http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Thu, 16 May 2013 08:59:10 +0000 http://www.hindawi.com/isrn/neurology/2013/964572/ Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system (CNS) in young adults. The proinflammatory cytokines such as interferon-gamma (IFN-), tumor necrosis factor-alpha (TNF-), and nitric oxide (NO) which are known to be produced by inflammatory cells play a key role in the pathogenesis of MS. Some metabolic changes may have an effect on axonal transmission, and white blood cells NO and other inflammatory mediators such as cytokines may be affected from cooling process. In this study, we evaluated the effects of body cooling procedure on proinflammatory cytokines such as TNF-, IFN-, and NO levels. Twenty patients with MS were evaluated. Thirteen of the patients were women, 7 were men (mean age:  yrs.). Body temperature was reduced by an average of 1°C approximately in 1 hour with using the “Medivance Arctic Sun Temperature Management System” device. In our study, the decrease in TNF-, IFN- levels after the cooling procedure has no statistical significance, whereas the decrease in the mean level of NO level after the cooling procedure is  mol/L which has statistical significance (). These results suggested that the decrease in NO level improves conduction block in demyelinated axonal segments after cooling procedure in multiple sclerosis. Turan Poyraz, Egemen Idiman, Sezer Uysal, Leyla Iyilikci, Serkan Özakbaş, Esra Coskuner Poyraz, and Fethi Idiman Copyright © 2013 Turan Poyraz et al. All rights reserved. Wed, 08 May 2013 08:38:11 +0000 http://www.hindawi.com/isrn/neurology/2013/201719/ In the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), autistic characteristics in social interaction and communication are described as qualitative impairments. However, the difference between autistics and nonautistics in the draft of the 5th edition (DSM-5 draft) is quantitative rather than qualitative. The word “qualitative” is deleted in the draft text, and it is specified that the relation between social demands and individual limited capacities is critical for symptom manifestation (criterion C). Because the proposed levels of support requirement in the draft are mere observable outcomes of social vulnerability, the boundary between level 1 and nonautistic condition is determined by the relation between social demands and individual capacities. In addition to the introduction of the single category (autism spectrum disorder (ASD)) to cover the entire case spectrum, the DSM-5 draft is clearly based on a conviction that ASD is indistinguishable from the normal behavioral range. This concise review provides an explanation for this implicit paradigm shift from qualitative to quantitative. Importantly, the conditional role of social demands for symptom manifestation in the draft can be plausibly interpreted using a unique liability-probability model. Shinji Ijichi, Naomi Ijichi, Yukina Ijichi, Kazumi Hirotaki, Hisami Sameshima, Yoichi Kawaike, and Hirofumi Morioka Copyright © 2013 Shinji Ijichi et al. All rights reserved. Tue, 07 May 2013 15:12:26 +0000 http://www.hindawi.com/isrn/neurology/2013/875834/ The absence epilepsy typical electroencephalographic pattern of sharp spikes and slow waves (SWDs) is considered to be due to an interaction of an initiation site in the cortex and a resonant circuit in the thalamus. The hyperpolarization-activated cyclic nucleotide-gated cationic Ih pacemaker channels (HCN) play an important role in the enhanced cortical excitability. The role of thalamic HCN in SWD occurrence is less clear. Absence epilepsy in the WAG/Rij strain is accompanied by deficiency of the activity of dopaminergic system, which weakens the formation of an emotional positive state, causes depression-like symptoms, and counteracts learning and memory processes. It also enhances GABAA receptor activity in the striatum, globus pallidus, and reticular thalamic nucleus, causing a rise of SWD activity in the cortico-thalamo-cortical networks. One of the reasons for the occurrence of absences is that several genes coding of GABAA receptors are mutated. The question arises: what the role of DA receptors is. Two mechanisms that cause an infringement of the function of DA receptors in this genetic absence epilepsy model are proposed. A. S. Bazyan and G. van Luijtelaar Copyright © 2013 A. S. Bazyan and G. van Luijtelaar. All rights reserved. Tue, 30 Apr 2013 11:09:37 +0000 http://www.hindawi.com/isrn/neurology/2013/417194/ Objective. The purpose of this review of the literature was to summarise studies regarding the psychosocial impact of growing up with a sibling with autism and to identify gaps in the related literature. Methods. Electronic databases were reviewed in order to critically appraise the 14 articles relevant to the topic. The search included a combination of the following key words: autism*, quality of life, well-being, sibling*, ASD, ASD sibling*, family, adjust*, psychological functioning. Results. The majority of studies involved mixed children and adolescent samples, leading to confounding results and an inability