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Disconnection syndromes

Riho Nakajima, Masashi Kinoshita, Tetsutaro Yahata, Mitsutoshi Nakada
OBJECTIVESupplementary motor area (SMA) syndrome is defined as temporary paralysis after the resection of brain tumor localized in the SMA. Although in most cases paralysis induced by SMA resection resolves within a short period, the time until complete recovery varies and has not been precisely analyzed to date. In this study, the authors investigated factors for predicting the time required for recovery from paralysis after SMA resection.METHODSData from 20 cases were analyzed. All 20 patients (mean age 54...
February 8, 2019: Journal of Neurosurgery
Matthew R Krafft, John Y Nasr
The advancement of pancreatic endotherapy has increased the availability of minimally invasive endoscopic pancreatic ductal drainage techniques. In this regard, familiarity with endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) is critical for treatment of obstructed pancreatic ductal systems, especially in nonsurgical candidates and in patients desiring a minimally invasive approach. Two distinct forms of EUS-PDD exist, viz. rendezvous-assisted endoscopic retrograde pancreatography (rendezvous-assisted ERP) and anterograde EUS-PDD...
February 7, 2019: Digestive Diseases and Sciences
Hiroshi Yamauchi, Tomohisa Iwai, Mitsuhiro Kida, Kosuke Okuwaki, Takahiro Kurosu, Masafumi Watanabe, Kai Adachi, Masayoshi Tadehara, Hiroshi Imaizumi, Wasaburo Koizumi
BACKGROUND: Endoscopic transmural drainage is performed for symptomatic peripancreatic fluid collections (PPFCs). Long-term transmural double-pigtail stent (DPS) placement is useful in preventing recurrences. There are few reports on the long-term safety of DPS placement. Thus, this study aimed to examine the complications of long-term indwelling DPS for PPFCs. METHODS: Among 53 patients who underwent endoscopic ultrasound-guided transmural drainage for symptomatic PPFCs between April 2006 and March 2017, those followed up for over one year were included...
February 6, 2019: Digestive Diseases and Sciences
Joey A Contreras, Andrea Avena-Koenigsberger, Shannon L Risacher, John D West, Eileen Tallman, Brenna C McDonald, Martin R Farlow, Liana G Apostolova, Joaquín Goñi, Mario Dzemidzic, Yu-Chien Wu, Daniel Kessler, Lucas Jeub, Santo Fortunato, Andrew J Saykin, Olaf Sporns
Alzheimer's disease is considered a disconnection syndrome, motivating the use of brain network measures to detect changes in whole-brain resting state functional connectivity (FC). We investigated changes in FC within and among resting state networks (RSN) across four different stages in the Alzheimer's disease continuum. FC changes were examined in two independent cohorts of individuals (84 and 58 individuals, respectively) each comprising control, subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia groups...
January 22, 2019: NeuroImage: Clinical
Massimo Tonolini, Emilia Bareggi, Pietro Gambitta
In recent years, technological advancements including endoscopic ultrasound (EUS) guidance and availability of specifically designed stents further expanded the indications and possibilities of interventional endoscopy. Although technically demanding and associated with non-negligible morbidity, advanced pancreatic endoscopic techniques now provide an effective minimally invasive treatment for complications of acute and chronic pancreatitis.Aiming to provide radiologists with an adequate familiarity, this pictorial essay reviews the indications, techniques, results and pre- and post-procedural cross-sectional imaging appearances of advanced endoscopic interventions on the pancreas and pancreatic ductal system...
January 28, 2019: Insights Into Imaging
Sascha Sajer, Giulio Sauro Guardiero, Bianca Maria Scicchitano
Neuromuscular disorders, disuse, inadequate nutrition, metabolic diseases, cancer and aging produce muscle atrophy and this implies that there are different types of molecular triggers and signaling pathways for muscle wasting. Exercise and muscle contractions may counteract muscle atrophy by releasing a group of peptides, termed myokines, to protect the functionality and to enhance the exercise capacity of skeletal muscle. In this review, we are looking at the role of myokines in the recovery of permanent denervated and elderly skeletal muscle tissue...
November 2, 2018: European Journal of Translational Myology
Jean-Marc Dumonceau, Myriam Delhaye, Andrea Tringali, Marianna Arvanitakis, Andres Sanchez-Yague, Thierry Vaysse, Guruprasad P Aithal, Andrea Anderloni, Marco Bruno, Paolo Cantú, Jacques Devière, Juan Enrique Domínguez-Muñoz, Selma Lekkerkerker, Jan-Werner Poley, Mohan Ramchandani, Nageshwar Reddy, Jeanin E van Hooft
ESGE suggests endoscopic therapy and/or extracorporeal shockwave lithotripsy (ESWL) as the first-line therapy for painful uncomplicated chronic pancreatitis (CP) with an obstructed main pancreatic duct (MPD) in the head/body of the pancreas. The clinical response should be evaluated at 6 - 8 weeks; if it appears unsatisfactory, the patient's case should be discussed again in a multidisciplinary team and surgical options should be considered.Weak recommendation, low quality evidence.ESGE suggests, for the selection of patients for initial or continued endoscopic therapy and/or ESWL, taking into consideration predictive factors associated with a good long-term outcome...
