Detection of early motor involvement in diabetic polyneuropathy using a novel MUNE method – MScanFit MUNE

ObjectiveDetection of motor involvement in diabetic polyneuropathy (DPN) by nerve conduction studies (NCS) does not occur until there is substantial loss of motor units, because collateral reinnervation maintains compound muscle action potential (CMAP) amplitude. Motor unit number estimation (MUNE) methods may therefore be more sensitive. This study was undertaken to test whether the novel method, MScanFit MUNE (MScan) can detect motor involvement in DPN despite normal NCS.MethodsFifty-two type-2 diabetic patients and 38 healthy controls were included. The median nerve was examined in all participants using standard NCS and a detailed CMAP scan, used for MScan. Additional lower extremity NCS in patients were used for DPN diagnosis.ResultsOf 52 diabetic patients, 21 had NCS-defined DPN while lower extremity NCS were normal in 31 patients. MScan motor unit number and size showed higher sensitivity and incidence of abnormality than motor NCS parameters, and a similar sensitivity to sensory NCS.ConclusionsMScan is able to detect motor axonal damage at times when collateral reinnervation limits NCS changes.SignificanceMScan is a sensitive method to detect motor involvement in DPN, which our data suggests is present as early as sensory.     

Mesencephalic enlarged Virchow–Robin spaces in a 6-year-old boy: a case-based update

Background  

Perivascular spaces or Virchow–Robin spaces are normal anatomical structures within the brain, typically less than 5 mm in diameter. Rarely, they can reach much larger sizes and adopt bizarre single or multi-cystic configurations, as was the case in the patient that we report on. When there is such markedly gross dilatation, the phenomenon is known as Giant or tumefactive perivascular space enlargement.     

Assessing mental health services in a rural setting: Service providers’ perspective

Addressing the inadequate and poor provision of mental health services in rural areas is a world-wide challenge. Most people with mental illness in these areas do not have access to mental health services. Using eight attributes of good mental health service as criteria, the purpose of this study was to assess mental health services at Mashashane, a rural area in the Limpopo Province, South Africa. A survey was conducted with a purposively selected sample of health care professionals from four health establishments serving Mashashane. Data was collected using a questionnaire with closed and open-ended questions. Quantitative and qualitative data analyses were used. The results show that out of eight attributes assessed only comprehensiveness was positively perceived. This is an indication of the inadequacy of mental health services, hence their inability to improve the well-being of people with mental illness and their families. Lack of resources was identified as the major hindrance to the delivery of appropriate mental health services. The findings highlighted aspects that contributed to the development of a framework for a community-based program to improve the well-being of people with mental illness and their families in a rural setting.     

“Sex,Lies and Videotapes”: Gathering and Assessing Evidence of Child Abuse in Family Law Cases

Determining the veracity of allegations of child abuse raised in post-separation parenting disputes is difficult, because family courts in Australia do not have their own investigatory power or capacity. They rely on evidence brought before them from State/Territory child protection authorities, police, and other experts who may have interviewed and assessed the child/family. This article describes the gap between Commonwealth and State/Territory responsibilities and mechanisms, and data from a recent evaluation of an innovative program designed to bridge this jurisdictional gap: the Family Court of Australia's “Magellan” case-management model. The views of judges and other key stakeholders from the Family Court and intersecting agencies are presented about the evidence that is put forward in family law disputes in which child sexual abuse or serious physical abuse is alleged. It is important to ensure children's best interests are served, even when it is difficult to adduce evidence and distil truth.     

“Muscle Pics”, a new body-checking behavior in muscle dysmorphia?

Background and aimsThe internalization of ideal hypermuscular body and pro-muscularity media's influence have shown their importance in muscle dysmorphia development. The aim of the current study is to have a better understanding of links between specific body checking behaviors and muscle dysmorphia in social network context.MethodsIn total, 342 students practicing weightlifting at the university gym in Bordeaux answered to a survey with sociodemographic information and body checking symptoms including taking specific selfies of muscles and muscularity “Muscle Pics” and the MDDI (Muscle Dysmorphic Disorder Inventory).ResultsMuscle dysmorphia was prevalent in 18.7% of our population (64 students). We observed that muscle dysmorphia was correlated to “Muscle Pics”, “Follow-up”, “Message”, “Selfie”, and gym mirror checking with significant results (P < 0.01). Also, « Muscle Pics » were linked to APEDs use, pro-muscularity websites, fitness model comparison and gym mirror checking (P < 0.01). For muscle dysmorphia, “Muscle Pics” have strong predictive results (OR = 5.10, P = 0.000) and (OR = 4.08, P = 0.000) for adjusted. “Follow up” (OR = 4.76, P = 0.000) and (OR = 3.83, P = 0.000) for adjusted, “Muscle Pics Selfie” (OR = 11.20, P = 0.000) and (OR = 11.55, P = 0.000) for adjusted, “Muscle Pics Message” (OR = 4.49, P = 0.001) and (OR = 5.78, P = 0.001) for adjusted.Conclusion“Muscle Pics” showed several links with muscle dysmorphia for global score “drive for size”, “functional impairment” but not for “appearance intolerance” dimension. Pro-muscularity websites, fitness model comparisons and gym mirror checking are linked to muscle dysmorphia and “Muscle Pics”. Future research on “Muscle Pics” will help to provide a better understanding of muscle dysmorphia and its link with pro-muscularity influence websites.     