to draw accurate conclusions about these distinct life stages. Autism appears to contribute to unique environmental stressors for the typically developing sibling. When experienced in the context of additional demographic risk factors, these stressors can result in difficulties adjusting to the demands of a special-needs child. Despite some vulnerability to behavioural and emotional dysfunction in at-risk children, siblings have the potential to not only adjust but to thrive in the face of disability adversity. Conclusion. Growing up with a sibling with autism appears to manifest in both positive and negative outcomes for siblings, depending upon important demographical, family, and individual variables. Laura Green Copyright © 2013 Laura Green. All rights reserved. Tue, 30 Apr 2013 10:14:59 +0000 http://www.hindawi.com/isrn/neurology/2013/375852/ Noncoding RNAs are widely known for their various essential roles in the development of central nervous system. It involves neurogenesis, neural stem cells generation, maintenance and maturation, neurotransmission, neural network plasticity, formation of synapses, and even brain aging and DNA damage responses. In this review, we will discuss the biogenesis of microRNA, various functions of noncoding RNA's specifically microRNAs (miRNAs) that act as the chief regulators of gene expression, and focus in particular on misregulation of miRNAs which leads to several neurodegenerative diseases as well as its therapeutic outcome. Recent evidences has shown that miRNAs expression levels are changed in patients with neurodegenerative diseases; hence, miRNA can be used as a potential diagnostic biomarker and serve as an effective therapeutic tool in overcoming various neurodegenerative disease processes. Shraddha D. Rege, Thangiah Geetha, Satyanarayana R. Pondugula, Claire A. Zizza, Catherine M. Wernette, and Jeganathan Ramesh Babu Copyright © 2013 Shraddha D. Rege et al. All rights reserved. Sun, 28 Apr 2013 14:54:02 +0000 http://www.hindawi.com/isrn/neurology/2013/152076/ Directed carotid cavernous fistula means high blood flow shunts between the internal carotid artery and the cavernous sinus. Obstructing the abnormal shunt between the internal carotid artery and the cavernous sinus while preserving the internal carotid artery is the key role in fistula treatment. Transarterial balloon embolization is currently the gold standard treatment for most of the carotid cavernous fistulas. But there are still some technical difficulties in the use of detachable balloon to treat carotid cavernous fistulas. Here, we describe undetachable balloon-assisted technique in the embolization of three patients who got complete immediate occlusion of the shunt and preserved the internal carotid artery at the same time. Ning Xu, Yubo Wang, Qi Luo, and Honglei Wang Copyright © 2013 Ning Xu et al. All rights reserved. Thu, 18 Apr 2013 17:16:03 +0000 http://www.hindawi.com/isrn/neurology/2013/147065/ Background. Our aim was to investigate the association between migraine, tension type headache, and metabolic syndrome. Methods. Presence of tension type headache and migraine was investigated in 120 patients diagnosed as metabolic syndrome. The severity of the headache was recorded according to the visual analog scale. Results. Mean age of the patients was years (range, 29–84 yrs). Diagnoses of tension type headache and migraine without aura were made for 39 (32.5%) and 18 (15%) patients, respectively. Mean age of migraine patients was significantly lower relative to the patients with tension type headache and no headache. Incidence of hypertriglyceridemia was significantly higher in migraine patients when compared with cases tension type headache and without headache. In the tension type headache group, requirement for analgesics decreased as HDL cholesterol levels increased, while need for analgesic drugs increased in line with higher diastolic blood pressures. In the migraine group duration of headache was found to be prolonged with decreasing HDL cholesterol levels. Conclusion. In patients presenting with headache, its association with metabolic syndrome should be considered, and the patients should be especially observed with respect to response to analgesic and the presence of hypertension and hyperlipidemia. Eren Gozke, Muge Unal, Hayriye Engin, and Nurbanu Gurbuzer Copyright © 2013 Eren Gozke et al. All rights reserved. Thu, 14 Mar 2013 08:50:35 +0000 http://www.hindawi.com/isrn/neurology/2013/892459/ Frontal lobe syndromes, better termed as frontal network systems, are relatively unique in that they may manifest from almost any brain region, due to their widespread connectivity. The understandings of the manifold expressions seen clinically are helped by considering evolutionary origins, the contribution of the state-dependent ascending monoaminergic neurotransmitter systems, and cerebral connectivity. Hence, the so-called networktopathies may be a better term for the syndromes encountered clinically. An increasing array of metric tests are becoming available that complement that long standing history of qualitative bedside assessments