Behavioural Neurology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Orofacial Pain during Mastication in People with Dementia: Reliability Testing of the Orofacial Pain Scale for Non-Verbal Individuals Mon, 08 Feb 2016 07:21:17 +0000 Objectives. The aim of this study was to establish the reliability of the “chewing” subscale of the OPS-NVI, a novel tool designed to estimate presence and severity of orofacial pain in nonverbal patients. Methods. The OPS-NVI consists of 16 items for observed behavior, classified into four categories and a subjective estimate of pain. Two observers used the OPS-NVI for 237 video clips of people with dementia in Dutch nursing homes during their meal to observe their behavior and to estimate the intensity of orofacial pain. Six weeks later, the same observers rated the video clips a second time. Results. Bottom and ceiling effects for some items were found. This resulted in exclusion of these items from the statistical analyses. The categories which included the remaining items () showed reliability varying between fair-to-good and excellent (interobserver reliability, ICC: 0.40–0.47; intraobserver reliability, ICC: 0.40–0.92). Conclusions. The “chewing” subscale of the OPS-NVI showed a fair-to-good to excellent interobserver and intraobserver reliability in this dementia population. This study contributes to the validation process of the OPS-NVI as a whole and stresses the need for further assessment of the reliability of the OPS-NVI with subjects that might already show signs of orofacial pain. Merlijn W. de Vries, Corine Visscher, Suzanne Delwel, Jenny T. van der Steen, Marjoleine J. C. Pieper, Erik J. A. Scherder, Wilco P. Achterberg, and Frank Lobbezoo Copyright © 2016 Merlijn W. de Vries et al. All rights reserved. Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument Mon, 01 Feb 2016 14:33:37 +0000 Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon index absolute informativity, as an indicator of an instrument’s power to differentiate between individuals within a specific group or health state, was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 “Role Physical,” “Role Emotional,” and “Social Functioning” subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly. When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument. Nicole von Steinbuechel, Amra Covic, Suzanne Polinder, Thomas Kohlmann, Ugne Cepulyte, Herbert Poinstingl, Joy Backhaus, Wilbert Bakx, Monika Bullinger, Anne-Lise Christensen, Rita Formisano, Henning Gibbons, Stefan Höfer, Sanna Koskinen, Andrew Maas, Edmund Neugebauer, Jane Powell, Jaana Sarajuuri, Nadine Sasse, Silke Schmidt, Holger Mühlan, Klaus von Wild, George Zitnay, and Jean-Luc Truelle Copyright © 2016 Nicole von Steinbuechel et al. All rights reserved. The Effect of Task-Irrelevant Fearful-Face Distractor on Working Memory Processing in Mild Cognitive Impairment versus Healthy Controls: An Exploratory fMRI Study in Female Participants Mon, 01 Feb 2016 11:19:41 +0000 In mild cognitive impairment (MCI), a risk state for Alzheimer’s disease, patients have objective cognitive deficits with relatively preserved functioning. fMRI studies have identified anomalies during working memory (WM) processing in individuals with MCI. The effect of task-irrelevant emotional face distractor on WM processing in MCI remains unclear. We aim to explore the impact of fearful-face task-irrelevant distractor on WM processing in MCI using fMRI. Hypothesis. Compared to healthy controls (HC), MCI patients will show significantly higher BOLD signal in a priori identified regions of interest (ROIs) during a WM task with a task-irrelevant emotional face distractor. Methods. 9 right-handed female participants with MCI and 12 matched HC performed a WM task with standardized task-irrelevant fearful versus neutral face distractors randomized and counterbalanced across WM trials. MRI images were acquired during the WM task and BOLD signal was analyzed using statistical parametric mapping (SPM) to identify signal patterns during the task response phase. Results. Task-irrelevant fearful-face distractor resulted in higher activation in the amygdala, anterior cingulate, and frontal areas, in MCI participants compared to HC. Conclusions. This exploratory study suggests altered WM processing as a result of fearful-face distractor in MCI. Amer M. Burhan, Udunna C. Anazodo, Jun Ku Chung, Amanda Arena, Ariel Graff-Guerrero, and Derek G. V. Mitchell Copyright © 2016 Amer M. Burhan et al. All rights reserved. Mechanism of Forelimb Motor Function Restoration after Cervical Spinal Cord Hemisection in Rats: A Comparison of Juveniles and