Behavioural Neurology The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Sleep Duration and Sleep Quality following Acute Mild Traumatic Brain Injury: A Propensity Score Analysis Tue, 17 Mar 2015 07:09:46 +0000 Introduction. Mild traumatic brain injury (mTBI) has been widely studied and the effects of injury can be long term or even lifelong. This research aims to characterize the sleep problems of patients following acute mTBI. Methods. A total of 171 patients with mTBI within one month and 145 non-mTBI controls were recruited in this study. The questionnaire, Pittsburgh Sleep Quality Index (PSQI), was used to evaluate seven aspects of sleep problems. A propensity score method was used to generate a quasirandomized design to account for the background information, including gender, age, Beck’s Anxiety Index, Beck’s Depression Index, and Epworth Sleepiness Scale. The effect was evaluated via cumulative logit regression including propensity scores as a covariate. Results. Before adjustment, about 60% mTBI patients and over three quarters of control subjects had mild sleep disturbance while one third mTBI patients had moderate sleep disturbance. After adjusting by the propensity scores, the scores of sleep quality and duration were significant between mTBI and control groups. Conclusion. Our study supports that sleep problem is common in mTBI group. After adjusting the confounders by propensity score, sleep duration and subjective sleep quality are the most frequently reported problems in mTBI patients within one month after the injury. Ting-Yun Huang, Hon-Ping Ma, Shin-Han Tsai, Yung-Hsiao Chiang, Chaur-Jong Hu, and Juchi Ou Copyright © 2015 Ting-Yun Huang et al. All rights reserved. The Neural Correlates of Spatial and Object Working Memory in Elderly and Parkinson’s Disease Subjects Mon, 16 Mar 2015 09:59:23 +0000 This fMRI study deals with the neural correlates of spatial and objects working memory (SWM and OWM) in elderly subjects (ESs) and idiopathic Parkinson’s disease (IPD). Normal aging and IPD can be associated with a WM decline. In IPD population, some studies reported similar SWM and OWM deficits; others reported a greater SWM than OWM impairment. In the present fMRI research, we investigated whether compensated IPD patients and elderly subjects with comparable performance during the execution of SWM and OWM tasks would present differences in WM-related brain activations. We found that the two groups recruited a prevalent left frontoparietal network when performing the SWM task and a bilateral network during OWM task execution. More specifically, the ESs showed bilateral frontal and subcortical activations in SWM, at difference with the IPD patients who showed a strict left lateralized network, consistent with frontostriatal degeneration in IPD. The overall brain activation in the IPD group was more extended as number of voxels with respect to ESs, suggesting underlying compensatory mechanisms. In conclusion, notwithstanding comparable WM performance, the two groups showed consistencies and differences in the WM activated networks. The latter underline the compensatory processes of normal typical and pathological aging. Silvia P. Caminiti, Chiara Siri, Lucia Guidi, Angelo Antonini, and Daniela Perani Copyright © 2015 Silvia P. Caminiti et al. All rights reserved. Recent Advances in Methamphetamine Neurotoxicity Mechanisms and Its Molecular Pathophysiology Thu, 12 Mar 2015 13:29:54 +0000 Methamphetamine (METH) is a sympathomimetic amine that belongs to phenethylamine and amphetamine class of psychoactive drugs, which are widely abused for their stimulant, euphoric, empathogenic, and hallucinogenic properties. Many of these effects result from acute increases in dopamine and serotonin neurotransmission. Subsequent to these acute effects, METH produces persistent damage to dopamine and serotonin release in nerve terminals, gliosis, and apoptosis. This review summarized the numerous interdependent mechanisms including excessive dopamine, ubiquitin-proteasome system dysfunction, protein nitration, endoplasmic reticulum stress, p53 expression, inflammatory molecular, D3 receptor, microtubule deacetylation, and HIV-1 Tat protein that have been demonstrated to contribute to this damage. In addition, the feasible therapeutic strategies according to recent studies were also summarized ranging from drug and protein to gene level. Shaobin Yu, Ling Zhu, Qiang Shen, Xue Bai, and Xuhui Di Copyright © 2015 Shaobin Yu et al. All rights reserved. The Short-Term Effects of Transcranial Direct Current Stimulation on Electroencephalography in Children with Autism: A Randomized Crossover Controlled Trial Thu, 12 Mar 2015 12:03:14 +0000 Abnormal synaptic maturation and connectivity are possible etiologies of autism. Previous studies showed significantly less alpha activity in autism than normal children. Therefore, we studied the effects of anodal tDCS on peak alpha frequency (PAF) related to autism treatment evaluation checklist (ATEC). Twenty male children with autism were randomly assigned in a crossover design to receive a single session of both active and sham tDCS stimulation (11 mA) over F3 (left dorsolateral prefrontal cortex). Pre- to postsession changes in a measure of cortical activity impacted by tDCS (PAF) and ATEC were compared between groups. We also examined the associations between pre- and postsession changes in the PAF and ATEC. The results show significant pre- to postsession improvements in two domains of ATEC (social and health/behavior domains) following active tDCS, relative to sham treatment. PAF also significantly increased at the stimulation site, and an increase in PAF was significantly associated with improvements in the two domains of ATEC impacted by tDCS. The findings suggest that a single session of anodal tDCS over the F3 may have clinical benefits in children with autism and that those benefits may be related to an increase in PAF. Anuwat Amatachaya, Mark P. Jensen, Niramol Patjanasoontorn, Narong Auvichayapat, Chanyut Suphakunpinyo, Suparerk Janjarasjitt, Niran Ngernyam, Benchaporn Aree-uea, and Paradee Auvichayapat Copyright © 2015 Anuwat Amatachaya et al. All rights reserved. Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia Wed, 04 Feb 2015 06:00:41 +0000 Juxtaposed alongside the ongoing rise in the incidence and prevalence of dementia, is the surge of recent research confirming widespread exposure and bioaccumulation of chemical toxicants. Evidence from sources such as the Centers for Disease Control reveals that most people have accrued varying degrees of assorted toxic pollutants including heavy metals, flame retardants, and pesticide residues within their bodies. It has been well established that many of these toxicants have neurodegenerative as well as neurodevelopmental impact as a result of various pathophysiologic mechanisms including neuronal mitochondrial toxicity and disruption of neurotransmitter regulation. Elimination of stockpiled toxicants from the body may diminish adverse toxicant impact on human biology and allow restoration of normal physiological function. Incorporating a review of medical literature on toxicant exposure and dementia with a case history of a lead-exposed individual diagnosed with dementia, this paper will discuss a much overlooked and potentially widespread cause of declining brain function and dementia. Stephen J. Genuis and Kasie L. Kelln Copyright © 2015 Stephen J. Genuis and Kasie L. Kelln. All rights reserved. Modulatory Role of Simvastatin against Aluminium Chloride-Induced Behavioural and Biochemical Changes in Rats Sat, 31 Jan 2015 14:22:36 +0000 Objectives. Aluminium, a neurotoxic agent in humans, has been implicated in the pathogenesis of neurodegenerative disorders. In this study, we examined the behavioral and biochemical effects of aluminium in rats with special emphasis on memory centres, namely, hippocampus and frontal cortex. Further, the effect of simvastatin treatment on aluminium intoxication was evaluated. Methods. Rats were exposed to aluminium chloride (AlCl3) for 60 days. Simvastatin (10 mg/kg/p.o.) and rivastigmine (1 mg/kg/p.o.) were administered daily prior to AlCl3. Behavioral parameters were assessed using Morris water maze test and actophotometer followed by biochemical investigations, namely, acetylcholinesterase (AChE) activity, TNF-α level, antioxidant enzymes (GSH, catalase), lipid peroxidation, and nitrite level in hippocampus and frontal cortex. Triglycerides, total cholesterol, LDL, and HDL levels in serum were also determined. Key Findings. Simvastatin treatment improved cognitive function and locomotor activity in rats. Simvastatin reversed hyperlipidemia and significantly rectified the deleterious effect of AlCl3 on AChE activity. Further, in hippocampus and frontal cortex, aluminium-induced elevation in nitrite and TNF-α and reduction in antioxidant enzymes were inhibited by simvastatin. Conclusion. To conclude, the present study suggests that simvastatin per se protects the neurons in hippocampus and frontal cortex from AlCl3, an environmental toxin. Madhavan Nampoothiri, Jessy John, Nitesh Kumar, Jayesh Mudgal, Gopalan Kutty Nampurath, and Mallikarjuna Rao Chamallamudi Copyright © 2015 Madhavan Nampoothiri et al. All rights reserved. Language and Visual Perception Associations: Meta-Analytic Connectivity Modeling of Brodmann Area 37 Mon, 12 Jan 2015 05:59:23 +0000 Background. Understanding the functions of different brain areas has represented a major endeavor of neurosciences. Historically, brain functions have been associated with specific cortical brain areas; however, modern neuroimaging developments suggest cognitive functions are associated to networks rather than to areas. Objectives. The purpose of this paper was to analyze the connectivity of Brodmann area (BA) 37 (posterior, inferior, and temporal/fusiform gyrus) in relation to (1) language and (2) visual processing. Methods. Two meta-analyses were initially conducted (first level analysis). The first one was intended to assess the language network in which BA37 is involved. The second one was intended to assess the visual perception network. A third meta-analysis (second level analysis) was then performed to assess contrasts and convergence between the two cognitive domains (language and visual perception). The DataBase of Brainmap was used. Results. Our results support the role of BA37 in language but by means of a distinct network from the network that supports its second most important function: visual perception. Conclusion. It was concluded that left BA37 is a common node of two distinct networks—visual recognition (perception) and semantic language functions. Alfredo Ardila, Byron Bernal, and Monica Rosselli Copyright © 2015 Alfredo Ardila et al. All rights reserved. Prefronto-Cerebellar Transcranial Direct Current Stimulation Improves Sleep Quality in Euthymic Bipolar Patients: A Brief Report Sun, 07 Dec 2014 00:10:35 +0000 Introduction. Sleep problems are common in bipolar disorder (BD) and may persist during the euthymic phase of the disease. The aim of the study was to improve sleep quality of euthymic BD patients through the administration of prefronto-cerebellar transcranial direct current stimulation (tDCS). Methods. 