Editorial board page for “Journal of Clinical and Experimental Neuropsychology”, Volume 12, Number 6

Abstract

This is a scanned image of the original Editorial Board page(s) for this issue.     

Extensive surgical excision of large hemispheric “malignant” astrocytoma in a 6-week-old infant

A massive hemispheric high-grade astrocytoma, diagnosed in a 6-week-old infant, was totally excised by means of two craniotomies. The child is still alive and well with minimal neurological dysfunction 1.5 years after operation. This case report illustrates the benefit of aggressive surgical excision (without radiation or chemotherapy) of massive malignant neonatal astrocytomas. While surgical deficits may be minimized by the plasticity of the developing nervous system, extensive excision may yield occasional long-term palliation.     

Editorial board page for “Neurocase”, Volume 6, Number 6

Abstract

This is a scanned image of the original Editorial Board page(s) for this issue.     

A paranoid syndrome in a 12-year-old boy—A contribution to the question of “paranoia”

Psychiatric Quarterly -     

Comparison Between a “Traditional” Memory Test and a “Behavioral” Memory Battery in Spanish Patients

To determine whether neuropsychological testing is fatiguing, and whether it is more fatiguing to older than younger adults, 351 healthy, community living adults, between 18 and 91 years of age, completed a 3 to 4 hour battery of tests focusing on sensation, perception, attention, memory and knowledge. The battery included 3 critical tests: one for assessing the speed of making simple reactions and two for assessing the speed of making decisions. For half of the participants, the critical tests were administered only once, at the end of the session; for the remaining participants, the critical tests were given at the beginning and end of the session. The results show no evidence of fatigue effects with participants from any age group. In view of the type and variety of instruments in our battery, we believe our results will generalize to a wide range of testing situations. The participants in our study were healthy adult volunteers, however, and thus we recommend caution in generalizing the results to clinical populations.     

Assessing multiple sclerosis activity: is the in vitro production of tumor necrosis factor-α, interleukins 2, 6, 4, and 10, and immunoglobulin G of value?

Tumor necrosis factor (TNF) α, interleukins (IL) 2, 4, 6, and 10, and IgG oligoclonal bands (IgG OB) in vitro production was assessed, after whole-blood stimulation with lipopolysaccharide or concanavalin A, in 61 patients presenting with relapsing-remitting, relapsing-progressive, or chronic progressive multiple sclerosis. Multiple sclerosis patients were receiving no treatment or azathioprine (AZA), cyclosporin, cyclophosphamide, subcutaneous interferon (IFN) β1a, or corticosteroids (CST). Statistical correlations significantly showed that: (a) AZA lowers TNF-α (P = 0.002) and increases IL-4 production (P = 0.0024), and IFN-β1a increases TNF-α and decreases IL-4 levels; (b) CST has a negative effect on TNF-α, IL-6, and IL-4 synthesis; and (c) AZA, IFN-β1a, and CST diminish IgG OB synthesis (P = 0.001). Although our study of the dynamics of TNF-α, IL-2, IL-4, IL-6, and IL-10 in vitro production generally found no statistically significant correlations (partly explained by the limited number of values in the various groups), IL-6 was shown to drop during the periods surrounding relapse (P = 0.05) in the absence of treatment, while TNF-α (P = 0.04) and IL-6 (P < 0.05) dropped before exacerbation in the presence of AZA. In vitro production of TNF-α was closely and positively correlated with that of IL-6, independently of clinical features. The enhanced production of IL-10 detected before or at relapse with AZA and IFN-β1a (trends) may interfere with initiation of the immune reaction and with the development of new CNS lesions. Some discrepancies with previously published results stress the difficulties in studying the state of stimulation of different populations of leukocytes by using a variety of in vitro stimuli and in establishing a correlation between mRNA studies and the amount of final or active protein produced. Received: 16 September 1997 Received in revised form: 21 May 1999 Accepted: 8 June 1999     

Conversion,dissociative amnesia,and Ganser syndrome in a case of “chameleon” syndrome: Anatomo-functional findings

The term “chameleon” was first used in the seventeenth century by Sydenham to describe a patient with a protean semiology. We report a single case of “chameleon” syndrome that challenges the current international criteria for somatoform disorders, dissociative amnesia, and Ganser syndrome. The florid symptoms were as follows: anterograde and retrograde amnesia (including semantic, episodic, and procedural deficits), loss of identity, atypical neuropsychological impairment (approximate answers), left sensitive and motor deficit, and left pseudochoreoathetosis movement disorders. Additional behavioral disorders included the following: anxiety, clouded consciousness, hallucinations, and “belle indifference”. A single photon emission computed tomography examination showed bilateral temporal, frontal and a right caudate (in the head of the caudate nucleus) hypoperfusion concordant with a common mechanism of repression in these disorders.     

Nogo,a star protein in reticulon family

1 Introduction In higher vertebrate animals, from amphibian to mammalian, when the central nervous system (CNS) is injured, the neural tissue itself is difficult for most animals to regenerate. Earlier functional studies indicated that in- hibitory proteins, such as myelin-associated glycoprotein (MAG)[1], oligodendrocyte-myelin glycoprotein (OMgp)[2 ] and Nogo[3], are enriched in myelin and oligodendrocytes. Among these proteins, Nogo has attracted more and more interest, although the fun…