Adults Thu, 28 Jan 2016 14:08:29 +0000 The aim of this study was to investigate forelimb motor function after cervical spinal cord injury in juvenile and adult rats. Both rats received a left segmental hemisection of the spinal cord after C3-C4 laminectomy. Behavioral evaluation of motor function was monitored and assessed using the New Rating Scale (NRS) and Forelimb Locomotor Scale (FLS) and by measuring the range of motion (ROM) of both the elbow and wrist. Complete left forelimb motor paralysis was observed in both rats. The NRS showed motor function recovery restored to in juvenile rats and in adult rats. FLS was in juvenile rats and in adult rats. ROM of the elbow and wrist were and in juvenile rats and and in adult rats. Thus, the NRS and ROM of the elbow showed a significant difference between age groups. These results indicate that left hemisection of the cervical spinal cord was not related to right-sided motor functions. Moreover, while motor paralysis of the left forelimb gradually recovered in both groups, the improvement was greater in juvenile rats. Atsushi Hasegawa, Masahito Takahashi, Kazuhiko Satomi, Hideaki Ohne, Takumi Takeuchi, Shunsuke Sato, and Shoichi Ichimura Copyright © 2016 Atsushi Hasegawa et al. All rights reserved. Cox-2 Plays a Vital Role in the Impaired Anxiety Like Behavior in Colchicine Induced Rat Model of Alzheimer Disease Sun, 10 Jan 2016 07:53:52 +0000 The anxiety status is changed along with memory impairments in intracerebroventricular colchicine injected rat model of Alzheimer Disease (cAD) due to neurodegeneration, which has been indicated to be mediated by inflammation. Inducible cox-2, involved in inflammation, may have important role in the colchicine induced alteration of anxiety status. Therefore, the present study was designed to investigate the role of cox-2 on the anxiety behavior (response to novelty in an elevated open field space) of cAD by inhibiting it with three different doses (10, 20, and 30 mg) of etoricoxib (a cox-2 blocker) in two time points (14 and 21 days). The results showed anxiolytic behavior in cAD along with lower serum corticosterone level, both of which were recovered at all the doses of etoricoxib on day 21. On day 14 all of the anxiety parameters showed similar results to that of day 21 at high doses but not at 10 mg/kg body weight. Results indicate that the parameters of anxiety were dependent on neuronal circuitries that were probably sensitive to etoricoxib induced blocking of neurodegeneration. The present study showed that anxiolytic behavior in cADr is predominantly due to cox-2 mediated neuroinflammation induced neurodegeneration in the brain. Susmita Sil and Tusharkanti Ghosh Copyright © 2016 Susmita Sil and Tusharkanti Ghosh. All rights reserved. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness Wed, 30 Dec 2015 12:38:07 +0000 Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: versus controls: ; ). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. Christoph Best, Regine Tschan, Nikola Stieber, Manfred E. Beutel, Annegret Eckhardt-Henn, and Marianne Dieterich Copyright © 2015 Christoph Best et al. All rights reserved. Sex Differences in the Study of Neurological Illnesses Tue, 29 Dec 2015 09:16:26 +0000 Hrayr Attarian, Jan Brandes, Rima Dafer, Elizabeth Gerard, and Barbara Giesser Copyright © 2015 Hrayr Attarian et al. All rights reserved. Loss in Executive Functioning Best Explains Changes in Pain Responsiveness in Patients with Dementia-Related Cognitive Decline Mon, 14 Dec 2015 06:40:36 +0000 There is ample evidence that dementia changes the processing of pain. However, it is not known whether this change in pain processing is related to the general decline in cognitive functioning or whether it may be related to specific domains of cognitive functioning. With the present study we tried to answer this question. We assessed different cognitive domains (orientation, memory, abstract thinking/executive function, aphasia and apraxia, and information processing speed) in 70 older patients with cognitive impairment (mild cognitive impairment up to moderate degrees of dementia). Pain responsiveness was assessed by measuring the nociceptive flexion reflex (NFR) threshold and facial responses to noxious electrical stimulation. Using regression analyses, we assessed which domain of cognitive functioning best predicted variance in pain responsiveness. Variance in pain responsiveness (NFR and facial expressions) was best explained by those items assessing executive functioning even when controlling for overall cognitive performance and memory functioning. The close association between