25 euthymic outpatients with a diagnosis of BD Type I or II have been enrolled in the study. tDCS montage was as follows: cathode on the right cerebellar cortex and anode over the left dorsolateral prefrontal cortex (DLPFC); the intensity of stimulation was set at 2 mA and delivered for 20 min/die for 3 consecutive weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline and after the tDCS treatment. Results. PSQI total score and all PSQI subdomains, with the exception of “sleep medication,” significantly improved after treatment. Discussion. This is the first study where a positive effect of tDCS on the quality of sleep in euthymic BD patients has been reported. As both prefrontal cortex and cerebellum may play a role in regulating sleep processes, concomitant cathodal (inhibitory) stimulation of cerebellum and anodal (excitatory) stimulation of DLPFC may have the potential to modulate prefrontal-thalamic-cerebellar circuits leading to improvements of sleep quality. Amedeo Minichino, Francesco Saverio Bersani, Francesco Spagnoli, Alessandra Corrado, Francesco De Michele, Wanda Katharina Calò, Martina Primavera, Baoran Yang, Laura Bernabei, Francesco Macrì, Lucilla Vergnani, Massimo Biondi, and Roberto Delle Chiaie Copyright © 2014 Amedeo Minichino et al. All rights reserved. Counterfactual Thinking in Tourette’s Syndrome: A Study Using Three Measures Sun, 30 Nov 2014 00:10:18 +0000 Pathophysiological evidence suggests an involvement of frontostriatal circuits in Tourette syndrome (TS) and cognitive abnormalities have been detected in tasks sensitive to cognitive deficits associated with prefrontal damage (verbal fluency, planning, attention shifting, working memory, cognitive flexibility, and social reasoning). A disorder in counterfactual thinking (CFT), a behavioural executive process linked to the prefrontal cortex functioning, has not been investigated in TS. CFT refers to the generation of a mental simulation of alternatives to past factual events, actions, and outcomes. It is a pervasive cognitive feature in everyday life and it is closely related to decision-making, planning, problem-solving, and experience-driven learning—cognitive processes that involve wide neuronal networks in which prefrontal lobes play a fundamental role. Clinical observations in patients with focal prefrontal lobe damage or with neurological and psychiatric diseases related to frontal lobe dysfunction (e.g., Parkinson’s disease, Huntington’s disease, and schizophrenia) show counterfactual thinking impairments. In this work, we evaluate the performance of CFT in a group of patients with Tourette’s syndrome compared with a group of healthy participants. Overall results showed no statistical differences in counterfactual thinking between TS patients and controls in the three counterfactual measures proposed. The possible explanations of this unexpected result are discussed below. Stefano Zago, Adriana Delli Ponti, Silvia Mastroianni, Federica Solca, Emanuele Tomasini, Barbara Poletti, Silvia Inglese, Giuseppe Sartori, and Mauro Porta Copyright © 2014 Stefano Zago et al. All rights reserved. Cadmium Increases the Sensitivity of Adolescent Female Mice to Nicotine-Related Behavioral Deficits Sun, 16 Nov 2014 00:00:00 +0000 This study investigates spatial and nonspatial working memory, anxiety related behavior, and motor activities in cadmium and/or nicotine exposed female adolescent mice. P28 female adolescent mice (albino strain) were divided into four groups of five () mice each. A set of mice (Nic) received subcutaneous nicotine (2.0 mg/kg) while a separate set (Cd) was treated with 2.0 mg/kg cadmium (subcutaneous). For the combined treatments of cadmium and nicotine, we administered 2.0 mg/kg Nicotine and 2.0 mg/kg of Cd. Subsequently, a separate group of animals (; control) received normal saline. The total duration of treatment for all groups was 28 days (P28–P56). At P56, the treatment was discontinued, after which the animals were examined in behavioural tests. Nicotine and cadmium increased the metabolism and food intake in the female adolescent mice. This also corresponded to an increase in weight when compared with the control. However, a combined nicotine-cadmium treatment induced a decline in weight of the animals versus the control. Also, nicotine administration increased the motor function, while cadmium and nicotine-cadmium treatment caused a decline in motor activity. Both nicotine and cadmium induced a reduction in memory index; however, nicotine-cadmium treatment induced the most significant decrease in nonspatial working memory. Philip Adeyemi Adeniyi, Babawale Peter Olatunji, Azeez Olakunle Ishola, Duyilemi Chris Ajonijebu, and Olalekan Michael Ogundele Copyright © 2014 Philip Adeyemi Adeniyi et al. All rights reserved. Can Meditation Influence Quality of Life, Depression, and Disease Outcome in Multiple Sclerosis? Findings from a Large International Web-Based Study Wed, 12 Nov 2014 08:48:19 +0000 Objectives. To explore the association between meditation and health related quality of life (HRQOL), depression, fatigue, disability level, relapse rates, and disease activity in a large international sample of people with multiple sclerosis (MS). Methods. Participants were invited to take part in an online survey and answer questions relating to HRQOL, depression, fatigue, disability, relapse rates, and their involvement in meditation practices. Results. Statistically and potentially clinically significant differences between those who meditated once a week or more and participants who never meditated were present