抑郁症共病焦虑障碍患者脑结构网络拓扑属性研究

本文为了分析抑郁症共病焦虑障碍(共病)患者、抑郁症患者及健康人的大脑结构网络拓扑属性,研究共病及抑郁症的神经病理机制,通过对20例共病患者、18例抑郁症患者及28名健康人进行弥散张量成像扫描,采用确定性纤维跟踪方法构建大脑白质结构网络,基于图论理论分析脑结构网络属性,并对三组人群大脑结构网络全局属性及节点属性进行统计分析。结果显示,1三组人群的大脑结构网络均呈现出小世界属性,核心节点主要分布在联合皮层;2抑郁症患者比健康人呈现出较低的局部效率和全局效率,共病患者比健康人呈现出较高的局部效率和全局效率;3共病患者与抑郁症患者相比,网络属性(聚类系数、特征路径长度、局部效率、全局效率)存在的差异具有统计学意义;4与共病患者和健康人相比较,抑郁症患者的节点效率在颞叶、双侧额上回等脑区存在显著改变。分析结果表明,与健康人相比,共病患者、抑郁症患者大脑结构网络节点属性都有显著改变,并且两组患者呈现出相反的变化趋势,本文研究结果可为共病患者与抑郁症患者的临床辅助诊断提供一种新的影像指标。     

轻度认知障碍老年人脑电的非线性相互依赖脑网络分析

本研究旨在初步探究患轻度认知障碍(MCI)的老年人及正常老年人进行情绪调控时的大脑网络特性。记录了14位MCI患者及18个正常人进行认知重评的情绪调控实验时的头皮脑电信号(EEG),包括中性观看、负性观看和负性重评任务。并采用非线性相互依赖性的方法衡量不同频段的大脑区域间的连接强度,然后根据非线性相互依赖性指数构建两组受试者的大脑功能网络,并运用全局效率和平均局部效率来分析脑区的信息传递效率。研究结果显示,MCI患者脑电theta(F=6.805, P=0.014,η²=0.185)和alpha(负性观看任务:t=2.437,P=0.021, Cohen's d=0.865)活动的非线性相互依赖性指数显著低于正常对照组。在特定阈值下(低gamma频段阈值0.070;theta频段阈值0.075;alpha频段阈值0.115和0.125),MCI患者的网络效率显著低于正常对照组。此外还发现(阈值0.115)正常对照组表现出显著的重评效应(F=5.549,P=0.008,η²=0.246),即负性观看条件下(P=0.018) 的alpha全局效率(0.713±0.042)显著高于负性重评条件下的alpha全局效率(0.699±0.045),MCI组没有发现类似的重评效应。研究表明,MCI患者的情绪调控脑网络异常,表现在大脑信息交换效率低下。未发现非线性相互依赖性、网络效率与行为学、认知分数之间的显著皮尔逊相关性。未来可以对非线性相关性进行深入研究,从而发现更稳定的MCI情绪调控脑网络特征。     

低频重复经颅磁刺激刺激初级运动皮层对大脑功能连接影响的研究

重复经颅磁刺激(rTMS)能对刺激脑区及与其相连接的远端脑区产生影响。本文将从大脑功能连接、脑区之间相互协调工作状态改变的角度,研究低频rTMS刺激脑初级运动皮层对大脑的影响作用。募集了10名健康受试者,采用1 Hz rTMS刺激脑初级运动皮层20 min,采集刺激前后1 min闭目静息状态下的脑电(EEG)数据。对EEG进行相位同步分析,建立脑功能网络,并计算脑功能网络特征参数。最后使用符号秩和检验进行统计学分析。结果表明,低频rTMS刺激使大脑alpha频段全局相位同步指数显著降低(P0.05)。两两脑区分析表现为刺激侧的运动皮层与额叶皮层和顶叶皮层、非刺激侧顶叶皮层与双侧额叶皮层之间alpha频段相位同步显著降低。alpha频段脑功能网络的平均度、全局效率降低(P0.05),平均最短路径长度显著增加(P0.05)。表明低频rTMS使脑功能网络的信息传输变慢,传输效率变低。本文从大脑功能连接性的角度上证明了低频rTMS对大脑活动的抑制作用,说明低频rTMS能够对刺激脑区及与刺激脑区相连接的远端脑区产生影响。本研究有望为低频rTMS应用于临床疾病的治疗提供一定的指导。     