executive functioning and pain responsiveness suggests that dementia-related neurodegeneration in prefrontal areas might result not only in reduced executive functioning but also in a loss of pain inhibitory potency, rendering the patient more vulnerable to pain. Our findings also suggest that pain assessment in dementia should be regularly completed by tests of cognitive functions. Miriam Kunz, Veit Mylius, Karsten Schepelmann, and Stefan Lautenbacher Copyright © 2015 Miriam Kunz et al. All rights reserved. The Oscillating Component of the Internal Jugular Vein Flow: The Overlooked Element of Cerebral Circulation Wed, 09 Dec 2015 08:45:03 +0000 The jugular venous pulse (JVP) provides valuable information about cardiac haemodynamics and filling pressures and is an indirect estimate of the central venous pressure (CVP). Recently it has been proven that JVP can be obtained by measuring the cross-sectional area (CSA) of the IJV on each sonogram of an ultrasound B-mode sonogram sequence. It has also been proven that during its pulsation the IJV is distended and hence that the pressure gradient drives the IJV haemodynamics. If this is true, then it will imply the following: (i) the blood velocity in the IJV is a periodic function of the time with period equal to the cardiac period and (ii) the instantaneous blood velocity is given by a time function that can be derived from a flow-dynamics theory that uses the instantaneous pressure gradient as a parameter. The aim of the present study is to confirm the hypothesis that JVP regulates the IJV blood flow and that pressure waves are transmitted from the heart toward the brain through the IJV wall. Francesco Sisini, Eleuterio Toro, Mauro Gambaccini, and Paolo Zamboni Copyright © 2015 Francesco Sisini et al. All rights reserved. Cognitive Impairment after Severe Traumatic Brain Injury, Clinical Course and Impact on Outcome: A Swedish-Icelandic Study Wed, 09 Dec 2015 07:55:32 +0000 Objective. To assess the clinical course of cognitive and emotional impairments in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to study associations with outcomes at 1 year. Methods. Prospective, multicenter, observational study of sTBI in Sweden and Iceland. Patients aged 18–65 years with acute Glasgow Coma Scale 3–8 were assessed with the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended (GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R). Results. Cognition was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75 patients at 3 months, and 78 patients at 1 year. Cognition improved over time, especially from 3 weeks to 3 months. The BNIS subscales “orientation” and “visuospatial and visual problem solving” were associated with the GOSE and RLAS-R at 1 year. Conclusion. Cognition seemed to improve over time after sTBI and appeared to be rather stable from 3 months to 1 year. Since cognitive function was associated with outcomes, these results indicate that early screening of cognitive function could be of importance for rehabilitation planning in a clinical setting. Maud Stenberg, Alison K. Godbolt, Catharina Nygren De Boussard, Richard Levi, and Britt-Marie Stålnacke Copyright © 2015 Maud Stenberg et al. All rights reserved. The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma Mon, 07 Dec 2015 14:06:49 +0000 This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs’ Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health’s Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients’ emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers’ relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed. Lillian Flores Stevens, Treven C. Pickett, Kathryn P. Wilder Schaaf, Brent C. Taylor, Amy Gravely, Courtney Harold Van Houtven, Greta Friedemann-Sánchez, and Joan M. Griffin Copyright © 2015 Lillian Flores Stevens et al. All rights reserved. Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted Tue, 24 Nov 2015 06:44:53 +0000 The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI. Cecilie Røe, Toril Skandsen, Unn Manskow, Tiina Ader, and Audny Anke Copyright © 2015 Cecilie Røe et al. All rights reserved. Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results Mon, 16 Nov 2015 09:52:12 +0000 Presently, there are no valid biomarkers to identify individuals with eating disorders (ED). The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM) technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa) were compared against 17 body mass index-matched healthy controls (HC). Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice. Antonio Cerasa, Isabella Castiglioni, Christian Salvatore, Angela Funaro, Iolanda Martino, Stefania Alfano, Giulia Donzuso, Paolo Perrotta, Maria Cecilia Gioia, Maria Carla Gilardi, and Aldo Quattrone Copyright © 2015 Antonio Cerasa et al. All rights reserved. Gender Differences in the Behavioral Symptom Severity of Prader-Willi Syndrome Sun, 08 Nov 2015 09:59:01 +0000 Objectives. This study measured gender differences in Prader-Willi syndrome (PWS) in regard to the severity of behavioral symptoms. Methods. The Food Related Problem Questionnaire (FRPQ), the Aberrant Behavior Checklist Japanese Version, the Childhood Routines Inventory, the Pervasive Developmental Disorders Autism Society Japan Rating Scale, and Japanese ADHD-RS were administered to PWS patients (45 males aged 6 to 58 and 37 females aged 6 to 45). To examine the effects that gender and genotype have on the severity of each symptom, two-way ANOVAs were conducted. Results. Significant interactions were found only in regard to FRPQ scores, such as FRPQ total score ( = 8.43, ). The FRPQ of male deletion (DEL) individuals was higher than that of female DEL and male mUPD. The FRPQ of male maternal uniparental disomy (mUPD) was lower than that of female mUPD. Conclusions. In terms of problem behaviors, routines, autistic behaviors, and hyperactivity, no significant differences were found. Food-related behaviors in DEL were more severe in males, although those in mUPD were less severe in males. Masao Gito, Hiroshi Ihara, Hiroyuki Ogata, Masayuki Sayama, Nobuyuki Murakami, Toshiro Nagai, Tadayuki Ayabe, Yuji Oto, and Kazutaka Shimoda Copyright © 2015 Masao Gito et al. All rights reserved. Autism-Like Behavior and Epigenetic Changes Associated with Autism as Consequences of In Utero Exposure to Environmental Pollutants in a Mouse Model Mon, 26 Oct 2015 09:19:22 +0000 We tested the hypothesis that in utero exposure to heavy metals increases autism-like behavioral phenotypes in adult animals and induces epigenetic changes in genes that have roles in the etiology of autism. Mouse dams were treated with cadmium, lead, arsenate, manganese, and mercury via drinking water from gestational days (E) 1–10. Valproic acid (VPA) injected intraperitoneally once on (E) 8.5 served as a positive control. Young male offspring were tested for behavioral deficits using four standardized behavioral assays. In this study, in utero exposure to heavy metals resulted in multiple behavioral abnormalities that persisted into adulthood. VPA and manganese induced changes in perseverative/impulsive behavior and social dominance behavior, arsenic caused changes only in perseverative/impulsive behavior, and lead induced abnormalities in social interaction in comparison to the control animals. Brain samples from Mn, Pb, and VPA treated and control animals were evaluated for changes in CpG island methylation in promoter regions and associated changes in gene expression. The Chd7 gene, essential for neural crest cell migration and patterning, was found to be hypomethylated in each experimental animal tested compared to water-treated controls. Furthermore, distinct patterns of CpG island methylation yielded novel candidate genes for further investigation. Denise S. Hill, Robert Cabrera, Deeann Wallis Schultz, Huiping Zhu, Wei Lu, Richard H. Finnell, and Bogdan J. Wlodarczyk Copyright © 2015 Denise S. Hill et al. All rights reserved. Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson’s Disease Mon, 26 Oct 2015 08:10:21 +0000 Background. Neurological assessment of a patient with Parkinson’s disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE). Results. In women with PD, Kendall’s tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration. Kadri Medijainen, Mati Pääsuke, Aet Lukmann, and Pille Taba Copyright © 2015 Kadri Medijainen et al. All rights reserved. The Effects of Gender Differences in Patients with Depression on Their Emotional Working Memory and Emotional Experience Thu, 22 Oct 2015 08:59:01 +0000 A large amount of research has been conducted on the effects of sex hormones on gender differences in patients with depression, yet research on cognitive differences between male and female patients with depression is insufficient. This study uses emotion pictures to investigate the differences of the emotional working memory ability and emotional experience in male and female patients with depression. Despite identifying that the working memory of patients with depression is impaired, our study found no significant gender differences in emotional working memory. Moreover, the research results revealed that memory effects of mood congruence are produced in both men and women, which may explain why the depression state can be