pioneered by Alexander Luria, for example. An understanding of the vast panoply of frontal systems' syndromes has been pivotal in understanding and diagnosing the most common dementia syndrome under the age of 60, for example, frontotemporal lobe degeneration. New treatment options are also progressively becoming available, with recent evidence of dopaminergic augmentation, for example, being helpful in traumatic brain injury. The latter include not only psychopharmacological options but also device-based therapies including mirror visual feedback therapy. Michael Hoffmann Copyright © 2013 Michael Hoffmann. All rights reserved. Tue, 05 Mar 2013 13:55:05 +0000 http://www.hindawi.com/isrn/neurology/2013/124390/ To date there is only one single-center study that has exclusively reported characteristics, location, and outcomes of spontaneous intracerebral hemorrhages (ICH) among cocaine users. We aimed to describe the radiological location and characteristics along with clinical outcomes of spontaneous ICH in a similar population. We conducted a retrospective chart review of consecutive patients admitted to a tertiary care hospital, with a spontaneous ICH, who had a urine drug screen performed within 48 hours of admission. Exposure to cocaine was defined by a positive urine drug screen within 48 hours of hospital admission. Demographics, radiographic features of ICH, and short-term clinical outcomes of patients with a positive urine drug screen were analyzed and compared with the cocaine negative group. Among the 102 patients analyzed, 20 (19.6%) had documented exposure to cocaine. There was a predominance of males in both groups with significantly more Blacks in the cocaine positive group (). A statistically significant number of patients with cocaine use had ICH in a subcortical location () when compared to cocaine negative patients. There was no difference in GCS, ICH volume, intraventricular extension, ICU days, hospital days, hospital cost, mortality, and ICH score. ICH in cocaine use is more frequently seen in the subcortical location. Abubakr A. Bajwa, Scott Silliman, James D. Cury, Vandana Seeram, Adil Shujaat, Faisal Usman, and Vinny Samuel Copyright © 2013 Abubakr A. Bajwa et al. All rights reserved. Wed, 27 Feb 2013 08:44:49 +0000 http://www.hindawi.com/isrn/neurology/2013/892072/ Evidence suggests that cognitive performance deteriorates in noisy backgrounds and the problems are more pronounced in older people due to brain deficits and changes. The present study used functional MRI (fMRI) to investigate the neural correlates of this phenomenon during short-term memory using a forward repeat task performed in quiet (STMQ) and in noise: 5-dB SNR (STMN) on four groups of participants of different ages. The performance of short-term memory tasks was measured behaviourally. No significant difference was found across age groups in STMQ. However, older adults (50–65 year olds) performed relatively poorly on the STMN. fMRI results on the laterality index indicate changes in hemispheric laterality in the superior temporal gyrus (STG), Heschl’s gyrus (HG), and cerebellum, and a leftward asymmetry in younger participants which changes to a more rightward asymmetry in older participants. The results also indicate that the onset of the laterality shift varies from one brain region to another. STG and HG show a late shift while the cerebellum shows an earlier shift. The results also reveal that noise influences this shifting. Finally, the results support the hypothesis that functional networks that underlie STG, HG, and cerebellum undergo reorganization to compensate for the neural deficit/cognitive decline. Hanani Abdul Manan, Ahmad Nazlim Yusoff, Elizabeth A. Franz, and Siti Zamratol-Mai Sarah Mukari Copyright © 2013 Hanani Abdul Manan et al. All rights reserved. Thu, 07 Feb 2013 15:38:47 +0000 http://www.hindawi.com/isrn/neurology/2013/908317/ Purpose. The aim of this study was to develop a streamlined mutation screening protocol for the DMD gene in order to confirm a clinical diagnosis of Duchenne or Becker muscular dystrophy in affected males and to clarify the carrier status of female family members. Methods. Sequence analysis and array comparative genomic hybridization (aCGH) were used to identify mutations in the dystrophin DMD gene. We analysed genomic DNA from six individuals with a range of previously characterised mutations and from eight individuals who had not previously undergone any form of molecular analysis. Results. We successfully identified the known mutations in all six patients. A molecular diagnosis was also made in three of the four patients with a clinical diagnosis who had not undergone prior genetic screening, and testing for familial mutations was successfully completed for the remaining four patients. Conclusion. The mutation screening protocol described here meets best practice guidelines for molecular testing of the DMD gene in a diagnostic laboratory. The aCGH method is a superior alternative to more conventional assays such as multiplex ligation-dependent probe amplification (MLPA). The combination of aCGH and sequence analysis