Hasil untuk "Neurophysiology and neuropsychology"

Andrew Zillgitt, David E Burdette, Atheel Yako et al.

Clobazam (CLB) and cenobamate (CNB) are commonly used antiseizure medications (ASMs) in the treatment of patients with drug-resistant epilepsy (DRE). However, concomitant use of these two ASMs may lead to significant treatment-related adverse events (TRAE). Furthermore, these TRAE may be exacerbated in individuals with genetic polymorphisms involving the P450 system. In patients with DRE, epilepsy surgery, including neuromodulation, may lead to improved seizure control and a reduction in systemic TRAE from ASMs. This case report describes a patient with drug-resistant idiopathic generalized epilepsy (IGE) who experienced persistent excessive somnolence correlated with elevated N-desmethylclobazam (N-CLB) levels. Pharmacogenetic testing revealed poor metabolism of CYP2C19, and N-CLB levels remained elevated and detectable for nearly one year after the discontinuation of treatment with CLB and CNB. Responsive neurostimulator (RNS) implantation within the bilateral centromedian nuclei (CMN) of the thalamus resulted in seizure freedom until N-CLB levels fell, after which there was an 83–93 % reduction in the frequency of generalized tonic-clonic seizures (GTC).

Anna Csilla Kegyes-Brassai, R. Pierson-Bartel, Gergo Bolla et al.

Alzheimer’s disease (AD) is the leading cause of dementia, often associated with impaired sleep quality and disorganized sleep structure. This study aimed to characterize changes in sleep macrostructure and K-complex density in AD, in relation to neuropsychological performance and brain structural changes. We enrolled 30 AD and 30 healthy control participants, conducting neuropsychological exams, brain MRI, and one-night polysomnography. AD patients had significantly reduced total sleep time (TST), sleep efficiency, and relative durations of non-rapid eye movement (NREM) stages 2 (S2), 3 (S3), and rapid eye movement (REM) sleep (p < 0.01). K-complex (KC) density during the entire sleep period and S2 (p < 0.001) was significantly decreased in AD. We found strong correlations between global cognitive performance and relative S3 (p < 0.001; r = 0.86) and REM durations (p < 0.001; r = 0.87). TST and NREM stage 1 (S1) durations showed a moderate negative correlation with amygdaloid and hippocampal volumes (p < 0.02; r = 0.51–0.55), while S3 and REM sleep had a moderate positive correlation with cingulate cortex volume (p < 0.02; r = 0.45–0.61). KC density strongly correlated with global cognitive function (p < 0.001; r = 0.66) and the thickness of the anterior cingulate cortex (p < 0.05; r = 0.45–0.47). Our results indicate significant sleep organization changes in AD, paralleling cognitive decline. Decreased slow wave sleep and KCs are strongly associated with cingulate cortex atrophy. Since sleep changes are prominent in early AD, they may serve as prognostic markers or therapeutic targets.

Zhang Y, Wang H, Yang J et al.

