bluuebunny/crossref_metadata_2025 huggingface dataset:
Salivary Levels of CGRP and VIP in Rhinosinusitis and Migraine Patients
Authors: Bellamy Jaime L. , Cady Roger K. , Durham Paul L.
Published: January 2006

Background.—Secretion of calcitonin gene‐related peptide (CGRP) from trigeminal nerves and vasoactive intestinal peptide (VIP) from parasympathetic nerves is involved in the pathophysiology of migraine and rhinosinusitis. Analysis of these neuropeptides in human saliva samples can be used as markers of trigeminal and parasympathetic nerve activity in patients between and during attacks as well as in response to specific treatments.

Objective.—To compare the amount of trigeminal sensory and parasympathetic nerve activation by measuring CGRP and VIP levels in the saliva of subjects experiencing noninfectious allergic rhinosinusitis, migraine with sinus symptoms, and no symptoms.

Methods.—Subjects were enrolled in three groups. Group A: subjects without a history of migraine, “sinus” headache, or allergic rhinosinusitis within the previous 6 months. Group B: subjects with chronic recurrent noninfectious rhinosinusitis and no history of migraine or “sinus” headache. Group C: subjects with self‐described “sinus” headaches whose symptoms met International Headache Society diagnostic criteria (1.1 or 1.2) for migraine. The total amount of CGRP and VIP present in saliva collected under normal, pathological, and therapeutic conditions was determined by radioimmunoassay. Neuropeptide levels were normalized to total volume and amount of protein, and levels were correlated to onset and change in clinical symptoms.

Results.—Total volume, total protein, and CGRP and VIP levels did not significantly change in saliva collected on consecutive days in the clinic and at the subject's home, respectively. No appreciable change in baseline salivary levels of CGRP and VIP was detected in control subjects. However, baseline salivary levels of CGRP and VIP were significantly elevated between attacks in allergic rhinosinusitis and migraine subjects compared to control values. For rhinosinusitis subjects, the amount of CGRP and VIP during attacks returned to baseline values following treatment with pseudoephedrine and relief of symptoms. Similarly, CGRP and VIP levels during a migraine headache were significantly reduced within 2 hours after sumatriptan treatment and reported symptom relief.

Conclusion.—Correlation of CGRP and VIP saliva levels observed in our study supports physiologically coordinated regulation of trigeminal and parasympathetic nerve activation in allergic rhinosinusitis and migraine patients between and during attacks as well as following treatment. Furthermore, our findings demonstrate that analysis of human saliva neuropeptides may provide a semiquantitative index of pathological and therapeutic states and, therefore, function as a clinical model for studying neuronal mechanisms involved in migraine and rhinosinusitis.
Is Low Blood Magnesium Level Associated With Hemodialysis Headache?
Authors: Goksel Basak Karakurum , Torun Dilek , Karaca Sibel , Karatas Mehmet , Tan Meliha , Sezgin Nurzen , Benli Sibel , Sezer Siren , Ozdemir Nurhan
Published: January 2006

Objective.—The aim of this study was to evaluate the prevalence, demographic, clinical features, and possible risk factors for hemodialysis headache (HDH).

Background.—HDH has been recognized for many years, but the pathophysiology of this condition is not known. High arterial blood pressure, decreased serum osmolality, sodium washout, and high blood urea nitrogen level are reported risk factors for HDH. Low serum magnesium (Mg) level is known to cause some types of headache, including migraine (menstrual migraine in particular), tension‐type headaches, and cluster and posttraumatic headaches. Low Mg has also been reported in HDH patients.

Methods.—A total of 250 hemodialysis (HD) patients were questioned about problems with headache. Of these, 75 were diagnosed with HDH according to the revised International Headache Society criteria for 2003. Eighty age‐ and sex‐matched HD patients without HDH were selected as a control group. For each HDH and control subject, arterial diastolic and systolic blood pressure, body weight, and serum levels of sodium, blood urea nitrogen, creatinine, and Mg were measured before and after one HD session. Urea reduction rate and ultrafiltration were determined. Serum levels of phosphorus, calcium, albumin, and parathormone were measured only before the session. Findings in the HDH and control group were statistically compared.

Results.—As noted, 75 (30%) of the total 250 HD patients surveyed were diagnosed with HDH. The mean headache duration in this group was 5.17 ± 5 hours. Vertex location, bilateral headache, dull nature, and moderate severity were the most prevalent features of HDH. There were no statistically significant differences between the HDH and control groups with respect to causes of end‐stage renal disease. There were no significant differences between the HDH and control groups with respect to predialysis values for blood urea nitrogen, body weight, and arterial blood pressure (P > .05), and the same was true for comparisons of the postdialysis values for these parameters. The mean predialysis sodium level in the HDH group was higher than in the control group (P= .003). Both the mean predialysis and mean postdialysis Mg levels in the HDH group were significantly lower than the corresponding levels in the control group (P= .05 and P= .02, respectively).

Conclusions.—The results suggest that low blood Mg level and high blood sodium level may be risk factors for HDH. Magnesium supplementation may help patients with HDH whose serum Mg levels are found to be low.
Subclinical Left Ventricular Dysfunction in Migraine Attacks
Authors: Vidalón Manuel
Published: January 2006

Objective.—The aim of the present study was to evaluate cardiac performance of patients with migraine attacks during the overload produced by phenylephrine infusion.

