bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuropsychiatric Behaviors in the MPTP Marmoset Model of Parkinson’s Disease
Authors: Fox Susan H. , Visanji Naomi , Reyes Gaby , Huot Philippe , Gomez-Ramirez Jordi , Johnston Tom , Brotchie Jonathan M. 
Published: December 2014

Objectives:Neuropsychiatric symptoms are increasingly recognised as a significant problem in patients with Parkinson's disease (PD). These symptoms may be due to ‘sensitisation’ following repeated levodopa treatment or a direct effect of dopamine on the disease state. The levodopa-treated MPTP-lesioned marmoset was used as a model of neuropsychiatric symptoms in PD patients. Here we compare the time course of levodopa-induced motor fluctuations and neuropsychiatric-like behaviors to determine the relationship between duration of treatment and onset of symptoms.Methods:Marmosets were administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (2.0 mg/kg s.c.) for five days, resulting in stable parkinsonism. Levodopa (15 mg/kg and benserazide, 3.75 mg/kg) p.o. b.i.d. was administered for 30 days. Animals were evaluated for parkinsonian disability, dyskinesia and on-time (motor fluctuations) and neuropsychiatric-like behaviors on Day 0 (prior to levodopa) and on Days 1, 7, 13, 27 and 30 of treatment using post hoc DVD analysis by a trained rater, blind to the treatment day.Results:The neuropsychiatric-like behavior rating scale demonstrated high interrater reliability between three trained raters of differing professional backgrounds. As anticipated, animals exhibited a progressive increase in levodopa-induced motor fluctuations, dyskinesia and wearing-off, that correlated with the duration of levodopa therapy. In contrast, levodopa-induced neuropsychiatric-like behaviors were present on Day 1 of levodopa treatment and their severity did not correlate with duration of treatment.Conclusions:The data suggest that neuropsychiatric disorders in PD are more likely an interaction between levodopa and the disease state than a consequence of sensitisation to repeated dopaminergic therapy.
Neuronal Intranuclear Inclusion Disease Presenting as Juvenile Parkinsonism
Authors: Wiltshire Katie M. , Dunham Christopher , Reid Stuart , Auer Roland N. , Suchowersky Oksana 
Published: December 2014

Background:Diagnostic considerations for juvenile onset Parkinsonism (onset at <21 years of age) include juvenile Huntington disease, Wilson disease, dentatorubral-pallidoluysian atrophy (DRPLA), storage diseases, and mitochondrial cytopathies. Neuronal Intranuclear Inclusion Disease (NIID) must also be considered.Case Report:We present a case of juvenile onset NIID with a predominantly Parkinsonian presentation, followed later by corticospinal, cerebellar, and lower motor neuron symptoms.Conclusion:Diagnosis of NIID can be made antemortem through rectal biopsy, however it was missed in this case. Rectal biopsy should be performed in all suspected cases, reviewed by an experienced neuropathologist and repeated if the suspicion for NIID is high. Pathologically, SUMO-1 immunohistochemistry appears to reliably label the neuronal inclusions and abnormal SUMOylation may play a part in the pathogenesis.
Risk Factors of Stroke in Pakistan: A Dedicated Stroke Clinic Experience
Authors: Taj Fawad , Zahid Rehan , Syeda Umm-e-Rubab , Murtaza Muhammed , Ahmed Shahzad , Kamal Ayeesha Kamran 
Published: December 2014

Background:Secondary prevention of cerebrovascular disease through dedicated stroke clinics has been shown to decrease recurrent vascular events in patients. However, there is limited literature describing such stroke clinic experiences from low and middle income countries. This study describes patient characteristics and observations made at the first systematized stroke clinic in Pakistan.Methods:Aretrospective audit of medical records of all patients presenting between September 2006 and August 2008 with a cerebrovascular event was conducted. Information about clinical presentation, modifiable risk factors and laboratory and radiological investigations was collected. Burden of disability was assessed using Modified Rankin score. Data was entered and analyzed using SPSS 14.0.Results:159 patients with a mean age of 57.0 ± 13.9 years were included in this study and 34.6% of all patients were women. 108 patients were diagnosed with ischemic stroke (67.9%) while 34 patients presented with hemorrhagic stroke (21.4%) and 17 patients presented with transient ischemic attacks (10.7%). Hypertension was the most common modifiable risk factor seen in 78.0%, followed by diabetes in 40.3% and dyslipidemia in 31.5%. At presentation to clinic, only 26.0% patients with dyslipidemia and 64.5% patients with hypertension were on appropriate medications.Conclusion:A high prevalence of modifiable risk factors such as hypertension in stroke patients was observed and it presents an opportunity for conventional interventions in Pakistan. Systematized clinics for stroke and an algorithmic approach in primary care towards stroke may improve the implementation of evidence based secondary prevention strategies in developing countries.
Examining Ontario Deaths Due to All-Terrain Vehicles, and Targets for Prevention
Authors: Lord Sarah , Tator Charles H. , Wells Sandy 
Published: December 2014