Yating Zhang,1 Hongyan Wang,1 Jie Yang,2 Sanchun Wang,1 Weifang Tong,1 Bo Teng1 1Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China; 2Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Bo Teng, Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun, Jilin Province, 130000, People’s Republic of China, Email tengbo1975@163.comPurpose: This investigation sought to elucidate the genetic underpinnings that connect obesity indicators, circulating blood lipid levels, adipokines levels and obstructive sleep apnea syndrome (OSAS), employing a bidirectional two-sample Mendelian randomization (MR) analysis that utilizes data derived from extensive genome-wide association studies (GWAS).Methods: We harnessed genetic datasets of OSAS available from the FinnGen consortium and summary data of four obesity indices (including neck circumference), seven blood lipid (including triglycerides) and eleven adipokines (including leptin) from the IEU OpenGWAS database. We primarily utilized inverse variance weighted (IVW), weighted median, and MR-Egger methods, alongside MR-PRESSO and Cochran’s Q tests, to validate and assess the diversity and heterogeneity of our findings.Results: After applying the Bonferroni correction, we identified significant correlations between OSAS and increased neck circumference (Odds Ratio [OR]: 3.472, 95% Confidence Interval [CI]: 1.954– 6.169, P= 2.201E-05) and decreased high-density lipoprotein (HDL) cholesterol levels (OR: 0.904, 95% CI: 0.858– 0.952, P= 1.251E-04). Concurrently, OSAS was linked to lower leptin levels (OR: 1.355, 95% CI: 1.069– 1.718, P= 0.012) and leptin receptor levels (OR: 0.722, 95% CI: 0.530– 0.996, P= 0.047). Sensitivity analyses revealed heterogeneity in HDL cholesterol and leptin indicators, but further multiplicative random effects IVW method analysis confirmed these correlations as significant (P< 0.05) without notable heterogeneity or horizontal pleiotropy in other instrumental variables.Conclusion: This investigation compellingly supports the hypothesis that OSAS could be a genetic predisposition for elevated neck circumference, dyslipidemia, and adipokine imbalance. These findings unveil potential genetic interactions between OSAS and metabolic syndrome, providing new pathways for research in this domain. Future investigations should aim to delineate the specific biological pathways by which OSAS impacts metabolic syndrome. Understanding these mechanisms is critical for developing targeted prevention and therapeutic strategies.Keywords: sleep disorders, metabolic syndrome, causal inference, GWAS

Joe Bathelt, Kathleen Rastle, J. S. H. Taylor

B. Frauscher, C. Bénar, J. Engel et al.

Since the discovery of the human electroencephalogram (EEG), neurophysiology techniques have become indispensable tools in our armamentarium to localize epileptic seizures. New signal analysis techniques and the prospects of artificial intelligence and big data will offer unprecedented opportunities to further advance the field in the near future, ultimately resulting in improved quality of life for many patients with drug-resistant epilepsy. This article summarizes selected presentations from Day 1 of the two-day symposium "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". Day 1 was dedicated to highlighting and honoring the work of Dr. Jean Gotman, a pioneer in EEG, intracranial EEG, simultaneous EEG/ functional magnetic resonance imaging, and signal analysis of epilepsy. The program focused on two main research directions of Dr. Gotman, and was dedicated to "High-frequency oscillations, a new biomarker of epilepsy" and "Probing the epileptic focus from inside and outside". All talks were presented by colleagues and former trainees of Dr. Gotman. The extended summaries provide an overview of historical and current work in the neurophysiology of epilepsy with emphasis on novel EEG biomarkers of epilepsy and source imaging and concluded with an outlook on the future of epilepsy research, and what is needed to bring the field to the next level.

M. Smith, G. Risse, Viviane Sziklas et al.

This article summarizes selected presentations from a session titled "Cognition and Sensory Systems in Healthy and Diseased Subjects", held to highlight and honor the work of Dr. Marilyn Jones-Gotman. The session was part of a two-day symposium, "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". The session presented research on epilepsy and sensory systems by colleagues and former trainees of Dr. Jones-Gotman. The extended summaries provide an overview of historical and current work in the neuropsychology of epilepsy, neuropsychological and neuroimaging approaches to understanding brain organization, sex differences in brain mechanisms underlying neurological disorders, dietary influences on brain function and cognition, and expertise in olfactory training and language experiences and their implications for brain organization and structure.

Felicia A. Hardi, Leigh G. Goetschius, Scott Tillem et al.

Unstable and unpredictable environments are linked to risk for psychopathology, but the underlying neural mechanisms that explain how instability relate to subsequent mental health concerns remain unclear. In particular, few studies have focused on the association between instability and white matter structures despite white matter playing a crucial role for neural development. In a longitudinal sample recruited from a population-based study (N = 237), household instability (residential moves, changes in household composition, caregiver transitions in the first 5 years) was examined in association with adolescent structural network organization (network integration, segregation, and robustness of white matter connectomes; Mage = 15.87) and young adulthood anxiety and depression (six years later). Results indicate that greater instability related to greater global network efficiency, and this association remained after accounting for other types of adversity (e.g., harsh parenting, neglect, food insecurity). Moreover, instability predicted increased depressive symptoms via increased network efficiency even after controlling for previous levels of symptoms. Exploratory analyses showed that structural connectivity involving the left fronto-lateral and temporal regions were most strongly related to instability. Findings suggest that structural network efficiency relating to household instability may be a neural mechanism of risk for later depression and highlight the ways in which instability modulates neural development.