Background.—It is known that circulatory changes occur during migraine. However, the relationship between this finding and transient cardiac dysfunction is still unknown.

Methods.—By means of two‐dimensional direct M‐mode echocardiography, we measured fractional shortening, ejection fraction, and mean velocity of circumferential fibers shortening in 18 patients with migraine and in 10 normal subjects as a control group. These measures were performed in two different periods: during attack‐free intervals and during attacks. Pain intensity of typical migraine attack was evaluated on a 0 to 10 scale.

Results.—Cardiac size and function were normal at rest in both groups. However, during migraine attacks, phenylephrine infusion provoked significant decrease in fractional shortening, EF, and mean velocity of circumferential fibers shortening, followed by concomitant increase of headache severity. On the other hand, during the attack‐free interval and in the control group phenylephrine infusion did not show significant changes in cardiac function parameters.

Conclusions.—Our data suggest that left ventricular dysfunction during the phenylephrine test could participate in the complex pathophysiological mechanism of migraine attacks.
Translating Instruments for Cross‐Cultural Studies in Headache Research
Authors: Peters Michele , Passchier Jan
Published: January 2006

Objective.—To describe translation methods, to outline current recommendations for translation and to give an overview of translation procedures used in headache.

Background.—In health‐care research, particularly in the domain of health‐related quality of life, an increasing number of questionnaires are translated for cross‐ cultural comparison. A number of headache‐related questionnaires have also been translated. To ensure true cross‐cultural comparison, it is important to use rigorous translation methods to ensure a high quality translated version of the instruments.

Methods.—Literature relevant to cross‐cultural translations was reviewed, as well as literature concerning translation of headache‐related instruments.

Conclusion.—More information on the translation process for headache‐related instruments is essential to carry out high quality cross‐cultural research. Recommendation are given to encourage good translation practices.
Cusums to Measure Chronic Daily Headache
Authors: Freidank‐Mueschenborn Edda , Fox Anthony W.
Published: January 2006

Objective.—To investigate whether cumulated summed differences (cusums) can be used as a method for detecting effective interventions in chronic daily headache (CDH). If so, then can such interventions be detected sooner than 28 days?

Background.—CDH probably represents the greatest current challenge in the field of headache treatment. Clinical trial methodologies for its study are not standardized but usually use fixed 28‐day observation periods. Similarly, 28‐day observation periods are common review intervals for stepped‐care patient management strategies.

Methods.—A theoretical patient was modeled, with daily headache scores that had maximal variation for 28 consecutive daily measures. The cusums for this “norm” or control data set were plotted and correlated with time using a simple spreadsheet. Departure of a postintervention cusum from the 95% confidence interval of the control data set was chosen as an indicator of sensitivity to various model perturbations that had clinical correlates.

Results.—When 1 to 17 randomly distributed headache‐free days were used to perturb the 28‐day model, cusums consistently diverged from the norm. If at least 3 headache‐free days occurred, then the cusum detected the intervention in less than 28 days of observation. Reanalysis of a previously published study of magnesium oxide suggests that its negative conclusions should be reconsidered.

Conclusion.—Cusums can be useful tools for detecting change in CDH, whether at the level of the clinical trial or when managing patients using stepped‐care treatment algorithms.
Jugular Compression and Radionuclide Cisternographic Patterns in Patients With Chronic Headache
Authors: Horikoshi Toru , Uchida Mikito , Watanabe Arata , Ikegawa Hiroaki , Umeda Takako
Published: January 2006

Objective.—We investigated the value of the jugular compression test (JCT) in screening patients with chronic headache attributable to persistent cerebrospinal fluid (CSF) leakage.

Methods.—Clinical records of 35 consecutive patients who underwent both 111In‐diethylenetriamine pentaacetic acid radioisotope (RI) cisternography and JCT were retrospectively analyzed.

Results.—A strong correlation was seen between JCT and RI cisternographic findings. Most patients who reported a feeling of fullness in the ear, hearing loss or headache during JCT had positive findings on RI cisternograms indicative of CSF leakage. In contrast, no RI study abnormalities were seen in patients reporting no symptoms in JCT.

Conclusions.—Among patients complaining of refractory headache and other miscellaneous symptoms, JCT may represent a simple, economic, and reliable technique in the screening of candidates for RI cisternography to evaluate CSF leakage. A subgroup of patients with chronic headache may have persistent CSF leakage.
Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis—Part I
Authors: Martin Vincent T. , Behbehani Michael
Published: January 2006

Ovarian hormones have a significant effect on the central nervous system of female migraineurs. Reproductive milestones such as menarche, pregnancy, and menopause are associated with changes in the clinical course of migraine headache. Migraine attacks are commonly triggered during declines in serum estrogen levels that occur before and during the time of menstruation. Therefore, substantial clinical evidence suggests that changes in ovarian hormones affect migraine headache. This represents the first of two manuscripts defining the role of ovarian hormones in the pathogenesis of migraine headache. The purpose of the first article will be to review the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine headache. The second manuscript will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.
Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack
Authors: Aurora Sheena K. , Kori Shashidhar H. , Barrodale Pat , McDonald Susan A. , Haseley David
Published: January 2006

Objective.—The aim of this article is to evaluate gastric motility and emptying in the ictal and interictal period in migraine.

