bluuebunny/crossref_metadata_2025 huggingface dataset:
Gamba spirits, gender relations, and healing in post‐civil war Gorongosa, Mozambique
Authors: Igreja Victor , Dias‐Lambranca Béatrice , Richters Annemiek
Published: May 2008

This article describes the ways in which in post‐civil war Gorongosa (central Mozambique), women (and occasionally men) with personal and/or family experiences of extreme suffering are the focal point of possession by male, war‐related spirits named gamba. However, gamba spirits also create post‐war healing in which memory work and gender politics play an essential role. This type of post‐war healing is demonstrated through a secret, contractual ceremony in which a male living suitor demands permission from a gamba spirit, lodged in the body of a young woman (his deemed wife), to marry that woman. An account of the ceremony is preceded by a description of the conditions that gave rise to the emergence of gamba spirits in central Mozambique, and is followed by an analysis of the meaning of the voice of the spirit and its impact on the relation between the living husband and wife and, more generally, on Gorongosa post‐war society. We argue that the performance of gamba spirits contributes to a certain form of moral renewal. In the process, we locate relationships between spirits and hosts within wider systems of meaning in which they are created and reproduced, and we reinforce approaches to possession that see it as constituted by ‘a practice and politics of voice’ (Lambek).

L'article décrit comment, au Mozambique d'après la guerre civile, dans la région du Gorongosa au centre du pays, les femmes (et parfois les hommes) ayant fait une expérience personnelle et/ou familiale de souffrance extrême sont possédées par des esprits mâles liés à la guerre appelés gamba. Les esprits gamba sont cependant aussi facteurs d'une guérison dans laquelle le travail de mémoire et la politique des genres jouent un rôle essentiel. Ce type de guérison d'après‐guerre est démontré par une cérémonie contractuelle secrète, au laquelle un prétendant vivant demande à un esprit gamba logé dans le corps d'une jeune femme (considérée comme son épouse) la permission d’épouser cette femme. Le récit de la cérémonie est précédé d'une description des conditions suscitant l’émergence des esprits gamba dans le centre du Mozambique, et suivi par l'analyse de la signification de la voix des esprits et de son impact dans la relation entre le mari vivant et sa femme, et plus généralement dans la société d'après‐guerre du Gorongosa. Les auteurs de l'article affirment que les performances des esprits gamba contribuent à une certaine forme de renouvellement moral. Ce faisant, ils resituent les relations entre les esprits et leurs hôtes dans des systèmes plus larges de significations dans lesquels elles sont créées et reproduites, et confortent les approches qui considèrent la possession comme constituée par « une pratique et une politique de la voix » (Lambek).
Why there are no ‘colour universals’ in language and thought
Authors: Wierzbicka Anna
Published: May 2008

Do all people live in a world full of colours? Perceptually, yes (unless they are visually impaired), but conceptually, no: there are many languages which have no word for ‘colour’ and in which the question ‘what colour is it?’ cannot be asked and presumably does not arise. Yet the powerful and still immensely influential theory of Berlin and Kay assumes otherwise. While building on my earlier work on colour semantics, this article brings new evidence against the Berlin and Kay paradigm, and presents a fundamentally different approach. The new data on which the argument is based come from Australian languages. In particular, the article presents a detailed study of the visual world reflected in the Australian language Warlpiri and in Warlpiri ways of speaking, showing that while Warlpiri people have no ‘colour‐talk’ (and no ‘colour‐practices’), they have a rich visual discourse of other kinds, linked with their own cultural practices. It also offers a methodology for identifying indigenous meanings without the grid of the English concept ‘colour’, and for revealing ‘the native's point of view’.

Tout le monde vit‐il dans un monde plein de couleurs ? Du point de vue de la perception, la réponse est oui (sauf en cas de handicap visuel), mais au niveau des concepts, c'est non : dans de nombreuses langues, le mot « couleur » n'existe pas et la question « de quelle couleur est ceci ? » ne peut pas être posée, et ne se pose probablement même pas. Pourtant, théorie de Berlin et Kay, puissante et encore immensément influente, affirme le contraire. Tout en exploitant ses travaux antérieurs sur la sémantique des couleurs, l'auteur apporte de nouvelles preuves à l'encontre du paradigme de Berlin et Kay et présente une approche fondamentalement différente. Les nouvelles données sur lesquelles se base son argumentation proviennent des langues australiennes. L'article présente en particulier une étude détaillée du monde visuel tel qu'en rend compte la langue australienne warlpiri. Les expressions dans cette langue montrent que bien que les Warlpiri n'aient pas de « langage des couleurs » (ni de « pratique des couleurs »), ils ont un riche discours visuel à propos d'autres propriétés liées à leur propre pratique culturelle. L'article expose également une méthodologie pour identifier les significations indigènes en dehors de la grille du concept occidental de « couleur », et pour révéler « le point de vue indigène ».
Smoke exposure increases the risk for multiple sclerosis
Authors: Sundström P. , Nyström L. , Hallmans G.
Published: May 2008

Purpose and methods:  To estimate the effect of exposure to smoking on the risk for multiple sclerosis (MS), we analyzed nicotine metabolite (cotinine) levels in biobank samples from 109 MS cases and 218 matched referents.