Background:All-terrain vehicle (ATV) use is increasingly popular among people of all ages. Although ATV use is known to cause significant morbidity due to head and neck trauma, there is a lack of published data detailing ATV-related fatalities. We examined all ATV-related fatalities in Ontario from 1996 - 2005 to determine the epidemiology and risk factors as a guide for improved injury prevention strategies.Methods:All ATV-related fatalities from 1996 - 2005 in Ontario were examined through Coroner's reports in the Office of the Chief Coroner of Ontario. Epidemiologic information and risk factors relating to the driver, environment, and vehicle were recorded.Results:There were 74 ATV-related fatalities from 1996 - 2005. There was only one fatality per year in 1996 and 1997 and a peak of 16 per year in 2004 and 2005. Head and neck injuries were the commonest causes of death. Males comprised 90.5% of the cases. The highest risk was from age 15 - 29, and 21% of fatalities occurred in children under 16. Northeastern Ontario had the highest fatality rate.Conclusions:There was a major increase in the incidence of ATV-related fatalities in Ontario from 1996 - 2005 with the majority due to head trauma. Notable risk factors included alcohol use, riding at night, lack of helmet use, and excessive speed. We recommend the adoption of laws that focus on helmet requirements, a minimum driver age of 16, and certified training courses. Aggressive injury prevention efforts should be targeted toward males aged 15 - 29.
Outcomes of Patients with Parkinson Disease and Pathological Gambling
Authors: Bharmal A. , Lu C. , Quickfall J. , Crockford D. , Suchowersky O. 
Published: December 2014

Objective:To determine the outcomes of patients with Parkinson disease (PD) with pathological gambling (PG) from one Canadian Movement Disorders Clinic.Methods:Assessments were performed in-person during routine clinic visits of all patients currently followed by one neurologist (OS). Pathological gambling was defined according to DSM-IV-TR criteria. Chart review was performed to obtain details on medication use, dosages, and patient demographics. Follow-up of patients with PG collected information on gambling behavior, PG management interventions, medications, treatment, and psychosocial outcomes.Results:146 patients were surveyed with an overall prevalence of PG of 4.1% (6/146). The rate of pathological gambling for those patients on dopamine agonist therapy (DA) was 8.1% (6/74). Only patients who were recreational gamblers prior to starting DA developed PG. All PG patients discontinued, decreased, or switched to another DA, and experienced a partial or full remission of PG. 3 (50%) patients described financial losses of $100,000 or more, and 75% (3/4) patients described significant marital stresses. At follow-up (August 2008), 4 of the 6 patients with PG continued to gamble in a controlled fashion despite medication changes. No significant difference in levodopa equivalent daily dose (LEDD) pre- and post-PG were observed; however, the relative amount of DA was decreased (p= 0.0593), while levodopa was relatively increased (p= 0.5277). Despite control of PG, patients still experience financial and marital strains.Conclusions:DA (in combination with levodopa) was associated with a significantly higher prevalence of PG in PD, particularly in patients who were recreational gamblers previously. Despite control of PG, patients continued to experience significant financial and marital stresses that should be regularly enquired upon in follow-up care and managed appropriately.
Abrogating HSP Response Augments Cell Death Induced by As2O3 in Glioma Cell Lines
Authors: Song Xueming , Chen Zhiqiang , Wu Chunbo , Zhao Shiguang 
Published: December 2014