Background.—Nausea is a predominant symptom of migraine and the basis of it is thought to be gastric stasis. Objective methods to establish this are however lacking. We utilized gastric scintigraphy studies to determine gastric motility in the ictal and interictal period of migraine.

Methods.—Ten migraine subjects were compared to equal number of age and sex matched controls. Gastric scintigraphy using a standard meal was performed in all control subjects once and in all 10 migraine subjects in the interictal period and nine studies were performed in the ictal period migraine.

Results.—The time to half emptying was delayed in migraine ictally (78%) and interictal period (80%) using normative data at this institution. Gastric stasis was less pronounced ictally (149.9 minutes) compared to interictal period (188.8 minutes). There was a significant delay compared to nonmigrainous controls (migraine 188.8 minutes vs normal controls 111.8 minutes; P < .05). These data were replicated in percentage of radioactive material remaining in the stomach at 2 hours.

Conclusions.—Contrary to previous belief, this study has demonstrated that migraineurs suffer from gastric stasis both during and outside an acute migraine attack. This may suggest that migraineurs may have an abnormal autonomic function compared to nonmigrainous controls. The potential role of this in pathophysiology of migraine is discussed and avenues for further investigations are explored.
Solitary Fourth Ventricular Neurocysticercosis Presenting as Status Migrainosus
Authors: Shukla Rakesh , Paliwal Vimal Kumar , Jha Deepak
Published: January 2006

Fourth ventricular cysts in patients with neurocysticercosis are generally solitary without accompanying parenchymal cysts and hence present with hydrocephalic symptoms at the time of implantation. We report a patient with status migrainosus‐like presentation in whom the neurological examination was normal and the diagnosis was made by imaging (CT and MRI scan).
Chronic Bilateral Stimulation of the Anterior Thalamus of Kainate‐treated Rats Increases Seizure Frequency
Authors: Lado Fred A.
Published: January 2006

Summary:  Purpose: Electrical stimulation of the anterior nucleus of the thalamus (ANT) is receiving increased attention as a novel means of controlling intractable epilepsy, and has entered human clinical trial. Animal data supporting the anticonvulsant benefit of ANT stimulation, however, has been obtained from acute chemoconvulsant models of epilepsy rather than models of chronic epilepsy with spontaneous seizures. It is unknown whether ANT stimulation is effective in models of chronic epilepsy.

Methods: Bilateral ANT stimulation was evaluated in rats with chronic epilepsy following acute status epilepticus (SE) produced by systemic kainic acid (KA) administration. The evolution of epilepsy following KA SE and the effects of ANT stimulation were monitored by continuous video‐EEG.

Results: Following KA SE, most rats have 2–8 seizures per day, and the average seizure rate increases over time, doubling over the course of 14 weeks. Behavioral seizure severity, after the initial development of epilepsy, remains stable. Seizure frequency during ANT stimulation was 2.5 times the baseline seizure frequency. In some cases stimulation triggered seizures were observed. The effects of stimulation were specific to the ANT. Stimulation applied to electrodes placed outside the ANT did not significantly worsen seizure frequency.

Conclusions: ANT stimulation exacerbated seizure frequency in rats with chronic epilepsy following kainate status epilepticus.
Hippocampal T2 Signal Change during Amygdala Kindling Epileptogenesis
Authors: Jupp Bianca , Williams John P. , Tesiram Yasvir A. , Vosmansky Milosh , O'Brien Terence J.
Published: January 2006

Summary:  Purpose: The rat electrical amygdala kindling model is one of the most widely studied animal models of temporal lobe epilepsy (TLE); however, the processes underlying epileptogenesis in this model remain incompletely understood. Magnetic resonance imaging (MRI) is a powerful method to investigate epileptogenesis, allowing serial imaging of associated structural and functional changes in vivo. Here we report on the results of serial MRI acquisitions during epileptogenesis in this model.

Methods: Serial T2‐weighted MR images were acquired before, during, and after the induction of kindling, to investigate the development and progression of imaging abnormalities.

Results: T2‐weighted acquisitions demonstrated the development of regions of increased signal in the rostral ipsilateral regions of CA1 and dentate gyrus in kindled (five of seven) but not in control rats (p < 0.05). Quantification of the T2 signal demonstrated a significant increase in kindled animals when compared with controls, 2 weeks after kindling ceased, in the ipsilateral hippocampus and the hippocampal sub regions of CA1 and the dentate gyrus (p < 0.05). No significant difference was observed in hippocampal volumes between kindled or control animals at any of the times.

Conclusions: The results of this study validate a method for acquiring serial MRI during amygdala kindling and demonstrate the induction of T2 signal abnormalities in focal regions of the hippocampus. These regions may be important sites for the neurobiologic changes that contribute to epileptogenesis in this model.
Open‐field Behaviors and Water‐maze Learning in the F Substrain of Ihara Epileptic Rats
Authors: Okaichi Yoko , Amano Shigeru , Ihara Nobuo , Hayase Yoneko , Tazumi Tooru , Okaichi Hiroshige
Published: January 2006

Summary: Purpose:Genetically epileptic model rats, Ihara epileptic rat (IER/F substrain), have neuropathologic abnormalities and develop generalized convulsive seizures when they reach the age of ∼5 months. Because the neuromorphologic abnormalities are centered in the hippocampus, we expected to observe spatial cognitive deficits. The present study aimed to evaluate emotionality and learning ability of the F substrain of IER.