for mean mental health composite (MHC) scores, cognitive function scale, and health perception scale. The MHC results remained statistically significant on multivariate regression modelling when covariates were accounted for. Physical health composite (PHC) scores were higher in those that meditated; however, the differences were probably not clinically significant. Among those who meditated, fewer screened positive for depression, but there was no relationship with fatigue or relapse rate. Those with worsened disability levels were more likely to meditate. Discussion. The study reveals a significant association between meditation, lower risk of depression, and improved HRQOL in people with MS. Adam B. Levin, Emily J. Hadgkiss, Tracey J. Weiland, Claudia H. Marck, Dania M. van der Meer, Naresh G. Pereira, and George A. Jelinek Copyright © 2014 Adam B. Levin et al. All rights reserved. Mental Practice Combined with Physical Practice to Enhance Hand Recovery in Stroke Patients Sun, 09 Nov 2014 12:08:18 +0000 Objectives. To evaluate whether combining mental practice with physical practice training enhances hand function in patients with stroke. Methods. 10 for treatment and 10 for control were recruited for this pre/posttraining matched case control study. In the treatment group, subjects underwent combining mental practice with physical practice for four weeks. In the control group, subjects only participated in physical practice. Change of hand function and the number of activated voxels of the contralateral somatosensory motor cortex (SMC) acquired by functional magnetic resonance imaging were measured. Results. After training, the Action Research Arm Test score increased by 12.65 for treatment and by 5.20 for control. There was a significant difference in the Action Research Arm Test score between the two groups (). The activated voxels number of the contralateral SMC increased in both groups, but the activated voxels number in the contralateral SMC and the improvement of hand function for treatment were greater than for control. In the treatment group, the number of activated voxels of the contralateral SMC was positively correlated with better hand function scores. Conclusions. Combining mental practice with physical practice may be a more effective treatment strategy than physical training alone for hand recovery in stroke patients. Hua Liu, Lu-ping Song, and Tong Zhang Copyright © 2014 Hua Liu et al. All rights reserved. Modafinil Effects on Behavior and Oxidative Damage Parameters in Brain of Wistar Rats Thu, 06 Nov 2014 00:00:00 +0000 The effects of modafinil (MD) on behavioral and oxidative damage to protein and lipid in the brain of rats were evaluated. Wistar rats were given a single administration by gavage of water or MD (75, 150, or 300 mg/kg). Behavioral parameters were evaluated in open-field apparatus 1, 2, and 3 h after drug administration. Thiobarbituric acid reactive substances (TBARS) and protein carbonyl formation were measured in the brain. MD increased locomotor activity at the highest dose 1 and 3 h after administration. MD administration at the dose of 300 mg/kg increased visits to the center of open-field 1 h after administration; however, 3 h after administration, all administered doses of MD increased visits to the open-field center. MD 300 mg/kg increased lipid damage in the amygdala, hippocampus, and striatum. Besides, MD increased protein damage in the prefrontal cortex, amygdala, and hippocampus; however, this effect varies depending on the dose administered. In contrast, the administration of MD 75 and 300 mg/kg decreased the protein damage in the striatum. This study demonstrated that the MD administration induces behavioral changes, which was depending on the dose used. In addition, the effects of MD on oxidative damage parameters seemed to be in specific brain region and doses. Felipe Ornell, Samira S. Valvassori, Amanda V. Steckert, Pedro F. Deroza, Wilson R. Resende, Roger B. Varela, and João Quevedo Copyright © 2014 Felipe Ornell et al. All rights reserved. Effect of Anodal Transcranial Direct Current Stimulation on Autism: A Randomized Double-Blind Crossover Trial Thu, 30 Oct 2014 08:34:15 +0000 The aim of this study was to evaluate the Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), and Children’s Global Assessment Scale (CGAS) after anodal transcranial direct current stimulation (tDCS) in individuals with autism. Twenty patients with autism received 5 consecutive days of both sham and active tDCS stimulation (1 mA) in a randomized double-blind crossover trial over the left dorsolateral prefrontal cortex (F3) for 20 minutes in different orders. Measures of CARS, ATEC, and CGAS were administered before treatment and at 7 days posttreatment. The result showed statistical decrease in CARS score (). ATEC total was decreased from 67.25 to 58 (). CGAS was increased at 7 days posttreatment (). Our study suggests that anodal tDCS over the F3 may be a useful clinical tool in autism. Anuwat Amatachaya, Narong Auvichayapat, Niramol Patjanasoontorn, Chanyut Suphakunpinyo, Niran Ngernyam, Benchaporn Aree-uea, Keattichai Keeratitanont, and Paradee Auvichayapat Copyright © 2014 Anuwat Amatachaya et al. All rights reserved. Behavioral Disorder amongst Adolescents Attending Secondary School in Southeast Nigeria Mon, 08 Sep 2014 05:45:16 +0000 Background. Adolescents are prone to various forms of behavioral problems. These behavioral issues in adolescents can have serious consequences for the adolescents. Objectives. The objectives of the study are to determine the causative factors of adolescent problems