will detect mutations in 98% of patients with the Duchenne or Becker muscular dystrophy. Renate Marquis-Nicholson, Daniel Lai, Chuan-Ching Lan, Jennifer M. Love, and Donald R. Love Copyright © 2013 Renate Marquis-Nicholson et al. All rights reserved. Thu, 17 Jan 2013 14:27:52 +0000 http://www.hindawi.com/isrn/neurology/2013/451429/ The strategies used to perform a verbal fluency task appear to be reflective of cognitive abilities necessary for successful daily functioning. In the present study, we explored potential differences in verbal fluency strategies (switching and clustering) used to maximize word production by patients with relapsing-remitting multiple sclerosis (RRMS) versus patients with secondary progressive multiple sclerosis (SPMS). We further assessed impairment rates and potential differences in the sensitivity and specificity of phonological versus semantic verbal fluency tasks in discriminating between those with a diagnosis of MS and healthy adults. We found that the overall rate of impaired verbal fluency in our MS sample was consistent with that in other studies. However, we found no differences between types of MS (SPMS, RRMS), on semantic or phonological fluency word production, or the strategies used to maximize semantic fluency. In contrast, we found that the number of switches differed significantly in the phonological fluency task between the SPMS and RRMS subtypes. The clinical utility of semantic versus phonological fluency in discriminating MS patients from healthy controls did not indicate any significant differences. Further, the strategies used to maximize performance did not differentiate MS subgroups or MS patients from healthy controls. L. Messinis, M. H. Kosmidis, C. Vlahou, A. C. Malegiannaki, G. Gatzounis, N. Dimisianos, A. Karra, G. Kiosseoglou, P. Gourzis, and P. Papathanasopoulos Copyright © 2013 L. Messinis et al. All rights reserved. Thu, 10 Jan 2013 15:54:53 +0000 http://www.hindawi.com/isrn/neurology/2013/592398/ Testosterone has been shown to worsen histological and neurological impairment during cerebral ischemia in animal models. Cell culture studies revealed that testosterone is implicated in protecting neural and glial cells against insults, and they started to elucidate testosterone pathways that underlie these protective effects. These studies support the hypothesis that testosterone can be neuroprotective throughout an episode of cerebral ischemia. Therefore, we evaluated the mechanisms underlying the shift between testosterone protective and deleterious effects via block testosterone aromatization and androgen receptors in rats subjected to 60-minute middle cerebral artery occlusion. Fifty rats were divided into five equal groups: gonadally intact male; castrated male; intact male + flutamide; intact male + letrozole; intact male + combination flutamide and letrozole. Our results indicated that castration has the ability to reduce histological damage and to improve neurological score 24 hours after middle cerebral artery occlusion. Moreover, flutamide improved histologic and neurological impairment better than castration. Letrozole induced increases in striatal infarct volume and seizures in gonadally intact rats. Combination of flutamide and letrozole showed that letrozole can reverse beneficial effects of flutamide. In conclusion, it seems that the beneficial effects of flutamide are the prevention of the deleterious effects and enhancement of neuroprotective effects of testosterone during cerebral ischemia. Hamed Fanaei, Hamid Reza Sadeghipour, Seyed Morteza Karimian, and Gholamreza Hassanzade Copyright © 2013 Hamed Fanaei et al. All rights reserved. Sun, 30 Dec 2012 10:24:33 +0000 http://www.hindawi.com/isrn/neurology/2012/769412/ Myelinating glia, oligodendrocytes in central nervous system and Schwann cells in peripheral nervous system, form myelin sheath, a multilayered membrane system around axons enabling salutatory nerve impulse conduction and maintaining axonal integrity. Myelin sheath is a polarized structure localized in the axonal side and therefore is supposed to be formed based on the preceding polarization of myelinating glia. Thus, myelination process is closely associated with polarization of myelinating glia. However, cell polarization has been less extensively studied in myelinating glia than other cell types such as epithelial cells. The ultimate goal of this paper is to provide insights for the field of myelination research by applying the information obtained in polarity study in other cell types, especially epithelial cells, to cell polarization of myelinating glia. Thus, in this paper, the main aspects of cell polarization study in general are summarized. Then, they will be compared with polarization in oligodendrocytes. Finally, the achievements obtained in polarization study for epithelial cells, oligodendrocytes, and other types of cells will be translated into polarization/myelination process by Schwann cells. Then, based on this model, the perspectives in the study of Schwann cell polarization/myelination will be discussed. Toshihiro Masaki Copyright © 2012 Toshihiro Masaki. All