Methods:To determine whether deficits are caused by inborn neuropathologic abnormalities or by repeated generalized convulsions, we tested nine 6‐ to 12‐week‐old IER/F rats that had not yet experienced seizures (experiment 1) and nine 7‐ to 9‐month‐old IER/F rats that had repeatedly experienced seizures (experiment 2) with identical tasks: an open‐field test and the Morris water‐maze place and cue tasks.

Results:Both groups of IER/Fs showed behaviors that were different from those of control rats in the open‐field test, and extensive learning impairments were seen in both the place task, which requires spatial cognition, and the cue task, which does not require spatial cognition but requires simple association learning. Their impaired performance of the cue task indicates that their deficiency was not limited to spatial cognition.

Conclusions:Because young IER/F rats without seizure experiences also showed severe learning impairments, genetically programmed microdysgenesis in the hippocampus was suspected as a cause of the severe learning deficits of IER/Fs.
Reduction of AEDs in Postsurgical Patients Who Attain Remission
Authors: Berg Anne T. , Vickrey Barbara G. , Langfitt John T. , Sperling Michael R. , Shinnar Shlomo , Bazil Carl , Walczak Thaddeus , Spencer Susan S. ,   for the Multicenter Study of Epilepsy Surgery
Published: January 2006

Summary:  Purpose: Little evidence guides practice regarding the reduction of antiepileptic drugs (AEDs) in individuals who achieve significant periods of remission after resective surgery.

Methods: In a prospective study of 396 individuals who underwent resective surgery for intractable seizures, the impact of reducing AEDs on relapse and predictors of relapse were examined.

Results: Of 301 study subjects who attained a 1‐year seizure remission after surgery, 129 reduced from two to one or from one to no AEDs after achieving remission, and 162 did not reduce drugs. Ten patients who stopped all AEDs before attaining remission were excluded from analysis. In all, 114 (39%) patients relapsed: 73 (45%) of 162 in the nonreduction group and 41 (32%) of 129 in the reduction group (p = 0.02). Patients who reduced drugs were more likely to have remitted immediately after hospital discharge (p<0.0001). After adjustment for this factor, little or no apparent impact of drug reduction on the rate of relapse was noted [rate ratio (RR), 1.1; 95% CI, 0.72–1.71; p=0.64 for reducing from two to one AED, and RR, 0.85; 95% CI, 0.50–1.45; p=0.56 for reducing from one to no AEDs]. Within the 129 patients who reduced AEDs, only delayed remission after hospital discharge was significantly associated with an increased rate of relapse (RR, 2.26; 95% CI, 1.15– 4.48; p=0.02). Continued auras had a marginally significant association with relapse (RR, 2.06; p=0.07)

Conclusions: Although many relapses in this cohort of postsurgical patients who achieved remission occurred in the context of reducing or completely eliminating AEDs, the risk was no higher than in those who continued AEDs. Randomized studies are needed to test the impact of drug reduction in seizure‐free postsurgical patients.
Efficacy and Safety of Levetiracetam (up to 2000 mg/day) in Taiwanese Patients with Refractory Partial Seizures: A Multicenter, Randomized, Double‐blind, Placebo‐controlled Study
Authors: Tsai Jing‐Jane , Yen Der‐Jen , Hsih Mo‐Song , Chen Shung‐Sheng , Hiersemenzel Reinhard , Edrich Pascal , Lai Chi‐Wan
Published: January 2006

Summary: Purpose:To assess the efficacy and safety of adjunctive levetiracetam (LEV) therapy in controlling partial‐onset seizures refractory to other antiepileptic drugs (AEDs) in a multicenter study in Taiwanese adults.

Methods:Ninety‐four patients aged 16–60 years with refractory partial seizures were randomized to receive LEV (n = 47) or placebo (47) for 14 weeks and composed the intention‐to‐treat (ITT) population. After the first 2 weeks, LEV patients had their dosage increased from 500 mg twice daily to 1,000 mg twice daily. A 12‐week maintenance phase followed, after which patients switched to long‐term, open‐label LEV therapy or entered a 4‐week phase of medication discontinuation.

Results:All patients from the ITT population, except one LEV‐treated patient with missing seizure‐count data, were included in the primary efficacy analysis. The least square mean of logarithmically transformed weekly partial‐seizure frequency was significantly lower in the LEV than in the placebo group (0.813 vs. 1.085; p = 0.001). LEV reduced log‐transformed weekly partial‐seizure frequency by 23.8% (95% confidence interval, 10.4–35.2%) relative to placebo. Significantly more LEV than placebo patients (43.5% vs. 10.6%) experienced a response of a ≥50% decrease from baseline in weekly frequency of partial seizures [odds ratio, 6.5 (95% CI, 2.2–19.3); p < 0.001]. Adverse events were reported in 34 (72.3%) of 47 LEV‐treated patients and 32 (68.1%) of 47 placebo patients. The three most common adverse events in the LEV and placebo groups were somnolence (40.4% and 14.9%), dizziness (14.9% and 8.5%), and headache (10.6% and 8.5%), respectively. Only four patients (three LEV‐treated patients and one placebo patient) were withdrawn from the study because of adverse events.