Objectives:We previously reported that Arsenic trioxide (ATO) can inhibit glioma growth both in vitro and in vivo. While the use of ATO alone for solid tumor treatment sometimes was found to be ineffective which may be due to the protective pathways including heat shock proteins (HSPs) response induced by ATO. In this study, we modified HSPs expression to investigate whether HSPs had some effect on ATO induced glioma cell death.Methods:Trypan bule exclusion assay, mitochondrial membrane potential (MMP) Assay, and SubG1 detection were used to evaluate cell viability and western-blot was employed to detect HSPs and some apoptosis markers expression induced by ATO. Heat pre-treatment, HSPs inhibitor, or Heat Shock factor-1 (HSF1) knockdown by SiRNA was employed to modify HSPs levels.Results:It was showed that KNK437 (HSPs inhibitor) or HSF1 knockdown significantly enhanced cell death, MMP disruption, JNK phosphorylation and caspase-3 cleavage induced by ATO, which was accompanied by abrogation of HSPs induction, while heat pre-treatment with clear HSPs induction had strong protection on the effects mentioned above.Conclusion:Those data suggested that HSPs play protective roles on ATO induced cell death in glioma. Inhibition of HSPs may have a synergistic effect with ATO on glioma treatment.
Blunt Cerebrovascular Injuries: Diagnosis and Management Outcomes
Authors: Wei Corie W. , Montanera Walter , Selchen Daniel , Lian Jackie , Stevens Christopher , de Tilly Lyne Noël 
Published: December 2014

Background:Blunt cerebrovascular injury (BCVI) to the carotid and vertebral arteries is a potentially devastating injury in trauma patients. The optimal management for BCVI has not been standardized. At our institution, 64-slice multi-detector computed tomographic angiography (CTA) has been used as the initial screening exam for BCVI in patients who met predefined screening criteria. The purpose of this study is to review the incidence of CTA-diagnosed BCVI in at-risk patients and to evaluate the treatment and clinical outcome of patients with BCVI.Methods:This study included trauma patients with a positive diagnosis of BCVI on CTA during a 41-month study period. The medical records and relevant radiographic findings were retrospectively reviewed.Results:Twenty seven of 222 blunt trauma patients evaluated with CTA had a positive diagnosis of BCVI, with an occurrence rate of 12.2%. Traumatic brain injury (72.2%) and basal skull fractures (55.6%) were the most frequent associated injuries with carotid trauma while 100% of blunt vertebral injuries occurred in the setting of cervical fractures. Fourteen (51.8%) patients received medical therapy; Eleven (40.7%) patients received conservative treatment. Endovascular treatment was attempted in a single case of vertebral arteriovenous fistula. BCVI-related stroke was found in four patients (14.8%), one of whom developed an infarct while on medical treatment.Conclusions:BCVI is found in a significant portion of blunt trauma patients with identifiable risk factors, and screening CTA has high diagnostic yield in detecting these lesions. Medical therapy is the mainstay of treatment at our institution; however, BCVI-related stroke may occur despite treatment.
Diffusion Tensor Imaging Abnormalities in Cognitively Impaired Multiple Sclerosis Patients
Authors: Akbar Nadine , Lobaugh Nancy J. , O'Connor Paul , Moradzadeh Linda , Scott Christopher J. M. , Feinstein Anthony 
Published: December 2014

Background:Cognitive impairment can add to the burden of disease in patients with multiple sclerosis (MS). The aim of this study was to assess the relative importance of diffusion tensor imaging (DTI) indices derived from normal appearing white matter (NAWM) and grey matter (NAGM) in determining cognitive dysfunction in MS patients.Methods:Sixty two MS patients [51 female, mean age= 41 (sd=9.6) years, median expanded disability status scale (EDSS)=2.5] meeting modified McDonald criteria for MS underwent neuropsychological testing using the Neuropsychological Screening Battery for MS (NSBMS) and magnetic resonance imaging (MRI, 1.5T GE) that included DTI sequences. Total T1 hypointense and T2 hyperintense lesion volumes were obtained using semi-automated software. Lesion volumes were subtracted from whole-brain parenchyma to obtain measures of NAWM and NAGM. Fractional anisotropy (FA) of NAWM and mean diffusivity (MD) of NAGM were obtained.Results:Cognitive impairment was present in 11 patients (18%). These patients had higher EDSS scores, were less educated, and were more likely to have secondary progressive MS. They also had higher hypointense (p=0.001) and hyperintense (p=0.004) lesion volumes, greater NAWM atrophy (p=0.007), lower FA of total NAWM (p=0.003), and higher MD of total NAGM (p=0.015). Using a logistic regression analysis, and after controlling for demographic and disease-related differences between groups, FA of NAWM emerged as a significant predictor of cognitive impairment adding to the variance derived from lesion and atrophy data.Conclusion:This study underlies the important role of normal-appearing brain tissue in the pathogenesis of MS-related cognitive impairment.
Corpus Callosum Volume and Interhemispheric Transfer in Multiple Sclerosis
Authors: Brown L. N. , Zhang Y. , Mitchell J. R. , Zabad R. , Metz L. M. 
Published: December 2014