Steve Chung, Jurriaan M. Peters, Kamil Detyniecki et al.

Nasal administration of treatments for neurologic conditions, including rescue therapies to treat seizure clusters among people with epilepsy, represents a meaningful advance in patient care. Nasal anatomy and physiology underpin the multiple advantages of nasal administration but also present challenges that must be addressed in any successful nasal formulation. Nasal cavity anatomy is complex, with a modest surface area for absorption that limits the dose volume of an intranasal formulation. The mucociliary clearance mechanism and natural barriers of the nasal epithelia must be overcome for adequate absorption. An extensive vasculature and the presence of olfactory nerves in the nasal cavity enable both systemic and direct-to-brain delivery of drugs targeting the central nervous system. Two intranasal benzodiazepine rescue therapies have been approved by the US Food and Drug Administration for seizure-cluster treatment, in addition to the traditional rectal formulation. Nasal sprays are easy to use and offer the potential for quick and consistent bioavailability. This review aims to increase the clinician’s understanding of nasal anatomy and physiology and of the formulation of intranasal rescue therapies and to facilitate patient education and incorporate intranasal rescue therapies for seizure clusters (also known as acute repetitive seizures) into their seizure action plans.

Kirti Singhal, Surekha Chukkali

AbstractDespite the advances in studies conducted among healthcare professionals to explore the impact of the pandemic on their mental health, a large population still continues to display COVID-19 related psychological complaints. There has been recent awareness of moral injury related guilt and shame among doctors and nurses. However, the factors associated with moral injury have not received much attention, due to which the issue still persists. This study aims to explore the role of guilt-shame proneness, and locus of control in predicting moral injury among healthcare professionals. MISS-HP, PGI Locus of Control, and GASP scales were administered to a sample of 806 healthcare professionals. Pearson correlation coefficient indicated a significant positive relationship between moral injury and guilt-shame proneness, as well as the locus of control. Regression analysis indicated a significant role of guilt-shame proneness and locus of control in predicting moral injury. In conclusion, while studying moral injury, it becomes equally important to consider these factors to understand the concept better.

G. De Benedittis

Over the last decades hypnosis, which is the oldest psychotherapy, has matured as both as a fascinating topic for scientific research and an effective technique for clinical application. Hypnosis has been defined as “a state of consciousness involving focused attention and reduced, awareness characterized by an enhanced capacity for response to suggestion” (Elkins, Barabasz, Council, & Spiegel, 2015). In recent years, hypnotherapy practices have become increasingly popular in health care and education (Thompson et al., 2019). However, the neurophysiological and neuropsychological correlates of hypnosis experience and responses have not been fully explored and the mechanisms of action are not well understood. Consequently, many of the basic questions regarding the essential nature of hypnosis remain unanswered. Many changes and advances in the field of experimental hypnosis have transformed the research landscape with new theories, new methodologies, new findings. The current Special Issue is a survey of contemporary hypnosis research. To address some of these questions and improve understanding of hypnosis, leading researchers and clinicians have been invited to contribute their perspectives, research, and recommendations for future work. In this special issue, we include six peer reviewed articles addressing topics ranging from neural correlates of hypnosis and hypnotic analgesia, hypnotizability, neuropsychology, and emerging methodologies in hypnosis research. The articles in this special issue offer critical analysis, cutting edge research, clinical perspectives, and directions for future research and clinical practice. In taking stock, why do a consistent fraction of high hypnotizable subjects in the population (15%) survive to natural selection? It seems unlikely that it may have happened just due to their proneness to accept suggestions. Santarcangelo, Carli, and Sebastiani propose an intriguing, evolutionary interpretation of the highs, characterized by the presence of stronger functional equivalence between imagery and perception, favorable cardiovascular asset (i.e., better FMD or Flow Mediated Dilation following 5 minutes occlusion and preeminent parasympathetic control of heart rate), greater cortical excitability reducing their vulnerability to the consequences of brain injuries, ability to control pain in the absence of an efficient opioid mechanism, and greater interoceptive sensitivity. The authors hypothesize that these adaptive characteristics were greatly relevant to our ancestors’ survival, and that they may have facilitated the natural selection of individuals with hypnotic susceptibility due to the proneness to accept suggestions. From an evolutionary perspective the proneness to accept suggestions could be just a side effect of other physiological features, which were instead directly relevant to survival during human evolution. The role of hypnotic suggestibility, involuntariness, pain expectation, and subjective hypnotic depth in the prediction of placebo analgesia (PA) responsiveness have been explored by De Pascalis, Scacchia, and Vecchio. This study showed that placebo analgesia treatment coupled with suggestion effects was effective in pain reduction in both waking and hypnosis conditions. During waking, higher pain reductions were correlated with higher hypnotic suggestibility, subjective experience of hypnotic depth, pain expectation, and involuntariness in PA response, with involuntariness being the unique predictor of pain AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021, VOL. 63, NO. 4, 291–293 https://doi.org/10.1080/00029157.2021.1892411