Conclusions:Adjunctive LEV therapy, ≤1,000 mg twice daily, was significantly more effective than placebo and was generally well tolerated in Taiwanese adults with treatment‐resistant partial‐onset seizures.
Refractory Generalized Seizures: Response to Corpus Callosotomy and Vagal Nerve Stimulation
Authors: Nei Maromi , O'Connor Michael , Liporace Joyce , Sperling Michael R.
Published: January 2006

Summary:  Purpose: The vagal nerve stimulator (VNS) and corpus callosotomy can reduce seizure frequency when seizures are refractory to medications. However, the efficacy and safety of these two procedures have not been compared. This study evaluates the two procedures for generalized seizures.

Methods: All patients with refractory generalized seizures (generalized tonic–clonic, tonic, or atonic) who underwent a corpus callosotomy (anterior or complete) (n = 53) without other forms of epilepsy surgery and those who underwent VNS placement (n = 25) were evaluated for this study. Seizure response and procedure complications were evaluated.

Results: For those with a corpus callosotomy and generalized tonic–clonic seizures (n = 50), 79.5% had ≥50% decrease in the frequency of generalized tonic–clonic seizures, and 60% had ≥80% seizure reduction. For those with a VNS and generalized tonic–clonic seizures (n = 21), 50% had ≥50% seizure reduction, and 33% had ≥80% seizure reduction. Tonic and atonic seizures decreased after either VNS or a corpus callosotomy. The complication rate for corpus callosotomy was higher (21% all complications, 3.8% permanent) than that for VNS (8%; none permanent), but complications for both corpus callosotomy and VNS were rarely permanent.

Conclusions: Both corpus callosotomy and VNS are effective in reducing generalized seizures. Corpus callosotomy is associated with greater efficacy but higher risk for complications, although these were generally transient.
Ictal Brain Hyperperfusion Contralateral to Seizure Onset: The SPECT Mirror Image
Authors: Huberfeld Gilles , Habert Marie‐Odile , Clemenceau Stéphane , Maksud Philippe , Baulac Michel , Adam Claude
Published: January 2006

Summary:  Purpose: Ictal single‐photon emission computed tomography (SPECT) may help localize the seizure‐onset zone (SOZ) by detecting changes in regional cerebral blood flow induced by epileptic discharges. This imaging method also reveals hyperperfusions in areas of seizure propagation, including the hemisphere contralateral to the SOZ. We have studied the occurrence, the topography, and the clinical value of such contralateral ictal hyperperfusion areas (HPAs).

Methods: We examined data from presurgical evaluations of 36 consecutive patients with pharmacoresistant partial epilepsy of various localizations. Ictal and interictal SPECT examinations were made with 99mTc‐ECD, and the scans were processed for coregistration, normalization, subtraction, and merging with MRI images.

Results: Contralateral HPAs were observed in 72% of the patients: 50% of mesiotemporal epilepsy cases with hippocampal sclerosis, 85.7% of the other mesiotemporal epilepsies, 85.7% of neocortical lateral temporal epilepsies, and 87.5% of extratemporal epilepsies. Contralateral HPAs were usually symmetrical to the SOZ, forming a mirror image, observed in 57.1% of the patients. They could be slightly asymmetrical in mesiotemporal epilepsies, perhaps because of the particular anatomic pathways linking temporal lobes. In neocortical epilepsies, they were located in the cortex homotopic to the SOZ.

Conclusions: We show that the symmetrical nature of the mirror image usually does not disturb SPECT interpretation. It can confirm the location of the SOZ (11 patients) and even occasionally improve the precision of its definition (nine patients) by restraining several potential SOZ‐related HPAs to a single one or by permitting a restricted localization of the SOZ in a large HPA.
Hippocampal Sclerosis in Children with Lesional Epilepsy Is Influenced by Age at Seizure Onset
Authors: Riney Catherine J. , Harding Brian , Harkness William J. F. , Scott Rod C. , Cross J. Helen
Published: January 2006

Summary:  Purpose: Hippocampal sclerosis (HS) is the most common lesion underlying drug‐resistant temporal lobe epilepsy. Whether HS is a developmental or acquired pathology remains unclear. Whereas HS has been causally linked to prolonged febrile convulsions in childhood, evidence also exists that it may coexist with extrahippocampal abnormalities, the concept of “dual pathology.” The aims of this study were to address whether hippocampal abnormality consistent with HS (a) occurs in children with lesional extrahippocampal epilepsy, (b) is more commonly seen in association with developmental rather than acquired extrahippocampal pathologies, and (c) whether any effect of age at seizure onset is found on the occurrence of HS in lesional extrahippocampal epilepsy.

Methods: Clinical and histopathologic data of patients having resective surgery for extrahippocampal epilepsy that included the hippocampus were investigated.

Results: Twenty‐nine children were retrospectively included in this study, and 21 (72%) of 29 were found to have a hippocampal abnormality consistent with HS. No relation was noted between developmental or acquired extrahippocampal pathologies and the presence of hippocampal abnormality. Children with normal hippocampi on visual histologic assessment had a significantly younger age at seizure onset (p < 0.001). Duration of epilepsy was not correlated with the presence of hippocampal abnormality.