rights reserved. Sat, 29 Dec 2012 18:42:30 +0000 http://www.hindawi.com/isrn/neurology/2012/613595/ Aims. While studies on healthy subjects have shown a partial overlap between the motor execution and motor imagery neural circuits, few have investigated brain activity during motor imagery in stroke patients with hemiparesis. This work is aimed at examining similarities between motor imagery and execution in a group of stroke patients. Materials and Methods. Eleven patients were asked to perform a visuomotor tracking task by either physically or mentally tracking a sine wave force target using their thumb and index finger during fMRI scanning. MIQ-RS questionnaire has been administered. Results and Conclusion. Whole-brain analyses confirmed shared neural substrates between motor imagery and motor execution in bilateral premotor cortex, SMA, and in the contralesional inferior parietal lobule. Additional region of interest-based analyses revealed a negative correlation between kinaesthetic imagery ability and percentage BOLD change in areas 4p and 3a; higher imagery ability was associated with negative and lower percentage BOLD change in primary sensorimotor areas during motor imagery. Linda Confalonieri, Giuseppe Pagnoni, Lawrence W. Barsalou, Justin Rajendra, Simon B. Eickhoff, and Andrew J. Butler Copyright © 2012 Linda Confalonieri et al. All rights reserved. Sun, 23 Dec 2012 10:14:54 +0000 http://www.hindawi.com/isrn/neurology/2012/786872/ This review focuses on three main topics related to the nature of poststroke language recovery and reorganization. The first topic pertains to the nature of anatomical and physiological substrates in the infarcted hemisphere in poststroke aphasia, including the nature of the hemodynamic response in patients with poststroke aphasia, the nature of the peri-infarct tissue, and the neuronal plasticity potential in the infarcted hemisphere. The second section of the paper reviews the current neuroimaging evidence for language recovery in the acute, subacute, and chronic stages of recovery. The third and final section examines changes in connectivity as a function of recovery in poststroke aphasia, specifically in terms of changes in white matter connectivity, changes in functional effective connectivity, and changes in resting state connectivity after stroke. While much progress has been made in our understanding of language recovery, more work needs to be done. Future studies will need to examine whether reorganization of language in poststroke aphasia corresponds to a tighter, more coherent, and efficient network of residual and new regions in the brain. Answering these questions will go a long way towards being able to predict which patients are likely to recover and may benefit from future rehabilitation. Swathi Kiran Copyright © 2012 Swathi Kiran. All rights reserved. Sat, 22 Dec 2012 12:13:21 +0000 http://www.hindawi.com/isrn/neurology/2012/451457/ Although therapy switch is common among patients with multiple sclerosis (MS), sometimes the initial prescribed treatment is maintained for a long period with clinical stability, low disability, and nonsignificant side effects. We aim to describe demographic and clinical characteristics of patients treated in our MS clinic with the same disease-modifying drug (DMD) lasting for >12 years. From the cohort of 51 patients followed in our MS clinic with relapse-remitting MS who started an DMD between 1996 and 1999, we found a high percentage (51%) of patients who were efficiently treated with the first DMD. These patients were mainly females, with low annualized relapse rate and Multiple Sclerosis Severity Score (MSSS). Our results may be related to the open and multidisciplinary model of our MS clinic organization. Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness. Ana Teresa Carvalho and Maria José Sá Copyright © 2012 Ana Teresa Carvalho and Maria José Sá. All rights reserved. Thu, 13 Dec 2012 07:41:05 +0000 http://www.hindawi.com/isrn/neurology/2012/372030/ In advanced-stage Parkinson’s disease (PD), motor fluctuation is a frequent and disabling problem. Assessment of motor fluctuation depends on patient’s subjective self-statement. We examined whether the subjective fluctuation matched the objective motor fluctuation defined by gait disorders. Using a new device, the portable gait rhythmogram, we recorded gait cadence and acceleration continuously over the 24-hour period in 54 patients with PD and 17 normal controls, for the quantitative evaluation of motor fluctuation. The patients were asked to estimate motor fluctuation every hour. In 44 of 54 patients, changes in the cadence were associated with simultaneous changes in acceleration. We examined the subjective fluctuation in these 44 patients who were confirmed to have motor fluctuation. Nineteen (82.7%) of 23 patients who felt no fluctuation showed distinct gait disorders. During off time, they walked with marked short or bradykinetic stepping. No matching changes were observed in either the cadence or acceleration in 11 (52.4%) of 21 patients who perceived motor fluctuation. No synchronization was noted in 30 (68.2%) of the 44 patients, between the times of subjectively assessed motor fluctuation and those of quantitative analysis of gait disorder. This discrepancy suggests that the objective continuous recording of the cadence and acceleration is necessary to understand motor fluctuation. Hiroya Utsumi, Hiroo Terashi, Yohei Ishimura, Tomoko Takazawa, Yasuyuki Okuma, Mitsuru Yoneyama, and Hiroshi Mitoma Copyright © 2012 Hiroya Utsumi et al. All rights reserved. Tue, 04 Dec 2012 18:01:18 +0000 http://www.hindawi.com/isrn/neurology/2012/637453/ Autism is a pervasive neurodevelopment disorder, primarily encompassing difficulties in the social, language, and communicative domains. One of the most common social cognitive theories of autism is based on theory of mind (ToM), the “mentalizing” ability needed to infer that others have their own beliefs and desires in order to understand their behavior. In the current study, this hypothesis was tested using Wellman and Liu's scaled ToM tasks. These were employed in the assessment of ToM development of verbal, school-aged high-functioning boys with autism spectrum disorder (ASD). The results indicated that children with ASD performed significantly worse than normal children on ToM tasks (; ). However, it was shown that some of the ASD children were able to pass desire and false-belief tasks whereas none of them could succeed in knowledge and real-apparent emotion tasks. Abbas Bakhshipour, Majid Mahmood Aliloo, Hassan Shahrokhi, Toraj Hashemi, Shahrokh Amiri, Leila Mehdizadeh Fanid, Neda Yadegari, and Farzin Hagnazari Copyright © 2012 Abbas Bakhshipour et al. All rights reserved. Sun, 25 Nov 2012 14:15:30 +0000 http://www.hindawi.com/isrn/neurology/2012/410629/ Background. Studies on the clinical course of multiple sclerosis have indicated that certain initial clinical factors are predictive of disease progression. Regions with a low prevalence for disease, which have environmental and genetic factors that differ from areas of high prevalence, lack studies on the progressive course and disabling characteristics of the disease. Objective. To analyse the long-term evolution to the progressive phase of the relapsing-remitting multiple sclerosis and its prognosis factors in mixed population. Methods. We performed a survival study and logistic regression to examine the influence of demographic and initial clinical factors on disease progression. Among 553 relapsing-remitting patients assisted at a Brazilian reference centre for multiple sclerosis, we reviewed the medical records of 150 patients who had a disease for ten or more years. Results. African ancestry was a factor that conferred more risk for secondary progression followed by age at the onset of the disease and the number of relapses in the year after diagnosis. A greater understanding of the influence of ancestry on prognosis serves to stimulate genetics and pharmacogenomics research and may clarify the poorly understood neurodegenerative progression of MS. Claudia Cristina Ferreira Vasconcelos, Gutemberg Augusto Cruz dos Santos, Luiz Claudio Thuler, Solange Maria Camargo, and Regina Maria Papais Alvarenga Copyright © 2012 Claudia Cristina Ferreira Vasconcelos et al. All rights reserved. Wed, 14 Nov 2012 11:13:16 +0000 http://www.hindawi.com/isrn/neurology/2012/924081/ Purpose. To evaluate the clinical utility of dense array electroencephalography (dEEG) for detecting and localizing interictal spikes in temporal lobe epilepsy. Methods. Simultaneous invasive and noninvasive recordings were performed across two different groups. (1) The first group underwent both noninvasive recording with 128 channels of (scalp) dEEG and invasive sphenoidal electrode recording. (2) The second group underwent both noninvasive recording with 256 channels of (scalp) dEEG and invasive intracranial EEG (icEEG) involving coverage with grids and strips over the lateral and mesial temporal lobe. A noninvasive to noninvasive comparison was made comparing the overall spike detection rate of the dEEG to that of conventional 10/20 EEG. A noninvasive to invasive comparison was made comparing the spike detection rate of dEEG to that of conventional 10/20 EEG plus sphenoidal electrodes. And finally, a noninvasive to invasive evaluation measuring the source localization ability of the dEEG using the icEEG as validation. Results. In the 128-channel dEEG study (1), 90.4% of the interictal spikes detected by the dEEG were not detected in the 10/20 montage. 