and specific manifestations. Methods. Behavioral problems were investigated using a random sampling of adolescents from secondary schools in southeast Nigeria from February to April, 2014. A self-administered questionnaire was developed from Health Kids Colorado Questionnaire. Results. A total of 763 subjects completed the questionnaire. Adolescents who reported to have used tobacco 3 to 5 and 6 to 9 times during the last 30 days are just 3.14% and 3.4%, respectively. Nineteen (2.49%) adolescents claimed that they have had sex before but not in the last 3 months. Adolescents who attempted suicide are from 15 years and peaked at 18. Eighty-three (11%) adolescents who are 15 years old attempted suicide in a year; this peaks at 17 years where 235 (30.8%) committed suicide. Majority of adolescents with behavioral disorder are from the upper class family. Conclusion. This study revealed that adolescents exhibit several forms of behavioral problems. J. M. Chinawa, P. C. Manyike, H. A. Obu, O. I. Odetunde, E. C. Aniwada, I. K. Ndu, and A. T. Chinawa Copyright © 2014 J. M. Chinawa et al. All rights reserved. Quantitative Evaluation of the Use of Actigraphy for Neurological and Psychiatric Disorders Tue, 19 Aug 2014 07:53:21 +0000 Quantitative and objective evaluation of disease severity and/or drug effect is necessary in clinical practice. Wearable accelerometers such as an actigraph enable long-term recording of a patient’s movement during activities and they can be used for quantitative assessment of symptoms due to various diseases. We reviewed some applications of actigraphy with analytical methods that are sufficiently sensitive and reliable to determine the severity of diseases and disorders such as motor and nonmotor disorders like Parkinson’s disease, sleep disorders, depression, behavioral and psychological symptoms of dementia (BPSD) for vascular dementia (VD), seasonal affective disorder (SAD), and stroke, as well as the effects of drugs used to treat them. We believe it is possible to develop analytical methods to assess more neurological or psychopathic disorders using actigraphy records. Weidong Pan, Yu Song, Shin Kwak, Sohei Yoshida, and Yoshiharu Yamamoto Copyright © 2014 Weidong Pan et al. All rights reserved. Inhibitory Effect of NMDA Receptors in the Ventral Tegmental Area on Hormonal and Eating Behavior Responses to Stress in Rats Thu, 07 Aug 2014 07:18:25 +0000 Background. Stress and its consequences are among the causes of accidents. Objective. The effects of intraventral tegmental area (I-VTA) memantine on the plasma corticosterone and eating parameters disturbance induced by acute stress were investigated. Methods. Male Wistar rats (W: 250–300 g) were divided into control and experiential groups, each of which received memantine either intra-VTA or peripherally. One week after bilateral cannulation, the rats received memantine (1 and 5 μg/Rat) five min before electroshock stress. The other experimental groups received memantine (1 and 5 mg/kg) intraperitoneally 30 min before stress. The control groups received saline or memantine but did not experience stress. Food and water intake and plasma corticosterone level were recorded. Results. Results showed that stress decreases food intake but does not change water intake and increase in plasma corticosterone level. Intraperitoneal memantine administration slightly inhibits the stress effects on food intake. However, water intake and plasma corticosterone level were increased. Intra-VTA memantine reduces the effects of stress on corticosterone and water intake. Conclusion. It could be concluded that inhibition of glutamate NMDA receptors in the VTA by memantine leads to the inhibition of the eating behavior parameters and plasma corticosterone level disturbance induced by stress in rats. Zohreh Sadat Nasihatkon, Maryam Khosravi, Zahra Bourbour, Hedayat Sahraei, Mina Ranjbaran, Seyedeh Maryam Hassantash, Mohammad Sahraei, and Kefayat Baghlani Copyright © 2014 Zohreh Sadat Nasihatkon et al. All rights reserved. Correlation Analysis of Sleep Quality and Youth Ischemic Stroke Tue, 05 Aug 2014 13:02:57 +0000 Objective. To study risk factors related to ischemic stroke (IS) in youth and the influence of sleep quality on youth ischemic stroke incidence. Methods. 223 patients aged 18 to 45 years who were admitted to Puyang People’s Hospital from June 2011 to February 2013 with a first-ever ischemic stroke were selected as the research cases. 158 young people with a normal physical examination were selected as the control group. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to analyse the correlation between sleep quality and youth IS incidence. The US National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (MRS) scores were used to assess cases’ state of illness and prognosis three months after IS. Results. Univariate and multivariate logistic regression analysis showed that the association of these risk factors with youth IS incidence, from highest to lowest, was hypertension, hyperlipidaemia, smoking history, high homocysteine, the quality of sleep, family history of stroke, and alcoholism. Poor sleep quality ranked fifth among all risk factors and was positively correlated with poor prognosis for youth IS patients. Conclusion. The results of this study showed that sleep quality is an important factor in the pathogenesis and prognosis of youth IS. Shunqing Zhang, Cheng Chang, Juan Zhang, Bo Song, Hui Fang, and YuMing Xu Copyright © 2014 Shunqing Zhang et al. All rights reserved. Memory Functioning in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes Sun, 03 Aug 2014 