Conclusions: Hippocampal abnormalities are seen in similar proportions with both acquired and developmental extra‐hippocampal pathologies, suggesting that these abnormalities are the result of seizures from the focus that is remote from the hippocampus. In addition, children who have their initial seizure at an early age are less likely to develop seizure‐induced hippocampal injury.
Hippocampal and Thalamic Diffusion Abnormalities in Children with Temporal Lobe Epilepsy
Authors: Kimiwada Tomomi , Juhász Csaba , Makki Malek , Muzik Otto , Chugani Diane C. , Asano Eishi , Chugani Harry T.
Published: January 2006

Summary:  Purpose: Previous studies using diffusion MRI in patients with temporal lobe epilepsy have shown abnormal water diffusion in the hippocampus. Because thalamus and lentiform nuclei are considered important for the regulation of cortical excitability and seizure propagation, we analyzed diffusion tensor imaging (DTI) abnormalities in these subcortical structures and in hippocampus of children with partial epilepsy with and without secondary generalization.

Methods: Fourteen children with partial epilepsy involving the temporal lobe underwent MRI including a DTI sequence. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained in the hippocampus, thalamus, and lentiform nucleus, and compared with DTI data of 14 control children with no epilepsy, as well as glucose positron emission tomography (PET) findings.

Results: Decreased FA (p < 0.001) and increased ADC (p = 0.003) values were found in the hippocampi ipsilateral to the seizure focus. Significant FA decreases (p = 0.002) also were seen in the contralateral hippocampi, despite unilateral seizure onset and excellent surgical outcome in patients who underwent surgery. ADC values showed a trend for increase in the thalami ipsilateral to the epileptic focus in the seven children with secondarily generalized seizures (p = 0.09). No group differences of ADC or FA were found in the lentiform nuclei. The DTI variables did not correlate with regional glucose metabolism in any of the structures analyzed.

Conclusions: Increased ADC values in hippocampus can assist in lateralizing the seizure focus, but decreased FA in the contralateral hippocampus suggests that it too may be dysfunctional despite unilateral seizure onset. Less‐robust thalamic abnormalities of water diffusion in patients with secondarily generalized seizures suggest secondary involvement of the thalamus, perhaps due to recruitment of this structure into the epileptic network; however, this must be confirmed in a larger population. DTI appears to be a sensitive method for detection abnormalities in children with partial epilepsy, even in structures without apparent changes on conventional MRI.
Community‐based, Prospective, Controlled Study of Obstetric and Neonatal Outcome of 179 Pregnancies in Women with Epilepsy
Authors: Viinikainen Katriina , Heinonen Seppo , Eriksson Kai , Kälviäinen Reetta
Published: January 2006

Summary:  Purpose: This study evaluated obstetric and neonatal outcome in a community‐based cohort of women with active epilepsy (WWAE) compared with the general pregnant population receiving modern obstetric care.

Methods: We reviewed the total population who gave birth between January 1989 and October 2000 at Kuopio University Hospital. Obstetric, demographic, and epilepsy data were collected prospectively from 179 singleton pregnancies of women with epilepsy and from 24,778 singleton pregnancies of unaffected controls. The obstetric data from the pregnancy register was supplemented with detailed neurologic data retrieved from the medical records. The data retrieved were comprehensive because of a follow‐up strategy according to a predecided protocol.

Results: During pregnancy, the seizure frequency was unchanged, or the change was for the better in the majority (83%) of the patients. We found no significant differences between WWAE and controls in the incidence of preeclampsia, preterm labor, or in the rates of caesarean sections, perinatal mortality, or low birth weight. However, the rate of small‐for‐gestational‐age infants was significantly higher, and the head circumference was significantly smaller in WWAE. Apgar score at 1 min was lower in children of WWAE, and the need for care in the neonatal ward and neonatal intensive care were increased as compared with controls. The frequency of major malformations was 4.8% (−0.6–10.2%; 95% confidence interval) in the 127 children of WWAE.

Conclusions: Pregnancy course is uncomplicated and neonatal outcome is good in the majority of cases when a predecided protocol is used for the follow‐up of WWAE in antenatal and neurologic care. Long‐term follow‐up of the neurologic and cognitive development of the children of WWAE is still needed.
Epilepsy in Colombia: Epidemiologic Profile and Classification of Epileptic Seizures and Syndromes
Authors: Velez Alberto , Eslava‐Cobos Jorge
Published: January 2006

Summary: Purpose:A national study was performed in Colombia to determine the general and regional prevalence of epilepsy, clinical profiles, seizure types, and clinical syndromes.

Methods:Based on the National Epidemiological Study of Neurological Diseases (EPINEURO), we evaluated and followed up for 1 year all the subjects with epilepsy from the National Sample. Clinical profiles were further assessed. Seizure types and epilepsy syndromes were established according to the international classifications.

Results:General prevalence was found to be 11.3 per 1,000, with little variation among regions, except the eastern region, where prevalence was 23 per 1,000; prevalence for active epilepsy was 10.1 per 1,000. Women have a slightly greater (not statistically significant) risk. Most seizures are focal (partial), frequently with secondary generalization. The most frequent epilepsy syndrome encountered was partial symptomatic/cryptogenic (80%). Epilepsy onset in Colombia occurs most frequently in childhood.

