks to provide a formal foundation for the representation of clinical and research data
Barone, Daniel A; Chokroverty, Sudansu
Sleep disorders and neurologic illness are common and burdensome in their own right; when combined, they can have tremendous negative impact at an individual level as well as societally. The socioeconomic burden of sleep disorders and neurologic illness can be identified, but the real cost of these conditions lies far beyond the financial realm. There is an urgent need for comprehensive care and support systems to help with the burden of disease. Further research in improving patient outcomes in those who suffer with these conditions will help patients and their families, and society in general. Copyright © 2016 Elsevier Inc. All rights reserved.
Cuero, Mauricio Ruiz; Varelas, Panayiotis N
Pregnant women are subject to the same complications as the general population, as well to specific neurologic complications associated with pregnancy, such as preeclampsia or eclampsia. The hormonal and physiologic changes during pregnancy lead to altered incidences of these complications, which usually present during the late period of pregnancy, labor, or the puerperium. In addition, the treatment of these conditions is different from that of nonpregnant women, because special attention is paid to avoid any abnormalities or death of the fetus. This article discusses the most common of these neurologic complications. Copyright © 2016 Elsevier Inc. All rights reserved.
Khoujah, Danya; Chang, Wan-Tsu W; Abraham, Michael K
Emergency neurology is a complex and rapidly changing field. Its evolution can be attributed in part to increased imaging options, debates about optimal treatment, and simply the growth of emergency medicine as a specialty. Every year, a number of articles published in emergency medicine or other specialty journals should become familiar to the emergency physician. This review summarizes neurology articles published in 2016, which the authors consider crucial to the practice of emergency medicine. The articles are categorized according to disease process, with the understanding that there can be significant overlap among articles. Copyright © 2017 Elsevier Inc. All rights reserved.
Ronca, Shannon E; Dineley, Kelly T; Paessler, Slobodan
The recent surge in viral clinical cases and associated neurological deficits have reminded us that viral infections can lead to detrimental, long-term effects, termed sequelae, in survivors. Alphaviruses are enveloped, single-stranded positive-sense RNA viruses in the Togaviridae family. Transmission of alphaviruses between and within species occurs mainly via the bite of an infected mosquito bite, giving alphaviruses a place among arboviruses, or arthropod-borne viruses. Alphaviruses are found throughout the world and typically cause arthralgic or encephalitic disease in infected humans. Originally detected in the 1930s, today the major encephalitic viruses include Venezuelan, Western, and Eastern equine encephalitis viruses (VEEV, WEEV, and EEEV, respectively). VEEV, WEEV, and EEEV are ende