The spectrum of Vogt–Koyanagi–Harada disease in Iran

Purpose

To report the spectrum of Vogt–Koyanagi–Harada (VKH) disease in Persians.

Materials and methods

This is a retrospective chart review of patients diagnosed with VKH disease at four referral centers in Iran. Patients’ demographics, ocular and extraocular manifestations, treatment modalities, complications, and visual outcomes were collected and analyzed.

Results

Eighty-eight patients with a mean age of 32.1 ± 12.6 years (range 7–79 years) were studied. Fifty-nine patients (67.0%) were female. Sunset glow fundus was seen in 40.9%, and nummular peripheral chorioretinal scars in 55.7% of eyes. Integumentary findings were noticed in 14.8% of the patients. In patients with acute presentation, exudative retinal detachment was the most common ocular finding (87.8%) followed by optic disk swelling (71.4%). Anterior uveitis and vitritis each were found in about half of the studied eyes. Auditory symptoms were reported by 38.8% of the patients. Overall, immunomodulatory agents were used in 72.7% of the patients. Ocular complications occurred in 36.4% of eyes (mean follow-up 3.8 years, range 6–228 months). Final visual acuity was 20/40 or better in 73.3% of eyes. Four patients (4.5%) were classified as having ‘complete’ type of the disease, 36 (40.9%) ‘incomplete’ type, and 48 (54.5%) ‘probable’ type.

Conclusion

In our series, there are clinical features that differ from those reported in other studies. While auditory symptoms occurred in more than one-third of patients, integumentary findings were rather rare. Most patients exhibited the ‘probable’ type of VKH disease. The overall visual prognosis was favorable.

     

Perception-action integration during inhibitory control is reflected in a concomitant multi-region processing of specific codes in the neurophysiological signal

The integration of perception and action has long been studied in psychological science using overarching cognitive frameworks. Despite these being very successful in explaining perception-action integration, little is known about its neurophysiological and especially the functional neuroanatomical foundations. It is unknown whether distinct brain structures are simultaneously involved in the processing of perception-action integration codes and also to what extent demands on perception-action integration modulate activities in these structures. We investigate these questions in an EEG study integrating temporal and ICA-based EEG signal decomposition with source localization. For this purpose, we used data from 32 healthy participants who performed a ‘TEC Go/Nogo’ task. We show that the EEG signal can be decomposed into components carrying different informational aspects or processing codes relevant for perception-action integration. Importantly, these specific codes are processed independently in different brain structures, and their specific roles during the processing of perception-action integration differ. Some regions (i.e., the anterior cingulate and insular cortex) take a ‘default role’ because these are not modulated in their activity by demands or the complexity of event file coding processes. In contrast, regions in the motor cortex, middle frontal, temporal, and superior parietal cortices were not activated by ‘default’ but revealed modulations depending on the complexity of perception-action integration (i.e., whether an event file has to be reconfigured). Perception-action integration thus reflects a multi-region processing of specific fractions of information in the neurophysiological signal. This needs to be taken into account when further developing a cognitive science framework detailing perception-action integration.     

Rehabilitation of a deep bite patient with worn dentition using minimally invasive approach: A 3‐year follow‐up

Full mouth rehabilitation of severely worn teeth represents a challenging situation for dental clinicians. This case report describes the minimally invasive interdisciplinary approach for treatment of severely worn dentition with a loss of vertical dimension of occlusion. After 3 years of follow‐up, no complication was observed.     

Longitudinal Synaptic Loss in Primary Tauopathies: An In Vivo [11C]UCB-J Positron Emission Tomography Study

Background

Synaptic loss is characteristic of many neurodegenerative diseases; it occurs early and is strongly related to functional deficits.

Objective

In this longitudinal observational study, we determine the rate at which synaptic density is reduced in the primary tauopathies of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), and we test the relationship with disease progression.

Methods

Our cross-sectional cohort included 32 participants with probable PSP and 16 with probable CBD (all amyloid-negative corticobasal syndrome), recruited from tertiary care centers in the United Kingdom, and 33 sex- and age-matched healthy control subjects. Synaptic density was estimated by positron emission tomography imaging with the radioligand [¹¹C]UCB-J that binds synaptic vesicle 2A. Clinical severity and cognition were assessed by the PSP Rating Scale and the Addenbrooke's cognitive examination. Regional [¹¹C]UCB-J nondisplaceable binding potential was estimated in Hammersmith Atlas regions of interest. Twenty-two participants with PSP/CBD had a follow-up [¹¹C]UCB-J positron emission tomography scan after 1 year. We calculated the annualized change in [¹¹C]UCB-J nondisplaceable binding potential and correlated this with the change in clinical severity.

Results

We found significant annual synaptic loss within the frontal lobe (−3.5%, P = 0.03) and the right caudate (−3.9%, P = 0.046). The degree of longitudinal synaptic loss within the frontal lobe correlated with the rate of change in the PSP Rating Scale (R = 0.47, P = 0.03) and cognition (Addenbrooke's Cognitive Examination–Revised, R = −0.62, P = 0.003).

Conclusions

We provide in vivo evidence for rapid progressive synaptic loss, correlating with clinical progression in primary tauopathies. Synaptic loss may be an important therapeutic target and outcome variable for early-phase clinical trials of disease-modifying treatments. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.     

The genetic factors contributing to the risk of cleft lip-cleft palate and their clinical utility

Oral and Maxillofacial Surgery - Cleft lip and cleft palate (CL/P) are among the most common congenital malformations in neonates and have syndromic or nonsyndromic forms. Nonsyndromic forms of...     

How to use mixed methods in oral health research

Wicked problems exist in the realm of oral health research. Due to their inherent complexity, using qualitative or quantitative methods alone may not be adequate for resolving them. Mixed methods approaches combine qualitative and quantitative methods, and thus, can provide a powerful tool for understanding and solving complex problems in dental public health. However, using mixed methods does not come without its challenges. This commentary outlines four main tips for researchers to consider when applying mixed methods to their research projects.