Results:  Elevated cotinine levels, even modest elevations, were associated with an increased risk for MS (all other categories versus lowest: OR = 2.9; 95% CI: 1.3–6.3). A similar but non‐significant risk increase was observed also in the small subset of individuals with samples collected before the onset of MS (all other categories versus lowest: OR = 2.4; 95% CI: 0.26–21). Elevated cotinine was associated with an increased risk for MS predominantly in women (all other categories versus lowest category: OR = 3.9; 95% CI: 1.3–12), whereas the risk increase in men was smaller and non‐significant.

Discussion:  Smoke exposure is associated with a higher risk for MS than previously estimated. There seems to be a threshold effect present in the lower range of cotinine in its relation to MS. Modestly elevated cotinine levels suggestive of passive smoking are associated with an increased risk for MS. Smoke exposure may explain the higher incidence of MS in women. These preliminary findings need to be confirmed in an expanded material of prospectively collected samples.
Activity, tolerability and efficacy of levetiracetam on cerebellar symptoms in multiple sclerosis patients: a pilot kinematic study
Authors: Solaro C. , Brichetto G. , Capello E. , Abuarqub S. , Sanguineti V.
Published: May 2008

Background and purpose:  The aim of this study was to evaluate the activity measured by kinematic analysis, tolerability and efficacy of levetiracetam (LEV) in multiple sclerosis (MS) patients affected by cerebellar symptoms, in a randomized single‐blind, placebo‐controlled cross‐over study.

Methods:  Eight MS subjects with cerebellar signs (five female and three male; mean EDSS: 4.77; mean disease duration 9.2) performed a reaching task on a digitizing tablet and their trajectories went through a kinematic analysis. The subjects were assessed at baseline, after 21 days of treatment, after wash‐out period (day 35) and after 21 days of treatment (day 56). LEV was used at the maximum dosage of 1500 mg daily. The primary outcome was the modification on smoothness (JERK) whilst aiming error (AAI) and centripetal acceleration (CA) were considered as secondary outcomes.

Results:  Two subjects were excluded from the final analysis. Primary outcome (i.e. JERK) was significantly affected by the administration of LEV overtime (nine arms in active treatment versus three arms in placebo decreased the mean values of their JERK). Regarding secondary outcomes CA was significantly affected by the administration of LEV. No statistical significant results were found comparing clinical scales during the four assessments.

Discussion:  The results indicate that LEV was able to modify kinematic parameter so the medication was active but no improvement in clinical scales was observed. LEV needs to be tested in a larger group of subjects designed to verify treatment efficacy using higher dosage of the medication.
Gelsolin concentration in cerebrospinal fluid from patients with multiple sclerosis and other neurological disorders
Authors: Kulakowska A. , Drozdowski W. , Sadzynski A. , Bucki R. , Janmey P. A.
Published: May 2008

Background:  Gelsolin is a highly conserved intracellular actin‐binding protein with an extracellular isoform, plasma gelsolin, for which there is not yet a clearly defined function.

Materials and methods:  In this study, we determined gelsolin concentrations in blood and cerebrospinal fluid (CSF) obtained from 25 subjects using immunoblotting and a functional assay that quantifies gelsolin’s ability to accelerate actin polymerization.

Results:  The gelsolin concentration in CSF, determined by quantitative immunoblotting was 1.2–15.9 μg/ml (average 5.9 ± 3.8 μg/ml). In samples obtained from patients diagnosed with conditions that do not alter standard CSF clinical tests [(idiopathic cephalgia, ischialgia due to discopathy, and idiopathic (Bell’s) facial nerve palsy or entrapment radial neuropathy)], the average gelsolin concentration was 7.2 ± 4.3 μg/ml. In contrast, the gelsolin concentration in samples obtained from patients diagnosed with multiple sclerosis was 2.1 ± 0.7 μg/ml, and a similar low concentration was found in a patient recovering from a subarachnoid hemorrhage. The range of CSF gelsolin concentrations determined by the actin polymerization assay was 0.61–9.97 μg/ml (average 3.6 ± 2.2 μg/ml). These lower values compared with those obtained from immunoblotting analysis suggest that CSF gelsolin may bind other CSF molecules leading to a reduction of its actin‐binding activity.

Conclusions:  The results presented here show that CSF gelsolin concentration is significantly altered in certain neurological conditions, including multiple sclerosis, indicating the possible utility of CSF gelsolin levels for diagnostic purposes.
The functional MAOA‐uVNTR promoter polymorphism in patients with frontotemporal dementia
Authors: Reif A. , Scarpini E. , Venturelli E. , Töpner T. , Fenoglio C. , Lesch K.‐P. , Galimberti D.
Published: May 2008

The genetic underpinnings of frontotemporal dementia (FTD), a rare yet early onset disorder still remains elusive. As FTD is characterized by a serotonergic deficit in the frontal lobe, and as some symptoms of FTD resemble conditions of monoamino oxidase A (MAO‐A) deficiency, MAO‐A is an attractive candidate gene for case–control association studies of FTD. We have thus ascertained 62 Italian FTD patients and 151 controls matched to age and genotyped them for a functional promoter polymorphism, termed MAOA‐uVNTR. However, no significant differences were observed between patients and controls. Bearing in mind the caveat of the small patient sample size, our data nevertheless argue against a major genetic role of MAO‐A polymorphism in FTD.
Microtubules in basalt glass from Hawaii Scientific Driling Project #2 phase 1 core and Hilina slope, Hawaii: evidence of the occurrence and behavior of endolithic microorganisms
Authors: WALTON A. W
Published: May 2008

