Deep brain stimulation of the subthalamic nucleus improves temperature sensation in patients with Parkinson's disease

Patients with Parkinson’s disease (PD) reportedly show deficits in sensory processing in addition to motor symptoms. However, little is known about the effects of bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS) on temperature sensation as measured by quantitative sensory testing (QST). This study was designed to quantitatively evaluate the effects of STN-DBS on temperature sensation and pain in PD patients. We conducted a QST study comparing the effects of STN-DBS on cold sense thresholds (CSTs) and warm sense thresholds (WSTs) as well as on cold-induced and heat-induced pain thresholds (CPT and HPT) in 17 PD patients and 14 healthy control subjects. The CSTs and WSTs of patients were significantly smaller during the DBS-on mode when compared with the DBS-off mode (P < .001), whereas the CSTs and WSTs of patients in the DBS-off mode were significantly greater than those of healthy control subjects (P < .02). The CPTs and HPTs in PD patients were significantly larger on the more affected side than on the less affected side (P < .02). Because elevations in thermal sense and pain thresholds of QST are reportedly almost compatible with decreases in sensation, our findings confirm that temperature sensations may be disturbed in PD patients when compared with healthy persons and that STN-DBS can be used to improve temperature sensation in these patients. The mechanisms underlying our findings are not well understood, but improvement in temperature sensation appears to be a sign of modulation of disease-related brain network abnormalities.     

Techniques to measure rigidity of ankle-foot orthosis: a review

We performed this review to provide a clearer understanding of how to effectively measure ankle-foot orthosis (AFO) rigidity. This information is important to ensure appropriate orthotic intervention in the treatment of patients with pathological gait. The two main approaches to the investigation of AFO rigidity are (1) bench-testing analyses, in which an AFO is fixed or attached to a measurement device, and (2) functional analyses, in which measurements are taken while a subject is walking with an AFO in situ. This review summarizes and classifies the current state of knowledge of AFO rigidity testing methods. We analyzed the strengths and weaknesses of the methods in order to recommend the most reliable techniques to measure AFO rigidity. The information obtained from this review article would, therefore, benefit both clinicians and engineers involved in the application and design of AFOs.     

The topographical features of EEGs in patients with affective disorders

EEG data were obtained in the basic state from 16 scalp sites of 44 patients with affective disorder, diagnosed by DSM-III criteria, and 44 normal controls. The EEG power spectra were computed and the t statistic significance probability mapping (SPM) was applied to visualize regions where the patient group showed differences in the EEG topogram from the controls. The results show: (1) left occipital predominance (P3, O1) of alpha activities in the patients with affective disorders, (2) decreased alpha activities in Fp2 and F8 areas in patients with major depression without melancholia, (3) decreased alpha activities in F7 area in patients with bipolar disorder, manic, and (4) increased beta₂ activity in F4 and C4 areas in patients with major depression with melancholia.These results suggest that inter-hemispheric and intra-hemispheric relationships may be disturbed in patients with affective disorder.     

Development of a novel questionnaire evaluating disability in activities of daily living in the upper extremities of patients undergoing maintenance hemodialysis

The aim of the present study was to develop a novel questionnaire evaluating disability in the activities of daily living in the upper extremities of hemodialysis (HD) patients (QDUE-HD). We recruited 83 patients (40 males and 43 females) aged 66 ± 8 years, and measured their muscle strength and range of motion in the upper extremities. Moreover, 14 patients performed a six-week exercise training regimen (the exercise group) and were compared with 15 patients not performing such training (the control group). In an initial questionnaire consisting of 37 items, 30 were taken from the Disabilities of the Arm, Shoulder and Hand questionnaire and the Activities of Daily Living Test, and the remaining seven were selected from activities that HD patients perceived as impossible or extremely difficult to perform. The principal factor analysis focused on 11 items, as 26 showing floor and ceiling effects were excluded. These 11 items were divided into two categories consisting of six items termed "light work" and five termed "holding activities". The scores for light work and holding activities correlated significantly and positively with both muscle strength and range of motion in the upper extremities. These scores increased significantly after the six-week exercise training as compared with those before training in the exercise group. We conclude that the QDUE-HD is clinically useful for evaluating disability in activities of daily living in the upper extremities of HD patients because of its high reliability, validity and responsiveness.     

Obsessive-compulsive spectrum disorders and anxiety disorders

Although obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV, recent considerations for a reclassification into an obsessive-compulsive spectrum disorders (OCSDs) cluster are gaining prominence. Hollander and colleague indicate that similarities in symptomatology, course of illness, patient population, and neurocircuitry of OCD and OCSD are supported by comorbidity, family, and neurological studies, which also offer a critical re-evaluation of the relationship between OCD and anxiety disorders. In February 2010, as a consequence, members of the DSM-5 Task Force and Work Groups have updated draft DSM-5 and have added many diagnostic-specific severity measures, including the Anxiety, Obsessive-Compulsive-Related, and Trauma-Related Disorders. Recently, however, there are some results indicated that support the current association of OCD with other anxiety disorders rather than with OCSDs. Thus, controversy surrounds the classification of OCSD symptoms. In this review, we investigated the relationship of OCD, OCSDs, and anxiety disorders to answer the question of where OCD should be located in the diagnostic system.