Sex-differential brain activation during exposure to female and male faces

Sex-discriminating facial features are examples of visual information involved in guiding social behavior. We used functional magnetic resonance imaging (fMRI) to assess brain responses in face-relevant brain areas in men and women during exposure to neutral male and female faces. An increased fMRI signal was found in the left amygdala and adjacent anterior temporal regions in men, but not in women, during exposure to faces of the opposite versus the same sex. These data indicate that the relationship between the sex of the subject and the sex of the face affects activity in the inferior temporal lobe. The sex-differential nature of this activation pattern may reflect sex differences in cognitive style and attentional processes when confronting faces of the opposite sex.     

Cognitive and behavioral profile in a case of right anterior temporal lobe neurodegeneration

Semantic dementia (SD) is a clinical variant of frontotemporal lobar degeneration (FTLD) characterized by progressive deterioration of semantic memory with relative sparing of other cognitive functions. It is associated with mainly left anterior temporal atrophy, and is also referred to as “left-temporal lobe variant” of FTLD. Recently, patients with mainly right-sided atrophy, or “right-temporal lobe variant”(RTLV), have been described. While some authors have reported that the initial and most significant deficit in these right-sided cases is a difficulty in recognizing famous people, others have observed that major behavioral abnormalities are the presenting symptoms. Here we report a detailed neuropsychological, language, behavioral and neuroimaging assessment of JT, a case of right temporal lobe variant of FTLD. JT showed early and prominent behavioral changes accompanied by a severe impairment in recognizing foods by their look, flavor or name. Later she also developed a difficulty in recognizing familiar people and objects. Standardized caregiver questionnaires of JT's pre- and post-morbid personality and interpersonal functioning showed that she went from being a flexible, dominant, extraverted, person to showing rigid, submissive and introverted behaviors. Her levels of neuroticism significantly increased, while her scores on agreeableness and cognitive and emotional empathy dropped. Voxel-based morphometry (VBM) showed most significant atrophy in the right amygdala/anterior hippocampal complex and collateral sulcus, extending to the right insula. We discuss the atypical cognitive and behavioral features of this case of RTLV of FTLD and stress the importance of behavioral changes and atypical semantic deficits for early diagnosis.     

Gender differences in the phenomenology of bipolar disorder

OBJECTIVES: To investigate gender differences in the phenomenology of episodes in bipolar disorder as according to ICD-10. METHODS: All patients who got a diagnosis of a manic episode/bipolar disorder in a period from 1994 to 2002 at the first outpatient treatment ever or at the first discharge from psychiatric hospitalization ever in Denmark were identified in a nationwide register. RESULTS: Totally, 682 outpatients and 1037 inpatients got a diagnosis of a manic episode/bipolar disorder at the first contact ever. Significantly more women were treated as outpatients than as inpatients. Women were treated for longer periods as inpatients but not as outpatients. In both settings, the prevalence of depressive versus manic/mixed episodes was similar for men and women and the severity of manic episodes (hypomanic /manic without psychosis/manic with psychosis) and the severity of depressive episodes (mild/moderate/severe without psychosis/severe with psychosis) did not differ between genders. The prevalence of psychotic symptoms at first contact was the same for both genders. Among patients treated in outpatient settings more men than women presented with comorbid substance abuse and among patients treated during hospitalization more women than men presented with mixed episodes. CONCLUSIONS: Besides differences in the prevalence of mixed episodes and comorbid substance abuse few gender differences are found among patients presenting with a manic episode/bipolar disorder at first contact in psychiatric inpatient or outpatient hospital settings.     

Neuronal activity-induced regulation of Lingo-1

Axonal regeneration after injury can be limited in the adult CNS by the presence of inhibitory proteins such as Nogo. Nogo binds to a receptor complex that consists of Nogo receptor (NgR), p75NTR, and Lingo-1. Nogo binding activates RhoA, which inhibits axonal outgrowth. Here we assessed Lingo-1 and NgR mRNA levels after delivery of BDNF into the rat hippocampal formation, Lingo-1 mRNA levels in rats subjected to kainic acid (KA) and running in running wheels. Lingo-1 mRNA was not changed by running. However, we found that Lingo-1 mRNA was strongly up-regulated while NgR mRNA was down-regulated in the dentate gyrus in both the BDNF and the KA experiments. Our data demonstrate inverse regulation of NgR and Lingo-1 in these situations, suggesting that Lingo-1 up-regulation is one characteristic of activity-induced neural plasticity responses.     