Elongate, fine tubes, ~1 µm wide and up to 200 µm long, extend from fractured surfaces, vesicle walls, and internal fractures into fragments of basalt glass in samples from the Hawaii Scientific Drilling Project #2 phase 1 (HSDP #21) core and the Hilina slope, Hawaii. Several features indicate that these tubes are microbial endolithic microborings: the tubes resemble many described microborings from oceanic basalt glass, their formation is postdepositional but restricted to certain but different ranges of time in the two sets of samples, and they are not uniformly distributed throughout glass fragments. Microtubules record several characteristic behaviors including boring into glass, mining, seeking olivine, and avoiding plagioclase. They also are highly associated with a particular form of glass‐replacing smectite. Evidence of behavior should join morphological and geochemical criteria in indicating microbial alteration of basalt glass.

In some samples, steeply conical tubes, ~10–20 µm in diameter tapering to 1 µm and commonly filled with smectite, appear to be modifications or elaborations of the microtubules. These also curve toward olivine and are associated with replacement smectite. In HSDP #21samples, microtubules initiated at margins of shards before palagonite replaced those margins and are preserved during palagonitization. In fact, microtubules appear to have provided routes that enhanced the efficiency of water's reaching of unaltered glass. In Hilina Slope samples, the microtubules appear to postdate palagonitization because they initiate at the boundary between palagonite and unaltered sideromelane.

Preservation of microtubules during palagonitization in samples together with recognition of other associated characteristics representing behavior suggests that such features may be recognizable in more heavily altered ancient rocks.
The Effects of Different Cranial Modules on Mechanical Properties of Cranial Suture in Lewis Rats and Same‐aged C57BL/6 Mice
Authors: Chien C. H. , Wu Y. D. , Chao Y. J. , Chen T. , Chen W. F. , Yu J. C. , Li X.
Published: May 2008

Abstract:  In this study we aimed at investigating size effects on mechanical properties of cranial suture in different animal research models. Lewis rats and C57BL/6 mice were selected as the larger research model and smaller research model, respectively. The objective of this study was to determine the mechanical properties of different cranial modules of cranial sutures in Lewis rats and same‐aged C57BL/6 mice. Ten sagittal sutures were harvested from 4‐month‐old Lewis rats and C57BL/6 mice. The specimens, kept moist, were mounted fresh and distracted until rupture. A load–displacement curve was constructed. The stiffness, Young's modulus, fracture stress and fracture energy were calculated. Moreover, scanning electron microscope (SEM) images and fracture mechanisms are discussed. Cranial modules in Lewis rats and same‐aged C57BL/6 mice are also provided. The results show differences between the two groups, with higher values from Lewis rat. Higher mechanical properties occurred mainly on the large type of cranial module in this mammalian system.
TOP INCOMES IN NEW ZEALAND 1921–2005: UNDERSTANDING THE EFFECTS OF MARGINAL TAX RATES, MIGRATION THREAT, AND THE MACROECONOMY
Authors: Atkinson A. B. , Leigh Andrew
Published: May 2008

Using taxation statistics, we estimate the income share held by top income groups in New Zealand over the period 1921–2005. We find that the income share of the richest fell during the 1930s, rose again after the Second World War, and steadily declined from the late‐1950s until the mid‐1980s. From the mid‐1980s until the mid‐1990s, top income shares rose rapidly, particularly at the very top of the distribution. We present evidence that top marginal tax rates and changing top income shares in Australia and the United Kingdom may have contributed to fluctuations in the income share of the richest 1 percent. Past economic growth does not seem to have a strong effect on the income share of the top percentile group.
THE VALUE OF VOLUNTEER LABOR AND THE FACTORS INFLUENCING PARTICIPATION: EVIDENCE FOR THE UNITED STATES FROM 2002 THROUGH 2005
Authors: Pho Yvon H.
Published: May 2008

According to the U.S. Department of Labor, the number of people who volunteered rose from 59.8 million in 2002 to 65.4 million in 2005. Those volunteering benefit from their activity in various ways; however, these benefits are non‐pecuniary and are generally not recognized in the national economic accounts used to measure gross domestic product (GDP). This paper uses data from the 2002–05 Current Population Survey Volunteer Supplements to assign a dollar value to volunteering. Different methodologies yield annual estimates from $116 to $153 billion (in 2005 dollars) over the four years (between 0.9 and 1.3 percent of 2005 GDP). Additionally, characteristics of individuals most likely to volunteer are identified. The volunteer rate varies by demographic characteristics in addition to geographic location, labor force participation, and business sector. Furthermore, the data suggest that volunteering is a “normal good” because participation increases with income even after controlling for observables.
LIFETIMES OF MACHINERY AND EQUIPMENT: EVIDENCE FROM DUTCH MANUFACTURING
Authors: Erumban Abdul Azeez
Published: May 2008