January 17, 2019: Endoscopy
Ellen Ji, Florian Lejuste, Samuel Sarrazin, Josselin Houenou
White matter (WM) abnormalities have implicated schizophrenia (SZ) and bipolar disorder (BD) as disconnection syndromes, yet the extent to which these abnormalities are shared versus distinct remains unclear. Diffusion tensor imaging (DTI) studies yield a putative measure of WM integrity while neuropathological studies provide more specific microstructural information. We therefore systematically reviewed all neuropathological (n = 12) and DTI (n = 11) studies directly comparing patients with SZ and BD...
January 7, 2019: Neuroscience and Biobehavioral Reviews
Jim van Os, Sinan Guloksuz, Thomas Willem Vijn, Anton Hafkenscheid, Philippe Delespaul
The content and organization of mental health care have been heavily influenced by the view that mental difficulties come as diagnosable disorders that can be treated by specialist practitioners who apply evidence-based practice (EBP) guidelines of symptom reduction at the group level. However, the EBP symptom-reduction model is under pressure, as it may be disconnected from what patients need, ignores evidence of the trans-syndromal nature of mental difficulties, overestimates the contribution of the technical aspects of treatment compared to the relational and ritual components of care, and underestimates the lack of EBP group-to-individual generalizability...
February 2019: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
Jennifer L Young, Ashley Pantaleao, Lori Zaspel, Jessica Bayer, June A Peters, Payal P Khincha, Renee C Bremer, Jennifer T Loud, Mark H Greene, Maria Isabel Achatz, Sharon A Savage, Allison Werner-Lin
PURPOSE: Li-Fraumeni Syndrome (LFS) is an inherited tumor predisposition syndrome with lifetime cancer risks approaching 100% and evolving risk-management strategies. This study evaluated couples' coping with LFS-related burdens. RESEARCH APPROACH: Constructivist grounded theory and anticipatory loss frameworks guided design and analysis. SAMPLE AND METHODS: Twenty-six individuals enrolled in the NCI LFS Family Study completed semi-structured interviews with their partner during annual screening visits...
December 28, 2018: Journal of Psychosocial Oncology
Calvin Pak-Wing Cheng, Sheung-Tak Cheng, Cindy Woon-Chi Tam, Wai-Chi Chan, Winnie Chiu-Wing Chu, Linda Chiu-Wa Lam
Mild cognitive impairment (MCI) has been extensively investigated in recent decades to identify groups with a high risk of dementia and to establish effective prevention methods during this period. Neuropsychological performance and cortical thickness are two important biomarkers used to predict progression from MCI to dementia. This study compares the cortical thickness and neuropsychological performance in people with MCI and cognitively healthy older adults. We further focus on the relationship between cortical thickness and neuropsychological performance in these two groups...
December 2018: Aging and Disease
Xiao-E Lang, Daomin Zhu, Guangya Zhang, Xiangdong Du, Qiufang Jia, Guangzhong Yin, Dachun Chen, Meihong Xiu, Bo Cao, Li Wang, Xiaosi Li, Jair C Soares, Xiang Yang Zhang
Accumulating evidence shows that disruption of white matter (WM) may be involved in the pathophysiology of schizophrenia, even at the onset of psychosis. However, very few studies have explored sex difference in its association with psychopathology in schizophrenia. This study aims to compare sex differences in clinical features and WM abnormalities in first-episode and drug-naive (FEDN) schizophrenia among Han Chinese inpatients. The WM fractional anisotropy (FA) values of the whole-brain were determined using voxel-based diffusion tensor imaging (DTI) in 39 (16 males and 23 females) FEDN patients with schizophrenia and 30 healthy controls (13 males and 17 females) matched for gender, age, and education...
December 18, 2018: Translational Psychiatry
Michelle C Nguyen, Latifah Sage Silski, Musab Alebrahim, Sylvester Black, Elmahdi Elkhammas, Ken Washburn, Ashraf El-Hinnawi
OBJECTIVES: Large spontaneous splenorenal shunts can result in portal vein steal syndrome and is a risk factor for portal vein thrombosis after orthotopic liver transplant. Disconnection of these shunts by left renal vein ligation has been suggested as a potential technique for improving portal venous flow and mitigating risk of portal vein thrombus, thus improving graft perfusion. We present a series of 6 patients who underwent left renal vein ligation for spontaneous splenorenal shunts and their outcomes...