91% of the dEEG-detected spikes were accurately localized to the medial temporal lobe. In the 256-channel dEEG study (2), 218 of 519 interictal spikes (42%) were detected by dEEG. 85% of these spikes were accurately localized to the medial temporal lobe, close to the position confirmed by subdural electrodes. Conclusion. Dense array EEG may provide more precise information than conventional EEG and has a potential for providing an alternative to sphenoidal electrode monitoring in patients with temporal lobe epilepsy. Madoka Yamazaki, Marie Terrill, Ayataka Fujimoto, Takamichi Yamamoto, and Don M. Tucker Copyright © 2012 Madoka Yamazaki et al. All rights reserved. Wed, 14 Nov 2012 09:31:36 +0000 http://www.hindawi.com/isrn/neurology/2012/907187/ Objective. The aim of our prospective study was to investigate the applicability and the diagnostic value of near-infrared spectroscopy (NIRS) in SAH patients using the cerebral oximeter INVOS 5100C. Methods. Measurement of cerebral oximetry was done continuously after spontaneous SAH. Decrease of regional oxygen saturation (rSO2) was analyzed and interpreted in view of the determined intrinsic and extrinsic factors. Changes of rSO2 values were matched with the values of ICP, tipO2, and TCD and the results of additional neuroimaging. Results. Continuous measurement of rSO2 was performed in nine patients with SAH (7 females and 2 males). Mean measurement time was 8.6 days (range 2–12 days). The clinical course was uneventful in 7 patients without occurrence of CVS. In these patients, NIRS measured constant and stable rSO2 values without relevant alterations. Special findings are demonstrated in 3 cases. Conclusion. Measurement of rSO2 with NIRS is a safe, easy to use, noninvasive additional measurement tool for cerebral oxygenation, which is used routinely during vascular and cardiac surgical procedures. NIRS is applicable over a long time period after SAH, especially in alert patients without invasive probes. Our observations were promising, whereby larger studies are needed to answer the open questions. Homajoun Maslehaty, Ulf Krause-Titz, Athanassios K. Petridis, Harald Barth, and Hubertus Maximilian Mehdorn Copyright © 2012 Homajoun Maslehaty et al. All rights reserved. Thu, 01 Nov 2012 16:18:30 +0000 http://www.hindawi.com/isrn/neurology/2012/792192/ Background. Clinically isolated syndrome (CIS) is the first neurologic episode of multiple sclerosis (MS). Magnetic resonance imaging (MRI) and clinical features are used to predict risk of conversion to MS. Objectives. The aim of this prospective study is to evaluate predictors of conversion of CIS to McDonald MS. Method. 97 patients with CIS have been followed for 2 years. Age of onset, gender, initial clinical presentation, and MRI brain and spine were assessed. The 2010 revised McDonald criteria were applied. Results. Fifty-nine patients (60.8%) with CIS converted to McDonald MS after 10.1 4.2 months. Thirty-seven (38.1%) of the convertors satisfied the diagnostic criteria based on the radiological parameters, while 21.7% sustained their second clinical events. A multivariate regression analysis revealed that high number of lesions in MRI () and earlier age of onset () predicted the conversion of CIS to McDonald MS. Gender () and initial clinical presentation (optic pathway (), supratentorial (), brain stem/ cerebellum (), and spinal ()) were not statistically significant. Conclusion. Age of onset and MRI parameters can be used as predictors of CIS conversion to McDonald MS. Application of the 2010 revised McDonald criteria allows an earlier MS diagnosis. R. Alroughani, J. Al Hashel, S. Lamdhade, and S. F. Ahmed Copyright © 2012 R. Alroughani et al. All rights reserved. Wed, 31 Oct 2012 09:56:51 +0000 http://www.hindawi.com/isrn/neurology/2012/316097/ Purpose. People with Multiple Sclerosis (PwMS) tent to have increased levels of fatigue which can impact on their balance and increase risk of falls. However, the relationship between fatigue and balance is poorly understood. The aim of the present study was to assess if an experimentally induced fatigue had an immediate effect on balance. Methods. 37 inpatients with multiple sclerosis were recruited; the mean age (standard deviation) was 48.7 (9.6) years. The average onset of the pathology was 15.3 (9.8) years before the start of the study. The median (1°–3° quartile) Expanded Disability Status Scale (EDSS) score was 5.5 (4.5–6.0). Before and after a fatiguing treadmill, session, subjects were assessed with the Berg Balance Scale and Dynamic Gait Index. Results. After the treadmill, no statistically significant differences were found in balance before and after a treadmill session (monopodalic stance: before 5.3s (10.3) and after 7.7s (13.9); walk with horizontal head turns: before 11.6 (6.9) seconds and after 11.3 (7.7)). There was no correlation between the EDSS score and the difference in balance skills before and after treadmill. Conclusion. After treadmil PwMS were mentally and physically fatigued; however, their balance performance did not change, indicating no increase in risk of falling with fatigue. Elisa Gervasoni, Davide Cattaneo, Angelo Montesano, and Johanna Jonsdottir Copyright © 2012 Elisa Gervasoni et al. All rights reserved. Tue, 16 Oct 2012 16:22:10 +0000 http://www.hindawi.com/isrn/neurology/2012/306816/ To examine the range of gait acceleration and cycle in daily walking of patients with Parkinson’s disease (PD), we compared the gait of 40 patients with PD and 17 normal controls by using a newly developed long-term monitoring device that extracts gait-related accelerations from overall movements-related accelerations. The range of change in gait acceleration, relative to the control, was less than 75% in 12 patients. The range of change in gait