This paper estimates service lifetimes for capital assets in Dutch manufacturing industries, using information on asset retirement patterns. A Weibull distribution function is estimated using a non‐linear regression technique to derive service lifetimes for three selected asset types: transport equipment, machinery and computers. For this purpose, benchmark capital stock surveys for different two‐digit industries are linked to annual discard surveys. On average the estimated lifetimes are 6, 9 and 26 years for transport equipment, computers and machinery, respectively. However, these estimates vary across industries. A comparison of our estimates with Canadian, U.S. and Japanese estimates shows notable differences in the lifetimes of all the asset types, with machinery showing the largest difference.
Study of Velocity and Shear Stress Distributions in the Impeller Passages and the Volute of a Bio‐centrifugal Ventricular Assist Device
Authors: Chua Leok Poh , Ong Kang Shiu , Song Guoliang
Published: May 2008

Abstract:  The velocity fields within the impeller passages of three different impellers of the Kyoto‐NTN bio‐centrifugal ventricular assist device are measured using laser Doppler velocimetry in this study. The 16 forward‐swept‐blade impeller has better performance than the 16 straight‐blade and 8 backward‐swept‐blade impellers in terms of smooth flow pattern, and has less high‐shear‐stress regions in the passages. The flow distributions are found to be similar with those measured by Yu et al. Through‐flow characteristics are found in the impeller when the passages open to the biggest volute space. The flow fields in the blade channels of the impeller were found to be axis symmetrical due to the double volute design with the objective of minimizing the imbalance of the radial thrust when the impeller is magnetically suspended. In addition, the high‐intensity vortex which was detected by Yu et al. at the discharge channel of the pump is effectively reduced when the end of the splitter plate is modified by increasing the taper ratio from 4 to 20. The new design would reduce the hemolysis of blood due to the high shear rate of the vortex.
The Impact of Malnutrition on Mortality in Patients on Maintenance Hemodialysis in Serbia
Authors: Stojanovic Miomir , Stojanovic Dusica , Stefanovic Vladisav
Published: May 2008

Abstract:  Numerous studies suggest a strong association between nutrition and clinical outcome in chronic hemodialysis (HD) patients. While determination of malnutrition is often based on objective measurements, such as biochemical parameters and anthropometric data, there is no single measurement that can reliably predict the risk for malnutrition or poor outcome. The aim of the present investigation was to determine the prevalence and severity of malnutrition among HD patients in a large university‐affiliated HD center in Serbia, and to examine the relationship between various nutritional and nonnutritional factors, and the clinical outcome in the period of 20 months follow‐up. The prospective observational cohort study included patients (n = 197) with more than 3 months on HD treatment before entering the study. Global nutritional status was evaluated by the dialysis malnutrition score (DMS). Body mass index (BMI), triceps skinfold thickness (TSF), mid‐arm circumference (MAC), and mid‐arm muscle circumference (MAMC), as well as several laboratory parameters and clinical examination, were recorded. Dose of HD and protein equivalence of nitrogen appearance normalized to ideal body weight (nPNA) were evaluated by the urea kinetic model. Mortality data were collected prospectively during the 20 months of follow‐up. A moderate/severe degree of malnutrition was presented in 39.2% of female and 22.8% of male patients, while signs of mild malnutrition existed in 45.5% and 66.9% of patients, respectively. Kaplan–Meier survival analysis showed that in the entire group of patients with DMS score >10, the mortality rate was higher (log rank 5.61; P < 0.05) than in those with DMS score ≤10. Multiple logistic regression analysis (after adjusting for age and gender) showed that the predictors of malnutrition were: comorbidity expressed as index of coexistent diseases (ICED) (odds ratio [OR] 10.2; P < 0.001), length of time on HD treatment before entering the study (OR 1.29; P < 0.05), and nPNA (OR 23.62; P < 0.05). At the end of the 20 months follow‐up period, a total of 40 patients died (20.3%) with cardiovascular diseases as the main cause of death (45% of the cases). After adjusting for age and sex, only comorbid medical problems expressed as ICED (OR 5.28; P < 0.01), DMS (OR 1.21; P < 0.01), and C‐reactive protein (CRP) (OR 1.04; P < 0.05) were significant predictors of mortality. In conclusion, malnutrition in the Serbian cohort of patients on HD was very common. Nutritional status at enrollment (expressed as DMS), presence of comorbidity (ICED index), and CRP level were strong predictors of mortality during the 20 months of follow‐up.
Albumin Dialysis in Critically Ill Patients: Use Versus Omission of Intradialytic Heparin
Authors: Yang Wen Shin , Tan Han Khim , Lui Hock Foong , Chow Pierce K. , Choong Hui Lin , Wong Kok Seng
Published: May 2008

