Next of kin’s Reactions to Results of Functional Neurodiagnostics of Disorders of Consciousness: a Question of Information Delivery or of Differing Epistemic Beliefs?

Our recent publication in Neuroethics re-constructed the perspectives of family caregivers of patients with disorders of consciousness (DOC) on functional neurodiagnostics (Schembs et al., Neuroethics, 2020). Two papers criticized some of our methodological decisions (Peterson, Neuroethics, 2020; Andersen et al., Neuroethics, 2020) and commented on some conclusions. In this commentary, we would like to further explain our methodological decisions. Despite the limitations of our findings, which we readily acknowledged, we continue to think they entail valid hypotheses that need further investigation. We conclude that some caregivers with high hopes for the recovery of their loved ones with DOC will most likely not consider results of functional neuroimaging as guiding information for treatment decisions, despite efforts taken to deliver information to them. Caregivers of that type might argue that such test-results are not a reliable source of information for the judgement of whether their loved one is likely going to recover or not (prognosis). We introduce the concept of epistemic beliefs to formulate this hypothesis and suggest that future qualitative studies in this area should be aware of such beliefs when investigating the effects of functional neurodiagnostics on knowledge communication and shared decision making for patients with DOC.

     

Effect of long-term low dose of aspirin on severity of disease following onset of acute cerebral infarction

IN T R O D U C T IO N P revention is a very im portant m easure to reduce the incidence of cerebrovasculardisease. Aspirin is a w ell-accepted effective drug in prevention ofcerebrovasculardisease [1-3]. Although the prevention of ischem ic cerebrovascula…     

Does the place of treatment influence the quality of life of schizophrenics?

OBJECTIVE: Chronically mentally ill patients in community mental health care report a better quality of life (QOL) than those in long-term hospital care, which suggests that the treatment setting per se influences their QOL. METHOD: In a region where both treatment settings are of a comparable high standard, we assessed the QOL of 96 schizophrenic patients from these two treatment settings, and the factors which most influenced their QOL. RESULTS: Community-care patients reported a better QOL than long-term hospital-care patients. However, when other factors influencing QOL were included in a regression analysis, the place of treatment was no longer significant, but rather the social support, the severity of the illness, educational level and certain illness concepts. CONCLUSION: It is probably not the place per se which influences the QOL, but apart from personal, sociodemographic and illness-related factors, the amount of social support that is provided in different settings.     

Regulation of β cleavage of amyloid precursor protein

Alzheimer’s disease ranks the first cause for senile dementia. The amyloid cascade is proposed to contribute to the pathogenesis of this disease. In this cascade, amyloid β peptide (Aβ) is produced through a sequential cleavage of amyloid precursor protein (APP) by β and γ secretases, while its cleavage by α secretase precludes Aβ production and generates neurotrophic sAPPα. Thus, enhancing αsecretase activity or suppressing βand γcleavage may reduce A βformation and ameliorate the pathological process of the disease. Several regulatory mechanisms of APP cleavage have been established. The present review mainly summarizes the signaling pathways pertinent to the regulation of APP β cleavage.     

Trajectories of brain development: point of vulnerability or window of opportunity?

Brain development is a remarkable process. Progenitor cells are born, differentiate, and migrate to their final locations. Axons and dendrites branch and form important synaptic connections that set the stage for encoding information potentially for the rest of life. In the mammalian brain, synapses and receptors within most regions are overproduced and eliminated by as much as 50% during two phases of life: immediately before birth and during the transitions from childhood, adolescence, to adulthood. This process results in different critical and sensitive periods of brain development. Since Hebb (1949) first postulated that the strengthening of synaptic elements occurs through functional validation, researchers have applied this approach to understanding the sculpting of the immature brain. In this manner, the brain becomes wired to match the needs of the environment. Extensions of this hypothesis posit that exposure to both positive and negative elements before adolescence can imprint on the final adult topography in a manner that differs from exposure to the same elements after adolescence. This review endeavors to provide an overview of key components of mammalian brain development while simultaneously providing a framework for how perturbations during these changes uniquely impinge on the final outcome.     

Behavioral responses to ingestion of different sources of fat. Involvement of serotonin?

In previous experiments, we described a decrease in extracellular hypothalamic serotonin, 5-hydroxy-tryptamine (5-HT), in response to ingestion of a lard meal. This effect was related to the low satiating potency of lard as compared with other nutrients. Since the composition in fatty acids might be important for these effects, the purpose of this study was to analyze the neurochemical and behavioral responses to ingestion of different sources of fat. Unique meals of three margarines used in human feeding were compared with a meal of lard with regard to their effects on hypothalamic 5-HT, satiety, anxiety-like behavior and sucrose consumption. A vegetable margarine with a high content in saturated fatty acids also decreased hypothalamic 5-HT while ingestion of a sunflower oil and an olive oil enriched margarines, both high in polyunsaturated fatty acids, did not affect significantly 5-HT levels. However, these two last ones were not the most satiating. The olive oil margarine induced a tendency to an anxiety-like behavior while lard increased sucrose consumption. Thus, ingestion of fats may alter specifically behavioral responses. The involvement of 5-HT is likely in the case of lard ingestion but probably not for the other sources of fat.     

