EEG mapping of left hemisphere dysfunction during motor performance in schizophrenia

With a newly developed system of brain electrical activity mapping we studied 10 right-handed, neuroleptic-treated schizophrenics (five of the disorganized, five of the paranoid type, corresponding to 295.1 and .3 in DSM-III), compared with 10 normal controls. Increasingly complex motor tasks were used for cortical activation, all functional states being referenced to resting states recorded after a special relaxation program. We found higher delta and theta amplitudes during rest, as noted in previous studies, and lower beta power values. As a major result, however, we found a widespread left hemisphere dysfunction in schizophrenics, predominantly in the left primary sensory and motor areas. Additionally, we found signs of a "compensatory" overactivation in patients in motor tasks, when this hemisphere is not "used" by normal persons. The results support our findings obtained with this method during multisensory motor coordination in schizophrenia. The results in these patients suggest that these are not merely vigilance, attention, or motivation dysfunctions, but rather specific cortical correlates of impaired motor performance.     

ASSOCIATIONS BETWEEN MOTHERS' EXPERIENCE WITH THE TROUBLES IN NORTHERN IRELAND AND MOTHERS' AND CHILDREN'S PSYCHOLOGICAL FUNCTIONING: THE MODERATING ROLE OF SOCIAL IDENTITY

Relatively little research has examined the relations between growing up in a community with a history of protracted violent political conflict and subsequent generations' well-being. The current article examines relations between mothers' self-report of the impact that the historical political violence in Northern Ireland (known as the Troubles) has on her and her child's current mental health. These relations are framed within the social identity model of stress, which provides a framework for understanding coping responses within societies that have experienced intergroup conflict. Mother-child dyads (N = 695) living in Belfast completed interviews. Results suggest that the mother-reported impact of the Troubles continue to be associated with mothers' mental health, which, in turn, is associated with her child's adjustment. The strength of mothers' social identity moderated pathways between the impact of the Troubles and her mental health, consistent with the social identity model of stress.     

Clinically Significant Gains in Skillful Grasp Coordination by an Individual With Tetraplegia Using an Implanted Brain-Computer Interface With Forearm Transcutaneous Muscle Stimulation

ObjectiveTo demonstrate naturalistic motor control speed, coordinated grasp, and carryover from trained to novel objects by an individual with tetraplegia using a brain-computer interface (BCI)-controlled neuroprosthetic.DesignPhase I trial for an intracortical BCI integrated with forearm functional electrical stimulation (FES). Data reported span postimplant days 137 to 1478.SettingTertiary care outpatient rehabilitation center.ParticipantA 27-year-old man with C5 class A (on the American Spinal Injury Association Impairment Scale) traumatic spinal cord injuryInterventionsAfter array implantation in his left (dominant) motor cortex, the participant trained with BCI-FES to control dynamic, coordinated forearm, wrist, and hand movements.Main Outcome MeasuresPerformance on standardized tests of arm motor ability (Graded Redefined Assessment of Strength, Sensibility, and Prehension [GRASSP], Action Research Arm Test [ARAT], Grasp and Release Test [GRT], Box and Block Test), grip myometry, and functional activity measures (Capabilities of Upper Extremity Test [CUE-T], Quadriplegia Index of Function-Short Form [QIF-SF], Spinal Cord Independence Measure–Self-Report [SCIM-SR]) with and without the BCI-FES.ResultsWith BCI-FES, scores improved from baseline on the following: Grip force (2.9 kg); ARAT cup, cylinders, ball, bar, and blocks; GRT can, fork, peg, weight, and tape; GRASSP strength and prehension (unscrewing lids, pouring from a bottle, transferring pegs); and CUE-T wrist and hand skills. QIF-SF and SCIM-SR eating, grooming, and toileting activities were expected to improve with home use of BCI-FES. Pincer grips and mobility were unaffected. BCI-FES grip skills enabled the participant to play an adapted “Battleship” game and manipulate household objects.ConclusionsUsing BCI-FES, the participant performed skillful and coordinated grasps and made clinically significant gains in tests of upper limb function. Practice generalized from training objects to household items and leisure activities. Motor ability improved for palmar, lateral, and tip-to-tip grips. The expects eventual home use to confer greater independence for activities of daily living, consistent with observed neurologic level gains from C5-6 to C7-T1. This marks a critical translational step toward clinical viability for BCI neuroprosthetics.     