Abstract:  Albumin liver dialysis using the Molecular Adsorbent Recirculating System (MARS) (Teraklin AG, Rostock, Germany) is used in severe acute liver failure (ALF). We hypothesized that intradialytic heparin worsens preexisting hemostatic defects without enhancing system longevity or therapeutic efficacy. This was a retrospective, single center study of 10 critically ill patients (M : F = 8:2; mean age 58.5 ± 16.5 years old; Acute Physiology and Chronic Health Evaluation II 25.0 ± 3.5) treated with 31 MARS sessions (intradialytically heparinized : nonheparinized = 18:13). Mortality in this cohort was 80%. All MARS circuits were primed with dilute heparinized saline before commencement. However, intradialytic, intermittent, bolus heparin was administered on an ad hoc basis with circuit saline flush where indicated. Acute renal replacement therapy was instituted where indicated. Average total intradialytic heparin used was 757 ± 389 IU. Circuit pressures were stable with or without intradialytic heparin. Significant reductions in serum urea, creatinine, ammonia, and total bilirubin were achieved using intradialytically heparinized and nonheparinized MARS. Thrombocytopenia and elevated activated partial thromboplastin time (aPTT) were further deranged post‐MARS for both circuit types, but significantly so in intradialytically heparinized MARS: pre‐ versus post‐MARS aPTT (s) 57.8 ± 17.6 versus 88.7 ± 48.0, P = 0.011, and platelet count (× 103/L) 102.9 ± 61.1 versus 84.4 ± 50.5; P = 0.009. The use of low dose, intradialytic heparin during MARS exacerbates preexisting severe coagulopathy and thrombocytopenia in patients with severe ALF without enhancing circuit function and longevity. However, the role and safety of heparinized saline prime need further investigation.
Pulse Push/Pull Hemodialysis: In Vitro Study on New Dialysis Modality With Higher Convective Efficiency
Authors: Lee Kyungsoo , Lee Sa Ram , Mun Cho Hae , Min Byoung Goo
Published: May 2008

Abstract:  Midsize molecule retention is related with renal‐failure‐associated mortality. Here, the authors describe a new dialysis modality, pulse push/pull hemodialysis (PPPHD), which increases convective clearance. Blood and dialysate are circulated by a pulsatile pump, but with pulsatile flow patterns that are 180° out of phase. This causes blood‐to‐dialysate pressure gradients that oscillate between positive and negative, and which cause consecutive periods of ultrafiltration and backfiltration. The devised PPPHD was compared with conventional high‐flux hemodialysis (CHFHD) in terms of solute clearances, albumin loss, and total protein levels. Human plasma containing dissolved uremic marker molecules was used as a blood substitute, and clearances were investigated for blood urea nitrogen, creatinine, vitamin B12, and inulin. Observed clearances were found to be significantly higher for PPPHD by approximately 3–14% for low‐molecular‐weight solutes, by 47–48% for vitamin B12, and by 38–49% for inulin than for CHFHD. No albumin loss was observed in either of these two study groups. The authors conclude that PPPHD offers a simple straightforward means of enhancing uremic molecule removal by increasing total ultrafiltration volume without the need to infuse replacement fluid.
The American Headache Society: Looking Back
Authors: Kunkel Robert S.
Published: May 2008

Dr. Kunkel, a former president and member of the American Headache Society from its most formative days, shares some personal recollections about the emergence of the society from a small group of like‐minded individuals through to its period of rapid growth in the late 1970s and 1980s.
Prophylaxis: Headaches That Never Happen
Authors: Loder Elizabeth
Published: May 2008

The discovery of preventive drugs for headache involved both serendipity and design. Despite modest efficacy and uncertainty about mechanisms, prophylaxis has transformed the lives of countless headache sufferers in the last 50 years. Realizing its full potential will be the work of the next half‐century.
Migraine Genetics: A Fascinating Journey Towards Improved Migraine Therapy
Authors: Ferrari Michel D.
Published: May 2008

The study of migraine genetics promises to deliver significant changes to migraine therapy. Dr. Ferrari explores the emergence of the field and its importance to headache medicine.
Defining a Pathway to Discovery from Bench to Bedside: The Trigeminovascular System and Sensitization
Authors: Moskowitz Michael A.
Published: May 2008

Over the past 50 years, investigations into the pathophysiology of migraine have yielded discoveries that both illuminate the various components of the “migraine process” and lend promise to the identification of new therapies unheralded in their specificity and effectiveness.
Drug‐Induced Refractory Headache
Authors: Ward Thomas N.
Published: May 2008

Two hundred patients who were taking daily symptomatic or immediate relief medications, often in excessive quantities, yet suffering from daily or near daily severe headaches were studied. One hundred and sixteen (58%) of them were also taking concomitant prophylactic medications and they were ineffective. Low‐tyramine, low‐caffeine dietary instructions and biofeedback training were given to all patients. The effect of continuing symptomatic medications, discontinuing symptomatic medications, and adding or changing prophylactic medications were studied in the various treatment groups. It is concluded that: (1) daily use of symptomatic or immediate relief medications results in chronic daily headache; (2) discontinuing daily symptomatic medication itself results in improvement of headache; (3) concomitant use of symptomatic medications nullifies the effect of prophylactic medications; (4) discontinuing daily symptomatic medications enhances the beneficial effect of prophylactic medications.
Change Mechanisms in EMG Biofeedback Training: Cognitive Changes Underlying Improvements in Tension Headache
Authors: Rains Jeanetta C.
Published: May 2008