基于同步似然分析的阿尔茨海默症静息态脑电功能连接特性的研究

阿尔茨海默症(AD)是以进行性认知功能障碍为主要特征的神经系统变性疾病,如何识别其大脑认知障碍的早期改变并干预治疗,对延缓痴呆的发生具有重要意义。已有研究表明AD与脑连接的异常变化有关。本文选取AD组和正常对照组各15名志愿者,采集清醒闭目状态的16导联脑电图(EEG)数据,分别对全频段和alpha频段(8~13Hz)EEG进行同步似然分析,选择合适阈值构建脑网络并计算网络的全局效率和聚类系数。结果表明,当阈值0.05≤T≤0.07时,AD组和正常对照组全频段脑网络的聚类系数无显著差异,阈值为0.06和0.07时AD组全频段网络全局效率比正常对照组小(P0.05);阈值范围(0.05≤T≤0.07)内,alpha网络AD组聚类系数和全局效率均低于正常对照组(P0.05)。AD患者静息态脑电alpha网络可能存在功能连接减弱现象,为从脑网络角度定量评估AD患者脑功能状态提供支持。     

阿尔茨海默病脑电信号的同步似然分析

目的：研究阿尔茨海默病（AD）患者脑电时间序列的同步性。方法采集AD患者和正常对照者各8名的16导联脑电图（EEG）数据,分别对2组EEG的全频段、δ（0.5~4 Hz）、θ（4~8 Hz）、α（8~13 Hz）和β频段（13~30 Hz）信号进行同步似然分析,比较不同频段的平均同步似然系数值并进行统计学分析。结果 AD组全频段、θ频段和α频段的平均同步似然系数值均小于对照组,差异有统计学意义（P<0.05）;2组δ和β频段的平均同步似然系数值差异无统计学意义（P>0.05）。结论 AD组全频段、θ频段和α频段的EEG同步性降低,提示在θ和α频段内AD患者不同脑区的协同信息处理能力下降,为进一步研究AD患者大脑功能连接特性提供支持。     

基于表面肌电信号的不同步行速度下肌肉协同及肌肉功能网络分析

深入了解步行过程中的下肢肌肉协作机制是提高神经肌肉功能障碍患者步态康复疗效的关键。本文研究了步行速度的变化对下肢肌肉协同模式及肌肉功能网络的影响。招募了8名健康受试者分别以三种不同速度在跑步机上执行步行任务，同步采集右下肢8块肌肉的表面肌电信号（sEMG），通过非负矩阵分解（NNMF）方法提取肌肉协同模式，利用互信息（MI）方法分别构建alpha频段（8～13 Hz）、beta频段（14～30 Hz）和gamma频段（31～60 Hz）肌肉功能网络，引入复杂网络分析方法量化不同网络差异。肌肉协同分析提取到5个肌肉协同模式，步行速度的变化没有改变肌肉协同的数量，但导致了肌肉权值的变化；肌肉网络分析发现在同一速度下，高频段具有更低的全局效率和聚类系数，随着步行速度的增加，局部肌肉之间的连接强度增加。研究结果表明不同速度的步行运动存在不同的肌肉协同模式和肌肉功能网络，本研究为探索不同步行速度下肌肉协同机制提供了新的视野，有望为神经肌肉功能障碍患者的步态功能评估提供理论支撑。     

持续短阵快速脉冲刺激对情绪加工脑网络影响的研究

本文旨在研究持续短阵快速脉冲刺激(c TBS)干预对情绪加工脑功能网络的影响。我们采用c TBS技术对10名受试者的左前额背外侧皮质(DLPFC)区域进行干预,同时记录干预前后受试者进行情绪面孔性别识别任务时的头皮脑电(EEG)信号,然后采用EEG信号相位同步值来衡量两个脑网络节点间的连接强度,并运用网络效率来描述脑区的信息传递效率。研究结果发现,经由c TBS技术干预受试者脑区,再采用情绪面孔图片刺激后,100~300 ms时间窗内的EEG信号的β频段的事件相关功率明显增强;不同的情绪图片刺激下,中性和负性情绪图片刺激的EEG信号全局相位同步值比正性情绪刺激下更高;情绪加工脑网络小世界特性增强。综上所述,本文通过研究左侧DLPFC活跃性改变对情绪加工脑网络的影响,初步探索了情绪加工脑网络机制,为以后的情绪加工脑网络研究提供了参考。     