cycle was less than 75% in 8 patients. The range of changes in both parameters was less than 75% in 4 patients. The results suggest narrow changes in gait parameters in PD. Hiroo Terashi, Hiroya Utsumi, Yohei Ishimura, Tomoko Takazawa, Yasuyuki Okuma, Mitsuru Yoneyama, and Hiroshi Mitoma Copyright © 2012 Hiroo Terashi et al. All rights reserved. Sun, 14 Oct 2012 16:28:13 +0000 http://www.hindawi.com/isrn/neurology/2012/768794/ Improving our understanding of sleep physiology and pathophysiology is an important goal for both medical and general wellness reasons. Although the gold standard for assessing sleep remains the laboratory polysomnogram, there is an increasing interest in portable monitoring devices that provide the opportunity for assessing sleep in real-world environments such as the home. Portable devices allow repeated measurements, evaluation of temporal patterns, and self-experimentation. We review recent developments in devices designed to monitor sleep-wake activity, as well as monitors designed for other purposes that could in principle be applied in the field of sleep (such as cardiac or respiratory sensing). As the body of supporting validation data grows, these devices hold promise for a variety of health and wellness goals. From a clinical and research standpoint, the capacity to obtain longitudinal sleep-wake data may improve disease phenotyping, individualized treatment decisions, and individualized health optimization. From a wellness standpoint, commercially available devices may allow individuals to track their own sleep with the goal of finding patterns and correlations with modifiable behaviors such as exercise, diet, and sleep aids. Jessica M. Kelly, Robert E. Strecker, and Matt T. Bianchi Copyright © 2012 Jessica M. Kelly et al. All rights reserved. Sun, 14 Oct 2012 16:25:02 +0000 http://www.hindawi.com/isrn/neurology/2012/427102/ Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis. Maria Skokou, Evanthia Soubasi, and Philippos Gourzis Copyright © 2012 Maria Skokou et al. All rights reserved. Sun, 14 Oct 2012 15:42:56 +0000 http://www.hindawi.com/isrn/neurology/2012/701950/ The innate immune system plays an important role in cerebral health and disease. In recent years the role of innate immune regulation by toll-like receptors in the brain has been highlighted. In this paper the expression of toll-like receptors and endogenous toll-like receptor ligands in the brain and their role in cerebral ischemia will be discussed. Further, the ability of systemic toll-like receptor ligands to induce cerebral inflammation will be reviewed. Finally, the capacity of toll-like receptors to both increase (sensitization) and decrease (preconditioning/tolerance) the vulnerability of the brain to damage will be disclosed. Studies investigating the role of toll-like receptors in the developing brain will be emphasized. Carina Mallard Copyright © 2012 Carina Mallard. All rights reserved. Sun, 14 Oct 2012 15:16:48 +0000 http://www.hindawi.com/isrn/neurology/2012/972607/ Drug addiction is a chronic, relapsing disorder defined by cyclic patterns of compulsive drug seeking and taking interspersed with episodes of abstinence. While genetic variability may increase the risk of addictive behaviours in an individual, exposure to a drug results in neuroadaptations in interconnected brain circuits which, in susceptible individuals, are believed to underlie the transition to, and maintenance of, an addicted state. These adaptations can occur at the cellular, molecular, or (epi)genetic level and are associated with synaptic plasticity and altered gene expression, the latter being mediated via both factors affecting translation (epigenetics) and transcription (non coding microRNAs) of the DNA or RNA itself. New advances using techniques such as optogenetics have the potential to increase our understanding of the microcircuitry mediating addictive behaviours. However, the processes leading to addiction are complex and multifactorial and thus we face a major contemporary challenge to elucidate the factors implicated in the development and maintenance of an addicted state. Jhodie R. Duncan Copyright © 2012 Jhodie R. Duncan. All rights reserved. Mon, 17 Sep 2012 11:56:21 +0000 http://www.hindawi.com/isrn/neurology/2012/508308/ The causal gene(s) for familial adult myoclonic epilepsy (FAME) remains undetermined. To identify it, an exome analysis was performed for the proband in a Japanese FAME family. Of the 383 missense/nonsense variants examined, only c.5720G>A mutation (p.Arg1907His) in the UBR5 gene was found in all of the affected individuals in the family, but not in the nonaffected members. Such mutation was not found in any of the 85 healthy individuals in the same community nor in any of the 24 individuals of various ethnicities. The present study demonstrated an FAME-associated mutation in the UBR5 gene, which is located close to the reported locus linked to Japanese FAME families. Takeo Kato, Gen Tamiya, Shingo Koyama, Tomohiro Nakamura, Satoshi Makino, Shigeki Arawaka, Toru Kawanami, and Ikuo Tooyama Copyright © 2012 Takeo Kato et al. All rights reserved.