Forty‐three college students suffering from recurrent tension headache were randomly assigned to 1 of 4 electromyographic (EMG) biofeedback training conditions. Although all subjects were led to believe they were learning to decrease frontal EMG activity, actual feedback was contingent on decreased EMG activity for half of the subjects and increased EMG activity for the other half. Within these 2 groups, subjects also viewed bogus video displays designed to convince them they were achieving large (high success) or small (moderate success) reductions in EMG activity. Regardless of actual changes in EMG activity, subjects receiving high‐success feedback showed substantially greater improvement in headache activity (53%) than subjects receiving moderate success feedback (26%). Performance feedback was also related to changes in locus of control and self‐efficacy. Changes in these 2 cognitive variables during biofeedback training were also correlated with reductions in headache activity following treatment, whereas changes in EMG activity exhibited during training were uncorrelated with outcome. These results suggest that the effectiveness of EMG biofeedback training with tension headache may be mediated by cognitive changes induced by performance feedback and not primarily by reductions in EMG activity.
American Headache Through the Decades: 1950 to 2008
Authors: Solomon Seymour , Diamond Seymour , Mathew Ninan , Loder Elizabeth
Published: May 2008

As the American Headache Society approaches its 50th anniversary, it seems worthwhile to step back and survey the many changes in the headache field since the 1950s. Many, perhaps most, of the trends, ideas, and changes we review in this article cannot easily be assigned to a particular decade but we have nonetheless chosen a by‐the‐decade format because it is a familiar and useful way of understanding history. Our focus is on events in the United States and the American Headache Society; space and the need to limit the scope of the article preclude a full description of the many parallel and influential trends, personalities, and ideas in other parts of the world or in other professional organizations. The authors hope you will find this summary of American Headache Medicine in the last half of the 20th and the beginning of the 21st centuries entertaining and educational.
The International Classification of Headache Disorders
Authors: Olesen Jes
Published: May 2008

A set of related medical disorders that lack a proper classification system and diagnostic criteria is like a society without laws. The result is incoherence at best, chaos at worst. For this reason, the International Classification of Headache Disorders (ICHD) is arguably the single most important breakthrough in headache medicine over the last 50 years. The ICHD identifies and categorizes more than a hundred different kinds of headache in a logical, hierarchal system. Even more important, it has provided explicit diagnostic criteria for all of the headache disorders listed. The ICHD quickly became universally accepted, and criticism of the classification has been minor relative to that directed at other disease classification systems. Over the 20 years following publication of the first edition of the ICHD, headache research has rapidly accelerated despite sparse allocation of resources to that effort. In summary, the ICHD has attained widespread acceptance at the international level and has substantially facilitated both clinical research and clinical care in the field of headache medicine.
Clinical correlates of pathological gambling symptoms in patients with epilepsy
Authors: Cavanna Andrea E. , Mula Marco , Strigaro Gionata , Servo Serena , Tota Grazia , Barbagli Davide , Collimedaglia Laura , Viana Michele , Cantello Roberto , Monaco Francesco
Published: May 2008

Summary

Pathological gambling symptoms (PGS), that is, the subjective urge to gamble and the actual gambling behaviors, are currently acknowledged as relatively common symptoms among Western countries, with an estimated point prevalence of 0.6–1.1% in the general population. Converging evidence suggests that PGS are overrepresented in patients with neurological conditions affecting dopaminergic reward pathways, and can be expressed in both impulse control disorders and obsessive‐compulsive spectrum disorders. This study explored the clinical correlates of PGS in patients with epilepsy. Eighty‐eight consecutive adult outpatients recruited at three epilepsy clinics in northern Italy were assessed using the Gambling‐Symptom Assessment Scale (G‐SAS), along with a battery of psychometric instruments to index depression (Beck Depression Inventory [BDI]), anxiety (Spielberger State‐Trait Anxiety Inventory [STAI]), and obsessionality (Yale‐Brown Obsessive Compulsive Scale [YBOCS]) symptoms. On the G‐SAS, patients with a diagnosis of temporal lobe epilepsy (TLE) reported a mean [sd] G‐SAS score of 2.0 [5.7], significantly higher than patients with frontal lobe epilepsy (FLE) (0.6 [1.7]) and idiopathic generalized epilepsy (IGE) (0.4 [1.4]). Moreover, multiple regression analysis showed that G‐SAS scores were selectively predicted by YBOCS scores, thus suggesting an association between the expression of obsessional spectrum symptoms and PGS in patients with TLE. Alterations in the mesolimbic reward system could represent the putative neuropathological substrate for this multifaceted clinical picture.
Occurrence of seizures in association with work‐related stress in young male army recruits
Authors: Moshe Shlomo , Shilo Michal , Chodick Gabriel , Yagev Yaron , Blatt Ilan , Korczyn Amos D. , Neufeld Miri Y.
Published: May 2008

Summary

Purpose: To examine the risk of undergoing an epileptic seizure as a function of differing levels of occupational stress (physical and mental) in new military recruits with no previous history of epilepsy or with epilepsy in remission for over 2 years.

Methods: The medical records of over 300,000 18‐year‐old men recruited to the Israeli army between mid‐eighties and mid‐nineties were used to assemble a cohort, which was followed for a period of 30 months. The severity of epilepsy at recruitment was determined according to four categories, 0 (no history of seizures) and 1–3 (history of seizures with different relapse‐free periods, with or without treatment). The soldiers were subdivided according to their occupational categories to: combat units (CU), maintenance units (MU), and administrative units (AU).

Results: The annual incidence rates per 100,000 in category 0 were 317, 298, and 401 in AU, MU, and CU, respectively. The incidence of seizures in category 0 was higher (relative risk [RR]= 1.29, CI = 1.03–1.62) in CU compared to AU and MU. No differences were found for seizure recurrence among various occupational groups.