maintained. Furthermore, female patients have more emotional experiences than male patients, which is particularly significant in terms of negative emotional experiences. This result provides cognitive evidence to explain why women suffer from longer terms of depression, are more susceptible to relapse, and can more easily suffer from major depressive disorder in the future. Mi Li, Shengfu Lu, Gang Wang, and Ning Zhong Copyright © 2015 Mi Li et al. All rights reserved. Whakawhiti Kōrero, a Method for the Development of a Cultural Assessment Tool, Te Waka Kuaka, in Māori Traumatic Brain Injury Wed, 21 Oct 2015 12:04:18 +0000 The importance of tools for the measurement of outcomes and needs in traumatic brain injury is well recognised. The development of tools for these injuries in indigenous communities has been limited despite the well-documented disparity of brain injury. The wairua theory of traumatic brain injury (TBI) in Māori proposes that a culturally defined injury occurs in tandem with the physical injury. A cultural response is therefore indicated. This research investigates a Māori method used in the development of cultural needs assessment tool designed to further examine needs associated with the culturally determined injury and in preparation for formal validation. Whakawhiti kōrero is a method used to develop better statements in the development of the assessment tool. Four wānanga (traditional fora) were held including one with whānau (extended family) with experience of traumatic brain injury. The approach was well received. A final version, Te Waka Kuaka, is now ready for validation. Whakawhiti kōrero is an indigenous method used in the development of cultural needs assessment tool in Māori traumatic brain injury. This method is likely to have wider applicability, such as Mental Health and Addictions Services, to ensure robust process of outcome measure and needs assessment development. Hinemoa Elder and Paula Kersten Copyright © 2015 Hinemoa Elder and Paula Kersten. All rights reserved. Depression and Anxiety among Patients with Epilepsy and Multiple Sclerosis: UAE Comparative Study Wed, 21 Oct 2015 07:38:32 +0000 Depression and anxiety are highly prevalent in patients with epilepsy (PWE), with prevalence rates ranging from 20% to 55%. The cause of this increased rate is multifactorial. Depression and epilepsy are thought to share the same pathogenic mechanism. Anxiety, on the other hand, seems to have a prevalence rate among PWE comparable to, or even higher than, those reported for depression, and it is closely linked to epilepsy. To test this hypothesis, we screened for depression and anxiety 186 and 160 patients attending the epilepsy and MS clinics, respectively, using standardized screening tools to determine the rates of both depression and anxiety, comparing these rates to 186 age, sex matched controls. Among the three groups, only patients with epilepsy were at increased risk of having depression (OR = 1.9), whereas anxiety was not. This finding could point to the shared pathogenic mechanisms hypothesis between depression and epilepsy. Taoufik Alsaadi, Khadija El Hammasi, Tarek M. Shahrour, Mustafa Shakra, Lamya Turkawi, Wassim Nasreddine, and Mufeed Raoof Copyright © 2015 Taoufik Alsaadi et al. All rights reserved. Gender Differences in Childhood Lyme Neuroborreliosis Tue, 20 Oct 2015 11:37:07 +0000 Background. Many neurological diseases show differences between genders. We studied gender differences in childhood Lyme neuroborreliosis (LNB) in an endemic area of Lyme borreliosis in Norway. Methods. In a population based study, all children (<14 years of age) with symptoms suspicious of LNB, including all children with acute facial nerve palsy, were evaluated for LNB by medical history, clinical examination, blood tests, and lumbar puncture. LNB was diagnosed according to international criteria. Results. 142 children were diagnosed with LNB during 2001–2009. Facial nerve palsy was more common in girls (86%) than in boys (62%) , but headache and/or neck stiffness as the only symptom was more common in boys (30%) than in girls (10%) . The girls were younger than boys and had a shorter duration of symptoms, but boys had a higher level of pleocytosis than girls. In a multivariate analysis, both gender and having headache and neck stiffness were associated with a higher level of pleocytosis. Conclusion. Girls and boys have different clinical presentations of LNB, and boys have a higher level of inflammation than girls independent of the clinical presentation. Dag Tveitnes and Knut Øymar Copyright © 2015 Dag Tveitnes and Knut Øymar. All rights reserved. Psychological