Conclusions:Prevalence rates of epilepsy in Colombia are similar to those reported in nations with comparable developmental status and have diminished over time. The study presents the distribution of seizures and syndromes. The most frequent types are focal syndromes.
Beta Activity in Status Epilepticus
Authors: Bonati Leo H. , Naegelin Yvonne , Wieser Heinz‐Gregor , Fuhr Peter , Ruegg Stephan
Published: January 2006

Summary:  Focal beta activity on scalp EEG is a rare seizure pattern that has most extensively been studied in patients undergoing evaluation for epilepsy surgery. However, ictal beta activity is uncommon beyond this population and has not been reported in human status epilepticus. We observed ictal focal beta activity as the predominant seizure pattern in a patient with refractory status epilepticus. Continuous left temporal beta activity clinically correlated with complex partial semiology on video‐EEG.
Mutation in Filamin A Causes Periventricular Heterotopia, Developmental Regression, and West Syndrome in Males
Authors: Masruha Marcelo R. , Caboclo Luis O. S. F. , Carrete Henrique , Cendes Íscia L. , Rodrigues Murilo G. , Garzon Eliana , Yacubian Elza M. T. , Sakamoto Américo C. , Sheen Volney , Harney Megan , Neal Jason , Sean Hill R. , Bodell Adria , Walsh Christopher , Vilanova Luiz C. P.
Published: January 2006

Summary:  Purpose: Familial periventricular heterotopia (PH) represents a disorder of neuronal migration resulting in multiple gray‐matter nodules along the lateral ventricular walls. Prior studies have shown that mutations in the filamin A (FLNA) gene can cause PH through an X‐linked dominant pattern. Heterozygotic female patients usually remain asymptomatic until the second or third decade of life, when they may have predominantly focal seizures, whereas hemizygotic male fetuses typically die in utero. Recent studies have also reported mutations in FLNA in male patients with PH who are cognitively normal. We describe PH in three male siblings with PH due to FLNA, severe developmental regression, and West syndrome.

Methods: The study includes the three affected brothers and their parents. Video‐EEG recordings and magnetic resonance image (MRI) scanning were performed on all individuals. Mutations for FLNA were detected by using polymerase chain reaction (PCR) on genomic DNA followed by single‐stranded conformational polymorphism (SSCP) analysis or sequencing.

Results: Two of the siblings are monozygotic twins, and all had West syndrome with hypsarrthymia on EEG. MRI of the brain revealed periventricular nodules of cerebral gray‐matter intensity, typical for PH. Mutational analyses demonstrated a cytosine‐to‐thymidine missense mutation (c. C1286T), resulting in a threonine‐to‐methionine amino acid substitution in exon 9 of the FLNA gene.

Conclusions: The association between PH and West syndrome, to our knowledge, has not been previously reported. Males with PH have been known to harbor FLNA mutations, although uniformly, they either show early lethality or survive and have a normal intellect. The current studies show that FLNA mutations can cause periventricular heterotopia, developmental regression, and West syndrome in male patients, suggesting that this type of FLNA mutation may contribute to severe neurologic deficits.
A Novel SCN2A Mutation in Family with Benign Familial Infantile Seizures
Authors: Striano Pasquale , Bordo Laura , Lispi Maria Luisa , Specchio Nicola , Minetti Carlo , Vigevano Federico , Zara Federico
Published: January 2006

Summary:  Benign familial infantile seizures (BFIS) is a clinical entity characterized by focal seizures with or without secondary generalization, occurring mostly in clusters, and usually first seen between 4 and 8 months of life. Psychomotor development is normal, and seizures usually resolve within the first year of life. BFIS is a genetically heterogenous condition with loci mapped to chromosomes 19 and 16. Mutations in the voltage‐gated sodium channel α2 subunit (SCN2A) gene on chromosome 2 were recently identified in families affected by neonatal and infantile seizures (benign familial neonatal–infantile seizures, BFNIS) with typical onset before 4 months of life. The identification of SCN2A mutations in families with only infantile seizures indicated that BFNIS and BFIS show overlapping clinical features.

We report a pedigree showing three affected individuals over three generations. All subjects experienced clusters of focal seizures with or without secondary generalization and onset between 4 and 12 months of life. Response to antiepileptic drugs and the outcome were good. No subjects had other forms of epilepsy later in the life. Neonatal or febrile seizures did not occur in the family. Genetic study in this family revealed a novel heterozygous mutation c.3003 T>A in the SCN2A gene. Comparative analysis of different sodium channel α subunits indicates that the mutated residue is highly conserved throughout the evolution, suggesting an important functional role for this domain. Additional families with the infantile form of benign familial seizures should be investigated to corroborate that BFIS and BFNIS may share the same genetic abnormality.
Neurotoxicants, Micronutrients, and Social Environments
Authors: Hubbs-Tait Laura , Nation Jack R. , Krebs Nancy F. , Bellinger David C.
Published: January 2006

SUMMARY—Systematic research evaluating the separate and interacting impacts of neurotoxicants, micronutrients, and social environments on children's cognition and behavior has only recently been initiated. Years of extensive human epidemiologic and animal experimental research document the deleterious impact of lead and other metals on the nervous system. However, discrepancies among human studies and between animal and human studies underscore the importance of variations in child nutrition as well as social and behavioral aspects of children's environments that mitigate or exacerbate the effects of neurotoxicants.

In this monograph, we review existing research on the impact of neurotoxic metals, nutrients, and social environments and interactions across the three domains. We examine the literature on lead, mercury, manganese, and cadmium in terms of dispersal, epidemiology, experimental animal studies, effects of social environments, and effects of nutrition.