Background:The corpus callosum (CC) is frequently compromised in patients with multiple sclerosis (MS). Structural and functional measurements of the CC may be useful to monitor the progression of the disease. The aim of this pilot study was to determine if bimanual tactile temporal thresholds correlates with CC volume. A tactile temporal threshold is the longest temporal interval that separates the onsets of two tactile stimuli when they are judged by the observer as simultaneous. Judgments to bimanual stimulations require interhemispheric transfer via the CC.Methods:Thresholds were examined in MS patients and matched controls. Magnetic resonance (MR) images were acquired on a 3T MR system within 48 hours of clinical assessment and measurement of thresholds.Results:Corpus callosum volume was assessed by using a semiautomatic livewire algorithm. The CC volume was smaller (by 21% on average, p < 0.01) and thresholds were higher (by 49% on average, p < 0.03) in MS patients when compared to controls. A significant correlation (r = -0.66, p = 0.01) between CC volume and thresholds emerged for the MS patients.Conclusion:Measuring treatment benefits of neuroprotective and repair therapies is a well recognized challenge in MS research. The overall findings of this study suggest that these measurements, which involve the transfer of information interhemispherically via the CC, may be promising outcome measures that warrant further scientific exploration to develop a model to measure recovery.
Clinical Significance of Molecular Biomarkers in Glioblastoma
Authors: Ang C. , Guiot M.-C. , Ramanakumar A. V. , Roberge D. , Kavan P. 
Published: December 2014

Aim:To review the impact of molecular biomarkers on response to therapy and survival in patients with primary glioblastoma (GBM).Materials & Methods:Tissue specimens were analyzed for p53 mutations, EGFR amplification, loss of PTEN and p16, and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation. Demographic and clinical data were gathered from medical records.Results:Clinical and pathological data of 125 patients were collected and analysed. MGMT promoter methylation was associated with improved median overall survival (OS) (61 vs. 42 weeks, p = 0.01) and was an important prognosticator independent of age at diagnosis, extent of resection and post-operative ECOG performance status (HR 2.04, 95% CI 1.11-3.75). Among patients with MGMT promoter methylation, survival was significantly improved with chemoradiotherapy (CRT) over radiotherapy (RT) alone (71 vs. 14 weeks, p < 0.01). Furthermore, amongst those treated with temozolomide (TMZ) based CRT, the presence of EGFR amplification, maintenance of PTEN and wild-type p53 and p16 were each associated with trends towards improved survival.Conclusion:MGMT promoter methylation is a strong, independent prognostic factor for OS in GBM. EGFR amplification, maintenance of PTEN, wild-type p53 and p16 all appear to be associated with improved survival in patients treated with CRT. However, the prognostic value of these biomarkers could not be ascertained and larger prospective studies are warranted.
Stroke- on- Awakening: Safety of CT-CTA Based Selection for Reperfusion Therapy
Authors: Bal Simerpreet , Bhatia Rohit , Shobha Nandavar , Menon Bijoy K. , Sohn Sung Il , Goyal Mayank , Demchuk Andrew M. , Hill Michael D. ,   for the Calgary CTA group
Published: December 2014

Background:We studied the safety of use of acute reperfusion therapies in patients with stroke- on- awakening using a computed tomographic angiography (Cta) based large vessel occlusion-good scan paradigm in clinical routine.Methods:the Cta database of the Calgary stroke program was reviewed for the period January 2003-March 2010. patients with stroke-on-awakening with large artery occlusions on Cta, who received conservative, iV thrombolytic and/or endovascular treatment at discretion of the attending stroke neurologist were analyzed. time of onset was defined by the time last seen or known to be normal. Baseline non-contrast Ct scan (nCCt) alberta Stroke program early Ct Score (aSpeCtS) > 7 was considered a good scan. hemorrhage was defined on follow-up brain imaging using eCaSS 3 criteria. independence (mrS≤2) at three months was considered a good clinical outcome. Standard descriptive statistics and multivariable analysis were done.Results:among 532 patients with large artery occlusions, 70 patients with stroke-on-awakening (13.1%) were identified. the median age was 69.5 (iQr 24) and 41 (58.6%) were female; 41 (58.6%) received anti-platelets only and 29 (41.4%) received thrombolytic treatment [iV-12 (17.1%), iV/ia-12 (17.1%) and ia-5(7.1%)]. unadjusted analysis showed that baseline nCCt aSpeCtS ≤ 7 (p=0.002) and higher nihSS scores (p=0.018) were associated with worse outcomes. there were no ph2 hemorrhages in the iV thrombolytic or endovascular treated group. functional outcome was not different by treatment.Conclusion:When carefully selected using Ct –Cta, by a good scan (aSpeCtS > 7) occlusion paradigm, acute reperfusion therapies in patients with stroke-on-awakening can be performed safely in clinical routine.
Expression of NF-κB, MCP-1 and MMP-9 in a Cerebral Aneurysm Rabbit Model
Authors: Liu Yan fei , Zhang Yongqiang , Dai Dawei , Xu Zheng 
Published: December 2014