Conclusion: The increased risk of seizures in CU compared to AU and MU may indicate contribution of service conditions in CU, like physical and mental stress. The equivalent rates of seizure relapse, regardless of the type of occupation, suggests the need for minimal occupational restrictions for epilepsy patients who have been free of seizures for long periods.
Microchromosomal deletions involving SCN1A and adjacent genes in severe myoclonic epilepsy in infancy
Authors: Wang Ji‐wen , Kurahashi Hirokazu , Ishii Atsushi , Kojima Toshio , Ohfu Masaharu , Inoue Takahito , Ogawa Atsushi , Yasumoto Sawa , Oguni Hirokazu , Kure Shigeo , Fujii Tatsuya , Ito Masatoshi , Okuno Takehiko , Shirasaka Yukiyoshi , Natsume Jun , Hasegawa Aki , Konagaya Akihiko , Kaneko Sunao , Hirose Shinichi
Published: May 2008

Summary

Purpose: Genetic abnormalities of the gene encoding α1 subunit of the sodium channel (SCN1A), which can be detected by direct sequencing, are present in more than 60% of patients with severe myoclonic epilepsy in infancy (SMEI) or its borderline phenotype (SMEB). Microchromosomal deletions have been recently reported as additional causes of SMEI. This study examines whether such microdeletions are associated with SMEI as well as with SMEB.

Methods: We recruited patients with SMEI (n = 35) and SMEB (n = 34), who were confirmed previously to have no mutations of SCN1A by direct sequencing. Microdeletions were sought by multiplex ligation‐dependent probe amplification (MLPA), and then confirmed and characterized by fluorescence in situ hybridization (FISH) and array‐based comparative genomic hybridization (aCGH), respectively.

Results: Heterozygous multiple exonic deletions were identified in 7/35 SMEI patients (20%) and 0/34 SMEB patients (0%), with a net frequency of 10.1% (7/69 patients). Deletions were confirmed by FISH and aCGH analysis. The concomitant deletions of adjacent genes were revealed by aCGH. None of the parents who agreed to undergo the analysis had such deletions suggesting that the deletions were de novo. The phenotypes of patients with the deletions were indistinguishable from those of SMEI resulting from point mutations.

Discussion: Our findings indicate that microchromosomal deletion, often involving not only SCN1A but also several adjacent genes, is associated with core SMEI. As microchromosomal deletion cannot be anticipated by the phenotypes or detected by conventional methods, genetic abnormalities in SMEI should be carefully sought by techniques that can detect microdeletions.
Psychoses of epilepsy in Babylon: The oldest account of the disorder
Authors: Reynolds Edward H. , Kinnier Wilson James V.
Published: May 2008

Summary

We have previously published translations of Babylonian texts on epilepsy and stroke, which we believe to be the oldest detailed accounts of these neurological disorders from the second millennium BC. We now present a short Babylonian text, which clearly describes what are today known as interictal or schizophrenia‐like psychoses of epilepsy. The text includes many of the classical symptoms of the syndrome, for example, paranoid delusions, hallucinations and mood disorders, as well as religiosity and hyposexuality, which have only been crystallized in the twentieth century. The Babylonians were remarkably good observers of human disease and behavior but had little or no understanding of pathology or brain function. Although they recognized many natural causes of disease, epilepsy and behavior disorders were attributed to supernatural, usually evil forces, the forerunner of the Greek concept of the Sacred Disease.
A cellular mechanism for dendritic spine loss in the pilocarpine model of status epilepticus
Authors: Kurz Jonathan E. , Moore Bryan J. , Henderson Scott C. , Campbell John N. , Churn Severn B.
Published: May 2008

Purpose:  Previous studies have documented a synaptic translocation of calcineurin (CaN) and increased CaN activity following status epilepticus (SE); however, the cellular effect of these changes in CaN in the pathology of SE remains to be elucidated. This study examined a CaN‐dependent modification of the dendritic cytoskeleton. CaN has been shown to induce dephosphorylation of cofilin, an actin depolymerization factor. The ensuing actin depolymerization can lead to a number of physiological changes that are of interest in SE.

Methods:  SE was induced by pilocarpine injection, and seizure activity was monitored by video‐EEG. Subcellular fractions were isolated by differential centrifugation. CaN activity was assayed using a paranitrophenol phosphate (pNPP) assay protocol. Cofilin phosphorylation was assessed using phosphocofilin‐specific antibodies. Cofilin–actin binding was determined by coimmunoprecipitation, and actin polymerization was measured using a triton‐solubilization protocol. Spines were visualized using a single‐section rapid Golgi impregnation procedure.

Results:  The immunoreactivity of phosphocofilin decreased significantly in hippocampal and cortical synaptosomal samples after SE. SE‐induced cofilin dephosphorylation could be partially blocked by the preinjection of CaN inhibitors. Cofilin activation could be further demonstrated by increased actin–cofilin binding and a significant depolymerization of neuronal actin, both of which were also blocked by CaN inhibitors. Finally, we demonstrated a CaN‐dependent loss of dendritic spines histologically.