Research documenting the negative impact of lead on cognition and behavior influenced reductions by the Center for Disease Control in child lead-screening guidelines from 30 micrograms per deciliter (μg/dL) in 1975 to 25 μg/dL in 1985 and to 10 μg/dL in 1991. A further reduction is currently being considered. Experimental animal research documents lead's alteration of glutamate-neurotransmitter (particularly N-methyl-D-aspartate) activity vital to learning and memory. In addition, lead induces changes in cholinergic and dopaminergic activity. Elevated lead concentrations in the blood are more common among children living in poverty and there is some evidence that socioeconomic status influences associations between lead and child outcomes. Micronutrients that influence the effects of lead include iron and zinc.

Research documenting the negative impact of mercury on children (as well as adults) has resulted in a reference dose (RfD) of 0.1 microgram per kilogram of body weight per day (μg/kg/day). In animal studies, mercury interferes with glutamatergic, cholinergic, and dopaminergic activity. Although evidence for interactions of mercury with children's social contexts is minimal, researchers are examining interactions of mercury with several nutrients.

Research on the effects of cadmium and manganese on child cognition and behavior is just beginning. Experimental animal research links cadmium to learning deficits, manganese to behaviors characteristic of Parkinson's disease, and both to altered dopaminergic functioning.

We close our review with a discussion of policy implications, and we recommend interdisciplinary research that will enable us to bridge gaps within and across domains.
The Impact of Inflation Measures on the Real Returns and Risk of U.S. Stocks
Authors: Jones Charles P. , Wilson Jack W.
Published: January 2006

Using different inflation measures produces economically significant differences in both the inflation record and inflation‐adjusted stock returns. We introduce a more consistent measure of the monthly Consumer Price Index (CPI) inflation rate to better measure real returns over 1913–2004, for which the official CPI exists. We also extend the series backward to 1871 on a monthly basis, an important addition to the data series. We analyze the impact of inflation on the real standard deviation of stock returns and find that, in contrast to the results for geometric mean returns, inflation adjustments have little impact on estimates of return variability.
Portfolio Effects and Valuation of Weather Derivatives
Authors: Brockett Patrick L. , Wang Mulong , Yang Chuanhou , Zou Hong
Published: January 2006

In a mean‐variance framework, the indifference pricing approach is adopted to value weather derivatives, taking account of portfolio effects. Our analysis shows how the magnitude of portfolio effects is related to the correlation between weather indexes and other risky assets, the correlation between weather indexes, and the payoff structures of the existing weather derivatives in an investor's asset portfolio. We also conduct some preliminary empirical analysis. This study contributes to the weather derivative pricing literature by incorporating both the hedgeable and unhedgeable parts of weather risks in illustrating the portfolio effects on the indifference prices of weather derivatives.
Inferring Public and Private Information from Trades and Quotes
Authors: Frijns Bart
Published: January 2006

We propose a new model that uses nonsynchronous, ultra‐high frequency data to analyze the sequential impact of trades and quotes on the price process. Private information is related to the impact of trades and public information to the impact of quotes. The model is extended to include various other factors that affect public and private information. For 20 active Nasdaq stocks, private information causes, on average, 9.43% of daily stock price movements. Additionally, quotes are more informative when (1) many dealers set the best price and (2) traditional market makers rather than Electronic Communication Networks set the best price.
Price Movements, Information, and Liquidity in the Night Trading Market
Authors: Giannetti Antoine , Larson Stephen J. , Lee Chun I. , Madura Jeff
Published: January 2006

Forward Links to Citing Articles
 
 
Erratum. The Financial Review 41: 2, 305. Online publication date: 11‐Apr‐2006.

Night trading provides an ideal laboratory to assess the behavior of stock markets when institutional liquidity providers are less active. The evidence indicates that extreme positive (winner) and negative (loser) stock‐price movements during night sessions are followed by reversals the next day. The reversals are more pronounced following extreme stock‐price movements that are associated with less trading volume and lower liquidity. Within‐the‐night sample reversals are less pronounced for stocks of companies issuing earnings announcements.
Your Pace or Mine? Culture, Time, and Negotiation
Authors: Macduff Ian
Published: January 2006

This article explores the impact that different perceptions of time may have on cross‐cultural negotiations. Beyond obvious issues of punctuality and timekeeping, differences may occur in the value placed on the uses of time and the priorities given to past, present, or future orientations. The role of time in negotiations involves two key dimensions: differing perceptions and values of time, and the management of time. Both dimensions, the author suggests, need to be on the negotiation table.
Women's Changing Attitudes Toward Divorce, 1974–2002: Evidence for an Educational Crossover
Authors: Martin Steven P. , Parashar Sangeeta
Published: January 2006

This article examines trends in divorce attitudes of young adult women in the United States by educational attainment from 1974 to 2002. Women with 4‐year college degrees, who previously had the most permissive attitudes toward divorce, have become more restrictive in their attitudes toward divorce than high school graduates and women with some college education, whereas women with no high school diplomas have increasingly permissive attitudes toward divorce. We examine this educational crossover in divorce attitudes in the context of variables correlated with women's educational attainment, including family attitudes and religion, income and occupational prestige, and family structure. We conclude that the educational crossover in divorce attitudes is associated most strongly with work and family structure variables.