Objective:We explored the early expression of NF-κB, MCP-1 and -MMP 9 in a rabbit carotid aneurysm model, and investigated the possible mechanism of aneurysm.Methods:twenty four adult new Zealand rabbits were divided into four groups. normal control (group a); rabbits received elastase induction for 1, 2 3 weeks (group b, C and d respectively); hematoxylin-eosin stains were performed for observation. the mrna and protein expression of NF-κB, MCP-1 and MMP-9 were analyzed using RT-PCR and immunohistochemical methods.Results:the expression of NF-κB and MCp-1 reached their peaks after induction for one week, then decreased. their expression in week 1 and week 2 had no statistical difference. the expression of MMP-9 increased after induction. We observed the highest expression at week 3. as the induction time increased, the number of smooth muscles reduced. endothelial cells were damaged; the aneurysm wall elastic layer was damaged.Conclusion:activation of NF-κB may be one of the initiating factors contributing to the occurrence and development of cerebral aneurysm. MCP-1 induced macrophage adhesion and infiltration in the artery wall of cerebral aneurysms, and contributed to the occurrence and development of brain aneurysm. damage to elastic fibers is one of the key factors for aneurysm formation. increased infiltration of inflammatory cells and the secretion of MMP-9 are the main reasons for elastic fiber damage.
The Portrayal of Tourette Syndrome in Film and Television
Authors: Calder-Sprackman Samantha , Sutherland Stephanie , Doja Asif 
Published: December 2014

Objective:To determine the representation of Tourette Syndrome (TS) in fictional movies and television programs by investigating recurrent themes and depictions.Background:Television and film can be a source of information and misinformation about medical disorders. Tourette Syndrome has received attention in the popular media, but no studies have been done on the accuracy of the depiction of the disorder.Methods:International internet movie databases were searched using the terms “Tourette’s”, “Tourette’s Syndrome”, and “tics” to generate all movies, shorts, and television programs featuring a character or scene with TS or a person imitating TS. Using a grounded theory approach, we identified the types of characters, tics, and co-morbidities depicted as well as the overall representation of TS.Results:Thirty-seven television programs and films were reviewed dating from 1976 to 2010. Fictional movies and television shows gave overall misrepresentations of TS. Coprolalia was overrepresented as a tic manifestation, characters were depicted having autism spectrum disorder symptoms rather than TS, and physicians were portrayed as unsympathetic and only focusing on medical therapies. School and family relationships were frequently depicted as being negatively impacted by TS, leading to poor quality of life.Conclusions:Film and television are easily accessible resources for patients and the public that may influence their beliefs about TS. Physicians should be aware that TS is often inaccurately represented in television programs and film and acknowledge misrepresentations in order to counsel patients accordingly.
Facial Motor Neuron Excitability in Hemifacial Spasm: A Facial MEP Study
Authors: Wilkinson Marshall F. , Kaufmann Anthony M. 
Published: December 2014

Introduction:Hemifacial spasm (HFS) may be due to peripheral axon ephapsis or central motor neuron hyperexcitability. Low facial motor evoked potential (MEP) thresholds or MEP responses to single pulse stimulation (normally multipulse stimulation is needed) may support the central hypothesis.Methods:We retrospectively compared response thresholds for facial MEPs in 65 patients undergoing surgical microvascular decompression (MVD) for HFS and 29 patients undergoing surgery for skull base tumors.Results:Single pulse stimulation elicited facial Mep in up to 87% of HFS patients whereas only 10% of tumor patients responded to single pulse stimulation. When comparing facial MEP thresholds using multi-pulse stimulus trains the voltage required in the HFS group were significantly lower then in skull base tumor patients (p < 0.001). the MEP latencies and amplitudes at threshold stimulation were similar between the two groups.Conclusions:these results suggest the facial corticobulbar pathway demonstrates enhanced excitability in HFS.