G. De Benedittis

In recent years, hypnosis has become increasingly popular in health care and education (De Benedittis, 2020; Hauser, Hagl, Schmierer, & Hansen, 2016). However, the role of hypnosis has not been fully explored, and the mechanisms of action are not well understood. This Special Issue represents Part 2 of an outstanding effort of the American Journal of Clinical Hypnosis to explore and elucidate the neurophysiological and neuropsychological underpinnings of hypnotic processes and responses, in order to improve understanding of hypnotic practices. For Part 2 we invited six additional leading researchers and clinicians from all over the world to contribute their perspectives, research, and recommendations for future work. The articles in this special issue address some crucial questions, such as: the role of hypnotizability and, particularly, of medium-responders, which represent the majority of the general population; clinical pain and neural correlates in patients suffering from TemporoMandibular Disorder (TMD); the real essence of hypnosis and its axiological uncertainty; the effects of hypnotic relaxation response on psychophysical indices of ANS activity; the role of the anterior cingulate cortex in mediating neurocognitive and somatosensory aspects of the hypnotic experience; and the effects of hypnotic suggestions in modulating the pain matrix activity in chronic pain patients. These peer-reviewed articles provide fascinating insights into hypnosis processes and responses. Critical analysis, cutting-edge research, emerging perspectives, and future directions for research and practice are presented, filling the gap between basic research and clinical practice. In taking stock of the papers in this issue, Perri critically addresses one of the major methodological issues of hypnosis research which is that clinical and experimental investigations on hypnosis utilize dichotomous comparison between highs and lows while neglecting the medium responders who represent the majority of the general population. The main risk of this medium-neglecting bias is to overshadow the most common hypnotic effects. In addition, methodological reasons suggest that the within-subjects design should be preferred over the between-subjects research design. Abrahmsen and Naish comparatively evaluate experimentally induced pain, clinical pain, and neural correlates (i.e., blink reflex) in patients suffering from TemporoMandibular Disorder (TMD). Patients were able to reduce their chronic self-reported pain, reduce self-reported experimental pain, produce changes in brain responses, and demonstrate hardly any involvement of brainstem reflex pathways, suggesting a top-down rather than a bottom-up mechanism. Hypnotic analgesia effects in both conditions showed little, or even no correlation, with the measured hypnotic susceptibility, possibly due to limitations of the standard susceptibility scales, that contain items with sensory-motor behavioral responses, but not experiential, subjective items (Acunzo & Terhune, 2021). The authors argue that right cerebral hemisphere and anxiety might have a significant role in differentially modulating the pain experience. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021, VOL. 64, NO. 1, 1–3 https://doi.org/10.1080/00029157.2021.1953309

Han Chen, Xiao-Fen Zhou, Da-Wei Zhou et al.