12:53:16 +0000 Specific cognitive deficits have been identified in children with epilepsy irrespective of results on intelligence tests. Memory deficits are traditionally attributed to temporal lobe epilepsy, whereas the impact of frontal lobe epilepsy on memory functions has remained controversial. The aim of this study was the examination of memory abilities in other childhood common epilepsy syndromes (frontal lobe epilepsy (FLE), childhood absence epilepsy (CAE), and benign epilepsy with centrotemporal spikes (BECTS)) and the influence of epilepsy-related variables. Memory was examined in 90 children with epilepsy (each epilepsy group consisted of 30 children), aged 6–15, and compared with 30 control children. Children with FLE showed significant deficits in verbal and visual memory. In addition, type of epilepsy, earlier age at epilepsy onset, and longer active duration of epilepsy were associated with memory problems. Seizure frequency and treatment, however, did not influence memory performance. This study indicates that children with FLE show greater risk of developing memory deficits than children with CAE or BECTS, thus highlighting the importance of assessing also memory functions in frontal lobe epilepsy. Ana Filipa Lopes, José Paulo Monteiro, Maria José Fonseca, Conceição Robalo, and Mário Rodrigues Simões Copyright © 2014 Ana Filipa Lopes et al. All rights reserved. Restless Leg Syndrome and Sleep Quality in Lumbar Radiculopathy Patients Tue, 08 Jul 2014 00:00:00 +0000 Background. To investigate the frequency of restless leg syndrome (RLS), sleep quality impairment, depression, fatigue, and sleep behavior disorder and to determine the effects of surgery on these parameters in radiculopathy patients resistant to conservative treatment. Methods. The present study included 66 lumbar radiculopathy patients, who were resistant to conservative treatment and had indication of surgery. Five different questionnaires were performed to assess depression (the Beck Depression Inventory (BDI)), sleep quality (the Pittsburgh Sleep Quality Index (PSQI)), fatigue (the Fatigue Severity Scale (FSS)), and presence of RLS and rapid eye movement sleep behavior disorder (RBD). The same questionnaires were also performed on a control group . Results. Of the radiculopathy patients, 68.1% had RLS and 92.4% had fatigue. Of the controls, 16.4% had RLS and 59% had fatigue. RBD was present in 8 (12.1%) patients and 3 (4.9%) controls. The PSQI revealed that sleep quality was impaired in 46 (69.7%) patients and 35 (57.4%) controls . The number of individuals having substantial depression according to the BDI was significantly higher in the patients than in the controls. Conclusions. There was a significant increase in the frequency of RLS, which was significantly decreased in the postoperative period in the radiculopathy patients. Ersoy Kocabicak, Murat Terzi, Kursad Akpinar, Kemal Paksoy, Ibrahim Cebeci, and Omer Iyigun Copyright © 2014 Ersoy Kocabicak et al. All rights reserved. Thalamic Lesions: A Radiological Review Wed, 02 Jul 2014 08:40:11 +0000 Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions). Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations. Dimitri Renard, Giovanni Castelnovo, Chantal Campello, Stephane Bouly, Anne Le Floch, Eric Thouvenot, Anne Waconge, and Guillaume Taieb Copyright © 2014 Dimitri Renard et al. All rights reserved. Attention Deficit Hyperactivity Disorder: A Neglected Issue in the Developing World Wed, 25 Jun 2014 07:11:55 +0000 Background. Attention deficit hyperactivity disorder (ADHD) is a neglected illness in a developing country. Objectives. The objectives of this study are to investigate the prevalence and pattern of ADHD among children in a Nigeria. Methods. A structured self-administered questionnaire was used to collect information from the parents of children (and older children) who attended children outpatients’ clinic during the study period. The DSM-IV-TR diagnostic criteria for attention deficit hyperactivity disorder were used. Results. Two hundred and seventy-three (273) out of 282 questionnaires were filled completely, giving a response rate of 96.8%. Nine (9) children fulfilled the stated criteria for ADHD giving a prevalence rate of 3.2%. There is no association between gender and ADHD (). Conclusions. The prevalence of ADHD in our setting is 3.2%, which is similar to that obtained elsewhere in the world. J. M. Chinawa, O. I. Odetunde, Herbert A. Obu, A. T. Chinawa, Muideen O. Bakare, and F. A. Ujunwa Copyright © 2014 J. M. Chinawa et al. All rights reserved. Negative Emotions in Migraineurs Dreams: The Increased Prevalence of Oneiric Fear and Anguish, Unrelated to Mood Disorders Tue, 24 Jun 2014 00:00:00 +0000 Background. Migraineurs brain has shown some functional peculiarities that reflect not only in phonophobia, and photophobia, but also in mood and sleep. Dreaming is a universal mental state characterized by hallucinatory features in which imagery, emotion, motor skills, and memory are created de novo. We evaluated dream contents and associated emotions in migraineurs. Materials and Methods. 