The quality of life of persons with severe mental illness across housing settings

The aim of the study was to compare the subjective quality of life of persons with severe mental illness in inpatient settings and two types of supported housing, small congregate community residences and independent living with support. Seventy-six persons living in three types of housing were interviewed using the Lancashire Quality of Life Profile. Analysis showed no differences in subjective and objective quality of life or in clinical and socio-demographic data between individuals living in the two types of supported community residences. Greater satisfaction in four life domains, living situation, social relations, leisure activities and work and two global measures, was registered by individuals in the pooled ratings from the two types of supported community residences as compared to those in inpatient settings. The former were also more satisfied than their counterparts were in inpatient settings concerning specific aspects of the living situation domain. It is concluded that differences in housing settings impact specifically on the living situation life domain but also on other life domains as well as on global quality of life, despite few differences in objective quality of life indicators. There was no evidence to support the concept of the quality of life gradient across housing settings.     

Advanced life support performance with manual and mechanical chest compressions in a randomized,multicentre manikin study

Aim of the studyClinical mechanical chest compression studies report diverging outcomes. Confounding effects of variability in hands-off fraction (HOF) and timing of necessary tasks during advanced life support (ALS) may contribute to this divergence. Study site variability in these factors coupled to randomization of cardiopulmonary resuscitation (CPR) method was studied during simulated cardiac arrest prior to a multicentre clinical trial.MethodAmbulance personnel from four sites were tested in randomized, simulated cardiac arrest scenarios with manual CPR or load-distributing band CPR (LDB-CPR) on manikins. Primary emphasis was on HOF and time spent before necessary predefined ALS task (ALS milestones). Results are presented as mean differences (confidence interval).ResultsAt the site with lowest HOF during manual CPR, HOF deteriorated with LDB-CPR by 0.06 (0.005, 0.118, p = 0.04), while it improved at the two sites with highest HOF during manual CPR by 0.07 (0.019, 0.112, p = 0.007) and 0.08 (0.004, 0.165, p = 0.042). Initial defibrillation was 29 (3, 55, p = 0.032) s delayed for LDB-CPR vs. manual CPR. Other ALS milestones trended toward earlier completion with LDB-CPR; only significant for intravenous access, mean difference 70 (24, 115, p = 0.003) s.ConclusionIn this manikin study, HOF for manual vs. mechanical chest compressions varied between sites. Study protocol implementation should be simulation tested before launching multicentre trials, to optimize performance and improve reliability and scientific interpretation.     

Students insert the laryngeal tube quicker and more often successful than the esophageal–tracheal combitube in a manikin

BackgroundEndotracheal intubation remains the standard of airway management. Because intubation skills are difficult to acquire, for medical students teaching of easier to learn techniques should be considered.MethodsWe retrospectively analyzed data that were collected in a University teaching facility. 264 medical students were taught how to use laryngeal tube (LT) and Esophageal Tracheal Combitube^® (ETC) in a manikin. The students underwent one of two different types of extraglottic airway management training consisting of either long lecture (30 min) and intensive training (2 h) (group IT, n = 48), or brief (10 min) lecture and 20 min of training (group BT, n = 216). Both groups underwent a test 6 weeks after training, group IT had an additional test 24 h after training.ResultsAfter 24 h students in group IT were faster using the LT than the ETC (31.7 s ± 2.1 vs. 51.9 s ± 5.8, p < 0.001). Up to 6 weeks after training students were able to place the LT significantly faster than the ETC in both groups (26.5 s ± 2.1 vs. 53.9 s ± 5.8 group IT and 43.4 s ± 1.6 vs. 103.8 s ± 4.4 group BT, p < 0.001). At 24 h and 6 weeks following intensive training, there was no statistical difference in the time required for insertion of either device.ConclusionFollowing different training scenarios in a manikin, students were able to place the LT much faster than the ETC. Even brief training was sufficient to generate short insertion times for the LT.