Discussion:  The data demonstrate a CaN‐dependent, cellular mechanism through which prolonged seizure activity results in loss of dendritic spines via cofilin activation. Further research into this area may provide useful insights into the pathology of SE and epileptogenic mechanisms.
Impaired NaV1.2 function and reduced cell surface expression in benign familial neonatal‐infantile seizures
Authors: Misra Sunita N. , Kahlig Kristopher M. , George Alfred L.
Published: May 2008

Summary

Purpose: Mutations in SCN2A, the gene encoding the brain voltage‐gated sodium channel α‐subunit Na
V
1.2, are associated with inherited epilepsies including benign familial neonatal‐infantile seizures (BFNIS). Functional characterization of three BFNIS mutations was performed to identify defects in channel function that underlie this disease.

Methods: We examined three BFNIS mutations (R1319Q, L1330F, and L1563V) using whole‐cell patch‐clamp recording of heterologously expressed human Na
V
1.2. Membrane biotinylation was employed to examine the cell surface protein expression of the four Na
V
1.2 alleles.

Results: R1319Q displayed mixed effects on activation and fast inactivation gating, consistent with a net loss of channel function. L1563V exhibited impaired fast inactivation predicting a net gain of channel function. The L1330F mutation significantly decreased overall channel availability during repetitive stimulation. Patch‐clamp analysis also revealed that cells expressing BFNIS mutants exhibited lower levels of sodium current compared to wild type (WT) Na

V

1.2. Biochemical experiments demonstrated that all three BFNIS mutations exhibited a significant reduction in cell surface expression compared to WT.

Discussion: Our findings indicate that BFNIS is associated with a range of biophysical defects accompanied by reduced levels of channel protein at the plasma membrane.
Refractory status epilepticus during pregnancy secondary to cavernous angioma
Authors: Aladdin Yasser , Gross Donald W.
Published: May 2008

Summary

First‐time seizure and status epilepticus during pregnancy have been previously reported as the initial manifestation of intracranial cavernous hemangioma. We report a woman with no history of seizures who presented with refractory status epilepticus at 10 weeks gestation. Cranial MRI revealed a right frontal cavernous hemangioma. The seizures remained refractory to conventional anticonvulsant medications and 48 h of general anesthetic. Termination of the pregnancy resulted in almost immediate resolution of the seizures. The dramatic response of the seizures to termination of the pregnancy suggests that hormonal factors were primarily responsible for the precipitous presentation in this patient.
Exposure to antiepileptic drugs and the risk of hip fracture: A case‐control study
Authors: Tsiropoulos Ioannis , Andersen Morten , Nymark Tine , Lauritsen Jens , Gaist David , Hallas Jesper
Published: May 2008

Purpose:  To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture.

Methods:  We performed a case‐control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals with a hip fracture during the period 1996–2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95% confidence intervals (CI) for hip fracture were estimated by unconditional logistic regression.

Results:  Fracture risk was increased with ever use of any AED (OR: 1.31; 95% CI: 1.16–1.48). The risk was also increased with use of only enzyme inducing (OR: 1.31; 95% CI: 1.14–1.51), but not with use of only noninducing AEDs (OR: 1.03; 95% CI: 0.77–1.37). Current (OR: 1.92; 95% CI: 1.58–2.33) and recent use, as well as high daily (OR: 1.50; 95% CI: 1.24–1.82) and cumulative dose increased fracture risk, but long treatment duration or previous use did not. The risk was modified by the presence of an epilepsy diagnosis.

Conclusion:  Use of AEDs modestly increases the risk of hip fracture. The risk increase is probably associated to a higher degree with a dose dependent effect on CNS with current and recent use, than with an effect on bone tissue.
Interictal spikes on intracranial recording: Behavior, physiology, and implications
Authors: Spencer Susan S. , Goncharova Irina I. , Duckrow Robert B. , Novotny Edward J. , Zaveri Hitten P.
Published: May 2008

Purpose:  The physiological, pathological, and clinical meaning of interictal spikes (IISs) remains controversial. We systematically analyzed the frequency, occurrence, and distribution of IISs recorded from multiple intracranial electrodes in 34 refractory epileptic patients with respect to seizures and antiepileptic drug (AED) changes.

Methods:  Continuous spike counts from all recorded contacts of all implanted electrodes, and also separately for the subset of contacts involved at seizure onset, were tabulated for every hour of every day of recording, and expressed as spikes per hour in six preselected, 24‐h intervals (defined to exclude seizures): (1) on medications; (2) prepreseizure; (3) preseizure; (4) postseizure; (5) off meds; and (6) resumed meds. Mean spike rates were analyzed for differences between designated 24‐h intervals.

Results:  Spike rate in all recorded contacts consistently and significantly decreased after AED withdrawal, despite variability in initial spike rate, diurnal occurrence, seizure character/number/localization of onset, and type(s) of AED continued or withdrawn (p < 0.0001). A significant increase in spike rate was noted in the 24  h after seizures of medial temporal origin, in the medial temporal lobe contacts; neocortical onset seizures did not show any increase.

Conclusions:  These observations confirm and extend previous reports, suggesting a general effect of AED withdrawal, and a more specific effect of medial temporal lobe seizures, on IIS rate. AED mechanisms and efficacy might be demonstrated by quantifying IIS with changes in AEDs. Furthermore, variability in IIS rate after seizures distinguishes localization of seizure onset in medial temporal versus neocortical locations.