412 subjects: 219 controls; and 148 migraineurs (66 with aura, MA; 82 without aura, MO), and 45 tension type headache patients (TTH). A semistructured retrospective self-reported questionnaire was used to evaluate dreams. The Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depression. Results. Migraineurs showed increased levels of anxiety ( for MA versus controls, for MO versus controls). Fear and anguish during dreaming were more frequently reported by migraine patients compared to controls, independently by anxiety and depression scores. Discussion. The brain of migraineurs seems to dream with some peculiar features, all with a negative connotation, as fear and anguish. It may be due to the recorded negative sensations induced by recurrent migraine pain, but it may just reflect a peculiar attitude of the mesolimbic structures of migraineurs brain, activated in both dreaming and migraine attacks. F. De Angeli, C. Lovati, L. Giani, C. Mariotti D'Alessandro, E. Raimondi, V. Scaglione, D. Castoldi, E. Capiluppi, and C. Mariani Copyright © 2014 F. De Angeli et al. All rights reserved. Blood Injury and Injection Phobia: The Neglected One Tue, 24 Jun 2014 00:00:00 +0000 Blood injury and injection (BII) phobia is a unique phobia associated with a diphasic cardiovascular response. The aim of this survey was to report the prevalence of BII phobia, its heritability, and clinical characteristics among the males and females in the Indian subcontinent. An interview and a survey were conducted using a developed BII phobia 21-item questionnaire among 3261 participant males () and females (). Cronbach’ alpha (α) of 0.972 of internal consistency was reported. The prevalence of BII phobia and associated fainting in females was slightly more than double in the males with a significant gender related effect. Similar avoidance behaviours involving hospital visits were reported for both males and females. The relative frequency of BII phobia among first and third degree relatives was found to be higher than among second degree relatives. Depression was found highly comorbid with BII phobia while a low rate of obsessive compulsion disorder (OCD) and social anxiety disorder (SAD) was reported. Morbidity associated with BII phobia may increase dramatically when other medical problems coincide with it. Ab Latif Wani, Anjum Ara, and Sajad Ahmad Bhat Copyright © 2014 Ab Latif Wani et al. All rights reserved. Apathy and Emotion-Based Decision-Making in Amnesic Mild Cognitive Impairment and Alzheimer’s Disease Sun, 22 Jun 2014 12:16:58 +0000 Background. Apathy and reduced emotion-based decision-making are two behavioral modifications independently described in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). Objectives. The aims of this study were to investigate decision-making based on emotional feedback processing in AD and aMCI and to study the impact of reduced decision-making performances on apathy. Methods. We recruited 20 patients with AD, 20 participants with aMCI, and 20 healthy controls. All participants completed the Lille apathy rating scale (LARS) and the Iowa gambling task (IGT). Results. Both aMCI and AD participants had reduced performances on the IGT and were more apathetic compared to controls without any difference between aMCI and AD groups. For the entire sample, LARS initiation dimension was related to IGT disadvantageous decision-making profile. Conclusions. We provide the first study showing that both aMCI and AD individuals make less profitable decisions than controls, whereas aMCI and AD did not differ. Disadvantageous decision-making profile on the IGT was associated with higher level of apathy on the action initiation dimension. The role of an abnormal IGT performance as a risk factor for the development of apathy needs to be investigated in other clinical populations and in normal aging. Sophie Bayard, Jean-Pierre Jacus, Stéphane Raffard, and Marie-Christine Gely-Nargeot Copyright © 2014 Sophie Bayard et al. All rights reserved. Insulin Blocks Glutamate-Induced Neurotoxicity in Differentiated SH-SY5Y Neuronal Cells Sun, 15 Jun 2014 05:29:07 +0000 Insulin is a cytokine which promotes cell growth. Recently, a few published reports on insulin in different cell lines support the antiapoptotic effect of insulin. But the reports fail to explain the role of insulin in modulating glutamate-mediated neuronal cell death through excitotoxicity. Thus, we examined the neuroprotective effect of insulin on glutamate-induced toxicity on differentiated SH-SY5Y neuronal cells. Changes in cell viability were measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) based assay, while apoptotic damage was detected by acridine orange/ethidium bromide and Hoechst staining. Intracellular reactive oxygen species (ROS) accumulation and morphological alterations were also measured. Treatment with glutamate induced apoptosis, elevated ROS levels and caused damage to neurons. Insulin was able to attenuate the glutamate-induced excitotoxic damage to neuronal cells. Madhavan Nampoothiri, Neetinkumar D. Reddy, Jessy John, Nitesh Kumar, Gopalan Kutty Nampurath, and Mallikarjuna Rao Chamallamudi Copyright © 2014 Madhavan Nampoothiri et al. All rights reserved. Brain and Language: Evidence for Neural Multifunctionality Mon, 09 Jun 2014 05:07:05 +0000 This review paper presents converging evidence from studies of brain damage and longitudinal studies of language in aging which supports the following thesis: the neural basis of language can best be understood by the concept of neural multifunctionality. In this paper the term “neural multifunctionality” refers to incorporation of nonlinguistic functions into language models of the intact brain, reflecting a multifunctional perspective whereby a constant and dynamic interaction exists among neural networks subserving cognitive, affective, and praxic functions with neural networks specialized for lexical retrieval, sentence comprehension, and discourse processing, giving rise to language as we know it. By way of example, we consider effects of executive system functions on aspects of semantic processing among