Outcome in Young Survivors of Severe TBI: A Cross-Informant Comparison Thu, 15 Oct 2015 08:46:59 +0000 Objective. To investigate the psychological outcome and the agreement between self-ratings and proxy-ratings in young individuals after severe traumatic brain injury (TBI). Methods. Twenty pairs of former patients who sustained a severe TBI in their adolescence or early adulthood and their significant others (SOs) were contacted around 66 months after injury to complete a measure of psychological and behavioral problems. The Adult Self-Report 18–59 and the Adult Behavior Checklist 18–59 were used. Results. Results showed significant differences compared to the normative sample in the domains withdrawal, attention, and intrusive and internalizing problems. Good or excellent levels of agreement were found between the self-rating and the proxy-rating in overt areas such as somatic complaints and aggressive and intrusive behavior. Fair or poor levels of agreement were found in nonovert areas such as anxiety and depression, withdrawal, thought and attention problems, and personal strength. Conclusion. The findings show that young patients experience psychological dysfunction. Our study suggests that the use of either a self-rating or a proxy-rating would be appropriate for evaluating overt domains, regarding the good to excellent levels of agreement. However, in nonovert domains, such as withdrawal and attention, an additional proxy-rating from a SO could provide supplementary information and build a more complete objective assessment. Karoline Doser, Ingrid Poulsen, and Anne Norup Copyright © 2015 Karoline Doser et al. All rights reserved. Life after Adolescent and Adult Moderate and Severe Traumatic Brain Injury: Self-Reported Executive, Emotional, and Behavioural Function 2–5 Years after Injury Tue, 13 Oct 2015 16:46:01 +0000 Survivors of moderate-severe Traumatic Brain Injury (TBI) are at risk for long-term cognitive, emotional, and behavioural problems. This prospective cohort study investigated self-reported executive, emotional, and behavioural problems in the late chronic phase of moderate and severe TBI, if demographic characteristics (i.e., age, years of education), injury characteristics (Glasgow Coma Scale score, MRI findings such as traumatic axonal injury (TAI), or duration of posttraumatic amnesia), symptoms of depression, or neuropsychological variables in the first year after injury predicted long-term self-reported function. Self-reported executive, emotional, and behavioural functioning were assessed among individuals with moderate and severe TBI (, age range 15–65 years at time of injury) 2–5 years after TBI, compared to a healthy matched control group . Results revealed significantly more attentional, emotional regulation, and psychological difficulties in the TBI group than controls. Demographic and early clinical variables were associated with poorer cognitive and emotional outcome. Fewer years of education and depressive symptoms predicted greater executive dysfunction. Younger age at injury predicted more aggressive and rule-breaking behaviour. TAI and depressive symptoms predicted Internalizing problems and greater executive dysfunction. In conclusion, age, education, TAI, and depression appear to elevate risk for poor long-term outcome, emphasising the need for long-term follow-up of patients presenting with risk factors. Torun Gangaune Finnanger, Alexander Olsen, Toril Skandsen, Stian Lydersen, Anne Vik, Kari Anne I. Evensen, Cathy Catroppa, Asta K. Håberg, Stein Andersson, and Marit S. Indredavik Copyright © 2015 Torun Gangaune Finnanger et al. All rights reserved. Music in the Brain: From Listening to Playing Mon, 12 Oct 2015 13:16:01 +0000 Masayuki Satoh, Stefan Evers, Shinichi Furuya, and Kentaro Ono Copyright © 2015 Masayuki Satoh et al. All rights reserved. Music Engineering as a Novel Strategy for Enhancing Music Enjoyment in the Cochlear Implant Recipient Mon, 12 Oct 2015 09:49:37 +0000 Objective. Enjoyment of music remains an elusive goal following cochlear implantation. We test the hypothesis that reengineering music to reduce its complexity can enhance the listening experience for the cochlear implant (CI) listener. Methods. Normal hearing (NH) adults () and CI listeners () evaluated a piece of country music on three enjoyment modalities: pleasantness, musicality, and naturalness. Participants listened to the original version along with 20 modified, less complex, versions created by including subsets of the musical instruments from the original song. NH participants listened to the segments both with and without CI simulation