Abstract Background To evaluate the impact of positive end-expiratory pressure (PEEP) on intracranial pressure (ICP) in animals with different respiratory mechanics, baseline ICP and volume status. Methods A total of 50 male adult Bama miniature pigs were involved in four different protocols (n = 20, 12, 12, and 6, respectively). Under the monitoring of ICP, brain tissue oxygen tension and hemodynamical parameters, PEEP was applied in increments of 5 cm H2O from 5 to 25 cm H2O. Measurements were taken in pigs with normal ICP and normovolemia (Series I), or with intracranial hypertension (via inflating intracranial balloon catheter) and normovolemia (Series II), or with intracranial hypertension and hypovolemia (via exsanguination) (Series III). Pigs randomized to the control group received only hydrochloride instillation while the intervention group received additional chest wall strapping. Common carotid arterial blood flow before and after exsanguination at each PEEP level was measured in pigs with intracranial hypertension and chest wall strapping (Series IV). Results ICP was elevated by increased PEEP in both normal ICP and intracranial hypertension conditions in animals with normal blood volume, while resulted in decreased ICP with PEEP increments in animals with hypovolemia. Increasing PEEP resulted in a decrease in brain tissue oxygen tension in both normovolemic and hypovolemic conditions. The impacts of PEEP on hemodynamical parameters, ICP and brain tissue oxygen tension became more evident with increased chest wall elastance. Compare to normovolemic condition, common carotid arterial blood flow was further lowered when PEEP was raised in the condition of hypovolemia. Conclusions The impacts of PEEP on ICP and cerebral oxygenation are determined by both volume status and respiratory mechanics. Potential conditions that may increase chest wall elastance should also be ruled out to avoid the deleterious effects of PEEP.

Teruhiko Higuchi, Tadafumi Kato, Mari Miyajima et al.

Abstract Background The current study evaluated the long-term (52 week) safety and impact on symptom measures of lurasidone (with or without lithium or valproate) for the treatment of bipolar I disorder in Japanese patients. Methods Bipolar patients for this open-label flexibly dosed lurasidone (20–120 mg/day) study were recruited from those with a recent/current depressive episode who completed an initial 6 week, double-blind, placebo-controlled, lurasidone study (depressed group), and those with a recent/current manic, hypomanic, or mixed episode (non-depressed group) who agreed to enroll directly into the long-term study. Measures of adverse events and safety included treatment-emergent adverse events, vital signs, body weight, ECG, laboratory tests, and measures of suicidality and extrapyramidal symptoms. Symptom measures included Montgomery Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Results The most common adverse events associated with lurasidone were akathisia (30.7%), nasopharyngitis (26.6%), nausea (12.1%), and somnolence (12.1%). Minimal changes in lipids and measures of glycemic control occurred. Mean change in body weight was + 1.0 kg in the non-depressed group and − 0.8 kg in the depressed group. MADRS total scores declined by a mean (SD) of 2.0 (14.7) points from long-term baseline to endpoint in the depressed group who had received placebo in the prior 6 week trial. The depressed group that had received lurasidone during the prior 6 week study maintained their depressive symptom improvements. For the non-depressed group, YMRS total scores decreased over time. Limitations No control group was included, treatment was open-label, and 49.7% of patients completed the 52 week study. Conclusions Long-term treatment with lurasidone 20–120 mg/day for Japanese patients with bipolar disorder maintained improvements in depressive symptoms for depressed patients who were treated in a prior 6 week trial and led to improvements in manic symptoms among a newly recruited subgroup of patients with a recent/current manic, hypomanic, or mixed episode. Few changes in weight or metabolic parameters were evident. Clinical trial registration: JapicCTI-132319, clinicaltrials.gov—NCT01986114.

Keith Press

Gary Shkedy, Dalia Shkedy, Aileen H. Sandoval-Norton et al.