November 28, 2018: Experimental and Clinical Transplantation
T L Poon, C Ht Lui, I Chan, D Yw Siu
Epilepsy is defined as drug-resistant after failure of two adequate trials of appropriately chosen and administered antiepileptic drugs. Approximately 30% of patients with epilepsy have drug-resistant epilepsy. Reasons for treatment failure include failure to recognise epilepsy syndrome, poor drug compliance, and lifestyle factors. Patients with drug-resistant epilepsy should be encouraged to have early referral to a tertiary epilepsy centre for presurgical evaluation. Comprehensive neurophysiology, structural neuroimaging, neuropsychological, and psychiatric assessments are regarded as essential for determining suitability for epilepsy surgery...
November 27, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Kaylan M Brady, Jonathan A Blau, Spencer J Serras, Jeremy T Neuman, Richard Sidlow
Multilevel cervical disconnection syndrome (MCDS) is a rare malformation of the cervical spine previously documented in two toddlers. We present a case of a newborn first thought to have hypoxic-ischemic encephalopathy who was subsequently diagnosed with MCDS. The possibility of in utero presentation of the syndrome in this patient and the categorization of this syndrome in the spectrum of basilar skull/upper cervical malformation syndromes is discussed.
2018: Case Reports in Neurological Medicine
Joseph R Hoyt, Kate E Langwig, J Paul White, Heather M Kaarakka, Jennifer A Redell, Allen Kurta, John E DePue, William H Scullon, Katy L Parise, Jeffrey T Foster, Winifred F Frick, A Marm Kilpatrick
Understanding host interactions that lead to pathogen transmission is fundamental to the prediction and control of epidemics1-5 . Although the majority of transmissions often occurs within social groups6-9 , the contribution of connections that bridge groups and species to pathogen dynamics is poorly understood10-12 . These cryptic connections-which are often indirect or infrequent-provide transmission routes between otherwise disconnected individuals and may have a key role in large-scale outbreaks that span multiple populations or species...
November 19, 2018: Nature
Paula Salgado, Ricardo Taipa, Joana Domingos, Daniel Dias, Manuel Melo Pires, Marina Magalhães
Background: Chorea may occur as a manifestation of an acute stroke. Patients with vascular-related chorea typically present with an acute or subacute onset of hemichorea, contralateral to the lesion. Methods and Findings: In this clinico-pathological case, we report a 90-year-old female who presented, at age 81, with a transient episode of generalized chorea. Over the years, the patient continued to have intermittent episodes of generalized chorea or hemichorea, followed by a progressive dementia syndrome with gait and sphincter disturbance...
November 2017: Movement Disorders Clinical Practice
Łukasz Przepiórka, Przemysław Kunert, Paulina Juszyńska, Michał Zawadzki, Bogdan Ciszek, Mariusz Głowacki, Andrzej Marchel
Spinal dural arteriovenous fistula (SDAVF) is the most common vascular malformation of the spine in adults. However, the coincidence of tethered cord syndrome, lipoma, and SDAVF on the sacral level is exceptionally rare. We describe two patients, probably the fifth and sixth ever reported. The first was a 33 year-old female who underwent surgical cord de-tethering. Surprisingly, a sacral SDAVF was discovered intraoperatively, despite negative digital subtraction angiography (DSA). The second patient was a 30 year-old male with similar pathologies...
2018: Frontiers in Neurology
Qing Ye, Feng Bai
Vascular cognitive impairment (VCI) describes all forms of cognitive impairment caused by any type of cerebrovascular disease. Early identification of VCI is quite difficult due to the lack of both sensitive and specific biomarkers. Extensive damage to the white matter tracts, which connect the cortical and subcortical regions, has been shown in subcortical VCI (SVCI), the most common subtype of VCI that is caused by small vessel disease. Two specific MRI sequences, including diffusion tensor imaging (DTI) and functional MRI (fMRI), have emerged as useful tools for identifying subtle white matter changes and the intrinsic connectivity between distinct cortical regions...
September 2018: Stroke and Vascular Neurology
Michele Veldsman, Amy Brodtmann
Modern clinical neuroscience was built on observations of how localized damage caused specific functional, cognitive and behavioral deficits. Stroke neurology was a cornerstone of understanding this functional specialization in the brain. But most lesion-symptom mapping provides little prognostic value above clinical observations. Stroke topography remains a poor indicator of long-term outcome, and with stroke a major risk factor for dementia, there is strong incentive to find markers of predictive value. There is now growing recognition that the damage caused by stroke does not occur in isolation but is embedded within a complex, highly interconnected, organized and dynamic system: the connectome...
October 5, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
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