processing. Results. Compared to the original song, modified versions containing only 1–3 instruments were less enjoyable to the NH listeners but more enjoyable to the CI listeners and the NH listeners with CI simulation. Excluding vocals and including rhythmic instruments improved enjoyment for NH listeners with CI simulation but made no difference for CI listeners. Conclusions. Reengineering a piece of music to reduce its complexity has the potential to enhance music enjoyment for the cochlear implantee. Thus, in addition to improvements in software and hardware, engineering music specifically for the CI listener may be an alternative means to enhance their listening experience. Gavriel D. Kohlberg, Dean M. Mancuso, Divya A. Chari, and Anil K. Lalwani Copyright © 2015 Gavriel D. Kohlberg et al. All rights reserved. Differences according to Sex in Sociosexuality and Infidelity after Traumatic Brain Injury Mon, 12 Oct 2015 08:58:27 +0000 Objective. To explore differences according to sex in sociosexuality and infidelity in individuals with TBI and in healthy controls. Participants. Forty-two individuals with mild, moderate, and severe TBI having completed a postacute TBI rehabilitation program, at least six months after injury, and 47 healthy controls. Main Measures. Sociosexual Orientation Inventory-Revised (SOI-R) and Attitudes toward Infidelity Scale. Results. Overall, men score significantly higher than women in sociosexuality. However, there was a nonsignificant trend towards a reduction of sociosexuality levels in men with TBI. Infidelity levels were comparable in healthy controls and individuals with TBI. In individuals with TBI, less acceptance of infidelity was significantly associated with an unrestricted sociosexual orientation, but not in healthy controls. Conclusions. As documented in previous cross-cultural studies, men have higher levels of sociosexuality than women. However, men with TBI showed a tendency towards the reduction of sociosexuality. The possibility of a latent explanatory variable is suggested (e.g., post-TBI neuroendocrinological changes). TBI does not seem to have an impact on infidelity, but individuals with TBI who express less acceptance of infidelity also report a more promiscuous mating strategy regarding their behavior, attitudes, and desire. Theoretical implications are discussed in terms of evolutionary theories of human sexuality and neuropsychology. Jhon Alexander Moreno and Michelle McKerral Copyright © 2015 Jhon Alexander Moreno and Michelle McKerral. All rights reserved. Sex Differences in Neuropsychiatric Symptoms of Alzheimer’s Disease: The Modifying Effect of Apolipoprotein E ε4 Status Sun, 11 Oct 2015 13:36:44 +0000 Sex differences in neuropsychiatric symptoms of Alzheimer’s disease (AD) have been demonstrated in previous studies, and apolipoprotein E (ApoE) ε4 status influences psychiatric manifestations of AD. However, whether ApoE ε4 status modifies the sex differences in neuropsychiatric symptoms of AD is still unclear. In this study, sex differences in neuropsychiatric abnormalities were stratified and analyzed by ApoE ε4 status in mild AD and moderate to severe AD separately. The Clinical Dementia Rating (CDR) scale and the Neuropsychiatric Inventory (NPI) were used to assess dementia severity and neuropsychiatric symptoms. No sex differences were found in mild AD. In moderate to severe AD, among ε4 positive individuals, disinhibition was significantly more prevalent (8.0% in men versus 43.2% in women, ) and severer in female patients. The frequency (16.0% in men versus 51.4% in women, ) and score of irritability were of borderline significance after strict Bonferroni correction. In conclusion, this study supported the modifying effect of ApoE ε4 status on sex differences in neuropsychiatric symptoms of AD, and this modifying effect was pronounced in moderate to severe stage of AD. The interaction between gender and ApoE ε4 status should be considered in studies on neuropsychiatric symptoms of AD. Yi Xing, Yi Tang, and Jianping Jia Copyright © 2015 Yi Xing et al. All rights reserved. Relationship between Postmenopausal Estrogen Deficiency and Aneurysmal Subarachnoid Hemorrhage Sun, 11 Oct 2015 08:13:59 +0000 Aneurysmal subarachnoid hemorrhage (SAH) is one of the most severe forms of stroke, which results from the rupture of a cerebral aneurysm. SAH is the only type of stroke with a female predominance, suggesting that reproductive factors may play a significant role in the etiology. Estrogen has important effects on vascular physiology and pathophysiology of cerebral aneurysm and SAH and, thus, potential therapeutic