Per the Centers for Disease Control, approximately 31% of children with Autism Spectrum Disorder (ASD) are classified as intellectually disabled and between 25% and 50% of children with ASD do not develop functional verbal communication. This study was conducted to test the effectiveness of Visual Communication Analysis (VCA) as a method to teach communication and reduce maladaptive behaviors in non-verbal children with severe autism. VCA is the application of a well-established theory of motivation-The Self-Determination Theory. Since it is currently impossible to test the IQ of this subset of children with standard measures, changes in the number of letters typed correctly per minute was used to measure of progress. An additional measure used was the frequency of maladaptive behaviors at the beginning of the study compared to the frequency at the end of the study. Using both of these measures, individuals utilizing VCA in this study showed statistically significant improvements in communication as well as a decrease in maladaptive behaviors. In addition to demonstrating the efficacy of VCA, these results lead to the questioning of the validity of the original diagnosis of intellectual disability given to this subset of children with ASD. Results also highlight the need for continued research and application of well-established theories of motivation to the special needs population.

M. Kaga

Wasan Abd Wahab, Kathy Collinson, Donald W Gross

We report a case of a 52-year-old man with drug-resistant temporal lobe epilepsy, with post-ictal violent aggressive behaviors. Postictal violent outbursts would occur 3–4 times per year following clusters of seizures or generalized tonic–clonic convulsions. The violent outbursts were traumatizing for his family, and lead to multiple emergency department presentations as well as conflicts with police over the course of nine years. After initiation of pindolol the patient has had no episodes of violent behavior in two years despite experiencing the same frequency and severity of seizures as before pindolol. The abrupt cessation of postictal violent outbursts after introduction of pindolol in this case provides a novel management option for the treatment of postictal violence in patients with drug-resistant epilepsy and supports the importance of the beta adrenergic and potentially serotonergic systems in postictal violent behavior.

A. Mitz, Ravi V. Chacko, Philip T. Putnam et al.

M. Pąchalska, Jolanta Góral-Półrola, A. Mueller et al.

Johanna Buchcik, Joachim Westenhöfer, Mick Fleming et al.

Objective: The Sf-36 is the most widely used instrument to measure health-related quality of life (HRQoL) with the most convincing evidence of both internal consistency and test–retest reliability. In addition, it is appropriate for use among elderly and minority groups like migrants. The aim of this study is to investigate and compare the reliability and the factorial structure of the Sf-36 in a sample of elderly migrants and natives. The hypothesis is that the construct (the HRQoL consisting of eight dimensions correlated with two components) is the same for elderly Turkish migrants, Polish migrants and German natives. This means that the Sf-36 model shows good psychometric properties and model invariance for the three groups investigated in this study. Methods: The Sf-36 v.2 was forward and backward translated to Turkish and Polish. In this cross-sectional study, interviews were conducted with a sample of elderly migrants from Turkey (n = 100), from Poland (n = 103) and a sample of elderly German natives (n = 101). All data were entered and analysed using SPSS version 21 and AMOS Graphics. Cronbach’s α was used to analyse the reliability of the Sf-36. Multi-group confirmatory factor analysis (MGCFA) and structural equation modelling (SEM) were used for the Sf-36 model invariance testing. Results: The reliability of the Sf-36 was good to excellent for all Sf-36 dimensions (α > 0.7) except for General Health (0.55) in the Polish group. Multi-group confirmatory factor analysis (MGCFA) showed non-invariance between the three groups (CMIN: 180.172, df: 51, CMIN/df: 3.533, p < 0.001, CFI: 0.895, RMSEA: 0.092 for the unconstrained model). Model modifications resulted in a good model fit for the Polish group. However, an applicable common Sf-36 model for the three groups was not attained. Conclusion: This study doesn’t support the idea that the factorial structure of the Sf-36 with two components and eight dimensions is the same across three ethnically and culturally diverse groups of elderly subjects. Therefore, comparing subscale scores of the Sf-36 between different ethnic groups may be problematic.