persons with and without aphasia, as well as the interaction of executive and language functions among older adults. We conclude by indicating how this multifunctional view of brain-language relations extends to the realm of language recovery from aphasia, where evidence of the influence of nonlinguistic factors on the reshaping of neural circuitry for aphasia rehabilitation is clearly emerging. Dalia Cahana-Amitay and Martin L. Albert Copyright © 2014 Dalia Cahana-Amitay and Martin L. Albert. All rights reserved. Posterior AD-Type Pathology: Cognitive Subtypes Emerging from a Cluster Analysis Thu, 05 Jun 2014 18:33:48 +0000 Background. “Posterior shift” of the neuropathological changes of Alzheimer's disease (AD) produces a syndrome (posterior cortical atrophy) (PCA) dominated by high-level visual deficits. Objective. To explore in patients with AD-type pathology whether a data-driven analysis (cluster analysis) based on neuropsychological findings resulted in the emergence of different subgroups of patients; in particular to find out whether it was possible to identify patients with visuospatial deficits consistent with the hypothesis that PCA is a “dorsal stream” syndrome or, rather, whether there were subgroups of patients with different types of impairment within the high-level visual domain. Methods. 23 PCA and 16 DAT patients were studied. By a principal component analysis performed on a wide range of neuropsychological tasks, 15 variables were obtained that loaded onto five main factors (memory, language, perceptual, visuospatial, and calculation) which entered a hierarchical cluster analysis. Results. Four clusters of cognitive impairment emerged: visuospatial/perceptual, memory, perceptual/calculation, and language. Only in the first cluster a visuospatial deficit clearly emerged. Conclusions. AD pathology produces not only variants dominated by memory (DAT) and, to a lesser extent, visuospatial deficit (PCA), but also other distinct syndromic subtypes with disorders in visual perception and language which reflect a different vulnerability of specific functional networks. Antonella Cappa, Nicoletta Ciccarelli, Eleonora Baldonero, Marialuisa Martelli, and Maria Caterina Silveri Copyright © 2014 Antonella Cappa et al. All rights reserved. Heterogeneity of Radiological Spectrum in Tacrolimus-Associated Encephalopathy after Lung Transplantation Tue, 27 May 2014 08:21:32 +0000 Background. Tacrolimus-associated encephalopathy (TAC-E) is usually described under the term of posterior reversible encephalopathy syndrome (PRES). However, a large amount of data has suggested that TAC-E is not a homogenous entity: indeed, TAC-E which is often presented with atypical and potentially misleading imaging characteristics does not always correspond to PRES. Objective. We aimed to identify the spectrum of brain MR imaging of TAC-E and discuss the underlying pathophysiological features. Methods. From September 2008 to October 2010, the neurological statuses of 45 patients, who underwent lung transplantation with TAC as posttransplantation immunosuppressive therapy, were regularly assessed in a prospective study. MRI was repeatedly performed, until recovery, in patients who developed central neurological symptoms. Results. Symptoms suggestive of encephalopathy occurred in five out of 45 patients (11.1%). According to our MRI study, two patients presented with reversible bilateral and relatively symmetric subcortical white matter edema with proximal vasospasms on MRA; however, three other patients were characterized by coexistence of two different lesions including laminar cortical infarcts with hemorrhagic transformation not typically found in PRES and reversible deep white matter edema, associated with distal vasospasms on MRA. Conclusions. It is considered that the mechanism of TAC-E would be more heterogenous than commonly perceived. Qisi Wu, Christian Marescaux, Xinyue Qin, Romain Kessler, and Jun Yang Copyright © 2014 Qisi Wu et al. All rights reserved. Delaying Onset of Dementia: Are Two Languages Enough? Sun, 18 May 2014 10:42:18 +0000 There is an emerging literature suggesting that speaking two or more languages may significantly delay the onset of dementia. Although the mechanisms are unknown, it has been suggested that these may involve cognitive reserve, a concept that has been associated with factors such as higher levels of education, occupational status, social networks, and physical exercise. In the case of bilingualism, cognitive reserve may involve reorganization and strengthening of neural networks that enhance executive control. We review evidence for protective effects of bilingualism from a multicultural perspective involving studies in Toronto and Montreal, Canada, and Hyderabad, India. Reports from Toronto and Hyderabad showed a significant effect of speaking two or more languages in delaying onset of Alzheimer’s disease by up to 5 years, whereas the Montreal study showed a significant protective effect of speaking at least four languages and a protective effect of speaking at least two languages in immigrants. Although there were differences in results across studies, a common theme was the significant effect of language use history as one of the factors in determining the onset of Alzheimer’s disease. Moreover, the Hyderabad study extended the findings to frontotemporal dementia and vascular dementia. Morris Freedman, Suvarna Alladi, Howard Chertkow, Ellen Bialystok, Fergus I. M. Craik, Natalie A. Phillips, Vasanta Duggirala, Surampudi Bapi Raju, and Thomas H. Bak Copyright © 2014 Morris Freedman et al. All rights reserved.