大学生焦虑人群情绪冲突反应的脑功能网络研究

利用基于图论的复杂网络分析方法,对脑网络的拓扑结构和属性进行分析, 探讨大学生焦虑人群情绪冲突反应的脑功能网络特点。选取焦虑组和正常对照组各16名志愿者,进行情绪词-面孔stroop冲突任务,同步记录 64导脑电(EEG)数据。分别对beta(14～30 Hz)和高gamma(50～80 Hz)节律的EEG数据进行同步似然分析,选择合适阈值构建脑网络拓扑结构,并计算网络的节点度和聚类系数。结果显示,在 beta 和高gamma 节律中,焦虑组额叶、颞叶及顶叶等脑区存在异常连接,额叶和顶叶的节点度均小于正常组的数值(P <0.05),而颞叶的节点度均高于正常组的数值(P <0.05)(如在beta节律,焦虑组额叶FP1、顶叶CP1和颞叶T7电极处的节点度分别是5.21±0.62、6.25±0.53、7.91±0.71,而正常组的节点度分别为10.42±1.53、7.94±0.55、3.55±0.36),表明焦虑人群额顶叶功能减弱而颞叶功能异常增强;焦虑组脑网络的聚类系数低于正常组的值(P <0.05)(焦虑组 beta 和高gamma 节律的聚类系数分别是0.523 8±0.039 2、0.586 4±0.055 8,而正常组分别为0.603 2±0.071 1、0.664 7±0.060 1),表明焦虑人群的脑网络内部集团化程度、网络的信息传输能力下降。通过研究,为探索焦虑症、抑郁症等心理、精神类疾病的神经机制提供新的视角。     

基于静息态fMRI相位同步的ADHD儿童脑网络研究

探索相位同步和复杂网络方法在注意缺陷多动障碍(ADHD)脑网络机制研究中的应用, 选取135例ADHD患者和102例正常对照作为研究对象。以这237例被试的功能磁共振图像时间序列作为研究数据, 利用相位同步分析方法获得脑区间的连接关系, 并在此基础上构建脑网络。然后, 利用复杂网络的局部效率指标评估静息态脑功能, 并采用多元线性回归和方差分析等统计方法, 分析ADHD患者和正常对照在静息态下脑区的局部效率可能存在的差异。结果表明, ADHD患者与正常对照在年龄、性别、量表分值(注意力和自制力)、3种智商值(语言智商、操作智商和总智商)等方面均无统计学差异, 在诊断和头动参数上有显著差异(P<0.05, 校正后)。诊断方面发现, 11个局部效率正常对照组与ADHD组具有统计学差异的脑区(P<0.05), 其中主要的脑区为左侧尾状核(0.118±0.317 vs 278±0.433)、丘脑(0.345±0.425 vs 0.541±0.435)、颞横回(0.467±0.476 vs 0.654±0.444)和右侧背外侧额上回(0.536±0.401 vs 0.681±0.333)、额中回(0.505±0.377vs 0.641±0.331)、尾状核(0.144±0.329 vs 0.298±0.423)。在静息态下, ADHD患者和正常对照在左侧中央前回、尾状核、丘脑等脑区的局部效率差异可能与患者尾状核、丘脑等特定脑区的功能异常有关, 也可能与患者注意和执行有关的神经网络损伤有关。     

IAPS图片诱导首发抑郁症患者的情绪偏向性

目的:探讨首发抑郁症患者情绪处理偏向性的特征。方法:应用国际情绪图片系统(IAPS)的正性、中性及负性标准化情绪图片,诱导30例首发抑郁症患者及30例匹配的健康对照者,进行情绪体验等级(ESR)评分,两组间进行病例一对照配对研究。结果:(1)所选IAPS中的正性、中性及负性情绪图片的评分与IAPS标准分之间差异无显著性(P>0.05)。(2)抑郁症患者组对正性图片的评分为(7.1±0.1)分,对照组为(7.2±0.1)分,患者组低于对照组(P<0.05);两组对中性及负性图片的评分差异无显著性(P>0.05)。结论:首发抑郁症患者存在情绪信息的负性偏向性。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

État de l’art : nouveaux anticoagulants et transfusion

Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. We propose an update on DOAC-associated bleeding management, integrating the availability of idarucizumab and the critical place of DOAC concentration measurements.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.