Bilateral impairments in task-dependent modulation of the long-latency stretch reflex following stroke

ObjectiveModulation of the long-latency reflex (LLR) is important for sensorimotor control during interaction with different mechanical loads. Transcortical pathways usually contribute to LLR modulation, but the integrity of pathways projecting to the paretic and non-paretic arms of stroke survivors is compromised. We hypothesize that disruption of transcortical reflex pathways reduces the capacity for stroke survivors to appropriately regulate the LLR bilaterally.MethodsElbow perturbations were applied to the paretic and non-paretic arms of persons with stroke, and the dominant arm of age-matched controls as subjects interacted with Stiff or Compliant environments rendered by a linear actuator. Reflexes were quantified using surface electromyograms, recorded from biceps.ResultsLLR amplitude was significantly larger during interaction with the Compliant load compared to the Stiff load in controls. However, there was no significant change in LLR amplitude for the paretic or non-paretic arm of stroke survivors.ConclusionModulation of the LLR is altered in the paretic and non-paretic arms after stroke.SignificanceOur results are indicative of bilateral sensorimotor impairments following stroke. The inability to regulate the LLR may contribute to bilateral deficits in tasks that require precise control of limb mechanics and stability.     

Severe craniosynostosis in an infant with deletion 22q11.2 syndrome

We report a male infant with 22q11.2 deletion syndrome and very severe multi‐sutural craniosynostosis associated with increased intracranial pressure, marked displacement of brain structures, and extensive erosion of the skull. While uni‐ or bi‐sultural craniosynostosis is a recognized (though relatively uncommon) feature of 22q11 deletion syndrome, a severe multi‐sutural presentation of this nature has never been reported. SNP Microarray was otherwise normal and the patient did not have common mutations in FGFR2, FGFR3, or TWIST associated with craniosynostosis. While markedly variable expressivity is an acknowledged feature of deletion 22q11 syndrome, herein we also consider and discuss the possibility that this infant may have been additionally affected with an undiagnosed single gene disorder. © 2012 Wiley Periodicals, Inc.     

Spatial Characteristics of White Matter Abnormalities in Schizophrenia

There is considerable evidence implicating brain white matter (WM) abnormalities in the pathophysiology of schizophrenia; however, the spatial localization of WM abnormalities reported in the existing studies is heterogeneous. Thus, the goal of this study was to quantify the spatial characteristics of WM abnormalities in schizophrenia. One hundred and fourteen patients with schizophrenia and 138 matched controls participated in this multisite study involving the Universities of Iowa, Minnesota, and New Mexico, and the Massachusetts General Hospital. We measured fractional anisotropy (FA) in brain WM regions extracted using 3 different image-processing algorithms: regions of interest, tract-based spatial statistics, and the pothole approach. We found that FA was significantly lower in patients using each of the 3 image-processing algorithms. The region-of-interest approach showed multiple regions with lower FA in patients with schizophrenia, with overlap at all 4 sites in the corpus callosum and posterior thalamic radiation. The tract-based spatial statistic approach showed (1) global differences in 3 of the 4 cohorts and (2) lower frontal FA at the Iowa site. Finally, the pothole approach showed a significantly greater number of WM potholes in patients compared to controls at each of the 4 sites. In conclusion, the spatial characteristics of WM abnormalities in schizophrenia reflect a combination of a global low-level decrease in FA, suggesting a diffuse process, coupled with widely dispersed focal reductions in FA that vary spatially among individuals (ie, potholes).Key words: diffusion tensor imaging, fractional anisotropy, pothole, tract-based spatial statistics     

Assessment Tools for Self-Harm Behavior Among Those with Eating Disorders

There appears to be a substantial minority of eating disorder patients who report self-harm behaviors. This paper reviews the available assessment tools relating to individuals with eating disorders and self-harm behaviors. Current eating disorder assessments do not contain any items relating to self-harm behaviors. Several of the self-harm measures contain some eating disorder items, but not a sufficient number to provide an eating disorder diagnosis. Among the self-harm measures, only three offer items relating to eating pathology as well as overt self-harm and high-lethal behaviors. One of the three has an established scoring that predicts borderline personality disorder. In summary, there are no currently available assessment tools that are able to simultaneously diagnose eating disorder pathology as well as measure self-harm behaviors.     

The Prevalence of Personality Disorders Among Those with Eating Disorders

The genuine prevalence of personality disorders among those with eating disorders is unknown. However, in this paper, we summarize the existing data, with careful acknowledgment of our approach to interpretation as well as the limitations of previous studies. Our findings indicate that obsessive-compulsive personality is the most common personality disorder in restricting-type anorexia nervosa, while borderline personality is the most common personality disorder in binge-eating/purging type anorexia nervosa. Borderline personality is the most common personality disorder in bulimia nervosa, as well. In those with binge eating disorder, obsessive-compulsive personality is the most common personality disorder although, compared with the preceding eating disorder diagnoses, there are broader clusters of personality disorders represented in this group. We discuss the implications of these findings.     

Gastric Bypass Surgery: A Survey of Primary Care Physicians

Gastric bypass surgery has become an increasingly recognized treatment option for individuals suffering from morbid obesity. However, no previous empirical studies have examined the beliefs and attitudes of primary care physicians with regard to this type of intervention. Using a cross-sectional survey approach, we queried 99 primary care physicians about their beliefs and attitudes. With the exception of queries about insurance coverage, the response patterns evidenced a clear majority for most items. For several items, there were some interesting inconsistencies, which may suggest physician ambivalence. In the final analysis, 84% of respondents supported the recommendation of gastric bypass surgery for qualifying patients. However, there was a significant gender difference, with female physicians being less supportive than male physicians. We discuss the implications of these results.     

Community Led Co-Design of a Social Networking Platform with Adolescents with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - Adolescents with ASD face challenges in forming positive friendships due to their ASD condition. This study developed a social networking platform...