Aspects linguistiques des troubles de la vigilance au cours des lésions temporales antérointernes droite et gauche

Etude du comportement verbal de deux sujets atteints de lésion unilatérale de la pointe du lobe temporal, droite et gauche, sans détérioration ni phénomène amnésique importants, mais avec trouble de la vigilance de type attentionnel. L'organisation du discours révèle l'incidence de ces troubles dont les deux pôles peuvent être interprétés comme distractibilité et persévération (inachèvement continu des phrases; persévérations écholaliques et itératives). L'analyse linguistique montre que ces deux pôles sont présents dans les deux cas, mais en proportion inverse. Ces troubles se manifestent en outre, selon le côté lésé, dans les domaines propres à la dominance fonctionnelle hémisphérique (code linguistique, organisation spatiale). Les rapports de ces troubles avec les données de l'expérimentation animale sont discutés.

A study of the verbal behaviour of two subjects with unilateral, left or right, lesions of the tip of the temporal lobe; the subjects had no great deterioration nor amnesia but have a disturbance of vigilance (attention type). The organisation of speech shows the incidence of these disturbances, the two extremes of which are distractibility and perseveration (inability to finish a sentence; echolalia and iterative perseverations). The linguistic analysis shows that both extremes are present in both cases, but in inverse proportions. Furthermore, the side of the lesion determines the function in which these disturbances will become manifest (linguistic code, spatial organisation). The relationship of these disturbances with the results of experments on animals is discussed.     

Stroke in patients with heparin-induced thrombocytopenia and the effect of argatroban therapy

OBJECTIVE: To investigate the frequency, mortality rate, and characteristics of stroke in heparin-induced thrombocytopenia and the effect of argatroban therapy in that setting. DESIGN: Retrospective analysis of two prospective studies of argatroban therapy in heparin-induced thrombocytopenia. SETTING: Hospitalized care. PATIENTS: Patients were 960 patients with heparin-induced thrombocytopenia (767 argatroban-treated patients, 193 historical controls). INTERVENTIONS: Argatroban 2 microg x kg x min, adjusted to achieve activated partial thromboplastin times 1.5-3 times baseline MEASUREMENTS AND MAIN RESULTS: Case records were reviewed to identify patients with stroke present at or within 37 days of study entry and to assess 37-day outcomes. Stroke occurred in 30 (3.1%) patients (stroke at entry, n = 9; new stroke during follow-up, n = 24; more than one stroke, n = 4). By logistic regression with treatment, protocol, age, and gender as covariates, females were significantly more likely to suffer stroke (odds ratio, 2.48; 95% confidence interval, 1.11-5.53; p =.026) and stroke-associated mortality (odds ratio, 4.10; 95% CI, 1.12-15.01; p =.033), and argatroban-treated patients had significantly reduced odds, vs. control, of new stroke (odds ratio, 0.31; 95% confidence interval, 0.10-0.96; p =.041) and stroke-associated mortality (odds ratio, 0.18; 95% confidence interval, 0.03-0.92; p =.039). Stroke (odds ratio, 3.66; 95% confidence interval, 1.73-7.73; p <.001) and age (odds ratio per year, 1.017; 95% confidence interval, 1.004-1.029; p =.008) were significant predictors of all-cause death. In the argatroban group, baseline platelet counts were significantly less in patients with, vs. without, stroke (medians, 42 x 10/L vs. 72 x 10/L; p =.006). Of 35 stroke events, 33 (94%) were ischemic and two (6%) were hemorrhagic (one per group, none during argatroban infusion); 30 (86%) were present at or within 13 days of entry. CONCLUSIONS: Stroke, particularly ischemic stroke, is common in heparin-induced thrombocytopenia and significantly increases mortality risk. Stroke in heparin-induced thrombocytopenia occurs most often in females, in patients with more severe thrombocytopenia, and within 2 wks of heparin-induced thrombocytopenia presentation. Argatroban therapy vs. control significantly reduces the likelihood of new stroke and stroke-associated mortality in heparin-induced thrombocytopenia without increasing intracranial hemorrhage.