Injury of mitochondria and the expressions of fas and bax mRNA in the hippocampus of epileptic rats of different latency

IN T R O D U C T IO N M itochondria provide cells energy through oxidative phosphorylation by m eans of ATP. Biochem icalevidence indicates that m ost ATP consum ptions in brain are used forthe electric activity ofneurons, so the sufficientenergy supply f…     

Holger Hydén's technique of preparation of single Deiters' neurons and study of permeability characteristics of their plasma membranes

The protocols described here refer to Hydén's technique of isolation and microdissection of vestibular Deiters' neurons from adult mammals. The isolation of Deiters' cells from bovine is described and an example is given of the immunocytochemical visualization of their GABA(A) receptors by monoclonal antibodies against the beta(2/3) subunit. In addition, the protocol of the method for isolation of Deiters' cells from adult rabbit brain stem, the preparation of their plasma membranes and the study of their permeability characteristics is presented. Also in this case, examples of its application to the determination of chloride permeability and its modulation by GABA are given.     

The role of post-translational modifications of huntingtin in the pathogenesis of Huntington’s disease

Post-translational modifications are rapid, effective and reversible ways to regulate protein stability, localization, function, and their interactions with other molecules. Post-translational modifications usually occur as chemical modifications at amino acid residues, including SUMOylation, phosphorylation, palmitoylation, acetylation, etc. These complex biochemical modifications tightly regulate and control a variety of cellular processes. Several forms of post-translational modifications of huntingtin (Htt) have been described. These modifications affect Htt metabolism, protein-protein interactions and cellular toxicity. Cleavage and clearance of mutant Htt, and the interactions between mutant Htt and other cellular proteins are important biochemical events leading to Huntington’s disease (HD). Therefore, identifying signaling pathways of Htt modification and evaluating the significance of Htt modifications would lead to a better understanding of the normal function of wild-type Htt and the pathogenic mechanisms of mutant Htt.     

Limits of deinstitutionalization?--perspective of the specialty clinic

Deinstitutionalization is a complex process that in the past was often misunderstood solely as a run down or even closure of psychiatric hospitals. Although chronically mentally ill patients were prevented from long term hospitalisation some fundamental mistakes were repeated often: patients were simply discharged without any preparations and outpatient care was badly organised. In some cases this led to therapeutic neglect, social disintegration, homelessness, incarceration or other forms of dramatic loss of quality of life. These findings are internationally confirmed although there are remarkable differences between various health care systems. Especially when primarily determined by purely economic interests deinstitutionalization constitutes a severe danger for the whole psychiatric system of care and in particular for chronic patients. Intensive research is required to avoid severe disadvantages for the further development of psychiatry.     

Continuous spectrum of pharyngeal-cervical-brachial variant of Guillain-Barré syndrome

BACKGROUND: Pharyngeal-cervical-brachial weakness (PCB) is considered a variant of Guillain-Barré syndrome (GBS). Because of its rarity, there have been no studies of large numbers of patients with PCB. OBJECTIVE: To clarify the nosological classification of PCB. DESIGN: Retrospective study. SETTING: Academic research. Patients Medical records were reviewed of patients who manifested progressive weakness of the pharynx, neck, and upper limbs within 4 weeks of initial onset. MAIN OUTCOME MEASURES: Clinical features were analyzed, and antecedent infections and antiganglioside antibodies were investigated. RESULTS: Diagnoses for 100 patients were "pure PCB" (n = 13), PCB with preserved muscle stretch reflexes (n = 8), GBS overlap (n = 48), Fisher syndrome overlap (n = 26), and Bickerstaff brainstem encephalitis overlap (n = 5). Serological test results showed that 31.0% of antecedent infections in PCB were caused by Campylobacter jejuni. Of the antiganglioside antibodies tested, anti-GT1a IgG antibodies were positive in 51.0% of the patients. Anti-GQ1b IgG antibodies (a serological marker of Fisher syndrome and Bickerstaff brainstem encephalitis) were positive in 39.0%. The IgG antibodies to GM1, GM1b, GD1a, or GalNAc-GD1a (serological markers of an axonal GBS subtype) were positive in 27.0%. CONCLUSION: This large study identified the clinical profiles of PCB. Clinical overlapping, frequent C jejuni infection, and common antiganglioside antibodies present in PCB, GBS, Fisher syndrome, and Bickerstaff brainstem encephalitis provide conclusive evidence that PCB and these conditions form a continuous spectrum.