implications. There have been growing bodies of epidemiological and experimental studies which support the hypothesis of a significant relationship between estrogen deficiency and cerebral aneurysm formation with subsequent SAH. This hypothesis is the focus of this review as well as possible pathology-based therapeutics with regard to aspects of molecular pathophysiology, especially related to women’s health. Sadaharu Tabuchi Copyright © 2015 Sadaharu Tabuchi. All rights reserved. A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers Sun, 11 Oct 2015 07:52:02 +0000 Background. Multiple sclerosis (MS) rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown. Methods. This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Burden Inventory), health-related quality of life (HRQOL; Short Form-36), and social support (Interpersonal Support Evaluation List-12) in 81 (66.7% women) Mexican MS caregivers. Results. As compared to men caregivers, women had lower mental health (), HRQOL (), and social support (). This was partially explained by women caregivers providing care for nearly twice as many hours/week as men (79.28 versus 48.48, ) and for nearly three times as many months (66.31 versus 24.30, ). Conclusions. Because gender roles in Latin America influence women to assume more substantial caregiving duties, MS caregiver interventions in Latin America—particularly for women caregivers—should address the influence of gender-role conformity on care and psychosocial functioning. Paul B. Perrin, Ivan Panyavin, Alejandra Morlett Paredes, Adriana Aguayo, Miguel Angel Macias, Brenda Rabago, Sandra J. Fulton Picot, and Juan Carlos Arango-Lasprilla Copyright © 2015 Paul B. Perrin et al. All rights reserved. Traumatic Brain Injury Rehabilitation in Hong Kong: A Review of Practice and Research Thu, 08 Oct 2015 17:25:27 +0000 Background. The rising public health concern regarding traumatic brain injury (TBI) implies a growing need for rehabilitation services for patients surviving TBI. Methods. To this end, this paper reviews the practices and research on TBI rehabilitation in Hong Kong so as to inform future developments in this area. This paper begins by introducing the general situation of TBI patients in Hong Kong and the need for rehabilitation. Next, the trauma system in Hong Kong is introduced. Following that is a detailed description of the rehabilitation services for TBI patients in Hong Kong, as exemplified by a rehabilitation hospital in Hong Kong. This paper will also review intervention studies on rehabilitating brain-injured populations in Hong Kong with respect to various rehabilitation goals. Lastly, the implications of culture-related issues will be discussed in relation to TBI. Results/Conclusions. The intervention studies conducted in Hong Kong are generally successful in achieving various rehabilitative outcomes. Additionally, certain cultural-related issues, such as the stigma associated with TBI, may impede the rehabilitative process and lead to various psychosocial problems. Junhong Yu, Helena M. K. Tam, and Tatia M. C. Lee Copyright © 2015 Junhong Yu et al. All rights reserved. Musical Sequence Learning and EEG Correlates of Audiomotor Processing Wed, 07 Oct 2015 13:06:18 +0000 Our motor and auditory systems are functionally connected during musical performance, and functional imaging suggests that the association is strong enough that passive music listening can engage the motor system. As predictive coding constrains movement sequence selections, could the motor system contribute to sequential processing of musical passages? If this is the case, then we hypothesized that the motor system should respond preferentially to passages of music that contain similar sequential information, even if other aspects of music, such as the absolute pitch, have been altered. We trained piano naive subjects with a learn-to play-by-ear paradigm, to play a simple melodic sequence over five days. After training, we recorded EEG of subjects listening to the song they learned to play, a transposed version of that song, and a control song with different notes and sequence from the learned song. Beta band power over sensorimotor scalp showed increased suppression for the learned song, a moderate level of suppression for the transposed song, and no suppression for the control song. As beta power is associated with attention and motor processing, we interpret this as support of the motor system’s activity during covert perception of music one can play and similar musical sequences. Matt D. Schalles and Jaime A. Pineda Copyright © 2015 Matt D. Schalles and Jaime A. Pineda. All rights reserved.